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Rebecca Chapman

Additional Visitor Guidance for Rest Homes at Level 1

By NZACA Industry AdviceNo Comments

19 June 2020

Visitors

Click here to download this as a PDF

Visits should be managed to minimise the risks of infection, but visitation must be allowed at Level 1 unless exceptional risk factors are identified.

Exceptional risks include any Covid-19 symptoms or recent arrival from overseas.

Visiting Protocols

  • Ensure all visitors are aware of the need for ongoing infection prevention measures due to the vulnerable population in aged residential care.
  • There must be a register of visitors for the purposes of contact tracing. This should include a declaration that the visitor has no potentially infectious illness.
  • Visitors should not be allowed into a facility if they have any Covid-19 symptoms or a recent contact (in the last 2 weeks) with a person with Covid-19 symptoms.
  • Appointments or pre-arrangement may be required in order to ensure that everyone entering the facility is safe to do so and understands what is required of them to keep everyone safe.

Overseas Visitors

  • No visitor who arrives in New Zealand at Level 1 should visit a facility without providing evidence of a negative Covid-19 test.
  • Currently for overseas visitors, there must be 2 negative tests and 14-days quarantine.
  • NZACA recommends the additional precaution of a surgical mask for visitors who have come out of quarantine.
  • If there is any doubt, an additional 14-day period symptom free and/or use of PPE (a surgical mask) is recommended prior to allowing a visitor into a facility.
  • If a person’s work involves overseas travel or close contact with people who have overseas travel NZACA recommends that they wear a surgical mask.

Rhonda Sherriff, NZACA Clinical Advisor, is available for members to seek clinical advice between 9.00am and 5.00pm Monday to Friday (excluding public holidays) on 0800 445 200 or helpline@nzaca.org.nz

 

Neil Miller
Senior Policy Advisor

Contact

Guidance for Rest Homes at Level 1

By NZACA Industry AdviceNo Comments

Updated 18 June 2020

NZACA Guidance to Aged Residential Care at Covid-19 Level 1                 

Click here to download this as a PDF

Covid-19 Level 1 consists of a removal of domestic Covid-19 restrictions due to elimination of Covid-19 in New Zealand.  Physical distancing is no longer specifically required.

Attention to infection prevention and control practices need to be maintained. This is a good time to review IPC policies and procedures to ensure they reflect Covid-19 additions and learnings.

Screening

A COVID-19 screening form has been developed for Alert Level 1 by the Ministry of Health. This form must be completed a maximum of 48 hours before proposed transfer or admission to an Aged Residential Care facility.

Testing

Covid-19 testing is only required in accordance with the Covid-19 case definition.

14-day Isolation

14-day isolation for new admissions is no longer required.

Visiting

Ensure all visitors are aware of the need for ongoing infection prevention measures due to the vulnerable population in aged residential care.

There must be a register of visitors for the purposes of contact tracing. This should include a declaration that the visitor has no potentially infectious illness. Visits may continue to be by appointment or pre-arrangement but should not be restricted.

No visitor who arrives in New Zealand at level 1 should visit a facility without providing evidence of a negative Covid-19 test and a surgical mask is recommended. See additional guidance.

Short term respite

All respite and day care can recommence.

PPE

PPE is not required except for Covid-19 suspect, probable or confirmed cases where full contact and droplet precautions are recommended. This includes PPE to be worn, including N95 masks.  A confirmed case is likely to lead to a change in the national Covid-19 risk level.

Leaving the facility

Leaving the facility is a right and cannot be restricted at level 1. Residents can be encouraged to be responsible for good hygiene practice and to keep a record of their movements for the purposes of contract tracing.

Regular activities

Regular activities can all recommence.  Ensure all providers of services are aware of the need for ongoing infection prevention measures and that they must not attend or continue with sessions if at all unwell.

