Service User Complaints Policy

Background

Herts Aid is committed to eliminating racism, sexism and all forms of discrimination. We will not discriminate on grounds of age, colour, disability, ethnic origin, gender, gender reassignment, culture, health status, marital status, social or economic status, nationality or national origins, race, religious beliefs or non beliefs, responsibility for dependents, sexuality, trade union membership or hours of work. We recognise that this requires action through positive policies to redress inequalities.

1. Introduction

1.1 The Complaints Policy and related procedures provide an effective framework for service users, their carers, relatives or representatives to complain about the quality or nature of services provided by, or decisions taken by, Herts Aid

1.2 Herts Aid will promote a culture in which service users are encouraged to comment on the services they receive. This is an important part of the on-going effort to improve the quality of Herts Aid services and to learn from any shortcomings.

1.3 This Policy provides an overview of complaints handling within Herts Aid and is underpinned by local protocols for the handling of complaints.

1.4 This Policy relates to the following standards within ‘Standards for Better Health’ (Department of Health, 2004):
First domain Patient Safety – standard C1: “Health care organisations protect patients through systems that identify and learn from all patient safety incidents and other reportable incidents, and make improvements in practice based on local and national experience and information derived from the analysis of incidents

Fourth domain Patient Focus – standard C14: “Health care organisations have systems in place to ensure that service users, their relatives and carers

a) have suitable and accessible information about, and clear access to, procedures to register formal complaints and feedback on the quality of services;

b) are not discriminated against when complaints are made; and

c) are assured that organisations act appropriately on any concerns and, where appropriate, make changes to ensure improvements in service delivery.

2. Principles of the Complaints Policy

2.1 When Herts Aid receives and investigates a complaint, we pay particular attention to the relevant provisions of your rights under the Human Rights Act 1998. This includes Respect for your private and family life (Article and also not exercising any form of discrimination in the recognition of your rights under Article 8 (Article 14). An example of respect for your private life is that if a complaint is brought to our attention by someone other than yourself, and which is about care or treatment that you have received, we will not disclose any confidential information about you to that person without your consent to do so.

2.2 Complaints are seen as a positive and essential opportunity to listen to and learn from people using services;

2.3 Herts Aid’s aim to resolve complaints fairly and consistently, as close to the point of service delivery as is acceptable and appropriate and with an emphasis on early and effective resolution;

2.4 Complainants, service users, relatives and their carers can be confident that their complaints have been taken seriously, that their care or treatment will not be prejudiced in any way, and that services will improve as a result of their experiences;

2.5 Herts Aid will put in place a flexible approach, with effective support for people who find it difficult to voice their complaints, including the right to advocacy;

2.6 Herts Aid will demonstrate a culture of openness and fairness when dealing with complaints, for both people using and delivering services;

2.7 There will be a demonstrable change in the quality of services as a direct result of what people tell Herts Aid via the complaints procedure.

2.8 If maintaining of complaints handling indicates that the complaints policy is not being implemented effectively, this will be reviewed and may include re-launching the policy through staff briefing or additional staff training. If the policy is shown to be defective the policy will be reviewed

3. Definitions

3.1 A Complaint is a written or oral expression of dissatisfaction with the service provided (or not provided), or the circumstances associated with its provision, which requires a response.

3.2 An informal complaint, comment or concern can be resolved quickly, without the need for formal investigation and formal correspondence.

3.3 A formal complaint requires formal investigation and formal correspondence.

3.4 A complex complaint involves Herts Aid and more another external organisation.

3.5 Local resolution is the first stage of the Herts Aid complaints procedure, which aims to resolve a complaint as close as possible to where the complaint originally arose.

3.6 The Investigating Manager/Officer is responsible for handling and investigating an individual complaint.

4. Responsibilities

4.1 Herts Aid is responsible for:

Investigating complaints raised against Herts Aid and the services it provides as part of Local Resolution;

Providing advice and guidance to volunteers and staff at the Local Resolution stage;

Co-operating with any investigation carried out by the Healthcare Commission and the Health Service Ombudsman.

4.2 The Board of Herts Aid are responsible for ensuring that local complaints arrangements are robust and able to deliver a full and accurate response to complainants, and for ensuring that the learning from complaints is used to support overall service improvements.

