Reporting a Care Concern in England

Who this guide is for

Anyone worried about the care someone is getting from a health or adult social care service in England, such as a care home, a home care agency, a hospital or a GP. That includes the person getting the care, their family and friends, and people who work at the service. It covers:

• What to do if someone is in danger, or is being abused or neglected.
• Telling the Care Quality Commission (CQC), and what it can and cannot do.
• Making a complaint to the service or to the council.
• Where to go if you are not happy with the answer to your complaint.
• Complaints about how the Mental Health Act has been used.

What this guide does not cover

• Care in Wales, Scotland or Northern Ireland: the CQC only covers services in England.
• Children's homes, fostering and adoption agencies and other children's social care settings: Ofsted regulates those, not the CQC.
• The standards a care provider must meet: see our CQC compliance guide.
• Council decisions about care needs, care assessments and charges: see our social care guide.
• The full NHS complaints process: see our NHS complaints guide.
• Your rights as a worker if you are treated badly for raising a concern: see our whistleblowing guide.
• Compensation claims, including clinical negligence: get legal advice.
• Care home contracts, fees and being asked to leave a care home: ask Citizens Advice.

At a glance

• If someone is in immediate danger, call 999. If a crime such as an assault or a theft may have happened, tell the police.
• Abuse or neglect of an adult who needs care goes to the council's adult safeguarding team. The council makes the enquiries, not the CQC.
• To get an answer about what happened, complain to the service itself first. It must have a complaints procedure.
• Tell the CQC as well. It will not sort out your complaint for you, but it uses what people tell it to check on services and it can take action against a provider.
• Not happy with the answer? Adult social care complaints go to the Local Government and Social Care Ombudsman, and NHS complaints go to the Public Service Ombudsman (formerly the Parliamentary and Health Service Ombudsman). Both are free.
• A complaint about how the Mental Health Act has been used can go straight to the CQC.

What the rules depend on

• Is anyone in danger now, or has a crime happened?
• Is it abuse or neglect of an adult who needs care and support?
• What kind of service is it: adult social care (a care home or care at home) or health care (NHS or private)?
• Who pays for the care: the council, the NHS or the person themselves?
• Is the service in England?
• Have you complained to the service yet, and have you had its final answer?
• Do you work at the service?

"Someone is being abused or neglected"

• If someone is in immediate danger or needs urgent medical help, call 999.
• If you think a crime has happened, whether it is physical or about money, tell the police.
• Report the abuse or neglect of an adult to the local council for the area where the person is. Ask for the adult safeguarding team.
• Under section 42 of the Care Act 2014, the council must make, or arrange, whatever enquiries it thinks necessary when it has reasonable cause to suspect three things about an adult in its area. The adult has needs for care and support (whether or not the council is meeting them), is experiencing or at risk of abuse or neglect, and because of those needs cannot protect themselves. The enquiries decide whether anything should be done and, if so, what and by whom.
• Because the test is reasonable cause to suspect, report what you have seen or been told. You do not need proof.
• The duty covers an adult who is in the council's area even if they do not normally live there, and it does not depend on whether they would qualify for council-funded care.
• Abuse includes financial abuse, such as having money or property stolen, being defrauded, being put under pressure about money or property, or having money or property misused.
• If it happened at a care service, tell the CQC too. It will not investigate the individual case, but what you tell it helps it check on the service and protect other people.

"Should I tell the CQC?"

