Dramatic shifts in the use of restraint due to fundamental changes in clinical management in an inpatient setting following intense public scrutiny and formal investigation through the Oakden Inquiry in South Australia

In late 2016, a family member met with the Chief Executive Officer of the Northern Adelaide Local Health Network regarding the care provided for her husband, who had been admitted to the Oakden Older Persons’ Mental Health Service for management of extreme behavioural and psychological symptoms of dementia. This meeting resulted in the commissioning of the South Australian Chief Psychiatrist’s Oakden Report, which was released on 20th April 2017. What followed was an intense period of turmoil and scandal as the failings in care, resourcing and governance, including extremely high levels of restraint, occurring at the Oakden Campus became the focus of state and national media, public and political attention, leading to several further significant review processes and upheaval across the aged care sector.

This presentation will provide a narrative review of the Oakden experience, focusing firstly the events initiating the Review process and the experience of the Review panel, before considering the period of service reform occurring since the release of the Oakden Report. There have been progressive changes in the model of care and service culture, resulting in significant reductions in the use of restrictive practices and transformation towards compassionate person and family centred care. Reduction in restrictive practices has been underpinned by realignment of governance with embedded accountability to older people, carers and the community, redevelopment of a values-based workforce, connection with key partners, such as Dementia Support Australia, and creative approaches to care, with awareness of the need for therapeutic sensory environments and resources and leadership from a rich interdisciplinary team. The transition from the Oakden Campus to new services at Northgate House and a new model of care for older persons’ mental health services in South Australia will be described.

TERP FORUM

TERP focuses on identifying, avoiding and reducing harm across all environments in which the care of people with mental ill health is provided. TERP inforces Australia’s commitment to reduce the use of, and eliminate restrictive practices as a priority for action. Each jurisdiction, in conjunction with the Safety and Quality Partnership Standing Committee and the Commonwealth Government, works towards this vision by holding a series of forums providing an opportunity to learn and grow from local and national initiatives to eliminate restrictive practices and create a dialogue for future care.

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