4.3 The Director(or deputy) will sign all written responses and be responsible for ensuring there is appropriate local policy and procedural guidance available to all staff.

4.4 Any member of staff receiving a complaint should attempt to seek solutions to complaints brought to their attention. The organisation encourages staff to do this, as informal resolution at an operational level is regarded as the best way of dealing with most cases. If the complaint cannot be investigated adequately or necessary reassurances given, the complaint should be referred to a line manager or senior manager

5. Issues Not Suitable For the Herts Aid Service User Complaints Procedure

The complaints procedure is for users of the service or their representatives. The following issues do not fall within this complaints procedure:

Staff Grievances

Staff grievances should be managed via the Grievance Policy.

Staff Complaints about Service User Care

Staff who have concerns about service user care or services should report the issue to their line manager, complete an incident form or invoke the Whistleblowing procedure.

Compensation and Litigation

Once legal action begins, the complaints process should be suspended as the two processes are not compatible. Where a complainant explicitly indicates an intention to take legal action the matter should be referred to the Director.

Disciplinary Procedure

Action under the Disciplinary Policy must be kept separate from the complaints procedure.

Criminal Matters

Where there are allegations relating to assault or other serious criminal matters the Director must be informed immediately for a decision to be taken on whether to refer the matter to the Police.

6. Making a Complaint

6.1 A complaint may be made by:

A service user

A person who is affected by, or likely to be affected by, the action, omission or decision of Herts Aid

A person acting on behalf of a person mentioned above (i.e. as a representative) where that person:

Has died

Is a child

In unable, due to physical or mental incapacity, to make the complaint themselves

Has requested the representative to act on their behalf

A representative must:

Have, or have had, an interest in the person’s welfare, and

Be a suitable person to act as a representative

6.2 When the complainant is not the Service user, patient authorisation is required in order that Herts Aid can investigate and respond to the complaint. If the service user is unable to give their authorisation, this is not a reason to deny an investigation into the issues raised on their behalf under the complaints procedure. Authorisation is required from the service users representative for example spouse, relative, friend, MP and ICAS etc. This must be done before confidential or information of a sensitive nature is released to a third party.

6.3 Forms will be sent to the complainant to obtain authorisation from the service user.

6.4 Verbal Complaints

6.4.1 Every effort shall be made by any member of staff to resolve a minor complaint which they receive verbally and which is within their power or that of their line manager to resolve to the satisfaction of the person making the complaint.

6.4.2 Whether a complaint shall be deemed to be minor shall be based on the views of the person making the complaint. If the person making the verbal complaint considers that their complaint is of a more serious nature than can be resolved at organisational level, they shall be advised of the options in paragraph 6.4.4 below

6.4.3 If an effort is made to resolve a verbal complaint but the person making the complaint remains dissatisfied, they shall be advised of the option in paragraph 6.4.4 below.

6.4.4 People making verbal complaints that they consider to be more serious than being capable of resolution at the first level or which cannot be resolved at this level shall be advised to put their complaint in writing to the Director of Herts Aid

6.4.5 Even if a person making a complaint considers their complaint to be minor, if a member of staff considers that the complaint is in fact of a serious nature, they shall discuss this with their line manager. If a line manager agrees that the complaint is of a serious nature, they shall contact the person making the complaint to request their agreement for the complaint to be considered as a formal complaint.

6.4.6 All verbal complaints and actions taken to resolve them shall be recorded at the point the complaint is received. A copy of the record shall also be sent through to the Director for onward reporting of complaints data to appropriate commissioners managing Herts Aid’s contracts. The records kept at organisational level shall also be used in team meetings or sessions arranged specifically for the purpose of learning from complaints.

6.5 Initial response to a complaint

6.5.1 It is not intended that every concern will warrant a full complaints investigation, and front line staff are empowered to resolve minor problems immediately and informally.

6.5.2 Herts Aid will therefore seek to distinguish between requests for assistance in resolving a perceived problem, and an actual complaint. The former will be dealt with in a flexible manner which is appropriate to their nature, and the latter will be dealt with strictly in accordance with complaints regulations and procedures.

6.5.3 The decision as to whether a matter is dealt with informally or investigated as a formal complaint should lie with the service user or their representative, but the decision should be based on information about the options available provided by Herts Aid staff.

