Aged care news highlights from the week ending 30 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

Infection Control Spot Checks

The Aged Car Quality and Safety Commission is undertaking unannounced assessment contacts with residential aged care services through site visits to services. The focus of the site visit is to observe infection control defences at the service to prevent transmission and to recognise and respond to symptoms of COVID-19; this is to ensure that everyone is adhering to infection control arrangements including safe PPE protocols.

The site visit is a monitoring visit, not a performance assessment. Where issues or concerns are identified, such as staff not applying correct PPE or adhering to other infection control practices, the Commission will consider further regulatory action to ensure that the provider is meeting their quality and safety obligations. This may include a performance assessment against the Quality Standards or imposing sanctions.

Inquiry supports hospitalisation of COVID-positive residents

According to Australian Ageing Agenda, the increasing number of COVID-19 cases among Newmarch House residents and staff throughout April “fuelled a vicious cycle” of staff and protective equipment shortages and poor infection protection and control practices, an independent review has found. The reviewers identified a pressing need to lift the standards of education and training in infection control among 20 key learnings, which are contained in their final report released by the Federal Government on Monday. Other learnings include that approved providers consider surge workforce capacity on the assumption that at least half of its staff may be furloughed, and as the soon as an outbreak is declared, residents should be transferred to hospital until the facility is deemed safe for residents to return.

Funding boost for aged care COVID response

According to Australian Ageing Agenda, the Federal Government has announced an additional $171 million for its pandemic aged care response package. It brings the commonwealth’s total investment since the coronavirus pandemic started to more than $1 billion, Prime Minister Scott Morrison announced at a press conference on Friday afternoon. The additional funding includes $9.1 million to support the further operations of the Victorian Aged Care Response Centre (VACRC) and $103.4 million to support the response including emergency call centre surge capability for communication with families, surge workforce support, training for new workers and quarantine costs for interstate healthcare workers.

Reinforcement of Australia’s aged care sector with additional funding

(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 Australian Government will scale up aged care support programs in Victoria and across Australia with an additional $171.5 million to boost a new COVID-19 response plan agreed by all states and territories at National Cabinet on 21 August 2020. Read the full announcement from the Prime Minister on the additional funding here.

Calls for more measures to prevent aged care outbreaks

According to Australian Ageing Agenda, provider groups have welcomed the government’s latest measures to support the aged care sector’s COVID-19 response, but there are calls for more action to prevent outbreaks. Following Friday’s meeting of government leaders, Prime Minister Scott Morrison announced that National Cabinet endorsed a Commonwealth, state and territory plan to strengthen the aged care sector’s preparedness for responding to a rapid escalation of COVID-19. The plan includes actions for Commonwealth, state and territory governments such as ongoing assessment of the preparedness of aged care providers, risk profiling by the Aged Care Quality and Safety Commission, an audit of state and territory emergency response capabilities and additional face-to-face infection control training.

National Aged Care Emergency Response Program

(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 Commonwealth Department of Health has partnered with the aged care industry to develop the National Aged Care Emergency Response (NACER) Program. The initiative mobilises aged care staff from areas across Australia not experiencing community transmission, to assist in caring for people in aged care facilities impacted by COVID-19. While the initial focus is on supporting Victoria, it is a national program that can be expanded where and when it is needed.

NACER is seeking experienced Registered Nurses, Enrolled Nurses, Personal Care Workers and Cleaners who are currently working in aged care to provide surge workforce support. An attractive remuneration and support package is on offer including a $5,000 bonus for successful completion of a rotation.

Further information on the NACER Program is available on the department’s website.

Victorian Aged Care Response Centre Hub

(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 Aged Care Response Centre is coordinating the response to COVID-19 outbreaks in aged care centres and has established the Victorian Health Services Coordination Hub, to enhance surveillance of outbreaks in the aged care sector. The hub network unifies the efforts of public and private health systems, ensuring COVID-19 outbreaks at aged care facilities are managed with the best available resourcing across a number of local services. The full release can be found here.

Updated NSW Health advice for aged care 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, the NSW Chief Health Officer provided updated advice to residential aged care facilities and home care providers. In response to questions received from residential aged care facilities about implementing this guidance, a series of FAQs has been prepared and is available here.

