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Annual Complaints Report Adult Social Care 2020-21

Introduction

The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 dictate that complaints to be resolved by the Council follow a one stage process. If the complainant remains unhappy with the outcome of their complaint, they have the right to approach the Local Government and Social Care Ombudsman who may choose to investigate their complaint.

Part of the statutory requirement is the production of an annual report on complaints, which is available to members of the public, our staff, and our elected Councillors.

This report contains information on complaints and other feedback received about Adult Social Care Services between 1 April 2020 and 31 March 2021.

The Adult Social Care Complaints Procedure is administered by the Customer Relations Team, with oversight from the Customer Relations Manager. The complaints procedure and wider policy are available from the Customer Relations website.

Complaints should be regarded as an important tool and be performance monitored to ensure the Council can evidence that we are a learning organisation.

Compliments should also be valued and communicated effectively to staff. Good practice and learning should be disseminated. However, for reasons highlighted below compliments data is not available for this reporting period but will be made available for future reports.

The information in this report is provided in the following context: Due to the unprecedented situation in relation to Coronavirus (COVID-19) and the requirement for operational services within Devon County Council to redirect their resources to managing the crisis during the first response phase, and beyond, this impacted on the Council’s ability to deal with complaints.

In line with Ombudsman guidance, Devon County Council assessed individual complaints as they were received, and only accepted those that raised high risk or safeguarding matters. The County Council did not progress any other complaints between 31 March 2020 and 29 June 2020 which is reflected in the information recorded for Quarter 1 (Q1) throughout this report.

What is a complaint?

A complaint is defined as a written or verbal expression of dissatisfaction about the service provided by the Council. We aim to acknowledge complaints within three working days. The target date for response is agreed with the complainant on a case by case basis. Should the investigation proceed beyond the agreed timescale, we will advise the complainant of any delay.

If the complainant requires clarity of any of the points in their complaint response, following investigation, they can contact the person who responded to their complaint or the Customer Relations Team for further information.

Feedback received

The following information is based on all feedback that has been registered with the Customer Relations Team in the period 1st April 2020 to 31 March 2021.

The information is set against a base of 13,512 long term clients supported in the year and a Mid-Year Estimated Devon Population of 662,640 aged 18+ yrs.

The table below indicates the number of Adult Social Care Complaints received in 2020-2021.

Service Q1 Q2 Q3 Q4 YTD
Adult Care Operations and Health (CHSC) – Eastern 9 12 11 14 46
Adult Care Operations and Health (CHSC) – Northern 5 4 3 12
Adult Care Operations and Health (CHSC) – Southern 3 8 9 4 24
Adult Care Operations and Health (CDP) – Eastern 1 1 3 5
Adult Care Operations and Health (CDP) – Northern 3 1 0 1 5
Adult Care Operations and Health (CDP) – Southern 1 1 2
Countywide Services – Autism and ADHD Service 3 3 2 1 9
Countywide Services – Charging for Care Services 3 1 5 3 12
Countywide Services – Court of Protection Team 1 1
Countywide Services – Specialist Placement Team 1 1 2
Countywide Services – Supported Living review Team 1 1 2
Adult Commissioning and Health – Commissioning 1 1
Adult Provision – Social Care Reablement 1 1 1 3
Exeternal Providers (Domiciliary Care) 1 1
Grand Total 26 33 37 29 125

The table below indicates the number of Adult Social Care MP Enquiries in 2020- 2021.

Team Q1 Q2 Q3 Q4 YTD
Adult Care Operations and Health (CHSC) – Eastern 3 2 11 9 25
Adult Care Operations and Health (CHSC) – Northern 1 1 4 1 7
Adult Care Operations and Health (CHSC) – Southern 1 1 2
Adult Care Operations and Health (CDP) – Eastern 1 1 1 3
Adult Care Operations and Health (CDP) – Northern 0
Adult Care Operations and Health (CDP) – Southern 1 1
Countywide Services – Autism and ADHD Service 1 1 2
Countywide Services – Care Direct 2 2
Countywide Services – Charging for Care Services 1 1 1 1 4
Adult Commissioning and Health – Adult Provision Reviews 1 1
Adult Provision – Social Care Reablement 2 2
Adult Provision – Dementia Care Homes (Mapleton) 1 1
External Providers – Residential Respite (Budlike Residential Home) 1 1
Grand Total 7 7 25 12 51

The table below indicates the number of Adult Social Care Representations received in 2020-2021. A representation is a comment or concern that is not intended or eligible to be a formal complaint but requires a formal response.