6.5.4 Any service user or their representative who is dissatisfied with the preliminary response to a matter which has been dealt with informally will be advised of their right to pursue the matter formally through the complaints procedure and advised of the support mechanisms available.

6.6 Serious complaints

An immediate referral to the Director will be made if it becomes clear that there are serious issues that may require:

An investigation under the disciplinary procedure.

The need for referral to one of the professional regulatory bodies.

An investigation into a Serious Untoward Incident.

An investigation of a criminal offence.

The potential for significant adverse publicity.

6.7 Serious untoward incident (SUI)

Some complaints will also be subject to a SUI investigation. When this is the case, it is often not possible to respond to the complaint until the SUI investigation of the complaint is complete, as the issues raised in the complaint will be similar to those raised in the SUI inquiry. However, throughout the SUI investigation, it should be remembered that the
issues raised in the complaint would not always be exactly the same as those raised in the SUI investigation. A separate and full response to the complaint will therefore generally be required.

6.8 Complaints of a disciplinary nature

The purpose of the Complaints Procedure is not to apportion blame. Where the initial complaint alleges negligence or malpractice on the part of an individual member of staff, details of the allegation will be passed to the appropriate line manager who will consider whether a disciplinary investigation is appropriate. If a disciplinary investigation is considered to be appropriate, it will be carried out strictly in accordance with the Disciplinary Policy. A decision to refer all or part of the complaint for consideration as a disciplinary matter may be taken at any time during the investigation into the complaint. Although the matter requiring disciplinary action will cease to be investigated as part of the complaints procedure, investigations will continue simultaneously into any aspect of the complaint not subject to the disciplinary investigation. A response should, where possible, be provided within the standard timescale of twenty-five days. The complainant will be advised that those specific aspects of the complaint are being dealt with as a disciplinary matter but, for reasons of confidentiality, will not be advised of the outcome. The person managing the investigation into the complaint will play no part in deciding whether to carry out a disciplinary investigation or in determining any disciplinary action arising out of the complaint.

7. Local Resolution

7.1 Complaints should be raised within six months of the event which has given rise to the complaint, or within six months of the complainant becoming aware that there was cause for complaint.

7.2 Herts Aid staff are encouraged, in conjunction with their line manager and if appropriate, the senior management team, to deal with concerns to which they can provide an immediate response.

7.3 If the matter remains unresolved, the service user or their representative should be informed about the formal complaints procedure.

7.4 When a complaint is received, the Director or the Investigating Manager will contact the complainant directly to clarify the issues raised and agree a plan for investigation (including how the complainant will be kept informed of progress). Complainants must feel that they can take an active role in finding a resolution, and must feel confident that the steps being taken are safe and appropriate.

7.5 A meeting can be offered as part of the local resolution stage, aided by a dispute resolution process such as conciliation or mediation, if required. Full commitment to this procedure is essential, and therefore written agreement to conciliation or mediation is required from both parties.

7.6 An action plan should be produced where any actions or service improvements are required as a result of a complaint. This should form part of the complaints file, and will be the basis for monitoring service improvements.

8. Legal Action

8.1 Any indication of possible legal action should be discussed with the Director of Herts Aid at the earliest opportunity.

8.2 If the complainant gives an indication that they may take legal action in respect of the ongoing complaint, the complaints process should cease.

9. Support for Complainants

9.1 Complainants will be offered independent support when making a complaint through specialist advocacy services where appropriate.

9.2 Making a complaint does not mean that a complainant will receive less help or that things will be made difficult for them. Everyone can expect to be treated fairly and equally regardless of age, disability, race, culture, nationality, gender and sexual orientation. Herts Aid has an ‘Equal Opportunities Policy’ (see separate document).

9.3 Complainants will also be given support to address any difficulties in communication, for example via the provision of interpreters.

10. Support for Staff

10.1 Staff who are the subject of a complaint

10.1.1 Herts Aid will handle all complaints in a fair and equitable way. Staff will be informed of the details of any complaint, and will be kept informed of the progress and outcome of the complaint by their line manager.

10.1.2 Herts Aid will fully support staff working in a service where public expectations are higher than available resources, and where complaints are generated as a result.

