Adapting practice: YOU Massage Therapy Ltd: Infection Risk Assessment and Mitigation Record
This document provides a written record of the heightened infection control measures that this clinic has put into place to ensure the safety of all staff and patients during COVID-19.
This risk assessment and mitigation record is to be undertaken in conjunction with review of the iO’s guidance ‘Infection control and PPE’ and ‘Adapting practice guide’ available to review here.
Table 1: This is an overview of the measures we have taken that forms our policy for operating during COVID-19 and is available to all staff and patients.
Table 2: Areas assessed for risk and mitigating action taken. This records in detail the areas of potential risks we have identified and record of the mitigating actions we have taken and when.
- Table 2a – Protection for staff and patient before and when in clinic
- Table 2b – Heightened hygiene measures
Table 3: For completion to outline our PPE policy for staff in our practice
Table 4: Detail of how we will communicate to staff and patients our policies
Table 5: After our Risk Assessment, you will find our ‘Client Intake Form’ which details how each day and visitor will be recorded by our Receptionist to assure we have up to date logs and tight practices
We have assessed our practice for risks outlined and put in additional processes as detailed below
Table 1: This is an overview of the measures we have taken that forms our policy for operating during COVID-19 and is available to all staff and patients.
|Undertaken a risk assessment||· Risk assessment for offering osteopathy treatments with Tim carried out 6/6/20 by Caz.
· New risk assessment must be carried out before opening any more of the studio.
|Heightened cleaning regimes||· Reception area will be wiped over at the end of each shift.
· Treatment rooms will be cleaned between in each patient.
· Surfaces such as door handles, light switches, door frames, banisters, taps, door locks etc will all be cleaned after each person enters and exits the studio.
· Plastic coverings changed if utilised in the reception area
|Increased protection measures||· Entrance to be kept locked and receptionist will be responsible for letting people into and out of the building upon verbal pre-screening and temperature checks
· Desks doubled up to ensure appropriate distance is kept between receptionist and client and masking tape on floor to show suitable distance
· All bookings to be made in advance, either on the phone, online or rebooked directly after treatment, no walk ins permitted
· Only one client in the building at a time, unless chaperone is requested and pre-screened
· All treatments pre-paid online or over the phone to avoid tactile payments
· Staff PPE (gloves, face masks, cleaning spray and cloths for each room)
· All unnecessary items removed from each room
· Plastic covering on seats
· Single use hand towels, handed out with gloves after being kept covered
|Put in place distancing measures||· Only one client in the building at a time
· Double up reception desk
· Tape on the floor in areas that people are likely to meet (doorways, corridor)
|Staff training||· Info sent on how to safely put on and remove PPE
· Info sent on extra precautions to be taken when traveling to and from work.
· Training discussion on how to interact with staff and clients while in the studio.
· Training discussion on customer journey from booking to treatment. (checklist for each booking to ensure all points covered)
|Providing remote/ telehealth consultations||Detail here what telehealth/remote consultations you are offering e.g.
· All patients will have telephone pre-screening email
· Online consultations still available for those who would like advice rather than face to face treatment.
|Table 2a. Protection of staff and patients before they visit, and when in, the clinic.
We have assessed the following areas of risk in our practice and put in place the following precautions to
|When introduced||Mitigating action||When introduced|
|Pre-screening for risk before public/patients visit the clinic
|16/6/20||· Pre-screening questionnaire completed on booking or a min of 48 hours before treatment – emailed to all clients and available online
· Reconfirmation of questionnaire upon arrival at the studio to ensure nothing has changed since appointment booking.
|Protecting members of staff||16/6/20||· Check list for staff to agree to before the start of each shift (same questions as the ones for patients)
· PPE and correct training for use/disposal.
· Returning to work interview, training and well-being measures monitored
|Confirmed cases of COVID 19 amongst staff or patients?||16/6/20||· Compile a list of people who attended the studio on the same day.
· Contact all of them to inform them
· Use the flow charts available for confirmed cases to determine the course of action regarding self-isolating.
· Refer to Peninsula document ‘reporting suspected cases’
|Travel to and from the clinic
|16/6/20||· Ask patients to not arrive earlier than 5 mins before appointment and warn them the door will be locked so we can control who comes in and out
· Try to minimise use of public transport
· Patients asked to avoid each other on the patio, receptionist will monitor
· Sanitizer out front
|Entering and exiting the building||Risk of encountering people or surfaces that other people have touched.||· All staff to change into work clothing at the clinic and place work clothing in a separate cloth bag to take home for washing.
· Fresh clean uniform to be worn and laundered in house at 60’ daily.
· Verbal agreement poster on door
· Patients not to arrive early or late for their appointment to avoid overcrowding.
· Door locked so that we do not have more than one patient in the building at a time.
· Clear and specific routes to be marked with signs and tape, also reception staff can guide people into and out of the building.
