We look into complaints where someone believes they have experienced an injustice or hardship because an organisation has not acted properly, or has given a poor service and not put things right.
We consider whether an organisation has already taken appropriate action to try to resolve the complaint. If we find an organisation has not done so, we usually make recommendations on how to put things right.
How we decide what to recommend
In deciding what to recommend, we look to put the person affected back into a position where they would have been, had there not been a negative impact on them.
If this is not possible, for example, where the injustice has been caused by distress or unnecessary pain, we may suggest that a financial payment is made to the complainant.
To assist us in considering an appropriate level of financial remedy, as well as casework policy and guidance, we use our severity of injustice scale. We also refer to previous cases where we have made similar recommendations.
In determining an appropriate amount to recommend, we take into consideration financial amounts recommended or already paid by other organisations, awarded by courts, or paid following mediation before legal action.
Our severity of injustice scale
Our scale allows us to ensure the recommendations we make are consistent and transparent for everyone who uses our service.
The figures included in the scale represent the Ombudsman’s judgement about the sort of sums that are both appropriate and proportionate for us to recommend.
We do not have standard amounts that we suggest for specific failings as these may impact the person affected differently in different circumstances. We consider the individual facts of a case in deciding what level of financial payment is appropriate to recommend.
We will only use our scale to determine financial recommendations for non-financial loss, for example, distress. If a complaint relates to a direct financial loss such as care home fees or benefit payments, we will recommend the organisation reimburses the amount the complainant has lost, including any interest due.
Our scale contains six different levels of injustice that a complaint could fall into, which increase in severity. Each level is then linked to a range of the financial amounts we would usually recommend in those circumstances.
A case will generally be level one if we consider the person affected has experienced a low impact injustice such as annoyance, frustration, worry or inconvenience. This would typically arise from a single (one-off) incidence of maladministration or service failure, where the effect on the person complaining is of short duration, and where there are no other adverse effects or ongoing wider impact.
We will usually consider an apology to be an appropriate remedy for these cases.
A level two injustice will typically arise when what has gone wrong has had a relatively low impact on the person affected. This will often result in a degree of distress, inconvenience or minor pain. This could also include instances where an injustice was more serious but only took place once, or was of short duration.
In these cases we consider that an apology is not suitable by itself.
Level three cases would have a moderate impact on the person affected (for example, in terms of distress, worry or inconvenience). For a case to be level three, that impact would usually have been experienced over a significant period of time.
A case may also be level three if the impact on the person affected was significant, but was only sustained for a short period of time.
A case at level four will involve the person affected experiencing a significant and/or lasting impact, so much so that to some extent it has affected their ability to live a relatively normal life.
In these cases the injustice will go beyond distress or inconvenience, except where this has been for a very prolonged period of time.
Typically, level five cases will be when the person affected has experienced a marked and damaging effect on their ability to live a relatively normal life.
In these cases recovery is likely to take a significant amount of time.
|6||£10,000 or more||
Level six cases are the most serious we see, involving profound, devastating or irreversible impacts on the person affected. This includes circumstances where the individual may be affected permanently, or where recovery is likely to take several years, and cases involving avoidable death.
It would also cover circumstances where a reduced quality of life has been endured for a considerable period. This would include significantly reduced life expectancy or injuries resulting in permanent disability or disfigurement.
Download our more detailed guidance on financial remedy [PDF 306KB] with a breakdown of possible injustice types by category.
Download our Service Model Guidance [PDF 2.3KB]