Rhonda Sherriff, NZACA Clinical Advisor, is available for members to seek clinical advice between 9.00am and 5.00pm Monday to Friday (excluding public holidays) on 0800 445 200 or helpline@nzaca.org.nz

 

Neil Miller
Senior Policy Advisor

Contact

Immigration NZ COVID-19 Updates

By Immigration NZNo Comments

Immigration NZ COVID-19 Updates

INZ Operational Amendment Circular (2020-20) | View here

2 July 2020

Immigration New Zealand COVID-19 Update 2 July 2020 | View here

18 June 2020

Immigration New Zealand COVID-19 Update 18 June 2020 | View here

12 June 2020

Immigration New Zealand COVID-19 Update 28 May 2020 | View here

28 May 2020

Immigration New Zealand COVID-19 Update 28 May 2020 | View here 

Immigration New Zealand Information for employers of temporary migrants May 2020 | View here

21 May 2020

Immigration New Zealand COVID-19 Update 21 May 2020 | View here

14 May 2020

Immigration New Zealand COVID-19 Update 14 May 2020 | View here

13 May 2020

Immigration New Zealand COVID-19 Update 13 May 2020 | View here

15 April 2020

Immigration New Zealand Update including relaxed visa conditions | View here

 

 

COVID-19: NZACA in the Media

By MediaNo Comments

NZACA media coverage throughout COVID-19

17 June 2020

Newsroom – Health board’s PPE squeeze revealed | View here

12 June 2020

NZ Herald – Covid 19 coronavirus: Aged care/rest home review finds delays meant outbreaks ‘accelerated’ | View here

RNZ – Aged care staff unfamiliar with Covid-19 epidemiological terminology – report | View here

Otago Daily Times – Infections worsened by delay | View here

11 June 2020

Newshub – Coronavirus: Ministry of Health report reveals aged care staff were ‘highly stressed’ by lack of communication over COVID-19 clusters | View here 

RNZ – Aged care clusters introduced by staff or visitors – review | View here

RNZ Checkpoint – ‘We play a huge role’ in NZ health – Aged Care Association boss | Listen here

RNZ – Review shows rest home workers ill prepared for Covid-19 | View here

Stuff – Report on aged-care clusters reveals how virus got in to facilities | View here

NZ Herald – Covid 19: Rest home review finds confusion and lack of PPE as virus struck | View here

1 News – All rest home Covid-19 clusters were started by staff or visitors, review finds | View here

RNZ Checkpoint – Aged care faces crisis as nurses paid less than DHB peers | Listen here

5 June 2020

Stuff – Aged-care nurses fed up with wage disparity launch campaign for fair pay | View here

28 May 2020

NZ Herald – Coronavirus: Dangerous testing gaps not rest home’s fault, says Aged Care Association | View here

22 May 2020

Stuff – Coronavirus: Low staff levels must be part of any reviews into rest home outbreaks | View here

19 May 2020

NZ Herald – Covid-19 Budget fails aged care workers | View here

16 May 2020

NZ Herald – Covid 19 coronavirus: Inside the deadly St Margaret’s rest home cluster | View here 

13 May 2020

Stuff – Time to ‘loosen the rope’ in rest homes: Visiting rules in Covid-19 Alert Level 2 explained | View here

12 May 2020

RNZ – Today is international nurses day, aged care nurses underpaid | Listen here 

Newstalk ZB – How rest homes will operate under alert level 2 | Listen here

Newshub – How frontline medical staff celebrated International Nurses Day amid the coronavirus pandemic | View here

Seven Sharp – Seven Sharp celebrates nurses on International Nurses Day | View here

Stuff – Move to Alert Level 2 receives mixed reactions from experts | View here

Newshub – Whanganui grandmother counting down days to alert level 2 to be reunited with grandchild | View here

Media release – Celebrating New Zealand aged care nurses on International Nurses Day | View here 

11 May 2020

Stuff – Move to Alert Level 2 receives mixed reactions from experts | View here

8 May 2020

NZ Herald Premium – Covid-19: 37 staff down, 3 residents positive; Inside the Atawhai Assisi Rest Home cluster | View here (Premium subscription required)

Stuff – Visitors welcome back to rest homes in Covid-19 alert level 2 | View here

