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Aged Care Complaints

Strategic Plan 2010-14 Aged Care Complaints Scheme

The Aged Care Complaints Scheme provides a means through which concerns about a service or the quality of care can be considered and acted upon

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Email agedcomplaintscomms@health.gov.au or write to:
Communication and Stakeholder Management Section Aged Care Complaints Scheme Department of Health and Ageing GPO Box 9848, MDP 451 Canberra ACT 2601

Background

The Aged Care Complaints Scheme (the Scheme) was introduced on 1 May 2007 to replace the Aged Care Complaints Resolution Scheme. The approaches to resolving a complaint under the previous Scheme included negotiation, mediation and determination.

The Scheme provides a means through which concerns about a service or the quality of care can be considered and acted upon.

In 2009, in response to industry and community concerns about the operation of the Scheme, the then Minister for Ageing called for an independent review of the Scheme.

Merrilyn Walton, Associate Professor of Medical Education at the University of Sydney, completed a review and in late 2009, recommended a number of changes to improve the operation, timeliness, transparency and consumer focus of the Scheme.

The Australian Government accepted the majority of Associate Professor Walton’s recommendations, and allocated $50.6 million in the 2010–11 Budget as part of the Building an Australian Aged Care System: Improving Consumer Focus and Protection in Aged Care
reform program to improve the Scheme.

This reform program will be implemented over four years and will focus on improving the way the Scheme handles complaints by:

• increasing options to resolve complaints, for example early resolution and conciliation
• improving the timeliness of complaints resolution
• improving communication with aged care consumers and the industry
• providing additional resources to reduce case loads.
• The reforms are part of the Australian Government’s broader national health reform agenda, which will deliver better health outcomes for Australians. Engagement and communication with stakeholders will continue throughout these reforms.

It is acknowledged that the wider health and aged care reform agenda, including the transition of Home and Community Care Services to the Commonwealth, the establishment of single entry points to the aged care system to direct people to the most appropriate care, and the Productivity Commission inquiry into aged care, may have potential impacts on the implementation of the reform program and the delivery of the Scheme.

About this Strategic Plan

The Strategic Plan for 2010–14 outlines the Scheme’s key intentions and commitments in delivering the Scheme.
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The aim of this Strategic Plan is to:

• describe to the community what we will achieve over the next four years
• provide direction to our staff on how their work contributes to achieving our objectives
• guide our operational planning and allocation of resources.
• The reform program involves a four-year approach to improving the Scheme. While various aspects of the Scheme will be strengthened across the four years, each year will have a main focus. These are:
• 2010–11 (Phase 1): Getting the basics right and preparing for change
• 2011–12 (Phase 2): Implementing and communicating change
• 2012–13 (Phase 3): Communicating outcomes and influencing industry
• 2013–14 (Phase 4): Leading good practice in complaints management.
• We intend to review the Strategic Plan in the third year of the reform program during 2012–13, to ensure the objectives continue to be valid in the delivery of the Scheme.

Strategic intent

Our vision

Our vision is to improve and protect the safety and wellbeing of recipients of aged care.

Our purpose

Our purpose is to:

• manage a complaints scheme that is responsive to and seeks to resolve concerns raised by care recipients, their representatives and others regarding the quality of care and services provided through Australian Government subsidised aged care services
• assess compliance against certain responsibilities of approved providers of Australian Government subsidised residential aged care services as they relate to individual care recipients.

In doing this, we will:

• assist in improving the experience of the individual care recipient
• support the resolution of concerns at the local level
• encourage continuous improvements in the delivery of aged care.

Our scope

The Scheme can consider concerns about the quality of care or services provided through Australian Government subsidised aged care services where these concerns relate to an approved provider’s responsibilities under the Aged Care Act 1997. Such concerns may be raised by care recipients, their representatives or others.

The Scheme cannot deal with matters that do not relate to the Aged Care Act 1997. For example, the Scheme cannot:

• deal with a complaint about an aged care service that does not receive Australian Government funding
• decide who should make financial, legal or health decisions on behalf of a person receiving care
• comment on industrial matters such as wages or employment conditions or
• provide legal advice.
• The Scheme also monitors certain responsibilities of an approved provider of Australian Government subsidised aged care services, where those responsibilities relate to an individual care recipient, including the requirements in relation to reportable assaults and unexplained absences of a resident.

The role of the Scheme in relation to these matters is to:

• assess whether the approved provider has met its reporting responsibilities as prescribed in the Aged Care Act 1997
• confirm the approved provider has taken appropriate action to ensure the ongoing safety of residents.
• The Scheme also supports a broader notification process for the Department of Health and Ageing (the Department) and the Australian Government in relation to significant communicable disease outbreaks and emergency events, for example floods, fire and cyclones, when they impact upon Australian Government subsidised aged care services.

When required, the Scheme refers concerns in relation to approved provider responsibilities to the compliance area of the Department for appropriate action. This may include giving the approved provider a notice of non-compliance or imposing a sanction.

