The current Aged Care Complaints Investigation Scheme is the third reincarnation of a complaints scheme for Australian aged care. It is managed by the Office of Aged Care Quality and Compliance (OACQC), and was set up as a result of the rape allegations fiasco in a Victorian nursing home under Santo Santoro's time as Minister for Ageing - back in 2006. Unfortunately this, along with the previous complaints schemes, has been generally ineffective in enforcing the laws and protecting residents from neglect and abuse.

On paper, the complaints scheme sounds effective, but there are many problems. Interviews with current and former nursing home employees, family members, nursing home reform activists, resident advocates reveal that neglect and abuse or a pattern of poor quality of care is not always detected and remedied.

The complaints investigation process rarely seems to substantiate the submitted complaints. Unless the investigator finds a "smoking gun," the complaint will usually remain unsubstantiated. Therefore, if a family member files a complaint with the scheme, it is important to have documented the problem thoroughly. This includes noting names of staff and the dates and times of incidents. If possible, take plenty of photographs showing the result of neglect and abuse of the elder such as bedsores or bruises, etc.

Even those nursing homes where the accreditation agency has discovered poor quality of care do not always change poor practices. The reasons for the failure of accreditation of nursing homes are numerous. The following are some of those reasons:

• Many people are shocked to learn that a proportion of visits from the agency are known.  
• Because of the advanced knowledge (eg, particularly when the accreditation process is imminent), staffing and supplies are often increased dramatically during accreditation to give the auditors or investigation officers the illusion that the facility has sufficient staffing and supplies to provide good quality of care. This charade only lasts as long as the assessors or investigators are in the facility. Staffing and supplies disappear quickly once the assessors or investigators leave.
• Corporate pre-survey teams and/or aged care consultants descend on a nursing home to prepare for accreditation.
• Meetings are held with nursing home staff prior to a survey to lay out the ground rules such as advising the nursing staff they should not communicate with the assessors or investigators.
• Assessors or investigators can only go by what they observe and see in the records. Complaints by family members and/or staff of poor conditions in a nursing home are often ignored by the investigators or assessors because they can not "see it" or "find it" in the records.
• Since charting of resident records are done mainly to satisfy assessors, many of the charts have been described by employees as a "good work of fiction." Care is often charted as being provided when it has not such - for example the turning and repositioning of residents every two hours, adequate bowel care, grooming and oral care. Also, the percentages of food eaten are sometimes overestimated and, therefore, inaccurate. Resident charts are relied on by the assessors when they are reviewed. Certain records might be hidden during accreditation - or sent interstate to "head office".
• When there are deficiencies, the nursing home can submit a "corrective plan of action" that appears good on paper, but might not be enacted. Deficiencies might be repeated each year with the same "corrective plan of action" submitted.
• Serious deficiencies are often appealed by the nursing home through various means, such as appealing against any sanctions that may be applied by the accreditation agency. 
• Diligent assessors may be pressured to back off nursing homes when they find serious problems.

Complaints FAQs

How do I know how many complaints have been formally lodged against a facility?

There is no provision under current legislation that allows access to this information.

Where do I find the latest statistics on how many complaints have been lodged with the "new" Complaints Investigation Scheme?

A six monthly report (1 Jul 07 - 31 Dec 07) on the operation of The Office of Aged Care Quality and Compliance (OACQC) was published on the Department of Health and Ageing's website in April of this year.