Advice for staff and operators of aged care facilities

Visitor restrictions from 11.59pm Tuesday 21 December

The ACT has tightened visitor restrictions for residential aged care facilities to help keep vulnerable elderly residents safe from the Omicron variant of COVID-19.

From Wednesday 22 December:

  • up to 5 visitors are allowed to visit a resident at any one time
  • there is a limit of up to 5 visitors per resident per day
  • there is no daily limit on the number of visitors for end of life care visits
  • people who are providing a service to the resident including a health service or professional or other service are not included as part of the visitor limitations
  • prospective residents can visit an aged care facility with up to 4 people accompanying them

Staff must wear a mask when working in a residential aged care facility.

All visitors aged 12 years and over must wear a mask while visiting indoors and follow COVID-Safe behaviours.

Consideration should be given to children aged between 8 and 11 years wearing a mask while visiting indoors, as this is at the discretion of the parent or carer accompanying them.

Visits should not be in any inside communal areas.

Visits should be either in the resident's room or an outside area.

Visitors who have returned from overseas

Visitors who have returned from overseas in the last 14 days should not enter a residential aged care facility for 14 days after entering Australia without first obtaining approval from the facility. Visitors who have returned from overseas in the last 14 days and are required to quarantine must not enter a high-risk setting for 14 days after entering Australia.

Anyone who has been identified as a close contact can only enter an aged care facility with an exemption within the 14 days since the exposure occurred, regardless of vaccination status.

Aged care facilities should continue to screen visitors using the screening questions listed on the Advice to High Risk Settings page and ensure that people who are prohibited from entering do not enter or remain on the premises.

Festive guidance

Below is guidance for RACFs on managing the festive season safely:

  • loved ones are not limited in the time that they spend with their spouse/relative.
  • facilities should ensure that visitors stay within their groups, limit physical movement around the facility, and that there is at least 1.5m between groups when having an outside event.
  • where physical distancing is not possible, facilities should make plans to spread the event over more than one occasion and minimise the number of external visitors to the event.
  • facilities should avoid activities that require queuing.
  • if your facility plans to hold an event, please ensure:
    • high-tough surfaces are regularly wiped down and other shared spaces (e.g. toilets) are regularly cleaned.
    • consider games and activities and that involve use of a person’s own equipment to minimise cross-contamination.
    • make arrangements for enhanced cleaning after the event.
  • Facilities may hold an event like a musical performance such as choirs, carol singers and musicians. Facilities should ensure that:
    • performers are subject to entry and screening requirements, and physical distancing requirements, and these are communicated to them in advance
    • allow your staff enough time to effectively undertake the entry and screening process
    • where possible, events should be held outside but in the event of an indoor event this should be in a well-ventilated space that supports physical distancing.
    • consider holding several smaller events for safe physical distancing or offer alternative options for residents to participate such as video streaming from residents' rooms.
  • Facilities should take steps to reduce cross-contamination during meal times. These include:
    • minimising shared implements, utensils or condiments
    • avoiding shared platters, and using plated or boxed meals instead
    • ensure physical distancing between resident groups in communal areas – prioritise outdoor dining options and consider holding the event on different days and times.
    • consider minimising groups from different households seated together.

Health practitioners who visit a residential aged care facility to provide care to residents must also be fully vaccinated for COVID-19 to enter the facility.

Anyone who has been overseas in the last 14 days should not enter a high-risk setting without first obtaining approval from the facility. This is regardless of vaccination status.

Anyone who has been identified as a close contact can only enter an aged care facility with an exemption within the 14 days since the exposure occurred, regardless of vaccination status.

ACT Health can be contacted on the CDC Information Line (02) 5124 9213 (press option 2 and ask for the Infection Control Team) or (02) 9962 4155 after business hours.

If you are concerned that a COVID-19 case attended your facility while infectious, please immediately phone (02) 5124 5498 (8am to 8pm) or (02) 9962 4155 after business hours.

Managing COVID-19 exposures and outbreaks in residential aged care facilitiesCOVID-19 Outbreak Preparedness

Facilities should have a strong infection control program to prevent and control the spread of COVID-19 and other viruses.

Facilities are urged to have a COVID-19 Outbreak Management Plan (OMP) in place. This will help prepare for a case or outbreak of COVID-19 among staff and/or residents. Find detailed guidelines on preparing for and managing a COVID-19 outbreak in the Australian Department of Health’s COVID-19 guidelines for outbreaks in residential care facilities.

