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Aged Care Complaints

Reforming the aged care complaints management framework

Presentation of 7 July 2011.

Today’s presentation

• About the Aged Care Complaints Scheme
• Reforms to the Scheme
• Complaints management framework
• Implementation approach
• Quality management framework

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Aged care quality and compliance framework

Standards:

• Residential care standards
• Community care standards
• Indigenous flexible services

Regulation:

• Market entry
• Supply of place
• Funding
• Quality of care
• Protecting resident's funds

Monitoring

• Approved provider's responsibilities:
  • Quality of care
  • Key personnel
  • Financial management
  • Police checks
  • Fire safety
  • Emergency management
• Compulsory reporting
• Accreditation
• Quality reporting
• Prudential compliance
• ACFI

Complaints (saftey net)
Quality

• Skilled workforce
• Promoting quality practice
• Informed consumers
• National Aged Care Advocacy Program
• Community Visitors Scheme

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Aged Care Complaints Scheme

• We manage complaints about care and services provided by Australian Government subsidised aged care services (community and residential).
• Free service open to all – complaints can be made openly, confidentially or anonymously.
• Service delivery through the Department’s state and territory offices.
• Policy and procedures through central office.
• We also receive notifications from approved providers:
  • Missing residents
  • Reportable assaults
  • Communicable disease (not compulsory).

Our history

1997: Aged Care Complaints Resolution Scheme

• Emphasis on mediation
• Criticised for poor accessibility and poor responsiveness

2007: Aged Care Complaints Investigation Scheme (CIS)

• Emphasis on investigation
• Independent review in 2009

2011: Aged Care Complaints Scheme

• Implementation from 1 September
• Range of complaint resolution processes, including early resolution; approved provider resolution; conciliation; investigation and mediation

Walton review

• Independent review conducted by Associate Professor Merrilyn Walton.
• Recommendations aimed at improving the operation, timeliness, transparency and consumer focus of the Scheme.
• $50.6 million over four years in the May 2010 Budget to implement reforms.

Complaints management framework

Strengthened framework seeks to address Walton’s recommendations, with a view to ensuring the Scheme is customer-focused:

• expands the range of resolution techniques
• encourages local resolution, where possible
• care recipient at the centre of decision making
• risk assessment
• focuses on achieving a sustainable and quality outcome
• broadens review rights
• maintains right to complain confidentially or anonymously
• a greater focus on education and support.
• Strengthened processes: natural justice, evidence-based decision making, clear and ongoing communication, access to advocacy at any time.
• Improved information for consumers and industry.

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Implementation approach

• A four-year phased approach to implementation:
  • 2010-11 (Phase 1): Get the basics right and prepare for change
  • 2011-12 (Phase 2): Implement and communicate change
  • 2012-13 (Phase 3): Communicate outcomes and influence industry
  • 2013-14 (Phase 4): Lead good practice in complaints management
• Reforms are being implemented within a quality management framework

Internal support

• Comprehensive training, including:
  • Overview of Aged Care legislation
  • Good decision making
  • Scheme policies and procedures
  • Managing difficult conversations
  • Procedures clinics
• Revised recruitment materials to better reflect the enhanced range of complaint resolution techniques
• Revised procedural guidelines and risk assessment tools
• Policy on managing unreasonable complainant conduct
• Enhanced access to clinical expertise to inform decision making

Communication

• Consultation with industry, consumers and staff on roll-out of reforms:
  • draft framework,
  • draft legislation,
  • risk matrix,
  • consumer materials.
• Establishment of national, ongoing communication channels:
  • Internal channels:
    • Internal blog
    • Fortnightly Five-Pointer updates for managers
    • National forum visits
    • STO visits
  • External channels:
    • Website with blog functionality
    • Consumer materials
    • Service charter
    • More to come

Performance information

• Performance measures for the Scheme, reflecting key principles from the Australian Standard on Complaints management.
• Performance management initiatives and reporting:
  • Post-complaint satisfaction surveys for complainants and approved providers
  • Market research
• Analysis of reports from the Aged Care Commissioner and Commonwealth Ombudsman
• Program of internal quality audits

Industry feedback

• Development of strategies to analyse and feed back data collected by the Scheme to the aged care industry, with a view to promoting industry improvement.
  • Position statements: to communicate the Scheme’s position on a key aged care quality or safety issue.
  • Alerts: issued in respect of non-routine problems or events that may have implications for the health or safety of aged care recipients.
  • Analytics program: combines analysis of data with clinical expertise and/or literature reviews.

Thank you

Any questions?

Lucelle Veneros
Assistant Secretary
Aged Care Complaints Scheme
Department of Health and Ageing

Email:Aged Care Complaints

Online: Aged Care Complaints
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