SIRS introduced to home care

From Thursday 1 December, the Serious Incident Response Scheme will apply in home care service settings – both home care and flexible care.

In operation in residential aged care settings since 1 April 2021, SIRS requires aged care providers to report Priority 1 incidents to the Aged Care Quality and Safety Commission within 24 hours of becoming aware of an event; Priority 2 incidents must be reported within 30 days.

Providers can utilise the SIRS decision support tool to determine the difference between Priority 1 and Priority 2 reportable incidents.

In all, there are eight types of reportable incidents under the SIRS:

• unreasonable use of force – for example, hitting, pushing, shoving, or rough handling a person who receives aged care
• unlawful sexual contact or inappropriate sexual conduct – such as sexual threats against a person who receives aged care, stalking, or sexual activities without consent
• neglect of a person who receives aged care – for example, withholding personal care, untreated wounds, or insufficient assistance during meals
• psychological or emotional abuse – such as yelling, name calling, ignoring a person who receives aged care, threatening gestures, or refusing access to care or services as a means of punishment
• unexpected death – where reasonable steps were not taken by the provider to prevent the death, the death is the result of care or services provided by the provider or a failure by the provider to provide care and services
• stealing or financial coercion by a staff member – for example, if a staff member coerces a person to change their will to their advantage, or steals valuables from them 
• inappropriate use of restrictive practices such as where a restrictive practice is used without prior consent or without notifying the person’s representative as soon as practicable; where a restrictive practice is used in a non-emergency situation; when a provider issues a drug to a person to influence their behaviour as a form of restrictive practice
• unexplained absence from care – where the person is absent from the service without explanation and there are reasonable grounds to report the absence to the police.

Speaking to Australian Ageing Agenda, CEO of the Aged & Community Care Providers Association Tom Symondson said: “The extension of the Serious Incidents Response Scheme to home and community care will improve the transparency and quality of information associated with the delivery of in-home care services to older Australians. It will also go some way towards informing the future design of in-home services.”

Mr Symondson said ACCPA supports the expansion of SIRS as it will assist providers and consumers to understand the nature and frequency with which serious incidents occur. “SIRS will also help to inform the strengthening of consumer protections for receiving care and support at home and in the community.”

Meanwhile, Older Persons Advocacy Network CEO Craig Gear told AAA SIRS was a really important initiative. “People receiving care in their home now have the same level of scrutiny over serious incidents that people in residential aged care have.”

Mr Gear said it’s important, moving forward, that home care workers are across the detail of the reporting scheme. “People need to be aware of the boundaries of the SIRS, they need to actually engage with older people and their families in relation to incidents, particularly in the response that the provider is doing to support the older person, deal with the incident and prevent it happening again.”

Guideline changes

Up until recently, incidents of a sexual nature could be lodged as both Priority 1 and Priority 2.

However, as of 3 October, the SIRS form in the My Aged Care service provider portal was changed so that providers can now only choose Priority 1 as an option when reporting incidents of a sexual nature.

Providers must also file a police report within 24 hours of incidents that are unlawful or considered to be of a criminal nature – such as sexual assault.

Recent guideline changes have also been made to questions about psychological or physical impacts of incidents. If reporting there was no impact from an incident, providers must now need to explain to the commission the rationale behind the assessment.

Other amendments to the guidelines include:

• replacing some references to ‘distress’ and ‘impact’ with ‘harm’ and/or ‘discomfort’ to align with aged care legislation
• more clearly defining ‘could reasonably have been expected to have caused’
• providing more guidance on the repeated use of restrictive practices.

A suite of resources have been developed to support home care service providers, their workforce and aged care recipients to understand their rights and responsibilities under SIRS.

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