COMPLAINTS POLICY. Version: 1.0. Ratified by. Trust Quality & Performance Committee. Date ratified: 22 August 2013.

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1 COMPLAINTS POLICY Version: 1.0 Ratified by Trust Quality & Performance Committee Date ratified: 22 August 2013 Name of author: Melanie Coombes, Director of Nursing Name of responsible Director of Nursing committee / individual: Name of executive lead: Melanie Coombes, Director of Nursing Date issued: 23 August 2013 Review date: 31 July 2016 Target audience; All Trust staff Page 1 of 49

2 CONTENTS 1. Introduction Purpose Definitions Duties and Responsibilities 5 5. Process Duty of Candour Implementation Training and Support Guiding Principles Monitoring Compliance References Associated Trust Documents Version Control Equality Impact Assessment Appendix Appendix Appendix Appendix Appendix Appendix Appendix Appendix Appendix Page 2 of 49

3 1. INTRODUCTION Complaints, Concerns and Patient Experience are one way of identifying the Users perspective of the service provided. They can act as an early indicator that a system may not be functioning effectively or may be placing patients at risk. Appropriate trend analysis of the factors which prompted complaints, concerns and enquiries can provide invaluable insight into areas where improvements may be required. The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 set out to sustain public confidence in the regulation of healthcare professionals. These regulations are the Legislative framework for managing complaints against NHS bodies, all statutory providers of NHS care (including Foundation Trusts and Primary Care providers), Voluntary and Independent Sector organisations who provide services under contract to the NHS, and to Local Authorities who provide Adult Social Services and incorporates the need for effective handling of concerns about healthcare professionals. The NHS Constitution (DOH, 2012) outlines to the public their rights when making a complaint. The policy contains detailed guidance in relation to the stages of the NHS Complaints procedure: Local Resolution Investigation by the Parliamentary and Health Service Ombudsman The Health Service Ombudsman considers six principles in relation to management of complaints, these principles are listed below: Getting it Right Being Customer Focused Being open and accountable Acting fairly and proportionately Putting things right Seeking continuous improvement CAMBRIDGESHIRE and PETERBOROUGH Foundation Trust (the Trust) must, under the regulations, make arrangements for the handling and consideration of complaints. The arrangements must ensure that: Complaints are dealt with efficiently Complaints are properly investigated Complainants are treated with respect and courtesy Complainants receive as far as is reasonably practical Assistance to enable them to understand the procedure in relation to complaints Page 3 of 49

4 Advice on where they can obtain such assistance Complainants receive a timely and appropriate response Complaints are told the outcome of the investigation of their complaint and actions are taken if necessary in the light of the outcome of a complaint The arrangements will be accessible and such as to ensure that complaints are dealt with speedily and efficiently, that complainants are treated courteously and sympathetically, and as far as possible involved in decisions about how their complaints are handled and considered. The Trust takes all complaints very seriously. In addition, it welcomes all feedback, including concerns, suggestions and compliments, because it provides opportunities for service development and forms an important part of the Trust s plans for improving the quality of services. 2. PURPOSE This policy describes the procedure by which the Trust will meet the statutory legislation and describes the means by which patients; relatives, carers and members of the public can make formal complaints, raise concerns and make suggestions and compliments. It also provides information for all Trust staff regarding their responsibilities should they receive a complaint. The policy outlines the process which will be followed by the Trust in response to such feedback and in addition, the process by which the Trust aims to make improvements to services as a result of the feedback. The purpose of the Complaints Procedure is not to apportion blame amongst staff but to investigate complaints to the satisfaction of the complainant whilst being scrupulously fair to staff and to learn any lessons for improvement in service delivery. However some complaints will identify information about serious matters which indicates a need for disciplinary investigation. Consideration as to whether disciplinary action is warranted must be subject to a separate process of investigation. Papers that have accumulated during the investigation of the complaint may be passed to the appropriate person who will be considering the need for disciplinary or any other form of investigation. Care must be taken by the Trust to bear in mind the right of staff to confidentiality and to avoid disclosure to the complainant of any disciplinary action that has taken place as a result of a complaint. The policy takes into account information from complainants who have given anecdotal feedback of the complaints handling process as well as a number of relevant public documents (see no.11). Page 4 of 49

