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Nicole (care worker in her own home): Hi mum. Yep, yeah, I'll be there and pick you up.
Plane lands at 4:25 right?
Answering machine: Thank you for calling. The number you've dialled is currently busy.
Nicole (care worker in her own home): Hi Sarah. Yeah, dreadful. I'm waiting for a modem to
be delivered. It was meant to be here at 11 and it's now 2.30. Yeah, I'm going to have
to complain.
Narrator: We're all consumers and when a product or service isn't up to scratch, we all have
a right to complain. The scenario we've just seen had a service provider not meeting expectations,
a common reason why people make complaints. 10 3:05 --------- 3:07 Nicole (care worker in her own home): Hi, look, I was actually having a modem delivered
this morning. Your letter said between 7 and 11. I actually waited home until 2.30 and
had to go out to the airport to pick my mother up. I'm actually really annoyed.
Narrator: As consumers, there are many systems and processes that let us voice our complaints
and have them responded to seriously. Not everyone finds it easy to complain.
Some people are naturally shy. Complaining can also be difficult for those whose English
isn't good.
People from different cultural backgrounds and those who feel vulnerable, and that can
include older people may fear what might happen if they voice a complaint.
As stated in the Community Care Common Standards, which we'll refer to simply as the Standards,
aged care service providers and their employees have a variety of responsibilities around
complaints handling and the rights and responsibilities of clients. We'll explore these in today's
program.
First of all, what is a complaint?
A complaint is defined as expressing dissatisfaction or concern about something. A concern can
include one or more issues, which, if not addressed, can escalate into a complaint.
Clients make complaints about the care they're receiving to fix issues which are affecting
their lives.
A complaint can be made by anyone - the client, or the client's family members, friends, representatives
and advocates, as well as aged care staff, carers, health and medical professionals and
volunteers.
Service providers are required to have a complaints system that clients are made aware of, a system
that is accessible and that makes it simple and easy for clients to give feedback. Feedback
about services, including complaints, can be made verbally or in writing.
Complainants can raise their concern with anyone from the service provider in person,
by phone, using a feedback form or by letter. Service providers are encouraged to resolve
complaints within the service.
Fixing the problems directly can help to build more effective relationships by finding timely
solutions that can be sustained in the longer term.
In cases where the service cannot resolve the complaint despite genuine attempts to address
it, a complainant can contact the Aged Care Complaints Scheme.
The Scheme provides a free service for people to raise their concerns about the quality
of care or services from an Australian Government subsidised service.
Clients have the right to complain about various aspects of the service they're receiving,
from issues relating to fees and charges to food, cleanliness, safety, comfort or choice
of activities.
It's important to remember that things that seem small can be important to a client. The
first scenario we saw showed that even a late delivery, which may seem minor, can ruin someone's
day. Clients receiving care, like all consumers, have a right to complain when the service
isn't up to standard.
That right, the Charter of Rights and Responsibilities for community care, includes the right to:
Complain without fear of losing care or being disadvantaged, have complaints explored fairly
and confidentially and have appropriate steps taken to resolve issues of concern.
We'll be using several scenarios in today's program drawn from real life situations to
demonstrate the steps and actions that carers and their organisations can take when they
receive complaints, ranging from the simplest to a more complex case.
Audrey (care recipient): Sorry, Nicole, you've rushed through that a bit. There's still some
dirt left under the table. My cleaner used to put the chairs on the table before she
swept.
Nicole (care worker): I'm sorry, our policies and procedures say we're not allowed to pick
up furniture for safety reasons.
Audrey (care recipient): But the floor's still dirty... that's where everything falls. This
happens every week and I'm really not happy.
Nicole (care worker): Yes, I see that, now. How about I move the chairs out individually
and sweep underneath. Would that work for you?
Audrey (care recipient): Yes thanks. That would be a lot better. It's just that I can't
get down any more.
Nicole (care worker): Is there anything else you're not happy with?
Audrey (care recipient): Well, now that you mention it, would you mind not leaving the
dish cloth crunched up. Just hang it over the top so it dries. I know it
doesn't sound like much, but you get used to things a certain way and... it's the way
I like it.
