Adults Services Complaints Annual
Report
April 2007 – March 2008
Gemma Gordon-Johnson
Complaints Manager, Adults & Children’s
Services
Date July 2008
Telephone: 020 7641 3482
Email: [email protected]
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1.
1.1
1.2
1.3
1.4
Introduction & overview
This report provides information about complaints made during the twelve
months between 1 April 2007 and 31 March 2008 under the Adults Services
complaints procedure.
This report only looks at Adults Services Complaints that can be investigated
under the statutory complaints procedure i.e. complaints from service users
who receive a service from Adults Services or their partners.
What is a complaint?
A complaint is an expression of dissatisfaction or disquiet with our service that
requires a response.
Who can make a complaint?
Anyone can make a complaint as long as the local authority has a power or
duty to provide or secure a service for them. This can also include a service
provided by a contractor on behalf of Westminster City Council; service users
can either use contracted services’ complaints procedures or the statutory
Adults Services procedure.
Complaints can be accepted from individuals acting on behalf of a service
user, for example, an advocate or family member, so long as service user has
given consent. Where there are issues around service users’ mental capacity
we look at whether the person pursuing the complaint has the service user’s
best interests at heart.
Self funded users of independent services cannot use Adults Services
complaints procedure but must use their own procedures as stipulated in The
Care Standards Act 200 which was updated in 2005.
2.
2.1
2.2
2.3
2.4
Adults Services Complaints Procedure
The Adults Services Complaints procedure has three internal stages, and
then if a complainant remains dissatisfied they can approach the Local
Government Ombudsman.
Stage 1 – Local Resolution
This is the most important stage of the process; staff and external contractors
should focus on resolving complaints at this stage, wherever possible. At this
stage a response is required within 10 working days (with an extension to 20
working days), which fully answers the complaint, ensures we accept the
feedback and ensures that we learn from our mistakes.
Stage 2 – Independent Investigation
This stage is usually entered into when a complainant is unhappy with the
response at Stage 1. We use only external investigators at this stage, as we
feel it is important to get an independent view. An Assistant Director
adjudicates at this stage. The timescale at this stage is between 25 – 65
working days.
Stage 3 – Review Panel
This is the third and final stage of the Adults Services complaints procedure,
where a review panel is arranged. The panel makes recommendations to the
Director who then makes a decision on the complaint and any action to be
taken. The review panels are made up of an independent chair, an
independent panel member and a local Councillor. There are various
timescales relating to stage 3 complaints, these will be explored later in the
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3.
3.1
3.2
3.3
3.4
3.5
4.
4.1
report.
Activity
The complaints team recorded 39 complaints during the year compared with
39 last year. This figure is the total number of complaints that the Complaints
team handled including complaints about contracted services reported directly
to the complaints team. Complaints received directly by contracted services
are reported in section 4. As some of these complaints are still live (having
entered our monitoring system before 31 March and not yet concluded) they
will be included in next year’s report.
Total complaints made:
From 1 April 2007 – 31 March 2008, we received and closed 29 complaints.
Of these 6 progressed to stage 2. Of those 4 complaints proceeded to Stage
3.
Comparison with the preceding year
This indicates the total number of complaints recorded is the same as the
previous year. This shows that we are handling complaints in a consistent
manner and that where we take remedial actions and implement learning this
does minimise repeat complaints.
Representations
Representations can be defined as any other ‘customer’ feedback other than
a complaint; these include ‘grumbles’, request for service, concerns,
suggestions, enquiries and compliments.
The total number of representations recorded by Adults Services was 107.
This is a good indication that staff within the service are valuing service user’s
feedback. This is also an improvement on 27 (within 6 months) recorded last
year. It is of great importance to deal with feedback at a more local level and
thus service users do not have to use the more formal complaints procedure.
Stage 1 Outcomes
19 stage 1 complaints were upheld (either fully or partially), 19 were not
upheld, and one complaint was withdrawn. In comparison with last year, the
outcomes recorded are the same. There has been a vast improvement in
teams ensuring to make clear decisions on complaints and informing
complainants of the outcome of their complaints.
Stage 1 response times
Adults Services responded to 29 complaints (74.36%) within 10 working days,
8 complaints within 20 working days. This equates to 94.82%, 2.5% increase
compared with last year. It is good that Adults Services are improving the time
they take to respond to complaints. However, it should be noted that the
teams are still not notifying complainants when they enter into the extended
10 working days. It is important that complainants are notified of any delay, as
if they are not and they do not hear from the team within 20 working days,
they have an automatic right to stage 2, independent investigation.
