Aged Care - COVID-19

To reduce the spread of COVID-19 within South Australia, the State Coordinator has issued a Direction under the Emergency Management Act 2004 to limit entry into residential aged care facilities (RACF) in South Australia. The Emergency Management (Residential Aged Care Facilities No 44) (COVID-19) Direction 2021 came into effect at 12.49 pm on 8 December 2021.

A new Direction, the Emergency Management (Residential Aged Care Facilities No 45) (COVID-19) Direction 2022, comes into effect at 12:01 am 29 January 2022 and revokes the Emergency Management (Residential Aged Care Facilities No 44) (COVID-19) Direction 2021.

RACF staff, contractors and volunteers can receive their COVID-19 vaccine at any of the South Australian vaccination sites or at a dedicated clinic:

Highgate Park COVID-19 Vaccination Clinic
Medindie COVID-19 Vaccination Clinic
North Brighton COVID-19 Vaccination Clinic
Pooraka Northern Vaccination Centre


Interim guidance for COVID-19 outbreak management in Residential Aged Care Facilities (RACF)


In response to the significant COVID-19 outbreak the Chief Public Health Officer has released Information for Residential Aged Care Facilities - Interim guidance for COVID-19 outbreak management (PDF 312KB).


The aim of the guidance document is to provide clear recommendations to RACF operators to reduce the impact of COVID-19 and to assist the RACF to manage an outbreak. The document authorises the Chief Executive (or equivalent) of the RACF to grant work permissions during a period of quarantine to provide direct personal or nursing care.

Visitors

COVID-19 vaccination requirements

To enter a Residential Aged Care Facility (RACF), you must have:

  • Received at least one dose of a TGA approved or recognised COVID-19 vaccination; and
  • Received, or have evidence of a booking to receive, a second dose of a TGA approved COVID-19 vaccine within the interval after the first dose recommended by the Australian Technical Advisory Group on Immunisation (ATAGI) for that COVID-19 vaccine
  • From 29 January 2022, within four weeks of becoming eligible, you must receive a third dose (booster) of a TGA approved COVID-19 vaccine.
  • Provided the operator of the RACF with proof of their vaccination status upon request.

Exemptions are limited to the below circumstances:

  • They have a medical certificate or a letter from a legally qualified medical practitioner certifying that the person:
    • Has a medical exemption from receiving a COVID-19 vaccine on either a permanent or temporary basis in accordance with guidelines published by ATAGI (Australian Technical Advisory Group on Immunisation).
    • Has a medical exemption on either a permanent or temporary basis from receiving the preferred vaccine as recommended by ATAGI for the person’s age.
    • Has an appointment to be assessed by a medical specialist or has started an assessment to determine if they have a medical exemption
    • The certificate or letter specifies the nature of the exemption and the basis on which it applies;
    • The Chief Public Health Officer or her delegate has endorsed the exemption, and
    • The person provides the operator of the healthcare setting with a copy of the endorsement.
  • They are child aged 12 years and 2 months or less; or
  • The person is entering for an end of life visit who is not able to access the COVID-19 vaccine before their visit to the Residential Aged Care Facility and who takes all reasonable steps to access the COVID-19 vaccine as soon as practicable after their initial visit, provided that the person wears appropriate personal protective equipment while on the premises of the Residential Aged Care Facility.
  • The person is responding in the provision of emergency services in the event of an emergency.

You cannot enter an aged care facility if:

  • you have had contact with a positive COVID-19 person within 14 days prior to entry
  • you have a temperature higher than 38 degrees Celsius, history of fever or chills within the preceding 72hours, or have symptoms of acute respiratory infection or loss of taste or smell
  • you have not received the 2021 influenza vaccination
  • you have undertaken a COVID-19 test and are awaiting the test result, unless part of routine surveillance testing and are not displaying symptoms.