Nicole (care worker): Yeah, that's okay.
Narrator: In many cases, if care workers talk openly about small issues with clients, make
compromises and respond to concerns, it can prevent small problems getting out of control.
There are a number of steps to be followed when a care worker receives a complaint.
Each organisation will have a different complaints handling policy that care workers are required
to use. Often, care workers will need to refer to their service's policy, provide the client
with an outline of the complaints process, notify their supervisors of the complaint,
update the client on its progress and discuss with their supervisor how to work with the
client while the complaint is being handled.
As the first point of contact, the care worker may need to actively listen to the client
and reassure them that their concerns are being responded to.
Nicole (care worker): Audrey, I'm just writing in your notes to let your other carers know.
Also thank you for the feedback. It's helpful to know because I want to
do a good job.
Audrey (care recipient): Yes I'm sure you do.
Nicole (care worker): Ok, I've got a complaints and feedback form here, if you'd like to fill
that in for me. And while you're doing that Iím going to go out and call my supervisor to let her know.
Narrator: Some complaints are more easily resolved than others but all clients need
to be heard. In this instance, Audrey's expectations were different to Nicole's.
People often think of complaints as a negative, but an effective complaints management procedure
has benefits for everyone involved. Clients have the right to have their concerns heard,
looked at and fixed.
Looking into complaints often involves active listening by the carer, which promotes trust
and mutual respect between carers and clients.
It's also an opportunity to reach the best outcome quickly for both parties preventing
smaller issues from escalating unnecessarily. When handled effectively, complaints improve
relationships between clients, carers and the service encouraging a culture where complaints
are seen as positive and carers are happy to help clients to make complaints.
The feedback is also an opportunity to improve the quality of care and service being delivered
which can improve relationships within the service as well, when staff are actively involved,
working together to reach a good outcome.
To summarise, an effective complaints handling system allows clients to be heard, promotes
mutual respect and builds trust, improving relationships between clients, carers and
the service.
Effective complaint handling also enhances the services by preventing issues from escalating,
achieving timely and sustainable outcomes and identifying opportunities for improving
systems.
Nicole (care worker): Clients complain because they're unhappy about something. They want
us to listen to them and they also want the problem resolved. A complaint is a really
positive thing, we're able to listen to clients' concerns and problems and help them to resolve
the issues.
Di (coordinator): When a client asks for additional tasks to be done that aren't on the task list
and are not on the agreed care plan then we do ask the direct care worker to feed back
directly to us in the office what the client is requesting. The task list is a really detailed
list of what the care workers do for a client. So if they're unsure, it's very important
that they ring the office and ask for clarification. We need to be really up to date on everything
that direct care workers are doing for clients.
Audrey (care recipient): I was a little apprehensive. It was something that I knew I needed to say
and I was a bit nervous about saying it but she made it easy. She found a way that she
could help me and she handled it quite well.
Narrator: Of course, not all concerns can be resolved on the spot. Many are reported
directly to the organisation and require the involvement of the care worker's managers.
Whether a complaint is raised by the client or a family member, friend, or representative,
it's critical that the client is involved throughout the process in resolving the complaint.
Helen (coordinator): Hi, Miss Jones, it's Helen calling from Villa Maria. I just wanted
to speak to you regarding the letter that you sent us about the care support that your
father's receiving. I'm so sorry to hear that. Look, I've made notes and I'll certainly
speak to the care worker about it. Thanks so much for bringing this to our attention
- we'll get onto it straight away. Yep, I'll let you know how we plan to resolve it and
will also make sure that your father, is involved in the resolution process and satisfied with
the outcome. I'll speak to you soon. Thanks again, Miss Jones. Bye bye!
Di, have you got a minute? (Yeah sure) There was something I wanted to discuss with you
to see if you can help me to resolve it. That was Mr. Jones' daughter. She said that Di
has been arriving late.
Di (coordinator): Oh dear, that really is not acceptable. We probably need to
speak with Di about it. It's possible that there's an explanation.
Helen (coordinator): Will do, I don't think she fully understands the effect that it has
on the client. Apparently Mr. Jones was waiting for her to come and shower him and because
she was late, he didn't end up having his shower and he was going to his GP appointment.
