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Inspection report

Date of Inspection: 15 March and 13 April 2011
Date of Publication: 6 June 2011
Inspection Report published 6 June 2011 PDF

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People should have their complaints listened to and acted on properly (outcome 17)

Meeting this standard

We checked that people who use this service

  • Are sure that their comments and complaints are listened to and acted on effectively.
  • Know that they will not be discriminated against for making a complaint.

How this check was done

Our judgement

People who use services cannot be sure their comments and complaints are acted on effectively because information about making a complaint is not always accessible and the provider does not have robust systems in place to manage comments and complaints.

User experience

We asked eight patients and relatives what they would do if they had a complaint or concern about the hospital. Three people said they would write to the hospital manager if they had concerns; two people did not know what the complaint process was but said they would go to the PALS office to find out. One told us they had used the PALS service before to leave a positive comment about the care they had received. They were all confident the hospital would take any concerns seriously. The patients we spoke with were not worried they might be treated differently if they made a complaint, nor that it would be detrimental to their care and treatment.

One patient told us they were given information about the feedback process on admission. Another person showed us a form they had been given to complete if they had comments or concerns to make about their stay in the hospital. Some of the forms we saw during our visits were poorly photo-copied with small, faint or distorted print, and were not adequate for requesting feedback.

Other evidence

There was a Patient Advisory Liaison Service (PALS) office in the hospital and we saw signs and leaflets about their services in each department we visited. Newark Hospital PALS currently has over 200 volunteers who help find out patients’ experiences, through surveys, interviews and visits. PALS also informs and discusses with patients how complaints can be made, escalated and resolved. Their information includes the support they can provide and an explanation of the two stage NHS complaints process. PALS provides feedback forms, pens and post boxes in six areas of the hospital where people can leave their complaints and comments. Feedback can be anonymous if preferred and PALS told us this does not affect the way complaints were dealt with.

Newark Hospital does not have a complaints office on site and all formal complaints are initially sent to Kings Mill Hospital with a copy given to the Newark Hospital manager. We saw a record of recent complaints about services at the hospital, with each step documented and a record of when each complaint is sent to the trust’s Chief Executive Officer. The hospital implements the trust’s complaints procedure, which meets the Department of Health requirements on complaints. There is a named person with responsibility to co-ordinate investigations into complaints and make judgements about whether they are upheld or not.

During the period April 2010 to March 2011, Newark Hospital received 89 formal complaints, a 45% increase on the previous year. The trust acknowledged all complaints (87% within three days) but a third of the complaints were not dealt with within the trust’s own time scales. The trust told us this could be explained by significant staff sickness and absence in the complaints department last year. The trust shared with us a break down of the nature of complaints received at Newark Hospital and the outcome and learning from nine investigated complaints, but was not able to provide us with a summary of the complaints with the responses made, as required under the relevant legislation.

The NHS Litigation Authority (NHSLA) handles negligence claims and works to improve risk management practices in the NHS. The trust has achieved NHSLA level 1. This means it has an approved documented process for listening, responding and improving when people raise concerns or complaints, but not that they monitor compliance with the process.

During our visit, staff accessed the intranet to show us a copy of the complaints leaflet, which explained the complaints process and the trust’s commitment to respond within pre determined timescales, but we did not see this leaflet displayed around the hospital. The leaflet says the information and guidance on complaints is available in other languages and in Braille on request, but we did not see this information made available in different languages and formats. Findings from the NHS inpatient survey (April 2011) support this as only a third of 280 patients said they saw posters or leaflets explaining how to complain, although the survey was across the whole trust not just Newark Hospital.

Each month, PALS presents information on patient and visitor feedback to senior members of the hospital team, so that managers are made aware of themes and trends, both in compliments and concerns. Staff told us they receive feedback and guidance on their team’s practice from their managers if a complaint about their service has been made and upheld. One person said they may also receive individual feedback through appraisals. Three staff from different departments said that the main concern patients talked to them about was waiting times, but that people were generally satisfied when staff explained the reasons. It is not clear how patients’ and visitors’ informal concerns are captured and fed back to senior managers. We spoke with three staff from different hospital departments about receiving complaints and it was clear they understood the process and would tak