The landscape of aged care is continually changing, with a strong move toward supporting older Australians who wish to remain living independently in their own homes. This shift brings new responsibilities, particularly regarding the safety and wellbeing of those receiving services outside traditional residential facilities. A significant step in reinforcing this commitment to safety is the expansion of the Serious Incident Response Scheme (SIRS) to include home and community aged care providers.

No longer is SIRS a concept solely for residential settings. Since December 1, 2022, SIRS applies to all government-subsidized aged care services delivered in a home or community setting. This change recognizes the unique vulnerabilities that can arise when care is provided in private dwellings and makes certain that a robust system is in place to manage and prevent incidents, regardless of where the service takes place.

What is SIRS?

The Serious Incident Response Scheme is a framework designed to identify and stop abuse and neglect among people receiving aged care. Its core purpose is to make aged care safer by setting clear requirements for providers to manage incidents effectively and take reasonable action to prevent them from happening again.

The scheme mandates that providers must have an Incident Management System (IMS) in place. An effective IMS helps providers to:

• Spot, handle, and solve incidents that occur during the giving of care and services.
• Stop future incidents.

Why the Expansion to Home Care Matters

The decision to extend SIRS coverage reflects a recognition that people receiving care at home deserve the same protections as those in residential care. However, home care presents unique challenges for monitoring and reporting incidents:

1. Private Settings: Unlike a residential facility, care is delivered in the recipient's private home. This setting lacks the constant staff presence and oversight of a facility, making it harder to detect signs of potential abuse, neglect, or other incidents.
2. Increased Isolation: Many home care recipients may be more isolated, which can reduce the number of people who might witness or report an incident.
3. Staff Independence: Home care staff often work independently, without direct, immediate supervision from their management.

The expansion of SIRS addresses these issues by setting clear expectations for home care providers, demanding they meet their responsibility to manage risk and report serious incidents.

Types of Incidents Covered Under SIRS

SIRS categorizes reportable incidents, requiring providers to report them to the Aged Care Quality and Safety Commission. The types of incidents covered include:

• Unreasonable Use of Force: This includes physical acts such as hitting, pushing, shoving, or rough handling of a care recipient.
• Neglect: Failing to provide appropriate care or services, which could result in harm. Examples include withholding personal care, leaving untreated wounds, or failing to give sufficient assistance during meals.
• Unlawful Sexual Contact or Inappropriate Sexual Conduct: This covers sexual activities without consent, sexual threats, or stalking.
• Psychological or Emotional Abuse: Acts such as yelling, name-calling, ignoring, making threatening gestures, or refusing access to care or services as a way of punishment.
• Stealing or Financial Coercion by a Staff Member: This covers acts like coercing someone to change their will or stealing belongings.
• Inappropriate Use of Restrictive Practices: Using a restrictive practice without proper consent or in a non-emergency situation, or using a drug to influence a person’s behavior as a restriction.
• Unexpected Death: A death where the provider did not take reasonable steps to stop it, or a death that is a direct result of something the provider did or did not do.
• Missing Person: An incident where a care recipient is unaccounted for.

For home services, these incidents must occur while the person is receiving care, or be caused by a staff member or another person receiving care from the same provider.

The Provider's Role in a SIRS-Compliant System

Home services providers must adjust their procedures to meet the SIRS requirements. This involves more than just reporting. It demands a culture of safety and transparency.

Incident Management System (IMS): Providers must implement a strong IMS. This system serves as the backbone of their incident response. It must allow staff to correctly:

1. Identify: Recognize when an incident has occurred.
2. Manage: Respond immediately and appropriately to the incident to keep the care recipient safe.
3. Report: Submit the incident to the Aged Care Quality and Safety Commission within the required timeframe (either 24 hours for Priority 1 incidents, or 30 days for Priority 2 incidents).
4. Investigate: Look into the root cause of the incident thoroughly.
5. Resolve: Take action to fix the issue and prevent recurrence.