Complaints and feedback annual report 2023 - 2024
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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
1. Context
This year, the Adult Social Care department supported over 27,700 people aged 18 and over living in East Sussex to live healthy and independent lives, whatever that may look like for them.
The department also had lead responsibility for safeguarding adults at risk of harm by others. It received and responded to over 6,100 reports of concerns or allegations of adult abuse during the year.
2. Overview of complaints
This year the Complaints and Feedback Team recorded 376 complaints about Adult Social Care & Health, compared with 430 last year.
We have continued to strengthen our complaints duty function to provide a person centred and resolution focussed approach, helping to resolve matters before going into the complaints process. This year we resolved 547 enquiries out of a total of 560 Just 13 (2%) enquiries could not be resolved through this triage approach.
| Year | Number of complaints |
|---|---|
| 2023-24 | 376 |
| 2022 – 23 | 430 |
| 2021 – 22 | 342 |
| 2020 – 21 | 255 |
| 2019 – 20 | 399 |
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.
| Service | Number of complaints | Upheld and partly upheld | Average time to respond |
|---|---|---|---|
| Adult Social Care Operations |
303 (351) |
139 = 46% (51%) |
31 days (36 days) |
| Strategy, Commissioning and Supply Management | 27 (20) | 11 = 41% (45%) | 30 days (30 days) |
| Planning, Performance and Engagement | 3 (7) | 2 = 67% (57%) | 14 days (22 days) |
| Independent providers – home care agencies, residential and nursing homes | 43 (51) | 16 = 37% (53%) | 46 days (30 days) |
| Public Health | 0 (1) | N/a (0%) | N/a (10 days) |
| Total | 376 (430) | 168 = 45% (51%) | 33 days (34 days) |
2.3 Upheld complaints
Just under half (45%) of the complaints recorded were upheld in full or in part.
2.4 Target response times for ASCH
Our target time for responding to complaints is 10 to 20 working days, where possible.
This year:
- 31% (118) of complaints received a response within our target times.
- 59% (222) complaints did not receive a response within the timescales. In these cases, complainants were given progress updates.
- 10% (36) were still open at the time of reporting.
Going forward we will continue to aim to respond to complaints within our target time but recognise that the resolution of complaints may take longer to implement.
2.5 Comparison with last year
Overall, there has been a 12% decrease in complaints received about Adult Social Care & Health, including external independent providers, compared to last year. This is a decrease of 54 complaints.
- The proportion of complaints upheld in full or in part has decreased from 51% in 2022 - 23 to 45% in 2023 - 24.
- 31% of complaints received a response within our target times of 10 to 20 working days, compared to 33% in 2022 – 23.
- 52% of complaints received a response within 30 working days, compared to 55% in 2022 - 23.
- Timescales for independent providers to respond were longer than last year, rising to 46 working days from 30 working days. These complaints would typically involve other services too.
3. Complaints about Adult Social Care & Health 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. Details of these complaints can be found on pages 8 to 9.
| Adult Social Care & Health services | Number and percentage of complaints upheld 2023 – 24 | Number and percentage of complaints upheld 2022 – 23 |
|---|---|---|
| Blue Badge Team | 15 27% | 10 30% |
| Continuing Health Care Team | 3 0% | 0 0% |
| Countywide Reviewing Team | 1 100% | 2 0% |
| Emergency Duty Service/Approved Mental Health Practitioner Team | 4 25% | 0 0% |
| Financial Assessment and Charging | 59 64% | 90 67% |
| Health and Social Care Connect | 6 50% | 9 33% |
| Hospital Assessment and Care Management Teams | 57 49% | 31 39% |
| Joint Community Rehabilitation Service | 1 100% | 3 33% |
| Learning Disability – Assessment and Care Management | 16 50% | 25 56% |
| Learning Disability Directly Provided Services (Day Care, Community Support, Residential and Respite) | 2 100% | 1 0% |
| Mental Health and Substance Misuse Teams (working age adults) | 32 26% | 49 39% |
| Mental Health Older People’s Team (over 65 years) | 14 64% | 24 63% |
| Deprivation of Liberty Safeguards Team | 1 100% | 0 0% |
| Neighbourhood Support Teams | 64 33% | 86 51% |
| Occupational Therapy Reablement Services | 4 50% | 8 25% |
| Older People’s Directly Provided Services (Day Care, Respite, Residential) | 5 60% | 2 50% |
| Planning, Performance and Engagement | 3 67% | 7 57% |
| Public Health | 0 0% | 1 0% |
| Safeguarding Development Team | 2 0% | 1 0% |
| Sensory Impairment Reablement Services | 3 67% | 0 0% |
| Supply Management | 16 44% | 6 50% |
| Support with Confidence | 1 0% | 0 0% |
| Strategic Commissioning | 10 40% | 14 43% |
| Transition Team | 14 57% | 10 40% |
| Total | 333 45% | 379 50% |
You may notice:
- Hospital Assessment and Care Management Teams saw an 83% increase in complaints compared with last year. Uphold rates were also higher at 49% compared with 39% last year. This may reflect recruitment challenges and the continued pressures on hospital discharges to the community.
- Financial Assessment and charging recorded 59 complaints compared with 90 last year. This is a reduction of 34% and is a likely outcome of the review of the Direct Payments and Financial Assessment processes. It is of note that the number of complaints partly/fully upheld (64%) is higher than the departmental average of 45%.
- Mental Health and Substance Misuse Services recorded 35% less complaints with just over a quarter upheld (26%). This is13% less than last year.
- Neighbourhood Support Teams have seen a 26% reduction in complaints, alongside an 18% reduction in the number of complaints upheld (33%). Emphasis on strength-based assessments and the use of the appeals process to achieve an agreed care and support plan may be contributory factors.
- The Joint Community Rehabilitation Service recorded 1 complaint compared with 1,286 compliments recorded for this year. The support provided by both health and social care professionals to regain independence within the community is clearly valued highly.
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 | 0 (1) | 0% (0.3%) |
| Allocation of funding / grants | 11 (20) | 3% (5%) |
| Appeal | 1 (2) | 0.3% (0%) |
| Assessment | 80 (97) | 24% (26%) |
| Care plan | 0 (1) | 0% (0.3%) |
| Carer’s assessment | 3 (2) | 0.9% (0.6%) |
| Carers’ services | 0 (1) | 0% (0.3%) |
| Consultation and engagement | 0 (1) | 0% (0.3%) |
| Contracts | 1 (0) | 0.3% (0%) |
| Data protection | 0 (4) | 0% (1%) |
| Direct payments administration | 6 (22) | 2% (6%) |
| Employee enquiries | 0 (0) | 0% (0%) |
| Equipment – adaptations | 1 (2) | 0.3% (0.6%) |
| Equipment – daily living | 12 (8) | 4% (2%) |
| Hospital discharge | 23 (14) | 7% (4%) |
| Information provision | 31 (22) | 9% (6%) |
| Initial contact | 0 (4) | 0% (1%) |
| Invoicing | 46 (38) | 14% (10%) |
| Mental capacity assessment | 1 (3) | 0.3% (1%) |
| Policy | 10 (10) | 3% (3%) |
| Provision of service | 78 (83) | 23% (22%) |
| Review | 3 (6) | 1% (2%) |
| Safeguarding enquiry | 15 (11) | 5% (3%) |
| Service environment | 0 (0) | 0% (0%) |
| Service user behaviour | 0 (2) | 0% (0.6%) |
| Staff actions / behaviour | 11 (25) | 3% (7%) |
3.2 Themes of complaints
3.2a Assessment
The biggest area of complaints related to assessment, which was just under a quarter (24%) of all complaints received (80 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. Also, financial assessments, which find how much someone will pay towards their support.
| Complaint type | Number of complaints | % of total |
|---|---|---|
| Assessment – Social Care | 34 (51) | 10% (15%) |
| Assessment – Financial | 36 (39) | 11% (10%) |
| Assessment – Blue Badge | 10 (7) | 3% (2%) |
Just over half of the complaints (41) in relation to assessment were upheld or partially upheld. Of these, just over a third (14 complaints) were in relation to a delay.
| Complaint primary cause | Number of complaints | % of total complaints upheld in relation to assessments |
|---|---|---|
| Delay in doing something | 14 | 34% |
| Not to the quality or standard expected | 9 | 22% |
| Unhappy with decision | 7 | 17% |
3.2b Provision of service (last year’s figures and percentages are in brackets)
The second biggest area of complaints related to provision of service, which was just over a fifth (23%) of all complaints received (78 complaints).
37 complaints (47%) were upheld or partially upheld in relation to provision of service. Of these, just over half (20 complaints) were in relation to the service not being to the quality or standard expected.
| Complaint primary cause | Number of complaints | % of total complaints upheld in relation to provision of service |
|---|---|---|
| Not to the quality or standard expected | 20 | 53% |
| Delay in communication | 5 | 14% |
| Delay in doing something | 3 | 8% |
3.2c Invoicing
The third biggest area of complaints related to invoicing, which was 14% of all complaints received (46 complaints).
21 complaints (46%) were upheld or partially upheld in relation to invoicing.
| Complaint primary cause | Number of complaints | % of total complaints upheld in relation to Invoicing | |
|---|---|---|---|
| Disagree with charge received | 13 | 62% | |
| Other payments or disputed charges cause | 5 | 24% |
Complaints about charges were often related to people not being aware they would be charged for services and/or the service itself falling below expectation. We have reviewed our information on charges for services and are launching a consultation to help people understand more about what ASC does and how much it costs.
4. Complaints about external providers
We pay for external providers to deliver a lot of our care and support services. For example, residential care, nursing care, supported accommodation, shared lives, home care and telecare equipment. We have recorded 43 complaints this year about external providers, which is slightly lower than last year, when 51 complaints were recorded. Of the complaints recorded this year:
-
37 related to community services including:
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Home care providers - 31
-
Home alarm care systems - 5
- Supported accommodation -1
-
- 5 were about residential care providers.
The number of complaints recorded by the department for external providers is low compared with the volume of services delivered. As commissioners of the service, we will become involved when the provider has not been able to resolve matters through their own complaints process.
We expect providers to be fair, open and responsive to all complaints about their service.
4.1 Response times
- 1 (2%) of the complaints received a response within 10 working days.
- 4 (9%) of the complaints received a response within 20 working days.
- 31 (70%) 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 increased from 30 days in 2022 – 23 to 46 days in 2023 – 24.
4.2 How many complaints about external providers were upheld?
Out of the 43 complaints received for external providers:
- 16 (39%) of the complaints were upheld in full or part.
- 19 (43%) were not upheld.
- 8 (18%) were still open at the time of reporting.
4.3 Types of complaints about external providers
Of the 16 complaints upheld, concerns were about one or more of the following:
- charging or invoicing issues.
- service fell below expectation.
- delay in provision of service.
- staff behaviour or actions.
5. Local Government & Social Care Ombudsman
After our final response at local resolution, people can ask the Local Government and Social Care Ombudsman (the Ombudsman) to review their complaint if they still are 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 85 complaints for the Council, of these, 27 (32%) related to ASC, like the previous year when 33% were about ASC.
| Year | Investigations Upheld | Investigations Not upheld | Closed at Initial enquiries | Invalid/ complete | Referred back | Advice Given | Total |
|---|---|---|---|---|---|---|---|
| 2023/24 | 13 | 2 | 8 | 1 | 8 | 0 | 32 |
| 2022/23 | 6 | 3 | 8 | 3 | 7 | 1 | 28 |
| 2021/22 | 17 | 4 | 7 | 4 | 6 | 0 | 38 |
The LGSCO decided on 32 complaints, compared with 28 the previous year. This is a 14% increase. 87% of investigations were upheld. Of these, most had been upheld by the council already, but the LGSCO made additional recommendations to remedy the impact on the people involved and improve services for people who might use the service in the future.
Examples of service improvement recommendations included:
- Remind relevant staff of the importance of keeping the adult who is the subject of a safeguarding enquiry at the centre of the enquiry.
- Remind staff and, if necessary, provide training about how to assess capacity where there is fluctuating capacity, in particular cases where there is substance misuse. Review policies and procedures so they address assessing and supporting people with fluctuating capacity. Remind staff about taking prompt action in response to safeguarding concerns and to follow action plans and include them as part of the care management process if they arise out of safeguarding. Remind staff and review procedures about the need for personalised housing plans and when individuals should receive them.
- Take action to ensure staff maintain appropriate boundaries when dealing with colleagues who are acting as members of the public.
- Ensure a local adult social care provider issues a reminder to all staff about staying the full length of time and to log in and out correctly using the electronic call monitoring system.
The department completed all the recommendations made in these investigation decisions.
All the investigation decisions are published on the LGSCO website and can be found using this link: Your council’s performance (lgo.org.uk)
6. Learning and actions from complaints at our local resolution stage
Learning from complaints to improve our services, at local resolution is important to us. We have increased our focus on making sure that every complaint that is upheld helps us improve services. We have recorded 258 actions in total, including an apology with:
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individual staff development through supervision, coaching and training.
