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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Weekly Wrap: 17 May 2020

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Weekly Wrap: 17 May 2020

Aged care news highlights from the week ending 17 May 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

Aged care visitor code launched

According to Australian Ageing Agenda, a group of 13 provider peak bodies and consumer advocacy organisations have released a co-developed industry code outlining provider and visitor rights and responsibilities for aged facilities during the coronavirus pandemic. The ‘Industry Code for Visiting Residential Aged Care Homes during COVID-19’ creates a nationally consistent approach that ensures residents can receive visitors while minimising the risk of spreading COVID-19. It includes the providers’ responsibility to facilitate safe in-person visits and connections in other ways between residents and their loved ones, including using technology, windows and balconies. It also highlights that providers will increase communication when they need to limit the number of in-person visits or replace them with other ways to connect in order to minimise the introduction of the virus into a facility.

 

Visitor survey backs up sector’s COVID-19 strategy: peak

According to Aged Care Insite, aged care providers remain steadfast in their belief that visitor restrictions are supported by those in the sector and the wider community, and have released more research to back it up. Leading Age Services Australia (LASA) yesterday said its national survey of members showed the vast majority of staff, and residents and their loved ones, approve of restrictions on visits. The survey centred on residential care and canvassed the opinions of more than 860 participants. It revealed that 90 per cent of family and friends, and 82 per cent of residents, agreed or strongly agreed with the restrictions imposed on visits to protect residents from COVID-19.

 

Govt to pay providers for residents’ leave during COVID

According to Australian Ageing Agenda, the Federal Government will pay for aged care residents to take extended leave because of a public crisis so neither residents nor providers are financially disadvantaged. Minister for Aged Care Richard Colbeck announced amendments to aged care legislation passed on Thursday to allow aged care residents to access emergency leave during volatile situations including natural disasters and health epidemics. Permanent residents are entitled to 52 days of social leave away from their aged care home for non-hospital related reasons, after which the Government stops paying the subsidy to facilities who in turn usually pass the cost on to the residents. The emergency leave mechanism aims to avoid residents being penalised or disadvantaged for moving out of a facility during a crisis.

 

Union demands paid COVID leave

According to Australian Ageing Agenda, The United Workers Union is campaigning for aged care workers to be paid for leave they need take because of concerns related to coronavirus. The #FundMyLeave campaign launched last Friday wants the Federal Government and employers to commit to two weeks paid COVID-19 leave for aged care staff. The special leave aims to allow staff to stay home without fear of losing income if they or a family member is experiencing any symptoms related to coronavirus.

 

Investigation into impact of COVID-19 on aged care

​​According to the Royal Commission into Aged Care Quality and Safety, on 28 April 2020, the Commissioners made a general request for submissions from aged care providers, people who received aged care services, and their families about the impact on the aged care sector of the coronavirus (COVID-19). The Commissioners thank those who have made submissions to date and continue to encourage others to make submissions. As part of their ongoing inquiry into the quality and safety of aged care services in Australia the Commissioners will inquire into certain issues arising from the responses to COVID-19.

 

Minimising the use of restraints - resources

The Aged Care Quality and Safety Commission has issued a range of resources related to minimising the use of restraints in aged care.

 

Further Translated Coronavirus (COVID-19) Resources

According to The Department of Health, further aged care resources including an in home care fact sheet have been made available in languages other than English.

 

Inside the Newmarch cluster

According to 7am podcast, an aged care facility in NSW is the site of one of Australia’s biggest clusters of Covid-19. Now, with 16 dead, the centre’s owners have been threatened with sanctions and the loss of their licence. Today, Rick Morton on what went wrong at Newmarch House.

 

Prevention and communication the priorities, providers told

According to Australian Ageing Agenda, residential aged care providers need to focus on preventative measures including hand hygiene, staff training and leadership to reduce the risk of coronavirus entering aged care facilities, says Australia’s chief nurse. The Department of Health held a webinar for residential aged care providers and staff on COVID-19 preparedness and prevention on Friday afternoon. The webinar discussion covered preparing for an outbreak, a suspected or confirmed outbreak and the expectations of the aged care quality regulator. Australia’s chief nurse and midwifery officer Alison McMillan said prevention was the most important strategy for aged care providers need to focus on.

 

Bupa hit with $6 million penalty by ACCC over ‘extra services’ charged to residents after voluntarily reporting issue – how will it impact on their bottom line?

According to The Source, Bupa will pay out $18.3 million to repay residents and families plus $6 million in penalties after reaching a settlement with the Australian Competition and Consumer Commission (ACCC) over non-clinical ‘extra services’ provided to residents in 20 of its 72 aged care homes. An internal review in 2018 of the extra ‘hotel-type’ services being offered to residents – such as gardens or rooms for those living with dementia, separate buildings for leisure activities and individual heating and cooling system – had found that some had not been provided. Bupa voluntarily reported the issue to the ACCC and other regulators and began a remediation program – with around 85% of the affected residents paid back with interest since July 2018 or in the process of receiving final payments. Bupa will also be required to implement an Australian Consumer Law compliance program.

