Hancock: social care staff and care home residents with Covid-19 symptoms to get tested

Story updated 15 April

The government will roll out Covid-19 testing to all symptomatic adult social care staff, their family members and care home residents, following mounting concerns about the coronavirus’s impact on the sector.

Tests will also be provided to all residents admitted to care homes from hospital and, eventually, from the community, health and social care secretary Matt Hancock said today, ahead of the launch of a Covid-19 action plan for adult social care.

Testing will be made available for all patients discharged to a care home from hospital “with immediate effect”, while there was already testing capacity for all social care workers who need a test to have one, said the Department of Health and Social Care.

Hancock’s announcement came as providers, unions, charities and councils highlighted the severe pressures care homes – and the wider social care sector – were facing from Covid-19 without the resources and equipment to deal with them. This included fears of a mounting death toll within residential and nursing homes.

However, while it was welcomed by social care leaders, the United Kingdom Homecare Association (UKHCA) criticised the fact that testing would not be rolled out to home care service users with symptoms.

Today’s plan is part of the target of delivering 100,000 tests a day by the end of the month, by rolling out access beyond people who are seriously ill in hospital with, or requiring admission for, pneumonia or flu-like symptoms, increasing numbers of NHS staff and up to five residents in a care setting where there has been an outbreak.

‘Among the most vulnerable to coronavirus’

“I am deeply conscious that people in residential care are among the most vulnerable to coronavirus,” said Hancock. “We are doing everything we can to keep workers, residents and their families safe, and I am determined to ensure that everyone who needs a coronavirus test should be able to have access to one.

“We have already begun testing social care workers and will roll this out nationwide over the coming days. And as we continue to ramp up our testing programme, we will test all current care home residents with coronavirus symptoms and all new care home residents who are discharged from hospital into care.”

The plan was welcomed by provider leaders. Martin Green, chief executive of Care England, said: “During this dreadful pandemic it is hard to find things to be positive about, but today’s announcement from DHSC that testing will be available for all social care staff and residents that need it is indeed welcome.

“Care homes will be in a much better position to face this virus head on once they have been able to test both their staff, residents and new residents who have been discharged from hospital into their care homes.”

However, his counterpart at the UKHCA, Jane Townson, said it was wrong that testing would not be rolled out to those receiving home care.

After lobbying for weeks, @ukhca welcomes the announcement to make #COVID19 testing available for all careworkers, and #carehome residents, with symptoms. Excluding #homecare clients makes no sense but is typical. Still inadequate testing capacity. https://t.co/XUHPlzqr3o (7:02) pic.twitter.com/PkmzIw3h8E

— Jane Townson (@drjanetownson) April 15, 2020

The CQC said it was launching a tool to enable home care providers to feed back the impact that Covid-19 was having on their services, including through reporting confirmed or suspected cases.

How testing will be rolled out

Up to now, relatively few social care staff have been tested and, among care home residents, tests have been available for up to five symptomatic residents per care home where there has been an outbreak, and those admitted from hospital critical care wards with pneumonia, acute respiratory distress or flu-like symptoms.

The government is saying that testing will now be rolled out to:

• All care home residents who display symptoms.
• Everyone discharged to a care home from hospital, including those who are asymptomatic.
• All symptomatic adult social care staff – including those working in home care – and anyone in their household who displays symptoms.

In time, it will also be rolled out to anyone admitted to a care home from the community.

Testing for care staff will be co-ordinated by the Care Quality Commission, who will have contacted all 30,000 care providers that it regulates within the next few days with the offer of tests. Providers will then be able to refer staff who are eligible to their local testing centre.

The roll out is within the context of the government’s plan to be carrying out 100,000 tests a day by the end of April.

On 13 April, the last day for which figures are available, 14,982 tests were carried out, well below the 25,000 the government is aiming to reach by mid-April, though Hancock said this was due to a lack of demand, not capacity.

The government has also tightened guidance on the isolation of people discharged from hospital into care homes, recommending that those who are asymptomatic and have tested negative for Covid-19 be isolated, along with those who have symptoms or have tested positive.

Where the care home is not able to provide isolation, the government said local authorities would need to find alternative accommodation for the person.

Recording deaths

The testing roll out comes amid mounting concern about the number of deaths of people from, or with, Covid-19 in care homes.

Office for National Statistics figures released yesterday said there had been 217 registered deaths involving Covid-19 in care homes up to 3 April. But the current figure is expected to be much bigger, with one of the largest providers, HC-One, saying that 311 of its residents had died with suspected or confirmed Covid-19 as of Monday (13 April).

To better track deaths in care homes, the CQC said that providers would be able to record whether a person had died with suspected or confirmed Covid-19 in the death notifications they are required to send to the regulator.

The CQC will then publish regular updates on these, broken down by region, with the method and frequency of publication to be confirmed.

Chief inspector of adult social care Kate Terroni said: “As well as giving a fuller picture of deaths in care settings, this will provide a regional view which allows an assessment of which areas are most impacted and may need additional support as a result.”

She also urged providers to keep reporting concerns – including about a lack of access to personal protective equipment (PPE) for staff – to the regulator, which it would escalate to local and central government.

“We are acutely aware that adult social care providers are facing extraordinary pressures, and our priority is working with them to provide support at this time,” Terroni added.

“Providers across the sector are raising concerns directly with us, including access to personal protective equipment and challenges with workforce and we urge them to keep doing so.”