Lessons from the pandemic: how Standards have evolved

We’re now two years into the pandemic, and the care and support sector has had to make some major adjustments to their service delivery in response to the COVID-19 crisis.

A number of standards have been amended or updated with significant new changes, to provide guidance on improving and standardising infection control processes, as well as ensuring that there are processes to manage workforce capacity and disaster readiness.

We’ve updated our self-assessments in SPP to reflect these changes, and thought it would be helpful to summarise the core themes that have emerged across the different major standards.  

Core infection control and disaster response themes

The core themes that have appeared consistently in standards updates include:

  • ensuring the workforce has the capacity, skills, training and equipment to implement infection prevention and control systems,
  • planning for and sourcing an alternative workforce in the event of disruptions,
  • developing, testing and reviewing an emergency and disaster management plan,
  • reporting to the governing body on infection control processes and implementation/testing of the emergency and disaster management plan,
  • testing, fitting and training in the use of PPE,
  • training in hand hygiene, respiratory hygiene and cough etiquette,
  • implementing stringent processes for communicating relevant information to family, patients and carers,
  • undertaking routine environmental cleaning,
  • ensuring workplace policies and procedures are in line with the relevant state or territory public health requirements,
  • managing movement of staff between areas and supporting staff required to isolate, and
  • procedures for waste management including safe storage and disposal of clinical waste.

These are some key areas that service providers should be addressing to ensure they are on top of their compliance requirements. Providers should check that they are familiar with any updates to standards that apply to their organisation. SPP can assist you with this, as we always update the modules on our platform in response to changes to standards.

Here are the main standards that have been updated to incorporate infection control requirements so far:

The updated Standards

National Safety and Quality Health Service Standards (NSQHS)

Changes to the NSQHS were introduced in May 2021 and include requirements to:

  • plan for public health and pandemic risks,
  • ensure the workforce has the capacity, skills, training and equipment to implement infection prevention and control systems,
  • test, fit, train workers and use PPE, and
  • ensure policies and procedures are in line with the relevant state or territory public health requirements.

NDIS Practice Standards

In November 2021 the NDIS Commission released a number of changes to these standards, to address:

  • planning for alternative workforce arrangements in the event of disruptions,
  • developing, testing, and reviewing emergency and disaster management plans,
  • implementing infection prevention and control precautions throughout all settings,
  • ongoing training on and supplies of PPE for workers, and
  • waste management including safe disposal of clinical waste.

QIC Health and Community Service Standards

In February this year, an updated version of the QIC Standards was released, with updates addressing infection control requirements including:

  • staff training in hand hygiene,
  • infection prevention management program aligning with state and territory guidelines,
  • regular cleaning of the environment, and
  • waste management.

Australian Community Industry Standard

The Australian Community Industry Standard was also updated towards the end of last year to include the following infection prevention and control requirements:

  • workplace preparation for pandemic,
  • workforce response to pandemic consistent with advice from health authorities, and
  • implementing and documenting an outbreak management plan.

RACGP Standards for General Practitioners

The RACGP Standards have seen a number of updates throughout 2021 and more recently in 2022, with the most recent update being in February 2022. The updated requirements address:

  • increased requirements around telehealth consultations (e.g. ensuring privacy etc.),
  • managing the risk of cross infection during a home visit,
  • updated processes for isolating patients and traceability processes for identifying patients who have used instruments,
  • establishing protocols for managing outbreaks of infectious disease in line with local, state and national guidance, and
  • environmental cleaning.

Aged Care Quality Standards

While the Aged Care Quality Standards haven’t been updated with new infection control requirements, the Aged Care Quality and Safety Commission has released a number of resources to guide providers in their implementation of infection control requirements. 