His daughter said he felt really ashamed, he thought that the GP would think he was not looking after his
personal hygiene and just came out dirty on purpose. I think I'd better give her a call
Narrator: We would all feel terrible if we had to go out unwashed. It would take away
our dignity because we'd worry what people would think of us. In this scenario, Di's
supervisor Helen discussed the matter with her privately in her office.
Di was consulted to understand what was causing the problem, the impact it had on the client
was explained to her, expectations were clarified and arrangements were made so that the client's
needs and expectations would be met in future. When complaints are handled well, there are
benefits for clients, the service, and the care workers.
Di (care worker): I didn't realise how much of an impact it has on the client, Helen.
I apologise. It won't happen again.
Helen (coordinator): That would be great. Thanks Di.
Good morning Mr. Jones, it's Helen calling from Villa Maria. How are you today? Good to hear.
Look I just wanted to let you know that I've had a chance to speak to Di, your support worker
and she has assured me that she will endeavour to be on time from now on.
Yep, that's fine. And look, we're hoping to come out and see you tomorrow, the both of
us, if that suits you.
Oh fantastic. OK now I just wanted to let you know that we'll make a call to your daughter
to let her know how we've addressed the issue.
Narrator: Complaints can provide feedback on the performance of a care worker, helping
service providers improve by increasing staff training, allocating extra resources and reassessing
clients' arrangements.
It improves client trust in the organisation because they know their complaints are heard
and acted on and it promotes staff relationships with care workers as they are consulted throughout
the process.
Michelle (coordinator) If there's one thing that would eliminate a lot of problems, I
think it would be to emphasise to care workers to follow their rosters, follow their care
plans and task lists and to use feedback to help to deliver a better service and
really listen to what the client is telling them, and consider the clients' feelings.
A good feedback system just helps us to give better care to the clients, being able to
know where they are at at any one time with their general wellbeing and just being able
to make sure that all people involved in their care are aware of what's happening
at any time.
Di (care worker): I view complaints as positive because I see it as a chance to improve on
my caring abilities.
Narrator: It's important that care workers understand that when something has to be done
differently, it's just an opportunity to improve. There are many ways of managing client expectations.
And not all complaints received by service organisations are to do with the actions of
care workers but can be about how the arrangements in place can work better.
Kathleen was relieved and excited when her GP referred her to the Aged Care Assessment
Team who found her eligible for a variety of services under the Community Aged Care
Package. But after a few months, Kathleen was no longer as happy.
Lesley (care worker): Kathleen, can I have a word with you, please?
Kathleen (care recipient): Yes of course, what is it?
Lesley (care worker): Have I done something to upset you? You seemed a bit unhappy yesterday.
Kathleen (care recipient): Oh no. No. It's not you, it's me. It's because I always do
my meditation at the time that you come and I do like to do it. I wondered if it was possible
that I could have a different time, that you could come to me at a different time. Don't
think I'm not grateful for what you do, because I don't know what I would do without you.
Lesley (care worker): Thank goodness you've told me Kathleen. I thought that I'd done
something and you weren't going to say anything.
Kathleen (care recipient): Oh, no, dear. Not at all! I thought I'd get used to it but I
didn't and so I didn't say anything because I didn't want all my services taken away and
that was what I was afraid of. It's not that I don't want you to come out, I don't want
you to come so early.
Lesley (care worker): I'm sure we can fix this up for you Kathleen -- don't worry no
one's going to take anything away from you. We've got Standards in place that won't penalise
you for speaking up and there is a process that we follow so we know how to handle things.
Okay, the first thing we're going to do is, we are going to look through this brochure
and feedback forms. Do you remember the feedback forms and leaflets we gave you for complaints at our first meeting?
Yes, I do. After this we'll call my supervisor and we can make arrangements
that will suit you better.
Narrator: Lesley has handled this situation well. He has thanked Kathleen for speaking
up, understood her concerns, documented the complaint, assured her there will be no negative
consequences for raising her concern and informed her of the steps that will be taken.
Care workers have an important role to play in the complaints handling process.