5 3. DEFINITIONS 3.1. Complaint A complaint is defined as: Any expression of dissatisfaction, about a Trust service or member of staff, who is undertaking duties on behalf of the Trust. Complaints can be made orally or in writing Complaints are either locally resolved by no later than the next working day or they are dealt with under the NHS Complaints Procedure. Either way all complaints must be forwarded to the Complaints Department to be recorded and monitored Where the person would prefer support to resolve an issue rather than make a complaint they can be referred to the Patient Advice and Liaison Service (PALS see 4.5) if a member of staff is unable to assist Full details of types of complaint which fall outside this procedure can be found in Regulation 8 of the Local Authority Social Services and National Health Service Complaints (England) Regulations Responsible Body means a Local Authority, NHS Body, Primary Care Provider or Independent Provider 3.3. Local Resolution investigation and resolution of complaints under the first stage of the NHS Complaints Procedure 3.4. Confidentiality non-disclosure of personal information to a third party 3.5. Investigation the act or process of investigating; a careful search or examination in order to discover facts 4. DUTIES AND RESPONSIBILITIES 4.1. The Chief Executive the Chief Executive is ultimately accountable for the quality of care within the organisation, and therefore, as part of governance arrangements, needs an overview of all recorded dissatisfaction being expressed by service users and carers. The results of all complaint investigations will be submitted to the Chief Executive who will sign the final letter of response to the complainant. Where for good reason the Chief Executive is not able to sign the letter, it will be countersigned by a nominated person acting on the Chief Executive s behalf. The Chief Executive is made aware of all breaches in the timescale for providing a final response to complainants and the reasons for these Director of Nursing and Quality The Director of Nursing Quality has been designated by the Trust Board to take overall responsibility for the Trust Complaints, Concerns, Suggestions and Page 5 of 49

6 Compliments Policy and Procedure and for ensuring that it complies with the Complaints Regulations. The Director of Nursing and Quality is also ultimately responsible for ensuring that action is taken if necessary in the light of the outcome of a complaint. The Director of Nursing and Quality will, in turn, delegate to the Head of Patient Experience the responsibility for the operational management of the Trust s complaints handling in line with its Complaints Policy and Procedure Head of Patient Experience Operational Management of the Trust s Complaint Handling in line with the Complaint Policy and Procedure. In each financial year, the Head of Patient Experience will audit a random sample (i.e. 50 cases) of complaints, concerns and comments that have been made over the previous twelve months to ensure that the policy has been adhered to. The audit will consist of measuring the effectiveness of this policy but will include as a minimum an examination of the following items: The duties The process for raising concerns The process for ensuring that patients, relatives and their carers are not treated differently as a result of raising a concern or complaint The process by which the organisation aims to make changes as a result of a formal complaint or concern being raised The complaints management process, which includes internal and external communication, and collaboration with other organisations when necessary Acknowledgment times of complaints Formulate a report of findings and present to Quality and Performance Committee 4.4. Complaint Manager Responsible for overseeing the operation of the procedure including providing support in ensuring staff awareness Providing support in ensuring public awareness, through the provision of leaflets and posters Collating all complaints, concerns, suggestions and compliments Ensuring that all formal complaints are dealt with and registered in accordance with the Complaints Procedure Liaising with the relevant Director/General Manager where necessary regarding the appointment of an appropriate Investigating Officer Ensuring complaints are acknowledged within 3 working days Page 6 of 49

7 Ensuring complains are answered within the agreed timescale and ensure non-compliance with timescales escalated to the Chief Executive together with the reasons for this Completion of the Statutory Monitoring Forms (KO41A), for monitoring the Trust Register of Complaints Prepare the Annual Report on Complaints for the Trust Board and the Care Quality Commission Maintaining records of all outcomes and recommendations Monitoring action taken as a result of complaints and that where appropriate lessons learned are shared across the Trust Liaising with the Ombudsman in relation to complaints that cannot be resolved locally to the complainants satisfaction Ensuring that where relevant, complaints are highlighted as possible claims Ensuring divisions are sent monthly reports on all PALs and complaints data 4.5. PALS/Complaints Interface The Patient Advice and Liaison Service (PALS) is integrated within the Customer Services Team to ensure a coherent and seamless approach to resolving patients and service users concerns. There is a clear differentiation between the roles of PALS and Complaints. PALS do not investigate complaints and their role is to inform and support people to access the complaints procedure when requested. PALS provides assistance to members of the public, patients, service users and carers with queries about health related matters when they first have a concern or issue they wish to raise Role of Directors and General Managers Directors and General Managers have overall responsibility for the operation of this Policy and Procedure within their specific area. This involves ensuring that all staff are fully conversant and compliant with the policy, procedure and in completing the Risk Assessment Matrix (Appendix 6). The General Managers will, where appropriate, be responsible for ensuring the implementation of any service improvements that have been identified as a result of a complaint. Page 7 of 49

