Complaints Handling Policy

If you have a concern or complaint that you haven't been able to resolve by talking with your service provider, we can support you, with information and options, to resolve your concern. Our Complaints Handling Policy explains:

how we handle complaints
who can make a complaint
the types of complaints we can help with
when a complaint can be made.

There are 5 sections to our Complaints Handling Policy:

1.Overview

1.1 Policy statement

This policy provides guidance on how the Aged Care Quality and Safety Commission’s complaints function delivers a high-quality complaints-handling service.

Our complaints process is focused on upholding the rights of older people. By regulating approved aged care providers (providers), their governing persons* and aged care workers (workers).

*Governing person: A person who is key personnel of an approved provider, for example a manager responsible for the day-to-day operations of the service. See Section 8B of the Aged Care Quality and Safety Commission Act 2018 (Commission Act) for a full definition. Within this document, 'workers' refers collectively to governing persons and aged care workers.

We will:

uphold an older person’s rights under the Charter of Aged Care Rights (rights), and
protect and enhance their:
- safety
- health
- wellbeing
- quality of life.

We are committed to empowering older people and their supporters to be active partners in their care. We also want to empower them to speak up when things aren’t right.

Complaints tell us what is not working and give older people, their supporters and providers an opportunity to work together to:

remedy the problem
restore the relationship and build trust and confidence
prevent that poor experience from happening again.

We will work with the older person and provider to ensure the issues raised are addressed, and respond to any risk or harm in a way that:

considers the wishes of the older person
ensures providers are meeting their responsibilities under the legislation or their funding agreement (see note below)
is risk-based and proportionate
focuses on achieving meaningful and sustainable outcomes.

Note: Both the Commonwealth Home Support Programme (CHSP) and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP) are Commonwealth-funded aged care services that operate outside of the Aged Care Act 1997 (Aged Care Act), under funding agreements with the Commonwealth. Unlike approved providers under the legislation, organisations which provide services through the CHSP or NATSIFACP programs are required to provide services in line with their funding agreements with the Commonwealth.

A CHSP service provider must comply with the CHSP Manual, which forms part of their funding agreement. Similarly, NATSIFACP service providers must comply with the National Aboriginal and Torres Strait Islander Flexible Aged Care Program Manual which forms a part of their funding agreement.

1.2 Policy and legislative framework

Aged care legislation and policies provide the legal basis for the Commission’s role in managing complaints. We work under the:

Aged Care Act
- This Act outlines the responsibilities that aged care providers must follow to receive subsidies from the Australian Government.
Aged Care Quality and Safety Commission Act 2018 (Commission Act)
- Section 16(d) of the Commission Act provides that the complaints function is a function of the Commissioner.
- Section 18 provides that the complaints function deals with complaints made, or information given, to the Commission about:
  - an approved provider’s responsibilities under the Aged Care Act or the Quality of Care Principles 2014 (Principles)
  - the responsibilities of a service provider of an Australian Government-funded aged care service, under the related funding agreement.
Aged Care Quality and Safety Commission Rules 2018 (Rules)
- Part 2 establishes the Commission’s scheme for dealing with complaints made to us about matters outlined under Section 18 of the Commission Act.

This Complaints Handling Policy, in conjunction with our Regulatory Strategy and other Commission policies, guide us on how we consistently:

comply with our legislative role and responsibilities
apply good decision-making principles
safeguard the wellbeing and rights of older people receiving aged care in a coordinated way.

1.3 Scope

The Commission is the national regulator of Australian Government-funded aged care services. We work with older people, providers, and workers to foster a world-class aged care sector that safeguards the wellbeing and the rights of older people receiving aged care.

We work with older people and providers to address issues raised through complaints made to the Commission, and ensure providers are meeting their relevant responsibilities. We may do this via a complaints resolution process, or by working with other areas of the Commission to undertake:

monitoring activities
compliance actions
enforcement actions.

We also regularly analyse the intelligence we receive through complaints and share what we learn within the Commission and with the aged care sector. This ensures older people’s experience of aged care informs our understanding of provider and sector performance. It also ensures the voice of older people helps guide both us and providers in improving services for older people.

The Rules set out a complaint as someone raising issues about the responsibilities of:

an approved provider of an aged care service under the Aged Care Act or the Principles
a service provider of an Australian Government-funded aged care service under the funding agreement that relates to the service.

In scope

Who can make complaints to us?

Anyone can make a complaint to the Commission.

What can we take complaints about?

Under the legislation, we can handle complaints about whether an aged care provider is meeting their responsibilities under the Aged Care Act, Principles or relevant Commonwealth funding agreement.

For example, this may include concerns about:

health care
personal care assistance
communication
staff numbers
living environment
some fees and charges in care agreements
choice and preferences.

When can a complaint be raised with the Commission?

A complaint can be raised with the Commission at any time and does not need to be raised with the provider first.

The Commission does encourage older people and their supporters to raise the complaint directly with the provider, if they can. This is often the easiest and quickest way to resolve a complaint.

However, if someone does not feel comfortable doing this, they can contact us at any time, and we can help. We can also help if they’re having trouble getting a provider to resolve a complaint.

Out of scope

Under the complaints function, we do not:

handle complaints about the Commission. For this, please visit our review and complaints about us webpage
give local care or service availability advice
advise on financial, legal or health decisions. We also do not advise on who should make these decisions for an older person
comment on employment matters. This includes wages or employment conditions
ask service providers to terminate employment
give legal advice on care agreements
give clinical advice on what treatment the older person should receive
investigate the cause of death. This is the role of the coroner
investigate whether there has been a criminal offence. This is the role of the police
determine if specific events occurred, especially where there are conflicting accounts.

1.3.1 Complaints about workers

When the Commission receives complaints that include concerns about workers, we will work with the associated provider to address the issue/s. This is because the provider is ultimately accountable for the safety and quality of care delivered. For example, providers have a responsibility to take steps to ensure their workers comply with the Code of Conduct for Aged Care.

There will be times where we cannot address concerns about workers through engagement with a provider. For example:

the worker is no longer employed by, or volunteers for, the provider
the issue/s is better addressed by engaging directly with the worker.

If the issue/s cannot be addressed through a provider, the Commission can look to address the issue/s through:

investigating to inform possible actions we may take in relation to that worker
encouraging the worker to take specific actions to manage the risks (compliance actions)
stronger measures such as a banning order that can stop or restrict a worker’s involvement in the aged care sector (enforcement actions).

We will keep the complainant informed to the extent possible about our regulatory activities and associated outcomes in relation to the worker. There may be things we cannot share with the complainant because we have a legislated responsibility to protect the personal information we collect about individuals and certain information about the affairs of a provider. There are serious consequences if we breach our legal responsibilities.