Complaints procedure in a care home: policy, timescales and how to handle a complaint

Every care home needs a complaints procedure that people can find, understand and use, and a manager who treats a complaint as information rather than an attack. Regulation 16 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 requires it, the Local Government and Social Care Ombudsman will judge you against it, and CQC will ask to see the last twelve months of complaints and what changed as a result. This guide sets out what a care home complaints policy must contain, which procedure applies depending on who funds the care, the timescales to work to, how to investigate and respond, and how to turn complaints into the kind of evidence inspectors look for.

The short answer

Acknowledge every complaint in writing within three working days. Agree with the complainant how it will be handled and when they will get an answer, and aim to respond fully within 20 working days, or 28 at the outside, telling them if it will take longer and why. Investigate properly: read the records, speak to the people involved, and look at what the system allowed to happen rather than only at who was on shift. Respond in writing, address every point they raised, say plainly what you found, apologise where you should, and set out what you are changing. Tell them how to go to the Local Government and Social Care Ombudsman if they are not satisfied. Record everything in one log, review the log quarterly for patterns, and make sure the changes you promised actually happened.

Why complaints are worth more than they cost

A complaint is free information about a failure you did not know about, delivered by someone who still cares enough to tell you. Homes with very few complaints are almost never the best homes. They are usually the ones where people do not believe complaining is worth the trouble, or where relatives fear their family member will suffer for it.

Inspectors know this. A home reporting two complaints a year in a 50-bed service invites the question of what happened to all the others, and the answer is usually that concerns were handled verbally and never recorded. Under the quality statement on listening to and involving people, a healthy volume of recorded complaints with good responses scores better than an empty log.

The law: Regulation 16

Regulation 16 requires registered providers to have and operate an effective and accessible system for identifying, receiving, handling and responding to complaints from people using the service or anyone acting on their behalf. It requires that complaints are investigated and that necessary and proportionate action is taken in response. It also requires you to give CQC a summary of complaints received, the outcomes and any action taken, when CQC asks for it, and CQC does ask.

Three words in that regulation do the work. Accessible means people can actually use it, including people who do not read, do not speak English as a first language or have a learning disability. Investigated means someone looked at the evidence, not that the manager remembered what happened. Action means something changed, and you can show what.

Regulation 17 on good governance requires you to keep records of complaints and to use them to improve quality. Regulation 20, the duty of candour, may also apply when the complaint concerns a notifiable safety incident.

Which complaints procedure applies?

This is where managers get caught out. There is not one complaints procedure in health and social care. The route depends on who arranged and who funds the care, and a person can have more than one route open.

Your policy should say all of this in plain English rather than just naming the ombudsman at the bottom of the page. People need to know which door to knock on.

What a care home complaints policy must contain

• A statement that complaints are welcome and that nobody will be treated differently for making one
• Who can complain: the resident, a relative, a friend, an advocate, a visitor, a professional
• How to complain: in person, by phone, in writing, by email, through a form, anonymously
• The name and contact details of the person responsible for complaints, and a second name for complaints about that person
• What happens at each stage, with timescales: acknowledgement, investigation, response, review
• How the home will support someone to complain, including advocacy and interpreting
• What the home will do if the complaint suggests abuse, a crime or a notifiable incident
• How records are kept and who sees them
• The escalation route, with the full contact details of the Local Government and Social Care Ombudsman and its 12-month time limit
• A clear statement that CQC cannot investigate individual complaints but wants to be told about concerns
• The review date and version number of the policy itself

It should be no more than two pages. A ten-page policy is a policy nobody reads, including your staff.

Making it genuinely accessible

An accessible procedure is not a poster in the entrance hall. Produce a short easy-read version with symbols for residents with a learning disability, a large-print version, and translations for the languages actually spoken in your home. Give a copy to every resident and representative on admission and again at every care plan review. Put it in the residents' handbook, on your website and in the visitors' book area.

Under the Equality Act 2010 you must make reasonable adjustments, and under the accessible information standard you need to identify, record and meet communication needs. For a resident who communicates with objects or signs, accessibility means a named worker who checks in weekly and knows how that person shows they are unhappy. A complaint does not have to arrive as a letter.

