Extension of SIRS to home care

From 1 December 2022, the Serious Incident Response Scheme (SIRS) will be extended to home care and flexible care delivered in a home or community setting.

Are you a home care provider preparing to implement the SIRS in your service? Read on to understand how these new obligations will apply to you.

What is the SIRS?

We have previously discussed the SIRS in an earlier blog post. The SIRS was introduced in the residential aged care setting on 1 April 2021, and was developed to ensure incidents of abuse and neglect of older people in residential care are appropriately dealt with and prevented. To learn more about the SIRS, click here to read our blog post from 2021.

New legislation has been introduced to extend the operation of the SIRS to home care and flexible care delivered in a home or community setting. This includes providers of Home Care Packages, CHSP services and flexible care services through which short-term restorative care is provided in a home care setting. 

The concept of the SIRS remains largely similar, however there are some key differences in how the scheme will operate in the home care context.

The legislation is currently in draft form, so please note that the following advice is subject to change.

What is required of providers?

From 1 December 2022, providers of home and flexible care must have an incident management system in place, and inform the Aged Care Quality and Safety Commission (the Commission) if a reportable incident occurs.

What is a reportable incident?

A reportable incident is:

  • an incident that has occurred, or is alleged or suspected of having occurred, in connection with the provision of care to a consumer;
  • the incident has caused harm, or could reasonably have been expected to have caused harm, to a consumer; and
  • the incident is one of the following types of incidents:
    • unreasonable use of force
    • unlawful sexual contact or inappropriate sexual conduct
    • psychological or emotional abuse
    • unexpected death
    • stealing or financial coercion
    • neglect
    • inappropriate use of restrictive practices, or
    • missing consumers.

For home services, this may include any incidents:

  • resulting from the action (or inaction) of a staff member of the provider (including subcontracted individuals or organisations, those managing care coordination, administration, etc. and volunteers),
  • that occur while care and services are being delivered to a consumer.

Classifying incidents (Priority 1 vs Priority 2)

All actual, suspected or alleged reportable incidents must be reported to the Commission. Incidents will fall into categories: Priority 1, or Priority 2.

Priority 1

A Priority 1 reportable incident is a reportable incident:

  • that caused, or could reasonably have been expected to have caused, a consumer physical or psychological injury or discomfort that requires medical or psychological treatment to resolve
  • where there are reasonable grounds to report the incident to police
  • involving unlawful sexual contact or inappropriate sexual conduct inflicted on a consumer
  • that is an unexpected death of a consumer, or
  • where a consumer goes missing in the course of provision of home services.

If you become aware of a reportable incident and have reasonable grounds to believe it is Priority 1 reportable incident, you must notify the Commission within 24 hours of becoming aware of the incident.

Priority 2

A Priority 2 reportable incident is any reportable incident that does not meet the Priority 1 criteria as described above.

All Priority 2 reportable incidents must be notified to the Commission within 30 calendar days of becoming aware of the reportable incident.

So, how does SIRS in the home care/flexible care setting differ from the residential setting?

As mentioned, many of the SIRS requirements for home/flexible care are consistent with the existing SIRS regime that applies to residential care. However, there a couple of key differences in the new application of SIRS for home care that you should note.

Additional reportable incident: missing consumer

The new legislation includes an additional type of reportable incident, to cover occurrences where:

  • a care recipient goes missing in the course of a provider providing home care, or flexible care provided in a community setting, to the care recipient; and
  • there are reasonable grounds to report that fact to the police.

The phrase ‘in the course of providing … care’ is significant; this definition is intended to capture situations where a provider has the consumer in their physical care immediately prior to the consumer going missing.

This definition is not intended to require providers to report to the Commission where a staff member arrives for a scheduled visit and the consumer is not present, or where a consumer leaves their home while home maintenance services are being provided, as an example.

Different definition of unexpected death for home care

The circumstances in which home care providers are required to report unexpected deaths are more limited than in residential care.

