In this article, Stuart Lowe and Tayla Gorman review the draft Residential Care Visitor Access Code and explain its impact.
Residential aged care providers will be aware of the public health directions issued to date by various State Governments in response to the COVID-19 pandemic, based on National Cabinet guidance, restricting care and support visits as to frequency, duration and number of visitors. However, some providers have opted to implement stricter measures to ensure the safety of residents, such as total lockdowns. In recent weeks, various levels of Government have pressured these providers to relax visiting restrictions, in line with Government guidelines, despite:
- the significant outbreak at Newmarch House in Sydney;
- devastating death tolls in overseas aged care facilities;
- an Essential poll revealing that two thirds of Australians support aged care homes on visitor bans; and
- neither the national guidelines nor State Government directions providing any indemnity from providers’ broader duty of care.
In response to threats of Government intervention, various aged care peak bodies last week released a draft Residential Care Visitor Access Code (the Code). A copy of the draft Code can be found here. It is intended that, once finalised, the Code will be a voluntary code, providing a nationally consistent visitation policy for residential aged care facilities during the COVID-19 pandemic. While the draft Code has been “considered” by National Cabinet, it remains to be seen whether it will receive Government support and, if so, in what form.
The draft Code is currently open for consultation, with the consultation period ending at 3.00 pm on Thursday, 7 May 2020. It is envisaged the Code will be finalised by Monday, 11 May 2020.
What can aged care service providers do to comply with the Code?
A major underlying principle of the Code is the need for providers to actively facilitate connections between residents and their family, family of choice or friends during the COVID-19 pandemic, while minimising the risk of its introduction to a residential aged care facility.
Providers who opt in to the Code must:
- ensure that each facility has its own solution for on-site visiting – this could include a dedicated visiting room, visiting window, or requiring visitors to attend each resident’s room;
- allow residents to continue to use public spaces within the facility, subject to social distancing requirements (e.g. limits on numbers), if the facility is not affected by an outbreak;
- maintain residents’ access to external medical and related services on a safe but prompt basis, with appropriate use of telehealth options;
- accept delivery of any letters, parcels and other items from friends and family on behalf of the resident;
- facilitate regular electronic communication and ensure that each facility has a means of regular and responsive communication with residents’ families;
- as needed, ensure that visits within the resident’s room (or a dedicated area), longer visitations, additional infection control training and personal protective equipment are provided for the following two visitation situations:
- residents who are dying and in their final weeks – in which case, providers may err on the side of compassion and allow in-person visits from a small number of loved ones on a regular basis, with regard to the dignity and comfort of the resident and their individual circumstances; and
- visitors who have a clearly established pattern of involvement in providing a resident’s care and support – in which case, the length, frequency and nature of the visits should reflect the resident’s care needs and be consistent with established practices and routines;
- ensure that residents’ legal representatives are heard and their substituted decisions are upheld;
- ensure that all staff are vaccinated, consistent with current requirements;
- appropriately support staff to facilitate in-person visits; and
- if an outbreak of COVID-19 occurs at a facility:
- implement a full lockdown of the facility in a transparent and well-communicated way, with an indication of likely timeframe and when the lockdown will next be reviewed; and
- continue to attend to residents’ overall needs, offer activities and exercise contributing to quality of life, notwithstanding that this may need to occur in residents’ rooms.
In addition to the above, providers who opt in to the Code may:
- require visitors to remain at the facility only for short periods, and introduce additional procedures such as booking systems. The Code does not define ‘short periods’, however does note that providers will need to adopt a flexible and compassionate approach to visiting times to allow visitations to occur at different times (e.g. to accommodate visitors who work during business hours);
- refuse entry to their facility to any person, for any justifiable reason consistent with the Code; and
- elect to implement a full lockdown when an outbreak has occurred within the facility, or a declared outbreak has occurred in the local area, or if there are other extraordinary circumstances requiring a full lockdown.
The Aged Care Quality Standards and Charter of Aged Care Rights will continue to apply throughout the pandemic.
What can providers require from visitors?
Visitors must comply with infection control processes put in place by the provider, and must not enter a facility if they have any cold, flu or other COVID-19 symptoms. Providers will need to make their own decisions on appropriate infection control procedures for their facility, however the Code expressly notes the following as minimum entry requirements for visitors:
- responding honestly to screening questions about COVID-19 risk factors;
- demonstrating an up to date flu vaccination; and
- complying with the provider’s other requirements, including hand hygiene, having their temperature checked upon arrival, wearing personal protective equipment (if required) and remaining in a resident’s room or designated visiting area.
Additional funding for providers
Residential aged care providers already incur considerable internal costs to comply with Australia’s regulatory framework. The additional staffing, equipment and technology costs caused by the COVID-19 pandemic has only exacerbated this situation.
The Federal Government’s announcement of an emergency funding package to support providers has therefore come as welcome news to the industry. Providers can now expect to receive once-off additional funding of $900 per occupied residential care bed in metropolitan areas, or $1,350 per occupied bed in rural or remote areas.
Implementation of the Code
The Code is expected to be finalised by Monday, 11 May 2020, and will presumably commence shortly thereafter.
The draft Code states that it will be reviewed four weeks after its implementation.
We will continue to provide further updates on the Code as they become available.
In the meantime, please do not hesitate to contact us with any questions relating to aged care operations in this unprecedented time.
