ADULT SERVICES
COMPLAINTS-COMPLIMENTS-REPRESENTATIONS
APRIL 2007 – MARCH 2008
ANNUAL REPORT

October 2008

CONTENTS

Page
Contents / 1
Executive Summary / 2
Section A
Introduction / 4
The statutory complaints procedure / 4
Management and administration / 5
Publicity and information / 5
Advocacy and special needs / 6
Equality and diversity / 6
Performance measures / 7
Section B
Overview of activity
-Comments
-Registered stage 1 complaints
-Complaints dealt with at stage 2 & 3
-Referrals to the Local Government Ombudsman
-Other relevant complaint procedures
-(corporate complaints & Supporting People) / 8
10
13
14
14
Section C
Learning from complaints and service changes / 16
Complaints handling by independent sector providers / 16
Future developments and emerging challenges / 18

LIST OF TABLES

1. Comments received / 8
2. How comments and complaints are made / 10
3. New complaints registered in year / 10
4. Complaints completed in 2007-8 / 10
5. Stage 1 complaints response time / 11
6. Outcomes of stage 1 complaints received in year / 11
7. Issues of complaints and concerns / 11
8. Service profile of complaints and concerns / 12
9. Profile of complainants / 12
10. Stage 2 complaints completed in year / 13
11. Recommendations to resolve stage 2 complaints / 13
12. Recommendations to resolve stage 3 complaints / 14
13. Corporate Complaints / 15

Appendix 1: Summary table of community based services 18

- Comments, Concerns & Complaints.

Executive Summary

This report covers the period 1 April 2007 to 31 March 2008 during which time Adult Services provided services to 9431 people.

Complaints and negative comments were received from less than 1% of all service users. This has been the consistent picture for the past four year.

Positive comments were received from 6.5% of service users. The number of positive comments rose by 16% (from 524 to 610). This has resulted in Adult Services achieving a ratio of positive comments v negative comment and complaints of 5.5:1. We exceeded the target set for the Directorate of a ratio of 4.8:1.

The number of complaints registered in the year fell by 45% compared with 2006 -7 to 44. This is the fourth consecutive year that the number of registered complaints has fallen. In addition there were a further 31 issues of concern dealt with through informal resolution so that they did not become registered complaints.

The Occupational Therapy service and Equipment Direct continue to be the services that receive the most praise. The practical aids and adaptations provided to people to help them live as independently as possible at home is highly appreciated.

The independent sector care at home providers continue to be the services which receive the largest volume of complaints. In a survey of home care service users 19% of people reported that they did not know how to complain about their services. The contract conditions for the handling of complaints by specialist providers have been updated and enhanced to improve the service users’ access to their complaints procedures. These provider organisations have had their procedures assessed and guidance given on how to improve. This will be extended to all care at home providers in 2008-9

There has been a significant drop in the number of older people registering a complaint. It is not clear why this has happened and further work needs to be done to understand the cause. Most complaints are usually received in the autumn and winter period but this did not happen in 2007-8.

There was a backlog of cases from the previous year that was cleared in 2007-8. However, this resulted in a substantial rise in the number of stage 2 (independent investigations) and stage 3 (independent review panels) complaints dealt with in the year. This also affected the timescales for responding to complaints, increasing the time taken.

Just under half of all complaints at stage 1 were fully or partially upheld (48%). 80% of complaints investigated at stage 2 were fully or partially upheld. 66% of complaints reviewed by the independent review panels were fully or partially upheld.

Most complaints were resolved by an apology and a clear explanation of what had happened. The complaints investigation and review process resulted in a number of significant proposals for changes and improvements. These include:

  • Revision of terms and conditions of placement in the resource centres to clarify the rights and responsibilities of the service user, including charges.
  • New roles and responsibilities guidance for hospital social workers around hospital discharge, particularly in regard to communication with families and residential homes.
  • New cross-agency procedures to deal with infestations in the homes of vulnerable service users to prevent unnecessary admission to respite care.
  • Improved procedure for the management of “no replies” alerts with electronic monitoring of decisions and actions to improve service user safety.

Work began on developing a comprehensive knowledge / intelligence sharing system across the Safeguarding Adults, Contracts. Supporting People and Complaints services to enable trends to be detected early and prevent problems escalating.

The contract conditions on the handling of complaints by the independent sector were enhanced. Organisations were given advice on how to achieve improvements in their systems and comply with the contract. A baseline was established from surveys of how the independent sector organisations currently deal with complaints they receive. This will be the starting point from which we will assess the effectiveness of this work over time.

The current complaints regulations and procedures are under review by the Government as set out in the white paper “Our health, our care, our say”. We have been chosen to be an Early Adopter of the new system and will be working with colleagues in health services, both regionally and nationally, throughout 2008-9 to identify the changes necessary to the current procedures and guidance covering complaints handling.

Section A

Introduction

The Adult Services complaints procedure derives from The NHS and Community Care Act 1990 (section 50), The Health and Social Care (Community Health & Standards Act) 2003, and The Local Authorities Social Services Complaint (England) Regulations 2006. These Acts and Regulations set down the procedures that Councils with Social Services Responsibility (CSSR) have to follow when a complaint is made. The guidance to the legislation and regulations requires each CSSR to produce an annual report.

Adult Services values the feedback it receives about its services from service and carers in the form of comments, suggestions and complaints; user surveys and consultation. The information gathered from comments, complaints and suggestions makes an important contribution to our service planning and improvement.

This report gives a breakdown of the comments, complaints and suggestions received by Adult Services from 1 April 2007 to 31 March 2008, and an understanding of the issues highlighted by these complaints and representations.

This report focuses mainly on complaints made through the statutory route. There is also information on complaint-related queries and compliments received about our services.

Some complaints could not be examined using the statutory complaints procedure because the person making the complaint did not qualify under the regulations, e.g. where the person making the complaint was not the service user or carer. These complaints were considered using the Council’s corporate complaints process. A summary of these is included here. More detailed information is included in the Corporate Complaints’ annual report.

In addition there is information on complaints concerning Supporting People services commissioned by Adult Services.

Annual reports from previous years are available on our website:

The statutory complaints procedure

When we are first contacted by a service user or their representative with a concern we try to solve that problem informally with the manager of the service. If this is not possible the concern is registered as a statutory complaint.

The statutory complaints procedure consists of three stages.

Stage 1 is local resolution by asenior manager responsible for the service or staff who are the subject of the complaint. The manager examines what has gone wrong in their service and tries to resolve the issues of concern directly with the service user. If the person who made the complaint is dissatisfied with the actions taken by the manager to resolve their complaint they may ask for it to be examined at the next stage of the complaints process.

Stage 2 is an investigation by either the Customer Relations Officeror an independent investigator. They write a report with recommendations for improvement. The head of the service complained about responds to this report in writing stating if they agree with the investigating officer’s conclusions and how they will implement any recommendations made. If the person making the complaint is still dissatisfied they may ask for the investigation to be reviewed.

Stage 3 is a review of the investigation and the Head of Service response to it by an independent review panel. The Director of Adult Services responds in writing to the findings and recommendations of the review panel setting out what he intends to do.

If the person making the complaint is still dissatisfied at the end of stage 3 they can ask the Local Government Ombudsman to review their complaint and how it was dealt with through the statutory process. The Ombudsman will decide if the local authority was at fault in any way and what action it should take to put things right.

If the complaint also concerns the actions of a partner organization, such as a hospital, the Customer Relations Team agrees with them who will coordinate the investigation of the complaint. The lead organization then provides the service user with a response to all aspects of the complaint.

Management and administration of the complaints procedure

In 2007 – 8 the complaints procedure was managed by the Customer Relations Team within the Performance Division of Adult Services. This arrangement ensured that the Unit was independent and at arms length to operational adult care services.

This consisted of:

  • Staffing of 1 Complaints Manager; 1 Customer Relations Officer; 1 Complaints Officer; 1 Administrative Assistant. All posts, except for the dedicated Customer Relations Officer, have a shared responsibility for children’s social care complaints.
  • Independent investigations and review panelscontracted on a “case by case” basis
  • Information and promotion of the complaints process .

Publicity and Information

Publicity and information continued to be provided routinely in several languages and formats such as audiotape. This facilitates easier access to the complaints process. All new service users received a freepost comments leaflet in their information pack on which to record and send back their views on the service they receive.

Despite this promotion activity 19% of home care service users reported that they did not know how to make a complaint or who to when they were surveyed in March 2008.

The Customer Relations Team coordinated the Adult Services’ presence at the MELA (an annual cultural festival for minority ethnic communities) providing information about Adult Services and promoting access to the complaints process.

The Customer Relations Team maintained direct contact with the majority of complainants, their carers, representatives or advocates and provided additional or more detailed advice and support as requested.

Advocacy and special needs

Vulnerable service users are encouraged and supported to express their views and to access the complaints procedure. During 2007/2008, 1 complaint (2.2%) was made by a formal advocate on behalf of the service use; 2 complaints (4.4%) were made by the main carer (spouse) acting as an advocates on behalf of the service user; and 20 complaints (46%) were made by relatives acting as advocates on behalf of their family member.

The Customer Relations Team did not make any referrals to advocacy services in 2007-8 as all those eligible were already in contact with the relevant organisations. These are Newcastle CVS citizens’ advocacy; Newcastle CVS case advocacy (specifically for people with mental health issues); Skills for People (specifically for people with learning difficulties andmental capacity advocacy). Each of these is funded by Adult Services. Newcastle Citizens Advice Bureau also receives funding to provide general information, advice, and support to people making a complaint.

The Complaints Manager is a member of the Newcastle Advocacy Steering Group.

We have the discretion to appoint an independent person to monitor and report on the conduct of a stage 2 investigations for vulnerable service users. In 2007-8 one independent person was appointed for an investigation where the service user did not require an advocate. We felt they would have greater confidence in the outcome of their complaint if there was an independent element.

All the stage 3 review panels were undertaken by fully independent panellists.

Equality and diversity

We monitor complaints against ethnicity, age, and gender.

3.4% of all people who receive services from Adult Services come from minority ethnic communities. There was only one complaint (2.2%) received from a member of the minority ethnic community in 2007-8, and less than 1% of all comments received came from these communities. This situation has not changed significantly over the past three despite our work with the Black & Minority Ethnic Advocacy Group coordinated by Newcastle Council for Voluntary Service, and promoting access to complaints at events such as the MELA.

2007-8 was unusual in that half of all complaints were made by men yet they account for only 35% of all service users. In previous years the number of complaints received from men was proportionate.

50% of service users who made a complaint in 2007-8 were aged over 65 years of age. This was not proportionate to the number of older people who receive services, which is 71% of all service users. In previous years the number of older people making a complaint tendedto be roughly equal to the number of older people receiving services. There has been an overall drop in complaints received in 2007-8. This was particularly noticeable in relation to homecareservices in the second half of the year.

Further work needs to be done to fully understand these changes.

Performance measures

In 2007-8, 9431 people received services. Less than 1% of these people made any negative comment or complaint about the services they received.

Newcastle City Council uses a balanced scorecard to measure and monitor the performance and effectiveness of its services. The target set for Adult Services is to achieve a ratio of 4.8 positive comments for every 1 complaint or negative comment received about its services. In 2007 -8 Adult Services achieved a ratio of 5.5:1.

Section B

Overview of activity

Comments

Table 1: Comments received

95% of comments received in 2007-8 were positive. This has been a consistent picture since 2004-5. All comments and suggestions are recorded, acknowledged and sent on to the manager of the relevant service for their information and follow-up action.

The majority of positive comments received concerned the Occupational Therapy service and Equipment Direct in relation to aids and adaptations. Most refer to the speedy and efficient delivery and installation of equipment, and the attitude and courtesy of the staff.

“…The assessment, delivery, installation, testing and comprehensive instruction on its use was outstanding.”

“Response to my request was very quick, explained to me so I understood, and was helpful. Thank you”

“Everything these people did was perfect, manners, jobs, plus cleaning. Thank you all.”

“It has made for a great deal easier way of life for me and given me back some independence.”

“services have greatly improved over the last few years when just applying for a wheelchair was, for me at any rate, an absolute nightmare.”

Even the negative comments about these services tend to be qualified with praise

“… service has been very good even if there is a delay between interview and getting the job done. The only thing I can’t understand is why my wife can’t have a grab rail at the back door as she goes out to the back garden 10 times more often than out the front door. We were not given any choice between front and back door.”

One negative comment alerted us to the fact that the contact telephone number on information sent by Equipment Direct was incorrect.

Independent sector care at home services received the largest number of negative comments (11) accounting for 48% of all adverse comments. A typical example is:

“…the morning and weekend service is erratic and the staff are obviously under great time pressure; this results in not enough attention being afforded”.

Many comments highlight the long term improvement to people’s lives as a result of Adult Services involvement

“Thank you for having faith in me and putting me on the road to recovery. Without your help God knows where I would be today.” (Drugs & Alcohol Service user)

“Just to say I’m still doing ok and nearly 21 months sober! Have started a voluntary job and been on a five day holiday to Rome with a friend in AA. My life is good today.” (Drugs & Alcohol Service user)

“I am very pleased with the help and advice given to me. Already I have received a supply of Tynesound tapes and the Directory Enquiries have been set up by B.T. I have applied for a disabled parking badge and am waiting to hear from other referrals made on my behalf. I appreciate the kindness and understanding shown to me and feel less worried about my vision problems now I know that such good help is available” (Sensory Support service user).

“Support given by current carer has significantly improved my quality of life. Provision of care alert button has increased my confidence and given me peace of mind.” (Care at Home service user)

“I stayed at the end of ‘88 and again for a little while in ’90 …I always have fond thoughts if my time in the hostel. I have never looked back since my time at Sunny Crest and will always be grateful for the independence and common sense I learnt then…I am still with T who I met at the hostel…we have been together 17 years this November.” (Mental health resource centre service user).

Table 2: How comments & complaints are made

Method of Communication / Comment / Complaint
Standard form on complaints leaflet / 66% / 28%
Standard form in large print format / 8% / 2%
By letter or card / 20% / 8%
By telephone / 4% / 56%
On-line / 0.5%
In person / 0.5% / 5%
Other / 1%

The number of comments received and the ratio of positive to negative comments has remained constant despite a drop of 45% in the number of complaints registered.