Level 2 complaints 104-02040000

Quality checking ensures appropriate standards and integrity are developed and maintained and is an effective tool for managers and business owners to assist with:

• assessing data quality
• monitoring the integrity of the business process end-to-end
• identifying weaknesses in the interpretation and application of business rules, policies and procedures
• measuring alignment with the principles of the Services Australia Customer Complaints and Feedback Policy
• monitoring of trends
• identification of systemic issues and individual or team training needs
• developing and implementing strategies to address identified issues

Quality checking for Level 2 complaints includes:

• pre-finalisation checks for all complaints from identified customer groups
• checking a sample of complaints and feedback outcomes for every Complaints Officer to assess whether relevant policies and Operational Blueprint content have been appropriately applied
• targeted checks and decision monitoring evaluation across Escalated Complaints
• communicating quality checking outcomes to the Escalated Complaints team for review, training and implementation of improvement processes

Note: the following does not apply to Child Support.

Program Managers allocate decisions to quality checkers for checking from the monthly Customer Feedback Report and record the sample selection to ensure a complaint from each Level 2 Complaints Officer is quality checked.

The quality checker:

• opens the Escalated Complaints QA Survey and completes the mandatory identifying information prior to commencing the checks
• assesses the complaint using resources such as:
• legislation referenced in or relevant to the decision located in the Guide or Federal Register of Legislation, see the References page
• Operational Blueprint
• other relevant approved agency resources
• completes all relevant evaluation questions detailed in the Survey to assess if the decision/process has been actioned in accordance with all relevant legislation, policies and procedures
• completes the evaluation questions to determine if a critical error has been made:
• a critical error is one which has the potential to adversely impact the customer, for example where incorrect figures have been used in calculating the decision, or where the customer hasn't been afforded procedural fairness as the required contact attempts have not been made
• a non-critical error is one where the impact on the customer is much less, for example where there are typographical errors in the decision or where the error doesn't impact on the final outcome
• submits the results once all evaluation questions have been completed

The results of the quality checks are recorded in a pre-shared quality assurance survey sent to Quality Checkers. The survey form is linked to a file that stores all of the information provided during a check. This provides visibility of all checks undertaken and allows for further analysis of quality checking results in their entirety.

Recording the results also assists in the evaluation of specific questions or processes undertaken and checked.

The outcomes recorded from quality checking inform a database which records all outcomes and comments made. Additional analysis of the information stored in the database is completed regularly to:

• identify trends
• determine root causes and underlying factors
• identify systemic issues
• identify gaps in business processes

The information captured in the quality checking processes determines if further analysis is required at the time or in the future.

The quality checking process is not complete until feedback has been provided to the original decision maker. Feedback provides an opportunity for open and honest discussion and an opportunity to identify further training that addresses development needs. It may also assist in the identification of gaps in processing knowledge or relevant procedural instructions.

The quality checker:

• provides immediate feedback after the quality check has been completed if a critical error is identified
• provides feedback within 21 days after the quality check has been completed via the auto generated email which results from each quality assurance evaluation
• includes positive feedback to the Complaints Officer for those interactions identified as error free. Quality checkers should make particular note where an officer has managed an aspect of the case particularly well
• provides feedback to the Complaints Officer's Team Leader where feedback includes identified errors, providing all details to the Team Leader so they can discuss with their officer

Team Leaders:

• identify why the error occurred
• the description of the error, and
• appropriate corrective action

In order to provide quality assurance on the checking process a regular check the checker process is conducted. This includes:

• annual calibration exercise - a small sample of finalised cases is provided to all checkers for completion. The outcome of these results will be compared for consistency and discussion held on items where variance occurred
• for new checkers - in their first round of quality checking, 3 of the quality checkers completed evaluations are checked by an existing checker to confirm checks are being undertaken in a consistent manner

Complaints can help business areas improve the services provided. Resolving a person's complaint is not the last step in the process. The complaint may point to a systemic or administrative problem within a business area or the customer may suggest ways to improve service delivery.

A systemic issue is a problem or error that has the ability to reoccur and impact business if not addressed. It has the potential to affect a customer base, business area, product or service, or the agency as a whole. A systemic issue is a problem due to issues inherent in the overall system, rather than due to a specific, distinct isolated factor. The 'system' can be a process, policy, how a service was delivered or an entire service delivery program.

Decide if the issue is a potential systemic issue:

• Is the problem related to 1 of the agency’s customer information and processing systems, for example, Customer First, CICS, CDMS, PDS or Cuba?
• Is the issue about a telephony system and is it case specific?
• Is the issue related to internal or external policies, procedures (including work practices and tools) or legislation?
• Is it only affecting 1 customer? Or is there a possibility that other customers are or will be impacted?
• Is the agency’s reputation being affected or is it likely to be affected and should you report it?

Sometimes an issue is known to the business owner and does not have to be reported.

Complaints Officers should:

• Review the Operational Messaging System updates for information about issues impacting on the agency’s products and service delivery
• Search in the Network News Update (NNU) for ICT system related information

Potential systemic issues can be identified when managing a complaint that has come straight to Level 2 or a complaint that has been escalated from Level 1.

For Centrelink and Medicare Level 2 Complaints Officer, report the issue to the Systemic Issues Resolution Group (SIRG) representative.

In the Customer Feedback Tool:

• select the Potential Systemic Issues check box if using the Guided Procedure to record the complaint
• record all details of the possible systemic issue in the feedback details free text box
• record any suggestions provided by the complainant to resolve the issue or improve the agency procedures, legislation or policy

For Child Support Level 2 Complaints Officers, report the issue to the Systemic Issues team by completing the systemic issue template and sending the issue to the mailbox. If it is determined the issue is a potential systemic issue, it will be recorded in the Systemic Issues Register (SIR).

If it is not possible to escalate an issue to a Systemic Issue representative in a reasonable timeframe due to the urgency of the issue, send an immediate email to your Service Support Manager or Program Manager.