Lessons from COVID outbreaks in Victorian Residential Care

Written by Ilsa Bird, Sector Support Coordinator

Last month, an independent review was published to inquire into the COVID-19 outbreaks in St Basil’s Home for the Aged and Heritage Care Epping Gardens in Victoria that occurred in July and August this year. At St Basil’s, 94 residents and 94 staff members were infected, and 45 residents died with COVID-19. At Epping Gardens, 103 residents and 86 staff were infected, with 38 resident deaths. The review highlighted the lessons learned from the outbreaks in both facilities.

The inadequacies listed in the review included:

• Limited or no emergency planning and preparedness e.g. no Outbreak Management Committee
• Substandard infection prevention and control (IPC) e.g. IPC training only commenced after the outbreak
• Inadequately prepared leadership and management e.g. an independent advisor was only appointed more than a week after the first case was identified
• Insufficient surge workforce planning e.g. inadequate numbers and skill level of replacement staff and COVID-positive staff continuing to work
• Communication challenges and support between the health department and other agencies e.g. Department of Health was not notified about the initial case
• Delays in pathology tests e.g. failed courier collection due to miscommunication and staff results received 3 days following tests
• Unsatisfactory family and carer experiences e.g. delays in hospital transfers, unnecessary resident sedation, delayed and inaccurate communication

The learnings outlined in the review include:

Leadership and management: Effective clinical governance is key for quality and safety in aged care. During a crisis, roles and responsibilities must be clearly defined and governing bodies must be actively involved with clinical governance.

Effective communication: Delayed communication resulted in rumor and alarm. There is need for a proactive communication strategy including immediate access to emergency 1800 numbers.

Emergency planning and preparedness: A site specific outbreak management plan must be developed and include command and control, communication, IPC and workforce contingency. All plans should be tested and updated regularly.

Infection control and prevention: Routine IPC training, education and practice must be embedded in organizational culture.

Emergency management: A business continuity plan should be developed by the provider to maintain operation. These should be assessed as part of the Aged Care Quality Standards.

Pathology testing: Communication procedures must be improved to ensure results are passed on in a timely fashion.

Workforce: It is recommended that specialized roles be introduced including a safety officer, nutrition assistant and visiting assistant to support residential care staff. Formation of an Aged Care Reserve workforce; volunteer and standby staff to be utilized in outbreak events.

What can Home and Community Care Providers Learn from this Review?

It is clear from the review that inaction and lack of planning were keys in exacerbating the outbreaks at St Basil’s and Epping Gardens. Below is a list of seven immediate actions that home and community care providers can apply in preparation for a potential outbreak.

To download the full Independent Review, click here.

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