TIPS on dealing with difficult complainant relationships

Working with violent situations/clients

Conducting interviews/doing your job in someone's home

TIPS on dealing with difficult complainant relationships

From NHS Wales guide to complaints (external link)

DO

• avoid risk to yourself and others
• look confident, not arrogant – a confident person is less likely to be attacked
• avoid confrontation
• try to deflect or defuse the situation
• be prepared to escape from a situation when in real danger.

DON’T

• meet aggression with aggression; ‘strong language’ and tone that is interpreted as condescension is often seen as aggressive behaviour
• get physically involved
• patronise or otherwise demean the complainant with sarcasm
• look uninterested or bored or impatient – watch your mannerisms, such as tapping pencil on desk or reading a file while the other person is talking.

Working with violent situations/clients: useful links

National Task Force on Violence (Social Care) (external link)
This report contains a self-audit tool for employers, checklist for employees and overview of research, published by the National Task Force on Violence Against Social Care Staff in 2000.

NHS Zero Tolerance Zone (external link)
Provides resources, guidelines, checklists, etc.

Training (external link)
Useful management tool. Gives detailed guidance on the context and content of training for equipping staff to deal with the frustration and aggression of patients, family, friends and bystanders. Advises that a risk assessment will identify whether other types of training, including training in physical techniques, are appropriate. Ideally, it says, managers should receive the same training as their staff to ensure continuity.

Dealing with harassment by NHS Service Users: a guide for managers and staff (external link)

Violence in NHS Medical Practice (external link)

Summary of Final Report prepared by Department of Social & Political Science Royal Holloway, University of London (2001). The aims were to ascertain views of

• the extent, types and causes of violence
• those features of practice environment, organisation and culture conducive to risk or its reduction
• possible strategies for managing incidents

RCN Working Group (external link)

The Royal College of Nursing have convened a small working group to produce guidance for best practice in the management of actual or potential aggression in care organisations. The Working Group are aiming to publish generic guidance for course curricula and content that encompasses a wide variety of issues associated with the management of aggression in healthcare settings.

The Outline Curriculum is a resource for management: gives an idea of the issues which need to be covered. Core aims are to provide staff with knowledge and understanding of effective and appropriate interventions for the management of actual or potential aggression, using an evidence-based approach which

• explores a range of intrusive and non-intrusive conflict management skills
• emphasises the importance of safety for service users and workers
• promotes an understanding of ethical, legal and professional issues central to the management of actual or potential aggression
• focuses on promoting the personal as well as the professional development of staff.

Training notes in the Wales Complaints Guide (external link)
see page 195

Violence at Work, A guide to risk prevention for UNISON branches, stewards and safety representatives (1999) (external link) available from UNISON.
Acrobat PDF version of guidance (external link)

Personal Safety at Work: Guidance for all Employees available from the Suzy Lamplugh Trust. (external link)

Disturbing Behaviour (USA site) (external link)
Consultancy site with resources, articles, etc.

Guidelines for preventing violence to health and social care staff (external link)

Combating violence in general practice: Guidance for GPs available from the British Medical Association.

Risk Assessment at Work: Practical Examples in the NHS available from Health Education Authority.

Conducting interviews/doing your job in someone's home

NHS Zero tolerance Zone: home visiting policies (external link)
Site is full of valuable checklists and contact details of organisations who have developed policies (e.g. Camden & Islington)

Link to ICAS providers protocols and procedures

Extract from (external link)

“Lone workers such as staff making home visits should take steps to minimise risks to their safety. Local managers should ensure that there is a designated member of staff with specific responsibility for ensuring quick responses when a member of staff does not report when expected. Before setting out, staff should:

• get as much information as possible about the patient/client, their families and the location to be visited;
• wherever possible, phone or write to make appointments for visits, ensuring that people know who you are and what your role is. If staff are unable to keep an appointment at the agreed time, they should let the patient know;
• follow team procedures to ensure that another member of staff knows where they are going and when they should return. Make sure they know if the itinerary changes; and
• if possible, schedule visits to problem areas for particular times of the day, such as the morning when parents are around taking children to school, and when drug activity and drunkenness should be minimal.

When travelling, staff should:

• as far as is practicable, not display 'on call' stickers or anything that identifies the vehicle with a healthcare professional;
• lock their vehicle while driving; and
• drive with bags, drugs and equipment concealed so that they are not seen to be hiding them as they park.

When arriving at a patient's home, staff should:

• assess the situation as they approach and not enter a location if they have doubts about their safety. Make an excuse not to go in if the person answering the door gives any cause for concern, e.g. if they are drunk, if the patient is not in, or a potentially dangerous relative is present;
• stand well clear of the doorway after ringing or knocking. Stand sideways on so that they present a narrow, protected target;
• show identity badges;
• follow the occupants in when entering houses and other buildings;
• remain aware of the environment and maintain escape routes in case problems arise; and
• treat patients courteously, remembering that they are a guest in their home."

Disturbing Behaviour (USA site)
Assessing danger on a home visit: checklist (external link)