Regulator cracking down on infection control, PPE practices

The Aged Care Quality and Safety Commission has announced surprise compliance checks on practices and procedures related to infection control and personal protective equipment in response to the growing number of COVID-19 outbreaks in Victoria’s aged care facilities.

A provider group is questioning the regulator’s approach while groups agree that facilities have put a lot of focus on preparation and training over thelast six months, provider peaks tell Australian Ageing Agenda.

More than 880 Victorian aged care residents have tested positive to coronavirus and at least 125 of those infected have died since July as of Tuesday, Federal Government data shows.

There are 1,186 active cases relating to aged care facilities including four aged care homes with more than 100 positive cases among residents and staff, and 10 homes with have more than 50 cases, the Victorian government reported on Tuesday.

Aged Care Quality and Safety Commissioner Janet Anderson wrote to providers on Friday, telling them the commission would make unannounced checks on adherence to infection control practices and the safe use of PPE starting with aged care homes in the greater Melbourne metropolitan area and Mitchell Shire in Victoria.

“In the first instance, priority is being given to checks on residential aged care homes without outbreaks in these zones,” Ms Anderson told AAA.

The quality and safety commission is using the full range of regulatory powers during the pandemic to ensure providers meet their compliance obligations and implement all necessary steps to mitigate the risks of transmission of the virus, Ms Anderson told providers.

Providers are responsible for ensuring they have sufficient staff with the skills and knowledge to provide safe quality care including the necessary training in infection control practices and procedures, and in the appropriate use of PPE including gloves, face masks, face shields and gowns, she said.

“Where staff are found not to be applying correct PPE or other infection control practices, the commission will consider taking appropriate regulatory action including consideration of sanctions,” Ms Anderson said.

Preparing for the second wave of COVID

Aged and Community Services Australia CEO Patricia Sparrow acknowledged the quality and safety commission had a job to do but questioned its approach on an already stressed system.

“One of the questions we have is the way we’re going about it at the moment – respecting their role – is adding stress to an already stressed system.

“We want to make sure that the interventions that they make are the best possible outcome for the resident, staff and providers, so I think there is some room for improvement about how it is actually being done for a system that is so under stress,” Ms Sparrow told AAA.

She said providers were largely prepared for the first wave of coronavirus based on their experience of managing gastro and flu but this second wave was beyond that.

“What we’re seeing now, particularly the scale of what we’re seeing in Victoria, is showing that there is a need for more hospital level containment and aged care providers aren’t set up to provide that,” Ms Sparrow said.

She said access to PPE had improved, but providers still lacked the level of stock they would like to have.

Leading Age Services Australia CEO Sean Rooney echoed Ms Sparrow’s comments about provider preparedness.

“Providers have been on increasing alert since February. They have detailed emergency plans and their staff have undergone intensive infection control training.” Mr Rooney told AAA.

“However, it is important that vigilance is maintained because we are in a particularly challenging situation, where there is widespread community transmission of COVID-19,” he said.

Mr Rooney welcomed the Victorian Aged Care Response Centre, which is starting to improve access to PPE.

“LASA is working closely with federal and state authorities to ensure protective equipment is provided in a timely manner and that providers have sufficient stockpiles, especially in hotspot areas.”

A key lesson learned from the outbreaks is that communication with staff, residents and families is vital, he said.

Providers are accountable  

Ms Anderson said specific guidance has been available since March and that the quality and safety commission will hold aged care providers accountable for non-compliance. 

“The commission will continue to monitor and assess provider performance through our regulatory functions to make sure that every facility is vigilant in controlling risks in the context of the pandemic and detected local levels of community transmission,” she said.

10 homes linked to more than 50 cases

Active aged care outbreaks with the highest cumulative case numbers on Tuesday are:

• 142 cases linked to St Basil’s Homes for the Aged in Fawkner
• 135 cases linked to Epping Gardens Aged Care in Epping
• 110 cases linked to Kirkbrae Presbyterian Homes in Kilsyth
• 107 cases linked to Estia Aged Care Facility in Ardeer
• 89 cases linked to Estia Aged Care in Heidelberg
• 65 cases linked to Glendale Aged Care in Werribee
• 64 cases linked to Aurrum Aged Care in Plenty
• 64 cases linked to Menarock Life Aged Care in Essendon
• 63 cases linked to Outlook Gardens Aged Care in Dandenong North
• 56 cases linked to BaptCare Wyndham Lodge Community in Werribee.

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