Unit 519 - O1
Unit 519 - O1
UAN: J/602/2336
Level: Level 5
Credit value: 6
GLH: 40
Relationship to NOS: This unit is linked to LMCS E9
Aim The purpose of this unit is to assess the learner’s knowledge, understanding and skills required
to developing, implementing and reviewing procedures and practices to address concerns and
complaints. It covers the relevant regulatory requirements, codes of practice and relevant guidance,
and analyses the impact of these on service provision.
OUTCOME 3 AND 4 AND SOME PARTS OF THE OTHER OUTCOMES ARE BASED ON YOUR
OWN PERSONAL WORKPLACE PROCEDURES. I HAVE GIVEN IDEAS AND INDICATIONS OF
THE TYPE OF AREAS YOUR ASSESSOR MAY WISH TO OBSERVE, WHERE THIS IS
APPROPRIATE.
1.1 Identify the regulatory requirements, codes of practice and relevant guidance for
managing concerns and complaints in own area of work
1.2 Analyse how regulatory requirements, codes of practice and relevant guidance for
managing concerns and complaints affect service provision within own area of work
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The Government made a commitment in the 2006 White Paper “Our health, our care,
our say” to develop a comprehensive single complaints system across health and social
care by 2009.
‘The Local Authority Social Services and National Health 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. It helped organisations to deal with complaints
better, in order to make services more effective, personal and safe. The new
complaints approach is structured around three main principles: listening, responding
and improving. In other words, helping 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 Care Quality Commission, are the independent regulator of all health and social
care services in England and set the national standards which cover all aspects of care.
The CQC set the standards called the Essential Standards for Quality and safety
which all care providers are expected to meet. The standards were set to meet the
requirements of the Health and Social Care Act 2008. The Standards consist of
outcomes and Outcome 17 deals with Complaints.
Complaints
19.—(1) For the purposes of assessing, and preventing or reducing the impact of, unsafe
or inappropriate care or treatment, the registered person must have an effective
system in place (referred to in this regulation as “the complaints system”) for
identifying, receiving, handling and responding appropriately to complaints and
comments made by service users, or persons acting on their behalf, in relation to the
carrying on of the regulated activity.
(2) In particular, the registered person must—
(a) bring the complaints system to the attention of service users and persons acting on
their behalf in a suitable manner and format;
(b) provide service users and those acting on their behalf with support to bring a
complaint or make a comment, where such assistance is necessary;
(c) ensure that any complaint made is fully investigated and, so far as reasonably
practicable, resolved to the satisfaction of the service user, or the person acting on
the service user’s behalf; and
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Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities)
Regulations 2010
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 practice
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. The code 3.7 states that you should be:
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 guidance regarding good complaint
handling and this can be 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) Regulations 2010 requires you to be able to
demonstrate that you have taken account of the outcomes and prompts when judging
your compliance with the regulations in your day-to-day activities. The CQC must be
sure 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 work area in respect of complaints.
Outcome 1: 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.
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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—
(i) the complaints and comments made, and views (including the descriptions of their
experiences of care and treatment) expressed, by service users, and those acting on
their behalf, pursuant to sub-paragraph (e) and regulation 19,
• Improve the service by learning from adverse events, incidents, errors and near
misses that happen, the outcome 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.
● 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-publicised, and reflects
established principles of good complaint handling. The process will ensure:
– that the details of the complaint, and the desired outcome, have been properly
understood
– that advice and advocacy support is available to those who wish or need such support
– that what is required to resolve the complaint, and the likely timescale, is explained.
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2.1 Explain why individuals might be reluctant to raise concerns and make complaints
Individuals and their carers are reluctant to raise concerns or complain 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 significant deterrents as can the fear that nothing will
be done. Many elderly people are reluctant to complain about their treatment because
they do not want to get their care workers into trouble and fearing that they may then
not get care at all. This is a fact both in the community and in residential care. Women
and those living alone are particularly worried about complaining because of fears of
services being taken away or of being asked to leave residential care.
2.2 Outline steps that can be taken to encourage individuals to raise concerns or complaints
When people are admitted, provide a booklet, leaflet or information sheet that gives
clear information on how they can complain if they are unhappy about the service they
receive. Having a fair, open and honest culture around complaints means:
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If people feel comfortable about raising concerns with frontline staff – and staff act
promptly to address the issues raised – it is less likely that problems will need to be
addressed through the official complaints procedure.
