setting out privacy principles that must be followed when creating information and document handling systems Refer to the or the Ombudsman Act 1976 This legislation sets out the Ombudsman’s role, responsibilities and powers, which include: investigating complaints about the administrative actions of Australian Government officials and agencies, and reviewing statutory compliance by agencies developing policies and principles for accountability. Refer to the Accountability Public Governance, Performance and Accountability Act 2013 This legislation provides a framework for the proper management of public money and public property. Refer to the Accountability Public Service Act 1999 This legislation sets out the values which public servants need to uphold and a code of conduct for public service employees, as well as external processes through which public servants can be held accountable. Refer to the Accountability Policy on preventing and managing unreasonable conduct from external parties This outlines how the National Aged Care Regulatory Programme, including the Scheme, will manage unreasonable conduct from external parties. It is expected that complainants will treat Scheme officers fairly and respectfully; this expectation. Scheme’s notice of collection The Scheme’s outlines what the Scheme may collect, use and disclose. Accountability Scheme’s Service Commitment The Scheme’s describes the level of service that complainants and service providers can expect from the Scheme during a resolution process. Accountability
4.26 Out-of-scope enquiries – essential information to collect Activity 4: Providing information 4.27 Determining the of information to provide 4.28 Complaints - essential information to provide 4.29 In-scope enquiries - essential information to provide 4.30 Out-of-scope enquiries – essential information to provide Activity 5: Finalising enquiries 4.31 When to finalise an enquiry 4.32 When to finalise an out-of-scope enquiry 4.33 Sending correspondence for or out-of-scope enquiries Activity 6: Escalating complaints to a manager 4.34 Timeframes for escalating a complaint to a manager 4.35 Using the intake escalation matrix Activity 7: Preliminary assessment of service provider history 4.36 Who completes the preliminary assessment of service provider history? 4.37 Determining the level of service provider history required 4.38 Using service provider history to inform decision making Activity 8: Supporting early resolution of complaints 4.39 Supporting early complaint resolution in the intake phase 4.40 Which complaints are suitable for early resolution? 4.41 How can support for resolution be provided? 4.42 Sending correspondence about early resolution 4.43 When can the complaint be finalised? 4.44 What happens if resolution falls outside of 14 days? Activity 9: Acknowledging receipt of the complaint 4.45 Contents of an acknowledgement letter 4.46 When to send an acknowledgement letter Activity 10: Workflow to the detailed assessment 4.47 When to workflow to the detailed assessment phase Note: For information on the management of complaints in relation to Australian Government subsidised aged care programmes under a Comprehensive Grant Agreement, refer to Chapter 10 of these Guidelines. Note: Reference to an 'officer' includes both an officer and a manager. A 'delegate' refers to an individual with a delegated authority.
Activity 3: Supporting early resolution 5.20 Supporting early complaint resolution 5.21 Which complaints are suitable for early resolution? 5.22 What support can be provided and when can the complaint be finalised? 5.23 What to do when early resolution is not successful Activity 4: Taking no further action 5.24 Who may decide to take no further action? 5.25 The grounds for taking no further action during the detailed assessment phase 5.26 The issue was not raised in good faith 5.27 The issue has been, or is, the subject of a legal proceeding 5.28 The issue has previously been dealt with by the Scheme 5.29 The issue relates to an event that occurred more than one year ago and is not ongoing 5.30 The issue is subject to a coronial inquiry 5.31 The care recipient in the complaint does not wish the issue to be considered 5.32 The issue is better dealt with by another organisation 5.33 Having regard to all circumstances, a resolution process in relation to the issue is not warranted 5.34 Advising the parties to the complaint of the decision to take no further action Activity 5: Referral to areas or organisations 5.35 When the Scheme may refer information or complaint issues 5.36 Releasing protected information outside of the department 5.37 Consultation required for referrals outside of the Scheme 5.38 Releasing information to other areas within the department 5.39 What happens to the complaints resolution process if a referral is made? 5.40 Informing complainants and service providers about referrals Activity 6: Correspondence about the progress of the complaint 5.41 Contact with the complainant 5.42 How to get the issues right 0 When to send a feedback letter 5.44 When to send the acknowledgement and confirmation of issues letter Activity 7: Workflow to the resolution phase 5.45 Tasks to do once the RARP has been completed 5.46 Who workflows the complaint? Note: For information on the management of complaints in relation to Australian Government subsidised aged care programmes under a Comprehensive Grant Agreement, refer to Chapter 10 of these Guidelines.