Team Q1 Q2 Q3 Q4 YTD
Adult Care Operations and Health – CHSC (Eastern) 3 1 2 6
Adult Care Operations and Health – CHSC (Northern) 3 3
Adult Care Operations and Health – CHSC (Southern) 1 1 2
CDP (Eastern) 1 1
CDP (Northern) 1 1
CDP (Southern)
Countywide Services (Court of Protection Team) 2 2
Countywide Services (Charging for Care Services) 3 2 5
Adult Commissioning and Health – Commissioning (Direct Payments Policy) 1 1
Adult Provision – Dementia Care Homes 1 1
Adult Provision – Residential Respite (New Treetops) 1 1
Adult Provision – Social Care Reablement 3 3
Grand Total 0 8 8 10 26

Complaint outcomes

Of the 125 complaints received regarding Adult Social Care in 2020-2021, 85 were closed; the table below details the number of complaints responded to in Quarter (Q) and percentage of those complaints that were either partially or fully upheld.

Adult Care and Health complaint outcomes 2020-21 No responded to (Q1) % upheld (Q1) No responded to (Q2) % upheld (Q2) No responded to (Q3) % upheld (Q3) No responded to (Q4) % upheld (Q4) No responded to (YTD) % upheld (YTD)
Adult Care Operations and Health – CHSC (Eastern) 5 0% 8 13% 7 29% 13 38% 33 24%
Adult Care Operations and Health – CHSC (Northern) 1 0% 3 33% 5 60% 2 50% 11 45%
Adult Care Operations and Health – CHSC (Southern) 4 50% 5 0% 3 33% 12 25%
CDP (Eastern) 2 0% 1 0% 2 0% 5 0%
CDP (Northern) 2 0% 2 0%
CDP (Southern)
HDT (Dawlish) 1 0% 1 0%
Countywide Services (Autism and ADHD Service) 1 0% 3 100% 2 50% 6 67%
Countywide Services (Charging for Care Services) 1 100% 2 50% 5 80% 8 75%
Countywide Services – Court of Protection Team 1 0% 1 0%
Countywide Services – Specialist Placement Team 1 0% 1 100% 2 50%
Countywide Services – Supported Living Review Team 1 100% 1 100%
Adult Commissining and Health – Commissioning 1 100% 1 2 50%
External Providers – Domiciliary Care 0
Grant Total 11 23 43% 24 29% 27 48% 85 35%

 

Response times

The following table summarises the response times for complaints across Adult Care and Health. The target date for response is agreed with the complainant on a case by case basis. It should be noted that the complaint regulations allow for a negotiation to the deadline for response to be made with the customer, and therefore all responses could realistically be made within time. 60% of responses were made in time throughout 2020-21.

Adult Care and Health complaint response times 2020-21 No responded to (Q1) % upheld (Q1) No responded to (Q2) % upheld (Q2) No responded to (Q3) % upheld (Q3) No responded to (Q4) % upheld (Q4) No responded to (YTD) % upheld (YTD)
Adult Care Operations and Health – CHSC – Eastern 5 0% 8 63% 7 100% 13 23% 33 45%
Adult Care Operations and Health – CHSC – Northern 1 0% 3 67% 5 40% 2 100% 11 55%
Adult Care Operations and Health – CHSC – Southern 4 25% 5 80% 3 67% 12 58%
CDP (Eastern) 2 50% 1 100% 2 100% 5 80%
CDP (Northern) 2 0% 2 0%
CDP (Southern)
HDT – Dawlish 1 100% 1 100%
Countywide Services – Autism and ADHD Service 1 100% 3 100% 2 50% 6 83%
Countywide Services – Charging for Care Services 1 100% 2 100% 5 100% 8 100%
Countywide Services – Court of Protection Team 1 0% 1 0%
Countywide Services – Specilaist Placement Team 1 100% 1 100% 2 100%
Countywide Services – Supported Living Review Team 1 100% 1 100%
Adult Commissioning and Health – Commissioning 1 100% 1 100%
Adult Provision – Social Care Reablement 1 100% 1 2 50%
External Providers – Domiciliary Care
Grand Total 11 36% 23 65% 24 75% 27 52% 85 60%

What was complained about

The most complained about issues in 2020-21 were Assessments and Reviews. There were 121 issues recorded, across 85 closed complaints and 71 of these issues related to Assessments and Reviews (59%).

