The CEO of one of Australia’s largest privately run aged care operators, Rachel speaks from experience.
With 77 aged care homes across NSW, Victoria, Queensland, and WA, Rachel’s responsibilities are many.
She has a duty of care to over 6,800 residents plus their families, and also leads Opal’s team of over 9,000 team members.
On Sunday, 22 March – just over a month ago – Rachel faced the situation that no operator wants to find themselves in – a case of COVID-19 was confirmed at Opal’s Bankstown aged care home in Western Sydney.
Six cases were eventually diagnosed at the home – three residents and three team members. Sadly, two residents passed away.
Last week, the home was given the all-clear by the Director of the South Western Sydney LHD Public Health Unit.
There are no confirmed positive cases of COVID-19 in any Opal care home at the time of writing.
We talked to Rachel about the experience – and the learnings that Opal has taken away.
Active screening of residents since 31 January
The CEO credits the efforts of the Bankstown team and the team at Liverpool Hospital, and the early preventive measures initiated by Opal for the all-clear at the home.
Opal began active screening on 31 January – almost three months ago – and twice daily monitoring of all residents for any respiratory symptoms, including temperature – which Rachel says meant that they were able to detect symptoms quickly and act on them urgently.
“Rapid and expansive testing and contact tracing were activated immediately, and an important part of the response,” she said.
The home was also completely segregated into various ‘wings’ or areas to prevent cross-contamination.
Over 45,000 calls to families during COVID-19
Open, transparent communication during the crisis was also key, Rachel says.
Across all its aged care homes, Opal has logged 45,492 calls to family members to keep them updated on their loved one’s wellbeing throughout the pandemic.
Their communications team at Bankstown kept all relatives closely informed through regular phone calls, while their People and Culture team coordinated staffing rosters.
“Our team were allocated to work in certain areas of the home only, with a dedicated team room and bathrooms in those areas, to reduce the risk of cross contamination within the home,” Rachel said.
Team anxious and concerned
Rachel says the team at Bankstown was anxious and concerned when the first case was confirmed.
“Some certainly had initial hesitations about coming to work, and given what we know of this incredibly infectious illness, that was understandable,” she said.
She attributes regular, open conversations with the team about these fears as essential to working through this.
The CEO adds that all team performed above and beyond – with many working additional hours throughout the outbreak.
Support from hospital and health authorities
Opal also had support from NSW Health, the South Western Sydney LHD Public Health Unit, the Department of Health, and the Aged Care Quality and Safety Commission (ACQSC).
“We are very grateful for their assistance as we navigated through what was an extremely complex and challenging situation for everyone,” Rachel said.
In a sign of the close relationship that developed between the hospital and the team, at the end of the outbreak the team at Bankstown sent a video of thanks in song to the hospital, performed by the team and resident choir from the home, and the hospital team then did one back for Bankstown.
Key learnings on reducing risk of cross-contamination in a care home
Here are Rachel’s thoughts:
“The more I reflect on the challenge of keeping this highly infectious disease from spreading within a home, the more evident it seems that, where possible, it is desirable that residents who are COVID-19 positive should be cared for in hospitals. This affords greater protection for the healthy cohort of residents back at the home, where it can be challenging to contain the infection,” she said.
“We are seeing that in the experiences of other nursing homes both in Australia and overseas and while our hospitals are not overrun with cases it seems the safest and most responsible thing to do.”
This is a serious point. Cases from overseas have shown that the virus can spread quickly in residential care.
But this also depends on hospitals having the beds available to care for residents – a situation that has proven difficult in the United States and the UK with intensive care units filling up and instead looking to discharge their patients into nursing homes.
Team and PPE critical to COVID-19 response
Rachel says a key learning that Opal has taken away is the need to have the team and PPE available when needed – not an easy task for every operator, particularly smaller and regional services.
“The ability to have a qualified and dedicated team who know our residents available to augment our rosters when we need more people on hand is critical,” she said. “We now have greater insight into PPE supply across our homes and how we can mitigate future risk in that area.”
Opal also consulted with an external infection control expert who audited all of the processes in the home to ensure no details were overlooked.
In addition, the operator is investing in a new Infection Control Clinical Nurse Consultant role to build this capability across all their care homes.
88% of respondents to Opal’s Family survey are supportive of Opal’s response
The CEO also points to the importance of being able to seek feedback from families and residents about how they can improve.
A current family survey shows that of those who responded, 88% were supportive of Opal’s response to COVID-19 to date.
Rachel acknowledges the difficult balance in protecting lives and enabling people to safely visit their loved ones. Opal has recently further eased restrictions on visitation.
“We are assessing the situation daily and are refining our pathway out of COVID-19 restrictions accordingly. In doing so, we must balance our need to protect our residents and team from COVID-19, with the wishes of relatives who want to visit, and those of residents and families who are very concerned at the potential risk that presents. We have allowed compassionate visits throughout the period of restricted access and this of course will continue.”
The CEO adds that while team, residents and families at Bankstown are still grieving the residents who passed away, they are all relieved that the three team members affected have now recovered.
Advice for other operators
Rachel’s advice for other providers?
“Communicate openly, make sure your team know they are supported, ask for help when you need it from Commonwealth, State and local health professionals,” she concluded.
“Err on the side of caution because this illness is incredibly infectious, and find ways to capture the data that will help inform your actions.”
“Thank and appreciate the dedicated team at the home, and supportive larger community of families and volunteers who are all part of its broader care community.”
Rachel Argaman was appointed as the CEO of Opal Aged Care in August 2018 after heading up Australian hotel and hospitality management company TFE Hotels (previously Toga Hospitality) – and its 3,000-plus employees and nearly 100 hotels across five countries since 2007.