Home care providers will be required to notify any death where the provider (including staff and health professionals engaged by the provider):

  • made a mistake resulting in death; or
  • did not deliver care and services in line with a consumer’s assessed care needs, resulting in death; or
  • provided care and services that were poorly managed or not in line with best practice, resulting in death.

This definition differs from the definition used in residential care. This difference acknowledges that home care providers have limited control and visibility over a consumer’s day-to-day living circumstances when compared to residential care settings. Home care providers may not become aware of a consumer dying until some time after the death occurs and may never be aware of the circumstances of their death.

Providers are not required to notify the Commission of the death if the cause of death was unrelated to the care or services provided by the provider or a failure by the provider to provide care and services.

Different definition of inappropriate use of restrictive practice for home care

The new legislation states that the use of a restrictive practice in the course of providing home care or flexible care in a community setting is not a reportable incident if:

  • the restrictive practice is used in the course of providing home care or flexible care in a community setting; and
  • before the restrictive practice is used, the following matters were set out in the care and services plan for the care recipient:
    • the circumstances in which the restrictive practice may be used in relation to the recipient, including the recipient’s behaviours of concern that are relevant to the need for the use;
    • the manner in which the restrictive practice is to be used, including its duration, frequency and intended outcome; and
  • the restrictive practice is used:
    • in the circumstances set out in the plan; and
    • in the manner set out in the plan; and
    • in accordance with any other provisions of the plan that relate to the use; and
  • details about the use of the restrictive practice are documented as soon as practicable after the restrictive practice is used.

This differs from the rules for residential care, where use of restrictive practices must be documented in a behaviour support plan.

The residential care environment is different to the operating environment of home care or flexible care provided in home or community settings, where care recipients generally have greater autonomy and less complex requirements. In the home care setting, a behaviour support plan may not be required.

However, providers of home care and flexible care delivered in a home or community setting must still implement a care and services plan for each care recipient that satisfies the requirements set out in the Aged Care Quality Standards.

Exception: incidents of neglect in the home care setting which are not a reportable incident

Despite neglect being a reportable incident under the Aged Care Act, the new legislation provides for circumstances in which certain incidents in the home/flexible care setting are not reportable incidents under the SIRS. An incident is not a reportable incident if:

  • the incident occurred, is alleged to have occurred, or is suspected of having occurred, in connection with the provision of home care, or flexible care provided in a community setting, to a care recipient; and
  • the incident results from a choice made by the care recipient about the care or services the provider is to provide to the care recipient, or how the care or services are to be provided by the provider; and
  • before the incident occurred, is alleged to have occurred, or is suspected of having occurred, the choice had been communicated by the care recipient to the provider, and the provider had recorded the choice in writing.

This amendment reflects feedback received by the Commission that home care/flexible care recipients should be able to maintain choice and autonomy over their living situation. The home care or flexible care provider must have recorded the choice that the care recipient communicated to them in writing before the incident occurred, and must also be satisfied that the care recipient has the capacity to make this decision.

Summing up

We hope our overview has helped you get up to speed on these new home care requirements.

We recommend providers take a look at the full draft Serious Incident Response Scheme Guidelines for providers of home services for more thorough guidance on the Scheme.


Do you need help with incident management?

SIRS, the new aged care incident scheme

The Aged Care Quality and Safety Commission’s (the Commission) Serious Incident Response Scheme (SIRS) for government-funded Residential Aged Care Providers is set to commence in April 2021.  The new SIRS aims to further safeguard aged care consumers from abuse and neglect by empowering consumers, and by ensuring that providers follow the incident response procedures specified in the scheme.

The SIRS brings the requirements of incident reporting in aged care into alignment with those of the NDIS. For providers of both aged care and NDIS services, and providers familiar with the NDIS requirements, the new scheme will not present new compliance concepts.

