Guidance
UKHSA has issued COVID guidance to support the governments living with COVID 19.
UPDATE:
From the 31st August 2022 NHS England acting upon advice from UKHSA, has set out plans for COVID-19 testing in periods of low prevalence Prevalence in the community following the current Omicron wave has fallen and remains at a comparatively low level. The likelihood that individuals entering high-risk settings such as the NHS are infectious has also reduced and the risk of onward transmission into these settings is regarded as much lower. As a result of this, routine asymptomatic testing in a number of settings will be paused including NHS organisations and adult social care
https://www.gov.uk/government/news/regular-asymptomatic-testing-paused-inadditional-settings
Main changes:
• NHS patient facing staff and adult social care staff (staff in care homes, homecare organisations, eligible extra care and supported living services, eligible adult day care centres, personal assistants, Shared Lives carers) are no longer required to test twice weekly with LFDs when asymptomatic.
• Symptomatic NHS staff and adult social care staff should test themselves using LFDs.
• Staff who test positive should continue to follow the current return to work guidance. LFDs to support this guidance will continue to be available through the gov.uk portal for NHS staff in England.
• Staff who are household contacts of a positive COVID-19 case will continue to work as normal providing they remain asymptomatic and will no longer be required to test twice weekly with LFD tests.
This guidance has been updated with the following:
NHS patient facing
Patient-facing healthcare staff will no longer be required to undertake routine asymptomatic testing for COVID-19 using LFD tests.
https://www.gov.uk/government/news/regular-asymptomatic-testing-paused-inadditional-settings
Adult Social care staff
Asymptomatic staff should no longer conduct regular asymptomatic staff testing. Some staff without COVID-19 symptoms may be asked to undertake testing as part of rapid response testing for care homes and high-risk extra care and supported living services or as part of outbreak testing in care homes.
https://www.gov.uk/government/publications/coronavirus-covid-19-testing-for-adultsocial-care-settings/covid-19-testing-in-adult-social-care
Symptomatic testing will continue for both NHS patient facing staff, and social care staff based on the current list of COVID-19 symptoms.
• fever,
• a new and continuous cough,
• anosmia (loss of smell) and ageusia (loss of taste),
it is important to remember that COVID-19 can present as a wide range of other symptoms including, for example, shortness of breath, fatigue, loss of appetite, myalgia (muscle ache), sore throat, headache, nasal congestion (stuffy nose), runny nose, diarrhoea, nausea and vomiting.
All Provide staff: Anyone who has symptoms of a respiratory infection and has a high temperature or does not feel well enough to go to work, is advised to stay at home and avoid contact with other people. They should follow the guidance for people with symptoms of a respiratory infection including COVID-19.
Access to LFD tests are available https://www.gov.uk/order-coronavirus-rapid-lateralflow-tests
This SOP has been developed to support local implementation of this guidance related to the self -isolation and return to work of staff and should be followed by all staff in the Provide Community.
Managing staff with symptoms of respiratory infection including COVID 19.
All Provide staff
All staff who have received a positive COVID-19 test result, regardless of whether they have symptoms, are advised not to attend work for 5 days. They should follow guidance for people with a positive COVID-19 test result
Managing NHS patient facing staff with symptoms of respiratory infection including COVID 19
Patient-facing healthcare staff who have symptoms of a respiratory infection, and who have a high temperature or do not feel well enough to attend work, should take an LFD test as soon as they feel unwell. If the LFD test result is negative, they can attend work if they are clinically well enough to do so and they do not have a high temperature. Access to LFD tests available https://www.gov.uk/ordercoronavirusrapid-lateral-flow-tests
Patient-facing staff return to work:
Patient-facing healthcare staff can return to work when they have had 2 consecutive negative LFD test results (taken at least 24 hours apart).
The first LFD test should only be taken 5 days after the day their symptoms started (or the day their first positive test was taken if they did not have symptoms); this is described as day 0.
If both LFD tests results are negative, they may return to work immediately after the second negative LFD test result, provided they meet the criteria below:
• the staff member feels well enough to work, and they do not have a high temperature.
• if the staff member works with patients whose immune system means that they are at higher risk of serious illness despite vaccination, a risk assessment should be undertaken, and consideration should be given to redeployment until 10 days after their symptoms started (or the day their first positive test was taken if they did not have symptoms)
• the staff member must continue to comply rigorously with all relevant infection control precautions and personal protective equipment (PPE) must be worn properly throughout the day
If the day 5 LFD test is positive, they should continue to test daily until they have received two negative LFD test results, taken 24 hrs apart. If the staff member’s LFD test result is positive on the 10th day, they should discuss this with their line manager who may undertake a risk assessment
If a staff member is identified as a contact of a COVID-19 case
People who live in the same household as someone with COVID-19 or overnight contact of someone who has had a positive COVID-19 test result, are at the highest risk of becoming infected because they are most likely to have prolonged close contact.
If a staff member is identified as a contact of household case a risk assessment should be conducted and the following considerations taken:
• redeployment to lower risk areas for patient-facing healthcare staff, especially if the member of staff works with patients whose immune system means that they are at higher risk of serious illness despite vaccination
• working from home for non patient-facing healthcare staff
• limiting close contact with other people especially in crowded, enclosed or poorly ventilated spaces
Whilst they are attending work, staff must continue to comply rigorously with all relevant infection control precautions.
Managing respiratory infection in adult social health care staff and LFD testing
This guidance is for testing in adult social care and applies to the following staff groups: care homes, homecare organisations, extra care and supported living services, adult day care centres, personal assistants, shared lives carers, social worker. In Provide this applies to our supported living services including Fern Lodge.
https://www.gov.uk/government/publications/coronavirus-covid-19-testing-for-adultsocial-care-settings/covid-19-testing-in-adult-social-care
Symptomatic
If a staff member experiences any of the main symptoms of coronavirus (COVID-19), they should immediately take a lateral flow device (LFD) test as soon as they develop symptoms. There is no need to take a PCR test after a positive lateral flow test result. Symptomatic staff should stay away from work and conduct the LFD test at home.
Return to work
• Adult social care staff with COVID-19 should not attend work until they have had 2 consecutive negative lateral flow test results (taken at least 24 hours apart).
• The first lateral flow test should only be taken from 5 days after day 0 (the day their symptoms started, or the day of their positive test).
• If both lateral flow tests results are negative, they may return to work immediately after the second negative lateral flow test on day 6, and their symptoms have resolved.
• If the staff member cares for people who are at higher risk of becoming seriously unwell with COVID-19 (seek clinical advice as necessary), careful assessment should be undertaken, and consideration given to redeployment until 10 days after their symptoms started (or the day their positive test was taken).
• The staff member should continue to comply with all relevant infection control precautions and PPE should be worn properly throughout the day.
• If the staff member’s lateral flow test result remains positive on the 10th day, they should continue to take daily lateral flow tests. They can return to work after a single negative lateral flow test result
• If the staff member’s lateral flow test result is still positive on the 14th day, they can stop testing and return to work on day 15. If the staff member works with people who are especially vulnerable to COVID-19 a risk assessment should be undertaken, and consideration given to redeployment.
Staff contacts of confirmed cases
Staff who are contacts of confirmed cases can continue working. They should comply with all relevant infection control precautions and PPE should be worn properly throughout the day. They no longer need to undertake any additional testing, unless required as part of rapid testing or outbreak testing
https://www.gov.uk/government/publications/coronavirus-covid-19-testing-for-adultsocial-care-settings/covid-19-testing-in-adult-social-care
Rapid response and outbreak testing
During periods of increased prevalence where 1 or more positive case of staff or residents are found in a care home, or high-risk extra care and supported living setting, asymptomatic testing maybe required. Daily rapid LFD testing should be conducted for 5 consecutive days for all staff working on those days. This is not extended if further positive cases are found within the 5 days. If further positive cases are found further testing will be advised under outbreak measures. Only the staff working in the setting over the rapid response testing period need to be tested; those not working during this period do not need to be tested. You should not bring people into work to get tested on their non-working day
If the staff member develops symptoms, they should follow the guidance for staff with symptoms (see above).
If the staff member works with people who are especially vulnerable to COVID-19 (seek clinical advice as necessary), a risk assessment should be undertaken, and consideration given to redeployment during the 10 days following their last contact with the case
Staff Self-Isolation & Return to Work Risk Assessment
Date of Virtual Risk Assessment
Details of Manager completing the RA
Name of staff member
Name: Role: Service:
Name: Role: Service:
Date of symptom onset
Date of LFD Test
Result of LFD test
Complete Part A: for staff identified as a contact of a positive COVID-19 Case
Complete Part B: for staff who are symptomatic/have tested positive for COVID-19
Part A
Before a staff member can be considered for return to work they must meet all the criteria highlighted as green in the table below
Criteria for Patient facing Staff Identified as a Contact
Has the staff member got any symptoms of COVID?
Does the staff member have access to PPE and able to comply with IPC requirements to limit risk to others?
No
No Are the exemption criteria above all green and return to work possible? Yes No
Does the staff member work with people who are especially vulnerable to becoming seriously ill if they develop COVID? If yes, the return to work must include a discussion on appropriate work placement.
Part B
Before a staff member can be considered for return to work they must meet all the criteria highlighted as green in the table below
Criteria for Patient facing Staff who Have Tested Positive for COVID
Has the staff member got any respiratory symptoms or symptoms of COVID 19? Yes No
Has the staff member agreed and taken LFD tests on day 5 and 6 of their 10 day isolation period? Yes NO
Are days 5 and 6 LFD tests negative and been taken 24 hours apart?
Does the staff member have access to PPE and able to comply with IPC requirements to limit risk to others?
Are the exemption criteria above all green and return to work possible?
Does the staff member work with people who are especially vulnerable to becoming seriously ill if they develop COVID? If yes, the return to work must include a discussion on appropriate work placement.
Yes NO
Yes No
Yes No
Yes No
Return to Work Plan
At any time if the staff member becomes symptomatic or known to have LFD positive test, they must self-isolate immediately and inform their line manager
All staff identified as a contact of a household positive case even if fully vaccinated, could still carry and transmit the virus to others in the 10 days following their exposure. It is therefore imperative they follow very good infection prevention and control practice on return to work
Check they have had recent updates in the following
• Use of PPE including donning and doffing guidance
• Hand washing
• Transmission based precautions in line with UK National IPC manual for England
If the Staff member works with people (colleagues or service users) who are especially vulnerable the line manager will need to consider the people at risk and how they can be protected Depending on the risk identified managers may consider a range of options including but not limited to:
• Redeploying the staff member to work with lower risk service users or colleagues
• Redeploy them to an alternative service where the risk is lower
• Support the member of staff to work from home where possible (consideration needs to be given to overall staffing numbers and patient /service user safety and whether backfill with bank/agency or redeployed staff is available to maintain safety) In all cases infection prevention measures must be in place and adhered to by all staff in that service areas.
A balance of risk must be achieved to ensure services can operate safely with sufficient staff While minimising risk to colleagues and service users. Managers can seek further advice and support from their Assistant Director and the Infection Prevention Team as needed
Provide details of risks identified and agreed plan for mitigation of the risks
Risks:
Mitigations:
Return to work Plan:
Completed Risk Assessment should be virtually reviewed by the Divisional Assistant Director Responsible for the Service Risk Assessment Review by Divisional Assistant Director
Name of AD
Date of Review
Decision on return to work approved
