What is mandatory reporting in aged care?

Aug 1, 2022 | NAVIGATING AGED CARE

When planning for a loved one to transition into residential aged care, peace of mind is an obvious priority.

All seniors in residential aged care have the right to be treated with dignity and respect. They also have the right to receive access to the food, comfort and any medical treatment required for their individual needs. To ensure this happens in Australia, there are very strict rules and regulations in place. These ensure any non-compliance is quickly noticed, rectified and prevented from recurring.

The Aged Care Act of 1997, details what incidents must be reported in aged care, and how mandatory reporting in aged care in Australia works.

Australia’s Aged Care Act and other legislation

The Aged Care Act in Australia is a set of laws that protect the rights of older people who live in aged care facilities.

It covers the following:

Funding
Regulation
Approval of providers
Subsidies and fees
Standards
Quality of care
Rights of people receiving care
Non-compliance

Other legislation related to aged care complaints and accreditation includes:

Accountability Principles
Information Principles
Quality of Care Principles (including Accreditation Standards)
Records Principles
Sanctions Principles
User Rights Principles

The Act is regularly updated to ensure it encourages best practices in care.

Who is responsible for aged care in Australia?

The Parliament of Australia states that the regulation of aged care service quality is shared between the Department of Health (the Department) and the Aged Care Quality and Safety Commission (the Commission).

The Department approves aged care providers under the Aged Care Act. If aged care providers fail to comply with their responsibilities under the Act, the Secretary can issue a notice of non-compliance or impose sanctions.

The Commission is an independent statutory agency established under the Commission Act. It is responsible for quality assessment and monitoring of aged care providers against the Aged Care Quality Standards. It also handles complaints, consumer engagement and provider education.

Aged Care Quality Standards

The rights of people who receive care in Australia are covered by what are referred to as Quality Standards.

There are eight specific Aged Care Quality Standards that reflect the level of care all individuals should expect:

Consumer dignity and choice
Ongoing assessment and planning
Personal and clinical care
Services and supports for daily living
Organisation’s service environment (meaning everyone should feel safe and comfortable)
Feedback and complaints
Human resources
Organisational governance (meaning the organisation should be well run and the resident should feel like a partner in improving the delivery of care and services

Every residential aged care facility should be able to demonstrate to the Aged Care Quality and Safety Commission that it meets aged care quality standards.

To ensure this is the case, aged care facilities are regularly visited, monitored and reviewed by an Assessment Team. In addition, anyone who is involved with aged care, from staff and residents to family members is encouraged to share their feedback.

As part of Aged Care Quality Standards legislation, aged care facilities are required to:

encourage care recipients, their family, friends, carers and others to provide feedback and make complaints
make care recipients aware of, and facilitate access to, advocates, language services and other methods for complaint
take action to respond to complaints and use an open disclosure process if things go wrong
review feedback and complaints to improve quality of care and services

The Royal Commission into Aged Care and the Serious Incident Response Scheme

The Royal Commission into Aged Care commenced in 2018, with the goal of investigating the quality of care being provided to older Australians.

As a result of the Royal Commission, amendments to the Aged Care Quality and Safety Commission Rules 2018 (Commission Rules) were put in place.

These focused on the following key outcomes:

integrate and remove duplication in the management of non-compliance with the Aged Care Quality Standards
establish a regulatory framework with graduated and escalating responses to non-compliance
streamline existing performance assessment processes, providing greater clarity to consumers and transparency of decision-making for providers.

To ensure non-compliance is kept at a minimum and regularly monitored, an amendment to the Aged Care Act 1997 (Cth) was passed by the Federal Parliament in 2021, which replaced existing mandatory reporting requirements and introduced what’s called a ‘Serious Incident Response Scheme’ (SIRS).

Aged care, mandatory reporting and the Serious Incident Response Scheme

The SIRS helps aged care facilities and providers to identify, record, manage, resolve and report incidents that occur or are suspected to have occurred. It asks providers to have a documented set of protocols, processes and operating procedures to help manage what are referred to as ‘reportable incidents’.

Aged care reporting (also known as compulsory reporting or mandatory reporting in nursing) ensures serious incidents do not go undocumented and that they receive attention from the right people.

What are reportable incidents in aged care in Australia?

The term ‘reportable incidents’ include allegations or definite occurrences of the following:

Unreasonable use of force against an aged care resident
Unlawful or inappropriate sexual conduct
Psychological or emotional abuse
Unexpected death
Stealing or financial coercion
Neglect
Use of physical or chemical restraints
Unexplained absence of a resident from a facility

Reportable assaults, as per the legislation, must be shared with the police and the Department of Health within 24 hours.

As shared by agedcarequality.gov.au, “Notifying reportable incidents via the SIRS supports providers to identify trends and issues and pursue continuous improvement in service quality and safety. It also supports the Commission to assess and respond to risk at a service level, and to identify where improvements are needed across the sector.”

Providers are encouraged to share details about any steps required to ensure health and wellbeing, and how they will assess the cause and response to any incidents.

