Department for Health and Wellbeing Annual Report 2019-20
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Department for Health and Wellbeing Annual Report 2019-20
Reporting required under any other Act or Regulation (DHW Annual Report 2019 - 20)
Reporting required under any other Act or Regulation
| Act or regulation | Requirement |
|---|---|
|
Ageing and Adult Safeguarding Act 1995 |
Part 2 - Office for Ageing Well
11 - Annual Report (1) The Director must, on or before 31 October in each year, report to the Minister on the operations of the Office for Ageing. Well during the preceding financial year. (2) The Minister must, within 6 sitting days after receiving a report from the Director, have copies of the report laid before both Houses of Parliament. Part 3 - Adult Safeguarding Unit 17- Annual Report (1) The Director must, on or before 31 October in each year, report to the Minister on the operations of the Adult Safeguarding Unit during the preceding financial year. (2) The Minister must, within 6 sitting days after receiving a report from the Director, have copies of the report laid before both Houses of Parliament. (3) A report under this section may be combined with the annual report for the Office for Ageing Well under section 11. |
The Office for Ageing Well, established under the Ageing and Adult Safeguarding Act 1995 is located in the Department for Health and Wellbeing. Under this Act, the Office for Ageing Well objectives include:
- supporting South Australians of all ages to age well, unencumbered by stigma and discrimination
- achieving proper integration of ageing persons within the community thus ensuring that the skills and experience of the ageing are not lost to the community through social alienation
- creating social structures in which ageing persons are able to realise their full potential as individuals and as members of the community
- creating a social ethos in which ageing persons are accorded the dignity, appreciation and respect that properly belong to them
- ensuring that the multicultural nature of the community is reflected in the planning and implementation of programs and services relevant to ageing persons
- achieving a proper understanding within the community of the problems affecting ageing persons and other vulnerable adults and ameliorating those problems so far as it is practicable to do so by modification of social structures and attitudes.
To achieves its objectives, the Office for Ageing Well listens to the voices of older South Australians as it leads the development of policies and delivers programs and projects in partnership with a diverse range of stakeholders, in line with the priorities of the state government’s ageing well agenda, through the:
- Adult Safeguarding Unit
- Ageing Policy Unit
- Aged Care Strategy Unit
- Seniors Card Program
- Community Grants Program
- Retirement Villages Unit.
Adult Safeguarding Unit
The Office for Ageing Well has expanded its support function for adult safeguarding through the work of the Adult Safeguarding Unit (ASU), which commenced operations on 1 October 2019.
The ASU has legislative mandate to respond to reports of abuse of older people. For the first three years, the ASU will respond to reports of suspected or actual abuse of people 65 and over, and 50 and over for Aboriginal and Torres Strait Islander people. From 1 October 2020, the ASU will respond to reports for people with a disability who may be vulnerable and from 2022, the ASU’s legislative remit will expand to include all vulnerable adults who may be experiencing abuse.
The ASU has a strong focus on promoting and safeguarding the rights of adults at risk and works with a person to develop a safeguarding plan tailored to their needs, wishes and circumstances. The ASU has a range of information gathering powers to enable appropriate referral of matters and investigation of reports of serious abuse. In the majority of situations, a person’s consent is required before any action can be taken.
The ASU is responsible for raising community awareness of strategies that may assist to safeguard the rights of older South Australians and between 1 July 2019 and 30 June 2020 has met with 91 diverse stakeholders, including community members.
Reporting abuse to the ASU is voluntary and is made through the South Australian Elder Abuse Prevention Phone Line (Phone Line).
The Phone Line commenced in 2015 to provide an advice and referral service, and from 1 October 2019, the Phone Line also became the portal for making a report to the ASU. Since its commencement in October 2015, the ASU has taken more than 2,380 calls. Between 1 July 2019 and 30 June 2020, the ASU has received 946 calls. Of those calls, 306 resulted in a report to the ASU and the remaining 640 calls were for information and advice only. Of the 306 reports made to the ASU, 239 reports resulted in the ASU commencing an investigation. As at 30 June 2020; three reports resulted in referral to a state authority, specified person or body; three cases are currently being assessed; and in 61 cases no further action was taken by the ASU. Where no further action was taken, in the majority of cases this decision was based on information gathered by the ASU that confirmed the situation was being appropriately managed and/or safeguarded.
Data from the Phone Line consistently indicates that the most frequent callers are service providers (28 percent), and adult sons and daughters and other family members (37.1 percent). The most common types of abuse are financial (42.7 percent), emotional (35.6 percent), neglect (14 percent) and physical (13 percent). Adult sons (27.4 percent) and daughters (19 percent) of older people are most often reported as the alleged abuser.
Significant consultation has occurred in relation to the establishment and development of the ASU, including older people with lived experience and their families as well as with a broad range of stakeholders across the sector. Consultation will be ongoing to assist with the development of the ASU and expansion of its scope in 2022.
Ageing Policy Unit
To meet the priorities of the State Ageing Plan, in 2019-20 the Office for Ageing Well funded 15 ageing strategic projects, in partnership with a broad range of stakeholders from government, non-government and community organisations, including:
- Rolling out the Age Friendly Customer Services Guidelines project to state government organisations to ensure government services provide customer service to older people that is age friendly, respects their rights and includes them in service design. A website has also been developed to support ongoing age friendly services training.
- Piloting a project that will bring together kindergarten-aged children attending a child care centre and older people who live in a residential aged care facility to co-create opportunities for meaningful connections, facilitated by allied health students, and to challenge ageism.
- Working with the State Theatre Company to introduce a new program that will support older people to continue their enjoyment of theatre, despite changing life circumstances such as loss of a regular theatre-going companion.
- Partnering with COTA SA and the Multicultural Communities Council of SA to develop projects that seek to address and reduce social isolation caused by the COVID-19 pandemic, particularly to engage older people that are not digitally connected.
- To support safe and connected communities, eight Ageing Well Community Networks were established to raise awareness and increase community understanding of ageing well, elder abuse prevention strategies and the Adult Safeguarding Unit. The networks deliver information in culturally appropriate ways and through trusted networks to Aboriginal people, Lesbian, Gay, Bisexual, Transgender, Intersex, Queer communities, regional communities, and Culturally and Linguistically Diverse communities.
