Aged care direction is a tool that the Aged Care Quality and Safety Commission uses エイジング ケア 化粧品 to help service providers meet their responsibilities. If a direction is given, it requires that the service provider address issues and take immediate steps to address them.

A new report from two aged care commissioners found that infection prevention and control in residential aged care facilities is "deplorable" and the sector is a "dumbing down". They outlined a model that lacks staff training and professional support, resulting in residents not being adequately supported.
Essential Visitor Entry

Council on the Ageing (COTA) Australia is calling for State and Territory Governments to implement an 'Essential Visitor' provision to ensure older residents have access to at least one person at all times, even during a COVID-19 outbreak. This call comes in response to reports of Victorian nursing homes isolating residents in their rooms over multiple weeks based on orders from Public Health Units due to COVID-19 outbreaks.

Essential visitors must have a negative Rapid Antigen Test (RAT) on entry to the facility and comply with PPE and visiting protocols. They must also wear a surgical mask, face shield or goggles while indoors.

People with a positive RAT on entry should not enter the facility for at least 7 days after their positive test. They can then enter less often, if the RACF agrees.

RACFs must provide an opportunity for essential visitors to undertake a rapid COVID-19 test on entry if requested by the resident or their carer. It is up to the RACF to decide how frequent this testing should be, though a minimum interval of twice weekly would be recommended.

In addition, all essential visitors must be provided with a copy of the Aged Care Directions and any other relevant information on aged care or coronavirus. They should then be reminded of the importance of maintaining social distancing of 1.5m, particularly in communal areas where the resident may be prone to movement.

The RACF must also make all reasonable efforts to ensure that an essential visitor has proof of a COVID-19 vaccination, either through sighting or requesting evidence from the visitor. In some circumstances, this may be difficult to obtain.

However, if an essential visitor cannot provide this evidence, the RACF must ensure that the person is not permitted to enter the facility unless there are exceptional circumstances.

Other than the essential visitor, a range of service providers can enter a residential aged care facility including Fire Brigade, Ambulance staff and police who are not counted as visitors under the Aged Care Directions or other regulations. This includes clinical staff such as doctors, geriatricians, palliative care physicians and other medical specialists; pharmacy services; specialist nurses; diagnostics services; and allied health staff such as physiotherapists.
Personal Visitor Entry

Residential aged care facilities are important spaces for residents and their families to interact, support each other and share their experiences. As such, they require a strong and consistent approach to visitor management.

It is essential that facilities have a consistent and clear policy in place that is tailored to the specific needs of their community. This includes assessing any risks to employees or residents, in accordance with work health and safety obligations and developing visitor policies appropriate to the facility.

A COVID Smart visitor entry strategy is critical for ensuring residents have safe and ongoing access to family members, friends and carers, as well as other visitors who need to visit them. This strategy should include a comprehensive visitor registration process and ensure that all visitors are fully compliant with state public health orders and directions.

Visiting residents should be encouraged to minimise their time spent in indoor communal areas and spend most of their visiting time in the resident's room or an outside area. They should also maintain COVID Smart behaviours like physical distancing, hand hygiene and respiratory etiquette.

As part of a visitor entry procedure, facilities may require visitors to complete an influenza and health declaration or questionnaire at each visit. This is designed to assess whether a visitor has COVID-19 symptoms or been exposed to the virus within the previous 7 days.

If a visitor has been exposed to COVID-19 within the past 72 hours they should not enter a high risk setting like residential aged care homes without first consulting their GP, unless it is for urgent medical treatment. If this is not possible, they should be kept at home until their symptoms are resolved or they feel much better.

It is vital that visitors are fully compliant with the latest state or territory advice on entry to residential aged care homes. This is available on the COVID-19 Restriction Checker website and is regularly updated as new guidance becomes available.

In WA, all visitors must provide proof of full COVID-19 vaccination before they are able to visit residential aged care sites. This can be in the form of a digital certificate, Immunisation History Statement, or a valid vaccine card.
Restricted Visitor Entry

The State Government has announced a three-day restricted visitation period in parts of WA, which will be in place from 6am Monday 21 February 2022. During this time, residents will only be allowed to receive four visitors per day unless extenuating compassionate circumstances apply.

While the restrictions are intended to keep residents safe from infection, they have also sparked a significant level of frustration amongst families and friends, who struggle to understand the new visitor policies or whether their loved ones fall within an exception. This can lead to confusion, anger and even outrage amongst those who need to make urgent visits for essential reasons.

In a letter to aged care managers, the Director of Public Health wrote: "We are working closely with the Commonwealth to address issues that arise on a case-by-case basis and to provide clear guidance as to what is permissible for authorised individuals to do. This will allow approved providers to utilise systems and processes that remain compliant with both the Industry Code and the State Public Health Directions and Orders for COVID-19."

Restricted visitation will be allowed in aged care homes, where it can be determined that there is a genuine need to have visitors attend. However, there will still be strict infection control and safety measures in place, including screening visitors for symptomatic COVID-19.

To minimise the risk of infections transferring between residents, we encourage all visitors to complete a COVID-19 questionnaire before entering a facility, wear masks and follow hand hygiene, cough etiquette and physical distancing procedures. We also recommend visiting residents via video if possible to minimise the number of face-to-face interactions and reduce the risk of transmission.

As part of this strategy, Catholic Homes has introduced an electronic check-in system to our residences. This will reduce the administrative burden and streamline the process for all residents, visitors and staff.

We will continue to implement and adhere to all infection control and safety measures at our residences and apologise for any inconvenience this may cause. Please contact us with any questions or concerns and we will be happy to help you.
Critical Workforce Shortage

The Critical Workforce Shortage is a complex issue that must be addressed at all levels of the health care system. It affects not only hospitals, but also outpatient settings and home care agencies. It is a major factor in determining the quality of care provided by aged care workers, and it can have significant consequences for consumers.

The long-term care field faces a severe labor shortage of NAs, aides, and paraprofessional workers (i.e., nursing assistants and home health aides). This is due in part to a strong economy and the relatively high rate of unemployed people who want to work but lack the basic job skills required for such responsibilities (Rimer 2000).

A number of recent studies and media reports have highlighted the difficulty in finding qualified workers for these positions. In some cases, frustrated employees and their families have been willing to accept less-than-skilled work for low wages and benefits (Rimer 2000; Stone 2000).

These findings suggest that a frontline workforce development program must address not only recruitment and retention of new workers but also training and mentoring for existing ones. In addition, a frontline staff must be supported by an organizational structure and policies that foster employee retention and advancement. The organization's goals and strategies, formal structural and administrative policies, rewards systems, social environment and a culture of trust are all important aspects of the frontline work force's development and success.

As the population ages, and as it becomes increasingly difficult to attract and retain quality workers, the frontline care workforce will be more critical than ever. The current national shortage of aging and elderly caregivers is expected to continue for the foreseeable future, and it is likely that shortages will worsen as demand increases.

While some policymakers, researchers, and the general public have begun to pay attention to issues related to the frontline long-term care worker, a lot of research and implementation remains to be done. Despite this, efforts to address the critical workforce shortage are beginning to show signs of progress, especially at the federal and state levels.