Advice for staff and operators of aged care facilities

📌 Page last updated 8 September 2022

If you are responding to cases and outbreaks of acute respiratory illnesses, including COVID-19 and influenza, refer to the public health guidance for acute respiratory illnesses in residential aged care facilities page.

COVID-19 precautions in your facility

Staff

Staff must wear a mask when working in a residential aged care facility (RACF) under the Public Health (Mandatory Face masks) Emergency Direction 2022.

The Public Health (Aged Care Workers COVID-19 Vaccination) Emergency Direction, issued on 4 April 2022, states that an aged care worker must not work at a residential aged care facility in the ACT unless the worker:

  • is up to date with COVID-19 vaccination, or
  • has a COVID-19 vaccine exemption, or
  • had a COVID-19 infection within the previous 4 months.

This applies to health practitioners who visit a RACF to provide care to residents.

For information on medical and non-medical exemption application processes, see information for employees that require vaccination.

Influenza vaccines are strongly recommended for all residential aged care facility staff.

All staff entering a RACF should be screened on arrival to the facility using the facility’s screening process.

The screening questions and Check In CBR app can be used for this purpose.

Staff who have symptoms of an acute respiratory illness, even if mild, should not attend the workplace, but get tested for COVID-19 and stay at home.

They should stay home until their symptoms have improved, even if they test negative to COVID-19.

Further information about sick and carer’s leave is available on the Australian Government Fair Work site.

Regular surveillance testing

Staff working in residential aged care facilities (RACFs) are recommended to undergo regular surveillance testing by taking:

  • a COVID-19 rapid antigen test (RAT) a minimum of 3 times per week, or
  • have had a negative RAT result within 48 hours of attending a shift if they work part time.

Getting tested is only one component of a series of risk mitigation measures that should be implemented to minimise risk of COVID-19 exposure and transmission.

See COVID Smart behaviours for more information.

If workers have any COVID-19 symptoms, they should not attend work even if they have had a negative RAT.

Facilities who use a staff screening program should ensure that they have a documented process.

More information is available on the guidance on COVID-19 testing for community sector organisations.

For more information, see rapid antigen tests (RATs) for residential aged care facility workers.

Visitors

There are no visitor restrictions for ACT residential aged care facilities (RACFs).

However, ACT Public Health Directions may apply to some visitors at these facilities.

Restrictions apply to visitors who:

  • have tested positive to COVID-19 within the last 7 days, or
  • are awaiting the result of a COVID-19 test, or
  • are household contacts of COVID-19 cases when visiting high risk settings.

See key information for high-risk settings for current entry requirements for staff and visitors.

Additionally, all visitors aged 12 years and over must wear a face mask while visiting RACF indoor settings.

Further information is available on the face masks page.

Consideration should be given to children aged between 8 and 11 years wearing a mask when entering indoor settings. It is at the discretion of the parent or carer accompanying them on whether they wear a face mask.

Key considerations for facility operators in designing their own visitor policies

Household contacts are not permitted to enter a high risk setting for 7 days from the last time someone in the household tested positive for COVID-19 unless an exemption has been granted to the person by the relevant facility.

Household contacts are advised to limit their entry to high risk settings between days 8 to14 and seek prior approval from the facility.

For people with COVID-19 in the 2 days after the isolation period (that is, days 6 and 7 after a positive test), people must wear a mask when moving around in the community and cannot enter high risk settings without prior approval from the facility, unless accessing urgent medical care.

People with COVID-19 are also advised to stay at home until their symptoms are gone or they are feeling much better.

Facilities must:

  • assess any potential risks to employees or residents, in accordance with work health and safety obligations, and
  • any guidelines or policies in place when considering whether an exemption should be granted to a visitor who is a household contact, or someone who has completed their isolation for COVID-19 in the last two days.

For more detailed considerations for assessing if a visitor should be granted approval to visit your facility or service in the 2 days immediately following their mandatory isolation period for COVID-19, please see additional measures for recently cleared COVID-19 cases .

Facilities should have a clear screening process in place for staff and visitors on entry.

This can be done by signing up to the Check In CBR app or by adopting their screening questions.

Visitors should minimise time spent in indoor communal areas and spend most of their visiting time in the resident's room or an outside area.

Visitors should maintain COVID Smart behaviours, like physical distancing, hand hygiene and respiratory etiquette.

Residents

Residents of aged care facilities are at increased risk of acute respiratory illnesses like COVID-19, influenza or other viral infections.

They are also more vulnerable to serious complications if they do become infected.

For more information for public health guidance on managing residents when they become unwell, including testing and infection prevention and control measures, see immediate actions when a resident develops acute respiratory illness

Returning residents discharged from hospital or following leave episodes

When a resident returns to the facility on the same day after being admitted to hospital (including an Emergency Department admission) or attending a family gathering, it is recommended that they:

  • be screened for symptoms on entry to the facility, and
  • tested for COVID-19 with a rapid antigen test (RAT) on day 2 and day 5 of their return.

Day 0 is the day they returned to the facility.

They do not need to quarantine but should be monitored closely for symptoms.

Residents who do not return to the facility on the same day after being admitted to hospital should quarantine and have an initial RAT when they return to the facility (day 0).

If the RAT result is negative, and they do not have any symptoms, they can come out of quarantine.

They should have tests on day 2, and day 5 but do not need to quarantine during this time.

Residents who only visit hospital for a day visit (for example, day oncology or dialysis) do not need to be tested unless informed by the hospital that the resident is a contact following a potential exposure.

