As of 11 August 2022

With increasing COVID-19 in the community, it is important that home care service providers maintain a high degree of vigilance and continue to take precautionary actions such as regular screening of staff, mask wearing and hand hygiene.

In-home and community aged care and disability care workers are required to have 3 doses of a COVID-19 vaccine.

A vaccination exemption is in place until 6 September 2022, allowing a person to continue working without the third dose.

The advice on this page also applies to people working within the Commonwealth Home Support Programme.

Home care service providers who are household and close contacts should not attend vulnerable clients unless a specific COVID-19 return to work plan is in place

Winter flu season

  • Home care service providers 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 staff be vaccinated for influenza this winter, and that home care service providers communicate with their staff, families, and other visitors to remind them about the importance of influenza vaccination.

Staff

  • Staff, including students and contractors, should not provide a home care service if they have acute respiratory or influenza-like symptoms
  • It is recommended that home care staff undergo a COVID-19 RAT prior to commencement of each shift. At a minimum, testing should occur three times per week, as regular COVID-19 rapid antigen testing is more effective that singular tests to identify cases.
  • It is recommended that all home care staff wear a surgical mask whilst providing the home care. 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 providing in-home and community aged care or disability services 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 the provision of services to people with a disability or people receiving in-home and community 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 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. Providers 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

If a staff member has had a high-risk exposure to COVID-19, managers in aged care home services should refer to Appendix 2 of the Residential Aged Care Facility ARI Guidance; and managers in disability home care services should refer to Appendix 2 of the Disability Care Facility ARI Guidance for information on how to assess the level of risk and testing regimes supporting staff returning to work and assisting in maintaining the continuity of care.

Staff who are a household or close contact must comply with the NSW Health Household and Close Contact Guidelines and must not provide services 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 the return to work. This may include asking the staff member to take additional precautions to decrease the risk of transmission.

If a staff member is critical to service delivery and their absence would compromise delivery of care, please discuss with the local Public Health Unit whether a return to work within 7 days may be allowed with additional risk mitigating measures. Staff who have recovered from COVID-19 are able to continue to work if they come in contact with COVID-19 in the 4 weeks after recovery and remain asymptomatic.

COVID-19 safety measures for home care service providers

Minimise staff working across multiple settings (such as in-home and residential care). Where ceasing staff movement across settings is not practical, additional measures should be put in place, such as maintaining records of staff and work locations and increasing use of Personal Protective Equipment (PPE).

All in-home care service providers must maintain vigilance to prevent the introduction of COVID-19 into a person's home.

Ensure staff actively ask clients about symptoms on arrival. If staff become aware of a client with symptoms, that client should be isolated from others and arrangements made for COVID-19 testing.

Where a client has not been vaccinated only essential services should be performed in the home wearing appropriate PPE.

Day activity programs

Day activity programs are permitted to operate

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

  • encouraging all staff and volunteers to be fully vaccinated
  • encourage everyone to wear a mask when indoors
  • encouraging regular use of alcohol-based hand sanitiser
  • maintaining a distance of at least 1.5 meters from other people
  • have COVID-19 safe plans in place.

Staff and participants should not attend if they have any COVID-19 symptoms or have been exposed to COVID-19.

Managers in aged care home services should refer to Appendix 2 of the Residential Aged Care Facility ARI Guidance; and managers in disability home care services should refer to Appendix 2 of the Disability Care Facility ARI Guidance for further information on when staff can be permitted to work.

Where participants are not fully vaccinated, providers are encouraged to continue to also consider providing flexible options including online service delivery, individual activities and consider the appropriateness of larger group interactions given the higher risk of severe illness in older people.

Mask wearing

  • It is strongly recommended that both the home care worker and the resident wear a surgical mask during the provision of the service.
  • A home care worker or resident may remove their mask:
    • while communicating with a person who is deaf or hard of hearing
    • if wearing a mask creates a risk to health and safety
    • where clear enunciation or visibility of their mouth is essential
  • Anyone removing a mask for one of these reasons should maintain 1.5m distance from others wherever possible.
  • There are currently mandatory face mask rules in some settings. If a home care worker is taking a resident out of the home setting it is important to follow the rules and understand how to use a face mask.

Further information

  • The Commonwealth Department of Health has issued a Guide for Home Care Providers to assist staff in reducing the risk of COVID-19.
  • Please seek the advice of your local NSW Health Public Health Unit if you are in doubt about how to appropriately mitigate risk when providing home care services on 1300 066 055.
  • For more information about NDIS-related issues, including any funding issues relating to compliance with these measures for NDIS participants, contact:
Current as at: Thursday 11 August 2022
Contact page owner: Health Protection NSW