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About the Serious Incident Response Scheme (SIRS)

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There are three major components of SIRS that must be implemented by aged care providers:

There are three major components of SIRS that must be implemented by aged care providers providing care and services to consumers in home and community settings.

 

About SIRS

The SIRS is an initiative to help prevent and reduce incidents of harm to consumers and other people in Commonwealth-funded aged care services. There are three major components of SIRS that must be implemented by aged care providers providing care and services to consumers in home and community settings.

 

1

Incident management obligations

You must have effective systems and practices in place for preventing and managing all incidents. This includes using an Incident Management System (IMS).

2

Continuous improvement

You must use the data from your IMS to drive quality improvement in your service.

3

Serious incident reporting and response

You must notify the Commission of any reportable incidents and report to police where there are reasonable grounds to do so, in addition to managing incidents through your IMS.

1

Incident management obligations

Providers must have effective systems and practices in place for preventing and managing all incidents and near misses. This includes using an Incident Management System (IMS).

2

Continuous improvement

Providers must use the data from their IMS to drive quality improvement in service.

3

Serious incident reporting and response

Your service must notify the Commission of any reportable incidents and report to police where there are reasonable grounds to do so, in addition to managing incidents through your IMS.

Under the SIRS, providers must take all reasonable steps to reduce the risk of serious incidents. This means you are required to:

Cycle made of five items: Identify and mitigate harm, Respond to incidents quickly and decisively, Support consumers impacted by serious incidents, Drive continuous improvement, and Reduce preventable incidents

Key Actions

  1. Make sure your service has an effective IMS

  2. Make sure your IMS supports you to drive continuous improvement

  3. Make sure you understand how and when to notify the Commission of reportable incidents

Key Actions

  1. Make sure you understand your IMS and how to use it

  2. Make sure you know your role and responsibilities in incident reporting and prevention

  3. Make sure you know where to find policies, processes and guidelines for your service

Key Actions

  1. Make sure your service has an effective IMS

  2. Make sure your workers can recognise when incidents are in connection with care

  3. Make sure your workers understand how and when to notify the Commission of reportable incidents

Incident management systems (IMS)

Your service’s IMS is a system that helps you to prevent incidents and identify, respond to and manage them and any near misses that occur during the course of delivering care and services to consumers. The IMS includes policies and procedures that you will use to prevent and manage incidents, the tools that you will use to document information about incidents and find solutions, and the training and culture you rely on to continuously improve safety.

What is an incident?

An incident is an act, event or omission that occurred (or was suspected to have occurred) and caused harm to a consumer, or another person, or could reasonably have been expected to have caused harm.

A near miss is when an act, event or omission happens that does not result in harm but had the potential to do so. This could be an injury, illness or danger to the health of a consumer or another person.

Both incidents and near misses must be captured by your IMS.

Your IMS should include all incidents that:

  • occur at your service
  • occur during the delivery of care and services to consumers, whether at your service or out in the community such as when attending appointments, going shopping or participating in activities
  • occur while workers are undertaking duties as part of their role.

 

Incident management systems (IMS)

An IMS is a system used to prevent, manage and respond to incidents. Your service must have an effective IMS to manage and respond to all incidents and near misses to minimise the risk of reoccurrence. It is important for you to be familiar with these processes so that you can report and/or record an incident or near miss in your IMS if that is part of your role.

What is an incident?

Incidents include any acts, events, or omissions that occur (or are suspected to have occurred):

  1. in connection with your provider’s service
  2. that have harmed, or could have been expected to harm, a consumer or another person.

Your home service provider must work to manage and prevent all incidents that occur in connection with care.

‘Home service’ refers to all home- and community-based or flexible care.

Incidents in connection with care

The home service environment presents unique challenges for managing incidents. You and your workers must understand the distinction between incidents that occur in connection with care, and those that do not. Incidents in connection with care include the following:

Incidents in connection with care

The home service environment presents unique challenges for managing incidents. You must understand the distinction between incidents that occur in connection with care, and those that do not. Incidents in connection with care include the following:

Incidents occurring during the provision of care

  • Includes incidents that happen during normal hours of service, typically when a worker is present with a consumer. 
  • Includes where subcontracted workers or organisations are providing service on your behalf.

Example - a consumer falls while being helped into the shower by a worker.

Incidents arising out of the failure to provide care

  • Includes incidents that occur due to the expected level of care not being met.

Example - A worker is late arriving at a consumer's home to drive them to an appointment for important treatment, causing the treatment to be delayed. 

