Scott Memorial Hospital, Scone The Older Womens Network NSW submitted, for example, that the inadequate protections meant that staff lacked confidence to report abuse, and therefore reported assaults are the tip of the iceberg.[161]. [113], 11.90 Finally, the scheme will contribute to a better understanding of the nature of serious incidents occurring in aged care, and enable data to be captured in a centralised location, thus supporting other safeguarding mechanisms including enhanced employment screening.[114]. Department of Health (Cth), above n 8, 107. Previous. St Vincent's Hospital Instead, the precursors for the assault should be assessed, taking into consideration why the individual acted in the way they did, and a positive behaviour management plan be put in place.[136]. Sutherland Hospital & Community Health Service NSW Ageing and Disability Abuse Helpline 1800 628 221 launch (Monday - Friday, 9am - 5pm) How can we help Answer a few simple questions to find relevant information or services to report concerns of abuse, neglect or exploitation of an older person or adult with disability. Narrandera District Hospital Whether such a report is necessary within 24 hours should be considered in light of the purpose of the reporting. All staff have a responsibility to recognise and respond to safety, welfare or wellbeing concerns for children and young people and inform their principal or workplace manager. [104], 11.81 Mr Kinmond asserted that this provided a compelling case for legislative mandatory reporting for certain types of incidents.[105]. Coonabarabran District Hospital The practical effect is that, while anyone may make a complaint under the complaints function, there is a requirement for service providers to notify certain serious incidents under the DRIS. the worker resigns from the service. Telephone: 1800 424 079 (Monday to Friday, 9am-4.30pm) Email: info@seniorsrightsservice.org.au Website: www.seniorsrightsservice.org.au. Rylstone Multi-Purpose Health Service 11.93 If it is accepted that a key rationale for implementing a compulsory reporting regime is to enable visibility of such incidents so that appropriate action can be taken to protect and safeguard victims (and potential victims of abuse), it is important that any compulsory reporting scheme requires notification of an appropriate scope of serious conduct. Murwillumbah District Hospital St George Hospital Listen. NSW Ombudsman, Submission No 122 to Legislative Council General Purpose Standing Committee 2, Parliament of NSW, Inquiry into Elder Abuse in NSW (April 2016). It is not possible to do either when assaults are not reported and are not taken into account. Coolah Multi-Purpose Health Service For example, private enterprises including boarding houses and retirement homes and villages. Our responses to inquiries and reviews across NSW and Australia are available. Disability is defined as long-term physical, psychiatric, intellectual or sensory impairment that, in interaction with various barriers, may hinder the persons full and effective participation in the community on an equal basis with others: Disability Inclusion Act 2014 (NSW) s 7. Approved providers owe a duty of care to care recipients. Older Person It may be that a report to the police, or to the public advocate (see Chapter 3) is appropriate.[149]. The scheme should sit alongside existing complaint mechanisms, and strengthen the systems responses to complaints (including compulsory reports) of abuse and neglect. In some cases, this information could provide important background information and build evidence in support of future claims or potentially trigger action to mitigate risks. Review mechanisms that are independent ensure greater accountability and transparency: that decision making by the review body is based on relevant information and facts, and free from the influence of extraneous factors which ought not be considered. 11.51 The Departments unequivocal position is that investigation of alleged assault is the responsibility of the police who will determine whether the incident is criminal in nature and what further action is required.[76]. at any time. The Commissioner has said that the focus of her role is on ensuring service providers have acted appropriately to: ensure any affected residents are safe; find out what happened; ensure it doesnt happen again; and the right people are told.[80]. For information or to report concerns of abuse, neglect and exploitation of older people and adults with disability. Mandatory reporters are required by law to report suspected child abuse and neglect to government authorities. This serves an educative function for providers, while also enabling questions to be asked by the oversight body, if necessary, about organisational decisions related to the reporting of incidents, thus allowing a more considered and nuanced approach in respect of matters referred to the police. Manilla Health Service The applicable sections of legislation and/or regulation. Using these prevalence rates a clinician seeing 20 older patients/day may encounter a victim of elder abuse daily (Lachs and Pillemer 2004). Goulburn Base Hospital 11.114 The issue also arises in the disability service context. Need to disclose information between disability services and labour hire agencies relating to risks associated with employees, A service uses a labour hire agency to access casual staff. Trundle Multi-Purpose Service Tottenham Hospital [64], 11.38 An approved provider must report an allegation, or a suspicion on reasonable grounds, of a reportable assault on a care recipient to police and the Department of Health within 24 hours.