The SIRS will fit in alongside several other residential aged care compliance requirements. Under the Charter of Aged Care Rights, consumers have a right to live without abuse and neglect. Likewise, under the Aged Care Quality Standards, providers are required to uphold this consumer right by identifying and responding to abuse and neglect. Additionally, the scheme will uphold the principles and requirements of open disclosure.

The SIRS is made up of two key components, being incident management obligations and compulsory reporting obligations.

The incident management component consists of identifying, responding to, managing, and recording incidents, as well as improving to prevent similar future occurrences.

The compulsory reporting obligations require providers to submit reports to the Commission within specific timeframes, depending on the severity of the incident.

Defining incidents under the SIRS

It will be essential for workers to understand which occurrences constitute an incident, as well as the category of the incident (ie “Priority 1” or “Priority 2”) and the appropriate procedures that must be followed when an incident occurs.

The Commission’s documentation includes detailed explanations of the various categories of incidents, which are certain “alleged, suspected or actual occurrences … where the person affected by the incident is a consumer in residential aged care”.

The types of incidents as defined by the SIRS are:

  • unreasonable use of force;
  • unlawful or inappropriate sexual contact;
  • psychological or emotional abuse;
  • unexpected death;
  • stealing or financial coercion by a staff member;
  • neglect;
  • inappropriate physical or chemical restraint; and
  • unexplained absence from care.

It is important to note that providers must assess the degree of impact on, or harm to, the consumer for each incident.  If there is a higher level of impact on or harm to the consumer, then the incident must be categorised as a Priority 1 incident.

Unexpected deaths and unexplained absences will always be categorised as Priority 1 incidents.

Supporting affected individuals

One of the requirements under the new scheme will be to support aged care consumers affected by an incident. The central component of this requirement is clear, ongoing communication between the provider and affected consumers, in line with the principles of open disclosure. Affected consumers may also require trauma or counselling services, and the provider is expected to help consumers access these services.

Incident reporting to the Commission

The SIRS outlines timeframes within which providers must report alleged, suspected or actual Priority 1 and Priority 2 incidents to the Commission.

Timeframe for reporting Priority 1 incidents

Priority 1 incidents have the highest priority, with the Commission requiring an initial report within 24 hours. Additionally, a follow-up incident status report is required within 5 business days of a Priority incident occurring.

Timeframe for reporting Priority 2 incidents

On the other hand, Priority 2 incidents must be reported to the Commission within 30 days.

In some cases, the Commission will require providers to submit a final report detailing the findings from incident investigations and, where relevant, how an incident was resolved. If required by the Commission, the final report will be due within 60 days of the incident occurring.

SIRS record keeping requirements

The SIRS will bring only minor changes to the current record-keeping requirements related to incidents. Providers will need to continue recording the details of each incident which occurs, regardless of whether the incident was determined to be trivial or have negligible impact. The SIRS adds another record keeping requirement: the category of incident will need to be recorded and, in the case of Priority 1 or 2 incidents, whether the incident has been reported to the Commission.

Quality and Safety

One of the central goals of the scheme is to “drive learning and improvement at a system and service level to reduce the number of preventable serious incidents in the future”.  The SIRS will encourage organisations to use the quantitative and qualitative data collected from their incident management recording processes to refine their procedures, minimise the likelihood of incidents re-occurring, and to improve the overall quality and safety of the care they deliver.

Further reading

We have several resources to help providers identify, assess, investigate, manage, record and resolve incidents in line with the new scheme. Our resources are intended to complement one another, and have been updated to take into account the requirements of the SIRS.

Our aged care incident management resource templates include:

  • Policy: Incident Management Procedures (Aged Care SIRS)
  • Template: Incident Investigation Template (Aged Care SIRS)
  • Template: Incident Register (Aged Care SIRS)
  • Template: Incident Report Template (Aged Care SIRS)

To access these resources, and hundreds more, log in to SPP.

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