There are likely more than 52,000 unreported incidents of resident on resident abuse in aged care facilities nationally every year, according to a recently released study commissioned by the Federal Government.

Business advisory firm KPMG undertook a prevalence study of incidents of abuse between residents exempt from current reporting requirements as part of its preparatory work for the new Serious Incident Response Scheme (SIRS).

The Prevalence Study for a Serious Incident Response Scheme (SIRS) final report recommends two options for future reporting of the incidents with the most victim impact.

The final report was handed to the Federal Government in November 2019 but only released last week ahead of a $23 million funding announcement to rollout the new scheme from July 2021 (read more here).

  • Read our SIRS backgrounder here

Providers must report an allegation or a suspicion of a “reportable assault” on residents, which is defined under the Aged Care Act as unlawful sexual contact or unreasonable use of force.

But there are exemptions including if the perpetrator has an assessed cognitive impairment and behaviour management has been implemented.

KPMG looked at the number of exempted resident on resident incidents that meet the definition of a “reportable assault,” known as Type 1 incidents, and other incidents between residents that don’t meet the definition, known as Type 2 incidents.

The study involved 178 residential aged care services, all of whom volunteered to participate.

It found 1,717 incidents of abuse between residents over six months from February 2019 including 1,259 Type 1 incidents and 455 Type 2 incidents.

Based on this, the report found the total number of incidents among Australia’s 2,717 residential aged care services each year is estimated to be 38,898 Type 1 incidents and 13,757 Type 2 incidents.

The study found the number of incidents reported varied across services including:

  • 28 services reported zero Type 1 incidents
  • 81 services reported zero Type 2 incidents
  • 18 services reported 15 or more Type 1 incidents
  • some services averaged zero incidents over a six month period and others averaged more than two Type 1 incidents per month.

For Type 1 incidents, the study found that 95 per cent were classified as unreasonable use of force and just over 4 per cent involved unlawful sexual conduct.

Most incidents involved pushing or shoving, kicking, hitting, punching, slapping, biting or burning (82 per cent).

There was also no victim impact recorded in the majority of incidents (59 per cent), a minor physical or psychological injury or discomfort in just over a third of incidents (35 per cent) and an injury or illness requiring hospitalisation in 1 per cent of cases.

Participation in the survey was not representative from a jurisdiction point of view but appeared to be representative from a remoteness perspective, the report said.

Smaller services were under-represented but the sample was more representative of services nationally when considering occupancy, rather than number of bed licenses per service, it said.

Recommendations for future reporting

Based on the findings, KPMG identified and analysed eight options for the future reporting of resident on resident incidents in a SIRS.

The two preferred options involve reporting:

  • Type 1 incidents of a ‘higher’ level of impact only
  • Type 1 unlawful sexual contact and all Type 1 unreasonable use of force associated with a higher level of impact only.

It found benefits associated with both of these options include the collection of information about serious residents not currently available and targeted reporting that could inform system level and service specific interventions.

They would also provide a lower volume of incidents for both the providers and the Aged Care Quality and Safety Commission to respond to.

“Both options would require services to be clear as to which specific incidents are in scope for reporting. As such, there will be a need for clear and simple tools and resources to help services understand new requirements, and education to embed the new practices should either of these options be implemented,” the report found.

Access the report here.

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