Chiswick-Physio

COVID-19 Policy and Procedures

Updated November 1st 2020

This document is subject to amendment and could be withdrawn at any point. It should help to act as a minimum guide to facilitate the safe return of face to face appointments. This is designed to reduce the risk for transmission of Coronavirus (Covid-19) to both staff, and service users alike.
It has been written in accordance and following Public Health England (PHE) COVID-19 Infection Prevention and Control (IPC) guidelines and in conjunction with advice from the Health Professions Council (HPC), Physio First (PF) and the Chartered Society of Physiotherapy (CSP).
These recommendations are in addition to the normal clinic processes and policies, and do not replace normal procedures for smooth operational effectiveness of Chiswick-Physio.
This policy has been written in order to provide each member of staff at Chiswick-Physio is informed and supported to maintain the safety of our clients; the staff of Chiswick-Physio and the wider public and in order that we protect the reputation of Chiswick-Physio and the profession during this time. A ‘virtual first’ approach with remote consultations must remain standard practice at Chiswick-Physio during this period.
Chiswick-Physio implements a standard 24-hour cancellation policy for any client that does not show, cancels, or reschedules their appointment within 24 hours of their appointment time. Chiswick-Physio has a COVID policy that any face to face appointment will automatically be changed to a virtual call if a cancellation or reschedule is made within 24 hours of an appointment due to the client being told they have to quarantine.

NHS test and trace
Chiswick-Physio supports the expansion of tracking, tracing, and testing the contacts of those found to be COVID-19 positive, as this is critical to stopping onward community transmission. Please view here for more information re the implementation of the NHS Test and Trace. Each client’s details will therefore be used for contact tracing if required. Clients consent will be requested on the ‘Confirmation Email’ that is sent out and requested back before the client’s initial consultation.
If you have been in contact with someone that has tested positive with COVID-19 then Nathan Carter should be contacted immediately by emailing nathan@chiswick-physio.co.uk and calling his personal mobile number.
Current PHE guidance explains the steps and expectations to be followed if you have come into contact with a person who has a confirmed COVID-19 infection and who does not live with you. This was updated on the 20th September 2020.
This PHE guidance explains what you should do if the NHS Test and Trace service notifies you that you been in contact of a person who has tested positive for COVID-19 and you do not live with that person. It states that
– If you have been informed by the NHS Test and Trace service that you are a contact, you must self-isolate at home for 14 days from the date of your last contact with the person who has tested positive for COVID-19.
– Self-isolation means stay at home and do not leave the house for 14 days.
You may be feeling well and not have any symptoms, but it is still essential for you to follow the advice that you are given and self-isolate.
This is because, if you have been infected, you could be infectious to others at any point up to 14 days. Some people infected with the virus do not show any symptoms at all and it is therefore crucial to self-isolate to avoid unknowingly spreading the virus.
If you do not have symptoms, you must not seek a test, as the scientific evidence shows that the test may not be able to detect whether you have the virus.
However, everyone with symptoms of coronavirus (COVID-19) is now eligible for testing.
This information and further advice on how the NHS Test and Trace works can be found via this link
PF in accordance with CSP and PHE advice have also given the following information.
What will happen if a client I have seen tests positive for COVID-19?
• If a client, you have seen tests positive for Covid-19 you will be contacted by the tracers. If you can show that you have followed the appropriate PPE guidance for the task (AGP or non-AGP), you will not be asked to self-isolate for 14 days, regardless of the time you spent with the client. Therefore, it is essential to follow the guidance on what PPE clothing is to be worn in the relevant sections below.
What will happen if a colleague or friend tests positive?
• If you come into contact with a person, identified under this scheme, who tests positive, and you were not wearing appropriate PPE (not just facemask) at the time, then you would have to self-isolate for 14 days.
What will I have to do if I test positive for Covid-19?
• If you test positive for Covid-19 you will be contacted by the tracers and asked to list those you have been in contact with. In turn, they will contact these people advising them to self- isolate. However, as you should have been in full PPE while with the client you should not be asked to self-isolate.
PF would also encourage all staff while at work to keep social and professional contacts separate by turning off Bluetooth on your phone while at work. In this way, it may be easier to determine the context of any potential COVID contact, reducing the likelihood of you being asked to self-isolate.
You can read further information from PF regarding the current Guidance for Face to Face Consultations and Test and Trace FAQ’s.
PhysioFirst current guidelines re Track and Trace information in accordance with PHE advice. As Chiswick-Physio is a healthcare service it does not need to display a QR code for the NHS Test and Trace scheme. We maintain records of all staff and clients via our online practice management system. From the 26th of September the management of The Gym Clinic have a QR code displayed for an member that enters the Gym.

