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Knowing how to complain about a service without fear of retribution or complexity is a major issue for older people. Many people find it difficult to complain about a home or an individual – particularly someone who provides a face-to-face service on a daily basis. A Department of Health (DH) online survey found that the overwhelming majority of people (both public and professionals) feel that the complaints system is inadequate. The two main problems with the complaints procedure seem to be that it is difficult for people to understand how to make a complaint and that once it is lodged, very little changes as a result.

People may find it difficult to complain for several reasons, including communication issues and language barriers when English is not their first language. The DH survey found that people often fear being penalised if they complain. Relatives of people receiving care are concerned that if they complain staff will take their frustrations out on the service user.

Professionals are also scared of speaking out in case it affects their employment. Yet research shows that if people feel comfortable in raising concerns with front-line staff – and staff act promptly to address the issues raised – then escalation to the official complaints procedure is less likely and resources used on complaints can be kept to a minimum.

EVIDENCE

Research into what works well suggests that service user forums, particularly in residential settings, may help people to feel more comfortable in raising concerns. Such forums can also offer non-bureaucratic opportunities for service users to influence change. Acting promptly can help to reas sure people that their complaints will be listened to and that it is not necessary to enter into a bureaucratic process to get a good response.

Complaints procedures have been highlighted as a particular area for development. Every organisation should have a fair, open and honest culture around complaints that allows:

● People to feel confident in bringing concerns to attention.
● Staff and managers to view complaints as constructive and not a threat.

● Poor practice to be highlighted and rectified.
● Vulnerable people, or those who find it difficult to make their views heard, to feel protected with access to adequate support.

Where possible, people should be encouraged to approach the service first to see if the problem can be resolved at an early stage. If this is not an option (for example, because the complaint is about the manager or because the service user fears reprisals) it may be more appropriate to approach the commissioning or regulatory body instead. Service providers should have copies of their complaints procedures available and should keep a record of all conversations about complaints – even informal ones.

FURTHER INFORMATION

● Practice guide 09: Dignity in Care www.scie.org.uk
● The Audit Commission
● The Health Service Ombudsman
● Counsel and Care 
● Independent Complaints Advocacy Services (Icas)

Related article
Research Abstracts: Complaints and Adult Protection