All of us have been affected by the Coronavirus (COVID-19) pandemic and I'm committed to ensuring our service is as safe as possible moving forward. I've missed being able to offer you the treatments I know you love, and I’m looking forward to seeing you all again soon.My priority is to keep you and I, and our families as safe as possible, and prior to re-opening the business I have completed a full risk assessment, considered all of the information I have received from the Government, Professional Associations and my insurance company, and have consequently put together the following protocols and procedures.
There's lots of information to take in but please do take the time to read through everything below. Or if you'd prefer, you can download a PDF version here.
And if you have any concerns or questions, please don't hesitate to get in touch.
During the time of enforced closure, I’ve completed a number of infection control courses specifically aimed at the control of Coronavirus. These include:
* Coronavirus (COVID-19) Infection Prevention and Control – accredited by the Guild of Professional Beauty Therapists Ltd, the UK trade body for the Beauty industry.
* Gateway Workshops COVID-19 Certification – Year 2020.
* Putting on and removing PPE for contact and droplet precautions for COVID-19 – accredited by the World Health Organisation.
* Standard Precautions – Hand Hygiene – accredited by the World Health Organisation.
* Barbicide Certification for COVID-19 in a Professional Beauty/Spa.
* Barbicide Certification in Sanitation and Disinfection practices.
* Think Tree Hub Preparing to Return to Work in a COVID-19 World.
* Think Tree Hub Risk Assessment Checklist for Returning to Work in a COVID-19 Environment.
I’ve also been researching extensively throughout the pandemic and especially since the announcement that massage therapists can reopen their practices. I’ve been through the Government Guidelines for Close Contact Work and also the guidance for Working Safely in Other People’s Homes with a fine tooth comb, along with more detailed and massage specific guidance set out by various Professional Associations. I’ve attended multiple Zoominars speaking with a variety of leading industry professionals from the General Council of Massage Therapists (GCMT) and The Complementary and Natural Healthcare Council, through to advanced massage training schools and Balens insurance.
Working on a mobile basis carries higher risk of virus transmission than working from a treatment room or salon and these extra risk factors need mitigating in order to keep both you and I as safe as possible. In actual fact, the majority of Professional Associations and the guidance from the GCMT is that mobile work is not advisable at this time, and if done, should really be prioritised for higher need or urgent clients. Additionally, there are not only new COVID-19 related risks associated with massage therapy itself that we need to consider, but massage is usually a skin-on-skin prolonged treatment type and we now need to work in a different manner to which we are used to.
Having considered all of this information and completed a full Risk Assessment, the following protocols and procedures have been implemented to ensure the service is as safe as possible. I pride myself on offering a very professional and high standard service and therefore you’ll see that I’ve gone above and beyond the Government Guidelines, which are the minimum requirements necessary. This is to ensure I work best practice and to the highest ethical standards and to ensure your treatments are as safe as possible. I know whilst some clients will feel some measures are excessive, for other clients these measures will provide a sense of relief and confidence that they can once again enjoy massage treatments. I’ll continue to take advice from the Government, the NHS and my Professional Associations regarding safe practice and will review and amend protocols and procedures as necessary as we move through the pandemic.
Thank you for your patience, support and understanding at this tricky time.
Owner and Massage Therapist
If I, a member of my household, or a person I have recently been in close contact with outside of my household starts to feel ill or display any symptoms of COVID-19, or I am contacted by NHS Test and Trace, I will self-isolate immediately and cancel all upcoming appointments that fall within the recommended isolation period. I will access a COVID-19 test and follow NHS Test and Trace protocols. This may mean that I have to cancel your appointment at short notice. I appreciate that this may be inconvenient and disappointing for you, but it is done entirely for your own safety. If your appointment is cancelled, you will be able to re-book again once I have completed the required isolation period.
If you, anyone in your household, or a person you have recently been in close contact with outside of your household starts to feel ill or display any symptoms of COVlD-19, or if you’re contacted by NHS Test and Trace, please contact me to cancel your appointment immediately.
