Nigel Ellis, Executive Director, Local Government Ombudsman (LGO), discusses the LGO's work handling healthcare complaints and asks what lessons can be learned. This presentation was delivered at the QualityWatch annual conference on 28 October 2014. For more information, see: www.qualitywatch.org.uk/QW2014. QualityWatch is a joint research programme from the Nuffield Trust and the Health Foundation.

1. Indications of serious service failure
Nigel Ellis
Executive Director, Local Government Ombudsman

2. The Ombudsman’s experience
•We investigate complaints about councils and independent social care providers
•Free, impartial and final
•If we find something wrong, we recommend action to put it right
•12,000 complaints looked into last year
•Skewed towards failure

3. The complainant’s experience

4. The complainant’s experience

5. Last year our investigators handled 1,846 complaints about social care
This is the fastest growing area of our work
13.8% increase since 2012

6. Review of adult social care complaints 2013

9. “The council had not considered the risk to George of reducing his care package … it did not have regard to the importance of his dignity and privacy when relying on carers to carry out intimate tasks”
“Care home workers failed to call an ambulance for a vulnerable elderly stroke victim for more than five hours … both the home’s manager and a deputy were aware of Margaret’s situation, but both thought the other had called for assistance. ”

10. What can we piece together from these individual stories …
And what does it tell us about quality?

11. Are the lessons from service failure really so hard to see?
They highlight my areas of greatest risk …
… and tell me what my users care about.

12. •Care providers are often unable to resolve complaints at the first attempt – why?
•Given how hard it can be to complain, do we really hear the views of the most vulnerable service users?
Two key questions