By Leon Harris CPP
Published in ANHECA NEWS, June 2002

Good security management is an essential component of the philosophy and business practices of aged care facilities. One of the common reasons why management fails to achieve their desired aims in protecting people in their facility is as basic as poor communication between staff and management. The decision makers responsible for strategic security issues need critical information in an organised and timely manner from staff undertaking their operational duties. Unfortunately, communication between staff and management is often seriously downgraded because of poor practices between night shift and 'day time' management. The following case study illustrates this.

A security review was undertaken of a large aged care facility that comprised a nursing home and adjoining hostel. The consultant was advised by management that the nursing home did not have wandering residents, as they were not in a position to cater for their needs. Evening staff, however, painted a different picture, advising they had several residents who often opened external doors and walked out into the darkened grounds at night. When carrying out their rounds, staff would sometimes find a resident 'missing', and would leave the safety of the facility to carry out a search. Staff were concerned about the possibility of injury from falling over or possible assault from an intruder.

Also of concern was that the nursing home had a low perimeter gate. In addition, a retaining wall at the rear of the facility started at ground level and increased to approximately two metres in height. The section at ground level provided access along a perimeter fence to an un-gated driveway and public street. Thus the gate would not have prevented an able bodied or determined 'wanderer' from walking out.

When a wanderer incident occurred, the night RN would inform the morning shift. It was assumed by the night RN that the morning shift would advise management. Unfortunately the reality was this did not happen.

When this issue was raised with the DON she could not find any records where this type of incident had been documented, although staff had been instructed by memorandum that documentation of this type of incident was part of their duties.

The management of this facility needed to ask some important questions:

• If there were instructions to staff, why were they not carried out?
• What happened to the 'verbal' reporting of the incidents; in other words, why was there a failure to pass on the information about incidents to management?
• Why did evening/night staff not question the apparent non-action of management to remedy the 'reported' incidents?

Communication failures relating to security/safety incidents often result in no remedial action being undertaken by management. As a result, it strains relations between management and staff, as well as allowing the risks associated with the security/safety incidents to continue.

The following list should be considered, but is by no means complete:

• Instructions from management should always be in writing and incorporated in staff procedures.
• Standardised formal (incident) reporting needs to be established that will be directed to management for action.
• As with any continuous improvement process, it is important the originator of the report be provided with feedback as to what action will be taken to rectify concerns and for all staff to receive an update in the form of the latest procedures.
• A data base should be developed that will assist in detecting any trend that may require greater management input or resources.
• In some cases training or workshops for staff may be required.
• Facilities that tend to better overcome communication problems generated during the night/week-end shift and management appear to have common characteristics, i.e. a member of their senior management team on occasions visits the facility during the night and on week-ends as does the person(s) in charge of staff education/QA.

As a final note, staff training and information should mention that incident reports may be called upon in legal action involving an incident It looks poor when incident reports are not available for court matters.

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