The annual Stop Elder Abuse public awareness campaign was held between 3 May and 30 June 2020. This year’s campaign encouraged people to know the signs of elder abuse and to speak up. The campaign further built awareness of the Phone Line, where callers can obtain free, confidential advice and support or make a report to the ASU. In 2019-20, also co-designed the new Respect Connect #StopElderAbuse awareness campaign with Aboriginal Elders, which will be progressively rolled out in partnership with metropolitan and regional Aboriginal communities over the next five years.
To inform the development of South Australia’s Plan for Ageing Well 2020-2025, the Office for Ageing Well undertook significant consultation in 2019-20 with a diverse range of older South Australians and stakeholders. The consultation identified three key strategies: Home and community; Meaningful connections; and Navigating change. The Plan will be released in early July 2020 and will set the state government and community’s vision and priorities for ageing well over the next five years.
Aged Care Strategy Unit
Aged Care Assessment Teams in South Australia comprehensively assess the needs of frail older people to provide access to Commonwealth funded aged care services.
South Australia was one of the highest performing jurisdictions in 2019-20, actioning 26,478 referrals and 16,916 completed assessments as at 30 June 2020. South Australia maintained timely performance in the completion of assessments across all settings, with the median days from referral to assessment currently at 10 days, compared to 12 days nationally. Ninety-five percent of assessments were completed within 42 days compared to 64 days nationally.
In addition to managing the operations of the Aged Care Assessment Program in South Australia, the Aged Care Strategy Unit also has responsibility for progressing a range of strategic projects, including the SA Health CCTV Pilot Project; the Aged Care Assessment Program Reform Project; the National Health and Aged Care Interface Data Project; and responding to the Royal Commission into Aged Care Quality and Safety.
Seniors Card Program
The Seniors Card Program supports social and economic participation of older people and their connectedness to the community. It contributes to making SA an affordable place to live by increasing access to free public transport, providing important information about community news, events and services. It also delivers discounts and benefits from participating businesses.
In 2019-20, the total number of Seniors Card members increased to 400,000 and subscriptions to WeekendPlus, the fortnightly digital seniors’ magazine, increased by 10 percent to 80,000. Of the approximately 20,000 new Seniors Card applications received in 2019-20, 90 percent were made online. The number of 2019-20 Seniors Card business partners decreased by 2.8 percent to 745. Of these, 47 percent were based in regional areas of the state and 53 percent were based in metropolitan Adelaide.
Community Grants Program
The South Australian Government, through Office for Ageing Well, provides $600,000 in Ageing Community Grants to support community organisations and local government projects. These grant support South Australians to age well, and promote opportunities for older South Australians to be involved and active in their communities.
In 2019-20, the Office for Ageing Well ran the Grants for Seniors, Positive Ageing Fellowship Grants (PAFG) and Age Friendly SA Grants rounds concurrently through an open process aimed at local government and community organisations across metropolitan and regional South Australia.
In 2019-20:
- Grants for Seniors supported 28 projects at a total cost of $149,505
- PAFG supported six projects, totalling $200,000
- A targeted grant of $50,000 was provided to the Australian Centre for Social Innovation to deliver ongoing coaching, mentoring and support to PAFG recipients over the 12-month funding period to support sustainability
- Age Friendly SA Grants supported nine projects at a total cost of $200,000.
Outcomes achieved during the 2019-20 financial year include:
- purchase of equipment
- delivery of cultural, educational and sporting activities and programs
- initiatives to tackle ageing stereotypes and support positive perceptions of ageing
- initiatives that support ageing well, participation, learning and independence
- kick-starting age friendly innovation projects to support opportunities for older people to connect to local places and community activities.
In addition to the above, commencing in April 2020, the Office for Ageing Well led South Australia’s aged care COVID-19 response by bringing together a working group of aged care peak bodies, sector representatives and advocacy organisations for weekly meetings to discuss implications and implementation of legal directions and policies impacting residential aged care facilities in South Australia. the Office for Ageing Well also partnered with various organisations to deliver projects to address and reduce social isolation, and used the Senior Card network and other platforms to communicate targeted messages around social distancing, COVID-19 restrictions and other relevant information to retirement villages and older South Australians living in the community.
| Act or regulation | Requirement |
|---|---|
| Retirement Villages Act 2016 Retirement Villages Regulations 2017 |
Part 2 11 - Annual Report (1) The Registrar must, on or before 30 September in every year, forward to the Minister a report on his or her work and operations for the preceding financial year. (2) The Minister must, within 12 sitting days after receiving a report under this section, have copies of the report laid before both Houses of Parliament. |
Retirement Villages Unit
The Retirement Villages Unit (the RV Unit), within the Office for Ageing Well, provides information, assistance and education sessions on retirement village matters, clarifying areas of concern, as well as providing a mediation service to help resolve disputes between residents and operators. The RV Unit investigates and assesses complaints and allegations of breaches of the Retirement Villages Act 2016 and Regulations, underpinned by support and education rather than adversarial approaches to enforcement.
In 2019-20, legislative requirements under this Act were managed by the RV Unit, including one ASO7 Chief Retirement Villages Officer, one ASO6 Senior Information, Advice & Conciliation Officer, one ASO5 Senior Retirement Villages Officer and one ASO4 Retirement Villages Officer. As at 30 June 2020 the RV Unit:
- responded to 648 cases relating to retirement village issues
- conducted 54 meetings related to resident cases
- delivered 11 presentations and information sessions to residents and interested groups
- delivered monthly “retirement village information” sessions at the Catalyst Foundation
- undertook six mediations
- provided advice and recommendations to the Minister.
In February 2020, a compliance audit was undertaken reviewing compliance with Sections 33 and 34 of the Retirement
Villages Act 2016 in relation to residents’ annual meetings. Fifteen percent of operators were randomly selected and required to present documentation relating to the 2019 annual meeting of residents. The documentation was checked against the requirements of the legislation, feedback was provided to the operators and the majority of provisions were complied with. There was minor non-compliance identified in 17 cases and one instance of significant non-compliance. In each case, education has been provided to the operator and ongoing monitoring will occur.
As at 30 June 2020, 530 retirement villages were registered across the state. Information about registered retirement villages in South Australia is available on Data SA at https://data.sa.gov.au/data/dataset/retirement-villages-register
There were nine new villages registered in the past year and two small villages were voluntarily terminated. Three register records were consolidated into one village record. A review discovered that one village with three street frontages was incorrectly registered as three villages. Under the Retirement Villages Act 2016, it is a requirement for all retirement village schemes to be registered within 28 days of the first resident taking up occupation.
Voluntary termination of a village can only occur with Ministerial approval. Villages terminated during the year were identified as no longer being used for the purposes of a retirement village scheme and there were no outstanding funds owing to past residents.
In 2019-20, there were 18,792 residences in retirement villages in South Australia. Calculations based on past census data showed that 60 percent of all residences (11,275) housed one person only, while the remaining 40 percent (7,517) of residences had dual occupancy. It is estimated that the number of people living in retirement villages totalled approximately 26,309.
The vast majority of retirement villages offer independent living units only. A small section of the sector provides serviced apartment accommodation, which caters to residents requiring assistance, including provision of meals, some cleaning and the availability of extra services.
Under the Retirement Villages Act 1987, there were 194 villages with exemptions, which have continued under the associated provisions of the Retirement Villages Act 2016:
- Four under S18: With client consent, no need to hold premium in Trust (Retirement Villages Act 1987).
- Twelve under S26(1): Ingoing contribution does not have to be held in trust, max deposit $10,000 (Retirement Villages Act 2016).
- Forty-four under S22(c), 33(6), 34(8), 39, 40(4): Can have consolidated meetings and financial reports for resident funded and independent living resident groups (Retirement Villages Act 2016).
- One hundred and eleven under S22 & S23: Can have consolidated meetings, financial reports & interim financial reports (Retirement Villages Act 1987).
- Twenty under S31(3): Operator exempted from assuming responsibility for depreciation (Retirement Villages Act 2016).
- Two under S57(1): Operator abled to rent to persons not eligible under the Act (Retirement Villages Act 2016).
- One under S33: Operator is not required to hold annual meeting, while only one person in occupation (Retirement Villages Act 2016).
Retirement Village Residents Advocacy Program
Since 2014, the Office for Ageing Well has funded the Aged Rights Advocacy Service (ARAS) to provide an advocacy service to residents. The Retirement Village Residents Advocacy Program is a valuable resource to residents of retirement villages, providing advocacy support, information and advice on their rights.
The predominant contact with the Retirement Village Residents Advocacy Program is via telephone, with 79 percent of calls from metropolitan areas, 11 percent from rural areas with the remainder anonymous.
As at 30 June 2020, ARAS received 223 new requests for assistance. This included 142 cases relating to advocacy assistance and 81 requests for general information about rights and advocacy services. Advocates assisted with one South Australian Civil and Administrative Tribunal hearing.
ARAS delivered five specific information sessions within retirement villages for residents and staff of the villages, and incorporated information about the Retirement Village Residents Advocacy Program generally in other information sessions.
| Act or regulation | Requirement |
|---|---|
| Food Act 2001 | Part 9 – Administration Division 2 – Functions of enforcement agencies S 93 - Reports by enforcement agencies (1) The head of an enforcement agency (other than the relevant authority) is to report to the relevant authority, at such intervals as the relevant authority requires, on the performance of functions under this Act by persons employed or engaged by the agency. Division 4 – Agreement and consultation with local government sector on administration and enforcement of Act S 96 – Agreement and consultation with local government sector (1) The Minister must take reasonable steps to consult with the LGA from time to time in relation to the administration and enforcement of this Act. (2) If the Minister and the LGA enter into an agreement with respect to the exercise of functions under this Act by councils, then the Minister must prepare a report on the matter and cause copies of the report to be laid before both Houses of Parliament. (3) A report under subsection (2) must be accompanied by a copy of any relevant written agreement between the Minister and the LGA. (4) The Minister must consult with the LGA before a regulation that confers any function on councils is made under this Act. (5) The annual report of the Minister under this Act must include a specific report on (a) the outcome of any consultation undertaken under subsection (1) or (4); and (b) the operation of any agreement referred to in subsection (2). Part 11 - Miscellaneous S 109 - Annual report (1) The Minister must, on or before 30 September in each year, prepare a report on the operation of this Act for the financial year ending on the preceding 30 June. (2) The Minister must, within 6 sitting days after completing a report under this section, cause copies of the report to be laid before both Houses of Parliament. The objectives of the Food Act 2001 (the Act) are defined in Section 3 of the Act as: - Ensuring that food for sale is safe and suitable for human consumption - Preventing misleading conduct in connection with the sale of food - Providing for the application of the Food Standards Code The Act closely follows the content and structure of national model food provisions, which provide for the consistent administration and enforcement of food legislation in Australia. This uniform approach to national food legislation was formalised by the Inter-Governmental Food Regulation Agreement 2002. Under the Agreement all states and territories have adopted the Australia New Zealand Food Standards Code (the Code) through their Food Acts. While the Act contains important legal and administrative issues, such as defining offences and penalties, the Code details the specific requirements with which food businesses must comply. |
1. Activities of the Health Protection Operations Branch
Health Protection Operations administers the regulatory functions of the Food Act 2001 in the ‘Out-of-Council Areas’ within SA (‘unincorporated’ and Aboriginal Lands not serviced by a local council). These areas make up approximately 85 percent of the geographical area of SA and are typically very remote and often isolated, making staff safety a paramount element of all regulatory operations.
Health Protection Operations staff authorised under the Food Act 2001 are qualified Environmental Health Officers (EHOs) with extensive regulatory experience in rural, remote and Aboriginal communities. Food safety functions undertaken by Health Protection Operations include:
- Monitoring and enforcement of compliance with Food Safety Standards and of the safety and suitability of food
- Routine and follow-up inspections of food businesses to ensure that the premises, equipment and food handling practices will result in the supply and sale of safe and suitable food
- Food safety audits of businesses providing food to vulnerable populations
- Responding to complaints in relation to food businesses and investigating food poisoning and disease outbreaks
- Monitoring and taking action to ensure efficiency with which food is recalled for health and safety, and/or is removed from sale
- Receiving food business notifications for new businesses or change to business details
- Provision of food safety advice and delivery of educational programs and resources to food businesses, schools and communities.
The vast distances and extreme weather conditions associated with outback SA provide a challenging environment for both food business operators and regulators alike. Effective and thorough operational procedures and protocols ensure that risks associated with such an environment are well-managed and appropriate food safety and compliance standards are maintained.
Statistics about food businesses, staff and surveillance activities are provided below:
Table 4: Authorised officers
| Environmental health qualifications | Full-time |
|---|---|
| 6 | 6 |
Table 5: Food business and surveillance activity
| Area of operation | ~ 837,000 km²(≈ 85% of geographic area of the State) |
|---|---|
| Number of businesses | 116 |
| Routine inspections conducted | 124 |
| Follow-up inspections conducted | 6 |
| Food Safety Audits conducted | 9 |
| Complaint inspections conducted | 0 |
Table 6: Enforcement actions
| Business type | Prohibition order | Improvement notices | Expiations |
|---|---|---|---|
| Supermarket | 0 | 1 | 0 |
| Aged Care Facility | 0 | 1 | 0 |
| Total | 0 | 2 | 0 |
2. Activities of the Food and Controlled Drugs Branch
Monitoring Compliance with the Food Act 2001
The Food and Controlled Drugs Branch (FCDB) conduct sampling of various foods that are of public health concern, or to confirm compliance with the compositional and labelling requirements of the Food Standards Australia New Zealand (FSANZ) Food Standard Code (the Code). A key performance indicator has been established to analyse 800 food samples per year. For 2019-20, a total of 823 food samples were collected as part of food incident investigations.
Investigation of food safety issues 2019-20
Food safety related issues come to the attention of FCDB from a variety of sources including routine food surveys, complaints from members of the public, reports from the food industry itself, the Australian Competition and Consumer Commission (ACCC), EHOs in local government, other regulatory agencies, or notification of illness from the Communicable Disease Control Branch (CDCB). During the year 2019-20, a number of significant issues were investigated, summarised below:
- The FCDB collaborated with local councils on a total of five foodborne illness investigations after notification from CDCB. Details of some of the major outbreaks can be found in Appendix 2.
- Investigations included onsite assessment of food handling practices in food businesses, sampling of food and environmental swabbing. The primary objective of these investigations is to remove any risk to public health, establish the cause of the outbreak, and ensure food businesses implement short-term and long-term corrective action and determine if an offence has been committed against the Food Act 2001.
Post investigation review
FCDB regularly conducts post-incident debriefs to review the effectiveness of policies and procedures applied during incident investigation.
Food recalls
Food recalls conducted by all food businesses are nationally coordinated by FSANZ. A food business undertaking a recall is responsible for ensuring that the recall is carried out as soon as an issue is identified. Standard 3.2.2 of the Code requires a food business that engages in the wholesale supply, manufacture or importation of food, to have a system in place to ensure the recall of unsafe food. There are two levels of recall, a trade level and a consumer level recall. A trade level recall is conducted when the food has not been available for direct purchase by the public, such as food sold to wholesalers and caterers. A consumer level recall is conducted when the food has been available for retail sale. This usually includes advertisements in newspapers or on social media platforms to inform consumers of the recall. The department informs local councils statewide of the recall and requests that they check food businesses in their local council area to ensure food businesses are complying with the recall.
FSANZ acted as coordinator for 99 food recalls during the 2019-20 financial year. This consisted of 17 trade level recalls, where a company has only provided product to distribution centres, wholesalers and food services. As the product was not released in retail stores and could easily be retrieved, a consumer level recall was not required. In another seven instances, there were combined trade and consumer level recalls conducted as there was a possibility that a small amount of product may have been distributed. A further 75 recalls were consumer level recalls, where it was necessary to recover product from retail outlets and/or consumers. In total, SA was affected by 47 recalls where recalled product had been distributed in the state. Table 7 provides a summary of the 99 food recalls conducted during the 2019-20 financial year.
Table 7: Summary of recalls conducted in 2019-20
| Type of recall | Reason for recall | SA not affected | National | SA & other states affected | SA only |
|---|---|---|---|---|---|
| Consumer | 75 | Undeclared allergens | 47 | ||
| Trade | 17 | Micro contamination | 28 | ||
| Consumer / trade (combined) | 7 | Chemical Biotoxin |
7 3 |
||
| Foreign matter | 7 | ||||
| Labelling | 3 | ||||
| Other | 4 | ||||
| Total | 99 | 52 | 25 | 44 | 3 |
Enforcement actions
FCDB is responsible for monitoring food industry compliance with chapters 1 and 2 of the Code and also becomes involved with compliance matters associated with chapters 3 and 4 in the course of audits, surveys, complaints and investigation of illness. SA Health’s Public Health Services Enforcement Framework provides authorised officers with guidance about the manner in which enforcement activities are to be undertaken.
Local government is responsible for the conduct of routine food business inspections to verify compliance with chapter 3 of the Code (see Appendix 1 (PDF 532KB).
Where FCDB identifies non-compliance issues in food businesses, corrective actions are addressed through a graduated and proportionate response. Once effective corrective action is confirmed, no further enforcement action is undertaken. Should non-compliance remain unresolved, enforcement action can be escalated. Table 5 provides a summary of the enforcement activities undertaken by the FCDB.
Table 8: Enforcement activities undertaken in 2019-20
| Letters of warning | Expiations issued | Improvement notices | Emergency orders | Prosecutions |
|---|---|---|---|---|
| 1 | 0 | 0 | 0 | 0 |
Activities undertaken
The table below identifies the enquiries, complaints, referrals, incident management and food safety resource requests actioned by FCDB.
Table 9: Nature of activities in 2019-20
| Category | Number |
|---|---|
| Complaints | |
| Alleged food poisoning | 29 |
| Food contamination | 59 |
| Labelling | 40 |
| Alleged non-compliance with Food Standard 3.2.2 | 28 |
| Alleged non-compliance with Food Standard 3.2.3 | 6 |
| Enquiries | |
| General food matters | 487* |
| New business information | 16 |
| Food recall | 1 |
| Incident management | |
| Investigations | 18 |
| Referrals from CDCB | 250 |
| Requests for resources | 9 |
| TOTAL | 943 |
Note: *General food matters are reported as significantly higher than 2019-20 due to system fault.
Food safety management
Food safety programs (FSPs) have been mandated nationally for businesses providing food to vulnerable populations in hospitals, aged care facilities, child care centres, and via delivered meals organisations such as Meals on Wheels.
Food Safety Standard 3.3.1 (audited mandatory food safety programs for food services to vulnerable persons) became enforceable in SA in October 2008. The department has continued to liaise with industry, local government and food safety auditors to develop monitoring and review systems in order to ensure effective management of the audit process in SA food businesses to whom this standard applies.
In 2019-20, the department continued to conduct food safety audits of public hospitals, Department of Human Services (DHS) businesses such as Disability Services and not-for-profit social care and delivered meals organisations including Royal District Nursing Services (RDNS) SA and Meals on Wheels. These facilities are audited at the frequency determined by the performance of individual sites, in line with the priority classification for these businesses. Food audit statistics are provided below.
Table 10: Food audit statistics 2019-20
| Risk classification | Number of businesses | Routine audits |
|---|---|---|
| Public hospital | 71 | 74 |
| Not-for-profit delivered meals organisations | 40 | 40 |
| Aged care/child care audited in regional areas/ DCSI | 11 | 6 |
Note: *RDNS not operating due to COVID-19
Auditor Training for Department for Health and Wellbeing and Local Government Officers
The annual SA Health Auditor Forum was held 22 November 2019 to assist with improving consistency of interpretation and professional development for the auditor workforce. The department continues to facilitate the Lead Auditor in Food Safety Management Systems training sessions. Two training sessions were held in 2019-20 reporting period.
3. Foodborne disease investigations in SA 2019-20
Epidemiological investigations into foodborne disease outbreaks within SA are coordinated by the Disease Surveillance and Investigation Section (DSIS) and OzFoodNet staff who are based within the Communicable Disease Control Branch (CDCB) of SA Health.
OzFoodNet is a national network that conducts enhanced foodborne disease surveillance. OzFoodNet and other CDCB staff work in collaboration with a range of stakeholders when investigating outbreaks.
During 2019-20, SA Health investigated five outbreaks of gastrointestinal illness that were known or suspected to be foodborne and for which a common source was identified. The settings for the outbreaks were varied and included two associated with restaurants, and one outbreak each associated with primary production, a private residence and a take away venue.
In addition to these outbreaks, 11 clusters of potential foodborne illness for which no common source could be identified were also investigated in 2019-20. There were 10 clusters of Salmonella and one cluster of Yersinia Enterocolitica investigated. Hypothesis generating interviews were conducted in the majority of cases.
This summary does not include clusters or outbreaks that were suspected to be person-to-person transmission, animal-to-person transmission, or from an environmental source (including swimming pools). All investigation data is subject to change, as this is the nature of clusters and outbreaks.
In the reporting period 2019-20, there were three multi-jurisdictional outbreak investigations (MJOI) that included South Australian cases.
The first MJOI included people infected with Salmonella Weltevreden and the source of infection was identified as frozen ready-meals. There were 30 South Australian cases included in this MJOI, 28 of which reported consuming the same brand of frozen pre-made meals before onset of illness. The outbreak strain of Salmonella Weltevreden was identified in six samples of the frozen meals collected and tested in South Australia. Product recalls occurred on 19 October 2019 and 28 October 2019 with media releases from SA Health.
The second MJOI was into Salmonella Enteritidis and one South Australian resident was identified with the same strain of; Salmonella Enteritidis multi-locus sequence type (MLST) 1972, as cases in several other jurisdictions, and a retail chicken meat isolate from interstate. Traceback on poultry farm testing interstate was conducted, with no Salmonella detected.
The third MJOI was into Salmonella Typhimurium MLVA 05-16-13-11-490 and included 21 South Australian cases. The source of infection was hypothesised to be a fresh produce item. Fifteen of the South Australian cases ate lettuce or a bagged salad product. Multiple food items were sampled and Salmonella Typhimurium was not detected.
Further details about outbreaks investigated during 2019-20 and their exposure settings are found in Appendix 3. investigated during 2019-20 and their exposure settings are found in Appendix 3.
Table 11: Summary of foodborne disease investigations in SA in 2019-20
| N | Month and year | Organism | Setting | N ill | N laboratory confirmed | Evidence |
|---|---|---|---|---|---|---|
| 1 | Sep 2019 | S. Tm 9 | Private residence
|
5 | 5 | D |
| 2 | Nov 2019 | S. Saintpaul | Primary production
|
45 | 45 | D, S, M |
| 3 | Jan 2020 | S.Tm 9 | Take away
|
5 | 5 | D, M |
| 4 | Jan 2020 | S. Tm 9 | Restaurant | 5 | 5 | D |
| 5 | April 2020 | S. Tm RDNC | Restaurant | 2 | 2 | D |
Notes:
N – Number
D – Descriptive evidence (i.e. information obtained from interviewing cases and/or inspections of premises)
M – Microbiological evidence (i.e. the same bacteria/virus found in food or environmental samples as the unwell people)
S – Statistical evidence (i.e. a significant statistical association is found between an exposure and the illness by conducting an analytical study);
S.Tm – Salmonella Typhimurium.
RDNC – Reaction did not conform.
Cluster investigations
A cluster is defined as an increase in a specific infection in terms of time, person or place, where the source and mode of transmission remains unknown. A summary of clusters investigated from 1 July 2019 to 30 June 2020 are listed in Table 12. There were 10 clusters of Salmonella and one cluster of Yersinia Enterocolitica investigated. All clusters were general increases in specific infections in the community without a common point source identified and only descriptive evidence was available for all of the investigations.
Table 12: Summary of cluster investigations in SA, 1 July 2019 to 30 June 2020
| Number | Month and Year | Organism | Number ill |
|---|---|---|---|
| 1 | July 2019 | S. Tm 141 | 2 |
| 2 | July 2019 | S. Bovismorbificans | 4 |
| 3 | July 2019 | S.Tm 35 | 3 |
| 4 | July 2019 | S.Tm 108 | 4 |
| 5 | August 2019 | S. Tm 44 | 9 |
| 6 | October 2019 | Yersinia enterocolitica | 15 |
| 7 | October 2019 | S. Zanzibar | 4 |
| 8 | January 2020 | S. Muenchen | 9 |
| 9 | April 2020 |
S. Muenchen
|
4 |
| 10 | May 2020 | S. Tm 9 | 6 |
| 11 | May 2020 | S. Tm 135 | 4 |
Notes: S.Tm – Salmonella Typhimurium
4. Biosecurity SA activities under the Food Act 2001
Biosecurity SA is a division of the Department of Primary Industries and Regions SA (PIRSA). The Primary Produce (Food Safety Schemes) (Meat Industry) Regulations 2017 requires butcher shops to hold accreditation administered by PIRSA. Under the Memorandum of Understanding (MoU) between SA Health and PIRSA, both agencies share risk management principles that minimise regulatory burden and duplication. In practice, to avoid duplication butcher shops that sell food other than meat and conduct activities regulated under the Food Act 2001 are inspected by Biosecurity SA officers. A number of officers have been appointed authorised officers under the Food Act 2001.
During 2019-20, 545 audits were conducted by Biosecurity SA officers on 497 butcher shops including supermarkets, where a component of audits addressed other retail activities regulated under the Food Act 2001. During the audits, 23 Corrective Action Requests (CARs) were issued which related to their food safety program, hygiene or construction, and required follow up visits. No expiation notices or penalties were issued.
SA Meat Food Safety Advisory Committee
The department continues to participate as a member of the SA Meat Food Safety Advisory Committee (the Committee) under the Primary Produce (Food Safety Schemes) (Meat Food Safety Advisory Committee) Regulations 2016. The Committee considers issues pertinent to management of the Primary Produce (Food Safety Schemes) (Meat Industry) Regulations 2017 (Regulations) under the Primary Produce (Food Safety Scheme) Act 2004. The role of the Committee is to provide advice to the Minister for Primary Industries and Regional Development on the administration of the Regulations, and on matters relating to meat food safety in SA.
Following consideration of review recommendations, the regulations for the committee were rescinded on 22 May 2020.
| Act or regulation | Requirement |
|---|---|
| Safe Drinking water Act 2011 | Part 8 – Miscellaneous S 50 – Agreement and consultation with local government sector (1) The Minister must take reasonable steps to consult with the LGA from time to time in relation to the administration and enforcement of this Act. (2) If the Minister and the LGA enter into an agreement with respect to the exercise of functions under this Act by councils, then the Minister must prepare a report on the matter and cause copies of the report to be laid before both Houses of Parliament. (3) A report under subsection (2) must be accompanied by a copy of any relevant written agreement between the Minister and the LGA. (4) The Minister must consult with the LGA before a regulation that confers any function on councils is made under this Act. (5) The annual report of the Minister under this Act must include a specific report on - (a) the outcome of any consultation undertaken under subsection (1) or (4); and (b) the operation of any agreement referred to in subsection (2). S 51 – Annual report by Minister (1) The Minister must, on or before 30 September in each year, prepare a report on the operation of this Act for the financial year ending on the preceding 30 June. (2) The Minister must, within 6 sitting days after completing a report under subsection (1), cause copies of the report to be laid before both Houses of Parliament. S 52 – Annual reports by enforcement agencies (1) An enforcement agency (other than the Minister) must, on or before 30 September in each year, furnish to the Minister a report on the activities of the enforcement agency under this Act during the financial year ending on the preceding 30 June. (2) The Minister must, within 6 sitting days after receiving a report under subsection (1), cause copies of the report to be laid before both Houses of Parliament. |
The objectives of the Safe Drinking Water Act 2011 and Safe Drinking Water Regulations 2012 are to:
- ensure that drinking water supplied to the South Australian public is safe
- provide direction to drinking water providers on how to achieve a safe drinking water supply
- implement principles of the Australian Drinking Water Guidelines 2011.
The Safe Drinking Water Act 2011 requires:
- registration of drinking water providers
- development and implementation of Risk Management Plans (RMPs) for individual drinking water supplies including approved monitoring programs and incident protocols
- audit or inspection of drinking water supplies
- reporting of incidents to the department
- provision of water quality results to the public on request.
The department administers the Safe Drinking Water Act 2011 with assistance from local government. Activities are outlined in council reports in Appendix 3. Within the department, the Water Quality Unit is responsible for day-to-day administration of the Safe Drinking Water Act 2011, with assistance from the Health Protection Operations and Food Safety and Audit sections.
Registration of drinking water providers
During 2019-20, the department registered 19 new drinking water providers and five drinking water providers cancelled their registration. At 30 June 2020, there were 191 drinking water providers registered with the department. Some providers include multiple drinking water supplies under one registration. SA Water has a dual registration which includes a total of 87 water supplies while the Department for Education’s single registration includes 61 schools and preschools.
As required under Section 11 of the Safe Drinking Water Act 2011, the department maintains a list of registered drinking water providers on the SA Health website. Councils are advised of drinking water providers within their area on a minimum annual basis.
Risk management plans
All drinking water providers must have a RMP that includes an approved monitoring program and an incident protocol. During 2019-20, the department reviewed RMPs for new drinking water providers and provided assistance as required. Advice was also provided on the review and amendment of RMPs for existing providers where sought or required to rectify non-compliance identified as part of a drinking water inspection or audit.
Water quality incidents
Under Section 13 of the Safe Drinking Water Act 2011, a drinking water provider’s RMP must include a procedure for identifying, notifying and responding to water quality incidents. The department receives notification of incidents and provides advice and direction on remedial actions required to maintain safety of drinking water supplies.
Incidents reported by SA Water
SA Water incidents are reported according to the interagency Water/Wastewater Incident Notification and Communication Protocol (the Protocol). Under the Protocol the department fulfils the role of the Water Incident Coordinator. Incidents are classified as Priority Type 1, Type 1 or Type 2 health incidents.
