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: 20 September 2020

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Weekly Wrap: 20 September 2020

Aged care news highlights from the week ending 20 September 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

More paperwork, more stress: managers on new aged care standards

According to Aged Care Insite, the challenges of new regulations on top of the COVID-19 pandemic has left aged care managers struggling with added stress and paperwork. Managers and operators of more than 250 aged care service providers participated in a new report put together by aged care governance specialists CompliSpace. It found the vast majority of aged care managers (93 per cent) found that their workload had increased under the new Aged Care Quality Standards, which came into effect last year.

A similar number (92 per cent) reported that they were dealing with more paperwork that was reducing the amount of direct care time with residents, while more than three quarters (78 per cent) said they were experiencing increased stress levels. CompliSpace chief executive David Griffiths said there has been no comprehensive review into the impact of the new Aged Care Quality Standards on aged care homes since they commenced on 1 July 2019.

“Our aged care sector is under intense scrutiny amidst the Aged Care Royal Commission, 20 reviews over the last 20 years, and the handling of COVID-19,” Griffiths said. “It is also under intense stress as aged care staff endure more work in trying to meet the regulatory requirements, without further support or funding from the government. “What our study found was the administrative burden of the new regulations may be adding strain to the sector, putting staff retention at risk and pointing to reduced capacity to care for residents.

For related articles see: Aged care workforce stressed and under pressure and Report Finds New Standards Have Not Benefitted Aged Care Sector.

 

Weekly data snapshot of COVID-19 cases in residential aged care

(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 12 September, the Department released a new data snapshot of residential aged care facilities which have recorded COVID-19 infections. The report provides greater transparency for residents and their families around the situation in aged care facilities. You can read Minister Colbeck’s announcement on the release of COVID-19 infection data in aged care here.

The report includes data on the impact of COVID-19 in residential aged care facilities nationally that have had two or more cases, as well as information on the deployment of workforce, testing and PPE to support them. The report also highlights how Australia is performing internationally.

The report will be updated weekly and can be viewed on the Department’s website.

 

Victoria reports another day of aged care deaths, detailed aged care COVID numbers released by Government

According to Aged Care Insite, Victoria has announced 28 new cases of COVID-19 in Victoria in the past 24 hours with eight deaths, another day of comparatively low numbers as they continue on the road out of lockdown. Premier Daniel Andrews confirmed six of the eight deaths were linked to aged care, bringing the total death toll in aged care to 612 – 582 of which have occurred in Victorian homes. This news comes as the federal government decided to release weekly detailed data of where COVID-19 outbreaks are occurring in aged care nationwide.

 

Report shows decline in aged care deaths

According to Australian Ageing Agenda, around 1,000 fewer Australian aged care residents have died in the first seven months of this year compared to the same period last year, according to a new weekly report from the Commonwealth Government. The report provides a snapshot of the 213 residential aged care facilities that have recorded COVID-19 infections to date including a detailed list and COVID data of the 115 facilities with two or more cases, along with other statistics. As of 11 September, there were 83 active outbreaks in residential aged care in Victoria (82) and Queensland (1) among residents (454) and staff (166) and 580 aged care residents with COVID-19 had died.

 

Returning residents from hospital to residential care

(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, guidance is available for residential aged care facilities on the process for preparing to return residents back to their residential aged care facility from hospital.

The approach to returning residents is underpinned by the following principles:

  • Decision making that puts the preferences of residents and their families at the centre of the process
  • Ensuring residents return to a safe environment through sharing information and communication
  • A staged and planned approach in line with the capacity of the receiving facility and the associated logistical support (such as transport system)
  • Reducing any risk of transmission for the returning residents and any residents on site
  • Ensuring ongoing capacity in the hospital system to meet demand for clinical admissions.

The full factsheet, which has been released by the Aged Care Quality and Safety Commission is available here.

 

Updated Advice for NSW providers

(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, NSW Health is seeking to ensure that all appropriate preventative action is taken to avoid transmission of COVID into residential aged care facilities and home care settings.

NSW Health released updated advice on 11 September 2020. This advice confirmed the continuation of visitor restrictions for residential aged care facilities in metropolitan Sydney and the Nepean Blue Mountains and Central Coast regions. In addition, staff who work or live in these areas must wear masks whilst at work. This temporary requirement will be reviewed next week based on the incidence of COVID-19.