Concerns and complaints: the difference that matters

Most dissatisfaction arrives as a passing remark at the door: the laundry, a missed call bell, cold food, a lost cardigan. If your staff treat those as complaints and escalate every one, the system clogs. If they treat none of them as complaints, the log is empty and the pattern is invisible.

The workable split is this. A concern is something that can be sorted the same day by the person who hears it, and it is logged as a concern with a one-line outcome. A complaint is anything that cannot be sorted immediately, anything the person says they want treated as a complaint, and anything involving harm, dignity, money or safeguarding. Train staff on the split and give them somewhere quick to record a concern, or they will not bother.

Review concerns monthly. Twenty concerns about laundry is a complaint about your laundry system whether or not anyone used the word.

Timescales to work to

Recording a complaint: the fields you need

One log, one record per complaint, and these fields: reference number, date received, how it was received, who received it, complainant's name and relationship to the resident, resident's name, whether the resident consents to the complaint being handled with their information, a summary of each separate issue raised, date acknowledged, who is investigating, evidence reviewed, people interviewed, findings against each issue with an outcome of upheld, partly upheld or not upheld, actions with owners and dates, date of response, whether the complainant accepted the outcome, whether it escalated, and the date the actions were verified as complete.

Split multi-issue complaints into numbered issues from the start. A letter raising five things will get a response that misses two if you do not, and a missed point is the commonest reason the ombudsman finds fault.

The first conversation

How you respond in the first five minutes decides how much work the next month holds. Sit down. Do not do it at the office door. Let them say all of it before you explain anything. Write down each point and read it back so they know you heard it. Say sorry that they have had this experience, which is not an admission of fault and does not prejudice anything. Ask what outcome they are looking for, because it is often smaller than you fear and sometimes it is only an explanation.

Then be honest about what happens next and when. Do not promise a result. Promise a process and a date, and keep the date.

Investigating properly

1. Write out each issue as a separate question of fact that can be answered yes or no.
2. Gather the records: daily notes, MAR chart, care plan, risk assessments, body maps, incident forms, rota, call bell data, handover records, kitchen records, visitor log. Print or export them and note what you looked at.
3. Establish a timeline of what happened and when, from the records rather than from memory.
4. Speak to the staff involved, separately, and write up what each said.
5. Speak to the resident if they can take part, on their own if they wish, and record their view in their words.
6. Look for the system cause, not just the individual: staffing levels that night, an out-of-date care plan, a handover that did not happen, a rota gap filled by agency with no induction.
7. Reach a finding on each issue and say what evidence it is based on.
8. Decide the actions, with a named owner and a date for each.

If the complaint is about the registered manager, someone else must investigate, normally the provider, a regional manager or the nominated individual. A manager investigating a complaint about themselves is the finding an ombudsman will lead with.

Speaking to staff fairly

Staff panic when a complaint names them. Tell them what is alleged, in writing, give them time to respond, let them bring a colleague if they want, and make clear whether this is a fact-finding conversation or a disciplinary one. Keep the two apart. A complaints investigation that turns into a disciplinary hearing without warning is unfair and usually produces a worse account of what happened.

Most complaints that name an individual turn out to be about a system that set that individual up to fail. That is not an excuse, and sometimes conduct is the issue, but starting from the system produces better answers and keeps your team willing to tell you the truth next time.

Writing the response

A good response letter does eight things, in this order.

1. Thanks them for raising it and confirms the date it was received.
2. Lists the issues as you understood them, numbered.
3. Explains how you investigated: what records you read and who you spoke to.
4. Gives a clear finding on each issue, in plain words, saying whether it is upheld, partly upheld or not upheld.
5. Apologises specifically where something went wrong. "I am sorry your mother waited 40 minutes for help to the toilet on 3 March" is an apology. "I am sorry you feel that way" is not.
6. Sets out what you are changing, with dates.
7. Offers a meeting.
8. Explains the escalation route, with the ombudsman's contact details and time limit.