For your information, the most commonly reported symptoms associated with COVID-19 include:
* High temperature/Fever
* New, continuous cough
* Loss of or change to your sense of smell or taste
* Shortness of breath
* Muscle aches and pains
* Sore throat
I have amended the booking terms and conditions and you will not be charged for any appointments which you need to cancel at last minute due to illness.
Unfortunately, it is impossible to undertake physical therapies and bodywork whilst following strict social distancing rules and therefore there is a higher risk of virus transmission associated with this type of work.
As per the Government Guidance on Working Safely in Other People’s Homes, I am not permitted to enter a household in the following situations:
1. The household is isolating because one or more members has symptoms of COVID-19.
2. An individual within the household has been advised to shield (this means they are considered Clinically Extremely Vulnerable), even if the person affected is not my client.
For your information, people at high risk (Clinically Extremely Vulnerable) and who are advised to shield include:
* Anyone who has had an organ transplant
* Anyone who is having chemotherapy or antibody treatment for cancer, including immunotherapy
* Anyone who is having an intense course of radiotherapy (radical radiotherapy) for lung cancer
* Anyone who is having targeted cancer treatments that can affect the immune system (such as protein kinase inhibitors or PARP inhibitors)
* Anyone with blood or bone marrow cancer (such as leukaemia, lymphoma or myeloma)
* Anyone who has had a bone marrow or stem cell transplant in the past 6 months, or is still taking immunosuppressant medicine
* Anyone who has been told by a doctor they have a severe lung condition (such as Cystic Fibrosis, severe Asthma or severe COPD)
* Anyone with a condition that means they have a very high risk of getting infections (such as SCID or Sickle Cell)
* Anyone taking medicine that makes them much more likely to get infections (such as high doses of steroids or immunosuppressants)
* Anyone who is pregnant and has a serious heart condition
The Government Guidance on Working Safely in Other People’s Homes also states that “when working in a household where somebody is clinically vulnerable, but has not been asked to shield, for example, the home of someone over 70, prior arrangements should be made with vulnerable people to avoid any face-to-face contact”.
And, as per the NHS guidelines, the Clinically Vulnerable (moderate risk) people are still given the following advice:
“You can go out to work (if you cannot work from home) and for things like getting food or exercising. But you should try to stay at home as much as possible. It’s very important you follow the general advice on social distancing. This includes trying to stay at least 2 metres (3 steps) away from anyone you do not live with or anyone not in your support bubble”.
And the GCMT actually advises mobile therapists should not enter a home where a household member is shielding/Clinically Extremely Vulnerable, self-isolating or Clinically Vulnerable (moderate risk).
For your information, people at moderate risk (considered Clinically Vulnerable) include:
* Anyone 70 years of age or older
* Anyone with a lung condition that’s not severe (such as Asthma, COPD, Emphysema or Bronchitis)
* Anyone with heart disease (such as heart failure)
* Anyone with diabetes
* Anyone with chronic kidney disease
* Anyone with liver disease (such as hepatitis)
* Anyone with a condition affecting the brain or nerves (such as Parkinson’s disease, Motor Neurone disease, Multiple Sclerosis or Cerebral Palsy)
* Anyone with a condition that means they have a high risk of getting infections
* Anyone taking medicine that can affect the immune system (such as low doses of steroids)
* Anyone who is very obese (a BMI of 40 or above)
* Pregnant women (sorry ladies!). Just a quick note about Pregnancy as I know this will be a particularly disappointing one if you are healthy and experiencing a low risk and smooth pregnancy. The Royal Council for Obstetricians and Gynaecologists recommend that women over 28 weeks should continue to maintain 2m social distancing as there is evidence to suggest that the virus can be transmitted to the foetus. Pregnancy can also cause a reduced immune system, thus increasing susceptibility to virus transmission. I personally am not willing to risk you or the little person you are keeping safe and protecting so well. I will keep an eye on this guidance going forward and will adjust restrictions as and when I can.
Therefore, due to the higher risks associated with mobile working and taking into consideration all of the advice, I will not be able to treat people in the following situations:
1. If you or a member of your household is self-isolating due to symptoms of COVID-19.
2. If you or a member of your household is considered Clinically Extremely Vulnerable (high risk) and has been asked to shield.
