When an incident occurs in an aged care setting, staff and management face the difficult task of determining its cause. Was it a genuine, unavoidable accident or was it a preventable instance of neglect? This distinction is critical not only for regulatory compliance but for maintaining a high standard of care.

👵 Neglect in Aged Care

Neglect is defined as a failure to provide the care and services that a person needs to maintain health, well-being, and safety. Fundamentally, neglect is a breach of duty of care.

Duty of Care

A duty of care is a legal and ethical obligation for aged care providers and staff to take reasonable steps to prevent foreseeable harm to residents. A breach occurs when this expected standard of care is not met.

Gross Negligence

In severe cases, neglect can escalate to gross negligence. This involves a conscious and voluntary disregard for the need to use reasonable care, which is likely to cause predictable grave injury or harm. This goes beyond a simple mistake and indicates a serious dereliction of duty.

Examples of Neglect (Breach of Duty of Care):

• Failure to provide care: Not turning a bed-bound resident, leading to pressure ulcers.
• Inadequate supervision: Leaving a known fall risk resident unattended, resulting in a fall.
• Poor hygiene: Failing to assist a resident with toileting or bathing, leading to skin breakdown or infection.
• Medication errors: Consistently failing to administer medications on time or as prescribed.

🎯 Defining an Accident

An accident is an incident that is sudden, unplanned, and occurs without an intention or expectation of harmful results. It is an event that could not have been reasonably foreseen or prevented, even when all appropriate standards of care and procedures were followed.

Key characteristics of a genuine accident:

1. It occurred despite staff following all established protocols and care plans.
2. It was an unavoidable, often immediate, consequence of a medical event or circumstances outside the caregiver's control.
3. The facility and staff were not in breach of their duty of care.

📝 SIRS Definition

The Serious Incident Response Scheme (SIRS) provides a framework for defining and reporting incidents. Under SIRS, providers must investigate and report certain types of incidents, including those involving alleged or suspected neglect. The scheme helps formalize the distinction, ensuring that incidents are correctly categorized, investigated, and addressed to prevent recurrence.

🤝 Conclusion

The line between neglect and accident is drawn at the duty of care.

• An accident occurs when, despite the consistent fulfillment of all reasonable duty of care requirements, an unforeseen event causes harm.
• Neglect occurs when there is a failure to provide care-a clear breach of the duty of care-that directly contributes to the incident or harm.

Staff must be rigorously trained to understand and meet their duty of care obligations. Categorizing incidents correctly is not about assigning blame; it is about ensuring systematic failures that lead to neglect are identified and corrected, thereby upholding the safety and well-being of every resident.