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Reporting a notifiable incident webinar recording

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Clare Moran (SSR)
Good morning, everyone, and welcome to our webinar on reporting notifiable incidents.

We'll start in a few minutes while we wait for people to join.

Good morning, everybody, and welcome to our webinar on reporting notifiable incidents to the Social Services Regulator.

Thank you for joining us today.

My name is Clare Moran.

I am the manager for guidance and readiness at the Social Services Regulator and I'll be your facilitator for today.

A few items before we start – this session will be recorded and shared on the social services regulator website for anyone unable to attend today.

Live captioning is available for those who may need it. The session will be captioned by Bernadette.

Please click on the link in the chat.

We are also joined today by our two Auslan interpreters, Luke and Sarah.

Today's agenda.

Jonathan Kaplan, the Social Services Regulator will give an introduction and then he'll hand over to Richard Marks, who's the Director of Social Services Regulation, to take you through the process for reporting notifiable incidents to the Social Services Regulator.

There will be time for questions and answers at the end of the session and we will e-mail the presentation to all attendees after the session.

You should also be able to submit your questions in the chat and we'll try to answer as many as we can.

I ask you to keep your questions relevant to the topic for today, which is reporting notifiable incidents to the regulator.

And I will now hand over to Jonathan Kaplan, the Social Services Regulator.

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Jonathan Kaplan (SSR)
Thank you, Clare, and welcome everyone.

I'd like to begin by acknowledging the traditional owners of the lands on which we are meeting today.

I'm joining you from the lands of the lands of the Wurundjeri Woi Wurrung people of the Kulin Nation, and I would like to pay my respects to elders past present, as well as all Aboriginal and Torres Strait Islander people who are joining us today.

I'm just going to speak very briefly and then I'll hand over to Richard Marks who'll be able to take you through with some more detail and hopefully his presentation and discussion will answer any questions you've got, and if not, we'll try and respond to them either through the chat or afterwards.

What I'm very keen to do today is specifically on the issue of reporting, be able to say why we do it, how to do it and then also to give you some insight into what actually happens with the information once we've got it, which for me goes back to the why as well.

I've given a number of presentations already, both online and at various other forums, and there's a number of resources relative to that on our website and on other websites as well.

In terms of who and what the Social Services Regulator is and why the government introduced it, I won't go into any detail on that, just to say that we came into effect on the 1st of July.

And just emphasise today it's about a common series of social services standards to all service providers who fall within one of the categories that sit under the act and very importantly, we are an independent regulator separate from government, the department or any other service provider

And what we are going to talk about today is the reporting requirements relative to all registered providers.

You will already be registered.

Some will be going through the process of registering as we speak and some will be registering with us through the course of the next 9 to 12 months.

So that's what I'm keen for us to be able to cover off and support you with today.

So sorry, next slide please, team.

So why it's important we have a role set out in the legislation and in our statement of expectations from the Minister that we're accountable to which you can find a copy on our website, about promoting and supporting the safe delivery of social services.

And from the SSR’s perspective, that has two very important components. One is where, if possible, we identify where there is an opportunity to prevent further harm and then the secondary bit which is actually around positive assurance, which is by looking at these serious and critical incidents, we are able to give assurance that organisations are managing them well and that Victoria has a series of safe and well managed, well-governed and well-run social service providers.

So there is that positive piece as well also there is an ability over time for us to start to identify themes and trends potentially and then to be able to work with sectors to provide and hopefully better support through enhanced information, education, guidance…and so forth.

One thing and I've had the opportunity to spend a lot of time going out to visit service providers all around Victoria and last week I went out to East Gippsland in a number of places between Melbourne and Lakes entrance, and you know, reinforced it’s already clear that the purpose of the Social Services Regulator and the purpose of organisations delivering the services is around providing safe, secure and quality services to the Victorians who need them, some are vulnerable, some require protection, some just want to be able to be assured that there is a consistency of service provision across a range of services.

They may engage with, but I feel that and I'm very confident that our that we have a shared purpose and this is one of the components and elements of the work that allows us to give that assurance and also identify where.

On occasion, we may need to focus some of our attention to support organisations towards compliance if required.

Thank you. Next slide.

As I said, it is as much about you being able to demonstrate that you are managing well as well as identifying where there are areas where we might want to or need to make further enquiry.

So it's very important in my mind is that just because an organisation makes reports doesn't mean it's an organisation that we're worried about.

Some of you are very large organisations. Some of you are small but have very complex clients and some are large with many complex clients making reports and being confident about how they're managed is actually at the heart of it so we are taking a very balanced approach to that.

And what we're keen to do through the course of today is just to explain a bit about that try and keep it easy, accessible and understandable.

The most important regulatory tool that the SSR has is information, education and guidance.

So really through this it's an opportunity to explain what we're doing, but also collect any questions so that we can if necessary improve the information that supports you to meet your obligations and we and I know from having spoken to many, many of you, that that's absolutely what organisations want to do.

So very keen to work with you on that. Thank you.

OK, so I will now hand over to Richard Marks, who will take us through the detail. Also, just in case it hasn't gone up in the chat or mentioned, we will provide you with a copy of the slides.

They will be accessible and also some additional information in a built out slide deck. So don't worry about trying to scribble down everything that's written down.

We will get that to you as well.

We can answer some questions as it comes up in the chat I will look forward to hearing the conversation and discussion, and hopefully we can support you to deliver the kind of services I know that you are absolutely committed and working hard to do, so thank you.

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Richard Marks (SSR)
Thanks Jonathan.

