Discussion paper - Aged Care Complaints Scheme: Proposed Complaints Management Framework - February 2011
Background
The Aged Care Complaints Scheme (the Scheme) is managed by the Office of Aged Care Quality and Compliance within the Department of Health and Ageing (the Department). The Scheme was introduced in May 2007 to replace the Aged Care Complaints Resolution Scheme, which relied on alternative dispute resolution to resolve complaints.The Scheme was designed to strengthen the ability of the Department to investigate concerns and where necessary take action to ensure aged care providers (also referred to as approved providers) meet their responsibilities under the Aged Care Act 1997 (the Act).
While the Scheme retained the ability to broker the resolution of complaints through conciliation, in practice conciliation has not routinely been utilised to resolve complaints. In 2009, the Australian Government engaged Associate Professor Merrilyn Walton to independently review the operation of the Scheme and identify areas of improvement to ensure the Scheme achieves best practice aged care complaints management practices.
Members of the public and key stakeholders were invited to make submissions to the review. One hundred and nineteen submissions were received and 20 face-to-face consultations were conducted.
In April 2010, the Government released the results of Associate Professor Walton’s review. Her report, Review of the Aged Care Complaints Scheme (called the Walton Review), made a range of recommendations to improve the operation, timeliness and transparency of the Scheme.
Associate Professor Walton’s key recommendations included incorporating into the Scheme a broader range of alternative resolution processes to support the early resolution of complaints without investigation, and using a risk assessment framework to assess and prioritise complaints.
In response to the Walton Review, the Government—as part of the National Heath and Hospitals Network reforms—committed $50.6 million over four years to strengthen the Scheme’s capacity to respond to complaints about Australian Government subsidised aged care services. The Government’s proposed reforms included providing additional options for resolving complaints, such as mediation and conciliation, and early risk assessment of complaints.
To ensure consumers, the aged care industry, their staff and other key stakeholders have an opportunity to comment on the implementation of the Government’s proposed reforms to the Scheme, the Department has developed a proposed complaints management framework as a basis for consultation.
The proposed complaints management framework has been informed by an initial consultation and review process undertaken by the Department that included:
- a literature review on best practice complaint-handling
- consultation with other complaint-handling bodies such as the NSW Health Care Complaints Commission, WA Office of Health Review, WA Childcare Licensing and Standards Unit, Department of Veterans Affairs, NSW Ombudsman, Child Support Agency and ACT Human Rights Commission
- consultation with the Scheme’s staff in state and territory offices
- a review of approximately five per cent of current cases being managed by the Scheme.
The proposed reforms to the Scheme outlined in this discussion paper form one part of the Government’s broader reforms to improve the operation of the Scheme. The broader reforms the Government is implementing include:
- creating greater access to clinical expertise to assist in the assessment of complaints
- improving processes, procedures and training for the Scheme
- reviewing the Act and Aged Care Principles (Principles) to ensure that where appropriate the views and wishes of care recipients and/or their representatives guide the management of complaints
- strengthening the right of aggrieved persons and approved providers to seek an independent review of the Scheme’s decisions and processes
- improving procedures and practices for managing investigations
- creating more inclusive communication and consultation policies and procedures that facilitate ongoing and timely communication with complainants, approved providers and other key stakeholders.