Visiting Aged Care facilities during lockdown

The Industry Code for Visiting Residential Aged Care Facilities During COVID-19 https://www.cota.org.au/wp-content/uploads/2021/08/INDUSTRY-CODE-FOR-VISITING-RESIDENTIAL-AGED-CARE-HOMES-DURING-COVID_Code-Review-v5-6-August-2021-FINAL.pdf  was written by all segments of the aged care sector, including groups representing older people and families, to provide a firm framework about how residents of aged care centres can maintain critical relationships with their families.

The latest version was updated on 6 August 2021, taking into account the current situation in Australia regarding the Delta strain of the virus. It details what providers (aged care facilities and their management) must do for residents and families, and also the responsibilities of the family members who wish to visit. It is the key document to refer to when seeking information about who can and cannot visit during hard lockdown, and for those who can when, how often and under what circumstances.

The Industry Code makes reference to several other documents and concepts, the most important of which are detailed here.

1. Escalation Tiers. These have been devised by the Australian Department of Health, specifically to describe the situation as it relates to COVID, and to guide everybody as to the type of restrictions that may need to be imposed. The document can be found here https://www.health.gov.au/sites/default/files/documents/2020/11/coronavirus-covid-19-national-aged-care-guidance-escalation-tiers-and-aged-care-provider-responses.pdf.
   1. The document contains a couple of tables, the first of which explains the difference among the three tiers – and it is clear that we are now in Tier 3.
   2. The second table outlines very clearly “provider actions” that need to be taken to address each of the tiers. While these do impose certain restrictions, the expectation remains that providers will continue to “act”, positively, to ensure the health and wellbeing of residents, and to facilitate communication between residents and families. Looking at section 7 – Communication you can see there are 3 elements that relate to communication between families, and the responsibilities of aged care providers to enable this to happen. Often this can get overlooked.
   3. The advice about escalation tiers can be overridden by local health orders. The current NSW Health order (dated 16 August https://legislation.nsw.gov.au/information/covid19-legislation/temporary-movement-gathering-restrictions) does not make specific mention of residential aged care facilities. I will check as to whether or not in practice there are some aspects of the NSW Health orders which do have an impact.
2. The Industry Code commences with a statement of the respective rights and responsibilities of providers and families/visitors. Even though at times like this there will always be some level of negotiation required to ensure the rights of all are respected, and that the safety of everyone is assured, it is important that these practical measures are actually based on agreed principles and rights, and not on some vague notion of commonsense or “doing the right thing”. The Charter of Aged Care Rights can be viewed here https://www.myagedcare.gov.au/sites/default/files/2019-11/charter-of-aged-care-rights-booklet-english.pdf.
3. Below the section on Rights and Responsibilities there are a set of Principles articulated, the first of which clearly sets out that even during Tier 3 the providers have a responsibility to facilitate visits from family members and certain others, in line with the limitations imposed by the advice in the Escalation Tiers document.
4. The Principles make up the bulk of the code itself, and the sections on Resident preference for visits (4) and Visitor responsibilities (6) are particularly important to read and understand.
5. Principle 7 describes a relatively new initiative, namely Partners-In-Care https://www.agedcarequality.gov.au/sites/default/files/media/acqsc_partners_in_care_factsheet_final.pdf  , where a person with a long-term and close relationship with the resident, usually a family member, can visit and provide assistance to that person during periods of restricted visitation. The partner-in-care is recognised officially as such, and distinguished from casual and/infrequent visitors, with the latter understood as not providing necessary care or support. Providers are required to set up a process to induct partners-in-care to ensure they understand basic safety protocols, and how to conduct themselves in the aged care environment.
6. The Code does provide advice on how to make a complaint, and points to the Older Persons Advocacy Network (OPAN) to discuss whether or not there is an issue, how to deal with it, and if necessary to gain assistance directly from an advocate to resolve it. OPAN’s number is 1800 700 600. Making complaints is never easy, even at the best of times, and during a national emergency it can be particularly uncomfortable. Providers should, though, make it easy and agreeable for you to register some level of concern without becoming defensive or difficult, and if appears to you that they are resisting any criticism, or making you feel like this is not the time to be making a complaint, then that is often indicative of a deeper cultural problem which needs to be addressed. Generally, though, a measured approach and a negotiated outcome is usually better than having to register a formal complaint.
7. Finally, the code does provide some examples of situations that may arise, and how the code still may apply. For instance, on page 14 there is an example about a State directive for a Home to close (which is possibly what may have occurred at the Palms after the infections there), and it is clear that once safe to do so it should re-open and operate according to Tier 3 once more. The final example refers to “extended lockdown”, during which providers should be taking account of the mental wellbeing of residents, and should extend the ability to visit by people who do not necessarily fit under the Partners-in-Care definition.

If you have any questions please don’t hesitate to get in touch with Michael on michael@engadine,uunitingchurch.org.au or 0499 900 006.

By Michael Bleasdale
Community Engagement Officer
Engadine Uniting Church