Testing for COVID-19 in the Homeless, Domestic Violence Shelters and Respite Rooms

Who is this advice for?

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

  • night shelters
  • homeless shelters, hotels and other temporary accommodation
  • domestic violence shelters
  • respite rooms
  • other outreach services for homeless people, including drop-in centers

There are separate guidelines for prisons and other places of detention, retirement homes and accommodation for asylum seekers.

This guidance supersedes previous guidance for shelter services for people who are homeless and homeless on the streets, and for safe shelter environments in the event of domestic violence.

Background

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

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

These guidelines outline COVID-19 testing advice for homeless people, domestic violence shelters and respite services. The purpose of testing in these settings is to enable rapid identification of anyone who tests positive for COVID-19, so that action can be taken to reduce the spread. These parameters are eligible for free testing as:

  • the risk of transmission is higher due to overcrowding, many people sharing rooms, and poor ventilation.
  • there may be people at higher risk of serious illness from COVID-19 – due to a weakened immune system or other conditions

Test diets

The test regimes available in each parameter are:

Night shelters:

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

Homeless shelters, 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 centers and other local services:

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

Domestic Violence Shelters

  • symptomatic testing for staff and residents or service users

Symptomatic tests

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

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

If the second LFD the 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 about people with a negative COVID-19 result.

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

Asymptomatic testing

Asymptomatic testing aims to identify people who are infected with COVID-19 but do not have symptoms so they can engage in behaviors that reduce onward transmission. Parameters currently eligible for asymptomatic testing are described above.

Staff in eligible settings who do not have symptoms should perform 2 LFD tests per week, doing them before the start of labor, spaced 3 to 4 days apart.

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

Hatching test

An outbreak consists of 2 or more people who have a positive (or clinically suspected) COVID-19 test result linked to the same location over 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 carry out a risk assessment, including whether the cases are likely to be linked, and provide further guidance

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

The recommended hatch tests are one LFD testing 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 performed by all individuals on the same day, for example day 4. If an individual is unable to perform the test on that day, they should perform its second epidemic LFD test as soon as possible within the period of 4-7 days.

To ensure that the epidemic has ended, a third LFD testing should be done by all individuals at least 10 days after the date the last case of COVID-19 was identified (either the day they became symptomatic or tested positive, whichever comes first) ).

Test results

If a staff member tests positive

The staff who received a positive review LFD test result, whether or not they have symptoms, they are advised not to report to work for 5 days. They should follow advice for people who test positive for COVID-19 and should try to stay home and avoid contact with other people. They don’t need to take a PCR test.

Staff should only return to work after having had 2 consecutive negative results LFD test results (taken at least 24 hours apart), they feel fine and they don’t have a high temperature. The first one LFD the test should be taken from 5 days after the day their symptoms started (or the day their test was taken if they had no symptoms). If both LFD test results are negative, they can return to work immediately after the second negative result 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 elevated temperature after 10 days is unlikely. If the staff member LFD test result remains positive on day 10, they should continue to have daily lateral flow testing. They can return to work after a single negative result LFD test result.

a positive LFD test result after 14 days is very unlikely. If the staff member 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 ill with COVID-19, a Risk assessment should be undertaken and granted upon redeployment.

If a resident or service user tests positive

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

Whenever possible, staff should help residents or ward users with COVID-19 avoid contact with others and practice safe behaviors to reduce the spread of infection.

Staff must ensure that residents or service users:

  • are taken care of to avoid contact with other people
  • sleep in a separate bedroom and use a separate bathroom if possible
  • wearing a tight-fitting multi-layered face covering or surgical mask in shared areas
  • avoid contact with people who are at higher risk of becoming seriously ill if infected with COVID-19, especially those whose immune systems mean they are at higher risk of severe illness from COVID-19. 19
  • wash their hands regularly or use hand sanitizer and cover their mouth and nose when coughing or sneezing
  • ventilate their room (by opening the windows and leaving them open for at least 10 minutes after leaving the room)
  • regularly clean frequently touched surfaces, such as doorknobs and remote controls, and common areas such as kitchens and bathrooms

Individuals with a negative COVID-19 result

A symptomatic person who tests negative for COVID-19 may have another infectious disease such as the flu.

Staff with symptoms who receive a negative test result can return to work if they no longer feel sick and do not have an elevated temperature.

Symptomatic residents or service users should be advised to stay away from others until they no longer have an elevated temperature (if they had one) or until they no longer feel bad.

Reports LFD test results

Report the result of each LFD testing of staff and service users is encouraged, even if the result is negative or null. 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.

Ordered LFD test kits

To access the tests, eligible parameters will need to register on the self-reference portal. They will then receive a unique organization number, which can then be used to order test kits once it has been verified.

Further details on how to undertake testing within your settings can be found in the standard operating procedure which will be made available during the registration process.