In December 2022, the Australian Government released a new National COVID-19 Health Management Plan (National Plan) for 2023. A key part of the National Plan is the National Statement on Expectations on COVID-19 Management in Aged Care Settings (National Statement). This article will outline the main points of the National Statement and what they mean for aged care providers.
What is the National Statement?
The National Statement provides specific guidance to providers of aged care services, including residential and home care, on how to prepare for and manage the impact of COVID-19. The National Statement also reflects the expectations from the Government on the actions that providers should take when preparing for and responding to COVID-19, and is considered a document reflecting best practice.
The National Statement provides guidance on several matters relating to the impact of COVID-19, these include:
- planning and preparedness
- testing and case identification
- managing COVID-19 infections
- access to treatment and services
- reporting and communications.
In addition, the National Statement includes several key principles which should inform the actions of aged care providers when responding to each of the matters listed above:
- Preparations and responses against COVID-19 should be risk-based, and providers should continually assess the risk of COVID-19 within their service environment and the impact that this would have.
- Measures taken against COVID-19 should be proportionate to the risk. This means there should be a hierarchy of infection prevention and control measures and providers should strike a balance between responding to the risks and ensuring the wellbeing and quality of life of consumers.
- Providers should maintain a scalable capability to respond to a COVID-19 outbreak. This means ensuring that control strategies including Personal Protective Equipment (PPE) and other measures are planned for, readily available and understood by staff. In the event of an outbreak or when the impact of COVID-19 is identified as increasing within the community, providers are able to scale up their response appropriately and as quickly as possible.
- Responses to COVID-19 should be human-rights focused, and consider the profound impact of social isolation on consumers. This means ensuring that consumers retain access to appropriate medical care and lifestyle supports, including visitation.
What Does this Mean for Aged Care Providers?
Planning and Preparedness
Providers should continue to prepare to respond to COVID-19 in their service. This includes having appropriate infection prevention and control policies and procedures, maintaining currency of outbreak management plans, monitoring jurisdiction/local information and rules around COVID-19, and maintaining an appropriately qualified and competent workforce including an identified onsite Infection Prevention and Control Lead (for residential providers). Providers should maintain preparedness in these key areas:
- identifying leadership and governance for outbreak management
- workforce contingencies and training
- resource supplies, such as PPE
- clinical governance
- stakeholder communication
- arrangements to support visitation and recovery of consumers.
Testing and Case Identification
Providers should continue to implement effective testing measures to identify infections quickly and manage and minimise their impact on the service. This includes visitor screening for residential providers, and providing access to testing for staff in all aged care settings.
Surveillance screening in residential settings should occur at least twice a week and no more than 72 hours apart for staff. For home care providers who choose to implement surveillance screening, the same frequency should be followed. All consumers who exhibit respiratory symptoms or delirium should be tested. This may include RAT kits for case identification and PCR testing to confirm.
Managing COVID-19 Infections
Providers should continue to implement a hierarchy of infection prevention and control when managing the impacts of COVID-19. This includes minimising the risks of infection, maintaining workforce training and competency and clinical governance frameworks, where appropriate. Staff should be regularly trained, updated and competency assessed on hand hygiene, appropriate use of PPE and cleaning practices.
Residential providers should consider their arrangements relating to isolation of residents who test positive for COVID-19. This includes isolating for the shortest time clinically necessary and consideration of the impact on an older person’s dignity, choice and continuity of care. Residential providers should continue to maintain visitor access to residents at all times, including during the management of infections in the service. This may include basic infection control training for regular visitors, including the use of PPE.
Outbreak and infection management should include consideration of furloughing staff who test positive. Staff in both residential and home settings should not attend work for at least seven days after testing positive, and only return when they are symptom-free. Providers should facilitate leave for staff who test positive, including flexibility around leave payments where staff may not have accrued sufficient leave.
All aged care providers should continue to use PPE and ensure adequate stocks and commercial arrangements are in place to guarantee supply. Residential providers should encourage staff and visitors to wear masks when in close contact with residents, and home care provider should provide PPE for use in a consumer’s home. Providers must maintain the capability to scale up the provision of PPE during an outbreak.
Access to Treatment and Services
All aged care providers must ensure continued access to treatment and services for consumers impacted by COVID-19. This includes ensuring that consumers have access to primary care, antiviral treatment, and vaccination where appropriate and monitoring and support for consumers at risk of Long COVID. Providers must ensure that they maintain appropriate staffing levels and have arrangements for workforce surge capacity during an outbreak.
Reporting and Communication
Providers should be in regular contact with the Australian Government Department of Health and Aged Care and state or territory public health units when managing and outbreak or other impacts of COVID-19 infection. Providers should maintain outbreak communication plans to keep consumers, families, representatives, and other stakeholders informed.
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