The guidance on how to reduce the spread of COVID-19 in adult social care settings has been updated. Click here to read the full guidance.
These excerpts are not changes but you may want to refresh yourself with the guidance around isolation. We have highlighted areas which are most pertinent to you.
Other things you may want to consider:
(1) it is a provider’s duty of care to the service users that staff do not come in if they may spread infection (any infection)
(2) providers who have a ‘no pay’ sickness policy are more likely to have staff leave as there are other providers who will pay sick pay
(3) Ensure you have a strong case of evidence if you plan to ask HCC for support.
If a staff member develops COVID-19 symptoms
Anyone who has symptoms of a respiratory infection (see below) and has a high temperature, or anyone who has symptoms of a respiratory infection and does not feel well enough to work is advised to stay at home and avoid contact with other people.
For social care staff eligible for free testing, lateral flow tests are available for staff who are concerned they may be experiencing symptoms of COVID-19. Social care staff who have symptoms of a respiratory infection and who have a high temperature, or social care staff who have symptoms of a respiratory infection and do not feel well enough to attend work should take a lateral flow test as soon as they feel unwell (day 0). They should not go to work, and if at work, should leave as soon as possible. Staff with respiratory symptoms who feel well enough to work and do not have a temperature, do not need to take a symptomatic test and can continue working.
If the result of this lateral flow test is positive, staff should follow the advice in the section ‘If a staff member receives a positive lateral flow or PCR test result’.
If the lateral flow test result is negative, they should take another lateral flow test 48 hours later, staying away from work during this time.
If the second lateral flow test is also negative, they can return to work if well enough to do so.
If either test is positive, they should follow the guidance in the section ‘If a staff member receives a positive lateral flow or PCR test result’.
Free lateral flow tests have been provided for symptomatic testing and staff should ensure they have some at home for this purpose. For more information on accessing COVID-19 tests, see the adult social care testing guidance.
For staff who test negative but have a temperature or feel too unwell to work on the first day but then feel better the following day, in exceptional circumstances and subject to the below risk assessment, these staff may be able to work. If a risk assessment indicates a serious risk to social care service delivery, symptomatic staff who test negative on day 0, who do not have a temperature and feel well enough to do so may be asked to return to work. The risk assessment should consider avoiding contact with people at higher risk of serious illness where possible. Further information about assessing the risk of individuals can be found below in the risk assessment section of ‘IPC considerations for people receiving care’. On returning to work, the staff member must continue to comply rigorously with all relevant infection control precautions and PPE must be worn properly throughout the day. The staff member should take another lateral flow test 48 hours after their first test and if this second test is negative, they can remain working.
Symptoms of COVID-19, flu and common respiratory infections include:
- continuous cough
- high temperature, fever or chills
- loss of, or change in, your normal sense of taste or smell
- shortness of breath
- unexplained tiredness, lack of energy
- muscle aches or pains that are not due to exercise
- not wanting to eat or not feeling hungry
- headache that is unusual or longer lasting than usual
- sore throat, stuffy or runny nose
- diarrhoea, feeling sick or being sick
Any of these symptoms may also have another cause. Particular judgement should be applied to those who may experience symptoms on this list routinely as part of a pre-existing health condition in order to distinguish these symptoms from symptoms of COVID-19.
If staff members are concerned about their symptoms, they should seek medical advice.
If a staff member receives a positive lateral flow or PCR test result
To avoid passing on the virus, anyone who receives a positive lateral flow or PCR test result should follow the advice regarding staying at home and avoiding contact with other people from the day they test positive or develop symptoms (day 0). There is no need to take a PCR test after a positive lateral flow test result.
In addition, 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), they feel well and they do not have a high temperature. The first lateral flow test should only be taken from 5 days after day 0 (the day their symptoms started, or the day their test was taken if they did not have symptoms). If both lateral flow tests results are negative, they may return to work immediately after the second negative lateral flow test result on day 6, if their symptoms have resolved, or their only symptoms are cough or anosmia which can last for several weeks.
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 test was taken if they did not have symptoms). The staff member should continue to comply with all relevant infection control precautions and PPE should be worn properly throughout the day. Further information about assessing the risk of individuals can be found below in the risk assessment section of ‘IPC considerations for people receiving care’.
A positive lateral flow test in the absence of a high temperature after 10 days is unlikely. 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.
The likelihood of a positive lateral flow test after 14 days is considerably lower. 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 at higher risk of becoming seriously unwell with COVID-19 (seek clinical advice as necessary), a risk assessment should be undertaken, and consideration given to redeployment.
Managers can undertake a risk assessment of staff who test positive between 10 and 14 days and who do not have a high temperature or feel unwell, with a view to them returning to work depending on the work environment.
If a staff member receives a negative or inconclusive test result
Staff who had symptoms of COVID-19 and who received negative results (2 lateral flow tests 48 hours apart as per the symptomatic section above) can return to work providing they are medically fit to do so, subject to discussion with their line manager or employer and a local risk assessment.
Staff who receive an inconclusive test result should take another lateral flow test, and symptomatic staff who do not have immediate access to another lateral flow test should not attend work while waiting to receive another lateral flow test to take. If the test was being taken by an asymptomatic member of staff as part of outbreak testing, they can continue working but should still take the repeat test. If the repeat test result is positive, they should follow the advice on receiving a positive test (see above). If their test result is negative, they can return to work.
Staff who are contacts of confirmed COVID-19 cases
Staff who are contacts of confirmed COVID-19 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.
If the staff member develops symptoms, they should follow the guidance for ‘If a staff member receives a positive lateral flow or PCR test result’.
If the staff member works with people who are at higher risk of becoming seriously unwell with 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. Further information about assessing the risk of individuals can be found below in the risk assessment section of ‘IPC considerations for people receiving care’.
Consideration should be given to how to ensure staff can deliver safe care during the 10 days after being identified as a close contact of someone who has tested positive for COVID-19. This includes applying the measures known to reduce risk such as distancing, maximising ventilation, PPE and cohorting. This should be built into provider’s general risk assessments for responding to infectious diseases and ensuring safe staffing levels are maintained.
Care workers living with individuals they provide care and/or support to
Care workers who provide care and/or support to the person they live with may need to follow different guidance detailed in this section given the close proximity of the care and the relationship between carer and the individual receiving care.