Stand up for dignity - Complaints

If you complain that your breakfast is cold, you don't want to go through the complaints procedure - you want a hot lunch

Having a fair, open and honest culture around complaints means:

• people feel confident about complaining. Staff and managers see complaints as an opportunity to improve things, not as a threat
• problems are picked up at an early stage and lessons are learned
• poor practice is highlighted and put right
• vulnerable people, or those who find it difficult to make their views heard, are protected and have access to adequate support including advocacy.

If people feel comfortable about raising concerns with frontline staff – and staff act promptly to address the issues raised – it is less likely that problems will need to be addressed through the official complaints procedure.

• How to deal with complaints for workers and service providersOpen

  • Staff should be properly briefed on the complaints procedure.
  • Encourage people to raise their concerns – forums for people who services may help people to feel more comfortable in raising concerns.
  • Act promptly when people raise their concerns – this reassures people that their complaints will be listened to and that it is not necessary to ‘make an official complaint’ to get a good response.
  • Offer advocacy or support to the complainant where required.
  • Ensure the complainant is kept informed of progress.
  • Give a clear report of the outcome and information on what to do if the complainant is not satisfied.
  • People from seldom-heard groups (e.g. people with dementia or people from minority groups) should receive appropriate support to complain.

• How to complain for people who use services and their family and friendsOpen

  • Where possible, approach the service first to see if the problem can be resolved at an early stage. If this is not an option (for example, because the complaint is about the manager or because you fear reprisals) it may be more appropriate to approach the commissioning or regulatory body instead.
  • If the problem cannot be resolved informally, ask for a copy of the organisation’s complaints procedure. This should be available in different languages on request.
  • Keep a record of any phone calls, letters or conversations with staff regarding your complaint.
  • You can get support with making a complaint
  • If you are not satisfied with the outcome of the complaint you can refer it to an external body or ombudsman. The complaints procedure should give you information on who to contact if you are not satisfied.
  • If you think that a public body has made an unlawful decision you may want to challenge that in the courts through judicial review – the Public Law Project may help you with this process

What others are doing – ideas you could use

• Provide clear complaints information at the start
• Get electronic feedback  to improve services
• Use questionnaires to identify concerns before they become complaints
• Ask people whether they are satisfied with your service to help you improve on privacy and dignity
• Make a better first impression
• Empower patients and the public to carry out regular inspections of services

These practice examples are self-reported and have not been evaluated.

Care Quality Commission - what the regulator says

The CQC is the independent regulator for health and social care services. They have set out Essential Standards of Quality and Safety (CQC, 2010) for all those registered to provide health and social care services. There are 28 outcomes relating to the different aspects of care provision.

• What CQC outcomes say about complaintsOpen

  These are the outcomes that relate to complaints:

  Outcome 7 Safeguarding people who use services from abuse Providers must have effective means to monitor and review incidents, concerns and complaints that have the potential to become an abuse or safeguarding concern.

  See also:

  Outcome 16: Assessing and monitoring the quality of service provision Outcome 17: Complaints

  See all outcomes in the Care Quality Commission Essential Standards of Quality and Safety (PDF file)

Complaints - what the research and policy says

Key points:

• Some people are reluctant to complain because they worry that their service may be withdrawn. They may fear being seen as a 'trouble maker' and being treated differently as a result of their complaint; this concern was raised repeatedly in Healthcare Commission inspections Healthcare Commission et al., 2006.
• Being able to complain without fear of retribution was important to respondents to the Department of Health (DH) online survey alongside a need for clear and simple complaints procedures. DH, 2006d,
• The Department of Health has issued new regulations on complaints procedures for adult social services which emphasise the importance of encouraging people to speak out about their experiences - both good and bad - and to challenge poor practice when they come across it.
• The new DH regulations on complaints have shortened timescales for resolution at all stages of the process and given independent review panels a more precise brief to ensure less variation between local authorities and a more consistent response to complainants against measurable frameworks. The new procedures, Learning from Complaints, came into force on 1 September 2006.
• There is a commitment in the White Paper, 'Our health, our care our say' to introduce a single complaints process covering both health and social care in the near future.DH, 2006f

• Complaints - what the research and policy says in more detailOpen

  Many people find it difficult to complain for a number of reasons. It may be difficult for them to find their way around the system, for example because English is not their first language, or because they have a cognitive impairment. Some people are reluctant to complain because they worry that their service may be withdrawn. They may fear being seen as a 'trouble maker’ and being treated differently as a result of their complaint; this concern was raised repeatedly in Healthcare Commission inspections (Healthcare Commission et al., 2006).

  Being able to complain without fear of retribution was also raised in the Department of Health (DH) online survey (DH, 2006d), alongside a need for clear and simple complaints procedures. It may be particularly difficult to make a complaint about someone providing a face-to-face service on a daily basis - for example a home-care worker or residential staff - particularly if the complaint only applies to one aspect of their otherwise good work.

  As part of the drive to ensure dignity in care the Department of Health has issued new regulations on complaints procedures for adult social services. The new procedures emphasise the significance of providing an accessible, customer-focused service that encourages people to speak out about their experiences - both good and bad - and to challenge poor practice when they come across it.

  In addition, timescales for resolution at all stages of the process have been shortened and the independent review panels now have a more precise and focused brief to ensure less variation between local authorities and a more consistent response to complainants against measurable frameworks. The new procedures, Learning from Complaints, came into force on 1 September 2006.

  There is also guidance for NHS complaints managers: 'Supporting staff, improving services - guidance to support the implementation of the NHS (complaints) amended regulations 2006'.

  There is a commitment in the White Paper, 'Our health, our care our say' (DH, 2006f), to introduce a single complaints process covering both health and social care in the near future.

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