The recent announcement of the Royal Commission into Aged Care has been a reminder to all of us that atrocities can and do occur right under our noses, often to the people who are least able to defend themselves or advocate for their own rights. Recent media footage of elder abuse and neglect has a lot of us asking the same questions of the reporting systems in place.
Staff, contractors, subcontractors, volunteers and family members all have a legal obligation to report any and all abuse (that is, physical assault, unreasonable use of force, and sexual assault) and neglect, as well as unexplained injuries and absences. Additionally, one doesn’t have to actually witness something: it could simply be that as a carer you have witnessed a change in behaviour of the resident you are caring for. Why then, with such strict reporting legislation, are these things still happening?
Let’s take a look at a scenario to help answer this question.
You arrive on shift one afternoon and receive handover from a senior staff member, Sally. Sally gives you the rundown on how the morning went. All sounds pretty normal, except she mentions that Mr Bloggs was particularly difficult this morning during his personal care routine, and tells you to watch out for him today, as he seems a bit testy. Sally leaves her shift and you begin yours, attending to all your normal duties.
Later in the day, when attending to Mr Bloggs’ personal care, you notice several bruises on his arms and thigh. He is upset and claims that Sally was too rough with him this morning. You check the relevant progress notes and incident reports, but find nothing to explain how Mr Bloggs sustained his injuries. You enquire with a newer staff member, John, who was on shift earlier, and he tells you he was in the room and witnessed Sally use what he described as ‘a bit too much’ force getting Mr Bloggs into his shower chair. He tells you he didn’t know whether to report this because he is new, and Sally is a senior staff member. You both talk further and arrive at the same question: should we report this as abuse? Is it a Reportable Incident?
The difficulties faced by aged care workers in relation to reporting incidents are often very similar. Staff who witness abuse or neglect are often unsure whether or not to report, especially if they are new to a job or when the abuser is a senior worker or manager. Lack of certainty over job security, and not wanting to come across as a trouble-maker, often stops people from reporting incidents. In some cases, there is confusion over exactly how bad abuse must be to warrant a report – John might say he thinks Sally used more force than was probably necessary, but it was just a ‘little push’, and Mr Bloggs bruises pretty easily anyway. Additionally, where the abuser is a manager, staff may be unsure of exactly who to go to in order to report the incident, since they can’t get advice from the manager. Oftentimes, with all this uncertainty, staff may feel it is easier just to remain quiet and look the other way.
It is vitally important to remember here that residents depend on aged care staff for many things, especially their personal wellbeing. A phrase we often use in our external training sessions is, “if it quacks like a duck and walks like a duck, it’s probably a duck” – in all cases, it is better to report something than to not report it at all. That is not to say that you must physically submit the Departments Notification Form and report the incident yourself. Rather, your obligation is to report it through the relevant reporting lines within your company (a senior staff member, a manager, or even straight to the Director if you feel closer reporting lines are compromised). The person notified then has 24 hours to review the incident and submit a Reportable Incident Notification Form to the Department of Health if the incident relates to a physical assault, unreasonable use of force, sexual assault or an unexplained absence.
Your job here is now done: a simple email, phone call or conversation has ensured the safety and wellbeing of the people that rely on you.