COVID-19 safe behaviours
Aged care providers need to remain alert and prepared for a potential outbreak of COVID-19. We encourage providers to continue to stay alert and remember the key steps to keep yourself and others safe and maintain COVID-19 safe behaviours:
- do regular rapid antigen tests (RAT) to screen for infection
- wear a mask if indoors to help slow infection
- wash your hands frequently
- stay up to date with vaccinations
- stay home if unwell or COVID-19 positive.
All aged care workers and visitors should not attend work, and should stay at home, if they have respiratory symptoms to help prevent the spread, even if they receive a negative RAT result.
Workers who test positive for COVID-19 should not attend the workplace for at least 7 days, including those who provide close personal care to older people in their homes or the community.
The National Statement of Expectations on COVID-19 Management in Aged Care Settings is a best practice reference document for both residential and home care providers on their responsibilities for preparing for and responding to the impact of COVID-19.
Reduce infection risk – Screening staff and visitors
Although we have seen a recent reduction in cases and outbreaks, it is important that residential aged care homes remain vigilant. It is recommended that facilities continue to refer to CDNA guidance materials to underpin screening arrangements put in place, informed by local risk assessments. We are continuing to supply weekly Rapid Antigen Test (RAT) kits to residential aged care homes through the National Medical Stockpile which should form part of your surveillance screening.
Screening on entry to a residential aged care home is vital. Anyone who visits a residential care home should be well and free of respiratory symptoms. Visitors are also strongly encouraged to undertake a RAT prior to entry and wear a mask during their visit.
Visitors that have tested positive to COVID-19 should not enter a residential aged care home for at least 7 days and until they remain symptom free.
Having effective surveillance testing in place will let you detect COVID-19 much earlier and enact a swifter response.
We recommend conducting surveillance screening of staff at least 2 times per week and not more than 72 hours apart, or on entry for each visitor. This should increase to daily testing of staff, visitors and residents during an outbreak to help minimise the spread of infections.
Visitors can also use their own RAT kits prior to their visit and it is appropriate for you to ask for evidence of their test result.
Providers should regularly review screening arrangements in line with their risk assessment of the current COVID-19 risk in their area. The National COVID-19 Community Protection Framework provides information on measures which could be used depending on the level of community cases. You should stay up to date with current community case levels in your local area by regularly reviewing advice from your state or territory.
Use of personal protective equipment (PPE)
Aged care providers should make sure that all aged care homes and in-home care services have appropriate stocks of PPE available and arrangements with commercial suppliers to replenish PPE stocks as required.
Residential aged care services should encourage staff and visitors to wear a face mask when indoors and in close contact with other people at a residential care home.
All in-home care services should provide their staff with PPE to use in each consumer’s home, including any additional PPE required to support a consumer who has tested positive to COVID-19.
During an outbreak, aged care homes should extend the provision of PPE to all visitors and increase the PPE worn by staff. This includes gloves, gowns, eye protection and N95 face masks as well as dedicated stations to put on and take PPE off safely.
Particulate filter respirators (N95 or P2 masks) offer greater protection against airborne pathogens. The type of mask chosen should be informed by a risk assessment as part of a suite of measures in line with the hierarchy of controls in infection prevention and control.
Under state and territory workplace safety legislation, all aged care services are responsible for providing a safe working environment for their staff and visitors. This includes providing appropriate PPE as well as providing training on how to use and dispose of it.
Fit testing and fit checking N95 masks
Aged care workers who wear N95 masks should complete fit testing before first use and perform a fit check each time they are used. Providers are encouraged to organise fit testing for new staff and should ensure a buddy system is in place for checking.
Fit testing should be performed by an appropriately trained person to match the correct mask with an individual’s facial shape to ensures correct fit for the user’s face (ie, creates a seal) to minimise the number of particles that can bypass the filter through gaps between the user’s skin and the respirator seal.
Fit checking is performed by the wearer by gently inhaling and exhaling. If the mask is not drawn in towards the face, or air leaks around the face seal, readjust the mask and repeat process or check for defects in the mask.
COVID-19 vaccination for aged care residents
All older people who are eligible for their fourth dose but have not received the dose should be strongly encouraged to receive the dose if it has been 3 months since their most recent COVID-19 infection.
In a residential setting, aged care providers are responsible for supporting residents to access this fourth dose along with any other doses for other residents.
Changes to the administration of COVID-19 vaccination clinics are being implemented following the launch of the National COVID-19 Health Management Plan in December 2022.
For the next 12 months, COVID-19 vaccines will continue to be principally administered in residential aged care homes by primary care providers such as general practitioners and pharmacists. These primary care providers delivered the majority of COVID-19 vaccinations in residential aged care in 2022 and are well placed to continue this important work as we transition our COVID-19 response.
Additional help for aged care will be provided through the Vaccine Administration Partners Program (VAPP). The VAPP will be able to deliver COVID-19 in-reach clinics in residential aged care homes as a last resort option in circumstances where there is a shortfall in primary care availability to administer COVID-19 vaccinations in this setting.
We ask residential aged care homes not to approach VAPP providers directly. If you need COVID-19 vaccination support, please contact us at RACFVaccineClinics@health.gov.au and we will liaise with the relevant Primary Health Network to determine what assistance is available through primary care providers in your area.
Access to oral antiviral treatments
Older Australians in residential care or in their own homes should plan ahead for access to COVID-19 oral antiviral treatments. These treatments save lives, they are safe, effective and available to all Australians aged 70 or over and those in high-risk groups.
It is critical that COVID-19 oral antiviral treatments Paxlovid® (nirmatrelvir and ritonavir) and Lagevrio® (molnupiravir) are urgently accessible to every eligible Australian who has tested positive for COVID-19. Where possible, Paxlovid should be preferred but both options remain appropriate for treatment in older Australians.
All aged care services should support their residents and care recipients to be able to access antiviral treatment as soon as possible. Aged care services should have established links with primary care providers to rapidly assess residents and care recipients, and community pharmacies to get rapid supply of medications. This is really important as antivirals need to be administered within 5 days of symptom onset, and the sooner the better, for the best outcome.
Medicare telehealth services are now available with any GP for anyone with a confirmed COVID-19 diagnosis in the past 7 days. A long telehealth (phone) consultation by a GP for prescribing COVID-19 antiviral treatments is also available until 31 December 2023.
If you can't get an appointment for your residents or care recipients to talk about treatments, you can call HealthDirect's free helpline on 1800 022 222 or use the Service Finder to search for one nearby.
You can also find your nearest pharmacy with the oral treatments online.
To support prompt treatment of patients, GPs and nurse practitioners can add Lagevrio® and Paxlovid® to their Prescriber Bag supplies.
This means, for those residents and home care recipients you have had early discussions with about COVID oral antiviral treatment, who test positive to COVID-19 and have given consent to oral antiviral treatment, can get prompt administration of these medications.
Please continue to review the use of COVID-19 oral antivirals and discussions between residents and GPs about these treatments to determine suitability and eligibility.
Visitors to residential aged care homes
To understand more about resident rights and responsibilities we encourage you to review the Industry Code for Visiting Residential Aged Care Homes. The Aged Care Quality and Safety Commission (the Commission) has also produced a series of partnerships in care resources to support aged care residents, their family or close friends to continue their relationships of care and companionship, even during periods of an infectious disease outbreak.
Providers are expected to balance their responsibilities to reduce the risk of COVID-19 entering the site, with their responsibilities for meeting the physical, social and emotional needs of consumers.
The Commission recognises the known physical, psychosocial and nutritional impacts on older people if they experience extended periods of social isolation and has issued a statement on what their position is on provider responsibilities relating to visitor access. We encourage you to read the statement.