If you constantly gather feedback from individuals who regularly use services you are
able to use their responses to identify ways of improving services. This approach allows
early identification and rectification rather than reacting after individuals have
complained. Use a questionnaire to find out where best practice is being achieved and
to highlight areas where practice could be improved. Develop an action plan to address
the areas where service improvement is needed. Again early intervention will avoid
complaints being made.
2.3 Work with others in the development of procedures to address concerns and
complaints
YOUR ASSESSOR WILL REQUIRE TO OBSERVE YOU FOR THIS PART OF THE OUTCOME. SOME
SUGGESTIONS OF WHAT SHE MAY WISH TO OBSERVE ARE SHOWN BELOW
There will be various other people involved in the development of your procedures to
address concerns and complaints. This will include people who use the service, their
carer’s and significant others, members of your staff and other professionals.
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You could invite people from outside the service to gather feedback from the people
who use it. Their insights of service user’s and others feedback should offer a
different perspective to that of professionals. They may be able to gather and record
information in a less formal manner than you are able to as a professional. Individual’s
and staff may be more willing to make comments because the team take their time with
people in order to make them feel at ease and to encourage them to speak freely. The
outside team will observe and record concerns and monitor whether issues from the
previous visit have been addressed, they can also interact with staff about practices
and procedures. Their reports can then be studied and recommendations can be
formulated as a result.
After a complaint has been dealt with you need to send out a customer feedback
questionnaire to complainants following the resolution of a complaint. This will provide
an opportunity for complainants to comment on the complaints process and the manner
in which their complaint was handled. This is to ensure continuous improvement in
complaints handling and also evidence learning from people’s experience.
Dealing with a wide range of health, social and independent organisations can be
confusing for people. If something goes wrong it is important that the organisations
involved provide a
unified, responsive and effective service for complainants. This means that an
individual should only need to contact one organisation to identify a complaint and not
have to approach a variety of organisations about a range of issues. It is important to
develop and maintain effective working relationships with staff in other agencies and
other professionals in order to develop procedures to deal with complaints and
concerns.
This will ensure:
• A single consistent and agreed contact point for complainants to avoid confusion.
• Clarity about the responsibilities of each organisation.
• Regular and effective liaison and communication between the coordinating
complaints teams and complainants
improvements are identified. The lead complaints manager should ensure that any
learning points/identified actions are forwarded to their counterpart in the relevant
organisation
2.4 Ensure information on how to raise concerns and make complaints is available in
accessible formats
Legal requirements
The Equality Act came into force in October 2010 replacing the Disability
Discrimination Act (DDA) in England, Scotland and Wales. Like the DDA, the Equality
Act was introduced with the intention of comprehensively tackling the discrimination
which many disabled people face.
The Act makes it a legal requirement that you have a duty to make reasonable
adjustments for disabled people, including taking steps to put information into
accessible formats if a disabled person is at a substantial disadvantage if you do not do
this. Everyone has a right to equal access to information. The Act is 'anticipatory',
which means you cannot wait until a disabled person wants to use your services. You
must think in advance (and on an ongoing basis) about what disabled people with a range
of impairments (sight loss, hearing loss, mobility and cognitive impairments) might
reasonably need.
2.5 Review the procedures that have been developed against regulatory requirements,
codes of practice and relevant guidance
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Your complaints procedure will include a policy statement, it’s aims and goals. It will
detail the procedures you are to follow when a complaint is made and how it will be
investigated. You need to review this against the regulatory requirements, codes of
practice and guidance (AS IN OUTCOME 1.1 / 1.2 ) to show how your policy is meeting
each. Are there any changes you feel need to be made?
Whilst it should be your aim to treat every concern or complaint equally seriously,
whether informally or formally made, it must be recognised that many people value the
choice of whether the organisation uses an informal (discussion with local staff) or
formal route (Complaints Service) to address the matters they have raised. The new
Health and Social Care complaints system in April 2009 underlines the importance of
allowing for this flexibility in designing person-centred ways of resolving people’s
concerns and complaints. The new approach was a major shift away from fixed
processes and timescales towards person-centred and outcome-focused resolution. To
underscore their intention, the Department of Health published alongside the new
regulations a number of guidance and advice publications under the badge “Listening,
Responding and Improving.”
