NDIS Participant Complaint? A Provider’s Response Guide

A participant has made a complaint about your service, or the NDIS Quality and Safeguards Commission has been in touch. The right response is not to find a way out of it. In a safeguarding regime the participant’s rights and safety come first, and a good provider’s best protection is almost always the same thing as doing the right thing: knowing your obligations, responding fairly and on time, keeping clear records, reporting what must be reported, and dealing with the person and the Commission openly and honestly. This page explains what you owe and how to respond properly. The full Provider Response Guide gives you the step-by-step toolkit and adaptable templates.

Your obligations come first: the NDIS Code of Conduct

The NDIS Code of Conduct applies to all NDIS providers, whether or not you are registered, and to every worker you employ or engage. Part of complying with it is listening and responding appropriately to complaints. Under the Code, a provider and its workers must:

• act with respect for individual rights to freedom of expression, self-determination and decision-making;
• respect the privacy of people with disability;
• provide supports and services in a safe and competent manner, with care and skill;
• act with integrity, honesty and transparency;
• promptly take steps to raise and act on concerns about matters that may impact the quality and safety of supports and services;
• take all reasonable steps to prevent and respond to all forms of violence against, and exploitation, neglect and abuse of, people with disability; and
• take all reasonable steps to prevent and respond to sexual misconduct.

Two of these matter most when a complaint arrives. The obligation to promptly act on quality-and-safety concerns means you must act on the complaint, not suppress or deflect it. The obligation to act with integrity, honesty and transparency governs how you respond: you must not give the participant or the Commission a false or misleading account.

If you are a registered provider: your complaints system

Registered providers carry extra duties. You must implement and maintain a complaints management and resolution system that provides an easy and accessible process; ensures complaints are acknowledged, assessed and resolved in a fair, efficient and timely manner; tells complainants they can also raise the matter with the Commissioner; keeps complaint information confidential; affords procedural fairness; and is documented, with records kept for seven years. Note what the rules do not say: there is no fixed number of days to acknowledge or resolve a complaint. The standard is fairness, efficiency and timeliness, not a set deadline, so treat quoted figures like “acknowledge within two business days” as a service standard you may adopt, not a legal requirement.

A complaint versus a reportable incident

This is the distinction that gets providers into the most serious trouble when it is missed. A complaint is broad: any issue related to the supports or services you provide. A reportable incident is a defined list of serious events a registered provider must notify to the Commission:

• the death of a person with disability;
• serious injury of a person with disability;
• abuse or neglect of a person with disability;
• unlawful sexual or physical contact with, or assault of, a person with disability;
• sexual misconduct against, or in the presence of, a person with disability, including grooming; and
• the use of a restrictive practice in relation to a person with disability.

One matter can be both at once. If a complaint describes conduct that is also a reportable incident, you must handle it as a complaint and report it. Never treat a reportable incident as “just a complaint” to avoid reporting it.

The reporting timeframes (registered providers)

If you are a registered provider, a death, serious injury, abuse or neglect, unlawful sexual or physical contact or assault, or sexual misconduct (including grooming) must be notified to the Commissioner within 24 hours of becoming aware. Any other reportable incident, in practice the unauthorised use of a restrictive practice, is notified in writing within 5 business days. If you cannot gather full details within 24 hours, give the basic details in that window and the rest within 5 business days. The 24-hour window is short by design, so when a complaint lands, ask straight away whether what it describes might be reportable.

How to respond to the participant, step by step

A proper response is methodical and honest. Acknowledge the complaint and let the person know you are taking it seriously. Assess it fairly, with procedural fairness, which means not prejudging it and giving anyone whose conduct is in question a fair chance to respond. Keep the person informed and treat their information as confidential. Resolve the complaint where it is made out, or explain the outcome honestly with reasons where it is not. Document everything, and keep the record. Finally, tell the person they can escalate to the Commission, which is a positive duty of a registered provider’s system, not an optional courtesy.

When the Commission handles the complaint

A participant can take a complaint to the Commission whether or not they raised it with you first. The Commission may take no action, give assistance and advice, or run a resolution process. In a resolution process it may require you to examine and attempt to resolve the complaint and report back, take part in conciliation, receive advice, or take remedial action; it can also hold inquiries. Your duty is to cooperate, engage with the matter rather than evade it, and respond honestly and on time. If the Commissioner issues a compliance notice, you are legally required to take the specified actions by the stated time.

What never helps

The Commission has a graduated set of enforcement tools, from compliance and infringement notices and enforceable undertakings through to banning orders, injunctions, civil penalties for a Code breach, and suspension or revocation of registration. These escalate in response to non-compliance, danger or dishonesty, not to the mere existence of a complaint. What never helps is concealing or delaying a reportable incident, retaliating against the person who complained, altering or destroying records, or giving a false or misleading account. A provider that acknowledges a complaint, affords procedural fairness, reports what must be reported, cooperates and fixes genuine problems is operating exactly as the scheme intends, and that is the best protection there is.

Get the full Provider Response Guide – $29

This is general information about the law and procedure, not legal advice; Claim Done is not a law firm.

Questions people ask