COVID-19 updates for adult social care and health providers

4. Personal protective equipment (PPE)

(Last updated 14 April 2021)

PPE Guidance for Care Homes and Home Care – Clarification

On 10 April 2021 the national guidance on ‘How to work safely in Care Homes’ was updated and includes changes to the Fluid-repellent (Type IIR) surgical mask section.

Our colleagues in Public Health would like to highlight the following clarifications regarding use of PPE:

  • Care homes should acknowledge the different PPE requirements between providing close personal care in direct contact with the resident(s) and carrying out domestic cleaning duties.
  • Fluid-repellent (Type IIR) surgical masks provide additional protection from respiratory droplets produced by residents and clients (for example, when they cough or sneeze). Wearing a surgical mask also protects residents and clients by minimising the risk of you infecting them via secretions or droplets from your mouth, nose and lungs.
  • A new Fluid-repellent (Type IIR) surgical mask must be used while providing personal care for different residents with respiratory symptoms or with a positive COVID-19 test.
  • Care homes should risk assess their policy on Fluid-repellent (Type IIR) surgical masks for residents and clients that don’t have respiratory symptoms or with a positive COVID-19 test.
  • The maximum period of time for wearing a Fluid-repellent (Type IIR) surgical mask is 4 hours, and the mask must be changed if it becomes moist, wet or uncomfortable to wear.
  • In general, fluid-repellent surgical masks are not needed for domestic duties. However, if the care home already has a supply of fluid-repellent (Type IIR) surgical masks, these are acceptable.
  • If you have been giving personal care to residents and you are changing your work duties, for example, going to the staff only area or the office, then you need to remove and dispose of your face mask, clean your hands and then put on a new Type l or Type ll face mask.
  • The full guidance provides a minimum standard on PPE use, and organisations who adopt practices that differ from those recommended/stated in the national guidance are responsible for ensuring safe systems of work, including the completion of a risk assessment.

On 6 April 2021 ‘How to work safely in Domiciliary Care’ introduced recommendations to change PPE after each episode of personal care, and new recommendations around use of eye protection when delivering personal care within 2 metres.

  • Providers should acknowledge the different PPE requirements between providing close personal care in direct contact with clients and carrying out domestic cleaning duties.
  • Within Domiciliary Care a Fluid-repellent surgical mask must be single use and disposed of at the end of each homecare visit and a new fluid-repellent surgical mask applied when entering a different client’s house.
  • If you have been giving personal care to clients and you are changing your work duties, for example, going to visit or work in your organisation’s office, then you need to remove and dispose of your face mask, clean your hands and then put on a new Type l or Type ll face mask.
  • The maximum period of time for wearing a type II mask is 4 hours, and the mask must be changed if it becomes moist, wet or uncomfortable to wear.
  • In general, fluid-repellent surgical masks are not needed for domestic duties. However, if your employer already has a supply of fluid-repellent (Type IIR) surgical mask, these are acceptable.
  • This guidance provides a minimum standard on PPE use, and employers who adopt practices that differ from those recommended/stated in the national guidance are responsible for ensuring safe systems of work, including the completion of a risk assessment.

Free PPE for Health & Social Care Providers Until March 2022

The Government is extending the provision of free PPE to health and social care providers until March 2022, as the expectation of usage will remain high throughout the next financial year.

Eligible health and social care providers can order PPE through the portal to meet the increased need that has arisen as a result of the COVID-19 pandemic. Continued provision through this portal will ensure frontline workers can access rigorously tested and high-quality PPE.

The Government has warned the vaccine is not a silver bullet and the care sector must remain astute by maintaining high levels of infection prevention and control, therefore PPE will play a huge role in this.

Accessing PPE supplies

Eligible health and social care providers (residential and home care providers) can use the PPE portal to meet the extra need for PPE that has arisen as a direct result of the COVID-19 pandemic. Information on eligibility is in the PPE portal guidance.

You should not use the portal to order PPE for non-COVID-19 requirements. You should get this through your normal channels.

If you are not eligible for the portal and/or you cannot obtain PPE through any other route and have run out or will do so imminently, contact the National Supply Disruption Response (NSDR) on 0800 915 9964.

Good practice for sourcing PPE supplies

This guidance explains how to procure products that meet the essential safety requirements to provide adequate protection from COVID-19.

Impact of PPE on individuals with dementia

During the COVID-19 pandemic staff need to wear PPE. This can be quite disorientating and potentially scary for people receiving support, as well as making communication more difficult. This resource from NHS Lothian gives some suggestions of how to support people living with dementia when wearing PPE.

Respiratory mask fit testing

During periods of sustained transmission, Public Health England (PHE) recommend the use of respiratory protective equipment when undertaking any aerosol generating procedure (AGPs) regardless of symptoms or suspicion of COVID-19. The country remains in a period of sustained transmission. FFP3 or P3 respirators are recommended for use as respiratory protective equipment during aerosol generating procedures and require a fit test prior to use.

What do I need to know about fit testing for FFP3 (and FFP2/N95), Respiratory Protective Equipment?

It is the employer’s responsibility under Health and Safety at Work Act 1974 that staff required to wear disposable FFP3 (or reusable P3 respirators) should have access to them. Fit testing is a method for checking that a specific model and size of tight-fitting facepiece matches the wearer’s facial features and seals adequately to the wearer’s face. It will also help to identify unsuitable facepieces which should not be used. Staff must understand how to create and check the seal every time it is worn.

How to book a mask fit

East Sussex County Council have a service level agreement with East Sussex Healthcare NHS Trust to provide Respiratory FFP3 mask fit testing. To make an appointment either email: esht.maskfiteastbourne@nhs.net or call 01323 417400 (ext 4715).

Updated national guidance: gloves

The COVID-19: how to work safely in care homes and COVID-19: how to work safely in domiciliary care in England guidance has been updated on the use of vinyl gloves. In summary:

Gloves – protect you from picking up SARS-CoV-2 (the virus that causes COVID-19) from the environment (such as contaminated surfaces) or directly from people infected. The use of gloves may be based on a risk assessment of the task being carried out.
Vinyl gloves provide sufficient protection for the majority of duties in the care environment, providing the correct size of glove is chosen according to the wearer’s hand size. If there is a risk of gloves tearing, or the task requires a high level of dexterity, or requires an extended period of wear, then an alternative better fitting glove (e.g. Nitrile) should be considered.

If a change of gloves is required during a task because the glove is torn or punctured, then hand hygiene is needed after removal of the original gloves. Hands should be thoroughly dried to make the donning of new gloves easier and to reduce the risk of gloves tearing before donning a clean pair. Providers need to consider the characteristics of the different gloves available for the duties the care workers are doing. This includes the gloves required in relation to cleaning products.”

PPE guidance

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