Every service provider has its own guidelines and processes, but in general, care workers
should help clients make complaints by listening in a non-judgemental way, providing clients
with the information and materials they need to make a complaint, documenting and reporting
complaints to their supervisor and making sure they respect the client's - or their
representative's - right to complain and the client's rights to privacy, confidentiality
and dignity.
It's important to reassure the client that they won't be penalised for complaining as
many older people may worry about what will happen if they speak up.
Kathleen (care recipient): She said she would come and see me and to adjust things so that
the timing works better for me. And she said that I can phone her at any time for anything
that I need. (That's good) I'm so happy I said something -- I never thought it would
be this easy.
Narrator: Care workers aren't the only ones that have responsibilities about complaints
handling. Service providers also have processes to follow for handling complaints.
They must review and respond to all complaints quickly. This includes clarifying the issues
and expected outcomes with the complainant. They must keep an open mind and treat everyone
concerned with respect. As we saw earlier, small issues can have a major impact.
The organisation should involve all parties when looking into the complaint and in the
approach they take to resolve the issue.
They must actively involve the client even if the client isn't the one making the complaint.
The organisation must give clear feedback to the complainant, including possible solutions,
next steps and further options. In more difficult complaints, the provider should develop a
plan so everyone can see how the complaint will be addressed.
Complaints provide opportunities for continuous improvement. Issues raised may affect more
than one client or trends may be developing, which if resolved effectively, can help improve
systems within the service. Following an effective complaints handling process can save the organisation
time, effort and money and improve client services.
Lesley (care worker): Client feedback improves services because it builds trust between me
and the client. We also get to know exactly what the client needs. It resolves the issues
before they become greater. Clients complain either by telling me directly.Other times
family members might tell me, or otherwise I might notice something is wrong and I initiate
a conversation with them.
Look, whichever way, it's good to know when there's something wrong.
If a new care worker gets a complaint, I tell them to listen carefully, not to take it personally.
You need to make sure that the client feels that they can trust you to help them. If it's
something urgent that needs addressing then inform your supervisor.
Di (coordinator): If a service user needs to feed back something, we encourage them
to do that directly. We ask the direct care workers to support the service user in doing that.
That might mean giving them, encouraging them to ringing us immediately, perhaps even
dialing the number if the service user isn't sure. Direct care workers also carry with
them feedback forms that they can offer to the client and encourage the client to complete
it and send it to us.
Kathleen (care recipient): On their first visit when they came, they gave me these pamphlets
to look through, which I did, and one was for common rights and the other was for Your
Opinion Matters. And, I was really interested in that because it does matter.
The case manager comes round every six weeks and asks me if I'm happy and if there's anything
that can be improved. And, I'm so glad about that because it's a nice thought. It's not
such a big deal because they ask you all the time. And so it's quite easy.
Narrator: Many, if not most, complaints can be handled internally by following the processes
we've outlined in today's program.
But sometimes, despite the service provider's best efforts and those of the care worker,
a complaint needs to be referred to the Aged Care Complaints Scheme. In this scenario,
Andrew, who receives services under a Community Aged Care Package, has lodged a complaint.
While his care worker, Di, was fulfilling her duties under Andrew's Care Plan, Andrew
couldn't understand why Di wouldn't also walk the dog and water his plants. Some clients
may find it hard to understand why carers can't always agree to their wishes.
Today, Di has brought her supervisor, Helen, to explain things to Andrew as Andrew has
not been satisfied by a previous phone conversation and other steps taken by the service.
Andrew (care recipient): Well I've asked Dianne to take Lucy for a walk and to water my plants
and she's refused, saying that she can't do it, or something.
Helen (coordinator): Ok. Well I've been looking at your Care Plan that you would have been
a part of putting together and neither of those two items are actually listed as part
of your needs and goals so therefore they wouldn't appear as tasks on Di's task list.
Andrew (care recipient): But, can't she just do it while she's here?
Helen (coordinator): I have actually been speaking to our regional manager and we have
been trying to resolve your issues but I think we've reached a point where we really need
to contact the Aged Care Complaints Scheme to try and help resolve the issues you're
having. These are some brochures that will help explain all about the Aged Care Complaints
Scheme. They are very good and will help work through the issues and try and bring about
a good ending for all of us. Does that sound like a good idea?