Contracted Services
Within this financial year we have seen an increase in the number of
complaints received by our contracted services (including our in-house
service Chinese Domiciliary. This can be attributed to an additional contracted
service being included this year, better understanding by contracted services
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4.2
4.3
4.4
5.
5.1
about what is a complaint, and better understanding of our own complaints
procedures and that service user’s can access them if they wish if the Council
funds their care. We must also note that one of our provider’s has seen a
large number of complaints, as there have been major changes within their
organisation and how they operate. In total, 263 complaints were received
2007 –08 compared with 190 the previous year. Anchor Care received the
highest number of complaints (98), Housing 21 (76), Penfold Street (77),
Dependability (8), and Chinese Domiciliary (3). The Complaints Team are
working much closer with Contracted Services and Contracts Monitoring
teams to ensure that where problems are identified remedial action is sought
quickly to resolve concerns. It should be noted that the figures quoted above
are those complaints investigated under contracted services procedures, not
statutory Adults Services complaints procedures.
The majority of stage 1 complaints recorded for contracted services were
upheld, either fully or partially, 67.18%, this is a reduction of just under 10% in
comparison to 2006-07, which is a good indictor that where complaints have
previously been upheld, strategies have been implemented to reduce the
number of similar complaints. 41 complaints (15.65%) were not upheld, which
means that 17% of complaints have either no outcome, or an unknown
outcome. Again, we are working with our contracted service to improve the
recording of outcomes of complaints, as this information is key to establishing
which areas are causing more concern for the service.
At Stage 1, 72.9% of complaints were responded to within 10 working days;
however, 76.34% of all stage 1 complaints were responded to within 20
working days. This is a decrease 15% compared with last year’s figure of
91.8%. However, it should be noted that one additional contracted service
was not recording this information for 6 months, hence why we have 22.52%
unknown. Systems have been put in place in this service now so information
can be recorded accurately in future.
Appendix 1 shows the breakdown of types of complaints received about our
contracted services. Our service users complained mostly about poor quality
of service and staff. These types of complaints can range from carer
consistently being late, not completing tasks assigned on care plan, and that a
staff member was rude or unprofessional. We are monitoring these types of
complaints in conjunction with the Contracts team to ensure that services are
taking appropriate actions to ensure the service they provide is of a good
standard. It must be noted that there is a high turnover of staff in these
services, so although work has been done on addressing staff related
complaints, we may see that the number of complaints about this area remain
high next year.
Compliments
Adults Services received 62 compliments and our contracted services
received 278. The table below shows the number of compliments received
over the last 4 years, this year we have received a similar number of
compliments. The large increase in compliments recorded can be attributed to
one contracted service, which is Housing 21, who received 263 compliments.
2007-08
2006-07
2005-06
2004-05
Adults Services 62
60
29
6
Contracted
278
196
341
270
Services
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6.
Healthcare
We have received 0 complaints relating to Westminster City Council,
Westminster Primary Care Trust or Central North West London Foundation
Trust. Despite receiving 0 joint complaints we have set protocols on how to
handle such complaints. We have regular meetings with our healthcare
colleagues, and are acting as lead for Central VIAN group which has been set
up due to the work on the new one complaints procedure for Health and
Social Care due to be introduced in April 2009.
7.
7.1
Stage 1 complaints by team
See Appendix 2 for full breakdown of stage 1 complaints.
8.
Stage 2 complaints
Adults Services received 6 complaints at stage 2 this year compared with 2
that were investigated in 2006-07.
Within the year, we received 2 complaints that were about 2 different
contracted services. The first was a complaint about Anchor Care and its
failure to adhere to care plan and failure to safeguard a vulnerable adult. This
complaint was upheld in the main although it was not accepted that Anchor
Care had left the service user vulnerable and this had an adverse affect on
service user’s health. The complainant wanted the care provider to be
changed and for lessons to be learnt so that this would not happen again. As
a result of the complaint we developed an action plan to try and address some
of the failings by Anchor Care but unfortunately the problems still existed and
the complaint progressed to Stage 3. The stage 2 investigation took 44
working days to complete.
The second complaint about contracted service was about Dependability. The
complainant did not agree with the outcome of an occupational therapy
assessment and believed that a level access shower should be fitted at home.
Also, that a member of staff was rude when dealing with the assessment. The
complaint was upheld in that one of the occupational assessments was
flawed. However, it was correct in not recommending that a shower should be
installed, and there was no evidence to suggest the member of staff was rude
but they did write apologising for delay in dealing with their complaint. The
investigation took 49 working days to complete.
We received a complaint at stage 2 about failure for adaptations to be
installed at home for a service user, and about Adults Services lack of
assistance in sorting out their housing problems. The complaint was
investigated and was not upheld, it was found that the property was unsuitable
for adaptations and that the service user was on the housing list for suitable
properties but that this could take some time. The investigation took 26
working days and the complaint was not pursued any further.
Finally, we received 2 complaints that disagreed with the assessment of their
care needs. The first complainant had very complex care needs and had been
assessed at the level of 80 hours care a week but disagreed that this was
adequate to deal with the condition and to provide the carer with some respite.
The complaint was partially upheld because it was felt that a joint assessment
8.1
8.2
8.3
8.4
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with healthcare should be carried out to ensure that the complainant’s needs
were fully addressed. A carer’s assessment was also carried out to ensure
their needs were met in relation to this case. The complaint investigation took
42 working days to complete.
The second complaint was received from an elderly resident about inadequate
allocation of hours and how the current care package did not address needs,
and there was no provision for social activities within his care hour’s
allocation. The complainant requested that the level of care was increased to
fully address his needs. The complaint was not upheld however it was
recommended that a multi-disciplinary assessment should take place to
assess his needs. The investigation took 23 working days to complete.
9.
9.1
9.2
9.3
Stage 3
We received 4 stage 3 complaint requests and for all of them a review panel
was held.
We received 3 new stage 3 requests this year and one stage 3 complaint that
was received in the previous year but the review panel was held this year.
This complaint occurred when Adults Services moved the complainant into a
residential home from private accommodation. The complaint was that the
move was rushed, which meant the complainant could not retrieve all his
personal possessions and subsequently led to a number of these possessions
being stolen from the flat whilst it was vacant. The complainant wanted an
apology and reimbursement for lost possessions. The complaint was not
upheld. The Council empathised with the complainant’s case but could not be
held accountable for the loss of possessions.
The second complaint received centred on Adults Services failure to treat the
complainant’s concerns seriously, badly managed his housing allocation, and
failed to assess his vulnerability properly following a suicide attempt. The
complainant’s desired outcomes were:
 Referral to different team
 Compensation of £25,000 for distress and suffering
 An assurance that changes has been made so others do not have to
go through a similar situation.
The complaint was not upheld, and a referral was made to a different team,
but the complainant did not take up the service and no offer of compensation
was made.
A complaint previously investigated at stage 2 within this year escalated to
stage 3 due to continued poor performance by one of our contracted services,
Anchor Care. The complaint was about general poor service, poor level of
personal care, poor management of weekend and evening visits and putting a
vulnerable service user at more risk. The complainant’s desired outcomes
were: a full written apology from the care providers, an increased
compensation offer and an apology from the Council that they failed to
recognise neglect towards the service user and change the provider. All areas
of this complaint were upheld and many recommendations were made as a
result of this complaint. Action plans for both the Council and Anchor Care
have been developed and fully implemented and practices have changed as a
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9.4
9.5
10.
10.1
10.2
10.3
11.0
11.1
11.2
result of this complaint. The learning from this complaint can be found in
section 13.
Also at stage 3, the complainant disagreed with care management’s
assessment of their needs; they wanted the number of care hours increased.
This complaint was not upheld but the Council committed to undertaking a
multi-disciplinary assessment to ensure that the complainant’s full needs were
taken into consideration.
Stage 3 timescales
At Stage 3 there are 2 main timescales, firstly that the Panel produce a
response within 5 days detailing their decision and recommendations for the
Council. The Panel has 5 working days to produce their response. Secondly,
the Director has 15 working days to respond to those recommendations;
detailing what action the Council will be taking. All 4 complaints investigated
at stage 3 were dealt within timescale.
Local Government Ombudsman
We received 5 Ombudsman enquiries; 1 premature complaint that had not
completed internal procedures, 1 complaint which was primarily about
housing and we were asked to give details about our role in the case and 3
complaints taken on for investigation.
A service user complained that staff were rude to him and his accommodation
was not suitable. We were asked to submit information to the Ombudsman in
July and we still await their decision on this case. We will report this in next
year’s annual complaints report.
The Ombudsman took on one complaint for consideration; the complaint was
that there was a delay in reinstating the complainant’s Direct Payments and to
reimburse his care costs for the period of time when he was not receiving
Direct payments. The Ombudsman’s view was that the Council should pay
compensation of £500. The Council paid this and produced a new Direct
Payments contract for the service user.
We received correspondence from the Ombudsman in relation to a complaint
about multiple issues relating to a service user’s care management. We
submitted information to the Ombudsman as requested in October and we are
still awaiting communications from them about the case.
Percentage escalation figures
The following table indicates how many complaints have escalated from
Stage 1 to Stage 2 and from Stage 2 to Stage 3. We can gauge from these
figures whether we have an effective complaints procedure and identify
whether we are dealing with complaints at a local level.
