Covid-19 Risk Assessment

Background

This document provides a written record of the heightened infection control measures put into place to ensure the safety of clients and myself during the COVID-19 pandemic. It has been created according to guidance from the Council for Soft Tissue Therapies (“GCMT”) and my professional body, the Massage Training Institute (“MTI”)

The Government has given the green light for massage therapists to return to work from 13th July 2020, subject to specific government guidelines. The relevant professional body for me is the MTI who have issued their own guidelines as a condition of membership, including the creation of this Risk Assessment. I am fully insured through Balens Ltd, who support a return to work, recommending that therapists follow Government guidelines, abide by any legislative requirements, follow guidance issued by our Professional Body and execute our own professional judgement.

Bookings

Clients will telephone, email or text a request for a massage treatment in the usual way. In response, I will send the client an ‘Appointment Confirmation’ email (see Annex 5), which will confirm the appointment date and time and instruct the client to click on the link, which will direct them to my website’s Covid-19 page. Here the client can complete the online Consultation & Consent form and click Submit. The screening document (see Annex 1) can thus be completed at home and returned online, so no need for any paper. Also, I will arrange to talk with the client on the telephone to conduct a pre-session consultation. The purpose of this is to avoid the client leaving home if massage therapy is not appropriate and to minimise ‘talking time’ once they arrive for the treatment.

With the Consultation & Consent form received online, I will telephone the client. The following are considered red flags:-

• Clients shielding vulnerable family members, front-line NHS staff & carers

• Clients currently receiving treatment for cancer, any serious lung condition, anyone recently post-operative

• Clients experiencing severe post Covid-19 circulatory complications – DVT, micro-embolisms, CVA or PE

• Clients aged 70 years or older

• Clients who are pregnant

• Clients with mild heart & respiratory conditions – and suppressed immune systems

• Clients with Diabetes type 1 or 2

• Clients with BMI over 39

• Anyone who has been in contact with someone with Covid-19

The normal consultation will then be performed over the phone, as far as possible, again to minimise talking time in front of the client.

Client will be reminded to bring their own pen and a bottle of water and to arrive punctually or wait in the car if early. Also, the client will be asked to pay in advance using a bank transfer online. All these points will be confirmed in a ‘What to Expect’ email, which will include sort code and account number for payment (please see Annex 4). Key workers should shower after work and wear clean clothes to the appointment, though this should be their normal procedure anyway.

Client Arrival

The client will be asked to wait in the car until the appointment time. Also to leave all belongings in the car, except those needed for the treatment (put them in the boot out of sight). Wearing a face mask is optional for the client, but if they choose to wear one, it should be put on before leaving the car. I will be fully dressed in clean clothes including a button up shirt and PPE, which will consist of 11R Face Mask, Face Visor, Apron and Nitrile Gloves. These points will also be included in the ‘What to Expect’ email (see Annex 4). The client will ring the doorbell, which has been cleaned, and I will open the door.

Pinned to the door will be a laminated sign saying ‘Please ring the doorbell and wait for the door to be opened for you’ (see Annex 6)

Inside the door there will be another sign saying ‘Please remove your shoes and wash your hands in the bathroom - then please avoid touching anything else except your chair and the massage couch’ (see Annex 7)

The bathroom is right by the front door and will have been properly cleaned with a fresh towel just for the client. Nobody will use the same bathroom as the client, until it has been cleaned again.

Treatment Room

Everything has been removed from the treatment room, except for the fitted cupboards, the couch, two chairs, one table, massage oil and music player. The floor has a fitted carpet, so a large sheet has been spread over the carpet and this will be laundered after each client.

The client will be directed to sit in their chair. The table will be by the client’s chair. I will have placed two identical documents on the table, both already signed by me, and I will ask the client to sign both copies with the pen that they have brought. This document is called the Declaration (see Annex 8) and will be signed by both parties who will retain one copy each. The purpose of this Declaration is to confirm that neither of us have Covid symptoms to the best of our knowledge and that we have complied with all requirements thus far. All other client notes will be kept in a book and not handled during the session.

A lidded plastic container will be provided for all the client’s clothes and belongings. This can also be used to transfer laundry after the client has departed and then easily cleaned afterwards. The massage couch will be cleaned and covered with freshly laundered couch cover and face rest cover. A normal drape will be provided, and a small cushion sealed in a plastic container and covered with a cushion cover, instead of a pillow.

Laundry procedure

After the client has departed, couch cover, face rest cover, drape, cushion cover, bathroom towel and floor sheet will be transferred immediately in to the lidded plastic container. Before leaving the room, I will remove my apron and outer clothes and put these in the plastic container also. I will then take the container to the washing machine, transfer the contents into the machine and set it going at 60C. Only then will I remove my visor, face mask and gloves. Mask and gloves are disposable and will go into a lined pedal bin by the washing machine. The visor and apron are reusable and these, together with the plastic container, will be disinfected there and then. Finally, I will wash my hands and get dressed in clean clothes.

Cleaning Treatment Room

During cleaning, I shall wear a mask. Firstly, the outside door and all windows will be opened but the internal door will be kept closed. The room will be cleaned according to the Cleaning Chart (see Annex 2). According to Which?, soap and water are just as good at killing Covid-19 as disinfectant or other products like Dettol, and hopefully will cause less deterioration of the surfaces. However, the Government advice suggests cleaning with detergent and then disinfecting.

Therefore, using a solution of warm water and washing-up liquid, all surfaces will be cleaned, left wet and allowed to dry, as contact time for sanitising is an issue.

After 10 minutes, all surfaces will be cleaned again with a proprietary Antibacterial Cleaner + Disinfectant, using the recommended one wipe one direction technique with disposable paper towel.

Therapist’s hygiene

Just before the client arrives, I will dress in light cotton trousers and short sleeved shirt, buttoned up at the front. As I work from home, no travel is required. I will then remove my wedding ring and wash hands for 20 seconds. Then I will put on gloves and set the music playing, leaving the remote in a closed cupboard. If I subsequently have to adjust the music, the remote will be cleaned as part of the sanitisation regime. Finally, I will put on the apron, face mask and visor.

Clients will be reminded not to touch anything except the couch, their own chair and the lidded plastic container for their belongings

Massage Oils

Carrier oil will be used for all massages. It is stored in a squeezable bottle, which can be disinfected as part of the cleaning regime after every client.