Make A Complaint

Complaint Form

Complainant Details

Complain in Relation To

Accommodation Support

Institution / HostelCommunity ResidentialSupported Community Living

Therapy and Day Options

Disability Professional ServicesDay Options

Local Area Coordination

Respite and Family Support

Family Support and RespiteCareer and Family SupportOther Support

How is the Service Funded?

Western Australian State GovernmentNational Disability Insurance Scheme (NDIS)Other

Which Disability Service Standard/s does the complain relate to?

RightsIndividual OutcomesService AccessParticipation and InclusionFeedback and ComplaintsService Management

Staff Related Issues

Knowledge / Skills of workersStaff behaviour / AttitudeConcerns around discimination, abuse, neglect, intimidation, assault, bullyingPoor match between person and workersHigh turnover of workers / Staff rostering / Staff attendanceOther

Services Delivery, Management, Quality and Standards

Concerns around physical and personal health and safetyConcerns around compatibility of people who shares servicesConcerns about lack of choice of service / activitiesDissatisfied with quality of services providedInsufficient service / care providedThe provider does not encourage people to develop or maintainThe provider does not encourage people to be involved in the communityOther

Communication / Relationships

Insufficient communication by service providerPoor quality communicationOther

Service Access, Access Priority and Compatiblity

Wait time to access servicesCost of service / Funding issuesRequest for service refues as not assessed as having a disabilityRequest for service refused as not considered priority for access to servicesRequest for service refused as not compatible with level / type of person's disabilityRequest for service refused as not compatible / poor relations with other people sharing the serviceTransport issue(s)Other

Policy and Procedure

Concerns about policies / proceduresPrivacy / Breach of confidentialityThe way complaints have been handledOther

Carers Charter

Failure to consider needs of carerFailure to consult carerFailure to treat carer with respect and dignityUnsatisfactory complaint handlingOther

Other reasons

Other

How serious were the reason(s) for the complaint?

SeriousLess Serious

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