RESIDENTIAL CARE FACILITIES: COVID-19 & HEALTH, SAFETY AND WELFARE AT WORK GUIDELINES.

The Health Protection & Surveillance Centre (HPSC) has published detailed guidance for residential care facilities who are facing an outbreak of COVID-19 within their premises. The guidelines assist a residential care facility in the prevention and control of an outbreak of COVID-19. The guidelines published state:

“While this guideline focuses on Residential Care Facilities, the principles are applicable to many settings including residential facilities for people with physical and mental disabilities, other community-based health facilities (e.g. drug and alcohol services, community mental health) and any other setting where residents sleep, eat and live, either temporarily or on an ongoing basis”

In addition to the HPSC guidelines, Ireland has in place health and safety legislation to address the crisis currently facing workers at risk to exposure and infection of COVID-19. Employers who operate a facility such as a residential care home where there is a risk of infection must comply with the Safety, Health and Welfare at Work (Biological Agents) Regulations 2013. COVID-19 is considered to be a biological agent which is defined in the regulations as “one that causes severe human disease and is a serious hazard to employees and that may present a high risk of spreading to the community”.

Employer’s Risk Assessment & Exposure to COVID-19

The Safety, Health and Welfare at Work (Biological Agents) Regulations 2013 (“the regulations”) and the associated Code of Practice issued by the Health & Safety Authority address the protection of employees exposed to biological agents including COVID-19 at their place of work. Employers should note that although the Code of Practice relating to biological agents is not legally enforceable, Section 61(2) of the Safety, Health and Welfare at Work Act 2005 provides that any “failure to observe a code of practice” shall be admissible in evidence.

The Health and Safety Authority has published the following on their websiteIn workplaces where the nature of the work poses an occupational exposure health risk to COVID-19 such as healthcare and laboratory settings, employers are required to ensure that detailed biological agents risk assessments are carried out. These will need regular review and updating and will be based on current best practice in relation to infection prevention and control”.

The regulations impose an obligation to carry out a risk assessment in circumstances where the work that an employee is engaged in is likely to involve a risk of exposure to COVID-19. Employers are obligated to ensure that the number of employees exposed or likely to be exposed are kept to a minimum. The regulations further impose an obligation on an employer to ensure that work processes and control measures are applied in order to minimise the spread of the disease within the workplace.

An employer is required to ensure that each employee is provided with sufficient and appropriate training in line with all current safety advice available. Specifically the regulations state that the following instructions and information must be provided to an employee:

“(a) potential risks to health, (b) precautions to be taken to prevent exposure, (c) hygiene requirements, (d) wearing and use of suitable work clothing, special protective clothing and personal protective equipment, and (e) steps to be taken by employees in the case of incidents and to prevent incidents”

Residential Care Facilities & Outbreaks of COVID-19

The Infectious Diseases Regulations 1981 were amended on 28th February 2020 to take into account the onset of COVID-19 which is now a notifiable disease. The Infectious Diseases Regulations require a medical practitioner to notify the regional Medical Officer of Health (MOH) “as soon as he becomes aware or suspects that a person on whom he is in professional attendance is suffering from or is the carrier of an infectious disease”.

In relation to an outbreak of COVID-19, the guidelines prepared by the Health Protection & Surveillance Centre notes that the primary responsibility for managing an outbreak of COVID-19 lies with the residential care facility. The guidelines also highlight the legal obligation placed upon residential care facilities to report an outbreak to the regional Medical Officer of Health.  Importantly, the guidelines define an outbreak of COVID-19 as instances where two or more cases of infection have been acquired within the same residential care facility or instances where there is one confirmed case and other residents are either awaiting testing in itself or on the results. The guidelines also note that clinical judgment should be applied where there has been an acute onset of atypical symptoms associated with COVID-19. The guidelines emphasise that “All outbreaks of COVID-19 in Residential Care Facilities must be reported to the regional Medical Officer of Health (MOH) at the Department of Public Health at the earliest opportunity”.

Employers must continue to be aware of the most up to date official guidance issued from the Department of Health and associated government departments. You may access the guidelines prepared by the Health Protection & Surveillance Centre for residential care facilities by visiting www.hpsc.ie. You may also access the Code of Practice issued by the Health & Safety Authority relating to the protection of employees exposed to biological agents at work by visiting www.hsa.ie.