Advice to residential disability care facilities (RDCF)

As of 19 September 2023

Residential disability care facilities (RDCF) include:

• Supported independent living and/or specialised disability accommodation provided under the National Disability Insurance Scheme (NDIS).
• Disability group homes.
• Assisted boarding houses.
  

This advice includes information for:

1. Residents
2. Visitors
3. Staff
4. Ventilation

All NSW residents are recommended to stay at home and to have a COVID-19 test if they develop any cold or flu symptoms (runny nose, sore throat, cough, fever).

RDCFs may have residents who are at higher risk of severe illness if they develop COVID-19, influenza and respiratory syncytial virus (RSV). 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 appropriate preparedness plans in place to ensure a timely response to acute respiratory infections (ARIs). The plan should consider the wellbeing of the case/s 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.

Residents

Vaccination

• For the best protection against severe COVID-19 and influenza, it is strongly encouraged that residents stay up to date with all recommended vaccinations. The COVID-19 vaccine can be given on the same day as influenza vaccine.
• For information on recommended COVID-19 vaccine doses, see the Australian Technical Advisory Group on Immunisation (ATAGI)’s latest advice. ATAGI advises that those with medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs should consider an additional 2023 COVID-19 vaccine dose if 6 months have passed since their last dose, after discussion with their healthcare provider.
• Facilities can contact their Primary Health Network (PHN) for help finding primary care vaccination options, including for services provided on-site.

Pre-assessment for testing and antiviral medicines

• GPs and RDCFs are encouraged to use thePre-assessment action plan for respiratory infections to establish an action plan in the event of developing COVID-19 or influenza. This supports timely testing and access to antiviral medicines.
• The administration of antiviral treatment as soon as possible after symptom onset or diagnosis, especially for people with COVID-19 reduces the risk of severe disease and can prevent hospitalisation and death.

COVID-19 and influenza antiviral medicines

• COVID-19 antiviral medicines are available on the Pharmaceutical Benefits Scheme (PBS) for eligible RDCF residents.
• For further information on antivirals, refer to COVID-19 and influenza antiviral medicines – Advice for people at higher risk of severe illness.
  

Residents who test positive to COVID-19

• NSW residents who have tested positive to COVID-19 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 theGuidance for disability care facilities on the public health management of acute respiratory infections (RDCF ARI Guidance).
  
• From 12.01am 1 October 2023, the Service NSW RAT portal will be closed and you will no longer be able to register a positive rapid antigen test (RAT) result. Residents who have tested positive to COVID-19 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 of positive COVID-19 case(s) by completing the notification of event form online (for registered providers) or call 1800 035 544.
• If a resident develops new symptoms in the 4 weeks they have recovered, they should speak to their doctor about further testing for other respiratory pathogens, including influenza and respiratory syncytial virus (RSV).

Visitors

Receiving visitors is essential for wellbeing and helps to reduce the impacts of social isolation. RDCFs should ensure their residents are provided the opportunity to safely receive visitors. Facilities may determine their own advice to allow visitations to safely occur. 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:

• Highlighting that visitors should not enter RDCFs when respiratory symptoms are present.
• Where possible, visits should be held outdoors or in well-ventilated areas.

Entry restictions

• Visitors should not enter the facility if they have:
• Tested positive for COVID-19. Visitors should not enter an RDCF for at least 7 days after their positive test, unless for compassionate reasons.
• Any acute respiratory symptoms or are waiting for a COVID-19 or other respiratory pathogen test result. For further information please refer to the advice in the Advice for people exposed to COVID-19 factsheet.
• If a visit must occur, it is strongly recommended the visitor wears a mask whilst in the facility and that the visit occurs in an area with natural ventilation.

Mask wearing

For all visitors, wearing a mask indoors is encouraged when respiratory viruses are circulating at moderate or high levels in the community, as per the NSW respiratory surveillance report.

Staff

Entry restrictions

Staff, including students, contractors, volunteers, pathology collectors and therapists should not enter an RDCF if they have:

• Tested positive for COVID-19. Staff should not enter an RDCF for at least 7 days after their positive test and when symptoms have resolved. Facilities should follow Table 1, Page 8, of theRDCF ARI Guidance to determine when it is safe for staff to return to work. Eligible NDIS providers may be able to claim the Disability Worker COVID-19 Leave Grant. This grant replaces the previous High Risk Settings Pandemic Payment.
• Any acute respiratory or influenza-like symptoms.
• Been in close contact with a person who has COVID-19. See below for further information.
  

Staff exposed to COVID-19

• If the exposure has been in the workplace, managers should refer to Appendix 2 of the RDCF ARI Guidance to support decision making 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 fact sheet. Facilities are encouraged to determine their own advice for when it is safe for employees to return to work.

Testing for COVID-19

It’s encouraged that facilities provide free RATs to staff to promote testing as required but regular surveillance testing is not required when there are low levels of COVID-19 in the community. Please note that staff with respiratory symptoms should not attend work even with a negative RAT result.

Mask wearing

• Masks should be worn by staff particularly when there are moderate or high levels of respiratory viruses circulating in the community as indicated by the NSW respiratory surveillance report. The impact of COVID-19, influenza and RSV in a RDCF will vary depending on the facility and individual residents. Facilities are encouraged to refer to their COVID-19 occupational health and safety plan.
• When the facility is in an outbreak, refer to theRDCF ARI Guidance for additional PPE advice.

Vaccination

• Staff are strongly encouraged to stay up to date with all recommended vaccines including COVID-19 and influenza. 
• Providers should review staff COVID-19 vaccination records and facilitate access to vaccination for those who are due. For information on recommended COVID-19 vaccine doses seeATAGI’s latest advice. 
  
• For further information please see the Department of Health and Aged Care information for disability service providers about COVID-19 vaccines.
  

Ventilation of premises

Ventilation is an important factor in minimising spread of COVID-19 and other respiratory viral 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.