8 4.7. Role of Appointing Officers Appointing Officers are responsible for ensuring the appointment of suitable Investigating Officers with the relevant training and experience who have not been involved in the complaint. Where possible, good practise suggests Investigating Officers should not be from the same service area indicated in the complaint Role of Investigating Officer (See also 5.9) The Investigating Officer will be responsible for liaison with the complainant, ensuring that they carry out a thorough, fair and factual investigation into the complaint (see Appendix 5). They should ensure that they complete the report template provided to them to prepare an appropriate response letter detailing their findings, including a suggested response and complete the Risk Matrix (Appendix 6) provided to them. All formal complaint investigations are completed within set timescales stated in this policy and agreed with the complainant Role of all Staff To make sure they have read the policy and know what their individual responsibilities are for handling complaints and concerns. All staff should be aware of the correct procedure to follow should a patient or relative wish to make a formal complaint. All staff, regardless of their role and seniority, are responsible for supporting complainants with help and information about the procedure and for trying to resolve complaints quickly and appropriately as they arise. This will be done in line with the Trust s own values and with particular emphasis on treating complainants with respect and dignity. To request advice and guidance from the complaints department if they are unsure of what action to take. On receipt of a complaint or concern, all staff will follow the procedure outlined in Appendix 1. Suggestions and compliments also provide useful feedback and these should also be recorded using the same procedure. Page 8 of 49

9 4.10. The Quality and Performance Committee The Quality and Performance Committee has responsibility for ensuring that complaint handling throughout the Trust is monitored on behalf of the Trust Board, including: Reviewing and revising the Complaints Policy, ensuring that it:- Is easily accessible and well publicised Is applied Meets legal and other requirements Remains up-to-date in terms of regulations and Trust structural and organisational factors Receives and approves bi-monthly reports on complaints management ensuring:- Timelines of complaint management Numbers and categories Subject matter Trends Outcome of Investigations Timescales (including breaches) Lessons learnt as a result of complaints Details of complaints referred to the Ombudsman and the outcome of these Ensure that there is a robust system for auditing and sharing the lessons learned from complaints for service employment. Should remedial action be required, an action plan will be formulated and monitored by the Quality and Performance Committee Governance Forums Governance Forums will receive a monthly report detailing the complaints, to include the recommendations, actions taken and the lessons learnt (if indicated) Service Managers The Operational Services will be expected to provide confirmation that identified actions relating to complaints management have been completed, or identify action plans about how issues arising from complaints will be addressed. Service Managers will ensure that staff, service users and carers are kept fully informed of the complaints process, taking into consideration the assistance required to support those complainants who may not be able to read or write, Page 9 of 49

10 may not have English as their first language or may suffer from disabilities which make formal written complaints difficult. The Trust has access to interpretation at Translation Services and assistance in putting complaints in writing is available from the complaints departments. 5. PROCESS Complaints Management Process: Local Resolution (Stage 1) 5.1. Informal Complaints Minor criticisms can often be resolved at source. Concerns raised should be listened to sympathetically and it will frequently be possible for the member of staff to whom these were expressed, to provide an acceptable answer or explanation. Where remedial action has been or is to be taken, its nature should be explained to the person raising the concern. A record of the informal complaint and any action taken, if appropriate, should be documented using the Trust Feedback form (Appendix 1) and sent to the complaint and PALS team. Staff should always attempt to deal with complaints swiftly at the informal stage so that the complaint is resolved more quickly for the complainant. If you need help/support with handling an informal complaint you should contact the Customer Services Team Formal Complaints Who may complain? Complaints may be made directly to the Trust by: A patient Any person who is affected by or likely to be affected by the action, omission or decision of Trust A representative of either of the above in a case when that person: Has died Is a child Is unable by reason of physical or mental incapacity to make the complaint themselves Has requested the representative to act on his behalf and provides consent to allow this Page 10 of 49

11 5.3. Complaints made by a person other than a patient If the patient is competent to give consent and wishes a representative to act on their behalf, then signed authorisation will be sought by the complaints department. If the patient has died, or is incapacitated, the Complaints Manager in conjunction with the Caldecott guardian must decide whether the complainant is a suitable person to pursue a complaint. Consideration must be given to all relevant factors such as the closeness of the complainant s involvement with the patient over the time they had known them and the nature and frequency of their contact. Where the complainant has Lasting Power of Attorney (LPA) on behalf of a patient, the complaints department will ensure that this is valid, registered with the Office of the Public Guardian and the extent of the powers held, in order to decide whether consent from the patient is required. A copy of the LPA will be kept on the complaint file. Where the complaint is made on behalf of a child aged 16-18yrs, the complaint manager will check with the clinician to get an opinion as to whether the child has competency to give consent for the complaint to be made on their behalf by a parent or carer. If a child aged years makes a complaint in their own right the Complaints Manager will check with the clinician regarding their competency and the appropriateness of this Complaints made by Member of Parliament on behalf of Constituent Complaints and queries from MP s are usually addressed to the Chief Executive and where this is the case, the Chief Executive will send acknowledgment that the complaint has been received and passed to the complaints department. Contact should be made with the person concerned and the complaint processed through the formal procedure if that is what they want. Consent from the person concerned must be obtained if correspondence is to be copied to the MP Time limits for making complaints A complaint should be made within twelve months from the incident that caused the problem or within twelve months of the complainant becoming aware of the incident. The complaints manager has discretion to extend this time limit when the complainant had good reason for not making a complaint within that time limit; and it is still possible to investigate the complaint effectively and fairly. Page 11 of 49

