This booklet is for anyone who receives, or knows someone who receives, Australian Government subsidised residential or community aged care services.
This includes:

care recipients
partners, including same-sex partners
family members
friends
representatives
advocates
carers
health and medical professionals
approved providers (see definition on page 4)
aged care staff.

What is this booklet about?

This booklet explains why it is important to raise concerns, your options and the support available to help you resolve concerns.

This booklet has information about:

how you can resolve concerns
the role of the Aged Care Complaints Scheme (the Scheme)
what concerns the Scheme can examine
how the Scheme can work with you to resolve your concerns.

Why should you speak out?

Making a complaint is not ‘being difficult’. Complaints help to improve the quality of Australia’s aged care services.
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If you have a concern about the care you or someone else is receiving, it is important that you talk about it.
Complaints help approved providers improve the quality of care and services they provide to you or your loved one, so one complaint can help other people, too.
If you have a concern, you can raise it with the approved provider or the Aged Care Complaints Scheme.

Your rights

If you receive aged care services, you have rights.

You have the right to:
personal privacy
be involved in decisions that affect you
be treated with dignity and respect
good quality care that meets your needs
full and effective use of your personal, civil, legal and consumer rights
complain and take steps to sort out any problems
advocacy support.

You can read the Charter of Residents’ Rights and Responsibilities at health.gov.au/residentscharter and the Charter of Rights and Responsibilities for Community Care at health.gov.au/communitycharter

Aged care in Australia

More than 343,000 Australians receive some type of Australian Government subsidised aged care service, and every year, this number is increasing.

Most residential and community aged care services receive funding from the Australian Government. Other services receive funding from private organisations or state or territory governments, and some receive a mix of both.

Approved providers must meet a set of responsibilities listed in the Aged Care Act 1997 (the Act), which outlines the standards of care and services they must provide to care recipients. You can view the Act from our website agedcarecomplaints.govspace.gov.au

Approved providers do their best to provide quality care and services for older Australians. However, issues can occur so we need to ensure that people can raise their concerns in a constructive and supported way.

Complaints serve an important purpose because they can help approved providers immediately improve or identify opportunities to improve the quality of care and services provided to aged care recipients.

Aged care providers who receive funding from the Australian Government are called ‘approved providers’. This term is used throughout the booklet.
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About the Aged Care Complaints Scheme

We provide a free service for people to raise concerns about the quality of care and services delivered to people receiving Australian Government subsidised residential or community aged care services.

The Aged Care Complaints Scheme was introduced by the Australian Government in 1997, and is delivered by the Department of Health and Ageing. We have a statutory role to resolve complaints about aged care. Our vision is to protect and improve the safety and wellbeing of people receiving aged care.

We aim to resolve your concern and achieve the best possible outcome for the care recipient. We can resolve concerns in a number of different ways, ranging from simple, relatively quick and informal approaches, to more formal and lengthy processes.

We are impartial; we are not an advocate for the person making the complaint or the approved provider; we do not apportion blame; and we do not take sides.

We are improving the Scheme

In 2009, an independent review of the Scheme was conducted and in 2010, a four-year program of works commenced to improve the Scheme and expand the options available for people to resolve their concerns. More information about the reform is available on our website at agedcarecomplaints.govspace.gov.au

What we can do

We can support you to resolve your concern directly with the approved provider.

We can examine complaints relating to an approved provider’s responsibilities under the Act. This includes concerns about care, choice of activities, discrimination, catering, communication or the physical environment.

We treat each complaint on its own merits. We will examine complaints regardless of a person’s cultural background, disability, gender, sex and gender identity, sexual orientation or any other status.

We have a high degree of flexibility in deciding how to resolve concerns. This enables us to select the most relevant, practical and efficient approach.

We can refer complaints that fall outside of our scope to other organisations. If we can’t help you, we will try to identify who may be able to help you.
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Our Service Commitment

The service you can expect from us is outlined in Aged Care Complaints Scheme: Our Service Commitment, which is available on our website agedcarecomplaints.govspace.gov.au or by calling us on 1800 550 552.

What we cannot do

There are some things we are unable to do. For example, we cannot:

examine concerns about an aged care service that isn’t subsidised by the Australian Government
examine concerns that are not related to an approved provider’s responsibilities under the Act
say who should make financial, legal or health decisions on behalf of a care recipient
comment on industrial matters such as wages or employment conditions

provide legal advice
ask approved providers to terminate someone’s employment
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)
provide clinical advice about what treatment a person should be receiving.

Who can raise a concern?

Anyone can raise a concern, including:

care recipients
partners, including same-sex partners
family members
friends
representatives
advocates
aged care staff
volunteers
health and medical professionals
carers.