10.1.3 Herts Aid will not tolerate any form of abuse from service users or others directed towards staff handling complaints. Staff will be expected to discuss any such issues or concerns with their line manager, and report any such incident.

If required staff will be offered appropriate immediate and ongoing support by their manager this may be sourced internally or externally for example professional counselling. In the event of staff being called as a witness appropriate advice and guidance will be provided from internal and external sources e.g. Director or solicitors.

11. Service Improvements, Clinical Governance and Performance Monitoring

11.1 Risk Assessment

Each complaint should be risk assessed. If a significant risk is identified, then the Director should be notified and the risk entered onto the appropriate risk register. If information from complaints and/or other sources indicates that service users or staff may be at risk, the Director will have the discretion to discuss the matter confidentially with the appropriate staff within Herts Aid and may recommend:

Appropriate action under the disciplinary procedures

Referral to the police or fraud office

Reporting through appropriate protection procedures, for example following an incident of abuse

11.2 Learning from Complaints

11.2.1 Managers should use the issues raised in individual complaints, both formal and informal, to explore and, where appropriate, initiate service improvements.

Issues arising from formal and informal complaints and other feedback provided by service users is a standard item for discussion at team meetings and Board meetings

11.2.2 The Board of Trustees, together with the Director, will identify trends arising from complaints and all other forms of service user feedback received by Herts Aid and will work to promote a culture within the organisations in which lessons are learnt from adverse feedback and used to improve services and systems, and in which positive feedback is used to share best practice.

Aggregated reports on incidents, claims, complaints and reviews will be included in quarterly monitoring reports.

Action plans developed from the outcomes of complaints investigations which details individual actions with appropriate timescales and will be monitored by the Board of Trustees.

11.2.3 A quarterly report outlining statistics and trends within complaints will be submitted to the Contracts Commissioners, as well as an Annual Report The quarterly and annual reports will:

specify the number of complaints received;

specify the number of complaints responded to within time;

identify the subject matter of those complaints;

summarise the outcome of the investigations;

summarise the learning and action taken as a result of complaints.

To ensure that we are an ‘organisation with a memory’ we will promote lessons learnt from various risk management systems including incidents, complaints and claims.

12. Confidentiality, Data Protection and Records Management

12.1 Care should be taken throughout the complaints procedure to ensure that:

Any information relating to the service user which is disclosed during the course of an investigation is relevant to the investigation concerned;

Confidential information is only disclosed to people who have a demonstrable ‘need to know’ for the purpose of investigating and responding to the complaint, or for ensuring that the complaints procedure is adhered to.

12.2 Any person wishing to make a complaint on behalf of a service user must have written consent from the service user to do so. Every attempt must be made to obtain consent; the assistance of specialist advocates can be sought if appropriate.

12.3 If the patient or service user has died, or is not capable of providing consent, the Director will determine whether the potential complainant has sufficient interest in the service user’s welfare, or is suitable to act as a representative. If the Director does not consider this to be the case, then they will notify the appellant in writing, clearly stating the reasons for their decision.

12.4 The Director will be responsible for maintaining confidential master files for all complaints. The master file will be a comprehensive record containing all details of the investigation, including letters, memos, written correspondence and file notes of all telephone and personal conversations.

12.5 Notes regarding a complaint will not be filed in the service users files.

12.6 Complaints files relating to the investigation of complaints will be retained by
Herts Aid for a minimum of ten years.

13. Education and Training

13.1 Herts Aid recognises the importance and value of appropriate complaints management training, and is committed to ensuring that all staff within Herts Aid receive training in complaints handling.

13.2 All Herts Aid Line Managers will be responsible for identifying staff within their service who need training in the handling or investigation of complaints. Herts Aid will ensure that appropriate training packages are developed to support Managers to ensure staff understand and are able to follow the complaints procedure.

14. Monitoring the ethnicity of patients

Herts Aid monitors complaints to meet the requirements of the Race Relations Amendment Act and the Disability Discrimination Act.

15. Monitoring and Implementation of the Policy

The policy will be reviewed annually to accommodate any new legislation
If the policy is not effective or sufficient it will be updated by the Director
Awareness of the policy will be raised through staff induction, training,
staff briefing and team meetings.

Policy Updated April 2010