Complaint Policy

Definition:

A “complaint” is an expression of dissatisfaction related to the services and/or supports provided by Humana Community Services. A complaint may be expressed by a participant receiving service, a person acting on their behalf, or by the general public. A complaint may be made formally (such as a letter written to the agency) or informally (such as a verbal complaint expressed to an employee). A complaint as contemplated by this policy does not include feedback on matters unrelated to services and/or supports provided by Humana.

Policy Statement:

All staff at Humana Community Services advocate for the best interests of each program participant and reinforce the participant’s right to be heard. Program participants have the right to be informed about the complaint process and may raise complaints or concerns at any time without fear of reprisal. Persons acting on behalf of the participant may also use the complaints procedure on behalf of the program participant. At the point of admission and again no later than seven days from admission into every program or service, each participant and their parent/legal guardian/SDM are informed of their rights and responsibilities and how they can express their viewpoints, concerns and complaints about services or a violation of the participant’s rights. Procedures for both internal and external complaint mechanisms are shared. This material is presented again at one (1) month, two (2) months, three (3) months, six (6) months from the date of admission and every six (6) months thereafter or upon request. Each conversation about this topic is documented in the case record.

Humana Community Services is committed to responding to all concerns in a responsive, efficient, confidential and respectful manner. Humana’s aim is to resolve complaints as satisfactorily and expeditiously as possible and as close as possible to the staffing level at which the complaint occurred. A participant may make an anonymous complaint verbally, handwritten or by email. Unless the complaint is anonymous, all complainants will receive an acknowledgement that the complaint has been received within 24 hours. Updates are provided at prescribed intervals thereafter.

All complaints, including those from the general public, will be responded to with extreme care to fully understand the nature and importance to the participant. No expressed concern will be disregarded as being unimportant or not legitimate, nor shall the complainant experience reprisal or duress because of the decision to access either an internal or external complaint mechanism. Consideration is given to any conflict of interest or perceived conflict that exists or may arise between the complainant and those who may be involved in managing and/or resolving the complaint.

An information page outlining the complaint procedure is available on the agency web page, to the public upon request and made available in prominent places around the agency such as the lobby and in rooms commonly used for case-planning meetings. This information is available in French.

This policy operates in harmony with policies 07.10 Preparing for Admission to Live-in Care and 07.17 Protection of Personal Information. See also policy 08.11 Access to the Legal and Human Rights Systems if the complaint involves a violation of the Ontario Human Rights Code.

Most complaints are serious occurrences reportable to the relevant Ministry. See policy 8.57 Reporting Serious Occurrences for details and timelines.

Application/Procedure:

1. At each site, signage is visible informing program participants how to contact the office of the Ombudsman and the Information and Privacy Commissioner.

2. The complaint procedures are described in a document provided to every participant as part of the intake process and also posted on the web site and in public areas such as the agency lobby. This document is available in French and any other language suitable to the understanding of the participant who is entitled to make a complaint.

3. Every participant /parent/SDM/guardian or member of the general public will be provided with an opportunity to express concerns or complaints through either an informal or a formal process. Informal resolution of difficulties should be sought whenever possible before resorting to formal procedures.

4. Upon receiving a complaint from a participant/parent/guardian or member of the general public, the staff member will respond courteously and accept the complaint openly and without judgment. Acknowledgement of the complaint will occur within 24 hours. The affected participant will be asked if any actions can be offered to help while the investigation is occurring and will be provided with updates throughout the process. Specifically, the participant must receive an update no later than 15 days after receipt of the complaint and thereafter in intervals of no more than 15 days until the complaint has been resolved.

5. The informal procedure involves speaking directly to the participant involved. If the complainant is not comfortable dealing with the staff or participant involved they can speak to another staff. The complainant may also ask to have a third-party present for support and assistance. The complainant is responsible for participating in the complaint process in good faith with the goal of working towards resolution of the issue.

6. If the complaint is not resolved, the staff member receiving the complaint must advise the complainant that they may raise their concern utilizing the formal method.

7. If a participant, parent or member of the general public wishes to proceed with a formal complaint, the staff member first aware of this is to inform their Supervisor who in turn will notify the respective Director immediately. When a formal complaint is made it must be responded to by a person other than the person(s) to whom the complaint is made.

8. A request to resolve a specific concern or complaint may be made by the participant d i r e c t l y or by the parent/guardian or another person representing the participant.

