What ACE Readers had to Say: The Aged Care Quality Standards One Year On

Last week CompliSpace released the Aged Care Impact Report – One Year On. The Report revealed that the burden of adjusting to the new Aged Care Quality Standards and also coping with a once in 100-year pandemic are straining the aged care sector, putting staff retention at risk and pointing to reduced capacity to care for residents.

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Gaps in Aged Care Infection Control Plans: Follow Up to Our Webinar

On Wednesday 22 April 2020, we presented a webinar entitled “The Gaps in Infection Control Plans that Can Put Residential Aged Care Facilities at Risk.” We had over 250 attendees from 180 facilities attend the live webinar. Thank you to all those who attended, and to those who took the time to give feedback via our survey. Over 75% of survey respondents rated the webinar a 9 or 10.

The webinar recording and free resources (two COVID-19 audit tools) are now available to all Aged Care Essentials (ACE) subscribers. Simply click here to request access to the webinar and audit tools.

We received a number of questions and comments arising from the webinar. In this week's ACE article, we’ve listed the key questions and responses, along with some links to useful resources.

 

Webinar Q&A:

Immunisation Record Management

Can you tell us more about the register you demonstrated for recording vaccinations?

Recording vaccinations is not only good practice for infection control in residential aged care homes, it’s also about to become a legal requirement. As of 1 May 2020, it will be mandatory for aged care providers to keep records of information related to a person’s immunisation status, including current evidence that they have been vaccinated against the flu.

Most providers already maintain such records for their consumers and staff, but from 1 May, they will also have to obtain and record appropriate evidence of immunisation status, including flu vaccination, from visitors and other individuals seeking to enter the Home.

In the webinar we demonstrated the use of CompliCare’s assurance platform to record immunisation information. This platform includes registers for recording the details of all consumers, staff and visitors/other individuals who require entry to the Home. The registers allow you to store securely the recorded information and link to evidence of people’s vaccination status. Such evidence includes statement scans or photos of documents from a range of sources, such as the Express Plus Medicare mobile app. This minimises the paper storage you need to have, saves time related to these processes and places all the information in a central location.

Whatever register or database you maintain, it is essential that appropriate evidence of immunisation status is obtained from each individual seeking to enter the Home. Appropriate evidence may be a statement or record from a health practitioner, or an immunisation history statement from Medicare online or the Express Plus Medicare mobile app. It is the responsibility of the Provider to maintain these records to substantiate their compliance with these requirements.

Resources and references:

 

Refusal of Flu Vaccinations

How will Registered Aged Care Facilities manage the flu vaccine requirement if a resident/family member refuses to have the flu vaccination?

There are really two questions here: what happens if a resident/consumer refuses vaccination? And, what happens if a family member refuses vaccination?

All consumers have a right to make choices, including the choice to refuse vaccinations. Having said this, the Home should promote the benefits of vaccination to all consumers and explain the importance of protecting ourselves and others against influenza. Chatting with consumers one-on-one and answering their questions are key strategies in this respect.

If a consumer chooses not to be vaccinated this needs to be clearly documented. The Home also needs to assess any potential risks and prepare additional care management and infection prevention and transmission precaution strategies specifically aimed at protecting the consumer in the event of an outbreak. For this reason, information about the consumer who refuses to be vaccinated needs to be clearly recorded on the vaccination register of the Home and on the proposed infection control management plan in the Consumer’s individual care file.

The situation is very different for family members who refuse vaccination. Such individuals must not be allowed to enter the Home. Under current state and territory directions, from 1 May aged care providers are required to take all reasonable steps to ensure that a person who fails to meet the vaccination requirements does not enter the Home. The same applies to any person who fails to prove that they have met the requirements. Checking for evidence of vaccination should therefore be part of the Home’s process for screening all people who enter the Home.

It is essential that Homes communicate these upcoming requirements to consumers and their representatives, staff and potential visitors prior to 1 May.

Resources and references:

 

Structure of a COVID-19 Outbreak Management Plan

Can you provide more information about the four elements or pillars you described that should be used to develop a COVID-19 Outbreak Management Plan?

The four key elements or pillars that were described in the webinar were:

Element (1) Prevent

– Prevent Exposure

This element of the outbreak plan is about preventing the introduction of the virus into the Home. It’s also about preventing the spread of an infection to the community and other care homes once it’s been identified. This element of the Outbreak Management Plan should include a risk management plan for the Home and be carefully linked to appropriate and relevant risk control strategies.