Resources to help you

We’ve developed and updated a number of resources in our platform to assist providers to manage infection control requirements under the standards that apply to them, as well as implement best practice processes. Here are some examples of how we can help:

  • a module for the “First 24 hours – managing COVID-19 in a residential aged care facility”,
  • a module to guide organisations to implement COVID-safe operations based on recommendations from Safe Work Australia,
  • a module to guide organisations through the components they should address in developing infection control / respiratory outbreak plan based on recommendations from various sources including the Department of Health, the Aged Care Quality and Safety Commission, and the NDIS Quality and Safeguards Commission,
  • resource templates including:
    • an outbreak management plan checklist,
    • an information sheet for employers on staff vaccination against COVID-19,
    • first 24 hours – managing COVID-19 in a Residential Aged Care facility checklist,
    • an emergency and disaster management plan,
    • emergency and disaster management procedures,
    • working from home policy,
    • working from home agreement,
    • client risk assessment.

Want to take a closer look at our Covid-19 resources?

COVID-19 in residential aged care – how to respond in the first 24 hours

The prospect of dealing with a case of COVID-19 in your aged care facility is a daunting one. However, preparation is key, and an effective response in the first 24 hours of an outbreak can mitigate the extent of the outbreak dramatically. Here’s why you should get a handle on your response plan now.

The Commonwealth Government Department of Health has released a fact sheet called First 24 hours – managing COVID-19 in a residential aged care facility. This fact sheet walks providers through the steps they should follow in their immediate response to the identification of a COVID-19 positive case. These steps are based on the Communicable Diseases Network Australia (CDNA) national guidelines for the prevention, control and public health management of COVID-19 outbreaks in residential care facilities.

The guidelines identify the following key steps providers should take, in the time periods as follows:

First 30 minutes

  • Isolate and inform the COVID-19 positive case(s)
  • Contact your local Public Health Unit (PHU)
  • Contact the Department of Health
  • Lockdown the residential aged care facility

Minutes 30-60

  • Convene your outbreak management team
  • Activate your outbreak management plan
  • Establish screening protocol
  • Release an initial communication 

Hours 2-3

  • Contact tracing
  • Identify key documents
  • PPE stocktake
  • Communication

Hours 4-6

  • First meeting of the Outbreak Management Team
  • Bolster your staff and plan your roster
  • Conduct testing
  • Clinical management of COVID-positive cases

Hours 6-12

  • Cohorting and relocation
  • Move to a command-based governance structure
  • Rapid PPE supply
  • Infection control

Hours 12-24

  • Clinical First Responder from Aspen to commence
  • Review advance care directives
  • Establish strong induction and control processes
  • Maintaining social contact
  • Follow up communications
  • Continue primary health care
  • Support your staff
  • Continue to monitor state/territory guidelines

Our First 24 hours self-assessment

We’ve built a self-assessment in SPP called Aged Care Facilities – COVID-19 Outbreak First 24 Hours, that follows each of the above steps in the Commonwealth’s guidelines. This self-assessment will serve as a useful tool to prepare your organisation for potential outbreaks. We have broken down the key steps into separate modules and quizzes, which providers can work through to help familiarise themselves with the processes they will need to follow in the event of an outbreak. By self-assessing against the guidelines, you can identify gaps in your existing systems, and download an Action Plan to address these gaps.

We strongly advise that you self-assess against these steps now, well ahead of any outbreak.  Many of the processes required in the first 24 hours following an identified case of COVID-19, will need to have already been established, ahead of time. For example in minutes 30-60 of an outbreak, providers are asked:

“As part of an effective outbreak management plan, has the provider already drafted some pre-prepared email templates for this initial communication?”

Here, it is flagged for providers that they should have email templates prepared, in anticipation of any outbreaks.

Similarly in hours 2-3, providers are asked:

“Does the provider supply the following information to the PHU and the state branch of the Commonwealth:

  • a detailed floor plan which include residents’ rooms, communal areas, food preparation areas, wings, and how staff are apportioned to each area;
  • an up-to-date list of residents, identifying residents with COVID-like symptoms, onset date, testing status, their location in the facility, and staff contacts;
  • a list of all staff employed by the facility; and
  • a list of the respiratory specimens collected and the results of tests?”

This signals to providers what information they will need to have already collected and stored on record somewhere that is easily accessible, if this has not yet been done.