9. Upon receiving the complaint, the Supervisor will engage the complainant and others involved in a problem-solving process, documenting the process and gathering any additional necessary information, working towards a satisfactory resolution of the complaint. The Supervisor will ensure the respective Director is fully apprised of the situation and the status of the complaint. The details of the complaint and the steps taken to respond to the complaint must be documented in the participant’s case file. Reasonable efforts must be made to ensure any person who is informed of the results of the complaints review and understand those results.

10. If the complaint is not satisfactorily resolved, the supervisor will advise the complainant to raise the issue with the Director and provide the complainant the name and phone number of that person. The Director will ask the complainant to put their concerns in writing and assistance will be provided if necessary. A copy of the written complaint will be provided to the complainant. The Supervisor will provide the Director all documentation that has been collected in the resolution process thus far.

11. Upon receiving the complaint, the Supervisor will advise the Director and review the steps for resolution that have occurred. The Director may conduct a review if appropriate.

12. After consultation with the Director and CEO, an Investigating Officer may be appointed, if deemed necessary. When possible, the investigator should not be in a position of direct authority of any of the people involved in the complaint. This process will assist in conducting an unbiased and transparent investigation. This should occur within one (1) week of the receipt of a written and formal complaint.

13. If it is determined during the review/investigation that there has been a violation of rights of a participant as defined through legislation, the Director in consultation with the program’s Supervisor must determine whether there are any measures that could be implemented to prevent the same violation from recurring and implement any such measures.

14. A written summary of the complaint, including steps taken in response to the complaint must be sent to the participant’s placing agency or person who placed the participant at Humana.

15. If the complaint still remains unresolved, the complainant will be advised to submit their concerns to the President of the Board of Directors. This should be submitted within one (1) week of the discussion with the Director and CEO.

16. At any time, the complainant has the option to access either the Ontario Ombudsman or the Program Supervisor at the local office of the Ministry of Children and Community Social Services (MCCSS) and/or Ministry of Health and Long-Term Care (MOHLTC) and/or the Information and Privacy Commissioner. Any participant who expresses a desire to contact these body will be assisted to do so.

Debriefing:

In the case of child and youth participants in Humana programs, the submission and resolution of a complaint must be followed by a de-briefing process with both the complainant and the person to whom the complaint relates. Young witnesses are offered a be-brief where applicable.

Any de-briefing involving a child or young person is structured to accommodate their psychological, communication and emotional needs and cognitive capacity, and focused on understanding their experiences that led to the complaint as well as what the service provider can do to better meet the needs of the child or young person.

There are three stages to the de-brief process.

1. A debrief must be conducted with the persons to whom the complaint relates, in the absence of any children or young persons.

2. A second debrief must be conducted with the child or young person who made, or is the subject of, the complaint, in the absence of the persons to whom the complaint relates. If requested by the child or young person, an adult they identify as a support person is included.

3. A third debrief must be offered to any children or young persons who witnessed any conduct that gave rise to the complaint and must be conducted if any such children or young persons wish to participate in the debriefing process. They may have a support person present.

The debriefs must be conducted within seven days after the complaint has been reviewed or as soon as possible thereafter.

Specifics of the de-brief to be noted in the case record include:

• The date, time and duration of each debriefing and the names and titles (where applicable) of all persons involved

• The name of each child or young witness who was offered and declined the opportunity of a de-brief

• A description of the efforts made to conduct the debriefing processes required by this this policy that includes the names of the persons who made those efforts.

• Any circumstances preventing a de-brief being held within seven (7) days

Documentation:

The initial complaint and all efforts at investigation and resolution are recorded in the participant’s case record.

All features of the de-brief process are recorded in the case record as above.

The complaint and the subsequent actions and review findings are documented in a Serious Occurrence and submitted to the relevant Ministry within applicable timelines. A copy of the SOR is retained in the participant’s case record.

Agency-Level Review:

1. On or before the 5th day of every month, in relation to the previous month, the Directors will prepare a written analysis of every complaint received pursuant to the complaints procedure and the results of the review including whether any changes are required to the manner in which the rights of participants are respected when providing service. The written analysis is provided to the applicable Ministry via the Serious Occurrence Reporting, Residential Licensing (SOR-RL) database.

2. The agency tracks the themes of complaints and monitors the outcomes. All complaints are reviewed with the Board of Directors at least annually.

3. This policy is reviewed at least once every 12 months, including a written evaluation of the complaints that includes the effectiveness of the written complaints procedures and the need for any changes to the procedures to improve their effectiveness.