• The Care Quality Commission (CQC) regulates health and adult social care services in England, such as care homes, care agencies, hospitals and GPs.
• You can tell the CQC about any experience of care, good or bad. People who work at a service can also tell it about a concern there.
• The CQC does not take up individual complaints or resolve them for you. Telling the CQC is not the same as making a formal complaint: for that, you must contact the service itself.
• The CQC looks at what you tell it alongside other information, such as what the service itself tells it and what it found on its last visit. It uses this to monitor and inspect services, and it can take action against a provider.
• The CQC will want to know the name and location of the service, when you used it (or worked there), whether you have complained to the service or contacted anyone else, and whether it can contact you.
• You can give feedback anonymously. The CQC says it is more likely to be able to take action if it can contact you.
• How to tell the CQC: the Give feedback on care page on the CQC website, phone 03000 616161 (Monday to Friday, 8.30am to 5.30pm, not bank holidays) or email enquiries@cqc.org.uk.
• If you think someone is providing health or adult social care without being registered with the CQC, you can report that to the CQC.
• You can look up a service's latest CQC rating and inspection report on the CQC website.

"How do I make a complaint?"

• You have a right to complain to the organisation that provided the care or the one that paid for it.
• By law every health and social care service must have a procedure for dealing with complaints. Ask to see it: it tells you how to complain.
• Start with the service itself, such as the care home, the home care agency, the hospital or the GP surgery.
• If the council funded or arranged the social care, you can complain to the council.
• For NHS care, you can complain to the body that paid for it instead of to the service. Your local Healthwatch can point you to help with an NHS complaint.
• Councils normally expect a complaint within 12 months of the problem. An NHS complaint should be made within 12 months of what happened or of when you found out about it. For a private care provider, check its complaints procedure for any time limit.
• Keep a note of what happened and when, who you spoke to, and copies of anything you send or receive.

"I am not happy with the answer"

• Adult social care, such as a care home or care at home: go to the Local Government and Social Care Ombudsman. It can look at complaints about all adult care services, whether the council pays or the person pays with their own money. It normally looks at a complaint only after the council or the care provider has had the chance to deal with it, and you should usually go to it within 12 months of when you first knew about the problem.
• NHS care, including NHS-funded care given by a private provider: go to the Public Service Ombudsman. It normally needs the final response first, and it may not help with a complaint that is over 12 months old.
• Private health care that is not NHS-funded (not dental or eye care): if the provider subscribes to the Independent Sector Complaints Adjudication Service (ISCAS), you can take your complaint there after the provider has dealt with it.
• Private dental care: go to the Dental Complaints Service.
• Private eye care: this guide does not cover where to go next. Ask Citizens Advice.

"The service is rated inadequate"

• The CQC rates services as outstanding, good, requires improvement or inadequate.
• A service rated inadequate may be placed in special measures. The CQC then sets a timeframe for it to improve and, if it does not, the CQC can take further action, such as cancelling its registration.
• A poor rating does not change what you do: complain to the service, report abuse or neglect to the council, and tell the CQC what you have seen.

"It is about the Mental Health Act"

• You can complain to the CQC about the way the Mental Health Act has been used, and the CQC will investigate.
• This is different from other complaints about care, which the CQC does not take up.

"I work at the service"

• You can tell the CQC about a concern at a service you work for, in the same ways as anyone else, and you do not have to give your name.
• If a crime has happened or someone is in danger, contact the police, and report abuse or neglect of an adult to the council.
• For your rights if you are treated badly for raising a concern, see our whistleblowing guide.

Deadlines

• Danger, abuse or neglect: report it straight away.
• Complaint to a council: normally within 12 months of the problem.
• NHS complaint: within 12 months of what happened or of finding out.
• Local Government and Social Care Ombudsman: usually within 12 months of when you first knew about the problem.
• Public Service Ombudsman: it may not help with a complaint that is over 12 months old.
• Telling the CQC: as soon as you can.

Money figures

• This guide gives no money amounts.

Where to go for help

Traps

• Telling the CQC is not a complaint. If you want an answer about what happened, complain to the service as well.
• The CQC does not investigate abuse or neglect of an individual adult: the council makes safeguarding enquiries, and the police deal with crimes.
• The ombudsmen normally expect you to have complained to the service or the council first.
• The CQC only covers services in England.
• A complaint is not a compensation claim, and it does not stop the time limit for one.