COVID-19 outbreak management Plan and Preparedness Checklist have also been developed by ACT Health to support enhanced OMPs and preparations for a COVID-19 outbreak.

As soon as a COVID-19 outbreak has been declared, ACT Health will need information from the facility very quickly to organise urgent COVID-19 testing and to assist with the management of the outbreak.

ACT Health will need specific information on staff and residents as well as staff rosters, floor plans, and visitor information. To ensure you have the information that ACT Health needs, we recommend that you complete this spreadsheet for staff and residents ahead of time and keep it up-to-date.

Check-in CBR

Facilities are strongly recommended to use Check-in CBR and to require all staff and visitors to check-in using the app when they enter the facility. Using Check-in CBR assists ACT Health to undertake contact tracing quickly in the event of a COVID-19 outbreak in a residential aged care facility.

Facilities using a commercial app that combines check-in and screening should continue to use the commercial app for screening however it is recommended that an additional check-in be done with Check In CBR.

Facilities can find information on setting up a Check In CBR QR code on the Business registration page. If you have any questions about using the Check In CBR app, please contact the Access Canberra Business Liaison Line on (02) 6205 0900.

Facilities should continue to screen people entering the facility as per the screening questions in the CHO advice for high-risk settings.

Managing COVID-19 exposures and outbreaks in residential aged care facilities

Information on managing COVID-19 exposures and outbreaks in residential aged care facilities.

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.

ACT Health and members of the Residential Aged Care Facility COVID-19 Working Group developed the Plan.

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

Visitors

COVID-19 Vaccination

It is up to the residential aged care facility to determine whether visitors must have a COVID-19 vaccination prior to entry to its facility.

Evidence of COVID-19 vaccination can include:

  • Online immunisation history statement or
  • COVID-19 digital certificate from the Australian Immunisation Register

If a visitor is unable to be vaccinated due to a medical contraindication, they must provide a copy of their completed ACT Government COVID-19 Vaccine Medical Contraindication or Temporary Exemption Form to the operator of the facility. The operator can then grant an exemption to the visitor upon viewing their completed form. The ACT Government COVID-19 Vaccine Medical Contraindication or Temporary Exemption form can only be signed by a registered medical practitioner.

Health practitioners who visit a residential aged care facility to provide care to residents must also be fully vaccinated for COVID-19 to enter the facility.

Measures to reduce risk of transmission during visits

  • All visitors aged 12 years of age and over must wear a surgical mask while visiting indoors and follow COVID-safe behaviours.
  • Consideration should be given to children aged between 8 and 11 years wearing a mask while visiting indoors – this is at the discretion of the parent or carer accompanying them.
  • All visitors entering a facility must be screened for symptoms and risk factors on arrival to the facility. Refer to the CHO advice for high-risks settings for the current entry screening questions.

Staff

A public health direction states all residential aged care facility workers must have a second dose of COVID-19 vaccination by 1 December. Prior to 1 December, workers must have received at least one dose of COVID-19 vaccine in order to work at a residential aged care facility.

All staff entering a residential aged care facility should be screened for symptoms and risk factors on arrival to the facility. Refer to the CHO advice for high-risks settings for the current entry screening questions.

Staff who have symptoms of COVID-19, even if mild, should be excluded from the workplace and get tested immediately. Sick leave policies should enable employees to stay home if they have any of the COVID-19 symptoms. Further information about sick and carer’s leave is available on the Australian Government Fair Work site.

Residents

Residents of aged care facilities are at increased risk of COVID-19 infection. They are also more vulnerable to serious complications if they do become infected.

Residents with acute respiratory infection (for example, a runny or blocked nose, cough, sore throat, shortness of breath, new loss of smell or taste) or fever should be promptly isolated in a single room with an ensuite and tested with a COVID-19 PCR test, including at any time following COVID-19 or influenza vaccination. Any staff entering the resident’s room need to use contact, droplet and airborne PPE precautions. Further information is available from:

As elderly residents often have non-classic respiratory symptoms, and fever may be absent, you should consider testing any resident with any new respiratory symptom.

Other symptoms of COVID-19 in the elderly include increased confusion and loss of appetite. Consider testing individuals with these symptoms if there is no clear alternative cause.

Symptoms like fatigue, headache, muscle or joint pains, may also occur following COVID-19 or influenza vaccination. Testing for COVID-19 should be considered if symptoms are worse than expected, or last for longer than 48 hours following vaccination. Most symptoms after vaccination will only last 1-2 days.

