Complaint stages

‘Organisations should have processes in place to consider which complaints can be responded to as early as possible, and which require further consideration. Organisations should consider factors such as the complexity of the complaint and whether the individual is vulnerable or at risk. Most stage 1 complaints can be resolved promptly, and an explanation, apology or resolution provided to the individual.’ (Paragraph 6.1 of the Complaint Handling Code)

Triaging complaints

Organisations should have effective triage processes in place to help ensure complaints are dealt with promptly. This should include:

• checking whether a complaint may be a service request;
• checking whether the person is someone who can complain;
• checking whether it is a matter that can be complained about;
• checking whether there are opportunities to resolve complaints quickly; and
• identifying the most appropriate person to handle the complaint.

If organisations find that a large number of individuals are registering service requests through the complaints process, it may be necessary to understand why this is the case. In most cases this is because the service area does not have adequate contact methods in place for the public so they resort to contacting the organisation through the complaints process.

Complaints can be excluded at any point in the complaint process if new information comes to light or the circumstances of the complaint or complainant change. Organisations should ensure complaint handlers are aware of exclusions in local policies.

When considering complaints, organisations should focus on the following questions:

• What, if anything, has gone wrong?
• What was the impact on the person complaining or the wider public?
• What action should be taken to put things right?

These points do not always need to be answered sequentially. For example, a good complaints system will focus on outcomes people are seeking and opportunities for resolving complaints early.

In a small number of cases, it may be appropriate for organisations to go straight to stage 2 of the process, bypassing stage 1 altogether. This would be appropriate when handling complaints about the actions of the most senior officers in the organisation where it would not be possible to find someone else to consider a further complaint. It may also be appropriate in circumstances where the complainant is considered vexatious or unreasonably persistent.

Acknowledging complaints

Organisations may have systems in place which automatically acknowledge receipt of complaints. Automatic acknowledgements do not have to be considered as formal acknowledgements under the Code.

An acknowledgement is an affirmative confirmation by the organisation that the complaint has been accepted.

Organisations may wish to include an explanation of this within any automatic acknowledgment generated in response to receipt of a complaint. For example:

“This is an automatic email/ message to confirm we have received your complaint. We will send you a further acknowledgment within 5 working days to confirm we have accepted your complaint.”

Stage 1 complaints: a proportionate approach

Organisations may take a proportionate approach to complaints received at stage 1. Organisations will deal with a higher volume of complaints at stage 1 compared to stage 2 and so it is important that these are dealt with efficiently.

The most effective way to do this is to consider whether any action can be taken quickly to resolve complaints. Organisations should look for opportunities to resolve complaints without the need for a detailed investigation. This saves time and resources for both the organisation and the complainant.

If a complaint can be resolved without the need for a detailed investigation, and the complainant agrees with the proposed action, the organisation should consider closing the complaint on that basis. The organisation should still signpost to stage 2. This provides the complainant with an opportunity to raise a complaint if any agreed action is not completed as expected or they later change their mind about the resolution offered.

However, organisations should not seek to resolve complaints by providing services the complainant is not entitled to or providing financial remedies without justification.

If a complaint cannot be resolved quickly, organisations should consider the potential impact of the alleged fault on the individual as well as the extent of the fault alleged. This will help organisations to decide how much resource is required to respond to the issue raised appropriately.

Understanding the potential impact of alleged fault on the individual or the wider public can help inform the level of resource necessary to respond to a complaint. Not all complaints require a detailed investigation. For example, it may be disproportionate to carry out a detailed investigation into complaints about small inconsequential faults. In these cases, an organisation’s stage 1 response may:

• explain the relevant law and the organisations standard processes unless there is any clear fault that can be acknowledged; and
• thank the individual for highlighting the issue and pass this on to the relevant service area as feedback. The individual should still be signposted to stage 2.

By taking this approach, organisations can ensure they are focusing their resources on addressing complaints about matters which have the greatest impact on individuals and the wider public.

If a complaint cannot be resolved, and any potential fault may have had a significant impact on the individual or the wider public, further investigation may be necessary. We have published a good practice guide for complaint handlers which sets out how to plan an investigation and reach sound decisions.

