Blog: New complaints process helps target resources to people who may be at risk

By Marie Paterson, Service Manager Complaints and Inspection

The Care Inspectorate is here to ensure that people receive safe, high-quality, compassionate care that meets their needs and promotes their rights and choices. Providing a clear and easily accessible procedure for people to raise any concerns is an essential part of our duties as a scrutiny and improvement body.

Most care in Scotland is good, but sometimes things do go wrong. We really value the concerns that people raise with us. First and foremost, we can often help things to improve for the people who raise concerns with us. Second, they help us to get an accurate picture of the level and quality of services being offered and delivered from the perspective of people experiencing or choosing care. We use this vital source of feedback and learning to help services improve. Complaints can also provide an early warning of problems in a care service.

By making our complaints procedure easy to access and use, it helps us to identify issues earlier and make improvements before they escalate. That’s why we have been reviewing our procedures to make sure all concerns are addressed in a timely way and most importantly that we can target resources to those complaints where people experiencing care may be at risk.

What to expect

We’ve made some changes to our procedures from 1 November. So what can you expect if you have a concern?

First of all, if you are not happy with the level of care you or someone you care for is experiencing, we would encourage you to first of all speak to the care service itself about your concerns. This is often the quickest way to resolve a problem.

However, you can choose to raise your concern directly with us by either:

•filling in our complaints form online

•calling us on 0345 600 9527

•writing to any of our offices.

Once we have received your concern we will be aim to make contact with you within two working days and let you know how we are going to deal with the issue. This may involve frontline resolution or full investigation. You will be given a named inspector who will deal with your case and keep you informed of developments. You don’t need to tell us your name when you make a complaint, but it helps us a lot if you do.

Risk assessment

We are now applying a new risk assessment process to allow concerns to be triaged, ensuring that the Care Inspectorate quickly targets resources to those complaints where people experiencing care may be at risk.

Concerns will be assessed as either low, medium or high. In this way, we can ensure that complaints that present the highest risk to people who use care services are investigated at the earliest opportunity.

The complaints inspector may wish to speak with you at an early stage to discuss your views and make sure we understand the issue clearly.

When responding to concerns and complaints, there are four routes we can take:

1 We use the information you have given us as intelligence about the service

We will treat the information you have given us as intelligence and pass it to the inspector responsible for regulating the service. This will help inform future scrutiny activity.

2 Frontline resolution, where we talk to the care service on your behalf

Where we assess your complaint as being appropriate for frontline resolution, we will contact the care service on your behalf and ask them to engage in frontline resolution directly with you to resolve the complaint. We will discuss this with you before making any contact with the care service.

3 Investigation by the care service

We may assess your complaint as being appropriate for investigation by the care service and we will contact the care service, asking them to investigate and then send us written confirmation of the action taken and resolution. The inspector for that service will assess the written response to establish if the complaint has been dealt with appropriately. If we don’t think the complaint has been dealt with appropriately then we may investigate it ourselves.

4 Investigation by the Care Inspectorate

Not all complaints are suitable for frontline or resolution by the care service. Depending on our assessment of risk, we may decide we need to investigate a complaint ourselves.

How we will investigate

Our investigations aim to establish all the relevant facts and give you a full, objective and proportionate response that sets out whether we uphold your complaint. The investigating inspector will speak with you and discuss your complaint. They will then write to you to tell you about the areas we will investigate.

An investigation aims to establish all the facts relevant to the points made in the complaint and to give the complainant a full, objective and proportionate response that represents our findings based on evidence and professional judgement.

We investigate complaints in an independent, impartial and fair way. We believe that complainants have a right to be heard, understood and respected and we aim to be as open and accessible as we can.

In most cases, the Care Inspectorate will inform the complainant of the elements it will investigate within 10 working days of contact, and will aim to provide a full response as soon as possible, but no later than 40 working days.

However, not all investigations will be able to meet this deadline. Some complaints are so complex that they require careful consideration and detailed investigation beyond the 40-day limit. If there are clear and justifiable reasons for extending the timescale, the inspector will inform the complainant of the reason for the delay and give them a revised date for completion.

The investigation may include an unannounced visit to the care service by the Care Inspectorate to investigate the complaint and examine and assess the evidence, which includes checking documentation and speaking to relevant people.

However, there may be times when it is appropriate for the Care Inspectorate to inform the service of the visit. In this case, there would generally be no more than three days’ notice to the visit, and the service will not normally be informed in advance of the nature of the complaint or complainant details.

Investigation outcomes

There are two possible outcomes of complaints investigations:

1 Upheld

This is used where the facts giving rise to an allegation have been established in the investigation. In this situation, any action will be based on the professional judgement of Care Inspectorate staff, based on the available evidence. Both the complainant and the care service will be informed in a report of any requirements or recommendations made of the care service. The Care Inspectorate will require that the service provider submits an action plan to demonstrate how they will improve outcomes for people who use care services. We may also re-grade a service following a complaint.

2 Not Upheld

This occurs where the facts giving rise to an allegation have not been established in the investigation.

Review

The inspector will provide verbal feedback on the outcome of the investigation to both the complainant and the care service, and will send a report to both. Each has the opportunity to request a review of the decisions in the report, and ask for a post investigation review.

If you would like to know more about raising a concern please visit the Complaints section on our website.