BetterCareNDIS

INCIDENT MANAGEMENT POLICY

210310_BCN_POL1_Incident_Management_Policy_V02

March 20,2021

1 .   PURPOSE AND SCOPE

Bettercarendis endeavours to facilitate the reimbursement process for NDIS participants in collaboration with Bettercaremarket, an ecommerce website that sources assistive healthcare products for people with a condition. The overall objective is to facilitate living at home in a convenient and practical way limiting the need for physical assistance and prolonging the individual’s independency.

This policy provides a general guideline for the required behaviour and response when an accident, incident (including critical and reportable incidents), or near miss affecting staff or participants occurs.

Given the nature of Bettercarendis activities relative to the NDIS, sections in this policy providing information on child-related Mandatory Reporting (see the Preventing and Responding to Abuse, Neglect, and Exploitation Policy and Procedure) are intended for general understanding of Bettercarendis staff.

This policy aligns with the Work Health and Safety Act 2011 (NSW), the Work Health and Safety Regulations 2017 (NSW), National Disability Insurance Scheme (Incident Management and Reportable Incidents) Rules 2018 (Cwth), and the NDIS Quality and Safeguards Commission Reportable Incidents Guidance (2018).

This policy applies to the General Manager, and any additional staff, students, contractors, and volunteers, considering that Bettercarendis is not exposed to direct or physical contact with NDIS participants.

Separately, practical operational procedures for the daily activities of Bettercarendis will be captured various Policies, Procedures and Reports, see addendum 1.

2. DEFINATIONS

Accident – an unforeseen event that causes damage to property, injury, or death.

Hazard – a situation that has the potential to harm a person (cause death, illness, or injury) or environment or damage property.

Hazard identification – a process that involves identifying all foreseeable hazards in the work place and understanding the possible harm that each hazard may cause

Hazard management – a structured process of hazard identification, risk assessment, and control, aimed at providing safe and healthy conditions for staff members, contractors, and visitors while on the premises

Harm – includes death, or injury, illness (physical or psychological), or disease that may be suffered by a person as a consequence of exposure to a hazard, and is the resultingimpact of the act, omission, event or circumstance that occurs, and can include physical,emotional or psychological impacts such as physical injuries, emotional impacts such asfear or poor self-esteem, and psychological impacts such as depression or impacts on a person’s learning and development.

Incident – an incident is defined as an act, omission, event or circumstance. It may mean any of the following:

  • Acts, omissions, events or circumstances that occur in connection with providing NDIS supports or services to a person with disability and have, or could have, caused harm to the person with disability
  • Acts by a person with disability that occur in connection with providing NDIS supports or services to the person with disability and which have caused serious harm, or a risk of serious harm, to another person
  • Reportable incidents that have or are alleged to have occurred in connection with providing NDIS supports or services to a person with disability

Mandatory Reporter Guide (MRG) - assisting mandatory reporters to determine childrelated reporting requirements, the MRG is part of the NSW Child story initiative.

Mandatory reporting the legal obligation of certain professionals and community member store port when they believe, on reasonable grounds, that a child is in need of protection from harm. In NSW, any staff working directly with children who have reasonable grounds to suspect that a child or children are at risk of significant harm from abuse or neglect are required to use the NSW Mandatory Reporter Guide to help determine whether the concern they have meets the statutory threshold for reporting.

NDIS Quality and Safeguards Commission (the Commission) - the regulatory body established to oversee the registration of NDIS providers and monitor compliance, respond to complaints and reportable incidents, monitor behaviour support and restrictive practices, and undertake investigation and enforcement.

Near Miss – any incident which, although not resulting in any injury, illness, or damage, had the potential to do so

Notifiable Incident – any extremely serious incident arising out of the conduct of a business or undertaking at a workplace, relating to any person — whether an employee, contractor, or member of the public.

Under the Work Health and Safety Act 2011 (NSW) and the Work Health and Safety Regulations 2017 (NSW), businesses are obligated to notify Safe Work NSW in the event of:

  • the death of a person;
  • a serious injury or illness of a person
  • a potentially dangerous incident

Participant Incident – acts, omissions, events or circumstances that occur in connection with providing supports or services to a person with disability who receives funding under the NDIS or the Commonwealth Continuity of Support Programme relating to Specialist Disability Services for Older People.