I'm just gonna check how we're going with the technology, Clare. Was there any housekeeping we needed to do in that space?

Couple of people saying they can't see the slides. I'm assuming that someone can see the slides and therefore it's not our end.

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Clare Moran (SSR)
Sorry, yep so I think we have answered a comment in the chat, so there should be a view button on the top of the screen where you can change the view and we also just wanted to remind people that we were, the captioning link is in also in the chat, we're just a little bit delayed getting up there, but that is in there if anyone needs it.

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Richard Marks (SSR)
Terrific. Thanks, Clare.

Alright, welcome everybody. Thank you for joining us.

Apologies for the lighting in my office. Occasionally it looks like I'm sent from heaven.

Occasionally I just disappear into the background but will persist and the slides are what you're going to be looking at much more than me anyway.

So, you're not missing anything, So what we want to talk about is notifiable incidents today.

These notifiable incidents come up as a requirement in the legislation so they're not something that we have a choice about whether you do or not, whether we implement it or not.

And they come up after someone is registered, so you're required to register for to provide in scope social services and then this becomes a requirement post your registration so.

And a critical element of this is, during the delivery of a social service, and this is something we've had questions about and I'll deal with a little bit more fulsomely later…but we're interested in what happens during the delivery of a social service.

Now a lot of you run services where people who have been in very challenging situations are coming to you seeking a service.

So the example that we had recently was a sexual assault service.

So someone has been sexually assaulted. That's why they're seeking your service.

That is not a reportable incident, but if someone was sexually assaulted while you're engaging with them, either you know by another service user by a staff member while you were delivering a service user that would be a reportable incident.

So that's a key concept. It's during the course of service delivery.

And we're working on some sort of more specific guidance where there's a couple of complexities around that in particular around child protection.

So there are some providers who aren't registered yet.

We're going through a progressive registration process at the moment.

Many of you will be in that, for many of you, this is just a continuation of previous reporting requirements, particularly for the support of residential services sector. Notifiable incidents were required to be notified under that scheme, they are required to be notified under this scheme.

There is a slight difference in terms of process, but there's no difference in terms of what needs to be reported and the timeframes so.

There aren't exceptions as well, so that's a key point.

We're not providing exemptions from reporting and we're being consistent across the regulatory spectrum.

So it doesn't matter if you're the department delivering every service through a workforce of 4000 people or, you know, an SRS that employs 20 people, you know it is consistent across the board.

These are the registration timeframes, you will probably know these already. All of the organisations that were previously registered under the Human Services Regulator under the department were deemed to be registered by the Social Services Regulator as at 1st of July.

We've also brought in the department in July and August for the services that they deliver. And we're going through a process at the moment to bring in family violence services and the next will be homelessness services and then next year we bring in sexual assault services and then disability services funded by the TAC and WorkSafe.

So that's when organisations will come on board.

If you want to deliver a new type of social service, I have to say you must register for that. These timeframes don't apply to new services.

What we're talking about today, there are two types of notification and I just wanted to be really clear about this.

So there are changes to the organisation and operational matters, so that is essentially the information on your registration that section 47 of the legislation and that's not what we're talking about today. We're about to publish some guidance on that but that is organisational change.

What we're talking about today is incident reporting on notifiable incidents. These all come under section 48 of the Social Services Regulation Act.

The other thing I wanted to talk about in this slide is that there are incidents that need to be reported under section 48 and a subset of those incidents also have to be reported as critical notifiable incidents.

So all of them have to be reported under section 48. All of them are notifiable incidents. A subset of those also have to be reported within a shorter time frame and I'll talk more about what that looks like.

So I've talked a little bit about during service delivery and I've given example of that and there's a bit more information on this slide. And as Jonathan said, we will send these slides out.

This information is also in the guidance. So there's guidance on the website and there’s a downloadable form of that guidance as well.

So you can take that, peruse that, share it with your staff so that they can build their understanding as well.

What I'll talk to on this slide is serious harm and serious risk, and it is a little bit complicated the way it's articulated in the legislation. So we try to simplify it as much as we can in the guidance.

In here as well. So serious harm is an incident that has resulted in harm. That's pretty straightforward.

Harm or injury and there are particular sub types of that that we'll get into in more detail.

Serious risk is a bit more difficult to articulate, but that's where there's been an incident that was reasonably likely to have caused serious harm to a service user.

So there's a little bit of judgement in this one and you guys know your services really well. You'll know the type of issues that can cause harm, but serious risk also needs to be reported.

So what we're interested in is what is the incident that did or could have resulted in harm to a service user?

So it's the incident, not necessarily the consequence, because what we're about is making sure that people are controlling, you know, putting reasonable controls in to prevent harm. That's why that's important.

So we'll talk first about notifiable incidents. So the broad category, so the overarching everything within this category needs to be reported.

And here are some of the key thresholds around what needs to be reported. So, and again, this is defined in legislation, so serious harm or injury likely to cause ongoing trauma, a pattern of incidents that cause harm, so that cumulative effect. Emotional and psychological abuse, that can be a bit more difficult to identify and characterise.

Behaviours that reject, isolate, or intimidate are the examples we've got there.

Financial abuse. Many of you run services where individuals are very reliant on you for their life.

Some of you manage finances on behalf of residents. For example, in some services, so making sure that you're really aware of the risk of financial abuse and misappropriation of assets, that kind of thing. That's why those need to be reported.

Self-harm attempted suicide. The services that you run, offer for people who are in really challenging situations, those kinds of incidents will happen.

Sexual exploitation. Of poor quality of care or neglect.

