AGED CARE INVESTIGATIONS

The Serious Incident Response Scheme (SIRS) is an initiative of the Australian Aged Care Quality and Safety Commission, instituted to assist in the safeguarding of elderly Australians accessing residential aged care services that are subsidised by the Australian Government. The SIRS sets out mandatory incident management and Reportable Incident obligations for providers of residential aged care services and requires them to have an incident management system in place to effectively manage and respond to all allegations and incidents of abuse and neglect.

According to the SIRS mandatory incident management and response requirements, “appropriate action” must be taken by service providers in response to alleged, suspected or witnessed incidents. Appropriate action includes fully investigating and documenting the incident and reporting the incident to external authorities within statutory timeframes. Depending on the nature and severity of the incident, a more in-depth investigation may also be required.

Edge Investigations provides services aligned with safeguarding elderly consumers of residential aged care services, assisting residential aged care service providers to investigate alleged, suspected or witnessed Reportable Incidents of abuse and neglect. The investigative support offered by Edge Investigations extends to holistic service-based or site-based reviews that can assist service providers to:

identify or discover situations of abuse and neglect,
rectify inadequate processes and procedures intended to identify abuse and neglect.

CONSUMERS OF RESIDENTIAL AGED CARE SERVICES AS ‘VULNERABLE ADULTS’

Elderly people who are consumers of residential aged care services – including live-in residential aged care facilities and flexible care services provided in a residential setting, such as the elderly person’s own home – are considered to be ‘Vulnerable Adults’. As such, providers of residential aged care services are required by law to provide support to elderly consumers, including:

putting rigorous systems in place to: (1) consistently monitor the health and safety of vulnerable persons, (2) monitor services to ensure abuse does not occur, (3) take reasonable steps to prevent incidents of abuse or neglect,
responding quickly to manage, mitigate and investigate alleged, suspected or witnessed incidents of abuse or neglect,
taking decisive action against perpetrators of abuse and neglect.

Edge Investigations assists providers of Australian Government-subsidised residential aged care services in safeguarding their vulnerable adult consumers, by guiding or undertaking investigations into alleged, suspected or witnessed Reportable Incidents of abuse and neglect.

WHAT CONSTITUTES A REPORTABLE INCIDENT?

The Aged Care Quality and Safety Commission considers a Reportable Incident to have occurred when vulnerable adults accessing residential aged care services experience:

unreasonable use of force
Unlawful sexual contact or inappropriate sexual conduct
Neglect
Psychological or emotional abuse
Unexpected death
Stealing or financial coercion by a staff member
Inappropriate physical or chemical restraint
Unexplained absence from care

UNREASONABLE USE OF FORCE

Unreasonable use of force refers to incidents of physical abuse, including physical harm or violence, such as infliction of pain, unpleasant sensations, or physical injury. Examples include deliberate rough handling when administering care, hitting, beating, kicking, pushing or shoving, or attempted suffocation.

UNLAWFUL SEXUAL CONTACT OR INAPPROPRIATE SEXUAL CONDUCT

Unlawful sexual contact or inappropriate sexual conduct, in the context of caring for an elderly vulnerable adult, encompasses any sexual activity with a person who lacks the capacity to give or withhold consent and/or has been coerced, threatened, or forced to engage in sexual behaviour.

Unlawful sexual contact (sexual abuse) includes sexual interference, non-consensual sexual contact, indecent assault, or rape.

Inappropriate sexual contact (sexual misconduct) refers to lower-level sexual harassment, including sexual threats or stalking, and crossing professional boundaries through cultivation of an inappropriate and overly personal or intimate relationship with a vulnerable adult.

NEGLECT

Neglect is a failure to provide basic physical and emotional necessities, either actively or passively. In the context of caring for an elderly vulnerable adult, examples may include withholding personal care or physical assistance; denial of proper medical care, such as withholding medication or leaving wounds untreated; failing to provide sufficient assistance during meals; failure to provide adequate nutrition, protection or supervision; placing a vulnerable adult at undue risk of harm to their physical, mental or emotional health by exposing them to unsafe environments or practices, or by failing to protect them from serious abuse.

PSYCHOLOGICAL OR EMOTIONAL ABUSE

Psychological or emotional abuse is generally characterised by behaviours such as verbal abuse, deliberate failure to acknowledge or interact with a person, gaslighting, humiliation or intimidation, threats of mistreatment, isolation, harassment and bullying, and denial of the vulnerable elderly person’s religious or cultural needs, beliefs or preferences. Examples may include yelling, name calling, threatening gestures, and refusing access to care or services as a means of punishment.

UNEXPECTED DEATH

In the context of providing residential aged care services to an elderly vulnerable adult, unexpected death may result from an entirely unpreventable accident, but it may also be the result of an intentional or reckless failure to provide adequate supervision, care, protection or support to the elderly person. Examples may include where unexpected death occurs following a fall, or due to an untreated pressure injury, or when the actions of one elderly consumer of a residential aged care service result in the death of another elderly consumer of that same residential aged care service.

STEALING OR FINANCIAL COERCION BY A STAFF MEMBER

Stealing or financial coercion by a staff member is considered a form of financial abuse. Financial abuse involves the intentional misuse or misappropriation of an individual’s money, property, or resources. Examples of financial coercion by a staff member may include situations where a carer employed by a residential aged care service provider coerces or pressures an elderly consumer of that residential aged care service to provide the carer with financial benefits, such as cash gifts or loans, or to change their will to the advantage of the carer.

INAPPROPRIATE PHYSICAL OR CHEMICAL RESTRAINT

Inappropriate physical or chemical restraint is a form of physical assault involving unauthorized use of certain restrictive practices, include situations where physical or chemical restraint is used without prior consent or without notifying the elderly consumer’s representative as soon as practicable; or where physical restraint is used in a non-emergency situation. Physical restraint includes any means of impeding or preventing movement, such as:

applying physical pressure, e.g., kneeling on someone to prevent movement,
unauthorised use of a device designed to limit movement, such as raising bed rails to prevent a person from getting out of bed,
inappropriate use of a device, e.g., locking the wheels and base of a tray table around the legs of a chair in an attempt to prevent a person from standing.

Chemical restraint is the use of medications, such as sedatives or antipsychotics, to restrict a person’s movement. For example, when a provider issues a drug to an elderly consumer of a residential aged care service to influence their behaviour and make them more compliant.

UNEXPLAINED ABSENCE FROM CARE

An unexplained absence from care occurs when an elderly consumer who resides in a residential aged care service is found to be absent from the service, without explanation, and the absence has been reported to the police. Failure to act on an unexplained absence from care is considered a serious breach of the residential aged care service provider’s duty of care.

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LEGAL REQUIREMENTS FOR THE INVESTIGATION OF REPORTABLE INCIDENTS IN AGED CARE

In accordance with the standards set out by Aged Care Quality and Safety Commission, and the Compulsory Reporting requirements of the Aged Care Act 1997 (Section 62-1 & Section 63), Australia has laws and regulations in place to ensure that elderly vulnerable adults who access Australian Government-subsidised residential aged care services are protected from abuse and neglect.

Providers of government-subsidised residential aged care services are responsible for ensuring they have robust processes in place for identifying, preventing, responding to and managing Reportable Incidents involving their elderly consumers, and it is a legislative requirement that all serious Reportable Incidents be investigated.

While it may be sufficient for the initial investigation of the alleged, suspected or witnessed incident to be undertaken internally by the service provider, more serious or complex incidents often require more in-depth investigation, or outsourcing to an independent investigator. Edge Investigations provides independent investigative services that are aligned with safeguarding across the aged care industry.

WHY DO INVESTIGATIONS OF REPORTABLE INCIDENTS IN AGED CARE REQUIRE SPECIALISED PROCESSES AND PROCEDURES?

Investigations of Reportable Incidents that occur within an aged care service setting require specialised processes and procedures that adhere to relevant legal principles, follow recommended guidelines, meet Aged Care Quality and Safety Commission standards and comply with legislative and regulatory requirements. Use of these specialised processes and procedures also helps to ensure that the findings are impartial and grounded in fact.

Investigations of these Reportable Incidents must be undertaken with sensitivity and professionalism, but also necessitate:

an awareness of the general concept of human rights violations,
a proper understanding of what constitutes ‘elder abuse’,
the ability to effectively recognise the signs that abuse has occurred or continues to occur,
a thorough knowledge of the requirements of Aged Care Quality Standards,
familiarity with the Compulsory Reporting requirements of the Aged Care Act 1997, and
commitment to safeguarding consumers of Government-subsidised aged care services.

Edge Investigations’ specialised investigative procedures and stringent practices and processes enable our team of qualified investigators to make fair, unbiased and robust determinations and deliver reliable investigation reports that meet Residential Aged Care Service Providers’ legal obligations and are strong enough to withstand the scrutiny of legal and regulatory bodies.

HOW CAN EDGE INVESTIGATIONS ASSIST YOUR ORGANISATION TO CONDUCT EFFECTIVE INVESTIGATIONS OF REPORTABLE INCIDENTS IN RESIDENTIAL AGED CARE SETTINGS?

Edge Investigations offers Residential Aged Care Service Providers a full suite of investigative services, including:

comprehensive investigations of Reportable Incidents,
supported investigation services that assist Residential Aged Care Service Providers to conduct their own investigations, and
holistic site-based reviews.

Edge Investigations conduct every investigation to the highest standards, in full compliance with all applicable legal and regulatory requirements. Our team of professional, experienced and highly trained investigators are well-versed in the legal and procedural requirements for conducting specialised investigations – particularly those that investigate serious allegations of physical, sexual, financial, and psychological abuse or neglect of elderly vulnerable adults.

Flawed or botched investigations can be extremely damaging to all parties involved, so it pays to have an experienced and unbiased independent investigator handle the investigation.

If you require assistance with investigating a Reportable Incident associated with the provision of care to an elderly vulnerable adult living in or accessing an Australian Government-subsidised Residential Aged Care service, contact Edge Investigations today.