Coronavirus (COVID-19) residential rehabilitation - testing, vaccination and infection control: status report

Report providing an improved estimate of current COVID-19 testing and vaccination in residential rehab settings in Scotland and to better understand how services are adapting to minimise the risk of infection within their service.

3. Main findings

3.1 Response rates

Of the 20 residential rehab facilities surveyed, 17 replied[6]. Thirteen of the facilities provided residential treatment for both alcohol and drug addiction (76%), 3 provided treatment for drugs only (18%) and 1 provided treatment for alcohol only (6%). Twelve (70%) of services were voluntary or not-for-profit, 2 facilities (12%) were privately funded, and 2 facilities (12%) were funded by the NHS. A full list of all rehab providers, including those who contributed to this analysis are provided in Appendix A.

3.2 Testing of COVID-19

Of the facilities who provided a response to the survey, the vast majority (n = 16; 94%) reported testing of staff, however, only 8 (47%) reported testing of residents. Currently visitors are being tested at 5 facilities (29%), however a number of those not testing do not allow visitors within the facility. Of those who are currently allowing visitors (n=10), half reported testing visitors on arrival (n=5, 50%).

A mixed picture emerged across the rehab facilitates around types of tests used, frequency and method of administration, processing and recording of test results. Facilities who reported the use of testing tended to use a combination of PCR and LFD testing which, for the most part, were administered as self-tests. Where carried out, PCR tests tended to be administered weekly and LFD twice weekly, and were mostly used for testing staff. Where carried out, tests were either self-processed or processed by nursing or admin staff at the facility. The process of recording results varied by facility and tended to be recorded both by the facilities themselves and on different external databases/ online portals.

The majority of facilities (82%) reported that they felt residents would be able to conduct supervised self-testing should this be deemed appropriate. Facilities who reported concerns around supervised self-testing noted that this was primarily due to staff capacity and available resources, as opposed to the ability of the resident to carry out the testing procedure themselves.

3.3 COVID-19 Vaccination estimates

At the time of survey, the vast majority of members of staff at residential rehab facilities had received their first dose of a COVID-19 vaccination (86%). A total of 244 out of 284 members of staff had received their first COVID-19 vaccination across the residential rehab facilities who provided a response to this question at the time of the survey.[7] Of the facilities surveyed, on average, there was a 1:1 staff to resident ratio.[8]

At the time of survey, over half of residents currently living within a residential rehab facility had received their first dose of a COVID-19 vaccination (57%). A total of 101 out of 177 residents had received their first COVID-19 vaccination across the residential rehab facilities who provided a response to this question at the time of the survey.[9]

The vast majority of facilities (94%) reported that they would be able to provide assistance should a resident need to be accompanied to their vaccination appointment.

All facilities made contact with residents prior to admission, with just under half (n= 8, 47%) reporting having a dedicated person who remains in contact with a new resident in the immediate period leading up to admission. The remaining facilities reported either having a team who maintains contact with the individual entering their program, have a single pre-admission appointment or failed to detail their specific pre-admission procedures.

3.4 COVID-19 Isolation procedures

The majority of facilities (71%) surveyed reported isolating residents upon arrival. Of those adopting isolation protocols, a number facilities reported that this was for either a period of 14 days, or until a negative PCR or two negative LFD tests were obtained. One facility noted that they had reduced their period of self-isolation to minimise the potentially negative impact this period has on an individual's recovery. This is due to the relative vulnerability of an individual in the period immediately after admission to rehab and increased likelihood of unplanned exit.

All facilities reported having specific isolation protocols in place in the event of a resident contracting COVID-19 whilst residing at their facility. Specific protocols varied but were focused around a period for self-isolation for 10-14 days and notifying track and trace teams.

3.5 COVID-19 procedures around visitors

Ten facilities (59%) reported currently allowing visitors to their facility. Of these, some reported only allowing visitors to meet residents outdoors and only allowing limited numbers of pre-planned visitors per resident. Of those who reported that visitors are currently not allowed to their facility, some mentioned they did in exceptional circumstances allow for a limited number of pre-planned visitors deemed essential to the recovery and wellbeing of an individual as well as other essential maintenance staff, trades people and contactors to the facility.

All facilities reported adopting specific protocols around visitors to their facility. Specific protocols varied across different facilities but were focused on social distancing and making use of LFD testing, temperature checks, personal protective equipment (PPE) and hand washing procedures.



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