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January 25, 2021
  • THE MAGAZINE OF THE NSW NURSES AND MIDWIVES’ ASSOCIATION
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Aged Care

Aged Care information on COVID-19

January 15, 2021 by Gia Hayne 8 Comments

The NSW Nurses and Midwives’ Association is providing support and advice to any members seeking information regarding the novel coronavirus (COVID-19).

Ensure you’re covered at work by joining the NSWNMA.

If you’re working for a private aged care provider, please check this page for information around self-isolation and your workplace entitlements

Click here for the latest advice from the Chief Health Officer

The evolving nature of the COVID-19 outbreak means our public health advice will continue to change. One thing remaining consistent however, is the contribution frontline nurses and health sector professionals are making to address it.

The Commonwealth Department of Health website contains detailed guidance for health sector workers and is updated regularly.

On 14 January 2021, NSW Health released amended advice for Residential Aged Care Facilities (RACFs) to be followed until further notice.

Visitor Restrictions – Northern Beaches, Wollongong, Cumberland, Canterbury, Mt Druitt and Rooty Hill

​​​All residential aged care facilities in the Northern Area of the Northern Beaches, City of Wollongong, Cumberland City Council, the Canterbury Ward of Canterbury Bankstown Council, Mt Druitt (suburb) and Rooty Hill (suburb).

  • must exclude all visitors, except those performing essential caring functions
  • all staff and visitors must wear a surgical mask while in a residential aged care facility
  • should avoid residents leaving the facility unless it is essential (for example, a medical appointment) or for exercise
  • should ensure that residents are provided with appropriate PPE and infection control advice if they need to leave the facility.

Visitor Restrictions – all other RACFs in NSW

Until further notice, all staff and visitors must wear a surgical mask while in a residential aged care facility. In addition:

  • ensure residents in Greater Sydney (including Blue Mountains and Central Coast Local Government Areas) have a maximum of only two visitors each day. They may have different visitors each day.
  • exclude all staff and visitors who have been to the Grand Chancellor Hotel in Brisbane since 30 December 2020.
  • exclude visitors from the Northern Area of the Northern Beaches, City of Wollongong, Cumberland City Council, the Canterbury Ward of Canterbury Bankstown Council, Mt Druitt (suburb) and Rooty Hill (suburb).
  • exclude visitors and non-essential staff who have been in the following Local Government Areas of Queensland since 2 January 2021: City of Brisbane, Logan City, City of Ipswich, Moreton Bay Region, Redland City, Lockyer Valley Region, Scenic Rim Region or Somerset Region .  Visitors from these regions should be excluded.
  • staff who have been to the Queensland local government areas of City of Brisbane, Logan City, City of Ipswich, Moreton Bay Region, Redland City, Lockyer Valley Region, Scenic Rim Region or Somerset Region since 2 January 2021 and are essential for maintaining the service should have a risk assessment performed in consultation with the local public health.

NSW public orders and guidance from the Chief Health Officer must be followed and applied across the state at this point in time. This means that the current NSW Health advice supersedes national guidance in the Industry Code for Visiting Residential Aged Care Homes during COVID-19 and the COVID-19 Escalation Tiers and Aged Care Provider Responses.

Support for residents
Where visit restrictions are in place, arrangements should be put in place for residents and their families to regularly communicate. If residents are not able to get together with their loved ones during the festive season, providers can:

  • ensure residents can continue to move freely around the facility wherever possible to ensure personal welfare and mental health
  • help facilitate phone calls or video conferencing between residents and families when possible
  • continue to run / expand their usual activities for residents
  • expand and roster on additional lifestyle staff.

Asymptomatic testing for residents and workers
The Australian Government has expanded capacity for testing asymptomatic aged care residents and workers in Sydney’s Northern Beaches. Residential aged care services in this area have been or will be contacted to offer in-reach testing for aged care residents and workers. The testing provider will then contact the services directly to arrange for the testing teams to come on site.

Testing will be carried out on a voluntary basis but all services are strongly encouraged to take up the asymptomatic testing service.

Single site employment (Northern Beaches)

On 13 January 2021, the federal government removed the ‘Commonwealth Hotspot’ declaration previously applied to the Northern Beaches LGA. As a result, the additional support provided by the government for hotspots will now begin to taper. This includes the supplementary funding to RACFs to support the single site employment framework set out in the previous update to members from 23 December, 2020.

Recognising that RACF providers and workers will need time to transition to new rosters and that RACFs may continue to incur costs as they transition, the federal government has agreed that the arrangements will be funded for a further two weeks beyond the removal of the declaration, in this case till 29 January 2021. This means 18 December 2020 to 29 January 2021 is the period that federal funding will be available to providers to underpin these arrangements.

The Association, and indeed provider representatives, have indicated to the federal government that this transitional period of some two weeks is the bare minimum required to facilitate an orderly return to ‘usual’ working/rostering arrangements.

