Everyone makes mistakes. The big question for any organisation is how willing you are to admit that, put things right and learn lessons to avoid similar problems in future. We know from experience that the best service providers are not afraid to get service complaints, and instead, welcome every contact they receive as a way to improve their services. The Care Quality Commission’s (CQC) report Complaints Matter, shared that view, and found that more needs to be done to encourage people to come forward with their complaints.
The care regulator has said that it will be making complaints handling central to its inspections and will feed this into its regulatory judgements about how responsive a provider is to people’s needs. As the social care ombudsman, we welcome the CQC’s report, and have been working with the regulator to provide a seamless process when people first contact us allowing easy transfer of calls if they have come to the wrong organisation.
We’ve also been working with the Parliamentary and Health Services Ombudsman (PHSO) and Healthwatch England, listening to people who use public services to understand what they want from an effective complaints system. This research has led to our ground-breaking joint report, My expectations for raising concerns and complaints.
The report presents the vision that was created and the findings of the primary research with patients, service users, frontline staff and stakeholders that lay behind it. The vision lays out a comprehensive guide to what good outcomes for patients and service users look like if complaints are handled well. It does this by presenting a series of ‘I statements’ laid out across a complaint journey.
The ‘I statements’ are expressions of what patients and service users might say if their experience of making a complaint was a good one. The journey describes the different stages that patients and service users must go through when making a complaint, from initial consideration, through the communications with staff and institutions, to final reflection on the experience.
We believe that the common sense principles set out in this report should be at the heart of every care provider’s process.
Effective complaints handling
Across all areas, we heard that people wanted to know that they have a right to complain, they wanted to know where to complain, to be kept informed and feel their complaint makes a difference and they want to feel confident they can complain again if the need arises.
A person-centred complaints procedure needs to take this into account – and, while we would never advocate a ‘one-size-fits-all’ blueprint for complaints handling, a good process needs to be accessible, effective and accountable. It needs to be transparent and people need to know who to turn to if they have a problem, with no barriers placed in their way.
People want to know that they are being heard. Sadly, in many of the cases we investigate, organisations could have sorted out the problem at an early stage by simply acknowledging concerns and apologising. From our own research we also know that people get frustrated when the complaints process appears to be taking too long. We know that communication is the key to helping the process run smoothly. People want to be kept informed and updated regularly, and want to have a personal point of contact for their complaint.
The final stage
In our role as the social care ombudsman, the LGO provides the final stage of the care complaints process. Where a service user remains dissatisfied with the provider’s response to a complaint, we can conduct a free, fair and independent review of the matter. We investigate complaints about all types of social care. If we find fault we will recommend a remedy to put things right for the person who has complained. If we don’t, we’ll bring the issue to a clear conclusion. Our enquiries, recommendations and remedies also aim to help prevent similar problems in future.
Last year we registered 2,456 complaints and enquiries about adult social care. Just nine per cent of those (213) were about privately-funded care – a share that has remained constant since our remit was widened nearly five years ago. We’d like to understand a bit more about why we receive so few complaints about private care. It may be that the sector has high levels of satisfaction and does a really good job of handling complaints before they reach us, or it could be that customers do not have a clear idea about where they can take their complaints if they have not been resolved to their satisfaction. In all likelihood, there will be a mix of different factors in different parts of the private care market.
In our 2014 annual review of adult social care complaints, we recommended a number of ways that the complaints process could be improved nationally. While these are not statutory requirements, many care providers are looking at how they can implement some of them as a means of improving the transparency of their own complaints processes.
In the report, we suggested that there should be better signposting to ensure that service users, their families and representatives understand how to complain, and understand that there is an independent avenue for redress through the LGO when things go wrong. To that end, we suggested that every care setting should have appropriate, but prominent, signs, posters and leaflets outlining how a person can make a complaint or raise a concern, who they can turn to for independent support and that they have the right to go to an independent ombudsman if they remain dissatisfied. We also suggested that all social care providers and commissioners should have an annual review of complaints, which would increase the ownership and understanding of complaints, as well as driving the improvement of services.
The LGO offers practical, one-day training sessions specifically for groups of people who deal with adult social care complaints. We have been running these courses for local authority complaints handlers for a number of years, and we will soon be launching courses aimed at supervisory and frontline staff in the private care sector too. A pilot of the private provider course received excellent feedback.
All our decisions are published on our website, and complaints handlers can look at our online statements to find out how we have recommended other authorities or providers can remedy similar complaints.
People who specifically deal with adult social care complaints can also receive the ASC Matters newsletter.
Michael King, Executive Director at the Local Government Ombudsman. www.lgo.org.uk
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