COVID-19: Can employees in aged care be required to get the vaccine?

Right now there are a lot of discussions happening around New Zealand asking “Can employees in aged care be required to get the vaccine?” Associate Jaenine Badenhorst of Rainey Collins Law has cleared up some of the confusion, with some of the below facts, as of September 07th 2021.

In Brief

Under the New Zealand Government’s vaccine campaign, it is not mandatory for employees to be vaccinated against the Covid-19 virus.  Employers can therefore not require their employees to be vaccinated, unless it is necessary for health or safety reasons for a particular role.

If an employee works in a role where the risk of exposure to Covid-19 is higher and/or the consequences of contracting Covid-19 is more serious, the role may demand employees who are vaccinated to fill it.  Due to the likely risk to the Health and Safety of aged individuals, it is highly likely to be reasonable for employers to require aged care worker roles to be filled be vaccinated individuals.

Health and Safety Laws

Persons conducting a business or undertaking (PCBUs) owe duties, under the Health and Safety at Work Act (“the HSW Act”) to ensure, as far as is reasonably practicable, the Health and Safety of its workers, patrons, customer and clients.

Covid-19 poses a risk to the Health and Safety of others, and therefore PCBUs are required to undertake a risk assessment in their particular work environment, so that they can implement safeguards and protocols to eliminate or reduce that risk.

Health and Safety risk assessments must be done in consultation with workers, unions, and other relevant representatives.

If a Health and Safety risk assessment of a particular role indicates that vaccination is necessary to comply with Health and Safety obligations, an employer may require whomever fills that role, to be vaccinated.

It is important to note that rather than any ‘employee’ requiring vaccination, it is the particular ‘role’ that requires a vaccinated employee to carry it out.

When is vaccination likely to be required for the performance of a role?

Under the COVID-19 Public Health Response (Vaccinations) Order 2021, some work at the border can only be done by vaccinated workers.  Employers in this case need not do individual Health and Safety risk assessments, as all work covered by the Order must only be done by vaccinated workers.

It is possible further Orders could be made to require other roles to be filled only by vaccinated individuals.  In the absence of an Order, it will be up to each PCBU to make a decision for their work place, based on the Health and Safety risk assessments they have completed.

At present, PCBUs in the aged care sector will have to individually assess each role to determine whether it should to be filled by a vaccinated person for Health and Safety reasons.

Health and Safety risk assessments will typically require vaccination if a role involves a high likelihood of exposure to Covid-19 in the workplace and/or significant consequences to others in regular contact with the individual performing that role.  Examples will include roles where employees have lots of contact with customers and clients or other employees, especially where contact will be with vulnerable people.

Workers in aged care roles are likely to have contact with many individuals each week, and these individuals are likely to be more seriously affected by the impacts of Covid-19 if they contract it.  It is therefore highly likely that many aged care worker roles will require vaccinated individuals to fill them, so that PCBUs are compliant with their obligations under the HSW Act.

In each case, however, the PCBU must assess the risk on a case by case basis.  It is also important for the PCBU to consult with the workers in these roles, to help the PCBU assess the risk and ways to best eliminate or minimise it.

Recruiting new employees:

An employer may require vaccination for new employees, however this must be reasonable for the particular role.

Additionally, employers must take care to ensure they are not unlawfully discriminating under the Human Rights Act or affecting the right to refuse medical treatment under the New Zealand Bill of Rights Act.

Does an employee have to tell their employer if they have been vaccinated?

If an employee refuses to inform their employer of their vaccination status, the employer may assume that employee is not vaccinated in order to manage its Health and Safety obligations.  If an employer makes this assumption, it must inform the employee of its intention to do so, and what the possible consequences may be.

What if vaccination is refused?

If an employee refuses vaccination following a risk assessment that identifies it as necessary for the employee’s role, an employer may consult with their employee to change their work arrangements, duties or leave, or restructure their work or employment conditions.

Redundancy or dismissal should be considered as final options after changes to the employee’s duties or redeployment to other roles have been considered.  Without consideration of all reasonable alternatives, dismissal of an employee who refuses to be vaccinated will nearly always be unjustified.

