Testing and tracing - challenges for care homes

Government has introduced new NHS Testing and tracing guidance. The purpose is to prevent any further spread by identifying the exposed people soon and asking them to isolate to avoid any community spread of COVID. 

How does it work?

  • Taking a test - If you or people living with you have symptoms of coronavirus, you can request for a test. You can find more details on taking the test here. 
  • Results - You and anyone in your household should stay at home until the results are back. The result can be positive, negative or inconclusive. 
  • Negative test results - You can stop self-isolating if you have results negative and no one else in your home has any symptoms. You can go back to your routine. 
  • Positive - You must self isolate for seven days from when the symptoms started, and everyone in your household should stay at home for 14 days. 
  • Inconclusive results - Repeat the test. Follow the isolation process as described above if you are symptomatic. Find more details here
  • Contact - If you are positive, you will be contacted by testing and tracing team by phone, text or email. You will be asked to sign in to the NHS tracing website to provide more details. 
  • You will be asked the following: Name, DOB and Postcode, people living with you, anyone you had come in contact in the last 48 hours before the symptoms started. PHE will not disclose your identity to the people you have come in contact. Anyone who has come in contact with you will be advised to self-isolate for 14 days. 

Symptomatic staff - care home

Making things complicated for care homes

Things will get complicated when a worker is exposed to COVID infection from the household, their community or the workplace. The government guidelines make it clear staff should follow the guidance "How to work safely in care homes?" while working in a care home. 

The worker exposed to infection while caring for positive residents will have to self isolate. If you are wearing PPE as per the guidance, there is no need to self-isolate.

Close contact means:

  • having face-to-face contact with someone (less than 1 metre away)
  • spending more than 15 minutes within 2 metres of someone
  • travelling in a car or other small vehicle with someone (even on a short journey) or close to them on a plane

The above criteria mean if staff stay together during break times or comes in contact while travelling together without PPE, they both will have to self isolate for 7-14 days. 

 

Asymptomatic care home staff

Potential implications for a care home:

  • A good number of your team would have to self isolate if one of the staff becomes positive if they had a 'contact'. 
  • Question about the breach of PPE and social distancing within the workplace. 
  • Employer compliance with HSE regulations. 
  • Staff exposure to be reported to RIDDOR. 

Practical steps to avoid the above problems:

  • Train staff about the use of PPE while caring for vulnerable residents. 
  • Ask the staff not to come for work if unwell or they have any symptoms. Remember the 'contact' is defined as 48 hours before the symptoms started. 
  • Strict adherence to social distancing within the workplace or wearing PPE when in close contact. 
  • Staggering the breaks to one at a time if possible. 
  • Rearranging the break rooms to remind about social distancing. 
  • Arranging day-offs in blocks. E.g., three long days and four days off. 
  • Complete a risk assessment and implement action plans to avoid any breaches of PPE usage or occupational exposure of COVID. 
  • Always get in touch with local PHE for any advise. 
  • Supply masks for staff to wear if they are using public transport.
  • Install a handwashing facility at the entrance for visitors to use. 
  • You can also use the Infection control fund to put measures in place and for paying staff for isolation. 

 NB: This article is valid at the time of writing. 

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