· Temperature check before allowing entry to patients.
· All patients and staff to sanitize their hands and apply mask prior to entering the building.
|Reception and common areas||Risk of encountering people or surfaces that other people have touched.||· Reception staff will work from home where possible and will have appropriate training and PPE when working from home is not possible.
· Markings on the floor to easily enable social distancing where possible.
· Signage to encourage hand washing and clearly show the way to the bathrooms and exit to minimise interaction with staff.
· Plastic covering on seat
· No water provided
· Clear posters in the waiting area
· Therapist will take clients straight through where possible
|Social/physical distancing measures in place||Risk of spread||· No more than 2 staff in the building at once (one reception and one therapist)
· No more than one patient in the building at once, unless a chaperone is needed.
· If a guest/builder is required access, they will also be pre-screened, wear PPE, assure they sanitize all workspace before and after the work is carried out and will not be allowed to touch anything in client areas or be present when clients are
· Markers on floors.
· Different doors and touch points for entry and exit.
· Separate bathrooms for staff and clients, clearly marked
|Face to face consultations (in-clinic room)||Risk of spread||· Distance markers on treatment room floor to maintain distance when/where possible.
· Appropriate PPE worn by therapist at all times.
· One parent/guardian only with visits for children, pre-screened
· Patients to attend appointment alone unless a chaperone is required.
· Chaperones also required to complete pre-screening questionnaire.
· Plastic covering for each client
|Table 2b Hygiene measures
We have assessed the following areas of risk in our practice and put in place the following heightened hygiene measures
|Description of risk||Mitigating action||When introduced|
|Increased sanitisation and cleaning||Touch points, Massage tables, furniture, cough droplets||· Clinic rooms between each patient – couch, desk, door, door handles, equipment, chairs, every touch point
· Reception surfaces, doors and door handles, chairs, bathroom surfaces, door locks, toilet seat, toilet flush, taps, light switches, banisters, high traffic walls,
· Use of at least 60% alcohol sanitisers/wipes, using bleach-based detergents for floors
· Keep doors open where possible to minimise the need to touch things.
· Tissues provided in all areas in case of coughs or sneezes
|Aeration of rooms||Allow the room to air between clients, no windows open during visit||· Leaving the window open and the door closed for 10 minutes after each patient
· Removal of fans and other air-circulation mechanisms
· Reception windows open for 20 mins half way through the day.
|Staff hand hygiene measures||Every time they touch something they must be aware of cross contamination||· Bare below the elbow/hand washing before and after patients with soap and water for at least 20 seconds, including forearms/use of hand sanitiser gel/ use of gloves if requested/necessary
· Hand washing poster reminders in every room
· Staff to wash hands as part of the surface cleaning routine that is carried out after the arrival and departure of any clients and at the start and end of each shift and to use gloves to carry out all cleaning duties
|Respiratory and cough hygiene||· Communication of cough hygiene measures for staff and patients with ‘Catch it, bin it, kill it’ posters and hand washing reminders.
· Provision of disposable, single-use tissues waste bins (lined and foot-operated)
· Hand hygiene facilities available for patients, visitors, and staff
· All persons in the building will be wearing a suitable face mask and advised not to touch it
|Cleaning rota/regimes||· Time to change covers and clean treatment room between each patient.
· Scheduled time for staff to clean treatment room, reception area, corridors, floors and bathrooms at the end of each shift
|Table 3. Personal Protective Equipment: Detail here your policy for use and disposal of PPE|
|Clinicians will wear the following PPE||· Mask
· Optional gloves depending on type of treatment being applied
· Plastic sheet on table
|When PPE will be replaced||· Non disposable items to be replaced every 4 hours, or after touching
· Disposable masks and gloves must be replaced between patients or once taken off (once used and taken off it must not be put back on, even same day)
· Reusable (cloth masks etc) must be put into a cloth bag and washed between uses.
· Apron and plastic sheet changed after every client
|Reception staff will wear the following PPE||· Fluid resistant masks to be worn
· Disposable gloves
|Patients will be asked to wear the following PPE||Insist on a mask and given proper guidance on how to apply one|
|PPE disposal||· All cleaning cloths to be bagged carefully (no shaking) and placed in the wash after use on a 60 degree wash cycle.
· All uniform and cloth masks to be put in a cloth drawstring bag or pillowcase and placed directly in the wash before leaving work
· Any disposable PPE must be placed in refuse sacks, double bagged and left in the back garden for at least 72 hours before being put out for collection.
|Table 4. Communicating with patients: Detail here how you will advise patients of measures that we have taken to ensure their safety and the policies that have been put in place in our clinic|
|Publishing your updated clinic policy||· Publish on social media
· Publish on the website
· Print and make available in the studio
· Provide as part of appointment confirmation emails
|Information on how you have adapted practice to mitigate risk||· Updating of website and via your social media accounts
· Email to your client base
· Posters in house
· Client intake procedure to screen every client
· Staff training
· Client communication stepped up
|Pre-appointment screening||· Pre-screening questionnaire to be completed prior to confirmation
· If online booking, questionnaire to be emailed in confirmation message.
