In these uncertain times when the COVID-19 pandemic has challenged so much of what we have previously taken for granted, it behoves us all to double down on our shared commitment to protect the safety, health and wellbeing of those receiving aged care.
This edition of the Bulletin includes a summary of the Commission’s recent regulatory activities undertaken as part of our proportionate, risk-based response to COVID-19. As the national regulator, we are striving to strike the best balance between assessment, monitoring, education, support and compliance action as we continue to hold aged care providers to account for the quality, safety and prudential compliance of their care and services.
There is no doubt that providers’ adherence to the Quality Standards will continue to play a significant part in ensuring the safety and wellbeing of older people receiving aged care and services. Treating consumers with dignity and respect and finding ways to meet their social needs as well as keeping them safe has never been more important.
The Commission and the Department of Health have been putting extra effort into making sure that up-to-date information and guidance in relation to COVID-19 is available to the sector. If you haven’t already done so, I encourage you to visit the dedicated COVID-19 area on our website where you will find a range of useful resources as well as links to relevant information from other reliable sources.
Advising the Department of Health of an outbreak of COVID-19
Providers are urged to advise the Department of Health of any confirmed cases of either residents/care recipients or workers in your facility, service or program. Once you have advised of any confirmed cases, the Government can quickly assist with:
- Staff supplementation and reimbursement
Please advise agedcareCOVIDcases@health.gov.au and the department will be in touch promptly to discuss options for support.
This information will be shared with the Commission to enable ongoing actions to ensure that aged care providers are supported in providing safe, quality care during the pandemic.
Priority and process for ordering PPE
As advised by the Department of Health*, aged care facilities, program and workers where there has been a confirmed case of COVID-19 are being prioritised for access to personal protective equipment (PPE) from the national stockpile.
Aged care providers requesting access to PPE should email firstname.lastname@example.org.
The following information must be included in a provider’s email request
- the facility, program or service requiring PPE
- if you have had a confirmed case of COVID-19 at your facility, program or service
- types and quantities of PPE required – please note, only masks are available at this stage and other PPE will be provided when available
- details of other suppliers you have attempted to source PPE stock from.
Requests can be made by aged care services and any workers providing support to people receiving aged care support living in the community.
All requests are being triaged by the Department of Health, and Departmental staff may be in contact with a provider for further information. Approved requests will be actioned through State and Territory governments who will distribute the supplies.
If your facility, program or service is experiencing an outbreak of influenza, the above process also applies.
It is important to remember that if you do not have a confirmed case of COVID-19 within your facility, program or service, you should expect delays in receiving your PPE due to the increase in demand.
*If you are not receiving the ‘Protecting Older Australians: COVID-19 update’ on a regular basis, you can subscribe here: agedcare.health.gov.au/AgedCareUpdates
Requirements regarding the annual influenza vaccination this year
In the current situation, the importance of the annual influenza vaccination cannot be overstated. We all have a role to play in protecting ourselves and others in the community, including older Australians, from what is a largely preventable disease. While the influenza vaccination will not protect you or others from COVID-19, it is important for people to have the vaccine because the symptoms of the two can be confused, and also, contracting both would put a person’s health at greater risk.
From 1 May 2020, as part of recently announced restrictions on visitors to residential aged care services, all visitors and staff will be required to have the influenza vaccination.
This strengthens the existing requirement under the Aged Care Quality Standards for aged care providers to encourage staff and volunteers to get vaccinated, including by being required to offer free flu vaccinations to them every year, and to keep records of their vaccinations. For more information, refer to the Quality of Care Principles 2014 and the Records Principles 2014.
You can read the Department of Health’s fact sheet on restrictions on entry into and visitors to aged care services on its website.
Proactive contact with residential providers on infection control and pandemic preparedness
Between 17 and 26 March 2020, the Commission undertook brief assessment contacts by telephone with all residential aged care approved providers to monitor and support their preparation for a COVID-19 outbreak. Approved providers were asked to discuss their responsibilities under the Aged Care Quality Standards and to outline their response to guidance material that has been released including the Communicable Diseases Network Australia (CDNA) infection control guidelines and the Australian Health Protection Principal Committee (AHPPC) advice on visits to vulnerable groups including residential aged care services.
