Serious Incident Response Scheme (SIRS)

All residential aged care consumers have the right to receive safe and high-quality care (ACQSC 2020).

In April 2021, a new federal government initiative known as the Serious Incident Response Scheme (SIRS) will commence, aiming to reduce the risk of abuse and neglect in residential aged care (ACQSC 2020).

The SIRS expands upon the protections to older adults in residential aged care currently offered by the Aged Care Act 1997.

What are the Current Requirements?

Under the Aged Care Act 1997, residential aged care providers are required to report alleged, suspected or actual reportable assaults to the police and Department of Health. This must be done within 24 hours of either an allegation or reasonable suspicion that a reportable assault has occurred (DoH 2019). ‘Reportable assaults’ include:

• Unlawful sexual contact (any non-consensual sexual contact, including cases where a consumer cannot give informed consent due to cognitive or mental impairment); and
• Unreasonable use of force (unwarranted physical contact, even if it does not cause visible harm).

(Ma 2020)

Notably, neglect, inappropriate physical and chemical restraint, intentional and reckless staff behaviour, and poor personal care are not listed as types of reportable assault under the Act (Ma 2020).

Furthermore, there are two situations in which residential aged care providers are not required to report a reportable assault, these being:

• If the perpetrator is a consumer who has been assessed to have a cognitive or mental impairment, and arrangements can be made to manage their behaviour within 24 hours; or
• The same (or essentially the same) incident has already been reported to the police and Department of Health.

(DoH 2019; Ma 2020)

Due to these exemptions, along with the narrow definition of ‘reportable assault’, there is concern that potentially-serious incidents are ‘falling through the gaps’, with the exact nature and frequency of these events unknown. Therefore, current legislation may not offer enough protection for older adults in residential aged care (DoH 2019; Ma 2020).

What is the Serious Incident Response Scheme (SIRS)?

The SIRS was established based on recommendations from the Australian Law Reform Commission (ALRC). The ALRC proposed that reportable incidents should be expanded to include situations that are not specified in the Aged Care Act 1997 and that greater emphasis should be placed on investigating and responding to incidents rather than reporting their occurrence (DoH 2019).

Under the SIRS, residential aged care providers will be required to identify, record, manage and resolve all serious incidents, as well as take appropriate steps to prevent similar incidents from occurring again in the future. The SIRS also requires providers to put into practice an incident management system (DoH 2020).

The SIRS aims to ensure that service providers deliver safe and effective care, and that consumers are adequately supported if an incident does occur. Through the implementation of an effective incident management system, providers should be able to respond to incidents more appropriately, provide consumers with access to support and continuously improve their services (ACQSC 2020; DoH 2019).

The SIRS will ensure that service providers are held responsible for managing incidents that occur in their facilities (DoH 2019).

The SIRS will sit alongside the Aged Care Quality Standards, Charter of Aged Care Rights and Open Disclosure Framework and Guidance (DoH 2020).

Incident Management Systems

Underpinning the SIRS is the importance of establishing an effective incident management system. This system should comprise processes and procedures for:

• Identifying, assessing, recording, managing and resolving incidents;
• Taking appropriate action in response to incidents (e.g. removing consumers from harm, documenting, reporting);
• Reporting incidents to the Aged Care Quality and Safety Commission;
• Reporting incidents to the police if necessary;
• Notifying consumers’ families and decision-makers if necessary;
• Supporting consumers who have been affected by incidents to ensure their health, safety and wellbeing (including those whom allegations have been made against);
• Involving consumers and other relevant parties in the management and resolution of incidents (in accordance with open disclosure principles);
• Investigating incidents or participating in external investigations;
• Taking and monitoring corrective actions; and
• Using incident data to facilitate continuous improvement and prevent similar incidents from occurring again in the future.

(ACQSC 2020; DoH 2020b)

What are Serious Incidents Reportable Under the SIRS?

The SIRS covers situations where an incident has been perpetrated against a consumer, by either a staff member, family member, visitor or another consumer (even if that consumer has cognitive or mental impairment) (DoH 2020a, b).

Any allegation, suspicion or witness account of the following will be required to be reported to the Aged Care Quality and Safety Commission:

(ACQSC 2020; DoH 2020b)

Exemptions

Providers are not required to report an incident if:

• The event is assessed not to be a serious incident, as the consumer was being reasonably cared for or managed in line with relevant codes of conduct and professional standards (e.g. a consumer stepping on the road into traffic and being grabbed by a staff member to remove them from harm); or
• The incident relates to or is essentially the same as a previous incident that was reported under the SIRS (same date, time, people involved etc.).

(DoH 2020b)

Additional Resources

• Aged Care Quality and Safety Commission, Serious Incident Response Scheme
• Australian Department of Health, Serious Incident Response Scheme for Commonwealth-funded Residential Aged Care - Model for Implementation

References

• Aged Care Quality and Safety Commission 2020, Serious Incident Response Scheme, ACQSC, viewed 11 January 2021, https://www.agedcarequality.gov.au/consumers/serious-incident-response-scheme
• Australian Department of Health 2019, Serious Incident Response Scheme for Commonwealth-funded Residential Aged Care, DoH, viewed 11 January 2021, https://agedcare.royalcommission.gov.au/system/files/2020-06/RCD.9999.0174.0021.pdf
• Australian Department of Health 2020b, Serious Incident Response Scheme for Commonwealth-funded Residential Aged Care - Model for Implementation, DoH, viewed 12 January 2021, https://www.health.gov.au/sites/default/files/documents/2020/10/serious-incident-response-scheme-for-commonwealth-funded-residential-aged-care-model-for-implementation_0.pdf
• Australian Department of Health 2020a, Serious Incident Response Scheme (SIRS), DoH, viewed 11 January 2021, https://www.health.gov.au/initiatives-and-programs/serious-incident-response-scheme-sirs
• Ma, J 2020, ‘New Serious Incident Response Scheme: What we Know so Far About Aged Care Providers’ Obligations’, Aged Care Essentials, 30 June, viewed 11 January 2021, https://www.agedcareessentials.com.au/news/new-serious-incident-response-scheme-what-we-know-so-far-about-aged-care-providers-obligations