3. If you or a member of your household is considered Clinically Vulnerable (moderate risk). (Please see the Ventilation section below for a possible exception to this rule).
Please understand this is for your own safety and for that of your household members. I understand this may be disappointing to those of you who are considered low risk yourself, but who live with a high or moderate risk household member, but I have to be considerate of all household members and prioritise their safety. This will be reviewed regularly as we move through the pandemic and the risk of transmission reduces. Please see additional information on this topic in the Ventilation section below.
The Government Guidance for Close Contact Work requests therapists to review working practices to minimise the duration of contact with the client and consider how the length of the appointment can be minimised where extended treatments are undertaken, such as massages.
Therefore, to keep face-to-face contact time and overall appointment length as short as possible, an online screening and consultation process has been implemented. You will be sent an electronic consultation form prior to your appointments. This will cover COVID-19 specific screening questions as well as general health and wellbeing questions to give me an update on any changes in your health, conditions or symptoms since your previous appointment. This will enable me to give you the most beneficial treatment possible in the time we have together. This form will be very straightforward and is designed to be completed online and returned to me electronically at the push of a button. You will not need any particular computer software, printers or scanners, and it also avoids any need for the exchange of pens or paperwork between us at the time of the appointment.
The reason it’s important to screen for COVID-19 is the fact that we can be asymptomatic and carry it unknowingly. Additionally, COVID-19 related Coagulopathy (blood clotting) is a part of the disease process that unfortunately affects some people who contract the virus. However blood clots can remain for months after the initial isolation and recovery period has passed. Blood clotting in general is contraindicated with massage and therefore it’s very important to try to identify whether there is a risk that a client has any underlying blood clots.
These additional screening questions have therefore been devised in order to help identify any risk factors and symptoms that:
1. You have been exposed to the virus and are unknowingly carrying it.
2. You may have residual underlying blood clots following a known or unknown COVID-19 infection.
All clients will be required to complete this screening questionnaire prior to each and every treatment.
One of the biggest risks of working on a mobile basis is the risk of cross-contamination and transmission of the virus through the movement of both the therapist and their equipment from one household to the next. Additionally it is near impossible for mobile therapists to control the working environment in a way that is possible when working from a treatment room or salon. Therefore, in order to minimise these risks and make my own mobile service as safe as possible, I will be implementing the following measures…
Good ventilation of the treatment area is one of the primary methods of reducing the risk of virus transmission. We know rate of transmission is much lower outside then in indoor areas. Therefore, the better the ventilation, the lower the risk is of virus transmission. Therefore, I will be asking the following of my clients:
1. Please choose a treatment area that offers the best possible ventilation.
2. If possible, please have windows and/or doors open throughout the treatment to allow a supply of fresh air.
3. Please note, in the absence of a fresh air supply, please do not use fans in the treatment area as they will simply re-circulate the potentially infected air within the enclosed space.
4. Some people have expressed an interest in having their treatments in an outdoor area of their home. This is very much welcomed, obviously weather dependent, and as long as you are warm and comfortable enough to do so. Please note, in some circumstances, this may also enable treatments of healthy, low risk clients who are otherwise restricted from having treatments due to living with Clinically Vulnerable (moderate risk) household members. The risk of transmission to you and your household members would be much reduced through working outdoors and due to myself not spending time within your home. However it would be highly recommended that the client have a shower immediately after the treatment and wear a face covering for as much of the treatment time as possible. Please understand this is still not without risk and would be assessed on a case by case basis. Unfortunately, I will not be offering this option for clients who live with Clinically Extremely Vulnerable (high risk) persons. Please note, you will more than likely be able to access treatments from a therapist working from a salon or treatment room in this instance.
Please don’t be surprised or upset that I choose to wear Personal Protective Equipment (PPE) throughout the duration of my visit. This is for your safety. I’ll be channelling my inner Darth Vader!
* I will be wearing a clean pair of scrubs at each household. In line with Government Guidance which recommends that uniforms should not be worn to and from work, I will be donning and doffing the scrubs outside of your home, before and after your appointment, so as to avoid any risk of contamination of my car and subsequent transfer on to the next household. These will be put into a washable sealed laundry bag inside a sealed plastic laundry bin inside the car ready to be laundered upon my arrival home.