Additional Resources

Guiding Principles for NSW RACFs – single site employment

Support Hub for RACFs


Visitor Guidelines for RACFs:

Directives around masks and visitors

Exclude staff and visitors who:

  • live in a household with a person who is currently self-isolating
  • have been to any of the latest COVID-19 locations in NSW at the times and dates listed, excluding the monitor for symptoms list
  • have been to the Grand Chancellor Hotel in Brisbane since 30 December 2020
  • have a fever (37. 5°C or higher) or symptoms of COVID-19 (acute blocked nose congestion has been added to the list of symptoms)
  • are a close contact of a person with confirmed COVID-19 and are within their self-isolation period.

Visit the NSW COVID-19 website at least daily for updates on areas of active community transmission.

In response to questions received from residential aged care facilities about implementing this guidance, a series of FAQs is available here.

Refer to the Infection Control Expert Group (ICEG) Guidelines on the use of face shields and other protective eyewear in health and residential care facilities.

Visitor guidelines

All residential aged care facilities in NSW should support visits for residents, unless they are experiencing a COVID-19 outbreak, or in a situation where restriction of access is required (see below). Allowing visits while maintaining appropriate screening and infection prevention measures improves the health and wellbeing of your residents. Please note that extra precautions may be required for some visitors – as detailed below.

Visitor access should be in line with the screening requirements set out in the Public Health (COVID-19 Aged Care Facilities) Order (No 3) 2020, and the guidance outlined in the Industry Code for Visiting Residential Aged Care Homes during COVID-19 and the CDNA National Guidelines for the prevention, control and public health management of COVID-19 outbreaks in residential care facilities in Australia.

Facilities are asked to:

  • Record every visitor’s name and contact details, electronically where possible
  • Ensure children are closely supervised
  • Ask visitors to undertake hand hygiene on entering and leaving the facility, and on entering and leaving the resident’s room (or designated visiting area)
  • Encourage visitors to remain within the resident’s room, or go to a designated outdoor area or alternative room where the resident and their visitors can keep apart from other residents
  • Allow no more than two visitors per resident at a time – this does not mean only the same two people can ever visit a resident.

Situations where extra precautions are needed

Visitors who have been in the last 14 days:

  • in an area with increased testing or
  • to large shopping centre listed on the monitor for symptoms web page marked as “not excluded from visiting a residential aged care facility or residential disability care facility” must wear masks while in the facility and be escorted by facility staff when going to and from a resident’s room (or designated visiting area).

Facilities located in area with increased testing may accept visitors, however extra precautions are required. Facilities must ensure that visitors wear a mask while in the facility and are escorted by facility staff when going to and from the resident’s room (or designated visiting area).


Access to the Commonwealth Pandemic Leave Disaster Payment

The NSW Premier has partnered with the Commonwealth to give workers without leave entitlements access to the Pandemic Leave Disaster Payment arrangements. The media release can be accessed here.

To access the Pandemic Leave Disaster Payment – New South Wales, a worker will need to meet several criteria, set out here.  Below is an extract of the criteria:

You may be eligible if NSW Health has told you to self-isolate or quarantine. They need to give you these directions for any of the following reasons:

  • you have coronavirus (COVID-19)
  • you’ve been in close contact with a person who has COVID-19
  • you care for a child, 16 years or under, who has COVID-19
  • you care for a child, 16 years or under, who’s been in close contact with a person who has COVID-19.

You may also be eligible if you’re caring for someone who has COVID-19.

You must also meet all of the following:

  • you’re at least 17 years old and live in New South Wales
  • you’re an Australian resident or hold a visa that gives you the right to work in Australia
  • you’re unable to go to work and earn an income
  • you have no appropriate leave entitlements, including pandemic sick leave, personal leave or leave to care for another person
  • your period of quarantine is after 17 September 2020.

It is also noted that:

You won’t be eligible if, during your 14 day isolation period, you get:

  • any income, earnings or salary from paid work
  • any income support payments, ABSTUDY Living Allowance, Paid Parental Leave or Dad and Partner Pay
  • JobKeeper Payment.

If workers or their households are struggling, there are other financial supports that may be available in NSW, and if considered this may be of some assistance to them or their families. Click here for a full listing.

3rd Workforce Retention Bonus Payment

The government will provide a third Workforce Retention Payment, based on employment, at 30 November 2020.

The final Aged Care Workforce Retention Payment will be paid in January 2021. The value of this payment will be equal to the second payment, unless a variation to funding is required.

This third payment will have the same eligibility criteria as the first two rounds (the first paid in July, the second scheduled for September) of the workforce retention bonus.

  • Eligible residential care workers will receive up to $800 before tax, per quarter, for two quarters.
  • Eligible home care workers will receive up to $600 before tax, per quarter, for two quarters.

Your employer must have made an application for the retention bonus in order for you to receive it.

The government has released frequently asked questions (FAQs) to provide further information:

  • FAQs for care workers

The ANMF has also released an information sheet on the retention bonus for workers:

  • ANMF information sheet for workers

Use this template letter to ask your employer if they have applied on your behalf.

National Aged Care Emergency Response Program

The government has announced a National Aged Care Emergency Response (NACER) Program, which aims to mobilise 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.

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. A remuneration and support package is on offer, including a $5,000 bonus for successful completion of a rotation.

Ideally teams of six will be coordinated by the aged care provider and sent on placement for four weeks, followed by two weeks of quarantine.

