Test and Protect Lateral Flow Device testing (LFD) in care homes : Webinar pack - January 2021 - The Scottish Government
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Test and Protect
Lateral Flow Device testing (LFD) in care homes :
Webinar pack
January 2021
DRAFT | OFFICIAL - SENSITIVE
Contents
This session will provide an overview of the Care Home Visitor testing pathway and
a forum to share key questions and any concerns about delivery
Item Slide
Welcome -
Lateral flow Device testing in care homes –
3-4
update January 2021 and Key points
What is a Lateral Flow Device Test (LFD)? 5
Overall service map 5
Testing supply, delivery and support 6
Learning and training resources 7-9
Carrying out LFD tests walkthrough 9-19
Current visiting guidance 20
Q&A, next steps & close 21
Current visiting guidance 22
DRAFT | OFFICIAL - SENSITIVELateral flow Device testing in care homes – update January 2021
Dec 20 - LFDs introduced for designated visitors – currently
suspended in Level 4 restrictions
Jan 21 - SAGE scientific review – expansion of LFD testing
in care homes due to new COVID variant, recommended:
1. Continue with weekly PCR testing for all staff
2. Twice weekly LFD staff testing
3. Testing of professional visitors to care homes (mostly
through employers) LFDs
4. Outbreak management – testing staff for at least 7
consecutive days
6th Jan 2021 – 10,000 LFDs conducted in Care Homes in
Scotland
DRAFT | OFFICIAL - SENSITIVE
3Expanded LFD testing in care homes – Staff testing key points
Twice weekly staff testing (LFDs) - The first LFD test should be done on the
same day as the PCR. If the result is positive the member of staff should self-
isolate and await the PCR result to confirm second test.
Can be carried out by either the care home testing lead or the individual staff
member. (sensitivity decreases slightly when an individual is responsible for the
end to end self-testing process and recording of results but not in a way that
increases the risk substantially.)
Outbreak management – testing staff for at least 7 consecutive days
whole home outbreak management process triggered immediately if a +ve case
in resident or staff. Supervised by HPTs. Use home’s stocks of LFDs to do
simultaneous testing of all staff in addition to PCR. Residents LFD test may be
useful for a first suspected case pending PCR confirmation.
Any staff immediately identified as positive for COVID by LFD test must self-
isolate pending the PCR result. Any residents identified as positive must be
isolated and managed in line with the relevant guidance. Staff who initially test
negative should continue to be tested daily for at least 7 consecutive days
DRAFT | OFFICIAL - SENSITIVE
4What is a Lateral Flow Device Test (LFD)?
• A Lateral Flow Device Test (LFD) is a form of rapid testing to identify Covid-19
in individuals
• People undergoing lateral flow testing complete a throat and nasal swab and
insert this into an LFD device, which produces a result in 30 minutes
• The LFDs are small, meaning they are portable and can be distributed across
settings
• LFDs do not rely on labs for testing and offer faster testing for visitors
versus standard PCR testing
DRAFT | OFFICIAL - SENSITIVE
5Testing supply, delivery and support
National
Device
Allocation
Devices
SG Stock National Lateral Flow
Prioritisation Distribution Tests
& Allocation Centre Guidance
Devices
Used
Care Home
Device Dispose of
Address and Sykes Royal Mail Staff
Care Home Used
Device Global Courier Take Test
Device
Allocation
Devices Outcome
and Assist
Report
Order Positive
Record result –
More confirmatory
result
Devices PCR
Negative
COVID Test
Order Portal
Booking Enter Care NSS testing LFT Support
System Home portal and Helpline
DRAFT | OFFICIAL - SENSITIVE
6Training resources – NES TURAS Assisting care home visitors to test for COVID-19
using a Lateral Flow Device (LFD) | Turas | Learn (nhs.scot)
DRAFT | OFFICIAL - SENSITIVE
7Care home visitor COVID-19 LFD testing learning materials
Guidance document
Guide for care-home staff assisting visitors to test for coronavirus using a
Lateral Flow Device (LFD)
Video
Lateral Flow Device: COVID-19 care home visitor testing
Competency assessment
Lateral flow test : competency assessment framework
Slideset
Using a Lateral Flow Device (LFD) to assist care home visitors test for
COVID-19
Poster
Guide for care-home staff assisting visitors to test for coronavirus using a
Lateral Flow Device (LFD)
Visitor leaflet
Information for people visiting care homes in Scotland
DRAFT | OFFICIAL - SENSITIVE
8Lateral Flow Device
COVID-19 Care Home
staff testing
Using a Lateral Flow Device (LFD) to assist care home staff test for COVID-19Overview
Here is a quick checklist for how to use the COVID-19 LFD tests. It
is really important that you follow these steps in the correct order.