Requesting an exemption

  1. You will need to get a medical certificate form a qualified medical practitioner that clearly outlines the reason for an exemption in line with the Australian Technical Advisory Group on Immunisation (ATAGI) guideline: www.health.gov.au/resources/publications/atagi-expanded-guidance-on-temporary-medical-exemptions-for-covid-19-vaccines
  2. Your medical practitioner must complete an SA Health Chief Public Health Officer Immunisation Exemption Application Form.
  3. Submit your completed form and medical certificate to Health.NJNPExemptions@sa.gov.au.
  4. Your application for an exemption must be approved by the Chief Public Health Officer (CPHO). If approved, the CPHO will provide a signed exemption letter that can be provided to the RACF.

Influenza vaccinations

All staff and visitors to a RACF must be vaccinated against influenza. Except for:

  • infants too young to be vaccinated;
  • exceptional end of life circumstances;
  • if a person has a medical contraindication to the influenza vaccine. A letter from a medical practitioner must be provided to the RACF by any unvaccinated person seeking to enter under this exemption.
  • if a person is following the recommended 7 days waiting period between receiving the COVID-19 vaccine and the influenza vaccine. The person will need to provide evidence of the date of receipt of a COVID-19 vaccination to the RACF and take all reasonable steps to ensure they are vaccinated as soon as is reasonably practicable.
  • if the vaccine is not reasonably available and
  • emergency situations.

Visitor limits

For a resident of a RACF with more than 70% of its residents who have had at least one dose of a COVID-19 vaccine, there is no limit of care and support visits per day.

A resident of a RACF with less than 70% of residents who have had at least one dose of a COVID-19 vaccine, may have one care and support visit of two persons or two separate visits from one person, per day.

  • Processes should be put in place to ensure that residents are able to receive visitors safely. This includes ensuring visitors have appropriate PPE (face masks) and screening of visitors (PDF 87KB) upon entry to the RACF.
  • Upon entry, all visitors must wear a face mask over their mouth and nose (other than children 12 years or younger).
  • Anyone entering a RACF, including employees, contractors, volunteers and visitors, must use COVID SAfe Check-In (QR Code) to capture their relevant contact details. If they are not able to use the COVID Safe Check-In, they must sign in using a paper record.
  • Where possible, visits should be conducted in a resident’s room, outdoors, or in a specific area designated by the RACF, rather than communal areas.
  • Physical distancing of 1.5m should be adhered to wherever possible.
  • A person may enter a RACF for the purpose of participating in a group activity led or supervised by an employee, contractor, student or volunteer of the facility.

Compassionate visits

Visits for the purpose of providing end of life support to a resident are permitted and numbers of visitors are not restricted in these circumstances.

Visitors during COVID-19 outbreaks

Wherever possible, processes should be put in place to ensure that residents are able to receive essential visitors safely during an outbreak.

For further information, refer to the Industry Code for Visiting Residential Aged Care Homes during COVID-19.

Overseas travellers

Vaccinated people can travel to South Australia from overseas, however they are not permitted entry into high risk settings (including RACF) for 7 days after arrival.
Unvaccinated travellers to South Australia must quarantine as directed for 14 days after arrival.

Visit the Travel webpage for more information.

COVID-19 outbreak strategy

In the event of a COVID-19 outbreak in a RACF, the following strategy documents have been developed:

Aged care workforce

Operators of RACF need to implement a number of changes to the way that employees and contractors at their facilities work.