Employers will need to endorse staff as having the right character, skills and experience, and the ability to work under pressure and in confronting environments.

Employers should carefully consider their own operational needs before agreeing to release staff – they will still be required to provide adequate staffing levels across all their sites to meet residents’ needs.

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

Precautions for caring for residents with suspected, probable, or confirmed COVID-19

When caring for residents with suspected, probable or confirmed COVID-19 in aged care homes, staff must use personal protective equipment (PPE) as recommended in the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019) and by their state or territory.

For areas with significant community transmission of COVID-19, the Infection Control Expert Group has provided guidance regarding use of P2/N95 masks and protective eye wear/face shields in aged care homes. Specific national guidance has also been developed to support aged care homes’ response to COVID-19.

The Australian Commission on Safety and Quality in Health Care (the Commission) has developed this poster to support aged care workers with step-by-step instructions on how to put on and remove PPE, and how to fit check P2/N95 respirator masks, where they are required to be used.

Advice for home care service providers in NSW

NSW Health recommends the implementation of the following measures:

  • Any staff with fever or respiratory symptoms, even mild, should be excluded from work. They should be advised to isolate at home and seek COVID-19 testing.
  • Any staff who have been in any of the locations listed on the self-isolate and get tested immediately page, at the times and dates listed should not attend work
  • When providing care to clients who live in, or have visited the above areas, staff must wear a surgical mask while providing services.
  • Staff actively ask clients about symptoms on arrival. If staff become aware of a client with symptoms, that client should be isolated from others, and arrangements made for COVID-19 testing.

Process for requesting PPE

The Australian Government is prioritising Personal Protective Equipment (PPE) distribution from the National Medical Stockpile to aged care services that are most in need.

To ensure PPE from the National Medical Stockpile is effectively prioritised on a needs-basis, providers are being asked to complete a new Aged Care PPE Request Form. This form will be sent to you via email after an initial inquiry is made via the agedcarecovidppe@health.gov.au email address.

Providers will be asked a number of questions relating to their PPE needs, including staff numbers (or home client visits per day), number of care recipients, PPE supplies on hands, and PPE requirements. It is recommended someone with an appropriate level of operational knowledge complete the form.

If you have a confirmed or suspected case of COVID-19, a case manager will work with you on your PPE requirements.

At this stage, generally only masks are being distributed to residential and in home aged care services who are in a priority category.

A priority category is a residential or in home aged care service who:

  • cannot access PPE through their usual means, and
  • the Australian Government or State or Territory Government requires workers to wear masks in relation to a community transmission region, or
  • they deliver personal care or other activities that require close physical contact, where:
    • there is an outbreak or suspected case of COVID-19 or another notifiable infectious respiratory disease, or
    • there is an immediate threat to the continuity of safe quality care due to a lack of access to PPE supplies.

Providers should also continue to try to source the PPE through suppliers while awaiting a response. Providers need to establish an ongoing general PPE supply.

Providers should be undertaking routine screening of staff and visitors on entry irrespective of size or location. It is especially important for residential services located in communities (and/or drawing their staff from communities) where there is a local cluster of people with confirmed or suspected COVID-19, or which are considered to be at higher risk of an outbreak.

Entry screening advice for residential aged care facilities can be found here.

Use of face masks in the community to protect against COVID-19

The Australian Commission on Safety and Quality in Health Care has developed new resources to provide guidance to consumers on the use of face masks to protect against COVID-19. Wearing a face mask is now recommended by Australian health experts in areas where community transmission of COVID-19 is high, if physical distancing is not possible.

Fact sheet and FAQs from the Australian Commission on Safety and Quality in Health Care
The new fact sheet and answers to frequently asked questions will assist people to decide whether to wear a mask in the community, and provide advice on how to use face masks safely.

  • Fact sheet on COVID-19 and face masks for consumers
  • FAQs on community use of face masks

Current advice
The new resources support the recommendation of the Australian Government and Victorian Government to wear face masks in areas where there is community transmission of COVID-19. They explain how to safely put on and remove face masks, and reinforce the importance of existing prevention measures.

Wearing a face mask is currently recommended to help protect against droplets when a person with COVID-19 coughs, speaks or sneezes, if you are less than 1.5 metres away. Wearing a mask will also help protect others if you are infected with the virus.

Translation of COVID-19 Resources

For more translated resources, the Department of Home Affairs has a dedicated website – COVID-19 information in your language. This provides culturally and linguistically diverse communities with a single source of information in 63 languages other than English.

Updates to the CDNA Guidelines for Public Health Units

The Communicable Diseases Network Australia (CDNA) guidelines for public health units have been updated to include a new section on outbreak investigation and management in high-risk settings, including residential aged care.

The purpose of the guidelines is to provide nationally consistent advice and guidance to public health units in responding to a notifiable disease event. These guidelines capture the knowledge of experienced professionals, built on past research efforts, and provide advice on best practice based upon the best available evidence.

Face to face assessments

From 25 May, Regional Assessment Services (RASs) and Aged Care Assessment Teams (ACATs) should offer face to face aged care assessments, where it is possible and safe to do so.

