FLOORING AND CARPETED AREAS
If you are clearing cushions and covering upholstered furniture with couch roll – the carpeted areas will require the same clinical approach.
We suggest you take up all rugs and lay either of the following mobile flooring on fixed carpets. This would be for walk in and the changing area. Anywhere a client might step.
- Black rubber matting: www.floormats.co.uk/circular-studded-rubber-matting
- Clear plastic runners: www.amazon.co.uk/gp/product/B076M65PHW
ISSUES AROUND PPE
There are so many questions here – and everyone has their own interpretation. But we need to look at the bigger picture. Yes, it is a nuisance to wear PPE, but we are in the middle of a pandemic and whether we like it or not, safety is paramount.
The government guidelines are a minimum standard and if used, will be consistent with your insurance companies’ requirements. GCMT’s recommendation – based on the current usage for osteopaths – is to wear full PPE for vulnerable clients or practitioners. This ensures as much safety as possible for you and for your clients, and to reassure clients who may be uncertain for their safety. This means gloves, apron, visor – and mask. Use your common sense and consider the risk the client poses, or risks the practitioner pose for that client.
You are required to wear a visor, plus a Type II mask. Your client also has to wear a mask, unless they are exempt.
With aprons and clothing there are several variations you can try. Ideally an apron per client, then it’s easy. If you have very few clients, fresh clothing per client is OK – but you must be able to take the top off without pulling it over your head and touching your face, arms & hair in the process. Most recommended clothing is button up shirts/t-shirts – as long as they are short sleeved.
With gloves, again, there is concern that wearing them will compromise the massage. On the contrary, gloves these days are surprisingly sensitive, and you can feel everything through them. The client will have almost no awareness – or none – that you’re wearing gloves. You just need enough oil to stop friction. Yes, repeated hand washing is vital – especially right up to the elbows – but stick with the gloves whatever.
TRACK & TRACING
- Businesses, including mobile therapists, have to download the NHS Track and Trace app and print out and display a QR code.
- Communicate this with your clients and remind them to scan the QR code if they have downloaded the NHS Track and Trace app into their phones.
As we are working on a one to one basis, your diary or appointment calendar will be also listing the people who have come to see you or who you are seeing. There may be doubling up of some of the information, for example via the client declaration forms. Clients’ name and contact details collected through manual manual track and trace systems (e.g. the client declaration forms) should be kept for 3 weeks.
This is moot. Ideally your clients should be responsible for their own temperature taking, and you can provide a chart for them to complete. You can take their temperature on arrival. Government guidance does not insist on temperature taking, so use common sense and do what is right for your own risk assessment.
As we can’t diagnose, we can only show whether there is fever or not. This is very much up to you how far you wish to go.
- I work in a care home & I have been asked by the management to massage the patients. They say I am covered by the care home insurance.
Look for alternative methods with a similar outcome. It is unlikely you will be doing much other than hands and feet. Holds can be equally as effective. No facial work.
- Should I take a course?
It is a recommendation and worth doing. They will cover not only cleaning substances and cleaning protocols, but also how put on and take off PPE properly.
There are many on-line courses ranging in price from £10 to £25. The one below is free.
The questions in the consent forms in this document are all suggestions – with the exception of the final clause where you sign, which is a legal must. You can add or subtract as you wish. These are additional questions.
- Can we create a combined consent form that both client & therapist sign? Yes of course
- Do we complete a new consent form for every client visit? Yes, or adapt the form so they sign it each time.
WORKING FROM HOME
Complete a risk assessment, looking at areas the client will pass through, and the room used. Respond to those risks by following the government guidelines. You need to ensure that you have all risks covered if you work from home. Abide by government guidelines regarding visitors to your house. And make sure your insurer knows you are back to work.
HOME AND MOBILE VISITS
Perform a full risk assessment, and abide by the government guidelines
MANAGING SESSION TIMINGS AND COSTS
- I have bought lots of PPE and other items. Should I charge more – build it into my session fees?
- How to I budget for the pe-session consultations?
- Do I give a 45-minute massage if I have done a 15-minute consultation on-line previously?
- Should I give a shorter massage for safety reasons?
All these choices are up to you. What you feel comfortable doing, and whether your clients will react positively.
It has been recommended that should a client cancel at the last minute, as they might have Covid-19 symptoms, you don’t charge a cancellation fee.
- Are there any specific or additional guidelines?
People from a Black, Asian or Minority Ethnic (BAME) Background are considered higher risk, which has to be reflected in your risk assessment. If you wear full PPE and are diligent with your cleansing protocol, you have the same level of protection as everyone else.
