COVID-19 testing in homelessness, domestic abuse refuge, respite room and asylum seeker accommodation settings
Information on coronavirus (COVID-19) testing in homelessness, domestic abuse refuge, respite room and asylum seeker accommodation settings
Applies to England
What has changed
This guidance has been updated in line with the decision to pause routine asymptomatic testing for staff and residents or service users on 31 August. The guidance has also been updated to include advice on testing in asylum seeker accommodation settings. The guidance for providers of accommodation for asylum seekers has now been withdrawn.
Further information on the changes to asymptomatic testing in high-risk settings is available.
Who this guidance is for
This guidance is for commissioners, providers and staff in the following settings and services:
- night shelters
- homelessness hostels, hotels, and other temporary accommodation
- domestic abuse refuges
- respite rooms
- other homelessness outreach services including day centres
- asylum seeker accommodation settings (hostel accommodation and reception centres)
There is separate guidance for prisons and places of detention (including immigration removal centres) and adult social care settings.
This guidance replaces previous guidance for hostel services for people experiencing homelessness and rough sleeping, for domestic abuse safe-accommodation settings and for asylum seeker accommodation settings.
Background
As part of the Living with coronavirus (COVID-19) plan there is guidance on what do to if someone has symptoms of a respiratory infection including COVID-19, or a positive test result for COVID-19. There is also guidance on reducing the spread of respiratory infections, including COVID-19, in the workplace. This includes advice on vaccination, ventilating indoor spaces, hand and respiratory hygiene and face coverings.
Managers have a duty to consult with their employees, or their representatives, on health and safety matters. The Health and Safety Executive has issued guidance on how to keep people safe and healthy at work.
This guidance sets out COVID-19 testing advice for homelessness, domestic abuse refuge and respite services, and asylum seeker accommodation settings. The aim of testing in these settings is to enable rapid identification of anyone who tests positive for COVID-19, so action can be taken to reduce the spread. These settings are eligible for free testing as:
- there is a higher risk of transmission due to crowding, people sharing rooms and poor ventilation
- there may be individuals at higher risk of severe illness from COVID-19 - due to a weak immune system or other conditions
- individuals in these settings may not be able to isolate or take other actions to prevent the spread of COVID-19, and outbreaks may have a greater impact than in other settings
Testing regimes
Information on current COVID-19 testing arrangements in high-risk settings is available. The testing regimes available in each of the settings covered by this guidance are set out below.
Night shelters:
- symptomatic testing for staff, residents and service users
- outbreak testing for staff only
Homelessness hostels, hotels, temporary accommodation and respite rooms:
- symptomatic testing for staff, residents and service users
- outbreak testing for staff, residents and service users
Day centres and other outreach services:
- symptomatic testing for staff and service users
Domestic abuse refuges:
- symptomatic testing for staff, residents and service users
Asylum hostel accommodation:
- symptomatic testing for staff, residents and service users
- outbreak testing for staff, residents and service users
Asylum reception centres:
- symptomatic testing for staff, residents and service users
Symptomatic testing
Staff, residents and service users who have symptoms of a respiratory infection and have a high temperature, or who have symptoms of a respiratory infection and are too unwell to carry out their normal activities, should take a lateral flow device (LFD) test as soon as they feel unwell.
If this first test result is negative, they should take another LFD test 48 hours later.
During this period:
- staff should stay at home
- residents and service users should be supported to stay in their accommodation and avoid contact with other people, particularly those whose immune system means that they are at higher risk of serious illness from COVID-19
If the second LFD test result is also negative they can return to their usual activities once they no longer have a high temperature and feel well enough to do so. See information on individuals with a negative COVID-19 result.
Guidance on what to do if either test result is positive can be found in the section on test results.
Outbreak testing
An outbreak consists of 2 or more people who have a positive COVID-19 test result (or have symptoms compatible with COVID-19) linked to the same place within a 14-day period. This includes residents, service users and staff who have been in the same setting.
If an outbreak is suspected local health protection team (HPT) or local authority (in accordance with local protocols) should be contacted. They will conduct a risk assessment, including on whether the cases are likely to be linked, and provide further advice including details of further testing arrangements.
