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Supporting health and social care providers in Devon

Personal protective equipment (PPE)

Last Updated 10:00am, 30 November 2020


Introduction

If you have any specific issues or questions that you would like to raise with us please do so as follows:

Ordering eye protection PPE

Eye protection is recommended for care of clients where there is risk of droplets or secretions from the client’s mouth, nose, lungs or from body fluids reaching the eyes (e.g. caring for someone who is repeatedly coughing). Social care guidance requires assessment of the above risk to establish whether eye protection is required.

If eye protection is required, regulated providers can order visors via the PPE Portal. If providers are unable to access PPE through the Portal, and they require emergency stocks, they can request visors, glasses / goggles and 70% alcohol wipes from Devon County Council by completing the PPE Request form.

Unregulated providers, Personal Assistants and Carers can access PPE for free via DCC.

Images on the use of face coverings and masks

Devon County Council and NHS Devon have produced two simple images reminding care staff of the difference between face coverings for use by the general public and surgical masks for use when undertaking care work. The images are suitable for sharing on social media or printing out as staff notices.

Image 1

Image 2

National guidance

PPE guidance for community settings

Public Health England have issued illustrated guidance on the use of PPE by health and social care workers working in community settings.

Care homes safety guidance

Public Health England issued new guidance for care homes on how to work safely during this period of sustained transmission of COVID-19. The new guidance includes a document about how to work safely as well as a video about putting on and removing PPE.

Personal care settings guidance

Public Health England issued new guidance on how to work safely in domiciliary care settings during this period of sustained transmission of COVID-19.

Infection prevention and control

Public Health England guidance on infection prevention and control for COVID-19.

Public Health England contact details

If you require clarification or have concerns about infection control, please escalate them to your Line Manager in the first instance.
Managers can also contact the Public Health England Health Protection Team for advice on 0300 303 8162 or email swhpt@phe.gov.uk.

PPE distribution and supply

National and local PPE supply

For CQC registered providers. The central PPE portal – Clipper.

Providers should order PPE through their normal supply routes for the standard volumes of PPE required before the pandemic as the free national PPE Clipper portal is for additional PPE required over and above normal pre-COVID-19 use.

The national Clipper system supplies free packages of PPE to all CQC registered providers, who should register directly with the Clipper portal. Although a number of providers have signed up to this portal, and received some PPE, we are aware that not all providers have registered. If you are CQC-registered, we would encourage you to register on the portal and place an order. You will need to use the email you have registered with the CQC. If this has changed, you will need to first update your email details with the CQC before signing up to the portal. Please note that the portal registration process includes an email confirmation. If you don’t receive one please check your junk mailbox. Once registered, you can order a small level of PPE as shown below, and multiple orders can be made within that limit, not just a single weekly order. Currently the PPE is supplied free of charge, so it is worth taking up this offer to help replenish your emergency PPE stock levels.

Domiciliary care providers (updated 18 November)

Domiciliary care providers with fewer than 20 clients can order up to (per week):

  • 200 IIR masks
  • 400 aprons
  • 800 gloves (400 pairs)
  • 1 bottles of hand hygiene (usually 500ml)
  • 1 box of small hand hygiene (usually 24 bottles of 100ml)
  • 200 visors

Domiciliary care providers with between 20 and 49 clients can order up to (per week):

  • 800 IIR masks
  • 800 aprons
  • 1,600 gloves (800 pairs)
  • 24 bottles of hand hygiene (usually 500ml)
  • 2 boxes of small hand hygiene (usually 24 bottles of 100ml)
  • 200 visors

Domiciliary care providers with between 50 and 99 clients can order up to (per week):

  • 2,000 IIR masks
  • 2,000 aprons
  • 4,000 gloves (2,000 pairs)
  • 2 bottles of hand hygiene (usually 500ml)
  • 2 boxes of small hand hygiene (usually 24 bottles of 100ml)
  • 200 visors

Domiciliary care providers with between 100 and 149 clients can order up to (per week):

  • 2,000 IIR masks
  • 3,000 aprons
  • 6,000 gloves (3,000 pairs)
  • 3 bottles of hand hygiene (usually 500ml)
  • 3 boxes of small hand hygiene (usually 24 bottles of 100ml)
  • 200 visors

Domiciliary care providers with between 150 and 500 clients can order up to (per week):

