The Industry Code for Visiting Residential Aged Care Homes During COVID 19 (‘The Code’) came into effect on 13 May 2020 and was reviewed and updated on 3 July 2020. The Code is designed to create a uniform approach to receiving visitors across the aged care industry. It provides guidance on how aged care homes can take a proportionate approach to keeping residents safe against COVID-19.

In a previous article we summarised why this has happened and what it means for your aged care home. Today we are updating that article to take account of the updates made to the Code on 3 July 2020.

What Changed in the 3 July Updates?

The Code was updated to reflect that:

• “spouses or other close relatives or social supports” are not limited in the number of hours they spend with relatives
• children under 16 are once again able to visit aged care homes
• all visitors must be vaccinated against influenza
• all visitors should practice social distancing
• staff are required to screen visitors, educate visitors about social distancing and hygiene during their visit, but not supervise visits
• visits should occur in a resident’s room, outdoors or in a designated visiting area – but not in communal areas
• there is a maximum of two visitors per resident at any one time
• residents are able to leave to attend small family gatherings (with providers undertaking a risk assessment prior to the outing and a screening process post)
• in the event of an outbreak of COVID-19 in the home or a local cluster in the community – increased restrictions, including supervised visits and suspension of external excursions may be reintroduced.

How was the Code Developed and Why?

The Code was developed after mounting pressure from the Commonwealth Government for aged care homes to ease visitation restrictions that go beyond baseline recommendations.

Despite health care directives allowing a maximum of two visitors per resident, some homes implemented more severe restrictions. Some considered such restrictions a necessary precaution to protect the group that is the most vulnerable to COVID-19, with the majority of deaths occurring in people aged 60 and above. Others, including the Commonwealth Government, did not agree, having concerns about the impact of social isolation on residents.

In response to threatened government intervention, the Code was developed by a group of aged care peak bodies and consumer advocacy organisations. A number of aged care providers, including church-based providers and not-for-profits, were part of the development process, which also took into account input from consumers, their families, friends and representatives and aged care providers and staff during a webinar held on 7 May 2020.

Am I Legally Required to Follow the Code?

No. The Code is not a law. It was not issued by government or the Aged Care Quality and Safety Commission; it was issued by organisations within the industry and is described as “an agreed industry approach.”

However, much of what is in the Code overlaps with existing laws and registration requirements, so that if you breach the Code you are probably breaching your legal requirements as well.

When Does the Code Apply?

The Code commenced on 13 May 2020. The Code says, “This industry code will be adopted during the period of COVID-19, after which usual practices will return.”

The Code is flexible and acknowledges that some of its principles will not apply in the event of an outbreak, when providers will have to bring in stricter controls.

Who is Covered by the Code?

The Code applies to residential aged providers, residents and visitors.

What’s in the Code?

The Code contains 14 principles and outlines the rights and responsibilities of providers, residents, and visitors. It also provides a Complaints Process to address any issue arising from the Code.

Providers have flexibility as to how the Code is implemented, but should adhere to the Code’s core principle, which is to facilitate connections between residents and their families, families of choice or friends during the COVID-19 pandemic, whilst minimising the risk of an infection being introduced to the home or an outbreak occurring in the home.  

Summary of the Principles

• Providers must continue to adhere to their other legislative obligations, including the Aged Care Act and its related principles, including the Aged Care Quality Standards, and state/territory health directives. This means continuing person-centred care and prioritising the wishes and preferences of residents and adhering to infection prevention and control guidelines.

• Providers have flexibility regarding the conditions of visitation they use to minimise the risk of the introduction COVID-19 into the home. Such conditions might include:
  • utilising “additional ways” of connecting residents with their loved ones, such as video conferencing and telephone calls
  • restricting the total number of visitors at any given time
  • setting up a “booking system” for shorter visits.

• Residents can continue to:
  • receive deliveries, including non-perishable food, letters and communication devices. Perishable foods are also permitted as long as they meet food handling/safety guidelines
  • use public spaces within the home, including outdoor spaces, provided social distancing is practised and there is no COVID-19 outbreak within the home
  • have the right to access medical and related services, including outside the home provided infection prevention and control measures, that are proportionate, reasonable and risk-based, are followed.

• Providers will vary their own response to COVID-19 as risks change within their local community.

“Shorter Visits” vs “Longer Visits”

Shorter Visits can be between 30 mins (minimum visitation time advised by the Code) and two hours (maximum time allowed by State/Territory health directives).

Principle 7 provides conditions under which Longer Visits can occur, which includes visiting a resident who is palliative or approaching the end of life.

Other Providers’ Responsibilities

• Support staff to facilitate visits, whether face-to-face or via alternative means
• Support residents to maintain contact with the local community outside the home, which might include cultural or religious gatherings held online, or over the phone
• Comply with consumers’ legal wishes, including advanced care plans and directives, Power of Attorney decisions etc
• Uphold residents’ and visitors’ rights to receive timely and regular updates
• Uphold the right of residents to transfer to alternative accommodation if required by public health directives, or on the resident’s wishes, or in accordance with assessed support needs (e.g. palliative care)
• Ensure all staff are vaccinated under the State/Territory directives
• Only refuse entry to the home if the reason for refusal is consistent with the Code
• Increase visitor restrictions proportionately to the current health requirements and environment, which includes the occurrence of an outbreak within the home, or if an outbreak is declared or clusters have occurred within the home’s community. The Code makes it clear that any restrictions that go beyond the baseline will be closely monitored

Resident and Visitor Responsibilities

• Not visit the home if they are unwell or displaying any cold/flu or COVID-19 symptoms
• Respond truthfully to COVID-19 screening questions asked by the home’s staff
• Follow the home’s visitation requirements including:
  • adhering to the home’s booking system
  • meeting vaccination requirements and providing up to date evidence of vaccination
  • practising social distancing requirements
  • practising hand hygiene and cough/sneeze etiquette

Note that although these points are listed in the Code under “Residents and Visitors Responsibilities”, most of them apply only to visitors.

What Next?

Aged care homes are not legally required to comply with the Code. However, the Commonwealth Government has threatened intervention if it doesn’t see changes within the industry with respect to receiving visitors. This could result in the Code, in whole or part, becoming a legal requirement.

Much will depend on the number of coronavirus cases in and around aged care homes. If cases increase (as they did in Victoria and New South Wales in July), concerns about health and safety will trump concerns about visitor access, and the Government, media and community will probably be more likely to accept tighter visitor controls in aged care homes and less likely to impose the Code as a legal requirement.