If you are raising a concern on behalf of someone else, make sure the person (or his or her representative) knows about it.
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Getting help to resolve your concern

Step 1

“Can the approved provider resolve my concern?”

Try to raise your concern with the approved provider first.
Resolution by approved providers can achieve a fast and sustainable outcome. Go to page 12 for more information.
You can ask an advocate to support you. Learn more about advocacy on page 20.

Step 2

“Can the Aged Care Complaints Scheme help me?”

If you are unable to resolve your concern with the approved provider, contact us on 1800 550 552.
We can support you to raise your concern with the approved provider or we can examine your concern. Go to page 13 for more information.
We can accept confidential or anonymous complaints. However, this may limit what we can do. See page 21 for more information.

Step 3

“What happens when I first contact the Scheme?”

We will gather as much information as possible about your concern. This helps us to understand all the issues and your expectations.
We will provide information about how the Scheme works and the options for resolving your concern.
We will assess the complaint on its own merits. We will take into account factors such as safety, dignity and choice of the care recipient; the quality of care and services being delivered; and the approved provider’s responsiveness to the complaint.
We will decide how quickly to escalate your complaint and how best to resolve your concern.

Step 4

“What happens after I lodge my concern?”

We can support you to resolve your concern directly with the approved provider.
If that approach is not possible, we can examine your concern. If so, we will write to you and the approved provider to confirm the issues that we will examine.
We will work with you and the approved provider to resolve your concern as quickly as possible.
Go to page 13 for more information.

Step 5

“How will I know my concern has been resolved?”

We will consult you regularly throughout the process.
We will write to you and the approved provider at the end of the process to advise the outcome and any required actions.
Go to page 18 for more information.

Step 6

“I am not satisfied with the decision or how my complaint was handled”

You can provide feedback to us anytime throughout the process.
You can ask us to reconsider a decision or review our process.
You can ask the Aged Care Commissioner to independently review the process or decision.
Go to page 22 for more information.

Our goal is to help you resolve your concern and achieve a positive outcome for the care recipient.
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Raising your concern with the approved provider

We encourage you to try to raise your concern with the approved provider.
Resolution at the local level can achieve a fast and sustainable outcome.

Complaints give approved providers an opportunity to improve the quality of the services they provide to you or your loved one, so one complaint can help other people too.

All approved providers must have a complaints mechanism in place and have their complaints policy displayed prominently.

If you are unable to resolve your concern with the approved provider, you can contact us on 1800 550 552.

You can arrange for an advocate to support you. Turn to page 20 for more information.

How we can help you

You can lodge your concern with us by phone on 1800 550 552, in writing or online. The details are on page 24.

We can help you to resolve your concern in these ways:

Early resolution

You manage the concern, with our support

We can support you to resolve your concern quickly and directly with the approved provider. Go to page 14 for more information.

Complaint resolution

We can use one or more approaches to help you to resolve your concern:

approved provider resolution
conciliation
mediation
investigation.
Go to page 15 for more information.

In a small number of cases, we may not take action. For example, we may not take action if the matter is subject to legal proceedings or a coronial inquiry, or if the person receiving care does not want the complaint to be examined.
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Early resolution

You manage the concern, with our support

We can support and empower you to resolve your concern directly with the approved provider, early and quickly. Many concerns can be resolved at this stage without needing further action.

We can support you in any or all of the following ways:

help you to clarify the issues in your complaint
phone the approved provider on your behalf to discuss the issues
advise you and the approved provider of both parties’ rights and responsibilities under the Act
phone an advocacy agency on your behalf to explain your concerns and arrange for them to contact you.

The approved provider is not required to tell us what action they took to address your concern. However, you can contact us again if you are not satisfied.

Complaint resolution

We examine your concern

We can use a range of different tools and techniques to help you to resolve your concern, and we will talk to you about the different approaches.

Our focus is on reaching the best outcome, as quickly as possible. Complex or more formal resolution processes may take longer.

The best result can be achieved when:
all parties work cooperatively
discussions are open
information is provided in a timely manner.

Please provide as much relevant information as you can, as early as you can, so we understand all the issues. Be specific and tell us what outcome you would like to see.
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We can select one or more of the following approaches to resolve the issues in your concern.

Approved provider resolution

We can ask the approved provider to examine your concern within a specified timeframe. This may involve working with you to achieve an outcome. They are required to outline, in writing, how they resolved your concern.

Conciliation

We can help you and the approved provider to discuss the issues and reach an agreement that resolves your concern. This may involve a few phone calls, informal discussions and/or formal meetings. We document the process and outline the outcome in writing to both parties. While we do not monitor or enforce the agreement, it can provide a strong basis for your ongoing relationship with the approved provider.

