Managing COVID-19 outbreaks in Victorian disability residential settings

Project Details

Disability residential settings pose unique risks for the acquisition and transmission of SARS-CoV-2 because people with disability living in those settings are in contact with multiple workers and so implementing optimal infection control may be difficult. Some residents may also have underlying health conditions, which place them at greater risk of serious disease or death if they are infected with SARS-CoV-2, the virus that causes COVID-19 disease. Despite the recognised risks of outbreaks in disability residential settings early in the pandemic, we observed outbreaks in over 50 disability group homes in Victoria’s second wave between late June and October 2020.

This project focuses on interviews with senior managers, team leaders and disability support workers from disability residential homes about managing COVID-19 outbreaks during Victoria's second wave.

The main findings

Government and organisational responses

• Governments lacked understanding of people with disability living in and staff working in residential settings
• Governments often responded late, and their responses reflected their lack of understanding of these settings
• There was a lack of coordination between Commonwealth and State and Territory governments and agencies creating challenges for services in how to respond to the rapidly evolving pandemic

Access to information, training, PPE, testing and tracing

• In the absence of leadership from government, services developed their own pandemic response plans
• Access to information and training was challenging, placed pressure on staff and took considerable time with some providers paying for specialist infection control advice and support
• While online training was available, interviewees emphasised the importance of practical hands-on training to consolidate learning
• Senior managers and TLs reported that in some cases, workers lacked confidence or were not prepared to work in COVID positive settings, sometimes because they thought other workers were not complying with COVID-safe practices
• Access to PPE was difficult even when it was possible to claim through participants’ plans, with services and staff purchasing their own
• Some services reported doing their own contact tracing when COVID-19 cases occurred because there were considerable delays in the Victorian Department of Health and Human Services (DHHS) contacting them
• Communications within organisations was challenging, with TLs feeling the responsibility for communications fell to them; particular difficulties were encountered with casual and agency staff
• TLs and DSWs were responsible for communicating with residents, sometimes developing their own resources with the support of therapists
• COVID-19 resulted in additional expenditure by services and extra hours by staff in order to provide information and training and PPE

Impact of COVID-19 on the health and wellbeing of residents, staff and families

• Interviewees reported that some residents found being at home preferable to going to their day programs and were likely to seek new options when public health restrictions were reduced
• TLs and DSWs reported that residents’ lack of contact with other people through employment, family visits, and in the community impacted on the mental health and wellbeing of residents and sometimes saw escalation of behaviours of concern or new behaviours emerge
• Interviewees noted the additional pressures on families unable to visit family members living in disability residential settings and the challenges for families who were unable to use respite services they had access to prior to the pandemic
• TLs and DSWs also reported mental health problems, which they felt went unrecognised although some found innovative ways to support each other
• Financial pressures were also noted by staff who could not access JobKeeper and who had reduced hours during the pandemic with flow on effects for their mental health

To read about our recommendations, download the full report here

Researchers

Ms Marie Huska, University of Melbourne
Professor Helen Dickinson, UNSW Canberra 
Professor Anne Kavanagh, University of Melbourne
Dr Alexandra Devine, University of Melbourne
Ms Stefanie Dimov, University of Melbourne

Funding

Centre of Research Excellence in Disability and Health (CRE-DH)
Disability and Health unit, University of Melbourne

Research Publications

Huska M, Dickinson H,  Kavanagh A, Devine A & Dimov S (2021). Managing outbreaks of COVID-19 in residential disability settings: Lessons from Victoria’s second wave - Research Report. Melbourne: The University of Melbourne. https://doi.org/10.26188/14669568