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Are Aged Care providers listening to clients and staff?

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This article was first published in the Nov/Dec 2019 print issue of Australian Ageing Agenda magazine and online in Jan 2020.

"Well, we haven’t had any complaints."

It’s a phrase we sometimes hear on the news when a reporter is putting pressure on a company spokesperson about their latest customer service problem. Name an industry and you’ll be able to find an example without looking too hard.

This phrase can reveal significant insights into an organisation’s attitude towards consumer feedback. In my experience, there are three broad scenarios where “we haven’t had any complaints” tends to apply:

  • It’s all good. Things are running so well that nobody at all has any problems.
  • People aren’t telling you about their problems for some reason.
  • You’re not listening – or worse, you’re listening but then ignoring what you hear.

Complaints best-practice research tells us that organisations need more than just fit-for-purpose policies and processes to be successful. Effective complaints management depends on employees’ attitudes and the leadership behaviour demonstrated by their managers.

Ultimately, people’s behaviour towards complaints on a day-to-day basis is what creates an organisational culture that is either welcoming or defensive.

This was discussed by Kate Carnell and Ron Paterson in their 2017 review of aged care quality regulatory processes.

Aged care providers with a genuine commitment to consumer-centred care and improvement recognise that mistakes happen and complaints matter. Rather than fear the consequences, they value learning from complaints and embrace open disclosure, apology and careful attention to analysing and rectifying problems.

Professor Ron Paterson • 2017 Review into Aged Care

With consumer complaints and feedback under the spotlight of both Royal Commission hearings and the Aged Care Quality and Safety Commission, it’s time to take an honest look at how your organisation and people behave when faced with complaints and feedback.


Are you being defensive?

At a personal level, it’s easy to understand how people on the receiving end of criticism and complaints can respond with an emotionally defensive reaction. It takes skill and knowledge to overcome the fight or flight instinct we all have and treat complaints from a different perspective.

Seeing complaints as situations to learn from rather than a threat doesn’t come naturally to some people.

Research also shows that individually defensive behaviour by managers and employees is adopted by the organisation creating defensive organisational behaviour [1].

The Royal Commission hearings have provided examples of this, such as complaints and complainants met with defensive actions and attitudes from people at all levels in some organisations.

With Aged Care Quality Standard 6 focusing on your organisation’s approach to complaints and feedback, it’s vital to identify whether you are acting defensively, and to take actions that change that behaviour if you are.



How defensive organisational behaviour looks

The signs of defensive behaviour can appear in:

  • acquiring complaints
  • handling complaints
  • making use of complaints information.
When acquiring complaints, a defensive organisation may try to isolate itself from complaints and feedback. Examples could include restricting the way complaints can be made, not communicating responsively to complaints received, or failing to make it clear where, how, or to whom people can complain.

Employees might show hostile behaviour towards complainants, such as rudeness, dismissive attitudes, denying responsibility for registering complaints or blaming complaints for the failure. This results in the second scenario in my initial list above as complainants will respond by not telling you about their issues, as they have no faith that the organisation will take it seriously or respond appropriately.

We know this happens in aged care because both the Carnell-Paterson review and Royal Commission heard evidence that a ‘culture of fear’ exists among consumers and staff. Fear is a strong word, but the evidence shows people are genuinely concerned that raising a complaint may lead to some form of retribution being taken against them or others.

The Carnell-Paterson review cited 57 percent of aged care workers were afraid of fear of retribution if they made a complaint.

Now I’ve never seen vengeance listed in any organisation’s corporate values so there must be a serious disconnect between policies on paper and people’s behaviour on the ground for this situation to arise.

If complaints aren’t avoided, defensive organisational behaviour may restrict the transmission of complaints to an organisation’s managers and senior executives. Where complaints do get through, there may be bias or distortion in the information transmitted to managers.

Other research studies have clearly demonstrated that employee and managerial attitude towards complaints is directly connected to the amount of information about complaints that flows through an organisation’s chain of command.

It’s also clear that this is an area where a manager’s behaviour and actions directly influences their employees. Management leads by example and employees are constantly watching managers’ behaviour and attitude towards complaints. They’ll follow the example they see. Again, evidence of this situation was given to the Royal Commission.

Finally, we can see defensive behaviour in the way an organisation utilises complaints and complaints data. Inadequate handling of complaints, a lack of analysis of complaint trends and root causes of dissatisfaction, and a failure of those in leadership positions to use complaints data effectively for decision making or to make improvements are all symptoms of defensive organisational behaviour.

That covers off the third scenario in my initial list. Hand on heart, do any of these situations ring true in your organisation? Or maybe you haven’t had any complaints?



Creating a positive complaints culture

Aged Care Quality Standard 6 reflects best-practice based on the AS/NZ 10002 Australian Standard for Complaints Management. This is a world-leading international standard that comprehensively covers all aspects of organisational complaint management.

In reality, whilst values and processes are an absolutely essential start, achieving cultural change requires people to take individual action that changes what they do day-to-day. Without individuals doing things differently, better practice remains confined to a policy document, divorced from the reality of the consumer experience.

Changing defensive behaviour starts with leadership from the top, but cultures only change when people believe in the message, not because managers tell them what to think.

Use this quick self-assessment checklist to test whether your organisation is delivering complaints best-practice or acting defensively.

Can you see evidence of:

  • leadership by example, based on a convincing belief in the value of complaints
  • open and transparent communication, making it easy for people to complain
  • clear policies, procedures and processes, followed in practice
  • consumers and staff readily offering feedback, without fear of the consequences
  • opportunities to participate in lessons-learnt exercises, analyse problems and propose solutions
  • leadership by example, based on a convincing belief in the value of complaints
  • independent, unbiased collection, reporting and analysis of complaints data
  • information about things that went wrong and what’s being done to resolve it
  • support, education and training emphasising the value of complaints for learning
  • staff performance mechanisms that reflect in practice policies written on paper?

Ideally, you want 100 per cent of dissatisfied people to tell you what’s wrong. Complaint numbers will go up, but it’s what you do about them that counts, not the number you receive.

Don’t be afraid of more complaints – welcome and encourage them. It’s only by listening that you can learn how to improve service delivery for everyone.


References

  1. Homburg, C. & Fürst, A., 2007. See no evil, hear no evil, speak no evil: a study of defensive organizational behavior towards customer complaints. Journal of the Academy of marketing Science, 35(4), pp.523–536.


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