  • 4,000 IIR masks
  • 3,000 aprons
  • 6,000 gloves (3,000 pairs)
  • 4 bottles of hand hygiene (usually 500ml)
  • 4 boxes of small hand hygiene (usually 24 bottles of 100ml)
  • 200 visors

Domiciliary care providers with between 500 and 999 clients can order up to (per week):

  • 6,000 IIR masks
  • 7,000 aprons
  • 12,000 gloves (6,000 pairs)
  • 5 bottles of hand hygiene (usually 500ml)
  • 5 boxes of small hand hygiene (usually 24 bottles of 100ml)
  • 200 visors

Domiciliary care providers with more than 1,000 clients can order up to (per week):

  • 8,000 IIR masks
  • 10,000 aprons
  • 14,000 gloves (7,000 pairs)
  • 5 bottles of hand hygiene (usually 500ml)
  • 5 boxes of small hand hygiene (usually 24 bottles of 100ml)
  • 200 visors

Care homes (updated 18 November)

Care homes with fewer than 10 beds can order up to (per week):

  • 200 IIR masks
  • 400 aprons
  • 800 gloves (400 pairs)
  • 2 bottles of hand hygiene (usually 500ml)
  • 100 visors

Care homes with between 10 and 24 beds can order up to (per week):

  • 300 IIR masks
  • 1,200 aprons
  • 2,400 gloves (1,200 pairs)
  • 4 bottles of hand hygiene (usually 500ml)
  • 200 visors

Care homes with between 25 and 49 beds can order up to (per week):

  • 500 IIR masks
  • 2,000 aprons
  • 4,000 gloves (2,000 pairs)
  • 6 bottles of hand hygiene (usually 500ml)
  • 200 visors

Care homes with between 50 and 99 beds can order up to (per week):

  • 1,000 IIR masks
  • 5,000 aprons
  • 8,000 gloves (4,000 pairs)
  • 8 bottles of hand hygiene (usually 500ml)
  • 200 visors

Care homes with 100 or more beds can order up to (per week):

  • 2,000 IIR masks
  • 7,000 aprons
  • 12,000 gloves (6,000 pairs)
  • 10 bottles of hand hygiene (usually 500ml)
  • 200 visors

We encourage all providers to make use of this opportunity, as the PPE is currently free of charge and can be repeat ordered on a weekly basis.

If you have any queries about to the national PPE portal, including how to register, please ring the PPE customer service team on 0800 876 6802. This number can also be used for concerns about a product’s suitability.

DCC will alert providers when changes are made to the volume of items which can be ordered from Clipper. The volumes have recently been increased.

DCC will continue to provide limited supplies of PPE to CQC registered providers, but only in emergencies when other supply sources have failed. Providers must evidence that they have tried to order PPE through the other routes and must describe why the emergency stock is required. Any such emergency supply will need to be collected from local PPE stores in Barnstaple, Newton Abbot, Exeter or Tavistock.

For local emergency PPE orders, all CQC-registered providers should complete this DCC PPE request form.

For non-CQC registered providers, Unpaid Carers and Personal Assistants

Providers should continue to order PPE through their normal supply routes for the standard volumes of PPE required pre-COVID-19.

From 1 October, free additional PPE will be available via DCC in accordance with national guidelines.

All unregulated services/organisations, unpaid carers and personal assistants should complete this PPE request form if they require PPE and allow at least seven days’ notice when submitting a request for supplies. Due to the expected increase in demand under these new arrangements, supplies will have to be collected from local PPE stores in Barnstaple, Newton Abbot, Exeter or Tavistock.

VAT zero rating for PPE

This tax information and impact note is about a new temporary zero rate that will apply to supplies of personal protective equipment (PPE).

Advice on safe use of PPE

National quality assurance of PPE

This national guidance note provides information on the products below, which are safe for use, and clarifies the central assurance undertaken to approve release of these items into the supply chain:

  • Type IIR masks and latex labelling
  • Weian face masks
  • Blue sail nitrile gloves
  • INTCO nitrile gloves
  • Cardinal FFP3 respirator masks
  • 3M 9330+ FFP3 respirators
  • Reminder about registering product or PPE safety queries

PPE Face Masks – Latex Warning

We have become aware that latex may be used in the manufacture of some face masks as well as gloves. Latex can produce an allergic reaction in some individuals which can vary in severity from a runny nose and itchy eyes to anaphylaxis.

Any product, which contains a CE mark on the packaging and where latex has been used in the manufacture of that product, will be labelled with the following symbol and/or appropriate warning on its packaging.

