Aged care news highlights from the week ending 16 August 2020.

The information in the Weekly Wrap is aggregated from other news sources to provide you with news that is relevant to the aged care sector across Australia and worldwide. Each paragraph is a summary of the subject matter covered in the particular news article. The information does not necessarily reflect the views of CompliSpace and Critical Success Solutions.

Coronavirus / COVID-19 News

Pandemic eroding confidence in aged care system: survey

According to Australian Ageing Agenda, more than half of Australians say their level of confidence in the aged care system has fallen since the start of COVID-19 health pandemic, a new survey has found. The National Aged Care Confidence Survey 2020 conducted by Fifth Dimension Consulting explores how confident people are in Australia’s aged care system and their intentions regarding family members who are current and future aged care recipients. The representative survey involving 1,000 Australians aged 18 years and over was conducted online between 31 July and 3 August. It found that 53 per cent of Australians have less confidence in the aged care system now than they had before the pandemic. It also found that 54 per cent of people with a loved one or friend living in residential aged care is now considering taking them out of care. Of these people, two in three are considering a temporary move, while the remaining are considering a permanent change.

Virus ‘starkly exposed’ aged care flaws

According to Aged Care Insite, coronavirus has starkly exposed flaws in Australia’s aged care system including inadequate staff training and a lack of pandemic planning, the aged care royal commission has heard. In an opening statement on Monday, counsel assisting the commission Peter Rozen described the global pandemic as the greatest challenge facing the sector. “It is hardly surprising that the aged care sector has struggled to respond to COVID-19,” he said. Rozen said evidence would reveal neither the Commonwealth Department of Health nor the aged care regulator developed a COVID-19 sector-specific plan. This was despite federal Health Minister Greg Hunt saying in late July aged care was “immensely prepared”, he added.

Aged care death rate among highest in the world, government had no plan for sector, royal commission told

According to Aged Care Insite, the aged care royal commission has heard evidence that the government had no COVID-19 plan for the aged care sector, leading to one of the highest aged care death rates in the world. In his opening remarks on Monday, counsel assisting Peter Rozen told the commission that 68 per cent of all deaths due to COVID-19 in Australia have occurred in aged care. “Over 1000 residents have been diagnosed with COVID-19. Of these people, 168 have died; grandparents, parents, siblings and friends, a human tragedy,” Rozen said. “This makes Australia the country with one of the highest rates in the world of residential aged care deaths as a proportion of deaths from COVID-19.”

Rozen took time to praise the bravery shown by aged care workers who have worked in poor conditions during the pandemic but also criticised the system which has led to the current crisis. “As much as we have been distressed by these stories of human suffering, we have been impressed by the stories of the care workers who have worked in unimaginable conditions to provide these residents with the care they need.”

Ten new aged care deaths, Victoria records deadliest day yet

According to Aged Care Insite, Victoria has announced 19 deaths due to COVID-19 today, and 322 new cases of the virus on the state’s deadliest day of the pandemic. The new figures, officially released ahead of the Premier’s press conference for the first time, eclipses the previous record death toll of 17, which was reached on Sunday. Ten of those deaths were connected to aged-care outbreaks, taking the death toll of aged care residents to 172 in Victoria and 203 nationwide.

SA Premier announces new restrictions in aged care to stop coronavirus spread

According to 9News, South Australian Premier Steven Marshall has announced changes to the state's aged care procedures in response to Australia's ongoing outbreak of COVID-19. Two major changes will be made to ensure the state continues its "unblemished record" as no new coronavirus cases are recorded for the sixth day in a row. As of two weeks today, from 27 August, all personal care workers will not be permitted to work at more than one residential aged care facility," Mr Marshall said. "All doctors, nurses, allied health workers will be required to wear PPE when they come within 1.5 metres of a resident." Compulsory PPE will include facemasks and gloves the Premier said. There have been zero cases of infection or fatality at residential aged care facilities in South Australia.