- Tea tree – is it safe to use?
Stick to government guidelines regarding sanitisers
- Do we have to use bleach? I can’t stand the smell
Use appropriate sanitisers that are effective against coronavirus
- Can I cleanse the air and space with frankincense…?
Ventilation is the best way to clean the air of the clinic space. Open a window/door.
Email and GDPR (MTI member forum 20th July):
Email and GDPR – if you are sending client information over email, here’s what you need to know:
- If you are seeing an existing client you already have their details, so would only need for them to complete the Covid-19 form over the phone and you don’t need to add any identifying information to the form you send them.
- If a new client, then you’d need all new paperwork – but you can ask for their contact details over the phone so no identifying data needs be on any forms. You can use their initials on the consultation form for example.
- Ideally the consultation is face to face on Zoom, or via phone. You ask the questions as if you were in a room together and write in the answers, without the client even seeing the documents. Then when the client comes, they sign & date, using their own pen.
- You can certainly send documents for a client to look at before the consultation. If they want to fill in bits, make sure they don’t put their contact details on the form.
- If you do send documents with identifying info, ask clients to save the documents into a secure folder (so on a password protected desktop or cloud system) – so they’re data protected – then ask them to delete the attachments from emails.
- You can also encrypt your emails and send an encryption key to your client in another way, eg by text. Here’s how it’s done on Microsoft Office, search for ‘encrypt email’ plus your email provider name to get details for your system.
GCMT ADVICE REGARDING
RETURNING TO WORK POST LOCKDOWN 3 (April 2021
YOUR QUESTIONS ANSWERED
The return-to-work date for close contact work in England and Wales is now confirmed as 12th April. Scotland recently announced their return date as 26th April.
Unless stated, all previous advice still applies including updating your risk assessment since last working, continued use of full PPE, client using a face mask unless exempt, shortened treatment times, heightened cleaning, increased ventilation etc.
Of course, it will be necessary for a thorough, deep clean if your premises has been unoccupied for a long period of time.
Q Am I able to be vaccinated as a healthcare provider?
As a healthcare provider you may qualify for a vaccine, and this can be booked through the NHS website. However, bear in mind that each local area has a Clinical Commissioning Group (CCG) that act independently, so advice and services may be different in each area and country.
Click here to make a booking and for additional useful information.
Q What does vaccination mean in terms of how I can work now?
Even if fully vaccinated it does not provide 100% immunity for either you or your client – so you must continue to work in a Covid Secure environment and continue wearing full PPE, until the government gives guidance otherwise.
You are also likely to be working with a mix of clients who have had both, one, or no vaccinations, hence another reason the pre-lockdown guidance remains current.
Q Are there any contraindications to giving massage post vaccine?
There is no official guidance on massage following vaccination, but we suggest avoiding the site of injection if it is still painful and not treating whilst anyone has post-vaccination side-effects.
As previously, a virtual consultation prior to treatment should identify any problems and your risk assessment will enable you to decide whether a massage is appropriate. It may be necessary to defer treatment until the client is symptom free.
Q Can we return to face-to-face consultations?
We advise continuing with online consultations to minimise client contact until we are advised otherwise.
Q Are the length of sessions still restricted?
We still advise keeping timings to a minimum until we are advised otherwise. The current Guidelines still suggest minimising face-to-face contact and treatment times.
Q Are there any legal constraints surrounding vaccination?
People are not legally obliged to have a vaccination. It is your choice as to whether or not you treat non-vaccinated clients.
Your decision to massage will always be based on a full risk assessment and consultation. Full PPE for you and a mask for your client, as advised, will maintain the same experience as last autumn before vaccinations became available.
Q Does my documentation require updating?
Yes. You need to add clauses to the:
- Risk Assessment
- Covid Consent Form
- Both therapist and/or client declaration
*Suggested updates are at the end of the document.
Q What do I need to know about the vaccine?
We suggest you familiarise yourself with information about the vaccine to demonstrate Duty of Care. This link to the NHS website gives all the necessary information. Please particularly note the Health Conditions & Vaccination at the end of the page.
Q Do I need to use lateral flow tests?
Some therapists may wish to buy lateral flow tests to use for themselves and/or their clients. This is not a legal requirement, but very useful to help stop the spread of Covid. Beware – they are surprisingly expensive.
Q Do I still need to use the Test & Trace QR code?
The Test & Trace process is still in place, so make sure you display your code.
Be advised that you may now supply drinks in disposable cups or bottles.
Provision of assistance in the event of an emergency or a First Aid situation, does not require social distancing. Particular attention to sanitation must be made immediately following the incident.