Page 2851 - Week 09 - Wednesday, 17 September 2014
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These risks are assessed, I am advised, on a daily basis, and staff monitor people as per their allocated observation level. If required, redeployment of staff occurs to ensure that staff-to-patient ratios are appropriate, and extra staff are provided if acuity is high, although I do accept from my dealings with the ANMF that there is still probably disagreement about whether those patient ratios are appropriate, and that is subject to ongoing discussion between the union and management of the unit.
All staff are aware of or trained in early support and intervention principles which are used to de-escalate episodes of acute distress or agitation which may lead to an episode of aggression. I did lose Mrs Jones’s logic or understanding towards the end of her speech about my ideological crusade. I was not entirely sure how she formed that view or where there is any evidence of that. But, if it is around balancing the needs of the patients with the safety of the staff, I do agree that there is a balance to be found there, but I certainly do not rate one higher than the other, nor have I ever sought to push that view or put forward that view in any way.
I would go to the issue of seclusion, though. I have met with staff in the adult mental health unit and prior when staff were working in a greatly inferior facility in the psychiatric services unit, which is about to be demolished, at Canberra Hospital. The staff were actually very proud of the low rate of seclusion. It reflects the skill that they have demonstrated in treating people that there is not the level of demand for seclusion. So it is a direct correlation to their professional capacity. Yes, we are proud of that result because I think it reflects very well on our staff, but if a person needs seclusion or restraint that option is available to staff and it is used by staff as necessary. But rather than seeing it as a tool that is used against staff it is actually much more linked to the outstanding work they perform in supporting patients and de-escalating some of the challenging behaviour in their workplace.
Some of the information quoted in the Canberra Times and the motion regarding the number of staff that have had time off work due to workplace injury, as Mrs Jones alluded to, was from the accepted Comcare claims and includes all categories of workplace injuries not just those relating to aggression from patients within the unit. There is further work being undertaken on the RiskMan reports to date; however, early indications suggest that the incidence of aggression and violence in the unit is not increasing year on year.If we go to the provisional improvement notice, on 25 July the health safety representative at the adult mental health unit placed a PIN, under section 90 of the Work Health and Safety Act 2011, on the adult mental health unit. The PIN contained three specific points: that within eight days—and this is in early August or by early August—the number of consumers in the unit must be reduced to a level satisfactory to the health and safety rep or temporary measures to increase the number of skilled nursing staff to a level satisfactory to the health and safety rep; that within six weeks—ie, by 5 September—the number of permanent nursing staff within the AMHU must be increased to a level satisfactory to the HSR; and that within six weeks the post-occupancy evaluation must be finalised.
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