COVID fears could boost demand for community care

According to Australian Ageing Agenda, a COVID-driven backlash against residential care could contribute to increased demand for community-based care in coming years, a dementia symposium has heard. John Pollaers, the former chair of the aged care workforce strategy taskforce, predicted the provision of community care will be the most important question for aged care over the next five years. “We’ve got about 300,000 people in residential care and 1.3 million at home needing home support and those numbers will grow to about 3 million by 2050,” Professor Pollaers said in a keynote address to the Dementia Australia National Symposium Series on Tuesday. “We’ve got to start to develop community capability and we need to start to engage the whole health system and the government around how to support the more serious support needs within the community … for me it’s the most important question of the next five years.”

Revised CDNA and PHLN guidelines for release from isolation

(Note: this excerpt is from the Department of Health newsletter. We cannot provide a link to the full version of this story until the Department of Health uploads it to their website.)

According to The Department of Health, CDNA and PHLN have revised their advice on the release from isolation of persons who have had COVID-19. This includes people who live or are returning to work in settings considered high-risk for outbreaks. These settings include hospitals, aged care facilities, remote mining sites, and other residential communities. The revised criteria can be read here.

Counselling for Victorian aged care workers

(Note: this excerpt is from the Department of Health newsletter. We cannot provide a link to the full version of this story until the Department of Health uploads it to their website.)

According to The Department of Health, the Federal Government, industry, peak bodies and unions are working together to help reduce the spread of COVID-19 infections in residential aged care facilities. On Monday 27 July 2020, industry released The Guiding Principles for residential aged care - keeping Victorian residents and workers safe (the Principles) with the support of Government, peak bodies and unions.

Support is available to aged care workers whose regular working arrangements have changed as a result of the Principles. These workers can get free counselling services from Converge International.

Converge International will deliver up to five free counselling sessions per person. Services include employee and manager support, career guidance, financial counselling and family support. These services are available for a three month period to 10 November 2020. Phone 1800 697 327 (free call) or visit www.convergeinternational.com.au to book an appointment. Make sure you state that you are from the "VIC Residential Aged Care Workforce" when booking. In addition, a Support Hub is available for Victorian aged care providers using the Principles. The Guiding Principles Support Hub by ACSA and LASA is available by phoning 1800 491 793 (free call).

Letter to Victorian residential aged care providers from the Victorian Aged Care Response Centre

(Note: this excerpt is from the Department of Health newsletter. We cannot provide a link to the full version of this story until the Department of Health uploads it to their website.)

According to The Department of Health, on Friday 7 August, the Victorian Aged Care Response Centre (VACRC) wrote to residential aged care providers in Victoria requesting notification in the event of a suspected case of COVID-19. The letter provided information regarding the notification process of a suspected case of COVID-19 in an aged care facility, which does not already have a confirmed case of COVID-19. Facilities are required to email their notification to VACRC.COVID19Notifications@health.gov.au and include the text SUSPECTED COVID19 CASE REPORTING in the subject heading.

In the body of the email, include the following:

• your Residential Aged Care ID number
• de-identified information on how many suspected cases you have
• a mobile phone number contact for your facility for the purposes of VACRC being able to make contact to follow up this notification.

For queries or to report a case call 0413 399 020 9am to 7pm, seven days a week. Please note that in the event this is a positive test, then please follow the usual process for notifying this to the Department of Health including emailing agedcareCOVIDcases@health.gov.au.

Free face-to-face PPE training in Victoria

(Note: this excerpt is from the Department of Health newsletter. We cannot provide a link to the full version of this story until the Department of Health uploads it to their website.)

According to The Department of Health, free face-to-face infection control training is now available for people working in residential aged care facilities in Victoria. This new training program announced by the Minister for Aged Care and Senior Australians Richard Colbeck, builds upon the online training program released by the Commonwealth Government earlier in the year. This free training is being delivered by Monash University, in partnership with the Victorian government.

Bookings are welcomed from all residential aged care facilities across Victoria without any current cases of coronavirus (COVID-19) among their staff and residents. Please fill in the booking request form or contact PPE.Project@monash.edu for more information.

The Commonwealth Department of Health has also developed online training for care workers across all health care settings, including aged care. This training covers the fundamentals of infection prevention and control for coronavirus (COVID-19).