RNZ – New screening criteria for aged care facilities | Listen here

7 May 2020

RNZ – Covid-19 screening expanded for rest home residents | View here 

2 May 2020

NZ Herald – A toll of 11: Inside the deadly Rosewood rest home cluster | View here

Stuff – Inside Rosewood: The rest home with over half of NZ’s Covid-19 deaths | View here

30 April 2020

Stuff – Aged-care sector doing its utmost to protect the vulnerable | View here

Stuff – NZ Aged Care Association gets audience with Ministry over rest home testing | View here

28 April 2020

Newsroom – Slow movers on PPE called out | View here

24 April 2020

Newshub – Rest home residents call on Ministry of Health for increased coronavirus testing | View here

23 April 2020

Stuff – Ministry’s refusal to allow testing of asymptomatic aged care residents criticised | View here

Newsroom – Will pharmacies, GPs and dentists survive Covid-19? | View here

Stuff – Coronavirus: Christchurch woman stuck in hospital unable to get Covid-19 test | View here

Newshub – Ministry of Health continuing rest home audits during COVID-19 lockdown prompting ‘huge concern’ | View here

Stuff – Coronavirus: $26m aged care top-up doesn’t go far enough, industry leader says | View here

Stuff – Christchurch woman stuck in heartbreaking ‘predicament’ given Covid-19 test to allow her to leave hospital | View here

Stuff – Ministry’s refusal to allow testing of asymptomatic aged care residents criticised | View here

22 April 2020

New Zealand Parliament – Epidemic Response Committee Meeting Recording: Wednesday 22 April | View here

Hansard Transcript Epidemic Response Committee 22 April 2020 | View here

Radio NZ – Epidemic Response Committee challenges government’s health response | View here

Newshub – Coronavirus: Health workers threatened with disciplinary action for speaking out over PPE issues | View here

One News at Six – Clashes over rest home testing, flu vaccinations at Epidemic Response hearing | View here 

NZ Herald – ‘Decades of neglect’ of the health system have caused Covid-19 breakdown issues | View here

Otago Daily Times – Health sector critical of Govt’s Covid response | View here

Star News – Govt criticised over flu vaccine ‘debacle’, Covid funding | View here

Newshub Wednesday 22 April | View here

21 April 2020

Stuff – Hutt Valley DHB backs down, allowing 93yo to have Covid-19 test against government advice | View here

18 April 2020

Stuff – Government funds $276m for PPE, Pharmac and residential aged care | View here

17 April 2020

Newsroom – Why rest homes will get millions from taxpayers | View here

15 April 2020

ODT – Aged-care facilities in focus as deaths rise | View here

NZ Herald – Targeted inspections of aged-care facilities after rest-home outbreaks | View here

Stuff – Aged care facility at centre of sixth significant cluster in Auckland | View here

NZ National Party –  Rest homes should have testing kits | View here

14 April 2020

RNZ Conan Young – ‘Requests fallen on deaf ears’: Rest homes consider buying Covid-19 tests | View here

RNZ Morning Report – Coronavirus: Aged Care Association CEO on plan to buy test kits | Listen here

Newsroom – Rosewood residents relocated, isolated | View here

TNVZ Breakfast 14 April | Watch here (from 34’35”)

Newstalk ZB – Aged care review announced as death toll grows |  Listen here

RNZ Checkpoint – Some exceptions for visiting dying relatives at rest homes | Listen here

One News at Six 14 April | Watch here

NZ Herald – Aged care review announced as Christchurch’s Rosewood Resthome death toll reaches 6 | View here 

13 April 2020

NZ Herald – Covid 19 coronavirus: New Zealanders should ‘take heart’ in declining case numbers but grave fears remain for a group of dementia patients | View here

Newstalk ZB – Calls for mandatory testing of people moving into rest homes after deaths | Listen here

12 April 2020

Newshub – Rest home bosses perplexed at lack of COVID-19 testing for new residents | View here

Newshub – Coronavirus: Ministry of Health stands by not testing all new rest home residents | View here

Stuff – Another lonely death from Covid-19, as the virus spreads into another aged care home | View here

Stuff – Coronavirus: Deficiencies found at rest homes with Covid-19 cases | View here