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team development through discussion, revisiting information and guidance.
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service and organisational development through policy reviews, improvement projects, training, and communication.
Here are a few examples of learning this year:
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In our 2022/2023 report we reported the review of the Direct Payments process for care and support. The review considered the information shared with people to ensure it was provided at an earlier stage in the process and was informative and accessible. It also developed how teams worked together to achieve quicker and smoother outcomes. This year we recorded 6 complaints about the Directs Payments process compared with 22 in 2022-2023, this represents a 73% reduction.
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To avoid delay and improve collaborative working, our Appointee and Deputyship Team have reviewed their process for circumstances where a person dies without being in contact with family and a funeral needs to take place.
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Related to Domestic Abuse, Harassment and Stalking risk management, we have revised the guidance in the Multi Agency Risk Assessment Conference (MARAC) Operating Protocol that governs the MARAC process. It now makes it clear when letters that show a MARAC discussion, should be issued.
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Work is underway to review waiting times for assessment. This includes supporting teams to run a consistent approach to waiting lists, and to provide helpful and consistent information to people who are waiting for an assessment.
7. Compliments
Compliments provide valuable information about the quality of our services and show where they are working well. The sincere expressions of gratitude we have recorded prove how much these services are valued by people who use them and their families and friends.
This year, we recorded a total of 2,307 compliments. ASCH has continued to receive far more compliments (2,307) about our services than complaints (376). This year the ratio per compliment to complaint is 6.1 compared to 4.3 last year.
| Adult Social Care Teams | Total for 2023 – 2024 |
|---|---|
| Blue Badge Team | 10 |
| Continuing Health Care Team | 5 |
| Countywide Reviewing Team | 3 |
| Deprivation of Liberty Safeguards Team | 2 |
| Emergency Duty Service | 0 |
| Finance | |
| Appointee and Deputyship | 2 |
| Direct Payments | 2 |
| Finance and Benefits | 21 |
| Protection of Property | 0 |
| Revenue Team | 1 |
| Service Agreement | 2 |
| Health and Social Care Connect | 8 |
| Hospital Teams | 36 |
| Community Learning Disability Team | 32 |
| Learning disability - Directly Provided Services | |
| Respite (Grangemead, Greenwood) | 30 |
| Day Care (Beeching Park, Hookstead, Linden Court) | 9 |
| Employment (Steps to Work) | 27 |
| Learning Disability Transitions Team | |
| Mental Health | |
| Mental Health and Substance Misuse Teams | 31 |
| Mental Health Older Peoples Teams | 11 |
| Mental Health Specialist Services | 5 |
| Occupational Therapy | |
| Occupational Therapy Housing | 20 |
| Occupational Reablement Teams | 44 |
| Sensory Impairment Reablement Services | 11 |
| Older Peoples Directly Provided Services | |
| Carers Breaks/Dementia Teams | 375 |
| Joint Community Rehabilitation Service | 1286 |
| Milton Grange | 49 |
| Partnership/HFU Team | 8 |
| Planning, Performance and Engagement | 12 |
| Safeguarding | 0 |
| Strategy, Commissioning and Supply Management | 0 |
| Support With Confidence | 35 |
| Shared Lives & Supported Accommodation (SAILS) | 61 |
| Total | 2264 |
| Listening 2 You survey feedback | Total for 2023 – 2024 |
| Overall Adult Social Care & Health | 15 |
| Finance | 4 |
| Homecare | 19 |
| Residential | 5 |
| Total | 43 |
8. Conclusion
Currently, there is increasing demand for care and support, this is alongside pressures on budgets, staffing and access to services. We also know there are health inequalities for some groups of people in our communities. We want to overcome any barriers, to ensure people experience the best care and support possible.
Complaints and feedback give us valuable information about what’s not working so well, and what people particularly value.
This year, feedback shows that people have valued being listened to, being kept informed and being supported to regain their independence when they are at their most vulnerable. People have been frustrated by delays in assessments and difficulties in contacting teams to get information about what’s happening next. The cost of living is worrying people, and is, at times, influencing the care and support they will accept.
We don’t always get things right, but we do always try to learn from our mistakes. We have responded to peoples’ concerns and focussed on sorting things out quickly and fairly. The actions we have agreed to improve other people’s experience in the future have been wide ranging, and the current project on understanding and managing waiting times better, is an example of this. We will continue to strengthen how we use positive and negative feedback to improve services through 2024 and 2025.