Madeline Walsh and Lucinda Smith

New Aged Care Directions – further restrictions on visitor access and new workforce management requirements in QLD and updated guidance for NSW

Madeline Walsh and Lucinda Smith

August 3, 2020

Aged Care Retirement Villages

Update to Aged Care Directions in Queensland 

On 30 July 2020, Aged Care Direction (No. 8) came into force in Queensland in response to the evolving situation relating to the new reported cases of COVID-19 in South East Queensland.

There are a number of new requirements aged care providers in Queensland should be aware of.

Firstly, the Directions now distinguish between ‘restricted residential aged care facilities’ and facilities other than ‘restricted residential aged care facilities’.

The new requirements that apply to all residential aged care facilities in Queensland include:

  • if a person is attending a facility to visit a resident (i.e. they are permitted to do so subject to the restrictions in place as detailed below), they must practice physical distancing and limit their contact with persons at the facility other than the resident they are visiting;
  • new workforce management requirements including:
    • a limitation on staff working between facilities; and
    • new record keeping requirements.

The new requirements that apply to ‘restricted residential aged care facilities’ in Queensland include:

  • no visitor access except to provide end of life support to a resident;
  • a person providing health, medical, personal care or pharmaceutical care to a resident may enter an aged care facility for that purpose, but must wear appropriate personal protective equipment (PPE) if they are providing those services to multiple residents;
  • residents can only leave a facility for limited purposes, including to attend medical appointments or a funeral;
  • everyone (excluding residents) entering an aged care facility must wear a single use surgical face mask;
  • providers must ensure, to the extent reasonably practicable, that employees, contractors and volunteers do not work across multiple residential aged care facilities;
  • providers must take reasonable steps to ensure that:
    • employees, contractors and volunteers who do work across multiple aged care facilities doff and don appropriate PPE in accordance with the Australian Guidelines for the Prevention and Control of Infection in Healthcare 2019 (the Australian Guidelines);
    • there is adequate supply and stock management of PPE.

Find out more about these changes below.

Directions that apply to all aged care facilities in Queensland 

There are a number of new directions that apply to all aged care facilities in Queensland, as outlined below.

Access restrictions

The requirements that have applied to all aged care facilities in Queensland for some time continue to apply, for example a person must not enter the facility if they:

  • do not have an up to date vaccination against influenza, if the vaccination is available to the person; or
  • have been in a COVID-19 hotspot during the last 14 days.

There is a new requirement that applies to all residential aged care facilities in Queensland. That is, if a person is attending a residential aged care facility to visit a resident, they must, to the extent reasonably practicable:

  • practice physical distancing; and
  • limit their contact with other persons at the facility.

Workforce Management for all residential aged care facilities in Queensland

There is a new requirement for all operators of residential aged care facilities in Queensland to develop a Workforce Management Plan that requires employees, contractors and volunteers:

  • to notify a residential aged care facility of any additional place of employment; and
  • if they become aware of a COVID-19 case identified at an additional place of employment, to notify the operator of a residential aged care facility.

The purpose of the Workforce Management Plan is to assist with contact tracing when an identified case of COVID-19 is confirmed.

The Direction refers to “any additional place of employment”, i.e. it is not limited to disclosing other aged care related employment. In our view, this means providers should gather information about any additional place of employment for each employee, contractor and volunteer, regardless of whether the other employment is aged care related or not.

Record keeping requirements for all residential aged care facilities

Aged care providers in Queensland must collect and securely store contact information about all visitors, including volunteers and contractors, for a period of 56 days, after which time it should be deleted. Again the collection of this information is to assist with contact tracing if needed. The information must include the visitor’s name, phone number, email address, and the date and time of their visit.

Providers must be prepared to provide this information to the government within a stated time.

Directions that apply to ‘restricted residential aged care facilities’

There are also a number of new restrictions that apply to ‘restricted aged care facilities’ in Queensland.

A ‘restricted residential aged care facility’ is a facility in a ‘restricted area’. The list of restricted areas, decided by the Chief Health Officer, are published on the Queensland Health website. At the time of publication of this update, the restricted areas are:

  • all suburbs within the Metro South Hospital and Health Service area;
  • a number of suburbs within the West Moreton Hospital and Health Service, including Ipswich, North Ipswich and Raceview.

As the situation can evolve rapidly, providers are encouraged to monitor the Queensland Health website regularly as these areas may change.

We have summarised the new restrictions that apply to ‘restricted residential aged care facilities’ in the table below.

