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Review into CIS calls for new scheme

Review finds a separate commission would remove concerns around Department’s conflict of interest.

The Complaint Investigation Scheme (CIS) should be abolished and replaced with an independent authority, the review into the CIS has recommended.

The Aged Care Complaints Commissioner, appointed by the Minister for Ageing, would be responsible for the independent body known as Aged Care Complaints Commission.

The review into the CIS, authored by Merrilyn Walton, associate professor of medical education at the University of Sydney, found a separate commission would remove any concerns of partiality or conflicts of interest that surrounded the scheme.

An independent professional organisation dedicated to the role of complaints is necessary to meet growing community expectation, the review found. The large and complex bureaucracy of the department currently lacks the resources and focus to fulfil this role.

“Over the last four years the issue of independence or perception of independence has not receded with the introduction of the CIS; rather the call for an independent complaint body has consolidated,” said the review, released by the Department of Health and Ageing.

While there was a strong voice for an independent complaint scheme in the 2005 Senate inquiry into aged care, that inquiry fell short of recommending a separate body.

An independent statutory authority, separate to the department which primarily funds and regulates aged care, will remove concerns about the impartiality or unreliability of decisions that arise from the scheme’s current structure.

“The stakes are high for the complainants in a complaint investigation and when the same organisation is responsible for all the regulatory functions it lessens the will or capacity to admit failures and commit to improvements,” the review said.

“Any complaint scheme requires transparency in its processes to engender trust from all the parties as well as the community; when complaints reside in the organisation responsible for overall quality of the services that may be subject of complaints, there is incentive to limit data about complaints, the main areas complained about and the problems in the public arena.”

During the review’s consultation concerns were expressed regarding the ability to achieve high quality outcomes in view of significant workloads and competing priorities of CIS staff.

Walsh said more specific and ongoing training is necessary, including an in-house investigation training program and improved clinical advice from doctors and nurses to assist in assessment and early resolution.

An aged care complaints risk assessment framework would also assist officers to determine the most appropriate method for resolving complaints.

Following a principle of natural justice, Walsh said a provider must be given an opportunity to respond to a complaint before deciding that the provider has breached its responsibilities or a notice of required actions is issued.

Last week, the government announced a $25 million investment to improve consumer focus and to strengthen protections for residents which will include improved access to mediation and conciliation services as part of the complaints process.

Additional resources would also aim to reduce case loads in the current scheme and improve the timeliness and thoroughness of investigations.

Over the next four years, the government will spend $22 million to protect monies held in refundable accommodation bonds.

The legislative reforms will increase the accountability of providers by clearly articulating the permitted use of bonds and improving reporting requirements.

The full CIS review is at www.health.gov.au/internet/main/publishing.nsf/Content/ageing-review-cis.htm

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