Worried about someone’s care

Most people raise a concern with the regulator, hear nothing, and conclude that nothing was done. The truth is more useful than that, and it is worth ten minutes: which door you need depends entirely on what you want to happen.

The thing almost nobody is told about CQC

The Care Quality Commission registers and inspects services, and you can and should tell it about poor care. But it does not take up your complaint on your behalf. In its own words, on its own page for the public:

“If you’ve experienced or seen poor care, you have a right to feed back or complain to the organisation that provided or paid for the care. We cannot make these complaints for you or take them up on your behalf. That may seem confusing but it’s because we do not have powers to investigate or resolve them.”

What telling CQC does do is shape inspection: “Your information helps us decide when, where and what to inspect.” That is real, and it is worth doing — a pattern of concerns about one service is exactly what brings inspectors through the door, and you can raise a concern anonymously. It is simply not the route that gets your mother’s missed medication sorted out this month. Both things are worth doing, and they are different things.

Tell CQC at cqc.org.uk — report a concern. CQC also says that concerns about a care home or home care agency should go to the relevant council.

Four doors, and what each one can actually do

Work out what you want to happen. That decides where to go, and using the wrong door is the commonest reason families feel ignored.

The route that actually fixes things

Every registered provider in England must have a complaints procedure. This is not a courtesy — under Regulation 16 of the regulations CQC enforces, they must have an accessible system for receiving and handling complaints, must investigate them, and must take proportionate action. A provider that has no procedure, or will not give you a copy, has already told you something.

Ask for the complaints procedure in writing. Put the complaint in writing too, even if you have already said it all out loud — a verbal complaint at the door on a Tuesday tends to become a conversation that never happened. Keep a copy. Say clearly what you want to happen, not only what went wrong; “I want the care plan updated so this cannot recur, and I want to be told what changed” is far harder to deflect than “I am unhappy”.

Ask the manager for a meeting, and take someone with you. Ask for what is agreed to be confirmed in writing afterwards, with dates. If it is not written down, it did not happen.

If the provider does not put it right

The Local Government and Social Care Ombudsman is free, independent, and the thing most families do not realise exists. Two facts matter most.

• It covers privately funded care, not only council-arranged care. In its own words: “We look at all adult social care complaints. This includes care that is funded privately without council involvement.” If you are paying the fees yourself, you are not on your own with it.
• You normally have to go through the provider’s own complaints process first, and all stages of it — but you can also go to the Ombudsman if you complained and did not get a response within a reasonable time. Silence is not a wall.

There is normally a 12-month limit from when you first knew about the problem, so a complaint left to run for a year while you wait for someone to come back to you is a real risk. Start the clock deliberately: write the date on your first letter.

Details and how to complain: lgo.org.uk — make a complaint, and their own tips for complaining about a care provider.

Two variations worth knowing. If the council arranged or funds the care, complain to the councilas well as the provider — the council keeps responsibility for care it arranges. And if the care is NHS-funded— Continuing Healthcare, or care given in a hospital — the Ombudsman you need is the Parliamentary and Health Service Ombudsman instead: ombudsman.org.uk.

The fear nobody says out loud: “will they take it out on her?”

This is the reason most concerns are never raised, and it deserves an honest answer rather than reassurance. Nobody can promise you that a relationship with a home will feel the same afterwards. What is true is that a provider cannot simply put someone out: a placement is governed by a contract with notice periods, and where the council arranged the care it retains duties towards the person. Retaliating against someone for complaining is itself the kind of thing that goes badly for a provider when it is documented.

Which is the practical point. The single best protection is a written record made at the time, sent to a named person, with a date. Raise things early and in a low key while they are still small; a calm note about one missed visit is easier to answer, and much easier to escalate later, than a year of silence followed by everything at once.

If you would rather not be identified at all, CQC accepts concerns anonymously, and safeguarding referrals can be made by anyone.

What to write down

Complaints are won or lost on contemporaneous detail. Notes made on the day carry weight that a recollection three months later does not. This is the part worth printing and keeping by the phone.

A person has a right of access to their own records, and someone acting for them with the proper authority can usually ask on their behalf. If that is refused, say in writing that you are asking for it and keep the reply.

Free help, and someone on your side

• Age UK — free advice on care, including complaints. Their advice line is 0800 678 1602.
• Healthwatch — there is one for every area; they help people navigate health and social care complaints and can point you at local advocacy.
• Carers UK — if you are the one doing the caring, this is help for you, and you have your own right to a carer’s assessment.
• Independent advocacy— ask the council; in some circumstances there is a legal right to an advocate, particularly where someone would otherwise have substantial difficulty taking part in decisions about their own care.

Two things worth doing alongside

Check the service’s CQC record and the date on it— a rating published four years ago describes a service that may have changed hands twice since. Look the service up, and see how to read a rating. Remember what the data does not hold: nothing about staffing levels this week, fees, or what is happening on a particular shift.

And if you are starting to think about a move, do it as a separate, calmer decision rather than in the middle of a complaint — moving an older person is itself hard on them. What makes a type of care stop working and what to look for on a visit are the two worth reading first.

General information about how the process works in England, checked against each organisation’s own published guidance. It is not legal advice, it is not a judgement about any service, and nothing here says whether a particular concern is justified — that is for the people with the power to look into it.