Staff
Staff at Chiswick-Physio cannot attend with ANY cold or flu like symptoms. If you are displaying any symptoms contact must be made immediately to Nathan Carter by emailing nathan@chisiwck- physio.co.uk and calling his personal mobile number and you must not come into the clinic. Staff are encouraged to come to work by walking/cycling or driving. If coming by public transport they must wear a face covering as per Gov.uk guidance.
Staff can only be present at the clinic at the time they are scheduled, and not congregate in communal areas.
All personal clothing and bags should be stored in the cupboard in the 2nd room. Food can be stored in the fridge provided in the kitchen. Food must not be consumed in the reception area or treatment rooms at any point of the day.

Client screening pre-arrival
Clients should be screened at the point of any (first and subsequent) appointment booking, and on the day (if different) of the appointment, to ensure that they do not have any signs or symptoms of Coronavirus. On the first appointment involving a face to face treatment the client must be contacted to go over a ‘Client Specific Risk Assessment’. The Google form must be filled in with the client while on the phone and then this form must be uploaded to the client’s personal documents on our practice management system Gensolve.
Some of the questions involved in the screen are listed below:
Do you or anyone in your household currently have Covid-19, or have had symptoms in the last 14 days suggestive of Covid-19 including:
– New and persistent dry cough
– Shortness of breath
– Temporary loss of smell or taste
– Temperature above 37.5 degrees
If the answer to the above is ‘yes’, do not book face to face sessions, and (if relevant) advise the client to contact the appropriate medical service (such as NHS 111) for advice.
If the client still wishes to book an appointment a ‘Virtual’ online appointment can be booked. All clients must be sent an email revalidating their current health within 24 hours of their appointment time if the ‘Pre-arrival screen for Chiswick-Physio’ has been received outside of this window.

Client risk assessment and clinical reasoning
A ‘virtual first’ approach with remote consultations must remain standard practice at Chiswick-Physio during this period.
When considering a face to face consultation (F2F) a risk assessment must be undertaken. A ‘Client risk assessment during COVID-19’ must be filled out for each individual case. This form must be uploaded to the client’s personal documents on our practice management system Gensolve. A copy of the ‘Client risk assessment during COVID-19’ can be found on Chiswick-Physio shared google forms or on request by emailing admin@chiswick-physio.co.uk

What is appropriate for face to face?
In offering a F2F appointment it must be in line with the CSP advice. At present this is:
– Where there is a suspicion of, or the risk of deterioration from underlying pathology
– Where there is an urgent rehabilitation need that would otherwise require the intervention from their GP, secondary or social care
– To support rapid discharge from secondary care
The CSP make it clear, that where a F2F appointment is provided, the treating professional should clearly document the rationale for doing so. This should be recorded in the client’s notes taken during the initial assessment.
Other factors to consider when justifying and making a F2F appointment is:
– Escalating pain
– Reduced function
– Condition is likely to deteriorate
– Chronic exacerbation of condition
– Pain negatively affecting mental health
– Post-operative rehabilitation
– Not responding to virtual treatment
– Not responding to self-management
Where the CSP updates its policy to broaden acceptable reasons for providing F2F physiotherapy, we will support this.

Client pre-arrival to appointment
Following the risk assessment if it is deemed appropriate for the client to have a F2F appointment a ‘Consent and Confirmation’ email should be sent to the client.
This includes date and time of the appointment including a PDF attachment of the ‘Procedures Chiswick-Physio’ has in place during this time. This email must be sent back to the clinic as a documentation of consent to treatment by the client.
A copy of the ‘Consent and Confirmation’ email can be found under the template name ‘Confirmation email COVID-19’.
All relevant personal information will be obtained from the client prior to their appointment to avoid unnecessary paperwork and further contact points of potential contamination.

