The Local Government Ombudsman Dr Jane Martin Care

The Local Government Ombudsman Dr Jane Martin Care England Conference 12 November 2015

Our service § Investigate complaints against local councils and adult social care providers § Independent, impartial, free § LGO has two roles: remedying injustice and improving local services § Aim to put things right if they have gone wrong – through service improvements and redress § We want complaints to be resolved at the local level wherever possible and usually won’t consider a complaint until the body has had the chance resolve it.

Our service § Our findings are binding, our recommendations are not (although almost all bodies comply). § We publish all decisions on our website – www. lgo. org. uk § Publish public interest reports where the body does not agree with the recommendations or it is in the public interest to do so. § We are able to conduct joint investigations with the Parliamentary and Health Service Ombudsman (PHSO) where a complaint involves both health and social care.

Our role in adult social care § We are the Social Care Ombudsman § Jurisdiction extended to include independent social care providers operational since October 2010 § We can investigate unresolved complaints about care arranged, funded and provided with or without the involvement of a local council § Providers and councils should clearly and consistently signpost people who make a complaint to the LGO as the final stage of their complaints process § Commissioning and contract arrangements should clearly state how complaints will be handled – the council remains accountable

Local Government Ombudsman and CQC § We both have a role in complaints – can be a complex message for the public § We transfer calls between our organisations to make sure the person speaks to body best placed to help them § We inform CQC where we consider there may have been a breach of Fundamental Standards § We share information about all our investigation decisions to inform their approach to targeted inspections Ø to edit Master text styles

Review of Adult Social Care Complaints § Today we launch our annual Review of Adult Social Care Complaints 2014/15 § 2, 803 complaints and enquiries received during the year § 18% increase on the previous year § 923 complaints about social care provision (residential care, home care etc. ) § 1, 878 complaints about arrangement of social care support by councils § to edit Master text styles

Complaints about Residential Care § Common themes: § Lack of proper consideration of individual needs § Poor communication with residents and family members § Inconsistent and ineffective liaison with other agencies (GPs, pharmacies etc. ) § Incomplete or inaccurate care records § Incorrect administration of medication § to edit Master text styles

Residential Care – case study § Stephen’s father had dementia and had been living in a residential care home for some years when he was asked to find another care home as staff could no longer cope with his deteriorating behaviour. § When moving his father’s belongings, Stephen found a bin liner half filled with his father’s medications and made a complaint. § We investigated and found that medications were incomplete and frequently marked as ‘not given’ or ‘refused’. This had never been raised with a GP and there was no evidence that staff had tried different ways to ensure Stephen’s father had his medication. The complaint was upheld. § We recommended for the care home to review and update its medications policy, apologise and offer £ 500 for the distress caused by moving to another home.

Complaints about Home Care § Common themes: § Failure to provide a service, including being late, not staying long enough or cancelling visits § Receiving care from too many care workers § Care that lacked consideration for the person’s dignity § Failing to seek appropriate and timely medical help § Poor communication between the provider and the council that commissioned the care

Home care – case study § Edith received a care package from her council to support her to get up, have her meals and go to bed. The council commissioned the care from a home care provider. § The provider missed a number visits, failed to attend on time and sent a number of carers to support Edith. The provider also failed to send female carers to put her to bed, on occasion leaving Edith to spend the night in her chair, being put to bed too early, or in her clothes. § Edith’s daughter complained to the council but were left unsatisfied with the response and came the LGO. We investigated and recognised the distress, discomfort and lack of dignity experienced by Edith. § We found the council was at fault as the care it had commissioned was inadequate. The council agreed to make payments to the family to acknowledge the distress caused.

Putting things right § Our recommendations are intended to put the person back in the position they were before the fault occurred. We may recommend: § Apology § Procedural change § Staff training § Financial redress § Reassessment § Reimbursement

Promoting good complaint handling locally § Resources available for providers on our website § My Expectations – a framework § Thematic reports draw together the learning from our complaints to highlight issues to the public, providers, councils and policy makers § Training for councils in good complaint handling, soon to be extended to care providers

Looking Ahead § Previous government consulted on proposals for a Single Public Service Ombudsman § Queen’s Speech announced a draft bill – we expect it to be published in Spring 2016 § We welcome the proposals and want to see: Ø Seamless, simple access for the public Ø Modernised powers and remit Ø Larger role supporting service improvement Ø Retention of sectoral expertise

Messages to take away § Signpost people who make a complaint clearly and consistently to the LGO. § Make sure you are clear with your commissioner or contracts officer about how complaints are to be managed. § Make sure all staff understand their role in complaints - empower staff to resolve matters quickly, where it is appropriate to do so. § Self assess your service against My Expectations – can you demonstrate that you actively welcome concerns and complaints and respond in a way that improves services for others?

Any questions?