12 When the timescale is not extended, complainants will be advised of their right to refer the complaint to the Parliamentary and Health Service Ombudsman for a review of this decision Procedure for making a Complaint, Suggestion, Compliment or Raising Concern Complaints, concerns, suggestions and compliments may be made to any member of the Trust staff or directly to the Chief Executive or complaints department or Clinical Commissioning Group. They may be made orally or in writing (including electronically). On receipt of a complaint, concern, suggestion or compliment, staff must complete a Feedback form and follow the procedure outlined in the guidelines at Appendix Acknowledgments All written complaints must be acknowledged within three working days. If the complaint is addressed to a member of staff outside the complaints department, the addressee will send an acknowledgment confirming that the complaint has been referred to the complaints manager. The complaints manager will send an acknowledgment of complaints received whether they were received directly from the complainant or via a member of staff. When a complaint is made orally which requires investigation as a formal complaint, the acknowledgment must be accompanied by a written account of the complaint, with an invitation to the complainant to confirm the accuracy by signing and returning it. When the complainant is not the patient and written authority from the patient for the complainant to pursue the matter on their behalf has not been supplied, the completion of a consent form will be requested. Where consent cannot be obtained for a third party to make a complaint about the care and treatment of a patient, no response will be given which includes specific or confidential information about the patient. The acknowledgment will contain information about support available from the Independent Complaints Advocacy Service (ICAS see Appendix 6) and information on the complaints process and about disclosure of information. Any disclosure must be confined to that which is relevant to the investigation of the complaint and only disclosed to those people who have a demonstrable need to know it for the purpose of investigating the complaint Complaints relating to Local Authority or other NHS Body (App 5) In cases when the complaint relates in part to a Local Authority, or another NHS body, the involved organisations must co-operate in coordinating the handling of the complaint and ensuring that the complainant, with their agreement, receives a coordinated response to the complaint. This includes agreeing which organisation takes the lead in coordinating the handling of the complaint and communicating with the complainant. This discussion will take place within a target of 2 working days of receipt of a complaint. Staff will endeavour to work with private organisations/agencies in the same way. Page 12 of 49

13 Each organisation must provide information relevant to the complaint and attend any meeting required in connection with the complaint. When the complaint relates entirely to services provided by another NHS body, or local authority, the complaint manager will seek the consent of the complainant to forward the complaint to the relevant body within a target of 3 working days Investigation (see also 4.9) The complaints department will liaise with the Appointing Officer to ensure the appointment of an appropriate Investigating Officer. The Investigating Officer will be someone independent of the area(s) and staff that are subject of the complaint. This will be the start of the complaints handling process outlined in Appendix 4. The aim of an effective investigation is to gather a sufficient amount of relevant clinical, factual and other information to be able to determine what has occurred and to identify any appropriate action required (Appendix 5). The Risk Assessment Matrix (Appendix 6) will assist in determining the level of investigation required. It can assist in ensuring that the process is proportionate to the seriousness of the complaint and the likelihood of recurrence. The investigation will be fair to all parties. Investigating Officers will ensure that anyone who is the subject of a complaint is given a proper opportunity to talk to them and is kept informed of progress. All information relevant to the investigation must be recorded, sent back to the complaints department on completion of the investigation, and kept in the complaint file. This will include records of interviews and telephone conversations. The case file will be forwarded to the complaints manager at the end of the investigation, as it may be required at a later stage by Commissioners or the Ombudsman. Where the complaint involves clinical issues, the findings and the response must be shared with the relevant clinicians to ensure factual accuracy in respect of those clinical issues. The complaints manager may, where appropriate and with the agreement of the complainant, make arrangements for conciliation, mediation or other assistance for the purposes of resolving the complaint. The Investigating Officer is responsible for ensuring that the complainant is kept up to date with progress at intervals agreed with them at the start of the complaint process. Where a complaint relates to the actions of the Chief Executive or Chairman of the Trust, special arrangements will be made to ensure a fair investigation. This may be for example via a neighbouring NHS Trust or Local Authority Data Protection Act It is essential when dealing with complaints that staff comply with the Confidentiality Policy, Data Protection Policy and Access to Health Records Page 13 of 49

