Complaints and feedback annual report 2022 to 23
Page contents
- 1. Context
- 2. Overview of complaints
- 3. Complaints about ASCH services and teams
- 4. Complaints about external providers
- 5. Local Government and Social Care Ombudsman
- 6. Compliments
- 7. Conclusion
- 8. Comments
1. Context
Adult Social Care and Health (ASCH) works with many people throughout the county. This year, the department supported over 27,000 people (clients and carers).
The department also has lead responsibility for safeguarding adults at risk of harm by others. It received and responded to over 5,800 reports of concerns or allegations of adult abuse during the year.
2. Overview of complaints
This year the Complaints and Feedback Team recorded 430 complaints about Adult Social Care & Health, compared with 342 last year.
We have continued to strengthen our complaints duty function to provide a person centred and resolution focused approach, helping to resolve matters before going into the complaints process. This year we resolved 548 enquiries out of a total of 555. Just 7 (1%) enquiries could not be resolved through this triage approach and went into the complaints process.
| Year | Number of complaints |
|---|---|
| 2022 – 23 | 430 |
| 2021 – 22 | 342 |
| 2020 – 21 | 255 |
| 2019 – 20 | 399 |
| 2018 – 19 | 411 |
2.2 Complaints received by service areas
The table below shows the number of complaints received, findings and response times for each service area. Last year’s totals are in brackets.
2.2 The table below shows the number of complaints received, findings and response times for each service area. Last year’s totals are in brackets.
2.3 Upheld complaints
Just over half (51%) of the complaints recorded were upheld in full or in part.
| Service | Number of complaints | Upheld and partly upheld | Average time to respond |
|---|---|---|---|
| Adult Social Care Operations | 351 (299) | 171 = 51% (43%) | 36 days (38 days) |
| Strategy, Commissioning and Supply Management | 20 (18) | 9 = 45% (61%) | 30 days (34 days) |
| Planning, Performance and Engagement | 7 (0) | 4 = 57% | 22 days |
| Independent providers – home care agencies, residential and nursing homes | 51 (22) | 27 = 53% (32%) | 30 days (30 days) |
| Total | 430 (342) | 218 = 51% (44%) | 34 days (37 days) |
2.4 Target response times for ASCH
Our target time for responding to complaints is 10 to 20 working days, where possible. If the complaint was considered complex (involving a few services) we notified people that it may take 30 working days.
This year:
- 33% (133) of complaints received a response within our target times of 10 – 20 working days.
- 22% (89) of complaints received a response within 30 working days.
- 45% (182) complaints did not receive a response within the timescales.
- 6% (26) were still open at the time of reporting.
- In almost all cases people were kept informed of the progress of their complaint, particularly if it was taking longer than first anticipated.
2.5 Comparison with last year
Overall, there has been a 26% increase in complaints received regarding Adult Social Care & Health, including external independent providers, compared to last year. This represents an increase of 88 complaints.
- The proportion of complaints upheld in full or in part has increased from 44% in 2021-22 to 51% in 2021- 23.
- 33% of complaints received a response within our target times of 10 to 20 working days, compared to 29% in 2021 – 22.
- 55% of complaints received a response within 30 working days, compared to 48% in 2021 - 22.
| Service | Number of complaints | Upheld and partly upheld | Average time to respond |
|---|---|---|---|
| Adult Social Care Operations | 351 (299) | 171 + 51% (43%) | 36 days (38 days) |
| Strategy, Commissioning and Supply Management | 20 (18) | 9 = 45% (61%) | 30 days (34 days) |
| Planning, Performance and Engagement | 7 (0) | 4 = 57% | 22 days |
| Independent providers – home care agencies, residential and nursing homes | 51 (22) | 27 = 53% (32%) | 30 days (30 days) |
| Public Health | 1 (3) | 0 = 0% (67%) | 10 days (9 days) |
| Total | 430 (342) | 218 = 51% (44%) | 34 days (37 days) |
3. Complaints about ASCH services and teams
The table below sets out the number of complaints recorded for each service provided by Adult Social Care & Health, and the percentage of complaints upheld in full or part.
