10.9 Complaints

1. Introduction

A complaint can be made by an adult who has applied for or is in receipt of a service in relation to care and support, including a carer, or a person acting on their behalf. A service should not be delayed, withdrawn or suspended because a person has made a complaint.

The complaints procedure aims to achieve the best outcome for:

• the adult receiving the service,
• the complainant (if different); and
• adult social care.

Each complaint should be seen as an opportunity to improve the service offered.

The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 set out the process local authorities must follow when responding to complaints about adult social care services. This includes where the local authority has commissioned another organisation to provide care or services on its behalf.

There is no statutory guidance to accompany the regulations, but the Local Government and Social Care Ombudsman (LGSCO) has published good practice guidance:

•  Adult Social Care Complaints, Reviews and Appeals: A Good Practice Guide for Local Authorities;
• Guide for Complaint Managers: Designing and Delivering Effective Complaint Systems.

2. Principles of Good Complaint Handling

Best practice when responding appropriately to complaints includes:

• getting it right (legally and procedurally);
• being customer focused;
• being open and accountable;
• acting fairly and proportionately;
• putting things right;
• seeking continuous improvement.

3. What People Can Complain About

The local authority adult social care complaints procedure may be used in relation to:

• service quality or appropriateness of services provided;
• delays in decision making or service provision;
• assessments, reviews and care plans;
• failure to follow procedures;
• failure to provide a service;
• incorrect charges;
• attitude or behaviour of staff;
• application of eligibility or assessment criteria.

The local authority’s complaints procedure does not apply when the complaint:

• relates to the actions of another local authority or an independent provider;
• has already been investigated;
• is about a Court decision;
• should be dealt with under court proceedings, criminal proceedings, disciplinary proceedings, grievance proceedings or a tribunal;
• is out of time (see Section 4, Time Limit for Making a Complaint).

4. Time Limit for Making a Complaint

A complaint must be made not later than 12 months from the date the issue occurred or came to the notice of the complainant, unless the complainant had good reasons for not making the complaint within that time and it is still possible to investigate the complaint effectively and fairly.

5. Accessibility and Publicising the Complaints Procedure

Adults and carers, and their representatives, should be informed of the Complaints Procedure and how they can use it.

People must have access to advice and information about making complaints, including how to complain and who to.

This information should be accessible, jargon free, user friendly, available in different formats and languages and give advice on how to obtain more information and support.  Online systems must be able to be used by people who have accessibility needs.

Translation and interpretation facilities should be available if needed (see Interpreting, Signing and Communication Needs chapter).

The local authority should ensure that all staff and third party commissioned services (for example care providers) are aware of this complaints policy and how people can make a complaint.

See also Accessible Communication Formats (gov.uk)

6. Supporting People to Make Complaints

People should be provided with the opportunity to request any reasonable adjustments when making a complaint and to receive assistance to help them to understand the complaints process.  Agreed reasonable adjustments should be recorded to avoid the complainant having to repeatedly request them.  There are a number of services that can help, including:

• the Customer Relations Team which can provide advice and support to people who receive services and their representatives;
• advocacy services which can be used to help some people to make a complaint and to provide support given during the investigative process (see Independent Advocacy chapter).

Adults who are not entitled to the services of an independent advocate could be supported / represented by a friend or family member. Representatives should act with the best interests of the complainant in mind and should generally have the adult’s consent or another lawful basis for acting on their behalf, such as power of attorney. However, if a complaint is made on behalf of a person who does not have the mental capacity to give consent and there is no one who can legally act on their behalf (for example deputy or power of attorney), the local authority should not automatically decline the complaint but consider whether the person raising the complaint is suitable to act on the adult’s behalf.

The local authority should not place restrictions on the actions of representatives unless there are good reasons for doing so. For example, if a complainant wants to attend a meeting with a friend or family member for support, the local authority should not prevent that person from speaking in the meeting without good reason (for example there are concerns about the representative exerting coercive control over the complainant, or not acting in their best interests).

The Local Government and Social Care Ombudsman provides guidance on Unreasonable Actions by Representatives.

7. Receiving and Acknowledging Complaints

Complaints may be made orally, in writing or electronically, and the local authority should ensure complainants can raise concerns and challenge decisions through a range of channels. The adult or their representative does not have to use the word ‘complaint’ for it to be treated as such.

If the complaint is made orally, the local authority must:

• make a written record of the complaint; and
• provide a copy of the written record to the complainant.

The local authority must acknowledge a complaint within three working days after the day on which it was received. The acknowledgement can be made verbally or in writing. If made verbally, a written file note should be kept.

When the local authority acknowledges a complaint, it must offer to discuss the complaint with the complainant and provide information about how the complaint will be handled including how long it will take to respond.

8. Safeguarding

Where any safeguarding issues are identified, the member of staff or manager should immediately refer the concerns under the local Safeguarding Adults  Board procedures (see Responding to Safeguarding Concerns chapter).

If a safeguarding investigation is required under Section 42 Care Act 2014, this will take priority over a complaint investigation and at this point the complaint will be paused.

Following the safeguarding investigation, if the complainant wishes to pursue their complaint, it will be reconsidered.

9. Considering Complaints

The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 provide for a single stage of complaint investigation.

However, Adult Social Care Complaints, Reviews and Appeals: A Good Practice Guide for Local Authorities (Local Government and Social Care Ombudsman) suggests a process using two internal steps which local authorities can follow to support the resolution of complaints at the earliest opportunity.

9.1 Early resolution

Where possible, complaints should be resolved at an early stage, for example:

• providing mediation between the service and the complainant or their family;
• putting services in place, restoring a service that had broken down, carrying out an assessment or reassessment; or
• making an apology.

Before closing the complaint, the relevant manager should ensure the complainant is satisfied with the outcome and there are no risks to others using services, for example because the complaint raises serious issues.

The Local Government and Social Care Ombudsman (LGSCO) suggests that this step should take no more than around 20 working days. If the complaint cannot be resolved in this timescale it should be escalated to an investigation. However, the local authority should continue to seek to resolve the complaint at an earlier stage if possible whilst an investigation takes place.

Any complaint received should be recorded and the Customer Relations Team should be notified even where early resolution is achieved.

9.2 Investigation

If early resolution of the complaint cannot be achieved or the complainant wishes to make a formal complaint, details should be passed to the relevant operational manager so they can obtain the information required to assess the seriousness of the complaint.

After receiving a complaint where early resolution is not possible, the Customer Relations Team should be notified within one working day and the complaint should be acknowledged within three working days. The acknowledgement may be made verbally or in writing.

When the complaint is acknowledged the complainant must be offered a discussion in relation to the way in which the complaint will be handled, by whom, and the timescale for investigation. This is the complaint action plan and should be notified to the Customer Relations Team.

Where the complaint relates to two organisations, it should be agreed between them which will take the lead, and a single point of contact should be given to the complainant.

The lead person will then be responsible for liaising with the other organisation and the complainant throughout the duration of the complaint.

Complaints can be resolved more effectively if it has been made clear from the outset what the person complaining expects as an outcome. If this is not a feasible or realistic outcome, then this must be explained to the complainant.

The complaint process offers a range of options for resolving complaints. The approach chosen should aim to achieve a timely, proportionate and appropriate response to the complaint.

The purpose of an investigation is to establish the facts of what occurred. This should include – where appropriate – reviewing records, interviewing staff, conducting visits to the location involved and receiving specialist advice.

The complainant will be kept informed as far as reasonably practicable as to the progress of the complaint.

It is important that investigators are objective and unbiased.

The complaint should be investigated to the extent necessary and in a way that is most appropriate to resolve the issues speedily and efficiently. The investigator will make every effort to interview all relevant parties including the complainant and any witnesses to events, such as staff, family members or other partners.

Mediation may be useful in some cases.

10. The Outcome

After completing the investigation, the complainant must be sent a response in writing which includes:

• an explanation of the complaint and how it was considered;

• the conclusions reached;
• confirmation as to whether action needed in relation to the complaint has been taken or is proposed to be taken.

The complainant will be advised to contact the Customer Relations Team if they are not satisfied with the outcome to their complaint.  A senior manager within the service will be asked to consider whether there is any further action that can be taken to resolve the complaint.

The final response must be sent no later than six months from the date the complaint was first received. An extension to this timescale should only be necessary in rare cases.

Where a complaint remains unresolved a final response will be sent to the complainant. The letter will inform the complainant of their right to take the matter to the Local Government and Social Care Ombudsman, if they are not satisfied.

11. Joint Investigations with Health or other Partner Organisations

Many complaints about care services also include concerns about other services such as those delivered by health bodies. The Regulations set out a ‘duty to co-operate’ when handling complaints that cover health and care services. This includes a duty to ‘co-ordinate the handling of the complaint’ and ‘ensuring the complainant receives a co-ordinated response to the complaint’. Bodies are required to agree which should take the lead in co-ordinating the handling of the complaint and communicating with the complainant and must provide relevant information to each other when requested and attend or be represented at any relevant meetings.

Where more than one organisation is involved in providing care, the person (or their representative) can complain to any of them. They do not have to contact each organisation separately.

Where the local authority identifies there is a need for a joint investigation, it should seek consent from the person affected to share their information with other organisations. If they are not able to give consent (for example because they lack the mental capacity to do so), the local authority should seek consent from someone able to act on their behalf. If the complainant does not want their information to be shared, the local authority will only respond to the complaint relating to its services.

Where organisations are not able to cooperate on considering complaints or agree about responsibility for any fault, this may need to be escalated to a senior level within each organisation concerned to try to resolve any areas where there is disagreement. A response to a complaint should not be delayed by disagreements between the relevant organisations. Where it is not possible to reach agreement, the organisations should write to the person who made the complaint and explain why it has not been possible to provide a co-ordinated response to their complaint. Each organisation should provide its own individual response to the complaint and signpost to both the Local Government and Social Care Ombudsman (for social care matters) and Parliamentary and Health Service Ombudsman (for health service matters).

12. Complaints about Commissioned Care Services

Where the local authority has commissioned another organisation to provide care or services on its behalf, the contractual agreement should include the arrangements for handling of complaints. This should include setting out who is responsible for telling complainants about the arrangements and when; who will be responsible for responding to the complaint; and how complaints will be passed between each party.

Complaints should be dealt with in line with Local Government and Social Care Ombudsman guidance Managing Complaints in Contracted and Commissioned Services: A Good Practice Guide.

It may be appropriate to allow care services to deal with complaints as a part of the early resolution step of the complaint process It may not be practical for services to alert the local authority every time a complaint is received and resolved to the complainant’s satisfaction, however the number of complaints received and outcomes may form part of regular contract management oversight arrangements.

If a complainant remains unhappy with the care provider’s response, the local authority should be notified and reach a view on whether the provider should signpost the complainant to the LGSCO or whether the local authority should investigate the complaint. The local authority does not need to investigate every complaint but may take account of:

• the seriousness of the issues raised;
• the impact on the person complaining or others; and
• the wider impact of any potential faults.

The local authority should have processes in place to be able to access care provider records where necessary. This may be through contract arrangements or obtaining consent from complainants to access their records. This supports the effective complaint handling and avoids unnecessary delays as a result of disputes about access to records.

13. Unreasonable or Vexatious Complaints

See Managing Unreasonable Actions by Complainants: A Guide for Organisations (Local Government and Social Care Ombudsman)

Sometimes, complainants can behave in a way that is unreasonable, such as by being unreasonably persistent in relation to their contact and submission of information.  Unreasonable actions are those which, because of the nature or frequency of contact with an organisation, hinder the organisation’s delivery of services or consideration of complaints and can have a significant impact on staff wellbeing.

Whether a complainant’s actions are ‘persistent’ or ‘unreasonably persistent’ depends on the circumstances of the case.  Examples of actions which may be considered unreasonable include:

• being abusive, threatening or acting in a manner intended to intimidate staff;
• making excessive demands on the time and resources of staff with lengthy phone calls and correspondence;

• frequently changing the basis of the complaint as the investigation proceeds;
• raising many detailed but unimportant questions, and insisting they are all answered;
• making unjustified complaints about staff who are trying to deal with the issues, and seeking to have them replaced;
• adopting a ‘scatter gun’ approach: pursuing parallel complaints or contact about the same issue with various organisations.

Unreasonable complainants can be issued with informal or formal warnings and, as a last resort, restrictions can be placed on their contact with the organisation.  Restrictions may include:

• restricting contact to an individual named officer or generic inbox;
• placing correspondence on file without acknowledgement or reply;
• restricting access to certain buildings or premises controlled by the organisation;
• restricting contact to written contact only (having regard to any agreed reasonable adjustments);
• restricting the length and frequency of telephone calls;
• restricting access to discretionary services.

Restrictions should be reviewed at least every 12 months.

In extreme circumstances risk assessments may be conducted and the police involved (see Workplace Harassment and Violence to staff chapter).

14. Monitoring, Annual Report and Learning Lessons

The Customer Relations Team should ensure a record of complaints is kept, including outcomes and lessons learned, together with any actions taken to improve services.

This information will be regularly shared with all managers.

An annual report is produced by the Customer Relations Team and presented to senior managers, including:

• the number of complaints received;
• analysis of the issues raised by the complaints;
• the number of complaints upheld;
• actions taken to improve services as a result; and
• the number of cases referred to an Ombudsman.

The report must be made available to anyone who requests it.

In addition, the information return requested by the Care Quality Commission (CQC) at the start of its assessment of local authority adult social care asks for a summary of compliments / complaints received in relation to Care Act duties over the preceding twelve months.

15. Further Reading

Adult Social Care Complaints, Reviews and Appeals: A Good Practice Guide for Local Authorities (Local Government and Social Care Ombudsman)

Guide for Complaint Managers: Designing and Delivering Effective Complaint Systems (Local Government and Social Care Ombudsman)

Making a Complaint (Local Government and Social Care Ombudsman)

Adult Social Care Resources (Local Government and Social Care Ombudsman)