14 Policy. Any request to access clinical/medical records will be dealt with under the Data Protection Act (1998). As the Data Protection Act only relates to living persons access to deceased patient s records is via the Access to Health Records Act (1990). Any disclosure must be confined to that which is relevant to the investigation of the complaint and only disclosed to those people who have a demonstrable need to know it for the purpose of investigating the complaint. Records of complaints should not routinely be kept on patients files PREVENT Strategy If a staff member becomes concerned that an adult with risk behaviour indicates they may be being drawn into terrorist-related activity they must follow the process Raising Concerns that an individual is being radicalised/selfradicalised into extremist activities and should contact the Trust Prevent Lead as soon as possible Whistle Blowing The Whistleblowing Policy (raising concerns) should be accessed instead of the Complaints Policy when an employee or worker provides certain types of information, usually about illegal or dishonest practises to the employer or a regulator, which has come to their attention through work Complaints, Legal Action & Criminal Proceedings Where a complainant states they are commencing legal action against the Trust in relation to their complaint, the complaints manager will notify the Trust Legal Team, and information collated during an investigation of a complaint, may have to be disclosed when legal action is taken. (It should be noted that the updated Complaints Regulations 2009 no longer states that the complaint should be halted where legal action has started). It should also not necessarily be assumed that a complaint made via a Solicitor means that the complainant has decided to take legal action. If consent has been received, a response should be made in the normal matter. An apology is not necessarily an admission of liability. If the subject of the complaint is a matter being referred to the police, the complaints procedure will be suspended pending the outcome of that investigation and the complainant will be informed of the reasons for this delay. Once the outcome is known the complaint may continue if appropriate Complaints and Disciplinary Action Complaints can be investigated even if disciplinary action is being considered or taken against a member of staff. However, the confidentiality of the member of staff concerned must be respected Response to Complainants A final response letter will be sent out at the end of the investigation. In all cases the Investigating Officer will agree with the complainant, at the beginning Page 14 of 49

15 of the complaint process, the date that they will receive their response. The Trust aims to provide a response within 25 working days. There are circumstances (see ) when this is not possible and in this case the Investigating Officer will agree timescales with the complainant and will then notify the complaints manager. The final response letter will be signed by the Chief Executive. If for good reason the Chief Executive is not able to countersign the final response, it will be signed by a Director acting on behalf of the Chief Executive. The response will be in the format of a letter and will include a summary of the nature and substance of the complaint, an open and honest description of the investigation and its findings and any recommendations to be taken as a result of the complaint. It will also include appropriate apology for any omissions by the Trust and the distress caused. The response will also include the offer of further opportunities to clarify or discuss remaining concerns and advice to complainants, regarding the right to refer the complaint to the Parliamentary and Health Service Ombudsman (see Appendix 6) if they remain dissatisfied following the Trust s conclusion of the complaint Exceptional Circumstances Examples of these are: The patient is in acute phase of their illness/in hospital and the complaint is unclear and requires clarification with them, contact should be made with relevant clinician to establish this and must be documented. The complaint is very complex e.g. involves a death, serious harm or goes back more than 12 months. This is likely to also fall under the Serious Untoward Incident Procedure. Key witnesses whose statements are required are on annual leave or sick this should be identified at the start of the investigation and explained to the complainant if a member of staff is on long-term leave it may not be possible to wait. In these circumstances advice should be sought from the complaints manager. The Investigating Officer goes on sick leave after starting an investigation in this case the complaint should be reallocated immediately and any delays kept to the minimum. Please note: if is it known that the Investigating Officer will be on planned leave this is not an exceptional circumstance and this must be considered when allocating a complaint to that person. They must be able to meet the 25 day deadline. The complainant must be informed in all cases of the above and agreement should be sought on when the complaint will be completed. Any extensions in excess of the 25 day timescale together with the reason must be documented and will be monitored closely. This will also monitored by audit. Page 15 of 49

16 5.17. Learning from Complaints When the investigation is complete, the Investigating Officer will agree with the Service Manager or General Manager, the findings and where appropriate agree achievable recommendations, in the form of an action plan. The identified recommendations will be sent by the complaints department to the relevant Appointing Officer for discussion and monitoring at the Local Governance meetings. An electronic tracker will be updated following the Local Governance meetings (which charts progress) or otherwise this information will be sent back to the complaints department. This information will be reported to the Quality and Performance Committee. General Managers will receive a copy of the service area and are responsible for ensuring they are disseminated (and where appropriate), applied within their service area. Where lessons from complaints have value, wider than the service concerned i.e. teaching staff and adoption of good practise, complainants will be approached to participate in sharing their story (with their consent), for on-going dissemination and spread of lessons learnt across the organisation Discrimination Complainants need to feel confident that their care will not be affected as a result of their having made a complaint. This commitment will be communicated to patients throughout the Complaints Process. Complainants will be invited to complete a questionnaire (see Appendix 2) at the end of the procedure and results will be monitored to identify any discrimination and action to be taken. The questionnaire will also provide reassurance that internal complaint handling processes are being followed and that complainants are satisfied with this Support for Staff The Trust recognises that complaints made against individual members of staff can be distressing. Support is available for staff from their Line Managers, the Occupational Health Department, Employee IAPT Service, and Union Representatives Unreasonable and Persistent Complainants Habitual complainants are becoming an increasing problem for NHS Staff, causing undue stress and placing a strain on time and resources. Staff are trained to respond with patience and sympathy to the needs of all complainants, but there are times when there is nothing further which can reasonably be done to assist them or to rectify a real of perceived problem. The Trust will ensure that the Complaints Procedure is followed so far as possible and that no material element of a complaint is overlooked, as complaints from unreasonable and persistent complainants may have some substance. In cases where an unreasonable and persistent complainant has been identified, the complaints manager will discuss the case with the Chief Executive and decide what action to take. This may include a review of all the complaints documentation or seeking legal advice. Once a decision has been made, the Chief Executive will write to the complainant and a record kept of the reasons why a complainant has been classed as unreasonable and persistent. Page 16 of 49