Any changes, dismissals, or risk assessments must be carried out in good faith.

If there are concerns in your business in relation to employees receiving the Covid-19 vaccination, it is wise to speak with a professional experienced in the area.

Moreh Home HCSL

Testimonial – Moreh Home

Thank you, Gillian, for all your support. The Healthcare Compliance Solutions Ltd (HCSL) aged care program gives a structured clear pathway through the obstacle course of Certification.

The HSCL program was extremely user friendly and appears very nicely laid out and easy to locate care plans and patient’s information. The general feedback from the staff has been positive.

The policies and procedures were easy to follow, and well presented. We appreciated how thorough these policies were, and how much work had gone into developing them.

We all felt well supported throughout, and it was so nice knowing that you were on the end of the phone/email or zoom. Even when we met in person, you were incredibly positive and encouraging, thank you!

We would recommend this system to anyone needing assistance with the challenge that is Certification.

Barbara Adams

Board Chair-person /Acting Manager.

Celebrating the COVID-19 vaccination

The following is contributed by Infection Prevention and Control Consultant (RN) Ruth Barrett –

I am 61 years old, a practicing nurse and recently I had a little celebration. I received my 2nd COVID-19 vaccination from a lovely team in Ashburton Hospital in Canterbury.

I feel like celebrating because I have played a small part towards helping New Zealand (and the world) fight this pandemic and get it under control. By having the vaccine, I am helping to keep my whanau and friends safe from catching the virus from me if I get infected, especially if I don’t have any symptoms. It also means I am happier to continue to look after vulnerable people, knowing I won’t be passing on the virus. It is reassuring to know that the vaccine will stop me getting really sick and ending up in hospital or worse. So, if we do have another large outbreak, my hospital bed can go to someone else.

We are lucky in New Zealand to have access to a vaccine that is very safe and very effective, and recent reports show that it is also works against the new variants that are out there.

I was a little nervous about getting the second dose and how I would feel afterwards. Although I have the influenza vaccine every year without any side effects, this time I needed two jabs. But in the end it was all good – I only needed two paracetamols about 6 hours later, had a good sleep, and then, apart from a sore arm for a day and a half, I felt fine.

Of course, I know that vaccinations are not the only thing that keeps us safe – all our public health measures and infection prevention and control activities are just as important. But if you are a healthcare worker, a parent, a partner, a friend, a child, a sibling, a grandchild or other, you can make a difference in your community by having the COVID-19 vaccine.

 

Ruth Barratt RN, BSc, MAdvPrac (Hons), CICP-E

Infection Prevention and Control Consultant

Christchurch, New Zealand

Avoiding Personal Grievance claims

One thing new and seasoned managers often fear is having a staff member raise a personal grievance against them.  We asked Rainey Collins Law Associate Jaenine Badenhorst for some ideas to support management avoid personal grievances.  The following advice was the response:

We would recommend that you do these key things to help avoid a personal grievance being raised against you/your business. 

 

  1. The first key thing to do is to hire the right candidate in the first instance. (Yes, we know that isn’t always easy)!  You want to make sure you have a robust interview and reference checking system in place.  You could also consider your existing team meeting the candidate to make sure there is a good personality fit.  There is also the possibility of a work trial or probation period, depending on the circumstances.

2.   Have a written employment agreement which clearly sets out the parties expectations (for instance about work hours, flexibility, responsibilities, reporting lines, raising problems, and so on).  It is helpful for these matters to be discussed beforehand, so that everyone is on the same page.  This helps to avoid confusion and misunderstandings.  Employee manuals can also be very helpful to cover more detailed rules and guidelines (for example internet use, health and safety, bullying and harassment, etc.).

3.   Keep accurate employee records and files.  This should cover hours worked, leave taken, superannuation or other agreed deductions, discussion around various work conditions and so on.  The employee file should also cover any issues with performance or misconduct (detailing fair processes followed, and outcomes reached). 

4.   Act in good faith towards each other (by being honest and approachable; as well as open and communicative).  Being a good employer, and having a relationship with employees where they feel free to raise issues early on is the best way to resolve problems before they turn into formal grievances.  Regular catch-ups (like weekly or monthly meetings) is a good way of checking in with employees, and letting them know if there are any issues with their conduct or performance. 

5.   Knowing your obligations around the law and the contract you have with your employee is also very important.  This way you are less likely to cause issues which will turn into grievances.  If you are unsure of your obligations, you should seek professional advice. 

Thanks Jaenine, we hope that helps managers of services who might be struggling with this issue. Following due process and keeping accurate records will also support why you have made decisions and how.  Even with the best processes in place, sometimes you cannot completing avoid a grievance but follow professional advice and you can certainly minimise risk of a claim against you or your organisation.

There will be further articles published here supplied by Rainey Collins Law in relation to supporting your employment processes.

Care Technology HCSL

Aged care going digital a raging success!

Receiving emails from our clients who have made the transition from paper-based to digital give us a lot of satisfaction. One provider who had been under DHB monitoring after an audit that didn’t achieve as well as they could have said they saved $100,000 after implementing the HCSL programme.  They had been spending a lot of time researching, writing and submitting corrective actions to audit findings for quite some time.  This doesn’t happen anymore. They have no findings!

Comments which reflect how very easy they found the process of transition reinforce our concept of where possible we opt for one click instead of two in our design processes.  Some client had used other digital packages in the past which they described as cumbersome and clumsy.  Those packages didn’t integrate with other packages so to find all the information needed, staff had to use multiple sources of information.  This made some reluctant to try something new.  Arriving on site at a client one day Gillian was taken to meet two care staff.  Both were very excited to tell her how due to them both having dyslexia, neither had been able to write their own notes before.  Now with the simplicity combined with spell-check in the digital progress notes, they were able to write their own notes.

The co-design of solutions with our clients maintains the philosophy of simplicity being as easy to use as a basic mobile phone or Facebook.

Early on we identified inequity between the resources available to corporate owned multi-site providers and independently or small group owned aged care services. This inequity, in conjunction with shortages of staff led us to work alongside aged care, retirement village and community services to design a one-stop-shop programme and in 2015 HCSL aged care software  went LIVE.  It has continued to be developed since then to a fully cloud based solution.

Clients said they’d like everything in one place. Despite there being other options we were continually pressured to create a NZ specific product that supports not only benchmarking, quality and risk but also all aspects of providing care while incorporating compliance throughout each aspect of the programme.

The integration with Medi-map medication administration systems will further streamline access to resident care information for remote assessment and treatment planning.  More integrations are underway currently to support as seamless flow of resident information regardless of where those needing information to provide care are situated. Clinical records are now accessible and able to be updated from anywhere with an internet / wi-fi connection.

Having been appointed as the step-in temporary manager at Rosewood Resthome and Hospital during the COVID-19 outbreak, Gillian Robinson was able to implement HCSL cloud-based software for telehealth support This programme was literally set up overnight and being used by staff with no training as there simply wasn’t time.  The great test for the system was to note the staff were able to successfully use the digital online care-planning and progress notes without any training other than to be supplied their login.  The uploading of a photograph of a wound for the doctor to review remotely was able to done easily after watching the 5 minute instructional video on ‘how to’.

Community, Disability services and mental health residential services along with retirement villages throughout NZ are now enjoying efficient cloud based records.  To find out how you can use this ready to use, NZ specific programme contact us.

Testimonial – Nurse Consultant

Nurse consultant Healthcare Compliance Solutions Ltd

As a RN, Facility Manager and Consultant in Aged Care I have used various Aged Care software packages over the years.

Feedback I have received from RNs and caregivers using HCSL system includes the following:

  • Takes less time to find information about residents
  • More resident focused and less task focused than using tick box task lists.
  • Able to edit information quickly.
  • Easy to upload and save information in the documents folder.
  • Easier to do monthly quality analysis as the information is quicker to find.

I am very impressed with HCSL software as I have found it delivers in the following ways and is:

  • Intuitive  and timesaving – the software prompts the operator – for example to create a short term care plan if documenting an  adverse event  such as wound care. The one click action means less time taken trying to open a new screen or change functions such as finding care plans or progress notes.
  • Quality Assurance is able to be maintained in a timely and comprehensive manner with an internal audit system and corrective action logs in addition to monthly analysis of adverse events and infections.
  • NZ ARC compliance requirements are continuously updated – in care

planning, and resident information requirements documentation and procedures and policies in the individualised  Facility  Documentation library.

