Welcome .org.uk @LGOmbudsman Today you will be able to: 1 Meet the - - PowerPoint PPT Presentation

Welcome

.org.uk

@LGOmbudsman

Today you will be able to:

1 Meet the new Ombudsman

2 Learn how to use complaints to your benefit 3 Network with others who deal with complaints 4 Hear about our experience of investigating complaints from self-funders about registered care providers

3 offices 165 staff (FTE)

Our twin aims are to

REMEDY

INJUSTICE INJUSTICE

IMPROVE

SER SERVICES VICES

• &-

17% 15% 13% 13% 12% 10% 9% 5%

Education & Childrens Services Adult Care Services Benefits & Tax Planning & Development Housing Highways & Transport Environmental Services Corporate & Other Services Health Other or NULL [2015-16]

20,100

received cases

17% 15% 13% 13% 12% 10% 9% 5%

Education & Childrens Services Adult Care Services Benefits & Tax Planning & Development Housing Highways & Transport Environmental Services Corporate & Other Services Health Other or NULL [2015-16]

20,100

received cases

Upheld Cases

237 Benefits & Tax 650 Adult Care Services 255 Housing 482 Education & Children 074 Corporate & Other 121 Highways & Transport 381 Planning & Development 142 Environmental Services

100 200 300 400 500

2010-11 2011-12 2012-13 2013-14 2014-15 2015-16

▲ 80%

number of cases against private care providers in two years

24% 9% 68%

0% 25% 50% 75% 100%

Home care Other Residential care

PRIVATE CARE PROVIDERS What do people complain about?

We publish (almost) all our decisions

• n our website:

.org.uk /decisions

Michael King Ombudsman

Who and what is the Ombudsman?

• Origins – Scandinavia to the 1960s
• Our role – the court of common sense

How we work:

• Free for the public and provider, funding from

state

• Apex of the complaints system
• Investigations – work on co-operation and

powers

• Decisions based on law, guidance, policies and

standards

• We remedy injustice caused by fault
• We are independent but we liaise with CQC
• My role – Chair and Ombudsman

Our role in social care

• The Local Government Ombudsman c1974
• Complaints about council’s social services

departments

• Care planning, assessment, funding,

safeguarding and direct provision

• Commissioned care delivered on behalf of

councils

• LGO c2010 - The Social Care Ombudsman
• The Health Act 2009 – an expanded role
• All Adult Care, no matter how funded or

arranged

• Everything registerable with CQC
• Home care, residential care and anything

‘connected’

• Users have a statutory right to an

independent investigation

• Now the biggest part of our role

The Local Government and Social Care Ombudsman

Health and Social Care integration

Public confusion over how to complain

• Many complaints overlap health and care
• Multiple bodies involved
• Services span public and private
• Better Care Fund, Combined Authorities, etc.
• LGO principles for simple redress

Public confusion at Ombudsman level

• Social Care: LGO/Health: PHSO/Housing: HOS
• Joint Working Team to make things simpler
• Reform - Bill to create a single Ombudsman

25%

increase in cases about home care

65%

uphold rate for cases about home care

Donna Campbell Assistant Ombudsman

Complaints: threats or opportunities?

• Ombudsman’s process
• Putting things right
• Learning from complaints

22

Our role in adult social care

• Providers and councils should clearly and

consistently signpost people who make a complaint to the Ombudsman as the final stage

• f their complaints process
• Commissioning and contract arrangements

should clearly state how complaints will be handled – the council remains accountable

• Naming providers in decisions

Ombudsman & CQC

• We both have a role in complaints – can be a

complex message for the public

• We transfer calls between our organisations to

make sure the person speaks to the body best placed to help them

• We inform CQC where we consider there may

have been a breach of Fundamental Standards

• We share information about all our

investigation decisions to inform their approach to targeted inspections

Before the involvement of the Ombudsman

• Opportunity to get it right:
• DO have a clear, accessible complaints

procedure

• DO investigate objectively
• DO be evidenced-based in your response
• DO admit if you have got it wrong

