Aged Care - COVID-19
To reduce the spread of COVID-19 within South Australia, the State Coordinator has issued a Direction under the Emergency Management Act 2004 to limit entry into residential aged care facilities (RACF) in South Australia. The Emergency Management (Residential Aged Care Facilities No 41) (COVID-19) Direction 2021 came into effect at 10.57 am on 20 August 2021.
Mandatory vaccination of aged care workers
From 17 September 2021, all RACF staff, contractors and volunteers are required to have received at least one dose of a TGA approved COVID-19 vaccine and have evidence of a booking to receive, or have received, a second dose.
To ensure priority access to COVID-19 vaccination, additional vaccination clinics for all RACF staff, contractors and volunteers have been set up, including:
When attending your appointment, you must complete a declaration of eligibility to verify that you are currently employed or contracted to work or volunteer at a RACF. All RACF staff are eligible, including health practitioners, personal care workers, kitchen staff, cleaners and administrative staff.
RACF staff, contractors and volunteers can also receive their COVID-19 vaccine at any of the South Australian vaccination sites.
For more information see the RACF COVID-19 vaccine Frequently Asked Questions (PDF 167KB).
COVID-19 outbreak policy
In the event of a COVID-19 outbreak in a South Australian Residential Aged Care Facility (RACF), the following policy documents have been developed:
- The COVID-19 Strategy for Residential Aged Care Facilities (PDF 1MB) is available as a resource document to guide individual Residential Aged Care Facilities in the prevention, preparation, management and recovery stages of responding to COVID-19 situations in South Australia.
- To supplement the Strategy, an Integrated Response Framework for the Management of Multiple Outbreaks in Residential Aged Care Facilities in South Australia (PDF 780KB) has been developed. This document outlines the South Australian integrated response to the risk of multiple concurrent outbreaks of COVID-19 in residential aged care facilities, establishes a blueprint to guide the collaborative roles and responsibilities of accountable responders, and identifies specific challenges and solutions associated with a range of escalating scenarios.
- The Joint Protocol: Management of COVID-19 Outbreaks in South Australia Residential Aged Care Facilities (PDF 728KB) formalises the coordination of government support to an aged care provider in their management of a COVID-19 outbreak in a Commonwealth funded residential aged care facility in South Australia. The protocol outlines the governance structures, escalation procedures and expectations around information sharing, coordination activities and timeframes.
Aged care workforce
Operators of RACF need to implement a number of changes to the way that employees and contractors at their facilities work.
- Single site restrictions for personal care workers - To the extent reasonably possible, personal care workers must not provide personal care to residents at more than one RACF. Operators of a RACF should make best endeavours to support the personal care workforce to implement this practice but in the event that this is not possible, workers are not restricted from working across multiple sites. All employees, contractors and volunteers must notify the operator of the RACF (as soon as possible) of any additional place of employment and any COVID-19 case identified at their additional place of employment.
- Medi-hotel workers - RACF Workers must inform their employer if they are employed at a medi-hotel and may not enter or remain on a RACF premises if they have worked in the a medi-hotel in the last 14 days as per the Supervised Quarantine Direction.
- COVID-19 Vaccine Records - All employees, contractors and volunteers must notify the RACF of any COVID-19 vaccination received (and provide evidence of same) if that vaccination was not conducted at a clinic held at the RACF. Operators of a RACF are required to maintain records of COVID-19 vaccinations received by those persons. The operator of a RACF must also, as far as is reasonably practicable, maintain a record of residents in the RACF who have received COVID-19 vaccinations. This must be made immediately available for inspection at the request of an authorised officer.
- PPE requirements - For information about PPE, see Infection Prevention and Control Residential Aged Care Facilities – PPE (PDF 217KB).
- PPE Training - Training staff in the correct use of PPE minimises the potential of COVID-19 transmission within residential aged care facilities amongst workers and residents. The SA Health Training Tool for the Correct Use of Personal Protective Equipment (PPE) for Residential Aged Care Facilities (PDF 232KB) provides information about training staff in the use of PPE and resources for residential aged care staff. The Personal Protective Equipment (PPE) Education and Training PowerPoint (PDF 1MB) can also be used for education and training purposes. The training tool provides a standardised approach to training and competency assessment in the safe use of PPE.
The following video can be used as an additional resource for staff training: COVID-19 Personal Protective Equipment (PPE) Education and Training for Residential Aged Care Facilities.
- Training requirements - All employees or contractors who provide personal care or nursing care to residents must complete Understanding COVID-19 for Aged Care Workers before entering or remaining on the premises of a RACF. Refresher training must be completed every two months.
- Workforce Management Plans - All RACF must have in place a Workforce Management Plan to keep records of all outside employment undertaken by their employees, contractors or volunteers. This is to assist with contract tracing if required.