Reportable incidents – reportable incidents are serious incidents or alleged incidents which result in harm to an NDIS participant and occur in connection with NDIS supports and services, as defined in section 73Z(4) of the Act and section 16 of the NDIS (Incident Management and Reportable Incidents) Rules 2018

Specific types of reportable incidents include:

  • the death of a person with disability
  • serious injury of a person with disability.
  • abuse or neglect of a person with disability.
  • unlawful sexual or physical contact with, or assault of, a person with disability (excluding, in the case of unlawful physical assault, contact with, and impact on, the person that is negligible).
  • sexual misconduct committed against, or in the presence of, a person with disability, including grooming of the person for sexual activity.
  • the use of a restrictive practice in relation to a person with disability, other than where the use is in accordance with an authorisation (however described) of a State or Territory in relation to the person or a behaviour support plan for the person.
  • The incident must have occurred or be alleged to have occurred in connection with the provision of supports or services Bettercarendis is or was providing.

    For further examples, Bettercarendis recommends to consult the NDIS Quality and Safeguards Commission Reportable Incidents Guidance.

3 . POLICY

Staff are required to be vigilant in reporting incidents when they occur so that appropriate support can be provided to those affected and the circumstances can be analysed to reduce the likelihood of a similar event occurring again.

All staff, contractors, volunteers, and students have a responsibility to ensure that details of any incident are recorded and reported to their immediate supervisor (or General Manager, as appropriate).
Principles of the NDIS Reportable Incidents Scheme

  1. Centred on people with disability: management of an incident is respectful of, and responsive to, a person with disability’s preferences, needs, and values while supporting the person’s safety and wellbeing
  2. Outcome focused:management of an incident should reveal the factors which contributed to the incident occurring, and seek to prevent incidents from reoccurring, where appropriate.
  3. Clear, Simple, and Consistent: the process for dealing with reportable incidents is easy to understand, accessible, and consistently applied.
  4. Accountable: providers are responsible for appropriately managing the response to reportable incidents. Everyone involved in the management of a reportable incident understands their role and responsibilities and will be accountable for decisions or actions taken in regard to an incident.
  5. Continual improvement: the incident management process facilitates the ongoing identification of issues and implementation of changes to improve the quality and safety of NDIS supports and services.
  6. Proportionate: the nature of any investigation or actions following an incident will be proportionate to the harm caused and any risk of future harm to people with disability.

4 . PROCEDURE

Overview: All incident

Incidents may be reportable to one or more agencies:

  • Notifiable incidents to the Safe Work NSW
  • Reportable incidents to NDIS Quality and Safeguards Commission
  • Child-related incidents to Family and Community Services via the Mandatory Reporters Guide (MRG)
  • Violent, sudden, and unexplained deaths to the NSW Coroner’s Office and NSW Police
  • Incidents involving criminal activity to the NSW Police.

Abuse and neglect in community settings should be reported to the NSW Ombudsman:

  • Telephone: 02 9286 1000, or 1800 451 524 (outside Sydney metro)
  • Email: nswombo@ombo.nsw.gov.au
  • Address: HSBC Centre 24/580 George St, Sydney NSW 2000
  • Website: www.ombo.nsw.gov.au

Participants affected by incidents must be provided with information about how incidents involving them have been managed.

Internal Reporting: All Incidents

All incidents and near misses must be reported to the General Manager (supervisor or nominated NDIS incident reporter) as soon as practicable and within 24 hours through completion of an Incident Report.

If an incident is (or maybe) Notifiable or Reportable, it must be reported to the General Manager immediately. Information required includes the:

  • name and address of the person giving notice;
  • date and time of the event;
  • place where the event happened;
  • apparent cause;
  • nature and extent of the damage;
  • work that was being carried out at the time of the incident; and
  • name and contact details of any injured or affected parties.

Accidents, incidents, and near misses are to be reported to the Management Team monthly by the General Manager as part of their WHS reporting.

The General Manager will track progress and outcomes of accidents, incidents, and near misses in the Incident Report Register and refer any relevant items for inclusion in the Continuous Improvement Plan.

Responding to accidents and violence

Assess the situation to ensure a safe and secure environment. Remove the source of danger or the person from the source of danger if safe to do so.

In urgent cases, call 000 – NSW Police and other emergency services should be called immediately (e.g., where a crime is suspected or alleged, or where there is ongoing danger). If any person requires immediate medical attention, a medical practitioner or ambulance should be called, or the participant conveyed to the nearest hospital accident and emergency department.

Where injuries do not require immediate attention, support the person to see a doctor for assessment and treatment of any injuries, including psychological trauma.

The site where the incident occurred should not be disturbed until Safe Work NSW, the Police, or the General Manager lift the requirement to preserve the area.

Debrief and Support

For all persons involved in an accident, incident, or near miss, if required, the General Manager must:

  • facilitate an informal de brief amongst supervisors, colleagues or peers; and
  • ensure appropriate support and access to counselling is made available.

