COMPLAINTS LOG: TO BE USED WHERE THERE IS LEARNING TO BE IMPLEMENTED:
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Complaint Reference Number & Service Area:
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Date of Complaint:
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Date of Complaint Conclusion:
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Outcome of Complaint:
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Upheld
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Not upheld
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Partially upheld
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(circle as appropriate)
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Investigating Officer:
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Brief Complaint Outline:
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Do we need something saying who is responsible for implementing actions – who is probably not investigating officer?
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Action
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Action Number:
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Action Detail:
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Responsible Agency/Professional:
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By Which Date:
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Complete? (Y/N)
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Outstanding and Unresolved Action(s):
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Action Number:
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Action Detail:
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Why Outstanding/Unresolved:
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Action to be Reviewed? (Y/N)
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Responsible Agency:
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What We Did Well:
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What Could We Have Done Better:
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Follow Up:
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Is a Follow-Up required:
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Yes / No
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Required Follow Up
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Person Undertaking the Follow-Up
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Date
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Name:
Title:
Organisation:
Contact details:
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Name:
Title:
Organisation:
Contact details:
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Name:
Title:
Organisation:
Contact details:
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Final Outcome Identified to Ensure Learning:
☐ policy change
☐ procedure review
☐ staff training
☐ team meetings/agenda items
☐ other
Brief overview:
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Decision maker:
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Sign Off / Complaint Closes
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Have All the Actions Identified Been Actioned:
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Yes / No
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If no, please provide a summary of why not and any intended future action
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Date Closed (following discussion at Practice Board)
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Signed off by (name and role)
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