17 Refer to the Guidance for Handling Unreasonably Persistent Complainants (Appendix 8) Reimbursement Requests for reimbursement via the Complaints process will be considered in line with the Trust s procedures via the Standing Orders (see Trust Secretary for access to this) Parliamentary and Health Service Ombudsman (PHSO) (Stage 2) If after all attempts at local resolution the complainant remains dissatisfied with the response to their complaint they have the right to ask the Parliamentary and Health Service Ombudsman to review their complaint The Role of Ombudsman The Ombudsman is independent of the National Health Service and the Government. The Ombudsman is appointed by the Queen and is answerable to a Select Committee. The role of the Ombudsman is to identify cases of genuine hardship or injustice or any unfairness of complaint management under the NHS Complaint Procedure. The Ombudsman may decide to investigate complaints about services received from the NHS if not resolved to the complainant s satisfaction locally through Local Resolution. The Ombudsman has powers to investigate complaints about NHS providers and purchasers and non-nhs providers which are funded by the NHS, on such matters as care and treatment, clinical judgment, maladministration causing hardship or injustice, service provision and complaints handling. It is intended that complainants should fully exhaust the complaints procedure before referring to the Ombudsman. However, the Ombudsman shall have discretion, exceptionally, to override this requirement. In deciding whether to investigate a complaint, the Ombudsman will require access to all papers relating to Local Resolution of the complaint. The Ombudsman will not investigate complaints about disciplinary or other personnel matters. The Trust s works to the PHSO Principles of good Complaint Handling, which identifies six principles an organisation is expected to understand when dealing with complaints. The six principles include: Getting it right Being customer focused Being open and accountable Acting fairly and proportionately Page 17 of 49

18 Putting things right seeking continuous improvement Parliamentary Health Service Ombudsman If the Trust received a notification that a case has been referred to the Ombudsman the complaints department will: Ensure the Ombudsman is sent copies of the complaint investigation file within the timescale set by the Ombudsman Liaise with the offices of the Ombudsman to provide additional information as requested Update the Central database in relation to the complaint to indicate its referral to the Ombudsman Report any complaint referred to the Ombudsman via the Complaints Report to the Quality and Performance Committee Co-ordinate the formulation of an action plan for any actions identified as needed as a result of the Ombudsman s review of the complaint Communicate the outcomes of the Ombudsman s reviews to the Commissioners and Quality and Performance Committee along with any resultant Action Plans Submit any action plan produced to the appropriate Local Governance Group for monitoring Accessing the Complaints Department The CPFT PALs and Complaints team can be accessed by telephone ( ) or by or in person at Fulbourn, Elizabeth House, Cambridge, CB21 5EF Response Times The team operates within normal office hours. The team will aim to respond to contacts relating to concerns or enquiries, where possible the same day and no later than the next working day Record Keeping All concerns and enquiries will be analysed on arrival in the department and coded by main theme, sub theme, staff type and service. This information along with the personal details of the person raising the concern or enquiry, and details of the contact, will be entered onto the Database, which will be kept up to date and accurate. An enquiry form will be completed for each enquiry that is made to the team. Clients may wish their personal details remain anonymous and these wishes would be respected, however, the issue would be recorded on an enquiry form so as to ensure that trends are identified and reported Confidentiality and Consent The complaints team will treat all information received about patients and staff in strict confidence. Information about a caller, including the fact that they have made contact, will not be disclosed to a third party even to a partner or family member without the express consent of the caller. Page 18 of 49

19 The majority of concerns or enquiries will be received by telephone. In order to facilitate the speedy response of enquiries, verbal consent will be gained from enquirers. However, callers will be asked to sign and return a formal consent form to the complaints department should the issues raised require more detailed investigation and discussion with service providers. If the enquiry is on behalf of a child under the age of 16, it is not necessary to obtain consent from the child. 6. DUTY OF CANDOUR (Being Open) From April 2013 all NHS organisations will be required to comply with the Duty of Candour and tell patients if their safety has been compromised. CPFT will ensure that patients (and their carers if appropriate) receive a prompt apology for any incidents when this has occurred, whether or not a complaint has been made or information has been requested and ensure that lessons are learnt to prevent them from being repeated. 7. IMPLEMENTATION This policy will be disseminated via the Trust s All User function and will be accessible to staff via the Trust s Intranet. It is the responsibility of managers to ensure that all staff are aware of this policy and their individual responsibilities (see Appendix 1). 8. TRAINING AND SUPPORT Complaints information relating to this policy will be provided through Trust Induction, Investigating Officer and Team Training sessions within service areas. Root Cause Analysis Training will be provided to staff who have been designated as Investigating Officers. 9. GUIDING PRINCIPLES Principle of Acknowledgment All complaints and concerns should be treated with compassion and understanding by all staff. Service users and families should be provided with information about what had happened based on facts known at the time. Staff should explain that new information may emerge as the investigation processes. Service users, their families and carers should be given clear and unambiguous information and be provided with a single point of contact for any questions they may have. Jargon should not be used. If for any reason, it becomes clear during the initial discussion that the service user would prefer to speak to a different professional, the service users wish should be respected and a substitute with whom the service user is satisfied should be provided. Page 19 of 49

20 Principle of Apology (see Duty of Candour, section 6) Service user, their families or carers should receive a sincere expression of apology or regret for the distress/harm that has resulted. This should be in the form of an appropriately worded apology, as early as possible. Both verbal and written apologies should be given. The decision on which staff member should give the apology should include consideration of the staff s seniority and the relationship to the service user. It is important not to delay giving an apology. A written apology which clearly states that the Trust is sorry for the suffering and distress is not an admission of liability. Principle of Professional Support Openness and honesty creates an environment for all staff. Managers should ensure that staff feel supported throughout the investigation process. Principle of Confidentiality Confidentiality must be maintained at all times. Service user, their families, carers and staff must be assured of this. The consent of the individual concerned must be sought prior to disclosing information beyond the clinicians involved in treating the service user. Where this is not practicable or an individual refuses to consent to the disclosure, disclosure may still be lawful if justified in the public interest. Communications with those outside the clinical team should be on a need to know basis and where possible, be anonymous. Principle of recognising service user and carer expectations Service users, their families and carers should be treated sympathetically, with respect and consideration. They should be offered support as required such as an independent service user Advocate or translator. Principle of continuity of care Service users are entitled to expect they will receive their usual care and treatment and continue to be treated with respect and compassion. If a service user expresses a preference for their care to transfer to another team/individual. Appropriate arrangements should be made to meet this request. Page 20 of 49

21 10. MONITORING COMPLIANCE Aspect of compliance or effectiveness being monitored Process for listening and responding to concerns/ complaints of service users, their relatives and carers Monitoring Method PALS/ Complaints Dashboard (Frequency of contacts) Complaints Annual Report Individual department responsible e for the monitoring Safety and Quality Safety and Quality Frequency of the monitoring activity Monthly Annually Group/ committee which will receive the findings/ monitoring report Patient Experience & Risk Patient Experience & Risk Group/committee/ individual responsible for ensuring that the actions are completed Quality & Performance Committee Quality & Performance Committee Process for the handling of joint complaints between organisation Complaints Annual Report Safety and Quality Annually Patient Experience & Risk Quality &Performance Committee Process for ensuring that service users, their relatives and carers are not treated differently as a result of raising a concern/ complaint Complaints Annual Report Audit Safety and Quality Head of Patient Experience Annually Annually Patient Expertise & Risk Patient Experience & risk Quality & Performance Committee Quality & Performance Committee Process by which the organisation aims to improve as a result of concerns/ complaints being raised E-Learning Complaints Annual Report Safety and Quality Safety and Quality Monthly Annually Patient Experience & Risk Patient Experience & Risk Quality & Performance Committee Quality & Performance Committee Page 21 of 49

22 Process by which all the above will be monitored Audit Involving a random sample of 50 cases. A formal report will be presented to the Q & P committtee Head of Patient Experience Annually Patient Experience & Risk Quality & Performance Committee 11. REFERENCES The following documents and publications have been directly referenced or have been considered in the drafting of this policy: Access to Health Records Act (1990) Data Protection Act (1998) The Principles of Good Complaint Handling (Parliamentary and Health Service Ombudsman, 2008) Listening, responding, and improving a guide to better customer care. Local Authority Social Services and NHS Complaints England DH, 2009 NHS Consultation (DH 2012) NHS Litigation Authority Guidance about Complaints The Local Authority Social Services and National Health Service Complaints (England) 2009 Being Open Communicating Patient Safety Incidents with Patients and their carers (NSPA, 2009) Robert Francis Inquiry Report into Mid-Staffordshire NHS Foundation Trust (2010) Listening and Learning: the Ombudsman s Review of complaint Handling by the NHS in England Listening and Learning: the Ombudsman s Review of complaint Handling by the NHS in England Building Partnerships, Staying Safe The Health Sector contribution to HM Government s Prevent Strategy: guidance for healthcare organisation (DH 2011) 12. ASSOCIATED TRUST DOCUMENTS For any support or questions regarding this Policy, please contact the Head of Patient Experience or complaint manager (see Appendix 7): Incident Reporting Policy Access to Health Records Policy Supporting Staff involved in an Incident, Complaint of Claim Policy Confidentiality Policy Being Open Policy Care Records Management Policy Page 22 of 49