The Scheme may also refer complaints to other organisations such as professional registration boards, police or health care complaints bodies.

We deliver our services through the Department via a network of staff in state and territory offices. This network is part of a broader partnership approach for the delivery of services to the aged population across the continuum of care.
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Our governance structure

Our commitment

In working with care recipients, their families, approved providers, the public and our staff, we commit to:

• provide clear, consistent and timely advice
• make evidence-based decisions that provide equal opportunity for parties to have a say
• be thorough, robust and accountable in our work
• engage with empathy and understanding
• be fair, ethical and transparent
• ensure accessibility
• engage and work collaboratively with our stakeholders to improve the Scheme and the delivery of aged care services in Australia
• focus on continuous quality improvement of the Scheme.

Our stakeholders

We commit to working with the aged care sector, care recipients and their representatives, aged care staff, the industry and the broader community to develop and implement a quality Scheme across residential care, community care and flexible care services funded under the Aged Care Act 1997.

Our objectives

We recognise that in delivering our Vision and Purpose, we will require an integrated approach to all components of an effective complaints management system.

To achieve this, we are focused on four objectives:

• Effective governance
• Effective workforce
• Effective relationships
• Effective enablers

1. Effective governance

Effective governance is a vital factor that will enable the delivery of an integrated and accountable Scheme. Our intention is to enhance accountability and decision-making by strengthening governance structures and processes. We commit to:

1.1 Implementing a clearly structured and articulated national approach to complaints management that sits within and is supported by a
sound legislative framework.

1.2 Cultivating strong leadership through the Scheme’s governance committees.

1.3 Ensuring quality through increasing the focus on internal reconsideration of cases and providing opportunity for independent review by the
Aged Care Commissioner.

1.4 Improving our staff’s access to clinical advice through the establishment of the Scheme’s Clinical Unit.

1.5 Focusing on transparent, accountable and consistent decision making and continual improvement in service delivery through implementing quality assurance processes.

1.6 Reporting publicly about the work of the Scheme.
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2. Effective workforce

Our workforce is the foundation of delivering an effective complaints management system. Our intention is to continue to cultivate a skilled and responsive workforce that operates effectively, and employs good practice standards in complaints management.

We commit to:

2.1 Implementing the Department’s People Strategy 2010–2015 through the ongoing:

• attraction of talented, skilled and diverse people for the Scheme
• retention of our people by valuing and rewarding their contribution and supporting them through personal and professional challenges
• encouragement of a culture of collaboration, engagement, innovation and respect
• consideration of people management information to support effective workforce planning, taking account of local, national, and international work pressures.

2.2 Using people’s capabilities and building these through training and professional development opportunities.

2.3 Promoting the sharing of ideas and learning among our staff through effective internal communication processes.

2.4 Providing clear direction and guidance by senior management and fostering an effective staff support system.

3. Effective relationships

The success of the Scheme is dependent on strong relationships with care recipients, their representatives, aged care staff, the industry and the broader community. Our intention is to develop stronger links with our stakeholders, and to listen to and learn from their experiences.

We commit to:

3.1 Raising awareness among aged care consumers, aged care staff, the industry and the community about the Scheme and the package of reforms to improve the Scheme, including the options available to resolve concerns.

3.2 Empowering individuals to self•manage certain concerns through regular, ongoing and strategic communication activities.

3.3 Encouraging approved providers to more effectively manage complaints at the local level through promoting and supporting early resolution.

3.4 Promoting awareness of good clinical practice with service providers and aged care staff by improving communication, sharing learnings and assisting to identify opportunities for continuous improvement.

3.5 Building strong and productive relationships with key stakeholders, including advocacy groups, clinical groups, peak bodies, service providers, complaints bodies and aged care staff and their representatives, to enable sharing of experience, learning and expertise to improve the Scheme and industry.

3.6 Strengthening relationships with the Aged Care Commissioner and the Aged Care Standards and Accreditation Agency Ltd through regular communication, sharing learnings and information, and incorporating feedback in accordance with communication protocols.

3.7 Raising awareness of, and building commitment to, the Scheme’s strategic direction, the reforms, and the importance of a national approach across the Department’s central, state and territory offices, through internal communication strategies.

4. Effective enablers

A key rationale for reform of the Scheme is the need to deliver a suitable, equitable, accountable and effective complaints management
system. Our intention is to enhance our enablers, including risk assessment tools, information technology and national procedures.

We commit to:

4.1 Developing and implementing a risk assessment framework to assist with the assessment of complaints.

4.2 Improving our information technology and information management capabilities.

4.3 Strengthening the National Aged Care Complaints Guidelines.

4.4 Supporting the ongoing development and review of appropriate tools to facilitate continuous improvement.

4.5 Ensuring our physical and administrative infrastructure supports our workforce.

Our performance monitoring

We will monitor and measure the Scheme’s performance against a set of performance indicators and satisfaction indices.

The performance of the Scheme will be reported in the Report on the Operation of the Aged Care Act 1997 and the Department’s Annual Report.
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