Which of the following policy statements may include an escalation contact in the event that the person dealing with the situation needs to know who to contact?

If you have a concern or complaint that you have not been able to resolve by talking with your service provider, the Aged Care Quality and Safety Commission (the Commission) can support you, with information and options, to resolve your concern with the service provider.

When you contact us, we will listen to you and ask you questions about your concern to help us understand the issues and your expectations. We will let you know if your concern or complaint is an issue that we can help you with.

What we can do

We can help you with concerns and complaints about a service provider’s responsibilities under the Aged Care Act 1997 or under their funding agreement with the Commonwealth. Some concerns we can assist with include:

• health care, for example wound care, medication and care assessment
• personal care assistance, for example showering, dispensing medication, feeding and mobility
• communication, for example how information is shared with you and how your questions are responded to, including complaints
• staff roles, for example how they do their job and provide care
• living environment, for example safety, security, and cleaning
• some fees and charges in care agreements
• choice and preferences, for example showering and meal arrangements and tailored activities.

We treat each concern or complaint on its own merits and we will carefully assess the information we receive and obtain.

We can select one or more approaches to resolve the complaint you raise: either service provider resolution, conciliation, mediation or investigation. More information about these approaches can be found in our Resolving concerns about aged care fact sheet (PDF, 866.47 KB).

What we cannot do

There are some things we are unable to do:

• provide advice on the availability of care or services in your local area
• provide advice on who should make financial, legal or health decisions on behalf of a person
• comment on industrial matters such as wages or employment conditions
• ask service providers to terminate someone’s employment
• provide legal advice or what to include in your care agreement
• provide clinical advice about what treatment a person should be receiving
• investigate the cause of death (this is the role of the coroner)
• determine whether or not a specific event occurred (especially if we receive conflicting accounts of the event)

Even when a complaint relates to an issue we can look at, we may not be able to take action. For example, where the issue is part of legal proceedings or a coronial inquiry, or the consumer does not want the complaint to be examined.

If we can’t help you we can refer complaints to other organisations that may be able to address the issue you raised. For example, the Department of Health, professional registration boards or other complaints bodies.

How can you submit a complaint?

Complaints can be lodged by phone, in writing or online. To find out how you can make a complaint, read the Lodge a complaint page.

If you are lodging a complaint about the care someone else is receiving – it could be your mother, father, a friend – it is important that they or their representative know you are lodging a complaint.

You have the right to complain anonymously or confidentially; we will explain how these options may limit what we can do to resolve your concern. It is best to submit your complaint openly; that is, provide your name and contact details. We can talk about the difference between open, anonymous and confidential complaints when you contact us.

Open complaint

• we will know your identity and contact details
• the service provider will know your identity
• we will keep you informed about the progress of your complaint and you will be able to provide us with more information
• you may have review rights.

Confidential complaint

• we will know your identity and contact details
• we will endeavour not to disclose your identity to the service provider when we discuss your complaint issues with them
• we will keep you informed about the progress of your complaint and you will be able to provide us with more information
• you may have review rights.

Anonymous complaint

• we will not know your identity
• the service provider will not know your identity
• we will not be able to keep you informed about the complaint’s progress or outcome and you will not be able to provide more information
• you will not have review rights.

What can you expect when you first raise a concern with the Commission?

When you first contact us we will promptly acknowledge your complaint. One of our complaints officers will assess your concerns, record your information and discuss your options and our complaints process.

In raising a complaint, you have the right to expect:

• your personal information will be handled appropriately
• to be informed about the process and involved in decisions that affect you
• to be treated with dignity and respect
• to be informed about your review rights.

We will examine complaints regardless of a person’s cultural background, disability, gender, sex and gender identity, sexual orientation or any other status.

We will gather information to understand the issues and the outcome you are seeking. You can help us by giving as much information about your complaint as early as possible, our page on how to make an effective complaint may help you.

If we are unable to look into your concern, we will try to refer you to someone who can.

If we can look into your concern, we will explain how we resolve complaints and what might be achieved.

When we can look into your concerns

We will undertake a detailed assessment of the issues you raise in your concern and establish the level of risk to the consumer. We consider the safety, dignity and choice of the consumer and the quality of care and services being delivered. We might also:

• contact the consumer (or their representative) to confirm if they wish us to examine the concern or complaint
• review basic information about the consumer
• undertake a more detailed review of the service provider’s history
• engage with relevant people, for example the laundry staff if the complaint is about laundry
• review any other information that is necessary and relevant to your complaint.

Once the detailed assessment is complete, we may assist you to resolve your concern directly with the service provider. Alternatively, we may commence a formal complaint resolution process. A complaints officer will explain the next steps and keep you informed about the progress of your complaint.

When examining your complaint through a 'resolution process'

We will select one or more of the following approaches to resolve the issues in your complaint:

Conciliation

We can help you and the service provider to discuss the issues and reach an agreement that resolves your concern. This may involve phone calls, discussions and meetings.

Investigation

We can investigate an issue. Investigations can be simple, for example gathering information and discussing the issues with both parties; or they can be more complex, involving visits to the service, analysing records and conducting interviews.

Service provider resolution

We can ask the service provider to examine your concern within a specified time frame. This may involve working with you to achieve an outcome. We will check with you whether your concerns have been addressed.

Mediation

If we are unable to achieve the outcome you are seeking, we may suggest that you and the service provider engage an independent mediator. There would be a cost involved, which you and the service provider would need to discuss and agree to.

While resolving your complaint through the approaches above we may:

• consult professionals about clinical or technical matters
• ask for information from you, the service provider or other people
• visit the service involved
• review any relevant information given to us
• refer an issue to another organisation if they can more appropriately deal with it.

To help us achieve the best possible resolution to your complaint, we have put together some tips for How to make an effective complaint.

What will we do with your personal information?

The Privacy Act 1988 (Privacy Act) and Australian Privacy Principles (APPs) regulate how Australian Government agencies handle an individual’s personal information, including how they collect, store, use and/or disclose personal information.

In resolving complaints the Commission complies with the Privacy Act and APPs.

Our Privacy Policy and Notice of Collection outlines how we manage personal information. This includes how personal information is used, when this information may be disclosed to other parties, and how individuals can access or seek correction of personal information held about them.

When an incident strikes, the best-case scenario is that your on-call engineer or SRE can resolve it quickly and on their own. 

Of course, in the real world, that isn’t always the case. Sometimes resolution calls for a larger team, specialized knowledge, or more senior skills. Which is why any organization with more than two tech professionals needs a plan and policy for incident escalation.