 

80 percent of nurses reported no increase in staffing to prepare for COVID-19

According to Aged Care Guide, peak body for nurses, midwives and carers, the Australian Nursing and Midwifery Federation (ANMF), released their national Aged Care COVID-19 Survey revealing that 80 percent of participants experienced no increase in care staff to prepare for a potential COVID-19 outbreak. Federal Secretary of the ANMF, Annie Butler, believes Australia managed the overall pandemic well across States and Territories, however, the organisation still has concerns around how the aged care sector prepared for dealing with a potential coronavirus outbreak. "Our concern is due both to the chronic understaffing and widespread lack of skills in the sector, so clearly identified by the Aged Care Royal Commission and the increasingly well-known risks for older people from COVID-19," says Ms Butler.

 

Tasmania tests out stricter aged care visits for two weeks

According to The Examiner, Tasmania's aged care visitor restrictions were eased on Monday but the state's regulations will remain stricter than advised by the National Cabinet for another two weeks. The National Cabinet advised limiting visits to a maximum of two visitors, at one time, per day. However in Tasmania residents are only allowed a visit once a week until May 25. The state's largest not-for-profit aged care provider Southern Cross Care has implemented the Tasmanian government's regulations.

 

My Aged Care case management team working with providers

According to Community Care Review, the government has established a special My Aged Care case management team to link the most vulnerable older people to providers during COVID-19. The health department’s channel management director Catherine Burkitt told a webinar on Wednesday the team was established in response to the pandemic to help clients with complex needs or lack of family support who are struggling to get the help they need. “The team makes sure they fully understand the client’s needs,” she told an OPAN webinar on navigating aged care services during COVID.

 

How will you handle temporary closure?

According to AJP, the Victorian Pharmacy Authority has issued advice for pharmacies around planning for temporary closures due to COVID-19. “As part of contingency planning for the temporary closure of a pharmacy due to COVID-19, licensees are encouraged to prepare for and address a range of consumer expectations,” says the VPA in offering general advice. As restrictions imposed to manage the progression of the pandemic began to relax around the country, stakeholders continue to warn that outbreaks can and will occur, underlining the importance of keeping up measures to contain them. “Cases appear in mandatory quarantine. So we can’t pledge that, while there’s an international situation, that there will be zero cases in Australia,” Health Minister Greg Hunt told Sky News’ Kieran Gilbert on Sunday. “But there can be outbreaks, and they’re the things we’re focused on, being ready to jump on an outbreak, wherever it is in Australia.”

 

Security of Tenure During COVID-19

(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, security of tenure for residents within an aged care facility differs during COVID-19. If there is an instance of confirmed COVID-19 or suspected cases of COVID-19 in an aged care home, or where a resident wishes to return to an aged care home while suffering from or suspected to be suffering from COVID-19, there may be a need to temporarily move a resident to another room within a facility, or in some circumstances to a different care location. If a resident needs to be moved, this move should be made on a temporary basis in consultation with the resident and their family, and preferably with the resident’s agreement. In situations, however, where an aged care facility wanted to permanently move a resident to a new room or out of the facility, then normal security of tenure arrangements apply during the COVID-19 pandemic.

 

Rapid virus response for SA nursing homes

According to Aged Care Insite, a rapid response team has been established to deal with any COVID-19 infections in South Australian nursing homes, as health authorities warn against complacency in the fight against the virus. The dedicated SA Pathology team has been assembled to provide greater protection for some of the state’s most vulnerable citizens. If an outbreak occurs, the team will immediately test everyone in the facility, helping to quickly identify cases, limit the spread and protect both residents and staff.

 

Medication Reviews Expanded

According to AJP, the government has announced changes to HMRs and RMMRs including added follow-ups and broader referral pathways. From Tuesday, accredited pharmacists will be allowed two additional follow-ups for Home Medicines Reviews (HMRs) and Residential Medication Management Reviews (RMMRs) with patients within nine months of the initial review, the PSA and Federal Government have announced. Accredited pharmacists were previously allowed just one review per patient every 24 months. The move is another win for pharmacists, following closely behind the announcement that pharmacists will be able to provide medication reviews via telehealth – a measure that was passed in response to the COVID-19 pandemic.

 

Working Towards a COVIDSafe Australia

(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, Australians aged 70 years or older, 65 years or older with chronic health problems, Indigenous Australians 50 years or older or with chronic health problems and people with compromised (weakened) immune systems will continue to be encouraged to stay at home where possible, as governments across Australia move forward with a new 3-step COVIDSafe plan. National Cabinet announced its 3-step plan on Friday 8 May. The plan provides a pathway for states and territories to move toward COVIDSafe communities in a way that suits their circumstances. States and territories will be able to move between the steps on the pathway at different times, in line with their public health situation and local conditions. They’ll need to maintain steady case numbers and be able to rapidly contain any outbreaks. Vulnerable people should continue to stay home where possible.

