On Wednesday 22 April 2020, we presented a webinar entitled “The Gaps in Infection Control Plans that Can Put Residential Aged Care Facilities at Risk.” We had over 250 attendees from 180 facilities attend the live webinar. Thank you to all those who attended, and to those who took the time to give feedback via our survey. Over 75% of survey respondents rated the webinar a 9 or 10.

The webinar recording and free resources (two COVID-19 audit tools) are now available to all Aged Care Essentials (ACE) subscribers. Simply click here to request access to the webinar and audit tools.

We received a number of questions and comments arising from the webinar. In this week's ACE article, we’ve listed the key questions and responses, along with some links to useful resources.

Webinar Q&A:

Immunisation Record Management

Can you tell us more about the register you demonstrated for recording vaccinations?

Recording vaccinations is not only good practice for infection control in residential aged care homes, it’s also about to become a legal requirement. As of 1 May 2020, it will be mandatory for aged care providers to keep records of information related to a person’s immunisation status, including current evidence that they have been vaccinated against the flu.

Most providers already maintain such records for their consumers and staff, but from 1 May, they will also have to obtain and record appropriate evidence of immunisation status, including flu vaccination, from visitors and other individuals seeking to enter the Home.

In the webinar we demonstrated the use of CompliCare’s assurance platform to record immunisation information. This platform includes registers for recording the details of all consumers, staff and visitors/other individuals who require entry to the Home. The registers allow you to store securely the recorded information and link to evidence of people’s vaccination status. Such evidence includes statement scans or photos of documents from a range of sources, such as the Express Plus Medicare mobile app. This minimises the paper storage you need to have, saves time related to these processes and places all the information in a central location.

Whatever register or database you maintain, it is essential that appropriate evidence of immunisation status is obtained from each individual seeking to enter the Home. Appropriate evidence may be a statement or record from a health practitioner, or an immunisation history statement from Medicare online or the Express Plus Medicare mobile app. It is the responsibility of the Provider to maintain these records to substantiate their compliance with these requirements.

Resources and references:

• Coronavirus (COVID-19) – Restrictions on entry into and visitors to aged care facilities

• Important information for residential aged care providers from the Chief Clinical Advisor (22 April 2020) Screening of people entering residential aged care facilities

Refusal of Flu Vaccinations

How will Registered Aged Care Facilities manage the flu vaccine requirement if a resident/family member refuses to have the flu vaccination?

There are really two questions here: what happens if a resident/consumer refuses vaccination? And, what happens if a family member refuses vaccination?

All consumers have a right to make choices, including the choice to refuse vaccinations. Having said this, the Home should promote the benefits of vaccination to all consumers and explain the importance of protecting ourselves and others against influenza. Chatting with consumers one-on-one and answering their questions are key strategies in this respect.

If a consumer chooses not to be vaccinated this needs to be clearly documented. The Home also needs to assess any potential risks and prepare additional care management and infection prevention and transmission precaution strategies specifically aimed at protecting the consumer in the event of an outbreak. For this reason, information about the consumer who refuses to be vaccinated needs to be clearly recorded on the vaccination register of the Home and on the proposed infection control management plan in the Consumer’s individual care file.

The situation is very different for family members who refuse vaccination. Such individuals must not be allowed to enter the Home. Under current state and territory directions, from 1 May aged care providers are required to take all reasonable steps to ensure that a person who fails to meet the vaccination requirements does not enter the Home. The same applies to any person who fails to prove that they have met the requirements. Checking for evidence of vaccination should therefore be part of the Home’s process for screening all people who enter the Home.

It is essential that Homes communicate these upcoming requirements to consumers and their representatives, staff and potential visitors prior to 1 May.

Resources and references:

• FAQs Restrictions on entry into and visitors to aged care facilities
• Coronavirus (COVID-19) – Restrictions on entry into and visitors to aged care facilities
• Important information for residential aged care providers from the Chief Clinical Advisor (22 April 2020) Screening of people entering residential aged care facilities

Structure of a COVID-19 Outbreak Management Plan

Can you provide more information about the four elements or pillars you described that should be used to develop a COVID-19 Outbreak Management Plan?

