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Test and Protect

Lateral Flow Device testing (LFD) in care homes :

Webinar pack

January 2021

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Contents

Item Slide

Welcome -

Lateral flow Device testing in care homes –

update January 2021 and Key points 3-4

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

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

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Lateral 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

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Expanded 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

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What 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

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Testing supply, delivery and support

Staff

Take Test

Enter Care

Home

Report

result –

confirmatory

PCR

Devices

and AssistOutcome

Positive

Negative

Dispose of

Used

Device

Used

Device

National

Device

Allocation

National

Distribution

Centre

Sykes

Global

Royal Mail

CourierCare Home

COVID Test

Portal

Booking

System

Devices

Devices

Order

More

Devices

Order

Lateral Flow

Tests

Guidance

Care Home

Address and

Device

Allocation

SG Stock

Prioritisation

& Allocation

LFT Support

and Helpline

NSS testing

portal

Record

result

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Training resources – NES TURAS Assisting care home visitors to test for COVID-19 using a Lateral Flow Device (LFD) | Turas | Learn (nhs.scot)

https://learn.nes.nhs.scot/40860/covid-19-diagnostic-swabbing-for-health-and-social-care-staff/assisting-care-home-visitors-to-test-for-covid-19-using-a-lateral-flow-device-lfd

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Care home visitor COVID-19 LFD testing learning materials

Guidance documentGuide for care-home staff assisting visitors to test for coronavirus using a Lateral Flow Device (LFD)

VideoLateral Flow Device: COVID-19 care home visitor testing

Competency assessmentLateral flow test : competency assessment framework

SlidesetUsing a Lateral Flow Device (LFD) to assist care home visitors test for COVID-19

PosterGuide for care-home staff assisting visitors to test for coronavirus using a Lateral Flow Device (LFD)

Visitor leafletInformation for people visiting care homes in Scotland

https://learn.nes.nhs.scot/40874https://vimeo.com/492239981/41aa04f941https://learn.nes.nhs.scot/41108/covid-19-diagnostic-swabbing-for-health-and-social-care-staff/assisting-care-home-visitors-to-test-for-covid-19-using-a-lateral-flow-device-lfd/care-home-visitor-covid-19-testing-learning-materials/lateral-flow-test-competency-assessment-frameworkhttps://learn.nes.nhs.scot/40873https://learn.nes.nhs.scot/41109https://learn.nes.nhs.scot/40872

Lateral Flow DeviceCOVID-19 Care Home

staff testing

Using a Lateral Flow Device (LFD) to assist care home staff test for COVID-19

Overview

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 equipment

LFD Test Kit

Foil pouch

Sterilised swab

Extraction tube and cap

Test cartridge (device)

Extraction buffer bottle

Instruction leaflet

Preparing to perform the test

Place the test cartridge on a clean

flat surface

Hold solution bottle vertically and dispense

6 drops only of test solution into the extraction tube

Place extraction tube in a small clean

container

6drops

Taking the swab

Rub the fabric tip of the swab against

both tonsils (or where they would have

been). Swab for 10 seconds or 5

rotations

1010

Gently tilt the head back and insert

the swab to 2.5 cms into the nostril

and rotate the swab 10 seconds

seconds seconds

Performing the test

Swirl the tip of the swab in the solution fluid whilst squeezing the

tube from the outside for ten seconds

Tightly place the cap on the extraction tube

Remove the swab from the extraction

tube and dispose into domestic rubbish bag

10secs

Completing the test

Dispense two drops of the specimen solution vertically into the specimen well on

the device: marked S

Set a timer for 30 minutes

2drops

specimen well

30mins

Results

Negative InvalidPositive

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.

Please note:

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:

Proceed to work in the care home ensuring that IPC measures are adhered to.

If the test result is invalid:

Repeat the test with a new test kit.

Results should be recorded using the NHS Scotland COVID Testing and Registration System by the care home member. COVID Testing Portal (service-now.com)

Care Home Visitor Test Results recording sheet (Excel file) can be completed by the Care Home Staff where there are problems with the Testing and Registration system or internet failure.

https://nhsnsstest.service-now.com/covidtesting?id=test_home

Disposal advice may be subject to change based upon future waste disposal guidance.

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

https://www.gov.scot/publications/coronavirus-covid-19-adult-care-home-visitor-testing-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.

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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.

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• 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

• Feedback sessions to share updates and learning

• Monitoring & evaluation of roll out

• Care home working group feedback with representatives

Q&A, next steps and close

What next nationally?

What you need to do next:

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Next steps and close

Thank you for your time today

• Do you have any questions about what was discussed

today?

• Any concerns or problems you can foresee?

Questions