The aim of the organisation is to ensure that its complaints procedure is well publicised and fairly applied and that complaints are dealt with promptly, efficiently, and properly in all cases.?
This organisation prides itself on the high quality of the services that it provides and our aim is to maintain our standards as consistently as we can and to rarely have complaints. However, the organisation accepts that it is the fundamental right of service users, their families or friends or representatives, to complain about the services they are receiving if they feel unhappy with them. The organisation accepts that complaints do happen from time to time and that it is an important part in the running of any service to listen to the feedback from service users, to investigate and admit when things do go wrong and to learn from mistakes so that they are not made again.?
The organisation, therefore, welcomes complaints and views them as an opportunity to learn and to improve. The organisation believes that a failure to listen to or acknowledge a complaint can lead to problems getting worse and a breakdown in relationships.?
The organisation believes that it is far better to deal with a complaint early, openly and honestly, for everyone's benefit.?
This organisation understands the importance of having an effective system in place for identifying, receiving, handling, and responding appropriately to complaints and comments made by service users, or persons acting on their behalf.?
In addition to the above, this organisation recognises that providing a robust and accessible complaints system and responding to complaints quickly and effectively is an important part of compliance with the registration requirements of the Care Quality Commission.?
CQC regulation and the 5 key-question test?
Fundamental standards requirements?
The Health and Social Care Act 2008 (Regulated Activities} Regulations 2014 apply to adult social care service providers. The regulations include the fundamental standards, below which care must not fall. They are enforced by the Care Quality Commission through inspection and registration.?
With respect to complaints, the following regulations apply:
• Regulation 16: Receiving and acting on complaints, states that any complaint received by a health or social care provider must be investigated and necessary and proportionate action must be taken in response to any failure identified by the complaint or investigation. It also places a duty on providers to provide information about a complaint within 28 days if requested to by the CQC.
• Regulation 17: Good governance, states that systems or processes must be established to assess, monitor and improve the quality and safety of the services provided.
• Regulation 20: Duty of candour, states that registered persons must act in an open and transparent way with relevant persons in relation to care and treatment provided to service users in carrying on a regulated activity.
Guidance for providers on meeting the regulations, published by CQC in March 2015, provides guidance on how service providers should comply with the regulations.?
The guidance states that:?
• People must be able to make a complaint to any member of staff, either verbally or in writing.
• All staff must know how to respond when they receive a complaint.
• Unless they are anonymous, all complaints should be acknowledged whether they are written or verbal.
• Complainants must not be discriminated against or victimised. In particular, people's care and treatment must not be affected if they make a complaint, or if somebody complains on their behalf.
• Appropriate action must be taken without delay to respond to any failures identified by a complaint or the investigation of a complaint.
• Information must be available to a complainant about how to take action if they are not satisfied with how the provider manages and/or responds to their complaint.
• Information should include the internal procedures that the provider must follow and should explain when complaints should/will be escalated to other appropriate bodies.
• Where complainants escalate their complaint externally because they are dissatisfied with the local outcome, the provider should cooperate with any independent review or process
The 5 key-question test?
When inspecting a healthcare or social care service, this organisation understands that inspectors are prompted by CQC guidance on the 5 key-question test to ask a series of questions called Key Lines of Enquiry (KLOE). These include asking how does the service routinely listen and learn from people's experiences, concerns and complaints??
To answer this, the organisation understands that inspectors are prompted to:?
• Ask how people's concerns and complaints are encouraged, explored and responded to in good time
• Ask whether people know how to share their experiences or raise a concern or complaint, and if they feel comfortable doing so?
• Ask if concerns and complaints are used by the organisation as an opportunity for learning or improvement?
• Review concerns/complaints management systems, records of investigations and the response provided and associated action plans, minutes of meetings or?associated quality assurance data.?
The organisation understands that assessment under the 5 key-question test contributes to the quality rating given to the service.?
Best practice guidance?
The organisation will be informed by and will adhere to best practice guidance, including Complaints Matter, published in December 2014 by the CQC.?
In the report the CQC state that, in their view, for too long complaints have not been taken seriously enough, and too often they are met with a "defensive culture" instead of honesty and a "willingness to listen and learn."?
In the report the CQC encourages service providers to take a positive approach to complaints handling, welcoming complaints and helping service users to complain and express their concerns.?
In this organisation:?
General Principals are that:?
• Every complaint will be welcomed and taken seriously as an opportunity for the organisation to learn and improve.
• The service encourages and supports a culture of openness that ensures any comment or complaint is listened to and acted on, a record of concern is in place to records general concerns/comments.
• The organisation requires that a full record of each complaint is logged in line with the service's procedures.
• All complaints will be treated entirely confidentially.
• A complaint can be made verbally, in sign language or in writing, whatever is easiest or most comfortable for a complainant.
• All complaints should be acknowledged and appropriately investigated, no matter how they are made.
• A complaint can be made at any time to any member of staff.
• All staff will be trained to accept complaints and to deal with them according to this policy.
• In this service the right to complain is fully upheld and all service users will be given sufficient information about the complaints process and support to help them complain if they require it. All service users should be given a leaflet explaining the organisations complaints policy, a summary of which is included in the Service User Guide. The organisation will ensure that the information is accessible to any service user who has sensory disabilities or special needs.
