National Care Service - complaints co-design: findings summary

Complaints landscape and processes

The Crerar review

The Crerar review took place in 2007. This was an independent review of regulation, audit, inspection and complaints handling of public services in Scotland. It found the landscape of complaints handling bodies in Scotland was complex and complaints processes could be difficult to access. Since then, work has been done to simplify the complaints landscape and processes. The Scottish Public Services Ombudsman has led the development of standardised complaints handling procedures across the public sector in Scotland. The model complaints handling procedures are different for each sector. However, they share key elements. This includes:

• a shared definition of what is a complaint
• a focus on resolution
• a two stage process for handling complaints within set timescales

The Scottish Public Services Ombudsman has also issued a Statement of Complaint Handling Principles. This has been approved by the Scottish Parliament.

Complexities in the landscape and processes

There has been a lot of work to make it easier for people to make complaints. However, we have found that it can still be a complex process for some people.

There are different ways for people to complain if their complaint relates to a social work, social care or health service. The difference between the services is not always clear to the people using them. In some cases, complaints will span more than one type of service.

There are different ways for people to complain if their complaint is about an individual professional’s fitness to practice, rather than the quality of care. The difference is not always clear, and some complaints could relate to both of these. This means that people might need to pursue a complaint through two different organisations.

There is overlap in the jurisdiction of the Scottish Public Services Ombudsman and the Care Inspectorate. Both have oversight of local authority social care. People might be confused about who to contact first about their complaint.

Not all care services have the same complaints handling processes. For example, local authority social care services must follow the Scottish Public Services Ombudsman’s model complaints handling procedures. However, private social care services do not have to follow this model. Private social care services must register with the Care Inspectorate. Under the legislation^[3], they must have an accessible complaints process. They must provide their complaints process in writing to people accessing their service. They must also respond to complaints within 20 working days.

For some types of complaints, people must fully use the service’s complaints process before they can take it to an independent body. For other types, including complaints about the quality of social care, people can complain directly to an independent body.

There are local differences in how complaints about integrated services are managed. Across the 31 Health and Social Care Partnerships, some will consider complaints about integrated services. Others tell people they must complain to the health board or local authority.

Independent Review of Inspection, Scrutiny and Regulation of Social Care in Scotland

In September 2023, the Scottish Government published the Independent Review of Inspection, Scrutiny and Regulation of Social Care in Scotland. The review considered how regulation and inspection of social care support and linked services can ensure a human rights based approach that improves outcomes for people. Key findings of the review included:

• people may need support to navigate a complaints process
• people may need specific support with communication
• people may be time constrained
• people may feel under pressure to follow a complaints process during challenging situations

Two of the report’s recommendations are about complaints. They are:

• recommendation 7: people making complaints should have access to independent advocacy to support them and make sure their rights are respected
• recommendation 25: public information about complaints processes should be clear and accessible, and the processes should be easy to use

Scottish Ministers have accepted all 38 of the recommendations made by the review.