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’ (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 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 I will ask them to remove their shoes and direct them to use the hand sanitiser then ask them to avoid touching anything on their way to the massage couch.
The bathroom will have been properly cleaned with a fresh towel just for the client. Nobody will ever 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 couch, two chairs, one cube storage unit, a storage ladder and a leather sofa (which will be covered in plastic) a room divider, a plastic clothes basket for their clothes, massage oil and music player.
The client will be directed to sit in their chair. Between us will be the couch on which I will have placed two identical documents, 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 7) 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 plastic folder and not handled during the session.
A plastic basket will be provided for all the client’s clothes and belongings. This can then be 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 towel.
Laundry procedure
After the client has departed, couch cover, face rest cover, drape and towel will be transferred immediately in to the 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 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. The room will be cleaned according to the Cleaning Chart (see Annex 2). According to Which?, soap and water are just as good 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 set the music playing. I will then dress in sports leggings and short sleeved shirt, buttoned up at the front. As I work from home, no travel is required. I will wash my hands for 20 seconds. Then I will put on gloves, apron, face mask and visor.
Clients will be reminded not to touch anything except the couch, their own chair and the plastic container for their belongings.
Massage Oils
Carrier oil will be used for all massages. It is stored in a bottle, which can be disinfected as part of the cleaning regime after every client.
Annex 1
To view the online Consultation and Consent document for Covid-19 screening, please click on the Covid-19 link
Annex 2
Cleaning Chart
Date
Time
Item {tick when cleaned}
Apron
Visor
Plastic box
Door handles
Massage Table
Face Cradle
Oil bottle
Both chairs
Light switches
Music IPod & Speaker
Cupboard doors & tops
Ladder
Window sill
Skirting boards
Bathroom toilet, sink and surfaces
Bathroom door handles, light switches
Bathroom soap bottle
Front door
Door bell
Annex 3
Check List
Date of Appt
Client Initials
Appointment Confirmation email sent
Covid Screening Form Received
Pre-Consultation on phone complete
Confirmed no symptoms
Decided to massage?
Appt time {must be 30 minutes after previous}
Pre-paid?
‘What to Expect/Bring’ email sent to client
All areas cleaned (see cleaning chart)
Clean towel and sanitiser in bathroom
Sign on display
‘Cleaning Chart’ on display
Clothes container ready
Mask for client by front door (optional)
Set music playing
This ‘Checklist’ on display
Wash hands
Clean clothes & wearing PPE
Annex 4
Example 'What to Expect' email
Dear <client name>
Thank you for your Consultation and Consent form, which I have reviewed. We have discussed your appointment on the telephone and I look forward to seeing you on <date> at <time>. Obviously if your health changes at all in the meantime, please contact me immediately. However, please also record your temperature before leaving home as I will need this for our Declaration form, to be signed when you arrive.
Could I ask you to settle your account before the appointment by direct transfer. My account number is < > sort code < > and account name is Sarah Askey.
Please bring with you a pen (to sign the Declaration form), a bottle of water for yourself and a face mask if you wish to wear one during the appointment (it is optional). Please remove all jewellery, watches, etc and wear clean clothes. Bring only your pen, water and any other essential items into the house, leaving bags, coats etc. in the car.
On arrival, please ring the doorbell, which has been cleaned, but then wait for the door to be opened for you. Please be assured that the whole area has been deep cleaned for you and all linen is freshly laundered. I will be already wearing my PPE as I open the door. If you have requested a face mask, this will be waiting for you by the door. Please avoid touching everything once in the house. I will ask you to remove your shoes and use the hand sanitiser and then I will lead you into the treatment room, where I can direct you to your chair. I will ask you to sign both the Declaration documents and ask you to retain one copy for yourself. This document confirms we are both symptom free and that we have both complied with all special requirements leading up to the appointment.
At last we can start the treatment! A container will be provided for your clothes, but otherwise everything will be as you would expect. I am assured that you will not be able to tell that I am wearing gloves. Please note that during the appointment, I will keep all conversation to a minimum.
After the treatment, you can get dressed and collect your personal belongings. Please leave everything else for me to take care of. At the door, there will be a bin for your face mask if you wish. Please sanitise your hands again, put on your shoes and allow me to open the door for you.
If you need to visit the bathroom at any time, please be assured that it has also been deep cleaned and there is one clean towel for you to use.
If you have any questions, please do not hesitate to contact me. Otherwise I look forward to seeing you soon
Best wishes
Sarah Askey BA, BSc (physiotherapy), MTI
Annex 5
Example 'Appointment Confirmation' email
Dear <client name>
Thank you for booking an appointment with me on <date> at <time>.
Since lockdown has now been relaxed enough to allow massage therapists to return to work, I have implemented all the recommended procedures and am therefore ready to see clients again. There will be some changes in the process both before and during each session, to help ensure both yours and my safety.
At this stage, please go to my website (or click on the link below)
www.bodyinbalancemassage.co.uk
and select the Covid-19 page.
Then fill out the online Consultation & Consent form and click Submit at the end. Let me know if you have any problems. The purpose of this document is to establish if it is safe to go ahead with the appointment.
Once I have received your form, I will contact you again on the telephone to conduct a pre-session consultation. The purpose of this is to do as much of the talking before the appointment and therefore minimise ‘talking time’ during the treatment.
Best wishes
Sarah Askey BA, BSc (physiotherapy), MTI
Annex 6
Sign
Please leave as much as possible in your car
If you wish to wear a facemark, please put it on now
Please ring the doorbell which has been cleaned and wait for the door to be opened for you
Annex 7
Declaration
Therapist Declaration
I do not have Covid-19 to my knowledge. I have not been tested.
I have taken my temperature today and it was normal.
To my knowledge, I have not been in contact with anyone with Covid-19. If either I, or a client, or anyone else with whom I have had contact, tests positive for Covid-19, I will inform you, the client, immediately.
Since our initial contact to make an appointment, I have followed the guidelines issued by the GCMT and the MTI, my professional body, and evidence of this is on display for you in my clinic (‘Cleaning Chart’ and ‘Checklist’)
Signed _________________________________________________ Sarah Askey (Massage Therapist)
1 Humble Bee Park, Hampton Bishop, HR1 4LG
Client Declaration
I do not have Covid-19 to my knowledge. I have completed the online form ‘Consultation and Consent’ provided on the Teme Valley Massage Therapy website and submitted the results to Philip Congrave. Since completing the form, my state of health has not changed. I took my temperature today and it was normal.
To my knowledge, I have not been in contact with anyone with Covid-19. If either I, or anyone else with whom I have had contact, tests positive for Covid-19, I will inform you, the therapist, immediately.
Signed _________________________________________________
Name: _________________________________________________
Postcode: ___________________
Date and Time ___________________________________________