What are we seeing?

In addition to the National Cabinet’s four 'enhanced arrangements' for residential aged care facilities (detailed below), we have observed a number of providers implement a range of other measures during these unusual times.

While the Federal Government has not imposed a full 'lock down' of aged care facilities, we have seen clients impose lock down measures as a precaution, along with other strict guidelines in order to protect the health and wellbeing of residents and staff.

In addition to full lock downs, we have seen a range of other measures including:

• restrictions on lifestyle activities that take place outside of residential aged care facilities
• additional training for staff about hygiene
• restrictions on volunteer programs and school visits
• establishing special teams to deal with the evolving COVID-19 situation
• time limits and visitation hours imposed
• visitors restricted to family members only
• single point coordination for responding to requests from family members to bring children under the age of 16 onsite for visits.

We have observed that residential aged care providers are not making these decisions lightly and that at the forefront of every decision being made is the health, safety and wellbeing of residents, staff and visitors.

These are particularly challenging times for residential aged care in Australia and the added burden on staff of monitoring the proper implementation of these additional measures will be challenging but hopefully effective in protecting our elderly.

What is clear from the Government’s response is that providers and Government should continue to work together to ensure the delivery of safe and quality care to senior Australians and to support the aged care workforce in doing so.

The National Cabinet’s 'Enhanced Arrangements'

The National Cabinet has announced the following four enhanced arrangements to 'protect older Australians in residential aged care facilities and in the community':

Restrictions on entry into aged care facilities

'The following visitors and staff (including visiting workers) should not be permitted to enter the facility:

• Those who have returned from overseas in the last 14 days;
• Those who have been in contact with a confirmed case of COVID-19 in the last 14 days;
• Those with fever or symptoms of acute respiratory infection (e.g. cough, sore throat, runny nose, shortness of breath); and
• Those who have not been vaccinated against influenza (after 1 May).'

Visitors

'Aged care facilities should implement the following measures for restricting visits and visitors to reduce the risk of transmission to residents, including:

• Limiting visits to a short duration;
• Limiting visits to a maximum of two immediate social supports (family members, close friends) or professional service or advocacy at one time, per day;
• Visits should be conducted in a resident’s room, outdoors, or in a specific area designated by the aged care facility, rather than communal areas where the risk of transmission to residents is greater;
• No large group visits or gatherings, including social activities or entertainment, should be permitted at this time;
• No school groups of any size should be allowed to visit aged care facilities.
• Visitors should also be encouraged to practise social distancing practices where possible, including maintaining a distance of 1.5 metres.
• Children aged 16 years or less must be permitted only by exception, as they are generally unable to comply with hygiene measures. Exemptions can be assessed on a case-by-case basis, for example, where the resident is in a palliative care scenario.
• Measures such as phone or video calls must be accessible to all residents to enable more regular communication with family members. Family and friends should be encouraged to maintain contact with residents by phone and other social communication apps, as appropriate.'

Managing illness in visitors and staff

'Aged care facilities should advise all regular visitors and staff to be vigilant for illness and use hygiene measures including social distancing, and to monitor for symptoms of COVID-19, specifically fever and acute respiratory illness. They should be instructed to stay away when unwell, for their own and residents’ protection.

Given the high vulnerability of this particular group, aged care facilities should request that staff and visitors provide details on their current health status, particularly presentation of symptoms consistent with COVID-19. Screening for fever could also be considered upon entry.

These additional measures should be implemented in order to better protect residents and prompt individuals entering the aged care facility to consider their current state of health prior to entry. Both individuals and management need to take responsibility for the health of visitors and staff at facilities to protect our most vulnerable community members.

These are the recommendations of the AHPPC, individual facilities may choose to implement additional measures as they see fit for their circumstances.'

Symptomatic staff

'Staff should be made aware of early signs and symptoms of COVID-19. Any staff with fever or symptoms of acute respiratory infection (e.g. cough, sore throat, runny nose, shortness of breath) should be excluded from the workplace and tested for COVID-19. Staff must report their symptoms to the aged care facility.'

Despite these measures, the Prime Minister acknowledged that with regard to end of life care, each facility has the discretion to make 'very strict arrangements' for families to visit depending on the circumstances, provided the general principles of social distancing and other measures are followed.

The Prime Minister also emphasised the need for scalable and sustainable measures to be put in place. With that in mind, the Chief Medical Officer Brendan Murphy said that there should not be a complete lockdown of aged care because we cannot deny access to an elderly person to their families and loved ones for six months and that a lock down for any shorter period 'would have no long-term benefit'.

In an effort to increase the available workforce to help with the health response facing Australia, the Government has also lifted work restrictions on 20,000 student nurses.

Maddocks has produced guides to a range of legal issues raised by the coronavirus (COVID-19). You can access these guides here.