Advice for high-risk settings

📌 This page was last updated on 14 October 2022

Most recent changes:

  • Changes to isolation requirements
  • Advice for entering high-risk settings
  • High-risk community site risk assessment matrix
  • High-risk community site - staff return to work advice

High-risk settings definition

A high-risk setting is defined as:

  • a setting where there are a large number of people who are at risk of severe disease from COVID-19 (for example, due to age or chronic medical conditions), and
  • where there is a higher risk of COVID-19 transmission due to close proximity and difficulties maintaining physical distancing.

High-risk settings include:

  • hospitals
  • residential aged care facilities
  • residential accommodation facilities that support people who require frequent, close personal care and who are at risk of severe disease from COVID-19.

Key information for high-risk settings

Entering a high-risk setting

Staff and visitors entering high-risk settings are required to wear a face mask.

High-risk settings are encouraged to screen staff and visitors using a health screening tool.

Some example questions are available below.

Staff or visitors should not attend high-risk settings without prior approval if they are:

If entry is necessary, these individuals should seek approval from the relevant facility prior to entry.

Anyone who requires urgent healthcare can enter a high-risk setting at any time to access this care.

Visitors

People who have tested positive to COVID-19 should avoid visiting high-risk settings unless they are seeking urgent medicare care:

  • for at least 7 days after their positive test, and
  • until their COVID-19 symptoms are gone, and
  • they are feeling much better.

The following people should avoid visiting high-risk settings:

  • people who have tested positive for COVID-19 more than 7 days ago but continue to experience symptoms
  • people who are household contacts should not visit high-risk settings for 14 days after the last time someone tested positive in their household.

People in these categories should seek approval to attend by the facility, unless attending for urgent medical care.

Entry screening questions

High-risk settings are recommended to use the following questions to screen all staff and visitors.

These questions are relevant regardless of COVID-19 vaccination status.

  1. Do you have any COVID-19 symptoms?
  2. Do you live with a person who has tested positive for COVID-19 within the last 14 days?
  3. Have you tested positive for COVID-19 in the last 7 days?
  4. Have you recovered from COVID-19 in the last week but have ongoing symptoms?

If a person answers yes to any of the above questions, they should not enter the facility unless prior approval from the facility is granted.

Check in CBR Health Screening Tool

ACT Health has expanded the functionality of the Check in CBR app to include a Check in CBR Health Screening Tool, which is available for use in high-risk settings only (at this stage).

The health screening questions on the app mirror those under ‘Entry screening questions’ on this page.

The health screening tool is not mandatory for use by providers but provides an optional, consistent and familiar resource for individual facilities to use and implement if their current system is no longer adequate.

A new Check in QR code is not required, however facilities are required to notify ACT Health that they wish to incorporate the Tool into their existing Check in CBR QR Code.

Those facilities who have not previously registered for Check in CBR can also apply for the Check in CBR Health Screening Tool.

To register for access to the health screening tool, high-risk settings should complete this form.

Residents leaving facilities

  • Residents/clients of high-risk settings can leave the setting to attend family gatherings or for other reasons but should practise COVID Smart behaviours and follow other relevant recommendations.
  • Visitors to facilities and residents/clients leaving the facility should consider the following measures to reduce risks:
    • outdoor gatherings are recommended where possible
    • COVID Smart behaviours – wear a mask where one is required, physically distance when possible, practise hand hygiene, and use the Check-in CBR app (where required)
    • those attending gatherings should not have any COVID-19 symptoms, be a household or high-risk contact, be awaiting a COVID-19 test result or live with someone awaiting a COVID-19 test result.

Strategies to reduce likelihood of transmission in staff

High-risk settings should limit contact between staff who are working different shifts.

For example:

  • conduct handovers via the phone instead of in person
  • minimise staff contact across a facility by cohorting staff to working in certain areas/wings
  • minimise staff mixing across shifts by rostering the same staff on together where possible
  • limit social contact between staff working different shifts
  • hold meetings virtually
  • ensure staff working change over shifts are not using the same locker room or shared facilities at shift change over
  • have strategies in place to avoid staff spending time together unmasked in tea rooms – this may require rostering of meal breaks and/or staff eating outside if weather permits.

Mask advice for high-risk settings

Surgical face masks must be worn by staff and visitors who are 12 years and over in high-risk settings.

Visitors and staff may remove their masks under certain circumstances such as eating and drinking.

Staff who work in high-risk settings

What does a staff member need to do if they are identified as a household contact?

