Purpose of the item: To provide a detailed summary of complaints, Ombudsman investigations and compliments in Adult Social Care for the period April - September 2022.
Minutes:
Witnesses:
Mark Nuti – Cabinet Member for Adults and Health
Liz Uliasz – Chief Operating Officer, Adult Social Care
Kathryn Pyper – Chief of Staff, Adult Social Care
Maria Millwood – Board Director, Healthwatch Surrey
Yasmin Broome – Involvement Lead, Surrey Coalition of Disabled
People
Key points raised during the discussion:
1. A Member asked how officers were ensuring that ASC colleagues learnt from complaints that were upheld by the Ombudsman. The Chief Operating Officer explained that all complaints were monitored, and they aimed to respond within 20 days. The complainant would be contacted if the process would need to take longer. Team managers, area directors, and senior managers had oversight of complaints. There were lunch and learn sessions, whereby learnings from complaints were shared with teams. Trends and issues of complaints were also monitored. The Council would always promote the option for a complainant to go to the Ombudsman if not satisfied with the outcome.
2. The Chairman asked about the training offer and how much of it was mandatory. The Chief Operating Officer shared that she was the workforce lead in her new role and was going to go through the current training offer and decide what should be mandatory. The training offer would sit within the academy, and it would be much clearer. Attendance at training was tracked, however, managers could be firmer when staff do not attend.
3. A Member asked how ASC was working with other directorates and external partners to understand the nature of complaints and improve services accordingly. The Chief Operating Officer explained that the customer relations manager was part of a Southeast network and an Integrated Care System Network. The Chief of Staff added that internally they worked with colleagues in other customer relations teams, as there were often joint complaints.
Cllr Robert Evans and Cllr Abby King left the meeting at 12:58pm.
4. In response to a question on improving the timeliness of assessment processes, the Chief Operating Officer explained that they did not currently measure timeliness, as assessment could start later for a range of reasons and strength-based approach assessments would take longer. There were gaps in some teams. The Member asked if the process was being standardised. The Chief Operating Officer shared that it was part of the integration agenda and still needed to be done. The Chairman noted that the streamlining of record systems should have already happened. The Chief Operating Officer explained that it was a national issue and the Cabinet Member added that the tech was there, but the issue was around confidence from partners around the risks of wider access.
Cllr Frank Kelly left the meeting at 1:05pm.
5. A Member asked about urgent cases. The Chief Operating Officer explained that all Member and MP enquires were monitored and counted as formal complaints. They would be sent to the area director to deal with directly and Member enquires would be copied in. The Chief Operating Officer filtered the complaints which went to the Executive Director. The Cabinet Member noted that this method bypasses all other routes and responses were provided quickly.
6. A Member asked about how issues of concern were recorded, and the Chairman noted that this had been raised on multiple occasions. The Cabinet Member explained that the Executive Director for Customer and Communities was working on this work with her team. The Chief of Staff added that the Head of Resources (ASC) was leading on a piece of work on the digital front door which encompassed this. There was also a briefing set up for the Committee Members on 18 January 2023 to discuss this in greater detail.
7. In response to a question on supporting individuals with complex needs to make complaints, the Chief Operating Officer explained that advocacy providers were utilised to support people. This could be a Care Act advocate or a capacity advocate. Easy read versions were also provided for complaints documentation and Healthwatch Surrey feedback themes and patterns which reviews of the process were based on.
8. A Member noted that there were significantly fewer complaints from carers and asked how ASC were ensuring that carers had a true voice. The Board Director of Healthwatch Surrey asked how their insights could be included in the report going forward and their role in assisting to raise awareness for carers. The Chief Operating Officer responded that they were happy to include insight and feedback into the report. The Chief of Staff explained that they met with the lead for carers and established an action plan. They would approach Healthwatch to involve them in the process going forward.
9. The Chairman asked how complaints could be considered closed if they remained subject to a safeguarding enquiry. The Chief of Staff explained that in those cases, the safeguarding issue was prioritised. In the past, the complaint would be left open, but it would make the process long. Thus, it was decided to close the complaint and exhaust the safeguarding issue, and then check that the complaint had been addressed. The Chairman raised that such cases should not be recorded as resolved outside of the process if the enquiry was still ongoing. The Chief Operating Officer responded that they would look into differentiating the recording for such cases.
10.The Involvement Lead at Surrey Coalition of Disabled People queried why similar complaints kept arising and why lessons learnt from their study in collaboration with the Council on direct payments had not been implemented. The Chief Operating Officer responded that they would work on this outside of the meeting.
11.A Member asked how complaints made on social media were monitored. The Chief of Staff explained that the Council’s corporate communications team monitored such complaints, and they would go to the customer relations team, but would be flagged to ASC colleagues. It was important to establish whether a complaint was genuine or vexatious.
12.A Member asked about the advantages and disadvantages of resolving a complaint outside of the complaints procedure. The Chief of Staff explained that often verbal complaints could be responded to quickly and were quite straightforward or complaints were taken forward as a safeguarding enquiry instead. The complaints were still tracked, however, there was no formal investigation or response in the same way. The statutory guidelines allowed for this and the CQC encouraged this approach.
13.In response to a question on learning from other local authorities’ management of complaints, the Chief of Staff explained that the complaints manager heard about other experiences when meeting as part of the networks. The Chief Operating Officer regularly met with Healthwatch to receive their feedback and also looked at Ombudsman reports and comparator. They were also a part of the Association of Directors of Adult Social Services.
14.The Board Director asked about the impact on service users from changes made following complaints. The Chief of Staff explained that the impact on the individual would be dealt with locally. The Chief Operating Officer added that they looked at learning from trends and broad issues. In future reports, they could include examples of changes in practice.
Actions/requests for further information:
1. The Chief Operating Officer to share the revised training offer and academy once formulated.
2. A breakdown of trends and data over the last few months regarding complaints made on social media to be provided.
Recommendations
Senior Programme Manager for Adult Social Care & Chief Operating Officer for Adult Social Care:
1. That frontline Adult Social Care Staff are receiving adequate mandatory and consistent training on improving staff conduct and attitude, and that training and staff conduct, including that of partner organisations, are routinely monitored, with consequences put in place for unacceptable failures to attend such mandatory training.
2. That further progress is made toward increasing the timeliness of assessment processes.
3. That Issues of Concern are more effectively recorded, including through exploring technological avenues to do so; and that these are also utilised to improve Adult Social Care Services.
Cllr Neil Houston left the meeting at 1:50pm.
The meeting paused at 1:50pm. The meeting recommenced at 2:08pm.
Supporting documents: