Changes to reportable incidents in aged care better safeguard older people

Last week, the ACQSC updated the guidelines to include sexual abuse as a Priority 1 reportable incident for aged care facilities.

Catherine Barrett, Founder and Director of Celebrate Ageing, says that this change is a “step in the right direction”.

“It represents leadership on the part of the Aged Care Quality and Safety Commission, and I thank them for taking this step,” she says.

What are reportable incidents?

Reportable incidents fall under the Serious Incident Response Scheme (SIRS). This initiative aims to reduce and prevent harm to older people living in residential aged care.

Incidents of sexual assault now fall under the Priority 1 requirements and must be reported by aged care workers of a facility to the Commission within 24 hours. This includes ‘near misses’ where an incident could have occurred but was avoided.

Once an incident is on record, the provider must make sure their response to an incident is timely and appropriate. Additionally, the issue will be documented with the ACQSC.

This will help reduce the overall impact it had on the resident and makes sure the risk of the incident happening again is reduced.

The SIRS initiative is an important system to make sure all older Australians living in aged care feel safe and are able to live free from violence and abuse.

Importance of stronger safeguards

The ACQSC released a report this year that found that 530 sexual assaults occurred within residential aged care facilities in the October to December quarter of 2021.

On top of this, a report from KPMG found that 58 percent of the aged care workforce did not believe sexual assault had a negative impact on an older person in aged care.

Having these stronger safeguards in place ensures that there is no questioning in a facility, or among staff, on whether sexual assault is a reportable incident or not.

Previously, it was up to a facility’s management to decide if unlawful sexual contact or inappropriate sexual conduct was a Priority 1 or Priority 2 incident. Priority 2 incidents need to be reported to the Commission within a month of a facility becoming aware of them.

Prior to the Commission’s change in guidelines, Ms Barrett says the reporting requirements for sexual assault “did not meet the pub test”.

Ms Barrett says, “It didn’t sit with people’s sense of fair play, justice, and equality. And I think a lot of people saw that as a viewing of older people, and older women in particular, as less than.”

She adds that prior to this change to the reportable incidents, the system conceptualised the idea that if sexual assault happens to older women “it doesn’t matter” because they “will forget” and “it doesn’t affect them”.

“If you thought about that response in a childcare centre, you would never get away with it,” explains Ms Barrett.

“… We wouldn’t allow it to happen. The leadership I applaud, this [change] says it really matters. So much it needs to be a Priority 1 [incident]. That sends the message that sexual assault in residential aged care matters. Older people matter.”

Reportable offences

The eight types of reportable incidents are:

• Unreasonable use of force
• Unlawful sexual contact or inappropriate sexual conduct
• Neglect of a consumer
• Psychological or emotional abuse
• Unexpected death
• Stealing or financial coercion by a staff member
• Inappropriate use of restrictive practices
• Unexplained absence from care

While unlawful sexual contact or inappropriate sexual conduct was already a reportable incident, it was up to the facility to determine whether an incident caused a consumer harm and whether it would be considered a Priority 1 or 2 incident.

Under a Priority 1 reportable incident, all unlawful sexual contact or inappropriate sexual conduct must be reported to the Commission within 24 hours of the facility becoming aware that the incident had taken place or could have taken place.

Any action that would be ‘reasonable grounds to contact the police’ is considered a reportable incident. Of course, your facility would also need to report an incident to the police if there are grounds to do so.

“One of the things residential service providers say to me is ‘we are so lucky [sexual assault] doesn’t happen here’. And I say, ‘It’s not about luck, it’s about the system and it’s about cultural change, policy and guidelines’. And this step by the Commission demonstrates the seriousness of sexual assault,” says Ms Barrett.

What is unlawful sexual contact?

Unlawful sexual contact or inappropriate sexual conduct is defined by the ACQSC as:

• Non-consensual contact or conduct that is sexual in nature by any person towards a consumer, including sexual assault, an indecent act, or sharing of intimate images
• Contact or conduct that is sexual in nature by a staff member or volunteer to a consumer, regardless of whether the consumer actually consented to it
• Touching of a consumer’s genital area, including anal areas or breasts, where it is not necessary when providing care or services – regardless of if the consumer consented to the touching
• Conduct toward a consumer that had the intention of ‘making it easier’ to procure the engagement of sexual contact or conduct from a consumer

This reportable incident does not cover consensual contact or conduct between a consumer and a person who does not work or volunteer for a facility.

Additionally, if a staff member was to show a ‘gesture of comfort’ like a pat on the back or knee, this would not be considered inappropriate conduct as long as it aligns with a consumer’s personal preferences.

For more information about sexual assault and improving systems in aged care, or support and advocacy assistance, head to the Celebrate Ageing website.