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We must improve the social care complaints system

Carer holding hands with an older person

For the first time the Local Government Ombudsman has published complaints statistics for all social care providers. Ombudsman Dr Jane Martin explains what this means for social care complaints…

Adult social care is the fastest growing area of our work and with the highest uphold rate.

Our report highlights some of the challenges that are currently faced in the social care complaints system.

Perhaps more importantly it also identifies some opportunities which, if acted upon, could offer greater accessibility, effectiveness and accountability in social care complaints.

More accessible

An essential element of making the complaints system more accessible is ensuring that people know about their right to complain. We have proposed that there should be an obligation on all providers of social care to clearly explain how to make a complaint. This could include having a sign in every care setting as a simple means of ensuring that people are more aware of how to complain when things go wrong.

Of course, fear and lack of support can also act as a barrier to complaining. We are therefore also calling for the availability of advocacy to cover social care provision so that users would have access to greater support and reassurance.

More effective

An effective complaints system is one where complaints are handled properly at the local level. It seems that the effectiveness of local complaint handling varies from provider to provider. If we were to set common complaint standards for all providers and commissioners of care services it could provide reassurance that complaints will be looked at properly irrespective of where you live or how your care is funded. These standards could be underpinned by the existing regulatory regime to further demonstrate the importance of effective, local complaint handling.

More accountable

If we are to measure whether the complaints system is becoming more accessible and effective, providers need to be accountable for the way they respond to complaints. An annual review of complaints by all providers and commissioners would encourage reflective local leadership about learning from complaints and would provide the information needed to support local scrutiny and accountability. Similarly a mandated data return on patterns of complaints to the Care Quality Commission would be a step towards a more open and transparent approach to complaints.

What has been your experience of social care? Do you think the proposals above would make complaining about services better for you?

Which? Conversation provides guest spots to external contributors. This is from Dr Jane Martin, the Local Government Ombudsman – all opinions expressed here are Jane’s own, not necessarily those of Which?.

Comments
Member

An issue you might address urgently is to provide a confidential reportiing system for complaints from “insiders” (I hate the somewhat derogatory term “whistleblower”). These are people who may see accumulations of bad practices or mistreatments that merit speedy investigation.

I also am suspicious of the wish for “learning from complaints”. We hear a lot about “lessons will be learned” when responding to criticism of failures. However, in many cases I believe the lessons are fundamental, and should have already been dealt with in an individual’s training. We are supposedly employing professionals to manage our social care and to train those who work under them.

Member

I couldn’t agree more with the need for confidential reporting from “insiders”.

My wife was a Senior Carer for 11 years while I was the Community Engagement Worker for the Shropshire LINk. I had as many comments from “insiders” in the NHS as in the private sector, working in hospitals, GP surgeries and care homes, as I had from patients, carers, family members, etc. The insiders were all too scared to speak openly in fear of retribution or being sacked.

In the NHS case, this was often ascribed to the management culture created and enforced by Sir David NICHOLSON, now living comfortably on his publicly funded pension. The private employees had the same fears, but based on being seen to undermine the care providers profits.

The main concern amongst family members was the perceived lack of care and compassion, while being unable to understand why fees were so high, but staff (who were supposed to provide care and compassion) were paid little more, if at all, than the minimum wage, usually the main cause for high ratios of patients to staff.

In both sectors, sharp end staff saw management systems, whether officially imposed or by choice, to be unnecessarily complicated and often duplicated, while providing no assurance that the data provided could be applied to improve services. Regretfully, this appears to be the growing problem in so many public service areas where highly paid managers have little, if any experience of sharp reality, such as in social care for children.

As for “learning from complaints” the evidence shows quite the opposite with the same problems in the services allow the same disasters to happen to the vulnerable, followed by yet another manager claiming “we will ensure that this never happens again” … until the next time.

And my wife has no intention that either of us will ever end up in a care home, however much we may be able to afford!

Member
Gerald says:
10 June 2014

Dear Vixl,
I have seen the developement of both the Private Sector and the Public sector over a period of 30 years and have been directly involved in the transition between the Care of the elderly from the 20 bed Geareatric Wards in Hospitals Run by so called experts into Nursing Homes with single ensuite bedrooms with spacious Lounges and dining rooms with in house entertainment etc. mostly managed and run by staff from the old wards unencombered by the so called experts and all done at a quarter of the cost of the NHS . I am proud of what we have acheived, all done at a pittance of what has been thrown at the NHS .Why has no one done a “value for money exercise” on this I am sure if one involves the client/ patient in this exercise they will soon get the message that the Public ,in general, really do appreciate the value for money that the Private Sector offers as in hotels one cannot expect a the Ritz at the price of a Travel Lodge. Bye the way I do not class the NHS provision as the Ritz in this equation

Member
Gerald says:
28 May 2014

At last , now we might get a balanced picture instead of the previous paranoia concentrating solely on the Private Sector care homes.Recent events has shown quite clearly that the Public Sector including the NHS and BBC are responsible for massive coverups including bribery and intimidation of whistle blowers

I have often criticized WHICH? in the past ,it looks like they seem to have woken up at last, keep up the good work and help me to restore my confidence in WHICH?

Member
Lessismore says:
29 May 2014

Carers are underpaid and are overtimetabled by their employers. (After all most people want to get up/eat their meals/go to bed within a certain time zone. 3 people @ half an hour each in different places at 9am just doesn’t work!) It is totally ridiculous that travelling time between people is not taken into account when allocated time per person can be as little as 15 min. This means that they have to cut corners which upsets the people who they care for and those who pay for the care. If one person has a problem/fall etc they can’t just leave them and go to the next – they have to stay longer. Whoever is less visibly needy suffers with less care.

This caring routine causes stress to conscientious carers. who are the switched-on ones who can walk into a house and immediately have a good idea of what to do/needs doing. Whereas the less conscientious carers do the absolute minimum, rushing in and out not staying for the allocated time implying that someone needs them more, and make it uncomfortable for the cared for to ask for help with anything – even though it may be something simple like having a look for a hearing aid (not a full scale search) or changing a hearing aid battery (fiddly and nigh impossible when your fingers don’t work well and you can’t see but a doddle if this is not the case). The elderly won’t ask for this help when they feel that there is someone in a worse situation than they are – making their situation worse. This job is not something that should be treated as a tick box one but too often is – both by the Local Authority and the less conscientious carer.

A switched-on carer will be able to assess the situation as soon as they walk into the house. The unconscious one won’t see the obvious because they don’t want to.

Member

Our appreciation of adult social care provision comes down fundamentally to the quality of care delivered by the people employed: the specialists, the care staff, the domestic staff, and the management, and this is heavily conditioned by training, supervision, and organisational culture. I would say that the organisational culture has been the big weakness and stumbling block, and whether it is driven by the profit motive in the private sector or the need for economies in the state sector the outcome has been the same. Until there is a perpetual condition of honesty and openness about the quality of care, and avenues for listening to complaints, addressing them meaningfuly and protecting those who raise them, things will not get better. But until all the people involved in the delivery of care are appropriately valued, respected, rewarded [not just financially]. and invested in through support, training, and development better complaints monitoring and reaction are not enough to bring about all the change required.

Member

ABSOLUTELY John.

Your comment covers everything but the biggest problem of getting them implemented is that they will have to be put in place by the very people who appear to be, on past and existing experience, the least likely to understand why and how… and unwilling to involve others who do.

Still, when their example is set by our politicians, what else can one expect?

Member

I agree with you and it perplexes me. In the UK we have top flight Universities and Schools in every appropriate discipline, Royal Colleges rich in eminent practitioners in every field of mental and physical illness or disability, a Civil Service stuffed with golden brains, a whole legion of Commissions and Champions, and a voluntary sector that is intelligent, observant, supportive, and compassionate – and not without resources. I cannot see why these powerful forces cannot be brought to bear on the problems; obviously it is not a national priority in the same way as other issues are [like plastic bags, wind farms and the TV licence fee]. Of course, we also have politicians, a taxation system that does little to assist those struggling to care for their elderly relatives [unlike the tax benefits for raisin