As of 18 July 2022

This advice includes information for:

With increasing COVID-19 and influenza in the community, it is important that residential disability care facilities (RDCF) maintain a high degree of vigilance and continue to take precautionary actions such as regular screening of staff and visitors for symptoms, use of rapid antigen tests in addition to screening, mask wearing and hand hygiene. It is also important for staff and visitors to maintain social distancing where possible, and visits are encouraged to occur outdoors.

  • Residents should also be offered the second COVID-19 booster (winter booster) and the influenza vaccine as a priority.
  • A person who provides a disability service is required to have 3 doses of a COVID-19 vaccination. There are 2 exemptions related to booster vaccinations. See below.
  • Visitors and staff who are household or close contacts of a COVID-19 case must have a COVID-19 risk assessment as per these guidelines.

Winter flu season

  • RDCFs should take precautionary steps in managing the 2022 winter flu season.
  • All residents should be strongly encouraged to receive the 2022 seasonal flu vaccine, which can be given on the same day or at any time before or after their second COVID-19 booster (winter booster). The second COVID-19 booster should be given 3 months after their first booster dose, or 3 months after a confirmed COVID-19 infection.
  • It is strongly recommended that all visitors and staff be vaccinated for influenza this winter and that facilities communicate with their staff, families and other visitors to remind them about the importance of influenza vaccination.

Disability day programs

Disability day programs are permitted to operate.

In arranging activities, day program providers should maintain COVID-19 safe practices these include:

  • encourage all people with disability to be fully vaccinated
  • all people providing a service must have 3 doses of a COVID-19 vaccine, this includes volunteers (see staff section below)
  • encourage everyone to wear a mask when indoors
  • encourage regular use of alcohol-based hand sanitiser
  • maintain a distance of at least 1.5 meters from other people where practical
  • have COVID-19 safety plans in place

Staff and participants should not attend if they have any COVID-19 symptoms or if they are a household or close contact of a confirmed COVID-19 case or have had a high risk exposure to COVID-19.

Managers should refer to the COVID-19 Guidance to support assessment of workers, residents and visitors in Residential Disability Care to help with assessing the risk exposure for residents, visitors and staff and to determine when staff can return to work.

Where participants are not fully vaccinated, providers are encouraged to continue to provide flexible options including online service delivery, individual activities and avoid group interactions unless the participants are from the same household.

Visitors

Testing for COVID-19

Visitors should provide evidence of a negative COVID-19 rapid antigen test (RAT) result taken just before entry. Visitors providing essential care and entering on a regular basis can, with the agreement of the RDF, do less frequent testing. In these circumstances, the minimum recommended interval is twice weekly.

Emergency service providers are not considered visitors and are not required to do a COVID-19 test prior to entry.

Limitation on numbers

Visitor restrictions are no longer included in the Public Health Order. However, the recommended limit for visitors is 2 adults and 2 children per resident within a 24-hour period. Providers may increase the number of visitors for a resident depending on their circumstances, for example:

  • A special occasion such a birthday
  • Visitors have travelled a long distance
  • Visitors have not seen the resident for an extended period of time
  • It is for the purposes of end of life

Additional measures

  • Where possible visits should be held outdoors or in well ventilated areas away from other residents
  • All visitors over 12 years of age must wear a surgical mask over their nose and mouth while visiting indoors. For reasons when masks can be removed, please see Additional Advice – Mandatory mask wearing.
  • Visitors and staff should maintain social distance and limit interactions
  • Visitors should not move between different areas of the facility and should only visit the resident in their room or in an outdoor location.

Vaccination

  • Visitors are strongly encouraged to be vaccinated for COVID-19 and to receive their booster when it is due.
  • Similarly, visitors are strongly encouraged to be vaccinated for seasonal influenza.

Visitors must not enter a RDCF if they:

  • Have COVID-19 symptoms
  • Are a household or close contact. These people must comply with the directions in the NSW Health Household and Close Contact Guideline and must not visit a RDCF for at least 7 days after the last person in their house had a positive COVID-19 test. They should continue to avoid RDCFs for an additional 7 days where possible. If there are extenuating compassionate reasons for visiting a RDCF and the visitor does not have symptoms of COVID-19, the facility may risk assess to determine whether a visit can safely occur 
  • Are waiting for a COVID-19 test result
  • Have tested positive for COVID-19 in the past 10 days.