Type of restriction Details
Persons permitted to enter In addition to the requirements that apply to all aged care facilities in Queensland (e.g. in relation to influenza vaccination), a person must not enter a restricted aged care facility unless the person is:

  • an employee or contractor;
  • entering for the purposes of providing goods or services that are necessary for the effective operation of the service;
  • entering for the purposes of providing health, medical, personal care, or pharmaceutical services to a resident;
  • entering to provide end of life support to a resident;
  • required to enter for the purposes of emergency management, law enforcement or the exercise of a power or function of a government agency or entity under a law; or
  • a prospective resident or a prospective resident’s support person.
Resident movement Residents, excluding end of life residents, can only leave the service:

  • to receive or access health care;
  • to attend a funeral; or
  • in the case of emergency or on any other compassionate grounds.
Wearing of face masks Everyone (excluding residents) entering or remaining on the premises must wear a single use surgical face mask.

There are no exceptions – a person who does not, or is unable to wear a mask, must not enter a restricted residential aged care facility.

Workforce management Providers operating a restricted residential aged care facility must ensure, to the extent reasonably practicable, that employees, contractors and volunteers do not work across multiple residential aged care facilities.
Personal Protective Equipment (PPE) Providers operating a restricted residential aged care facility must ensure that employees, contractors and volunteers who do work across multiple residential aged care facilities:

  • wear appropriate PPE, in line with the Australian Guidelines; and
  • use new PPE when entering a different facility, with the doffing and donning of PPE to be in accordance with the Australian Guidelines.

A person providing health, medical, personal care or pharmaceutical services to multiple residents in a restricted residential aged care facility must ensure compliance with the wearing of PPE in accordance with the Australian Guidelines

Providers must take all reasonable steps to ensure these requirements are met and that there is adequate supply and stock management of PPE.

We are mindful of the impact these new restrictions will have on facilities operating in restricted areas, including the significant implications with respect to workforce management and record keeping. If you have any questions about compliance with the new directions, please contact a member of our Health, Aged Care and Retirement Villages team in Brisbane.

Update to News South Wales Advice

New South Wales has not at the date of this post updated its order for aged care.  However NSW has issued further advice to aged care facilities in relation to measures which should be taken, depending on geographic location.

The last order was made on 22 June and can be accessed here.  The advice is being issued by the Chief Health Officer (CHO) and is not made under a public health order.  However, all providers should comply with the advice and have systems in place to monitor changes as it is being updated regularly.

The advice issued on 30 July is summarised below.

Infection prevention and control

Providers should:

  • have an infection control lead/champion at each facility
  • ensure that staff are well trained in infection control and know how to use PPE
  • ensure they have enough PPE on site.

The CHO has asked Local Health Districts to support residential care facilities in preparing.

Screening and entry restrictions

The advice asks all providers to “please implement the following measures”.  These measures are in addition to the requirements of the order (note there are some areas of overlap/duplication).

All facilities in NSW should:

  • exclude all staff and visitors who have a fever of >37.5 or respiratory symptoms, even if they are mild. Providers should advice those people to isolate at home and get tested. This is an ongoing requirement;
  • exclude all staff and visitors who have been in Victoria in the last 14 days (special arrangements apply for border communities – see here). This is an ongoing requirement;
  • exclude any visitors who have been in the following local government areas in the last 14 days: Bankstown, Waverley, Woollahra, Randwick, eastern part of City of Sydney, Parramatta, Fairfield, Liverpool, Campbelltown, Camden, Wingecarribee and Wollondilly. This requirement is until further notice;
  • all aged care staff who reside in the LGAs listed must wear a mask while in the facility. This is an ongoing requirement;
  • exclude all staff and visitors who have visited certain locations on the same date as a COVID-19 case for 14 days since their last visit to that location. The list of locations is here. This is an ongoing requirement.

The list of LGAs and list of COVID-19 locations will be updated regularly.  Providers should ensure that systems are in place to monitor changes to these lists and that screening processes are being updated accordingly on site.

Facilities which are operating in the affected LGAs and border communities are required to take additional steps:

  • all staff who work in the affected LGAs must wear a mask while in the facility, regardless of where they live. This is an ongoing requirement;
  • facilities in the listed LGAs should not allow any visitors. Visitors performing essential caring functions may be allowed but must wear a mask. This requirement is until further notice.

If a facility is closed to visitors, exceptions can be sought from the public health unit.  We understand that exceptions will only be granted in very limited circumstances. During this period the advice suggests video and phone calls for families and friends to maintain contact with residents.  The Code (covered in our previous blog posts – found here) goes into more detail about alternative means of contact during these periods.

If you have any questions about the order or the advice, please contact a member of our Health, Aged Care and Retirement Villages team in Sydney.