The aged care watchdog may be given additional powers that allow it to impose fines on providers that fail to comply with new rules about reporting neglect and abuse in aged care homes.

The proposal to increase the powers of the Aged Care Quality and Safety Commission, which will be debated when parliament resumes next month, comes as data reveals an estimated 39.2 per cent of aged care residents experience some form of abuse.

Between July and September, the regulator also revealed that 1,384 “reportable assaults’’ (defined as serious physical and sexual assaults) took place, taking the total for the first nine months of 2020 to a shocking 4,034 cases. 

Almost 40% of aged care residents experience abuse

Data about the extent of abuse in aged care homes was contained in a report released by the Royal Commission into Aged Care Quality and Safety just before Christmas. 

The report shows that almost two in every five aged care residents experience emotional abuse, physical abuse and/or neglect in aged care homes. (The figure does not include financial or sexual abuse.)

The researchers estimate that 30.8% of residents experience neglect, including having concerns about how they are helped to shower, eat, and toilet, concerns about how medication is managed and wounds are looked after, concerns about accessing a GP, dentist, mental and health services, and care staff who “rarely” spend enough time attending to individual needs.

And 22.6 per cent of residents experience emotional or psychological abuse, including feeling like they were being treated like children, being shouted at, or not having their concerns listened to.

One in every 20 residents, 5%, reported having been physically abused, including being hurt or roughly treated by staff, restrained, or not being allowed out of their bed, chair or room. With more than 200,000 Australians living in residential aged care, the estimates suggest that more than 10,000 older people could be experiencing physical abuse in aged care homes.

These figures have been extrapolated from data obtained last year, when aged care residents were surveyed for the royal commission, not to measure the prevalence of elder abuse, but the responses from the survey have been able to be used to create “experimental estimates” of the prevalence of elder abuse in Australian residential aged care. 

The estimates are based on responses from 391 aged care residents living in 67 different homes.

Serious Incident Response Scheme to be expanded

In December, the Minister for Education, Dan Tehan, told parliament the Serious Incident Response Scheme will help to reduce the incidence of abuse and neglect of older Australians living in residential aged care. 

The SIRS will expand both the range of incidents that must be reported, and power of the regulator, the Aged Care Quality and Safety Commission, which will administer the scheme.

“The scheme will provide greater protections for older Australians by taking into account broader instances of abuse and neglect, by introducing more robust requirements for residential aged-care providers to respond and report, and by providing the Aged Care Quality and Safety Commission with more functions and powers,” Teehan said.

Aged care regulator’s powers expanded

Should the Bill be passed, the Aged Care Quality and Safety Commissioner will be granted additional powers to help it administer the scheme, including the power to gain additional documentation from providers and the power to impose civil penalties, or fines, on providers.

“These powers will… enable the commission to take more effective action to protect consumers,” Mr Tehan said.

Whistleblowers given added protections

The bill will also strengthen protections for people who report abuse or neglect in a residential aged care home.

A statement from the Department of Health said, “From 1 April 2021 (subject to the passage of legislation), these protections will ensure that people disclosing abuse or neglect, are not subject to any civil or criminal liability, or threats or victimisation.

“The protections also ensure that staff are unable to be terminated for breach of contract for making the disclosure.

“The Bill introduces civil penalties for any person (or body corporates) found to have victimised a discloser.”

Mr Tehan said, “These changes are necessary to ensure those who witness or suspect that a serious incident has occurred do not face repercussions, such as civil or criminal liability, for making such reports.”

“Any abuse of a person in residential aged care is unacceptable and it is important that these incidents are reported, managed and prevented from occurring in future,” he said.

Resident-on-resident abuse with cognitive impairment no longer exempt

Importantly, incidents of resident-on-resident incidents where the resident has an assessed cognitive impairment will no longer be exempt from reporting.

The Scheme will be rolled out in two stages, first in April 2021, when incidents that result in physical or psychological injury or illness requiring onsite medical or psychological treatment will have to be reported.

From 1 April 2021, aged care providers will have added responsibilities to identify, record, manage and resolve all incidents of abuse that occur in their homes. Providers will be required to report “serious incidents” to the Aged Care Quality and Safety Commission, including alleged, suspected or known incidents.

“Reportable incidents” will include various categories of abuse and neglect, including unreasonable use of force, inappropriate sexual conduct, psychological or emotional abuse, stealing by a staff member, inappropriate use of physical or chemical restraint, neglect, and unexpected death. 

And then from mid-2021, the Scheme will be expanded to include all other serious incidents. 

Providers are being asked to keep detailed records of a broader range of incidents from 1 April 2021.

Image: fiztok, iStock.

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