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Are face masks doing more harm than good in care homes?

Now that we have all come to terms with Boris Johnston’s new age of freedom, we are no longer required to wear face masks when we go out shopping or participate in many social activities. However, this is not the case in care homes where staff and visitors are still required to wear them.

Given the success of vaccinations and the drop-in death rates in care homes. Some providers are beginning to question whether they are doing more harm than good to the welfare of care home residents.

Damaging the well being of residents

The need for the current level of Covid infection control measures in homes where the vaccine has been rolled out among residents and staff is “increasingly diminishing”, according to Sunrise Senior Living and Gracewell Healthcare.

The group, which has 45 homes across England and one in Wales, has written to Sajid Javid, the Health Secretary, warning that some of these measures are now damaging the well-being of care home residents.

The letter to Mr Javid says: “The requirement for visitors to wear face masks, aside from those exempt, is an example of a policy which is now causing more damage to the welfare of residents than it offers in medical protection.

“For many residents, a visit from their family member has provided invaluable improvements to their well-being, but the requirement for these visitors to wear a face mask degrades the level of connection and therefore devalues the positive impacts their visits can have.

“This restrictive policy, along with various others from both the DHSC and PHE (Public Health England), should be reconsidered as we approach this next step in England’s roadmap out of lockdown.”

The letter said the success of the vaccination programme among care home staff and residents meant the majority of homes “are now set to confidently return back to an enhanced degree of normality”.

All 46 Sunrise and Gracewell homes have at least 90 per cent of residents vaccinated and all but one have more than 80 per cent of staff jabbed. This is the threshold that the Scientific Advisory Group for Emergencies (Sage) says needs to be met in each setting to provide a minimum level of protection against Covid outbreaks.

Last week, Helen Whately, the care minister, said that even when lockdown restrictions ended on July 19, it was “unlikely” that visiting would completely return to normal. Speaking on Times Radio, she said it was likely that visitors and staff would still be required to wear masks.

The Department for Health and Social Care (DHSC) is expected to issue updated guidance on care homes, and whether or not masks will be mandatory in them, later this week. “I’ll be looking at the guidance, I’ll be making a judgment, but I’m not keen to wear one when I don’t need one – personally, it’s not something I enjoy doing,” she said.

“But I’m also really aware that there will be circumstances I’m expecting to continue in health and social care, clearly, where people will need to continue to wear PPE (personal protective equipment), which includes masks.”

Public Health England latest guidance

On the 19th July PHE issued the following guidance. Due to the nature of the settings and vulnerability of the population, PPE and other infection prevention and control (IPC) measures should continue to be practised in care homes.

Summary

The use of face masks in the community is a contentious issue. Many people will continue to wear face masks in the belief that they offer protection to oneself and others while other people will not think it is necessary to wear them.

In care homes because of the vulnerability of residents, PHE are taking the cautious view and require staff and visitors not wear them. To what extent the wearing of face masks by visitors is damaging the well-being of care home residents is open to debate. However, there is no doubt in my mind that the wearing of face masks inhibits clear communication and limits the quality of engagement with others by not being able to see their face.

Overall, if face masks are seen as an effective means of reducing the spread of infection then perhaps, we should err on side of caution and ask staff and visitors to care homes to continue to wear them.

Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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