[65]. The latest news, media releases and events from the Ageing and Disability Commission. 11.145 The proposed expanded scope of the definition of what is required to be notified should also expand whistleblower protections to those who report any incident that falls within that definition, provided the report is made in good faith. Prince of Wales Hospital Orange Health Service The benefits of reportable conduct schemes have been acknowledged, including their ability to improve systemic responses across a sector. If this is not what you are after, you can find other support service contacts that may better suit your needs here. It builds on the existing expertise of the Complaints Commissioner in relation to aged care; utilises and builds upon the existing complaints function; enables information captured across both functions to be utilised to develop an intelligence profile of approved providers and aged care staff and thus informs more comprehensive risk assessment and management of staff members and providers. For crisis support contact Lifeline 13 11 14 opens in new window Tocumwal Hospital If the person does not seem to have capacity consider referral to geriatrician for assessment and decision on future care. 11.47 Both the reportable assault scheme and the complaints scheme enable reports of abuse and neglect in aged care to be brought to light, by providing mechanisms where data relating to complaints of abuse against older people receiving Commonwealth funded aged care is captured. Overall 1 year prevalence all types of abuse 2.2-36.2% mean 14.3%. 11.117 This approach acknowledges the policy rationale behind the existing exemption, but recognises that such serious incidents should be reported, and is designed to ensure that the provider response is appropriate, transparent and accountable. Elder abuse can take various forms, including: financial, physical, psychological, emotional and sexual abuse, or neglect. Older people present at health settings more often than younger people and frontline health staff may be the first to identify abuse of an older person. These people include the person with disability that is the subject of the incident or their nominee. Armidale Rural Referral Hospital Download the NSW Elder Abuse Toolkit (PDF, 2.7 MB). Productivity Commission, Annual Review of Regulatory Burdens on Business: Social and Economic Infrastructure Services (Research Report, 2009) 50. The Australian Law Reform Commission acknowledges the traditional owners and custodians of country throughout Australia and acknowledges their continuing connection to land, sea and community. Lake Cargelligo District Hospital Coffs Harbour Base Hospital Proposal 113 The exemption to reporting provided by s 53 of the Accountability Principles 2014 (Cth), regarding alleged or suspected assaults committed by a care recipient with a pre-diagnosed cognitive impairment on another care recipient, should be removed. We promote the rights of older people and adults with disability to live free from abuse in their family, home and community. In NSW, mandatory reporting is regulated by the Children and Young Persons (Care and Protection) Act 1998 (the Care Act). 11.139 It is also critical that information sharing provisions enable the sharing of information comprising adverse findings that have been made against staff members, in circumstances where there are safety or significant welfare issues that would justify the exchange of information, with a national database which would contribute to enhanced employment screening. In summary, their concerns are that: the scope of conduct covered by the scheme was too limited and failed to include other serious forms of abuse; the scope was limited to care recipients in residential care; the exemption in respect of residentonresident assaults, where the offender had a pre-diagnosed cognitive impairment, afforded too broad a discretion to approved providers not to report, and resulted in a lack of understanding of how such incidents were managed, potentially raising broader safety issues in respect of other care recipients, and concealed the number and nature of such incidents. Wyong Public Hospital 11.55 The complaints scheme has already had several incarnations. Women were most commonly reported to be the victims (71% women cf. A police investigation substantiates the allegations, but due to technical reasons no charges are laid. Label the perpetrators behaviour as a crime and inform the older person of their right to pursue/ not to pursue, the crime with NSW Police to report the offence. Evidence to the Senate Standing Committee on Community Affairs, Parliament of Australia, Sydney, 27 August 2015, (Steve Kinmond). Quirindi Community Hospital Specifically, these should include the types of conduct provided for in the DRIS, namely sexual offences, incidents causing serious injury, incidents involving the use of a weapon, incidents that are part of a pattern of abuse.[142]. 28% men), and the most common age group of concern in the calls was 75-84 year olds . These officers are able to exercise a number of powers, including the power to search premises, take photographs, inspect documents and to ask people questions. 