SafeWork NSW: Notifiable Incidents

Reporting Notifiable Incidents

Notifiable incidents must be reported immediately to Safe Work NSW on 131050. Incidents can be notified 24 hours a day, 7 days a week.

Investigating Notifiable Incidents

The General Manager will work with Safe Work NSW and / or other relevant authorities to investigate the incident.

The General Manager or their nominated representative will:

  • commence investigations immediately upon receiving a completed Incident Report
  • (where a staff member is injured), involve them in the investigation;
  • implement the most effective controls practicable that do not introduce other hazards, and monitor and review these;
  • consult with staff who are, or are likely to be, directly affected;
  • provide information and feedback to the Management Team; and
  • track all relevant information in the Incident Register.

Upon completion of the investigation the General Manager must finalise the relevant Incident Report form and record the outcomes in the Incident Register.

The completed Incident Report should be stored on the relevant staff member’s file.

Reportable Incidents: NDIS Commission

Reportable incidents will be reported to the Commission when the incident occurred, or is alleged to have occurred in connection with the provision of supports or services by that provider and covers incidents that:

  • may have occurred during the course of supports or services being provided;
  • arise out of the provision, alteration or withdrawal of supports or services; and/or
  • may not have occurred during the provision of supports but are connected because it arose out of the provision of supports or services.

Reportable incidents will be reported to the Commission whilst occurring in a variety of settings provided there is a connection with the service like:

  • in the private home of a person with disability
  • in a residential care setting
  • in supported accommodation
  • in the premises of Bettercarendis

Responding to abuse and neglect

Assure the participant that the incident will be taken seriously, discuss their options with them and ask them how they would like to be supported throughout the process. If a staff member is accused or suspected of harming the participant, they should be removed from contact with all participants pending an investigation.

Where a participant is accused or suspected of harming another participant, they should be removed from contact with other participants, where possible, pending an investigation. Consider the impact of the incident on the other participants within the setting and provide them with appropriate support. It is important that they are not treated simply as potential witnesses. If they can provide informed consent to contact and receive specialist services, the participant (or, if not, his or her key support person) should be asked whether he or she wishes to contact specialist/victim support services such as crisis care, counselling, advocacy, a legal information service, or a lawyer.

Notify other service providers known to be working with that participant, if appropriate. Record agreed actions for the participant’s immediate and ongoing needs in the Participant Support Plan. This must include:

  • steps being taken to ensure the participant’s ongoing safety and wellbeing;
  • treatment or counselling the participant may access to address their safety and wellbeing;
  • modifications in the way services are provided (for example, same gender care or placement);
  • how best to support the participant through any action the participant takes to seek justice or redress, including making a report to police; and
  • any ongoing risk management strategy required where this is deemed appropriate.

Reportable Incidents: Reporting

Reportable Incidents may also qualify as Notifiable Incidents (see glossary above), criminal incidents, or child-related incidents, and should be reported to all appropriate agencies. Reportable Incidents – including alleged incidents – must be reported to the NDIS Commissioner.

The General Manager is responsible for reporting all Reportable Incidents unless the role is otherwise delegated. If a person with disability discloses an incident that occurred in the past, it should generally be treated in the same way as any other reportable incident, noting that the immediate response may differ. The reporting officer must provide the following information to the NDIS Commission where it can be collected:

  • the name and contact details of
  • ▪ the registered NDIS provider;
  • ▪ the person making the notification;
  • the name and contact details of the persons involved in the incident (alleged victim and alleged offender).
  • a description of the reportable incident, including:
  • ▪ the nature of any injuries sustained, and details such as time, date, and place it allegedly occurred;
  • a description of the impact on, or harm caused to, the person with disability (Note: where the reportable incident is a death this does not need to be provided);
  • the immediate actions taken by the provider in response to the reportable incident including any actions relating to the health, safety, and wellbeing of the participant involved in the incident including medical treatment provided, or whether the incident has been reported to the police or any other body.

Forms and Timeframes

Unauthorised use of restrictive practices must be reported to the NDIS Commission within five business days upon Bettercarendis becoming aware of the incident.

All other Reportable Incidents must be reported immediately, or within 24 hours of Bettercarendis key personnel becoming aware of the incident.