In rare cases, an individual may not make their reason for complaining clear. Where this is the case, and it has not been possible to clarify their reason for complaining with them either verbally or in writing, the stage 1 may be closed on the basis that there is insufficient information to be able to respond. The complainant should be signposted to stage 2 where they will have a further opportunity to explain their reasons for complaining.

If a complainant refuses to provide details of their complaint to try and bypass the organisation’s processes and come straight to the Ombudsman, the organisation can explain the Ombudsman expects the organisation to be given an opportunity to consider the complaint first. We may decline to consider a complaint if we don’t believe the organisation has had an opportunity to consider it first.

Responding to complaints at stage 1

Organisations should consider what type of response is suitable in each case.

If a complaint can be resolved at an early stage it may be possible to inform the individual of the outcome over the telephone and record that this has happened on the case record. It is considered good practice to follow up any telephone response briefly in writing with an explanation of how to escalate the complaint if the complainant remains unhappy. Even if a complaint is responded to verbally, individuals must be told how to escalate the complaint and a clear record made that this has happened. 

In cases where a formal investigation has taken place, complaint handlers should send a written response to the complainant either by e-mail or letter. Complaint handlers may also need to make the response available in other formats depending on what reasonable adjustments have been agreed with the complainant.  

Our good practice guide for complaint handlers sets out recommended standards for complaint responses.

Further contact following a stage 1 response

Sometimes people will contact an organisation following a stage 1 response to ask for clarification on certain issues. Organisations can respond to requests for clarification without the need to escalate a complaint to stage 2. However, organisations should exercise caution to ensure they do not become involved in prolonged interactions about the matter. Once the organisation has provided clarification on the stage 1 response, the complainant should be signposted to stage 2 of the process. If they require further clarification this should be dealt with through normal service delivery.

If the complainant expresses dissatisfaction with the stage 1 response the organisation should escalate the complaint to stage 2, even if the complainant is also seeking clarification. This can be provided as part of the stage 2 response.

Stage 2 complaints: a closer look

Stage 2 is the organisation’s final opportunity to respond to a complaint directly before an individual can raise a complaint with the Ombudsman. Therefore, it is important the organisation has processes in place to ensure any response at this stage captures the overall corporate position on the matter.

Organisations may still decide to take a proportionate approach to complaints at this stage and not every complaint will require a detailed investigation or response. If the organisation is satisfied the matter was properly considered at stage 1, the stage 2 process may simply confirm the organisation’s position and signpost the individual to the Ombudsman without further investigation of the complaint.

Individuals do not need to specifically request to escalate a complaint to stage 2. Organisations should consider whether this is appropriate if an individual raised the same or similar issues which have already been addressed at stage 1.

Complainants should not be expected to explain their reasons for escalating a complaint to stage 2. In some cases complainants may not be able to articulate the reasons why they remain unhappy but they will still feel dissatisfied with how they have been dealt with by the service they are complaining about or how their complaint has been handled.

It is good practice to ask complainants why they are unhappy with the stage 1 response as this can help the stage 2 investigation to focus on any matters the complainant feels have not been addressed. It also provides the organisation with an opportunity to try to resolve any outstanding issues where possible.

However, if a complainant is unable or unwilling to explain why they want a stage 2 the organisation should still respond to the complaint. Where this is not possible (e.g. the complainant has not made their reason for complaining clear) the organisation should explain why it is unable to respond to the complaint and signpost to the Ombudsman.

Time limit for raising a stage 2 complaint

Organisations should set out a timescale within which complainants are expected to raise a stage 2 complaint following a stage 1 response. We think 20 working days is a reasonable time for someone to escalate a complaint.

However, there will be occasions where it would be reasonable for someone to raise a stage 2 complaint outside this timeframe. This may be because the organisation has agreed to take action but there have been delays or the organisation has not taken the action the individual expected. It may also be the case that organisation resolved the complaint but the same or similar issues recurred at a later date.

In these cases, it may not be reasonable to expect individuals to go back through the stage 1 process, as this may result in situations where a complainant continually raised the same or issues at stage 1 without ever having an opportunity to escalate their complaint further.