Incidents that may not have occurred while services were being provided but are connected because the (potential) harm arose from the provision of services

  • Includes incidents that do not happen while a worker is providing care or services but are connected to the care or services. 

Example - Your worker has installed a grab rail in a consumer's shower, which collapses while a consumer is showering unassisted, injuring the consumer. 

Near Misses

near miss is a something that happens (or something that should happen but doesn't) that doesn't harm a consumer but has the potential to do so. 

You must record near misses in your IMS to help prevent similar incidents from happening in the future. 

Example

Ana is a consumer who receives home-based care from her provider. Part of the service provided includes installation of accessibility features in Ana’s home, including a grab rail in Ana’s shower.

Dan provides personal care in Ana’s home as part of the provider’s service. Ana advises Dan one morning she noticed that the grab rail in the shower had come loose overnight and no longer looked safe to use, however no harm had been caused.

Despite Ana not being directly harmed and the damage to the rail not occurring during Dan’s time at Ana’s home, Dan recorded the incident in his provider’s IMS. He then contacted the Case Manager for Ana to arrange for the grab rail to be fixed. He recognised that this incident was still in connection with care, as it was the provider’s responsibility to ensure that accessibility aids were safe to use.

Incidents not in connection with care

Workers may also witness incidents that are not connected with care. This may include acts committed by members of a consumer’s household or community who are not affiliated with you. While incident management and prevention requirements do not apply to these incidents, you still have a broader responsibility to protect the safety, health and wellbeing of consumers. You must take protective steps when you become aware of neglect or abuse (including suspected or alleged incidents) of consumers.

If an incident may be unlawful, such as a physical assault, or if there is any ongoing danger to any person, your service should contact the police.

You should also support consumers dealing with elder abuse or other issues by connecting them to further assistance, such as:

  • OPAN website – the Older Persons Advocacy Network provides free, confidential, and independent support to older people seeking or receiving care and their families or representatives.
  • 1800 ELDERHelp (1800 353 374) – a free and confidential National Elder Abuse phone line.

Incidents not in connection with care

You may also witness incidents that are not connected with care. This may include acts committed by members of a consumer’s household or community who are not affiliated with your service. While incident management and prevention requirements do not apply to these incidents, your service still has a broader responsibility to protect the safety, health and wellbeing of consumers. You must take protective steps when you become aware of neglect or abuse (including suspected or alleged incidents) of consumers.

If an incident may be unlawful, such as a physical assault, or if there is any ongoing danger to any person, your service should contact the police.

You should also support consumers dealing with elder abuse or other issues by connecting them to further assistance, such as:

  • OPAN website – the Older Persons Advocacy Network provides free, confidential, and independent support to older people seeking or receiving care and their families or representatives.
  • 1800 ELDERHelp (1800 353 374) – a free and confidential National Elder Abuse phone line.

Work tool

You can use the Finding Policies and Procedures worksheet to consider the policies and procedures for incident management and prevention at your service. If you cannot find a policy, please speak to your manager.

Example

While visiting his father in residential aged care, a consumer’s son noticed that the colour on the packet of insulin medication his father was about to be given was different to the usual colour. On mentioning this difference in colour, the Registered Nurse realised that the medication was not the correct insulin medication prescribed for the consumer.

The Registered Nurse recognised this as a near miss and recorded it in the service’s IMS.

The service investigated the near miss and applied systemic changes to respond to the issue that improved practice. These changes, designed to prevent a similar event from happening in future, were implemented and discussed with the consumer and his family.

Example

George is a carer for a home service provider who provides care for consumer Ray in his home. Ray regularly has family members in his home while George is carrying out his duties.

Ray has a son, Sam, who has been visiting more regularly in recent weeks. George noticed tension between Ray and Sam recently and overheard conversations in which Ray sounded uncomfortable. Later, Ray confided in George that Sam had been persistently asking for money and he felt pressured to give Sam access to his money.

This incident couldn't be managed under the SIRS, as it was not connected with the care they provide. Despite this, George and his manager came up with a plan to help Ray to access support. George was able to provide Ray with resources like the 1800 ELDERHelp Line and the OPAN website details. George would also continue to monitor the situation and check in with Ray.

Reportable incidents in connection with care

Reportable incidents include those that have harmed, or could have been expected to harm, a consumer in connection with care. These incidents must be reported to the Commission. See the Reportable incidents page for guidance.

An incident is not reportable if consumers have been unaffected. This includes where other individuals may have been harmed, such as workers or other household or community members. When in connection with care, such incidents must still be recorded and managed according to your IMS.

