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Protecting residential aged care residents

Residential Aged Care Direction (No.3)

What’s changed 6am AEST 23 July 2021

  • There are no restricted Local Government Areas. You can now enter a residential aged care facility if you follow visitor requirements.
  • Students on clinical placement can now enter a residential aged care facility without needing a COVID-19 vaccine as there are no Restricted Local Government areas.
  • Clarify that you can enter a residential aged care facility if you have been residing in the New South Wales border zone for the past 14 days.

Overview

For residential aged care facilities located in Queensland the following measures apply:

Visitors, staff or volunteers at a residential aged care facility should not be anyone who:

  • is unwell
  • has been diagnosed with COVID-19 or asked to quarantine
  • has returned from overseas in the last 14 days (excluding safe travel zone countries)
  • has had contact with a person with COVID-19 in the last 14 days
  • has visited a COVID-19 hotspot in the last 14 days or since the hotspot was declared (whichever is shorter)
  • has visited an interstate exposure venue in the last 14 days unless an exemption has been granted for an end of life visit
  • has been in an interstate area of concern in the last 14 days or since the identified start date (whichever is shorter), unless you fit into one of the categories of people who are allowed to enter a facility with a negative COVID-19 test
  • has been tested for COVID-19 and is waiting for the result (except for tests due to surveillance testing obligations)
  • has COVID-19 symptoms of fever (37.5 degrees or more), cough, shortness of breath, sore throat, loss of smell or taste, runny nose, diarrhoea, nausea, vomiting or fatigue

You may enter a residential aged care facility if you do not fit into any of the above categories.

Visitors should:

  • wash their hands before entering and leaving the facility
  • stay 1.5 metres away from others where possible
  • stay in the resident’s room, outside or in a specific area (avoiding communal spaces)
  • stay away when unwell
  • follow requests from the facility to help keep staff and residents safe.

For full details read the Residential Aged Care Direction (No.3).

Questions and answers about this Direction

What Local Government Areas are restricted?

There are currently no Local Government Areas where increased restrictions apply to residential aged care facilities.

Certain restrictions continue to apply to residential aged care facilities under the Residential Aged Care Direction.

Who can visit a residential aged care facility?

Visitors, staff or volunteers should not be anyone who:

  • is unwell
  • has been diagnosed with COVID-19 or asked to quarantine
  • has returned from overseas in the last 14 days (excluding safe travel zone countries)
  • is a close contact, unless their quarantine period has ended
  • has visited a COVID-19 hotspot in the last 14 days or since the hotspot was declared (whichever is shorter)
  • has been tested for COVID-19 and is waiting for the result (except for tests due to surveillance testing obligations)
  • has visited an interstate exposure venue in the last 14 days unless an exemption has been granted for an end of life visit
  • has been in an interstate area of concern in the last 14 days or since the identified start date (whichever is shorter), unless you fit into one of the categories of people who are allowed to enter a facility with a negative COVID-19 test
  • has COVID-19 symptoms of fever (37.5 degrees or more), cough, shortness of breath, sore throat, loss of smell or taste, runny nose, diarrhoea, nausea, vomiting or fatigue
  • has not had the 2021 flu vaccine, if it is available to them

You may enter a residential aged care facility if you do not fit into any of the above categories.

You may enter a residential aged care facility if you have been in an interstate area of concern in the last 14 days or since the identified start date (whichever is shorter) if you obtain a negative COVID-19 test result in Queensland and are:

  • an employee, contractor, or student of the facility
  • providing goods or services necessary for the facility’s operation
  • providing health, medical, personal care or pharmaceutical or pathology services to a resident
  • required for emergency management, law enforcement or to comply with a power or function of a government agency or entity
  • a prospective resident or a support person of a prospective resident
  • maintaining continuity of care for a resident that can’t be delivered by non-contact means – with permission of the facility’s operator
  • attending for an end of life visit

You may be requested to provide evidence of the negative COVID-19 test when entering the facility.

