1. Learning Outcomes 1.1 and 1.2
a)Identify the regulatory requirements, codes of practice and relevant guidance for managing concerns and complaints in your area of work. b)Analyse how each one affects service provision.
The Local Authority. Social Services and National Service Complaints (England) amendment Regulations 2009. came into effect in April 2009. The regulations created a single approach for dealing with complaints about health services and social care services. Before that there were two separate complaints systems, one for health care and one for social care. This helped organisations deal with complaints more effectively and helped ensure services were effective personal and safe. The new complaints approach is structured around three main principles:
Listening, Responding, and Improving. It helped organisations to : Take a more active approach to asking for people’s views.
Deal with complaints more effectively.
Use the information received to learn and improve.
The GSCC code of practice contains agreed codes of practice for social care workers and employers of social care workers describing the standards of conduct and practises within which they should work. As a social care worker, you must promote the independence of service users while protecting them as far as possible from danger or harm. Code 3.7 states that as a social care worker you should be: www.socialcareworker.co.uk code of conduct
Helping service users and carers to make complaints, taking complaints seriously and responding to them or passing them to the appropriate person:
The local Government Ombudsman have also issued guidelines regarding good complaints handling and this is summarised as follows: Getting it right
Being customer focused
Being open and accountable
Acting fairly and proportionately
Putting things right.
The regulatory requirements from the care quality commission (CQC) provide detailed outcomes and prompts for each regulation and indicate what you should be doing to meet the requirements of the regulations. Regulation 26 of the Health and Social Care Act 2008 (regulated activities) Regulation 2010 requires that you be able to demonstrate that you have take into account of the outcomes and prompts when judging your compliance with the regulations in your day to day activities. The CQC must ensure that your services are meeting the essential standards of quality and safety before they can register you. The following outcomes are regulatory requirements which affect the service provision within your area of work in respect of complaints. Outcome1; Respecting and Involving people who use services – People who use services are provided with information about, How to raise a concern or complaint about the service, and how it will be dealt with.
Outcome 7; Safeguarding people who use services from abuse: — Having effective means to monitor and review incidents, concerns and complaints that have the potential to become an abuse or safeguarding concern. Outcome 12; Requirements relating to workers- The provider contacts people using the service or others acting on their behalf at weekly intervals to monitor their satisfaction with the care provided by the new worker and any complaints that may arise. Outcome 16; Assessing and Monitoring the quality of service provision- The registered person must have regard to: The complaints and comments made, and views (including the descriptions of their experiences of care and treatment) expressed by the service user and those acting on their behalf, pursuant to paragraph (e) and regulation 19.
Improve the service by learning from adverse events, incidents, errors, and near misses that happen, the outcomes from comments and complaints, and the advice of other expert bodies where this information shows the service is not fully compliant. Gather information about the safety and quality of their service from all relevant sources including comments and complaints. Use information about the quality of experiences of people who use services or others acting on their behalf, the views of staff and the risks they are exposed to , including the outcomes of comments , complaints and investigations, to understand where improvements are needed.
Outcome 17: Complaints. www.cqc.org
1.Have systems in place to deal with comments and complaints including providing people who use the service with information about the system. 2.Support people who use services or others acting on their behalf to make comments and complaints.
3.Consider fully, respond appropriately and resolve where possible any comments and complaints.
You must Ensure:
There are clear procedures followed in practice, monitored and reviewed for receiving handling considering and responding to comments and complaints and a named contact who is accountable for doing so. The complaints process is available, understood and well published, and reflects established principles of good complaint handling. The process will ensure : 1.That the details of the complaint and the desired outcome have been properly understood. 2.That advice and advocacy support is available to those who wish or need support. 3.That what is required to resolve the complaint and the likely timescale is explained. 4.Investigations are both proportionate and sufficiently thorough.
5.A documented audit trail of the steps taken and the decision reached is kept. 6.Consideration of the complaint is undertaken by staff who are competent to address the issues raised, provide honest explanations, that are based on facts and include the reasons for the decisions made. 7.Whenever possible complaints are reviewed by someone not involved in the events leading to the complaint. 8.Comments and complaints are investigated and resolved to the satisfaction of the person raising the complaint unless: The complaint falls outside the remit of the provider’s responsibility.
The complaint cannot be upheld.
9.The service has clear procedures followed in practise monitored and reviewed for dealing with unreasonably persistent complaints in a fair and consistent manner, but ensures that the point they make is properly considered. 10.The service encourages and supports a culture of openness that ensures any comment or complaint is listened to and acted on. 11.The organisation ensures that a full record of the complaint is logged on line with the services procedures. 12.The information from complaints is used to identify non-compliance, or any risk of non- compliance with the regulations to decide what will be done to return to compliance. 13.The person knows how to contact the Care Quality Commission in order to inform the Commission of concerns they may have about carrying out the regulated activity. www.cqc.org.uk
www.socialcareworker.co.uk code of conduct
2. Learning Outcome 2.1
Explain why individuals might be reluctant to raise concerns and make complaints.
Individuals and carers are reluctant to raise concerns or complaints about health care services because they generally place a high level of trust in health care professionals and rely on them for their expertise. The fact that people are unwell makes them reluctant to express dissatisfaction or even to ask for explanations. Fears and concerns of repercussions or reprisals and simply not knowing how to go about lodging a complaint can also be deterrents as they can fear that nothing will be done.. Many elderly people or people with disabilities are reluctant to complain about treatment etc as they do not want to get their care workers into trouble, and fear that they may then not receive the required care.
Women and those living a lone are particularly worried as they fear if they complain then services will be taken away from them or if in residential care they may be asked to leave. People with disabilities fear if they complain that the care workers will treat them differently and therefore will not receive the required care support and activities they require, or even they may be asked to find alternative accommodation.
3. Learning Outcome 2.2
Outline the steps that can be taken to encourage individuals to raise concerns and make complaints.
When service users come to live at my place of work both the service users and carers/relatives are given information on how to make a complaint. The service user receives the information in picture format to ensure their understanding. Having a fair and open honest culture around complaints means: Individuals feel confident about complaining.
There is an easy accessible complaints procedure
Staff and Managers see complaints as an opportunity to improve things and not as a threat. Problems are picked up at an early stage and lessons are learned. Poor practice is highlighted and put right
Vulnerable people or those who find it difficult to make their views heard are protected and have access to adequate support including advocacy services. Maintaining Confidentiality. Information provided by those raising the concern or complaint is recorded carefully factually and securely by the person who receives in. al staff on duty adhere to guidelines and policies on both confidentiality and Data Protection, and ensure permission is gained before passing information on to others, ensuring only the required information is passed onto parties needing it. Being open and honest, all investigations into concerns and complaints should be transparent.
Where mistakes have been made or things have not gone so well responsibility should be taken by the appropriate person and a genuine apology given as soon as possible and in accordance with the organisional policies and procedures. Offering compassion and credibility is very important. All accounts given by the service user/family/carers or members of the public of their experiences are taken seriously and given credibility as people’s real experiences. Those raising concerns should always be treated with respect , empathy and compassion.
I have found if people feel comfortable raising concerns with frontline staff and his concern is acted upon promptly, then its less likely that the concern/ problem will need to be addressed through the formal complaint procedure.
As manager I encourage my staff who hold the service users monthly meetings to raise the complaints/concern procedure to the service users and ask questions to check their understanding of it. This has proved to be best practise for us as it has identified areas that have been improved on for example a service user wanted to go to church with another service user but thought he couldn’t ask (he thought she was special and was the only one allowed to go) this has now be addressed and he now attends church. We encourage our service users to fill out meals charts and they have to comment on the meals this is done by using the following
= very good
= not good or bad
= did not like it.
This has ensured that all the service users in my care can make comments even if they have non verbal communication. This has helped build their confidence and boost self esteem as the service users are treated as equal and their concerns and complaints are taken seriously and acted upon. I have found that by getting feedback from others who use our services it enables me to use their responses to identify ways to improve the quality of services as any early intervention prevents complaint from being made.
4. Learning Outcome 4.2
Evaluate the effectiveness of systems for addressing concerns and complaints.
It is important that systems for addressing concerns and complaints is effective. An effective complaint management system is an essential part of any delivery of services be it community , day services or residential.
The intention of a complaints procedure is to increase accountability, improve customer relations, promote quality assurance and prevent conflict and litigation. Potentionally the data from the complaints feedback mechanism can be used as an indicator of service quality and identify areas for change and improvement. Having an effective complaint system benefits the organisation in a variety of ways. www.sussexhealthcare.co.uk
It identifies areas that need changing and allows individuals to provide input to service improvement. It gives the organisation a second chance to serve and satisfy dissatisfied service users/families/carers. It provides an opportunity to strengthen public support for the organisation by enhancing the reputation of the service and prevent negative comments or publicity. It helps reduce organisational workloads saving time by responding quickly and reaching a resolution of complaints avoiding any escalation. Restores the trust and confidence of a service user/carer/family.
Promotes a culture of reporting and accountability
I have found that by having a good complaints system that is evaluated and reviewed regularly ensures it meets all the criteria that adversely affect or may affect the service users we support their families and the staff team. If I found that the criteria was no longer applicable to the service I manage I would inform H.R. and recommend the changes required, they who then address the operational manager and inform her of my concerns before amending the policy.
I evaluate how well the concern and complaints system is working by ensuring any complaints and concerns are used to help deliver continuous improvement, this can be done by: Ensuring that lessons learnt from complaints are gathered and feedback is used to improve service delivery. Systems are in place to record analyse and report on the learning from concerns.
As manager I make sure that I keep update with best practise, I also ensure that I review the local in house policy on complaints to ensure it is effective, The organisational policy on complaints is reviewed by the operational manager.
One of the service users in the home I manage, told one of the carers at day-care a member of staff within the home had pulled her hair. I was informed by the safeguarding team. I had to suspend the member of staff immediately whilst the investigation took place. All the information was gathered and reports written and submitted to the safe guarding team who them completed their own investigation. The incident was proved to have happened but by accident, the staff member was brushing the service user’s hair and the hair brush got caught in a knot. The safeguarding team did not take the incident any further. The service user in question has a risk assessment in place as she frequently makes allegations that are untrue.
The staff member was devastated by the allegation and had to receive counselling as she was really upset by the whole incident and allegation and it took her a long while to recover from it. She is now back at work. This incident made the staff team as a whole realise then even when a service user makes allegations that are not true it should be written in the daily dairy notes as it may be necessary to refer to these notes in allegations of abuse or if complaints are made. The team know realise the importance of having systems in place to record analyze and report any concerns or complaints.
Refrences : www.cqc.org.uk
www.socialcareworker.co.uk code of conduct