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: 27 September 2020

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Weekly Wrap: 27 September 2020

Aged care news highlights from the week ending 27 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

Emergency leave for aged care residents extended to 30 June 2021

(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, Minister Colbeck has announced an extension to the new emergency leave provision for permanent aged care residents until 30 June 2021. This will allow aged care residents to take emergency leave during the COVID-19 pandemic, rather than using and potentially exhausting their social leave entitlements.

It will also provide certainty and reassurance to residents who have temporarily relocated to stay with family during the COVID-19 pandemic. Aged care homes will continue to be paid residential care subsidy when residents are on emergency leave, ensuring neither residents nor providers are disadvantaged.

A copy of the media release is available here.

 

Extension of the Guiding Principles for 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, this is a reminder that the ‘Guiding Principles for residential aged care – keeping Victorian residents and workers safe’ (the Principles) are still in effect for workers in Greater Melbourne and Mitchell Shire. The Principles were originally in place from 27 July to 25 September 2020 but this has been extended to 26 October 2020 and may be extended further if necessary.

 

Information on how to use and clean face shields

(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.)

The Department of Health has published two new video resources from Chief Nursing and Midwifery Officer Allison McMillian to assist aged care workers who are required to wear face shields.

In the first video, How to don and doff a face shield, Professor McMillian explains how to safely put on and take off a face shield. In the second video, How to clean a face shield, Professor McMillan explains how to clean and disinfect reusable face shields.

The Commonwealth has published recommended minimum requirements for the use of masks or respirators by health and residential care workers in areas with significant community transmission. These are minimum requirements and aged care providers and workers must also consult the directives of their relevant state health authority.

Aged care workers and providers are also reminded that the Commonwealth has published a quick guide on face shield use during COVID-19.

 

General reminder on PPE usage and sourcing

(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, consistently and safely wearing PPE is an essential measure to protect your health, and the health of the older Australians in your care.

All aged care workers and providers are reminded of the need to ensure you are consistently following Commonwealth guidance, and state and territory government requirements and directions on PPE use. Depending on the incidence of COVID-19 in individual jurisdictions and localised areas within jurisdictions, states and territories may implement more stringent requirements on when to use PPE. It is important you remain up to date with the latest Commonwealth guidance and state/territory requirements.

The directions are available on the following websites:

New South Wales

Victoria

Queensland

South Australia

Western Australia

Tasmania

Australian Capital Territory

Northern Territory

If you urgently need PPE and cannot source it please submit an online application. The Commonwealth is prioritising requests for PPE from the National Medical Stockpile to aged care services that are most in need.

Residential and in home aged care services across Australia who are in a priority category can request surgical masks and P2/N95 respirator masks from the National Medical Stockpile. Requests for other PPE, will be assessed on a case-by-case basis and prioritised where there is an outbreak in a residential aged care facility.

Providers should also continue to try to source PPE through suppliers and establish an ongoing general PPE supply.

 

Reminder to providers on Aged Care specific training modules

(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, providers are reminded to ensure aged care staff have completed the COVID-19 infection control training.

This training covers the fundamentals of infection prevention and control for COVID-19. Additional training modules, specifically designed for aged care workers are also available. These additional modules are relevant for aged care workers in both residential and home care.

If you would like to access the aged care training, users will need to register their workplaces as ‘aged care’. If you have already registered for online training but not with ‘aged care’ as your workplace, email support@covid-19training.gov.au for a priority response.

 

Outbreaks decline in Victoria as efforts focus on prevention and recovery

(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, as COVID-19 case numbers in aged care continue to fall in Victoria in line with the fall in community transmission, the Victorian Aged Care Response Centre (VACRC) is shifting gear to focus on prevention and recovery, including returning residents to their homes, whilst continuing to support facilities with existing outbreaks.

The latest release from the VACRC outlines the current situation in Victoria and pays tribute to the staff in the aged care sector, noting all the work done to protect our most vulnerable seniors.

Full details are available here.

 

Updated NSW advice & distribution of PPE

(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 18 September 2020, NSW Health issued updated advice to Residential aged care facilities and Home Care Services in NSW with some of the recommended restrictions eased in certain areas based on the latest COVID-19 community transmission data. Advice will be reconsidered next week.

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

 

Distribution of PPE from the National Medical Stockpile

Residential aged care facilities on the NSW Central Coast and the Lithgow area started to receive dispatches of a range of PPE this week from the national medical stockpile, including single use face shields, gowns and surgical masks, to ensure they can implement appropriate infection control measures.

If you urgently need PPE and cannot source it please submit an online application.

 

National Cabinet: Update on state emergency plans

(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, at the National Cabinet on 18 September 2020 there was an update on the work being done to boost aged care preparedness at the provider, local, state and national level.

It was noted that while all states and territories are considered to have good existing emergency response capabilities and are on track with establishing and/or scaling up virtual or physical Response Centres, further practical actions will be undertaken to ensure a high level of preparedness.

Within each jurisdictions’ public health response structure, a dedicated aged care emergency response team has been established and key personnel identified at the state and Commonwealth level.

