Infection Control Spot Checks in Residential Aged Care: What Providers Need to Know

The Aged Care Quality and Safety Commission (ACQSC) is stepping up its program of infection control spot checks of residential aged care homes.

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Aged Care Entry Restrictions: Are Influenza Vaccinations Required?

The situation in Victoria has confused the issue of whether a person must have an influenza vaccination before entering an aged care home. In this article we clear up the confusion.

Recently, ACE received this question from a reader:

 

“Is it still mandatory for visitors and staff to have influenza vaccinations prior to entry of a facility? I have conflicting information that is providing confusion.”

 

In today’s article we answer this question and give you some tips on how to stay up to date with visitor restrictions. Meanwhile, we’re keen to hear more questions and suggestions from you, so click here to share your thoughts via our Suggestion Box

 

Is a person required to have an influenza vaccination before entering an aged care facility (as at 12 October 2020)?

 

ACT

Yes

NSW

Yes

NT

Yes

QLD

Yes

SA

Yes

VIC

No

TAS

Yes

WA

Yes

 

The Victorian requirement

Residential aged care entry restrictions in Victoria are set out in the Care Facilities Direction. As at 12 October 2020, the current version of the Care Facilities Direction is Care Facilities Direction (No. 13).

Care Facilities Direction (No. 13) does not require a person entering a Victorian aged care home to have an influenza vaccination.

In its latest fact sheet on visitors in residential aged care, the Victorian Department of Health and Human Services (DHHS) said: “While a requirement to have an up to date influenza vaccination is no longer a restriction of the directions, staff and volunteers are still required to be offered the vaccination program as per Commonwealth requirements.”

 

The Victorian confusion

The absence of an influenza vaccination entry requirement in Victoria has been confusing for Victorian aged care homes because:

  • every other state/territory in Australia has an influenza vaccination entry requirement
  • Victoria used to have an influenza vaccination entry requirement
  • in private correspondence with a Victorian aged care home, DHHS indicated that the omission of the requirement was a mistake that would soon be fixed, but
  • in its latest fact sheet on visitors in residential aged care, DHHS clearly states that the vaccine entry requirement does not apply in Victoria.

 

When was the flu vaccination requirement removed from the Victorian Directions?

Victoria’s old Care Facilities Direction (No. 7), section 2(e) said that a person must not enter a residential aged care facility if “the person does not have an up to date vaccination against influenza”.

On 22 July 2020, Care Facilities Direction (No 7) was revoked and replaced with Care Facilities Direction (No 8). The requirement to have an influenza vaccination was removed from Direction (No 8). Direction (No 8) did not mention vaccinations at all.

Influenza vaccinations were not mentioned in Care Facilities Directions 9, 10, 11 or 12. Nor are they mentioned in the current Direction 13.

 

Was the vaccination entry requirement removed from the Victorian Directions by mistake?

In early August 2020, ACE was forwarded correspondence between a Victorian aged care home and DHHS. In this correspondence, a DHHS representative described the removal of the vaccination entry requirement as “an unfortunate omission” and said that “the advice regarding all people attending a residential aged care service must have an up to date influenza vaccination in order to be present on the premises continues to stand.” The representative added that the mistake “will be rectified soon so please carry on as advised in previous directives.”

However, DHHS has rewritten and reissued the Care Facilities Direction five times since sending this correspondence, and the omission has not been corrected. And, in its latest fact sheet on visitors in residential aged care, DHHS said: “While a requirement to have an up to date influenza vaccination is no longer a restriction of the directions, staff and volunteers are still required to be offered the vaccination program as per Commonwealth requirements.”

So, even if the omission was originally a mistake, it is now being treated as if it were correct.  

 

Should Victorian aged care exclude unvaccinated people from entry to the home?

As we’ve seen, Victorian aged care homes are not currently required to exclude unvaccinated people from entry. But should they do so anyway?

The advice from the Commonwealth and every other state and territory is that they should. In any event, all homes should at least consider such exclusions as part of a broader risk-management strategy. Homes should also ensure that they clearly document the rationale behind their decision.

 

The old vaccination requirement in Care Facilities Direction (No 7)

If you do decide to exclude non-vaccinated people from entry to your Victorian aged care home, this is the rule you can follow, as set out in the old Victorian Care Facilities Direction (No 7):

A person must not enter, or remain on, the premises of a residential aged care facility if the person does not have an up to date vaccination against influenza, if such a vaccination is available to the person.

A vaccination is considered to be not “available to the person” if there is a good reason for the person not to receive the vaccination, such as the person having a medical condition that makes the vaccination unsafe for them.

 

Why are influenza vaccinations important?

In its fact sheet on restrictions on entry into aged care facilities and its advice on responsibilities of residential aged care providers, the Department of Health (commonwealth) advises that:

  • annual vaccination are the most effective way to reduce the impact of the flu in aged care homes
  • to help prevent and stop the spread of flu in aged care, aged care providers must have a process in place. This is a requirement to comply with the Aged Care Quality Standards

Similarly, State and Territory health information emphasises the vulnerability of aged care consumers to flu, and flu like diseases, highlighting the risks of serious pneumonia, hospitalisation and death.

This means that as an aged care provider you must take precautions to prevent and control the flu and minimise infection-related risks by: 

  • identifying and complying with all relevant Commonwealth and state or territory legislation and regulatory requirements 
  • having an effective infection prevention and control program that is in line with national guidelines
  • offering free flu vaccinations every year to your staff and volunteers, and keeping records of their vaccinations.

As part of this, you must also demonstrate:

  • how you have promoted and informed your staff and volunteers about the benefits of vaccination 
  • the steps you have taken to encourage staff and volunteers to get vaccinated.

 

How do I stay up to date with visitor restrictions?

Care Facilities Directions are changed frequently, so stay up to date by regularly checking these websites:

To stay up to date with the rapidly-changing COVID-19 regulations and advice, see CompliSpace’s free COVID-19 Regulatory Changes page.

For general advice on flu vaccination entry restrictions see the Commonwealth Department of Health’s FAQs.

Mark Bryan
ABOUT THE AUTHOR | Mark Bryan
Mark is a Legal Research Consultant at CompliSpace and the editor for ACE. Mark has worked as a Legal Policy Officer for the Commonwealth Attorney-General’s Department and the NSW Department of Justice. He also spent three years as lead editor for the private sessions narratives team at the Royal Commission into Institutional Responses to Child Sexual Abuse. Mark holds a bachelor’s degree in Arts/Law from the Australian National University with First Class Honours in Law, a Graduate Diploma in Writing from UTS and a Graduate Certificate in Film Directing from the Australian Film Television and Radio School.

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