Concerns about a care service

The Social Care Institute for Excellence (SCIE) provides guidance on what works in social care to enable those in the sector to improve practice. It is not within the remit of SCIE to deal with, respond to or advise on complaints about individual care or health services.

There are a number of ways in which you can challenge poor standards of care or raise concerns or complaints. This short guide provides the options open to you if you are unhappy with a social care service.

In brief

Crime

Call 999 for an emergency (e.g. a crime is currently being committed). You can also contact the police on 101 for non-emergency situations.

Safeguarding concerns about a child or young person (under 18 years of age)

If abuse or neglect is suspected it should be reported to the local authority, children’s services, the police or the NSPCC on 0808 800 5000. See other SCIE resources on safeguarding children.

Safeguarding concerns about an adult

If abuse or neglect is suspected it should be reported to the local authority. See other SCIE resources on safeguarding adults.

Poor care or service quality

Both the care provider and the local authority should give you information on the relevant complaints procedures. If you follow the complaints procedure and you are dissatisfied with the outcome you can contact the ombudsman.

How to complain about care services

When making a complaint about a service:

Help with complaining

Social care complaints regulations

The complaints procedure for adult social care is set out in regulations, which cover both the local authority and NHS procedures.

The regulations provide a framework for those handling a complaint relating to a local authority’s social care functions – this includes directly provided services and independent services provided through commissioning. The actions, omissions or decisions of the local authority in respect of a social care function are covered; the regulations do not, however, apply more generally to independent providers.

People who are paying for their own social care (self-funders) may complain to the local authority, for example about assessment, or failure to assess. Services people have arranged or purchased themselves are not covered but the local authority could be challenged if they commission those services. For example, on why they have commissioned a sub-standard service, or whether they are performance managing contracted services sufficiently.

Self-funders should raise concerns about their service with their care provider in the first instance. All providers are required as part of their registration requirements with the CQC to have a complaints procedure. If the complainant is not satisfied with the response they receive, they also may ask The Local Government Ombudsmanto investigate.

The duty of candour

The duty of candour requires registered persons (carrying out a regulated activity in health and care services) to be open and honest. When things go wrong they must make an apology and explain to those concerned how things will be rectified.

The duty is a direct response to recommendation 181 of the Francis Inquiry report into Mid Staffordshire NHS Foundation Trust (2013). The duty comes under Regulation 20 (the Care Act amends the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014).

See the CQC for further information.

Professional bodies

Many professionals, including doctors, nurses and social workers, are required to register with a professional body. These bodies aim to protect the public by setting and maintaining standards within the professions, by publishing codes of conduct, registering individuals and monitoring continuous professional development. Serious misconduct by an individual can be reported to these bodies.

Information for workers and service providers

Preventing formal complaints:

Dealing with formal complaints:

Whistleblowing for employers

Staff should be encouraged to raise concerns, at first internally, so that they can be dealt with promptly.

Organisations that do not respond to such concerns put themselves at risk to exposure of any wrongdoing through employees blowing the whistle externally.

The advantages of supporting people who raise concerns include:

Why it's important

View the full video

Employers should:

See the Department of Health Whistleblowing Guidance for Employers and Code of Practice

Whistleblowing for employees

Where there is no threat of immediate danger, whistleblowers should protect themselves. Potential whistleblowers should prepare carefully to make a disclosure, making a note of any relevant evidence (for example, record dates, times and the names of any witnesses), seek support and take external advice, possibly from Public Concern at Work, Speak Up,  a voluntary advice service or trade union.

Consider the following whistleblowing do’s and don’ts:

Do:

Don’t:

(Van Den Hende, 2001)

Legal protection

The law offers some protection to people who blow the whistle under the Public Interest Disclosure Act 1998. The Act offers protection, from victimisation in employment following a disclosure, to public, private and voluntary sector workers. The parameters of ‘protected disclosure’ are set out in the Employment Rights Act 1996 (ERA). The person making the disclosure should not commit an offence in doing so (e.g. breach the Official Secrets Act 1989) and must reasonably believe one or more of the following:

Seek advice from: