Complaints

1. Introduction

Anyone has the right to make a complaint (staff who wish to make a complaint should use staff procedures).

The service should ensure that the investigation of any complaint is both proportionate and sufficiently thorough.

If the service is not satisfied that an adult’s representative, who makes a complaint, is acting with the adult’s consent or in their best interests, it will inform them in writing, stating the reason/s why. Advocacy would only support a family member to make a complaint if they had care and support needs or mental ill health; a person could be supported by a generic advocate if the criteria is met (see Advocacy chapter).

Complaints can be made either verbally or in writing. The person making the complaint should be informed of the name of the member of staff responsible for receiving, handling, considering and responding to the complaint.

If the complaint is made verbally, it is the responsibility of the member of staff to document the complaint and inform the relevant manger within the service, who should take action.

Information and advice should be available to adults, family, friends or their representative in appropriate language and formats. It should also include information on support in making a complaint, including interpreting services where needed.

Adults and their family and friends should be confident that any comments and complaints they make about the service are listened to and acted upon, and that they will adversely affected for making a complaint; in particular, they should be reassured that the care and support they receive will not change as a result.

When complaints are made anonymously, the service will follow the complaints process as set out below, as far as possible.

Staff who investigate the adult’s complaint should have the right level of knowledge and skills required for this responsibility, including a comprehensive understanding of this complaints procedure and related national guidance.

The service must act in accordance with the Care Quality Commission’s Duty of Candour requirements (see Duty of Candour) in respect of complaints about care and treatment that have resulted in a notifiable incident.

2. Making a Complaint

When an adult starts to receive care and support from the service, they and / or their family must be given information about how to make a complaint, including how they can access support to make a complaint.

They should be informed about the complaints procedure and it should be available to them throughout the time they receive care and support from the service.

If an adult or their family wishes to make a complaint, they should first contact the service manager and inform them of their concerns. This applies whether the adult is a self-funder or their costs are funded by the local authority. If the adult is funded by the local authority and they are not satisfied with the response from the service, they can take it up with their local adult social care service, who should try to resolve the complaint and ensure the situation does not recur.

If the adult is not satisfied with the response from adult social care, they can further complain to the Local Government and Social Care Ombudsman (LGO). This is known as a ‘Stage 2’ complaint (see Section 4, Stage 2 of a Complaint). Adults who self-fund can also ask the LGO to take up their complaint if they are not satisfied with the service response.

3. Stage 1 of a Complaint

Whether a complaint is made in person or on the telephone, the member of staff receiving the complaint must tell the complainant that a written record of the complaint will be made.

All written complaints should be acknowledged within the timescale agreed by the service and should include the name of the staff member investigating the complaint.

Complaints must be made no later than 12 months after the date the event occurred, or if later the date the event came to the notice of the complainant.

The time limit will not apply if:

• the person making the complaint can give a good reason for not making it within the time limit; and
• despite the delay, it is still possible to investigate the complaint effectively and fairly.

The person making the complaint will receive (as far as possible):

• support to help them to understand this complaints procedure; and
• advice on where they may obtain any assistance required in making the complaint.

Complaints from an adult’s representative will be accepted where:

• the adult has consented, either verbally or in writing;
• the adult cannot complain unaided and cannot give consent because they lack capacity (see Mental Capacity) and the representative is acting in their best interests.

The service should aim to have all complaint investigations completed within 28 days unless a different timescale is agreed with the complainant;

The service must ensure that guidance on how to make a complaint is displayed and / or made available to all adults who use services and their family / friends. The address and telephone number of the Care Quality Commission (CQC) must be made available.

Issues of consent and confidentiality must be fully taken into account during the process unless there are reasons that would override these, such as a safeguarding adults concern.

Where the original complaint is deemed to be a safeguarding issue, the investigating officer will implement the Safeguarding Adults from Abuse and Neglect Procedure (see also Allegations against Persons in a Position of Trust).

4. Stage 2 of a Complaint

Once the complaint has been dealt with by the service, if the person is not satisfied with the outcome, it can be referred to the Local Government and Social Care Ombudsman (LGSCO), which provides a free and independent service. The person making the complaint can also refer it to their local authority or the CQC.

The LGO Advice Team can be contacted for information and advice, or to register the complaint.

5. Verbal Complaints

A staff member who receives a complaint should immediately refer it to the senior person on duty in the service.

That staff member should speak with the person making the complaint. They should document the discussion, including the outcome using the service’s complaints recording process.

Where the complaint is resolved at the time, the details of the complaint and the action taken and the outcome should all be recorded.

Where the complaint is not resolved, it should be immediately referred to the manager, to be dealt with as a written complaint.

All complaints received from a statutory body shall be referred to the manager.

6. Written Complaints

On receiving a written complaint or being informed of a non-resolved verbal complaint, the manager or delegated other should acknowledge the complaint in writing to the person making the complaint and inform them of next steps.

The manager should also commence a record of the complaint in the service complaints records system.

The manager of the service should inform their manager of any written or verbal non-resolved complaints received and they will decide whether the service manager can deal with the complaint or it requires further investigation as detailed below. They will also agree timescales for completing the investigation.

7. Investigating a Complaint

The complaint will be investigated and resolved to the satisfaction of the complainant unless:

• it falls outside of the remit of the service responsibility;
• the complaint cannot be upheld.

The complaint should be investigated by staff who understand the issues involved, and who are sufficiently competent and experienced to undertake this responsibility. This should be someone who was not involved in the circumstances resulting in the complaint, wherever possible.

Investigating a complaint should normally include meeting with the person making the complaint and their family / friends, as applicable. It should also include interviewing staff and anyone else involved in the circumstances surrounding the complaint and collating any other data that would be useful in assessing what happened. This may include the adult’s case file or incident records for example.

The manager / delegated member of staff must explain to the complainant the complaint process, including the likely timescale. Any reasons for delay in the timescales should be explained to the complainant. They should also inform their senior manager, as appropriate. Staff conducting investigations need to be able to provide honest explanations based on facts, and provide explanations for all decisions made.

A full record of all complaints should be kept by the service, in its complaints recording system. This enables the service to monitor each individual investigation as well as all complaints.

Adults and their families who have made complaints should confirm that the issues were resolved internally to their satisfaction. If the matter is not resolved to their satisfaction, further discussion may take place with the service to try to resolve their complaint. Complainants should be told about their right to contact the Care Quality Commission, so that they can inform them of any concerns they may have about the service.

The service will produce a summary of complaints when requested. The Care Quality Commission may ask the service for information about a complaint, which must be provided within 28 days of the request. They may also ask for information about overall complaints. This should be provided in a format set out by the CQC.

8. Completion of the Investigation

The manager / delegated member of staff will report their findings to the person who delegated this responsibility to them, within an agreed timescale.

The manager should write to the complainant with the findings and any actions taken, within the agreed timescale.

The manager should inform the complainant that they can meet with them to discuss the complaint or its outcome if they wish to do so, and also that they may take the matter further to either more senior personnel within the service or the CQC, adult social care and / or the LGO.

9. Monitoring of Complaints

The service should monitor all complaints over particular time periods, looking for trends and areas of risk for example, that may be addressed.

The complaints monitoring system should record the following:

• each complaint received, which is allocated a number;
• the subject matter and outcome;
• details of the reasons for any delay where an investigation took longer than agreed and
• the date the report / letter of the outcome of the investigation was sent to the complainant.

All complaints (verbal and written) must be logged on the system. Where no action is taken, the reasons for this should be recorded. The complaint should be categorised as closed by the senior manager, once it has been resolved / closed, but the record kept on the system for future reference and monitoring purposes.

Monitoring of incidents and complaints by the service should help identify potential abuse. Where analysis indicates such, the service manager and / or locality manager (if service manager is implicated in the abuse) should take immediate preventative actions, where appropriate (see Allegations against Persons in a Position of Trust).

10. Learning from Complaints

Complaints can be an opportunity for the organisation to learn, improve the service that is offered and ensure that risks are reduced.

In order to ensure this complaints should be reviewed over a period of time, noting learning opportunities. The results of the review should be communicated to senior managers and front line staff as appropriate.

An action plan should detail the actions needed in order to improve the service offered and minimise risks.

The analysis of complaints monitoring reports detailing concerns and complaints will help to ensure that any trends or wider issues are quickly identified and addressed.

Senior management should ensure that procedures are in place to act on analysis of complaints.

Complaints should be added to staff meeting agendas so these can be shared and discussed with the staff team.

Learning from overall complaints monitoring, as well as individual complaints, should be shared with staff either in team meetings or staff development events.

10. Persistent Complainants

There may be a number of reasons why someone may make unreasonable or persistent complaints about the service. They may have justified complaints or grievances but are pursuing them in inappropriate ways, or they keep pursuing complaints which appear to have no substance or which have already been investigated and the outcome determined.

The following steps can be taken in order to restrict persistent complainants:

• requesting contact only in a particular form (for example, letters) to reduce staff time involved in speaking to persistent complainants;
• requiring the complainant to only have contact with a named member of staff;
• restricting telephone calls to specific days and times; and / or
• asking the complainant to enter into an agreement about their future contact with the service – the nature of which is detailed.

It should be born in mind, however, that restricting contact with the organisation may increase risks to the adult / carer. This step should therefore be supported by a written risk assessment and with the agreement of senior managers in the service:

A decision to restrict contact may be reconsidered by senior management if the complainant demonstrates a more amenable approach.