Wellness Care Provider
Policy Statement
This policy sets out the values, principles and procedures, which underpin Wellness Care
Provider’s approach to handling complaints to comply with the Health and Social Care Act
2008 (Regulated Activities) Regulations 2014, Regulation 16: Receiving and Acting on
Complaints.
It also shows how Wellness Care Provider is meeting the Quality Statement, “Listening to and
Involving People”, which CQC is using from 2023 for its assessment purposes.
“We make it easy for people to share feedback and ideas or raise complaints about their care,
treatment and support. We involve them in decisions about their care and tell them what’s
changed as a result.”
Regulation 16 requires care providers to have an effective system to identify, receive, handle
and respond appropriately to complaints and comments made by people who use the service,
or persons acting on their behalf, and others involved with the service.
Regulation 16 is one of the fundamental standards with which providers must comply to meet
their registration requirements. It states the following.
- Any complaint received must be investigated and necessary and proportionate action
must be taken in response to any failure identified by the complaint or investigation. - The registered person must establish and operate effectively an accessible system for
identifying, receiving, recording, handling and responding to complaints by people who
use the service and other persons in relation to the carrying on of the regulated activity. - The registered person must provide to the Commission, when requested to do so and by
no later than 28 days beginning on the day after receipt of the request, a summary of:
a. complaints made under such complaints system
b. responses made by the registered person to such complaints and any further
correspondence with the complainants in relation to such complaints
c. any other relevant information in relation to such complaints as the Commission may
request.
To be compliant with this regulation, Wellness Care Provider will:
bring the complaints system to the attention of people who use the service and people
acting on their behalf in a suitable manner and format
facilitate the making of complaints when one is being made
acknowledge and investigate all verbal and written complaints and (where relevant),
work with other services where the complaint is of a joint nature to address the issues
raised
ensure that people who use the service have access to and the help of an independent
advocacy service, which they might need to make a complaint where they lack the
capacity or means to make the complaint without such assistance; an advocate can
assist the person at all stages in the complaints process (see also the separate policy on
Advocacy).
Where appropriate, Wellness Care Provider will also refer users to the leaflet published by the
Care Quality Commission (CQC), How to Complain About a Health or Social Care Service.
This policy should be read and used in relation to other policies on:
Responding to the Experiences of Service Users (England and Wales)
Quality Assurance and Management
Escalation
Duty of Candour
General safeguarding policies.
Wellness Care Provider works on the principle that if a person who uses the service or anyone
who acts in their best interests wishes to make a complaint or register a concern they should
find it easy to do so. It is Wellness Care Provider’s policy to welcome complaints and look upon
them as an opportunity to learn, adapt, improve and provide better services. This policy
ensures that complaints are dealt with properly and that all complaints or comments by
individuals and their relatives and carers are taken seriously.
The policy is not designed to apportion blame, to consider the possibility of negligence or to
provide compensation. It is not the same as the disciplinary policy. However, Wellness Care
Provider understands that failure to listen to or acknowledge complaints could lead to an
aggravation of problems, dissatisfaction of people who use the service and possible litigation.
Wellness Care Provider supports the principle that most complaints, if dealt with early, openly
and honestly, can be sorted at a local level, ie between the complainant and Wellness Care
Provider. If this fails due to the complainant being dissatisfied with the result, Wellness Care
Provider respects the right of the complainant to take the complaint to the next stage by
seeking a review with the relevant reviewing body of how the complaint was addressed.
The aim is always to make sure that the complaints procedure is properly and effectively
implemented and that individuals feel confident that their complaints and worries are listened
to and acted upon promptly and fairly.
Principles of Complaints Handling
- People who use the service, their representatives and carers are always made aware of
how to complain, for example, by having a complaints notice displayed prominently in
public areas, having copies of the complaints procedure included in the information
given to people who use the service, and having the procedure available in alternative
formats in line with users’ communication needs. - People who use the service, their representatives and carers are always made aware that
Wellness Care Provider provides easy-to-use opportunities for them to register their
complaints. - A named person is always responsible for the administration of the procedure.
- Every written complaint is acknowledged within two to three working days.
- Investigations into written complaints are held within 28 days.
- All complaints are responded to in writing by Wellness Care Provider.
- Complaints are dealt with promptly, fairly and sensitively with due regard to the upset
and worry that they can cause to people who use the service and those against whom
the complaint has been made. - Wellness Care Provider recognises national guidance on complaints’ handling, which
uses a three-stage (two stages for some self-funding people) model of:
a. local resolution
b. complaints review
c. independent external adjudication by Local Government and Social Care Ombudsman
(LGSCO), Health Service Ombudsman or through the Independent Healthcare Advisory
Services (IHAS).
- The person to whom complaints should be made is Esther Mburu.
The Complaints Procedure
Stage one: local resolution
Wellness Care Provider works on the basis that wherever possible, complaints are best dealt
with directly with the people who use the service by its staff and management, who will
arrange for the appropriate enquiries to be made in line with the nature of the complaint. This
can involve using an independent investigator as appropriate or if the complaint raises a
safeguarding matter a referral to the local safeguarding adults authority.
Stage two: complaints review
In line with national guidance, Wellness Care Provider then recognises that if the complaint is
still not resolved, the complainant has a right to take their complaint to the body responsible
for the commissioning of the service, eg local authority and/or health service (again depending
on the nature of the complaint and type of service involved). A self-funding person whose care
and support has no local authority involvement is entitled to go directly to the LGSCO for
resolution.
Stage three: independent external adjudication
If complainants are still dissatisfied with the management and outcome of their complaint,
Wellness Care Provider is aware that they can refer the matter to the LGSCO/Health Service
Ombudsman in respect of some private healthcare providers through the IHAS for external
independent adjudication.
