The new ‘normal’ after the COVID-19 crisis: considerations for home-care providers

Written by Lauranne Beernaert, Sector Support Coordinator

October 2021 was a very eventful month: we reached a few milestones in terms of vaccination which marked the beginning of a new ‘normal’ for many Australians. As international travel has resumed and with the increased movements of people within and across states, we know that we will have to live with COVID-19 in the community.

Caring for adults with COVID-19 in the community

NSW has adopted the use of virtual care to support management and monitoring of people with COVID-19 in the community. To determine the appropriateness for care in the community, both severity of illness (symptoms) and risk factors (medical and social) are considered.

If safe to do so, COVID-19 positive patients will be managed in the community via virtual care by a multidisciplinary team. There will be thorough and frequent clinical monitoring to detect any deterioration of the disease and assess the patient’s mental health.

There are many different protocols and guidelines that will be followed by the team in charge, as explained on the NSW Health’s website. The decision for care to be delivered in the home is determined based on multiple considerations and whether the person:

• consents to receiving care and isolating at home, as required
• is stable enough to receive care at home
• has risk factors that cannot be managed in the home
• has other medical conditions that cannot be managed in the home
• has appropriate caregivers at home
• has caregivers with the capacity to recognise signs of deterioration (as explained to them) and escalate care.
• is living with other people at higher risk of illness
• has access to food and other necessities
• lives within one hour of a hospital with an ICU
• has access to appropriate, recommended personal protective equipment (at a minimum, gloves and face masks).

You can read more about COVID-19 remote monitoring in this report which outlines three successful initiatives by various Local Health Districts and the St Vincent’s Health Network. You can also read this short article about the RPA COVID-19 Virtual Hospital which currently cares for patients in the community.

COVID-19 Home Care provider guidelines

A. Staff screening requirements

Home care and community aged care service providers are responsible to ensure that staff must not provide services if they:

• are a close contact of a person with confirmed COVID-19 in the last 14 days,
• are a casual contact of a person with confirmed COVID-19 and have not returned at least one negative nose/throat PCR test result,
• are unable to provide evidence of having received at least their first dose of a COVID-19 vaccine as per the Public Health (COVID-19 Care Services) Order 2021. On rare occasions, there may be a medical contraindication to COVID-19 vaccination. A COVID-19 medical contraindication certificateis required in this circumstance.
• have COVID-19 symptoms,
• are waiting for a COVID-19 test result,
• are a fully vaccinated person who has been overseas in the last 7 days. Additionally, they must show evidence of a negative COVID-19 test taken on or after day 7 following their arrival,
• are any other person who has been overseas in the last 14 days.

B. Safety measures

Other measures continue to apply to home care service providers, including:

• Minimise staff working across multiple settings (e.g. in-home and residential care). If this is not possible, maintaining records of staff and work locations and increasing use of Personal Protective Equipment (PPE) are required.
• Maintain vigilance to prevent the introduction of COVID-19 into a person’s home.
• Ensure staff actively ask clients about symptoms. If staff become aware of a client with symptoms, the client needs to be isolated from others and testing for COVID-19 must be arranged.

C. Mask wearing

• Both the home care worker and the resident should wear a surgical mask during the provision of the service.
• A home care worker or resident may remove their mask:
  • while communicating with a person who is deaf or hard of hearing
  • if wearing a mask creates a risk to health and safety
  • where clear enunciation or visibility of your mouth is essential
• Anyone removing a mask for one of these reasons should maintain 1.5m distance from others wherever possible.
• There are currently mandatory face mask rules in some settings. If a home care worker is taking a resident out of the home setting it is important to follow the rules and understand how to use a face mask.
• If a person cannot wear a face mask because of a disability, physical or mental health illness or condition, they must carry either
  • a medical certificate or letter signed by a registered health practitioner (such as a doctor) or a registered NDIS provider or
  • a statutory declaration.

The most up to date advice to home care service providers is available on the NSW Health’s website.

Additional resources:

– Guide for Home Care Providers: to assist staff in reducing the risk of COVID-19

– Guidance for risk screening and assessment for home visiting health services

Educating your workforce about COVID-19 vaccination

The Australian Nursing and Midwifery Federation is offering a range of education resources on COVID-19 vaccination and why it’s important, which could be customised for in-home and community aged care workers.

The ANMF can talk about the safety and effectiveness of COVID-19 vaccinations from a nursing perspective, how to engage with your workers to support their decision-making about getting vaccinated, and the resources available to support aged care workers. The sessions can also discuss how mandatory COVID-19 vaccination in residential aged care took place and considerations for both employers and employees.

Any service can request more information about these education resources at: anmffederal@anmf.org.au.

Accessing financial support for COVID-19 related costs: grants

Lastly, financial support is available to CHSP providers who can access emergency funds for costs associated to support staff to get vaccinated. This includes costs associated with staff taking leave to attend a vaccination clinic, or activities that encourage staff to get vaccinated, such as transport to and from a vaccination clinic. CHSP providers can apply for funding via GrantsConnect (GO3877) and applications close on 30 June 2022.

Additionally, the Department of Health will shortly announce a Home Care Packages Program COVID-19 Vaccination Support Grant Opportunity. It is expected to be announced in the beginning of November. First payments are expected to be made in late November 2021 and eligible grant activities will include:

• Facilitating and encouraging workforce COVID-19 vaccinations
• Coverage of costs for staff to take leave to get a COVID-19 vaccination or if they are sick after a COVID-19 vaccination
• Collecting and reporting workforce COVID-19 vaccination status data, and improving data quality
• ICT-related and professional advice costs to set-up processes and systems to track and report the COVID-19 vaccination status of their workforce.