However, it is important to note that while COVID-19 circumstances continue, face to face assessments are not mandatory where this would be unsuitable or inappropriate for a client, service provider or assessment organisation. RAS and ACATs will continue to consider their local circumstances and client choice when determining whether aged care assessments are conducted face to face or by telephone or telehealth.

Outbreak management

When an Outbreak is Suspected: Providers must immediately notify their local Public Health Unit (PHU), and the Australian Government Department of Health.

  • The PHU manages the outbreak, for example testing, contact tracing and infection control.
  • The Department of Health will work with the provider to support them to identify whether an outbreak has occurred, and deliver additional support if required, such as in-reach pathology testing, access to PPE and workforce assistance.

Workforce Management: A critical aspect in the preparation phase is understanding the workforce impact and needs. It is essential providers put in place strategies to identify where and how they will get additional staff if there is an outbreak. Aged care providers must exhaust all possible avenues including contacting other providers for support; contacting recruitment agencies; reaching out to local and private district hospitals. The workforce surge measures that are in place are a last resort and work to complement the workforce that providers have sourced. They are not the full solution for a provider.

When an Outbreak is Confirmed: When an outbreak is confirmed, providers must establish an outbreak management team to direct, monitor and oversee the outbreak, confirm roles and responsibilities and liaise with their relevant Australian Government Department of Health state/territory officer. Providers will also need to put in place additional infection prevention and control measures, including:

    • Isolation or cohorting of affected residents
    • Maintaining hand hygiene
    • Wearing appropriate PPE
    • Practising cough and sneeze etiquette
    • Enhanced environmental cleaning
    • Placing signage at entrances and other locations in the facility
    • Screening of staff and visitors.

The Department of Health’s guide to outbreak management outlines how to identify if there is an outbreak at your facility and the steps to take to manage the outbreak. Access the guide here.

Inform the Federal Department of Health of any confirmed COVID-19 cases via agedcareCOVIDcases@health.gov.au – this will facilitate Australian Government support for PPE and staff supplementation.

The Department can help with information on resources to manage an emergency or service delivery issues. If you need urgent assistance outside of normal business hours please contact the department on 1800 852 649.
This information is also available on the department’s website.

The Communicable Diseases Network of Australia also have National Guidelines for the Prevention, Control and Public Health Management of COVID-19 Outbreaks in Residential Care Facilities in Australia. This visual flowchart summarises the key steps aged care providers need to take around COVID-19 in an easy to read and understand format.

Outbreak management training

The outbreak management training module for aged care workers has been updated in accordance with the latest information from the CDNA.

Aged care workers are encourage to complete this updated training.

The training takes approximately 8 minutes to complete, and by the end of the module participants will be able to:

  • Identify what a COVID-19 outbreak is
  • Demonstrate the appropriate infection prevention control measures for a COVID-19 outbreak
  • Explain how to isolate and cohort residents during a COVID-19 outbreak
  • Identify appropriate cleaning and waste disposal procedures during a COVID-19 outbreak.

Access the Aged Care training modules here.

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.

Influenza vaccine requirement for workers

New legislation now requires all aged care workers to be vaccinated against Influenza

  • from 1 May, you must have had your influenza vaccination to work in or visit an aged care facility
  • if you’re a residential aged care worker, you must not go to work if you have a fever or symptoms of a respiratory illness

Your employer should be making sure all staff receive a vaccination as soon as possible and meet the cost.

An aged care worker who is unable (or their facility is unable) to access an influenza vaccination is able to continue employment beyond 1 May 2020 on the basis that the vaccination has not been available to the person (5(d)).

NSW Ministry of Health have stated those who have actively sought a flu vaccine before 1 May 2020 but have not yet received one because of shortage in supply may still attend work. However, they must have a vaccine as soon as one becomes available to them.

Aged care providers having trouble with supply can report this to the Department of Health at COVID-19FluVaccine@health.gov.au 

The Commonwealth is currently seeking to improve access to the vaccine:

  • The Australian Government has secured three million additional doses of seasonal influenza vaccine bringing the total number of flu vaccines to 16.5 million
  • To assist access to the flu vaccine, Primary Health Networks (PHNs) have been contacting all residential aged care providers by region to undertake a needs assessment and coordinate influenza vaccination programs for those services with an identified need. The provisions may include sourcing vaccine supply and qualified vaccine administrators (see here for further details).

Personal Protective Equipment (PPE)

Where you require PPE to do your job safely, it is your employer’s obligation to provide it. If you are caring for a resident who is suspected or confirmed COVID positive you should be provided with a surgical mask, disposable gloves, a long sleeved gown and goggles or a face mask. This should be put on before entering the resident’s room and removed on exit.  You shouldn’t reuse any PPE unless it is marked as reusable, and then only where it has been properly cleaned in line with the manufacturer’s instructions before you reuse it.  If you don’t have the PPE that you need to do a task safely, then you should not do that task until the PPE is provided.

Read more about PPE here.

Guidance for Symptom Monitoring

This guidance was developed by the Communicable Disease Network of Australia (CDNA) and endorsed by the Australian Health Protection Principal Committee (AHPPC).