COVID-19 Testing for Residents

COVID-19 PCR testing and specimen collection should be carried out by an appropriately trained GP, pathology provider, or nurse (RN or EN) at the facility.

If a COVID-19 test for a symptomatic resident cannot be done due to lack of consent, resistance or distress, the resident should be isolated until a test can be undertaken which returns a negative result and they no longer have symptoms or until an appropriate period of isolation has been completed. Contact the CDC Information Line for further advice.

To facilitate a fast turnaround for COVID-19 tests, send the specimen to ACT Pathology and use the dedicated ACT Pathology COVID request form for your facility.

Please ensure the facility name, address and fax number on the form are correct.

Further information is available in an information sheet on specimen collection in residential care facilities.

Returning residents discharged from hospital or following leave episodes

  • When a resident returns to the facility after being admitted to hospital (including an Emergency Department admission) or attending a family gathering for the day only, 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.
  • Residents who do not return the same day should be quarantined until they have a negative RAT on the day of return with subsequent tests on day 2, and day 5.
  • They do not need to quarantine but should be monitored closely for symptoms. Residents who only visit hospital for a day visit (e.g. day oncology or dialysis) do not need to be tested unless informed by the hospital that the resident is a contact.

Accepting new permanent or respite residents

  • Admissions of new residents from the community, either permanent or respite, can be accepted if the person doesn’t answer ‘yes’ to any of the entry screening questions (refer to the CHO advice for high-risks settings).
  • If the facility is under COVID-19 precautions, new admissions should only be accepted if the new resident is able to be cohorted separately from any residents within the facility who are currently required to quarantine. As for all outbreaks, a risk assessment should be worked through on a case by case basis by the facility (which should consider the urgency of the new admission), and the new resident and their family made aware that the facility is under COVID precautions.
  • If the person answers ‘yes’ to any of the entry screening questions, please seek advice from ACT Health before accepting this person.
  • It is recommended that all new residents have a negative COVID-19 RAT test 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.

Residents Identified as Contacts

A resident may be identified as a contact by checking the ACT’s COVID-19 website exposure site list, direct contact by ACT Health by phone or text message, or via the Check-in CBR app. Residents who are leaving the facility and attending venues in the community should use the Check-in CBR app and monitor the exposure locations daily on ACT exposure locations page.

If a resident is identified as a close or casual contact, they will need to:

  • follow the instructions on the ACT Health website for close and casual contacts.
  • quarantine in a single room with ensuite for their quarantine period.
  • With dedicated staff allocated to provide care using contact, droplet and airborne precautions
  • Have testing every 72 hours, or as directed by ACT Health, during their quarantine period if they are Close contacts to detect COVID-19 early.
  • Be monitored closely for symptoms for 14 days after their last exposure and if any symptoms develop, immediately arrange for another COVID-19 test.

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.

It is recommended that residents who are partially vaccinated or unvaccinated, only leave the facility to attend small family gatherings to protect them from the risk of COVID-19 exposure and should practise COVID-safe behaviours.

Facilities and residents leaving the facility – and their families – should consider the following measure to reduce risks:

  • Outdoor gatherings are recommended where possible
  • COVID-safe behaviours - wear a mask, physically distance as practicable, practise hand hygiene, and use the Check In CBR app
  • Those attending gatherings should not have any COVID-19 symptoms, be a close or casual contact, be awaiting a COVID-19 test result or live 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 questions in the CHO advice for high-risk settings.

COVID-19 vaccinations

See page the COVID-19 vaccination information for aged care workers page.

Personal protective equipment and training

If there is a COVID-19 outbreak at a facility, staff will need to wear appropriate PPE to protect themselves from exposure to COVID-19. Appropriate PPE means:

  • P2/N95 mask
  • Eye protection (e.g. 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 an COVID-19 outbreak. For example a 100 resident facility would need to have on-site over 2,000 sets of PPE for one day. For personal protective equipment (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.

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.

Penalties for non-compliance

If someone does not comply with the restrictions (without a reasonable reason), then penalties will apply.

The maximum penalties are:

  • In the case of a natural person (individual), $8,000 (50 penalty units)
  • In the case of a body corporate, $40,500 (50 penalty units)
  • In the case of a utility that is a body corporate $1,620,000 (2000 penalty units)

More information

Infection prevention and control

Advance Care Planning

Mental health support

ACT Office of the Senior Practitioner – restrictive practices

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: January 18 2022