Covid-19 and Respiratory Illnesses

ASC COVID-19 Guidance [03 April 2023]

In this section:

  • Testing
  • Staff or service users with a positive COVID-19 test result
  • Guidance specific to care homes
    • Outbreak management
    • Admissions
    • Visiting
  • Links to other resources

As a result of protection by high vaccination coverage, high immunity amongst the population, and increased access to COVID-19 treatments, guidance on the management of COVID-19 has been further aligned with the management of other common respiratory infections.

The approach to COVID-19 testing and IPC measures now focuses on protecting those most at risk of severe outcomes.

Testing for COVID-19

  • No asymptomatic, PCR or whole home testing.
  • Symptomatic testing is now advised only for those eligible for COVID-19 treatments and during suspected outbreaks in care homes.
  • Only the first 5 residents with symptoms of a respiratory infection will be asked to take an LFD test to identify if there is an outbreak of COVID-19. This is in addition to ongoing testing for symptomatic individuals eligible for COVID-19 treatments.
  • Care homes can order LFD test kits online. To do so, you will need:
  • Care homes can continue to call 119 for any questions about a test kit order.
  • If you are close to running out of stock and require an urgent and emergency delivery, please call 119.
  • Care home managers should support people who are potentially eligible for COVID-19 treatments. This includes ensuring there are enough tests stored on site for eligible individuals to test if they become symptomatic. We recommend you complete regular LFD test kit stock takes. 
  • If managers are unsure which of their residents are potentially eligible for treatments, they should contact their clinical lead (GP).

Staff or service users with a positive COVID-19 test result

  • People who test positive for COVID-19 can return to their usual activities after 5 days if they feel well and no longer have a high temperature. People who test positive for COVID-19 can return to their usual activities after 5 days if they feel well and no longer have a high temperature.
  • Testing is no longer required for individuals to return to normal before 10 days following a positive test.

Guidance specific to Care Homes 

Outbreak management 

  • If you suspect an outbreak of COVID-19 in your care home, you must complete a risk assessment to determine if there’s an outbreak and if so, what outbreak measures are required. 
  • Inform the HPT and Local Authority of the suspected outbreak
  • Test the first 5 linked symptomatic residents using LFD tests, irrespective of their eligibility for treatments. This is to determine if there are 2 or more linked cases of COVID-19 or another respiratory infection. Cases would not be considered linked if:
    • symptom onset was more than 14 days apart
    • the residents had no contact with each other in the last 14 days
  • If any of the first 5 suspected cases test negative on LFD and remain unwell, consider further clinical assessment of the symptoms and contact the HPT for further advice. 

If an outbreak is identified:

If the risk assessment determines that there are 2 or more linked positive cases of COVID-19 within the same setting within a 14-day period, additional measures to manage the outbreak should be considered, which may include:

  • proportionate reductions in communal activities
  • proportionate reductions in admissions which may include temporary closure of the home to further admissions
  • restriction of movement of staff providing direct care to avoid risk of outbreaks spreading between different parts of settings (for example wings)
  • proportionate changes to visiting. Some forms of visiting should continue for all residents. One visitor at a time per resident should always be able to visit inside the care home. This number can be flexible in the case that the visitor requires accompaniment (for example if they require support, or for a parent accompanying a child). End-of-life visiting should always be supported. There should be no restrictions on visits out for individuals who are not positive or symptomatic

Any measures that the care home chooses to implement must be proportionate, consider resident wellbeing, the care home’s legal obligations, and be risk-based. The care home manager should ensure staff, residents and their loved ones are informed of the outbreak and any relevant measures that have been implemented.

Outbreak measures can be lifted 5 days after the last suspected or confirmed case. This is from the day of the last positive test, or the day the last resident became unwell, whichever is latest.

The care home can contact the HPT for advice on further measures, which may include wider testing if there are specific issues of concern. These include but are not limited to:

  • greater severity than expected.
  • more deaths or hospitalisations than expected
  • rapidly increasing cases despite control measures
  • a suspected outbreak of another illness alongside COVID-19
  • a high proportion of residents have been offered or accessed COVID-19 treatments during the outbreak

Providers should seek advice from the local authority commissioners if there are staffing shortages or concerns about safety.

Page last updated on March 14th, 2024 at 11:38am

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