Client arrival and appointment
All clients will be asked not to arrive early for their appointment to prevent congregation in the reception area of The Gym Clinic. Clients will be asked to wait outside or in their car and the therapist will come out to get them when cleaning of the room has been finished. This instruction is attached to the pre-arrival email that is sent on confirmation of the client’s appointment.
The therapist should don PPE clothing as indicated in the relevant section below before the client comes into the clinic.
The client should be asked to come into the clinic at the time of their appointment and only after cleaning of the room and regular touch points have been cleaned.
With the opening of the Gym Clinic scheduled for the 25th July the front door, back door and side door to the gym will be encouraged to be left open to allow for a constant air flow through the clinic and gym. This will be dependent on weather conditions.
All clients will be asked to come on their own if possible. These instructions are to be attached to the ‘Consent and Confirmation’ email that is sent on confirmation of the client’s appointment. This is to limit footfall into the clinic to a bare minimum.
A carer or guardian may be allowed to accompany the client in appropriate circumstances so long as they are screened first and are free from COVID-19 signs or symptoms. The client will be provided with a face mask to place on if they do not have one.
Each client will be asked to wash/sanitise their hands upon arrival.
To avoid congregating in the waiting room all furniture and soft fittings (business cards, magazines, pamphlets) have been removed.
Each client will be asked to keep all keys, phones etc in their bag or pockets.
Any relevant subjective and objective notes taken from the client during the consultation will be taken electronically and recorded directly into the client’s notes off our practice management system, Gensolve.
The toilet facilities will not be in use for clients. This instruction is attached to the pre-arrival email that is sent on confirmation of the client’s appointment. We are asking all our clients not to use our toilet facilities to avoid creating more areas of possible transmission.
On entering a exiting the treatment room the therapist should open and close the door to prevent cross contamination of clients coming in and out of the clinic.

Outdoor Gym Space
If more space is needed to go through exercise prescription with the client, the gym space should be avoided at present.
The outdoor area continues to be safe if the advised social distancing rules are maintained with the client and any other members of the gym that may be using it.
The recommended PPE that you are wearing in the clinic room should be continued to be worn while using the outdoor gym space. Disposable gloves must be removed and disposed of in the bin provided once back in the treatment room. A new pair of gloves must be placed on.
If any outdoor equipment (bench, bar bells, weights etc) are used they must first be cleaned with the disinfectant wipes or antibacterial spray that is stored in the room.
– Any bacterial spray that is provided by Chiswick-Physio is a detergent disinfectant solution at a dilution of 1,000 parts per million available chlorine

Payment
Chiswick-Physio is no longer accepting cash payments in the clinic. Payment is by card only. The card terminal must be cleaned using the bacterial wipes provided before and after the use by a client. Clients will always have the option of paying by Bank transfer, if this is the option they prefer.

Social distancing guidelines at Chiswick-Physio
To follow social distancing guidelines a 2-meter separation of the client/therapist and other staff members must be maintained at all possible times. At Chiswick-Physio this is enforced by
– Staff avoiding sharing workstations
– One person at a time in the kitchen
Social distancing signs have been placed on the floor on entering the building. These are spaced the appropriate 2 meters apart in the reception and treatment rooms.
Social distancing is to be enforced during the subjective examination and exercise prescription where possible to reduce the contact time to a maximum of 15 minutes during the consultation.
– During both the subjective and objective examination, it is encouraged to use side-to-side approach whenever possible.
– Keep the chairs between the therapist and client within the 2m taped off distance

COVID-19 Prevention
To provide information to Chiswick-Physio staff and client posters will be in various positions around the clinic. These will include
– Safe hand hygiene
– Social distancing directives
There will be signs up on the front entrance to the clinic indicating that the clinic will not be open for walk in appointments and that only clients that have a pre-booked appointment will be allowed into the clinic.
As Chiswick-Physio is a healthcare service it does not need to display a QR code for the NHS Test and Trace scheme. We maintain records of all staff and clients via our online practice management system.
From the 26th of September the management of The Gym Clinic have a QR code displayed for any member that enters the Gym.