The staff member should advise their manager that they are a household contact as soon as possible and follow the advice applicable. For more information see the information for people exposed to COVID-19.

What does the staff member’s manager need to do?

Refer to the tools used to assess high-risk community sites and consider staffing and risk mitigation issues in relation to that staff members quarantine and return to work.

Staff who are contacts returning to work in a high-risk setting*

  • Staff who are household or high-risk contacts of a person diagnosed with COVID-19 should follow the instructions of their facility regarding permission to return to work
  • Risk mitigation measures should be practised by returning staff during the 14 days after the date of exposure.
  • Staff working in a Clinical Health Emergency Coordination Centre (CHECC) site should follow CHECC guidance in relation to attending work.

CHECC sites should refer directly to the CHECC advice on COVID-19 requirements for information about management of:

  • household and high-risk (close) contacts, and
  • moderate risk (casual) contacts among staff.

Return to work should be overseen by the organisation providing care.

*This advice should also be followed for providers of home-based care.

Visiting or returning to work in a high-risk setting after having COVID-19*

Staff members who  are less than 7 days since their positive COVID-19 test should follow the instructions of their facility regarding permission to return to work.

Repeat testing is not required prior to recommencing work.

For more information see recovering from COVID-19.

COVID-19 exposures in a high-risk setting

High-risk settings and facilities will activate their COVID-19 business continuity planning and contact tracing following any relevant exposure or outbreak.

ACT Health will continue to support high-risk settings and facilities who have exposures or outbreaks.

Tools used to assess COVID-19 exposures in high-risk community sites

These tools are updated over time so please refer to the website for the most up to date version.

Facilities and workplaces should use the ACT risk assessment matrix to assess the risk to clinical and non-clinical staff and residents/clients of high-risk settings who are exposed to a COVID-19 case while in that setting.

This individualised risk assessment approach acknowledges the importance of the continuity of healthcare services and takes into account the PPE that the staff member was wearing, and the type of contact they had with the case to determine whether the staff member is considered to be a contact.

Actions for staff identified as contacts from a COVID-19 exposure at a high-risk community site

Staff identified as contacts in these risk assessments or from outside of work exposures should follow return to work advice below.

Staff who are identified as household or high-risk contacts from a COVID-19 exposure in the community or workplace may be allowed to return to work in the event of workplace shortage with use of relevant risk mitigation strategies.

This should be discussed with your manager or designated contact at your facility.

Additional information supporting workplaces following an exposure to COVID-19 is available:

Please refer to the aged care page for more information regarding managing an exposure in aged care settings, including advice on how to manage a resident who is a household or high-risk contact.

Please refer to the disability care page for more information regarding exposure in disability care settings, including advice on how to manage a resident who is a household or high-risk contact.

Staff should wear appropriate PPE for contact with residents/clients of a high-risk setting who are in isolation or quarantine.

Personal Protective Equipment use during a COVID-19 exposure or outbreak in a facility

During a COVID-19 outbreak, staff will need to wear appropriate personal protective equipment (PPE) to protect themselves from exposure to COVID-19.

Appropriate PPE means:

  • P2 / N95 mask
  • eye protection (for example, face shield or goggles, not prescription glasses)
  • long-sleeved impermeable gown
  • gloves.

Ensure you have adequate supplies of PPE available immediately for use in a COVID-19 outbreak.

Residents and clients of a high-risk setting

Residents or clients who test positive for COVID-19 should receive their usual care.

Those providing this care will need to wear PPE (including P2 / N95 mask and eye protection) in order to protect themselves and other clients and residents.

They should continue to follow the public health guidance for the relevant high-risk setting.

These include managing residents, patients or clients in high-risk settings with COVID-19 with additional precautions such as control measures for 7 days after their positive test, or until their symptoms have significantly improved (whichever comes later).

Managing COVID-19 in disability care settings

For steps you should take if a COVID-19 case has had contact with a disability client or provider while infectious, refer to the public health guidance for acute respiratory illnesses in disability residential care facilities page.

This is public health advice intended to inform your response to a COVID-19 exposure and is not a requirement under a Public Health Direction.

Managing COVID-19 in Residential Aged Care Facilities

For steps you should take if a COVID-19 case has had contact with a residential aged care facility resident or staff member while infectious, see the residential aged care facilities page.

This is public health advice intended to inform your response to a COVID-19 exposure and is not a requirement under a Public Health Direction.

acknowledgement icon
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: November 02 2022