Providers are encouraged to share details such as:

Who was involved
When the incident occurred (or is alleged to have occurred)
Where it occurred
Who witnessed the incident
Who reported the incident
The cognitive abilities of the person/people involved
Who initially reported the incident
The circumstances leading up to the incident
What happened after the incident

Priority 1 Reportable Incidents

Compulsory reporting in aged care dictates that Priority 1 reportable incidents of accidents or elder abuse must be reported within 24 hours of the incident. Further details may be requested within five days of the incident.

An incident is Priority 1 if:

It has caused, or could reasonably have been expected to have caused a residential care recipient physical or psychological injury or discomfort that requires medical or psychological treatment to resolve; or
There are reasonable grounds to report the incident to police; or
It involves the unexpected death of a residential care recipient or the unexplained absence of a residential care recipient from the residential care services of the approved provider.

Priority 2 Reportable Incidents

As per agedcarequality.gov.au, Priority 2 reportable incidents are all those that do not meet the above criteria. If a Priority 2 incident occurs, it must be reported to the Commission within 30 days of a provider becoming aware of the incident.

To help providers and individuals decide if an incident is Priority 1 or Priority 2, there is an online tool, which can be accessed here: https://www.agedcarequality.gov.au/sirs/decision-support-tool

Who is responsible for mandatory reporting in aged care?

If there is a serious incident at an aged care facility, the facility is legally required to submit a report to the relevant authorities. However, there is protection for whistleblowers who may decide to submit a report of their own volition.

According to HealthLegal, “any person who makes a disclosure is also protected from victimisation. New section 54-6 of the Act creates a civil penalty of 500 penalty units ($111,000) for victimisation. A person contravenes this new provision if they cause detriment to another or they threaten to cause detriment.”

If a facility is operated correctly, there will be a system in place when it comes to incidents and compulsory reporting. However, staff do take initiative when issues arise for their own ethical reasons.

The Australian Nursing and Midwifery Federation states that:

Any abuse of a person is unacceptable.
In order for compulsory reporting to be effective, clear policies and protocols at the work place level must specify and support the process to be followed by the person making a report of any alleged abuse.
Registered nurses, enrolled nurses and assistants in nursing are required to report any suspected or actual abuse of people in their care. They must report to their employer and/or directly to the Police, the Department of Health (however named), the Aged Care Quality and Safety Commission, or where appropriate, the jurisdiction-based Health Care Complaints Commissioner or Health Ombudsman.
The person to whom the report is made, has a legal obligation to investigate and take action, and to advise the person making the report that action has been taken, and in what manner.
If the person making the report is not satisfied with the action taken, they have an obligation to make the report to a higher authority.
Registered nurses and enrolled nurses are bound by codes of ethics and professional conduct, with which they are required to comply when providing care and when responding to any maltreatment of people in their care.

Mandatory reporting in aged care and incident management

As part of the SIRS, aged care facilities are expected to implement processes and procedures to prevent, manage and respond to incidents.

Approved providers must have an effective incident management system (IMS) in place and use this to continuously improve the management and prevention of incidents. The IMS should support an aged care provider and their staff to take appropriate action when there is an alleged, suspected or witnessed incident.

Appropriate action in response to an incident includes:

action to remove consumer/s from harm and to reduce or address the impact on any consumer/s
identification and immediate internal reporting of the allegation, suspicion, or witnessed incident
documenting the incident
further investigation, if warranted
reporting to external authorities within statutory timeframes, including the police and the Commission.

Providers can follow aged care reporting requirements and report serious incidents by logging into the My Aged Care Provider Portal. Staff should be adequately trained to ensure they can access the portal and submit reports in a timely way.

Mandatory Reporting in Aged Care: Responses

When an incident is reported, the responsible body is the Aged Care Quality and Safety Commission. The Commission assesses reportable incident notices to determine the type of response required.

The Commission has the power to take action, to address non-compliance with provider responsibilities. It also has powers to issue compliance notices for suspected non-compliance with the SIRS obligations.

Find more information about mandatory reporting in aged care

If you are concerned about elder abuse or about an incident at an aged care facility, it is recommended that you raise your concern directly with the staff or managers at your aged care service first.

If the outcome of your concern doesn’t match your expectations or if you have a Serious Incident Response Scheme (SIRS) enquiry, you can call for free on 1800 081 549 between 9 am and 5 pm Monday to Friday or 8 am to 6 pm Saturday to Sunday, or email sirs@agedcarequality.gov.au.

You can also lodge an open, confidential or anonymous complaint by visiting: https://www.agedcarequality.gov.au/making-complaint/lodge-complaint

Find a quality aged care provider

Finding a vacancy in a residential aged care facility that adheres to all safety protocols is crucial for the wellbeing of your loved one.

At Aged Care Decisions we can assist you to find and compare vacancies in your area that suit your loved one’s care needs and preferences.

Aged care is an important and necessary service, and it’s crucial that the right decisions are made when it comes to choosing a facility for your loved one. Aged Care Decisions provides assistance to families at every stage of the aged care or home care journey. We assist tens of thousands of families every month, 100% free of charge.

Here’s how our 100% FREE service works.