Stuff – Coronavirus: A warning of more Covid-19 deaths as New Zealand marks a three-week low in new cases | View here

One News at Six | Watch here

Newshub 6 O’Clock News | Watch here

11 April 2020

Media Release – Aged Care Association renews call for COVID-19 testing for all new resident admissions | View here

Stuff – Scores of cases at rest homes, deaths a ‘tragedy waiting to happen’ | View here

Stuff – Coronavirus: Man in 70s becomes second Rosewood Rest Home death, fourth nationwide | View here

Stuff – Coronavirus: George Manning rest home in Christchurch reports 14 cases of Covid-19| View here

One News at Six | Watch here

6 April 2020

RNZ – Health staff working to deal with Dementia care facility COVID-19 cluster | View here

5 April 2020

Newshub – New rest home residents now need negative COVID-19 test first | View here

4 April 2020

Media Release – New aged care admissions policy for rest homes COVID-19 | View here 

NZ Herald – Rest homes get tough on new residents – no admittance without virus test | View here

RNZ – Rest homes will not admit residents without a negative Covid-19 test | View here

1 April 2020

RNZ Nine to Noon – Minister Iain Lees-Galloway and CE Simon Wallace speak to Kathryn Ryan on immigration changes | Listen here 

27 March 2020

RNZ Nine to Noon – CE Simon Wallace speaks to Kathryn Ryan on ARC staffing issues | Listen here  (from 12’17”)

23 March 2020

RNZ Checkpoint – Covid-19: Concerns for elderly under NZ lockdown | Listen here

18 March 2020

Newsroom – COVID-19 Elderly people’s double pandemic risk  | View here

8 March 2020

Newstalk ZB – Simon Wallace and Dr Ayesha Verrall with the latest on COVID-19 | Listen here

4 March 2020

TVNZ – ‘NZ rest homes ‘not geared up’ for coronavirus outbreak, calls for national action plan’ | View here

3 March 2020

NZ Herald – ‘Coronavirus: Rest homes, retirement villages plead for national aged care response plan’ | View here

RNZ Checkpoint – ‘Rest home worries over Coronavirus: They are ignoring us’ | View here

1 News at Six | Watch On Demand

Newshub | Watch On Demand

Media Release – Urgent national co-ordination needed on COVID-19 to support rest homes and retirement villages | Download here

Guidance for Rest Homes at Level 2

By NZACA Industry AdviceNo Comments

21 May 2020

NZACA Guidance to Rest Homes at Covid-19 Level 2

Click here to download this as a PDF

Covid-19 Level 2 consists of a gradual easing of lock down restrictions.  For aged residential care, most restrictions are at the discretion of the provider.

Best practice infection prevention and control practices are to be maintained.  Take a risk management approach using clinical judgement.

Below is the specific advice of the NZACA for level 2:

Screening

The Screening Form should be completed 2-days before admissions and provided to the rest home.

Testing

NZACA recommends a Covid-19 test with a negative result prior to admission of all new residents.

PPE

Wear a surgical mask for residents in 14-day isolation. Full PPE is not required for asymptomatic residents.

It is best practice to wear a surgical mask when in contact with residents.

Wearing of masks should be supported by hand hygiene.

For Covid-19 confirmed or probable cases full PPE to be worn, including N95 masks,

14-day Isolation

Maintain 14-day isolation for new admissions and re-admissions (after an over-night hospital stay).

Outpatient Appointments

There is not any requirement to put a resident into isolation following an outpatient appointment. It is advised that residents and staff wear surgical masks at appointments.

14-days isolation is advised if there are risks identified that must be mitigated. For example, if a resident enters a ‘red zone’ and/or is exposed to risks in an Emergency Department in a hospital.

Outings

Residents can leave the home, but it is advised that they maintain their ‘bubble’ and physical distancing. If they don’t, they may then be isolated for 14-days.

Staffing

Staff should maintain the practices they adopted under levels 3 and 4.

Continue to zone your facilities as far as practicable and restrict staff movement between zones.

Visiting

Visits are to be by appointment only. There must be a register of visitors.