This guidance is intended for health and residential aged care settings considering monitoring for symptoms. Health screening for health and aged care workers for symptoms of COVID-19 in these settings may be used as one of a suite of measures to detect and prevent outbreaks.

You can find the guidance here.

Screening

Recommendations on screening of people entering residential facilities from the Aged Care Quality and Safety Commission (22 April 2020):

  • Ideally, there should be a single point of entry to the facility, with someone tasked to continuously monitor that entry
  • Every staff member or visitor arriving at the facility should be asked, at the point of entry, to respond to a standard set of risk screening questions. Services may want to consider giving these questions to each staff member or visitor on a pre-printed form on arrival to assist with understanding and recording

The screening questions could include:

  • Have you been overseas in the last 14 days?
  • Have you been in contact with a confirmed or suspected case of COVID-19 in the last 14 days?
  • Are you in close contact with or caring for someone who is currently unwell?
  • Have you currently or within the last 7 days been unwell or been aware of any of the following symptoms:

– fever, night sweats or chills
– cough
– runny nose
– sore or scratchy throat
– shortness of breath

The staff member or visitor’s accurate response to the question about fever can be supported through temperature testing on entry. If temperature testing is used in addition to the standard screening questions, it is recommended that a no-touch method is adopted such as an infra-red temperature detection “gun” device.

Important processes

A reminder on some important processes that should be followed at all aged care facilities:

  • If there is an outbreak in your facility, all staff and residents should be tested for COVID-19. An outbreak is when there is two or more confirmed cases in three days.
  • Facilities should be recording if any of their staff work at multiple facilities or across services, whether for the same employer or another. This is important to contact trace if there is a suspected or confirmed case of COVID-19.

Discharging new and returning residents during COVID-19

The NSW Ministry of Health has developed advice for the safe and efficient discharge from hospital of new and returning residents of residential aged care facilities (RACFs). The advice includes a screening process and a discharge summary template.

A consistent approach will provide confidence that all new and returning residents at the time of discharge from hospital to RACFs have been screened by an appropriate medical officer and:

  • were not experiencing acute respiratory symptoms or fevers compatible with COVID-19 and
  • had not had any close contact with a confirmed COVID-19 patient in hospital.

NSW Health will now include a letter in the discharge paper work signed by the treating team confirming the person has been screened for COVID-19 symptoms. A template can be found here. 

Workers in RACF admitting residents returning from hospital should ensure they receive a copy of the discharge paperwork as part of their infection control management arrangements.

International Student Nurses

On 18 March, the Commonwealth Government announced it will relax international student nurse visa work conditions to provide workforce continuity for aged care facilities, home care providers and other health care workers.

This will allow international student nurses and other aged care workers to work more than the 40 hours a fortnight that they are currently. This measure will be examined on an ongoing basis. There are currently around 900 approved providers of residential aged care employers and around 1,000 approved providers of Home Care Packages. There are currently around 20,000 international student nurses studying in Australia.

COVID-19 support packages

On 31 August, the Federal Government announced an additional $563.3 million to extend support for the aged care sector’s response to COVID-19.

This takes government support to aged care to over $1.5 billion since the pandemic began.

On 1 May, the Prime Minister announced a COVID-19 specific support package for residential aged care providers, totalling $205 million. This translates to around $900 per resident in major metropolitan areas and around $1350 per resident in all other areas.

The funds are “aimed at ensuring aged care providers can offer reinforced levels of safety and care for those who need it most”.

The Australian Nursing and Midwifery Federation (ANMF) says the Federal Government must guarantee the funding is fully and directly used to employ more nurses and suitably-qualified care staff and ensure the availability of appropriate personal protective equipment (PPE) to combat the COVID-19 pandemic.

Aged care providers must address chronic understaffing and the ongoing shortages of PPE as a matter of urgency if Australia is to ensure the safety and protection of all residents.

Additional Commonwealth Funding

On 20 March, an additional $444.6 million in funding, including a retention bonus for workers, was announced for the aged care sector:

  • $234.9 million for a COVID-19 ‘retention bonus’ to ensure the continuity of the workforce for staff in both residential and home care. This means:

– Full-time direct care workers in residential care facilities will receive a payment of up to $800 after tax per quarter, paid for two quarters.
– Full-time home care workers will receive payments of up to $600 after tax per quarter, paid for two quarters.
– Part-time direct care workers receive a pro-rata payment for the amount of time you work. For example, if you work two days a week, you’ll receive 40 per cent of the payment.
– Payments will be made via your employer with the first payment expected in June (for the preceding quarter). The second payment will be paid in September.

The Australian Government Department of Health has been working on the mechanisms, processes and guidelines in order to release these funds for workers and providers.

In addition:

  • $78.3 million in additional funding for residential care to support continuity of workforce supply.
  • $26.9 million to increase the residential and home care Viability Supplements and the Homeless Supplement (including increased viability payments for National Aboriginal and Torres Strait Islander Flexible Aged Care Program providers and Multi-Purpose Services).
  • $92.2 million in additional support to home care providers and organisations which deliver the Commonwealth Home Support Programme, including for services such as meals on wheels.
  • An extra $12.3 million to support the My Aged Care call centre to respond to the needs of older Australia.