So they're the sort of overarching categories of notifiable incidents.

And again, more guidance on the website, more guidance in the, in the publication as well.

So there's a few questions that we've been getting pretty regularly, so I'm not sure if the incident meets one of the definitions.

Should I report it anyway? Should I report incidents that happened?

A few months ago, I didn't know at the time I needed to report them.

Why do I need to provide all this information to you?

I'm already providing to other regulators.

All good questions.

So if you think an incident has met one of the definitions, please fill out the incident reporting form. Part of what my team is doing is a bit of quality control on that at the moment and providing some feedback and guidance to service providers on what they're reporting.

It may take a little bit of time to for everyone to understand the nuances. Some of this reporting, if you think it meets the definition, please report it and we can provide, we can then target some guidance potentially.

If we're getting too many that look at that, that look like they might be out of scope.

Incidents that have happened post one July must be reported to the Social Services Regulator.

So if you've got incidents that you think should have been reported, please do.

Is much better for you to report that.

Actually I didn't know I should have reported these or we found these incidents or whatever.

Please do put them through one because it means that you're being forthright and upfront with the regulator, which is really important and important for us to be able to tell the community and the sector.

But secondly, it also helps us with that information, so we can help to understand what's going on.

What trends there are where extra guidance might be needed or potentially like in, I think rare cases, there might be some things that we need to follow up, but much better for you to report it then for us to come and find it or for someone else to alert us about it.

Why do you have to report to us as well as other regulators? We all have different roles, so we have different roles and functions to some other regulators that might be involved.

What we are trying to do is to align reporting as much as possible and try to make sure that we move into a space for you provide information once and it gets used multiple times.

So we're trying to, particularly we've done that through organisations that have to report to the department as well, and we're looking at other opportunities to streamline as well. But we want to make it clear that we need this information.

We don't have a choice about having it reported to us, as I said, that's in the legislation.

But we will, we need that information as well.

And as I said, we're working on methods to make it as streamlined as possible.

We also need it in a timely way so that we can act if we need to. That's really important.

So how do I report a notifiable incident?

So remember, this is the broad container all section 48 notifications and this is where we get into some terminology that might be foreign to some people. If it is foreign to you, it means that it doesn't apply to you.

So if you don't know what CIMS is, if you're not already using CIMS, then CIMS doesn't apply to you.

CIMS is the client incident management system that is used by the Department of Families, Fairness and Housing for incident reporting for organisations that it funds.

And it’s also used by itself to report incidents.

What we've done is we have come to an agreement with the department that we will also receive that information.

So if you report incidents through CIMS that are in scope for us, we will receive them through an agreement with the department. So you only have to report using CIMS in that space.

We get an extract of CIMS. We don't have access to the full CIMS system as you might expect.

We get an extract of the information, so it is an information provision tool.

I know that the department uses it for more than that. For us, it is just about providing information about incidents and the response to those incidents.

If you don't use CIMS, then you'll use the web form and that's the simplest way to articulate that.

So there's a form on our website.

There's a link that is no doubt in the slide pack that will take you to that incident reporting form. It contains similar fields to what's in CIMS.

We're getting similar information through both pathways.

It's just that some people have a system in place already that we've been able to utilise.

Many people don't. So that's the web form on our website.

There are a couple of other questions we've had around other systems that people use, for example, VHIMS, which is used by the Department of Health and Health funded organisations. We're not able to access that information at the moment. So, if you are reporting through VHIMS, unfortunately you have to report through our website as well.

We have not been able to align those processes.

The timing for this is within three business days, so it's not immediately after an incident has occurred.

You will have done your initial response.

You might have even done your initial investigation as to what caused it.

You will have taken whatever actions you need to do immediately to prevent further harm to that individual and to prevent harm to others.

Then you submit the report to us within that first three days with the content. That's that we require.

So touched on details about how you responded to the incident so and that is really about how have you minimised harm to the individual involved in the incident and then minimised risk to other service users.

Once you've reported it to us, we may ask for additional information if there are gaps in the incident report.

We will review the incidents if we are confident that the actions that have been taken are appropriate, you probably won't hear from us.

If we've got concerns or questions, that's when you might have some follow up from us. But we're expecting that to be the rarity rather than the rule.

This information will be important for us as I've mentioned, to identify trends within incidents.

So what are the themes?

What sort of and they may be, maybe by sector, they may be within a particular provider.

They may be that we're identifying themes around people are confused about a particular requirement, so it will enable us to target guidance, but also then potentially some of our other work as well.

So I talked about, that's the container, section 48. All of that, all incidents need to be reported in that way that meet the criteria.

There are a subset of incidents where they're particularly, where they meet a threshold where we can't wait three days to hear about them.

There is an expectation within the community within government, within the sector, that the regulator is aware of these incidents. And able to intervene if necessary.

Now we still won't intervene unless we think that something is concerning.

If there's a particular problem that led to the incident, or if we're concerned about the response to the incident, we might intervene. But really, we just need to know about these incidents quite early in the piece so that we're able to understand where the service users are being protected effectively.

So that must be reported by the close of business the next day.

So it's not straight away and we've been very deliberate in choosing the next business day because we know that you will be in the midst of dealing with the incident in that first 24 hours.

So you'll be dealing with the incident, you'll be trying to support and protect the service user involved.

We don't want to get in the way of that. We think the 24 hours, oh, sorry, next business day is a reasonable reporting timeframe for that, and we're only asking for some, really brief information about the incident, so we tried to both match the time frame to the criticality, but also make it as brief as possible so that you can deal with whatever you need to deal with at the time.

