NEWS RELEASE

Aged Care serious incident reporting to change: Roles and implications for Insurance and Risk

A Federal Government commissioned report by KPMG has recommended wide-ranging changes to improve serious incident responses in the aged care sector.

The KPMG report recommends broader definitions of reportable conduct by staff to residents including physical, sexual or financial abuse, and seriously inappropriate, improper, inhumane or cruel treatment and neglect.

It also recommends reporting of resident-to-resident conduct which includes sexual abuse, physical abuse causing serious injury, and incidents that might form part of a pattern of abuse.

A set of options has been provided. These form the next phase of the review for consideration:

Option 1) involves no change to the current arrangements
Option 2) involves developing guidance material to better enforce the current arrangements
Option 3) involves introducing a reportable conduct scheme which would require all aged care service providers to report abuse or neglect by a staff member against a consumer to the Aged Care Quality and Safety Commission (the Commission)
Option 4) involves expanding Option 3 to include unexplained serious injury in residential aged care as a serious incident
Option 5) involves expanding Option 3 to include aggression and abuse between consumers in residential aged care settings as a serious incident

Ansvar’s Senior Risk Consultant Anthony Black believes Option 5 is the most likely outcome.
“In April 2018, the Minister for Aged Care announced that options for a Serious Incident Response Scheme (SIRS) would be developed for the reporting and investigation of alleged incidents of abuse and neglect in aged care.
“This followed recommendations from the Australian Law Reform Commission’s inquiry into elder abuse and the Carnell-Paterson Review (which triggered the Royal Commission),” Anthony said.

Current Situation
“Existing provisions in the Aged Care Act 1997 require approved providers of residential aged care to report an allegation, or a suspicion, of a ‘reportable assault’ on a care recipient.
“However, it is widely considered that these current arrangements are ineffective and do not promote safe, quality care.
“It is clear that the report considers that risk management frameworks and incident response systems have not kept pace with the times; with many facilities operating amongst greater complexity today with frameworks and systems more attuned to 20 years ago.”

Report Recommendations & Options

• Set-up phase for a SIRS (January 2019 – current): Develop policy proposal, including cost and regulatory burden and seek decision from Government. This has bipartisan support; however, with caretaker governance imminent, further actions will be delayed.
• Detailed analysis (July – December 2020): Recruit a core establishment team, undertake detailed policy and legal analysis, and undertake consultations with the sector.
• Implementation (January 2020 to June 2021): Develop a detailed business and operating model, expand the core establishment team and undertake sector engagement, and change management activities, including training and education.
• Go live (July 2021 to December 2022): ‘Go live’ date of 1 July 2022 for a SIRS and test, monitor and improve systems.

Roles and Implications for Risk Management and Insurance

Anthony Black says Providers must take action now to review current approaches to serious incident reporting.

This includes:

• How SIR is defined and reported as part of their Clinical Governance Framework, including how it is incorporated in organisational policy
• The effectiveness of the incident reporting system and reporting culture
• Implementing open disclosure
• How the organisation Risk Management Framework responds to SIR; ensuring appropriate escalation to and oversight from board
• Understanding its insurance responsibilities to report serious incidents

Anthony concludes:

“Interestingly, the KPMG review lists no direct consultation with underwriters, brokers or any specific legal firm.
“As the report moves into next stage – to undertake preparatory work and detailed analysis for a new Serious Incident Response Scheme (SIRS) – it is important that the Insurance Sector and Underwriters step up and ensure we have a voice at the table.

“Ansvar are ready to offer our risk management services to customers as they continue to approach another disruptor to an already significantly disrupted sector.

“Please feel free to discuss with me if you have any views or questions.”

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The Ansvar Risk Consultants are here to help – we understand the sector, and we have a range of resources and tools to assist you in preparing for the Royal Commission.

Please contact us to discuss reviewing and strengthening your risk management
Anthony Black
0402 239 149
ablack@ansvarrisk.com.au

Disclaimer: Ansvar Insurance Limited ABN 21 007 216 506, AFSL 237806. This information is general advice only and does not take into account your individual circumstances.  Before making any decisions, please consider the appropriateness of this advice to your own objectives, financial situation or other needs.