Visitors should:

  • wash their hands before entering and leaving the facility
  • stay 1.5 metres away from others where possible
  • stay in the resident’s room, outside or in a specific area (avoiding communal spaces)
  • stay away when unwell
  • follow requests from the facility to help keep staff and residents safe.

I am a New South Wales border zone resident, can I enter a residential aged care facility in Queensland?

Yes. You can enter a residential aged care facility if you have been residing in the New South Wales border zone for the past 14 days and have not been outside the border zone.

Can I have physical contact with my family member when I visit them in a residential aged care facility?

If you are permitted to visit a residential aged care facility, please practice physical distancing where possible. It is particularly important that visitors ensure physical distancing when they are in communal areas or in proximity to other residents or staff members. We can all do our bit to help protect this vulnerable group, while ensuring residents stay connected with their loved ones.

Can I visit someone who is near their end of life in a residential aged care facility if I have been to an interstate exposure venue, hotspot or overseas in the last 14 days?

Visitors who have been to an interstate exposure venue, hotspot or overseas (other than a Queensland safe travel zone country) in the last 14 days must be granted an exemption by the Chief Health Officer. You must comply with all the conditions given under the exemption.

The residential aged care facility must also take reasonable steps to manage your visit in line with the conditions of the exemption. For example, this could mean:

  • the operator needs to ensure the resident you are visiting is in a single room
  • you wear appropriate personal protective equipment (PPE)
  • you are escorted to and from the room
  • you avoid common areas and contact with other residents.

To apply for an exemption for an end of life visit, complete the form online using the COVID-19 Services Portal. Call 134 COVID (13 42 68) if you need help making your application.

How can we support our loved ones if we are unable to visit them?

It’s important to stay connected with residents. If you are unable to visit your loved ones for any reason, you can keep in touch by:

  • phone calls
  • video calls
  • sending letters and postcards
  • sending artwork
  • sending home videos.

Can residents leave an aged care facility?

Residents can leave a residential aged care facility for any purpose. As members of the public, residents must follow all current Public Health Directions when leaving a facility.

Residents should stay home if they are sick. If leaving the facility, residents should:

  • practice physical distancing as much as possible – for example, on shared transport and in public spaces
  • wear a face mask when physical distancing isn’t possible
  • wash their hands often, using soap and water or hand sanitiser
  • sneeze or cough into their arm or a tissue, then put the tissue in the bin.

This advice should be followed even if residents have had the COVID-19 vaccine.

My loved one has dementia and doesn’t understand what’s happening.

Talk to the residential aged care facility and discuss ways you can safely support your loved one.

What happens if there is a spike of COVID-19 cases in the community?

If there is a spike in cases in the community, the residential aged care facility may need to limit when residents may leave the facility and restrict visitors to the facility. These measures will be needed to protect the health of our most vulnerable.

Does the Residential Aged Care Direction replace or amend any requirements under the Aged Care Act 1997 (Cth)?

The Commonwealth is responsible for regulating and funding aged care under the Aged Care Act 1997 (Cth).

The requirements set out in the Residential Aged Care Direction are intended to operate in addition to any existing requirements under the Aged Care Act, including any related subordinate legislation.

To the extent of any inconsistency between the Residential Aged Care Direction and a requirement under the Aged Care Act, the Act applies or prevails.

Questions about close contacts

Who is considered a close contact of a person with COVID-19?

The Residential Aged Care Direction states that a person must not enter a residential aged care facility if they are a close contact of someone who has been diagnosed with COVID-19.

A close contact is someone who has:

  • had face-to-face contact for any amount of time or shared a closed space for at least 1 hour with a confirmed case during their infectious period.
  • been to a venue or location where the risk of transmission is considered high based on public health assessment.
  • been identified by public health authorities to be at high risk for developing COVID-19 as they have or may have been in contact with someone with COVID-19, for example in a school or other institutional setting.
  • been advised they will be provided with a quarantine direction by an emergency officer – by text, email or phone call.
  • been confirmed a close contact or casual contact by an interstate government authority.

The Management of Close Contacts Direction outlines the quarantine, travel and testing requirements for close contacts.

