FAQs

This page will be updated to provide answers to frequently asked questions (FAQs). If you would like to submit a question, please send us an email or leave a comment below.

Questions

• I have a concern – what do I do?
• Who can make a complaint?
• If my complaint concerns someone else, should I tell them?
• Why should I raise a concern?
• If I have a concern, should I talk to the aged care provider?
• I want to raise a concern but I’m afraid. What are my options?
• What is advocacy?
• How can advocacy help me?
• How can I ask for an advocate to help me?
• What complaints can the Scheme examine?
• What types of services are covered by the Scheme?
• What concerns can’t the Scheme examine?
• What happens when I first contact the Scheme?
• What happens after I lodge a complaint?
• How is a complaint investigated?
• Can I supply photos as evidence?
• What outcomes can be achieved through the Scheme?
• How can I provide feedback about the Scheme or the person I was dealing with?
• Can I apply for a review of a decision about my complaint?
• What is the Aged Care Commissioner’s role?
• How can I contact the Aged Care Commissioner?

Answers

I have a concern – what do I do?

Some initial research can help you decide who you should contact to resolve your concern. Here are some ideas:

• The ‘Age Page’ in the White Pages has a list of contacts that may be able to help you
• You can talk to the aged care provider or a member of the care staff
• An advocacy service may be able to help you
• If your concern is about an Australian Government subsidised residential or community care aged care service, we may be able to help.

All approved aged care providers are required to have their own complaint management system. We encourage you to try to raise your concern with the aged care provider before contacting us. Ask the aged care provider how they can address your complaint. You can arrange to have an advocate with you to support you at this meeting.

If:

• you don’t want to discuss your concern with the provider
• the provider is unable to resolve your complaint
• you think we can help you with your complaint or
• you would like information about your options

then call us on 1800 550 552. Go to the Contact us page for more information.

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Who can make a complaint?

Anyone can make a complaint, including:

• care recipients
• partners, including same-sex partners
• family members
• friends
• representatives
• advocates
• aged care staff
• volunteers
• health and medical professionals
• carers.
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If my complaint concerns someone else, should I tell them?

Yes. 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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Why should I raise a concern?

Complaints are important because they help to improve the quality of Australia’s aged care services.

Complaints can help aged care providers assess and improve the quality of care and services they offer, so one complaint can help other people too.

If you have a concern about the care you or someone else is receiving, it is vital that you raise your concern with the aged care provider or the Scheme.

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If I have a concern, should I talk to the aged care provider?

We encourage you to try to raise your concern with the aged care provider, because resolution at the local level can achieve a fast and sustainable outcome. You can arrange for an advocate to support you.

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

If you don’t want to discuss your concern with the provider or are unable to resolve your complaint with them, you can contact the Scheme.

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I want to raise a concern but I’m afraid. What are my options?

Aged care services should provide an environment where you feel safe and supported to raise a concern. However, it is not always easy to raise a concern.

If you don’t feel able to raise your concern with the provider, you can submit your complaint to the Scheme. 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 you choose to remain confidential, your identity and contact details will be known to the Scheme but will not be passed on to the aged care provider without your agreement. You will be kept informed about the progress of your complaint, and you will be able to provide more information or evidence if required.

If you remain anonymous, your identity and contact details will not be known to the Scheme or the provider. However, the Scheme won’t be able to keep you informed about your complaint’s progress; you won’t be able to provide further information or evidence; you won’t know the outcome; and you won’t have review rights.

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What is advocacy?

Advocacy is defined as ‘the process of standing alongside an individual who is disadvantaged and speaking out on their behalf in a way that represents the best interests of that person.’

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How can advocacy help me?

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.

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How can I ask for an advocate to help me?

You can contact the National Aged Care Advocacy Line on 1800 700 600 or go to their website. With your permission, we can phone an advocacy agency on your behalf to explain your concerns and arrange for the advocacy agency to contact you.

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What complaints can the Scheme examine?

We can examine complaints relating to approved providers’ responsibilities under the Aged Care Act 1997.