6.21 Confirming the engagement of all parties 6.22 Conciliation meeting 6.23 Teleconferencing to facilitate conciliation 6.24 Speaking separately to the parties to facilitate conciliation Resolution approach - Service provider resolution 6.25 What does service provider resolution involve and what is the potential outcome? 6.26 What types of issues may be suitable for service provider resolution? 6.27 Planning service provider resolution 6.28 Confirming the engagement of all parties 6.29 Referring the issues to the service provider for resolution 6.30 Assessing the service provider’s resolution outcome 6.31 What happens when new information is received during service provider resolution? Resolution approach - Mediation 6.32 What does mediation involve and what is the potential outcome? 6.33 What types of issues may be suitable for initiated mediation? Resolution approach - Investigation 6.34 What does investigation involve and what is the potential outcome? 6.35 What types of issues may be suitable for investigation? 6.36 Role of the officer in meeting the principles of good investigation 6.37 Planning an investigation – using the aged care investigation matrix Activity 4: Collecting information 6.38 Collecting information – sources and types 6.39 Considerations about information the Scheme might receive 6.40 Can officers take photographs or voice record interviews? Activity 5: Undertaking a site visit or on-site meeting 6.41 What does an announced or unannounced site involve? 6.42 In what circumstances will a site visit to a residential service or service provider’s office be conducted? 0 When would an onsite meeting be conducted? 6.44 Powers of an authorised officer undertaking a site visit under the Aged Care Act 1997 6.45 Entry interview 6.46 Exit interview 6.47 When will a site visit to a private home be conducted? • ategy to resolve the complaint. Planning for a site visit to a private home 6.49 Analysing collected information
Outcome Phase This chapter sets out the key activities to be undertaken by officers during the outcome phase, the fourth and final phase of the complaints management process. Intake Phase Detailed Assessment Resolution Phase Outcome Phase Chapter contents Section Topic Overview of the outcome phase 7.1 Who can make a decision to end the complaint resolution process 7.2 Complaints management principles relevant to the outcome 0 Manager role at the outcome phase 7.4 Delegate’s role in the outcome phase 7.5 The available decisions to end the complaint resolution process in the outcome phase Decision to end - the issue has been resolved 7.6 When would the Scheme use the decision to end as the issue has been resolved? Decision to end - the service provider has addressed the 7.7 When would the Scheme use the decision to end as the service provider has addressed the issue to the satisfaction of the Scheme? Decision to end - the Scheme has issued directions 7.8 When would the Scheme use the decision to end through issuing directions to a service provider? 7.9 What information is included in directions? 7.10 Determining timeframes for directions to be met 0 Are directions enforceable? Decision to end - compliance action has been taken 7.12 When would the Scheme use the decision to end as the department has taken compliance action? Decision to end - the complainant has withdrawn from the process 7.13 When would the Scheme use the decision to end as the complainant has withdrawn from the process? Decision to end - the issue is better dealt with by another organisation 7.14 When would the Scheme use the decision to end as the issue is better dealt with by another organisation? 7.15 Will the Scheme seek feedback from the referral organisation? Decision to end - continuation of the 7.16 When would the Scheme use the decision to end as continuation of the resolution process is not warranted?
resolution process is not warranted 7.17 Circumstances giving rise to the complaint not being determined 7.18 Information not in good faith 7.19 Where the issue is subject to legal proceedings or coronial inquiry 7.20 Issue has been dealt with previously 7.21 Care recipient does not want the process to continue 7.22 Having regard to all circumstances continuation not warranted Feedback to complaint parties and referrals 7.23 What feedback must the Scheme give complainants and service providers when a complaint is finalised? 7.24 The importance of providing informal feedback throughout the resolution process 7.25 What information should be included in written feedback to the complainant and the service provider? 7.26 Should the complainant and the service provider receive the same feedback? 7.27 What review rights are afforded to the complainant and service provider? 7.28 Can feedback be given to others? 0 Restrictions on providing feedback about referrals Finalising the case 7.30 When the Scheme will not monitor resolution outcomes 7.31 Monitoring the service provider’s response to directions 7.32 What happens if the service provider to meet directions? 7.33 Finalising the case following directions 7.34 Finalising the case following the provision of feedback Note: For information on the management of complaints in relation to Australian Government subsidised aged care programmes under a Comprehensive Grant Agreement, refer to Chapter 10 of these Guidelines. Note: Reference to an 'officer' includes both an officer and a manager. A 'delegate' refers to an individual with a delegated authority.
