The Serious Incident Response Scheme (SIRS) is set to commence in early 2021. Here’s what residential aged care providers need to know.

According to The Department of Health, the new Serious Incident Response Scheme (SIRS) will start in early 2021. Today we summarise the key points of the SIRS, as laid out in the Department of Health’s Model for Implementation.

Overview

• The SIRS will place additional obligations on Aged Care Providers to have organisation-wide systems and processes to identify, record, manage and resolve incidents and report serious incidents.
• The SIRS will impose a system of mandatory reporting of alleged, suspected or actual serious incidents.
• Reporting under the SIRS will include a broad range of incidents, including neglect, psychological or emotional abuse and inappropriate physical or chemical restraint.
• The current exemption on mandatory reporting of resident on resident abuse where the perpetrator has an assessed cognitive impairment, will be removed.
• The Aged Care Quality and Safety Commission (ACQSC) will receive incident reports and will have enhanced powers to take regulatory action where needed.

What is the Serious Incident Response Scheme (SIRS)?

The SIRS is a national framework for incident management and reporting of serious incidents in residential aged care. It imposes obligations on aged care providers to manage and report on incidents, and expands the powers of the ACQSC.

When will the SIRS commence?

The government estimates the SIRS will commence in early 2021. The originally scheduled date was July 2021 but the date was brought forward as part of the government’s response to the Royal Commission into Aged Care Quality and Safety.

Implementation of SIRS mandatory reporting will be staged. From early 2021, aged care providers will be required to report to the ACQSC critical incidents and unexplained absences from care. Aged care providers will be required to report all other serious incidents to the ACQSC from 1 July 2022.

Aged Care Providers’ responsibilities under the SIRS

The SIRS is not just about how well an aged care provider responds to a particular incident. It is about the kinds of systems and processes that the provider has in place.

According to the Model for Implementation, the SIRS will require aged care providers to maintain organisation-wide risk management and governance systems and processes to:

• identify, assess, record, manage and resolve all incidents
• report alleged, suspected and actual serious incidents to the ACQSC
• report incidents to police where necessary and notify families and decision makers as required
• plan and provide the support and assistance to consumers affected by an incident (including those subject to allegations) to ensure the consumer’s health, safety and well-being
• engage a consumer and others affected by an incident in the management and resolution of the incident, in line with open disclosure principles
• conduct an investigation or contribute to an external investigation
• implement and monitor corrective actions taken; and
• use incident data to drive continuous improvement and prevent similar incidents from reoccurring.

Mandatory Reporting – what kinds of incidents will providers have to report?

Under the SIRS, aged care providers will have to report “serious incidents” to the ACQSC (and sometimes the police). According to the Model for Implementation, a serious incident is an alleged, suspected or actual occurrence of one of the following, where the person affected by the incident is a consumer in residential aged care:

• Unreasonable use of force
• Unlawful or inappropriate sexual conduct
• Psychological or emotional abuse
• Unexpected death
• Stealing or financial coercion by a staff member
• Neglect
• Inappropriate physical or chemical restraint
• Unexplained absence from care

Serious incidents will include acts perpetrated by consumers with a cognitive impairment

Before the SIRS, there was a “reporting exemption” that applied to acts committed by consumers with an assessed cognitive impairment. In broad terms, this meant that if a consumer with an assessed cognitive impairment did an act involving unreasonable use of force or unlawful or inappropriate sexual contact, the provider was not required to report it. Under the SIRS, that exemption will not apply. Aged care providers will have to report the incident, regardless of the consumer’s cognitive impairment.

Serious incidents of “psychological or emotional abuse” will include patterns of behaviour

Under the SIRS, “psychological or emotional abuse” will include incidents that may not be “serious” on their own but which, due to their repetition over time, have a cumulative impact that causes significant harm to the consumer.

What is not a serious incident?

The Model for Implementation says that an incident is not a “serious incident” if it involves “reasonable management or care of an aged care consumer taking into account any relevant code of conduct or professional standard that applied at the time.” For example:

• if a staff member raises his or her voice to attract attention or speak with an aged care consumer who has hearing difficulties
• when there is accidental contact (unless it is negligent)
• where a resident taps another resident on the hand as the result of a disagreement for example over a bingo card
• a resident alleges they had a blanket put on them and it was tucked in too tightly
• a resident being grabbed to remove them from harm for example stepping onto the road into traffic.

The SIRS reporting process

As part of the SIRS reporting process, aged care providers will be required to categorise incidents based on the impact to the person affected by an incident as either: “critical incidents” (higher impact) or “all other serious incidents” (low or no impact).

Critical incidents

Critical incidents will require a two-stage reporting process:

• Incident notification (and reporting to police where necessary) – to be provided to the ACQSC (and police if necessary) within 24 hours of the aged care provider becoming aware of the incident.
• Incident status report – to be provided to the ACQSC within five business days of the date of incident notification, or within another timeframe as specified by the ACQSC.

The ACQSC may decide that the incident status report is not required.

The ACQSC may decide that on top of the notification and incident status report, a final report is also required. The final report will be required within 60 business days of submitting the incident report (or a different period specified by the ACQSC).

All other serious incidents

All other serious incidents will require a one-stage reporting process:

• Incident report – to be provided to the ACQSC within 30 days of the provider either suspecting or becoming aware of the alleged or actual incident.

What Now?

There may be only a few months left before aged care providers are legally required to meet their obligations under the SIRS. Here’s some things to consider while you prepare:

• Review your internal incident reporting systems – are they sufficiently accessible by persons who can make a report? Is there an escalation process in the incident reporting process to ensure timely notification of the right people (e.g. management team)?
• Have you got clear reporting and recording procedures that all staff have been trained on?
• Have responsibilities for reporting been delegated?
• Are there policy review procedures in place to ensure your internal reporting policies can be updated efficiently when the changes come?
• Does your internal incident system provide you with the data, information and reports required to ensure timely and appropriate system improvements and expected resident outcomes?
• In conjunction with this, do these systems and the recorded information support the SIRS reporting process?

Most importantly, remember: the SIRS is not just about how well you respond to a particular incident. It is about the kinds of systems and processes you have in place.