PPE – what care workers should wear in care home & home care settings (updated December 2022)

Published: Monday 26th July 2021

This care worker personal protective equipment (PPE) guidance covers support for people using live-in care, home care, extra care housing and care homes.

We are following the latest Government guidance (15 December 2022) regarding recent relaxation on the mandatory use of face masks, alongside other PPE and infection, prevention and control measures.

Under these guidelines, each service location will have autonomy to risk assess use/non use of face masks according to their own particular circumstances. However there remain a number of circumstances where it is recommended that care workers and visitors to care settings wear masks to minimise the risk of transmission of COVID-19.

These are:

  • if the person being cared for is known or suspected to have COVID-19 (recommended Type IIR fluid-repellent surgical mask)
  • if the member of staff is a household or overnight contact of someone who has had a positive test result for COVID-19
  • if the care setting is in an outbreak – see section on outbreak management for further information

If a care recipient is particularly vulnerable to severe outcomes from COVID-19 (for example, potentially eligible for COVID-19 therapeutics ) mask wearing may be considered on an individual basis in accordance with their preferences.

Mask wearing may also be considered when an event or gathering is assessed as having a particularly high risk of transmission.

If the care recipient would prefer care workers or visitors to wear a mask while providing them with care then this should be supported. Providers should also support the personal preferences of care workers and visitors to wear a mask in scenarios over and above those recommended in this guidance.

As per the recommendations for standard precautions, type IIR masks should always be worn if there is a risk of splashing of blood or body fluids.

Where it is risk assessed that face masks or other PPE are still required the following guidance may still be applicable. At all times service users, relatives and advocates should be involved in these decisions.

Importance of hand and respiratory hygiene

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) where indicated by risk assessment?

We are following latest government guidance regarding PPE and infection prevention and control.

Team members should wear a type IIR mask, eye protection, apron and gloves when giving personal care to someone suspected or confirmed to have COVID-19, or when cleaning their room. When undertaking other tasks within 2 metres of someone suspected or confirmed to have COVID-19, a type IIR mask and eye protection should be worn. An apron and gloves should also be worn if it is risk assessed that contact with bloody or body fluids is likely. When carrying out personal care (or other tasks involving likely contact with blood or body fluids) for someone who is not suspected or confirmed to have COVID-19, a type I, II or IIR mask should be worn along with an apron and gloves. Eye protection should also be worn if risk assessed that splashing is likely.

Vinyl gloves provide sufficient protection for most care duties. However, Nitrile gloves can be provided based on risk factors in your care duties such as whether there is a risk of gloves being required for long periods. If gloves tear during any care duties, effective hand hygiene must be performed before changing into new gloves.

Use of face masks

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

Face masks must also be worn:

  • When working with clients and their household members
  • When in your work premises (office) including communal areas such as kitchens
  • In your 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 (generally face shields) is needed based on risk assessment of the individual service user and any symptoms. They usually 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, sneezing or who may be vomiting).

It 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

A risk assessment is required to assess the likelihood of encountering a person with Covid, individual vulnerabilities to infection, how the infection may be transmitted, and when to consider the use of masks and other PPE. A risk assessment is still required when the person and staff member have been fully vaccinated as Covid-19 is still transmissible.

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 face masks, 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 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 by care home workers?

Care home staff with PPE visors

In our care homes, with or without nursing:

The consideration of use of face masks should now be determined on a case by case fully risk assessed basis. Full consideration should be given to the preference and views of service users, their relatives and/ or advocates.

Face masks can be worn continuously for a period of duty until the employee takes a break or if the face mask becomes damaged, damp or uncomfortable where it can be changed.

Vinyl gloves provide sufficient protection for most care duties but, Nitrile gloves can be provided based on risk factors in your care duties, such as whether there is a risk of gloves being required for long periods. If gloves tear during any care duties, effective hand hygiene must be performed before changing into new gloves.

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.

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

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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