COVID 19 Update

1. DO NOT Treat anybody in the high risk category

High Risk Category

• Have had an organ transplant
• Are having chemotherapy or antibody treatment for cancer, including immunotherapy
• Are having an intense course of radiotherapy (radical radiotherapy) for lung cancer
• Are having targeted cancer treatments that can affect the immune system
• Have blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)
• Have had a bone marrow or stem cell transplant in the past six months or are still taking immunosuppressant medicine
• Have been told by a doctor that they have a severe lung condition such as cystic fibrosis, severe asthma, or severe chronic obstructive pulmonary disease (COPD)
• Have a condition that means they have a very high risk of getting infections such as severe combined immunodeficiency (SCID) or sickle cell
• Are taking medicine that makes them much more likely to get infections (such as high doses of steroids)
• Have a serious heart condition and are pregnant

2. If a client is in a moderate risk category :

• Seek advice from your insurance company about the risks associated with treating clients in the moderate risk category before proceeding.
• Use your professional judgement to decide if the potential benefits of treatment outweigh the risks.
• If you do proceed, take extra care with social distancing and hygiene measures.
• NHS frontline workers or personal carers who haven’t had a recent test for Covid 19

Moderate Risk Category

• 70 or older
• Pregnant
• Have a lung condition that’s not severe (such as asthma, COPD, emphysema or bronchitis)
• Have heart disease (such as heart failure)
• Have diabetes
• Have chronic kidney disease
• Have liver disease (such as hepatitis)
• Have a condition affecting the brain or nerves (such as Parkinson’s disease, motor neurone disease, multiple sclerosis or cerebral palsy)
• Have a condition that means they have a high risk of getting infections
• Are taking medicine that can affect the immune system (such as low doses of steroids)
• Are very obese (a BMI of 40 or above)
• Rashes on the body and feet have been shown to be related to severe cases of covid-19.  Although the research isn’t definitive, there have been links that if someone has these rashes and marks they may also be susceptible to post-covid blood clotting. (GP clearance required)
• Any cramping on legs and/or calves (GP clearance required).

3. Screening for Covid 19 symptoms

• Call client 24 hours before appointment to check if they or any of their household have had any symptoms including:

1. High temperature
2. Persistent cough
3. Loss of taste or smell

• Check my temperature every morning, if over 37.8 degrees cancel appointments and self-isolate for 14 days.
• Check client’s temperature on arrival, if over 37. 8 degrees refuse to treat client.

Do Not Treat clients face to face if any of the following occur:

• You or any member of your household have any covid-19 symptoms
• A client has covid-19 symptoms
• A client is self-isolating or in quarantine
• A member of a client’s household or anyone the client has been in contact with in the last 14 days has covid-19 symptoms
• A client is in the high risk group and is shielding

 Communication with clients before treatment date

In advance of re-opening, communicate with clients to explain the new working arrangements:

• Request that clients attend on their own to reduce the risk of additional contacts between people
• Ask clients to wait outside your premises until the appointment time
• Ask client to bring their own pen if relevant
• Request clients pay using a contactless card or via payment online. Only accept cash or cheque payment as a last resort

5. Client arrival

• Open the door yourself wherever possible
• DO NOT shake hands or hug the client
• Ask clients to disinfect hands on entry to premises (min 70% alcohol content)
• Maintain a minimum of 2 metres where possible
• Show the client the social distancing arrangements
• Ensure couch roll is placed on any non-wipeable seats and couches used by client
• Only use your own pen
• If a client needs to write, they must use their own pen or you can supply a pen which the client then disposes of
• Take client’s temperatures using a no touch thermometer. Record temperatures in client notes
• If a client shows signs of a fever or high temperature, do not treat the client. They must return home and may need to self-isolate. Suggest they call 111 for advice.

 Preparing treatment room before and after treatments:

• Sanitise hands
• Dispose safely in a bin with a lid all couch roll, disinfectant wipes and any other items used by or for the client. You may wish to use disposable gloves to do this
• Sanitise hands afterwards
• Disinfect any surface(s) touched by a client – this might include couch, chairs, door handles, consultation table, toilet area, handwashing area
• Open doors and windows to ventilate the treatment areas
• Replace couch roll on chairs and treatment couches in readiness for the next client
• Keep doors to areas not used by client closed
• Change masks and/or other PPE if being worn
• Allow 45 mins between clients
• Place chairs 2.5 metres apart

7. Steps to take at the end of the day

• Place all waste in sealable plastic bags and follow local waste disposal advice
• If worn place uniform in sealable plastic bag for laundering before leaving. Dispose of the bag afterwards
• Wash all uniforms, towels, coverings on a 60°C washing machine cycle
• Open doors and windows to ventilate the areas used by clients

8. During treatments

• Keep your premises well-ventilated, with windows open in your treatment room wherever possible, or use an extractor fan. Do not use air conditioning
• Remain a minimum of 2 metres from the client where possible
• There will be a maximum treatment time of 45 minutes per client per treatment.
• My treatments are restricted to not being able to treat the head, neck and shoulder area when laying supine (facing upwards). This means that I am unable to carry out Indian Head Massage or Head Reflexology at the moment.

9. Payment Arrangements

• Ask client to pay by contactless method using contactless cash machine or online payment
• If client can only pay by cash, ask client to bring correct amount in an envelope and open at the end of the day, disposing of envelope. Wash your hands thoroughly afterwards

10. Additional hygiene measures

• A lidded container where clients can place their clothing and belongings during treatment, where appropriate.
• Sterilise this bin between clients, including any handle and any areas touched by the client
• Change your PPE between clients. If disposable, then dispose of this safely by placing in sealed plastic bag. If washable then place in sealed laundry bin and wash at minimum 60 degrees along with all linen from treatment
• Do not use clinical tools or implements when providing hands-on treatment
• Avoid touching the client’s face during the treatment, some treatments may be temporarily unavailable.
• Clean oil bottle to be used for each client
• No fliers, business cards on display in room
• In bathroom provide paper towels and foot operated bin

11. My hygiene measures

• Take my temperature every morning
• No jewellery to be worn
• Wash and sanitise hands before during and after work
• Wear PPE including apron, mask and / or visor and change for each client
• All clothing to be washed at 60 degrees every day

12. Signage

Signage to display:

• Please wait in car and I will collect you. If you have no car please knock and wait until I open the door
• Please use hand steriliser on arrival and when leaving
• Please put all your belongings in the container provided
• Please pay by contactless where possible
• Maintain social distancing where possible
• Please use paper towels and dispose of in bin

12. Mobile Working

High risk – not offering this service