Adults Services
Percentage escalation
Stage 1 to Stage 2
15.38%
Stage 2 to Stage 3
66.67%
The escalation rate between Stage 1 and Stage 2 has increased in
comparison to last year and this can be attributed to service users being more
familiar with the complaints procedures which were introduced last year. The
escalation rate between Stage 2 and Stage 3 has remained exactly the same
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as last year; we tend to find that most complaints investigated at stage 2
progress to Stage 3.
12.
12.1
Expenditure
There are costs involved with running an effective Complaints Service and
ensuring that we provide independent investigators at both Stage 2 and 3.
Breakdown of costs
Stage 2 Investigating Officers
Stage 3 Panel
12.2
6768.4
3675.4
10,443.80
The cost of providing independent investigators has increased by over £8,000
in comparison to last year, however it should be noted that we operated under
current statutory complaints procedure for 6 months last year. The increase is
mainly due to the large number of complaints investigated at stage 2 and 3,
and also the complexity of these cases. This highlights the importance of
resolving complaints at Stage 1.
Compensation Payments
Stage 3
Ombudsman
Total
13.
13.1
13.2
500
500
1000
Access to Records/ Freedom of Information
Access to records
We have received 2 access to records request this year via the complaints
team and both were as a result of stage 2 complaints that then escalated to
stage 3. Both complainants wanted to ensure that certain information was in
the service user’s file and the wording of some records on file. Both requests
were handled within 40 working days.
Freedom of Information
The same complainant then made a freedom of information request for
information relating to how many complaints our contracted service; Anchor
Care had received in the last 2 years at each stage. Also, they requested the
same information about Adults Services; all targets were met in relation to this
freedom of information request.
14.
Learning Lessons/ Improvements
It is important that we treat complaints as valuable feedback and where they
highlight poor areas in our practices or decision making we take the
opportunity to learn and implement changes, to ultimately provide a better
service.
14.1
After receiving 2 complaints at stage 2 regarding the number of hours of care
allocated, we implemented a change in practice. Therefore, in future when we
receive a Stage 1 complaint about allocation of care hours we would do a reassessment, if one had not been undertaken within 6 months. This is to
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14.2
14.3
15.
15.1
15.2
ensure fair practice and also means that the complainant does not have to
wait for a Stage 2 investigation that would predominantly suggest that a reassessment is carried out. Since we have implemented this there have been
no complaints escalating to Stage 2.
Within this financial year we received a complaint (under our procedures)
about one of our contracted services that provides personal care for our
service users. The complaint centred on: poor level of care, provision of care
at the weekend, poor key management, and increasing vulnerability of service
user. The complaint went through all our internal stages, and subsequently
after the stage 3 panel we changed our practices to ensure that when we
receive a complaint about one of our contracted services and the quality of
service they are delivering that we would use the Stage 2 investigation as a
trigger to examine whether to change the care provider, so that if bad practice
continues, the service user does not have to continue to suffer.
We have received two stage 2 complaints about our contracted services this
year. Where there are serious concerns raised about these providers we will
in future assess whether their concerns should be treated as a Protection of
Vulnerable Adults firstly, and then if a complainant wishes to pursue the
complaint further it would be after POVA investigation. We have listened to
service user’s feedback and have taken on board their concerns about Adults
Services not getting involved in the complaint at an earlier stage and treating
the issues raised with the right level of severity. Whenever we receive a
representation/complaint about contracted service, the care manager is
notified and asked to monitor the situation so it does not escalate without
anyone within Adults Services knowing and taking appropriate remedial
action.
2008 – 09
The main priority for 2008-09 for the Complaints Team is to ensure that we
fully cooperate with the Department of Health’s implementation of a new
complaints procedure for Social Care, due to be introduced in April 2009. This
means we need to develop strong links with our Healthcare counterparts. The
Complaints Manager already leads Central London VIAN Group, which was
set up with this project in mind, and undertakes the role of Communications
Officer for London Complaints Manager’s Group.
We have been selected to trial the new proposed joint complaints procedure
for Social Care and Health, Early Adopters scheme. This means that we will
be adopting a two-staged approach with the first stage focusing more on
resolving the complaint and involving the complainant more in the process.
The trial runs from April 2008 for 6 months. We are currently working
alongside Central London Early Adopters Group and National Social Care
Early Adopters Group to share ideas and good practice, so we can produce a
system whereby complaints are dealt with fairly and quickly. The proposed
changes provide a new way of dealing with complaints, which focuses on
resolution and the complainant. This will have resource implications for
complaints team, as initially they will in conjunction with departmental
representative draw up a complaints action plan with complainants, which will
take longer but will hopefully prove more beneficial for all.
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