11.50 The Department of Health describes its role as confirming that reporting is made within the specified timeframe; that there are appropriate systems in place for reporting; and that appropriate action has been taken. Has anyone made you afraid, touched you in ways that you did not want, or hurt you physically? Concord Repatriation General Hospital Coolamon-Ganmain Health Service 11.96 These different categories have the capacity to respond to a number of concerns raised by stakeholders. Non-accidental acts that result in physical pain or injury, or physical coercion. NSW Police or other emergency services should be contacted when required. Many of these reforms are critical to achieving positive outcomes for complainants and for systemic improvements in service delivery in aged care along with identifying and rectifying matters of serious concern. Cooma Hospital & Health Service Have you relied on people for any of the following: bathing, dressing, shopping, banking, or meals? The scheme would replace the existing reporting regime in the Aged Care Act and, to be effective, it will be critical that adequate investment and resourcing is allocated to ensure the scheme can function effectively. The job of a mandated reporter is to stay alert and immediately report suspicions of elderly abuse. In circumstances where the head of the agency or Ombudsman has a reasonable belief that the person does not have capacity to understand the information or to nominate a person: Ibid s 25WA(2)(c). A common theme emerging in submissions was the need for whistleblower protections for workers who report incidents.[158]. Download free resources about abuse, neglect and exploitation. These include powers to require the production of documents, to require statements of information,[96] to enter and inspect premises,[97] to hold inquiries,[98] to make recommendations,[99] and to report to Parliament and to the public. Kyogle Memorial Hospital Hornsby Ku-ring-gai Hospital [66], 11.40 There are exemptions to reporting residentonresident incidents, where the resident alleged to have committed the offending conduct has a pre-diagnosed cognitive impairment, provided the approved provider implements arrangements to manage the persons behaviour within 24 hours. 11.45 The Complaints Commissioner submitted to the ALRC that, in the first six months of 2016, her office received just 113 complaints identifiable with the keyword abuse, representing 2% of all complaints received by her office in that period.[73]. Where a provider is receiving government funding, there may be contractual or regulatory compliance obligations to report such incidents to the funding body. Each of the 5 steps has practical information and tools which guide staff from identification of elder abuse, through to response. Barraba Multi Purpose Service There had been at least one previous unreportable assault with a pillow by the same man, and preventative measures were supposed to be in place. Serious Incident Response Scheme Serious Incident Response Scheme Introduction to the SIRS SIRS in residential aged care SIRS in home services SIRS decision support tool Resources for providers Incident management Frequently asked questions Your role in the SIRS Changed Monday, 24 April 2023 - 8:54am Was this page useful? Tamworth Rural Referral Hospital National Seniors Australia, Submission 154; Old Colonists Association of Victoria, Submission 16. Inflicting mental stress via actions and threats that cause fear, violence, isolation, deprivation and feelings of shame and powerlessness. Issues with the current mandatory reporting requirement for treating practitioners 5 Patient confidentiality 5 Focus on past conduct 6 Lack of national consistency 6 3. Where a provider fails to comply with the direction, the Commissioner may refer the matter to the Department to consider compliance action,[101] or to the Quality Agency to consider any systemic issues identified.[102]. 11.115 The category distinctions in the DRIS model are designed to strike a balance between the undesirability of reporting such incidents and the risk of criminalising people with cognitive impairment, with the need to ensure residentonresident incidents are not normalised, and are subject to an appropriate response. Commonwealth Parliamentary Debates, House of Representatives, 13 August 2015, 5240 (Mitch Fifield). Bowral Hospital 11.77 The NSW Ombudsman has substantial powers conferred upon it under the Ombudsman Act 1975 (NSW). Wollongong Hospital [100] These powers enable it to effectively oversee and monitor agencies that are subject to the scheme. 11.105 The Office of the Public Advocate Victoria asserted that the exception to mandatory reporting of assaults under these conditions is too lenient. Coonamble Health Service 11.49 Second, reportable assaults are not automatically treated as complaints, and therefore the response of approved providers to those incidents is not monitored. Intervention If Elder Abuse is suspected or disclosed: The 5step approach to identifying and responding to the abuse of older people, STEP 1: IDENTIFY ABUSE (suspected, witnessed or disclosed). Seniors Rights Service, Submission 169; Townsville Community Legal Service Inc, Submission 141; Office of the Public Advocate (Vic), Submission 95; Combined Pensioners & Superannuants Association of NSW Inc, Submission 76; NSW Nurses and Midwives Association, Submission 29; Quality Aged Care Action Group Incorporated, Submission 28. Frequent arguments or tension between the caregiver and the elderly person, Changes in personality or behavior in the elder, Unexplained signs of injury, such as bruises, welts, or