COVID-19 testing in homelessness, domestic abuse refuge and respite room settings - GOV.UK - ISS-G20 Laboratorium Repository

Who this guidance is for

This guidance is for commissioners, providers and staff in the following settings and services:

• night shelters
• homelessness hostels, hotels, and other temporary accommodation
• domestic abuse refuges
• respite rooms
• other homelessness outreach services including day centres

There is separate guidance for prisons and other places of detention, care homes and accommodation for asylum seekers.

This guidance replaces previous guidance for hostel services for people experiencing homelessness and rough sleeping, and for domestic abuse safe-accommodation settings.

Background

As part of the Living with coronavirus (COVID-19) Strategy there is guidance on what do to if someone has symptoms of a respiratory infection or a positive test result for COVID-19. There is also guidance on reducing the risk of catching COVID-19 and passing it on to others. This includes advice on vaccination, ventilating indoor spaces, hand and respiratory hygiene and face coverings.

Managers have a duty to consult with their employees, or their representatives, on health and safety matters. The Health and Safety Executive has guidance on how to keep people safe and healthy at work.

This guidance sets out COVID-19 testing advice for homelessness, domestic abuse refuge and respite services. The aim of testing in these settings is to enable rapid identification of anyone who tests positive for COVID-19, so action can be taken to reduce the spread. These settings are eligible for free testing as:

• there is a higher risk of transmission due to crowding, many people sharing rooms and poor ventilation.
• there may be individuals at higher risk of severe illness from COVID-19 -due to weak immune system or other conditions

Testing regimes

The testing regimes available in each setting are:

Night shelters:

• symptomatic testing for staff and residents or service users
• asymptomatic testing for staff only
• outbreak testing for staff only

Homelessness hostels, hotels, temporary accommodation and respite rooms:

• symptomatic testing for staff and residents or service users
• asymptomatic testing for staff only
• outbreak testing for staff and residents or service users

Day centres and other outreach services:

• symptomatic testing for staff and service users
• asymptomatic testing for staff only

Domestic abuse refuges

• symptomatic testing for staff and residents or service users

Symptomatic testing

Staff, residents and service users who have symptoms of a respiratory infection and have a high temperature, or who have symptoms of a respiratory infection and are too unwell to carry out their normal activities, should take a lateral flow device (LFD) test as soon as they feel unwell.

If this first test result is negative, they should take another LFD test 48 hours later. During this period:

• staff should stay at home
• residents and service users should be supported to stay in their accommodation and avoid contact with other people , particularly those whose immune system means that they are at higher risk of serious illness from COVID-19, despite vaccination

If the second LFD test result is also negative they can return to their usual activities once they no longer have a high temperature and feel well enough to do so. See information on individuals with a negative COVID-19 result.

Guidance on what to do if either test result is positive can be found in the section on test results.

Asymptomatic testing

Asymptomatic testing aims to identify individuals who are infectious with COVID-19 but do not have symptoms so that they are able to adopt behaviours that reduce onwards transmission. The settings that are currently eligible for asymptomatic testing are outlined above.

Staff in eligible settings who do not have symptoms should conduct 2 LFD tests per week, taking them before they begin work, spaced 3 to 4 days apart.

If the staff member has a positive test result they should follow the guidance for staff below.

Outbreak testing

An outbreak consists of 2 or more people who have a positive COVID-19 test result (or clinically suspected) linked to the same place within a 14-day period. This includes residents, service users and staff who have been in the same setting.

If an outbreak is suspected the local health protection team (HPT) or local authority (in accordance with local protocols) should be contacted. They will conduct a risk assessment, including on whether the cases are likely to be linked, and provide further advice

If an outbreak is suspected, further testing for staff, residents and service users should be undertaken as outlined above.

Recommended outbreak testing is one LFD test for all individuals (with or without symptoms) on day 1 of the outbreak, followed by a second LFD test between days 4 and 7. The second test should be taken by all individuals on the same day, for example on day 4. If an individual is unable to test on that day, they should take their second outbreak LFD test as soon as possible within the 4 to 7 day period.

To ensure that the outbreak has come to an end, a third LFD test should be taken by all individuals at least 10 days after the date the last COVID-19 case was identified (either the day they became symptomatic or had a positive test result, whichever was earlier).

Test results

If a staff member tests positive

Staff who have received a positive LFD test result, regardless of whether or not they have symptoms, are advised to not attend work for 5 days. They should follow guidance for people with a positive COVID-19 test result, and should try to stay at home and avoid contact with other people. They do not need to take a PCR test.

Staff should only return to work after they have had 2 consecutive negative LFD test results (taken at least 24 hours apart), they feel well and they do not have a high temperature. The first LFD test should be taken from 5 days after the day their symptoms started (or the day their test was taken if they did not have symptoms). If both LFD tests results are negative, they may return to work immediately after the second negative LFD test result on day 6 as long as they feel well enough and do not have a high temperature.

A positive lateral flow test without a high temperature after 10 days is unlikely. If the staff member’s LFD test result remains positive on day 10, they should continue to take daily lateral flow tests. They can return to work after a single negative LFD test result.

A positive LFD test result after 14 days is very unlikely. If the staff member’s LFD test result is still positive on day 14, they can stop testing and return to work on day 15. If the staff member works with people who are at higher risk of becoming seriously unwell with COVID-19 a risk assessment should be undertaken, and consideration given to redeployment.

If a resident or service user tests positive

Residents or service users with a positive COVID-19 test result should be advised to try to avoid contact with other people for 5 days.

Where possible, staff should support residents or service users with COVID-19 to avoid contact with others and practise safe behaviours to reduce the spread of infection.

Staff should ensure that residents or service users:

• are supported to avoid contact with other people
• sleep in a separate room and use a separate bathroom if possible
• wear a well fitted face covering made with multiple layers or a surgical face mask in shared areas
• avoid contact with individuals who are at higher risk of becoming severely unwell if they are infected with COVID-19, especially those whose immune system means they are at higher risk of serious illness from COVID-19
• wash their hands regularly, or use a hand sanitiser, and cover their mouth and nose when coughing or sneezing
• ventilate their rooms (by opening windows and leaving them open for at least 10 minutes after leaving the room)
• regularly clean frequently touched surfaces, such as door handles and remote controls, and shared areas such as kitchens and bathrooms

Individuals with a negative COVID-19 result

A symptomatic individual who has a negative test result for COVID-19 may have another infectious illness like flu.

Staff with symptoms who receive a negative test result can return to work if they are no longer unwell and they do not have a high temperature.

Symptomatic residents or service users should be advised to keep away from others until they no longer have a high temperature (if they had one) or until they no longer feel unwell.

Reporting LFD test results

Reporting the result of every LFD test in staff and service users is encouraged, even if the result is negative or void. Results can be reported on GOV.UK.

Some residents or service users may experience difficulty or be unable to report their test results and should be supported to do so whenever possible.

Ordering LFD test kits

To access tests, eligible settings will need to register on the self-referral portal. They will then receive a Unique Organisational Number, which can then use to order test kits once it is verified.

Further details of how to undertake testing in your settings can be found in the Standard Operating Procedure which will be made available during the registration process.

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