Whole Home Testing “Not Done” Reveals Survey

The National Care Forum (NCF), has conducted a survey with its members to gather data relating to the whole home testing experience for staff and residents.

The whole home testing portal went live on 11 May to all care homes with residents over the age of 65. Data gathered related to members’ experience of using this portal, including those who were part of the pilot that went live before 11 May up until 25 June 2020, as well as other testing routes for staff.

While all care homes for over 65s have been offered whole home testing, our findings reveal that not all staff and residents have actually been tested.

The survey represents the perspectives of a wide range of organisations who between them employ 24,681 staff and support 14,213 residents in 332 care homes. Our findings offer useful insight into who has been tested, speed of receiving test results and the urgent need for routine, repeat tests that are less invasive.

The government pledged to offer testing to all staff and residents in care homes for over-65s by the beginning of June. Data from our members would suggest that this either hasn’t happened or care homes have been unable to access tests for their staff and residents which may be the result of another reason (e.g. staff absences, new staff, new admission, etc.).

Respondents told us that a total of 2,318 (9%) of staff and 1,706 (12%) of residents in care homes are still awaiting COVID-19 testing.

The majority of respondents stated that on average, it takes 1-2 days or 3-4 days to receive test results, with the longest time taken to receive a test result reported as between 2 days and 28 days.

Of the small number of staff (3%) and residents (8%) who had tested positive, 53% of staff (239) and 30% of residents (233) were asymptomatic. Though a relatively small number, it’s a vital indication of the need for routine and repeat testing in care homes to manage the risk of transmission.

Respondents told us that routine, regular testing was important and necessary to keep people safe and monitor the spread of the virus.

“One-time testing is pointless in this setting. You have staff teams running a 24-hour service who are going out into the community daily and could transmit the virus to the residents. Regular testing is the only way to attempt to eradicate COVID-19 in care homes”

As demonstrated by international evidence (such as in Hong Kong), routine testing should be a necessary part of an effective test and trace system.

However, concerns were raised about the ongoing use of swab tests which can prove time-consuming to administer and process, and have the potential to cause distress for residents, and it was felt a saliva-style test would prove easier to administer.

“70% of our residents are living with dementia and the test is very traumatic. If a saliva test was available, we would encourage that weekly.”

Vic Rayner, Executive Director of the National Care Forum says:

“Testing of all those receiving care in care homes and the staff delivering it must continue to be an absolute priority. What we see from the results is the need for ongoing routine and regular testing of residents and staff in care homes.

“It’s encouraging to see the high number of care homes that have received COVID-19 testing to date, but this cannot be a one-time arrangement. It is vital that we move to regular and repeat testing in our fight against COVID-19 in care homes, in order to continue to keep people safe and prevent the spread of infection.

“We’re encouraged to seeing some improvements to the speed of receiving test results. However, we cannot lose sight of the number of residents and staff who are testing positive and are asymptomatic. This is a worrying trend that can only be effectively managed through repeat testing.

“In the past few months we have surveyed our members to gauge their experience of the testing arrangements and to get a clear picture of what’s happening on the ground. Our survey results highlight that we can’t take our eye off the ball just yet. Access to the right type of tests for vulnerable people must happen quickly and all care home residents and staff offered routine tests.”