COMPLAINTS MANAGEMENT
ANNUAL REPORT
2008 – 2009
Table of Contents
1. INTRODUCTION
2. OVERVIEW
3. WEST LONDON MENTAL HEALTH TRUST RESPONSIBILITIES TO THE HANDLING OF COMPLAINTS
4. COMPLAINTS RECEIVED FOR EACH QUARTER (Table 1)
5. PERFORMANCE (Table 2)
6. COMPLAINT CATEGORIES (Table 3 & 4)
7. INDIVIDUAL COMPLAINT ITEMS (Table 5 & 6)
8. DIATION MEETINGS
9. HEALTHCARE COMMISSION
10. CONCLUSION
The following appendices details specific data for each Service Delivery Unit and each notes Performance, Complaint Categories, Staff and Patient Ethnicity and Learning and Outcomes.
APPENDIX 1. HIGH SECURE SERVICES - LONDON
APPENDIX 2. HIGH SECURE SERVICES - SOUTH OF ENGLAND
APPENDIX 3. HIGH SECURE SERVICES - DSPD
APPENDIX 4. WEST LONDON FORENSIC SERVICES - MENS WEST
APPENDIX 5. WEST LONDON FORENSIC SERVICES - MENS CENTRAL
APPENDIX 6. WEST LONDON FORENSIC SERVICES - WOMENS
APPENDIX 7. WEST LONDON FORENSIC SERVICES - ADOLESCENT
APPENDIX 8. EALING SERVICE DELIVERY UNIT INCLUDING ADULT, OLDER PEOPLE & CHAMS
APPENDIX 9. HAMMERSMITH AND FULHAM SERVICE DELIVERY UNIT INCLUDING ADULT, OLDER PEOPLE, CHAMS AND THE GIC
APPENDIX 10. HOUNSLOW SERVICE DELIVERY UNIT INCLUDING ADULT, OLDER PEOPLE, CHAMS AND THE CASSEL HOSPITAL
1. Introduction
1.1 The West London Mental Health trust is committed to responding to complaints in an open, honest, comprehensive and timely manner. From April 1st 2008 to 31st March 2009 the Trust’s performance on responding to complaints within the NHS twenty five working day target has once again been a key priority alongside ensuring learning from complaints is shared across the Trust.
1.2 This report summarises the level and diversity of the complaints and the activity of the West London Mental Health NHS Trust during April 2008 to March 2009.
1.3 The number of formal complaints received in 2008/09 was 220 and the Trust’s performance in responding to complaints within 25 working days was 76%. In 2007/08 the data notes that the number of formal complaints received in this period was 240 and the Trust’s performance of complaints responded to within 20/25 working days was 80%.
1.4 The Trust received fewer complaints in 2008/09 and we believe that contributory factors are for example a greater number of PALS queries being resolved directly by the staff and continued commitment to empowering service users to raise and resolve issues locally.
1.3 The Trust has also seen a minor difference in complaints referred to the Healthcare Commission for investigation under the second stage of the NHS Complaints Procedure. The Trust received 13 referrals from the Healthcare Commission in 2008/09 compared to 9 in 2007/08 (further information regarding Healthcare Commission referrals will be available in section 12 of the report).
1.5 Alongside performance data this report describes the outcome of complaints which include positive changes to practice during 2008/09.
2. Overview
2.1 Complaints
2.2 The West London Mental Health Trust Complaints procedure includes two stages.
· Local Resolution Stage
This is a formal process whereby a complaint would be formally registered and investigated by a nominated individual from within the Service Delivery Unit. Following this the complainant would receive a response from the Chief Executive within 25 working days.
· Mediation Meetings
The Trust recognises that for some complainants, local investigation and a response does not always meet the needs of the individual complainant. Thus, opportunities for meeting with Trust staff in terms of mediation meetings have been of great benefit to complainants in resolving and providing closure to outstanding concerns and aiding learning.
· Healthcare Commission
Any complainant who remains dissatisfied with the outcome of a complaint following Local Resolution has the right to request an Independent Review through the Healthcare Commission and subsequently to approach the Health Service Ombudsman.
3. West London Mental Health Trust Responsibilities to the handling of complaints would include:-
· Investigating complaints within West London Mental Health Trust including co-operation with other agencies in the case of cross-boundary issues.
· Providing support and advice to staff in their handling of complaints
· Providing a mediation service
· Informing complainants of their rights through the Healthcare Commission.
· Co-operating with the Healthcare Commission in relation to any request for independent review.
4. Complaints Received for Each Quarter
4.1 This section notes the number of complaints received by directorate for each quarter of 2008/2009.
Table 1
Number of Complaints by Service Delivery Units / Complaint NumbersApr / May / Jun / Q1 / Jul / Aug / Sep / Q2 / Oct / Nov / Dec / Q3 / Jan / Feb / Mar / Q4 / Total
Ealing SDU
Adult / 2 / 4 / 2 / 8 / 4 / 4 / 4 / 12 / 3 / 1 / 4 / 8 / 3 / 0 / 2 / 5 / 33
OPS / 0 / 0 / 3 / 3 / 0 / 0 / 0 / 0 / 0 / 1 / 0 / 1 / 0 / 0 / 0 / 0 / 4
CAMHS / 0 / 0 / 0 / 0 / 0 / 1 / 0 / 1 / 0 / 1 / 0 / 1 / 0 / 0 / 0 / 0 / 2
Hammersmith & Fulham SDU
GIC / 0 / 1 / 0 / 1 / 0 / 1 / 0 / 1 / 0 / 0 / 1 / 1 / 0 / 1 / 0 / 1 / 4
Adult / 2 / 1 / 4 / 7 / 4 / 4 / 1 / 9 / 1 / 1 / 1 / 3 / 1 / 2 / 2 / 5 / 24
OPS / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 0 / 1 / 1
CAMHS / 0 / 0 / 0 / 0 / 0 / 1 / 0 / 1 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1
Hounslow SDU
Adult / 1 / 1 / 0 / 2 / 0 / 3 / 1 / 4 / 0 / 2 / 2 / 4 / 2 / 1 / 1 / 4 / 14
OPS / 0 / 0 / 0 / 0 / 0 / 2 / 1 / 3 / 0 / 0 / 1 / 1 / 0 / 0 / 0 / 0 / 4
CAMHS / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0
Cassel / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 0 / 1 / 2 / 2
High Secure Services
London / 2 / 7 / 2 / 11 / 2 / 4 / 3 / 9 / 0 / 1 / 0 / 1 / 0 / 2 / 1 / 3 / 24
South of England / 1 / 0 / 3 / 4 / 7 / 5 / 1 / 13 / 0 / 2 / 2 / 4 / 1 / 2 / 0 / 3 / 24
DSPD Unit / 4 / 0 / 3 / 7 / 7 / 5 / 2 / 14 / 6 / 2 / 0 / 8 / 2 / 1 / 3 / 6 / 35
West London Forensic Services
Women’s (The Orchard) / 1 / 0 / 2 / 3 / 1 / 2 / 1 / 4 / 4 / 0 / 1 / 5 / 0 / 0 / 0 / 0 / 12
Men’s West Cluster / 0 / 2 / 4 / 6 / 0 / 1 / 2 / 3 / 0 / 2 / 0 / 2 / 0 / 3 / 0 / 3 / 14
Men’s Central Cluster / 1 / 5 / 0 / 6 / 0 / 0 / 4 / 4 / 2 / 1 / 1 / 4 / 1 / 0 / 4 / 5 / 19
Forensic Adolescent / 1 / 1 / 0 / 2 / 0 / 0 / 0 / 0 / 0 / 0 / 1 / 1 / 0 / 1 / 0 / 1 / 3
TRUST TOTAL / 15 / 22 / 23 / 60 / 25 / 33 / 19 / 77 / 16 / 14 / 14 / 44 / 11 / 14 / 14 / 39 / 220
5. Trust Performance
5.1 Information in table 2 illustrates complaint performance on a directorate, divisional & Trust basis.
Table 2 Note: The Statutory response timescale is 25 working days.
Cumulative performance 2008/2009 / Total Number of Complaints Received / Number closed < 25 days / Performance (0 – 25 days)% / Number closed over 25 days / Number closed over 25 days with agreed extension / Still active / Note: High Secure South Directorate
This directorate cares for a number of individuals who make substantial numbers of complaints. 2008/9 1 patient made 6 complaints and 1 patients made 5. The remaining complaints were made by individual patients.
DSPD
2008/9 Data demonstrates that in the DSPD 1 patient made 6 complaints and 1 patient made 5 complaints and 1 patient made 3.
HIGH SECURE LONDON / 24 / 20 / 83% / 1 / 1 / 2
HIGH SECURE SOUTH OF ENGLAND / 24 / 18 / 75% / 6 / 0 / 0
HIGH SECURE DSPD / 35 / 25 / 71% / 10 / 0 / 0
WEST LONDON FORENSIC WOMEN’S / 12 / 6 / 50% / 5 / 0 / 1
WEST LONDON FORESNIC MEN’S WEST / 14 / 13 / 93% / 1 / 0 / 0
WEST LONDON FORESNIC MEN’S CENTRAL CLUSTER / 19 / 11 / 58% / 7 / 1 / 0
WEST LONDON FORENSIC ADOLESCENT / 3 / 2 / 67% / 0 / 0 / 1
EALING ADULT / 33 / 31 / 94% / 1 / 0 / 1
EALING OPS / 4 / 2 / 50% / 2 / 0 / 0
EALING CAMHS / 2 / 2 / 100% / 0 / 0 / 0
H&F ADULT / 24 / 15 / 62% / 8 / 1 / 0
H&F OPS / 1 / 0 / 0% / 1 / 0 / 0
H&F CAMHS / 1 / 0 / 0% / 1 / 0 / 0
GIC H&F / 4 / 3 / 75% / 1 / 0 / 0
HOUNSLOW ADULT / 14 / 12 / 86% / 2 / 0 / 0
HOUNSLOW OPS / 4 / 1 / 33% / 3 / 0 / 0
HOUNSLOW CAMHS / 0 / 0 / 0% / 0 / 0 / 0
CASSEL / 2 / 2 / 100% / 0 / 0 / 0
TRUST TOTAL / 220 / 163 / 74% / 49 / 3 / 5
6. Complaint Categories
6.1 The information noted in tables 3 & 4 relate to the global category to which a complaint is assigned on a divisional basis. The categories are defined by the Department of Health.
Table 3 Forensic Services
Subject of Complaint / Total / Other categories include:-· Delay in receiving post
· Security
· Lack of access to fresh air
· Decision following appeal
· Not protecting patients from other fellow patients
· Postal Department
· Breach of Confidence
· Ward Policies
· Staff Behaviour
· Visitors delayed by staff
· Excessive restraint
· Patients sustained injuries
· Security
· Sexual assault by staff
· Inaccurate Mental Health Review Tribunal Report
· Hygiene
· Lack of communication with patient’s family
· Alleged assault
· Patient’s safety
· Escorted ground leave
· Alleged racism with regard to doctor
· Medication chart
· Playstation Ban
· Alleged indecent exposure
· Staff Shortages
Admission, discharge and transfer arrangements / 2
Aids and appliances, equipment, premises (including access)
Appointments delay/cancellation (inpatient) / 1
Appointments delay/cancellation (outpatient)
Patient’s status, discrimination / 1
Appointment waiting time
Staff attitude / 48
All aspects of clinical treatment / 15
Communication / 4
Consent to treatment
Complaints handling
Patients privacy and dignity / 3
Patients property and expenses / 6
Personal records/information/CPA etc / 2
Failure to follow agreed procedures / 3
Discrimination
Transport
Policy
Hotel services / 6
Other / 40
Total / 131
6.2 Local Services
Table 4
Subject of Complaint / Total / Other categories include:-· Running of the Day Centre is biased towards Afro-Caribbean culture
· Breach of Confidentiality
· Leave Entitlement
· Lack of Communication
· Lack of response
· An overdose of medication given by CPN
· Lack of provisions for patients
· Inappropriate removal of patient from ward
· Duty of Care
· Visits
· Alleged Assault
· Food
· Theft of money
· Medication treatment to wound
· Nursing staff not complying with medication request
· Policy and commercial decisions
· Restraints
Admission, discharge and transfer arrangements / 2
Aids and appliances, equipment, premises (including access)
Appointments delay/cancellation (inpatient) / 1
Appointments delay/cancellation (outpatient) / 2
Patient’s status, discrimination
Appointment waiting time
Staff attitude / 13
All aspects of clinical treatment / 50
Communication / 5
Consent to treatment
Complaints handling
Patients privacy and dignity / 2
Patients property and expenses
Personal records/information/CPA etc
Failure to follow agreed procedures
Discrimination
Transport
Policy / 1
Hotel services
Other / 13
Total / 89
7. Individual Complaint Items
Table 5 and 6 illustrate the number of complaint items received and the associated outcome.
For each complaint received there may be more than one component, know as complaint ‘items’. This information provides greater clarity on the concerns raised by patients/carers and visitors, and allows for analysis of each in terms of them being substantiated or unsubstantiated.
7.1 In the Forensic Services Division the 131 closed complaints elicited 324 individual Complaint items. 20% of individual items were upheld/substantiated including those identified as being partially upheld.
Table 5 - Forensic Services
Subject of Complaint / TotalComplaint Items / Substantiated
(inc partially) / Unsubstantiated / Other* / Other categories include:-
· Visiting
· Inappropriate questioning by staff
· Inappropriate comments
· Goading by staff
· Not received dental treatment
· Service user finds hospital stressful
· Service user would like to go back to prison
· Canteen privileges removed
· Bullying
· Staff threw dirty towel at service user
· Wrongly secluded
· Service user feels set up by staff
· Complaint about room searches
· Service user told nurse that she was overweight and was escorted back to the ward
Appointment waiting time
Staff attitude / 99 / 14 / 78 / 7
All aspects of clinical treatment / 72 / 11 / 60 / 1
Communication / 7 / 4 / 2 / 1
Consent to treatment
Complaints handling / 1 / 1
Patients privacy and dignity / 3 / 3
Patients property and expenses / 13 / 6 / 5 / 2
Personal records/information/CPA etc / 3 / 2 / 1
Failure to follow agreed procedures / 9 / 8 / 1
Discrimination
Transport
Policy / 5 / 5
Hotel services / 17 / 2 / 15
Other / 95 / 27 / 60 / 8
Total / 324 / 64 / 239 / 21
7.2 Local Services