Use of face shields and goggles in residential aged care facilities

(Note: this excerpt is from the Department of Health newsletter. We cannot provide a link to the full version of this story until the Department of Health uploads it to their website.)

According to The Department of Health, in residential aged care facilities, face shields or other protective eyewear (such as goggles) should be worn for the routine care of suspected, probable or confirmed cases of COVID-19. Guidance on the use of Personal Protective Equipment (PPE) in areas with significant community transmission is available on the Department's website. The risk of COVID-19 from transmission via the eye is unknown. However, as the predominant mode of transmission is via droplets, eye (and conjunctival) protection should be worn until further evidence emerges.

In geographical areas with significant community transmission, face shields should be worn by all staff working in residential aged care facilities (in addition to other PPE, including a surgical mask or particulate filter respirator). This includes support staff who do not have patient contact. This is due to the high risk or transmission in residential care facilities and the vulnerability of residents to infection.

Use of P2/N95 Respirators in Victoria

(Note: this excerpt is from the Department of Health newsletter. We cannot provide a link to the full version of this story until the Department of Health uploads it to their website.)

According to The Department of Health, Due to an increased risk of transmission of COVID-19, the Victorian PPE Taskforce has updated its advice for all healthcare workers  in Victoria. The Victorian government has issued guidance on the use of P2/N95 respirators. Health care workers must wear a N95/P2 respirator:

• in settings where suspected or confirmed coronavirus (COVID-19) patients are cohorted and where frequent, prolonged episodes of care are provided (i.e. providing care for a patient on a dedicated COVID-19 ward).
• in uncontrolled settings where suspected or confirmed coronavirus (COVID-19) patients are cohorted, to avoid the need for frequent changes of N95/P2 respirators.
• where suspected or confirmed coronavirus (COVID-19) patients are cohorted and there is risk of unplanned aerosol generating procedures (AGPs) and/or aerosol generating behaviours.
• when undertaking an AGP on suspected or confirmed coronavirus (COVID-19) patient.

Victorian Permitted Worker Scheme

(Note: this excerpt is from the Department of Health newsletter. We cannot provide a link to the full version of this story until the Department of Health uploads it to their website.)

According to The Department of Health, under Stage 4 restrictions, employers that require their staff to attend a work site must issue a worker permit to their employees. The Victorian Department of Health and Human Services has provided the following advice:

• Workers in aged care and disability need a permit. 
• A registered nurse who primarily works for a non-government provider of aged care or disability will also need a permit to work in those settings. 
• A hospital or health worker who is exempt from needing to obtain and carry a permit will retain that exemption if they are seconded to work temporarily in a non-government aged care setting. (with photo ID etc). This exemption extends to AUSMAT teams.

More about the Victorian Permitted Worker Scheme COVID-19 can be found here.

Updated Restrictions and advice from NSW

(Note: this excerpt is from the Department of Health newsletter. We cannot provide a link to the full version of this story until the Department of Health uploads it to their website.)

According to The Department of Health, The NSW Chief Health Officer has released new advice to aged care providers. As part of preparedness planning, aged care providers should put in place arrangements to limit staff working across facilities. Where ceasing staff movement across facilities is not practicable, staff movement should be minimised and additional measures should be put in place, such as maintaining records of staff and work locations and increasing use of PPE. The local government area of Hornsby Shire and Hills District, has also been added to the list of regions required to implement the following measures:

• Any visitors to any residential aged care facility who have been in the following local government areas in the previous 14 days should be excluded from the facility: Hornsby Shire, Hills District, Newcastle, Merrylands (suburb), Guildford (suburb), Canterbury-Bankstown (Bankstown part), Waverley, Woollahra, eastern part of City of Sydney (Sydney, Surry Hills, Darlinghurst, Woolloomooloo, Potts Point, Rushcutters Bay, Elizabeth Bay, Centennial Park. Removed: Eveleigh, Alexandria, Beaconsfield, Rosebery and Eastlakes), Parramatta, Fairfield, Liverpool, Campbelltown and Camden.
• All aged care staff who reside in the above local government areas or a NSW/VIC border community must wear a surgical mask while in the facility.
• Staff and visitors who have visited any of the locations on the same date as a COVID-19 case (see updated list of venues and dates) should be excluded for a period of 14 days since their visit to the listed location.
• All residential aged care staff who work in residential aged care facilities located within the above LGAs and in communities along the NSW/VIC border must wear a surgical mask while in the facility.
• Residential aged care facilities in the above local government areas should not allow any visitors (visitors performing essential caring functions may be allowed but must wear a mask). In exceptional circumstances, seek advice from your local NSW Health public health unit on 1300 066 055.

Home Care Service Providers who either live or work in any of these designated local government areas must also wear face masks while providing services.

In NSW/VIC border communities, only visitors from NSW are permitted providing:

• The facility must obtain name and contact detail of visitors (in case there is a need for contact tracing)
• The visitor is checked against the above questions
• The temperature of the visitor is checked to be below 37.5 degrees Celsius
• The visitor is escorted directly to the room (single room) of their loved one, and must remain within the room for the duration of the visit. At the completion of the visit, the visitor is to be escorted directly back to the reception area
• A surgical mask is to be worn at all times
• Hand hygiene is facilitated
• Visits are restricted to once/day for each person
• A maximum of two visitors at a time; children are to be closely supervised.

Measures such as phone or video calls should be made available to all residents to enable continuation of communication with family, friends or others who are not allowed to enter the facility at this time. Read the latest NSW advice for residential aged care providers and home care service providers.

Hospitalising residents with COVID under spotlight

According to Australian Ageing Agenda, aged care provider peaks have called for all states and territories to commit to transferring COVID-positive residents to hospital as Queensland becomes the second state to do so. The news comes as the aged care royal commission this week heard about the reluctance of health authorities in New South Wales to hospitalise COVID-19 positive residents from Anglicare’s Newmarch House during an outbreak that started in April this year and resulted in 19 deaths. Following South Australia’s lead, state health department Queensland Health has confirmed to the aged care sector that COVID-positive residents from aged care facilities in Queensland will be treated in hospital. Only in extremely rare individual situations will Queensland Health look at managing residents in their own room such as late stage end of life, according to advice from Queensland Chief Health Officer Dr Jeannette Young seen by Australian Ageing Agenda.

Should COVID-positive aged care residents be transferred to hospital?

According to Aged Care Insite, aged care providers are equipped to deal with the flu and gastro, not unprecedented worldwide pandemics. That’s why Aged and Community Services Australia (ACSA) chief executive Patricia Sparrow believes all residents who test positive for COVID-19 should be transferred to hospital. “Immediate transfer to hospital of the first people in residential care diagnosed with COVID is the best possible protection measure against the terrible tragedy we are seeing unfold in Victoria,” Sparrow said.

Other News

Uniting workers to be back-paid $3.3m

According to Aged Care Insite, more than 9500 aged care and disability support workers will be back-paid $3.3 million after one of NSW’s biggest providers admitted underpaying them over seven years. The Uniting Church in Australia Property Trust (NSW), which runs more than 70 aged care facilities in NSW and the ACT, discovered the underpayments after complaints from employees. The registered charity then self-reported to the Fair Work Ombudsman. The organisation made errors in providing laundry, uniform and vehicle allowances, and did not provide an extra week of annual leave each year to shift workers entitled to it. Uniting is back-paying 9561 workers a total of $3.36 million, including interest, for underpayments between 2013 and 2019. Individual payments range from less than $1 to more than $11,000.

Legislation

No significant developments this week.

Resources and Upcoming Events

LASA National Congress – online 12-23 October 2020

According to Australian Ageing Agenda, designed for any member of our industry – from managers to carers – this vital professional development opportunity will provide you with a full schedule of quality sessions.

New Aged Care Quality and Safety Commission Resources – issued June 2020

The ACQSC has issued the following resources:

Aged Care Quality and Safety Commission Glossary: The Commission has produced a glossary of common terms to aid understanding of the aged care services sector. The list is not intended to be exhaustive and is provided as general information only.