Incidents must be documented using the following forms:

  • 210310_BCN_REP1_Staff_Incident_Report_Form_V02
  • 210310_BCN_REP2_Client_Incident_Report_Form_V02
  • 200315_BCN_REP3_Product_Incident_Report_Form_V01
  • 200315_BCN_REP4_General_Complaint_Report_Form_V01
  • 200315_BCN_REP5_Product_Complaint_Report_Form_V01
  • 210310_BCN_REP6_Client_Complaint_Report_Form_V02
  • 210320_BCN_REP7_Hazard_Report_Form_V02
  • 210320_BCN_REP8_Clinet_Incident_Form_V02
  • 210320_BCN_REP9_Client_Complaint_Report_V02

Working with Police

A police investigation takes priority over a reportable incident investigation. Clearance must be obtained from police before taking any action that might compromise the investigation. Bettercarendis will manage any ongoing risk and should maintain an open dialogue with police about any investigation they are conducting.

Bettercarendis will inform the NDIS Commission where a Police investigation delays conducting are quired investigation and finalising a report.

NDIS Commission: Investigating Incidents

Bettercarendis will investigate and respond to all Reportable Incidents. The nature of any investigation or actions following an incident will be proportionate to the harm caused and any risk of future harm to people with disability. If the NDIS Commission requires a Reportable Incident to be investigated, either internally or by an external independent investigator, Bettercarendis will fully comply with the Commission’s requests.

Where an incident relates to potential staff-to-participant abuse or poor quality of care, some degree of independence is required for the investigation. Depending on the nature of the incident and the organisation, one of the following may be appropriate to conduct the investigation:

  • an area of the organisation that is sufficiently independent from staff who are the subject of any allegations, such as another division or an independent investigative function;
  • another service provider independent from the staff who are the subject of any allegations;
  • an external investigative body.
  • An investigation must:

  • be in proportion to the nature and significance of the incident and any associated allegations;
  • include the identification of any previous relevant allegations that should be considered regarding the relevant individuals;
  • include a degree of independence appropriate to the seriousness of the incident;
  • adopt a person-centred and rights-centred approach, taking into account what is important to the participant;
  • abide by the standard principles of good investigations:
    • procedural fairness,
    • confidentiality and privacy,
    • appropriate interview techniques,
    • evidence based,
    • properly documented, and
    • result in an investigation report.

Internal and external investigators must be appropriately trained in conducting serious workplace investigations, including investigating serious incidents that may involve a criminal element.

The General Manager (or delegated investigator) will appropriately assess and/or investigate all incidents having regard to the views of any person with disability impacted by an incident and including the following:

  • whether the incident could have been prevented;
  • how well the incident was managed and resolved;
  • what, if any, remedial action needs to be undertaken to prevent further similar incidents from occurring, or to minimise their impact
  • whether other persons or bodies need to be notified of the incident.

Investigation Reports

If required, Bettercarendis will supply details to the NDIS Commission in connection with any internal or external investigation or assessment that has been undertaken in relation to the reportable incident, including:

  • the name and position of the person who undertook the investigation;
  • when the investigation was undertaken;
  • details of any findings made;
  • details of any corrective or other action taken after the investigation;
  • a copy of any report relating to the investigation;
  • information about whether persons with disability impacted by the incident (or their representative) have been kept informed of the progress, findings, and actions relating to the investigation or assessment;
  • any other information required by the NDIS Commission.

The details outlined above should be included in the final report to the NDIS Commission which must be provided within 60 business days following the initial notification. The NDIS Commission may extend the period for providing the final report – for example, if there is a concurrent police investigation the reportable incident investigation will be justifiably delayed. The notification must be made in writing, by completing a form approved by the NDIS Commission and returning it to the NDIS Commission via email.

NDIS Commission: Corrective and Restorative Action

Participants affected by incidents will be provided information about how the incident has been managed and the measures taken to ensure against recurrence. All investigations should determine whether corrective and/or restorative measures are required. The NDIS Commission may require Bettercarendis to take corrective and/or restorative measures. The NDIS Commission may work with Bettercarendis to implement the measures and monitor progress.

Restorative measures may include, but are not limited to:

  • providing ongoing support to people with disability impacted by a reportable incident,
  • giving an apology,
  • providing compensation, e.g., through an enforceable undertaking.

Corrective measures may include, but are not limited to:

  • disciplinary action,
  • training or education of workers,
  • modification of the environment,
  • develop mentor amendment of a policy or procedure,
  • changes to the way in which supports or services are provided, or
  • other practice improvements

Supporting Participants through the Justice Process

Bettercarendis will support participants through the justice process, including police investigation, prosecution, and crimes compensation processes as appropriate. This may include:

  • ensuring the participant has access to appropriate communication aides and tools to facilitate disclosures and the provision of evidence.
  • ensuring the participant has access to an interpreter should they be from culturally or linguistically diverse backgrounds.
  • ensuring the participant has access to a key support person of their choosing or by providing information about advocates and other supports.
  • alerting police to the need for an Independent Person or advocate, the participant's particular communication support needs, and the need for timely interviews to facilitate the recall of information.
  • facilitating arrangements with police for interviews and examination of evidence.
  • facilitating arrangements with specialist support services.
  • working proactively with the participant to consider whether they will provide a witness statement, including making sure they understand they have time to make their decision if they are initially reluctant and the right to seek independent legal advice (in some instances NSW Police may be better placed to provide this information).
  • including participants affected by incidents in the management and resolution of the incident, where doing so does not expose the participant to added trauma or risk, by:
    • keeping the participant informed of the investigation,
    • consulting with the participant, where possible, concerning:
    • - the release of information to third parties,
    • - the investigation process, and
    • − corrective actions.
    • supporting participants who were witness to an incident.

Where a participant perpetrates a reportable offence and requires legal representation and assistance during the investigation and hearing, Bettercarendis will assist the participant or contact the service most directly responsible for the participant’s care to organise support.

NDIS Commission: Record Keeping

Records of all reportable incidents that occur or are alleged to have occurred must be kept for a period of 7 (seven) years from the date of notifying the NDIS Commission.

Bettercarendis will retain:

  • completed reportable incident notification forms,
  • records of investigations, including:
    • records of interviews,
    • evidence collected,
    • any relevant correspondence
    • investigation reports and outcomes.

Incidents involving participants under 18 years old should be kept until the participant turns (or would have turned) 25 years old. The General Manager (or delegate) will be responsible for creating and maintaining incident records, while the provider will be required to retain them.

Child-related: Mandatory Reporter Guide (MRG)

The MRG is an online automated decision-making tool which generates decisions in response to input information, assisting mandatory reporters determine how to respond to and report child-related abuse and neglect. Responses include:

  • Immediate Report to Community Services – staff should report concerns to the Helpline immediately, following the instructions on the screen.
  • Consult with a Professional – the indicators border on the threshold for Risk of Significant Harm. Staff should consider further action to address child wellbeing concerns, consulting their supervisors or other informed parties about referral options or other strategies
  • Consult with your Referral Network – indicates that there is no risk of significant harm but the family may benefit from a referral to additional services and has shown a willingness to accept services. For example, there may be a need for specialist mental health services or respite care
  • Document and Continue Relationship – indicates that concerns don’t meet the threshold for reporting. Where Bettercarendis has a continuing relationship with the participant, staff should monitor the situation and note any deterioration in the family’s circumstances, and to use that information to review the MRG.
    Where staff strongly disagree with the MRG decision, they should ensure their Decision Tree selections best fit their concerns, particularly in the case of neglect and/or where they strongly believe that there exists a Risk of Significant Harm.

Where new information becomes available, review the MRG’s decision accordingly.

Review of Incident Management System

The incident management system will be regularly reviewed on the guidance of the frequency and seriousness of reported incidents occurring in one quarter. Reviews will then include:

  • a document review of policies and procedures,
  • a review of the causes, handling, and outcomes of incidents,
  • participant and worker input, and
  • other relevant feedback

Where policies, procedures and processes are revised, changes will be communicated to staff, participants and their supporters as appropriate.

Addendum 1

Bettercarendis practical operational procedures capturing the daily activities working with NDIS Participants:

Policies,

  • 210320_BCN_POL1_Incident_Management Policy_V02
  • 210320_BCN_POL2_Work_Health_Safety_V02
  • 210320_BCN_POL3_WHS_Risk_Management_Policy_V02

Procedures

  • 213020_BCN_SOP1_Incident_Investigation_V02
  • 210320_BCN_SOP3_Incident_Resolution_V02
  • 210320_BCN_SOP5_Hazard_Risk_Register_V02
  • 210320_BCN_SOP6_NDIS_Complaints_Management_V02
  • 210320_BCN_SOP7_NDIS_Risk_Management_V02

Reports

  • 210320_BCN_REP1_Staff_Incident_Report_Form_V02
  • 210320_BCN_REP2_Client_Incident_Report_Form_V02
  • 210320_BCN_REP3_Product_Incident_Report_Form_V02
  • 210320_BCN_REP4_General_Complaint_Report_Form_V02
  • 210320_BCN_REP5_Product_Complaint_Report_Form_V02
  • 210320_BCN_REP6_Client_Complaint_Form_V02
  • 210320_BCN_REP7_Hazard_Report_Form_V02
  • 210320_BCN_REP8_Client_Incident_Form_V02
  • 210320_BCN_REP9_Client_Complaint_Report_V02

Register

  • 210320_BCN_REG2_Incident&Complaint_Register_V02