Residential disability care facilities (RDCFs) should conduct a local risk assessment to guide the implementation of public health measures for preventing, preparing for and responding to acute respiratory infections (ARI).
Residential disability care facilities (RDCFs) include:
All NSW residents are recommended to stay at home if they develop any cold or flu symptoms (runny nose, sore throat, cough, fever). People at higher risk of severe illness should also do a test if they have cold or flu symptoms so they can access early treatment.
RDCFs may have residents who are at higher risk of severe illness if they develop COVID-19, influenza and respiratory syncytial virus (RSV) infections. Providers of residential disability care need to balance their responsibilities to reduce the risk of COVID-19, influenza and RSV transmission in RDCFs while meeting the physical, social, and emotional needs of residents.
Facilities should have preparedness plans in place to ensure a timely response to acute respiratory infections (ARIs). The plan should consider the well-being of the case/cases as well as the vulnerability of others living within the facility. Facilities should refer to Guidance for disability care facilities on the public health management of acute respiratory infections (RDCF ARI Guidance) for outbreak management advice in facilities with six or more residents.
Disability care providers are encouraged to make their own decisions on public health measures appropriate to their internal risk assessments. Providers can adapt their public health measures (including mask-wearing advice, advice to visitors and entry requirements) to their local circumstances. RDCFs should find the right balance between protecting residents from respiratory infections and providing them with social connections, care, and support.
Factors that RDCFs can consider in a risk assessment to inform public health measures include:
The outcome of the risk assessment should guide public health measures that can be escalated or de-escalated in proportion to risk, and balancing infection prevention and control with resident wellbeing.
It is strongly encouraged that residents stay up to date with all recommended vaccinations to protect them from severe illness. GPs should be encouraged to assess the resident's vaccination status as part of their annual health assessment and planning. GPs should advise which vaccinations are relevant for the resident based on their health needs.
The COVID-19 vaccine can be given on the same day as the influenza vaccine. Read the latest vaccination advice on:
An RSV vaccine is available to adults 50 – 59 years old if they have a medical condition that increases their risk of severe illness and to all people 60 years and above. Residents can talk to their GP about the benefits, their eligibility and the out-of-pocket cost of the RSV vaccine.
Facilities can contact their Primary Health Network (PHN) for help finding primary care vaccination options, including for services provided on-site.
GPs and RDCFs are encouraged to establish and annually update the Pre-assessment action plan for respiratory infections in case the resident develops COVID-19 or influenza. This supports timely testing and access to antiviral medicines.
Administering antiviral treatment as soon as possible after symptom onset or diagnosis reduces the risk of severe disease and can prevent hospitalisation and death.
COVID-19 or influenza antiviral medicines are available on the Pharmaceutical Benefits Scheme (PBS) for eligible RDCF residents. They can be prescribed by the resident’s doctor.
For further information on antivirals, refer to COVID-19 and influenza antiviral medicines – Advice for people at higher risk of severe illness.
NSW residents who have tested positive for a respiratory virus are advised to stay at home until their symptoms have resolved, and not to visit people at high risk of severe illness, hospitals, and aged and disability care facilities for at least 7 days.
For the latest guidance on managing acute respiratory infections in RDCFs see the Guidance for disability care facilities on the public health management of acute respiratory infections (RDCF ARI Guidance).
Residents who have tested positive to a respiratory virus should be supported to contact their doctor as soon as possible to discuss care and medical support.
NDIS-funded providers should notify the NDIS Quality and Safeguards Commission when the implication of COVID-19 (or another change or event) has a significant adverse effect. For more information, see the NDIS notice of changes and events.
Staff are strongly encouraged to stay up to date with all recommended vaccines, including COVID-19 and influenza.
Providers should review staff COVID-19 and influenza vaccination records and facilitate access to vaccination for those who are due. See the latest information on recommended COVID-19 and influenza vaccination.
Staff are also recommended to stay up to date with other vaccinations to protect themselves and the people they provide care for.
For further information, please see the Department of Health, Disability and Ageing information for disability service providers about COVID-19 vaccines.
Staff, including students, contractors, volunteers, pathology collectors and therapists should not enter an RDCF if they have:
If the exposure has been in the workplace, managers should refer to Appendix 2 of the RDCF ARI Guidance for when staff can safely return to work, particularly if they are critical to service delivery.
If the exposure has been outside of the workplace, staff should refer to the Advice for people exposed to COVID-19. Facilities are encouraged to determine their own advice for when it is safe for employees to return to work.
Facilities are encouraged to provide free RATs to staff to promote testing where there are moderate to high levels of COVID-19, or high levels of influenza or RSV in the community, as indicated by the NSW Health Respiratory Surveillance Report.
Staff with respiratory symptoms should not attend work even with a negative RAT result.
The impact of COVID-19, influenza and RSV in an RDCF will vary depending on the facility and individual residents. Facilities are encouraged to refer to their COVID-19 occupational health and safety plan.
In general, masks should be worn by staff when the weekly NSW Respiratory Surveillance Report reports:
RDCF staff should refer to the RDCF ARI Guidance for further guidance on PPE and mask wearing when caring for residents with ARI symptoms.
Please remember that masks can be removed for staff:
Staff removing a mask for one of the above reasons can decrease the risk of transmission by physically distancing from others, if appropriate.
When the facility is in an outbreak, refer to the RDCF ARI Guidance for additional PPE advice.
Receiving visitors is essential for wellbeing and helps to reduce social isolation. Facilities can determine their own advice to support visits while minimising risk to residents. Visits are allowed to occur even if there are COVID-19 cases in the facility.
The risk of spreading COVID-19 and other respiratory viruses can be reduced by supporting visits to occur in the safest possible way. Risk mitigation strategies include:
Visitors should not enter the facility if they have tested positive for a respiratory pathogen (such as COVID-19, influenza) - visitors should not enter an RDCF for at least 7 days after their positive test for COVID-19 or at least 5 days after a positive influenza test, unless for compassionate reasons, or any acute respiratory symptoms.
If a visitor with symptoms or a positive test must visit, it is strongly recommended that the visitor wear a mask whilst in the facility and that the visit occurs in an area with natural ventilation.
RDCFs are encouraged to review the weekly NSW Respiratory Surveillance Report to monitor the levels of circulating respiratory viruses in the community and consider their local context when determining mask guidance for visitors. Local context considerations include high COVID-19 and influenza vaccination coverage among residents and staff, number of high-risk residents, ability of residents to isolate etc.
In general, masks should be worn by visitors when the NSW Respiratory Surveillance Report reports:
Ventilation is an important factor in minimising the spread of respiratory infections. The key principle is to bring in fresh air to dilute the indoor air; simply re-circulating indoor air (for example, a fan) is not effective.
Natural ventilation should be used wherever possible. RDCFs can consider seeking professional advice from an occupational hygienist or ventilation engineer. Carbon dioxide (CO2) monitors and HEPA filters may play a role, but require users to have a good understanding of how to use them.