Prior to this, the Commonwealth Government announced a $2.4 billion health care package, with $101.2 million dedicated to the aged care sector to:

  • educate and train more aged care workers in infection control;
  • enable aged care providers to hire extra nurses and aged care workers for both residential and home care; and
  • bolster the Aged Care Quality and Safety Commission’s capacity to ensure providers are stepping up infection control measures.

Other useful resources

  • This document outlines special precautions when entering COVID-19 designated zones.
  • COVID-19 factsheet for aged care workers.  This is a 4 page document with information on things like visit restrictions, changes to work visa hours arrangements, when people should or shouldn’t come to work etc.
  • Cleaning – the Health Department has provided guidance on Environmental cleaning for residential aged care facilities.
  • Information for in-home care clients – “Its OK to have home care” – is designed so carers can print off and distribute before entering their clients home to reassure them that it is OK to continue to receive care
  • Flowchart/poster on when to use PPE in aged care settings
  • This document provides more detail on what kind of PPE to wear when treating suspected or confirmed cases of COVID-19 and how to wear it
  • PPE video from Australia’s Chief Nursing and Midwifery Officer, which provides a demonstration on how to appropriately use PPE

NSWNMA Support

If members are concerned their employer is not following the appropriate guidelines, the NSWNMA can provide assistance to ensure appropriate measures are in place. Contact us here.

Further information on PPE

Further information for private health nurses and midwives

 

Aged care failures show how little we value older people – and those who care for them

January 4, 2021 by Rayan Calimlim 1 Comment

As the royal commission begins investigating the failures of the residential aged care sector, it is important such a review also considers the broader socio-political factors that have contributed to this crisis.

The commission needs to go beyond the institutional problems at individual aged care facilities, as these are a symptom of a much broader rejection of ageing in society and marginalisation of older people.

Negative stereotyping of older people is reinforced in the media, and this both informs and reflects societal attitudes. In Western society especially, we fear dependency, invisibility and dying. Aged care is a silo of these fears. And until it affects us personally, we ignore it.

How older people are marginalised in society

We have an expiry date in our society. This is not the date we die, but a time when our skills and knowledge are no longer considered to be valid or useful. Our value is largely determined by our economic contributions to society. But for many older people, this is difficult to demonstrate because they’re no longer in the workforce.

The economic impact of societal rejection of ageing is significant. Modelling by Price Waterhouse Cooper indicates that Australia’s gross domestic product would increase by almost 5% if people were supported to work longer. And data from the Australian Bureau of Statistics reveal that many Australians would like to retire later if they could.

Yet, there is evidence that older people are routinely denied work. In 2016, Age Discrimination Commissioner Susan Ryan said there was an urgent need to “tackle the discrimination that forces people out of work years before they want to leave”.

While older people should be supported to work longer if they wish, over half of Australians between the ages of 65 and 80 report a moderate or severe disability, resulting in greater dependency. A 2017 study of late-life dependency published in The Lancet found that, on average, older people will require 24-hour care for 1.3 to 1.9 years of their lives.

However, it is important that older people are not considered redundant in their societal role when dependency increases.

Aged care workers are also undervalued

Residential aged care facilities fulfil an essential role in our society. Yet, our recent ethnographic study in two residential aged care facilities in Victoria shows how this role has been compromised by an under-skilled, under-valued and overworked aged care workforce.

Older people were exposed to a revolving door of anonymous workers, significantly reducing opportunities for teamwork and fostering relationships between staff and residents. In one of the not-for-profit facilities, a single registered nurse was responsible for the care of 73 residents. This contributed to the delegation of an increasing range of tasks to unregistered personal care assistants with minimal training and delays in recognising signs of health deterioration among residents.

A reliance on general practitioners also increased the likelihood of hospital transfer. And hospital transfers can sometimes prove harmful, with previous studies showing that the noisy, fast-paced environment, bright lights and anonymous faces can have a negative impact on residents, particularly those with dementia.

Within the healthcare sector, aged care has the lowest status of all specialty areas amongst nurses and doctors. Recruiting appropriately qualified and skilled people to work in aged care is thus a constant challenge. Australia is expected to increasingly rely on imported labour to staff its aged care sector in the near future.

Ways to fix the system

Encouraging more healthcare professionals to enter the aged care sector will require a multi-pronged approach, starting with finding ways to engender more professional respect for those working in the field.

Greater emphasis also needs to be placed on improving the gerontological expertise of aged care workers. This can be strengthened by prioritising aged care in medical school education and recognising “nursing home” care as a specialist medical area. It is also imperative that personal care assistants receive greater recognition of the roles and duties they perform.

Registration of personal care assistants as third-tier health care professionals is well overdue to ensure better oversight of their training and scope of their practice.

We also need to recognise the importance of human connection in residential aged care facilities. This requires strategies to build better relationships between residents and staff, and developing a formula for more accurate staffing allocations that reflect the real time commitments involved in aged care.

Who bears the ultimate responsibility?