23 Freedom of Information Policy Safeguarding Adults Policy Safeguarding Children Policy Loss and Compensation Policy Disciplinary (Conduct & Capability) Policy and Procedure Equal Partners Strategy Root Cause Analysis (RCA) Guidelines Whistle Blowing Policy 13. VERSION CONTROL Version Date Author (Name and Organisation) Status (Draft/Approved) Comments V1 22/8/2013 Melanie Coombes Approved Approved by Quality & Performance Committee 22/8/13 Page 23 of 49

24 14. EQUALITY IMPACT ASSESSMENT DOCUMENT/PROJECT NAME: Complaints Policy Yes/ Comments No Does the document affect one group less or more favourably than another on the basis of: Race No The Complaints Policy can be translated into another language if requested and the Complaints Team can access interpreters via the Translation Service if required to assist complainants. Human Rights No Gender (inc gender reassignment) No Religion or Belief No N/A Sexual Orientation No N/A Age No Can be provided in larger text if requested, however the Complaints policy reflects Statutory Regulations in that a complaint must be made by a parent, guardian or representative if a child is aged under 18 Disability (learning disabilities, physical disability, sensory impairment and mental health) Is there any evidence that some No groups are affected differently? If you have identified potential No discrimination are there any expectations valid, legal and / or justifiable? Is the impact of the document / No guidance likely to be negative? If so, can the impact be N/A avoided? What alternative is there to N/A achieving the document / guidance without the impact? Can we reduce the impact by No taking different actions? How has the consultation taken place and who with? Date of the Assessment: 28 June 2013 Can be provided in a variety of formats on request e.g. Audio Tape, Braille, Large Print, Large Print on yellow paper and Easy Read. The Independent Complaints Advocacy Service is available to anyone making an NHS Complaint Who with: Managers and staff across the organisation Page 24 of 49

25 PLEASE ENSURE THIS FORM IS FILLED OUT BY A MEMBER OF STAFF AND SEEN BY A MANAGER BEFORE SENDING Office Use Only Appendix 1 COMPLAINTS FEEDBACK FORM Date received: Ref number: Date closed; Name of staff completing form (please print clearly): Telephone number of staff completing form: Division and Team: CONTACT INFORMATION for person making the complaint/ raising concern Full Name: Address: Tel: (home/mobile/work) D.O.B: Ethnic Origin: Tick here if Service User information is as above (if not fill in details below) Service user name: Relationship to person raising concerns Address: Service user Tel: Service User D.O.B: Consent: Please detail here if consent is required, given or denied by Service User Details of initial complaint / query / issue (inc date received) Tick if Serious Incident: Tick if Incident: Tick if Safeguarding: Details of Actions taken by staff to resolve complaint / query / issue MANAGER TICK NEXT STEP OF COMPLAINTS TEAM: No action Make contact with person Contact Manager of more info: resolved local: making complaint: FOR OFFICE USE: Admission / Staff attitude Nursing Medical care discharge Care/treatment Communication Domestic Information Rights (patient) Waiting Lists Other agency Other COMPLAINT REPORT DUE: COMPLAINT COMPLETION DUE DATE: Send to FEEDBACK complaints department Elizabeth House, Fulbourn, Cambridge Page 25 of 49

26 Guidance Notes This form is to be completed by staff to ensure that staff are listening to concerns, comments and complaints. Please complete all parts of the form. Please do not give this form to patients, carers or relatives to complete If you receive a complaint or concern please ensure that there is no immediate risk to the complainant and / or others involved If you suspect there may be safeguarding issues, please call the Safeguarding Lead Fill in the form while the person is with you where possible and if they want to sign it, they can do so in the Consent box. Please ensure that the form is signed off by the Manager. Suggest to the person that although PALS will see this form, they may wish to contact PALS directly themselves to resolve issues speedily and informally. PALS number is XXXXXXXX PLEASE NOTE: You must alert your Director or Line Manager immediately if there may be indications of physical or sexual assault, financial misconduct or criminal offence. If out of hours, please contact the Manager on Call in first instance..complaint continued from overleaf:..action taken continued from overleaf: Page 26 of 49

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