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Protecting aged care residents

Aged Care Direction (No. 10)

This content was last updated on 25 September 2020.

From 1am Friday 25 September 2020 there are no Local Government Areas listed as Queensland COVID-19 restricted areas.

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

What changed on 11 September 2020

  • New requirements for all residential aged care facility operators to:
    • notify their local Health Emergency Operations Centre in the event of a critical workforce shortage for notification purposes
    • 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.
  • Clarify personal protective equipment (PPE) requirements, including that appropriate PPE should be worn in accordance with Queensland Health’s Residential Aged Care Facility and Disability Accommodation PPE Guidance
  • Clarify that students may enter a residential aged care facility to undertake a placement
  • Clarify that residential aged care facility operators in a restricted area may grant permission to people to enter the facility to provide continuity of care for a resident that cannot be delivered by electronic or non-contact means, for example support from a primary care giver to eat meals
  • Clarify that the Direction applies to residential aged care facilities funded under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program.

What will change from 8am 1 October 2020

  • New requirements for residential aged care facility operators to:
    • include information in their Workforce Management Plan about how workforce surge requirements will be met if there is a COVID-19 event at the facility
    • take reasonable steps to ensure employees, contractors who have contact with residents, volunteers and students undergo face to face infection control and PPE training
    • take reasonable steps to ensure they have an adequate supply of PPE available to respond to a confirmed case of COVID-19 within the facility.

Who can visit a residential aged care facility? Family or support person, aged care staff, emergency workers and police, volunteers, health workers, a visitor who is providing end of life support

Residents can have up to two visitors at any one time. There is no limit on the number of visits allowed in a day or the length of each visit.

  • Residents can have up to two visitors at any one time. There is no limit on the number of visits allowed in a day or the length of each visit.
  • Children under the age of 16 years can visit residential aged care facilities.
  • Service providers may visit the facility, including but not limited to:
    • hairdressers
    • legal advisors
    • mental health providers (e.g. diversional therapists and music therapists)
    • allied health providers (e.g. podiatrists).
  • Residents may now leave their residential aged care facility for a range of reasons, including but not limited to:
    • exercise
    • attending small family gatherings of up to 20 people (as long as physical distancing can be maintained)
    • receiving or accessing health care
    • attending a funeral
    • visit a service provider (e.g. hairdressers, beauty therapists and legal advisors)
    • visiting another residential aged care facility.
  • Residents who are part of a family group (e.g. couples or siblings) or close friends can leave the facility together.
  • Groups of residents cannot go on external excursions (e.g. a group of residents cannot be taken on a day trip to the beach).

A support person can provide care and support to the person they are visiting, including physical care and support.

Visitors, aged care staff, health workers, students, volunteers and anyone else entering a residential aged care facility will still not be allowed to enter the facility if they have not had the 2020 flu vaccine. There may be some exemptions, as outlined in the Australian Government’s Flu Vaccination Requirements for Aged Care Facilities.

All residential aged care facility operators, no matter where they are located:

  • Must have a workforce management plan in place that makes it mandatory for employees to:
    • Tell their residential aged care facility employer of any other places of employment at care facilities
    • Tell their residential aged care facility employer if a COVID-19 case is identified at their other workplace.

For full details read the Aged Care Direction (No. 10).

Visitors should:

  • visit a resident in the resident’s room, outdoors or a specified area in the aged care facility
  • 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

Visitors should not be anyone who:

  • is unwell
  • has returned from overseas in the last 14 days
  • has had contact with a person with COVID-19 in the last 14 days
  • has travelled to a COVID-19 hot spot in the last 14 days
  • has a fever (37.5 degrees or more)
  • has a cough, runny nose, sore throat, breathing difficulties, loss of taste and/or loss of smell.
  • after 1 May 2020, has not had the 2020 flu vaccination (unless it is unavailable to you).

Whether you are a visitor, worker or volunteer, if you have visited a COVID-19 hotspot in the last 14 days, you must be in quarantine, so you must not enter an aged care facility.

Flu vaccination requirement

After 1 May 2020, a person must not enter a residential aged care facility if they do not have a 2020 vaccination against influenza, if the vaccination is available to the person.  

Recognising there may be individuals who, for medical reasons, cannot be vaccinated against influenza, there are some limited exemptions to this requirement. These exemptions follow the recommendations and clinical advice provided in The Australian Immunisation Handbook.

If a vaccine is unavailable at the time of vaccination, the person is exempt from the requirements until the vaccine becomes available.

Questions and Answers about this Direction

What Local Government Areas are restricted?

Local Government Areas where restrictions apply to residential aged care facilities are listed on the Queensland Government website. Currently there are no restricted local government areas.

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

Questions and answers about visiting Queensland residential aged care facilities not in restricted local Government areas

Who can visit a residential aged care facility not in a restricted local government area?

Any person may now visit residents in aged care facilities not located in a restricted local government area unless you:

  • have returned from overseas in the last 14 days
  • had contact with a person with COVID-19 in the last 14 days
  • visited a COVID-19 hotspot in the last 14 days
  • have a fever (37.5 degrees or more)
  • have a cough, runny nose, sore throat or breathing difficulties
  • have not had the 2020 flu vaccination (unless it is unavailable to you, for example, you are allergic to the vaccine).

Can I visit a loved one in a residential aged care facility?

Yes. Residents of residential aged care facilities not located in a restricted local government area can have two visitors at any one time, for any length of time. Residents can have multiple groups of visitors per day. A support person can provide care and support to the person they are visiting, including physical care and support.

Can people under 16 years of age now visit an aged care facility?

Yes. Children under the age of 16 years can visit residential aged care facilities not located in a restricted local government area.

