Updated Sector Code for Visiting in Aged Care Homes
The updated Sector Code for Visiting in Aged Care Homes version 7.2 (the Code) (released 26 June 2023), by the Older Persons Advocacy Network (OPAN), is a nationally consistent approach that enables residents to receive visitors while minimising the risk of COVID-19 and other respiratory diseases.
The revised Code, developed by 12 aged care consumer and provider organisations following extensive consultation, aims to give clear guidance where information may not be readily available. Key points within the Code include:
- aged care residents, carers, staff, and visitors need a clear guide to support visits and minimise the risk of transmission of viral and other infections
- restrictions on visiting should be as least restrictive as possible, proportionate to the specific risk at hand and in place for as short a time as possible
- providers should enable each resident to always have an essential visitor, even during outbreaks or exposures. Essential visitors include:
- Partners in Care – Access by Partners in Care should be prioritised, recognising their role in the daily care and support of a resident such as helping with hydration, meals, hygiene and emotional support.
- Named Visitor – If a resident does not have a Partner-in-Care, they may nominate one person to be a named visitor. Aged care homes and families should also consider a backup named visitor where the usual named visitor becomes unwell or is unable to visit for another reason. A named visitor may include a volunteer if the resident desires.
- systems introduced during the COVID-19 pandemic are becoming an ongoing feature of aged care, such as strongly encouraging up-to-date vaccination of staff, residents and visitors, and other infection prevention and control measures and these measures should be applied to other types of viruses such as RSV, influenza and gastroenteritis.
As mentioned in the Code, the Department of Health and Aged Care and the Aged Care Quality and Safety Commission would like to remind providers that the impact of social isolation on elderly Australians’ mental, social, physical and emotional wellbeing is of vital importance. Aged care services should do what they can to ensure timely access to medically appropriate care services and ongoing access to visitors.
People who have tested positive for COVID-19 must not visit high-risk settings, like residential aged care homes, for at least 7 days after testing positive and until they have no symptoms of COVID-19.
Further information on the rights of care recipients to continue to have access to visitors is available on OPAN's website.
The Minister for Health and Aged Care, the Hon Mark Butler, has announced expanded access to subsidised oral antiviral, Paxlovid. You can read Minister Butlers full media release on the Department's website.
From 1 July 2023, the eligibility for treatment of COVID-19 has been expanded. People aged 50 to 59 with at least one risk factor, will now have access to the oral antiviral treatment, Paxlovid, if they test positive to COVID-19.
Eligible Australians are encouraged to have early discussions with their health care practitioner about their suitability for this treatment.
The Department of Health and Aged Care along with the Aged Care Quality and Safety Commission have training available for approved aged care providers and employees of approved providers. It covers the fundamentals of Infection Prevention and Control (IPC) for COVID-19 and other respiratory diseases.
Users can access the training at the Aged Care Quality and Safety Commission’s aged care learning information system (Alis). If you’re an approved provider, or work for an approved provider, you can access Alis for free. You can sign up or log in to Alis at: learning.agedcarequality.gov.au.
If you experience any difficulties with accessing the platform, please contact the Commission by emailing email@example.com.
Learners can download a completion certificate from Alis once the modules have been completed, and administrators have access to completion data for their staff.
Additional online IPC training that is suitable for the aged care sector is available at:
- Infection prevention and control for aged care | Australian Commission on Safety and Quality in Health Care – suitable for all aged care workers
- Infection prevention and control - advanced education eLearning modules | Australian Commission on Safety and Quality in Health Care- suitable for health care workers and organisations, aged and disability care workers and organisations, and workforce groups such as beauticians
- Partnerships in care | Aged Care Quality and Safety Commission - suitable for partners, or potential partners in care, or for other visitors to aged care homes.
It is important that aged care providers, including IPC lead nurses, are aware of the full suite of IPC training available for the aged care sector. All aged care workers are encouraged to complete IPC training at the start of their employment and annually to ensure their knowledge is current.