 

Vicarious trauma: a warning to healthcare workers

According to Hospital and Healthcare, healthcare workers battling on the COVID-19 frontline are being advised to keep tabs on their mental health, after a Manhattan-based ER doctor tragically lost her life to suicide last week. Dr Lorna Breen, aged 49, had no history of mental illness, according to her family, but was described as “detached” in the weeks leading up to her death. She had also opened up to her father about the “onslaught” of dying patients being brought to her by ambulances. Dr Cathy Kezelman, President of the Blue Knot Foundation, believes Breen, like many others in her profession, may have been suffering cumulative trauma (CT) as well as “vicarious” (secondary) trauma (VT) — the impact of working with traumatised people, distressing material or stories. Kezelman said it is important that healthcare workers keep a close eye on the early warning signs of these conditions.

 

Other News

No other news today.

 

Legislation

Aged Care Legislation Amendment (Emergency Leave) Act 2020 (Cth) – commenced 15.05.20

An Act to introduce a new type of leave that will enable approved providers to remain eligible for residential care subsidy in declared emergency situations. The Act will ensure that approved providers cannot decide to charge aged care residents a fee during a declared emergency in order to reserve their place in an aged care service. These emergency situations may include natural disasters, pandemics or other large-scale emergencies that may impact the safe provision of residential aged care and the safety of the resident. The amendments will allow aged care recipients to take leave from their residential aged care service during an emergency without having to pay any additional fees in order to maintain their place in a facility.

 

Anti-Discrimination Amendment (Religious Freedoms and Equality) Bill 2020 (NSW) – Bill introduced 13.05.20

A Private Member's Bill for an Act to amend the Anti-Discrimination Act 1977 to make discrimination on the ground of a person’s religious beliefs or activities unlawful; and for related purposes.

 

Pharmacist Supply on a Digital Image (PHEO #4 as Amended) (Vic) – commenced 11.05.20

The purpose of this Order is:

(1) to facilitate a registered medical practitioner, nurse practitioner, dentist, authorised midwife, authorised optometrist or authorised podiatrist (practitioner) to obtain and possess, use, sell or supply a Schedule 4 poison (other than a drug of dependence) for a patient who in the opinion of the practitioner is at risk of the COVID-19 virus;

(2) to enable pharmacists in Victoria to sell or supply a Schedule 4 poison (other than a drug of dependence) on an electronically transmitted digital image of an original prescription transmitted directly to the pharmacist from a practitioner;

(3) to amend PHEO #4 to clarify the requirement for the provision of the practitioner’s digital handwritten signature on an original prescription transmitted by digital image to a pharmacist and to clarify the process for pharmacists to retain a repeat authorisation form where repeat supply is authorised on a prescription.

 

Justice Legislation (COVID-19 Emergency Response—Wills and Enduring Documents) Regulation 2020 (No. 72 of 2020) (QLD) – commenced 15.05.20

The policy objectives of the Justice Legislation (COVID-19 Emergency Response–Wills and Enduring Documents) Regulation 2020 (the Regulation) is to prescribe modified requirements or arrangements, which will apply in addition to existing requirements, for the making, signing and witnessing of wills under the Succession Act 1981 (Succession Act) and enduring documents under the Powers of Attorney Act 1998 (POA) in reliance on section 9 of the COVID-19 Response Act 2020 (COVID-19 Response Act).

 

Resources and Upcoming Events

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.

 

2nd Governance in Aged Care Conference – 20-21 May 2020, Doltone House Hyde Park Sydney (Live Stream Online)

According to Criterion Conferences, the 2nd Governance in Aged Care conference has been developed in partnership with COTA Australia and ACSA to support you to effectively lead and govern your aged care service into the future. You will walk away with a deeper understanding of what good governance structures and culture looks like in practice, and how you could apply this to your own organisation.

 

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.

 

Quality Indicators (QIs) pilot – specific service types invited to participate

The Department of Health has engaged PricewaterhouseCoopers (PwC) to assist in the development and pilot to trial the new QIs relating to:

  • medication management
  • falls and fractures.

To ensure the pilot captures the views and experiences of residential aged care services nationally, the department would like to strongly encourage the following services to take part:

  • Services operating in Queensland or remote areas
  • Smaller services (less than 50 residential aged care places)
  • Previous QI Program pilot participants
  • Private (for profit) or State Government services.

Participation in the pilot is an opportunity for your service to trial and provide feedback on these indicators ahead of the implementation of the additional QIs from 1 July 2021. The pilot will commence in February 2020, please register your interest by 27 January 2020.

 

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?
ACE Editorial Team
ABOUT THE AUTHOR | ACE Editorial Team
ACE is published by CompliSpace and Critical Success Solutions. CompliSpace is an Australian company that specialises in helping organisations manage their legal and regulatory obligations. Critical Success Solutions is an Australian company that specialises in helping Aged Care and Disability Services manage their regulatory and legal requirements.

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