As of 14 February 2023

This advice includes information for:

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

Residential disability care facility providers are expected to balance their responsibilities to reduce the risk of COVID-19 transmission in RDCFs while meeting the physical, social, and emotional needs of residents.

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).

Residents

• RDCFs may have residents who are at high risk of severe illness if they develop COVID-19. Facilities should consider the individual risk of COVID-19 for each of their residents and have a 'COVID-19 occupational health and safety plan' for how to manage cases within the facility. The plan should consider the wellbeing of the case/s as well as the vulnerability of others living within the facility.
• COVID-19 occupational health and safety plans could consider:
• approaches to keep residents with COVID-19 separated from other residents, which may involve keeping residents with COVID-19 in their own room while they are symptomatic.
• ensuring mask wearing when residents with COVID-19 are moving between rooms such as walking to a shared bathroom. Where possible residents should wear a mask for up to 10 days after they test positive to COVID-19, particularly when there are other people around and in communal areas.
• utilisation of outdoor spaces or environments with fresh air e.g., the backyard garden.
• appropriate movement within the facility and safe areas that can be used for cases.
• appropriate RAT testing to detect COVID-19 early in residents who may have been in contact with a person with COVID-19.
• supporting residents to wear masks where possible when they leave the facility and enter public areas particularly during times of increased COVID-19 in the community.
• RDCFs should encourage residents to meet with their GPs to develop a care management plan, which will help to support vaccination, testing and treatment for COVID-19. Residents who are at high-risk of severe illness may be eligible for antiviral treatments.

Managing 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 seven days.

• If a resident still has symptoms after seven days, consider whether they need to be reviewed by their doctor based on their clinical condition.
• If the resident has COVID-19 or has been exposed to COVID-19, essential off-site health appointments (e.g., for renal dialysis or administration of medication) must continue. Residents should inform the offsite venue that they have COVID-19 or have been in contact with someone who has COVID-19 or have so the venue can make appropriate arrangements to keep others safe. Facilities should ensure that residents are provided with a mask and appropriate mask wearing advice if they need to leave the facility.
• Ensure residents with COVID-19 wear a mask when they are moving between rooms such as walking to a shared bathroom. Where possible residents should wear a mask for up to 10 days after they test positive to COVID-19, particularly when there are other people around and in communal areas.
• If a resident tests positive on a COVID-19 RAT, they should register their positive result through the Service NSW portal.
• Where a resident is unable to independently complete the information on the Service NSW portal, a provider should register the result on behalf of the resident by selecting the "continue as guest" option. A separate form will need to be completed for each resident that tests positive to COVID-19.
• 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)
• 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.
• Some people can remain PCR positive for many weeks after they have had COVID-19. This does not mean they are infectious. People who have recovered from COVID-19 within the previous four weeks who are then exposed to another person with COVID-19 are not recommended to be re-tested unless they have new symptoms.
• If a resident has recovered from COVID-19 and develops new symptoms they should be tested for COVID-19 and other respiratory pathogens, including influenza and respiratory syncytial virus (RSV) irrespective of the time after recovery.

Antiviral medicine usage

• COVID-19 antiviral medicines are available on the Pharmaceutical Benefits Scheme (PBS) for people over the age of 70 years, and RDCF residents with at least one risk factor.
• The administration of antiviral treatment as soon as possible after symptom onset for people with COVID-19 reduces disease severity and can prevent hospitalisation or death.
• GPs and RDCFs are encouraged to use the Antiviral Pre-Assessment form to establish an advance preference for residents to receive COVID-19 and influenza antiviral medicines to support timely access and safe administration.

Vaccination

For the best protection against severe illness it is important to be up to date for all vaccinations including COVID-19 and influenza. Residents should be strongly encouraged to receive both booster doses for COVID-19 if they are eligible. This helps provide added protection during times of increased COVID-19 in the community.

Visitors

Receiving visitors is essential for the residents' wellbeing and helps to reduce the impacts of social isolation on mental health. 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.

Simple things can be done to reduce the spread of COVID-19 including:

• ensuring visitors do not have symptoms of COVID-19, have not been in close contact with a person who has COVID-19, or have tested positive to COVID-19 in the last 7 days (see Entry restrictions below)
• the use of well-ventilated and outdoor areas for visits
• avoidance of crowding and encouraging physical distancing if possible, particularly when there are people at high risk of severe illness
• wearing of masks: all visitors should wear a mask when visiting RDCFs to help protect those most vulnerable, particularly when there are high rates of COVID-19 in the community or when a facility is experiencing an outbreak

Entry restrictions

RDCFs should ask visitors entering the facility if they have:

• undertaken and received a negative result from a COVID-19 RAT on the same day that they attend the care facility. Visitors providing essential care and entering on a regular basis can do less frequent testing, with the agreement of the RDCF. In these circumstances, the minimum recommended interval is twice weekly.
• been in close contact with someone who has COVID-19
• any symptoms of COVID-19 (other than symptoms caused by a known health condition or medication).

It is strongly recommended that visitors not enter a RDCF if they have:

• tested positive for COVID-19. Visitors should not enter an RDCF for at least 7 days after their positive test.
• been in close contact with someone who has COVID-19. They should follow the advice in the Advice for people exposed to COVID-19 factsheet and should avoid visiting a RDCF for at least 7 days.
• any COVID-19 symptoms or are waiting for a COVID-19 test result.

If a visitor meets any of the above criteria and a visit must occur, it is strongly recommended that a negative rapid antigen test is undertaken before entry, and the visitor wears a mask whilst in the facility.

Emergency service providers are not considered visitors.

Vaccination

For the best protection against severe illness it is important to be up to date for all vaccinations including COVID-19 and influenza.

Staff

For facilities with a number of staff members, they are encouraged to enjoy their meal breaks in areas with good natural ventilation or outdoors.

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. Facilities should follow Table 1, Page 8, of the RDCF ARI Guidance to determine when it is safe for staff to return to work. The Australian Government's High-Risk Settings Pandemic Payment is available for eligible staff who work in a high-risk setting, such as disability care facilities, and cannot go to work because they have tested positive for COVID-19.
• Been in close contact with a person who has COVID-19. Staff should refer to 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. This may include asking the staff member to take additional precautions to decrease the risk of transmission and test regularly after exposure to someone with COVID-19. Refer to COVID-19 advice for staff in high risk community and/or private settings for additional support.
• Any acute respiratory or influenza-like symptoms. For more detail about symptoms, refer to Page 4 of the RDCF ARI Guidance.

Staff exposed to COVID-19 in the workplace

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.

Testing for COVID-19

It is recommended that RDCF staff undergo a COVID-19 RAT at least every 3 days.

Mask wearing

Wearing a mask indoors is an important risk reduction strategy and is strongly encouraged. Mask should be worn by staff particularly during times of increased COVID-19 in the community. The impact of COVID-19 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 the RDCF ARI Guidance for additional PPE advice.

Vaccination

Staff are strongly encouraged to stay up to date with all vaccinations including COVID-19 and influenza to aid protection against severe disease for themselves and the people they care for. Providers should review staff COVID-19 vaccination rates and facilitate acces to vaccination for those who are due.

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 (e.g., fans) is not effective. Natural ventilation should be used wherever possible. RDCFs should consider seeking professional advice from an occupational hygienist or ventilation engineer. Carbon dioxide (CO2) monitors and HEPA filters can have a role but require users to have a good understanding of how to use them.