It’s not enough to be shocked by the aged care scandals uncovered by the media and the decision to appoint a royal commission to investigate. We must also make older people, their contributions and end-of-life needs more visible. Increased funding and oversight will only come when we collectively say it’s important.

It is incumbent on us to ensure that residential aged care facilities do not operate as holding bays for the silenced, or wastelands for the discarded, where the occupants are expected to demand nothing and be as little cost to society as possible.

We have an opportunity to reconstruct the delivery of residential aged care. Let’s begin with the end in mind: a society that not only values older people, but values the resources required to provide the care they need and deserve.The Conversation

Bridget Laging, PhD Candidate, La Trobe University, La Trobe University; Amanda Kenny, Violet Marshman Professor of Rural Health, La Trobe University, and Rhonda Nay, Emeritus Professor La Trobe University, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

“Regrettable” funding announcement gets us no closer to fixing aged care 

December 3, 2020 by Rayan Calimlim Leave a Comment

The Morrison Government’s response to the Aged Care Royal Commission recommendations on COVID-19 will not provide the staffing levels, training, or transparency needed to end the crisis in aged care, according to unions involved in the aged care sector.  

As deaths began to pile up through the COVID-19 pandemic, the Morrison Government first refused to take responsibility for the aged care system during the pandemic, and has since been slow to act despite clear demands from workers and the Royal Commission. 

Previous government announcements have called for improved infection control measures, aged care workers report that in many facilities infection control measures urgently recommended by the Royal Commission still aren’t in place. 

The most recent announcements have set out more funding for the sector. However, this has not been tied to accountability or safe staffing, much to the chagrin of aged care workers and their unions.  

Australian Unions Federal President, Michele O’Neil has called on the Government to do more to address the ongoing aged care crisis. 

“This Government needs to take responsibility for the years of understaffing and low wages in aged care. There have been 685 preventable deaths caused by COVID-19. 

“In the midst of a crisis in aged care which has been exacerbated by a pandemic, aged care workers need more funding. We need minimum staffing levels with a mandated mix of skills on every shift in every workplace.” 

Aged care nurses along with Australian Nursing and Midwifery Federation and Australian Unions officials met with Federal Parliamentarians in Canberra this week to discuss a solution to the crisis in the sector.

Unions across the country continue to demand action in aged care. Show your support here. 

Time to reward aged care workers

December 2, 2020 by Rayan Calimlim Leave a Comment

Royal commission lawyers call for mandatory staffing ratios, significant wage increases and a greater role for registered nurses in aged care.

Senior lawyers assisting the aged care royal commission say it is “high time” the dedication and commit-ment of aged care workers was properly rewarded.

“The vast majority are women and the low pay they receive is nothing less than the aged care system exploiting the goodness of their hearts,” say counsel assisting Peter Rozen QC and Peter Gray QC.

They argue that aged care workers “need better wages and conditions and enough colleagues to be able to complete their work safely and to the standard that they consider is appropriate”.

Rozen and Gray make the comments in a far-reaching plan to rebuild the aged care sector.

They recommend mandatory staff-to-resident ratios, significant wage increases and a greater role for registered nurses.

The recommendations are being considered by royal commissioners Tony Pagone and Lynelle Briggs, who will deliver their final report to the federal government in February.

Rozen and Gray’s 500-page submission says at least one in five residents have received “substandard care” under a system that “deprives people of their humanity”.

They cite a University of Wollongong report that on average, residents receive 180 minutes of care per day, of which 36 minutes are provided by RNs.

Some nursing homes provide far less care time, particularly from registered nurses.

Their submission says the federal government must “exercise a leadership role in planning for the future needs of the aged care workforce. The sector has not done this and cannot be relied upon to do it in the future”.

Pay needs to increase significantly

They call for nursing homes to be required by law to deliver minimum adequate care standards.

On wages, the submission notes that governments have made several failed attempts to give additional funds to providers “in the hope that they would be passed on to aged care workers by way of increased wages”.

However, “Unless aged care workers have a legal right to be paid more, they won’t be. A new approach is needed. It will only succeed if all parties – providers, unions and government – work together.”

Rozen and Gray propose a “significant increase” to award pay rates through a step-by-step process.

By 2030, staff providing personal, nursing and allied health care would be paid at “comparable levels to their counterparts working in the health and disability services systems”.

Government aged care subsidies would be tied to “an explicit policy of increasing wages and improving working conditions for aged care workers”.

On training, the submission recommends an immediate injection of funds into the sector for education and training to meet “an urgent need for skills acquisition” among aged care workers.

By 2030, all personal care workers should be registered and accredited with mandatory Certificate III qualifications as a minimum.

All staff should receive better training in dementia care, and high-level infection control overseen by trained infection control officers “will be the norm”.

Steps to better staffing

The royal commission counsel’s proposed staffing recommendation is in two parts – a first step on 1 July 2022 and a second step on 1 July 2024.

Step 1 would require providers to employ registered nurses, enrolled nurses, and personal care workers for at least 215 minutes per resident per day for the average resident, with at least 36 minutes of that staff time provided by a RN.

In addition, the “minimum staff time standard” should require each facility to have at least one RN on site for the morning and afternoon shifts (16 hours per day).