  • Single site restrictions for personal care workers - To the extent reasonably possible, personal care workers must not provide personal care to residents at more than one RACF. Operators of a RACF should make best endeavours to support the personal care workforce to implement this practice but in the event that this is not possible, workers are not restricted from working across multiple sites. All employees, contractors and volunteers must notify the operator of the RACF (as soon as possible) of any additional place of employment and any COVID-19 case identified at their additional place of employment.
  • COVID-19 Vaccine Records - All employees, contractors and volunteers must notify the RACF of any COVID-19 vaccination received (and provide evidence of same) if that vaccination was not conducted at a clinic held at the RACF. Operators of a RACF are required to maintain records of COVID-19 vaccinations received by those persons. The operator of a RACF must also, as far as is reasonably practicable, maintain a record of residents in the RACF who have received COVID-19 vaccinations. This must be made immediately available for inspection at the request of an authorised officer.
  • Training requirements - All employees or contractors who provide personal care or nursing care to residents must complete Understanding COVID-19 for Aged Care Workers before entering or remaining on the premises of a RACF. Refresher training must be completed every three months.
  • Workforce Management Plans - All RACF must have in place a Workforce Management Plan to keep records of all outside employment undertaken by their employees, contractors or volunteers. This is to assist with contract tracing if required.
  • COVID-19 Infection Control Plans - All RACF must submit a COVID-19 Infection Control Plan for all communal areas at the facility to the Department for Health and Wellbeing for approval via Health.COVIDInfectionControlPlan@sa.gov.au. To complete a plan, download the Residential Aged Care Facilities COVID Infection Control Plan Template (DOCX 597KB) and read the Residential Aged Care Facility COVID-19 Infection Control Plan Guidance (PDF 441KB).

Personal Protection Equipment (PPE)

Operators of RACF need to consider the appropriate PPE requirements for employees and contractors undertaking duties at their facilities.

For information about PPE, see the Infection Control and Personal Protective Equipment (PPE) advice webpage.

Training staff in the correct use of PPE minimises the potential of COVID-19 transmission within residential aged care facilities amongst workers and residents. For more information visit the staff protection from infections page.

Particulate Filter Respirators (PFR) (PDF 1.1MB) PFR are the recommended face mask to be worn in the event of COVID-19 exposure and outbreaks. PFR are also appropriate as part of the PPE required for all health care workers involved in aerosol-generating procedures and behaviours when a resident is confirmed or suspected of having a disease that may be transmitted via the droplet or airborne route, including COVID-19.

If RACFs use PFR face masks as part of their escalating PPE strategy, it may significantly reduce the likelihood that staff will need to be furloughed in the event of a COVID-19 outbreak in the RACF, however, the use of PFR is not a mandatory requirement.

For further information see:

RACFs can source stock of PPE from their usual supplier or through SA Health (at a cost) by emailing HealthPSCMSCOCustomerService@sa.gov.au.

Rapid Antigen Testing (RAT)

RAT kits are an important tool in protecting residents and workers in each residential aged care facility from COVID-19.

Outside of an outbreak situation, RACF are encouraged to use RATs as a workplace surveillance tool to screen people who do not have symptoms of COVID-19. By using RATs in this way, RACF may detect COVID-19 in asymptomatic individuals and prevent exposure in the RACF.

All RACF conducting RAT screening should:

  • Adhere to standard operating protocols and checklists
  • Use TGA approved RAT kits
  • Report results to SA Health.

For mor information, visit the Rapid antigen testing (RAT) for COVID-19 webpage.

Accessing RAT

The Australian Government is responsible for the distribution of RAT kits to RACF.
RAT kits supplied through this process are expected to be used for screening staff and residents where appropriate.

RACF can order RAT from the National Medical Stockpile by completing the online form.

RACF can also order RAT from their usual providers or from SA Health (at a cost):

Mandatory COVID-19 vaccination for aged care workers

A person cannot engage in work or duties at a RACF unless they have:

  • Received at least one dose of a TGA approved or recognised COVID-19 vaccination; and
  • Received, or have evidence of a booking to receive, a second dose of a TGA approved COVID-19 vaccine within the interval after the first dose recommended by the Australian Technical Advisory Group on Immunisation (ATAGI) for that COVID-19 vaccine Provided the operator of the health care setting with proof of their vaccination status upon request; and
  • From 29 January, within four weeks of becoming eligible in accordance with ATAGI guidelines, the person receives, or has evidence of a booking to receive, a third dose (booster) of a TGA approved COVID-19 vaccine.

The vaccination requirements apply to:

  • Volunteers, contractors and agency staff;
  • Direct care workers (nurses; personal care workers; allied health professionals; allied health assistants);
  • Administration staff (reception; management; administration);
  • Ancillary staff (food preparation; cleaning; laundry; garden; maintenance);
  • Lifestyle / social care (music/art therapy);
  • Transport drivers of residents of residential aged care facilities;
  • Students on placement at a residential aged care facility; and
  • Medical practitioners and allied health professionals who attend and provide care to residents of a residential aged care facility.