Complaint Review Mechanisms This chapter provides information on review mechanisms available to parties to a complaint during and following a complaints process. Chapter contents Section Topic Overview of complaints review mechanisms 8.1 Review mechanisms available for parties to a complaint 8.2 The department's role a concern is raised 8.3 The department's role where a concern is raised Any person involved in a complaint process may, at any time during complaint handling, a concern about the process the Scheme is undertaking or the conduct of an officer. The department has existing policies and procedures for dealing with such concerns or allegations. The DSS feedback team can receive concerns via: Email: DSSfeedback@dss.gov.au Post: DSS Feedback, PO Box 7576, Canberra Business Centre ACT 2610 Important! If officers receive complaints about their own conduct, or the conduct of another officer, this should immediately be raised with a manager and the concern referred to the DSS feedback team. The Aged Care Commissioner’s review role 8.4 The Ombudsman’s review role 8.5 Complaints management principles relevant to a review Reconsideration following completion of a resolution process 8.6 Who can seek reconsideration by the Scheme? 8.7 How are applications for reconsideration made to the Scheme? 8.8 Which officers in the Scheme can reconsider a decision? 8.9 Considerations when deciding whether a new process is necessary 8.10 What happens if the Scheme decides not to undertake a new resolution process? 8.11 What happens if the Scheme decides to undertake a new resolution process 8.12 officers will undertake the new resolution process? 8.13 What resolution process does the officer undertake? 8.14 Can the complainant and service provider seek external examination on the Scheme's reconsideration? 8.15 What decisions are examinable by the ACC?
issue a notice of intention to issue directions (NIID) to the approved provider before issuing directions, or go straight to issuing directions where prompt action is warranted. The steps would include, as relevant, completing a NIID Report, reviewing the service provider’s response to NIID and issuing directions where required. Officers will document the new process and its findings in the Detailed Resolution Report (DRR). The Scheme may issue a NIID or direction during an ACC-directed new resolution process without informing the ACC beforehand. However, the Scheme must provide findings to the ACC before finalising the case. Where the service provider has responded to a NIID, the Scheme will provide its draft feedback report to the ACC for comment before finalising the resolution process. directions are issued, the proposed reasons for ending the new resolution process on that basis, need to be provided to the ACC before finalising the case under Section 14 of the Complaints Principles 2014. Extension to the Scheme’s 46 day timeframe for an ACC-directed new resolution process The 46 day timeframe for undertaking a new resolution process may be extended by 28 days in exceptional circumstances or where extending the timeframe is likely to allow the Scheme to achieve better outcomes for the care recipient/s. Important! Delegates must discuss potential extensions with the Aged Care Complaints Branch in National Office. What can the ACC do if dissatisfied with the Scheme’s response to their direction to undertake a new resolution process? The ACC may, at any time, give a written report to the Minister on any matter relating to the ACC’s functions under Section 95A-11A of the Act. This may include reporting to the Minister if the ACC is dissatisfied with the Scheme’s response to a direction from the ACC. Complaints to the Aged Care Commissioner about the Scheme’s process Who can seek a process examination and when must they do so? Part 7 of the Complaints Principles provides for any party to the complaint to seek examination by the ACC of the Scheme’s processes for handling complaints. The Scheme’s processes may also be examined on the ACC’s own initiative, or at the direction of the Minister. Parties to the complaint have 12 months from the date of the completion of the process to lodge their complaint about the Scheme’s process with the ACC. What actions can the ACC take a process complaint application? Within 14 days of receiving a complaint about the Scheme’s process for handling complaints, the ACC must decide whether to examine the complaint. The ACC may
Service Provider Notifications This chapter provides information about how the Scheme manages service provider notifications during the intake phase. Intake Phase Detailed Assessment Phase Resolution Phase Outcome Phase Chapter contents Section Topic Overview of service provider notifications 9.1 What is a notification? 9.2 Complaints management principles relevant to intake of service provider notifications 9.3 Key activities in managing notifications Activity 1: Receiving service provider notifications 9.4 Types of service provider notifications the Scheme receives 9.5 How the Scheme handles information privacy requirements related to notifications 9.6 Non-compulsory notifications – What is an emergency event? 9.7 Compulsory notifications - What is a reportable assault or unexplained absence? 0 When must service providers make a compulsory notification and who should contact the Scheme? 9.9 What should I do when people report a missing care recipient 9.10 How do service providers make notifications? Activity 2: Escalating notifications to a manager 9.11 Why and when to use an intake escalation matrix (IEM) for notifications 9.12 Important timeframes for Scheme officers to escalate a compulsory notification Activity 3 and 4: Assessing reportable assault information 9.13 Information the Scheme needs to respond to reportable assaults 9.14 Assessing when a service provider is not required to report 9.15 Determining the Scheme’s response to a reportable assault Activity 3 and 4: Assessing unexplained absence information 9.16 When must a service provider make an unexplained absence notification Activity 3 and 4: Assessing emergency event information 9.17 Collecting key information an emergency event notification 9.18 When are emergency events considered significant?
