PPE (personal protective equipment) for care home & home care workers (updated 29 July)

Published: Monday 30th March 2020

PPE for carers – what care workers should wear in care home and home care settings

The guidance covers the support of people using the following care services during “sustained transmission” of COVID-19 (sustained transmission is when infection is widespread)

COVID-19 is generating unprecedented global demand for personal protective equipment (PPE). The Government, NHS Supply Chain, and the NHS are doing everything to work with industry to secure additional supplies and manufacture further PPE.

Our procurement and head office teams have been working around the clock to make sure we’re able to get PPE for our care workers and are providing regular updates based on government and Public Health England current advice.

Importance of hand and respiratory hygiene

Please note that the use of PPE is only truly effective where it is combined with:

      • Hand hygiene (cleaning your hands regularly and appropriately) and respiratory hygiene
      • Avoiding touching the face with your hands
      • Following standard infection prevention and control precautions

Care workers wearing PPE face masks

What PPE should be worn by home care workers (including extra care and supported living)?

Please note that it does not cover complex home care where aerosol generating procedures (AGPs) may be undertaken.

As there is “sustained transmission” of COVID-19, the use of a face mask is required, regardless of whether the person receiving care and support has symptoms or not.

Other items of PPE, such as eye protection, gloves and aprons will be dependent on the task that you are completing as follows:

Providing personal care (whether the person has symptoms or not), OR being within two metres of anyone in the household who is coughing

  • Single use disposable gloves
  • Single use disposable apron
  • Type IIR fluid resistant surgical mask
  • Eye protection (based on risk assessment)

When a home care visit does not require the worker to touch the client, but when they may need to be within two metres of the client (e.g. preparing medicines, preparing meals, domestic cleaning)

  • Type II surgical mask

See the detailed guidance for care workers delivering home care from Public Health England.

Use of face masks

Much confusion was caused in the previous guidance because the concept of “sessional use” was not clearly explained in relation to home care services.

Because face masks are intended for the protection of the care worker, the same mask may be worn between different home care visits, if it is safe to do so whilst travelling (eg. on foot or by car or by public transport), so long as the mask does not need to be taken off, or lowered from the face.

Face masks should be discarded and replaced and not be subject to continued use in any of the following circumstances:

  • If damaged
  • If soiled (e.g. with secretions or body fluids)
  • If damp
  • If uncomfortable or causing skin irritation
  • If difficult to breathe through

Previous guidance referred to wearing a face mask during personal care visits and within 2 metres of people in their own homes; the guidance has been updated to include other situations where a mask should be worn; these include:

  • When 2 metres or more away from clients and their household members
  • When in your work premises (office) including communal areas such as kitchens
  • In you office/work space if you come into contact with care workers who deliver care even if you do not deliver care yourself

Eye protection

Eye protection should be used where there is a risk of droplets or secretions from the client’s mouth, nose, lungs or from body fluids reaching the eyes (e.g. caring for someone who is repeatedly coughing or who may be vomiting).

Eye protection can also be used continuously while providing care, unless it needs to be removed from the face (e.g. to take a break from duties, or when driving).

Eye protection should be properly cleaned/sanitised after each use and NOT be subject to continued use in any of the following circumstances:

  • If damaged
  • If soiled (e.g. with secretions, body fluids)
  • If uncomfortable or causing skin irritation

Risk assessments

Risk assessment is required to assess the likelihood of encountering a person with COVID-19, how the infection may be transmitted and when to use PPE.

You must inform your manager to any changes in the condition of people you visit which will help determine when and for which clients or duties you need to wear items such as eye protection or fluid repellent surgical masks.

You might be instructed to wear eye protection and a fluid repellent mask for all the visits you will make that day. This would be appropriate when you are going to be providing direct care for clients who are known to be coughing, or who might be vomiting (to prevent droplets or secretions from the client reaching your eye).

What PPE should be worn by live-in care workers?

If you are living with your client on an ongoing basis, and this is your only client, then you are considered as part of the same household.

You should follow government guidance (e.g. on household isolation in the event that any person in the household develops symptoms of COVID-19) and use PPE as per standard infection and prevention control guidance.

Personal protective equipment (PPE) guidance would be relevant if you are a care worker living in the household of your only client, but you also visit other clients as well for domiciliary care.

What PPE should be worn in a care home?

Care home staff with PPE visors

In one of our care homes, with or without nursing:

  • For direct care of all residents – gloves, apron, fluid resistant surgical mask and eye protection – where there is risk of droplets/splashing etc
  • For non-direct contact (no touching) whatever your role (this applies to all staff including cleaners, receptionists & kitchen staff) – at a distance of 2 metres or more away from residents – no gloves or aprons required and surgical masks are to be worn at all times

The guidance no longer refers to ‘sessional use’ but instead states that a face mask can be worn for a set working period, such as until the care worker takes a break.

Risk assessment is required to assess the likelihood of encountering a person with COVID-19, how the infection may be transmitted and when to use PPE.

The following flow chart shows the simple process of risk assessment for residents and your work within a care home:

PPE care home flowchart

Additional guidance

We recognise that many care and support workers feel that they are placing themselves and their families at risk by the nature of the work they are doing. We also know that wearing a face mask for routine social contact can offer people a sense of additional protection when they are worried about their own safety, or that of their family.

A visual guide to safe PPE for carers

See more information on infection prevention and control of COVID-19.

How should I put on and take off PPE?

PPE should be put on and removed in an order that minimises the potential for self-contamination.

The order for PPE removal is:

  • Gloves
  • Hand hygiene
  • Apron
  • Eye protection
  • Hand hygiene
  • Surgical face mask
  • Hand hygiene

Putting on and removing PPE

This Public Health England video explains the standard COVID-19 PPE that is safe and appropriate for use in a range of health and social care settings.

Training provided to Agincare care workers

Agincare care workers are given comprehensive social care training from our training partner Training Now that includes correct usage of PPE.

View all our latest news, guidance and FAQs on coronavirus.

Find out more about care careers with Agincare.

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