• All service users should be helped to complain if they require assistance, including those who may have sensory disabilities or special needs or those who may require an independent advocate to speak for them.
• Where a complainant does not wish to be named, or wishes to complain anonymously through an advocate, the organisation will follow its full complaints procedure.
• Every complaint should be recorded in the organisations complaints book and any documents, letters or reports should be kept. Full records, data and logs of records should be provided to the CQC and to inspectors as required.
• In cases where the CQC asks for information about a specific complaint this will be provided within 28 days of the request.
• Making a complaint will not cause a service user to be discriminated against or have any negative effect on their care, treatment or support.
• Timely and appropriate action will be taken in response to any failures identified by a complaint or the investigation of a complaint.
• As part of its quality assurance and audit processes, the organisation will regularly review information from the complaints process to look for patterns and trends and to identify its planned improvements have been effectively implemented.
In the case of a general concern
• A concern can be made to any member of staff.
• The staff member will record the concern and any action taken.
• Managers will review concerns adjust working practices as required
In the case of verbal complaints:
• A verbal complaint can be made to any member of staff.
• Front-line staff who receive a verbal complaint should always welcome the complaint and seek to resolve the problem immediately.
• If staff cannot resolve the problem immediately then they should offer to get a senior member of staff or manager to deal with the problem.
• After discussing the problem the member of staff, or the manager, should suggest a course of action to resolve the complaint.
• If the course of action is acceptable then the agreement will be clarified and any follow-up action, such as a confirmation letter or a further meeting, agreed.
• If the course of action is not acceptable then the complainant should be asked to put their complaint in writing.
In the case of written complaints:
• A written complaint will be acknowledged in writing within two working days.
• Written complaints will be dealt with by the manager or their deputy or, if the complaint relates to the manager, by the registered owners.
• Every written complaint will be thoroughly investigated and a written response given within 28 days (Where a complaint is likely to take more than 28 days, in a particularly serious matter where legal advice is taken, for instance, the complainant will be notified of the delay and the reason for it).
• Complainants - and those who may be complained about - will be kept informed of the progress of any complaint as it is investigated.
• Our commitment is that all written complaints will be treated entirely confidentially and with tact and sensitivity. Details of a complaints investigation will however be recorded in a complaints book for recording and inspection purposes.
• Any decision made by the organisation will be fully explained. If a complaint is upheld then the organisation will apologise and suggest a plan by which the complaint can be resolved.
In cases where the complaint is resolved
• The complaint will be informed of the results of any investigation and about what will happen next. Where improvements are made as a result of the complaint they will be kept informed of these.
• In line with the Duty of Candour, complainants will be given a full explanation of what went wrong and a full apology.
In cases where the complaint remains unresolved
• The complaint will be referred to the registered owners of the organisation
• Where a complainant remains unhappy with the outcome of the complaints process then they will be given contact details of the local government ombudsman with whom they can escalate the complaint if they wish. They will also be provided with contact details of the Care Quality Commission (CQC).
• Where complainants escalate their complaint externally because they are dissatisfied with the local outcome, the organisation, and its managers and staff will cooperate fully with any independent review/process.
Managers and supervisors in the organisation have a duty to:
• Uphold the human rights of people receiving a service to express their opinions and complain if they wish.
• Ensure that this policy is operated throughout the organisation at all times and to keep all aspects of it monitored and under review.
• Communicate this policy to employees, agency staff, volunteers and relevant others.
• Ensure that all staff are fully trained in dealing with complaints and are aware of the complaints policy and procedure.
• Ensure that all service users are given full details of the complaints procedure, in a form which is accessible and understandable to them, and have these details explained to them if they require it.
• Respond to all complaints according to this process, treating all complaints fairly and impartially and keeping complainants informed at all stages.
• Keep a documented audit trail of the steps taken and the decisions reached.
• Investigate all complaints fully.
• Review the history of complaints on a regular basis to establish and investigate any trends or patterns which will contribute to the continuous quality improvement and assurance processes in the organisation.
• Drive forward improvements to the service as a result of complaints investigations or reviews, ensuring that lessons are learned.
• Ensure that no service users, or their families or loved ones, are discriminated against or subjected to poor treatment or care as a result of having complained.
• Ensure that the complaints procedure is regularly reviewed to ensure that it remains 'fit for purpose' and has any necessary improvements made - all such reviews should include feedback and involvement from service users and their families.
Provide training and guidance as appropriate and to ensure the attendance of staff, including training on Induction and management courses covering respect for service users and the complaints procedures.
Staff in this organisation have a duty to:
• Respect service users privacy and dignity at all times and treat service users with sensitivity, respect and thoughtfulness.
• Respond to all verbal complaints in a friendly, reasonable and professional manner according to this policy, welcoming the complaint and suggesting a way to resolve the problem, offering to refer the complaint to a senior member of staff or manager if required.
• Advise service users and their families and representatives about the complaints procedure.
• Keep information about service users confidential and never discuss private or personal issues with a service user in public or gossip about service users.
Applicability and scope?
This policy applies to all staff, service users, visitors, volunteers and contractors without exception. All staff at the organisation have responsibility for ensuring that they work within the remit of this policy and in the manner in which they have been trained.?
Responsibility for the implementation, monitoring and review of this policy lies with the care home manager.?