- COVID-19 Infection Control Plans - All RACF must submit a COVID-19 Infection Control Plan for all communal areas at the facility to the Department for Health and Wellbeing for approval via Health.COVIDInfectionControlPlan@sa.gov.au. To complete a plan, download the Residential Aged Care Facilities COVID Infection Control Plan Template (DOCX 597KB) and read the Residential Aged Care Facility COVID-19 Infection Control Plan Guidance (PDF 441KB).
Mandatory COVID-19 vaccination for aged care workers
From 17 September 2021, the following categories of residential aged care workers must have received at least one dose of a TGA approved COVID-19 vaccine and have evidence of a booking to receive, or have received, a second dose.
- People employed or engaged by or on behalf of a RACF (whether as an employee, contractor or agency staff) to work or perform duties at a premises of a RACF on a full time, part time or casual basis, including:
- Direct care workers (nurses; personal care workers; allied health professionals; and allied health assistants)
- Administration staff (reception; management; administration)
- Ancillary staff (food preparation; cleaning; laundry; garden; maintenance)
- Lifestyle / social care (music/art therapy)
- Transport drivers of residents of RACF
- Volunteers engaged by a RACF to undertake duties at a RACF
- Students on placement at a RACF; and
- Medical practitioners and allied health professionals who attend and provide care to residents of a RACF whether employed or engaged by the resident, RACF or another person.
COVID-19 vaccination is currently not mandatory for the following categories of people attending a RACF, however, it is strongly encouraged for everyone:
- People providing in-reach services who are not employed or engaged on or behalf of the RACF (except medical practitioners and allied health professionals as above).
- Emergency services personnel, including SA Ambulance Officers undertaking resident transport to/from hospital or providing treatment in a RACF.
- Trades people and delivery drivers.
- Volunteers who are not engaged by the RACF, for example community visitors providing companionship to a resident at the request of the resident.
- Family and friends of the resident.
COVID-19 mandatory vaccination exemptions
Exemptions to the mandatory COVID-19 vaccination requirement are limited to the below circumstances:
- The RACF must be provided with a medical certificate from a legally qualified medical practitioner certifying that the person has a medical exemption from receiving the COVID-19 vaccine.
- The medical certificate must include whether the exemption is required on either a permanent or temporary basis.
- AHPPC recommends that medical exemptions should be in line with the Australian Technical Advisory Group on Immunisation (ATAGI) clinical guidance on COVID-19 vaccine in Australia in 2021.
- The RACF must be provided with a medical certificate from a legally qualified medical practitioner certifying that the person pregnant.
Note: Pregnant women are encouraged to discuss vaccination and timing with their health professional. On 9 June 2021, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and ATAGI released a joint statement recommending that pregnant women are routinely offered the Pfizer vaccine at any stage of pregnancy due to the risk of severe outcomes from COVID-19 is significantly higher for pregnant women and their unborn baby.
Temporary exemption granted by an authorised officer for one of the following reasons:
- the person is not reasonably able to access a COVID-19 vaccine by 17 September 2021
- the person’s work or duties at a RACF is necessary to provide for specialist clinical care of a resident; or
- the person’s work or duties at a RACF is necessary to ensure maintenance of the quality of care available to residents.
Requests for temporary exemptions (not medical exemptions or pregnancy) must be made in writing to the Department for Health and Wellbeing via firstname.lastname@example.org.
- Applications should be submitted by the RACF or the person’s employer. All applications must include contact details of the applicant and any information relevant to the exemption request, including why that person’s work or duties are necessary to provide for specialist clinical care of a resident or to ensure maintenance of the quality of care available to residents.
- Exemptions will be granted on a case-by-case basis, at the discretion of an authorised officer, for a maximum period of 4 weeks. For example, a temporary exemption may be given where it has been necessary to deploy staff at short notice to ensure continuation of quality of care at a RACF or to ensure the provision of specialist clinical care in rural settings.
- Temporary exemptions may be granted, subject to the following conditions:
- The unvaccinated person must continue to wear a face mask (covering mouth and nose) at all times when in the physical presence of other persons on the premises of the RACF.
- The unvaccinated person must have weekly COVID-19 tests during the period of the temporary exemption and provide the RACF with evidence of a negative test result.
- The Department for Health and Wellbeing will provide the the RACF with written advice (via email) about whether or not the temporary exemption has been granted by an authorised officer.
- Requests for exemptions on other grounds will not be considered.
COVID-19 vaccine for residents
COVID-19 vaccination for RACF residents is strongly encouraged but not mandatory. The Commonwealth Department of Health have undertaken in-reach vaccination clinics for residents of RACF nationally.
Residents who wish to be vaccinated and have missed the in-reach clinic, should be supported by the RACF to access a COVID-19 vaccine. This could include arranging a GP to administer vaccinations onsite or travel to one of the vaccination sites.
For further information about COVID-19 vaccines in RACF, visit the Commonwealth Department of Health website.