And there is a short form on our website to complete these incident reports.

So, you will identify the incident. You will identify whether it meets the threshold to be a critical notifiable incident.

And I'll walk through what those are in a minute.

Complete the form on the site.

You will still do your full incident report and this is one thing that we need to be really clear on. So because the information provided in the critical incident form is so brief, we still need the proper incident report as a follow up that will give us the more comprehensive information about the incident.

Has been a flow chart there and again these slides will be provided.

So what is a critical notifiable incident?

I'll just take a simple example.

So the unexpected death of a service user within service delivery. Now that's obvious in terms of its criticality, in particular around, you know, have the appropriate services being engaged is, did the incident that led to the unexpected death have implications for other service users?

Do we need to intervene in some way?

Escape from a service secure facility. I think that should be reasonably obvious. Medication error.

But we're not saying all medication errors. We’re saying a medication error where the incident requires a service user to obtain medical treatment in a hospital, a medical treatment, not admission, is not the thresholder’s medical treatment in a hospital.

So that is a small subset of medication errors.

Other medication errors will need to be recorded and reported as normal physical abuse again.

Where the incident report results in a service user requiring medical treatment at a hospital.

Sexual abuse, where the incidents require police involvement and the service user has required medical treatment at a hospital and that one, as I said before, has been a particular interest to the sexual assault services.

It is not a sexual abuse incident that has led to someone presenting at a hospital and therefore needs your services. It is a sexual abuse in the course of service delivery.

And then a fire, flood or emergency event, that's really important, particularly where there's been a relocation of service users we found in the past that.

For particular accommodation services, if there's an emergency event and service uses are evacuated, we just need to make sure that they've got the supports that they need in place.

Sometimes we've seen service users sent off to hotels without their medication or without any supports.

You know next of kin and support people not notify those kinds of things so that that's why that one's in there is a critical notifiable incident.

I've talked a little bit about sexual assault, and I'll just need to work out how this one works. Yeah, so?

We've got managerial requirements to report all allegations of sexual assault to police.

Does that make the definition of having police involvement we hear regularly of things like sexual assault, about staff assault of a service user? Do they need to report to the regulator every time that works based on the hospital?

Does that make the definition of a service user receiving medical treatment in a hospital?

I'm hopeful given what I've said already, you can answer those questions on your own, but we'll run through the answers together.

So, if a sexual assault that happened during the course of service delivery required police involvement and medical treatment at a hospital, it is a critical notifiable incident and must be reported by the next business day.

Medical treatments received at a hospital and the incident occurred during service delivery, admits the critical threshold for some critical notifiable incidents, and we've talked about those in the last slide.

If an incident occurred that resulted in someone approaching your service to receive a service that is not during the course of service delivery.

So all that we're asking for in this critical notifiable incident form is what's the type of the incident, a really brief description of the incident, the names of the service users most impacted and your initial response. That is all it should take you no more than 5 or 10 minutes to complete that.

And it really is the bare minimum that we need to be able to perform our role under the Act, both in terms of protecting service users but also providing assurance.

So why do I even need to complete the full incident report again?

I've talked a little bit to this. Because the critical incident form is so brief and we've tried to deliberately keep it brief so that we're not interfering with your initial response.

We need that full incident report so that we've then got the full details about what happened and why and we can make a fulsome assessment about whether we need to intervene or not. And importantly, we can also provide assurance to the community that the incidents are being appropriately managed and appropriately reported.

So another question that we've had is.

We're still doing our investigation. We haven't got to the root cause of the incident. We're not ready to report.

For a critical notifiable incident, we're not actually asking for the root cause. We're asking for information about the incident itself. You might have commenced your investigation.

You might be able to comment on how that incident occurred, but we're not looking for a full investigation. It is only that brief information so.

Oops.

Have I moved forward? Yeah.

So, as part of your investigation, you might be trying to work out whether it is a critical incident or not.

We would urge you to.

Consider very early on in the process whether you think it's a critical notifiable incident and report it through.

We have tried to focus those definitions as much as possible to limit the reporting to what we need to know about what's really important.

Why the next business day?

I've talked a little bit about this.

I think I've probably covered what's on the slide and if not, we can come back to it in the questions.

I do want to make sure that we do save some time for questions.

So what do we do with it?

And again, I've touched on this a little bit.

So we review all of the information that you provide on a critical incident note, a critical notifiable incident and a notifiable incident report to make sure that it's complete.

Critical notifiable incidents we will review both items previously communicated that we're taking a graduated approach to.

We know that these requirements are new for some people, so we're trying to make sure that we're in the space at the moment with many providers, of helping them understand your requirement.

I will say though for some providers, this is not new, particularly the critical notifiable incident reporting is not new, so we'll have expectations that those services are/will be able to complete that report in a timely manner.

And there's a little bit about our decision-making principles as well.

So we will confirm the incidents in Skype in which category it falls into.

We may ask for further information if there are gaps, we'll assess the risk of the incident and determine a response.

So that might be my triage team might call you up and ask for a little bit more information.

It might be that they look at the incident, decide that it is low risk and has been appropriately dealt with and they close it off.

It might be they think there's a bit more in this and they'll refer it off to one of my operational teams to review it.

We will always use privacy principles in handling data.

So if you are putting residents names in incident reports, be confident that we have the data protection on our end to make sure that we've got that information held securely.

Our triage team will also record the incidents for intelligence purposes and identifying trends.

And they're starting to do some of that trend work at the moment.

Our response will most likely for most incidents be review the incident, review the response, determine whether we think that there are any gaps in that response, and if not close it. That is what I would imagine will happen with the vast bulk of incidents that are reported to us.

