The Independent Review of COVID-19 Outbreaks in Australian Residential Aged Care Facilities issued its final report on 1 November 2021. The review was conducted by Professor Lyn Gilbert AO and Adjunct Professor Alan Lilly.
In it's response to the report, the Government agreed to implement all 38 recommendations made in the report, heralding another raft of changes to the way residential aged care homes are regulated.
Here are the recommendations of the report that directly affect residential aged care homes, along with a summary of the Government’s plans for implementation.
Key recommendations: after a review of the current ventilation requirements, the Department of Health (the department) should consult with the aged care sector on phasing-out shared rooms and bathrooms to reduce the risk of COVID-19 transmission.
Government action: The Government will work with the aged care sector and relevant stakeholders to develop a reformed Residential Aged Care Accommodation framework, to commence from July 2024, and will further consider these recommendations in this context.
Key recommendations: Approved Providers should ensure that sufficient staff have completed online training and monitoring in emergency management and crisis leadership, to prepare them to manage an outbreak.
Government action: It’s not clear from the Government’s response whether they intend to do anything new about this requirement or whether they are satisfied that the recommendation is addressed by existing arrangements. The response says that “Government will work with relevant stakeholders to implement” the recommendation. But it also says that this requirement is already addressed by Standard 7 of the Aged Care Quality Standards and the work of the Aged Care Quality and Safety Commission in publishing guidance and monitoring and assessing compliance.
Key recommendations:
Government action: the Government is working with states and territories to arrange more funding and support. This includes $135.9 million to implement the new Australian National Aged Care Classification model for residential aged care, to be implemented from 1 October 2022.
In regard to clinical waste, “the department is working with the Commission and the Australian Commission on Safety and Quality in Health Care to revise the Aged Care Quality Standards and associated guidance material, and will consider strengthening requirements relating to clinical waste management as part of this process.”
Key recommendations: Approved Providers should consider individual leadership coaching to support managers in acquiring additional skills to enhance leadership capacity, in both business-as-usual and emergency management
Government action: the Government is investing $30.1 million from December 2021 to support aged care providers to improve their governance arrangements and meet strengthened legislative obligations through the 2021–22 Budget. Changes include:
The department has also funded the development of an emergency management training and mentoring program.
Key recommendations:
Government action: the Government supports these recommendations but has yet to specify what it will do about them. According to the Government’s response, they will “further consider implementation options” and “the Commission and the department will work together to develop any additional or more specific measures that might be considered in the review of the Standards.”
Many of the recommendations in this section relate to the steps providers should take to facilitate visitation. The Government’s view appears to be that these recommendations are covered by the existing powers and regulatory strategies of the Aged Care Quality and Safety Commission and by the Australian Health Protection Principal Committee’s (AHPPC) statement of 1 October 2021.
In regard to several of the other recommendations, the Government has indicated that it will take some action, though it has provided scant detail:
Key recommendations: Chief Health Officer (or equivalent) public health directions for residential aged care (however titled) should give effect to the Industry Code for Visiting Residential Aged Care Homes during COVID-19 and provide site access for the Older Persons Advocacy Network.
Government action: “The Industry Code continues to be reviewed and will be further adjusted as the sector transitions to living with COVID.”
Key recommendations:
Government action: the Government is “working to see an uplift in the ability of Approved Providers to support people with special needs, including people living with dementia, consistent with the findings of the Royal Commission that both diversity and dementia should be core business in the aged care sector.”
Key recommendations:
Government action: the Government will not be making changes in regard to these requirements, noting that these recommendations are “matters for Approved Providers and state and territory Governments”.
Key recommendations: the department reviews its “restricting workforce mobility” arrangements and consults with Approved Providers, residential aged care staff and their representatives.
Government action: the Government’s response suggests that the Government believes this issue is adequately covered by existing arrangements and no changes need to be made.
Providers should anticipate that major changes to outbreak management requirements will be introduced sometime in the next few months as the industry transitions into a state of “living with COVID”. Now is a good time to ensure that you have simple, efficient training and communication systems in place so that you can inform your board, update your procedures and train your staff quickly each time new requirements are introduced.