Intent of this requirement
This requirement covers the actions that an organisation is expected to take in response to complaints. It’s expected that the organisation will have a best practice system for managing and resolving complaints for consumers.
To create an environment that reduces harm to consumers, organisations need a culture where people feel supported and are encouraged to identify and report negative events. This gives organisations opportunities to find and act on things that can improve their systems. This includes how the organisation recognises when something has gone wrong that could harm, or has harmed, someone. The organisation is expected to tell the consumer about this, apologise, and explain what has happened. They should also explain why it happened and what they are doing to prevent it from happening again.
- What systems does the organisation have to make sure complaints are followed up and appropriate action is taken?
- When things go wrong, how does the organisation go about understanding what has happened?
- How does the organisation involve consumers? How are consumers able to add to information about a negative event and, where possible, take part in the incident review and in finding solutions and outcomes from complaints?
- When things go wrong, are there clear responsibilities within the organisation for communicating with consumers and their representatives so that they receive the information they need to understand what happened?
- What has the organisation done to promote and support a culture of learning from mistakes? What has it done to implement and sustain the changes needed in care and services from lessons learned?
- How does the organisation use the advice of advocates and community representatives to understand the best and most appropriate way to resolve a complaint for a consumer?
Examples of actions and evidence
- Consumers and their representatives are confident that the organisation acts appropriately and promptly when responding to feedback and complaints.
- Consumers are involved in finding options to resolve a complaint.
- Consumers feel that the organisation has given them an honest explanation from the organisation when things have gone wrong and are reassured that it won’t happen again.
- Consumers aren’t afraid the organisation will treat them badly after making a complaint.
Workforce and others
- The workforce can describe the complaint handling system in place in the organisation, and give examples of responding to complaints.
- Members of the workforce can provide examples of communicating with a consumer about a complaint and what the organisation is doing to resolve it.
- If something has gone wrong, members of the workforce can describe how the organisation took an open disclosure approach to communicating with consumers, their representatives and others.
- The workforce say the organisation encourages them to acknowledge mistakes without being afraid of the consequences.
- Workforce orientation, training or other records that show how the organisation supports the workforce to meet this requirement.
- Records that show application of a best practice complaints management system in operation for the organisation.
- Evidence that shows the organisation has clear responsibilities and timeframes for responding to complaints.
- Documented complaints and incidents. Evidence shows that the organisation has included consumers to find solutions and taken appropriate action.
- Policies and procedures that show how the organisation asks for feedback from consumers and representatives about how satisfied they are with the complaints management system.
- Evidence that communication by the organisation after adverse events is open, honest and timely. This may include communication between consumers, their representatives, members of the workforce and where relevant, between organisations.
- Evidence of how the organisation monitors, reports and keeps improving its performance against this requirement.