Aged care providers have reported the highest number of instances of “unreasonable force” in a quarter since records began two years ago, with the sector facing accusations that they have downplayed the harm caused.
Providers reported 7,663 instances of “unreasonable force” in the last three months of 2022, the highest quarterly figure since records began in April 2021.
The behaviours include squeezing, grabbing, pinching, rough handling, hitting, pushing and forcing someone to move against their will. In many cases, the incidents have caused injuries that may not be immediately apparent, such as blood clots.
More than eight in 10 incidents of force reported to the aged care quality and safety commission involved residents using force on another resident, commissioner Janet Anderson said.
“Nearly one in 10 notifications of unreasonable use of force involve staff. This concerns us,” Anderson said.
In the final three months of last year, 2,120 incidents of unreasonable force were considered “priority one” breaches, which means the provider judged they caused or were expected to cause injury and there were reasonable grounds to call police.
The commission’s chief clinical adviser, Melanie Wroth, criticised some providers for stating the majority of incidents posed little if any harm. Between October 2021 and July 2022, 6,000 of 20,000 breaches were classed as “priority one”.
“The tendency of providers to assess the impact of even serious incidents as minor is of concern to the commission,” Wroth said.
“It suggests that there may be insufficient understanding of impact, and insufficient attention to behaviour support plans and other strategies that can prevent such incidents from happening or recurring.
“Recognising the impact of stressful or violent events is fundamental to responding appropriately to incidents and to the assessment and management of risks associated with incidents in a service.”
The commission’s report details five examples of unreasonable force, including one resident pinning another to a chair after a dispute about cigarettes. Others involve a resident with dementia being slapped on the face or residents being pushed over.
The inappropriate use of force by staff against residents was not detailed in the report, despite being described as a concern, and will instead be the subject of a separate government investigation.
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Wroth said unreasonable force was “significantly more likely” to involve residents with cognitive impairment and urged providers not to place blame, but to understand what may be causing residents to behave violently.
“Although sometimes challenging, such incidents should never be considered unavoidable,” Wroth said. “Trying to establish who is ‘at fault’ or who ‘caused’ the incident may not always be easy and is often not clearcut.”
Aged care providers have been required to report serious instances of harm on a quarterly basis since 2021 to ensure greater accountability and transparency.
Neglect was reported 1,893 times in the final three months of 2022. Last year, an audit of 27,000 calls made by aged care residents, families and carers to aged care advocates revealed shocking instances of neglect. In one case, staff ignored a wound for so long that doctors deemed it “required amputation”.
The latest data also reveals 633 instances of “unlawful sexual conduct or inappropriate sexual contact”, which must be referred to the aged care quality and safety commission within 24 hours.
“The incident notifications are reviewed and assessed within 24 hours to ensure appropriate responses by providers including reporting to the police,” the latest report said.
More than 170 aged care services did not meet mandated quality standards in the final three months of 2022. The most common breaches were a lack of “safe and effective personal and clinical care” and “ineffective governance systems”.