There will be some where we will need to investigate the incident, so if there are potential indications that there was a non-compliance that contributed to an incident, we might want to investigate that.

We might provide further guidance material. We might take action if there is a non-compliance.

In particular, one of the things that we're looking at is – where do people not understand their requirements?

And this is one of those essential data sources that will help us to target additional guidance. That's probably all on that slide.

All of what I've just covered is on our website and in the guidance. So, the guidance I've got in front of me looks like that. It is downloadable from the pages that are listed there and it is a really good guide. I'm hoping that many of you have already read it.

If you haven't, I hope that you read it and it helps answer a lot of your questions. If it doesn't, get in touch with us, let us know where you've still got questions, where you're still confused, or where you think we may have, you know, we can improve our guidance as well.

So, general enquiries particular about guidance through the enquiries line notifiable incidents we've put up the incidents e-mail inbox. So, if you've got a particular query about an incident, you can potentially enquire through that as well.

Think that is all of the formal slideshow.

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Richard Marks (SSR)
I hope that's been useful and will now open the floor for questions.

I know there's been a bit happening in the chat.

I haven't been monitoring it and what I might do is just take the slides down and then we can do a bit of Q and A so.

Who? Clare, are you going to facilitate the Q&A?

1:43:46.299 --> 1:43:51.899
Clare Moran (SSR)
I think what we could do, I think a lot of the questions in the chat have been answered as we're going through.

So think what we might ask people to do is to pop their hand up, and if their question hasn't been answered, then we can go like that.

1:44:1.199 --> 1:44:2.759
Richard Marks (SSR)
Sure. OK. We've got a couple of hands up.

1:44:3.269 --> 1:44:3.549
Clare Moran (SSR)
Yeah.

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Richard Marks (SSR)
So Ayla, and apologies, I'm not sure how I pronounce that.

Sorry, was there a question?

Oh, accident.

Sorry. OK.

So we'll go to Samantha, I think it is Samantha Carey-Stephenson.

Need to be unmuted? Uh huh. OK.

Is someone in control of that?

1:44:42.249 --> 1:44:44.49
Clare Moran (SSR)
Ash is going to do that for us.

1:44:43.789 --> 1:44:47.189
Ash Bhattarai (SSR)
Yeah, she's already unmuted so she can access the mic now.

1:44:52.719 --> 1:44:54.879
Richard Marks (SSR)
Samantha, you can take yourself off mute.

I think you've been there. We go. Yep.

1:44:56.479 --> 1:44:57.439
Samantha Carey-Stephenson
Apologies, sorry.

Thanks for that.

Hi. Thank you for that presentation.

We're a very small organisation that provides services under the multiple complex needs initiative. It would be almost a daily event that we have people self-harming or engaging in serious high-risk behaviours.

I'm wondering what we do in that situation.

Do we continually report?

And it might be a sequence of self-harming or presentation in suicide attempts that continues over days to weeks.

So yeah, just wondering what we would do in that case.

1:45:33.149 --> 1:45:34.829
Richard Marks (SSR)
Yeah. Great question. Thanks Samantha.

And this goes to that point around. We've recognised that a lot of the services that you guys operate are for people with complex challenges in their lives, and there will be incidents.

So the fact that there are incidents does not to us indicate that there is a breach. In fact, in many of the services you provide, if there weren't any incidents, we'd be worried about what's going on and what's not being reported. So the short answer is.

Yes, they do need to be reported, but you might expect in that situation that would just be noted by us.

And we might then pick up on trends.

We might bring up some of those when we come and have a talk to you about. You know how you're operating your business and how you're supporting your residents or your service users with their complex problems, we are not clinical. I will say that we're not.

We're not looking over your shoulder saying with that individual, you did the right or the wrong thing.

We're looking at what are the systems, processes, structures you have in place around the services that you deliver to make sure that they’re delivered safely.

So we're not looking at clinical interactions, we're looking at what the incidents tell us about how you're operating your service.

1:46:46.859 --> 1:46:47.59
Samantha Carey-Stephenson
OK.

Thank you.

1:46:48.79 --> 1:46:48.639
Richard Marks (SSR)
Thanks Samantha.

Monica. You should be able to unmute yourself now, Monica.

1:47:5.309 --> 1:47:5.749
Ash Bhattarai (SSR)
Yeah.

1:47:6.389 --> 1:47:6.869
Richard Marks (SSR)
Oh, there we go.

1:47:12.959 --> 1:47:15.479
Monica
Hi. Yeah, it's Monica.

So my question is, could you tell me?

So all the rest and have been submitted from 1st July. I already did.

I did over 20 reports of that, but if as soon as I submit a report, I will get a response with over 10 or even 20 questions.

But even after I reply to all the questions, I still got another e-mail second day, so far I already got nearly 10 e-mail like that, so I can't reply to all the emails.

You know, so I'm very busy. You know, in SRS.

So yeah, you know very busy, very. So we have 20 residents and I have had to...

Yeah, I spend my energy on residence and family and medical team and also apartments like that and stuff.

So my questions – I feel not ending if I reply 11 e-mails for one resident and I will got another e-mail about regarding one only one resident and it’s never ending.

So it's like me crazy, you know. So what can I do?

1:48:58.259 --> 1:49:1.699
Richard Marks (SSR)
So, Monica, what I'd say is in terms of incident reporting.

So my triage team will follow up. If there are gaps in the report. So, if they, if there are things that aren't covered in the report, that should have been, they'll follow up with you and ask questions about that. If there are concerns about the incident report.

