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4.8 Critical Incidents

Last Modified: 03-May-2022 Review Date: 01-Jun-2019

 ‭(Hidden)‬ Legislation

Purpose

To provide information to residential care workers on the procedures required to keep children and staff safe before, during, and after a critical incident.

Practice Requirements
  • Critical incidents must be managed and responded to using the Sanctuary therapeutic approach and therapeutic crisis intervention (TCI) principles and practices.
  • Residential Care Workers must notify the manager (or on call manager) of critical incidents as soon as possible by email in the first instance, and record brief advice details on a Critical Incident Summary form and email as per distribution list stated on the form.  The summary form must be saved to the Objective Residential Care file
  • A Critical Incident Report must be completed within 10 days and emailed to the House Manager and House Psychologist.
  • The Manager must save the Critical Incident Report to the Objective Residential Care file and forward copies of the report to the child's case manager/team leader and others, as per distribution list stated on the report. Where a serious or contentious critical incident occurs, (one that will have ongoing repercussions to the child or the Department), residential care workers must inform the manager (or on-call manager) by phone immediately. 
  • Residential care workers must not contact the police as a child behaviour management tool.

Procedures

  • Definition
  • Introduction
  • During the incident
  • After the incident
  • Definition

    ​A critical incident is an event which involves an injury or potential for injury, and/or a strong stress reaction in a child or residential care workers. It is also any situation where residential care workers have used Therapeutic Crisis Intervention (TCI) restraint procedures. 

    A contentious critical event is one where a serious incident will have ongoing repercussions to the child or the Department and must be reported to the house manager (or on-call manager) and/or Director. The child does not have to have been on site for a critical incident to have occurred. 

    Examples of critical incidents include: 

      • serious risk of harm or injury 
      • self-harm or attempted suicide 
      • assault 
      • hospital admission 
      • severe property damage 
      • police involvement 
      • a restraint or physical intervention, and 
      • allegation of physical or sexual abuse. 

    NOTE: Critical incidents are not limited to these situations and if you are unsure please complete a Critical Incident Summary and the Manager will advise you of the need to complete a Critical Incident Report.

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    Introduction

    Children and young people in Residential Care can present with extremely challenging behaviour for example verbal threats, aggression, or deliberate slef-0harm that are expressions of trauma.

    Children, residential care workers and others have a right to interact in a way that is free from risks to their personal safety or wellbeing. 

    Residential care commits to taking appropriate action in response to incidents which affect, or have the potential, to affect the health, safety or wellbeing of staff, children or others whilst striving to provide a safe and therapeutic environment that promotes healing. 

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    During the incident

    Residential Care staff have a duty of care towards all children during an incident.  Residential care workers need to be trauma-informed in their responses and able to confidently assess risk, de-escalate heightened emptions and manage challenging situations. 

    Residential care workers must assess the situation and use appropriate Sanctuary and TCI strategies to de-escalate the child and maintain the safety of other children and workers. This may involve the use of restraint as per TCI. 

    Residential care workers must only contact the Police when they and/or the children are in danger and safety is not able to be maintained and all other strategies have been exhausted.   If staff are unable to call the Police, then the duress alarm should be activiated. 

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    After the incident

    • Residential care workers must maintain the physical and emotional well-being of the other children and staff.
    • Residential care workers must provide immediate emotional first aid to all children after the incident. 
    • Recording – Notes about the critical incident must be recorded in the Log Book and residential care workers can refer to these later when completing the case notes, Critical Incident Summary and the Critical Incident Report.
    • The Critical Incident Summary form must be emailed as per the distribution list stated on the form, as soon as practicable before the end of the shift.
    • A Critical Incident Report should be completed within 10 days and emailed as per the distribution lists stated on the form.  
    • If the issue is contentious the House Manager is to advise their Assistant Director as soon as practicable, and after-hours staff are to notify the On-Call Manager
    • All residential care workers and children involved in a critical incident should be given the opportunity for an initial debrief.  This may be done with the manager, psychologist or colleague.  An initial debrief concentrates upon providing emotional first aid.  It is not focused upon practice and may be of brief duration.  The goal is to promote coping in those affected.  Refer to Related Resource Initial Debrief Practice Guide for further information. 
    • Initial debriefing should not be done at the expense of care and supervision of children and may need to occur at a suitable later opportunity.   
    • All documents to be saved to the child's Residential Care file on Objective.

    For more information, also refer to 'Injuries to a Child' and 'Injuries to Staff' in 5.4 - Medical Emergency.

    For more information, also refer to 'Allegations of Abuse in Care' in 1.5 – Where the allegation relates to a Department employee.

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