Older persons COVID-19 support line

(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 Older Persons COVID-19 Support Line has been set up to provide information, support and connection for 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, supported by funding from the Australian Government.

Older Australians, their families, friends and carers can FREECALL 1800 171 866.

Australian Health Protection Principal Committee (AHPPC) statement on the national COVID-19 response for 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, AHPPC recognised early in the COVID-19 pandemic that residents of aged care facilities were particularly vulnerable, and at risk of severe illness from COVID-19. Accordingly, the health and wellbeing of this population has been in the deliberations of the AHPPC throughout the pandemic. A statement released by AHPPC on 22 August 2020 identifies a number of key national statements and guidelines reviewed and endorsed by the AHPPC relating to aged care. The full statement can be found here.

Aged care minister embarrassed at senate inquiry, government preparedness questioned

According to Aged Care Insite, Senator Richard Colbeck faced intense questioning at the Senate Select Committee hearing on Australia’s response to COVID-19 on Friday, and was criticised for appearing not to know how many people in aged care have died from COVID-19 since the beginning of the pandemic. The committee, made up of a senator from each of the major parties and chaired by Labor senator Katy Gallagher, tried to get to the bottom of whether the government was sufficiently prepared for outbreaks of the coronavirus in residential aged care, which resulted in a number of awkward, tense exchanges involving Senator Colbeck.

Virus national death toll tops 500 after more deaths in aged care

According to Aged Care Insite, the national COVID-19 death toll has topped 500, with many new fatalities again coming from the aged care sector in virus-hit Victoria. On Sunday, 11 deaths in Victorian aged care facilities were reported out of a total of 17. Today, there were 15 more deaths – all linked to aged care – taking the state toll to 430 and the national figure to 517. Federal Labor will today keep the heat on the Morrison government over its handling of the sector during the coronavirus pandemic as parliament sits for the first time for 10 weeks. Opposition health spokesperson Chris Bowen said the number of deaths in aged care homes during the crisis has been heartbreaking.

Independent review of Newmarch House

(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 independent review into the COVID-19 outbreak at Newmarch House was commissioned by the Department of Health to understand what occurred and what could be learned from the experience. The review was undertaken by Professor Lyn Gilbert and Adjunct Professor Alan Lilly. The Minister for Aged Care and Senior Australians, Senator the Hon Richard Colbeck has written to providers in relation to the release of the report. The full report on the Newmarch House COVID-19 experience is available on the department's website.

Review unpacks ‘vicious cycle’ of staffing and PPE shortages at Newmarch

According to Aged Care Insite, the government has today released the findings of a review into the outbreak of COVID-19 at Newmarch House in Sydney where 19 residents died. To unpack the virus’s spread and impact, review authors Professor Lyn Gilbert and Adjunct Professor Alan Lilly consulted with stakeholders, including staff and the family members of residents. They found a “vicious cycle” of staff and PPE shortages, and suboptimal infection prevention and control (IPAC) practice. “Providing sufficient, appropriately skilled staff to manage and deliver person-centred care to residents at Newmarch House proved to be one of the most significant challenges during the course of the outbreak,” the review’s authors wrote.

‘She looked terrified, absolutely terrified’: family of Epping Gardens resident speaks out

According to Aged Care Insite, “She looked like a scared mouse, her eyes were rolling in the back of her head, she looked terrified, absolutely terrified,” Sue Agnello says. She is describing the final moments of her mother-in-law’s life in a Melbourne hospital. Carmela Agnello was 92 when she died in the Northern Hospital from COVID-19 and her final goodbyes with her family were done over Skype. Carmela was one of the 211 cases of COVID-19 that have so far been linked to the controversial Epping Gardens Aged Care facility in Epping, Melbourne, where at least 20 residents have since passed away. Sue’s husband Sam Agnello is the lead plaintiff in a class action lawsuit against Epping Gardens and its owner, Heritage Care.

Identifying key personnel and roles during an outbreak

According to the Aged Care Quality and Safety Commission Bulletin, in the event of an outbreak of COVID-19 at a residential service, the service’s Outbreak Management Team and key personnel at the service will be working in close co-operation with public health authorities and other parties to ensure an effective emergency response.  A key personnel template has been developed to assist providers in identifying key personnel of the service and their contact details to support this response. 