Are healthcare workers considered to be close contacts?

The Residential Aged Care Direction states that a person must not enter a residential aged care facility if they are a close contact of someone who has been diagnosed with COVID-19.

Residential aged care workers, healthcare workers or practitioners providing health or medical care may provide care for suspected or confirmed COVID-19 cases. These workers are not considered close contacts for the purposes of the Direction where they have been wearing appropriate PPE (PDF) and followed recommended infection control precautions.

Questions about staff

What happens if I have to work across multiple care facilities? If I am casual staff, will I lose my job?

Casual staff will not lose their jobs. It is recommended that residential aged care facilities try to limit staff working across multiple care facilities wherever possible. This is to limit the potential spread of COVID-19 across facilities with vulnerable Queenslanders. If staff do work across multiple care facilities, you must:

What are care facilities?

Care facilities include but are not limited to hospitals, retirement villages, residential aged care facilities and distinct sections of a facility providing multiple types of care such as a Multi-Purpose Health Service.

I have received a negative COVID-19 test after returning from an interstate area of concern, when can I return to work/study/volunteer/support at an aged care facility?

You may enter a residential aged care facility if you have been in an interstate area of concern (excluding interstate exposure venues) in the last 14 days or since an identified start date (whichever is shorter), if you obtain a negative COVID-19 test and are:

  • an employee, contractor, or student of the facility
  • providing goods or services necessary for the facility’s operation
  • providing health, medical, personal care or pharmaceutical or pathology services to a resident
  • required for emergency management, law enforcement or to comply with a power or function of a government agency or entity
  • a prospective resident or a support person of a prospective resident
  • maintaining continuity of care for a resident that can’t be delivered by non-contact means – with permission of the facility’s operator
  • attending for an end of life visit.

You may be requested to provide evidence of the negative COVID-19 test when entering the facility.

If you fall into one of the above categories you can only enter the premises of a residential aged care facility, if you:

  • are not unwell
  • have not returned from overseas in the last 14 days (excluding safe travel zone countries)
  • have not had contact with a person with COVID-19 in the last 14 days
  • have not visited a COVID-19 hotspot in the last 14 days or since the hotspot was declared (whichever is shorter)
  • have not visited an interstate exposure venue in the last 14 days unless an exemption has been granted for an end of life visit
  • have no COVID-19 symptoms of fever (37.5 degrees or more), cough, shortness of breath, sore throat, loss of smell or taste, runny nose, diarrhoea, nausea, vomiting or fatigue.
  • can provide evidence of a negative COVID-19 test in Queensland since returning from an interstate area of concern
  • have had the 2021 flu vaccine, if it is available to you.

What happens if a residential aged care facility is short-staffed?

In the event of a critical workforce shortage, residential aged care facility operators must notify the local Health Emergency Operations Centre for notification purposes to support Queensland Health’s COVID-19 response. As part of the notification process, operators should also advise what their baseline staffing levels are, including skills mix and rostering requirements.

A critical workforce shortage is where the operator considers the lack of staff may impact resident care or the effective operation of the facility. This is a notification requirement only and is in place to inform Queensland Health planning for the statewide response to COVID-19. The operator of the residential aged care facility should also continue to address the shortage through normal workforce management practices.

What is critical workforce shortage?

A critical workforce shortage refers to a sustained workforce shortage that the operator of the residential aged care facility thinks may impact on resident care or the effective operation of the facility.

For example, a critical workforce shortage may be a shortage of more than 10 per cent of staff for a sustained period of 7 days or more. This number will be dependent on the size of the facility and baseline staffing levels. This will also need to take into consideration skills mix and rostering requirements.

Who has to wear personal protective equipment (PPE) when they enter a residential aged care facility?

Any residential aged care facility employees, contractors, volunteers or students who work across multiple care facilities must wear appropriate PPE as outlined in Queensland Health’s Residential Aged Care Facility and Disability Accommodation PPE Guidance (PDF). You should change your PPE if you are moving between facilities.

Are students allowed to undertake a placement at residential aged care facilities?