The table does not include complaints about external contracted providers.
| Adult Social Care & Health services |
Number and percentage of complaints upheld 2022 – 23 |
Number and percentage of complaints upheld 2021 – 22 |
|---|---|---|
| Blue Badge Team | 10 30% | 7 0% |
| Continuing Health Care Team | 0 0% | 2 50% |
| Countywide Reviewing Team | 2 0% | 0 0% |
| Emergency Duty Service | 0 0% | 0 0% |
| Financial Assessment and Charging | 90 67% | 59 58% |
| Health and Social Care Connect | 9 33% | 6 33% |
| Hospital Assessment and Care Management Teams | 31 39% | 43 37% |
| Joint Community Rehabilitation Service | 3 33% | 2 100% |
| Learning Disability – Assessment and Care Management | 25 56% | 15 40% |
| Learning Disability Directly Provided Services (Day Care, Community Support, Residential and Respite) | 1 0% | 0 0% |
| Mental Health and Substance Misuse Teams (working age adults) | 49 39% | 52 42% |
| Mental Health Older People’s Team (over 65 years) | 24 63% | 13 46% |
| Deprivation of Liberty Safeguards Team | 0 0% | 0 0% |
| Neighbourhood Support Teams | 86 51% | 74 39% |
| Occupational Therapy Reablement Services | 8 25% | 16 44% |
| Older People’s Directly Provided Services (Day Care, Respite, Residential) | 2 50% | 3 67% |
| Planning, Performance and Engagement | 7 57% | 0 0% |
| Public Health | 1 0% | 3 67% |
| Safeguarding Development Team | 1 0% | 0 0% |
| Sensory Impairment Reablement Services | 0 0% | 2 50% |
| Supply Management | 6 50% | 6 50% |
| Strategic Commissioning | 14 43% | 12 67% |
| Transition Team | 10 40% | 5 20% |
3.1 What were the complaints about?
Complaints are categorised by the type of work complained about and then the problem. The table below highlights the number of complaints by type of work. Last year’s figures and percentages are in brackets.
| Complaint type | Number of complaints | % of total |
|---|---|---|
| Advocacy | 1 (0) | 0.3% (0%) |
| Allocation of funding / grants | 20 (19) | 5% (6%) |
| Appeal | 2 (0) | 0.6% (0%) |
| Assessment | 97 (57) | 26% (18%) |
| Care plan | 1 (6) | 0.3% (2%) |
| Carer’s assessment | 2 (0) | 0.6% (0%) |
| Carers’ services | 1 (0) | 0.3% (0%) |
| Consultation and engagement | 1 (0) | 0.3% (0%) |
| Contracts | 0 (0) | 0% (0%) |
| Data protection | 4 (1) | 1% (1%) |
| Direct payments administration | 22 (12) | 6% (4%) |
| Employee enquiries | 0 (0) | 0% (0%) |
| Equipment – adaptations | 2 (5) | 0.6% (2%) |
| Equipment – daily living | 8 (9) | 2% (3%) |
| Hospital discharge | 14 (18) | 4% (6%) |
| Information provision | 22 (21) | 6% (7%) |
| Initial contact | 4 (0) | 1% (0%) |
| Invoicing | 38 (38) | 10% (12%) |
| Mental capacity assessment | 3 (4) | 1% (1%) |
| Policy | 10 (14) | 3% (4%) |
| Provision of service | 83 (64) | 22% (20%) |
| Review | 6 (3) | 2% (1%) |
| Safeguarding enquiry | 11 (13) | 3% (4%) |
| Service environment | 0 (0) | 0% (0%) |
| Service user behaviour | 2 (2) | 0.6% (1%) |
| Staff actions / behaviour | 25 (32) | 7% (10%) |
3.2 Themes of complaints
3.2a Assessment
The biggest area of complaints related to assessment, which was just over a quarter (26%) of all complaints received (97 complaints). Our assessment functions include eligibility assessments for social care support, including the value of a personal budget and mobility assessments for the provision of a Blue Badge. Financial assessments identify how much someone will pay towards their support.
| Complaint type | Number of complaints | % of total |
|---|---|---|
| Assessment – Social Care | 51 (31) | 14% (10%) |
| Assessment – Financial | 39 (24) | 10% (8%) |
| Assessment – Blue Badge | 7 (2) | 2% (1%) |
Nearly half of the complaints (45) in relation to an assessment were upheld or partially upheld. Of these, over a third (18 complaints) were in relation to a delay.
The top 3 issues that were upheld (with the percentage of the total number of complaints) were:
- delay in doing something - 18 (40%)
- Other communication cause - 7 (16%)
- Unhappy with decision - 5 (11%)
3.2b Provision of service
The second biggest area of complaints related to provision of service, which was just over a fifth (22%) of all complaints received (83 complaints).
