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    Serious risk

    The Quality Agency Principles 2013 S 2.63 (2) and S 3.18 (2) require that, if the CEO of the Quality Agency identifies a failure by an approved provider of a service to meet one or more expected outcomes of the applicable Standards, the CEO must decide whether there is evidence that the failure has placed, or may place the safety, health or wellbeing of a care recipient of the service at serious risk.

    The Quality Agency must act as soon as reasonably practicable to consider the impact of the failure on the safety, health or wellbeing and whether care recipients have been or may be placed at serious risk. When the Quality Agency makes a finding of serious risk the Quality Agency gives the approved provider of the service a written notice outlining the reasons for and evidence of the risk and also notifies the Department of Health. This ensures that prompt attention by the approved provider is given to rectifying the risk to care recipients.

    Definition of serious risk

    The following definition of the term “serious risk” is adopted by the Quality Agency and is based on the ordinary meaning of the words when used individually and when used together.

    Serious: Important, significant

    Risk: exposure to danger, injury or loss

    Identification and evidence of serious risk

    The Quality Agency assessment team collects information or evidence for the purpose of assessing the performance of an aged care service in relation to expected outcomes of the applicable Aged Care Standards. While undertaking a performance assessment against the applicable standards, the assessment team is required to gather sufficient evidence about the care and circumstances of care recipients. The assessment team may seek clarification from the approved provider of the service about any matters that require more information related to the circumstances of individual care recipients in relation to the expected outcomes of the Standards.

    The assessment team do not make decisions about serious risk to care recipients. When an assessment team identifies that an approved provider of a service may not meet one or more expected outcomes of the Standards (a failure to meet the Standards), they provide a report to the relevant State Office of the Quality Agency.

    Services include both residential care services and home care services and applicable standards refer to the Accreditation Standards, Home Care Standards or Flexible Care Standards.

    Notification of consideration of serious risk

    When the Quality Agency makes a finding that a service has not complied with one or more expected outcomes of the applicable standards we are required to consider the evidence for the purposes of understanding whether the failure has placed or may place a care recipient at serious risk.

    The Quality Agency will notify the approved provider of the service that serious risk is under consideration. The notification to the approved provider will detail specific information about the reasons for consideration of serious risk including evidence in relation to individual care recipient(s).

    The approved provider has an opportunity to respond to the notification of serious risk. Because of the nature of serious risk impacting on care recipient(s) the approved provider is given a short period to respond to evidence of serious risk.

    The approved provider’s response to the notification of serious risk should address the specific evidence relating to the failure in one or more expected outcomes of the applicable Standards AND the risk to the identified care recipient(s).

    The response provided by the service is considered when determining whether the failure to meet the applicable standards has placed, or may place, the safety, health or wellbeing of care recipients at serious risk.

    In making a decision as to whether the failure has placed or may place a care recipient at serious risk the delegate may decide that the failure has placed a care recipient at serious risk even if the failure has subsequently been addressed by the provider.