Students may undertake a placement at a residential aged care facility (in a restricted or non-restricted area), where they are under the supervision of an employee or contractor.

All requirements that apply to staff and contractors also apply to students, including:

  • having the flu vaccine, if it is available to them
  • notifying the residential aged care facility if they have another care facility workplace
  • wearing appropriate PPE if they work across multiple care facilities.

Students undertaking a placement in a restricted residential aged care facility can only enter for their placement if they have had two doses of the Pfizer or AstraZeneca COVID-19 vaccine.

Currently there are no restricted residential aged care facilities, which means students can enter without needing a COVID-19 vaccine.

Facilities may also impose their own additional requirements on students.

Questions about flu vaccines

Why do I need a flu vaccine to enter a residential aged care facility?

To protect the health of our most vulnerable older Queenslanders, everyone entering a residential aged care facility must have had the 2021 flu vaccine – if it is available to them. This includes visitors, facility staff, health care workers, volunteers, students and others (e.g. cleaners, tradesmen, gardeners and maintenance staff).

The vaccine will be considered not available to you, if you:

  • are within the recommended 7 day waiting period between having the COVID-19 vaccine and flu vaccine, or
  • have been given a medical exemption by a health care professional in line with the Contraindications and precautions for influenza vaccination as outlined in The Australian Immunisation Handbook.

What if I am unable to have the 2021 flu vaccine?

If you are unable to have the 2021 flu vaccine, you can continue to visit or work at a residential aged care facility provided you:

  • stay for a short time in the resident’s room or outside
  • avoid communal spaces
  • make sure the resident has no more than two visitors at a time, including doctors
  • wash your hands before entering and leaving the facility
  • stay 1.5 metres away from residents where possible
  • stay away when unwell.

What is a current flu vaccine?

The flu vaccine is made differently each year depending on the circulating influenza virus strains. You do not have the best protection against the flu until you have been vaccinated with the current year's vaccine. The 2021 flu vaccine is the most up to date flu vaccination available.

Do children need to have a flu vaccine to enter an aged care facility?

Yes. Children aged 6 months and over must have the 2021 flu vaccine if it is available to them, before entering a residential aged care facility.

Questions about workforce management plans and personal protective equipment (PPE)

What do residential aged care facilities need to consider in identifying their workforce surge requirements?

Experiences in other states and territories have shown that if a suspected or confirmed case of COVID-19 is identified in a residential aged care facility then a significant amount of the workforce will need to quarantine while awaiting their test results. This could be up to 50 or 80 per cent of the workforce. This means the facility will need to urgently access additional staff to maintain short term continuity of care.

Your planning should consider where additional staff will be sourced from, and how you will support continuity of care. You should also consider your ability to minimise the number of staff that would need to quarantine by putting in place measures such as co-horting and staggered breaks, and minimising the number of staff working across multiple care facilities.

What is a workforce management plan?

A workforce management plan is a document to reduce the risk of transmission of COVID-19 into Queensland workplaces and communities. It also outlines how facilities will manage operational requirements regarding staffing, including in the case of an outbreak.

Download a workforce management plan template (DOCX).

Do I have to keep a record of all the places my staff work?

Yes. Staff members working across multiple facilities and workplaces must advise each employer of their other workplaces. The residential aged care facility must keep a record of this advice.

This will assist with contact tracing if a COVID-19 case is confirmed.

What training do I need to provide my staff?

Residential aged care operators must take reasonable steps to ensure all employees, contractors who have contact with residents, volunteers and students of residential aged care facilities undergo face to face infection control and personal protective equipment training.

The training must cover the Residential Aged Care Facility and Disability Accommodation PPE Guidance (PDF). It must also include a face-to-face competency assessment on donning and doffing of PPE.

Some components of the training may be delivered by the trainer virtually.

Who can conduct the training?

The training must be conducted by:

  • a person who has specialist infection control experience
  • a person qualified to provide education/training who has experience in providing education/training about infection control and personal protective equipment
  • a registered nurse or other health practitioner who has experience in providing education sessions
  • a registered nurse who has completed an infection control and personal protective equipment train-the-trainer session led by a registered nurse or other health practitioner who has specialist infection control experience or experience in providing education sessions.