46 complaints (55%) were upheld or partially upheld in relation to provision of service. Of these, nearly a third (15 complaints) were in relation to the service not being to the quality or standard expected.
- 15 of these (33%) were in relation to the service not being to the quality or standard expected
- 13 (28%) related to a delay in doing something
- 7 (15%) were in connection with other communication causes.
Invoicing
10% of all complaints received (38 complaints) related to invoicing.
22 complaints (58%) were upheld or partially upheld in relation to invoicing.
The top 2 issues that were upheld were:
- 17 (77%) disagreed with charge received
- 2 (9%) disputed charges or other payments.
4. Complaints about external providers
We pay for external providers to deliver many of our care and support services. For example, residential care, nursing care, supported accommodation, shared lives, home care and alarm care systems. As commissioners of the service, we only become involved when the provider has not been able to resolve matters through their own complaints process.
We have recorded 51 complaints this year about external providers, which is over double on last year, when 22 complaints were recorded. Of the complaints recorded this year:
-
46 related to community services including:
-
Home alarm care systems = 22
-
Home care providers = 13
-
Direct Payments Support Services = 4
-
Personal Assistants = 3
-
Supported Accommodation = 2
-
Warm check scheme = 1
-
Cleaning company = 1
-
- 5 were about residential care providers.
4.1 Response times
-
6 (12%) of the complaints received a response within 10 working days.
-
14 (27%) of the complaints received a response within 20 working days.
-
31 (61%) of the complaints exceeded the 10 – 20 working day timescale; people were kept updated if there was a delay.
The average time to respond has remained the same as in 2021 – 22, at 30 days.
4.2 How many complaints about external providers were upheld?
Out of the 51 complaints received for external providers:
- 27 (53%) of the complaints were upheld in full or part.
- 24 (47%) were not upheld.
4.3 Types of complaints about external providers
Of the 27 complaints upheld, concerns were about one or more of the following:
- lack of communication and difficulty contacting the provider,
- the issuing or collection of equipment was delayed,
- service fell below expectation,
- staff behaviour or actions.
5. Local Government and Social Care Ombudsman
After our final complaint response, people can ask the Local Government and Social Care Ombudsman (the Ombudsman) to review their complaint if they remain unhappy. The Ombudsman will normally only consider complaints made within 12 months of our response but can decide to look at older complaints if there is a good reason to do so.
The Ombudsman investigates matters fairly and impartially and is free to use.
There are some matters the Ombudsman cannot or will not investigate. In these cases, they will explain the reason for its decision.
Every year, the Ombudsman sends the council a letter setting out the Ombudsman findings for complaints for the year. This year, the Ombudsman decided on 84 complaints for the council, of these, 28 (33%) related to ASCH. This is less than the previous year when 38 (43%) were about ASCH.
| Year | 2022 - 23 | 2021 - 22 | 2020 – 21 |
|---|---|---|---|
| Investigations upheld | 6 | 17 | 10 |
| Investigations not upheld | 3 | 4 | 6 |
| Closed after initial enquiries | 8 | 7 | 6 |
| Invalid or incomplete | 3 | 4 | 2 |
| Referred back | 7 | 6 | 4 |
| Advice given | 1 | 0 | 1 |
| Total | 28 | 38 | 29 |
There was a 26% decrease in the total number of complaints made to the LGSCO about ASCH. Only 9 went into investigation compared with 21 the previous year, which is a 57% decrease.
6 investigations found fault with the actions of the department. Recommendations were made to remedy the impact on the people involved and improve services for people who might use the service in the future. The department completed all the recommendations made in these investigation decisions.
The uphold rate of 67% is less than other similar councils who average 80%.
All the investigation decisions are published on the LGSCO website and can be found using this link: Your council’s performance (lgo.org.uk)
Where fault was found, recurring themes included shortfalls in proactive communication and support, alongside the impact of delays in completing assessments and care planning in a timely manner. These factors have consistently caused frustration and avoidable distress.
Learning and actions
Learning from complaints to improve our services is important to us. Here are some examples of learning this year:
-
In collaboration with our partners NHS Sussex, we undertook a range of actions to ensure the top-up payments for section 117 aftercare payments were in line with statutory guidance. We also reimbursed people who had been charged top-ups incorrectly.