The top root causes in relation to Assessments and Reviews were recorded as “quality of service provided” and “poor communication to customer”. Both of which represent 20 (17%) of the 121 issues. The “quality of service provided” and “poor communication to customer” represent 30% of issues that were upheld in 2020-21.

Learning from complaints

For every fully or partially upheld complaint the investigating officer completes an action plan, so that actions and wider learning are recorded and evidenced. The implementation of agreed actions is monitored and evidenced by the Customer Relations Team.

The table below highlights that there were 42 actions recorded as being required following the completion of complaints in 2020-21.

Adult Social Care and Health action categories 2020-21 Number recorded
Apology 12
Arrange staff training or guidance 4
Assessment required 1
Change or review policy or operational procedure 1
Change or review service 2
Discuss at team meeting 1
Management action required 1
Pay fees/costs/funding 2
Performance management – staff member 3
Provide additional information 6
Provide additional service 2
Request action from contractor or partner 1
Review resources 1
Waive fees/costs/funding 5
Grand Total 42

Selected complaint issues and actions for upheld complaints.

Countywide Services

Issue 1: I don’t know who my social worker is, and I was told that my case would be reallocated after encountering some very upsetting issues with X. I was also told that my son Y would have his case reallocated to the Learning Disability Team but it seems that hasn’t happened at all and X is still acting as his social worker despite putting into writing that she was transferring his case.

Response 1: I understand that X has continued to act as Y’s Social Worker in the short term, to progress your request for an increase in provision to support Y over the summer holiday period. The request for case transfer to the Exeter Health and Social Care Team who work with people with learning disability is now in progress. I am advised someone from this team will be available to start work with Y by the end of October.

I can confirm that X is still holding case responsibility for Y, however, this role will also transfer to Z as from the end of September. Following the case transfer to the new Social Workers a review of your own assessment, X and X’s assessment and the care and support plans will be undertaken. An advocate will be provided to support you during your own review as requested.

Action 1: To provide the named worker associated to the case and provide explanation.

Issue 2: This assessment has been submitted to court proceedings in evidence and my autistic learning disabled son was not contacted either before, during or after this assessment was carried out and it was done without his knowledge.

Response 2: I am sorry that it was necessary to submit information to the court before the adult assessment could be fully completed due to the timescales involved. I acknowledge that this was not ideal, however the status of the assessment was made clear to ensure the courts understanding of the position at the time.

Action 2: Apology and explanation. Also, confirmation that the review will be undertaken shortly.

Q3 CHSC

Issue: Transfer of previous care plan into new without checking that the information was correct, or changing relevant information

Action: Apology given in response letter, liaise with the wider team to try to ensure this does not happen again.

Q4 CHSC

Issue: Concerned that the 12-week property disregard has been unfairly applied.

Response: The 12-week property disregard has been applied in accordance with Devon County Council’s policies and procedures. In normal circumstances the period is not extended whilst someone is in hospital. Again, although I am satisfied the 12- week property disregard has been correctly applied, given the circumstances relating to X have also agreed to extend the 12-week property disregard to reflect the period she was admitted to hospital.

Action: I have also agreed to extend the 12-week property disregard to reflect the period X was admitted to hospital.

Local Government and Social Care Ombudsman

There were four complaints investigated by the Ombudsman in 2020-21. There were no complaints investigated in Q1 due to the coronavirus pandemic.

In Q2, one complaint was investigated. This was upheld with maladministration and injustice. In Q3 two complaints were investigated, one being upheld with maladministration and injustice, the other not being upheld. In Q4 two complaints were investigated, both were upheld with maladministration and injustice. The complaint summaries, findings and agreed recommendations are available at Appendix 1.

Appendix A

Local Government and Social Care Ombudsman Recommendations for Complaints with Maladministration and Injustice 2020-21.

Q2

Complaint Summary

Mrs B complains about Mallands Residential Care Home (the Home), a care home acting on behalf of the Council. Mrs B complains the Home did not:

  • communicate adequately with her in the last days of her late mother, Mrs D’s, life
  • check adequately on Mrs D in the last day of her life and may have left her alone when she was dying
  • allow Mrs B to visit her mother after she had died, before Mrs D was seen by a doctor and transferred to a mortuary; and
  • provide a timely response to Mrs B’s complaint or all the information she had requested.