The self-assessment also links to some key resources developed by the Communicable Diseases Network Australia (CDNA), that will be very useful in the event of an outbreak,  including a sample template letter to GPs, and a template report to the local Public Health Unit (PHU).

Our Respiratory Outbreak Preparedness self-assessment

We’ve also made available a self-assessment to guide providers through the components of an outbreak management plan. The self-assessment is based on recommendations from the Department of Health, the Aged Care Quality and Safety Commission, and the NDIS Quality and Safeguards Commission. See our earlier blog post on 6th May 2020 for more information. 

Items to address in an outbreak management plan include:

  • Identifying clients at greater risk and with complex support needs
  • Business continuity plan
  • Communication of the plan to staff, clients and families
  • Preparing a staff contingency plan
  • Maintenance of appropriate levels of necessary stock items
  • Implementation of regular health assessments of clients and staff
  • Preparation of a communications plan for keeping authorities, staff, clients and their families informed after an outbreak is identified
  • Cleaning plan
  • Plan to restrict visitors if relevant

Reviewing your practices against our First 24 Hours and Respiratory Outbreak self-assessments can help ensure your outbreak preparedness planning is up-to-speed, so that your facility is protected and well-prepared.

COVID-19 in aged care - outbreak management

Do you have a clear outbreak management plan? Are you  prepared for the actions you need to take during the first 24 hours of an outbreak?  Sign up to SPP to access our self-assessment, among many other resources.

Working from home during COVID-19

Working from home can present many challenges. Spending long hours on a laptop at the kitchen table can be both physically and mentally stressful. Employees must take reasonable care for their own health and safety, and must co-operate with employers to ensure the workplace is safe by following any guidelines and carrying out necessary checks. For many organisations the pandemic presents new challenges, however there is an abundance of resources that organisations can use to assist them to maintain a productive workplace, and to assist employees struggling with their mental health.

A few tips to help you work from home safely and effectively:

  • Have a comfortable workstation;
  • Take regular breaks: for some people this may mean putting triggers in place to remind us to have a break- including setting an alarm;
  • Set boundaries between work and home. Setting up a designated space can be a good way to signal when you aren’t working. Moving the workstation to the end of the table, putting it away or covering it can be a good way to establish work hours;
  • Stay connected with your workmates, whether through regular meetings or more casual virtual chats; and
  • Schedule physical or creative activities into each day- get outside if the weather allows, or do indoor activities such as Yoga or Pilates.

Comcare has developed a useful working from home checklist which can assist organisations to ensure that short-term working from home arrangements fulfil the minimum requirements to keep them safe and healthy.  

Mental Health and Working from Home

Comcare has also developed some practical resources to assist you and your workplace to maintain good mental health throughout this time. They are updating their website as the situation evolves, with newly developed fact sheets. Some of their current fact sheets include:

Employers have an important role to play in ensuring their employees maintain their mental health. Employers should:

  • Check in regularly;
  • Create team chats that allow for continued communication;
  • Provide employees with appropriate flexibility when they work;
  • Encourage employees to stay physically active as well as regularly go outside;
  • Ensure employees are effectively disengaging from their work at the end of the day; and
  • Be available, accessible and ready to listen.

Dr Jill Newby, Associate Professor of Psychology at UNSW, who is based at the Black Dog Institute, has noted some common feelings that people may be experiencing during this time when working from home, including:

  • struggling to ‘switch off’ after work hours;
  • feeling isolated or disconnected both socially and professionally;
  • feeling a lack of motivation; or
  • feeling uncertain about their progress.

She offers some practical tips for individuals to stay motivated and productive when working from home.

It is vital that workers are supported to reach out and seek professional help if they are struggling during this time. Beyond Blue has many useful resources to help individuals stay positive and stay connected. It also provides support services which allow people to talk with a counsellor or to connect with others through online forums.