PPE Clothing
The National IPC “Covid-19: infection prevention and control guidance” was updated on 21 August. It recommends the use of triage to stratify patients into low-, medium- and high-risk categories for Covid-19, and the choice of PPE is related to these categories.
– A breakdown of each category can be viewed on page 10 and 11 of this document.
– A triage tool can be found in Appendix 1 on page 43 to determine if the client is of low risk
‘PF and PHE have advised most physiotherapy outpatients will be in the medium risk pathway as most will not have had a test within the last 72 hours.’
In accordance with this current PHE and PF guidelines the recommended personal protective equipment must be worn by all therapists while working with clients at Chiswick-Physio:
– Disposable plastic apron for single use and replaced after each client
– Type IIR surgical face mask for sessional use *
– Disposable gloves for single use and replaced after each client
On the 24th September 2020 PF had confirmation from PHE that the use of eye protection such as face shields in the medium risk pathway can be risk assessed.
– Face shields must be worn if a risk assessment indicates these are required to prevent splashing to the eyes.
Administration/reception staff are required to wear type IIR face masks for sessional use.
– If cleaning is undertaken a disposable apron and gloves must be placed on.
– The gloves and apron should be removed once cleaning is finished and disposed of in accordance with Chiswick-Physio protocol
*A single session refers to a period where a worker is undertaking duties in a specific care setting/exposure environment e.g. providing ongoing care for outpatients. A session ends when the worker leaves the care setting/exposure environment. Sessional use should always be risk assessed and considered where there are high rates of hospital cases. PPE should be disposed of after each session or earlier if damaged, soiled, or uncomfortable.
Clients that are receiving treatment at Chiswick-Physio must also be wearing a surgical face mask once they enter the building. These will be provided by Chiswick-Physio if the client does not have one at the time.
Those clients who have an age, health, or disability reason for not wearing a face covering are exempt and will not be asked to wear one. In this event you as the therapist should make a risk assessment for each individual case. The wearing of a face shield by the therapist is recommended by Chiswick-Physio in this situation. This is to maintain the health and safety of both you and the client.
PPE does not need to be worn when with other team members of Chiswick-Physio if appropriate social distancing is followed. A surgical face mask is recommended during team meetings where the 2-meter distancing rule may not be possible.
During team meetings involving a practical session where there may be physical contact with other members of staff then appropriate PPE must be worn.
It must be remembered that face coverings are not a replacement for the other ways of managing risk, including minimising time spent in contact, using fixed teams, and partnering for close-up work, and increasing hand and surface washing. These other measures remain the best ways of managing risk in the workplace. Further current advice from PHE on working safety during coronavirus can be found here and PhysioFirst advice can be found at – Personal protective equipment (PPE) – guidance, resources and FAQs.
All PPE will be supplied by Chiswick-Physio and is stored in the filing cabinet in the second treatment room.

Donning and doffing PPE
PPE should be placed on in the order as indicated below:
– Disposable plastic apron
– Surgical mask
– Face shield and eye protection if required
– Disposable gloves
PPE should be removed in an order that minimises the potential self-contamination and, in the order, as indicated below.
– Disposable gloves
– Disposable plastic apron
– Face shield and eye protection
– Surgical mask must only be removed once the client has left the clinic
All staff must watch this video for correct procedures for placing on and off PPE. When wearing PPE to protect yourself and limit the spread of infection it is recommended to keep your hands away from your face and PPE being worn. Once the surgical face mask is put on it must not be touched and must immediately be replaced when it becomes moist or damaged.
Gloves must be never decontaminated with alcohol-based hand rub (ABHR) or soap between use.
– Double gloving is NOT recommended for routine clinical care of COVID-19 cases

Face Shields
Face shields must be worn together with a surgical mask and should not be worn in isolation. When worn together with a surgical mask, face shields offer protection from contamination to others, as well as to the wearer.
Face shields must be worn as eye protection if a risk assessment indicates these are required to prevent splashing to the eyes.