delivery of Commonwealth Home Support Programme services including operational requirements (Part A – The Programme and Appendices), and administration of the Commonwealth Home Support Programme, including funding and reporting arrangements (Part B – Administration of the Programme and Appendices). The manual outlines the services types that are available under the CHSP. These service types are funded under specific Sub-Programmes based on the CHSP 'target groups'. Details of each Sub-Programme, including eligibility and service types, and examples of special conditions for service delivery to 'non-target groups' are also provided in the manual. Note: The CHSP Programme Manual 2015 does not to HACC service providers funded by the Western Australia or Victoria governments. Note: Commonwealth HACC subsidised aged care programmes remain under continuing Funding Agreement requirements and the Commonwealth HACC Program Manual 2012 until 31 October 2015. The scope of CHSP and other service eligibility People who are assessed as eligible to receive aged care or disability services may access CHSP funded services and support in certain circumstances. This is to ensure people can access services until more appropriate care is available. The CHSP Schedule and the CHSP Programme Manual 2015 specify where CHSP service providers can deliver services to clients with other service eligibility. For example, clients assessed as eligible but waiting to receive a Home Care Package or clients of previous programmes (Commonwealth HACC, NRCP, DTC and ACHA programmes) who are not eligible for similar Commonwealth Home Support Programme services will be grandfathered until suitable services become available. Important! Officers need to collect enough information during the intake phase to determine whether a client is receiving CHSP services and thus whether the information is in-scope for the Scheme. The NATSIFACP Guidelines The Residential and Flexible Care Programme - National Aboriginal and Torres Strait Islander Flexible Aged Care Activity Programme Guidelines June 2015, set out the operational and administrative requirements supporting the delivery and management of NATSIFACP. Service providers must comply with the manual's requirements regarding the: The NATSIFACP activities (Activity Overview and Programme Guidelines) Terms and conditions applying to Selection/s, Financial and Other Arrangements, and Complaints. The manual outlines the entity that are eligible to provide NATSIFACP services and the NATSIFACP 'target groups'. Complaints mechanisms and service provider requirements
Home Care Standards (refer to Schedule 4 of the Quality of Care Principles 2014) The Home Care Standards to services under the CHSP. There are three Standards: Effective Management; Appropriate Access and Service Delivery; and Service User Rights and Responsibilities. are 18 expected outcomes: eight management outcomes; five service delivery outcomes; and five service user rights outcomes. Expected outcome 3.3: Complaints and Service User Feedback - Complaints and service user feedback are dealt with fairly, promptly, confidentially and without retribution. Also refer to Expected outcomes 1.3;1.5, 3.1, 3.2 NATSIFACP Quality Framework The standards within the NATSIFACP Quality Framework apply to services under the NATSIFACP. There are two Standards: Care Delivery and Information; Management and Accountability. There are 9 expected outcomes: five care delivery and information outcomes and four management and accountability outcomes. Expected outcome 2.2 Management Systems – Services have an accessible, culturally safe/retribution free complaints and feedback process Charter of rights and responsibilities - residential care or home care (refer to the User Rights Principles 2014) The Charter of care recipient rights and responsibilities - residential care (Schedule 1) and home care (Schedule 2) apply to services under the NATSIFACP. The Charter of care recipient rights and responsibilities - home care (Schedule 2) apply to services under the CHSP. The Charters aim to ensure that clients are aware of and confident in exercising their rights and responsibilities and that service providers understand their obligations. Residential care - (1)(s) to complain and take action to resolve disputes Home care - (1)(6) Comments and Complaints Police Certificate requirements The National Aboriginal and Torres Strait Islander Flexible Aged Care Programme Police Certificate Guidelines, Appendix C of the NATSIFACP Guidelines apply to services under the NATSIFACP. The Commonwealth Home Support Programme Police Certificate requirements, Service providers must ensure that staff involved in service delivery meet police certificate requirements under the relevant programme