* I will be wearing a clean mask/face covering to each household for the entirety of the appointment. This will be donned and doffed along with the scrubs outside of your house, before and after the appointment, and subsequently placed in the sealed laundry bag and box to be laundered.
* I will also be wearing a clear visor during the treatment itself in line with the mandatory Government Guidelines for close contact work. This provides a splash screen between us from respiratory droplets caused by sneezing, coughing or speaking.
There is growing evidence that wearing a face covering in an enclosed space helps protect individuals and those around them from COVID-19. As of 8th August 2020, it will become mandatory for clients to wear a face covering when visiting a massage, beauty, nail or hair salon apart from when necessary to remove it during the treatment. This is even more important in a mobile setting due to the higher risks associated with this type of working. Therefore, you will be required to wear a face covering for the majority of our appointment. Whilst I would not expect you to wear a face covering when face down on the massage couch, as this will likely be uncomfortable, you will need to wear a face covering when face up on the massage couch. Please note that you will need to provide your own face covering. This does not need to be a mask, any kind of covering you prefer (scarf, buff etc) is perfectly acceptable as long as it covers your mouth and nose.
All equipment has to be cleaned before and after each household and made from a non-porous washable/wipeable material. Therefore, in order to reduce the amount of equipment and the possible sites of cross-contamination going into and out of each house and my car, I will be implementing the following protocols to ensure only essential equipment is used.
* I will now be asking clients to provide their own linen/towels. I will provide a clean couch cover for each household, but you will need to provide two large bath sheets or towels for your treatment. It is highly recommended that these be laundered at 60 degrees immediately after our appointment. On completion of your treatment, the couch cover will be sealed in a washable laundry bag along with my scrubs and mask before being placed into the sealed plastic laundry bin in my car.
* My couch will be removed from its protective carry case as this is not easily washable between households.
* My kit bag will be made of hard clear PVC so that it can be cleaned and wiped down thoroughly between each household.
* Only essential items will be brought into the house in the kit bag, including oils, cleaning products, cloths, PPE, and my water bottle etc as all items touched will need to be cleaned between each household.
* If you usually make use of my foot bolster, please provide your own washable alternative (a rolled up towel works well).
Regardless of PPE, as per the Government Guidelines, social distancing, limiting contact time, and hand hygiene still remain the best ways to manage risk of virus transmission. They emphasise that face coverings and visors are not a replacement for these other measures, and they would therefore not expect to see businesses relying on face coverings as risk management for the purpose of their health and safety assessments. In fact, they state that where the social distancing guidelines cannot be followed in full, in relation to a particular activity, businesses should first consider whether that activity can be redesigned to maintain a 2m distance or 1m with risk mitigations where 2m is not viable. Further mitigating actions include further increasing the frequency of hand washing and surface cleaning and keeping the activity time involved as short as possible. They go on to suggest that where the social distancing guidelines cannot be followed in full, even through redesigning a particular activity, businesses should first consider whether that activity needs to continue for the business to operate, and if so, take all the mitigating actions possible to reduce the risk of transmission. This includes reviewing working practices to minimise the duration of contact with the client and where extended treatments are undertaken, such as massages, consider how the length of the appointment could be minimised. They further recommend that businesses should consider providing shorter, more basic treatments to keep the time to a minimum, or offering alternative treatments or services such as online tutorials etc.
Therefore, combining these mandatory Government Guidelines with the guidance from the various Professional Associations, insurance company and advanced massage training schools, I have put together and will be implementing the following protocols and procedures in order to reduce appointment length and contact time for every appointment:
2. On arrival outside your home, I will sanitise my hands and arms before donning a clean set of scrubs. I will then sanitise my hands again before donning a face mask and subsequently sanitise my hands and arms once again (as per WHO donning and doffing guidelines).
3. I respectfully ask that you ensure your hands are also washed with soap and hot water prior to your treatment. Please also ensure all make-up is removed so as to protect the integrity of the new waterproof head cradle covering. Where possible, please shower immediately before and after your treatment.