Symbol: black triangle with the word LATEX

If you have a CE marked boxes of masks, which does not contain this symbol and/or warnings on the packaging, then the product should not contain latex.

The Council has received assurances that non-CE marked PPE distributed nationally will be checked before we receive it and we will be notified of any concerns. In the light of this we are not requiring any such PPE to be withdrawn due to latex concerns.

If you have purchased any gloves or face masks that are not CE marked on the packaging, you should make enquires with the supplier to determine whether they contain latex if the packaging is not clear.

If you have any PPE, which contains latex, you will need to refer this to your Health and Safety Competent Person. We would suggest that you provide information for all staff on the possible effects of a latex allergy for early warning  and what to do if they do develop any of the symptoms.  You should also undertake a risk assessment and attempt to identify any individuals who may be aware that they might have a latex allergy.   Finally, we would suggest that you purchase additional stock of latex free products for those who develop symptoms and look to phase out any PPE stock you hold which does contain latex.

Re-usable PPE items

Please note that re-usable PPE items should be clearly marked as such and identified in advance by your organisation/manager. Re-usable PPE items may be used providing they are appropriately cleaned and stored between uses, according to the manufacturer’s instructions or local infection control policy. Your manager will advise you where this applies and there is national guidance on PPE reuse.  Goggles may be cleaned immediately after removal and hand hygiene is performed OR placed in designated closed container for later cleaning and disinfection.

Advice on cleaning equipment from NHS Devon

Protective Goggles – Following recent guidance, we have recommended that goggles with elastic straps are used for single use only and are not cleaned and reused.

Protective Glasses – Protective glasses with plastic arms can be cleaned with soap/detergent and water followed by disinfection using 70% alcohol wipes. Some protective glasses come with detachable catch lanyards. Please remove and dispose of these lanyards as they cannot be sufficiently disinfected.

Face Visors with foam strip – Face visors can be cleaned with soap/detergent and water followed by disinfection with 70% alcohol wipes. Some visors have a foam strip across the top on the inside. These visors can be cleaned but can only be reused by the same member of staff.

Aerosol Gas Procedures (AGPs) PPE FFP3 Masks

A woman wearing FFP3 maskFiltering Face Pieces (FFP) are non-reusable face masks used by Health and Social care workers when undertaking Aerosol Generating Procedures (AGP’s) on patients. There are different grades of FFP masks: FFP1 filters out 80% of airborne particles, FFP2 filters 94% and FFP3 99%.

Without the masks, carers are at high risk of catching and spreading corona virus. The Aerosol Generating Procedures produce fine infected droplets that are inhaled through the mouth or nose of the carer. The masks must be a secure fit to the wearers face forming a mechanical seal to prevent the aerosols being breathed in around the sides of the mask. Every face is different, therefore FFP3 masks come in a variety of shapes and sizes; different masks will fit different carers.

Once fit tested to a mask, a carer should continue to undertake a fit check every time a mask is worn. Facial hair can affect the fit of FFP3 masks and it is suggested carers are clean shaven.

A change of FFP3 mask type requires carers to be refit tested to the new brand of masks.

Clear examples and poster resources of how to apply and fit check an FFP3 mask

Classification of what an AGP

It includes, amongst others; intubation, manual ventilation, tracheostomy procedures, bronchoscopy, dental procedures, non-invasive ventilation; BiPAP and CPAP, high flow nasal oxygen, induction of sputum, respiratory tract suctioning, upper ENT airway procedures and upper gastro-intestinal endoscopy that involve respiratory tract suctioning, and high speed cutting in surgery/post-mortem procedures.

Carers that were fit tested during the first wave were fit tested to Cardinal and 3M brand masks.

There is limited stock of the 3M and Cardinal brands left within the Devon system. It is inevitable that carers will have to be refit tested during the winter period to the new type of masks. We have a limited number of trained Fit Testers.

Having your own in-house Fit Testers in your organisation will enable you to have a responsive approach for your staff and clients.

Free online Fit Tester Training

The fit testing kits, masks and solution are free and available through DCC. The fit testers do not have to be medically trained nor state registered.

We have two training dates available for fit tester training, with more dates to follow. There are 8 spaces on each course. Dates available are:

Friday 27 November 9am – 12noon
Friday 4 December 1pm – 4pm

More courses will be made available to meet demand.

Please contact d-ccg.ppestores@nhs.net to book a space and provide your staff with free training and the skills they need to wear the right PPE to care for patients.


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