Organisations should generally agree to escalate complaints within six months of a stage 1 response if an individual raises the same or similar complaint. This benefits individuals in being able to escalate complaints and also makes better use of the organisation’s resources as it avoids repeatedly dealing with the same matters.

Organisations should also carefully consider the circumstances of each complaint as it may be reasonable to accept a request to escalate a complaint to stage 2 where the stage 1 response was sent more than six months ago.

Individuals do not need to specifically request to escalate a complaint to stage 2. Organisations should consider whether this is appropriate if an individual raised the same or similar issues which have already been addressed at stage 1.

If an individual asks to raise a complaint about the same or similar issues more than 12 months after a stage 1 response has been issued, the organisation may decide to exclude this as a late complaint. However, organisations should consider exercising discretion to accept the escalation request if there are good reasons for the individual not escalating their complaint sooner or there has been a change in circumstances.

If an organisation decides not to deal with a complaint at stage 2 because of the time that has passed since it issued its stage 1 response, it may either open a new complaint at stage 1 or signpost the individual to the Ombudsman.

Where a complaint relates to an ongoing matter it would generally be considered good practice to consider a new complaint at stage 1. This may focus on any new issues raised rather than revisit historic issues which have already been responded to.

If no significantly new issues are raised, and the organisation decides the complaint has not been escalated in good time it may reject the complaint and signpost the individual to the Ombudsman.

Organisations should consider the risks of rejecting complaints that are not escalated in good time. The Ombudsman can look at matters raised within 12 months of a person becoming aware of a matter and we will reach our own view on whether to investigate beyond this timescale. Therefore, organisations should ensure they are confident in their stage 1 response before rejecting the complaint.

We have produced the following wording which organisations may wish to adopt into policies and procedures:

We generally expect individuals to ask to escalate complaints to stage 2 of the complaint process within 20 working days of receiving our stage 1 response. However, we understand that this is not always possible and that individuals may want to give us an opportunity to resolve matters before escalating their complaint further. Therefore, we will generally accept requests to escalate complaints to stage 2 which are made within six months of receiving our stage 1 response.

It is important that you escalate your complaint as soon as possible if you remain unhappy with our response. It can be challenging for us to properly consider complaints as more time passes between the issue you are complaining about and our consideration of your complaint. This is because it may be difficult to obtain relevant evidence and people involved may not be able to accurately recollect what happened.

Responding to complaints at stage 2

Stage 2 complaint responses should be in writing, either in a letter or an email. Organisations may need to make the response available in other formats depending on what reasonable adjustments have been agreed with the complainant.  

The Complaint Handling Code sets out details of what should be covered in a stage 2 response to ensure the organisation’s response is captured. This is further supported by our recommended standards for decision letters and reports set out in our good practice guide for complaint handlers. Stage 2 responses should include the following in clear, plain language:

• the complaint stage;
• the organisation’s understanding of the complaint;
• the decision on the complaint;
• the reasons for any decisions made;
• the details of any remedy offered to put things right;
• details of any outstanding actions; and
• details of how to escalate the matter to the Ombudsman if the individual remains dissatisfied.

If this has already been captured in the organisation’s stage 1 response and the organisation has nothing further to add at stage 2, it should provide a copy of the stage 1 response as an addendum to its stage 2 response. This will minimise the need for the Ombudsman or advice agencies to ask for earlier copies of complaint responses if the individual is unable to provide these.

Further contact following a stage 2 response

Sometimes people will contact an organisation following a stage 2 response to ask for clarification on certain issues. Organisations can respond to requests for clarification. However, organisations should exercise caution to ensure they do not become involved in prolonged interactions about the matter. Once the organisation has provided clarification on the stage 2 response, the complainant should be signposted to the Ombudsman. If they require further clarification this should be dealt with through normal service delivery.

If an individual contacts an organisation after receiving a stage 2 response from a third-party delivering services on its behalf, the organisation should signpost the complainant to the Ombudsman. The organisation may seek to resolve the matter but this should not prevent the individual from coming to the Ombudsman,

The Code says that an organisation’s complaints process should have two stages. If a third-party acting on the organisation’s behalf puts a complaint through a two stage process the individual should be able to bring their complaint to the Ombudsman without the organisation considering the complaint directly. There is further information available in our guide on managing complaints in contracted and commissioned services.