There is limited evidence of transmission of COVID-19 occurring in children, in Australia. Only two per cent of confirmed cases have occurred in school aged children. Based on the emerging evidence supporting the limited role of children in transmission of COVID-19, visitation of children to residential aged care facilities is likely to pose a low risk to residents. All visitors should observe appropriate hygiene and social distancing measures.

What should I do when I enter a residential aged care facility not located in a restricted local government area to work, volunteer or visit?

You should:

  • stay in the resident’s room, outside or in a specified area
  • 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.

Can a resident of an aged care facility not located in a restricted local government area leave the facility?

A resident may leave a residential aged care facility not located in a restricted local government area for a range of reasons, including but not limited to:

  • exercise
  • attend a small family gathering
  • receive or access healthcare including mental health and allied health services (e.g. podiatrists, diversional therapists, music therapists)
  • receive end of life or palliative care
  • visit a service provider, including:
    • hairdressers and beauty therapists
    • legal advisors
  • visit another residential aged care facility
  • attend a funeral.

Residents who are part of a family group (e.g. couples or siblings) or close friends can leave the facility together.

Residential aged care facilities should conduct a risk assessment for each family gathering a resident attends.

Groups of residents cannot go on external excursions (e.g. a group of residents cannot be taken on a day trip to the beach).

Why are external excursions for groups of residents not permitted?

Although restrictions are being eased for residential aged care facilities not located in restricted local government areas, it is still important to remain vigilant. Residents may leave the facility for a range of reasons, including to access health care services, exercise or attend small family gatherings. At this stage, it is recommended that external excursions not be organised with groups of residents to protect the health of our most vulnerable.

Restrictions for all residential aged care facilities

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 can leave the facility and restrict visitors such as hairdressers or allied health professionals. These measures will be needed to protect the health of our most vulnerable.

Does the 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 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 Aged Care Direction and a requirement under the Aged Care Act, the Act applies or prevails.

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.

Questions about staff

Why do staff need to limit working across multiple care facilities?

Limiting the care facilities that staff work across helps to limit the possible spread of COVID-19 across these facilities where vulnerable older Queenslanders live.

What happens if I have to work across multiple care facilities?

It is recommended that residential aged care facilities try to limit staff working across multiple care facilities wherever possible. 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.

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.

What about casual staff who normally work across multiple care facilities? Will they lose their jobs?

No, they will not lose their jobs. It is recommended that residential aged care facilities try to limit staff working across multiple care facilities, including other care facilities such as hospitals and retirement villages wherever possible. If required to work across different care facilities, staff must wear appropriate personal protective equipment (PPE) in accordance with Queensland Health’s Residential Aged Care Facility and Disability Accommodation PPE Guidance . You should change your PPE if you are moving between facilities. All staff must stay at home if they are sick, tell your employer if a COVID-19 case is confirmed at their other workplace.

Can I work across multiple care facilities?

It is recommended that staff should only work at one care facility where possible. However, if you need to work across multiple care facilities (including other care facilities such as hospitals and retirement villages), you must wear appropriate personal protective equipment (PPE) as outlined in Queensland Health’s Residential Aged Care Facility and Disability Accommodation PPE Guidance. You should change your PPE if you are moving between facilities. You must also inform your employer about your other place of employment and if a COVID-19 case is confirmed at your other workplace.

Residential aged care facilities who have staff working across multiple care facilities must ensure staff notify them of any additional workplaces and any cases of COVID-19 in their other workplaces, in accordance with their workforce management plan.

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. 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 2020 flu vaccination
  • notifying the residential aged care facility if they have another care facility workplace
  • wearing appropriate PPE if they work across multiple care facilities.

Facilities may also impose their own additional requirements on students.

Questions about flu vaccines

Does everyone entering a residential aged care facility need to be vaccinated against the flu?

Yes. You need to have had the 2020 flu vaccination to be able to enter a residential aged care facility. There may be some exemptions, as outlined in the Australian Government’s Flu Vaccination Requirements for Aged Care Facilities.

This applies to aged care staff, visitors, health care workers, volunteers, students and others (e.g. cleaners, tradesman, gardeners and maintenance staff).

What if I am unable to be vaccinated against the flu?

If you are unable to have the flu vaccination you can continue to work at or visit a resident in a residential aged care facility provided you:

  • stay for a short time in the resident’s room, outside or in a specified area
  • 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 an up to date flu vaccination?

The flu vaccine is formulated differently each year depending on the circulating influenza virus strains. You are not adequately protected against the flu until you have been vaccinated with the current year's vaccine. The 2020 flu vaccination is the most up to date flu vaccine available.

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

Why do some of the changes to the workforce management plan not come into effect until 8.00am 1 October 2020?

These changes have a delayed start to allow residential aged care facilities to put necessary processes in place.

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.

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?

From 8:00 am 1 October 2020, 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. 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?

From 8:00 am 1 October 2020, 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 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 – operators of residential aged care facilities

Why do I have to collect the contact information of visitors?

When a person is diagnosed with COVID-19, the local public health unit commences contact tracing. Public health officers will assess the movements of the person with COVID-19 while they were infectious and determine who in community are considered ‘close contacts’.

That’s why it’s important to provide accurate and legible contact information, so we can contact you if you are affected, helping us respond quickly and effectively to the spread of COVID-19 in the community, and to minimize potential for you to spread the disease to others.

What contact information do I have to collect?

Residential aged care facility operators must keep contact information about all visitors, including contractors and volunteers, for contact tracing purposes for a period of 56 days. If asked, this information must be provided to public health officers within the stated time.

For each visitor, this information must include:

  • Full name
  • Phone number
  • Email address (residential address if unavailable)
  • Date and time period of the visit

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

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