IMPORTANT UPDATE REGARDING VACCINATION ENTRY RESTRICTIONS IN VICTORIAN AGED CARE HOMES: ACE issued a version of this article on 3 August 2020 which stated that visitors to Victorian aged care homes were no longer required to have up-to-date influenza vaccinations. The article correctly reflected the changes made in Care Facilities Direction (No 8). However, in correspondence sent 5 August 2020, the Victorian Department of Health and Human Services advised that they made an error when drafting Care Facilities Direction (No 8). The Department said “the advice regarding all people attending a residential aged care service must have an up to date influenza vaccination in order to be present on the premises continues to stand” and the Care Facilities Direction will soon be changed to reflect this.

ACE has updated the article below to reflect the latest advice from the Victorian Department of Health and Human Services.

Since the beginning of the COVID-19 pandemic, the Victorian Government has used an instrument called a “Care Facilities Direction” to set the rules about who can and can’t enter a residential aged care facility.

On 22 July 2020, Victoria’s Deputy Health Commander revoked Care Facilities Direction (No 7) and issued Care Facilities Direction (No 8). Direction No 8 makes some major changes to the rules about visitor restrictions. In this article we summarise the key changes and give you some tips on how to stay up to date with the rapidly changing situation in Victoria.

Note: on 3 August 2020, Victoria’s Deputy Health Commander updated the Care Direction again. The new direction maintains the changes outlined in this article. As of 5 August 2020, the latest direction is Care Facilities Direction No 9. However, this is likely to change again soon. Scroll to the bottom of this article for tips on how to stay up to date with this rapidly changing situation.

Key Changes Made by the New Care Facilities Direction on 22 July 2020

Care Facilities Direction (No 8):

• changes the exclusion that applies to a person under 16 years
• adds a new exclusion for visitors who are awaiting the results of a COVID-19 test
• changes the definition of “Visitor” and the limits on the number of visitors, number of visits, and duration of visits in relation to certain kinds of visits.

The entry restrictions set out in Direction No 8 expire on 16 August 2020. On that day, or possibly before that day, the Victorian Government will likely reissue the same directions or a revised version of the direction.

Changes to the Exclusion that Applies to a Person Under 16 Years

The old direction (No 7) said that a person under 16 years is not allowed to enter an aged care facility unless they are visiting “for the purposes of end of life support for a resident of the facility”.

The new direction (No 8) makes that requirement even stricter. Now, a person under 16 years is not allowed to enter an aged care facility unless they are visiting “for the purposes of end of life support for a resident of the facility” AND they are a “child, grandchild or sibling of the resident”.

Given the unlikelihood of an aged care resident having a child or sibling under the age of 16, this restriction effectively means that the only people under 16 who are allowed inside Victorian facilities are grandchildren who are visiting to provide end of life support to their grandparents. Note: though it is probably just an oversight, the wording of the direction does not permit great-grandchildren to visit.

New Exclusion for Visitors Who are Awaiting the Results of a COVID-19 Test

The new direction (No 8) adds a new section which says that “in the case of a visitor” a person is not allowed to enter, or remain, in a Victorian facility if “the person has been tested for 2019-nCoV, and has not yet received the results of that test”.

This means that visitors who are awaiting COVID-19 test results are not allowed into Victorian aged care facilities. Providers in Victoria should therefore ensure that their visitor screening processes include asking visitors whether they are awaiting test results.

Note, this requirement explicitly applies to visitors only; it does not apply to staff.

Changes to the Definition of “Visitor” and Limits on Visits

The old direction (No 7) said that to be considered a legitimate “visitor” a person must be visiting the facility for one of four reasons:

• Providing care and support to a resident
• Providing end of life support to a resident
• As a prospective resident
• Accompanying a prospective resident

The old direction (No 7) set out these limits on “prospective residents” visits:

• Maximum of two people accompanying a prospective resident

The old direction (No 7) set out these limits on “care and support” visits:

• Maximum of two visits per day
• Maximum of two visitors per day
• Maximum of two hours visit time per day

The old direction (No7) did not set any limits on “end of life support” visits.

The new direction (No 8) completely restructures this section, dividing it into clear categories so that it is more specific and easier to read. These are the new visitor categories and limits relevant to aged care:

Parent, guardian, partner, carer or support person of a resident aged 18 years or over

A person may visit the resident at a care facility if the person is the parent, guardian, partner, carer or support person of the resident, and the person's visit is for the purpose of providing emotional and social support to the resident that cannot be provided by that person via electronic or other non-contact means.

Limit: only 1 visitor, once per day, for a maximum of 1 hour.

Resident of the facility who has a mental illness

A person may visit the resident at a care facility if the person is the resident's nominated person and the person's presence at the facility is for the purposes of matters relating to their role as nominated person.

Limit: only 1 visitor at any one time, for a maximum of 1 hour per visit.

Essential care and support for the resident's immediate physical wellbeing

A person may visit the resident at a care facility if the person's presence at the facility is for the purposes of providing essential care and support necessary for the resident's immediate physical wellbeing that optimises the care and support delivered by workers at the facility and cannot be provided by that person via electronic means.

Limit: only 1 visitor at any one time.

Example: providing ongoing support, assistance or personal care to a resident with activities of daily living such as showering, dressing, or meals.

Note: Care Direction (No 8) does not define what is meant by “electronic means.”

Essential care and support for the resident's immediate emotional and social wellbeing (including mental health supports)

A person may visit the resident at a care facility if the person's presence at the facility is for the purposes of providing essential care and support necessary for the resident's immediate emotional and social wellbeing (including mental health supports) that optimises the care and support delivered by workers at the facility and cannot be provided by that person via electronic means.

Limit: only 1 visitor at any one time.

Example: the person's physical presence is necessary to support individual behaviours of concern, such as for people living with dementia or who have a known or emerging serious mental illness.

Interpreters

A person may visit the resident at a care facility if the person's presence at the facility is for the purposes of providing interpreter or informal language support to enable the delivery of care by workers at the facility.

Limit: only 1 visitor at any one time.

People who are learning to support the resident ahead of the resident’s discharge

A person may visit the resident at a care facility if the person's presence at the facility is for the purposes of learning to support the resident's care upon the resident's discharge.

Limit: only 1 visitor, once per day, for a maximum of 1 hour.

Example: in preparation for providing in home care.

End of life support

A person may visit the resident at a care facility if the person's presence at the facility is for the purposes of providing end of life support to a resident of the facility.

Limit: maximum of 2 visitors at any one time.

Prospective residents

A person may visit the resident at a care facility if the person's presence at the facility is in the person's capacity as a prospective resident of the facility.

Limit: only 1 visitor at any one time.

People accompanying prospective residents

A person may visit the resident at a care facility if the person's presence at the facility is for the purposes of accompanying a prospective resident.

Limit: only 1 visitor at any one time.

How Long Will These Changes Last?

The new direction (No 8) says that the entry restrictions apply “between (and including) 11:59:00pm on 22 July 2020 and 11:59:00pm on 16 August 2020”.

On 16 August, or possibly before that day, the Victorian Government will likely reissue the same directions or a revised version of the directions.

Tips for Staying Up to Date with Entry Restrictions

It’s difficult to stay up to date with Victoria’s Care Directions because they change so often. In July alone, the Care Direction was updated three times. On top of this, with so many overlapping government departments with so many different names (Health and Human Services, Chief Health Officer, Deputy Public Health Commander) it’s hard to know where to look to get the latest information.

So here are two useful sites to help you stay on track:    

• Department of Health and Human Services: Victoria’s Restriction Levels – after you land on the page scroll down to Directions issued by Victoria’s Chief Health Officer and click Care facilities. There you will see the latest version of the Care Directions.
• ACE Weekly Wrap: our weekly summary of aged care news, including legislative developments and useful resources.