Question 1 - Do staff and residents still need to isolate for 7 days and will this be changed?
Current clinical advice, including the Communicable Diseases Network Australia (CDNA) Guidance, is that residents who test positive to COVID-19 should be isolated within the aged care service in line with IPC best practice but should not be isolated for any longer than is considered clinically necessary.
For residents, the period of isolation is seven days from the date of a positive test, or until all symptoms have resolved.
Isolation arrangements should be implemented with consideration to the older persons dignity, choice and continuity of care. This includes providing access to essential visitors.
All aged care workers should not attend work, and should stay at home, if they have respiratory symptoms to help prevent the spread of infection. Workers who test positive for COVID-19 should not attend the workplace for at least 7 days or until symptoms have gone, this includes those who provide close personal care to older people in their homes or the community to ensure the safety of the vulnerable Australians in those settings.
Question 2 - What is the advice for aged care workers that are close contacts?
If you are a close contact, you should monitor for signs and symptoms and get tested, via RAT and you should continue to follow COVIDSafe behaviours like
- doing regular RAT tests
- wearing masks indoors to help slow the spread of infection
- washing your hands frequently
- staying home if unwell or COVID-19 positive
To help prevent the spread of infectious diseases like COVID-19 or influenza, all residential aged care and home care workers should not attend work and should stay at home if they have respiratory symptoms.
Workers who test positive for COVID-19 should not attend the workplace for at least 7 days or until they no longer have symptoms, including those who provide close personal care to older people in their homes or the community. Home care and residential aged care providers and staff must adhere to all public health orders issued by the relevant state or territory government, including vaccination and testing requirements, and isolation protocols for close contacts and positive cases.
Question 3 - We recently had a large outbreak which also impacted staff so we did PCR testing on any staff with symptoms. Unfortunately those staff have received invoices from pathology (close to $100 each). As testing was time critical we couldn't wait for staff to see their own GP for a pathology referral. Is there a solution moving forward?
Bulk-billed COVID-19 PCR testing under Medicare is only available where the PCR test has been requested by a GP or nurse practitioner (treating practitioner) to assist with the clinical management of their patient. COVID-19 PCR testing performed without a request from a treating practitioner will incur a cost that will need to be covered by the patient or the employer of the worker.
Staff working in residential aged care facilities are recommended to undergo regular surveillance testing with a COVID-19 rapid antigen test (RAT) and during an outbreak, it is recommended this should increase to daily testing of staff to help minimise the spread of infections. Using COVID-19 RAT kits to screen aged care residents, staff and visitors for COVID-19 is part of a range of risk management options that residential aged care homes can use and a positive RAT test should be considered confirmation of a COVID-19 case.
The Commonwealth supply of the Pfizer 12 years+ (Purple) vaccine expired on 30 June 2023. Primary care providers are no longer able to order or administer this vaccine product.
Use of bivalent COVID-19 vaccines as a primary course
The Australian Technical Advisory Group on Immunisation (ATAGI) has reviewed the available evidence and advises that for people aged 12 years and older, a bivalent COVID-19 vaccine is now preferred over original (ancestral) vaccines for primary course vaccination.
This change to the advice is expected to impact only a small number of aged care residents who may be considering their primary course COVID-19 vaccination.
ATAGI advises that:
- People aged 18 years and older are recommended to receive either a BA.1-containing bivalent vaccine or a BA.4-5-containing bivalent vaccine for both the primary course and booster doses.
- People aged 12 and older who have commenced their primary course with an original (ancestral) vaccine are recommended to complete the course with a BA.4-5-containing bivalent vaccine.
ATAGI considers there to be no additional safety concerns when using bivalent vaccines for the primary course, compared with the original vaccines.
When using a bivalent vaccine for primary vaccination, the number of doses and the interval between the doses are the same as for the original (ancestral).
For further details read the ATAGI advice on the preferential use of bivalent COVID-19 vaccines.