In Step 2, the minimum would range from 215 to 264 minutes per resident per day for the average resident, with at least 44 to 36 minutes of that staff time provided by an RN. An RN would be employed on every shift.

These minimum standards would result in average staff increases of 20 per cent from 1 July 2022 and 37.2 per cent from 1 July 2024.

The final report is to be handed down in February 2021.

Pandemic fight needs more staff

December 2, 2020 by Rayan Calimlim Leave a Comment

The Aged Care Royal Commission criticised the federal government’s lack of planning and leadership over COVID-19.

The aged care royal commission has called on the federal government to immediately fund additional staff in nursing homes to cope with the COVID-19 pandemic.

The commission criticised the government’s lack of a dedicated plan or clear leadership in the aged care sector’s handling of the emergency.

The commission delivered its special report on COVID-19 and aged care to the government in October.

The report called for more funding for staff so families could visit loved ones in care, and measures to provide allied and mental health services to residents.

The Morrison government said it accepted the recommendations and announced an initial $40.6 million in extra funding.

It also announced an additional $10.8 million “to enhance skills and leadership of aged care nurses” by expanding the Australian College of Nursing scholarship program, establishing an aged care practice program and creating “skills development programs for nurses and personal care workers in aged care”.

The government said it would further respond to the special report by 1 December.

Royal Commissioners, Tony Pagone and Lynelle Briggs, said they had decided to produce a brief report on COVID-19 in advance of their final report to be delivered in February 2021.

They called the pandemic “the greatest challenge Australia’s aged care sector has faced. Those who have suffered the most have been the residents, their families and aged care staff”.

“It is clear to us that people receiving aged care services, their loved ones, those providing care and the aged care sector itself need immediate support and action,” they said.

They recommended the government require providers to appoint “infection control officers” and said the government should arrange to put “accredited infection prevention and control experts” into nursing homes.

They said the government’s actions were “insufficient” to ensure the aged care sector was fully prepared for the pandemic.

They concluded: “There was not a COVID-19 plan devoted solely to aged care. But there was a national COVID-19 plan that the Australian Government sought to adapt and apply to the aged care sector.”

All too often, the commissioners said, families, providers and health care workers “did not have an answer to the critical question: Who is in charge?”

The special report makes it clear that the government’s response to the pandemic in nursing homes was made largely without input from aged care experts.

For example, there was not a single aged care specialist among the 24 members of Communicable Diseases Network Australia, which is supposed to coordinate, lead and support best practice in the prevention and control of communicable diseases.

The special report makes it clear that authorities were too slow to recommend or mandate the use of face masks in aged care facilities.

Championing education for COVID-19

December 2, 2020 by Rayan Calimlim Leave a Comment

Nursing home “infection control champions” are on the frontline of the aged care sector’s response to COVID-19.

Registered nurse Ai Tahara works for a major aged care provider that has experienced COVID-19 outbreaks at some facilities.

Ai’s own inner-Sydney workplace has escaped infection so far.

Her employer introduced infection control champions last year, before the pandemic struck.

Ai describes them as “key resources in the outbreak management team. They conduct regular rounds to check that correct infection control procedures are being followed.”

Ai was appointed as an infection control champion three months ago and is about to start online infection control training for COVID-19.

Training for non-COVID infectious diseases – gastro, scabies, pneumonia and urinary tract infections, for example – is limited to reading a manual.

Ai hopes her training will lead to improved observance of infection protocols.

“Infection control knowledge among staff, especially AiNs, is quite minimal,” she says.

The aged care royal commission has recommended the federal government deploy accredited infection prevention and control experts into nursing homes to provide training, assist with the preparation of outbreak management plans and assist with outbreaks.

It also recommended that all nursing homes have one or more trained infection control officers as a condition of accreditation.

Ai believes all staff need some infection control training.

“I don’t think education should only be for infection control champions. Providers know that education is vital, so why not extend it to all staff in some form?”

According to researchers Philip Russo (Monash University) and Ramon Zenel Shaban (University of Sydney), nursing home infection control officers should have access to expert resources and be capable of implementing infection prev-ention programs.

“Employers would be required to support these nurses to take the infection prevention ‘champion’ role, and under the close supervision and guidance of the accredited experts, they could prepare plans for outbreaks like COVID-19,” Professors Russo and Shaban wrote recently.

“These plans would include ongoing education around the use of PPE, procedures regarding how to manage residents who become infected, and trigger points for escalating responses.”

They said a recent survey of aged care facilities found more than half reported a lack of staff with specialised qualifications and experience in infection prevention and control.

Ai says the heavy workload borne by aged care staff is a major barrier to improving infection control.

“Our aged care minister said numbers are not the only issue with aged care, but he should know that staff increases are essential.

“Even without COVID, when you look into an incident at a nursing home, such as a fall, it often happens because of understaffing – no one is available to attend to the resident.”

Ai welcomes the call by counsel assisting the royal commission for nursing homes to be required by 
law to deliver minimum adequate care standards.

Counsel assisting urged the commissioners to recommend minimum staffing standards would result in average staff increases of 20 per cent from 1 July 2022 and 37.2 per cent from 1 July 2024.

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