Putting on a face shield (donning)
• Bend forward slightly, holding on to the straps of the face shield with both hands. Do not touch the front of the face shield.
• Expand the elastic with your thumbs and place the elastic behind your head, so that the foam rests on your forehead.
• Once the shield is on, check to make sure it covers the front and sides of your face and no areas are left uncovered. The forehead band should sit about 3cm above your eyebrows, with the bottom of the shield sitting below chin level.
• You must always have the shield down. The shield should never be pushed to the “up” position.
• Face shields can be kept on for as long as they keep their shape and remain intact; and when appropriate steps are taken to avoid cross contamination
Removing a face shield (doffing)
• At no time should the front of the face shield be touched.
• Tilt your head forward slightly, grab the strap at the temple and pull forward and over your head.
• Clean the face shield after removing it and place on drying/storage hooks as provided
• Wash hands again.

Cleaning and disinfecting
• Each therapist must clean and care for their own shield.
• Carefully wipe the inside followed by the outside of the face shield using a water wipe.
Discard wipe.
• Wipe the outside of the face shield with a 2nd clean water wipe to remove residue.
• Fully dry (air dry on hooks allocated to each therapist making sure you do not touch one another’s mask).
• Perform hand hygiene.

Disposal of PPE clothing and cleaning products
Once the client has left the clinic the cleaning procedures outlined by Chiswick-Physio must be followed.
PPE clothing that the therapist is wearing during treatment of the client should be kept on during the cleaning procedure. Once the cleaning between clients has finished the PPE clothing should be placed in the rubbish bins provided in the reception and/or treatment rooms.
At the end of each day it is the responsibility of the therapist to empty the rubbish bins in each room. The white bags and its contents must be tied and placed into the large black bin outside.
– This is located at the back of the toilet block and secured behind the padlocked gate. The lid of the bin must be put back on securely after placing the contents in to prevent any spillage during the night and secured from animals.
The contents of the large black bin can be disposed of every Monday morning into the municipal waste after 72 hours of storage will have occurred. This is to be done by the lead therapist.

General Hygiene
It is not certain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature, or humidity of the environment). Please follow the protocols below for best practice at Chiswick-Physio

Hand hygiene
COVID-19 is mainly passed on by person-to-person spread between people who are in close contact with one another and by droplets produced when an infected person coughs or sneezes.
Good hand hygiene is essential to minimise transmission of infectious droplets.
Hands should be washed thoroughly with soap and water for at least 20 seconds, making sure they are dried thoroughly with a paper towel.
Guidance on correct hand washing and hygiene can be found here.
Current evidence base research for the use of paper towels when drying hands rather than hand dryers can be found here.
There will be an alcohol-based sanitizer (containing at least 60 percent alcohol) placed at the front of the reception on entering the clinic. On entering the clinic each client must be asked to sanitize their hands.
A second sanitising station will be on the desk within the treatment room for use by the client and staff.
If the client wishes to wash their hands with water and soap, they can be shown to the wash basin in the second room. Paper towels will be provided to dry their hands.
Each member of staff should wash their hands-on entering Chiswick-Physio.
– Dry your hands with disposable paper towels.
Disposable gloves must always be worn when doing cleaning at the end of the day. When cleaning is finished place the used gloves in one of the rubbish bins provided. Hands must be washed immediately after cleaning or handling of any cleaning items e.g. bucket, mop, PPE does not need to be worn when with other team members of Chiswick-Physio if appropriate social distancing is followed. A surgical face mask is recommended during team meetings where the 2-meter distancing rule may not be possible.
Skin care – Staff encouraged to protect the skin by applying emollient cream regularly.

Before treating a client
Wash your hands before applying PPE and dry your hands with disposable paper towels.
Please open a window/door in your treatment room and be aware of confidentiality with any noise that might carry. Please explain to the client if asked that flowing air lowers risk of transmission.
It is recommended that between each client treatment that the door to the treatment room be left
wide open to aid in ventilation of the room.