Mediation

If we are unable to achieve the outcome you are seeking, we may suggest that you and the approved provider engage a mediator. There is a cost associated with mediation, which you and the provider would need to discuss.

Investigation

We can conduct an investigation into 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.

We have the ability to initiate our own resolution process, if we receive information about an issue relating to an approved provider’s responsibilities.

In resolving your concern, we can do any of the following:

We can consult professionals about clinical or technical matters.
We can ask for information from you, the approved provider or other people.
We can conduct a planned or unannounced visit to the service.
We can review relevant information you and the approved provider give to us, such as correspondence, documents, policies, nursing files and photographs. We can only accept photos as evidence if the person in the photograph provides their consent.
We can interview staff, you, family members, other care recipients, witnesses to a specific event and health care providers.
We can refer an issue to another organisation if they can more appropriately deal with an issue. For example, we can refer issues to other complaints bodies or the Aged Care Standards and Accreditation Agency Ltd.

We base our decisions on available and relevant information, so please provide all relevant information as early as possible in the process.
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What outcomes can be achieved?

When your complaint is finalised, we will send you a letter that outlines the issues, process, information used to come to our decision, and the outcome.

We may be able to achieve any of the following outcomes:

Agreement

You and the approved provider both agree that your concerns have been addressed and the issues resolved. We provide written confirmation of this outcome to both parties.

Addressed

We are satisfied that the approved provider has addressed the issue. We provide written confirmation of this outcome to both parties.

Direction issued

Where we believe the approved provider is not meeting their responsibilities under the Act, we can issue a Direction. A Direction requires the approved provider to demonstrate how they have met or will meet their responsibilities.

Referred for compliance action

We can refer a matter to the Department of Health and Ageing’s compliance area for compliance action if we are concerned the approved provider has not complied with or is not complying with its responsibilities under Parts 4.1 to 4.3 of the Act.

No further action

We will not take further action if the matter is subject to legal proceedings or a coronial inquiry, or if the person receiving care does not want the complaint to be examined.

After a complaint resolution process, we can arrange a discussion between you and the approved provider to help foster a positive, ongoing relationship.

“I just want an acknowledgment of my concern” We can try to facilitate understanding between you and the approved provider about your concern, and we will select the process that will most likely achieve this outcome.
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Advocacy

An advocate is someone who stands beside you and works on your behalf and at your direction in a way that represents your expressed wishes.

An advocate can:

support you in making decisions that affect your quality of life
provide you with information about your rights and responsibilities, and discuss your options for taking action
support you when you raise an issue with us or the approved provider
support you at any stage of the complaints process.

They will always seek your permission before taking action.

You can call the National Aged Care Advocacy Line on 1800 700 600 or go to health.gov.au/agedcareadvocacy for the details of the advocacy agency in your state or territory.

With your permission, we can phone an advocacy agency on your behalf to explain your concerns and arrange for the agency to contact you.

Advocacy is free, confidential and independent.

Confidential and anonymous complaints

You should be able to voice your concerns, particularly in your own home.

Aged care services should provide an environment where you feel safe and supported to raise a concern. However, you may feel uncomfortable about raising a concern; you may not want to ‘rock the boat’, ‘get someone into trouble’ or ‘be seen as a trouble-maker’.

If you want to raise your concern with us, it is best to submit your complaint openly; that is, provide your name and contact details. However, you have the right to complain anonymously or confidentially if you wish.

If we cannot provide your details to the approved provider, we may be limited in what we can do. We can explain the differences between open, anonymous and confidential complaints when you contact us.

Some important information to know

If you remain confidential:
we will know your identity and contact details
we will not pass your information on to the approved provider without your consent (there are some circumstances when we can; we will talk to you about this)
you will be kept informed about the progress of your complaint
you will be able to provide more information if required
you will have review rights.

If you remain anonymous:

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

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Asking for a review

You can ask for a review if you are not satisfied with the way we have handled your complaint.

If you are not satisfied at any stage of the complaint, you can ask us to review a specific part of the process or the whole process, or reconsider our decision.

Reviews can help us ensure we achieve the best resolution to your concern. Reviews also give us an opportunity to improve the administration of the Scheme.

To ask for a review, call 1800 550 552 and ask to speak to the complaints manager in your state or territory.

Aged Care Commissioner

You can ask the Aged Care Commissioner to:

examine our process for handling your complaint (within 12 months)
examine our decision (within 28 days of receiving our letter outlining this decision).
In your request, you must state the reasons why you are requesting a review.

To find out more or to lodge a request, call 1800 500 294 or turn to page 25 for further contact details.