Write it as you would speak. No regulation numbers unless they asked, no defensive throat-clearing, no phrases like "it is regrettable that". If a point cannot be resolved because the records are inadequate, say so and say what you are doing about the records.

A worked example: Priya's complaint

Priya's mother has dementia and lives in a 40-bed residential home. Priya complains by email about three things: two cardigans lost in the laundry, her mother being found in someone else's clothes twice, and nobody telling her about a fall until her next visit.

The manager acknowledges within two days, numbers the three issues and calls Priya to check she has them right. The laundry and clothing issues are upheld: the labelling system relies on staff writing names in pen, which washes out. The fall notification is upheld: the incident form shows the fall was recorded at 21:40 and the family contact box is blank. The manager reads the notes, the incident form and the laundry process, and speaks to the night senior and the domestic.

The response, sent on day 16, apologises for all three, offers to replace the cardigans, and sets out three actions: heat-sealed woven name labels for every resident with a laundry audit at admission, a named person checking clothing at each personal care round for six weeks, and a mandatory family contact field on the incident form with the night senior responsible for calling before the end of shift. The manager offers a meeting, which Priya declines, and writes again at three months to confirm the changes held.

That complaint improved the home. It is also perfect inspection evidence, because it shows a specific failure, a specific finding and a specific change that was checked.

When a complaint becomes a safeguarding matter

Some complaints describe abuse or neglect. When that happens, the safeguarding process takes over and the complaint waits. Make a safeguarding referral to the local authority the same day, notify CQC where the regulations require it, call the police if a crime may have been committed, and tell the complainant that you are doing so and why.

Do not investigate in parallel with a section 42 enquiry unless the local authority asks you to. Interviewing your own staff before a strategy discussion can contaminate the enquiry. The route and the thresholds are in the guide to safeguarding adults in care homes, and what you must tell the regulator is in CQC notifications.

A worked example: Marcus

Marcus is 29 and lives in a supported living service. His sister complains that he has become withdrawn and flinches when one particular support worker is on shift. That is not a laundry complaint. The manager makes a safeguarding referral that morning, arranges the rota so the worker is not supporting Marcus pending the enquiry, notifies CQC, and tells the sister exactly what has been done and who will contact her.

The complaints process resumes afterwards, covering the parts the safeguarding enquiry did not deal with, such as why nobody noticed the change in Marcus and whether the key worker system was working. Both processes get a written outcome.

Duty of candour

Where a complaint concerns a notifiable safety incident, Regulation 20 applies whether or not anyone complained. Tell the person or their representative as soon as reasonably practicable, in person where possible, give a true account of what is known so far, apologise, explain what further enquiries you will make, and follow it up in writing. Keep a record of the conversation.

Candour and complaints handling overlap but are not the same duty. The complaint responds to what someone asked. Candour requires you to tell them even when nobody asked.

The Local Government and Social Care Ombudsman

The ombudsman is the independent final stage for adult social care complaints in England, including for people who fund their own care. People normally need to complain to you first and give you a reasonable chance to respond, usually up to twelve weeks, and they normally need to come to the ombudsman within twelve months of knowing about the problem.

The ombudsman can find fault causing injustice and recommend remedies: an apology, a service improvement, a refund or waiver of fees, and a financial payment for distress or avoidable time and trouble, often in the hundreds of pounds. Decisions are published anonymously and are worth reading, because they show exactly what good handling looks like.

The faults that recur in published decisions are the same every year: no written response, points not addressed, delay without explanation, no apology, no evidence the promised action happened, and records so poor the provider could not show what care was delivered. All six are avoidable.

Complaints about fees and money

A large share of care home complaints are about money: top-up fees, fees charged after death, notice periods, deposits, price rises and third-party contributions. The Competition and Markets Authority has been explicit about what is fair, and contract terms that are unfair are not enforceable under the Consumer Rights Act 2015.