 

Reporting to police

If you become aware of an incident that is potentially or likely to be criminal in nature, this should be reported to the police. This should be reported regardless of whether the incident is in connection with care.

Reportable incidents in connection with care

Reportable incidents include those that have harmed, or could have been expected to harm, a consumer in connection with care. These incidents must be reported to the Commission according to your provider’s IMS.

Incidents where the consumer was not directly affected are not reportable to the Commission. This includes where other individuals may have been harmed, such as staff or other household or community members. When in connection with care, such incidents must still be recorded and managed internally according to your IMS. Speak with your manager to ensure you are aware of your role in managing reportable incidents.

Reporting to police

If you become aware of an incident that is potentially or likely to be criminal in nature, then the incident should be reported to the police. Report any such incidents to your manager, as these should be reported to police regardless of connection with care.

My rights and reporting

If you do not think your service’s response to a reportable incident is sufficient, you should raise your concerns with your manager if you feel safe to do so. If you do not feel safe to raise the issue with your manager, or if you are not satisfied with your service’s response, you also have the right to contact the Commission directly. This is known as disclosure.

Disclosure protection

The Aged Care Act (1997) contains protections for people who disclose reportable incidents. These protections extend to disclosures from former workers, current and former consumers, families, volunteers and advocates.

If the information you are disclosing is protected under these provisions, you are protected from both civil and criminal liability for making the disclosure. You are also protected from victimisation and may be compensated if you are threatened or if action is taken against you.

How does the SIRS fit in with your other obligations?

The SIRS is one element of the legal framework that supports the provision of quality care and services and a safe environment for consumers. It sits alongside and complements your other obligations as an approved provider, particularly the Charter of Aged Care Rights, the Aged Care Quality Standards and restrictive practices obligations in the Quality of Care Principles 2014.  

Legislative requirements

The Aged Care Quality Standards

Open disclosure - Standard 6: Feedback and complaints and Standard 8: Organisational governance

You must use an open disclosure process when things go wrong. This means that you should facilitate an open discussion with consumers (and their representatives) when something happens that has harmed or had the potential to cause harm to a consumer. You are also expected to practice open disclosure in the prevention and management of any incidents impacting consumers.

Standard 6. Feedback and complaints
Standard 8. Organisational governance

Clinical governance - Standard 8: Requirement (3)(e)

If your service provides clinical care, you must use a clinical governance framework. This is an integrated set of leadership behaviours, policies, procedures, responsibilities, relationships, planning, monitoring and improvement mechanisms that are implemented to support safe, quality clinical care and good clinical outcomes for each consumer.

 
Standard 8. Organisational governance

Incident Management - Standard 8: Requirement (3)(d)(4)

You must have effective risk management systems and practices in place, including the use of IMS.

Standard 8. Organisational governance
The Charter of Aged Care Rights

Consumers have the right to safe and high-quality care and services, the right to be treated with dignity and respect, and the right to live without abuse and neglect.  Providers are required to uphold these rights and ensure consumers in their care understand their rights under the Charter.

Quality of Care Principles Part 4A

Restrictive practices

You have specific obligations when considering or using restrictive practices. Any use of restrictive practices that is not in line with these obligations is a reportable incident under the SIRS.

Work tool

You can assess your service’s level of SIRS compliance using the SIRS worker readiness work tool.

For protections to apply, you must meet these requirements:
  • the disclosure is made to your service, a police officer or to the Commission
  • you have reasonable grounds to suspect that the information indicates a reportable incident occurred
  • you tell the person you are disclosing to your name (disclosures cannot be anonymous)
  • your disclosure is made in good faith.

If you want help understanding if a disclosure may be protected, you can contact the Commission.

Factsheet

The What is the SIRS? Information for home services care recipients explains what the SIRS is, what is expected of providers, what a SIRS reportable incident is and how to seek help if needed.

Contact us

If you have a question about the SIRS, you can call us on 1800 081 549.

This phone line is open 9 am to 5 pm (AEST) Monday to Sunday.

You can also email us at sirs@agedcarequality.gov.au.

Facilitated workshops

The Commission provides facilitated workshops to sector participants.

Online learning

The Commission’s Aged Care Learning Information Solution, Alis provides free online education for employees of Commonwealth-funded aged care providers, including modules covering the SIRS.

You can access Alis at learning.agedcarequality.gov.au.

Disclaimer

The information contained on this page is intended to provide you with general guidance; however, it is your responsibility to be aware of your legislative requirements.