scars, especially if they appear symmetrically on two side of the body, Report of drug overdose or apparent failure to take medication regularly (a prescription has more remaining than it should), Signs of being restrained, such as rope marks on wrists, Caregiver's refusal to allow you to see the elder along, Threatening, belittling, or controlling caregiver behaviour that you witness, Behaviour from the elder that mimics dementia, such as rocking, sucking, or mumbling to oneself, Unexplained venereal disease or genital infections, Unusual weight loss, malnutrition, dehydration, Untreated physical problems, such as bed sores, Unsanitary living conditions: dirt, bugs, soiled bedding and clothes, Unsuitable clothing or covering for the weather, Unsafe living conditions (no heat or running water; faulty electrical wiring, other fire hazards), Significant withdrawals from the elders accounts, Sudden changes in the elders financial condition, Items or cash missing from the seniors household, Suspicious changes in wills, power of attorney, titles, and policies, Addition of names to the seniors signature card, Unpaid bills or lack of medical care, although the elder has enough money to pay for them, Financial activity the senior couldnt have done, such as an ATM withdrawal when the account holder is bedridden, Unnecessary services, goods, or subscriptions. Do not alert or confront the alleged abuse (when and how this is done requires professional decision making between agencies on a case by case basis). Such a design enables a provider to consider its plan to investigate and respond to the incident, and to provide a more thorough and considered report outlining its proposed course of action than the current 24 hour window. Reporting authority Further services/information Contact details; Department of Communities and Justice: The Department of Communities and Justice is responsible for handling reports of child abuse and neglect in New South Wales. The Maitland Hospital You can accessour apology to the Stolen Generations. In NSW, two years of call data (n = 3,388) to the NSW Elder Abuse hotline (NSW Elder Abuse Helpline and Resource Unit, 2015) reveal broadly similar patterns to the Queensland and Victorian data. [123] UnitingCare Australia commented that reports of reported assaults do not give a full picture[124] of abuse, because they do not extend to all forms of elder abuse. 11.122 In the ALRCs view, the current restricted application of the reporting requirement to residential care recipients affords less protection to care recipients receiving aged care outside the residential context. [148], 11.125 This does not mean that a person (including a staff member of an approved provider) who has concerns for the welfare of person receiving flexible or home care should not report their concerns to anyone, but merely that they are not required to do so under the compulsory reporting regime. See, eg, Leading Age Services Australia, Submission 104. NSW Ombudsman, Submission No 122 to Legislative Council General Purpose Standing Committee 2, Parliament of NSW, Inquiry into Elder Abuse in NSW (April 2016). Northern Beaches Hospital A range of free tools and resources are available to increase awareness of abuse, neglect and exploitation of older people and adults with disability, and how to respond when matters arise. Royal North Shore Hospital 6. Glen Innes District Hospital Find resources for mandatory reporters. Part 3C is modelled on Part 3A of the Ombudsman Act 1974, which has provided for a reportable conduct scheme since 1999. [146] In its view, the reporting requirements imposed on the industry had little positive effect and only concentrates on a limited area of aged care and does not include other forms of abuse.[147]. Calvary Mater Newcastle Aged Care Complaints Commissioner and Australian Aged Care Quality Agency, Memorandum of Understanding (2016); Department of Health (Cth) and Aged Care Complaints Commissioner, Memorandum of Understanding (2016). Elder Abuse Service Annual Report 2021-2022 Contact Us You can contact our service with any questions, referrals or to make an appointment by: Phone: (02) 4324 5611 Email: elderservice@legalaid.nsw.gov.au More information World Health Organisation: What is elder abuse? 11.98 The Australian College of Nursing noted that information relating to minor incidents can assist in assessing risk: There should be no provisions allowing aged care services to determine if a complaint should be reported, processed and assessed. 11.137 The Ombudsman described a number of examples that demonstrate the problem in the disability context, but which are apposite in the aged care arena: Need to disclose information between disability services relating to risks associated with employees. Legal Aid, Guardianship Tribunal, Mental Health services. Werris Creek Community Hospital 11.48 First, an approved provider is not required to take any action in response to a reportable assault, other than to report it and maintain appropriate records. 11.72 The Ombudsman reported that the DRIS legislation requires and enables it to, receive and assess notifications concerning reportable allegations or convictions, scrutinise agency systems for preventing reportable incidents, and for handling and responding to allegations of reportable incidents, monitor and oversight agency investigations of reportable incidents, respond to complaints about inappropriate handling of any reportable allegation or conviction, conduct direct investigations concerning reportable allegations or convictions, or any inappropriate handling of, or response to, a reportable incident or conviction, conduct audits and education and training activities to improve the understanding of, and responses to, reportable incidents, and, report on trends and issues in connection with reportable incident matters.