The frequency and length of visits may be restricted so that there is adequate oversight.

Visitors must be asked screening questions prior to entry. Staff must explain procedures to them.

Visitors are only to go to the place allocated for the visit, usually the resident’s room.

Please see the full NZACA Level-2 Visitor Guidelines here.

Allied Workers

Every allied worker or contractor will need to follow the similar guidelines set out for all incoming visitors. That includes a register and screening questions on being met on arrival by staff.

Maintain social distancing where possible. Follow IPC practices and wear appropriate PPE. For example, hairdressers to remain in their salon and have full PPE.

Exit the facility doffing and disposing of all PPE appropriately and signing out as required.

Rhonda Sherriff, NZACA Clinical Advisor, is available for members to seek clinical advice between 9.00am and 5.00pm Monday to Friday (excluding public holidays) on 0800 445 200 or helpline@nzaca.org.nz

 

Neil Miller
Senior Policy Advisor

Contact

Visitor Guidance for Rest Homes at Level 2

By NZACA Industry AdviceNo Comments

7 May 2020

NZACA Visitor Guidance for Rest Homes at Covid-19 Level 2

For facilities with no known cases of COVID-19

Click here to download this as a PDF

At level 2 it is anticipated that there will be high initial demand for visits. Not everyone is going to be able to
visit immediately.

The following recommendations are to manage visiting to minimise the risk of COVID-19 transmission to
residents and staff.

1. Specified facility visiting hours
• All visits to be by agreement with the clinical or facility manager.
• Consider regular visiting hours for each individual site / unit when staff are available to ensure adherence to additional health and safety / infection control requirements.
• Visits to be one person to each resident unless otherwise agreed by the clinical or facility manager.
• A roster of visiting times where visitors pick a regular time to visit each week may be helpful.

2. Maximum number of designated whanau or friends who are the resident’s sole visitors

• To facilitate a smooth transition and meet resident / visitor expectations identification of visitors and communication of the process should occur before level 2 commences if possible.
• Clinical or facility managers may limit to no more than two designated visitors per resident to manage the volumes of visits unless the facility has the additional resources to manage a higher number of visitors.
• Maintain a log of all visitors including their contact details and who they have contact with during their visit (i.e. staff and resident visited).
• Children under 12 years only with the prior approval of the clinical or facility manager.
• Staff supporting visitors are familiar with the correct process and the register is readily available.

3. Length of visits
• Length of visits to be at the discretion of the clinical manager taking into consideration:
– resident preferences
– how many visitors can safely be supported at any time by staff
– the needs of all residents
– extenuating situations (e.g. visitors travelling long distances and end of life visits).
• Visitors should be aware of the anticipated length of the visit prior to visiting.
• Clinical or facility managers may limit most visits to half an hour to manage the risks and the demand for visits.

4. Infection prevention and control (IPC)
• All visitors sign a declaration form which includes screening questions, including verifying visitors have no signs and symptoms of potentially infectious illness.
• Staff need to explain the IPC visitors are expected to follow.
• Hand hygiene is required for all visitors on entry and when requested by staff for IPC.
• Physical distancing of 2 metres is required during all visits, but limited physical contact can be allowed on compassionate grounds with the prior approval of the clinical or facility manager.
• Masks can be recommended to prevent the spread of droplets from carriers of COVID-19.
• Visitors to residents at the end of life may have the use of masks waived whilst in the resident’s room at the discretion of the facility manager.
• The use (putting on and taking off) of any additional PPE must be overseen by staff following instruction.
• Goods brought into the facility by the visitor must meet IPC guidelines (e.g. be wiped down) and is at the
discretion of the clinical or facility manager.

5. Designated areas
• Visitors should be advised where they can go during the visit.
• In most cases visits would be limited to the resident’s room.
• The visitor may be escorted by a designated staff member to and from the resident.

