What is Serious Incident Response Scheme (SIRS)?

This is a new Federal Government initiative to reduce the risk of abuse and neglect of the older Australian population in residential aged care services. This expands upon the pre-existing protection for older adults in residential homes offered by the Aged Care Act 1997.

What is the role of the scheme?

It was established upon the Australian Law Reform Commission (ALRC) recommendation to cover the situations not covered by the Aged Care Act 1997, emphasizing reporting, investigating, and responding to incidents.

It is geared towards ensuring service providers deliver safe and effective care to their customers and that customers are adequately supported if/when an incident occurs. 

The SIRS, when considered alongside the Aged Care Quality Standards, Open Disclosure Framework and Guidance and Charter of Aged Care Rights, help to ensure the responsibility and accountability of service providers in the management of incidents that occur in their facilities.

It is required that residential aged-care providers put an incident management system into practice. With which they are to identify, record, manage and resolve all serious incidents while putting in place mechanisms and precautions to prevent similar incidents from happening in the future.

 Using this information documentation and incident review method required by the SIRS, there is a positive drive for improvements in quality of service and safety of customers. This effectively strengthens aged care systems by reducing the risks of abuse and neglect and ensuring that people receiving aged care get the support they need.

Incident Management System

An incident Management system is a series of Procedures and processes to be followed in identifying, managing, and resolving incidents. An effective incident management system must be able to collect data that enables residential aged care providers to:

• Identify the occurrence of incidents
• Record the incidents
• Address issues in the quality of care provided
• Continuously improve both incident management and prevention in an iterative process
• Provide incident information to the aged care quality and service commission (as required)

The incident management system must have methods that clearly describe:

• Identification, recording, and reporting process for incidents
• How to take appropriate action in response to an incident to ensure the health, safety, and wellbeing of those affected by the Incident (including those whose allegations have been leveled against)
• When additional actions are to be taken and the nature of the actions
• Who within the organization is to report incidents to the Aged Care Quality and Safety Commission
• Reporting incidents to the police when necessary
• How involved customers and other relevant parties will be in the management and resolution of an incident.
• Approach to notifying customer’s family members and decision-makers when necessary
• Process for investigating incidents 

What are reportable incidents under the SIRS?

A reportable incident has occurred, alleged to have occurred or is suspected of having happened to a consumer, and was perpetrated by staff, family, friends, other visitors, or another Consumer (irrespective of said consumer's mental and cognitive state). The Incident must have occurred in connection with residential or flexible care provided in a residential setting.

 Any occurrence or allegation of any following items is to be reported to the Aged care Quality and Safety Commission.

• Unreasonable use of force; includes pushing, kicking, hitting, and rough handling of a consumer. 
• Unlawful sexual contact or inappropriate sexual conduct; includes stalking, non-consensual sexual activity, sharing an intimate image of a customer, etc.
• Unexpected death; occurs due to failure of preventive measures by the provider, e.g., falls or poorly treated pressure sores, clinical mistakes resulting in death, poor care and service delivery or not in line with best practices leading to death, etc.
• Psychological and emotional abuse; yelling at consumers, taunting, preventing access to care services as punishment, humiliation, etc
• Neglect; inadequate attention and assistance during meals, poor wound care, etc
• Inappropriate use of restraint; use of restraints without prior consent or without consumer's representative permission, drug issuance by a provider to control consumer behaviour, etc.
• Unexplained consumer absence; absence of consumer without explanation, with enough reason to warrant reporting this absence to the police
• Stealing or financial coercion by staff; stealing consumer valuables by staff, obtaining financial advantage at the expense of a customer by deception, and encouraging customers to give them gifts and/or money.

EXEMPTIONS

The provider may not have to report an incident when:

• The Incident is the same as a previous incident already registered under the SIRS, i.e., involving the same date, people, place, etc.
• The Incident was considered not a serious incident due to a user being cared for following relevant codes of conduct and professional standards, e.g., pulling a customer back quickly by a staff member to protect them from an oncoming vehicle.

Distinguishing Types of Incidents

Incidents can be classified into either priority 1 or Priority 2 incidents.

Priority 1 reportable incidents 

These are incidents  

• that caused or could have caused one physical and psychological injury enough to require medical or psychological treatment
• That involves an unexplained absence of consumers from the service
• That involves the unexpected death of a consumer

Priority 1 reportable incidents are to be reported to the Aged Care Quality and Safety Commission within 24 hours of awareness of the Incident by the service provider. Additional information not available within the first 24 hours should be provided within 5 calendar days of becoming aware of the Incident.

Priority 2 reportable incident

This includes any incident which does not meet the criteria for Priority 1. 

In these cases, the consumer's need for medical or psychological therapy is not required.

Priority 2 reportable incidents should be reported to the Aged Care Quality and Safety Commission commission within 30 days of the Incident's awareness by the service provider. 

An Excellent and Expository E-learning Programme On SIRS

Aged Care Learning Solutions have devised a fantastic e-learning programme on the Serious Incident Response Scheme (SIRS) to bring health workers up to speed on care for the aged and how to identify and reduce abuse and neglect of the senior population. This course is relevant for nurses and other health workers who provide geriatric services. To subscribe to this excellent e-learning programme, visit our website https://www.healthcarelink.com.au/cpd/listing/serious-incident-response-scheme-sirs/9855

References:

Serious Incident Response Scheme | Aged Care Quality and Safety Commission 

Serious Incident Response Scheme – Guidelines for residential aged care providers 

Serious Incident Response Scheme for Commonwealth-funded residential aged care. 

Serious Incident Response Scheme (SIRS) | Australian Government Department of Health 

Additional reading

Quality Standards 

Charter of Aged Care Rights (information for providers) 

Open disclosure Framework and guidance 

Aged Care Quality and Safety Commission