It is important that staff know what the definitions under SIRS are, understand what they may look like in aged care, know what to do and how to report and record when an allegation, suspicion or actual occurrence happens. The following are the top ten things providers should be aware of in preparation for April 2021.
1. What is SIRS?
The Serious Incident Response Scheme (SIRS) establishes a national framework for incident management and reporting of incidents.
SIRS defines a ‘reportable incident’ very broadly, and places a more detailed focus on a provider’s response to an incident, including:
- The supports a provider puts in place for impacted aged care consumers;
- Expectations for open disclosure when harm has occurred;
- Actions taken by the provider to continuously improve and reduce the likelihood of incidents reoccurring; and
- The way providers use information about incidents to inform organisation wide management of these risks, feedback and education to staff and to improve the service’s capability to prevent, manage and resolve incidents.
2. When is it scheduled to commence?
The SIRS Bill went before Parliament in December 2020.
It is largely anticipated that the Bill will pass unamended or with very few amendments when the Parliament returns in February.
Obligations for providers commence on 1 April 2021.
3. Enforcement Powers under the SIRS
The SIRS expands upon the authority of the Aged Care Quality and Safety Commission (ACQSC) and expands its enforcement powers to include:
- Civil penalty provisions;
- Infringement notices;
- Enforceable undertakings;
- Injunctions;
- Compliance notices; and
- Penalties for failure to comply with requirements for the production of information or documents.
4. Supporting staff – Definitions
‘Serious incidents’ required to be reported under SIRS are much broader than the current compulsory reporting requirements.
Under SIRS, staff of providers are required to report all instances where a serious incident is alleged to have occurred, suspected of occurring and actually occurred.
The SIRS defines a serious incident as including an allegation, suspicion or actual instance of:
- Unreasonable use of force;
- Unlawful inappropriate sexual contact;
- Psychological and or emotional abuse;
- Unexpected death;
- Theft or financial coercion by a staff member;
- Neglect;
- Inappropriate physical or chemical restraint; and
- Unexplained absence from aged care.
Serious incidents include incidents perpetrated by staff, other residents, family members and visitors.
Previously there were exemptions which did not require incidents of abuse or aggression perpetrated by a resident who had a cognitive impairment to be reported. This exemption has been removed.
Staff who are unfamiliar with the definitions under the SIRS may fail to identify, appropriately respond to, and effectively document a serious incident.
5. Supporting staff – Review of incidents
The SIRS requires providers to have a robust system to review and identify patterns of behaviour or repetitive behaviours that over time may cause harm to a resident.
6. Reporting – What to report
Providers must have procedures in place to enable the effective, thorough and timely reporting of all suspicions, allegations and actual occurrences of serious incidents.
Staff who have a practical understanding of what a serious incident may look like in residential aged care generally and in the context of your services, will be better equipped to identify and appropriately document them should they arise.
The proposed SIRS includes a protected disclosure regime for those who provide information related to a reportable incident .
7. Reporting – When to report
The SIRS Model for Implementation distinguishes reporting timeframes unexplained absences, critical incidents and serious incidents as follows:
| Incident | Report to | Timeframe for Report |
|---|---|---|
| Unexplained Absence | Police | As soon as possible after the absence has been identified |
| ACQSC | Unchanged from current requirements. As soon as reasonably practicable but no later than 24 hours after the absence was reported to the police. |
|
| ACQSC | Unchanged from current requirements. As soon as reasonably practicable but no later than 24 hours after the absence was reported to the police. |
|
| Critical Incident | Police (if the incident is of a criminal nature) | Within 24 hours of the provider becoming aware of the incident |
| ACQSC | Part A Initial Report Within 24 hours of the provider becoming aware of the incident |
|
| ACQSC | Part B Incident Status Report Five Business days or by the date specified by the ACQSC |
|
| ACQSC | Part C Final Report 60 Business Days after the Incident Report (Part A) is submitted, or a different date as specified by the ACQSC. Final Report to include:
|
|
| Serious Incident | ACQSC | Within 30 days of the provider either suspecting or becoming aware of the alleged or actual incident. NB days not business days. |
8. Reporting – What records must be kept
The SIRS Bill does not foreshadow any significant changes to the Records Principles 2014, meaning that providers will still be required to keep a general record of each incident, including the date, a brief description and the actions undertaken by the provider in response to the incident, for all incidents irrespective of whether it is a ‘serious incident’.
9. Reporting – Public reporting by the ACQSC
Public reporting of the data collected by the ACQSC is proposed to include annual reporting and trend reporting, including:
- Number of reports received annually;
- Collation of data on reports including report type, category of incident, who reported, who was the alleged, suspected or actual perpetrator, and identify incidents that were found to be unsubstantiated;
- Action taken by the ACQSC including the data related to the enforcement actions taken by the ACQSC; and
- Actions undertaken by providers to resolve and manage incidents.
10. Steps you may consider taking now to prepare
Now is the time for providers to reflect on whether it is enabling the first line of defence, providing its staff with policies, training, tools and resources to implement and comply with what will be required come 1 April 2021.
- Consider starting now to familiarise staff with the SIRS and ‘serious incidents’ through scenario based training, Information Sheets, tools and resources;
- Review your escalation procedure to ensure that it clearly encourages staff to escalate matters if they are ‘in doubt’;
- Review your incident management system reporting tools, are they robust and do they include scope to report allegations, suspicions as well as actual occurrences of serious incidents;
- Review your incident management system to determine if there are workflows or alerts to ensure that your systems can accommodate the proposed reporting timeframes;
- Review processes within your Clinical and Quality Teams, do they specifically include requirements for trend analysis and identification of patterns of behaviour in respect of incidents, or is it just done as part of business as usual?
- Reinforce and remind staff of the importance of quality, contemporaneous and thorough documentation.
How we can assist you
Our team is experienced in assisting providers of aged care services. Please do not hesitate to contact Sabine or Tamie to discuss how we can assist your organisation with practical solutions for your staff so they have the tools to ensure your organisation can efficiently demonstrate how you comply with your obligations.
This article was written by Sabine Phillips, Partner and Tamie Duncan-Bible, Senior Associate.