On 29 September 2021, the Local Government and Social Care Ombudsman (the Ombudsman) published its annual review of social care complaints. The review notes that a record number of complaints were upheld. The review pulled no punches in terms of the impact of inadequate funding, concluding that the care system ‘is increasingly failing to deliver for some of those who need it most’ and that in many cases the failings identified were the result of ‘exceptional and sometimes unorthodox measures being deployed simply to balance the books’.
The review identifies a number of emerging themes, many arising from the impact of the pandemic, including; delayed assessments preventing timely discharge from hospital and moves between providers, poor communication between hospitals and care homes both working in crisis conditions, care providers failing to manage risk appropriately (for example around the use of PPE and with symptomatic staff) and prolonged delays in accessing occupational therapy services and assessment and provision of aides and adaptations.
While the review makes for uncomfortable reading, it is refreshing to see those charged with upholding standards in the sector reflecting the reality of the pressures faced by providers. That is in stark contrast to the approach taken by the CQC, outlined in my ebriefing here.
Given the risk that the CQC will make no allowance for the pressures faced by providers, it is all the more important that every effort is made to ensure that appropriate funding is secured to provide safe and effective care. The Ombudsman highlights that in some cases councils are deliberately flouting the law due to funding pressures; as a result, providers should not be afraid to challenge commissioning decisions that fail to give people the care they need and are entitled to.
The review also highlights the valuable role that complaints can play in driving improvement, noting that ‘complaints are a cost-effective way to identify concerns and issues early and drive improvements; the best organisations will view them as central to good governance and accountability’.
That approach will not only assist providers in avoiding complaints being escalated to the Ombudsman but may also prove invaluable in adapting to the CQC’s new regulatory regime. With inspections increasingly focused on risk and taking place as a result of complaints, providers should use complaints and concerns raised as an early warning signal. The response should be to actively consider what lessons can be learned, review the suitability of policies and procedures and check the effectiveness of training and supervision. Where a review of a complaint identifies that mistakes have been made, management should actively consider why it has taken a complaint to bring this to their attention and what additional measures, support and guidance is required to ensure that expected standards are being met.
“Viewed through the lens of complaints from the public, and our impartial findings, the adult social care system is progressively failing to deliver for those who need it most. “Increasingly it is a system where exceptional and sometimes unorthodox measures are being deployed simply to balance the books – a reality we see frequently pleaded in their defence by the councils and care providers we investigate.