Over 870 approved providers were contacted. Key findings included:
- most approved providers were aware of, and had implemented, the CDNA infection control guidelines and/or AHPPC advice; and
- approved providers have concerns regarding access to Personal Protective Equipment (PPE).
Additionally, approved providers used this brief contact as an opportunity to ask questions of the Commission and we are following up with individual organisations where additional support is required.
The Commission also undertook a longer-form (10 question) online survey with residential aged care services designed to support them to evaluate their readiness for a Coronavirus (COVID-19) outbreak at their service, review infection control systems and to take action to identify, minimise and manage risks to the safety, health and well-being of consumers in their care.
At the conclusion of this activity, 2,262 services had responded to the survey out of a total 2,724 residential services. The Commission appreciates the effort made by services to complete this activity, which a number of services indicated they had found useful.
It is very encouraging that 99% of services reported having an infection control outbreak management plan that covers the key areas for COVID-19 preparedness. A similar proportion of respondents have implemented visitor restrictions as per the Australian Health Protection Principal Commission (AHPPC) guidance. It is clear that services are still working on ensuring that all staff know what is expected of them under this 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 survey questions were based on the CDNA National Guidelines for the Prevention, Control and Public Health Management of COVID-19 Outbreaks in Residential Care Facilities in Australia. You are urged to consult these guidelines for essential information.
The Commission will be following up the survey and assessment contacts with monitoring and support contacts for a number of individual services. Additionally, the assessment contact and survey findings at State and National levels will be used to plan further information and resources for the sector in consultation with the Department of Health and State health authorities.
We will continue to adjust our regulatory response to the COVID-19 outbreak in line with the latest advice and guidance from the Department of Health and other health authorities.
COVID-19 – resources and information
Our COVID-19 information page on our website is updated frequently – see the latest updates. The information is sorted by date and includes every message the Commissioner has issued to providers, as well as specific information relating to managing infection-related risks, updates on any changes to the Commission’s processes (such as the new risk-based question for providers) and links to useful content from other government agencies.
Liquidity Management for approved providers
Statutory obligations - Liquidity Management Strategy
In the current circumstances of the pandemic, it is timely to remind all approved providers holding a refundable accommodation deposit (RAD) of the need to have in place a documented strategy and sufficient liquidity to ensure they can meet their repayment obligations as they fall due. An approved provider’s liquidity management strategy should set out the amount, the factors that the approved provider had regard to in determining the level of liquidity, and the form in which it will maintain the minimum level of liquidity.
If an approved provider becomes aware that the liquidity management strategy no longer meets the requirements of the business, then the strategy must be modified or replaced.
More broadly, businesses need to ensure they have sufficient liquidity to meet their financial obligations in a timely manner. As business conditions change all organisations should be actively monitoring their liquidity levels.
Cash flow forecasting
As part of an approved provider’s liquidity management strategy it is important to actively monitor the likely cash requirements in the short and longer term.
It is essential that approved providers make realistic assumptions about:
- the level of occupancy, including the likely length of time for a vacancy to be filled
- RADs, including whether a new RAD will match the amount that was paid by a previous resident
- the total amount of liabilities and when they fall due
- the value of their investments if they are required to be used to meet operating needs.
Approved providers should consider modelling a number of scenarios to assess the likely impact on the business for each one.
his model should present a monthly cash flow balance over the coming six months at a minimum.
Focus on the Standards – Standard 7 Human resources
This month, we take a look at Standard 7, its overarching principles and requirements and links to supporting information, including guides, resources and case studies.
The consumer outcome statement for Standard 7 is:
I get quality care and services when I need them from people who are knowledgeable, capable and caring.