When dealing with a complaint you need to focus on the individual, respect and value
the knowledge, abilities and experiences of the individual and respond to their
complaint in a way that suits their particular needs, wishes and circumstances. You
should ensures the perspective of the individual is heard and considered in how the
matter is resolved. People are treated respectfully, courteously and sensitively. This
includes treating information confidentially. In fulfilling your role, you will try to
achieve the best possible outcomes for the individual and involve them in the process in
order to reach a resolution.
An effective complaints management system is one that is fully integrated into your
quality management system. This includes policy and guidelines for receiving, recording,
processing, responding to and reporting on complaints, as well as using the guidelines to
improve services and decision-making. The system should provide clarity to staff
on how to respond to complaints, as well as informing service users of the organisation’s
commitment to using complaints to continually improve the service.
3.2 ensure that others are informed about the procedure for raising concerns or making
complaints
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3.3 Use supervision to support workers to recognise and address concerns and complaints.
A complaints procedure will be effective only if the workplace shows commitment to it.
Staff should be properly briefed on the complaints procedure. You should give staff
clear and precise information about their role and responsibilities in dealing with
complaints. It is important that staff are aware of the procedures for making
complaints as they are then able to advise service users of what to do. This will enable
people to express their displeasure of a service, person, situation etc. It is useful if
the procedure includes a flowchart of how a complaint is dealt with so staff can clearly
see and follow the process. Staff may need increased support and supervision from
managers to help them cooperate with considerations under the procedure and to work
positively with the complainant. Training should be available to staff at all levels of the
organisation and should be tailored to the roles staff are expected to fulfil. A training
strategy is likely to include a basic introduction to the principles and working of the
complaints procedure along with skills development. It should also explore the
relationships between the complaints procedures and related policies, including whistle
blowing and the duties of staff to report improper behaviour and wrong-doing. Training
should also include raising understanding of the cultural and special needs of individual
complainants so that practice can be tailored to suit their needs.
It is essential that all staff formally capture and record complaints. It is only by doing
so that complaints can be tracked and where things have gone wrong managers can
ensure that matters are put right. You should therefore regularly encourage staff to
recognise and record complaints and report these. Staff should be given details
regards the complaints procedure during their induction and also in their staff
handbook. During supervision you can:
3.4 Implement systems and procedures which address concerns and complaints and fully inform
the complainant of the outcome within agreed time frames
The CQC – Essential Standards for Quality and Safety Outcome 17 states:
Complaints
19.—(1) For the purposes of assessing, and preventing or reducing the impact of, unsafe
or inappropriate care or treatment, the registered person must have an effective
system in place (referred to in this regulation as “the complaints system”) for
identifying, receiving,
handling and responding appropriately to complaints and comments made by service
users, or persons acting on their behalf, in relation to the carrying on of the regulated
activity.
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As Manager you need to ensure that the complaints system is in place and implemented,
to address concerns and complaints. This will include:
• receive complaints, enquiries and representations from service users and carers
• undertake complaint investigations as appropriate;
• provide reports to Team Managers on a regular basis regarding the trends and
progress of complaints;
• facilitate advocacy and support to complainants;
• Ensure effective access for all service users to the statutory and non-statutory
processes.
FOR THIS PART OF THE OUTCOME YOUR ASSESSOR WILL WANT TO SEE EVIDENCE OF HOW
YOU MONITOR, EVALUATE AND INVOLVE OTHERS IN THE REVIEW OF YOUR PROCEDURES
WHEN ADDRESSING CONCERNS AND COMPLAINTS. BELOW ARE SOME IDEASOF HOW YOU
MIGHT DO THIS
4.1 Monitor the use of systems for addressing concerns and complaints
Individuals and their complaints should be dealt with in accordance with the principles
of courtesy, fairness, openness and transparency. Having a responsive culture, which
resolves difficulties quickly, can help to improve the services you offer. In order to
ensure this, it is important to make sure you have systems and processes in place to
implement the policies and procedures and respond appropriately to the nature and
complexity of any concern or complaint. It is equally important that you monitor those
systems and processes on a regular basis. The complaints system can be a valuable
resource, particularly in terms of identifying potential problem areas. If a particular
issue becomes a regular source of complaint, there may be a number of reasons for
this, and monitoring can indicate that there may be a problem in a particular area or
department.