Residents

Positive COVID-19 rapid antigen test results

  • A resident must register their positive COVID-19 rapid antigen test 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 on the Service NSW portal. A separate form will need to be completed for each resident that tests positive to COVID-19.
  • When a positive rapid antigen test result is registered the person will be asked a series of questions that will help determine whether they are at risk of severe disease and will trigger additional NSW Health supports.
  • The Commonwealth has confirmed that eligible NDIS participants can purchase rapid antigen tests with funding from their NDIS plan, to ensure safe access to their supports in current COVID-19 outbreaks.
  • Testing for COVID-19 is not recommended for residents that have recovered from COVID-19 within the previous 4 weeks.
  • Recovered residents who are at higher risk of severe illness should be tested for COVID-19 and other respiratory pathogens, including influenza, if they develop new symptoms in the 4 weeks after they are released from isolation.

Leaving the facility

  • Residents may leave the facility to exercise, for recreational activities or to attend family gatherings but must follow  the current Public Health (COVID-19 General) Order 2022 (the Order) and rules for people in NSW.
  • Residents should not leave the facility if they have COVID-19 symptoms until they have had a RAT or PCR test and have received a negative result.
  • All facilities must ensure that residents are provided with appropriate personal protective equipment, infection control and mask wearing advice when they leave the facility. See the latest face mask rules     

    It is strongly recommended residents wear masks when they leave the facility to attend indoor events.
  • Where a rapid antigen test is available, residents who leave the facility to attend a family gathering should on return be supported to have a rapid antigen test on days 2 and 6 after they return. Should rapid antigen testing not be available, continue to follow infection prevention strategies. If they develop any signs or symptoms of COVID-19 they should immediately have a PCR (nose and throat swab) test and self-isolate until their symptoms are gone.

Vaccination

Residents should get a flu vaccine, COVID-19 booster dose or a second booster (winter booster) as soon as they are eligible.

Staff

  • Includes all people providing a service e.g. volunteers
  • All facilities located in NSW must ensure that all staff wear a surgical mask while in the facility. For reasons when masks can be removed please see Additional Advice – mask wearing.

Vaccination

All staff should be vaccinated according to the recommended schedule in the ATAGI guidance for residential aged care workers.

Under the Public Health (COVID-19 Care Services) Order (No 2) 2022, all staff, health practitioners and students entering a RDCF must have had 3 doses of a COVID-19 vaccine. The third dose is due 3 months after a person's second dose. For staff (including new staff) who have had 2 doses of a COVID-19 vaccine, they must have their third dose within 6 weeks of their third dose being due.

Exemptions under the Public Health (COVID-19 Care Services) Order (No 2) 2022 relating to the third dose of a COVID-19 vaccination may apply to some staff, including:

  • An exemption which allows a person who has had two doses of a COVID-19 vaccine to continue working without the third dose if they have been assessed by the facility as being essential to the operation of a RDCF or ongoing provision of aged care services.

    The exempt worker must take reasonable steps to get vaccinated as soon as practical. If they have not taken reasonable attempts, they are not exempt from their third COVID-19 vaccination.
  • An exemption which allows a person who has had two doses of a COVID-19 vaccine to continue working without the third dose if they:
    • were diagnosed with COVID-19 in the previous 4 months, and
    • can provide evidence of their diagnosis to the RACF and/or their employer. Evidence of diagnosis can be either proof of registration with Service NSW of a positive rapid antigen test result, or evidence of a positive COVID-19 PCR result.

See further information on Public Health Orders and Exemptions.

These exemptions do not permanently exempt the person from the requirement to have a third dose of a COVID-19 vaccine. Staff who do not meet the conditions in the exemption instrument must comply with the vaccination direction in the Public Health (COVID-19 Care Services) Order (No 2) 2022. Facilities should work with staff to make sure that they are able to access their third dose of a COVID-19 vaccine when it is due. 

Staff who have a medical contraindication to all reasonably available COVID-19 vaccinations will require a COVID-19 medical contraindication certificate.

Staff exposed to COVID-19

Staff must not enter the facility at all if they:

If there is a staff exposure to COVID-19 in a RDCF, managers should use Appendix 2 in the Acute Respiratory Infections Guidance to support decision making.

Staff who are a household or close contact must comply with the NSW Health Household and Close Contact Guidelines and must not enter a RDCF for at least 7 days after the last person in their household had a positive COVID-19 test. After 7 days, the employer must undertake a risk assessment before approving their return to work. This may include asking the staff member to take additional precautions to decrease the risk of transmission. This applies to all workers entering a RDCF to provide a service, including pathology collectors, therapists and other contractors, however does not apply to emergency service providers.

If a staff member is critical to service delivery and their absence would compromise ongoing care for residents, please discuss with the local Public Health Unit whether a return to work within 7 days may be allowed with additional risk mitigation measures.

Please refer to the NSW Government website for further information on NSW rules and restrictions.

For advice on essential staff who are necessary for operational purposes please see the advice on Exceptional circumstances for visiting a RDCF.

Please read Additional information for residential disability care facilities (RDCF).

Current as at: Thursday 28 July 2022
Contact page owner: Health Protection NSW