Kendal House Clinic, Risk Assessment Updated 27/6/2022

We have assessed our practice for risks outlined and put in additional processes as detailed below
 
Undertaken a risk assessment 20th may 2020
Heightened cleaning regimes  

·         Clinic rooms will be cleaned in between each patient

·         Common areas/washrooms will be cleaned after every patient

·         Hard surface in common areas will be cleaned after every patient

Increased protection measures  

·         All linens have been removed from the clinic

·         There is a screen in the reception area

·         Cashless payments only

·         Staff PPE is available

·         Hand sanitising station at reception entrance

Put in place distancing measures  

·         Appointments to be staggered

·         Reception/waiting area is now open

Staff training  

·         Correct handwashing technique best practice

·         Put on/remove PPE safely

·         Staff briefed and trained on updated clinic policies and infection measures

·         Cleaning of the beds ,pillows and hard surfaces and loos etc

Providing remote/ telehealth consultations .

·         All patients will have telephone pre-screening call 24 hours before an appointment for respiratory and infectious disease.

·         New patients and Previous patients that have not been in for 12 months to have a case history taken on the telephone

·         All patients to be screened by practitioner for susceptibility and suitability for on line or face to face consultation

·         Follow-up/maintenance appointments available via telephone/video call

   

 

 

 

 

 

Table 2a. Protection of staff and patients before they visit, and when in, the clinic.

We have assessed the following areas of risk in our practice and put in place the following precautions to

  Description of risk Mitigating action When introduced
Pre-screening for risk before public/patients visit the clinic   We will pre screen/triage for infection. We prefer to take the initial case history by telephone and part of this will be pre screening.

When arriving at the clinic the patient

·         Can wait in their car or in reception waiting area

·         they will be invited in when the practitioner has done the appropriate cleaning

·         the patient will then be asked to wash or sanitise their hands

·         the patient will be escorted to the treatment room

·         where possible the doors will be opened for the patient with the light switches on

 

NB: All triage pre-screening information must be documented in the patient notes.

 
Protecting members of staff   All staff have been contacted to see if they are shielding anyone or have health conditions that make them particularly susceptible to Covid 19

All staff to wash their hands when entering the clinic and at regular intervals in the day

·         Where possible the staff should stay behind the screen

·         Staff should bring their own drinking vessels and take them home to wash

·         Staff should clean the toilet after use

·         See PPE policy below to be followed by staff as well as clinicians

 

 
Confirmed cases of COVID 19 amongst staff or patients?   If staff or clinician have symptoms of Covid 19 they should get a test and self isolate until they get the results of the test.

 Anybody who has been in direct contact with that person should self isolate until the test results are made clear.

 

 
Travel to and from the clinic    The waiting room is now available and open.

 

 
Entering and exiting the building   ·         Clinic staff should not be in contact with patients so need not change their clothes

·          Clinicians will be asked to bring separate clothes to work in and change at the beginning and the end of their working day and to take the clinical clothes home to wash in a cloth bag or pillow case..

·         Patients can use the waiting room or wait in their car until contacted to enter the clinic

·         Patients will be asked to wash their hands with soap and water where possible and to sanitise if not eg if they are carrying a babe in arms.

 
Reception and common areas    

·         The waiting room is now open and available

·          We will ask for contactless or Bacs payments only. This information will be given at the pre screening

·         Hand sanitiser station at reception entrance

 
Social/physical distancing measures in place    

·          Staggered appointment times so that patients do not overlap in reception

·         Staffing as pre Covid/normal as at June 2022

 
Face to face consultations (in-clinic room)   ·          The chairs for the patient in the consultation room to be as far away from the desk as possible.

