'Be open to suggestions for change and do not be defensive'

What this means 

The people who are best placed to offer suggestions for change in services are those who are directly affected by those services. As a group member said: If someone is asking a question, or making a suggestion, they are usually doing it on behalf not only of themselves, but also for others who don’t feel able to. 

It’s important to take these suggestions in the spirit they are often meant - as a way to improve. Think about reframing complaints as opportunities to change things for the better; recognise that people with care and support needs wish to reduce waste and inefficiency as much as the people who work in them. 

Don’t forget to celebrate when things go well, when people are happy, and when positive change happens.  

I write twice as many thank you letters as complaints - there are good people, working hard.

The research 

The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 require local authorities to create an annual report on complaints about adult social care, and make it available to the public. While many local authorities publish this report on their website, others only make it available on request. 

There is some evidence that these local authority complaints reports are becoming less accessible to the public - in 2017, half of local authorities published a complaint report on their website, whereas in 2019 only a third did. In addition, half of the published complaints reports were difficult to find, often hidden in the appendices of committee papers or agendas (Healthwatch, 2019). 

Making information on complaints unavailable or hard to locate suggests a defensive culture. For local authorities, having an increasing number of complaints is frequently seen as ‘worse performance’ (Healthwatch, 2019). However, Gallagher et al. (2020) made it clear why social care should expect and welcome all kinds of feedback, including complaints: 

• Social care evolves and changes 
  This is often a strength within social care. However, change can also involve challenging old expectations, teething problems with new approaches, and change not happening uniformly across the organisation. 
• The work involves challenging practice 
  This can involve frank discussions about risk, about the limits of services, and about a person’s behaviour. 
• The work takes place in a pressurised environment 
  There is uncertainty and complexity in much of the work, and it often takes place against a fraught backdrop of time pressures and organisational expectations. 
• Public perceptions of social care are often negative and unrealistic
  There may be inaccurate expectations of what social care can do, and emotions may be heightened at times of social care involvement. 

None of these reasons mean that complaints should be taken less seriously (Gallagher et al., 2020; SCIE, 2020) – they highlight just why complaints should be expected and how important a non-defensive approach is. 

It’s also important to remember that complaints are relatively rare. People frequently don’t complain about poor service. For example, Citizens Advice found, in 2016, that, while 45% of people had experienced poor public service, only 22% had made a formal complaint. In addition, younger people, older people, and those on lower incomes, may find it more difficult to make a formal complaint. A defensive approach to complaints, and a reactive approach to gathering feedback, misses valuable opportunities for input from these groups (Citizens Advice, 2016). 

SWORD (The Social Work Organisational Resilience Diagnostic) is an evidence-informed project that aims to improve emotional resilience in social care. Two of its key foundational principles relate to a ‘sense of appreciation’ and being a ‘learning organisation’. Recognising and celebrating achievements, while seeking out areas for improvement, can therefore contribute to a culture of staff and organisational emotional resilience as well (Grant et al., 2020). 

What you can do 

If you are in direct practice: Ask for feedback! Ask for informal feedback; ask for people to put things in writing. 

Clearly explain how feedback will be used – as a way to improve things in the future. Let people know they won’t be getting people into trouble if they’ve had a difficult time; and that, if things went well, that the feedback will be used to learn from that too. 

You can learn from it in your practice, too. If you are a social worker, seeking feedback is a key part of meeting professional standards: Standard 4.1 of the Social Work England CPD standard states ‘As a social worker, I will incorporate feedback from a range of sources, including from people with lived experience of my social work practice.’ 

Challenge yourself to seek feedback every day. Discuss with your supervisor how the feedback can be shared and acted upon – and don’t forget to tell people how their feedback has been used. 

If you are in senior management: Look at how you use informal and formal feedback, both positive and negative, that you get. 

• Consider the Legal Ombudsman’s top tips for responding to complaints. In particular, pay attention to tip five, ‘don’t be afraid to apologise’, and tip 6, ‘appreciate feedback’. Does your organisation practice these tips in response to feedback, or is the response more defensive? 
• Reflect on feedback and how it can be used. For example, does feedback seem to relate to a process, which suggests improvements need to be made to systems, administration, timescales or paperwork? Or are there themes that seem more relationship-based, suggesting improvements might focus on individuals and/or team cultures? Or is it a mix of the two – for instance, practitioners who are difficult to get hold of may have structural factors impeding their ability to respond to people promptly, as well as work to be done on their own relationship-based approaches. 
• You may consider some awareness-training throughout the organisation on reframing complaints as suggestions for improvement. 
• Critically reflect on if, and how, you publish an annual report on complaints and compliments.
  • If you do, does it clearly state the learning that will be taken forward, with a timescale for when this will happen? Is it downloadable as a PDF document? Is it public-focused and attractive to read?
  • If you don’t, how can you change this?
• Always share positive feedback with individuals, teams, and the wider organisation! 

Further information 

Read

SCIE has a guide on Dealing with concerns from people who use care services. This is a comprehensive guide that includes the duty of candour and social care complaints regulations. Note: on the very first page, the heading is ‘Complaints are a good thing’! 

The SWORD tool and workbook, helping link feedback with improving emotional resilience.