Complaints and Lone Working

C o m p l a i n t s a n d L o n e W o r k i n g. This training module will detail how to handle complaints and provide guidance around lone working. This forms part of you statutory mandatory training. Aims and Intended Outcomes W hy t h e r e n e e d s t o b e a c o m p l a i n t s p r oc e d u r e How to handle complaints in the correct way Ho w t o r e m a i n s a f e wh e n w or k in g i n i s ol a t ion Complaints Handling W h a t i s a c omp l a i n t? According to NHS Choices, complaint policy “A complaint is an expression of dissatisfaction requiring a response, communicated verbally, electronically, or in writing. Complaints may be made by any users of our service”. Why do you need to follow a complaints procedure? During the course of your work in the healthcare sector you may encounter complaints against you and you need to ensure that these complaints are dealt with professionally and in accordance with your organisation’s complaints procedure. Your organisation or agency you work for will have a complaints procedure and it is important that you follow this when any person makes a complaint about you or the service your department has provided so that: The matter can be investigated by your organisation A ny i n v e s t i g a t i o n ca n i dent i f y t he t r u t h The individual complaining can have correct feedback You and your colleagues can learn from the situation A breeding ground for complaints All organisations will receive complaints from time to time but a Healthcare environment can be a breeding ground for heightened emotions, which can lead to complaints. It’s really important that you are aware of the causes of conflict which you should be aware of and try to minimise as much as possible: Lon g wa i t in g t im e s A p p oi n t m e nt dela y s C a nc e l l e d a pp o in t m e n t s C r owd e d e nviron m e n t s I nsu f f ici e nt s t a ff i ng l e v e ls L a c k o f k nowl e dg e b y s t a ff P r e ss u r e o n s t a ff P oo r cus t o m e r se r vic e f r o m s t a f f C o m m u n ic a t io n br e a k d o w n.

Poorly people – pain, illness, fear, anxiety, mental illness Patients who are under the influence of drugs or alcohol NHS Complaints handling The NHS publishes complaints policies to guide the service users through how to make a complaint and what to expect. NHS England’s policy can be found on the following link: https://www.england.nhs.uk/wp-content/uploads/2016/07/nhse-complaints-policy-june-2017.pdf T h e N HS Choice s w e b s it e contai n s a co m plai n t s po li c y w h ic h can b e fo un d: https://www.nhs.uk/about-the-nhs-website/aboutnhschoices/aboutus/documents/120117-nhs- choices-complaints-policy-v2-d01.pdf This policy was written in conjunction with the Care Quality Commission, the Department of Health complaints procedure and the Parliamentary and Health Service Ombudsman. The Parliamentary and Health Service Ombudsman – PHSO The organisation which deals with complaints from the general public about the NHS where an individual is perhaps dissatisfied by the outcome of an investigation or the way in which a complaint has been handled by the NHS. This organisation offers guidance as to the best way to conduct an investigation into a complaint. This organisation also promotes best practise within public bodies to ensure complaints are dealt with professionally and fairly. They believe that everybody has the right to good treatment and to expect a good service. In November 2008 the Parliamentary and Health Service Ombudsman published a report called “Principles of Good Complaint Handling”, stating that “ Good complaint handling should be led from the top, focused on outcomes, fair and proportionate, and sensitive to complainants’ needs. The process should be clear and straightforward, and readily accessible to customers. It should be well managed throughout so that decisions are taken quickly, things put right where necessary and lessons learnt for service improvement. In many of the complaints investigated by the Ombudsman we have found that poor complaint handling itself constituted maladministration or service failure leading to an injustice or hardship for the complainant. This was so even in cases in which we did not uphold the original complaint. The Principles set out here are intended to promote a shared understanding of what is meant by good complaint handling and to help public bodies in the Parliamentary and Health Service Ombudsman’s jurisdiction deliver first-class complaint handling to all their customers.” T he 6 P r inci p l e s o f g oo d co m p l a i nt h a n d lin g a r e : G e tt in g i t r ig ht B e in g C us t o m e r f ocus e d B e in g o p e n a nd a cc o u n t a b l e Acting fairly and proportionately P ut t i ng t hings r ig h t S e e k in g co n t in u ou s i m p r ov e m e nt.

Getting it right Good complaint handling requires strong and effective leadership within your organisation and those at the top should lead the way in ensuring there is a culture of good complaint handling and that this works in practice. An organisation should: set the complaint handling policy, and own both the policy and the process give priority and importance to good complaint handling, to set the tone and act as an example for all staff develop a culture that values and welcomes complaints as a way of putting things right and improving service b e r e s p ons i b l e a n d acc o un t a b l e f o r co m p l a i nt h a n d l ing ensure that effective governance arrangements underpin and support good complaint handling ensure the policy is delivered through a clear and accountable complaint handling process ensure learning from complaints is used to improve service. Being customer focused Your organisation should ensure their complaints procedure is simple and clear, involving as few steps as possible. Having too many complaint handling stages may unnecessarily complicate the process and deter complainants from pursuing their concerns. Ensure that their complaint handling arrangements are easily accessible to their customers. Let their customers know about any help or advice that may be available to them if they are considering making a complaint. For example, Community Legal Advice offers wide-ranging legal advice and the Independent Health Complaints Advocacy Service (IHCAS) provides advocacy for NHS complainants. Deal with complaints promptly, avoiding unnecessary delay, and in line with published service standards where appropriate. Resolving problems and complaints as soon as possible is best for both complainants and public bodies. Acknowledge the complaint and tell the complainant how long they can expect to wait to receive a reply. Public bodies should keep the complainant regularly informed about progress and the reasons for any delays and provide a point of contact throughout the course of the complaint. Treat complainants sensitively and in a way that takes account of their needs. Use language that is easy to understand and communicate with the complainant in a way that is appropriate to them and their circumstances. For example, public bodies should make arrangements for complainants with special needs or those whose first language is not English. Listen to and consider the complainant’s views, asking them to clarify where necessary, to make sure the public body understands clearly what the complaint is about and the outcome the complainant wants. Respond flexibly to the circumstances of the case. This means considering how the public body may need to adjust its normal approach to handling a complaint in the particular circumstances. Ensure, where complaints raise issues about services provided by more than one public body, that the complaint is dealt with in a co-ordinated way with other providers. If a public body cannot respond, it should refer the complainant quickly to other sources of help. Being open and accountable You and your organisation should do the following:.

Ensure that information about how to complain is easily available. Your organisation should provide clear, accurate and complete information to their customers about the scope of complaints the organisation can consider; what customers can and cannot expect from the complaint handling arrangements, including timescales and likely remedies; and how, when and where to take things further. Be open and honest when accounting for your decisions and actions. You should give clear, evidence- based explanations, and reasons for your decisions. When things have gone wrong, you and your organisation should explain fully and say what they will do to put matters right as quickly as possible. Create and maintain reliable and usable records as evidence of their activities. These records should include the evidence considered and the reasons for decisions. Public bodies should manage complaint records in line with recognised standards to ensure they are kept and can be retrieved for as long as there is a statutory duty or business need. This can include the need to respond to complaints or to provide relevant information to the Ombudsman. Handle and process information properly and appropriately, in line with the law and relevant guidance. So while the policies and procedures should be transparent, your organisation should also respect the privacy of personal and confidential information, as the law requires. Take responsibility for your actions and your organisation should take responsibility for their staff’s and t hose a c t in g o n beha l f o f t he p u b li c b o d y . Acting fairly and proportionately Your organisation and you should do the following: Understand and respect the diversity of the customers and ensure fair access to services regardless of background or circumstances. Investigate complaints thoroughly and fairly, basing the decisions on the available facts and evidence, and avoiding undue delay. Deal with complaints objectively, fairly and consistently, so that similar circumstances are handled similarly. Any different decisions about two similar complaints should be justified by the circumstances of the complaint or complainant. Seek to ensure, where a complaint relates to an ongoing relationship between the public body and complainant, that staff do not treat the complainant any differently during or after the complaint. Avoid taking a rigid, process-driven, ‘one-size-fits-all’ approach to complaint handling and ensure the response to an individual complaint is proportionate to the circumstances. This means considering the seriousness of the issues raised, the effect on the complainant, and whether any others may have suffered injustice or hardship as a result of the same problem. Ask a member of staff who was not involved in the events leading to the complaint to review the case. The public body can still put things right quickly for the complainant where appropriate. Act fairly towards staff as well as customers. This means ensuring members of staff know they have been complained about and, where appropriate, have an opportunity to respond. P u tt i n g th i n gs righ t Often a service user is looking for an apology and reassurance of remedial action but depending on the severity of the case they may be seeking more than this, such financial compensation. Putting things right for the complainant is very much dependent on the severity of the situation and any decisions need to be proportionate..

Seeking continuous Improvement Investigating a complaint can be an opportunity to identify areas for improvement so that mistakes or bad service can be rectified and prevented in the future. All organisations and individuals within the health sector should be se e k in g co n t in u ou s i m p r ov e m e nt t o t he se r vic e t h e y p r ov i d e . Complainants like to hear about changes or recommendations which have come about because of their complaint as they can feel justified in complaining and reassured that things issues won’t repeat. How to categorise complaints The NHS complaints procedure and BMA toolkit offers advice on how to categorise complaints and in turn how to give a proportionate response: S te p 1 – Deci d e h ow s eriou s t h e is s u e is.