1:49:2.679 --> 1:49:2.879
Monica
Mm hmm.

1:49:16.59 --> 1:49:23.659
Richard Marks (SSR)
Compliance concerns. One of my compliance teams will be following up and I suspect that's what's happened in this case is you've reported the incident.

That has triggered some concerns for the compliance team and the compliance team is following up with you.

I can have a chat to them about the particular circumstances.

That you're in, but we must, so where we have concerns about the safety of service users, we have to intervene in that way.

We have to ask questions. We have to satisfy ourselves that service users are safe, that the services you're providing are safe.

So that's what I suspect has happened in this case, and we may need to talk about.

Well, if you're getting questions repetitively then is there something in the answers that you're providing, or is there something in the questions that we're asking like we're obviously missing each other in that process and we might need to follow that up in, in a little bit more detail?

I'm happy to stay on afterwards and we can have a little chat about that and I can get some more information.

Thanks for the question, Monica.

1:50:23.899 --> 1:50:24.19
Monica
Hmm.

OK. Thank you.

1:50:27.769 --> 1:50:29.249
Richard Marks (SSR)
All right. We might go to Tony.

Tony should be on yep.

1:50:36.719 --> 1:50:37.199
Tony Box
Thanks.

Yeah. So I mean, thanks, Richard for that presentation.

My questions about critical notifiable incidents where there's a medication error, so if a service user is either recommended by a nurse online or ambulance Victoria and they're taken to a hospital but they don't receive any treatment because they either refuse treatment or they just leave, they're not prepared to wait through the triage process, does it still remain a critical notifiable incident or it's not because they didn't receive any treatment?

1:51:5.149 --> 1:51:12.429
Richard Marks (SSR)
That is a really good question. I think the wording is the service user requiring treatment in a hospital.

So if you've made the judgment or an ambulance provider has made the judgment, the person needs to go to hospital for treatment. I would say that is the trigger for a notifiable incident.

If they refuse treatment, that's up to them. If the hospital is unable to treat them. That's a problem with the hospital, frankly.

But the incident that occurred that required a person to seek treatment at a hospital that incident still qualifies.

Does that make sense? Thanks, Tony.

1:51:44.999 --> 1:51:45.359
Tony Box
Thank you.

1:51:52.239 --> 1:51:55.599
Richard Marks (SSR)
And Casey, Casey. Sorry I can't see the rest of your name.

1:51:57.89 --> 1:51:58.809
Casey- Alexandra Gardens
Hi, it's Casey Wong. Hi Richard.

Hello everybody.

1:51:59.409 --> 1:51:59.889
Richard Marks (SSR)
Hi, Casey.

1:52:0.729 --> 1:52:2.9
Casey- Alexandra Gardens
I have two questions.

Firstly, I have reported some of our incidents online already and I've noticed there are some categories.

One is the deterioration of health. And which I understand is like for example the client or the resident is acutely ill.

Suddenly we call an ambulance and then send them to the hospital and they are being admitted to the ward or they are not.

But they had a trip to the hospital, then we had to report. But again, just some extension from what Tony's said before.

Some of our residents, actually, they had a fall and then we called ambulance. Send them just for a check up to make sure everything OK. They don't have internal bleeding or they don't have fracture. And then they came back like in, like after six hours or seven hours.

1:52:47.489 --> 1:52:47.609
Richard Marks (SSR)
Hmm.

1:52:54.899 --> 1:52:59.499
Casey- Alexandra Gardens
Without any treatment and every everything was OK but does this meet the criteria of like reportable incident like even though they just having a short trip to the hospital?

1:53:10.899 --> 1:53:13.619
Richard Marks (SSR)
Yeah, so that's it. Thanks Casey for the question.

Not a critical notifiable incident.

So the incident that required hospitalisation and unless you identify that there was some sort of physical abuse involved in that in that person, you know, falling down.

Then that would not require reporting as a critical notifiable incident in terms of does it require reporting under section 48 as an incident?

Yes, because that could potentially indicate a problem with the care of that individual. So we would want to know about it.

We would go by the information that you provide, whether we actually need to do any follow up on that or not. But I think I'm right and I'll get the team to correct me if I'm wrong, but I think that incident would still need to be reported.

1:54:1.479 --> 1:54:9.679
Casey- Alexandra Gardens
Right. And also like the majority of our residents here are elderly and they slowly decline.

But do we have to still report that as deterioration of health, as well as an incident?

1:54:20.429 --> 1:54:31.469
Richard Marks (SSR)
To me, that would be. So again, we recognise that a lot of the people that all of your organisations support come to you with challenges, that's why they need your services.

So if someone is declining, particularly in an SRS space and we have an SRS specific forum in a couple of weeks. So we might actually dig into this a little bit more deeply in that forum.

But there is an additional reporting requirement for SRS around when you can't, can no longer care for a resident, or you can no longer provide the supports that a resident requires. To me that example that you've provided there Casey, would be an example of where a resident is actually deteriorating to the point where you can't support them.

I don't see that as being an incident that is reportable under section 48.

1:55:16.859 --> 1:55:18.179
Casey- Alexandra Gardens
And also thank you.

And my last question, there was one category as relocation of the client.

So if we identify that this client’s needs has increased and then we are not able to meet their needs anymore.

So we discussed with the family. They agreed we don't even need to initiate a vacate form.

So do we still have to report that or it's just like when we issue a form for them, like vacating?

