Our complaints process

How we deal with complaints

Anyone can make a complaint to us about an aged care provider, worker or responsible person (someone who is responsible for or has significant influence over the work of a provider). We receive complaints from older people, their family members and supporters, and from workers and other professionals in aged care.

We deal with complaints in-line with our Complaints Handling Policy.

What you can expect from us

When you first contact us to make a complaint, we'll:

let you know that we received your complaint within 3 business days
listen to your concerns
ask you for information and assess any risks
discuss what you want to happen
explain what we do and how we can help
take immediate action if an older person is at serious risk of harm.

We’ll work with you and the provider, worker or responsible person to resolve the complaint and respond to any risk or harm. We’ll do this in a way that:

reflects the wishes of the older person
makes sure that providers are meeting their obligations
is fair, balanced and in proportion to the risk to older people
aims to achieve meaningful outcomes, including restoring the older person’s trust in the provider.

If you make an open complaint (provide your contact details), we’ll:

involve you in the process
give you updates
check that the outcome meets your needs.

If you make a confidential complaint, we won’t give the provider, worker or responsible person:

your details
the identity of any person involved in the complaint
any specific information that you ask us not to share.

If you make an anonymous complaint we won’t ask for any identifying information.

Your role in the complaints process

You can help us manage your complaint by:

telling us if you need support to communicate with us, such as access to language services or the National Relay Service, so we can help you
working with us and responding to our requests for information quickly and accurately
treating our staff with courtesy and respect. We won’t accept behaviour that puts people at risk of harm. If this happens, we may take precautions, such as deciding to communicate only in writing
giving us feedback about how we managed your complaint so we can improve our services.

If we can't deal with any part of your complaint, we'll let you know as soon as possible and tell you who to contact.

The complaints process steps

1. Collect and triage

When you contact us to make a complaint, we’ll listen and ask questions to collect the information we need to work on the complaint.

We use information about the risk of harm to the older person to prioritise (triage) the complaint. This allows us to take action in proportion to the risk to the safety, health and wellbeing of the older person.

2. Assess

Our complaints officers analyse the information to understand the type of complaint and the circumstances. We assess:

the complaint to understand how best to start resolving it
information from different sources to help us assess the risk.

To get their views and understand how they want us to resolve the complaint, we communicate with the:

older person
person making the complaint
provider, worker or responsible person the complaint is about.

We also think about if other parts of the Commission need to work with the provider to keep older people safe.

3. Resolve

In this phase, we respond to the complaint. We:

work with the person who made the complaint and the older person, as well as the provider, worker or responsible person to fix the problem. Actions we may take to resolve the complaint include:
- provider-led resolution – with your permission, we refer your complaint to the provider to resolve. The provider needs to report to us about the action they take to resolve the complaint
- specified actions – we may request that the provider, worker or responsible person take specified action within a specified timeframe to resolve the complaint
- conciliation – a complaints officer helps you and the provider, worker or responsible person agree on an outcome
- investigation – we collect information from different sources and check if the provider, worker or responsible person is meeting their obligations
- discussion – with the person who made the complaint, the provider, worker or responsible person the complaint is about, or any other relevant person
- review information – we may consider information and documents in the resolution of the complaint
- restorative engagement – we may guide a restorative engagement process to meet the needs of the older person
- escalation through our Supervision Model – if the complaint highlights high, unresolved risk of harm to older people, we take regulatory actions.
keep everyone informed throughout the process
help the provider to:
- fix what went wrong (remedy)
- rebuild trust and restore the relationship with the older person (restore), including using open disclosure
- stop the problem from happening again (prevent).

4. Finalise

In this phase our complaints officers work with the person making the complaint, the older person and the provider to finalise the complaint. A complaint needs to be finalised within 90 days, unless there are reasons why it needs to take longer.

Before we finalise a complaint, we’ll check if the older person is happy with the outcome. If they are, we’ll explain the outcome to everyone involved, if we have their contact details. If the complaint is not ready to be finalised, we will continue working to resolve it.

5. Evaluate

In this phase we look at how effective our actions were in achieving the outcomes we wanted. This helps us improve our complaints handling processes. You are not usually involved in this step.

Open disclosure

Open disclosure is an open and honest discussion that a provider, worker or responsible person has with an older person when something’s gone wrong that’s caused, or could have caused, harm. The older person’s supporters can join the discussion.

Open disclosure is a key part of resolving complaints. It helps restore the trust between older people and the provider, worker or responsible person. As part of open disclosure, the provider needs to:

check that the older person is okay and provide any immediate support they need
acknowledge the harm and the effect it has had, and say sorry
find out what happened and explain it in a way the older person understands
learn from the experience and explain what they’ll do to stop it happening again.

If you make a complaint to us, we’ll work with the provider to make sure they use open disclosure when something goes wrong.

To learn more about open disclosure, see Open disclosure resources.

Rights of other affected people

A complaint can involve people other than the older person, the person making the complaint and the provider, worker or responsible persons.

We’ll regularly update other people who are affected about the progress of the complaint. If we think our decision could negatively affect someone, we'll speak to them and think about their views as we resolve the complaint.

Review rights

If you’re not satisfied with our decision about your complaint, you can ask us to review it. Providers, workers and responsible persons can sometimes ask for reviews too.

We can’t review our decision if:

you chose to be anonymous
you withdrew your complaint
the complaint was frivolous (not made seriously), vexatious (made to intentionally cause disorder or stress), or not made in good faith
we’ve already reviewed the decision.

We have a standard process for handling review requests. A review officer who wasn’t involved in the original complaints process handles the review.

You can find out more about your right to a review of a complaint decision in our:

Feedback and complaints about us

We welcome all feedback about our services, including how we handle complaints.

If you’re not happy with the way we handled your complaint, you can make a complaint about us. You can make this complaint:

to us, see Feedback about the Commission
to the Commonwealth Ombudsman.

Commonwealth Ombudsman

You have the right to make a complaint to the Commonwealth Ombudsman. Their role is to make sure our actions are fair and responsible.

The Commonwealth Ombudsman does not have the power to change our decision, but they can make recommendations. These can be about how we should have acted or what we can do to improve our processes.

You can find more information on the Ombudsman’s website.

How we collect feedback about our services

We welcome your feedback. It helps us to improve our service and protect your right to safe and quality care.

After we’ve handled your complaint, ORIMA Research (our survey supplier) may contact you to ask you for feedback about the complaints process through a short survey. Providers can also complete the survey. Please let us know if you don’t want to participate in the survey.

Your feedback will be confidential, and you’ll be anonymous. This means that only staff at ORIMA Research and the Commission will see your feedback, but we won’t know who gave us the feedback. It will only be used for research purposes.