COVID-19 mandatory vaccination exemptions for aged care workers

From 6 December 2021, exemptions to the mandatory COVID-19 vaccination requirement for RACF workers are limited to the below circumstances:

  • The RACF must be provided with a medical certificate or letter from a legally qualified medical practitioner certifying that the person:
    • has a medical exemption from receiving a TGA approved COVID-19 vaccine on either a permanent or temporary basis in accordance with the guidelines published from time to time by ATAGI; or
    • has a medical exemption on either a permanent or temporary basis from receiving the preferred vaccine as recommended by ATAGI for the person’s age; or
    • has an appointment to be assessed by a medical specialist or has commenced an assessment with a medical specialist to determine whether they have a medical exemption from receiving a COVID-19 vaccine on either a permanent or temporary basis in accordance with the guidelines published from time to time by ATAGI.
  • The certificate or letter must specify the nature of the exemption and the basis on which it applies, and the exemption must be endorsed by the Chief Public Health Officer or her delegate (which must be provided to the operator of the RACF).

Requesting an exemption

  1. You will need to get a medical certificate form a qualified medical practitioner that clearly outlines the reason for an exemption in line with the Australian Technical Advisory Group on Immunisation (ATAGI) guideline: www.health.gov.au/resources/publications/atagi-expanded-guidance-on-temporary-medical-exemptions-for-covid-19-vaccines
  2. Your medical practitioner must complete an SA Health Chief Public Health Officer Immunisation Exemption Application Form.
  3. Submit your completed form and medical certificate to Health.NJNPExemptions@sa.gov.au.
  4. Your application for an exemption must be approved by the Chief Public Health Officer (CPHO). If approved, the CPHO will provide a signed exemption letter that can be provided to the RACF.

COVID-19 vaccine for residents

COVID-19 vaccination for RACF residents is strongly encouraged but not mandatory. The Commonwealth Department of Health have undertaken in-reach vaccination clinics for residents of RACF nationally.

Residents who wish to be vaccinated and have missed the in-reach clinic, should be supported by the RACF to access a COVID-19 vaccine. This could include arranging a GP to administer vaccinations onsite or travel to one of the vaccination sites.

Residents in aged care facilities who received a second dose of a COVID-19 vaccine at least three months ago are eligible to receive a booster dose. Residents who are eligible will be offered a COVID-19 booster dose through Commonwealth in-reach clinics. Residents who are eligible for their booster dose ahead of their facility’s booster clinic can request a visiting GP or pharmacist to receive their booster dose.

For further information about COVID-19 vaccines in RACF, visit the Commonwealth Department of Health website.

For further information about the process for residential aged care providers to check whether new residents have been vaccinated for COVID-19, view the Australian Government Department of Health COVID-19 vaccination – New resident entrance protocol flow chart on the Commonwealth Department of Health website.

Residents and staff of SA Health operated RACF will receive information about their COVID-19 vaccination directly from their Local Health Network.

In-home and community aged care workers

Under the Emergency Management (In-home and Community Aged Care and Disability Workers Vaccination) (COVID-19) Direction 2021, from 8 December 2021, in-home and community aged care and disability support workers must have received at least one dose of a TGA approved or recognised COVID-19 vaccination and received, or have evidence of a booking to receive, a second dose of a TGA approved COVID-19 vaccine within the interval after the first dose recommended by ATAGI for that COVID-19 vaccine. In-home and community aged care and disability support workers must provide the operator of the health care setting with proof of their vaccination status upon request. For more information, read the Australian Government Department of Health In-home and Community Aged Care and Disability Support Workers Vaccination Q&A and the Information for in-home and community aged care providers fact sheet (PDF 182KB).

From 29 January 2022, disability support workers and in-home and community aged care worked need to have a COVID-19 booster shot, or have evidence of a booking to receive a COVID-19 booster shot, within 4 weeks of becoming eligible.

For more information

Fact sheets

Resources