1:55:44.799 --> 1:55:45.279
Richard Marks (SSR)
So. Yeah, so for an SRS, where a resident, residents are free to come and go that the people that exercise free will, if they decide with whatever support they need, that they no longer need your services. They no longer want to be a resident then that is, that's up to them.

We don't need to know about them. If you wish a notice to vacate, then there are certain types of notices to vacate that need to be notified to the department.

And again, we'll, we'll dig more deeply to this in the SRS specific forum, we've got in a couple of weeks.

1:56:18.299 --> 1:56:27.339
Casey- Alexandra Gardens
Right. So which to my understanding is if they agreed or they initiated the move to the next level, then we don't have to report.

1:56:28.79 --> 1:56:28.599
Richard Marks (SSR)
Correct. Yeah.

So if they're choosing to end their residential tenancies agreement with you, then that's a decision for them as it is when they come to your facility and start there.

1:56:35.979 --> 1:56:36.779
Casey- Alexandra Gardens
Right. OK.

Thank you.

1:56:42.179 --> 1:56:42.539
Richard Marks (SSR)
Thanks.

Viviana, I think is next.

Hang on. Sorry.

No. Yeah. Casey. Linda. Sorry, Linda.

1:56:56.709 --> 1:56:57.709
Linda Chatsworth Terrace
Can you hear me?

1:56:58.439 --> 1:57:4.239
Richard Marks (SSR)
I can, all your boxes are very small on the side of my screen so all I can see is a little bit of your name so apologies.

1:57:4.479 --> 1:57:5.559
Linda Chatsworth Terrace
Yeah, no worries.

Am I just gonna question?

Is that reporting an incident online? Is it?

Do I have to if two residents are like verbal like argument, not like aggressive like saying words to each right, so I still need to.

1:57:32.689 --> 1:57:39.449
Richard Marks (SSR)
Sorry, Linda, you're, you're breaking up terribly. I think the question is about resident on resident incidents.

Is that correct?

If yes just give me a nod.

1:57:42.519 --> 1:57:43.199
Linda Chatsworth Terrace
Yeah, that's if two residents like arguing but no physical touching or anything.

1:57:43.529 --> 1:57:43.689
Richard Marks (SSR)
Yeah.

1:57:48.399 --> 1:57:52.639
Linda Chatsworth Terrace
They just verbally arguing and then they go on this race. Do I need to report that?

1:57:53.199 --> 1:57:54.639
Richard Marks (SSR)
Not under section 48.

So again, what we're looking at is incidents that have resulted in serious harm or could have resulted in serious harm. So residents having an argument, that will happen, we acknowledge that we obviously want you to have practices in place to manage that, but it is not a reportable incident under section 48.

1:58:13.629 --> 1:58:15.469
Linda Chatsworth Terrace
And also just sorry, one more question.

1:58:13.849 --> 1:58:14.649
Richard Marks (SSR)
If that helps.

1:58:15.469 --> 1:58:17.69
Linda Chatsworth Terrace
Yeah, just one more question.

If I send a resident to hospital, could she's feeling unwell and the doctor has asked us to send her to hospital.

Is that, do I have to report that?

1:58:27.609 --> 1:58:37.289
Richard Marks (SSR)
So not as a critical notifiable incident and not within that next business day because that's about the type of incident that's reported in that's resulted in the need to hospitalise someone.

If they're, you might need to make some judgments about whether you need to report it under section 48.

So if it fits within the categories of harm, so physical abuse, sexual abuse, medication error, if you've got indications of that, then yes, it would need to be reported. If it is someone is sick and they needed some medical treatment, that's not reportable.

1:59:1.249 --> 1:59:2.409
Linda Chatsworth Terrace
That's all I wanted to know.

Thank you.

1:59:3.149 --> 1:59:3.629
Richard Marks (SSR)
Thanks Linda.

And I think Viviana now.

1:59:11.679 --> 1:59:14.399
Viviana Fernandes She/Her/Hers
Hello. Yes, thank you.

My question is a little bit, I guess simpler. I hope so.

Just going back in terms of processes. When we and our organisation do use things and report through things.

So when there is a follow up, we do normally, if we report something to the department, they will come back with, you know, feedback or whatever there is.

But if they don't answer or ask anything and you guys have a follow up or need of additional information, would that still go through things for critical, not critical?

You know when you're doing the normal incident reporting or is there a different way that we're going to need to provide that information?

1:59:54.749 --> 1:59:55.749
Richard Marks (SSR)
You have really good question. Thanks Viviana.

As I said, CIMS for us is just a data extract.

We don't actually have access to the CIMS system itself, so I suspect I know the answer to this, but I'm actually going to take the opportunity to throw it to Dan, who is actually the person who runs our triage function.

Dan, can you answer that from a process point of view? If you're able to unmute yourself?

You might need to stick up your hand so you come up to the front.

2:0:24.359 --> 2:0:25.79
Daniel Getley (SSR)
I'm here.

I'm sorry, I was answering questions in the chat, so I did miss that.

2:0:25.369 --> 2:0:25.689
Richard Marks (SSR)
Here we go.

2:0:28.39 --> 2:0:29.39
Daniel Getley (SSR)
Could you please repeat it?

2:0:31.129 --> 2:0:32.9
Richard Marks (SSR)
Vienna, do you wanna?

2:0:32.159 --> 2:0:33.359
Viviana Fernandes She/Her/Hers
Yeah, I'm happy to repeat.

So then it's mainly. We, our organisation, do the reporting through CIMS system. So if we get any feedback, normally from the department, we update, you know in the system and transmit to them.

If they don't ask any questions or further information, but the Social Services Regulator do need more information – what would be the process through CIMS or would be a separate process?