Infection control during treatments
There will be no coverings or paper towels on the couches.
Pillows will not be in use. Solid EVA foam bricks are to be used if the head is to be supported when in supine. Tissue paper should be used on the top of the brick in this instance.
The EVA brick should be cleaned at the end of each session, if used, with Clinell or antiseptic wipes.
The EVA brick should not be placed on the floor and should be placed on the filing cabinet between use.
If you use any laundry (we will encourage clients to bring their own towels), these should be placed in the black plastic bag within the laundry basket in the second treatment room. This will be removed at the end of each session and washed in accordance with Chiswick-Physio protocols.
Paper towels or water wipes must be used to wipe massage products off the client.
No towels or facecloths must be used for wiping massage products off the client.
Try to avoid massage products getting on to the plinth and no oil is to be used. If there is spillage wipe away immediately using soapy spray to prevent the vinyl cracking.
Client equipment which cannot be adequately disinfected such as elastic loops/ therabands, massage balls should be purchased for self-use by the client and bought to each session.
The therapist should avoid touching their face during client treatments
On entering a exiting the treatment room the therapist should open and close the door to prevent cross contamination of clients coming in and out of the clinic.

Clinic cleaning
COVID-19 is mainly passed on by person-to-person spread between people who are in close contact with one another and by droplets produced when an infected person coughs or sneezes. It can also spread through contact with a surface or object that has the virus on it. Cleaning helps minimise the spread of coronavirus (COVID-19).
Chiswick-Physio’s location at The Gym Clinic, 200a Power Road will be cleaned thoroughly by our contracted cleaners at a minimum 2 x per week and more as patient footfall increases.
Frequent cleaning and disinfecting of objects and surfaces during the day particularly in areas of high use indicated by the risk assessment (such as door handles, light switches, reception area) will be performed using the warm soapy water and Clinell wipes.
Cleaning during the day will be the responsibility of all staff who are in the clinic that day.
Fortunately, normal cleaning methods do kill this virus. Cleaning an area with normal household disinfectant after someone with suspected coronavirus (COVID-19) has left will reduce the risk of passing the infection on to other people. You are to wear the disposable gloves and aprons at the end of the day when doing a deep clean.
When cleaning thoroughly and efficiently it is good to remember two general principles.
• Top to bottom: start cleaning surfaces higher up and work your way to the floor. This method ensures that any particulates or debris fall to the floor which will be cleaned last.
• Clean to dirty: start by cleaning surfaces and objects that are cleaner and work your way to cleaning dirtier items (eg, toilets). Avoid going from an area that has not been cleaned to an area that has been cleaned.
An excel spreadsheet has been created that highlights the regular touch points of clients and therapists. Each therapist must make sure each of these touch points have been cleaned at the start, middle and end of their treatment session over and above the cleaning process between clients. A signature as confirmation that this has been completed must be recorded on the excel sheet. These sheets are to be left on the desk of each treatment room as a reminder.
• Please pass the excel sheet on to the Front Desk to be uploaded onto GPM once it is full.

Cleaning of hard surfaces
Hard surfaces consist of the desk skirtings and architraves, treatment couch hydraulics and arms, filing cabinets, reception desk and structural fixtures and fittings including floor and windows. These will be cleaned twice a week by our commercial cleaner:
– All floor surfaces will be cleaned initially by sweeping or vacuum.
– This will be followed by mopping appropriate floor coverings using combined detergent disinfectant solution at a dilution of 1,000 parts per million available chlorine
– Front windows will also be cleaned with step ladder access
– Any bacterial spray that is provided and used at Chiswick-Physio will be a combined detergent disinfectant solution at a dilution of 1,000 parts per million available chlorine
Use of disposable cloths or paper roll and disposable mop heads must be used to clean all hard surfaces, floors, chairs, door handles and sanitary fittings.

Protocol for cleaning room between clients:
There will be a 5-minute space between each client to clean all surfaces using spray and wipes provided in each room. It is important each therapist must stick to their appointment times to allow enough time to wipe down the room in between patients and change PPE.
PPE clothing that the therapist is wearing during treatment of the client should be kept on during the cleaning procedure.
Using the soap spray provided and a single use paper towel to clean:
– The chair handles of the patient chair
– The treatment plinth including attention to the nose hole area if the patient has been prone
– Clinell Wipes should be used to clean the nose hole after soap cleaning.
– Clinell Wipes should be used to clean any other client touch points after soap cleaning.
– Clinell Wipes should be used to clean medical equipment touched by the patient including items such as the treadmill screen or handles, swiss ball, traction belt, reflex hammer.
No alcohol wipes or bleach products to be used on the vinyl plinth as this results in the fabric cracking and adds to infection risk. Clinell wipes provided can be used around the nose hole if it is cleaned immediately after with the soapy water spray and removed with couch roll paper.