Andrew (care recipient): Do I have to do it on my own?
Helen (coordinator): No, you can have a friend or a family member or an advocate come and
help speak on your behalf. All the information you need is in these brochures, the phone
numbers, the contact people, everything's there. We can assist you with it, if you would
like?
Andrew (care recipient): I think I'd like that.
Tim O'Mahony (Scheme Officer): Hello, Mr. Dobson. What can I do for you today?
Narrator: Andrew was entirely satisfied with his experience of the Scheme. He agreed to
be reassessed and the services that the organisation can provide were better communicated to him.
Complaint handling by service providers is governed by the Community Care Common Standards
which sum up the information in today's program.
The Charter of Rights and Responsibilities for Community Care states that, 'Each user
and/or their representative' has the right (and responsibility) to have access to complaints
and advocacy and that complaints are dealt with in a way that is fair, prompt, confidential
and without negative consequences.
The Standard also states that complaints, and actions taken in response to complaints
including changes to the service, should be regularly reported to the board, management,
and senior executives to achieve continuous improvement.
In situations which have been more difficult for clients and providers to resolve the Aged
Care Complaints Scheme can assist in resolving concerns. Tim O'Mahony is a NSW Scheme Officer.
Tim O'Mahony (Scheme Officer): The Scheme comes into play when a service provider has
been unable to resolve a concern of a complainant and the Scheme will come in to assist in resolving
that and coming up with, I guess, an agreement between the different parties.
If a service provider is unable to resolve the complaint themselves, they should be helping
clients to be able to raise concerns with the Scheme.
And, once this is done they will be able to work closely to resolve those concerns with
both the service provider and the complainant.
Anyone can access the Scheme. So it can be someone who is receiving care, as long as
they're receiving care in an Australian Government subsidised service they can raise a concern.
Their representatives can raise a concern. We can have health practitioners raising concerns
or even a staff member of that service is able to raise concerns with us and we'll follow
those through.
Before people contact the scheme, it's really good to think of some concrete examples of
their concerns, if they can think of things like the time, the place and the person involved
in their concerns. Also, any previous contact you've had with the service provider to try
to resolve your complaint is really useful.
Finally you can visit our website, www.agedcarecomplaints.govspace.gov.au or call our information line on 1800 550 552.
People who have used the Scheme tell us they're very satisfied with the outcomes that we achieve,
they find that we have a timely resolution and also that we also act fairly. We don't
take sides.
On top of that, they find that we keep them updated throughout the process so they understand
what's happening at every point in time.
We encourage service providers and clients to resolve concerns locally. However, if this
doesn't work, we are able then to come in and help to resolve complaints in a timely
manner to mutually beneficial outcomes to ensure the health, safety and wellbeing of
care recipients.
Narrator: The Scheme is also developing a Complaint Handling Toolkit to support better
practice in complaints handling within aged care services. The toolkit will consist of
a variety of printed and digital resources to assist aged care staff to effectively handle
complaints within the service. There's a lot of nervousness around the complaints process.
People often don't want to make a complaint and people certainly don't want to be complained
about, but there are important benefits that flow from an effective complaints handling
process.
Andrew (care recipient): I was pleased, I felt like I had a voice. I felt that they
listened to what my concerns were and they explained just exactly what was going on.
I felt that they addressed all the concerns that I raised and addressed a lot more as
well, I now understand the process.
Narrator: And as carers, that's what our job is all about - helping older people and improving
their wellbeing.
Lesley (care worker): If a new care worker gets a complaint, I tell them to listen carefully,
not to take it personally. You need to make sure the client feels they can trust you to
help them.
Di (care worker): As a carer, you like to see people improve in their wellbeing so they
can get back to life and be comfortable with it again.
Nicole (care worker): My job as a carer is to look out for clients' wellbeing.
Kathleen (care recipient): Well, it's extremely important because it keeps you still as an
individual. It means you don't have to go under and accept. We all want to be individuals
all our lives. Not just at the beginning and in the middle bit, you want it in our old
age as well. To be an individual you've got to be able to say your piece and that's excellent