Examples of concerns we can examine include:

• Health and personal care (for example infection control, personal hygiene)
• Communication (for example information and internal complaints processes)
• Personnel (for example conduct and training)
• Physical environment (for example safety, cleaning and call bells).
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What types of services are covered by the Scheme?

We examine complaints about the following Australian Government subsidised aged care services:

• residential aged care
• community aged care packages (CACP)
• extended aged care at home packages (EACH)
• extended aged care at home – dementia packages (EACHD).
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What concerns can’t the Scheme examine?

We are unable to:

• examine complaints 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 Aged Care Act 1997
• 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.

We can refer complaints that fall outside of our scope to other organisations such as the Aged Care Standards and Accreditation Agency Ltd, professional registration boards or other complaints bodies. If you lodge a complaint with us and we can’t help you, we will try to identify who may be able to help you.

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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 then decide how quickly to escalate your complaint and how best to resolve your concern.

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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What happens after I lodge a complaint?

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. 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.

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How is a complaint examined?

We can use a range of different tools and techniques to help people to resolve their concerns, 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.

We can select one or more of the following approaches to resolve the issues in a concern.

Approved provider resolution: We can ask the approved provider to examine the concern within a specified timeframe.

Conciliation: We can help the complainant and approved provider to discuss the issues and reach an agreement that resolves the concern. This may involve a few phone calls, informal discussions and/or formal meetings.

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.

Mediation: If we are unable to achieve the outcome being sought, we may suggest that the complainant and approved provider engage a mediator. There is a cost associated with mediation, which both parties would need to discuss.

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Can I supply photos as evidence?

We can review relevant information that the complainant and 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. Please contact us if you would like information about this.

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What outcomes can be achieved through the Scheme?

When the complaint is finalised, we will send both parties 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: The complainant and the approved provider both agree that the 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 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 Aged Care Act 1997.

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 the complainant and the approved provider to help foster a positive, ongoing relationship.

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How can I provide feedback about the Scheme or the person I was dealing with?

At any stage of the process, you can provide feedback – positive or constructive. Please call us on 1800 550 552 and ask to speak to the complaints manager in your state or territory.

When your complaint has been finalised, you will receive a satisfaction survey with your letter. We encourage you to complete it so we can identify what we did well and how we can improve. Please complete this form and send it back to us in the enclosed pre-paid envelope.

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Can I apply for a review of a decision or the process?

The ability to seek a review helps us to address any concerns you may have about our work. Your feedback also helps to improve the administration of the Scheme.

We encourage you to contact us if you are not satisfied at any stage of the complaint or would like to provide feedback. Call 1800 550 552 and ask to speak to the complaints manager in your state or territory.

You can ask the Aged Care Commissioner to examine our process for handling your complaint (within 12 months) or examine our decision (within 28 days of receiving our letter outlining this decision). To find out more or to lodge a request, call 1800 500 294 or go to the Commissioner’s website.

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What is the Aged Care Commissioner’s role?

Complainants and approved providers can seek an independent review of the Scheme’s decisions and complaints processes through the Aged Care Commissioner. The Commissioner can make recommendations to the Scheme based on these examinations.

If you are not satisfied with the Scheme’s decision, you can ask the Commissioner to review it. Your request must be made within 28 days of receiving the Scheme’s decision letter and you must state the reasons why you are seeking a review.

You can also ask the Commissioner to look at the Scheme’s complaints process (within 12 months of when your concerns about the process arose). However, such a review cannot re-open or change the outcome of your complaint.

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How can I contact the Aged Care Commissioner?

Phone: 1800 500 294 (a free call from fixed lines; calls from mobiles may be charged)
Website: www.agedcarecommissioner.net.au (including an online complaint form)
Fax: (03) 9663 7369
Email: info@agedcarecommissioner.net.au
Write:
Aged Care Commissioner
Locked Bag 3
Collins Street East VICTORIA 8003
Visit:
9.00am to 5.00pm, Monday to Friday
Level 4, 12-20 Flinders Lane, Melbourne

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