Common questions you may want to ask residential aged care services about COVID-19: You, your friends and family have a right to know how your residential aged care service is responding to the COVID-19 pandemic. We have developed some common questions that you can ask your service provider during this time.

Service Compliance Ratings Fact Sheet: The Department of Health, in partnership with the Aged Care Quality and Safety Commission (the Commission), is introducing a service compliance rating system for residential aged care services. The rating system was developed in consultation with stakeholders, including senior Australians, their caregivers, aged care providers, and a range of peak bodies.

Flu vaccination poster

The Department of Health has issued this Flu Vaccination Poster. Residential aged care facilities may wish to display the attached poster at entrances, to alert anyone entering the facility of the flu vaccination requirements that came into effect on 1 May 2020.

Older Person’s COVID-19 Support Line

According to The Department of Health, a new Older Person’s COVID-19 Support Line has been set up to provide information, support and check on older Australians during the period of social distancing measures in response to the COVID-19 pandemic. COTA Australia, National Seniors, Dementia Australia and the Older Person’s Advocacy Network have banded together to deliver this service with support from the Australian Government.

Senior Australians, their families and carers can freecall 1800 171 866 if they:

• would like to talk with someone about what COVID-19 means for them or a loved one
• are feeling lonely or distressed
• are caring for a someone and need some information or a listening ear about what COVID-19 means for your circumstances
• are worried about COVID-19 means for their usual aged care service
• are worried about a friend or family member living with dementia.
• are unable to access information on the internet and would like up-to-date advice.

Home care services providers can also use the number and dial option 1 to refer home care clients who would like a call from an independent organisation to check on their wellbeing.

The service will include outbound and inbound calls to provide contact, reassurance and practical advice on connecting to services to maximise social engagement and wellbeing whilst at home.

Resources on diverse population groups are now available for aged care staff

According to The Department of Health, The End of Life Directions for Aged Care (ELDAC) website helps you to care for older Australians at the end of life. Our new diversity resources can help health workers and aged care staff to care for:

• Aboriginal and Torres Strait Islander peoples
• Care leavers
• Carers
• Culturally and linguistically diverse people
• Financially or socially disadvantaged people
• People experiencing homelessness
• Lesbian, gay, bisexual, transgender and intersex people
• People living in rural and remote areas
• People with spirituality and faith beliefs
• Veterans

How people think about death, dying and end of life is different for each person. Learning about these differences can help you to provide good palliative care. Access these resources on the Diverse Population Groups page of the ELDAC website.

Calculating residential accommodation payments in a leap year

This year is a leap year, with 366 days instead of 365. The Department of Health has received queries from approved providers of residential care seeking advice on how to calculate a daily accommodation payment (DAP) in a leap year. The calculators specified in the Fees and Payments Principles 2014 (No. 2) (the Principles) refer to 365 days for working out:

• the DAP (or contribution) equivalent to a refundable accommodation deposit (RAD) (or contribution)
• the amount of interest on a RAD (or contribution) balance or accommodation bond balance.

Even though 2020 is a leap year, residential care providers should continue to use 365 days when calculating DAP amounts and the interest payable on refunds of lump sum deposits. But please be aware that daily payments and daily contributions are payable for 366 days in 2020.

What Matters Most – New person centred care resources

According to The Department of Health, Palliative Care Australia, through a Dementia and Aged Care Services Fund grant, has launched a suite of resources to encourage early conversations about What Matters Most to older people, their care and their end of life preferences.

6 steps for safe prescribing antipsychotics and benzodiazepines in residential aged care

Issued by the Department of Health, this infographic outlines the 6 steps for safe prescribing antipsychotics and benzodiazepines in residential aged care.

Aged care video alert: Dignity of risk

According to Lexology, the concept of dignity of risk is not entirely new, however it now has a position of prominence in aged care with the Aged Care Quality Standards. In this video update, senior associate Dr Melanie Tan explains:

• What does dignity of risk mean?
• Where and when does dignity of risk apply?
• What is the duty of care within dignity of risk?