If an outbreak is suspected, further testing for staff, residents and service users is available in settings as outlined above.
Recommended outbreak testing is one LFD test for all individuals (with or without symptoms) on day 1 of the outbreak followed by a second LFD test between days 4 and 7. The second test should be taken by all individuals on the same day, for example on day 4. If an individual is unable to test on that day, they should take their second outbreak LFD test as soon as possible within the 4 to 7 day period.
To ensure that the outbreak has come to an end, a third LFD test should be taken by all individuals at least 10 days after the date the last COVID-19 case was identified (either the day they became symptomatic or had a positive test result, whichever was earlier).
Test results
If a staff member tests positive
Staff who have received a positive LFD test result, regardless of whether or not they have symptoms, are advised to not attend work for 5 days after the day they took their test. They should follow guidance for people with a positive COVID-19 test result, and should try to stay at home and avoid contact with other people. They do not need to take a PCR test.
Staff should only return to work after they have had 2 consecutive negative LFD test results (taken at least 24 hours apart), they feel well and they do not have a high temperature. The first LFD test should be taken from 5 days after the day their symptoms started (or the day their test was taken if they did not have symptoms). If both LFD tests results are negative, they may return to work immediately after the second negative LFD test result on day 6 as long as they feel well enough and do not have a high temperature.
A positive LFD test result without a high temperature after 10 days is unlikely. If the staff member’s LFD test result remains positive on day 10, they should continue to take daily LFD tests. They can return to work after a single negative LFD test result.
A positive LFD test result after 14 days is very unlikely. If the staff member’s LFD test result is still positive on day 14, they can stop testing and return to work on day 15. If the staff member works with people who are at higher risk of becoming seriously unwell with COVID-19 a risk assessment should be undertaken, and consideration given to redeployment.
If a resident or service user tests positive
Residents or service users with a positive COVID-19 test result should be advised to try to avoid contact with other people for 5 days.
Where possible, staff should support residents or service users with COVID-19 to avoid contact with others and practise safe behaviours to reduce the spread of infection.
Staff should ensure that residents or service users:
- are supported to avoid contact with other people
- sleep in a separate room and use a separate bathroom if possible
- wear a well fitted face covering made with multiple layers or a surgical face mask in shared areas
- avoid contact with individuals who are at higher risk of becoming severely unwell if they are infected with COVID-19, especially those whose immune system means they are at higher risk of serious illness from COVID-19
- wash their hands regularly, or use a hand sanitiser, and cover their mouth and nose when coughing or sneezing
- ventilate their rooms (by opening windows and leaving them open for at least 10 minutes after leaving the room)
- regularly clean frequently touched surfaces, such as door handles and remote controls, and shared areas such as kitchens and bathrooms
Individuals with a negative COVID-19 result
A symptomatic individual who has a negative test result for COVID-19 may have another infectious illness like flu.
Staff with symptoms who receive a negative test result can return to work if they are no longer unwell and they do not have a high temperature.
Symptomatic residents or service users should be advised to keep away from others until they no longer have a high temperature (if they had one) or until they no longer feel unwell.
Reporting LFD test results
Reporting every LFD test result of staff, residents and service users is encouraged, even if the result is negative or void. Results can be reported on GOV.UK.
Some residents or service users may experience difficulty or be unable to report their test results and should be supported to do so whenever possible.
Ordering LFD test kits
To access tests, eligible homeless, domestic abuse refuge, and respite settings will need to register on the self-referral portal. They will then receive a Unique Organisational Number, which can be used to order test kits once it is verified.
Asylum seeker accommodation settings do not need to order LFD test kits via the portal. LFD test orders will be placed directly by UKHSA and dispatched via UKHSA as per request from asylum settings.
Further details of how to undertake testing in these settings can be found in the Standard Operating Procedure which will be made available during the registration process.
Last updated 31 August 2022 + show all updates
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Updated guidance to cover asylum seeker accommodation settings. Updated in line with pause to asymptomatic testing from 31 August.
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Added note on pausing of routine asymptomatic testing from 31 August.
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First published.