Pre- infection outbreak:
Are visitors allowed into St Basil’s NSW/ACT facilities?
From 22 September 2020, visitor access at St Basil’s NSW/ACT facilities is being increased in line with NSW Public Health Unit advice. Contact is being made with legal Guardians and Next of Kin to make suitable arrangements for visitor access over the coming weeks. To manage the risk of community transmission, some restrictions are still in place and visitor numbers are carefully controlled at each facility.
This is a change to the situation in recent months. Prior to 22 September, all facilities in the Sydney Metropolitan region were advised by the NSW Department of Health to restrict access for all non-essential visitors as the risk of COVID-19 community transition was too high.
How are visitor restrictions determined?
Visitor restrictions are set by St Basil’s NSW/ACT. Our decisions are informed by government requirements, such as Public Health Orders and NSW Ministry of Health directives, as well as the assessment of risk determined by our experienced management team.
What is a Public Health Order?
Public Health Orders are issued by the NSW Government. They are legally enforceable requirements that are issued as a result of a declaration of serious risk to health. There are a variety of Public Health Orders that have been issued in response to the COVID-19 pandemic.
The current Public Health Order that specifically relates to residential aged care facilities is Public Health (COVID-19 Aged Care Facilities) Order (No 3) 2020, which is in force from 18 September 2020 to 17 December 2020.
What is a NSW Ministry of Health directive?
The NSW Ministry of Health issues COVID-19 advice to aged care providers on a semi regular basis. These come in the form of letters that identify COVID-19 hotspots and require aged care providers to restrict access to their facilities to individuals who may have come into contact with COVID-19.
Restricted individuals are typically identified by the local government area where they work or live. Depending on the advice received, these individuals may not be able to enter aged care facilities, or may require additional precautions and use of protective equipment before they can enter the facility. The latest lists of COVID-19 hotspots and suburbs that are subject to restrictions is always available at https://www.nsw.gov.au/covid-19/latest-news-and-updates
What are the current rules for Visitors to St Basil’s NSW/ACT
Each aged care facility must comply with the government requirements for infection control. On top of these rules, facility managers then work with their consumers, families, built environment and local community to manage the risk of community transmission at their facility.
The basic rules for visitors to St Basil’s NSW/ACT facilities are:
- Visitors must satisfy the following criteria:
- Provide proof of current influenza immunisation, or valid medical exemption
- Must not have been outside Australia within the 14 days prior to visiting the facility
- Must not have been in contact with a confirmed COVID-19 case within 14 days of the visit (even if the visitor has a negative test result to their own COVID-19 test)
- Have a body temperature below 37.5 degrees Celsius and not have symptoms of acute respiratory infection
- Visits must be by appointment
- The number of visitors in each facility is carefully managed to protect the entire resident group.
- Depending on the facility, this may include management of visits where consumers share rooms with other residents of the facility, or the requirement to manage the use of communal meeting rooms.
- Visitors must abide by restrictions on the length of visit and time and number of visitors set by the facility.
- Time limits allow as many of our families to visit as possible
- Visitor limits help to manage the exposure the entire facility has to community transmission
- In common areas, time limits also assist with cleaning and preparing the room for the next visitors.
What do I do when I get to the facility?
If you are arriving at the facility for a booked visitor appointment, you will be met at the front door by a staff member.
The staff member will help you to answer the questions about COVID-19 restrictions, take your temperature, wash or sanitise your hands and provide you with a fresh surgical mask.
You will be shown to the correct room or meeting area by the staff and given further instructions from there.
What do I do if I am unable to enter the facility?
Family and friends that are unable to enter a facility can arrange a video call, telephone call or window-visit. To discuss the options available or to book a time, please contact the facility directly.
Can I visit if I live or work in suburb that has had a COVID-19 outbreak?
The restrictions can be confusing and change regularly. If you are not sure about your eligibility, visitors are encouraged to call ahead and discuss this with the team before arriving at the facility.
Can I visit other consumers in the facility?
Many of our facilities support multiple members of families and some visitors have built strong relationships with more than one consumer or staff member. It can be tempting to stop by multiple rooms to see different residents or to track down staff in other parts of the facility to say hello.
Unfortunately, our infection control processes require visitors to travel directly to the visit location and the stay in that location for the entire visit. Visitors who do not abide by these rules may be asked to leave the facility before the end of their appointment.
Are you restricting volunteer staff attendance?
We have suspended all services from volunteers and non-essential contractors to minimise the risk of infection.
What are you doing if a staff member has been recently exposed in a known Sydney case location or if a person may have been in close contact with a confirmed case of COVID-19?
Our staff are subject to rigorous infection controls.
All staff are temperature checked at the beginning of every shift, preventing admission of anyone that displays symptoms or declares any exposure to a confirmed COVID-19 case or recent exposure through attendance at local hotspots. These individuals have been requested to get tested, stay home and isolate for 14 days. Updates on case locations by NSW Health are communicated to staff daily by text with a message to contact their manager BEFORE coming to work.
In addition, all staff are required to wear a surgical mask while in the facility (irrespective of where staff live or where they have visited)
How are you planning to isolate those infected and how will you ensure that my mother/ father is not left unattended?
We are already isolating new admissions in their rooms for a period of 14 days to ensure they do not present with the virus before integrating them into the broader facility community.
While we do not have any confirmed infections at present, our plan is to utilise isolation zones within our facilities that will be locked down to specified staff attendance. These areas have been modified to ensure protection and specialised attention for those people.
Nobody being isolated is left unattended. Indeed, we have workforce plans in place to ensure regular contact and attention to their developing clinical and emotional needs.
I understand that you have suspended the provision of services in many of the things in your additional services suite. Will you be also suspending the additional services fee?
While some activities and services have temporarily ceased, they have been replaced with other services, appropriate for COVID-19 measures. During the COVID-19 pandemic, cost of care and additional services has increased, not decreased.
A small number of external contractors were unable to provide lifestyle services as a result of recent restrictions. Staff in the facilities undertook replacement activities during the recent lockdowns and, where permitted, the contractors are being reintroduced over the coming weeks.
Are you prepared to put on more staff to meet the increased demands if an infection occurs?
We have a workforce plan to ensure safe staffing as needed, depending on the circumstances.
- A central pool of casual staff, managed from Head Office to ensure allocation of staff to facilities with the most need.
- Staff who apply for leave will only be approved if their workforce has guaranteed capacity to replace them at the time of the approval.
- Student Visa holders are free to increase their hours from 20 hours a week to 38 hours a week
- Leave will still be available to employees, to ensure adequate rest and worker health.
Our approach is to make sure that we have enough staff to adequately provide care and services to our customers.
How is St Basil’s NSW/ACT monitoring for COVID-19, assessing and testing for infection?
Every day we check the temperature of every person entering the building. We are also coordinating Covid-19 swab tests as needed for residents who display respiratory symptoms.
What is the Covid-19 Plan that St Basil’s NSW/ACT has in place? Pre an outbreak and, in the event of an outbreak?
Our Covid-19 Plan provides a framework so that we are as clear as possible on the distinct roles in outbreak management and communication as well as any required hierarchy/ chain of command in disseminating information internally and externally.
- Criteria for identifying and declaring an outbreak
- Formation of an Outbreak Management Team and a First Response Team at a local level
- Formation of a Communications team, its members and responsibilities with clear lines of action and response timeframes
- Action lists for the first 4, 8, 24, 48 hours and daily responsibilities thereafter with respect to Communication, Resident support, staffing and staff support, site and supplies, systems, etc
- Isolation zone identification and management
- Action lists for Government, industry and regulatory affairs
- Supporting communication processes for communication to staff, residents, families, operational partners and suppliers
- Tools for Status Management for Covid-19 positive cases, negative cases, potential exposures and swab tests for both staff and residents
- Controls to assess effectiveness in our response.
These plans have been assessed and validated by the Public Health Unit and the Aged Care Quality and Safety Commission during the preventative audits that these agencies have undertaken in recent months.
Our Infection Control policy can be provided upon request. Our Outbreak Management plan however is a living document, regularly updated as we learn from the experiences of other aged care operators and, regularly made available to the NSW Department of Health and the Australian Aged Care Quality & Safety Commission as we work closely together in this constantly evolving environment.
Are staff being shared across facilities?
No care staff are shared across St Basil’s NSW/ACT facilities. Our shared services functions such as IT have been reorganised such that there are dedicated staff to each facility. If this is not possible on a given day due to staff leave etc, services are provided remotely via Zoom or TeamViewer where they can assist at a desk top level with remote IT support. Our Maintenance staff are dedicated to each site. Our Management team are prioritising Zoom meetings and where this is not possible, do not visit more than one site per day according to our COVID SAFE plans.
We have worked with our staff to identify all staff members who have more than one place of employment and have implemented strict controls over shift times, infection controls, uniforms and protective equipment for staff who have increased exposure to community transmission.
St Basil’s NSW/ACT does not share any staff, equipment or resources with operators in other states or territories of Australia.
Upon confirmed case of Covid-19 infection:
What will St Basil’s NSW/ACT do if infection is identified?
- Activate our outbreak management plan and extra infection control practices
- Transfer exposed residents to specially prepared isolation zones within our facility
- Contact exposed employees to self-isolate at home
- Mobilise additional employees from our central pool of casual staff so that your loved ones are not left unattended.
- Speak with the preferred contact of the family, agree on the best method of contact for regular updates and discuss the best ways to stay in touch through video chat etc.
- Coordinate closely with NSW Health to manage the situation
- Provide regular updates by phone, email and SMS
How does isolation work?
We have mobilised specifically created isolation zones within our facilities that are locked down to specified staff attendance. These areas have been purpose built by our Property department to ensure protection and specialised attention for those people.
Nobody being isolated is left unattended. Indeed, we have workforce plans in place to ensure regular contact and attention to the clinical and emotional needs of each consumer.
How are you monitoring my parent for symptoms?
All residents are monitored every day by visual observation and temperature testing as required. COVID-19 testing and isolation of consumers with potential cases will continue in the event of an outbreak.
Will you be taking my parent to hospital for close attention if they are infected?
We are under the instruction of NSW Public Health Unit. Each of the 16 Local Health Districts in NSW have their own rules for hospital transfer and update these requirements regularly. When an infection is identified, the Public Health Unit will be informed, and we will follow their instructions regarding transfers to hospital.
Can I see my parent if they get infected?
You cannot visit an infected resident. The only exception is if they are at end of life. You will be required to wear full body PPE. This is a Public Health Order.
Will my mother/ father get the right food and assistance to eat?
In our Kitchens, we have contingency plans if the supply of food is interrupted by community outbreak and to manage any COVID-19 cases amongst kitchen or servery staff.
Food service remains central to our Model of Care and our workforce plans included provision for staff to spend the time with consumers to ensure they can still eat their meals.
How will you notify us and keep us updated?
We will be posting regular updates on our website regarding changes in rules and procedures. We will be staying in regular contact with family members to the best of our ability. More detailed discussions on the care of your loved one can be scheduled with the General Manager or their representative as needed.
If there is an escalation in your parent’s condition, we will be in immediate contact.
I have heard of some terrible situations of abandonment of care in aged care facilities in Melbourne. How will St Basil’s NSW/ACT ensure adequate care of my mother/ father if they are infected?
All our staff are dedicated individuals committed to the care of your loved one, no matter what the circumstance. We have adequate supplies of protective equipment which goes a long way to assisting staff to feel safe as they go about their work.
All staff have received training in the correct Infection Control procedures and Infection Control Coordinators have received additional training to support our staff throughout the working week. We are constantly in touch with our staff and listening to any concerns they may have about their own personal safety, utilising good education and communication to alleviate their concerns.
If things escalate quickly how will I be involved in the decisions needed around isolation, hospital transfers, advanced care directives, etc.
We will always make every endeavour to be in close contact with family and decision makers when there are significant changes to your loved one’s health and wellbeing. St Basil’s NSW/ACT are planning to remain involved in these decisions and to communicate with family members and guardians as required.
In the event that the Public Health Unit takes control of these processes, St Basil’s NSW/ACT will provide the PHU with a hard copy file for each resident, including contact details of family members and advance care directives.
Please ensure that you have provided correct contact details and advanced care directives.
Can I discharge the consumer and take them home?
The tenure of a consumer in residential aged care is controlled by the Commonwealth Government. Under the current rules, a consumer can terminate their agreement and be discharged from an aged care facility at any time that it is requested by the consumer or their legal decision maker(s).
If a family member wants to take an aged care consumer into their home, St Basil’s NSW/ACT recommend that the care needs of the consumer be carefully assessed. Some consumers will receive substandard care in the home environment. Other consumers may be comfortably supported at home for an extended period, but almost all consumers who are currently living in a residential aged care facility will need specialist care and support to provide adequate care at home.
It is very unlikely that consumers discharged from an aged care facility that has a COVID-19 outbreak will be accepted into another aged care facility without an extended quarantine period. Transfer of a discharged consumer from your home to a hospital will need to be discussed with the NSW Local Health Department in your area.
Have your care practices changed in any way during this situation and if so, what impact could I expect for my mother/ father?
Our care plans relate to the needs of the individual and are adjusted as needs change, in partnership with the consumer and their legal decision maker. What has changed is the manner of the contact. Physical contact is kept to a minimum and includes the use of personal protective equipment. Residents still experience socialisation with staff and fresh meals of choice, while adapting their daily routines to more restricted circles of contact for the period of the outbreak.
If my mother/ father is infected how can I keep in touch with them?
We have increased video conferencing resources. If you would like to video conference with your loved one, contact our Customer Service team in each facility to arrange this. Alternatively, we can also schedule a supervised phone call if your loved one is unable to manage a call by themselves.