Standard 7 is all about an organisation’s workforce, and includes four key concepts: that the organisation has enough skilled and qualified staff; that staff have the right skills, qualifications and knowledge to do their jobs effectively; that the organisation respects their staff’s diverse skills and qualities and support them, and; that the organisation regularly assesses, monitors and reviews its workforce through an effective human resources system.
The Commission expects organisations at any time to have an effective system to plan and monitor its workforce to meet consumers’ needs and deliver safe and quality care. It is expected that the organisation will have considered its staffing needs during an internal or external emergency. Providers are urged to review and adapt their workforce plan to meet changing circumstances and to identify and manage risks that might result from the COVID-19 pandemic. Where the existing arrangements of a COVID-19 affected residential service need to be augmented to cope with changed and extended demands, the Federal Government has announced measures to support workforce continuity. See the Department of Health for more information.
Additionally, Requirement (3)(b) focuses on ensuring workforce interactions with consumers are kind, caring and respectful of each consumer’s identity, culture and diversity. This is because the way a workforce interacts with consumers can have a big impact on the outcomes of the care and services, including the consumer’s safety, health and wellbeing.
It is important to remember that, other than noting that compliance by organisations will be required, this Standard does not consider work health and safety or areas of human resources that are dealt with in other Acts, legislation or codes.
As with all the Standards, it is recommended that organisations review the reflective questions for each of the Standard’s requirements, along with the examples of actions and evidence.
- Standard 7 – human resources
- Guidance and resources – Standard 7
- Quality Standards storyboards and user guide
- Case studies
Check out our new Alis video
The Commission has released a new video to accompany the recent launch of our online Aged Care Learning Information Solution – Alis.
The video, at just over a minute long, gives an overview of what aged care services providers can expect from Alis, including the kind of learning opportunities available and how to access Alis (all that’s needed is an internet connection and a suitable device!).
Alis, which launched in February with an initial focus on the Aged Care Quality Standards, features high quality video, real-life scenarios and knowledge checks so that users can gauge their progress as they go.
Alis will extend the reach of, and access to, the Commission’s education programs by ensuring that educational programs both for the sector and for Commission staff are available anywhere and at any time. Content is continuing to be updated including content relevant to managing the COVID-19 pandemic.
Watch the video on the Commission’s website.
Alis can be accessed using https://learning.agedcarequality.gov.au/
A learner account can be established through registration at the above URL. Registration ensures access to the learning modules.
Assessing against the Standards workshops
The Commission is working with the Department of Health to monitor developments and advice to the aged care sector regarding the COVID-19 situation. Each day new details are provided, and we are continuing to review the current situation to determine the best course of action to support the sector.
As a result, and in line with recent advice, the Commission has decided to postpone its face-to-face ‘Assessing against the Standards’ workshops for both residential and home services. In the meantime, we are considering options for providing this information and education via webinars and other online options where this is possible.
Initiatives to ease the stress
While the impact of COVID-19 is proving to be challenging, some aged care services across the world have come up with interesting ways of keeping consumers and their families engaged and connected in a time of social distancing and self-isolation.
Check out some examples below.
The BBC website reported that residents of St Vincent’s Retirement Home in Ryde, Isle of Wight have been making signs for their loved ones, while Metro.co.uk reports that residents at Bentley Manor Care Home in Crewe, Cheshire, have been making video messages for their friends and families and have been provided with iPads so they can make Skype calls.
In Wales, the Good News Network shared a video of residents at the Bryn Celyn Care Home in Maesteg playing real life Hungry, Hungry Hippos using baskets on sticks amid much laughter.
Over in the United States, The Post Searchlight in Georgia spoke to a number of facilities in the area to report that walking the grounds in the mild weather, resident-led church services, bingo and card games were keeping residents’ spirits up.
In Alabama, The News Courier found that Great Oaks Management has residents in two of its facilities practicing social distancing but maintaining social links by having hallway ice cream socials, birthday parties, bingo and trivia, as well as doorway bowling and kickball. They’ve also provided residents with individual activity kits with word searches, crossword and other puzzles.
If you see an example you think would be worthy of sharing in the next Quality Bulletin, please send them to email@example.com.