A proportionate approach to complaints

The regulations say a complaint must be investigated ‘in a manner appropriate to resolve it speedily and efficiently’. Therefore, it is important that councils have policies and processes in place to allow this.

The regulations set out a single stage complaints procedure. This means that people who raise complaints should not have to navigate multiple complaints stages to get a final response from the Council. This guide sets out two internal steps councils can follow to support councils to resolve complaints at the earliest opportunity.

Accepting complaints

The regulations do not define what constitutes a complaint. We consider a complaint to be:

‘an expression of dissatisfaction, however made, about decisions, the standard of service, actions or lack of action by the organisation, its own staff, or those acting on its behalf, affecting an individual or group of individuals.’

Councils may wish to adopt this definition or similar into published information about complaints procedures to support the public, staff and commissioned services to understand what constitutes a complaint. An individual should not have to use the word ‘complaint’ for it to be treated as such.

Complaints should be raised no later than 12 months after the date the matter complained of occurred or the date the matter complained of came to the notice of the person complaining.

The regulations say that the council must consider whether there were good reasons for the complaint not being made in time and whether it can carry out a fair and effective investigation.

Councils may also wish to set out a definition of a service request to clarify the difference between a complaint and a routine request for a service or service improvement. We consider a service request in adult social care services to be:

‘a request that the organisation provides or improves a service or fixes a problem’.

These issues could be addressed through normal service delivery in the first instance. If the complainant remains unhappy after the council has attempted to resolve the matter it should be dealt with as a complaint.

Receiving and acknowledging complaints

Complainants should also be able to raise complaints with any member of staff, including those providing their care. Complainants should not be required to register complaints in a specific way and should be able to raise concerns in a way that suits their needs.

Councils must have systems for accepting complaints made orally. This is a requirement of the regulations. Using the prompts above may support staff to capture the complaint.

If the complaint is made orally, councils must:

• make a written record of the complaint; and
• provide a copy of the written record to the complainant.

There is more information about good practice in receiving and acknowledging complaints in our guide for complaint managers. This includes good practice for meeting complainants to discuss their complaint and designing complaint forms.

Councils must acknowledge complaints within three working days after the day on which it was received either directly from the complainant or from another public body (e.g. local NHS Trust). The acknowledgement can be made orally or in writing.

When a council acknowledges a complaint, it must offer to discuss the complaint with the complainant along with an explanation of how their complaint will be handled including how long it will take to respond.

There is more information about receiving and acknowledging complaints in our good practice guides for complaint handlers and complaint managers.

Considering complaints

In order to resolve complaints efficiently and in an appropriate manner, councils should focus on being able to resolve complaints at an early stage. To facilitate this councils may pass complaints through internal steps before signposting the complainant to the Ombudsman. These steps, early resolution and investigation, mirror those set out in the NHS Model Complaint Handling Procedure to support a joint approach to complaint handling where appropriate.

It is important that the complainant does not have to navigate these steps. If the complaint cannot be resolved early the council should progress to an investigation. This is because the regulations set out a single stage complaint process and so complainants should not have to navigate complex complaints processes.

The steps do not need to be followed sequentially in every case. Councils should have processes in place to help decide which step is most appropriate for each individual complaint. For example, where a complainant raises multiple issues across a number of different services, it may be appropriate to start an investigation whilst also trying to resolve the matter at the same time. Similarly, it may be inappropriate for a front-line service to attempt to resolve the complaint where there is a breakdown in the relationship with the complainant or their family. Therefore, it may be more beneficial to attempt to try to resolve the complaint elsewhere (e.g. early resolution through a complaints team).

This process is considered good practice, but councils may decide to adopt different processes to meet the requirements of the regulations.

Early resolution

Front line services, including commissioned services (e.g. care providers), are often best placed to provide a resolution to a complaint. This may include restoring a service that had broken down, carrying out a new assessment or providing further services. If the complaint is made orally and resolved to the complainant’s satisfaction “no later than the next working day” then it does not have to be recorded under these regulations. If the issue cannot be resolved by the next working day, then a complaint needs to be registered under the regulations.

Sometimes, front line services are unable to provide a quick resolution to complaints. This may be due to a breakdown in the relationship between the service and the complainant or because of pressures and demands on the service. It may also be that the complainant has unreasonable expectations of services that can be provided.

Where this is the case, the council may consider whether there is anything further that can be done to resolve the complaint speedily and efficiently without the need for a detailed  investigation into what happened. This may include:

• providing mediation between the service and the complainant or their family;
• putting services in place, restoring a service that had broken down, carrying out an assessment or reassessment;
• an apology; or
• a remedy, including a financial payment where appropriate.

The focus at this step should be on finding ways to resolve the complaint. Therefore, councils may be able to resolve a complaint to the complainant’s satisfaction without finding that anything has gone wrong. However, councils should ensure the complainant is satisfied with the outcome before closing the complaint.

We think this step should take no more than around 20 working days. If the complaint cannot be resolved in this timescale it should be escalated to the next step. However, councils should continue to look to resolve the complaint whilst an investigation takes place. This timescale supports councils to resolve complaints within overall timescales set out in the regulations.

There is a risk that resolving complaints in this way may mean that systemic issues or risk factors are not identified. Councils may choose to monitor complaint data to help identify trends and ensure any risks to individuals are reported appropriately (e.g. through safeguarding processes).

Investigation (a closer look)

Not every complaint can be resolved and not every complainant will agree with suggested ways of resolving their complaint.

In these cases, councils should take a closer look at the issues raised and provide a final response that signposts the complainant to the Ombudsman.

We encourage councils to take a proportionate approach to responding to complaints at this step. Some complaints may require a detailed investigation to find out what happened, whilst others may require a brief response setting out the council’s final decision.

Councils may wish to consider the following when deciding on the proportionality of response required in each case:

• the seriousness of the issues raised;
• the impact on the person complaining or others; and
• the wider impact of any potential faults.

It is important that councils take a fair approach to complaints at this stage and where possible, ensure it is looked at by someone who was not directly involved in the matters complained about.

Councils may wish to ensure anyone investigating a complaint at this step has:

• the authority and autonomy to carry out a fair investigation;
• access to resources, support and time to carry out the investigation in a proportionate manner; and
• the authority to provide a remedy or take action to resolve the complaint, or access to senior officers who can approve this.

The final response must be sent no later than six months from the date the complaint was first received. The regulations allow councils to extend this timescale, however this should only be necessary in rare cases. Councils should be mindful that the longer it takes to respond to a complaint, the more it can add to an individual’s injustice.

The final response to the complaint must set out the council’s response to the issues raised, including any proposals of how to put things right if things went wrong through an apology, remedy or service improvements.

It must also clearly signpost the complainant to the Local Government and Social Care Ombudsman.