Prepare the test area and unpack your equipment onto a clean
and dry surface
Staff perform swab or self swab (throat then nasal swab) and
process the sample and wait 30 minutes
Read the result
Report and record the result
Safely dispose of test equipmentLFD Test Kit
Foil pouch
Sterilised swab
Extraction tube and cap
Test cartridge (device)
Extraction buffer bottle
Instruction leafletPreparing to perform the test
6
drops
Place the test Place extraction tube Hold solution bottle
cartridge on a clean in a small clean vertically and dispense
flat surface container 6 drops only of test
solution into the
extraction tubeTaking the swab
10 10
seconds seconds
Rub the fabric tip of the swab against Gently tilt the head back and insert
both tonsils (or where they would have the swab to 2.5 cms into the nostril
been). Swab for 10 seconds or 5 and rotate the swab 10 seconds
rotationsPerforming the test
10
secs
Swirl the tip of the swab Remove the swab Tightly place the cap
in the solution fluid from the extraction on the extraction tube
whilst squeezing the tube and dispose into
tube from the outside domestic rubbish bag
for ten secondsCompleting the test
2 30
drops mins
specimen well
Dispense two drops of the Set a timer for 30 minutes
specimen solution vertically
into the specimen well on
the device: marked SResults Negative Positive Invalid Please note: If your test result is negative you should not regard yourself as free from infection – the test could be a false negative – you may also go on to acquire the virus in the period before the next test. You should remain vigilant to the development of symptoms that could be due to COVID-19.
Reporting the results
If the test result is positive you must take a confirmatory PCR test following Scottish
Government guidelines and then leave the care home and go straight home and self-
isolate.
If the test result is negative: If the test result is invalid:
Proceed to work in the care home ensuring Repeat the test with a new test kit.
that IPC measures are adhered to.
Results should be recorded using the NHS Care Home Visitor Test Results recording
Scotland COVID Testing and Registration sheet (Excel file) can be completed by
System by the care home member. COVID the Care Home Staff where there are
Testing Portal (service-now.com) problems with the Testing and
Registration system or internet failure.Disposing of your test Carefully dispose of the test device and equipment and then wash your hands using warm water and soap. Do not dispose of in clinical waste (yellow or orange bags) For detailed advice on waste disposal of test kits, please refer to the Care Home Guidance for Designated Visitor Testing on the Scottish Government website: Coronavirus (COVID-19): adult care home visitor testing guidance https://www.gov.scot/publications/coronavirus-covid-19-adult-care- home-visitor-testing-guidance Disposal advice may be subject to change based upon future waste disposal guidance.
Further Information The manufacturer’s instructions for use (IFU) are included in the box and are detailed and very technical. These do not need to be followed as Care Homes will use the test in a slightly different way, which has been agreed with experts, discussed with the Medicines and Healthcare Regulatory Authority (MHRA) and the manufacturer has been informed.
Visiting – Current guidance
• Mainland Scotland level 4: At level 4, visiting is limited to essential indoor ,
window and garden visits only. In exceptional circumstances Directors of Public
Health may allow limited indoor visiting in some homes where it is safe.
• Island Boards Levels 3 continue with current guidance, a combination of:
• Essential visits
• Indoor visits with one designated person for up to four hours once a week.
• Garden visits with a maximum of 6 people from no more than 2 different households
60 minutes once a week.
• Window visits
• Testing: indoor visitors
• What is an essential visitor?
• Essential visits include circumstances where it is clear that the person’s health
and wellbeing is changing for the worse, where visiting may help with
communication difficulties, to ease significant personal stress or other pressing
circumstance.
• It is vital that these are generously and sympathetically supported by care
homes.
DRAFT | OFFICIAL - SENSITIVE
20Q&A, next steps and close
What next nationally?
• Feedback sessions to share updates and learning
• Monitoring & evaluation of roll out
• Care home working group feedback with representatives
What you need to do next:
• Complete available training
• Read the materials pack that we have provided for
reminders as and when you need them
• Receive initial delivery of Lateral Flow Tests stock
• Share your feedback with us
• Liaise with oversight team / Health Protection team
DRAFT | OFFICIAL - SENSITIVE
21Next steps and close
Questions
• Do you have any questions about what was discussed
today?
• Any concerns or problems you can foresee?
Thank you for your time today
DRAFT | OFFICIAL - SENSITIVE
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