Guidance on when to test children and staff, type of test that should be used, and how to order more tests.
Applies to England
This guidance supports children’s homes in using and ordering lateral flow device (LFD) and polymerase chain reaction (PCR) test kits for:
- testing upon entry into a secure children’s home for asymptomatic children
- regular, asymptomatic testing of all children’s home staff
- regular asymptomatic testing of secondary school-aged children in open residential homes
Read this guidance alongside:
- guidance for children’s social care services
- safe working in education, childcare and children’s social care settings, including the use of personal protective equipment (PPE)
- schools COVID-19 operational guidance
Open children’s homes – testing options
Staff and children in open children’s homes are advised to continue regular twice weekly testing (3 to 4 days apart).
Staff should access LFD test kits for twice weekly asymptomatic testing, via local pharmacies or Order coronavirus (COVID-19) rapid lateral flow tests. Staff should share their result with the children’s home setting to help with any cover arrangements.
Asymptomatic testing remains voluntary and staff do not need to provide proof of a negative test result to attend the workplace. Read the guidance on regular rapid COVID-19 tests if you do not have symptoms.
Open children’s homes will be able to order lateral flow device (LFD) test kits to test all children of secondary school age and above who are resident in the home.
Results should be reported to NHS Test and Trace, whether the result is positive, negative or void.
Secure children’s homes – testing options
Staff in secure children’s homes are advised to continue asymptomatic testing and will be supplied with LFD test kits to use for twice weekly testing (3-4 days apart) at home. For new entrants, they are advised to test twice on arrival (3 to 4 days apart) using LFD test kits. Previous isolation requirements for new entrants following testing are no longer required but should be reviewed as part of ongoing risk assessments.
For more guidance on what is required of settings in relation to health and safety risk assessments, and managing risk, read:
- Health and Safety Executive (HSE): working safely during the coronavirus (COVID-19) pandemic
- Use of PPE in education, childcare and children’s social care
Asymptomatic testing remains voluntary. Read the guidance on regular Rapid lateral flow coronavirus (COVID-19) tests if you do not have symptoms and staff do not need to provide proof of a negative test result to attend the workplace. LFD tests should not be used for those showing symptoms.
Results should be reported to NHS Test and Trace, whether the result is positive, negative or void. Staff should also share their result with their children’s home setting to help with any cover arrangements.
Consent to testing of children
For looked-after secondary school-aged children, the children’s home manager should in all cases get consent from the person or body who holds parental responsibility, via the placing authority, for the child’s participation.
Young people 16 years or over, who are able to provide informed consent, can complete the consent form, which is available on the document sharing platform. Home managers will provide the form to the young person.
For children younger than 16, or young people who are unable to give informed consent due to lack of mental capacity, informed consent will need to be obtained from the appropriate guardian or relevant responsible person from the child’s placing local authority.
One consent form for each child participating in testing should be completed.
If the child refuses, testing should not take place even if informed consent has been given by the appropriate guardian.
Children’s home managers should liaise with the placing local authority and consult the care plan for individual children as regards the types of decision, which might include testing and receiving test results, that can be taken on behalf of children.
Consent to testing of staff
Participation is voluntary for self-testing at home. Anyone participating in testing must be provided with all necessary information to help them make the decision to self-test. Secure children’s homes must make sure that staff and children are issued with the privacy notice for testing at home. Staff can still attend work and children can enter the home, if they don’t take part in the testing programme.
Children’s home managers need to follow the guidance as set out in the clinical standard operating procedure (SOP). This is available on the document sharing platform.
Ordering and replenishing test kits
All children’s homes registered on the national testing portal can order more test kits online. The following table summarises which cohorts within homes are eligible for text kits through the national portal.
|Setting/cohort||Testing access route|
|Open children’s homes: staff||Community testing routes – such as pharmacies or Order coronavirus (COVID-19) rapid lateral flow tests|
|Open children’s homes: children||Settings can order direct: Order coronavirus (COVID-19) tests for your organisation|
|Secure children’s homes: staff||Settings can order direct: Order coronavirus (COVID-19) tests for your organisation|
|Secure children’s homes: children||Testing on arrival only – settings should use their existing stock of LFD kits|
For new entrants to secure children’s homes, settings will be able use existing stocks of LFDs to allow them to test twice on entry to the home.
