Dealing with complaints

The Complaints Commissioner’s role is to improve the complaints process, providing another pathway for people to raise issues or concerns. The Rules set out the full process for how the Complaints Commissioner will manage any complaints or feedback they receive.

[Chapter 5 – Part 3 – Division 3]

The priorities for the complaints process are: 

• communicating regularly with all people involved
• having a clear resolution process
• having a clear process for review – reconsidering decisions.

Types of complaints or feedback

A person – the complainant – can make a complaint about:

• a provider, responsible person or aged care worker not following the Act
• a provider acting in a way that isn’t in line with the Statement of Rights.

Feedback is more general than a complaint and doesn’t need to be about whether someone is following the Act. A person can give feedback about a registered provider, responsible person or aged care worker. 

Someone can make a complaint or give feedback verbally or in writing. They can ask to be anonymous, or have certain information kept private. They can also withdraw the complaint or feedback if they choose. 

Whistleblower protections may apply to some complaints or feedback. The Complaints Commissioner must consider whether these protections apply during the complaints process. Chapter 7 includes details about whistleblower protections.

Complaints and feedback process

The general process and principles for dealing with complaints and feedback, as described in the Rules, is below.

• Support the person who made the complaint or gave the feedback. Also support anyone receiving care from the provider, responsible person, or aged care worker the complaint or feedback is about.
• Adhere to whistleblower protections if the complaint or feedback might be covered by these. Chapter 7 details the protections.
• Acknowledge the complaint or feedback within 3 business days of receiving it. Unless the complaint is anonymous or where other rules apply, such as rules around privacy.
• Refer the complaint or feedback on if it’s more appropriate that another person or organisation handle it.
• Communicate with the person who made the complaint. Set agreed timeframes for regular updates. The Complaints Commissioner may also communicate with a registered supporter or advocate if the older person has one. The Complaints Commissioner must also provide a proposed ‘complaint determination’, describing any action the Complaints Commissioner plans to take or recommend. The older person must have the chance to respond to the proposal.
• Communicate with the person the complaint is about as soon as possible after the complaint is made, except if there is a risk of harm to the person who made the complaint.
• Address the complaint by either carrying out a resolution process or by taking no further action. The resolution processes and conditions for not taking further action are outlined below.
• Make the complaint determination, describing any action the Complaints Commissioner has taken or that should be taken by someone else. They provide the determination to the person who made the complaint and anyone else involved. Generally, the Complaints Commissioner should complete this within 90 days of when the complaint was made.

Addressing the complaint

In addressing a complaint, the Complaints Commissioner will usually follow one of the below resolution pathways.

There are also cases where a complaint is resolved without the Complaints Commissioner using one of these pathways. This could be because the complaint is:

• withdrawn or referred to another person or organisation
• resolved through another more appropriate process
• the subject of legal proceedings
• frivolous, vexatious or not made in good faith – for example, about a very minor matter or only made to cause damage to someone
• related to events that the Complaints Commissioner can’t confirm or happened more than one year ago and have stopped occurring
• related to a coronial inquiry.

There may also be cases where nothing more can be done or the older person doesn’t want the Complaints Commissioner to address the complaint, if it was lodged on their behalf. 

Resolution pathways

Following a complaint, the Complaints Commissioner can use specific pathways to resolve the issue. The Rules describe these resolution pathways. The Complaints Commissioner can:

• require that the person the complaint is about – usually the aged care provider – try to resolve the issue or take other action and report back to the Complaints Commissioner within a set time
• investigate the causes of the complaint – including visiting the site where aged care services are delivered or requesting relevant information
• discuss the complaint with anyone involved
• support a conciliation process or manage a restorative engagement process
• take regulatory actions defined in Chapter 6.

Reconsideration

Both the complainant and the person the complaint is about can request the Complaints Commissioner review a decision to take no further action or to end a resolution process. This is called reconsideration of the complaint. Generally, people must request a reconsideration within 42 days of receiving the complaint determination. The Complaints Commissioner may set a longer period. 

When someone asks for a reconsideration, a person who was not involved in making the initial decision must review the request. This may include the Complaints Commissioner, someone who has been delegated the Complaints Commissioner’s functions or the Commissioner. They will then either:

• confirm the original decision
• set the decision aside and undertake a new resolution process.