Care provider COVID-19 testing

Testing arrangements and ordering tests for your organisation

At present there will be no charges for LFT tests for adult social care. Tests will continue to be provided through national testing scheme and should be applied for as per your usual ordering. 

If you are having trouble accessing PCR/LFD tests, please contact 119.

Eligibility criteria

Care homes are eligible for free testing if they are regulated by the Care Quality Commission (CQC).

The adult social care testing guidance (updated 15 December 2022) details the testing regimes for all staff, as well as any resident and outbreak testing where applicable.

COVID-19 testing guidance for adult social care services

The adult social care testing guidance (updated 15 December 2022) details the testing regimes for all staff, as well as any resident visitors for all adult social care services and outbreak testing where applicable.

Symptomatic testing

Symptomatic testing consists of 2 lateral flow device (LFD) tests taken 48 hours apart. This is available for:

  • All staff described in section 1.2
  • All residents in all care homes
  • All service users in extra care and supported living services which meet one or both of the criteria listed in section 1.2

See the COVID-19 supplement to the infection prevention and control (IPC) resource for adult social care for details of COVID-19 symptoms and when symptomatic testing is needed, as well as testing after a positive result.

Asymptomatic testing

During periods of high prevalence, asymptomatic testing will continue to mitigate risk. Testing will continue to be provided for:

  • Adult social care staff and a small number of visitors providing personal care
  • Hospice staff
  • Patient-facing staff in the NHS and NHS-funded independent healthcare provision

Rapid response testing in care homes and in high-risk extra care and supported living section 2.3.1

Rapid response testing is triggered if one or more positive staff or resident cases are found in:

  • A care home
  • A high-risk extra care and supported living setting

Rapid response testing consists of daily LFD tests taken by staff on their working days for 5 consecutive days only. This is not undertaken by residents or service users.

This is distinct from outbreak testing which is only undertaken by care homes in the event that 2 or more positive or suspected linked cases of COVID-19 occur in the same setting within a 14-day period (this means where the cases are linked to each other and transmission in the care setting is likely). Please refer to section 2.4 for further details.

Rapid response testing in small care homes 2.3.2

Rapid response testing is specific to small care homes. Please refer to section 1.2. High-risk extra care and supported living settings should continue to adhere to rapid response testing as outlined above in section 2.3.1.

If there is only 1 positive case in a small care home:

  • Rapid response testing should be initiated

If there are 2 or more positive cases in a small care home:

  • A small care home should start outbreak testing as soon as possible

Outbreak testing guidance section 2.4

Care home outbreak testing for all staff and residents will also continue all year.

Outbreak recovery testing section 2.4.1

For outbreak recovery testing, all staff and residents (who have not tested positive in the last 90 days) should be tested with a PCR test, no earlier than 10 days after the last resident or staff member had a positive test result or showed COVID-19 symptoms.

Coronavirus (COVID-19) testing for adult social care services

Details of the testing regimes for all staff, as well as any resident and outbreak testing where applicable adult social care testing guidance.

Ending isolation if the individual is a care home resident section 3.4.2.2

They should isolate in the care home for up to 10 days from when the symptoms started, or from the date of the test .To end isolation earlier see full guidance outlined in the COVID-19 supplement to the IPC resource for adult social care.

Accessing COVID-19 treatments if the individual is in the highest risk group from COVID-19

Individuals in the highest risk group should be supported to access COVID-19 therapeutics by contacting 119 or a local GP as required. Please refer to section 3.4.5.

Discharge from hospital into a care home

All information on this is now consolidated in Infection prevention and control in adult social care: COVID-19 supplement (GOV.UK).

Main changes:

  • People who test positive prior to discharge can be admitted to a care home if the home is satisfied that they can be cared for safely.
    A person will receive a PCR test within 48 hours prior to discharge, or a lateral flow test if they have tested positive for COVID-19 in the past 90 days.
  • Care home residents should not be required to self-isolate when discharged back to the care home following an admission into hospital, subject to a negative PCR or lateral flow test. Residents will still need to self-isolate for 10 days if they have been discharged from a part of hospital where there is an active outbreak. Updated discharge from hospital advice makes clear that the period of isolation is continuous and does not restart moving between services.

Testing for admission to care home from the community or another care setting

Residents admitted from the community, or another care setting should take a PCR test within the 72 hours before they are admitted (or a lateral flow test if they have tested positive for COVID-19 in the past 90 days) and a lateral flow test on the day of admission (day 0).

These tests should be provided by the care home. If an individual tests positive on either of these tests and continues to be admitted to the care home, they should be isolated on arrival.

If a care home resident is symptomatic, tests positive or is a contact of someone with COVID-19:

  • Care home residents with symptoms should take a lateral flow test as soon as they develop symptoms, and if this is negative take another lateral flow test 48 hours after the first test. They should isolate between these tests and ensure Accessing COVID-19 treatments for people in the highest risk group. View treatment for coronavirus (NHS)
  • Residents who test positive for COVID-19 on either test should isolate for 10 days and take part in daily lateral flow testing from day 5. They can end self-isolation after receiving two consecutive negative tests 24 hours apart, or after 10 days’ isolation.
  • Care home residents should only self-isolate if they test positive for COVID-19, or if they are admitted from a hospital where there is an active outbreak.

Reduced PCR availability

New changes in requirements for reduced PCR testing throughout the NHS following the testing guidance ‘Living with COVID’ meaning that patients on discharge are not routinely swabbed (unless symptomatic for COVID-19). 

  • Patients discharged to Nursing Homes are swabbed prior to discharge, in line with National Guidance
  • Transfer of patients to other inpatient Healthcare providers-swabbing is done, however this is not part of national guidance and is currently being reviewed by South West London (SWL) IPC Group

Read letter NHS Foundation Trust.

In line with the new testing national Guidance, high risk patients admitted to the following areas/departments in the hospital will have a PCR:

  • General ICU
  • Cardiothoracic ITU
  • Neuro ITU
  • Haematology and Oncology Departments 

Elective/ planned care:

  • Day surgery – swabbing is suspended
  • Clinically vulnerable, high risk and cardiac surgery patients – PCR testing: outside of new national Guidance

How to use a coronavirus (COVID-19) test

If you need assistance with how to administer nasal and throat swabs for residents, refer to the video tutorial below. You can also read:

List of COVID-19 testing guidance for Adult Social Care Services

The latest Government testing guidance for the various adult social care services can be found below:

Outbreak testing in care homes section 2.4

Older people care homes can request testing for residents and staff through this government portal. All types of care homes are now able to register for retesting.

There is a testing matrix detailing testing available for care homes in England.

Testing for Hospices

Weekend testing in care homes

The Director of Public Health, Shannon Kitayo has written a letter to care homes to consider spreading care home testing more evenly throughout the week by testing on weekends where possible to increase overall testing capacity.

Read Shannon Kitayo's letter to care home managers.

Antibody testing

The antibody testing offer has now ended.

Up to COVID-19 guidance for social, community and residential care providers

Updated: 24/07/2023