Role of the Care Quality Commission
Wellness Care Provider makes its users aware that the Care Quality Commission (CQC) does
not investigate any complaint directly, but it welcomes hearing about any concerns. It
accordingly provides users with information about how to contact the CQC by referring them
to the CQC’s leaflet How to Complain About a Health or Social Care Service (July 2013)
(available on the CQC website).
Wellness Care Provider also sends to the CQC any information about complaints requested or
required as part of CQC’s compliance reviewing policy.
Safeguarding issues
In the event of the complaint involving alleged abuse or a suspicion that abuse has occurred,
Wellness Care Provider refers the matter immediately to the local safeguarding adults’
authority, which will usually call a strategy meeting to decide on the actions to be taken next.
This could entail an assessment of the allegation by a member of the Safeguarding Authority
team.
Wellness Care Provider will also notify the CQC under the (revised) Care Quality Commission
(Registration) Regulations 2009, Regulation 18(e) Notification of Other Incidents of “any abuse
or allegation of abuse in relation to a service user”.
Verbal Complaints
Wellness Care Provider adopts the following procedures for responding to complaints and
concerns made verbally to staff or to managers.
- All verbal complaints, no matter how seemingly unimportant, are taken seriously and are
immediately acknowledged as concerns. - Front-line care staff who receive a verbal complaint are instructed to address the
problem straight away. - If staff cannot solve the problem immediately they should offer to get the manager to
deal with the problem. - All contact with the complainant should be polite, courteous and sympathetic. There is
nothing to be gained by staff adopting a defensive or aggressive attitude. - At all times staff should remain calm and respectful.
- Staff should not make excuses or blame other staff.
- If the complaint is being made on behalf of the person who uses the service by an
advocate it must first be verified that the person has permission to speak for the person
who uses the service, especially if confidential information is involved. It is very easy to
assume that the advocate has the right or power to act for the person who uses the
service when they may not. If in doubt it should be assumed that the person’s explicit
permission is needed prior to discussing the complaint with the advocate. - After talking the problem through, the manager or the member of staff dealing with the
complaint will suggest a course of action to resolve the complaint. If this course of action
is acceptable then the member of staff will clarify the agreement with the complainant
and agree a way in which the results of the complaint will be communicated to the
complainant (ie through another meeting or by letter). - If the suggested plan of action is not acceptable to the complainant then the member of
staff or manager will ask the complainant to put their complaint in writing and give them
a copy of the complaints procedure. - Details of all verbal complaints are recorded in the complaints book by the staff or
managers who receive the complaint and on the individual’s care records with
information on how a specific matter was addressed.
Written Complaints
Wellness Care Provider adopts the following procedures for responding to written complaints,
which might be made by letter or on a form which Wellness Care Provider makes available.
Preliminary steps
- When a complaint is received in writing it is passed on to a named person, eg the
registered manager or registered provider/complaints manager who records it in the
complaints book and sends an acknowledgement letter within two working days, which
describes the procedure to be followed. - The complaints manager/named person is responsible for dealing with the complaint
throughout the process, including for any investigations carried out by an independent
person, who will report to the named person/complaints manager. - If necessary, further details are obtained from the complainant by the person carrying
out the investigation. If the complaint is not made by the person who uses the service
but on their behalf, then consent of the person, wherever practical in writing, is obtained
from the complainant to provide that information. - If the complaint raises potentially serious matters, advice will be sought from a legal
advisor. If legal action is taken at this stage any investigation under the complaints
procedure should cease immediately pending the outcome of the legal intervention. - A complainant, who is not prepared to have the investigation conducted by Wellness
Care Provider or its parent organisation or is dissatisfied with the response to the
complaint, is advised to contact Wellness Care Provider or organisations responsible for
commissioning their services (local authority and/or health service) for a review of their
complaint.
- The complainant then has the option of taking the matter to independent external
adjudication and will be referred to the information provided by the CQC in its leaflet
How to Complain About a Health or Care Service (February 2014). - If the complaint involves safeguarding issues requiring an alert to the local safeguarding
authority, Wellness Care Provider will follow the safeguarding procedures, carrying out
any internal investigation in line with any plan agreed with the safeguarding staff (with
information shared with the CQC).
Investigation of a complaint (other than
safeguarding)
- Immediately on receipt of a written complaint, Wellness Care Provider will launch an
investigation and aims within 28 days to provide a full explanation to the complainant,
either in writing or by arranging a meeting with the individuals concerned. - If the issues are too complex to complete the investigation within 28 days, the
complainant will be informed of any delay and the reason for the delay.
Meeting
- If a meeting is arranged the complainant is advised that they may, if they wish, bring a
friend or relative or a representative such as an advocate. - At the meeting, a detailed explanation of the results of the investigation is given and an
apology if it is deemed appropriate (apologising for what has happened need not be an
admission of liability). - Such a meeting gives Wellness Care Provider the opportunity to show the complainant
that the matter has been taken seriously and has been thoroughly investigated.
Follow-up action
- After the meeting, or if the complainant does not want a meeting, a written account of
the investigation is sent to the complainant. - This includes details of how to take the complaint to the next stage if the complainant is
not satisfied with the outcome. - The outcomes of the investigation and the meeting are recorded in the complaints book
and any shortcomings in procedures are identified and acted upon. - The management reviews all complaints to determine what can be learned from them. It
regularly reviews the complaints procedure to make sure it is working properly and is
legally compliant.
Training
All care staff are trained to respond correctly to complaints of any kind. Complaints policy
training is included in the induction training for all new staff and updated as indicated by any
changes in the policy and procedures and in the light of experience of addressing complaints.