As this Quality Bulletin goes to press, the Prime Minister has just made a statement following a National Cabinet discussion about the visitor restrictions that have been applied to all residential aged care services.
There is no doubt that the visitor restrictions have been challenging for everyone – residents, family members and aged care service staff. We are aware that many providers have implemented the restrictions with care and compassion, and have rightly earned praise from their residents and families. However the Commission has also received complaints from some spouses and adult children of residents who have been prevented from seeing their loved one who they have visited and supported daily over many months and sometimes years. Others have contacted us to seek help in being allowed to see their loved one in the very final stages of that person’s life.
The Prime Minister’s statement on 21 April, supported by the Chief Medical Officer Dr Brendan Murphy, has clarified that in the evolving context of the COVID-19 pandemic, with growing evidence of low and reducing rates of community transmission and outbreaks, it is not reasonable for aged care residents who rely on family visits to be denied physical access to their families.
Of course, all necessary infection prevention and control measures must continue in aged care services, including rigorous screening of staff and visitors. Dr Melanie Wroth, the Commission’s Chief Clinical Advisor, has released guidance to assist residential services to establish or improve their screening process.
What National Cabinet has now clarified and underscored is the expectation that aged care providers will be caring, compassionate and proportionate in their implementation of the visitor restriction requirements that have been promulgated (and amended over time) at Commonwealth and individual state and territory levels. The Commission has developed advice for providers to assist them in implementing the restrictions.
In this issue of the Quality Bulletin (which we have decided to issue fortnightly for the next few months to ensure your timely access to relevant updates), you’ll find the high-level results of our recent residential aged care survey on preparedness for a COVID-19 outbreak. The survey results have provided valuable information to guide the Commission’s activities, in conjunction with federal and state health authorities. Thank you to all aged care residential providers who completed the survey.
Information is also provided on the Commonwealth Government’s announcement of the roll out of welfare checks for consumers who have chosen to defer aged care home services during the pandemic. It is clear that in these challenging times, a wide range of aged care stakeholders are working very effectively together to protect the wellbeing of older Australians, and are demonstrating fantastic innovation in their efforts.
Speaking of innovation, we have pulled together a few examples of how services across the country are exploring new ways of promoting consumers’ wellbeing and helping them to remain strongly connected to carers, other family members and friends. We would be very pleased to share more examples from providers, consumers and their families, so please check out the information provided at the end of this bulletin to help in sharing successful practice and innovation across the sector.
Residential aged care survey on preparedness for COVID-19
In the last edition of the Quality Bulletin, details of an online survey conducted with residential services were featured. The survey was designed to help services evaluate their readiness for a COVID-19 outbreak, review infection control systems and to act to identify, minimise and manage risks to the health, safety and wellbeing of consumers in their care.
Further analysis of the survey responses has now been undertaken and the findings are already proving to be a crucial input to supporting the Commission’s implementation of a proportionate, risk-based approach to our regulatory program.
The findings reveal encouraging progress against critical measures designed to minimise the risks of a COVID-19 outbreak. Positive findings include that 99.5% of residential aged care providers have finalised or are finalising an infectious control/respiratory outbreak management plan that includes all the areas identified in the CNDA National guidelines.
The results also showed that services are still working on ensuring that all staff know what is expected of them under an outbreak management plan relevant to their roles and responsibilities. Services are also grappling with staffing contingency plans if significant numbers of staff are unwell or not able to work. Around one-quarter of services signalled that they have further work to do on putting in place arrangements to ensure sufficient supplies of protective equipment, hygiene and cleaning products in anticipation of increased need.
The Commission is following up the survey with monitoring and support contacts for a number of individual providers, including any providers who are yet to complete the survey. Any provider who has not yet submitted their responses is urged to do so immediately.
The Commission will be continuing to conduct assessment contacts, surveys and work with providers to ensure we can support them in their preparation for the risk of a COVID-19 outbreak.
New survey rolled out to aged care home services
The Commission is currently contacting all approved providers of aged care home services by email to undertake an online self-assessment survey to monitor and support them in their preparation for a COVID-19 outbreak. The survey is due to be submitted by close of business Wednesday 29th April 2020.
Note that home services include services delivering home care packages, Commonwealth Home Support Programme (CHSP) services and flexible care services through which short-term restorative care is provided in a home care setting.
The online self-assessment survey is designed to support home services providers to evaluate their readiness for a Coronavirus (COVID-19) outbreak affecting their aged care home service(s), to review the infection control systems in place, and support home service providers to take action to identify, minimise and manage risks to the safety, health and well-being of their consumers.
The questions are based on the Department of Health COVID-19 Guide for Home Care Providers. Approved providers of aged care home services are urged to consult this guidance on the department's website.