-
People were finding the Direct Payment process for care and support difficult to navigate alongside shortfalls in its administration. The Direct Payments process was reviewed. The review considered the information shared with people to ensure it is provided at an earlier stage in the process and is informative and accessible. It has also improved how teams work together to achieve outcomes in a more timely and smooth way.
-
A service commissioned by Adult Social Care to provide an alarm care system recruited additional staff to ensure a more responsive service.
-
Financial Services reviewed its internal processes and procedures to identify improvements to managing incoming work to reduce timescales and provide a timelier outcome to financial assessments. This is ongoing, and so far, the changes have resulted in a significant reduction in time to complete a financial assessment. A new letter was also introduced to improve the information provided about how financial assessments are completed.
-
A review is underway to understand waiting times for assessment and how this is managed across the department.
6. Compliments
Compliments provide valuable information about the quality of our services and identify where they are working well. The sincere expressions of gratitude we have received show how much services are valued by the people who use them, their families and friends.
This year, we recorded a total of 1,855 compliments. ASCH has continued to receive far more compliments (1,855) about our services than complaints (430). This year the ratio per compliment to complaint is 4.3 compared to 5.6 last year.
| Countywide teams | Total for 2022 – 2023 |
|---|---|
| Appointee and Deputyship | 7 |
| Direct Payments | 3 |
| Finance and Benefits | 30 |
| Protection of Property | 0 |
| Revenue Team | 3 |
| Service Agreement Team | 0 |
| Approved Mental Health Professional Team | 3 |
| Blue Badge Team | 4 |
| Carers Breaks Dementia Engagement Team | 62 |
| Continuing Health Care Team | 3 |
| Countywide Reviewing Team | 1 |
| Deprivation of Liberty Safeguards Team | 3 |
| Emergency Duty Service | 4 |
| Health and Social Care Connect | 21 |
| Housing Occupational Therapy Service | 32 |
| Joint Community Rehabilitation Service | 947 |
| Learning Disability Community Support | 17 |
| Mental Health SAT | 1 |
| Occupational Therapy Housing | 32 |
| Partnership/HFU Team | 2 |
| Planning, Performance and Engagement | 6 |
| Safeguarding | 1 |
| Sensory Impairment Reablement Services | 18 |
| Strategy, Commissioning and Supply Management | 1 |
| Support With Confidence | 116 |
| Shared Lives & Supported Accommodation (SAILS) | 48 |
| Transition Team | 7 |
| Total | 1,372 |
| Locality Teams | Total for 2022 – 2023 |
|---|---|
| Learning Disability Directly Provided Services | 43 |
| Older People’s Directly Provided Services | 213 |
| Hospital Teams: Conquest, Eastbourne DGH & Sussex Downs | 13 |
| Learning Disability Assessment East & West | 16 |
| Adult Mental Health & Substance Misuse Teams | 28 |
| Older People’s Mental Health Teams | 13 |
| Neighbourhood Support Teams | 57 |
| Occupational Therapy Reablement Teams | 41 |
| Total | 424 |
| Listening 2 You survey feedback | Total for 2022 – 2023 |
|---|---|
| Overall Adult Social Care & Health | 25 |
| Social care assessments | 2 |
| Finance | 1 |
| Homecare | 27 |
| Residential | 4 |
| Total | 59 |
7. Conclusion
We want people to experience the best care and support possible, in partnership with our colleagues in the NHS, Police, Community and Voluntary Sector.
Feedback shows that people have valued being listened to, being kept informed and being supported through a complex adult social care system when they are perhaps at their most vulnerable. But, when it has been difficult to access information and support, they have felt frustrated and worried about next steps and the costs incurred.
The complaints and feedback process has responded to peoples’ concerns and has focussed on sorting things out quickly and fairly. We do recognise that we need to improve our response times and will look at this in the year ahead.
With lower numbers of people going to the Local Government and Social Care Ombudsman it seems that we have been generally successful in apologising for any shortfalls in our services and making up for any injustice caused. Individual staff, teams and services have learnt from mistakes and improved services for the future. We want to learn more widely across the department though, and we will be focussing on strengthening how we do this through 2023 and 2024.
8. Comments
If you have any comments about the content of this report please contact us:
Adult Social Care and Health Complaints and Feedback Team
East Sussex County Council
St Anne's Crescent
County Hall
Lewes
East Sussex
BN7 1SW
Telephone: 01273 481242
Email: asccomplaintsfeedback@eastsussex.gov.uk
Textphone: 07797 877777