  • Very responsive service- the  HCSL team quickly respond to questions and  seek and use client feedback to continuously develop and extend the software capabilities. HCSL is   New Zealand based so information is relevant to nursing and care giving in New Zealand.
  • Developed and managed by a very experienced NZ Nursing leader in aged care who has comprehensive knowledge of and experience in quality and compliance systems in NZ aged care.

Anne Sheard, RN.

Testimonial – Love your new admin function

I must say I love HCSL Version 2 software from an Admin perspective – It’s really simple to navigate through and I have added our Accountant as a user as well as she accesses Resident NOK information for sending accounts to etc.

 

It has also meant we have been able to delete a lot of Excel Spreadsheets we had in place for some of the information that is already gathered for us by your software automatically and all in one place!

Thanks

Naomi Nailor

Village Manager – Springlands Lifestyle Village (Blenheim)

November 2020

Testimonial – Holly Lea

Juliane

We have been working with Gillian and Healthcare Compliance Solutions Ltd (HCSL) for more than 4 years.

Compassion, quality of care services and their drive for excellence inspired by the quest for  excellence in care put Gillian and her  team at HCSL in a league of Its own.

In the ever evolving science of aged care,  HCSL systems and aged care software program has proven itself not only as a world class quality health system but also demonstrates that it’s  person centred  and current  best practice. It  is designed and developed based on scientific evidence to ensure the delivery of best quality of care and  supporting  best quality of life to all our clients.

The inclusive, consultative and the facility specific approach of Gillian and her team is absolutely outstanding with constant follow up on changes. These include new improved plans to ensure the best quality of care, practices and  bench-marking incorporating the latest best practices, outcome based, with the main focus on quality of care and safety for our residents and staff at all times.

Using HCSL and all the quality services it provides ensures we are up to date with the latest policies and procedures relevant to the current care practices. It also gives us peace of mind that we are audit ready at any given time.

Based on these systems, our residents are cared for in the best possible way resulting in the high demand for our care services and Holly Lea being a highly sought after facility.

For peace of mind and knowing you are dealing with the best quality system in Healthcare we cannot recommend HCSL highly enough.

 

Juliane Brand (RN, MPH)

General Manager

Holly Lea Village

Testimonial – Dr Hillary Currie-Gray – Christchurch

Thanks so much for the help at Rosewood. You did a fantastic job.

 

I have four facilities using HCSL. I have been impressed with HCSL. I frequently access it from home and on my phone. Because remote access is via the internet it enables me to interchange between HCSL and the medication chart easily unlike other systems that require remote access in via Citrix which “takes over” the computer. Log in is secure but quick.

 

Residents are easily searched for and once a file is open it immediately directs me to produce a new progress note. Care planning functions are easy to review and there is a simple tool for medical classifications with common conditions in a drop down list with room for free text below. On the whole this is an easy tool to access and one of the less cluttered programmes I have used.

Dr Hillary Currie-Gray

Christchurch

Testimonial – Dr Roderick Mulgan – Auckland

I operate a medical practice that specializes in aged-care facilities in Auckland. In the last two years most have adopted a system for keeping medical file notes electronically. There are a number of systems on the market and I have experience of four. None appear to have consulted end users when developing their functions. All of them have problems, which hopefully will be ironed out over time.

HCSL is one them.  The vital medical problem list is buried within the system and clunky when you find it. Some of its navigation is not intuitive. However, compared to the others it has a clean and uncluttered feel.

The tab buttons and the boxes for inserting text are large and easy to use. The ability to find previous medical file notes within all the nursing and caregiver entries (a vital consideration) is ahead of the pack. It is also smooth as silk to access from an offsite computer.

The team behind it are much easier to access, and more responsive to feedback, than anyone else. From what I know, HCSL is the system I would use if I was running an aged-care facility.

Dr Roderick Mulgan. FRNZCGP.