Rhonda Sherriff, NZACA Clinical Advisor, is available for members to seek clinical advice between 9.00am and 5.00pm Monday to Friday (excluding public holidays) on 0800 445 200 or helpline@nzaca.org.nz

 

Rhonda Sherriff
NZACA Clinical Advisor

Contact

Neil Miller
Senior Policy Advisor

Contact

Visitor Guidance for Rest Homes at Level 3

By NZACA Industry AdviceNo Comments

24 April 2020

NZACA Guidance for Rest Homes at Covid-19 Level 3

Click here to download this as a PDF

For aged residential care, Covid-19 Level 3 restrictions are recommended to be the same as Level 4 in most areas. Level 3 increases some of the risks and so there are three additional recommendations to all aged care providers:

1. It is best practice for masks to be worn by all care staff where available and we are working with DHBs on supply. Wearing of masks should be supported by thorough washing of hands.
2. Full PPE to be worn, including N95 masks, for Covid-19 confirmed or probable/suspected cases.
3. Restrict the length of time staff members spend completing tasks with an isolated symptomatic or Covid-19 confirmed/probable/suspected resident.

It is recognised there is increased risk of contamination with visits over 15 minutes.

The following advice remains from Level 4:

• End of life compassionate visits by a designated family member (approved by the facility/clinical manager) as a prior arrangement.

• Continue 14-day isolation for all new admissions.

• Recommend Covid-19 testing for new admissions and re-admissions.

• Zone your facilities as far as practicable and restrict staff movement between zones. Staff should be rostered to one area to work and remain in that area rather than be rostered throughout the complex. Tasks will need to be reviewed as part of this overall strategy. This lessens the risk of transmission throughthe complex.

• PPE to be changed when moving between residents/zones.

• Continue to monitor staff competency with PPE management and processes.

• Staff are not to work if they experience any Covid-19 or respiratory symptoms. They need to be tested for Covid-19, and are not to return to work until they have a negative result and no symptoms for 48-hours.

• Staff should not work in more than one facility.

• Management to keep a register of staff living arrangements i.e. whom and how many people they live or flat with in their bubble and what work they undertake. This will need to be revised again with the changes to Level 3 as some staff may increase their contacts to include siblings, children outside of their home, etc. This will ensure Public Health are able to track and trace staff movements and who may be at risk if further facilities announce Covid-19 cases.

• Staff should be advised of infection control protocols/practices to adhere to when finishing their duty/shift and going home. It’s advisable that staff remove their footwear before entering their place of residence, removing work clothing/uniform and launder them every day, shower immediately on arrival home to mitigate any risk of transmission alongside the usual infection control precautions of good hand washing practices and maintaining social
distancing.

Rhonda Sherriff, NZACA Clinical Advisor, is available for members to seek clinical advice between 9.00am and 5.00pm Monday to Friday (excluding public holidays) on 0800 445 200 or helpline@nzaca.org.nz

 

Rhonda Sherriff
NZACA Clinical Advisor

Contact

Neil Miller
Senior Policy Advisor

Contact

Infection Control Practices

By NZACA Industry AdviceNo Comments

13 April 2020

Covid-19 Infection Control Practices

Further to infection control advice given last week to members about keeping staff working in specific areas (units) rather than across whole facilities, it is recommended that management also develop a register of staff’s living accommodation (whom and how many people they live or flat with) and what work they undertake. This will assist management to ensure they are able to track and trace staff movements and identify who may be at risk on their staff in the event of any further Covid-19 cases.

Tracking and tracing of staff’s living arrangements has been highlighted by Public Health as a potential risk of transmission if aged care staff are living and working alongside family and friends (flatmates) who work in other aged care facilities or health care sites. This increases the risk of potential transmission and therefore staff should be advised of infection control protocols to adhere to when finishing their shift and going home.

It is advised that staff remove their footwear before entering their place of residence, remove clothing/uniform and shower immediately to mitigate any risk of transmission alongside the usual infection control precautions of hand washing and maintaining social distancing.

Rhonda Sherriff, NZACA Clinical Advisor, is available for members to seek clinical advice between 9.00am and 5.00pm Monday to Friday (excluding public holidays) on 0800 445 200 or helpline@nzaca.org.nz

 

Rhonda Sherriff
NZACA Clinical Advisor

Contact