Complain sailing

The quality gurus say that you should welcome, even encourage, complaints as free feedback from users which can help you improve services. On this basis a team which gets few complaints could be viewed as one that does not empower users to voice their concerns.

On the other hand managing complaints can be very time-consuming and demoralising to team members. Moreover, complaints only tell you what people think has gone wrong. Satisfied users don’t complain. This makes complaints a blunt instrument with which to develop better practice.

Far better if complaints are just one aspect of quality improvement. For example, seeking routine feedback by encouraging people to comment on and compliment services and staff also.

It is generally true that most people don’t like to complain. When a complaint is related to care services it is often a last resort. It is therefore likely to be surrounded by a mixture of emotions including frustration and anger.

It can also feel very difficult to complain about a service if you are afraid that doing so means you will be seen as a troublemaker or that the workers won’t like you or help you any more. Possibly, the more you need a service the harder it is to complain unless it is made clear to you that complaints are expected and welcomed as a means of improving the service. For example, some organisations have a pre-paid postcard for service users to send in with a message saying: “I am not happy. I would like to talk to you.” These go to a specific (maybe named) person who telephones the service user to talk through concerns or makes arrangements to visit them.

So what do users want when they complain? First, to be taken seriously and listened to. That’s one reason for having procedures that specify response times. Users can feel fearful about making a complaint and a delayed reply will only add to their discomfort. This can create pressure to respond to complaints quickly but every effort should be made to investigate them as fully as necessary. Put complaints to the top of your “to do” list.

Unnecessary delays can lead to complaints about handling complaints. The trick is to keep people informed – explain delays and most people will be content that you haven’t simply forgotten them.

Second, users want a clear explanation for what has happened and if appropriate an apology. Third, they want to be reassured that the same thing will not happen again. These three principles apply even to users whom you think are not being reasonable. You will only further their sense of injustice if you do not respond fairly.

Procedures are, of course, the easy part. It is very difficult to pick up the phone to set up a meeting with someone who is angry, but it is likely to be better in the long run. Show that you are prepared to listen. It is important in dealing with complaints that people feel that “the right thing has been done” as well as “things have been done right”. If you are feeling that the procedure is not proving helpful, then you should go back to its principles of fairness, transparency and so on, to see if there’s a better way to discuss or negotiate with the complainant.

As a manager it is possible to think about complaints only from an organisation’s viewpoint. The key to having an effective complaints system is to start with the service user and also to draw on your own experiences of complaining. Putting yourself in other people’s shoes nearly always helps you to see things more clearly.

Complaints procedures work best in the context of clear standards which have been clearly communicated to users. Sometimes all users need to know is how your organisation is deciding who gets what and who does not (or “prioritising scarce resources” in management speak). Such standards should also address issues of equality and rights so that users can have confidence in how you will manage complaints about abusive practice. It is in the greater interest to promote an open culture in care settings. Whistleblowing policies are very important here.

It should also be recognised that since, in social care, most complaints involve the actions (or inaction) of staff, it’s crucial to balance supporting the complainant with good feedback with support for the staff concerned.

It is essential that staff receive training to help them understand that complaints from service users are to be welcomed as part of improving services.

Christine Doorly is regional manager, national care standards commission; Des Kelly is partnership director, Bupa care homes; Janet Seden is a lecturer at The Open University; and Martin Willis is programme director, Inlogov, Birmingham University.

TOP TIPS

• Discuss complaints, comments and compliments openly with your team.
• Don’t be defensive.
• Keep people informed. Even when nothing is happening – tell them nothing is happening.
• Keep any promises you make.

RUBBISH TIPS

• Never say “sorry”, as the person you are apologising to could sue.
• Complaints procedures should be followed to the letter.
• All complaints can be resolved to the satisfaction of all involved.
• Leaflets alone are enough

When I was…

 “advising at a hearing of a complaint, an elderly resident in a care home claimed that she had been badly handled by a member of staff while transferring from an armchair to a wheelchair in the residents’ lounge. After extensive interviews the case seemed to boil down to the resident’s word against the staff member’s. However, about a dozen other residents sitting in the lounge at the time, who had all potentially witnessed this event,were not interviewed.

This is an example of where a forensic approach may have gathered corroborating evidence, which would have enabled a firm decision to be made.”

“…wanting recently to complain about the actions of a local authority department, no-one could even tell me who to speak to in the first instance!”

“…customer care manager, 75 per cent of all complaints had their root in poor communication.”