Annual Review of Adult Social Care complaints 2020/21
The recently published ‘Annual Review of Adult Social Care complaints 2020/21’ by the Local Government and Social Care Ombudsman pulls together the national picture of complaints about adult social care providers, arranged and funded privately, or by local authorities.
The review outlines critical themes from across the country, and some of the issues raised are extremely worrying. The human impact of these complaints involves poor standards of care, excessive charging and families split apart.
“The gulf between what the public expects and what it actually gets, when it comes to adult social care, has been starkly illustrated by these complaints.”
In the first annual review in 2014, the Ombudsman upheld 46% of the adult social care complaints investigated. In this annual review the figure is 72% – an increase from last year and more than the uphold rate across all other local government casework. This is a cause for alarm, and points to a system in crisis.
Cases that raise serious issues or highlight matters of public interest are given extra prominence and issued as public interest reports; this year the Ombudsman published 12.
It has been a challenging year for adult social care. Throughout the pandemic, those who arrange and deliver care and support have had to respond to significant demands and adjust to new operational realities. Many of the emerging themes in the complaints data are systemic problems that existed before COVID-19, others have been exacerbated by the pandemic.
The complaints raised are progressively caused by financial pressure and the measures employed by councils and care providers to mitigate the squeeze on their resources. This context has been reflected elsewhere, a recent survey from the Association of Directors in Adult Social Services highlighted a growing disconnect between increasing social care need and the financial ability and confidence of local authority Directors to meet that need.
“Increasingly this is a system where exceptional and sometimes unorthodox measures are being deployed simply to balance the books – a reality that is frequently pleaded in defence by the councils we investigate.”
At a time of pressure in the care system it is more important than ever to listen to public concerns. The review makes the case for more to be done by increasing awareness of adult social care complaint systems, increasing transparency around how care providers manage complaints, and better support for providers to learn and improve when things go wrong.
Emerging themes from the review:
- Delayed assessments preventing timely discharge from hospital and moves between providers
- Poor communication between hospitals and care homes, both working in crisis conditions
- Care settings and councils being inflexible and failing to properly communicate access to and availability of services, particularly when lockdown rules changed
- Care providers failing to manage risk appropriately, for example around the use of PPE and with symptomatic staff
- Prolonged delays in accessing occupational therapy services and assessment and provision of aides and adaptations
Learning from complaints
The law is clear that councils remain accountable for the actions of care providers they commission. Naturally while care matters primarily affect county and unitary authorities, there may also be an interface with services provided by lower tier councils.
It’s for individual councils to consider how they respond to the emerging themes in the latest annual review, and how they satisfy themselves that concerns are being dealt with area by area. But there is no question that scrutiny should be exploring these issues too. Scrutiny can support the delivery of services and learning from complaints by challenging those providing these services to account for their decisions and actions.
By looking at the big picture, scrutiny can examine trends and patterns in complaints data to identify underlying problems, and improve the design and delivery of local care services in the future. By listening to residents, scrutiny can understand the experiences of people who use services, and their families, to offer the crucial insight that providers and commissioners need to deliver quality services.
Crucially, scrutiny also provides the public forum for councillors to escalate concerns about services, for example if there are several separate complaints about a certain service or individual.
Using the data published by the Ombudsman, alongside local information, will help scrutiny assess how effectively lessons are learnt from complaints. By using the suggested questions on the last page of this latest annual review, scrutiny can check the health of the council’s approach to complaints (as well as the approach of the services it commissions).
As the government strives to improve the national assurance framework for social care, meaningful local engagement with the public relating to life and limb services such as these needs to be top of the agenda.