Before the involvement of the Ombudsman

• DON’T delay
• DON’T be defensive
• DON’T allow complaints to lead to recriminations

Organisational culture

• Develop a positive, person-centred approach
• Empower staff to put things right
• Ensure safeguards for whistle-blowers
• Accept things do sometimes go wrong
• Demonstrate the learning from complaints and

the improvements made

• Demonstrate strong leadership with Chief

Executives and Boards taking responsibility

Ombudsman’s process

• Making enquires
• Opportunity to supply information
• Powers of the High Court to obtain information –

potential threat of witness summons

Ombudsman’s process

Draft Decision

• Opportunity to comment and agree actions

Final Decision

• Opportunity to remedy complaint

Putting things right

• Our recommendations are intended to put the

person back in the position they were before the fault occurred. We may recommend:

• An apology
• Procedural change
• Staff training
• Financial redress
• Reassessment
• Reimbursement

Adverse Findings Notice

• Where the provider does not respond to a final

decision

• Where the Ombudsman is not satisfied with the

action the provider has taken or proposes to take

• Where the Ombudsman does not receive

confirmation that the provider has taken the action within the agreed time

Adverse Findings Notice

Biggest threat to reputation

Adverse Findings Notice

Learning From Complaints

• Free market research
• Root cause analysis reports to identify themes

& trends

• Ensures staff are capable, confident and

supported in dealing with complaints

• Staff are informed about the outcomes of

complaints and any service improvements

• Residents and relatives are informed about

the outcomes of complaints and any service improvements

Promoting good complaint-handling locally

• Resources available for providers on our

website

• My Expectations – a framework

www.ombudsman.org.uk/sites/default/files/Report_My_expectatio ns_for_raising_concerns_and_complaints.pdf

• Thematic reports draw together the learning

from our complaints to highlight issues to the public, providers, councils and policy-makers

and how to do it A

Apologies and how NOT to do it

“The Committee has considered the Ombudsman’s report and by 9 votes to 7 has resolved that I be instructed to offer you an

• apology. This letter constitutes that apology.

However, I must warn you that if such circumstances recur I will not hesitate to act as I did before.”

Case studies

Please read the case summary and on your table discuss what you think the remedy should be

Case study 1

• Person affected has died – injustice cannot be

remedied

• Apology to family
• Write off outstanding fees to reflect the failures

in the care and the distress caused to the family

Case study 2

• Apology from both council and care provider
• Financial remedy in recognition of inadequate

care, risk of harm and distress caused

• Assurances from council about ensuring the

provider complies with its contractual obligations and actions it will take if it does not

• Measures council will take to ensure experience

is not repeated if provider is changed in the future

Case study 3

• Outstanding fees waived

Case study 4

• Apology for failing to follow correct procedures
• Training for managers about responding to

complaints in line with home’s complaints procedure

Nicola Driver

External Training & Relationship Coordinator

Training for success

• We offer two courses for care providers:
• A full-day course for managers and other staff

who investigate complaints

• A half-day course for frontline staff who are
• ften the first people to receive complaints

What makes us different?

• All our courses are delivered by experienced

complaint-handlers

• We use case studies based on real complaints

that have been considered by the Ombudsman

• We provide useful follow-up resources after our

courses

What people say...

• “The course tutor was professional,

knowledgeable, friendly and engaging and this made for a very enjoyable and informative training session.”

• “An excellent course, which I feel is beneficial to

all organisations. I would definitely recommend it – a must to ensure transparency, integrity and trust.”

What people say...

• “Thank you for a very informative yet fun day. I

am feeling much more confident about investigating complaints from the knowledge and experiences gained during the training. It’s great to have received comprehensive information both on the day and links to resources that can be used.”

Get in touch

• n.driver@lgo.org.uk
• training@lgo.org.uk

Any questions?