Education Update: Serious Incident Response Scheme (31 March 2021)

The Serious Incident Response Scheme effective from 1st April 2021 is administered by the Aged Care Quality and Safety Commission (the Commission). The purpose being to set new arrangements for providers of residential aged care, including flexible care provided in a residential setting, to manage and take reasonable steps to prevent incidents, with a focus on the safety, health, well-being and quality of life of aged care consumers.

SIRS includes both incident management and reportable incident obligations includes reports of all incidents that are alleged or suspected to have occurred, or witnessed between consumers of an aged care service, including where the consumers who commits the incident has a cognitive or mental impairment (such as dementia).

Effective from 1st April 2021 all providers of residential aged care must report all ‘Priority 1’ incidents within 24 hours.

Priority 1 incidents include those that cause or could reasonably have caused physical or psychological injury or illness requiring some form of medical or psychological treatment, including instances of unexplained absence from care and unexpected death.

From 1st October 2021, all ‘Priority 2’ incidents (those that do not meet the criteria of ‘Priority 1’) must be reported within 30 days.

What is a reportable incident under the Serious Incident Response Scheme?

Reportable incidents include those listed below.

Serious incidents include those where consumer experience:Examples include:
Unreasonable use of forceHitting, pushing, shoving or rough handling
Unlawful sexual contact or inappropriate sexual conductSexual threats or stalking, or sexual activities without consent
NeglectWithholding personal care, untreated wounds, or insufficient assistance during meals
Psychological or emotional abuseYelling, name calling, ignoring a consumer, threatening gestures or refusing consumer access to care or services as a means of punishment.
Unexpected deathIn the event of a fall, untreated pressure injury, or when the actions of a consumer result in the death of another consumer.
Stealing or financial coercion by a staff memberIf a staff member coerces a consumer to change their will to their advantage or steals valuables from the resident.  
Inappropriate physical or chemical restraintWhere physical or chemical restraint is used without prior consent or without notifying the consumer’s representative as soon as practicable; where physical restraint is used in a non-emergency situation; or when a provider issues a drug to a consumer to influence their behaviour as a form of chemical restraint.
Unexplained absence from careThis occurs when the consumer is absent from the service, it is unexplained and has been reported to the police.

Who do I report the incident to?

For EENs, RNs and CNCs, the appropriate point of contact would be their immediate supervisor or the Director of Nursing. All HHG staff are reminded that any incidents of abuse should also be reported to the agency for appropriate follow up.  The facility manager will report the incident to the Aged Care Quality and Safety Commission within 24 hours of receiving report.

Home Care Worker’s will report directly to the Heather Hill Group (HHG) call centre and this will be referred to the Care Coordinator or Manager.

What happens after the allegation has been reported to the Director of Nursing or HHG?

Like any other incident, you are required to document the allegation in the appropriate documentation for that facility.  If you are unsure of what is required at the particular facility you are working at, please remember to ask permanent staff.  HHG has its own documentation and you will be required to document your observations and actions on that Performa.

What details need to be included in a report?

The following details should be included in any report of an abuse incident:

  • Full description of the incident
  • Note down if there were any witnesses
  • Note down any injury sustained, and the immediate action taken
  • Has the consumer been removed from danger and located to a safe place?
  • Has the Medical Officer been notified?
  • Have relatives been notified?
  • Determine whether the alleged offender is cognitively impaired.  If the offender is cognitively impaired then interventions are to be put in place within 24 hours of the incident occurring.  Interventions are to be appropriately recorded such as nursing plans.

What are the Employer’s responsibilities?

The employer has a responsibility to protect the identity of the resident, the person making the disclosure and the alleged offender.  The employer also has a responsibility to provide support to all three and make available to all any assistance they may require.

What should I do if I think someone is being abused?

Don’t jump to conclusions but if any of these signs are present there is cause for concern which you must report to your supervisor.  Report a potentially abusive situation if:

  • There is a change in behaviour or mood or any of the signs mentioned
  • You observe someone behaving towards an older person in a way that makes you feel uncomfortable
  • An older person tells you that they are being abused
  • An older person, staff member or visitor tells you that they have observed abusive acts
  • You observe an action or inaction that may be considered abusive
Never dismiss what a person with dementia tells you as mere “dementia talk”

What happens if I report the incident?  Will I be victimised by fellow staff or the organisation?

NO – Staff members who report such cases will not be victimised in any way.  If you have any concerns, please contact HHG immediately.

What are the reporting requirements?

You are required to report immediately to your supervisor any abuse that you have witnessed or any allegations that have been reported to you.   Even if the allegation is made over the weekend or outside business hours, you have a responsibility to report the alleged incident straight away to the immediate supervisor (i.e. RN, EEN or Home Care Co-ordinator). 

All HHG staff are reminded that any incidents of abuse should also be reported to the agency for appropriate follow up.  The Facility’s’ management team have a legal obligation to report the incident to the Aged Care Quality and Safety Commission within 24 hours of receiving a report.

Are there any exceptions to my reporting requirements?

There are no exceptions.  All cases need to be reported to your immediate Supervisor.  You are not in a position to make a “judgement call” or wait until an investigation has been made to determine whether abuse has occurred or not. If you see staff members, relatives, residents, or anybody else inflict abuse on residents, you must report the incident immediately.

What will happen if I do not report allegations of abuse?

If you do not report the allegation you will be in breach of the Aged Care Act 1997.   Due to the severe nature of these incidents if allegations of abuse are not formally reported to a supervisor or HHG, disciplinary action could lead to your termination of employment.

How would I know if someone is being abused?

Apart from obvious signs of physical abuse, a person experiencing abuse may be:

  • Afraid of a particular person or people
  • Worried and anxious for no obvious reason, irritable and overly emotional
  • Appearing helpless, hopeless, and sad
  • Using contradictory statements, not because of mental confusion
  • Reluctant to talk openly, withdrawn, self-isolation
  • Avoiding physical, eye, or verbal contact

How to respond to an abusive situation:

If there is an immediate threat to someone:

  • Remain calm
  • Consider whether you can safely take immediate action to stop the abuse occurring, without endangering the older person, yourself, or other people
  • Alert other staff
  • Report to or get someone else to contact your supervisor immediately
  • Reassure and comfort the person

After taking the necessary immediate action:

  • If a sexual assault has taken place, ensure the older person does not wash or shower before medical or police officers attend the scene
  • Do not disturb the area or remove any items involved in the incident
  • Record your observations or discussions with (or about) the older person that might indicate abuse has occurred, or complete an incident form
  • Don’t ask extra questions or investigate in any way – that’s not your job
  • Tell your supervisor any additional changes or concerns that you think of later