4. I will then proceed to enter your home. For your safety and to maintain social distancing as much as possible, please direct me to the room in which you would like the treatment to take place, ensuring all doors are open on route so I don’t need to touch any handles or common surfaces.
5. Where possible, please leave me alone to set up my equipment to reduce our overall contact time. If this isn’t possible, please ensure you are wearing a face covering. I also respectfully request that any other members of your household should remain outside of the selected treatment room to maintain social distancing and avoid any direct interaction with myself.
6. Once all equipment is set up, I will don my clear visor, sanitising my hands and arms thoroughly before and after and we will then commence the treatment utilising your own linen/towels. Please ensure you keep your face covering to hand if we are doing any face-up massage work.
8. On completion of the treatment, I will carefully fold your towels with as little disturbance as possible and ask you to remove them from the couch. (It is highly recommended that these be laundered at 60 degrees immediately after the treatment).
9. Where possible, please leave me to sanitise all equipment and pack up, again to reduce our overall contact time. If this isn’t possible, please ensure you wear a face covering during this time. Protocols for removing used laundry (couch covers/cleaning cloths) and any waste materials will be followed.
10. I will then proceed to leave your home. As on entry, please ensure all doors are open on route so I can avoid touching any handles or common surfaces.
11. Once outside of your home, I will then follow WHO guidelines for doffing my face covering and scrubs, placing them in a washable sealed laundry bag and then into the sealed plastic laundry bin in my car.
I understand the importance of hand hygiene and cleaning protocols and whilst this has always been a high priority for my service, with fresh linen and full couch cleaning having always been used and undertaken at every household anyway, this will be further enhanced to help protect against COVID-19.
* I will ensure that my hands and arms are cleaned in accordance with NHS and hand hygiene guidelines. This will be done for the donning and doffing protocols and before and after your treatment, as well as during where required. I respectfully ask that you ensure your hands are also washed with soap and hot water prior to your treatment. Where possible, please shower immediately before and after your treatment.
* All tools and equipment will be cleaned with a safe anti-viral cleaning spray (the active ingredient proven effective on COVID-19) and a clean cloth before and after your treatment.
* I will avoid as much as possible the unnecessary touching of any surfaces within your household. In the event that I do touch any surface, I will wipe clean these areas with the anti-viral spray. Any surfaces where products such as massage oil have been placed will also be cleaned before my departure.
* I will avoid the use of your bathroom facilities unless absolutely necessary to avoid the risk of cross-contamination of any additional areas of your home. I will use antibacterial hand gels and anti-viral sprays to clean my own hands whilst in your home and use soap and hot water as frequently as possible in between households. In the event that I do need to use your bathroom, I will ensure all contact surfaces are cleaned with the anti-viral cleaning product.
* My car forms part of my working environment and as such all frequently touched surfaces including door handles and internal surfaces will be cleaned regularly with the anti-viral cleaning product.
* Although I very much appreciate your kindness, I will not be able to accept any offers of food or drink whilst in your home to avoid cross-contamination through glasses and crockery etc. I will have my own reusable and washable water bottle with me in my kit bag.
* All used linen and PPE will be sealed in a washable laundry bag and placed inside a sealed laundry box inside my car and laundered immediately on my return home. A clean laundry bag will be used at each household so no bag needs to be unsealed throughout the day. The laundry box will be sanitised at the end of each day.
* As I will not be using any disposables, it is unlikely that I will create any waste materials, but in the event that I do, waste materials will be sealed in a bag and disposed of following waste disposal protocols.
A lot of my work involves treating multiple household members consecutively at the same appointment. Although I am able to continue to do so, I will be limiting this to two people at each appointment to reduce my overall time inside of your home, as the longer this extends, the greater the risk of virus transmission.
The protocols and procedures for this are as above with the addition that only one client is in the treatment area at a time so as to keep the overall contact time with each client to the minimum.
The treatment time per client remains at 60 minutes maximum.
I will also sanitise the face cradle, my visor, my hands and arms, and don a fresh face covering between each client. If clients wish to use different linen/towels, I will also do a full clean of the couch, replace the couch cover and change into a fresh pair of scrubs between each person.