· If questionnaire or payment has not been completed 48 hours beforehand, the appointment will be cancelled and the customer will need to contact us to reschedule.
· Everyone entering the building will need to agree to pre-screening verbally, which will be logged
|Information for patients displayed in the clinic||· Door notices advising of entry policy and asking anyone with symptoms not to enter the building.
· Notices on other public health measures e.g. hand washing/sanitising/Catch-it, bin it, kill it
· PPE info poster for staff and clients
· Safe practice posters
|Other patient communications||Follow up email to ask them to please let us know if they develop symptoms within 7 days of their visit.
Table 5: Daily Log and Client Intake Form
YOU Massage Daily COVID-19 INTAKE FORM
Receptionist Daily Signed Declaration:
I declare that nothing has changed in my circumstances since I was pre-screened in a back to work interview. I have changed my clothes and thoroughly cleaned the entire premises as per government guidance, prior to opening for business today. I am dedicated to the safety of all staff and clients and will assure that there is only 1 client at a time will be allowed in the building (or 2 in the case that a chaperone is required), that they have been pre-screened and apply by the instructions provided, all surfaces will be cleaned between clients and suitable PPE worn at all times. I will verbally verify these declarations with and test the temperatures of every person entering our premises prior to allowing entry today and I will carefully log all details below.
Date: __________________ Receptionist: _____________________ Temperature: _____________________
Therapist Daily Verbal Declaration:
I declare that nothing has changed in my circumstances since I was pre-screened in a back to work interview. I have changed my clothes and thoroughly cleaned and prepared my therapy space prior to opening for business today. I am dedicated to the safety of all staff and clients and will assure that clients and I wear suitable PPE worn at all times and that any disposable waste is properly bagged and removed immediately and that my room is aired and sanitized thoroughly between each visit.
Date: __________________ Therapist: ________________________ Temperature: _____________________
Guests/Builders Verbal Declaration:
I declare that nothing has changed in my circumstances since I was pre-screened. I am dedicated to the safety of all persons in the building and I will wear suitable PPE at all times and agree to touch nothing on the ground floor and only pass through when there are no clients in the communal area at the Receptionist’s consent. I will sanitize my workspace thoroughly at the end of any working day and agree to follow any and all guidelines applied by the staff.
Date: __________________ Guest: ________________________ Temperature: _____________________
Client Verbal Declaration:
I agree that there have been no changes in my circumstances since I completed the COVID-19 Pre-Screening form via my appointment confirmation process.
I agree to follow the instructions of the YOU Massage staff thoroughly and abide by the hygiene terms to assure the safety of all
I agree that I have been informed of the risks and I am still happy to go ahead with my treatment today.
|Prior to Visit|
|Pre-screening questionnaire complete|
|Appt confirmed and paid for|
|At the Door|
|Temperature Recorded here:|
|Verbal confirmation of no change in pre-screening answers|
|Face mask given (n/a if they have their own)|
|Hands sanitised on entry|
|Front door handles, knobs, locks and common touch points cleaned with Ultra AX spray|
|Inner white door handles and common touch points cleaned with Ultra AX spray|
|If Bathroom is used then clean: Bathroom sink, taps, both light switches, both door handles, both door locks, toilet flush, toilet seat, toilet lid and common touch points cleaned with Ultra AX spray (mark N/A unused)|
|If Waiting area is used then clean: any and all touch points with Ultra AX spray, change plastic sheet over chair (mark N/A if unused)|
|On Exit: Banisters/handrails, common touch points on walls cleaned with Ultra AX spray|
|End of the day:||Signed||Notes|
|All hand soaps and sanitizers topped up
|Correct disposal of PPE double bagged in garden
|Floors, surfaces, door handles, light switches, seating area etc cleaned with Ultra AX spray|
|Any cloths used for cleaning, as well as any other washable fabrics that have been in public spaces to be washed on a 60 degree cycle.|
|Uniform removed (peeled off to minimise contact) and placed into pillow case or drawstring bag and washed at 60 degrees.|
|Phone, desk, chair, pens, computer keyboard and mouse cleaned with Ultra AX spray|
|Doors locked and keys cleaned with Ultra AX spray before locking in the drawer.|
|Hoover and Hot Mop all floor space
|Check in : Therapist and Receptionist chat and any changes required discussed and reported to management|
|Key lockbox and gate touch points sanitized on Exit
Thank you for reviewing our documentation, this document was uploaded on 16/06/2020 and will be periodically reviewed.