See the full National Cabinet Media Release.

 

Fears aged care staff were ‘stealing’ PPE

According to Aged Care Insite, Victoria’s chief medical officer has defended the state’s PPE as reports emerge that Victoria’s supplies have fallen to alarmingly low levels. Personal protective equipment was not given to aged care facilities over fears it was being stolen by staff, an email released by the hotel quarantine inquiry says. It comes as reports emerge that Victoria’s supplies of N95 masks for health workers have fallen to alarmingly low levels during the coronavirus pandemic.

The email, written by deputy chief health officer Dr Annaliese van Diemen, stated the Department of Health and Human Services (DHHS) “cannot preposition (PPE) in facilities as people are stealing it”. But Health Workers Union secretary Diana Asmar told the newspaper she was “not aware of a single Victorian aged care worker or HWU member facing a disciplinary meeting due to theft of PPE”.

 

Slow, poor response increased aged care outbreaks, experts say

According to Australian Ageing Agenda, the aged care sector could have been more proactive in preventing and stopping COVID from entering aged care homes, an international dementia conference has heard. A panel of aged care and dementia experts from across the globe shared their perspectives of how their nations are coping with COVID and the lessons learned so far at the International Dementia Conference on Monday.

The panel agreed on the need to learn on the go due to the unpredictable nature of the pandemic. Professor Chris Poulos, head of HammondCare’s research and aged care clinical services, said Australia could have been more proactive in preventing the spread of COVID in aged care homes.

 

 

Other News

Unions launch campaign to “fix” aged care

According to Australian Ageing Agenda, a group of unions representing aged care workers has released a four-point plan to improve the aged care system that includes mandated minimum staffing levels and training requirements and transparency with how providers spend that funding. The campaign launched on Monday also calls for an increase in government funding for more staff, and largely has the support of provider groups.

It has been developed by the Health Services Union, the Australian Nursing and Midwifery Federation, the United Workers Union and the Australian Council of Trade Unions to improve care outcomes and provide support for aged care workforce during the pandemic.

The campaign calls for:

  • mandated minimum staffing levels and required mix of skills and qualifications in every residential facility on every shift
  • transparency and accountability for Government funding
  • mandated training requirements accessible to all staff and paid by the employer
  • an increase in government funding linked to the provision of care and the direct employment of permanent staff with decent pay and enough hours to live on.

 

Consumer groups launch aged care vision

According to Australian Ageing Agenda, a human-rights based aged care system that guarantees care within a month of assessment and a well-trained and registered workforce are among a set of principles an alliance of consumer groups has developed to improve aged care.

The vision statement released on Wednesday also calls for full transparency on staffing, quality measures, complaints, compliance and financial outcomes and a regulator that vigorously investigates and prosecutes providers for breaches of the standards.

The 10 principles, which were released on Wednesday, have been developed by Carers Australia, COTA Australia, Dementia Australia, the Federation of Ethnic Communities Council of Australia, National Seniors Australia and the Older Persons Advocacy Network.

 

Indexation rates for Residential Aged Care and Home Care Packages

(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, an update of the schedules for residential and home care fees and charges and subsidies and supplements will take effect from 20 September 2020. The new schedules are now available on the department’s website.

Services Australia’s quarterly review of fees and charges for all care recipients will be effective from 20 September 2020. Care recipients and providers will receive letters letting them know if there is a change to a care recipient’s fees and charges or if a refund may be due.

Schedule of fees and charges

View the updated Schedule of Fees and Charges for:

Residential and home care recipients who started care on or after 1 July 2014

Residential and home care recipients who started care before 1 July 2014

Schedule of subsidies and supplements

View the updated Schedule of Subsidies and Supplements. This update continues, from 1 September 2020, the temporary increases to the viability supplement and to the homeless supplement which had ended on 31 August 2020.

 

A fair share: why you should prepare to pay more for aged care

According to The Donaldson Sisters, the Royal Commission wrapped up its funding and financing hearings – and its final public hearings before it delivers its Final Report in February 2021 – this week.

While former Prime Minister Paul Keating’s HECS-style loan scheme made the biggest headlines, there was one clear message from the hearings: Australians must pay more for their aged care services in the future if they can afford to do so.

Professor Michael Woods – who steered the Productivity Commission’s influential ‘Caring for older Australians’ inquiry back in 2011 – labelled it “absolute madness” to have taxpayer funded aged care for those who can afford to pay for their own care through their assets.

 

No change to MPIR from 1 October 2020

(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 maximum permissible interest rate (MPIR) will remain at 4.10% for the period from 1 October to 31 December 2020 for calculating:

  • accommodation prices
  • interest on refunds of accommodation lump sum balances

View current and past rates of the MPIR.

Providers must ensure:

  • their published accommodation prices on the My Aged Care website are up to date. If you have any questions contact the My Aged Care service desk on 1800 836 799.
  • the accommodation prices published on their own website and in relevant written materials are up to date.