Protocol for cleaning room at end of session:
Please make sure before you leave the treatment room that you have used an antibacterial wipe to clean these touch points:
• Filing cabinet handles
• Top of filing cabinet and desk
• Any internal door handles
• Light switches
• Equipment used such as swiss balls, reflex hammers, massage lotion, mats, weights equipment Vacuum the treatment room floor
Workstations – Each keyboard, screen, mouse, and desk area should be wiped down using a disinfectant wipe at the start and end of each shift.
– Please do not share laptops during your shift with another staff member
– In the case that you are taking the laptop home you should still wipe down the mouse and keyboard with a 70% alcohol screen wipe even if removing to take home.
– No stationary items to be shared. Please keep your pen and similar items on you and bring to work each session.
– If a pen is needed for the client to sign a document it must be cleaned with a disinfectant wipe before and after use
– A silicone keyboard cover is to be used on each keyboard provided to prevent cross contamination. This must be wiped down at the beginning and end of end working shift by the therapist
It is the responsibility of the therapist that is closing to empty the treatment room bin, tying the top of the bag. Put a new bag in the bin
– Place the treatment room bin bag and the second room bin bag in the large black bin by the toilet block.
When you have removed your gloves, please wash your hands for 20 seconds.
If you have used the kitchen or toilet whilst at work, please ensure that all touch points are wiped down using the disinfectant spray and kitchen roll provided
At the end of each day it is the therapist’s responsibility to clean the laptop (screen and keyboard) and the mouse with a disinfectant wipe.

Last to leave the building
Before leaving the building please take a wipe and clean:
– Main Entrance Door handles in and out
Please hoover the entrance floor where needed as this is reflective of the patient first impression about hygiene.
Regular checks will be carried out to ensure that the necessary cleaning procedures are being followed.
Training will be implemented for all clinic staff at Chiswick-Physio in infection control procedures.
Wash your hands for 20 seconds before leaving the building.

Laundry
If any item of laundry is used, it must be placed inside the laundry basket located in the 2nd treatment room. This will be emptied at the end of each treatment session and washed in accordance with Chiswick-Physio protocols.
Please make sure there is a plastic bag inside the laundry basket prior to placing the laundry in the basket.
On removing the laundry and plastic bag please place another plastic bag in the basket for the start of the next treatment session. Plastic bags will be found at the bottom of the laundry basket. If the last bag is used please let the front desk know so further bags can be brought. Extra stock of all cleaning products can be found in the filing cabinets in the second room.
No towels or facecloths must be used for wiping massage products off the client.
All clothing that has been worn at work should be washed at the end of each shift and in accordance with the manufacturer’s instructions. Use the warmest water setting in accordance with the manufacturer’s instructions and dry items completely. In accordance with current PHE guidance dirty laundry that has been in contact with an unwell person can be washed with other people’s items.
It is advised that the staff uniform is not worn into the clinic if the commute is via public transport.
Clothing can be worn if the staff member is coming in via their own transport if they are travelling on their own and there is no contact with the general public.

Deliveries
Deliveries are to be received outside the front entrance to the clinic where possible.
All delivery packaging is to be disposed of immediately in the general waste, or external bins for large packaging. All delivered items are to be cleaned with a disinfectant wipe.
Staff are to wash their hands thoroughly after dealing with delivered items.

Waste
Any PPE clothing or cleaning waste should be placed in the available bin provided within the treatment rooms in the clinic. At the end of the day these should be double bagged and then placed in the 2nd bin for storage outside of the clinic.
This is located at the back of the toilet block and secured by the padlocked gate. The lid of the bin must be put back on securely after placing the contents in to prevent any spillage during the night and secured from children.
After 72 hours this can be disposed as municipal waste and will be placed in the communal waste.
The outside bin should be emptied into the communal waste at the beginning of the week on Monday morning by the lead therapist.

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