Salveo Care Feedback and Complaints Form FY25/26

Feedback and Complaints Form

We at Salveo Care are committed to constantly improving our services to better meet your needs. Your feedback is crucial for us to achieve this. We treat your information with the utmost respect and prioritise addressing your concerns quickly and carefully. Your input directly influences our service quality, and we thank you for sharing it.
Date & time the feedback was provided

DayMonthYear
Date
Hour MinutesAM/PM Option
Who is providing the feedback*

RelativeClient/Care Recipient/ConsumerStaff memberHealth ProfessionalOther
Would you like to remain anonymous?

YesNo
Note: We respect your right to remain anonymous and will do our best to respond to your feedback. We need to let you know that by remaining anonymous it may limit our capability to follow through with a resolution. Rest assured that all feedback will be handled with utmost sensitivity and confidentiality. Your privacy is of utmost importance to us.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: 0000 000 000.
OLD - Who is completing this form?

Salveo HomeCare StaffCare Recipient or representative
Your feedback is: - please choose from the following options*

ComplaintComplimentSuggestionFeedback
Is the feedback related to a care recipient?

YesNo
Name of care recipient feedback relates to

First NameLast Name
How was feedback provided? Please select the method used to provide feedback

Incoming Phone callEmailSalveo HomeCare Feedback Request Phone CallIn PersonOther
OLD - Please enter location or suburb
Please write your feedback here
What outcomes would you like as a result of your feedback?
Do you wish for your feedback to remain confidential?*
OLD - Address details for care recipient
Street name, suburb, State, Post code

Service involved in the feedback - please choose from the following options:

Salveo Home Care Package RecipientVeterans' Home Care (VHC)Brokerage Client (E.g. Healthability, Aunty Grace, etc.)Other
Compliment
How was the compliment responded to/actioned?
Was the compliment shared with the worker and team? Use the compliment as an example of what to do - implement this as an improvement for all staff to follow.
Investigation
When was the complaint/feedback acknowledged?

DayMonthYear
Date
Hour MinutesAM/PM Option

Topic of complaint

Service DeliveryStaff MemberStaff Inappropriate ConductEnvironmental HazardConcernBreach of PrivacyClientPayment and AccountsOther
Is an investigation required?

YesNo investigation required (e.g. compliment or general feedback)Review CommencedFull Investigation commenced
Support Services section - Includes using respectful language, avoiding re-traumatisation, offering support options, and allowing time and choice in communication.

Interpreter arrangedAdvocate engagedCultural considerations taken into accountTrauma-informed response considered
Complaint & Feedback Management – Task Checklist (Office use only)

Complaint / feedback received and loggedComplainant acknowledged within required timeframeManager informedRisk / seriousness consideredInvestigation decision madeReview or investigation commencedExternal reporting considered (if applicable)Support services considered or providedOutcome communicated to complainantComplaint closedContinuous Improvement Register updated (if required)Other
Description and impact of complaint
Complaint desired outcome
What activities will you undertake as part of the investigation?

Speak with support workerSpeak with client/relatives/representativeSpeak with other staff members (e.g. care coordinator, allocations team)Review case notesReview communication logsRoot cause analysisExternal notification or referral (if required, e.g. Aged Care Quality & Safety Commission)Other
Brief investigation summary - Use this field only to clarify or add context to the checklist above
e.g. spoke to client and their family, contacted the police, interviewed the SW, etc.
Investigation activities
e.g. spoke to client and their family, contacted the police, interviewed the SW, etc.
Investigation findings
Show results of investigation and what you have found
Complaint resolution proposed actions/actions completed
Actions taken in response to complaint and/or actions taken as a result of investigation
Complainant's complaint resolution satisfaction

SatisfiedNot satisfied - referred to Aged Care Quality Commission
Continuous Improvement
Continuous Improvement Resulting from Feedback
improvement activities implemented across the organisation
Improvement Implemented?

YesNoNot applicable
Complainant Feedback on Complaint Process
How did the complainant feel about how we handled and responded to the complaint?
Improvement action to complaint handling process required
Links to relevant information
Actioned by

First NameLast Name
Role
Status
Date closed

DayMonthYear
Date
Should be Empty:

Rows	Complainant / Feedback Provider Cotacted	Date Contacted	Method	Manager been Informed ?
Initial Acknowledgement & Communication

Feedback and Complaints Form

Compliment

Investigation

Continuous Improvement