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Having systems and processes in place to monitor and track complaints is particularly
important in responding to complaints in a timely manner. If the normal, reasonable
response time cannot be met, the complainant should be informed of this, and given the
reasons for the delay. Your complaint system needs to be kept relevant and up-to-date.
Changes in personnel, staff mobility, new administrative procedures, changes in the law
and new sources of complaints, may all have implications for the complaints system. The
complaints procedure needs to be continually monitored and reviewed by the person
with ultimate responsibility for its organisation and management to ensure any changes
are being made to procedures.
4.2 Evaluate the effectiveness of systems for addressing concerns and complaints
It is important that your system for addressing concerns and complaints is effective.
An effective complaint management system is an essential part of any service provider.
Complaints - and compliments - are valuable sources of information that organizations
can use to improve their services. A formal complaints procedure also enables
individuals to exercise some control over the quality of services you provide. When it
comes to customer dissatisfaction, ignorance is anything but bliss. Thriving
organisations know that having an effective system for receiving and responding to
individual’s complaints and concerns is a vital part of their success.
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it identifies areas that need changing and allows individuals to provide input to
service improvement;
it gives the organization a second chance to serve and satisfy dissatisfied
clients;
it provides an opportunity to strengthen public support for the organization by
enhancing the reputation of the service and prevent negative comments or
publicity
it helps reduce an organization's workload by saving time by the quick resolution
of complaints, avoiding escalation
restore the trust and confidence of a consumer or carer;
promote a culture of reporting and accountability;
create a more satisfactory working environment for staff; and
A good complaints system needs to respond to changing circumstances and events. You
will need to continually evaluate and review your system to ensure it meets all the
necessary criteria and make recommendations to the head of your organisation if, in
your opinion, current practices are adversely affecting the customer.
You can evaluate how well your concerns and complaints system is working by ensuring
that any complaints and concerns are used to help your organisation to deliver
continuous improvement. This can be done by making sure:
• Lessons learnt from complaints are gathered and feedback is used to improve
service design and delivery.
• Systems are in place to record, analyse and report on the learning from
concerns.
You must keep up to date with best practice, regularly review the organisation’s
complaint handling system.
4.3 Involve others in the review of procedures and practices for addressing concerns and
complaints.
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Complaint analysis should be part of the continuous cycle of review and improvement in
an agency. Refer to Outcome 2.3
4.4 Show how own management practice has provided a culture where the organisation
can learn from concerns and complaints
HERE YOU WILL NEED TO SHOW YOUR ASSESSOR WHAT YOU DO IN YOUR WORKPLACE TO
ENHANCE A CULTURE WHERE YOUR ORGANISATION CAN LEARN FROM CONCERNS AND
COMPLAINTS. BELOW ARE SOME IDEAS
It is important to instil a culture within your staff where they see complaints as an
opportunity to improve things, not as a threat. Your organisation must value complaints
as a means of strengthening your administration and improving your relations with
individual’s and the public. An organisation must value complaints and recognise that
effective complaint handling will benefit its reputation. Complaints can:
Your own management practice should ensure you are promoting a positive culture
amongst staff regards complaint handling. (REFER TO OUTCOME 3.3) You should be
the internal ‘face’ of the complaint handling team and should promote a positive culture
that values complaint handling. You should be the complaint ‘champion’, ensuring that
the organisation remains focused on having a strong, integrated complaint system.
To Summarise
• Staff at all levels understand and comply with the organisation’s policy on
complaint handling
• A senior manager is responsible for complaints
• Staff who handle complaints receive specialist training
• Sufficient resources are allocated to complaint handling
• Strong internal networks ensure that other staff help specialist complaint
handling staff
• There is an information technology system that supports complaint handling and
facilitates collection and analysis of complaint information
• Regular internal reports are produced on complaint trends and administrative
defects
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4.5 Demonstrate how recommendations from concern and complaint investigations have
been used to improve the quality of service
You will need to think of a complaint which has been received and where you have
recommended a change in your workplace practice. As we discussed previously
complaints should be seen as a positive and an opportunity to improve the services you
provide. This part of the Outcome will need to be answered from your own experience
but below are some simple examples of how a complaint may have been used to improve
the quality of service you provide.
Examples:
You may have extended the time when lunch can be served from 1 hour to 2 hours
You may have arranged further infection control training for staff
3. A service user has complained about a member of staff who doesn’t listen to
their needs and preferences