1. Why do I need to continue to wear a disposable surgical T11R facemask when cases are low?

The guidance has not changed regarding the expectation that care staff and office staff are to wear facemasks. We are now starting to see an increase in cases due to the new Delta variant, so you need to continue to wear your disposable surgical T11R facemask correctly to reduce this variant transmitting in your care home. Please note that visors alone are not sufficient to protect you or the people you support.

2. Why do I need to continue with ‘hands, face and space’ when I am vaccinated with the COVID-19 vaccine?

The vaccine even when you have completed the full course of 2 doses does not provide a 100% protection against COVID-19. It is effective against reducing severe infection and hospitalisation. COVID-19 infection can be very mild in some people and you may not know you are transmitting to others, so the current guidance is to continue to wear the mask in health and social care settings. This alone will not stop the transmission.
It is also vital that everyone continues with the other IPC principles to break the chain of infection.

To continue to protect yourself, your patients, your family, friends and colleagues you should follow the general advice at work, at home and when you are out and about:
• Practice social distancing.
• Wear a face mask.
• Clean your hands carefully and frequently. Ensure that there is access to hand sanitiser.
• Follow the current guidance and keep the environment and equipment clean.
• Open windows to improve ventilation to areas.

3. Is PPE required in my care home even when none of our residents have symptoms of COVID-19 or are positive on testing?

Yes. As there is sustained transmission of COVID-19 in the community we recommend you use PPE regardless of whether residents in your care home have symptoms. This will help to reduce the risk to both residents and staff.

4. How long does COVID-19 survive on surfaces?

The principal mode by which people are infected with SARS-CoV-2 (the virus that causes COVID-19) is through exposure to respiratory droplets carrying infectious virus. However, it is possible for people to be infected through contact with contaminated surfaces or objects (fomites), but the risk is generally considered to be low as it is dependent on a number of things such as the amount of virus on the surface; air flow, heat and evaporation and a need to transfer the virus from surface to hands and then on to face. That is why wearing a facemask correctly; cleaning your hands regularly; ventilating areas and cleaning surfaces and equipment with correct products at increased frequency can reduce the risk and break the change of infection. On fabric surfaces, studies report inability to detect viable virus within minutes to hours; on hard surfaces, viable virus can be detected for days to weeks. It is thought that in typical indoor environmental conditions virus can be detected for up to 3 days (72 hours) on common non-porous surfaces like stainless steel, plastic, and glass.

5. Are we banned from using fans in care homes?

Portable fans have been linked to cross infection in health and social care facilities. Each use and reuse should be risk assessed and documented. Local maintenance, cleaning of fan blades should continue, with frequency based on risk assessment and kept under review. A CAS alert was issued in 2019 and managers should review and ensure action as listed has been taken. Where there is poor air circulation within a volume, it may be beneficial to move air towards windows and mechanical extract. Fans should not be directed towards doors, driving air into other rooms. Fans will not cool staff wearing fluid repellent PPE, so they will be of limited practical value, and are therefore not advised. Review the national heatwave plan for other measures that can help. Fans should not be used if a resident is in isolation, is symptomatic with respiratory symptoms or has a positive test result for COVID-19.

6. Do residents still need to also be socially distanced in their own home environment?

The current guidance continues to recommend socially distancing of 2 metres as this will reduce the risk of transmitting the virus to others and preventing outbreaks. This applies currently even if people are vaccinated.

7. Why can I not hang my coat/jacket with other colleagues’ coats/jackets?

This advice is based on the principle that the coats/jackets can be contaminated with respiratory droplets so when hanging them together there is potential for transfer of the virus to surfaces and hands which in turn if you touch your eyes and nose can potentially led to infection with COVID-19. Managers should undertake reviews/observations of the staff areas and work to reduce this risk by providing disposable bags for items to be placed in or lockers for staff belongings. Lockers should be included on a cleaning schedule.

8. Can I use a homemade face covering or a cloth mask?

No, you should not wear fabric face coverings whilst at work in a health and social care settings as they will not adequately protect you or the people you care for or work with. The PPE guidance refers to using Type IIR disposable fluid resistant facemasks if providing direct personal care or if you are likely to have contact within 2 metres of anyone else (residents, visitors or other staff), you can wear a Type I or II surgical mask. Staff need to be clear of the differences between the face masks so you may decide that for all situations staff wear the T11R if you have adequate stock. Fluid-resistant surgical masks are Type IIR surgical masks that protect the wearer by providing a fluid repellent barrier between the wearer and the environment.

9. Can I start work whilst waiting for the results of my rapid lateral flow test?

It is recommended that staff rapid lateral flow testing takes place before shifts start. Staff should not commence work before the result of their rapid lateral flow test is known. Staff should not enter the staff changing areas until result is known. This will reduce the risk to others and reduce those who may need to be in self-isolation due to an exposure. If the test is positive the staff member must not proceed with work and requires an immediate confirmatory PCR test. Provide the staff member with a PCR test kit and ask the staff member to test on site then
isolate at home immediately, avoiding public transport and wearing a face mask appropriately. Ensure any spaces used have been cleaned and disinfected after staff have left.