Mrs B says that as a result, Mrs D may have been left alone at the end of her life and she and her mother missed out on the opportunity to spend that time together. Mrs B says she has been unable to get closure on the death of her mother and what really happened at that time.

Mrs B would like a meaningful apology and a copy of the record for her mother’s last day at the Home.

Final Decision Recommendations

The Ombudsman found no fault in the way the Home, acting on behalf of the Council, cared for Mrs D or its communication with Mrs B before Mrs D died. However, the Ombudsman found fault in the Home’s procedure, record keeping and communication with Mrs B after Mrs D died. As a result, the Council agreed to the Ombudsman’s following recommendation:

The Council will, within three months of my decision, send the Ombudsman and Mrs B an explanation of what it has done to ensure the Home has:

  • reviewed its policies and procedures on sudden and unexpected deaths in residential care, including record keeping, to ensure they comply with all relevant legislation and guidance; and
  • make all relevant staff aware of the reviewed policies and procedures

Q3

Complaint Summary

Ms X, complains the Council failed to deal properly with the assessment of her care needs and unreasonably stopped her personal budget, leaving her without any support.

Final Decision Recommendations

It was Ms X’s decision to cancel support from the Support Provider in December 2017. Since then the only way to move forward has been to reassess her needs under the Care Act. The Ombudsman cannot find fault with the Trust for not giving Ms X a direct payment without first reassessing her needs. It needed to satisfy itself that a direct payment would be used to meet eligible care needs. The faults identified by the Ombudsman have added unnecessarily to Ms X’s distress. They have also contributed to the failure to complete an assessment of her social care needs. As a result, the Council agreed to the Ombudsman’s following recommendation:

  • within four weeks, having first identified more flexible ways of assessing Ms X’s needs, write to her offering alternative approaches and apologising for the previous lack of flexibility, and pay her £500
  • within eight weeks produce an action plan explaining how the Trust is going to: a) improve its record keeping; and b) ensure officers take a more flexible approach to assessments, as required by the Care and Support Statutory Guidance

Q4

Complaint Summary

Mr X complains the Council and its care provider, Agency Assistance, failed to deal properly with his return home on 20 April 2020, resulting in him being asked to pay for the Care Workers’ gloves and being told he would have to go back to a care home if he did not agree to pay.

Final Decision Recommendations

The Ombudsman found that the Council did not handle Mr X’s concerns properly. On 20 April it told him it would check the position on paying for gloves but did not do so. On 27 April it discouraged Mr X from making a complaint. When the Council responded to Mr X’s complaint it told him he did not need to pay for gloves worn by Care Workers when providing care. But it did not address the question of whether that is what had happened. Nor did it consider whether other people may have been wrongly asked to pay for personal protective equipment. That is fault by the Council. It has caused injustice to Mr X by putting him to the time and trouble of pursing his complaint further. As a result, the Council agreed to the Ombudsman’s following recommendation:

  • within four weeks write to Mr X apologising for not addressing his concerns properly and pay him £100 to redress the injustice caused

Q4

Complaint Summary

Mr F complains on behalf of his mother, Mrs X. Mr F complains about the Council’s handling of Mrs X’s placement at Edenmore care home (The care home) from June 2018 which it arranged and commissioned. In particular Mr F complains

  • the Council’s decision to place Mrs X at the Care home was contrary to an agreed plan to care for her at home
  • about the Council’s best interest decision to keep Mrs X at the Care home rather than move her to an alternative placement which is the family’s preferred option
  • the care home failed to involve the family when it authorised Mrs X’s urgent Deprivation of Liberty Safeguard (DoLS) at the end of March 2019
  • about the Council’s decision to keep the DoLS in place
  • Mrs X has experienced poor care throughout her stay at the care home

Final Decision Recommendations

Mr F complained on behalf of his mother, Mrs X. Mr F complained about the Council’s handling of Mrs X’s placement at Edenmore Care home (the care home) which it arranged and commissioned. The Council was not fault for how it arranged Mrs X’s placement. There was also no fault in how the care home authorised Mrs X’s urgent Deprivation of Liberty Safeguard in April 2019. The care home failed to retain Mrs X’s medication records from July 2018 until March 2019.

This is fault. The Council agreed to apologise to Mr F for the uncertainty this caused him. I have not investigated Mr F’s complaints about the ongoing authorisation of Mrs X’s Deprivation of Liberty Safeguard or the Council’s best interest decision to keep Mrs X at the care home. This is because the Court of Protection is considering these matters.