[90]. The ALRC proposes that such protections be incorporated into the reportable incidents scheme. The Cootamundra Hospital [78], 11.57 When the legislation establishing the independence of the Complaints Commissioner was passed, part of the rationale was said to be that the change will result in a separation of complaints management from the funder and regulator, which reflects best practice in complaints handling. Bombala Multi Purpose Service Westmead Hospital These build on provisions in the DRIS and include enhanced information sharing provisions; whistleblower protections; and data capture capabilities. Contact Dr Clare Skinner, Director of Emergency Medicine for more details on clare.skinner@health.nsw.gov.au. In 2007 the Bill establishing the reporting regime was the subject of scrutiny by the Senate Standing Committee on Community Affairs, Parliament of Australia, Aged Care Amendment (Security and Protection) Bill 2007 (Provisions) (2007), which noted concerns that the discretion in relation to assaults by aged residents with mental impairments would detract from approved providers obligations to provide a safe environment for all aged care residents. IMPLEMENTATION Roles and responsibilities of the NSW Ministry of Health: These obligations include, for example, taking all appropriate legislative, administrative, social, educational and other measures to protect persons with disabilities from all forms of exploitation, violence and abuse.[89]. Physical assaults comprised the largest proportion of reports (38%), followed by neglect (20%). 11.69 It would be preferable to cast a wide net to ensure safeguards are extended to all older people receiving aged care, irrespective of whether the provider is regulated under the Aged Care Act. [125], 11.101 Under the DRIS, examples of neglect and ill-treatment include inappropriate use of restrictive practices to manage behaviour, leaving residents unsupervised for an extended period of time, withholding food, locking residents outside for extended periods and depriving them of food and water, and failing to connect or flush enteral nutrition tubes. This is concerning as it drastically reduces the accountability of an entire subset of staff members, volunteers or key personnel of aged care providers that do not fall within residential care. Seniors Rights Service, Submission 169; People with Disability Australia, Submission 167; Aged Care Crisis, Submission 165; Australian College of Nursing, Submission 147; Townsville Community Legal Service Inc, Submission 141; UNSW Law Society, Submission 117; National LGBTI Health Alliance, Submission 116; Office of the Public Advocate (Vic), Submission 95; Northern Territory Anti-Discrimination Commission, Submission 93; Law Council of Australia, Submission 61. Shoalhaven Hospital Ask open questions to initiate conversations e.g. [84], 11.65 The DRIS provides an instructive model upon which to base a reporting regime for aged care, as it captures people who are closer to the cohort of people the subject of this Inquiry, that is, older people with disability, and draws on 16 years of experience of the employment related child-protection function provided by Part 3A. Temora Hospital If the child or family belongs to a culturally and linguistically diverse community, Deciding to make a report and using the MRG, the basic physical or psychological needs of the child or young person are not being met (neglect), the parents or caregivers have not arranged necessary medical care for the child or young person (unwilling or unable to do so), the parents or caregivers have not arranged for the child or young person to receive an education in accordance with the, risk of physical or sexual abuse or ill-treatment, parent or caregivers behaviour towards the child causes or risks serious psychological harm (emotional abuse), incidents of domestic violence and as a consequence a child or young person is at risk of serious physical or psychological harm (domestic or family violence). The EASI was validated for use by family practitioners of cognitively intact seniors in ambulatory settings. Abuse in the home or community. Gulargambone Multi-Purpose Service The toolkit supports a consistent approach to identifying, responding and preventing the abuse of older people. Nyngan Multi-Purpose Service Australian Nursing & Midwifery Federation, Submission 163; Older Womens Network NSW, Submission 136. A recommendation, if it is persuasive and compelling, can change a mindset.[111]. This resource, funded by the Australian Government, is a national guide on making enduring powers of attorney for financial matters, with a focus on their usage in avoiding elder abuse. Campbell Hospital, Coraki WA, Qld, Vic. About a quarter of notifications of client-on-client incidents were for assault causing serious injury, and sexual offences and assault involving the use of a weapon comprised 20% of notifications respectively. For example, in the ACT it is mandatory to report physical and sexual abuse, while in NSW you may also be mandated to report neglect and exposure to family violence.
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