S te p 3 : C a te g o ri s e t h e ri s k. RARE UNLIKELY POSSIBLE LIKELY ALMOST CERTAIN LOW Low Low Low Moderate Moderate MEDIUM Low Moderate Moderate/High High Extreme HIGH Moderate High High Extreme Extreme.

Speech and language therapy staff; P hysi o t h e r a p is t s a n d O cc u p a t i on a l T h e r a p is t s. As a Lone Worker you may be vulnerable to increased risk of physical or verbal abuse and harassment form patients, clients and their relatives. They may also be at risk from members of the public of exposed to a variety of hazards that other workers are not exposed to. Because of this, there is a need to risk manage these workers and their environments and ensure there are a robust set of guidelines and a range of safety advice for lone wo r k e r s o r t h o s e wo r k i ng i n iso l a t io n t o f ol l ow. It is important that your safety and that of your service users is considered when working in isolation and your organisation should have policies and procedures in place for you to follow. This short module will talk you through some key safety advice to help you safeguard against any incidents. Organisational responsibilities Policy guidelines – Should be written and available to all staff members who may be exposed to wither working in isolation in a building or if their job requires them to be Lone Working. Risk assessments – need to be carried out to ensure that all possible measures are taken to protect lone workers. Training should be given – To all staff members, agency workers and contractors who me work in isolation or become lone workers. Incident monitoring – Any incidents occurring because of working in isolation or lone working need to be reviewed by the organisation for continuous improvement purposes. Your responsibilities Making sure that risk assessments are carried out and reviewed regularly and that you are involved in the process and copied into the risk assessment; Taking reasonable care of yourself and other people who may be affected by your actions; Co-operating by following rules and procedures designed for safe working; Reporting all incidents that may affect the health and safety of yourself or others and asking for guidance as appropriate; Taking part in training designed to meet the requirements of the policy; Reporting any dangers you identify or any concerns you might have in respect of working alone. General advice and guidance Lone working or ‘working in isolation in a building should be avoided where possible but it is sometimes necessary or part of a person’s job role. If you are working alone in an isolated building or part of a building you should: When treating a patient, you must ensure there is another professional present if you know someone may present a risk. If you are working alone in an isolated part of a building, ensure you have colleagues on standby to assist if need be. Make sure you are using all security measures available to you, like lock access..

When retrieving your car in an isolated car park make sure you: Park somewhere well-lit in a busy area with people and buildings around. H a v e your k e y s a t h a n d w h e n you r e t u r n t o y o ur car. C a rr y a t or c h wi t h you Make sure nobody is loitering when you are about to approach your car Always reverse into your space so you can drive away quickly and use your doors as a barrier. Have a good look around you before you get into your car. Do not leave your bag on the roof or bonnet. Check your car for any signs of tampering before you get in Travelling by car Keep your car regularly maintained so you reduce the risk of break downs. Loc k a l l your d oor s a s s oo n a s you g e t in t o y ou r car. Do n o t l e a v e v a l u a b l e s i n p l a i n sigh t . V a r y your r o u t e s Do not leave items which can personally identify you in your car Do not get boxed in whilst driving or when stationary in traffic Walking on Foot W a l k w i t h p u r p ose C a rr y y o ur k e ys, m o n e y a n d I D o n yo u . W a l k i n t he m i d d l e o f t he wa l k w a y Make sure your route is well lit and well popularised. W a l k f a cin g t he t r a f f ic Do n o t s t o p t o l o o k a t m a p s i n f ull vi e w If you feel that someone might be following you and you need to get away, walk fast rather than running and cross the street. Taxis A l l t a x i s sho u l d b e b oo k e d i n a d v a nce U s e r e p ut a b l e t a x i co m p a ni e s Agree a place to meet/greet which is well lit and popularised. Be aware of central locking, child locks and ensure you know how to get out of the car if you need to N e v e r g iv e ou t p e r so n a l in f o r m a t i o n t o t he driv e r Mobile Communications Have a back up to your preferred method of communication E nsure your devic e s a r e a l w a y s char g e d Make sure they are easily accessible in case of an emergency P ut e m e r g e ncy cont a c t s o n s p ee d di a l o n your m o b i l e p h o ne A g r e e cod e wo r d s wi t h coll e a g u e s.

Continual assessment Although your organisation will have carried out risk assessments, you have a duty and a responsibility to continually assess and review your working environment and to raise any concerns you may have. If you are concerned about your personal safety, you need to bring these concerns to the attention of your line manager..