The template is intended for a service to use in the event of an outbreak to communicate with multiple other parties who may be involved with the service during an outbreak. Services can modify and tailor the template to suit their needs and it is recommended that the completed template is provided to all involved parties and updated as required, with updates also printed out for use on site. 

Wearing of face shields

According to the Aged Care Quality and Safety Commission Bulletin, in addition to the requirement for all Victorian aged care workers to wear face masks, aged care workers in Victorian residential aged care facilities are now advised to wear face shields as a precautionary measure. Single use face shields are being distributed from the National Medical Stockpile to all residential aged care facilities in Victoria. Facilities will be directly contacted by delivery providers to receive the allocated face shields, with priority distribution to Greater Melbourne and Mitchell Shire. 

Read the Minister for Health’s announcement on face shields. 

Guidance on the use of face masks and shields by health care workers in areas with significant community transmission of COVID-19 can be found on the Department of Health’s website.

Cohorting Consumers with COVID-19

According to the Aged Care Quality and Safety Commission Bulletin, cohorting may be a fairly unfamiliar term for some residential aged care services. In the context of an infectious disease like COVID-19, it refers to separating consumers with a confirmed or suspected case of COVID-19 from those who do not have COVID-19 in residential care. This may involve temporarily moving a resident with COVID-19 to another room or area within the facility to create distance from other residents who have tested negative to the virus. Alternatively or in addition, it may involve temporarily moving a resident or residents to another facility such as a public or private hospital. The Commission has prepared FAQs on cohorting, which you can read here. 

Other News

Aged sector needs $621m to lift standards

According to Aged Care Insite, Australia’s aged care sector will need more than half a billion dollars annually just to achieve basic quality consistently in nursing homes, researchers say. The first of its kind study also found just 11 per cent of residential aged care facilities met all accreditation standards and had no complaints. “Australians expect that all are entitled to the best quality level of care in aged care homes,” Aged Care Commissioner Tony Pagone said in a statement on Thursday. “Additional funding will be needed to enable providers to meet those expectations consistently.”

Read the full report here.

Call for audit into wages paid to aged care workers

According to Australian Ageing Agenda, worker representative group Health Services Union is calling for an aged care sector wide audit to investigate instances of underpayment after two large operators admit to underpaying staff. The call comes as BaptistCare NSW and ACT becomes the second aged care provider in a week to enter into an enforceable undertaking with the Fair Work Ombudsman to resolve self-reported pay issue issues. BaptistCare said it miscalculated leave loading for shift workers between 1 December 2011 and 12 July 2018, affecting 2,140 staff and resulting in $1.2 million in underpayments and $1.37 million in overpayments.

The Commission’s regulatory activities

According to the Aged Care Quality and Safety Commission Bulletin, the Commission continues to take a proportionate risk-based approach in responding to the evolving COVID-19 (coronavirus) situation. With restrictions lifting in some states, the Commission will resume conducting reaccreditation site audits for residential aged care services from August in some states and territories. This step is being taken in line with advice from the Commission’s Chief Clinical Advisor and we have in place a comprehensive risk screening process relating to the Quality Assessment Team. We are also risk assessing circumstances at the aged care service prior to entry. In line with the return to site audits in some states, the Commission will also resume its weekend monitoring program in August. Residential aged care providers can expect that Quality Assessors may attend after hours and on weekends to conduct unannounced assessment and monitoring activities.

Better use of medications in aged care

According to the Aged Care Quality and Safety Commission Bulletin, the Commission has engaged Health Outcomes International (HOI) to conduct an evaluation of the work funded under the 2018-9 Better use of medications in aged care Budget measure. A part of this consultancy, HOI has produced a Discussion paper drawing on the key findings of a literature review of the evidence. Improving medication management for older adults in residential aged care continues to be a national priority. There is promising evidence that the introduction of well-designed interventions can support change in prescribing practices in these settings. You can access the discussion paper here. 

Assessing the Standards – residential aged care services

According to the Aged Care Quality and Safety Commission Bulletin, we are pleased to advise that online Assessing the Standards workshops for residential aged care services will commence in mid-August. This follows some intensive work by the Commission to translate our very popular in-person workshops for delivery through a virtual training environment. Participants are expected to have a sound knowledge and understanding of the Aged Care Quality Standards and their application. For further information and to register for the virtual workshops, please visit our website.

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?