Read NSW Health’s full advice for residential aged care facilities and home care providers.

 

Updated Advice for Queensland providers

(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, Queensland Health has issued Aged Care Direction (No 10) which came into effect from 11 September 2020.

The latest advice includes:

  • New requirements for all residential aged care facility operators to:
    • notify their local Health Emergency Operations Centre in the event of a critical workforce shortage for notification purposes
    • take reasonable steps to develop and document appropriate processes to ensure residents and their unique needs can be immediately identified in a COVID-19 event
  • Clarification of PPE requirements, including that appropriate PPE should be worn in accordance with Qld Health’s Residential Aged Care Facility and Disability Accommodation PPE Guidance
  • Clarification that students may enter a residential aged care facility to undertake a placement
  • Clarification that residential aged care facility operators in a restricted area may grant permission to people to enter the facility to provide continuity of care for a resident that cannot be delivered by electronic or non-contact means
  • Clarification that the Direction also applies to residential aged care facilities funded under the National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) Program.

Further changes are set to come in to effect from 8:00am on 1 October 2020 and these include new requirements for residential aged care facility operators to:

  • Include information in their Workforce Management Plan about how workforce surge requirements will be met if there is a COVID-19 event at the facility
  • Take reasonable steps to ensure employees, contractors who have contact with residents, volunteers and students undergo face to face infection control and PPE training
  • Take reasonable steps to ensure they have an adequate supply of PPE available to respond to a confirmed case of COVID-19 within the facility.

 

PPE reminder for 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, Aged care workers are reminded of the need to ensure they follow the guidance of both the Commonwealth and their relevant state health authority on the use of personal protective equipment (PPE) in residential aged care facilities.

The Commonwealth has set out the following guidelines and resources:

  • Recommended minimum requirements for the use of masks or respirators by health and residential care workers in areas with significant community transmission. These requirements can be found here. These are minimum requirements and aged care providers and workers must also consult the directives of their relevant state health authority.
  • A flow chart detailing when to use PPE in aged care. This can be found here. Aged care providers and workers must also reference the directives of their relevant state health authority.
  • A video from Alison McMillan, Australia’s Chief Nursing and Midwifery Officer, demonstrating how to wear personal protective equipment (PPE) in aged care. This can be found here.

 

PPE best practice webinar

(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 Victorian Age Care Response Centre (VACRC) will hold another of it’s ‘lunch and learn’ webinars, which feature subject matter experts from across the age services industry.

 

The topic is ‘PPE Best Practice’ on Friday 18 September from 1:00pm–1:45pm AEST and the final webinar of the series will be ‘Lessons Learnt on Friday 25 September.

On Wednesday, ‘Family engagement and communication’ was covered. And last week the topics were ‘Waste Requirements, Disposal and Management’ and ‘Coordination of COVID-19 Prevention & Preparation including Stress Testing COVID-19 Planning’.

Conveniently held at lunchtime and free to attend, the sessions are designed to equip providers with vital information on new and emerging issues from the pandemic. The forum allows for questions from participants.

Recordings will be made available to registrants after the session. You can find out more and register, on the Leading Age Services Australia website.

 

Support for 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, we want to again thank all the aged care workers and support staff who are doing a fantastic job to protect older Australians and maintain quality care during the challenges faced by the COVID-19 pandemic.

Australia’s Chief Nursing and Midwifery Officer, Alison McMillan this week encouraged healthcare professionals to look after one another and access the support that is available. Workers can access the COVID resources and support on the Head to Health website.

Financial support includes:

The Government’s SACWIC Grant opportunity includes a specific stream of funding for providers to ensure workers will not be disadvantaged as a result of the single site arrangements. This will minimise the risk of infection for workers and residents.

The Government’s third workforce retention bonus payment for direct care workers (employed as at 30 November) is further recognition of how valued your work is. This workflow chart explains who qualifies and how the payments are calculated.

Pandemic Leave Disaster Payment is support for workers in some states where you can't earn an income because you must self-isolate or quarantine at home, or are caring for someone with COVID-19

These financial measures are on top of the surge workforce teams, infection control training and PPE supplies, to help support you at work.