2:1:6.159 --> 2:1:10.799
Daniel Getley (SSR)
No. We would generally contact you via e-mail and we'd ask for that additional documentation or any other information and in best practice updating CIMS as well with that extra information would be positive as well.

But we will only contact you by e-mail, not through CIMS.

2:1:28.189 --> 2:1:37.549
Viviana Fernandes She/Her/Hers
OK. And so because I know the department approves or not some the report that comes through and close that off.

So I would imagine as best practice as you mentioned, we would provide that information and update that in CIMS? But then would you still get that information or do I give that information via e-mail to you as well as like two different actions?

It's just because I just want to make sure that my team is across any requests.

2:1:55.669 --> 2:1:57.469
Daniel Getley (SSR)
Yeah, if the department have asked you to make an amendment or update in CIMS, once you do that, it will be reflected within our data as well.

So we see those updates.

2:2:11.929 --> 2:2:21.9
Viviana Fernandes She/Her/Hers
But if they don't ask that and you ask something, would that generate any conflict with the department? They're like, why you updating when we didn't ask anything else?

2:2:12.399 --> 2:2:12.719
Daniel Getley (SSR)
Coming through.

2:2:21.9 --> 2:2:22.969
Viviana Fernandes She/Her/Hers
Because they already deemed OK.

2:2:22.549 --> 2:2:24.789
Daniel Getley (SSR)
No, no, I don't think so.

I think we have separate requirements for reporting. So I think they’re distinct from each other.

2:2:33.749 --> 2:2:35.829
Viviana Fernandes She/Her/Hers
So send you the information separately. OK.

2:2:37.469 --> 2:2:38.589
Daniel Getley (SSR)
Right. Yes. Yep.

2:2:38.489 --> 2:2:39.729
Viviana Fernandes She/Her/Hers
OK, perfect.

That's it. Thank you.

2:2:40.319 --> 2:2:42.119
Richard Marks (SSR)
Thanks Dan. Thanks Viviana.

We might just take one last question. I'm just conscious of time.

2:2:42.669 --> 2:2:43.69
Daniel Getley (SSR)
Yes.

2:2:46.119 --> 2:2:46.719
Richard Marks (SSR)
We can. We'll gather up all of the questions that have been asked in the chat as well, and we will provide answers for that, but we'll just take one more.

I think Avi got his hand up.

2:3:0.959 --> 2:3:2.439
Avi MacMull
Thanks for your presentation today.

You mentioned the word trends before and I think regulator has, you know, a lot of opportunity to collect data that we individual organisations can't see.

So I guess my question is beyond our usual risk management that we had in our case management, what plans does the regulator have in providing that information to bolster our risk management either for individual high risk clients or service delivery type system in hotspots that can be identified in geodemographic or any other cohorts?

2:3:42.199 --> 2:3:45.479
Jonathan Kaplan (SSR)
Sorry, it's Jonathan here. Social Services Regulator.

Over time, we will build up a series of data sets that will allow us to have a range of insights. We will look to use them to support the sectors through a range of mechanisms over time, we will.

And when we’re developed and we're comfortable with public reporting some information, we'll use our annual report separately from our website as well, but also through a series of consultative mechanisms. We will use that to feedback via peaks so that information can be used within specific sectors to hopefully improve and share.

By like where there might be good or positive practice as well as where there may be elements where a different approach may be required.

One of the other things is also we will always be looking at is maybe less about how the incident was managed, but more about reporting and other things we will always be using any information data to review our guidance and information because over time it may be that we're not clear about things just as much as there may be other and broader issues.

So there'll be a range of ways that we'll share it, but through our annual report, our website and then via peak bodies, hopefully to feedback into individual sectors as well.

2:5:4.399 --> 2:5:6.599
Richard Marks (SSR)
Love you thinking that way though, Avi, it's really good.

So sorry there, there are a few hands up and I apologise.

2:5:8.929 --> 2:5:9.89
Avi MacMull
OK. Thanks. Thanks for the response.

2:5:11.879 --> 2:5:17.959
Richard Marks (SSR)
We are over time, so we might have to wrap up there.

2:5:19.379 --> 2:5:22.419
Clare Moran (SSR)
I might just jump in Rich if I can to wrap up. Oh, sorry.

2:5:20.519 --> 2:5:31.319
Richard Marks (SSR)
Or just before you do, there are quite a few questions from SRS providers and there are some specific requirements under the legislation that apply to SRS proprietors that don't apply to the rest of the sector.

That's why we've got that dedicated session for SRS providers in a couple of weeks.

So just do a plug for that.

And thanks everyone for your attendance. Thanks for your questions.

We'll do what we can to provide as many answers if we can, and I'll throw back to Clare.

2:5:47.359 --> 2:5:48.279
Clare Moran (SSR)
Thanks Richard. So that concludes our event today.

Thank you very much everyone for joining us for asking questions and really engaging in this session.

We'd really appreciate if you could fill in a poll for us which should be coming up in the chat shortly.

So that will help us evaluate and improve this session.

So there you go. You should see it now.

And if you don't want to fill it in, that's OK.

You can just close it, but we'd really appreciate your feedback.

I'd like to say thank you to Jonathan, Richard and the whole SSR team who are working in the background to make these webinars happen.

I'd also like to thank Bernadette, who's been captioning for us and to our Auslan interpreters. Thank you. Luke and Sarah.

Have a great day, everyone, and see you next time.

2:6:38.909 --> 2:6:39.549
Richard Marks (SSR)
Thanks everyone.

Updated