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Care provider COVID-19 testing

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Testing arrangements

Updated and streamlined guidance on IPC and testing for adult social care is now available on GOV.UK. As set out in the letter from Claire Armstrong on ASC IPC changes, this took effect from 3 April 2023.

PCR tests will not be processed from 1 April and LFDs should be used instead of these.

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 LFD tests, call 119.

Anyone with a positive COVID-19 test result is advised to try to stay at home and avoid contact with other people for five days.

Eligibility criteria

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

Guidance on IPC and testing for adult social care includes all information on COVID-19 testing in adult social care, and details the testing regimes for eligible staff and residents and where outbreaks are suspected.

Symptomatic testing guidance

Symptomatic testing consists of two lateral flow device (LFD) tests taken 48 hours apart. This is available for residents who are symptomatic in care homes.

Where symptomatic testing is recommended, this should be based on the current list of COVID symptoms.

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.

Testing terms and conditions

View the COVID-19 testing terms and conditions on GOV.UK.

Individuals who test positive for COVID-19 should follow the guidance for people who have a positive COVID-19 test result.

Outbreak testing guidance

Care home outbreak testing for symptomatic residents will also continue through the use of LFDs and a limited number of tests are available.

Refer to the section on outbreaks in care homes in the guidance on IPC and testing for adult social care for further information.

  • If 2 or more linked care home residents develop symptoms of a respiratory infection within 14 days
  • This only applies to care homes.
  • During a suspected outbreak, there is no longer a need to test the whole home to identify COVID-19 cases.
  • Linked asymptomatic cases are no longer defined as outbreaks.
  • If 2 or more linked care home residents develop symptoms of a respiratory infection within 14 days of each other, the first 5 residents with symptoms should take a COVID-19 LFD test, whether or not they are eligible for COVID-19 treatments. After this, only residents who are eligible for COVID-19 treatments should take an LFD test if they become symptomatic.
  • If an outbreak is identified, care homes should revert to the guidance for management of single cases 5 days after the last positive or symptomatic case.

Further LFD testing in an outbreak should only be done following an HPT risk assessment and on HPT advice in relation to specific concerns.

How tests can be accessed and how essential workers can self-refer can be found on organisation testing registration: record of users. Guidance and spreadsheet to record the details of people you've tested for coronavirus on that day. 

Summary of current changes

The following changes were put in place on 3 April 2023.

Staff or service users with symptoms of a respiratory infection, including COVID-19

Symptomatic testing is now advised only for those eligible for COVID-19 treatments and during suspected outbreaks in care homes.

Staff or service users with a positive COVID-19 test result

People who test positive for COVID-19 can return to their usual activities after 5 days if they feel well and no longer have a high temperature.

Testing no longer required for individuals to return to normal before 10 days following a positive test.

Outbreaks in care homes

Only the first five residents with symptoms of a respiratory infection will be asked to take an LFD test to identify if there is an outbreak of COVID-19. This is in addition to ongoing testing for symptomatic individuals eligible for COVID-19 treatments. Removal of PCR and whole home testing.

Outbreak measures can be lifted 5 days after the last suspected or confirmed case.

No difference between advice for small care homes and other care homes.

Health protections teams (HPTs) can advise wider testing where there are specific concerns.

Visiting arrangements in care homes

Updated to be explicit that there should not be any restrictions on visits out for individuals who are not symptomatic or who have not tested positive in any circumstance.

Admission of care home residents

Those being admitted from hospital will take an LFD test within 48 hours before discharge. No requirement for PCR tests.

Admissions from the community are no longer advised to test.

Ordering tests

Removal of ‘COVID-19 testing in adult social care’ guidance, with remaining elements added into COVID-19 supplement.

Removal of PCR testing and references to this.

No requirement for rapid response testing for care homes and high-risk extra care and supported living.

Closure of dedicated test ordering routes for adult day care centres, home care, social care workers, personal assistants, and shared lives carers. Individuals working in these services can order tests via GOV.UK if they are eligible for COVID-19 treatments.

Signposting to NHS guidance for testing and access to COVID-19 treatments.

Changes to COVID-19 testing in England from 1 April - This guidance now also includes all information on COVID-19 testing in adult social care and details the testing regimes for eligible staff and residents and where outbreaks are suspected.

Staff or service users with a positive COVID-19 test result

Individuals who test positive for COVID-19 should follow the guidance for people who have a positive COVID-19 test result.

Staff or service users who are eligible for COVID-19 treatments

Individuals who are eligible for COVID-19 treatments and who have symptoms of a respiratory infection should take an LFD test immediately and follow the guidance for people who are eligible for COVID-19 treatments.

Service and care managers should support people who are potentially eligible for COVID-19 treatments. This includes ensuring there are enough tests stored on site for eligible individuals to test if they become symptomatic.

Accessing treatments for high risk groups

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

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 LFD test within 48 hours prior to discharge.
  • Admissions from the community are no longer advised to test.
  • 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 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.

How to use a 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:

Government guidance

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

Outbreak testing in care homes section

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

Guidance on testing for hospices sets out:

  • How hospices can access COVID-19 testing for staff and patients on-site, for staff visiting patients in their own homes, and for visitors to hospices.
  • How hospices should access and use coronavirus (COVID-19) lateral flow device (LFD) testing for patient-facing staff presenting with symptoms of COVID-19, symptomatic patients where having COVID-19 will affect their clinical management and for outbreak testing.
  • Staff who test positive for COVID-19 should discuss with their line manager and follow locally agreed protocols before they return to work in direct care activities.
  • That hospices will be responsible for ordering test kits for both ‘inpatient’ and ‘community-based’ settings.

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

Updated: 19 April 2023

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