Please make sure you are utilising all the support available and please reach out for help if you need it. Chief Nursing and Midwifery Officer Alison McMillan said this week, “it is a strength in calling out and saying that you are finding it difficult to deal with this situation, and to seek out the help that is necessary”.

 

NACER briefing pack for 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, this National Aged Care Emergency Response briefing pack for aged care workers has been updated. This pack answers questions for workers who redeploy to aged care facilities affected by COVID-19. The briefing pack for workers is available here.

 

VACRC marks seven weeks in operation

(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 its first seven weeks of operations, the Victorian Aged Care Response Centre has worked at rapid pace to deploy much-needed resources and expand operational capacity as part of its robust effort to stabilise Victoria’s residential aged care sector.

With 170 outbreaks in Victorian aged care facilities to date, the work of the Response Centre has seen the number of ‘Category 1’ facilities fall to zero from a high of 13 in early August. In addition, there were 119 facilities on the Response Centre’s ‘Category 2’ list of facilities at risk, which this week has reduced to only three.

Executive Officer of the Victorian Aged Care Response Centre, Joe Buffone, says “Our mission has always been the safety and care of residents, the safety of staff, and to stabilise a complex system through unification of effort”.

You can read the full media release here.

 

Other News

Aged care needs financial transparency says independent Commission report

According to Aged Care Guide, the Royal Commission into Aged Care Quality and Safety has released an independent report based on aged care providers' financial information, focussing on the insufficient financial transparency around the use of Government funding and people in aged care. The report found that it was difficult to measure the overall performance of the aged care industry because of the limited reporting obligations on aged care providers by the Australian Department of Health (DOH), the use of group entity structures by providers, transactions between related entities, and the deliver of non-aged care activities by some providers.

 

Where has all the money gone? $20 billion a year in financials under the spotlight

According to Aged Care Insite, nearly $20 billion of government money goes into the provision of aged care each year, but where does it all go? and how is it spent? It seems like we forgot to ask because, as the royal commission is now discovering, it turns out we don’t know.

The panel on ABC TV’s The Drum program discussed the topic and host Julia Baird put the question to Professor Jo Ibrahim. “Well, I don’t think anyone really knows,” he replied. He told his fellow panellists that he has no idea how many large providers make equally large profits whilst others “claim” to be near bankrupt. The system itself is morally bankrupt, he said, and it is hurting older people.

 

Capital financing for residential aged care: Call for submissions

The Royal Commission into Aged Care Quality and Safety are releasing a paper describing the history of capital financing arrangements in residential aged care, and how the current arrangements operate. Capital financing for residential aged care: Call for submissions also contains a number of questions for consideration, together with details on how to make a submission.

 

RC debates aged care pricing body

According to Australian Ageing Agenda, the aged care sector needs an independent national pricing authority to recommend prices to government but not set them, a health economist and head of the productivity commission inquiry into the sector has told the aged care royal commission. The Royal Commission into Aged Care Quality and Safety commenced its seven-day hearing inquiring into the funding, financing and prudential regulation of aged care on Monday. On Tuesday, health economist Professor Michael Woods reiterated calls for the establishment of an authority to evaluate costs and make recommendations about prices in aged care.

 

Keating pitches HECS-style aged care loans

According to Aged Care Insite, former Prime Minister Paul Keating has told the aged care royal commission it should consider recommending a HECS-style loan for older Australians to pay for their care. At today’s hearing, Keating said the approach was superior to a pre-funding model, like the longevity levy he once thought Australia needed. Under that option, Australians would pay a levy, “some people might die at 56 or 60 and their contribution funds the person who lives to 95 or 100”. “It’s a classic insurance system,” he said. “But then you’ve got issues about people’s ability to pay, who should get the funding, how is it levied, what is returned to the Commonwealth, etc.” Keating said he has since shifting his thinking to the need for a post-funding model, like HECS.

“Higher education charge is a post-paid system. These are loans advanced to students on… mostly an income-contingent basis. So if a student goes to university then leaves and then has gainful employment the tax system puts a garnishee on the wages and pays the university debt down. If in fact a person never had any employment thereafter the loan would never be repaid. So if we were to move and think of aged care as a post-paid system, the Commonwealth could then advance as loans to every aged Australian so much as to meet their needs in support services to stay at home or alternately in care accommodation.”