Providing feedback about our service

At any stage of the process, you can provide feedback.

To provide feedback, please call us on 1800 550 552 and ask to speak to the complaints manager in your state or territory.

Satisfaction survey

You can provide feedback by completing a satisfaction survey. You will receive a survey with the letter advising you of the outcome to the complaint. We encourage you to complete it so we can identify what we did well and how we can improve. The survey is confidential and you do not have to tell us your name. You can complete the survey online or by hand.

Market research

We are committed to continuous improvement and from time to time, we conduct market research. We may provide your details to external companies contracted to conduct research to improve the service we deliver. You do not have to participate in research; however, it is an opportunity to tell us what you think.

If we provide your details to a company for market research, your information will be kept secure and will not be used by that company for any other purpose. If you participate in market research, results never reveal the identity of any person who takes part.
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Contact us

Phone

1800 550 552*

If you are deaf or have a hearing or speech impairment, we can help through the National Relay Service:

Telephone Typewriter (TTY) users: phone 1800 555 677 and ask for 1800 550 552
Speak and Listen users: phone 1300 555 727 and ask for 1800 550 552
Internet Relay users: go to iprelay.com.au and enter 1800 550 552.

If you do not speak English, call the Translating and Interpreting Service on 131 450 and ask to be put through to the Aged Care Complaints Scheme on 1800 550 552.

Website

agedcarecomplaints.govspace.gov.au

You can submit a complaint online, however you cannot submit an anonymous complaint online.

In writing

You can write a letter to us. Address your letter to:
Aged Care Complaints Scheme
Department of Health and Ageing
GPO Box 9848
In your capital city

Make sure your letter includes:

your name, address and telephone number (if you are not lodging an anonymous complaint)
the date you are lodging your complaint
details of your complaint, including specific dates of events and relevant comments
the name of the aged care home or service and the state/territory in which it is located
the name of the care recipient (i.e. the person involved in the complaint).

* 1800 calls are free calls from fixed lines; however calls from mobiles may be charged.
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Other useful contacts

Aged Care Information
This number will provide a link to a wide range of aged care and support services that are available nationally and in your local region.
Phone1800 200 422*
Website agedcareaustralia.gov.au

Age Page®
Phone numbers and websites for health and aged care services are located in the Numbers you need section of the White Pages.

Aged Care Commissioner
Phone 1800 500 294*
Website agedcarecommissioner.net.au
Fax (03) 9663 7369
Email info@agedcarecommissioner.net.au
Write
Aged Care Commissioner
Locked Bag 3
Collins Street
East Victoria 8003

National Aged Care Advocacy Line
Phone 1800 700 600*
Website health.gov.au/agedcareadvocacy

* 1800 calls are free calls from fixed lines; however calls from mobiles may be charged.

Lifeline
Phone 13 11 14
Website lifeline.org.au

National Dementia Hotline
This telephone and support service is funded by the Australian Government and staffed by trained advisers from Alzheimer’s Australia.
Phone 1800 100 500*

Aged Care Standards and Accreditation Agency Ltd
The Accreditation Agency’s role is to promote high quality care through accreditation, and providing information, education and training to the industry.
Phone 1800 500 294*
Website accreditation.org.au

State and territory coroner’s offices

Every state and territory has a coroner’s office – please check the White Pages for contact details.

Privacy

Under the Aged Care Act 1997, the Aged Care Complaints Scheme can use any information it receives to help it perform its regulatory functions. The Scheme has procedures in place to ensure that personal information is protected against misuse and is not unlawfully disclosed.
If you have any concerns about the Scheme’s handling of your personal information you are encouraged, in the first instance, to discuss these with the manager of the Scheme in your state or territory on 1800 550 552. If you are still dissatisfied, you can raise concerns directly with the Federal Privacy Commissioner on 1300 363 992.

Disclaimer

This publication is intended to be used in conjunction with other Scheme information sources such as the Scheme’s telephone service 1800 550 552 and the Scheme’s website agedcarecomplaints.govspace.gov.au

The Australian Government accepts no responsibility or liability for any loss suffered as a result of reliance on the information contained in this booklet.

Paper-based publications

© Commonwealth of Australia 2011

This work is copyright. You may reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so.

Internet sites

© Commonwealth of Australia 2011

This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so.

Requests and enquiries about reproduction and rights

Email agedcomplaintscomms@health.gov.au
Or write to:
Communication and Stakeholder Relations Section
Aged Care Complaints Scheme
Department of Health and Ageing
GPO Box 9848, MDP 451
Canberra ACT 2601
1800 550 552
agedcarecomplaints.govspace.gov.au

All information in this publication is correct as at August 2011

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