National Care Service: complaints and redress research and co-design report

What we learned from desk research

Our previous research found that making a complaint can be very hard for some people. It can be complex and confusing. There can be different ways to make a complaint and different bodies involved, depending on what the complaint is about.

In this phase, we carried out desk research to understand:

• people’s experiences of submitting complaints, regardless of where they live or their circumstances
• how complaints are received and handled by local authorities and Health and Social Care Partnerships
• legal requirements, procedures, frameworks and rules that set out how complaints should be handled
• ideas and opportunities for improvement

This included activities to research and understand:

• the adult social care and community health complaints landscape in Scotland and what services and bodies are involved in receiving and handling complaints
• the complaints system of the 32 local authorities in Scotland to find what was common and what was different in the local areas
• the different stages in a complaint journey, from before submitting and after receiving
• how entry points for submitting complaints could be improved locally and nationally

The desk research confirmed that:

1. The adult social care complaints landscape is complex.

2. Legal requirements, processes and rules determine how complaints should be handled when they are received by different services.

3. There are different users and types of complaints.

4. Information on how to submit a complaint is not always accessible.

See below for more information.

The adult social care complaints landscape is complex

At present, a number of bodies in Scotland handle complaints about social care and social work and community health services. This is based on who delivers the service and what the subject matter is. This can make it difficult for people to identify who to submit their complaint to. It can result in different:

• types of information needed within a complaint submission
• ways that complaints are received and recorded
• systems and methods used to handle and resolve complaints.

Despite the complex landscape, common complaint handling processes exist in most local authorities.

Any future service improvements must connect with existing processes and services to avoid risk of duplication of complaints and adding more complexity to the process.

Legal requirements, processes and rules determine how complaints should be handled when they are received by different services

The complaints process follows 3 key stages set by the Scottish Public Services Ombudsman (SPSO):

• Stage 1 – simple front-line complaints
• Stage 2 – complex complaints
• Stage 3 – independent review of the complaint by the SPSO.

The details of these stages and what is expected from each service to provide good quality complaints handling is outlined in the local authority Model Complaints Handling Procedure. The decision of the SPSO is the final stage for adult social care complaints.

Services also follow the SPSO Statement of Complaints Handing Principles, UK Data Protection Law when gathering and handling personal data, and Adult Support and Protection Law to protect adults at risk of harm.

When someone submits a complaint, it goes through several steps where decisions are made about what happens next. This process can be complicated. We learned that local services use their understanding of the service being complained about to direct the complaint to the most appropriate place.

Any future service improvement should look to protect local decision making.

There are different users and types of complaints

There are 3 broad categories of user. These include:

• the person who makes the complaint
• the organisation receiving and dealing with the complaint
• other organisations connected to the complaint

We identified consistent complaint stages to focus on:

• before the issue arises
• before submitting a complaint
• submitting and receiving a complaint

In addition to simple complaints, there are more complex complaints. These have different elements that need to be considered. For example complaints:

• about multiple organisations
• that have been submitted multiple times
• that have been submitted by a third party (for example, a carer)
• about integrated services
• submitted anonymously

Understanding the needs of each user and type of complaint, for example where they agree and where they differ, is important when improving how complaints are submitted, received and handled.

Information on how to submit a complaint is not always accessible

We found some common themes relating to accessibility. These included:

• information about complaints, including how to submit a complaint are not always accessible to people with different needs
• most local authorities accept complaints in similar ways, with online and telephone most common
• every local authority has its own complaint forms to suit local needs, with many using online forms which directly feed complaints into their system.
• the process for submitting a complaint can be different for different services. The structure of the social care complaints service affects this. Some are part of the wider council services receiving complaints about all the services they offer, while others have separate submission points for adult social care complaints only

Any future service improvements must be flexible to allow for local differences or to create a consistent approach. Creating a single form for all authorities would be difficult without requiring major local changes.