BNG has also developed some resources which may be useful when working from home. Our working from home policy outlines the responsibilities of both employees and employers when working from home, and outlines the confidentiality requirements when taking home or accessing client files from home. Our working from home agreement ensures that employers are aware of their obligations when working from home, and that the employee has undertaken the appropriate health and safety checks on their workspace.  

These resources are now available in SPP:

  • Policy: Working from home
  • Template: Working from home agreement

You can access these resources by searching for “working” in the Reading Room. 

Contact us

Want to know more? Talk to our team.

NDIS Provider obligations during the COVID-19 pandemic

Given how quickly information about COVID-19 is moving, it can be difficult for NDIS Providers to understand what they must do, and what they should do to ensure that their workers and participants are as safe as possible. This blog post will give NDIS Providers a snapshot of the actions they are obligated to take, and the actions that they should take, to minimise the risks to workers and participants.  

Risk management and minimisation is at the heart of the NDIS Quality and Safeguards Commission’s messaging. Workers who are suspected of having, or are at high-risk of having, COVID-19 should be sent home immediately and work from home where possible. Hygiene, and particularly hand hygiene, practices should be reinforced, including proper cough and sneeze etiquette. Workers should also be informed of the organisation’s contingency plan, so that they are able to prepare for implementing activities that will continue to provide critical supports and services to participants, while reducing their risk of exposure to COVID-19. 

Another key theme that both the Commission and the Department of Health are asking providers to focus on is timely communication with the Commission, so that it can conduct risk assessments and help ensure that participants in need are provided with urgent assistance when necessary. This is especially important for providers who become aware of workers and participants who have, or are suspected of having, COVID-19. 

NDIS Provider obligations – the “Must Dos”

NDIS Providers must continue to provide supports in line with the NDIS Practice Standards. In the context of COVID-19, this means providing high quality, safe supports and includes the management of risks associated with service provision. NDIS Providers must: 

  • Manage risks associated with service delivery; 
  • Reduce the provision of group supports to a minimum; 
  • Have a business continuity plan in place which has been recently reviewed; 
  • Ensure workers who are at risk of COVID-19, or displaying symptoms, remain at home; 
  • Prioritise the immediate needs of participants; 
  • Comply with the Restrictions on non-essential services; 
  • Ensure that PPE is available for workers providing essential supports to a participant who is suspected of having COVID-19; and 
  • Notify the NDIS Quality and Safeguards Commission if there are any changes to your services. 

Best practice actions that providers can take – the “Should Dos”

To minimise the risk of exposure to participants and workers, NDIS Providers should, where possible; 

  • Encourage staff to get flu vaccination; 
  • Ensure there is adequate PPE for staff. PPE can be requested by emailing the National Medical Stockpile; 
  • Provide services virtually where possible; 
  • Reinforce staff hygiene practices. The Department of Health has released an online worker infection control training module; and 
  • Move services to a participant’s home. If this moves a provider to a different support category for which the provider is not registered, they should contact the Commission. 

Restrictive practices

It is important to note that isolating a participant based on medical advice, (consistent with the Commonwealth Chief Medical Officer), is not considered an NDIS Commission regulated restrictive practice If a participant is in a form of isolation that is inconsistent with the Chief Medical Officer’s advice, or directions from state and territory governments, it may be considered an environmental restraint or seclusion. 

How BNG can help providers navigate their obligations during COVID-19

We have a number of useful resources that can assist providers to stay prepared and plan for business continuity during the pandemicSome examples of some of our resources relevant to the “should dos” and “must dos” are: 

  • Policy: Business Continuity
  • Policy: Infection Prevention and Control 
  • Policy: Staff Succession Planning 
  • Policy: Risk Management 
  • Template: Staff Succession Plan 

We are currently developing a COVID-19 preparedness self-assessment for SPP, which will help providers to identify and improve their processes in managing a respiratory outbreak. Subscribers will receive an update regarding the COVID-19 preparedness self-assessment in the next week.  

Given the speed of change during this COVID-19 pandemic, providers should keep up to date by checking in as frequently as possible with the latest news from the Department of Health, as well as the NDIS Quality and Safeguards Commission.