Accepting new permanent or respite residents

It is recommended that all new residents should have a negative COVID-19 RAT result taken in the 72 hours prior to entering the facility and are tested on day 2 and day 5 with a RAT. Day 0 is the day that they entered the facility.

They do not need to quarantine if they have not been identified as a contact but should be monitored closely for symptoms.

If your facility is in outbreak precautions, see ‘New and returning resident admissions when your facility is under full outbreak precautions’ under actions for case and outbreak management.

External excursions

Residents are permitted to leave the facility to attend family gatherings or for other reasons but must abide by the current public health directions in place.

Facilities, residents and their families should consider the following measures to reduce risks including:

  • planning for outdoor gatherings where possible and/or practical, and
  • practising COVID Smart behaviours including wearing a mask, physically distancing and practising good hand and respiratory hygiene

Those attending gatherings should not:

  • have any COVID-19 symptoms
  • be a household or high-risk contact
  • be awaiting a COVID-19 test result
  • be living with someone awaiting a COVID-19 test result because that person has symptoms of COVID-19.

Residents entering the facility after being in the community should be screened at entry using the current entry screening process.

Outbreak prevention and preparedness

Key strategies to prevent and prepare for acute respiratory illnesses, including COVID-19 and influenza, in residential aged care facility include:

  • Staying up to date with vaccinations
    • COVID-19 vaccination is mandated for residential aged care facility staff in the ACT and influenza vaccinations are strongly recommended
    • Strategies to support residents to remain up to date with COVID-19 vaccinations and influenza vaccinations are strongly recommended
    • Monitor and record vaccination status of residents and staff
  • Planning for the impacts of respiratory illness in your facility
    • Ensure your facility outbreak management plan reflects the latest public health guidance
    • Facilities should have an established infection prevention and control (IPC) program to minimise the spread of COVID-19 and other viruses
    • Train and maintain regular education activities and competency assessment for staff in PPE use, infection prevention and control, risk mitigation and outbreak response
    • Ensure adequate supplies, including personal protective equipment (PPE), cleaning equipment, clinical waste bags and testing equipment, including PCR test kits and rapid antigen tests (RATs)
    • Plan for workforce surge capacity
    • Maintain an up to date line list for all residents
    • In collaboration with the residents’ primary care provider, facilities should support their residents to have a clinical management plan in the event they develop an acute respiratory illness. Specific resources to support this are listed under advice on the use of COVID-19 antiviral treatments in residential aged care facilities
    • Keep documentation for residents, including Advanced Care Directives, updated to reflect discussion with the resident and their family
  • Facilitate COVID Smart behaviours
    • Encourage staff and visitors to stay home if unwell and get tested for COVID-19. They should stay home and minimise contact with others until they are feeling better, even if they test negative to COVID-19
    • Support physical distancing where practical
    • Use signs and smart placement of alcohol-based hand sanitiser to encourage hand hygiene
    • Encourage mask usage, in accordance with current face mask mandates, and when it is not possible to maintain physical distancing in indoor settings
    • Screen visitors, staff and residents returning from excursions using a questionnaire or the Check in CBR Health Screening Tool on entry
    • Staff working in residential aged care facilities are recommended to undergo regular surveillance testing with COVID-19 rapid antigen test a minimum of 3 times per week, or have had a negative RAT result within 48 hours of attending a shift if they work part time.

The COVID-19 residential aged care sector preparedness and response plan

This plan outlines the roles and responsibilities of key stakeholders in preparing and responding to COVID-19 in the residential aged care sector in the ACT.

This plan has been developed by ACT Health and members of the Residential Aged Care Facility COVID-19 Working Group.

This group includes member from government, private and non-government residential aged care facilities.

Personal protective equipment and training

If there is an ARI outbreak at a facility, staff will need to wear appropriate personal protective equipment (PPE) to protect themselves from exposure.

Appropriate PPE means:

  • P2 / N95 mask
  • eye protection (for example, face shield or goggles, NOT prescription glasses)
  • long sleeved impervious gown
  • gloves

Please ensure you have adequate supplies of PPE available immediately for use in case of a COVID-19 outbreak at your facility.

Large amounts of PPE are used daily during a COVID-19 outbreak.

For example, a 100 resident facility would need to have onsite over 2,000 sets of PPE for one day.

For PPE supplies for residential aged care facilities, contact your regular supplier or parent organisation.

If you are unable to procure PPE through regular suppliers, you can email your request to the Australian Government Department of Health and Aged Care at agedcarecovidppe@health.gov.au

Staff should be trained and deemed competent in infection control and the proper use of PPE, including donning and doffing procedures.

Supervising donning and doffing (using a ‘spotter’) and regular refresher PPE training for all staff.

Cleaners should also be appropriately trained in correct cleaning techniques, equipment, and cleaning products.

More resources

Infection prevention and control

Advance Care Planning

COVID-19 vaccination

Mental health support

ACT Office of the Senior Practitioner

In the ACT, restrictive practices cannot be used to administer any voluntary medical procedures, including COVID-19 vaccines.

More information is available on the Community Services Directorate’s website, including a factsheet from the ACT’s Office of the Senior Practitioner.

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Acknowledgement of Country

We acknowledge the Traditional Custodians of the ACT, the Ngunnawal people. We acknowledge and respect their continuing culture and the contribution they make to the life of this city and this region.

Last Updated: September 16 2022