Policy for Consultation During COVID-19

Last updated: March 17th 2021
Consultant: Sophie Boucher-Giles

 

Introduction

 

The health, safety and wellbeing of clients (children, parents/carers & other adults) and the consultant, remains, as always, the highest priority. Since the COVID-19 pandemic, adaptations have been made to services, where appropriate, to provide consultation via remote methods more often. It is recognised, however, that this will often not be possible, appropriate, best-practice or most effective for some clients, due to age-range, needs (reason for consultation) and requirements and so home-visits are still being offered. Where this is the case, this can only take place with a risk assessment and if the consultant is satisfied it is appropriate.

 It has always been necessary to consider any risks associated with providing services to a client in their own home, clinic room, school, nursery or other setting. COVID-19 poses an additional risk to consider and needs to be met with a set of measures to ensure consultant and clients understand any risks, how they can best be reduced/mitigated, and whether they agree to proceed with the intended service.

 1.     A Remote approach

 Throughout the pandemic a remote working policy has been adopted where viable.

 Remote service (phone-based consultation) is the only option that presents a zero risk of COVID-19 transmission, so remote services are considered as a starting point for most referrals, self-referrals and current clients where appropriate, and are offered to all.

 Before any home-visits can be arranged, the commissioning adult (person paying for service and adult(s) present during consultation) must not pose a risk of COVID-19 transmission to the consultant or others, and should understand what this involves. Non-compliance risks forfeiture of full session payment.

 2.     Individual risk assessments for Home-Visits

It remains a policy of Gentle Start Family Consultancy, as a private practice, that no home-visits of any kind can take place if the client, the consultant, or a member of their household or with whom they have been in recent close contact (according to current government guidelines) is symptomatic, in quarantine or self-isolating due to possible or known exposure or travel.

Before each visit clients should be able to state, in the negative, the following:

1.     Have you, or anyone you are in contact with, had any COVID-19 symptoms?

2.     Have you been in contact with anyone with symptoms of or a diagnosis or clinical suspicion of COVID-19 in the last fourteen days?

3.     Are you, or anyone in your home, displaying symptoms of COVID-19

4.     Do you have any significant health problems that could increase your risk of a poor outcome should you contract COVID-19?

·      This does not necessarily preclude you from consultation but helps with the consultant’s practice and risk assessment.

 Arranging a home visit implies that you have considered all the relevant risks involved with face-to-face consultation.

In the event of a home-visit, risks will seek to be reduced, where appropriate, through the use of appropriate PPE (personal protective equipment) and other measures, as relevant, to make the visit as safe as possible.

3.     Personal Protective Equipment (PPE) for Home-visits

PPE for visits to Clients’ homes

 It is the policy of Gentle Start Family Consultancy that PPE (to include as a minimum type IIR fluid-resistant surgical mask) is to be used by the consultant for all visits that require entering a close environment such as a client’s home where this is appropriate for the client(s) and child(ren). In accordance with current guidelines, the consultant will also other PPE as appropriate if required.

PPE for visits in other settings

 For visits taking place in other settings (for example, but not limited to - schools, nurseries, child-minders and clinics) the consultant will follow the policy of the setting in relation to the usage of PPE as a minimum and may, at their discretion, chose to use PPE which exceeds the circumstances or policy.

 Risk can never be eliminated entirely during a home-visit, and it is the consultant’s policy to take an individual approach to risk assessment. This helps ensure that visits only take place if risks have been assessed and both clients and consultant understand these risks, how they will seek to minimise/mitigate these and both the client and consultant are willing to proceed.

Examples of considerations that will feature as part of the risk assessment process (which will not necessarily be provided in written form to the client, unless requested) will include but are not limited to:

  • The level of local COVID-19 transmission rates, as reflected in/by any local and/or national restrictions

  • The client’s status with regards to clinical vulnerability and ‘at risk’ groups

  • The client’s ability to understand and practice social distancing (client can be either parent/carer/legal guardian and/or the child if competent to make the decision (otherwise this will be made for them by the adult(s) legally responsible for them)

  • The environment in which the visit is planned and whether this can be well ventilated

  • Whether measures such as including outdoor time during visits (normal practice) may help reduce any risks.

 There are three possible outcomes of the home-visit risk assessment:

1.     That the consultant and therapist are in agreement with completing a visit, with the consultant using the appropriate PPE, and any other agreed measures to make the visit as safe as possible

2.     Heightened risks have been identified but the consultant’s opinion is that the visit can go ahead with relevant safeguards, and the client is in agreement with this, understanding the risks involved

3.     The risks are too great to make a home-visit possible and a remote-working solution is offered

 If clients do not disclose risk factors then the deposit paid will be forfeited and should the visit have to be cancelled after the time period for rescheduling has been exceeded, then the full session cost is payable. Full terms and conditions of the required notice period can be found on the Gentle-Start website terms and conditions page.

It is understood that due to COVID-19 unforeseen problems may arise, so in accordance with the terms and conditions, one rescheduling will be allowed, given adequate notice (see terms and conditions) or with less notice, at the discretion of the consultant.

 

Last Updated: March 18th 2021.

For review: April 18th 2021.

Prepared by: Sophie Boucher-Giles

Approved by: Sophie Boucher-Giles