Element (2) Prepare

 – Prepare for COVID-19 Outbreak

Preparation is a key part of any prevention strategy. It’s about identifying the risks and managing them to decrease the Home’s vulnerabilities, but it’s also about planning what to do if an outbreak does occur. Things to consider are staff training and availability, supply of resources, access to linked systems of the Home and the ongoing operation of such systems in the event of an outbreak.

Element (3) Respond – Responding to a COVID-19 Outbreak

This is about responding to a COVID-19 outbreak (or suspicion of an outbreak) and includes:

•     surveillance to ensure early identification of symptoms that may precede, or indicate early stages of an outbreak

•     identification and management of cases, including management of identified consumer needs

•     implementation and management of the Outbreak Management Plan.

Element (4) Recovery – Reviewing the Outbreak Management Plan

Ongoing monitoring and vigilance throughout this period is essential to prevent any further outbreaks and ensure the safety of consumers, staff and all stakeholders. Once you’ve declared that an outbreak is over it is time to reflect on what worked well during the outbreak and which policies, practices or procedures need to be modified to improve responses for future outbreaks.

 

Resources and references:

 

Infection Control and Prevention Training Resources

Can you provide a list of the training resources that you identified throughout the webinar?

First, we suggest that you explore the ACE publication Aged Care Guidelines: Resources List Responding to COVID-19 / Coronavirus – April 2020. This includes a section devoted to training resources.

Other training resources that you may find helpful include:

 

Can you recommend any specific training resources to support the care and services for a consumer living with Dementia?

This is a great question and identifies some key areas that need to be planned for and included in your COVID-19 Outbreak Management Plan. Recognising the needs of consumers living with dementia and the specific care and management strategies to support their health and wellbeing is essential. This includes ways to support them practising the required personal hygiene habits and social distancing requirements.

The first step in this process is workforce training, together with review of available guidelines to support and direct individual staff practices in the workplace. Where specific needs for consumers living with dementia are identified these should be documented as part of the care plan to ensure they can be implemented by all staff.

There are a range of quality and informative resources available to support the care and services for the individual consumer living with dementia. These resources cover a range of areas, including understanding and managing changed behaviours, issues that maybe experienced in an outbreak situation, and the specific and additional needs for a consumer living with dementia. Practical tips and care plan strategies can be found in the resources listed below.

Resources and references:

 

Can you tell me more about the P-LAR framework you mentioned in the webinar?

Aged Care Essentials publisher, CompliSpace, uses a proven and award-winning framework designed to achieve a culture of compliance by transforming policy to culture. P-LAR is an acronym that stands for Policy, Learning, Assurance and Reporting – the policy to culture lifecycle.

Each element of the P-LAR methodology helps our clients’ journey from policy to culture.

(P) Policy

Our framework begins with having a strong foundation of policies that we tailor to an organisation’s circumstances to support their compliance obligations. They cover the who, how, when, what and why of each policy.

(L) Learning

Our learning tools are designed to help members of the workforce understand the policies so that they can apply them in their everyday practice.

(A) Assurance

Our assurance workflow management and audit tools allow you to implement policies and monitor the outcomes being achieved. They ensure that key elements of an organisation’s policies ‘come to life’.

(R) Reporting

The Aged Care Quality Standards have a strong focus on using reported outcomes and consumer feedback to continuously improve care and services. The final part of our framework addresses this by providing high-quality reporting so that leadership can identify systemic issues and respond to feedback.

Resources and references:

 

Access the Webinar Recording and Resources

The webinar recording and free resources (two COVID-19 audit tools) are now available to all Aged Care Essentials (ACE) subscribers. Simply click the button below to request access to the webinar and audit tools:

Request the Webinar Recording

Ruth Greene
ABOUT THE AUTHOR | Ruth Greene
As a Registered Nurse with over 30 years’ experience across the healthcare industry, Ruth has been employed in a range of management and clinical positions, and for several years worked as a consultant in residential aged care. Understanding organisational governance, risk and related quality standards has been a pivotal part of her work practices and has included maintaining and monitoring of legislative and regulatory requirements, as well as developing linked policy documents. Ruth is Principal Consultant – Aged Care, at CompliSpace.

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