- Priority Type 1 incidents are likely to require an immediate interagency meeting to develop responses and consider possible issuing of public advice. In the absence of appropriate interventions these incidents could cause serious risk to human health
- Type 1 water quality incidents, in the absence of appropriate intervention could cause serious risk to human health
- Type 2 incidents represent a low risk to human health, but may provide preliminary warnings of more serious incidents.
During 2019-20, the department received notification of one Priority Type 1 incident, 36 Type 1 incidents and 63 Type 2 incidents from SA Water. The total number of reported incidents was higher compared to 2018-19. The increase can largely be attributed to incidents arising as a result of unauthorised access to reservoirs which were opened for recreational access during the reporting period. Incidents arising from the detection of cyanobacteria and enteric protozoa in source water also increased due to warmer than average temperatures and periods of above average rainfall respectively. The department:
- coordinated communication and responses to all Priority Type 1 and Type 1 incidents.
- provided advice and worked closely with SA Water in identifying appropriate remedial responses to the Priority Type 1 incident associated with the Kangaroo Island bushfires and the subsequent substantial rain event. Despite the fire damage to the water treatment plant, supply of safe drinking water through the Middle River system to Kingscote was maintained at all times.
- liaised with SA Water during Type 1 incidents to ensure remedial actions or responses were implemented in a timely manner. The Type 1 incidents included:
- increased numbers of cyanobacteria in source water
- potential contamination of source water due to unauthorised recreational activities
- elevated levels of a radionuclide in source water
- detection of non-human infectious Cryptosporidium in treated water
- short term interruptions to disinfection
- elevated levels of disinfection by products
- exceedances of chemical guideline values from the ADWG
- accidental contamination of water mains during repair works
- treated water storage tank contamination due to access by animals
- short term increase in filtered water turbidity.
Water quality incidents were notified by SA Water within prescribed time limits. Appropriate remedial actions were implemented and ensured that the protection of public health was maintained at all times. The department determined that no public notifications were required for these incidents.
Incidents reported by other drinking water providers
In 2019-20 there were 11 drinking water incidents reported to the department by providers other than SA Water. Eight out of the 11 reported incidents were due to the detection of Escherichia coli in drinking water supplies. The department provided advice on chlorination of water tanks and flushing of pipework with resampling of the water supply where required.
Other incidents reported were due to overdosing of chlorine and increased colour and turbidity of filtered rainwater. In each case appropriate responses were implemented.
Approval of auditors and inspectors
Auditors and inspectors are approved under Section 15 of the Safe Drinking Water Act 2011 in line with established competency criteria. Approval as either a Level 1 or 2 Auditor or Level 3 Inspector is based on technical skills and experience. The types of drinking water supply that can be audited or inspected by an individual are defined in approval conditions. In 2019-20, the department:
- approved one Level 2 Auditor and one Level 3 Inspector
- renewed approvals for three Level 2 Auditors and two Level 3 Inspectors following expiry of existing approvals
- provided access to online drinking water quality training for local government employees
- provided support and on-site training for local government auditors and inspectors.
At 30 June 2020 there were 37 approved auditors and inspectors including independent auditors, department staff, local government employees and officers from Dairysafe. The department maintains a list of approved auditors and inspectors here on the SA Health website.
Audits and inspections
The Safe Drinking Water Act 2011 requires that all drinking water providers are subject to an audit or inspection every year or every two years as described in a schedule published in the Government Gazette. Reports of all audits and inspections are required to be submitted to the department within 21 days of the audit or inspection being undertaken. Under Section 20(4) of the Safe Drinking Water Act 2011, the drinking water provider is responsible for ensuring the audit or inspection is carried out in accordance with the published schedule.
The Water Quality Unit oversees the audit and inspection program and where possible coordinates drinking water audit and inspections with the activities of the Health Protection Operation and Food Safety and Audit sections to avoid duplication and cost to providers. Audits and inspections are also performed by local government and independent auditors. Dairysafe undertakes inspections of independent drinking water supplies used by ten dairy processors as part of existing food safety audit activities.
During 2019-20 the department carried out a total of 28 audits and 12 inspections of drinking water supplies. The department also received copies of two audit and eight inspection reports from local government and independent auditors including a comprehensive audit report covering a number of SA Water supplies. The total number of audits and inspections undertaken was lower than in previous years due to disruptions associated with the COVID-19 pandemic. In many cases businesses either closed or operated in a limited capacity for several months. A risk assessment has been undertaken to prioritise return of audit/inspection processes undertaken by the Water Quality Unit. Regular communication with councils will continue in regards to inspection/audit processes.
The department maintains a database of non-compliances reported as an outcome of audit and inspection of drinking water providers. A range of non-compliances were noted in 2019-20 including incomplete or insufficient RMPs, failure to notify a water quality incident and lack of detail or absence of documentation relating to maintenance activities and water quality monitoring. None of the non-compliances resulted in a drinking water supply being declared unsafe. The department continues to provide advice and recommendations on improvements to documentation, operational practices and water treatment options for these providers. Follow-up processes or changes in inspection/audit frequency are implemented by the department as required to ensure compliance with the requirements of the Safe Drinking Water Act 2011.
Quality of water and provision of results
Under Section 27 of the Safe Drinking Water Act 2011, drinking water providers must make results of any monitoring program available to the public.
SA Water provides consumers with water quality information through publication of data on their website and in their annual report. Other drinking water providers can provide results to consumers on request by letter, email or telephone.
Approval of laboratories
No laboratories were approved during the reporting period. Approved water quality testing laboratories are listed here on the SA Health website.
Administration and enforcement
The Safe Drinking Water Act 2011 incorporates enforcement provisions including the appointment of authorised officers with appropriate qualifications and experience. An Instrument of Authorisation was signed by the Minister in November 2019 giving authorised officers authority to issue expiation notices pursuant to the Expiation of Offences Act 1996 for offences committed under the Act and Regulations.
In 2019-20, no new appointments were made within the department. At 30 June 2020 there were 13 authorised officers, all of whom are authorised to issue expiations. Authorised officers appointed by local government are provided in council annual reports (Appendix 3).
