Coronavirus (COVID-19): use of face coverings in social care settings including adult care homes

Guidance for staff on use of face coverings in these settings.

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Other information

Differences between fluid resistant surgical masks and face coverings

Face coverings are made of cloth or other textiles that cover the mouth and nose. Face coverings are largely intended to protect others, not the wearer, against the spread of infection because they cover the nose and mouth which are the main confirmed sources of transmission of the virus that causes COVID-19.

Type IIR fluid resistant surgical masks (FRSM) are surgical or medical grade masks that provide protection to the wearer as well as others. 

Differences between social care and healthcare settings

The recommendation to remove universal/routine face mask use in social care settings is based on the latest IPC, public health and clinical advice for social care settings at this stage in the pandemic.  Key drivers underpinning this recommendation have been: the reduction in severity of illness/hospitalisation from previous phases of the pandemic; the high level of vaccination among the staff and service user population; staff and service users traveling and participating in local communities with no mask use; and the impact of mask use on service user mental health and well-being.

The recommendations for social care currently differ from those in health care settings. This is because social care settings are fundamentally different. They have a higher proportion of individuals living with cognitive and sensory impairments for whom prolonged face mask use can be detrimental to wellbeing and can exacerbate communication difficulties. Furthermore many social care settings represent people’s homes. There are also differing risk factors for individuals using social care. Within in many healthcare settings, people may be unwell. While this may be true of some people using social care services, care home residents and other users of social care services are less likely to be receiving high risk procedures or therapy and additionally there are many people using social care services who share a similar risk profile as the wider population.

Fundamentally though at this stage of the pandemic, the advice is that routine face masks use can be paused in social care settings. This means that healthcare staff who visit social settings should now follow the advice for that setting unless otherwise indicated. Guidance for healthcare staff will be shortly be updated to reflect this change. The change is based on recent advice from ARHAI Scotland and Public Health Scotland who support a move away from universal mask wearing in social care settings given the current community prevalence and absence of controls within the community, and that where policy/guidance exists for a setting those providing care in that setting can follow the relevant guidance.

Guidance across both health and social care settings remains under continuous review and importantly the principles of IPC continue to be essential.

Considerations for update to guidance: removing face mask use at all times

In preparing this guidance we have considered:

  • Recommendations provided by Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland and advice from Public Health Scotland.
  • The severity of illness and current risk of hospitalisation from COVID-19 for supported individuals including older adults living in care homes.
  • The wider harms of face mask use to the mental health and wellbeing of supported individuals and communication barriers.
  • The COVID-19 risk and wider risks and harms to staff.
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