The Complaints Culture in Social Care Services
The Legal Position
Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) 10 requires care providers to have 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”.
It is incumbent upon the service then in order to reach compliance to have an effective complaints policy and system that brings to the attention of the Service User; and people acting on their behalf:
- The complaints policy and procedure in a suitable manner and chosen communication format.
- To facilitate and support people who may wish to make a complaint
- To fully investigate all complaints and (where relevant) work with other services where the complaint is of a joint nature to address the issues raised.
Complaints Culture in Social Care
Providers may sometimes see complaints from Service Users as a threat or a criticism of the service they provide. The Care Quality Commission (CQC) has found too many service providers have a defensive culture when dealing with complaints rather than one where complaints are listened too and acted upon.
Prof Sir Mike Richards, chief inspector of hospitals at the CQC, who led the review said: “A service that is safe, responsive and well-led will treat every concern as an opportunity to improve, will encourage its staff to raise concerns without fear of reprisal, and will respond to complaints openly and honestly.
If however the service adopts a fair, open and honest culture around complaints the manager and staff will see complaints as a means of learning and an opportunity to improve the service. The creation of such a culture will stem from the approach taken by the manager.
In an open and honest complaints culture the manager will ensure that Service Users; and people acting on their behalf are confident that they can make a complaint. Research has shown that some people are reluctant to complain. Fears may include withdrawal of the service, being seen as a ‘trouble maker’, being treated differently (Francis, 2013; Healthcare Commission et al., 2006). The NAO survey (2008) also found that 17 per cent of people were reluctant to complain for fear of damaging the relationship with their provider.
Supporting Service Users to Make a Complaint
If Services users are to be encouraged to make a complaint they must:
- Have a clear understanding of the complaints policy and process. Research has shown that some people have difficulty in finding their way around the complaints system, especially where English is not the person’s first language, or because they have a cognitive impairment.
- Be facilitated and supported through the complaints process.
- Be made aware of and have access to advocacy services to support them.
- Feel confident that they will be listened to.
- Have no fears of retribution.
- Have their complaint acknowledged and kept informed of progress and resolution.
What does a Transparent Complaints Culture Mean
A transparent complaints culture will mean the following:
- A commitment by management and staff to learning about the quality of service and recognition of the importance of Service Users complaints in the process.
- A complaints policy and system that is understood by Service Users
- Management and staff can demonstrate that they are prepared to support Service Users to make a complaint.
- Services Users will express confidence in the complaints system.
- Evidence that complaints have been listened to and actions taken to improve service.
- Evidence that complaints are resolved in a timely way.
- Complaints are seen as an opportunity for service improvement.
- Staff who are the subject of complaints are supported.
- There exists a no blame culture.
- A record of all complaints and their resolution are available to all Service Users and people acting on their behalf.
- People using the service can feel they have a voice and are able to influence change.
Moving from a defensive to a transparent complaints culture rests with management and staff within the care service. There are clear advantages for services in effectively dealing with complaints. Working in partnership with people using the service and carers, and fostering a responsive open attitude, is likely to reduce the need for formal complaints which can be time-consuming and costly to handle.
As CQC has found there are examples of good practice, but more needs to be done to encourage people to come forward with their complaints, to keep them informed on the progress, to reassure them that action will be taken as a result, and to assess that they are satisfied with how the complaint has been resolved. This in turn will lead to improvements in the quality of care. The Care Quality Commission is working to make the shift from a defensive to a listening culture that encourages and embraces complaints and concerns as opportunities to improve the quality of care.
Care Quality Commission: Complaints Matter 2014
Social Care Institute for Excellence: Dignity in Care 2013