Consultation with the local government sector
Under Section 50 of the Safe Drinking Water Act 2011, the Minister must take reasonable steps to consult with the LGA from time to time in relation to the administration and enforcement of the Act. During 2019-20, consultation between the department and the LGA continued, to ensure that local councils are supported and adequately resourced in the ongoing administration and enforcement of the Safe Drinking Water Act 2011. Discussions included methods of communication available to disseminate information to councils including promotion of new and existing resources and tailoring training packages.
Training opportunities to facilitate drinking water inspections and audits were discussed with a number of councils. This included delivering on-site training sessions for several councils during the reporting period. Strategies identified by a working group formed in 2017 continued to be implemented including consultation with targeted councils on the development of a drinking water inspector/auditor forum and the provision of an additional list of water providers including pending registrations and exempt businesses to all councils on an annual basis. Discussions specific to the impacts of COVID-19 on undertaking routine drinking water inspections/audits also occurred with councils during the reporting period.
Reporting required under the Carers Recognition Act 2005
The Carers Recognition Act 2005 is deemed applicable for the following: Department of Human Services, Department for Education, Department for Health and Wellbeing, Department of State Development, Department of Planning, Transport and Infrastructure, South Australia Police and TAFE SA.
Section 7: Compliance or non-compliance with section 6 of the Carers Recognition Act 2005 and (b) if a person or body provides relevant services under a contract with the organisation (other than a contract of employment), that person's or body's compliance or non-compliance with section 6.
SA Health continues to recognise the importance of carers through a commitment to ensuring better care engagement in shared decision-making in South Australian health facilities.
The SA Health Partnering with Carers Strategic Action Plan 2017-2020 (Strategic Action Plan) is underpinned by the Carers Recognition Act 2005 and the South Australian Carers Charter. The Strategic Action Plan oversees the state coordination and monitoring of the whole of health strategy which supports the implementation of the ***SA Health Partnering with Carers Policy
Directive (Policy Directive). The Strategic Action Plan is due to be reviewed this year along with the Policy Directive. This will be undertaken in consultation with carers, Carers SA and other stakeholders, for release in 2020-21.
The key priorities under the Strategic Action Plan include:
- Early identification and recognition
- Carers are engaged as partners in care
- Carers provide comments and feedback
- Carer-friendly workplace
- Celebrate carers during National Carers Week
- Staff education and training.
The Carer – Partnering with you website provides carers with information at www.sahealth.sa.gov.au/carers. Information includes the Policy Directive, Strategic Action Plan and key priorities. The website encourages carers to provide feedback and seek information on how carers can engage with health services in service planning, designing care, measuring and evaluating health services. Further information is provided on local and national carer support services. In 2019, the website was updated with COVID-19 information to support carers and the person they care for. Linked information included COVID-19 Mental Health Support, Carers SA and the Carer Gateway.
Engagement initiatives continue to improve across the LHNs to recognise that carers have separate needs to the person they care for and assisting them in their supporting role. Carers and families are encouraged to engage with nursing and medical staff to maximise collaboration in the care of their loved ones. Consumer and Carer Advisory Groups continue to have strong carer membership providing opportunities for feedback and consultation on policy and program development and operational service improvement activities within their local health service. Examples of SA Health engagement strategies include, but are not limited to:
- The Office of the Chief Psychiatrist (OCP), with the support of the Department for Health and Wellbeing (DHW), Safety & Quality and Carer Champions from each LHN, is leading a pilot project to implement the Mental Health Carer Experience Survey. The project engaged 24 mental health services working with children, adult and older people from all LHNs. The number of surveys completed by carers increased significantly from 2018-19 and will inform the statewide strategy for improving the experience of mental health carers when interacting with the public mental health system.
- A Carer Consultant is available within Central Adelaide Local Health Network (CALHN) and Northern Adelaide Local Health Network (NALHN) mental health services to follow up and provide support /information/advice to carers. The Carer Consultant is a person with lived experience (of caring for a person with mental health issues). The Carer Consultant plays a pivotal role between health services and consumers and is highly valued for the support and empowerment they provide to carers through information sharing, education and connection to mental health services. At CALHN a Carer Consultant brochure is available on all wards which provides detail on the role and the legal rights of carers in mental health services.
- NALHN is building networks with community organisations that provide support to carers through NDIS or in the home with practical support and equipment for in home services. Increasing staff knowledge of these services provides improved opportunity for a timely return home from a hospital admission.
- The development of an Aboriginal Consumer Reference Group for the oversight of Aboriginal Health Services in NALHN is an excellent example of evaluating services and making improvements within a co-design framework, e.g. improving the physical access by wheelchairs to services. The Aboriginal Liaison Unit at the Women’s and Children’s Health Network supports both staff and consumers with specific resources regarding carers and kinship within Aboriginal communities. The Aboriginal Health Unit at CALHN participated in discussions to improve access to interpreter and translation services to relieve the burden on carers/escorts on matters regarding consent, procedures and advanced care directives.
- Barossa Hills Fleurieu LHN and Yorke and Northern LHN have implemented the Comprehensive Care of the Older Person model of care. This model articulates a ‘commitment to engage and involve carers of patients with cognitive impairment as partners in care throughout the hospital experience’. This work has involved significant staff education and training in the importance of partnering with carers for nursing and allied health professionals.
Carer information on knowing your rights, medication safety, clinical communication, recognising and responding to clinical deterioration, pressure injury, falls, hand hygiene and infection control is displayed in all health sites.
National Carers week is celebrated annually in October to raise awareness of the challenges faced by carers. In 2019, to celebrate and recognise the invaluable contribution of unpaid carers Facebook posts and Twitter tweets were posted throughout the week, including a carer story.
Working in collaboration with Carers SA, a number of Partnering with Carers education and staff training forums were undertaken in June 2019. Forums were held on site in Karoonda, Port Pirie and Whyalla. Digital TeleNetworking (DTN) facilities enabled staff from Crystal Brook, Maitland, Port Broughton, Riverton and Roxby Downs to participate in the education and training forums. Carer champions and a local carer representative were nominated to present and be part of the education and training program.