The four key elements or pillars that were described in the webinar were:

Resources and references:

• Coronavirus (COVID-19) guidelines for outbreaks in residential care facilities
• Assessment contact on preparing for COVID-19 – questions
• Coronavirus (COVID-19) Plan for the Victorian Aged Care Sector, Victorian DHHS (March 2020)

Infection Control and Prevention Training Resources

Can you provide a list of the training resources that you identified throughout the webinar?

First, we suggest that you explore the ACE publication Aged Care Guidelines: Resources List Responding to COVID-19 / Coronavirus – April 2020. This includes a section devoted to training resources.

Other training resources that you may find helpful include:

• Coronavirus (COVID-19) resources for health professionals, including aged care providers, pathology providers and healthcare managers, Department of Health
• Information sheets (including translated fact sheets) that can be used for training or to provide information to families are available on the NSW Health website COVID-19: Advice for aged care services
• The Aged Care Quality and Safety Commission website has a range of training resources in the table titled Coronavirus (COVID-19) information and resources
• A video about how to wear PPE for aged care workers presented by Australia’s Chief Nursing and Midwifery Officer – Coronavirus (COVID-19) wearing personal protective equipment in aged care video
• The Department of Health COVID-19 Infection Control Training portal has a range of relevant on-line training courses and are well suited to individual learning and includes assessment questions and evidence of successful completion.

Can you recommend any specific training resources to support the care and services for a consumer living with Dementia?

This is a great question and identifies some key areas that need to be planned for and included in your COVID-19 Outbreak Management Plan. Recognising the needs of consumers living with dementia and the specific care and management strategies to support their health and wellbeing is essential. This includes ways to support them practising the required personal hygiene habits and social distancing requirements.

The first step in this process is workforce training, together with review of available guidelines to support and direct individual staff practices in the workplace. Where specific needs for consumers living with dementia are identified these should be documented as part of the care plan to ensure they can be implemented by all staff.

There are a range of quality and informative resources available to support the care and services for the individual consumer living with dementia. These resources cover a range of areas, including understanding and managing changed behaviours, issues that maybe experienced in an outbreak situation, and the specific and additional needs for a consumer living with dementia. Practical tips and care plan strategies can be found in the resources listed below.

Resources and references:

• Dementia Australia have available a range of resources including Coronavirus (COVID-19) - Tips for People Living with Dementia
• A range of dementia specific resources are available at Dementia Support Australia (DSA). This includes - How to understand and manage changed behaviours during COVID-19
• Dementia Training Australia has produced a publication called COVID-19 – An informative Resources Guide.
• This resource by Dementia Australia is specific for Carers, Families and Friends of People Living with Dementia.

Can you tell me more about the P-LAR framework you mentioned in the webinar?

Aged Care Essentials publisher, CompliSpace, uses a proven and award-winning framework designed to achieve a culture of compliance by transforming policy to culture. P-LAR is an acronym that stands for Policy, Learning, Assurance and Reporting – the policy to culture lifecycle.

Each element of the P-LAR methodology helps our clients’ journey from policy to culture.

(P) Policy

Our framework begins with having a strong foundation of policies that we tailor to an organisation’s circumstances to support their compliance obligations. They cover the who, how, when, what and why of each policy.

(L) Learning

Our learning tools are designed to help members of the workforce understand the policies so that they can apply them in their everyday practice.

(A) Assurance

Our assurance workflow management and audit tools allow you to implement policies and monitor the outcomes being achieved. They ensure that key elements of an organisation’s policies ‘come to life’.

(R) Reporting

The Aged Care Quality Standards have a strong focus on using reported outcomes and consumer feedback to continuously improve care and services. The final part of our framework addresses this by providing high-quality reporting so that leadership can identify systemic issues and respond to feedback.

Resources and references:

• Read more in the ACE article, How to Demonstrate that you Understand, Apply, Monitor and Continuously Improve ACQS Requirements.

Access the Webinar Recording and Resources

The webinar recording and free resources (two COVID-19 audit tools) are now available to all Aged Care Essentials (ACE) subscribers. Simply click the button below to request access to the webinar and audit tools: