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.

This document is part of 2 collections

What you should do

All health and social care staff and visiting professionals to social care settings should follow guidance set out in the National Infection Prevention Control Manual Appendix 22.

Wearing a face mask or covering provides source control. It minimises the risk of infectious droplets reaching an individual in close proximity.

If this mask is a FRSM it is a medical grade mask which provides a high level of protection to the wearer from any infectious droplet that they may come into contact with. 

Where masks or face coverings are worn by both parties the risk of transmission is minimised.

Staff providing direct care

Staff providing direct care to individuals in social care settings should wear a FRSM at all times throughout their shift, except when they are on a break, eating or drinking, and as per the safety measures detailed in this guidance document.

It is important the FRSM is worn correctly and is appropriately fitted to the face. 

The FRSM must be removed and replaced if it becomes contaminated, damaged, or moist, to remain effective. Staff should ensure they observe hand hygiene before the FRSM/ transparent face mask is removed and before putting another one on.

There is also a poster which contains key points and advice on how to wear a FRSM.

The increased use of FRSMs in health and social care settings due to the pandemic has resulted in additional challenges for staff and those who receive care and support. This includes individuals who are hearing impaired, or rely on lip-reading, as well as others with different communication needs.

To address this, a transparent face mask has been developed which features a clear anti-fog front panel, which has been positioned to prevent reflection and make lip reading easier and can be worn in health and social care settings where a Type IIR surgical face mask would be worn.

Health and social care staff should use their professional judgement, and undertake a risk assessment, in instances where it may be necessary to remove their FRSM for a short period.  Through the risk assessment, they should consider control measures they can take to minimise the risk of COVID-19 transmission for the period of time they are not wearing a FRSM. This may include increasing the physical distancing and ventilation. 

There will also be instances of staff who may suffer from breathing difficulties, or suffer from genuine distress when wearing a face mask. In these instances, consideration should be given to an occupational risk assessment. 

Staff in non-direct care roles

Staff who work in a kitchen, laundry room or office within a care home and do not provide direct care to residents or clients, do not need to wear an FRSM however they should wear a face covering within communal work areas.

The exception to this is when staff are working alone in a closed office, or where all other control measures are in place, including:

  • one-metre plus physical distancing between staff
  • screens between staff, or
  • for staff members who were exempt from wearing face coverings under the previous face covering legislation

Staff who work in non-direct care roles should wear a FRSM instead of a face covering when interacting with or in the same room as residents/ tenants or service users and staff who provide direct care to these individuals.

Employers will decide locally how best the guidance should be applied by staff in their facility/workplace.

All staff working in social care settings

Face coverings should be worn in communal work place areas such as corridors, changing rooms and staff social spaces. Direct care staff are advised to wear FRSMs in replace of face coverings as part of their PPE.

Staff do not need to wear an FRSM or face covering during mealtimes in staff dining areas or communal break areas when seated at a table. 

However, they are recommended to do so when queueing, entering or leaving the canteen or communal break area to minimise the risk of transmission of COVID-19 in these spaces. 

Care home residents

Residents in a care homes are not required to wear a FRSM or face covering within the care home, which is first and foremost their own home. It is a resident’s choice whether to wear one. As adult care homes are homes to multiple vulnerable people and have a higher level of visitors, both social and professional, as well as a variety of staff carrying out duties in the home, residents may wish to consider wearing a FRSM, as a final layer of protection in certain circumstances, such as during an outbreak. 

FRSMs are also recommended as an additional layer of protection when a resident is being transferred or transported to hospital, unless there are other control measures in place such as internal screens, which follow appropriate cleaning regimes and separate the resident from others, and the member of care staff supporting the resident is wearing a FRSM. 

However for the avoidance of doubt, if care staff who support the resident do not think the face mask or covering will be tolerated by the resident, or that it may negatively impact their wellbeing, health, or care, they should not be asked or encouraged to wear one in any setting within the care home. Additionally, a resident does not need to wear a face mask/covering if they choose not to.

Care home visitors

It is important that there is understanding among staff and visitors that the lack of face coverings/masks and/or physical distancing in Care Home situations can increase the risk of viral transmission to an often frail person or to the visitor, depending on the circumstances. 

Care Homes can offer visitors transparent face masks, where these are available, when residents have communication challenges. Transparent face masks are being made available through PPE hubs.

To support the resident’s mental health and wellbeing, and in discussion with the resident and Care Home staff, the visitor can choose not to wear a face covering within the residents’ personal room. 

However, visitors should continue to wear face coverings (or face masks where provided) in communal areas, including when transiting through communal spaces, at all times. 

Where the resident is self-isolating as a COVID-19 case or contact and during an outbreak, visitors are strongly recommended to wear a Fluid Resistant Surgical Mask (FRMS), provided by the Care Home, as part of their personal protective equipment . 

In end-of life situations, when residents are receiving essential visiting, loved ones can choose not to wear a face covering or FRSM, or physically distance in all scenarios, including during an outbreak or period of self-isolation for the resident. However, they should be made aware, particularly if the resident is self-isolating, that this increases the risk to them of viral transmission. 

Those in housing support, supported housing settings or who receive care at home

Individuals receiving care within their own homes, including supported housing settings, are not required to wear a face covering, however it may be beneficial for them to wear a face covering as an added layer of protection for care staff, when care activities require carers to be within two metres of their clients. This is because the maximum level of protection that can be provided to all, when activities are taking place in an inside environment without physical distancing, is when all parties wear masks or face coverings.

Carers are encouraged to discuss infection prevention and control layers of protection with individuals receiving care and their family members (where appropriate) prior to attending the home and should consider face coverings,  ventilation, appropriate physical distancing and minimisation of the number of people in contained spaces such as bedrooms.

It may be helpful to record the discussion and decision in the care plan so that temporary staff are aware of the decision on this, as well as evidencing the conversation has taken place.

When providing care and support to individuals in public spaces, social care staff should continue to wear their FRSM. Supported people are encouraged to Use 'Covid sense' to help protect yourself and others, including wearing face coverings in indoor settings and public transport, where appropriate, in line with the needs of the individual.

Waste Management

Used face masks and all waste items that have been in contact with the client (e.g. used tissues and disposable cleaning cloths) should be disposed in the way advised in the guidance.

Guidance for adult social care day services/ Community services

Supported people are encouraged to Use 'Covid sense' to help protect yourself and others, including wearing face coverings in indoor settings and public transport, where appropriate and in line with the needs of the individual.

Social care staff who provide direct care and support should continue to wear FRSMs as per the information for direct social care staff in this guidance. 

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