I have carried out a full risk assessment on all treatments and services and feel the treatments that I can offer most safely at present are:
* Holistic Massage (excluding facial work)
* Advanced and Deep Tissue Massage (excluding facial work)
* Myofascial Release (excluding facial work)
* Seated Acupressure
* Indian Head Massage (excluding facial work)
* Holistic Facials Online Tutorials for self-care
* Holistic Facials and Facial Massage – there is a significantly increased risk of virus transmission due to working in the high risk zone around your eyes, nose and mouth. Additionally, Holistic Facials requires a large amount of additional equipment to go in and out of each household, including the towel heater, vanity case and many product bottles, all of which form a potential transmission site and need to be sanitised before and after every client. Please note, all products used in my Holistic Facials are available to purchase from myself and I will be offering virtual/on-line tutorial appointments so you can undertake these facials yourself in the comfort of your own home in the meantime.
* Hot Stone Massage – Restricted purely due to working on a mobile basis and the need to keep the amount of equipment and thus possible contamination sites going in and out of each household to a minimum.
* Pregnancy Massage – Unfortunately Pregnant women are considered to be at moderate risk of COVID-19 and I will therefore be unable to offer pregnancy massage at this time. The Royal Council for Obstetricians and Gynaecologists recommend that women over 28 weeks should continue to maintain 2m social distancing as there is evidence to suggest that the virus can be transmitted to the foetus. Pregnancy can also cause a reduced immune system, thus increasing susceptibility to virus transmission. I personally am not willing to risk you or the little person you are keeping safe and protecting so well. I will keep an eye on this guidance going forward and will adjust restrictions as and when I can.
* Pamper Parties – The current Government Coronavirus Legislation permits members from only one other household inside your home at any one time and you will need to consider myself as one of those visitors. Therefore, it is not currently possible to offer Pamper Parties for people from different households inside your home. Additionally, to reduce overall time within your home and thus reduce risk of virus transmission, I am also limiting treatments to a maximum of two people at the same appointment.
* Corporate Massage Clinics – Due to the large number of employees usually seen at a clinic and the requirements for workplaces to maintain social distancing, it is not currently possible to offer corporate massage clinics safely.
In order to avoid handling cash, preferred method of payment is by bank transfer in advance or at the time of your treatment. If you are unable to pay by this method, please ensure you have the exact amount of cash ready as I will not be carrying a float to avoid the risk of cross-infection through the transfer of money from one client to the next.
Please note that I am required to be compliant with any request for data from the Government or the NHS for Test and Trace purposes. As such, this means that I may need to share your own personal data as part of these requests. Please note, as this is a Public Health issue, if you are not happy for your data to be shared for Test and Trace purposes, I will not be able to treat you at this time.
Pura Vida or ‘Pure Life’, if you like, was built around a passion to be environmentally friendly and sustainable. With the pandemic, there has been a massive increase in the use of disposable and single use plastic items, completely unnecessarily in some cases. I am very keen to avoid adding to this problem and to maintain Pura Vida’s ethics and principles, and as such I have outlined below how I will be achieving this.
* All PPE, uniforms, face coverings etc will be reusable and washable.
* The medical scrubs I have purchased have been made out of recycled plastic bottles.
* The proven anti-viral disinfectant I will be using for cleaning purposes is environmentally friendly, eco-friendly, not harmful for humans, animals or plants, refillable, cruelty free and vegan. It can even be used to disinfect water for human consumption!
* The hand sanitiser I will be using is ethically and sustainably made in the UK by Neal’s Yard Remedies and is also refillable.
* All cleaning cloths are made from bamboo and washable. Bamboo is the world’s fastest growing plant and a big solution to a world with stretched resources. These cloths are also naturally antibacterial.
* Pillowcases have been up-cycled into sealable laundry bags.
* If required, any wet wipes or tissues used will also be biodegradable and made from Bamboo by The Cheeky Panda. This company is also carbon balanced and invests back into protecting the rainforests.
* As always, all of my massage oils and skincare products are ethically made, sustainable, and cruelty free. Many are refillable and if not, fully recyclable, and the majority of them are also Vegan friendly.