 

Shortfall of aged care services in rural areas

According to Community Care Review, there is a shortage of aged care services in rural and regional areas, and older people are seeking care too late, new research shows. Researchers at La Trobe University have submitted a research report to the Royal Commission into Aged Care Quality and Safety. The report identified numerous issues, including limited choice of providers, long waiting lists and lack of knowledge about accessing care.

 

Free accounting and business advisory services for providers

(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, residential and home care service providers can access free independent business advisory services. These services aim to help providers review their operations and provide advice on business management and financial strategies.

PricewaterhouseCoopers (PwC) offers two tiers of services. Both tiers target the identification of strategies to help improve the provider’s business management and operations:

  • Tier 1 services delivered through a desktop review
  • Tier 2 services delivered by both desktop review and time spent with the provider (delivered currently through videoconference).

Service providers can apply to access the free business advisory services through the PwC website. The services will be available until 30 June 2021.

 

Services Australia Aged Care Quarterly Review

(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, Services Australia reviews the costs of aged care four times a year in January, March, July and September. This ensures the cost of a person’s aged care services aligns with changes in their financial circumstances. The next Quarterly Review for Residential Care and Home Care will take place on 26 September 2020, with a date of effect of 20 September 2020.

Services Australia will send letters to aged care providers and care recipients as soon as possible after the Quarterly Review. The Online Claiming system for Home Care will be unavailable from 8pm Friday 25 September until 8am Monday 28 September as Quarterly Review tasks are undertaken.

Further information is available on:

Schedule of Subsidies and Supplements for Aged Care

Schedule of Fees and Charges

Services Australia website

 

Aged Care Online Claiming updates

(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, Services Australia will be closing off access to Aged Care Online Claiming and Aged Care Online Services by 20 November 2020. The new Aged Care Provider Portal (ACPP) replaces both systems. The ACPP can be used to claim online for Home Care, Residential Care and Flexible Care services from the one secure place.

To access the ACPP for all services:

More information is available on the Services Australia website.

 

Awards to celebrate innovation in aged care

According to Community Care Review, nominations are open for the 2020 innovAGEING Awards which recognise innovation in the aged care sector. The national awards recognise providers for coming up with innovative ways of providing quality care, improving workforce and organisational structure, creating alternative revenue channels and keeping up with new demands. They are also open to providers of products and services.

 

Call for a focus on care delivered with love

According to Community Care Review, love is a crucial element of providing care and support for people living with dementia, a leading international theologian tells Australian Ageing Agenda. University of Aberdeen professor of practical theology and pastoral care John Swinton said caring with love helped to remove the negative attitudes and assumptions associated with dementia. “Love is a fundamental human need, but that often we fail adequately to consider its importance for people living with dementia and for their families and loved ones who very often share in the kind of cultural stigma that accompanies the term dementia,” Professor Swinton tells AAA.

 

Home in on design to better age in place: report

According to Aged Care Insite, Australians looking for the next home and who want to age in place should look at little closer at design – and so should policymakers. That’s according to a new RMIT report, which found that both paid and unpaid caregivers believe current home design can hinder their ability to support older adults. The researchers surveyed over 100 caregivers and found 95 per cent believe home design influences the level of care required in the home.

 

RC hears aged care redesign proposal

According to Australian Ageing Agenda, the aged care system should be redesigned into four streams with different funding models and simultaneous access, the co-author of the recent national study looking into the needs, costs and classification of residential aged care has told the aged care royal commission. University of Wollongong’s Australian Health Services Research Institute director Professor Kathy Eagar, who co-authored the 2019 Resource Utilisation and Classification Study report, discussed her previously submitted proposal at The Royal Commission into Aged Care Quality and Safety on Thursday.

 

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.

 

Clinical Governance in Aged Care Conference – online 28 and 28 October 2020

According to Australian Ageing Agenda, the Clinical Governance in Aged Care conference is taking place on 28th & 29th October 2020 via live stream and will support you with the knowledge and practical insights to improve safety, accountability and compliance. You'll learn strategies to help you deliver improved outcomes as an aged care provider for your customers through the pandemic and beyond.

 

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?
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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