1. New rights for people complaining about adult social care providers – an introduction

2. Objectives > Introduce the Local Government Ombudsman > Raise awareness about the LGOs’ new role in dealing with complaints about adult social care providers > Explore the implications and help prepare for new service 2

3. Who are LGO? > Commission for Local Administration in England - the Local Government Ombudsman Anne Seex Jane Martin YorkCoventry > Established in 1974 3

4. How LGO operates >‘Inquisitorial’ not ‘adversarial’ > Accessible and flexible > Apply ‘rules of natural justice’ > Authority delegated to managers & investigators 4

5. 1,000 complaints about social care issues each year

6. October 2010 – Complaints about action of adult social care provider in connection with adult social care 6

7. Note: ‘arrange and pay’ for social care includes > funding from own resources OR > using Direct Payments or a Personal Budget 7

8. New powers - the law Part 3A Local Government Act 1974 Introduced by Health Act 2009 – Section 35 and Schedule 5 8

9. LGO working assumptions Dealing directly with 13,000 providers across 27,000 locations will be very different to dealing with 387 local authorities Dealing with private contractual arrangements will be different to public law issues 9

10. LGO working assumptions Some complaints will involve local authority functions and private arrangements – our specialist Adult Social Care Teams will deal with both 10

11. LGO working assumptions Some complaints will raise safeguarding concerns We will encourage person who contacts us to refer to local authority / local procedures We will refer as ‘informed citizen’ if appropriate 11

12. The law says LGO can investigate Complaints by anyone claiming injustice caused by an adult social care provider in connection with a regulated social care activity IF… 12

13. …Ombudsman is satisfied that provider has been told about it and given a ‘reasonable opportunity’ to investigate and respond OR Ombudsman decides to pursue anyway. 13

14. LGO working assumptions As now, we will often need to contact the provider before judging whether has been given a ‘reasonable opportunity to consider and respond’ to a complaint. We need ways of doing this quickly. 14

15. LGO working assumptions When a provider has not been able to consider and respond, we will generally say it is not ‘reasonable’ to give that opportunity when: > grounds to believe may not handle effectively > already unreasonable delay by provider > significant adverse impact on person affected > in exceptional circumstances, where the provider requests. 15

16. The law says LGO cannot investigate >Employer / employee issues >‘Commencement or conduct’ of court proceedings >Anything we could investigate under existing powers >Anything the Health Services Ombudsman could investigate 16

17. The law says LGO cannot investigate > Matters more than 12 months old unless > Person affected has died or > LGO decides to pursue 17

18. The law says Ombudsman has the power to discontinue or not investigate a complaint explicitly, if ‘… satisfied with action which the adult social care provider concerned has taken or proposes to take…’ No-one has the ‘right’ to have their complaint investigated. 18

19. Ombudsman will not normally investigate if: > issue is trivial > claimed injustice is not significant > investigation is not practicable > no worthwhile outcome 19

20. Who can complain? The law says: >‘a member of the public who claims to have sustained injustice in consequence of the matter’ OR > someone authorised in writing by them OR > if dead or incapacitated > personal representative or someone LGO decides is ‘suitable’ 20

21. LGO working assumptions Many contacts & complaints will be made ‘on behalf of’ the person affected LGO must accept such complaints if person affected has given written authority and will accept if made by an appointed Deputy Otherwise, we will facilitate person affected to make complaint themselves unless they lack capacity 21

22. LGO working assumptions In many cases we may need personal contact with the person affected to: > check whether they want to make a complaint > decide whether to start an investigation. We will use ‘associates’ for many such contacts but investigators will make the decisions. 22

23. The law says: > investigations are in private > the LGO decides how to investigate > the LGO has powers of High Court Judge to obtain information > obstructing an investigation can be certified as contempt of court 23

24. The law says LGO can disclose information to CQC, other public service Ombudsmen and the Information Commissioner 24

25. LGO working assumptions We will write to the registered office of the provider to inform of and invite comments on a complaint Our enquiries will generally focus on the ‘location’ and will be addressed to the ‘individual’ or ‘partnership’ and/or the registered manager 25

26. LGO working assumptions We expect both parties to see any evidence that we rely upon in reaching a decision unless it is personal information about a third party Information obtained during or for the purposes of an investigation is exempt from disclosure under the Freedom of Information Act 26

27. The law says LGO must give the parties a statement of reasons for all decisions When an investigation is complete the statement must include conclusions and may include recommendations. 27

28. The law says A statement: > must identify the provider unless doing so would identify an individual and the LGO decides that would not be appropriate > must not identify an individual unless LGO decides doing so would be in public interest > can be copied to CQC and a council > can be published in whole, part or summary 28

29. LGO working assumptions We will send the statement of our reasons to the provider’s registered office and to the person who has complained 29

30. LGO working assumptions In certain circumstances we will share the statement of our reasons with CQC and the local authority – we are currently discussing the criteria for this 30

31. The law says If a LGO’s statement includes recommendations the provider must consider it and tell LGO of action it proposes to take. 31

32. The law says LGO’s decision is final No appeal except by application to High Court for Judicial Review 32

33. The law says ‘ Adverse findings notice’ if LGO: > does not get notification or > is not satisfied with proposed action or > is not satisfied that action has been taken in set timescale 33

34. LGO working assumptions We will draw on the knowledge & insights we gain from considering complaints to identify significant issues, common themes and good practice. We will contribute to improving care standards and provider practice by publishing such information. 34

35. Conclusion 35

36. Key message Ombudsmen are concerned with the individual’s experience 36

37. Hope you are now: > feeling acquainted with us > aware of our new jurisdiction over complaints about adult social care > briefed about how we work > able to explore the implications for your organisation or business 37

38. Any questions? 38