Residents and staff of SA Health operated RACF will receive information about their COVID-19 vaccination directly from their Local Health Network.
All staff and visitors to a RACF must be vaccinated against influenza. Except for:
- infants too young to be vaccinated;
- exceptional end of life circumstances;
- if a person has a medical contraindication to the influenza vaccine. A letter from a medical practitioner must be provided to the RACF by any unvaccinated person seeking to enter under this exemption.
- if a person is following the recommended 7 days waiting period between receiving the COVID-19 vaccine and the influenza vaccine. The person will need to provide evidence of the date of receipt of a COVID-19 vaccination to the RACF and take all reasonable steps to ensure they are vaccinated as soon as is reasonably practicable.
- if the vaccine is not reasonably available and
- emergency situations.
Currently, visits for the purpose of providing care and support to a resident (e.g. family and friends) are limited to a maximum of two visitors per day in RACF where less than 70% of residents have received a first dose of a COVID-19 vaccine. This may be two visits of one person each time, or one visit or two people together.
RACF with 70% or more of residents vaccinated against COVID-19 (with at least a first dose) are not impacted by these visitor restrictions and there are no restrictions on either the number of visitors a resident may receive or the duration visits.
- Processes should be put in place to ensure that residents are able to receive visitors safely. This includes ensuring visitors have appropriate PPE (face masks) and screening of visitors upon entry to the RACF.
- Upon entry, all visitors must wear a face mask over their mouth and nose (other than children 12 years or younger).
- Anyone entering a RACF, including employees, contractors, volunteers and visitors, must use COVID SAfe Check-In (QR Code) to capture their relevant contact details. If they are not able to use the COVID Safe Check-In, they must sign in using a paper record.
- Where possible, visits should be conducted in a resident’s room, outdoors, or in a specific area designated by the RACF, rather than communal areas.
- Physical distancing of 1.5m should be adhered to wherever possible.
- A person may enter a RACF for the purpose of participating in a group activity led or supervised by an employee, contractor, student or volunteer of the facility.
- Visits for the purpose of providing end of life support to a resident are permitted and numbers of visitors are not restricted in these circumstances.
Requesting an exemption in exceptional circumstances
SA Health authorised officers are able to provide exemptions to the Directions if they believe exceptional circumstances exist. All requests for exemptions must be made in writing to the Department for Health and Wellbeing via email@example.com. Requests should include contact details and any information relevant to the request, including the urgency of the situation.
SA Health will not consider additional requests for exemptions in relation to flu vaccination. The RACF is responsible for ensuring that prohibited persons do not enter or remain on the premises. The RACF operator is responsible for considering and accepting an unvaccinated person entering their facility under one of the exceptions, based on the evidence provided to them and appropriate documentation should be kept.
All interstate travellers must complete a cross border pre-approval form prior to arrival into South Australia. The cross border travel application form is available from SA Police.
Cross border community members who are permitted to enter and travel in South Australia under the Cross Border Direction are also permitted to enter residential aged care facilities located within South Australia.
Relatives who travel from anywhere other than a low community transmission zone to provide end of life support to a resident are permitted to visit a residential aged care facility (RACF) within 14 days of entering SA, however, they must wear appropriate PPE while on the premises of the RACF and provide written evidence of a negative COVID-19 test.
Visit the Cross-border travel page for more information.
Retirement village operators should refer to the fact sheet - COVID 19 advice for retirement village operators (PDF 203KB). This fact sheet provides information and advice to operators of retirement villages in South Australia and outlines the measures that operators should take to reduce the risk of COVID-19 to retirement village residents and others.
The Aged Care Direction does not apply to retirement villages, however, retirement villages and residents must comply with the restrictions outlined in the Public Activities Direction.
For more information
- Information for Operators of Residential Aged Care Facilities (Residential Aged Care Facilities Direction) (PDF 504KB)
- Information for Visitors to Residential Aged Care Facilities (PDF 352KB)
- COVID-19 Guideline for management in Residential Aged Care Facilities flowchart (PDF 319KB)
- Residential Aged Care Facilities co-located with other facilities (PDF 151KB)
- Management of COVID-19 in residential aged care facilities (PDF 218KB)
- Infection Prevention and Control Residential Aged Care Facilities – PPE (PDF 217KB)
- COVID-19 Advice for Retirement Village Operators (PDF 203KB)
- Screening Checklist for Residential Aged Care Facilities (PDF 150KB)
- Residential Aged Care Facilities COVID Infection Control Plan Template (DOCX 597KB)
- Residential Aged Care Facility COVID-19 Infection Control Plan Guidance (PDF 441KB)
- COVID-19 Strategy for Residential Aged Care Facilities (PDF 1MB)
- Guidelines for a Precautionary Response to a Community Outbreak (PDF 127KB)
- Infographic – Visiting Residential Aged Care Facilities (PDF 77KB)