 

Aged care system needs ‘fundamental reset’: Murphy

According to Aged Care Insite, Secretary of the Department of Health Brendan Murphy believes the aged care system needs a “fundamental reset”. Murphy, who was Australia’s chief health officer when COVID-19 hit Australia, was responding to a question posed to him at the Royal Commission into Aged Care Quality and Safety on Friday about whether the Department of Health believes the aged care provision ratio should remain in place.

“At the moment the Government’s focus has been very much on meeting the demand for home care packages… but I think we clearly accept that the system does need significant redesign, including in the costing and funding and transparency of that system.” When asked whether the department says the aged care provision ratio should be scrapped in favour of an uncapped system, Murphy said it agreed that the program should be demand driven.

 

Call for funding certainty

According to Australian Ageing Agenda, there needs to be an independent authority to review aged care pricing every year to ensure funding decisions are objective, a provider chief has told the aged care royal commission. Chris Mamarelis, CEO of not-for-profit aged care provider Whiddon, told the Royal Commission into Aged Care Quality and Safety on Monday that he supported the commission’s proposal for an independent pricing authority. Under the proposal the authority would ensure that prices for aged care services are determined independently on the basis of benchmarking and cost data, and set at a level intended to meet the cost of delivering services.

 

Trauma rife among aged-care residents, says researcher

According to Hospital and Healthcare, more than 70% of people within aged-care facilities have experienced a traumatic event in their lives and may need psychological intervention during COVID-19, says researcher Dr Monica Cations of Flinders University.

The high rate of trauma among aged-care users in part reflects their greater accumulation of traumatic life experiences. However, the aged-care experience can be distressing in and of itself, particularly during the pandemic, Dr Cations said. For those already living with trauma from a prior life event, these environmental pressures can cause flare-ups of psychological distress.

 

Post-COVID, post-royal commission, the future is home care

According to Aged Care Insite, home care has long been touted as a solution to the issues the aged care system is going through. As the Australian community grows and ages, the government and experts alike have spruiked the benefits of getting people to age in place. One hurdle, or the hurdle, is the thousands of people on waitlists for the various home care packages.

Government data released last year puts the number of people with access to a home care package at 134,930. However, there were 62,942 people seeking a home care package at their approved level who had not yet been offered access to a lower level package. The total number of people on the home care package waitlist currently sits at over 129,000.

However, with a pandemic ripping through aged care homes – and with providers accused of struggling to appropriately deal with the families of residents during outbreaks – the government will have to move quickly to cut these exorbitant wait times.

 

Legislation

Aged Care (Leave from Residential Care Services) (Situation of Emergency—Human Coronavirus with Pandemic Potential) Amendment Determination 2020 (Cth) – Commenced 19 September 2020

This instrument amends the Aged Care (Leave from Residential Care Services) (Situation of Emergency—Human Coronavirus with Pandemic Potential) Determination 2020 to provide for the situation of emergency to be extended and provide emergency leave to residential aged care recipients across Australia until 30 June 2021.

 

Aged Care Legislation Amendment (Subsidies—COVID-19 Support Supplement and Workforce Continuity Funding Measures No. 2) Instrument 2020 (Cth) – Commenced 19 September 2020

This instrument amends the Aged Care (Subsidy, Fees and Payments) Determination 2014, Aged Care (Transitional Provisions) Principles 2014, Aged Care (Transitional Provisions) (Subsidy and Other Measures) Determination 2014, and Subsidy Principles 2014 to prescribe a second COVID-19 support supplement payment, which is payable for each day in June 2020 that a care recipient was being provided residential care by their approved provider, and continue, from 1 September 2020, the temporary increases to the viability supplement and to the homeless supplement which had ended on 31 August 2020.

 

Guardianship and Administration Amendment (Advance Care Directives) Draft Bill 2020 (TAS) – submissions on draft Bill close Submissions close 5:00pm 16 October 2020

The Tasmanian Government is committed to providing opportunities for community involvement in the development of Government policy and are seeking input on the Guardianship and Administration Amendment (Advance Care Directives) Bill 2020 (the draft Bill).

Advance Care Directives are instructions about a person’s future decisions in relation to health care and treatment made by a person when they have decision making ability in anticipation of a time in the future when they do not have the ability to make those decisions due to illness or injury.

The draft Bill amends the Guardianship and Administration Act 1995 to provide for the giving, recognition and implementation of Advance Care Directives. All other Australian jurisdictions except New South Wales and Tasmania explicitly provide for Advance Care Directives in legislation. The draft Bill will amend the Guardianship and Administration Act 1995 to provide for this purpose.

The Bill progresses the recommendations of Tasmanian Law Reform Institute (TLRI) which relate to ACDs in the TLRI Report on the “Review of the Guardianship and Administration Act 1995 (Tas)”. The Report endorsed aspects of the Advance Care Directives Act 2013 of South Australia, and that Act has also informed development of the Bill.

While ACDs were part of significant consultation by the TLRI, release of the draft Bill provides an opportunity to take into account any issues raised by stakeholders about how to give effect to the recommendations arising from the TLRI Report.

 

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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