Guide to Covid-19 for residential child care settings

There are three documents with interlinking advice covering all the key information providers need to know. These are:

Safe working in education, childcare and children’s social care settings, including the use of personal protective equipment (update 16 June)

Coronavirus (COVID-19): implementing protective measures in education and childcare settings (updated 1 June)

Coronavirus (COVID-19): guidance on isolation for residential educational settings (updated 27 May 2020)

What happens if there is a confirmed case of coronavirus (Covid-19) in a setting?

When a child, young person or staff member develops symptoms compatible with coronavirus (Covid-19), they should be sent home and advised to self-isolate for seven days and arrange to have a test to see if they have Covid-19. They can do this by visiting NHS.UK to arrange or contact NHS 119 via telephone if they do not have internet access. Their fellow household members should self-isolate for 14 days. All staff and students who are attending an education or childcare setting will have access to a test if they display symptoms of coronavirus (Covid-19), and are encouraged to get tested in this scenario.

Where the child, young person or staff member tests negative, they can return to their setting and the fellow household members can end their self-isolation.

Where the child, young person or staff member tests positive, the rest of their class or group within their childcare or education setting should be sent home and advised to self-isolate for 14 days. The other household members of that wider class or group do not need to self-isolate unless the child, young person or staff member they live with in that group subsequently develops symptoms.

As part of the national test and trace programme, if other cases are detected within the cohort or in the wider setting, Public Health England’s local health protection teams will conduct a rapid investigation and will advise schools and other settings on the most appropriate action to take. In some cases a larger number of other children, young people may be asked to self-isolate at home as a precautionary measure – perhaps the whole class, site or year group. Where settings are observing guidance on infection prevention and control, which will reduce risk of transmission, closure of the whole setting will not generally be necessary.

Who can access testing?

Priority access to testing is available to all essential workers and their households. This includes anyone involved in education, childcare or social work - including both public and voluntary sector workers, as well as foster carers. Essential workers, and those who live with them, can book tests directly online.

Education, childcare and children’s social care settings, as employers, can obtain a log in to a secure online employer referral portal, through which they can upload a full list of names of self-isolating essential workers that need a test.

All children, young people, and other learners, as well as their households, also have access to a test if they display symptoms of coronavirus (Covid-19). Visit the guidance on coronavirus testing and how to arrange to have a test, or contact NHS 119 via telephone if you do not have internet access.

If anyone develops symptoms, they should be tested.

If they test negative, other members of their household can stop self-isolating. If they feel well and no longer have symptoms similar to coronavirus (Covid-19), they can stop self isolating. They could still have another virus, such as a cold or flu - in which case it is still best to avoid contact with other people until they are better.

If they test positive, they should follow the Coronavirus (Covid-19) stay at home guidance for households with possible or confirmed coronavirusinfection and education and childcare settings should follow guidance on implementing protective measures in education and childcare settings. Residential settings should follow isolation guidance for residential settings.

What care should be taken in residential care and education settings?

Residential settings in which no one is showing symptoms should respond to coronavirus (Covid-19) like any other domestic household. However, it is important that soft toys are not shared between children.

Where a child in a residential setting develops symptoms of coronavirus (Covid-19):

• staff can continue to enter and leave the home as required, consistent staff rotas should be used where possible and staff should follow good infection prevention control. The isolation guidance for residential settings should be followed
• staff should wear PPE for activities requiring close contact
• staff should adhere to social distancing guidelines as far as they are able to, but should take account of children’s emotional needs

How should I care for children who regularly spit or require physical contact?

If non-symptomatic children present behaviours which may increase the risk of droplet transmission (such as biting, licking, kissing or spitting) or require care that cannot be provided without close hands-on contact, they should continue to receive care in the same way, including any existing routine use of PPE.

In these circumstances, to reduce the risk of coronavirus (Covid-19) transmission, no additional PPE is necessary as these are non-symptomatic children in a non-healthcare setting and so the risk of viral transmission is very low. However, additional space and frequent cleaning of surfaces, objects and toys will be required.

Cleaning arrangements should be increased in all settings, with a specific focus on surfaces which are touched a lot.

Jonathan Stanley is chief executive of the National Centre for Excellence in Residential Child Care