Guild Insurance sees many insurance claims which have come about due to poor maintenance of a property.  In too many of these cases, the poor state of the building or its grounds is obvious and it’s quite surprising, as well as disappointing, that repairs haven’t been carried out before an incident has occurred.

What can go wrong?

There are a range of incidents which can occur due to poor maintenance of a property.  Staff can be injured leading to a worker’s compensation claim as well as staff being absent from work for an extended period.  Visitors to the premises, such as customers, clients or contractors, can also suffer injuries leading to public liability claims.  As well as the insurance claims which need to be managed, there’s the added stress of knowing that someone has been injured while at your premises.  Some of these injuries can be very serious and life changing.  Unfortunately, the hazards which lead to these injuries are often not viewed as seriously as they should be.  Yet with appropriate property maintenance many of these injuries could be avoided.

Case 1

A client entered a building and tripped over an edge of carpet which was ripped and curled up.  The client sustained a fractured wrist when they landed.

Case 2

An awning out the front of a building was old and worn out.  During heavy winds it broke off from the building and hit a person walking past at the time.

Case 3

While walking through the carpark of a premises, a staff member has tripped on a large crack in the asphalt which had caused the surface to be uneven.  They fractured their ankle as they fell.

Case 4

Poor maintenance doesn’t just lead to people suffering injuries, it can also lead to further damage to the property.  An old deteriorating roof collapsed when hit by heavy rain as it no longer had the strength to support the weight of this rainfall.  This led to excessive water damage within the building.

Property maintenance tips

• Have a documented maintenance program in place. This requires a schedule for regularly checking the property to identify hazards as well as details on what needs to be serviced, repaired or replaced and when.
• Be aware of the out-of-sight, out-of-mind hazards. Many properties have roofs, guttering and downpipes in poor condition due to a lack of maintenance as no one has thought to get up on the roof and inspect it. Include the less obvious hazards in the maintenance program.
• Have a maintenance budget. Some maintenance work can be planned, other work will come up unexpectedly when something breaks down. You need to be able to find money to fix hazards when identified.
• Be sure to use qualified tradespeople to undertaken maintenance work. While it can be tempting to undertake some DIY and save money, the risk of things not being maintained or repaired correctly will not be worth the savings in the long term.
• If you’re a tenant, be aware of what you’re responsible for maintaining and what’s the responsibility of the landlord. Not all tenancy agreements are the same, so you need to be across the details of your agreement.
• Don’t wait to undertake maintenance till a more convenient time. There are many cases of injuries occurring due to hazards which had been identified but not yet acted upon, usually due to costs, time or not acknowledging the risk of the hazard.
• All staff have a responsibility to create and maintain a safe workspace. Some hazards will be identified through regular property inspections, however, you can’t rely solely on these inspections. Therefore, encourage all staff to continually be on the lookout for hazards and to speak up when they see something.
• Don’t think it won’t happen to you and your property. These incidents are a lot more common that many people realise.

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Treating family members doesn’t usually feature in people’s thinking when they consider the complexities of dating a patient. However, whether that patient is the spouse, parent, or cousin, there’s still a personal relationship with the patient. Treating family members isn’t ideal and there are potential complications that need to be considered.

• Practitioners can feel obliged to treat their family members when asked to. Yet practitioners shouldn’t feel they have to say yes. If you would prefer to not treat your family members, think about why not and how you’ll explain this to them if asked. Having a response ready will assist when dealing with a potentially awkward situation appropriately.

• When practitioners treat family members, professional standards and expectations can drop away. Informed consent processes may not be followed as they should be, and clinical records can be lacking in detail. All health practitioners should understand the importance of and reason for informed consent and detailed clinical records – and professional expectations and requirements regarding these must always be met.

• Treating family members can blur personal and professional relationship boundaries that may impact the care provided. Will that family member be completely honest about their health history and symptoms with you, especially if somewhat personal? Will you be able to be as objective with them as you should be with all patients?

• If you do treat your family members, you should only do so in your clinic. Keeping treatment to the treatment room helps to maintain the professionalism of what you’re doing and lessens the likelihood of professional boundaries being blurred. Also, treating in a clinic room makes it easier to maintain usual standards with informed consent and record keeping.

• Most private health insurers don’t allow for rebates to be paid when treatment has been provided to a family member, and they have strict rules regarding who’s family. Both the practitioner and the patient need to be aware of the financial implications before treatment commences and should check with the insurer to be sure.

• When deciding whether to treat a family member, it’s best to think about what could go wrong before it does. If treatment doesn’t provide the patient with the outcome they were anticipating, this could complicate not only the treating relationship but also the personal family one.

Practitioners who form personal or intimate relationships with patients can face severe penalties from their regulator due to unprofessional conduct. These relationships breach professional boundaries which can affect the quality of care provided as well as a practitioner’s professional reputation.

• Some practitioners would state they’d never begin a relationship with a patient yet have done so with a family member of the patient, such as a parent or a child who’s attended appointments with their relative. However, these relationships still contribute to blurring the professional relationship with the patient. The family member is attending appointments as part of the care team and a personal relationship beginning under these circumstances may impair objectivity and decision making.

   

• Ending a treating relationship to begin a personal one can also be viewed as professionally inappropriate, especially when there’s little time between the two relationships. Practitioners need to consider the vulnerability of the patient and the power imbalance of the treating relationship.

   

• A patient asking out the practitioner, rather than the other way around, doesn’t make a personal relationship appropriate or acceptable. Patients often don’t understand the professional  expectations placed on health practitioners, and it’s always the responsibility of the practitioner to adhere to these. Practitioners should consider the possibility of being asked out by a patient and how they’ll respond before it occurs, to be prepared to deal with a challenging situation.

   

• Forming friendships with patients can be as problematic as intimate relationships. There’s still a blurring of the professional relationship and professional boundaries, plus the friendship can be impacted by the power imbalance of the treating relationship.

   

• Practitioners who work in small remote locations often point out that many of their patients are friends or at least acquaintances in some form. While maintaining a separation between patients and people you’re in personal relationships with is more challenging in some locations, it’s important to remember that your location doesn’t negate the need to adhere to professional obligations.