The training must include a competency assessment of donning and doffing personal protective equipment.

What new requirements are in place for supply of personal protective (PPE) equipment?

Residential aged care facility operators must take reasonable steps to ensure adequate supply of PPE is available to respond to a confirmed case of COVID-19 within the facility.

What is considered adequate supply of personal protective equipment (PPE)?

If a suspected or confirmed case of COVID-19 is identified in a residential aged care facility the facility will need to immediately implement enhanced infection control practices. This will require increased use of PPE by staff and residents. It is important that residential aged care facilities plan for this, and hold adequate supply on site to meet immediate needs, while waiting for resupply.

As a guide, it is suggested that urban and regional facilities may require 3 days’ worth of PPE, and regional and remote facilities may require 6 days’ worth of PPE. It will also depend on other factors such as the number of staff and residents in the residential aged care facility.

In deciding supply and stock management practices, the facility operator should consider:

  • their ability to isolate and cohort residents
  • the likely required use of PPE
  • the distribution and supply chain logistics.

Why does the direction talk about restricted/non restricted and the Queensland Health’s Residential Aged Care Facility and Disability Accommodation PPE Guidance refers to low/moderate/high?

The Queensland Health Residential Aged Care Facility and Disability Accommodation PPE Guidance (PDF) has been prepared to provide clinical guidance, whereas the restricted/non restricted areas are relevant to rules impacting the general public. Queensland Health will notify facilities and provide clinical guidance when their rating changes between low, moderate and high.

Questions about the collection of contact information

Why do visitor, volunteer and contractor details have to be collected?

Residential aged care facilities must collect contact information of visitors, volunteers and contractors using the Check In Qld app, unless an exception applies. This is so public health officials can contact individuals in the event of an outbreak of COVID-19 in Queensland.

Exceptions to using the Check In Qld app includes not requesting information from:

  • a person entering in an emergency to provide emergency services
  • a child under the age of 16 years who is not accompanied by a responsible adult
  • a person based on compassionate grounds or if it may pose a risk to a person’s safety.

How will visitor, volunteer and contractor details be collected? What is the responsibility of an individual?

The operator of a residential aged care facility must collect contact information by requesting visitors, volunteers and contractors use the Check In Qld app. If this can’t be done because the individual is unable to use the app – for example, because of age, disability or language barriers, or they do not have access to the app – the operator must register them through the Business Profile of the app. The Check In Qld app QR code must also be displayed at all entries to the facility.

All visitors, volunteers and contractors are responsible for providing their contact information by using the Check In Qld app upon entry to a facility, unless an exception applies. A person accompanying a person who is unable to use the app is also permitted to check in that person on their behalf.

What if contact details can’t be collected using the Check In Qld app?

If contact information can’t be collected using the Check In Qld app due to issues with the Check In Qld app or no mobile data connection, facilities must collect this information using another electronic or paper-based method.

For each visitor, this information must include:

  • name
  • phone number
  • email address (residential address if unavailable)
  • date and time period of the visit.

Facilities must use best endeavours to transfer this information to an electronic system within 24 hours and comply with the requirements for collection and storage. If asked, this information must be provided to a public health officer within the stated time.

Questions about requirements for residential aged care facility operators to have processes in place to identify residents

What process are in place to ensure residents can be identified in a COVID-19 event?

Residential aged care facilities must take reasonable steps to develop and document appropriate processes to ensure residents and their unique needs can be immediately identified in a COVID-19 event.

For example, this may include requirements for residents to wear identification if appropriate, and to ensure residents’ personal preferences and needs are documented appropriately. It could also include keeping a hard copy of each resident’s relevant records securely stored in the facility, including:

  • current medications list
  • personal care requirements and preferences
  • their advance care planning documents and directions.

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Questions and requests for exemptions

If you are seeking clarification on a Direction or have any questions, please call 134 COVID (13 42 68).

You can apply for an exemption to a Direction online.