Ombudsman sees rise in systemic, policy and procedural issues in social care

The Local Government and Social Care Ombudsman has warned of growing problems with systems, policies and the way procedures are being applied in social care, saying it was “no longer just one-off mistakes.”

Michael King’s comments came at the launch of the Ombudsman’s annual review of adult social care complaints.

The report reveals a 9% increase in complaints about charging. Of those complaints, it is upholding 67% - higher than the average uphold rate for adult social care of 62%, and greater still than the 57% uphold rate for all complaints the Ombudsman investigates.

Mr King said: “Assessment and care planning, and how care is paid for, remain some of the biggest areas of complaint. Even more concerning is that the issues we see demonstrate a shift from one-off mistakes to problems with whole systems and policies, or procedures being incorrectly applied.

“Adult social care has seen sustained high levels of complaints upheld compared to our general work. We know authorities are operating under an enormous amount of pressure and financial challenge to deliver care services. The stark reality of this is now playing out in the complaints we see.

“Despite this, when it comes to service delivery, we simply can’t make concessions for these pressures in the recommendations we make.”

The report also reveals that over the past year, the Ombudsman has made 274 recommendations to authorities and providers to improve procedures or undertake staff training – a 19% increase on the previous year.

In the past year, the Ombudsman has seen only one instance of an authority or care provider failing to comply with its recommendations.

Mr King said: “We are issuing this report because we want to work with the sector to share the wider learning and help improve services.

“Despite the problems we are seeing, I welcome local authorities and care providers’ willingness to work with us to improve services for people in their care, and the way they have complied with our recommendations over the past year.”

Professor Martin Green OBE, Chief Executive of Care England, said: “The LGSCO annual report on social care complaints is a valuable resource for councils and providers to learn from others and see trends.

“We welcome the fact that the LGSCO recognises that compliance with its recommendations continues to be high amongst providers, showing how providers want to put things right. We urge providers to use all the resources the LGSCO can offer to providers including practical advice on complaints handling and provider training events.”

Andrea Sutcliffe CBE, Chief Inspector of Adult Social Care at the Care Quality Commission (CQC), said: “In the current challenging circumstances for adult social care, it’s more important than ever that those in charge of running and commissioning care services actively listen and learn from people’s experiences, concerns and complaints. 

“CQC sees regular evidence of this in the four fifths of adult social care services currently rated as good or outstanding across the country, but as this report from the Local Government and Social Care Ombudsman once again highlights this isn’t the case for everyone. Ensuring complaints policies are accessible, that people know how to raise issues, their concerns are responded to and any promised action really does happen is all part of delivering truly responsive and well-led care.”

Responding to the Ombudsman’s report, Glen Garrod, President of the Association of Directors of Adult Social Services (ADASS), said: “We want people and their families who use adult social care services to receive high quality information, advice, care support and, if necessary safeguarding, and this is an important report which provides helpful recommendations on how councils can improve services as well as feedback as to where things have improved.

“It is essential that people who use services and their families have an opportunity to feed back so complaints can be addressed and rectified both for the individual in question, and for others.

“The report acknowledges that councils are operating under huge pressures and financial challenges and that this is now being reflected in some of the complaints seen. It is also important to note that the report welcomes how councils and care providers have worked with the Ombudsman to improve services and complied with recommendations over the past year.”

Cllr Ian Hudspeth, Chairman of the Local Government Association’s Community Wellbeing Board, said: “Councils’ priority is supporting people to live the lives they want to lead and therefore take all complaints about adult social care extremely seriously.

“The number of complaints since 2010, which includes people who privately fund their care, has increased but, as the report acknowledges, this may reflect the fact more people are comfortable raising concerns because providers and councils are listening and learning. This is reflected in the fact that the overwhelming majority of local authorities or care providers complied with the Ombudsman’s recommendations.

“The percentage of overall complaints upheld has fallen slightly in the last year, and councils are determined to reduce all complaints over adult social care and ensure high quality and dignified care is delivered to all those who need it.”

But Cllr Hudspeth added that the “stark reality” is that the quality and choice of care homes and home care, and people’s experience of social care, would likely get worse, “unless immediate action is taken to plug the funding gap facing adult social care that rises to £3.5 billion by 2025”.

He said: “Government needs to carefully consider the findings of the LGA’s green paper on adult social care for its own forthcoming Green Paper to secure the long-term future of care and support, and take action in the Local Government Finance Settlement next month to address the immediate crisis in adult social care.”