Home services assessment contacts
The Commission has recently been conducting telephone assessment contacts with home services. As part of these contacts, the Commission has been calling approved providers of home services to discuss their responsibilities under the Aged Care Quality Standards and to provide details about guidance material that has been released, including the Coronavirus (COVID-19) Guide for Home Care Providers guidelines for delivering home services to aged care consumers and the Australian Health Protection Principal Committee (AHPPC) advice of visits to vulnerable groups.
To date, themes emerging from the contacts include providers acknowledging the need to have appropriate plans in place to ensure continuity of service delivery during the pandemic; the impact on some services of a reduction in their volunteer workforce, and; the need to enhance staff knowledge and training regarding the need for and use of personal protective equipment (PPE).
Additionally, the Commission has been hearing of strategies providers are putting in place to best support consumers during this time. These include services working together to share PPE resources where needed; a partnership that delivered iPads (and training in use) to consumers to help alleviate feelings of isolation; adapting centre-based respite to home-based respite care; and meal delivery services adapted to no-contact drop to minimise risk to consumers.
The Commission will use the information gathered in these assessment contacts to inform other activities, as well as information and resource development.
Welfare checks to ensure the wellbeing of Senior Australians
Welfare checks can now be conducted with consumers who have elected to defer aged care home services during the COVID-19 pandemic.
Minister for Aged Care and Senior Australians Richard Colbeck announced recently that home care recipients who had suspended services to avoid the risk of contracting the virus could now receive phone calls to ensure their wellbeing.
Minister Colbeck said the Australian Government is working with a number of consumer organisations – including the Older Persons Advocacy Network (OPAN) - to provide the additional supports.
OPAN can now receive referrals from Home Care and CHSP providers, as well as My Aged Care, where the older person or their family are reducing or cancelling services due to COVID-19.
OPAN will call back the person to:
- Discuss their concerns
- Answer questions regarding care provision during COVID-19
- Consider the supports they may have in place and discuss the alternate aged care service provision that may be available.
As OPAN’s call back service increases, support will continue to be available through OPAN aged care advocates on 1800 700 600.
The Department of Health has produced a video with tips on how to assist senior Australians during this difficult time, along with a range of additional information and resources.
Examples of innovative consumer engagement
One of the more positive outcomes of the current situation is the creativity that providers, consumers and their families have demonstrated to maintain close links between consumers and their families where family members are not visiting in person.
As you would expect in a time of visitor restrictions and social distancing, technology is playing a huge role in helping people to stay in touch.
Catholic Healthcare has introduced additional technology to facilitate video calls, as well as running virtual events and ‘live-streamed’ concerts across most of its network of 41 homes, and is planning on introducing virtual tai chi shortly.
Perth’s Adventist Care has introduced photo sharing for residents and their families and has set up a live stream so that older people unable to leave their room can keep up with events at their facility.
Residents at an Opal facility on the Gold Coast were delighted to get an unexpected visit from the Easter Bunny who turned up outside their window, riding on a cherry picker borrowed for the occasion by a resident’s daughter. New heights in sartorial elegance have also been scaled in some Opal services with an ‘Hawaiian shirt day’ which definitely added a bit of fun to the daily routine.
A number of services, including Oryx Communities in WA, have introduced the ‘window of love’ – a simple idea that allows residents and their families to see and talk to each other through a closed window or pane of glass, either by phone or using specially installed microphones and speakers.
It’s not just residential services that are innovating – Community Vision has deployed a simple but effective idea to help their consumers feel safe and secure. Consumers are provided with a red card and a green card and encouraged to put one or other in their window to signal ‘I’m okay/I’m not okay.’ They are also running virtual catch ups to ensure their consumers stay connected.
If you would like to share your innovative ways to connect consumers and their families, the Commission would be pleased to hear from you and to help to share your idea more widely. Simply send an email with details of your idea, program or initiative to email@example.com.
You can also send any supporting videos, photos or other visual material (ensuring first that you have secured the permission of any people featured in videos and photos to share their image). We will “curate” a selection of the contributions received, and may contact you prior to publishing any submissions.
Upcoming events and other resources
The Older Persons Advocacy Network (OPAN) has a webinar recording available for anyone to view on its website, titled Safely receiving aged care services at home during COVID-19.
Advance Care Planning Australia (ACPA) and the End of Life Directions for Aged Care (ELDAC) program will host a series of webinars this month for various health sector audiences, including aged care services, GPs and healthcare/hospitals.
- COVID-19 and ACP Webinar for General Practitioners - 28 April 2020, 6.30 – 7.30 pm (AEST)
- End of Life Directions for Aged Care in Home Care - register - 30 April 2020 1.00-2.00 pm (AEST)