CARE home staff could risk assault charges if they assist or coerce elderly residents into wearing masks, an expert has warned.

Valerie Nelson, an independent registered social worker, believes updated government guidelines that include residential care settings could raise adult protection issues. 

Ms Nelson, who specialises in mental health and is also a former nurse, said the majority of people in care homes would qualify for exemptions because most have communication difficulties as a result of dementia or hearing impairments.

She said care staff could “inadvertently become perpetrators of harm” because many residents would not be able to give informed consent.

According to government guidelines, exemptions cover those who cannot put on, wear or remove a face covering because of a physical or mental illness, impairment or disability.

READ MORE: Major care provider breaks ranks over 'unfair and restrictive' mask guidelines 

The Scottish Government insists there had been no material change in the guidance since October and that masks should only be worn when residents are receiving personal care and in communal areas when it is not possible to be socially distant. 

It said the updated guidelines, which come into force on June 25, aimed to clarify that masks are nor required in the resident’s own living space and said anyone who was not able to wear one would not be required to do so.

One care home provider, Four Seasons Healthcare, said it “strongly disagreed” with the new measures but would adhere to them.

Ms Nelson, who worked in a care home for eight years and lives in Perth, said managers and workers may feel pressure to enforce mask wearing to achieve favourable inspection gradings.

She said: “I work independently which means I have much more freedom to express a view and to challenge. 

“Residents were never expected to wear masks before but the guidance has changed. 

“If face mask exemptions are promoted, there is no place for them in care settings because the majority of people have communication difficulties or hearing impairment.

READ MORE: 'These are residents' homes': Concern over 'inconceivable' new elderly mask rules

“The majority of people in care settings would not be able to give informed consent. It could be argued that if they did agree, it was through coercion or persuasion. My concern would be, that care staff would be under pressure to put masks on frail, vulnerable people and I would argue that that could be considered an assault and then we start getting into the horrible area of investigations.”

“The difficulty is the government is promoting something and it’s very difficult for professionals to argue against it. 

“This area is hugely contentious in terms of adult protection about consent, informed consent, about coercion, it’s just a minefield. The majority of my colleagues would agree with me but they are not free to express their views in the way that I am.

“I’m concerned about the detrimental effect on people who are being cared for and rely on facial expressions. 

“For people with dementia and learning disabilities having to live in a faceless world, I just find it inhuman and atrocious beyond belief.”

READ MORE: Warning over spiralling dementia diagnoses delays and support vaccum 

The Care Inspectorate said it was essential that people experiencing care had their rights respected "in their own home".

Ms Nelson said she was also concerned that there may be reluctance to exempt care home staff from wearing masks.

“The government is clear that the exemptions are there to be applied but in my experience, they are not tolerated. Tesco and Stagecoach have done more to promote exemptions that the health and social care sector.”

Age Scotland described the new guidance as “detached and ill-thought out”.

A spokesman for the Care Inspectorate said: “The Care Inspectorate expects all care services to support people to make informed choices about when and where to wear a mask in what is their own home.

“People who experience care must have their needs met and their rights respected and protected.”