Both open and secure children’s homes can also order 10 stand-alone PCR tests if required irrespective of the size of LFD order placed, that can be used in the exceptional circumstances that a symptomatic child or staff member is unable to access testing through the usual channels.
To place an order you will need a unique organisation number. You should receive an email with this number once your account has been approved.
You can look up your unique organisation reference number (UON) using your Ofsted unique reference number.
If you have any questions, concerns or need to report any issues about the supply, ordering and delivery of test kits, we advise you to call NHS Test and Trace on 119.
Action following LFD test results
If a child or member of staff has a positive LFD test result, they should follow the guidance COVID-19: people with COVID-19 and their contacts.
If a member of staff or child has a negative LFD result it is likely they were not infectious at the time the test was taken.
Children’s home managers must continue to follow Use of PPE in education, childcare and children’s social care for safe working in children’s social care.
If at any point a child or young person or staff member develops symptoms of a high temperature, a new, continuous cough or a loss or change to the sense of taste or smell, they should stay at home and avoid contact with other people. Follow When to stay at home if you have coronavirus (COVID-19) and what to do and get a PCR test.
This means that the test has not been run correctly and they should take another test as soon as possible, ideally on the same day.
A new test kit should be used, nothing can be reused from the first kit.
More information about what test results mean is available on the NHS website.
Registering completed test kits and receiving results
When registering your completed test kits you will need to give details of the person being tested. This includes their:
- date of birth
- symptoms (if any) and the date they started
- ethnic group
- email address and mobile number that the results will be sent to
- employment status (optional)
- NHS number (if known)
The home manager should register the completed test kits for any children in your care.
Children aged 11 must be assisted by an appropriate adult and the results should be reported on the LFD self-test portal by the appropriate adult using the home UON.
Children aged 12 to 17 may self-test with supervision and can report the results on the LFD self-test portal using the home UON with adult oversight.
Anyone 18 years and above may self-test without supervision where this is suitable, and report results on the LFD self-test portal using the home UON.
Children’s home managers should share the results of a child’s test with the placing local authority and local authority where the home is located (if different).
Children’s home managers should also ask members of staff to share the results of their at-home test immediately.
Storage of PCR and LFD test kits
PCR kits should be stored securely at ambient room temperature (5 to 22°C).
LFD kits should be stored securely at ambient room temperature (2 to 30°C).
It is crucial that action continues to be taken to break chains of transmission of COVID-19 and help safeguard the health of staff and residents of children’s social care settings.
Testing is in addition to and does not replace other protective measures such as:
- ensuring good respiratory hygiene (promoting the ‘catch it, bin it, kill it’ approach)
- maintaining enhanced cleaning including cleaning frequently touched surfaces, often using standard products such as detergents
- keeping occupied spaces well ventilated where appropriate
No child living in the setting should be denied education based on their compliance with any additional precautions.
Settings will continue to have a role in working with health protection teams in the case of a local outbreak. If there is a substantial increase in the number of positive cases in a setting or if central government offers the area an enhanced response package, a director of public health might advise a setting to temporarily reintroduce some control measures.
See the use of PPE in education, childcare and children’s social care for more information about how to manage outbreaks in children’s homes.
For most settings, it will make sense to think about taking extra action if the number of positive cases substantially increases. Information on what circumstances might lead you to consider taking additional action, and the steps you should work through, can be found in the education and childcare settings contingency framework.
For help and enquiries
For COVID-19 related queries, including issues with the supply of test kits, phone 119 NHS Test and Trace.
In addition, Test and Trace can also provide support:
- at any point throughout the testing journey
- in up to 650 languages, including British Sign Language (BSL)
- to order home test kits for symptomatic members of a household through the usual routes