The scope for incidents to be reported by residential care providers to the Government’s new Serious Incident Response Scheme (SIRS) being rolled out in early 2021 in response to the Royal Commission’s special COVID recommendations will be wide.
According to the 17-page implementation paper updated on Friday, the definition of a ‘serious incident’ includes:
- Unreasonable use of force – including hitting, pushing, shoving and rough handling by staff (this will also be expanded to remove the current reporting exemption for consumers with an assessed cognitive impairment).
- Unlawful or inappropriate sexual contact – including masturbation, sexual innuendos, sexually explicit language, grooming, stalking or making sexual threats and sexual assaults by staff.
- Psychological or emotional abuse – including yelling, name calling, ignoring a consumer, feigning violence, threats to withhold care or services, threatening gestures, punishing a consumer by refusing access to care or services, making disparaging comments about a person’s gender, sexual orientation, sexual identity, cultural identity or religious identity and repeatedly flicking, tapping, bumping etc. a resident by staff.
- Unexpected death – including a consumer falling while being moved or shifted by staff, with the injuries sustained resulting in the consumer’s death.
- Stealing or financial coercion by a staff member – including staff coercing a consumer to change their will in favour of them or stealing money or valuables from a resident.
- Neglect – including staff withholding personal care such as showering or oral care, leaving wounds untreated, leaving maggots on/in the consumer and leaving a resident outside unprotected in the sun resulting in significant burns and the provider not ensuring that a consumer’s meals are appropriately modified to account for their difficulty of swallowing (dysphagia) as recorded in their care plan, or providing insufficient assistance to the consumer to eat their food, resulting in the consumer either not being able to eat meals or the consumer choking.
- Inappropriate physical or chemical restraint – including a provider using physical restraint on a consumer, when it is not an emergency and the provider does not seek prior informed consent, when they do not inform the consumer’s representative as soon as practicable after the restraint starts to be used, or when a provider administers a drug to a consumer for the purpose of influencing their behaviour as chemical restraint and the consumer’s representative was not informed before the drug was administered, or shortly afterwards.
- Unexplained absence from care.
The only matters not considered serious incidents are what is termed “reasonable management or care of an aged care consumer taking into account any relevant code of conduct or professional standard that applied at the time”.
This could include a staff member raising his or her voice to attract attention or speak with an aged care resident who has hearing difficulties; when there is accidental contact (unless it is negligent); a resident alleging they had a blanket put on them that was tucked in too tightly, or a resident being grabbed to remove them from harm, like stepping onto the road or into traffic.
Serious incidents will also be treated separately to critical incidents where residents need to be admitted to hospital, pass away or have a significant physical or psychological impairment as a result.
Critical incidents will need to be reported within 24 hours – along with unexplained absences from care – to the Commission from early 2021, with all other serious incidents required to be reported within 30 days to the Commission from 1 July 2022.
As we reported here, the Department of Health is currently running a study to look at how to expand the scheme into home and community care.
Given the wide range of incidents that can happen in the home, we imagine its final list of reportable incidents will be even higher