The policy on chaperones is :-

·         Two parents for child appointments

·         Chaperones will be given the infection risks and the implications of coming into the clinic

·          All chaperones to do the hand washing routine. screen chaperones at same time as pre screen call

·          
Table 2b Hygiene measures

We have assessed the following areas of risk in our practice and put in place the following heightened hygiene measures

  Description of risk Mitigating action When introduced
Increased sanitisation and cleaning    Surfaces to be cleaned with  bleach wipes or Clinell wipes after every patient

·         Clinic rooms – plinths, desk, door handles, equipment chairs – between each patient

·         Reception surfaces, doors and door handles, chairs, taps, card machines to be cleaned. The credit card machine has a wipeable screen cover. The pin pad only needs to be used  for transactions which are not contactless or  where asked.

·         Use of at least 60% alcohol sanitisers/wipes, using bleach-based detergents

 To minimise the number of surfaces that need to be cleaned:-

·          All linen has been removed from the clinic There are now plastic pillows and just the plinths with no covers so that it can be cleaned in between each patient

·         The clinic has been decluttered of unnecessary items

·         Keeping doors between common areas open if safe and appropriate to do so, to reduce touch points

 
Aeration of rooms    

·         Leaving the window open and the front door open to aerate whole clinic at lunch time and during cleaning

 
Clinician  hand hygiene measures    

·         Bare below the elbow/hand washing before and after patients with soap and water for at least 20 seconds, including forearms/use of hand sanitiser gel.

·          use of gloves when treating clinically vulnerable patients. updated 5/5/22

·         Hand sanitiser available in all rooms and reception area

 
Respiratory and cough hygiene   Communication of cough hygiene measures for staff and clinicians

·         ‘Catch it, bin it, kill it’ posters

·         Provision of disposable, single-use tissues waste bins (lined )

·         Hand hygiene facilities available for patients, visitors, and staff

 
Cleaning rota/regimes   The taps in the toilet will be cleaned in between each patient the toilet will be cleaned if used

 

 A written record will be kept when the toilet is cleaned.

 
     
Table 3. Personal Protective Equipment: Detail here your policy for use and disposal of PPE
Clinicians will wear the following PPE  

·         Single-use nitrile gloves or similar and plastic aprons for clinically vulnerable patients updated 5/5/22

·         Fluid-resistant surgical masks (or higher grade) for vulnerable patients

·         Eye protection,  if the patient has hayfever or other runny nose that has proved not to be Covid19

When will PPE be replaced  

·         When potentially contaminated,  damaged, damp, or difficult to breathe through

·         IIr masks can be worn for 4 hours and Fpp2 for eight hours

Reception staff will wear the following PPE  

·         Fluid resistant surgical masks for those in direct contact with patients,

Patients will be asked to wear the following PPE Detail here in what circumstance you may ask patients to wear PPE, and what types e.g.

·         Fluid-resistant surgical masks if respiratory symptoms e.g. from hay fever or asthma

PPE disposal Double-plastic bagged and left for 72 hours before removal, keeping away from other household/garden waste, and then this can be placed in your normal waste for collection by your local authority.

·         Cloths and cleaning wipes also bagged and disposed of with PPE

Table 4. Communicating with patients: Detail here how you will advise patients of measures that we have taken to ensure their safety and the policies that have been put in place in our clinic
Publishing your updated clinic policy  

·         Publish on clinic notice board   and or available on request

 

·         Available on our website

 

Information on how you have adapted practice to mitigate risk Detail here what general information on steps taken and where it has been published

·         Updating of website and via our social media accounts

 

 

Pre-appointment screening calls  

·         24 hours/morning before a scheduled appointment

·         A receptionist or clinician will call.

·         If non-clinicians to be trained to ask if patient has fever , cough or feels unwell. To tell patient the practice procedure. To stay in car until called or use waiting room, then will wash hands, then go through to treatment room.

·         Payment by card only

·          All new patients and those who have not attended the clinic in the last 12 months to have new case history done over the phone or on WhatsApp by an osteopath

Information for patients displayed in the clinic .

         Notices on other public health measures e.g. hand washing/sanitising/Catch-it, bin it kill

 

 

 

Other patient communications Patients will be asked to contact us if they begin with symptoms of fever , cough or feeling unwell between  pre screening phone call and appointment or after they have had an appointment  for a period of 2 weeks.

 

Updated 27/06/2022