Handle these through the same procedure, with the same timescales, and get the contract out and read it before you answer. If your terms charge fees for an extended period after a resident dies, or impose a large non-refundable deposit, expect to lose at the ombudsman. Fee disputes with councils follow a different route, covered in care home fees and invoicing local authorities.

Complaints from staff are a different process

A member of staff raising a concern about care quality is speaking up, not complaining, and should go through your speaking-up and whistleblowing route with the protections of the Public Interest Disclosure Act 1998. Routing them into the customer complaints procedure tells them you have missed the point. A grievance about their own employment is a third route again. See whistleblowing in care homes for how to build the speaking-up route properly.

Anonymous and third-party complaints

Take anonymous complaints seriously and investigate what can be investigated. You cannot respond to the complainant, so record the outcome in the log and, where the concern touched on a resident, tell that resident or their representative what you found.

Where someone complains on behalf of a resident who has capacity, check the resident is content for their information to be discussed. Where the resident lacks capacity, a relative or representative can usually be involved under a best interests approach, and you should record the basis for sharing. An attorney or deputy has a formal right to information within the scope of their authority.

Persistent and unreasonable contact

Occasionally a complainant contacts the home many times a day, repeats resolved issues or becomes abusive to staff. You still owe the resident a service. Have a short unreasonable contact procedure: a written warning, a single named point of contact, agreed times and channels for communication, and a review date. Do not stop investigating genuine new issues, and never let the label become a way to avoid an uncomfortable complaint.

Learning from complaints: the quarterly review

Once a quarter, take the log to your governance meeting and answer six questions. How many complaints and concerns did we receive, and is that more or fewer than usual? What were the themes? How many were upheld or partly upheld? Did we meet our timescales? What actions did we promise, and have they actually been done? Did anything escalate, and why?

Write the answers down as a short report. That report is one of the most useful documents you will show an inspector, because it shows a cycle rather than a pile of letters. It is also where most homes fall down: the actions are promised and never verified.

Complaints as inspection evidence

Under the quality statement on listening to and involving people, CQC will look at your complaints log, a sample of responses, and whether the changes happened. They will also ask residents and families whether they know how to complain and whether they feel able to, and they will hear directly from people who complained to CQC. The written procedure counts for very little next to what a relative says in the lounge.

What scores well: a log with more entries than you might expect, responses that uphold complaints, actions with dates, evidence they were completed, and a manager who can name their last three complaints and what changed. Keeping complaints in the same record as incidents, care notes and audits, as Kiwi does through its compliance reporting, makes that report a filter rather than a fortnight's work. Further detail on what each key question expects is in the evidence inspectors ask for.

Compliments and low-level feedback

Log compliments in the same place. They tell you what is working, they balance the picture for staff who only ever hear about problems, and they give you something real to say at supervision. A monthly figure for concerns, complaints and compliments is a better health check on a home than almost any other single number.

Common mistakes

• Verbal complaints never recorded. The log is empty and the pattern is invisible.
• Answering some points and not others. The commonest ombudsman finding of fault.
• Defending before investigating. Staff loyalty is good, prejudging is not.
• Missing your own deadline without telling anyone. Silence turns a complaint into an escalation.
• Non-apologies. "Sorry you feel that way" reads as contempt.
• Promising actions nobody checks. Three months later nothing has changed and the family knows.
• Manager investigating a complaint about themselves. Always indefensible.
• No easy-read or translated version. Regulation 16 says accessible, and a PDF in English is not.
• Treating a safeguarding disclosure as a complaint. Refer first, investigate second.
• Never reviewing the log. Individual answers, no learning.

What good and bad look like

Bad: a policy in a folder, six complaints a year in a 60-bed home, responses that run to three lines, no findings, no actions, nothing checked, and a relative in the car park saying there is no point saying anything.

Good: a laminated easy-read leaflet in every room, concerns recorded by care staff on the floor, 30 entries a year, half of them upheld, responses that name the failure and the change, a quarterly report with verified actions, and a relative who says she raised something in March and it was sorted.

Final conclusion

A complaints procedure in a care home is a simple thing done consistently: make it easy to complain, acknowledge in three working days, understand every point, investigate the system as well as the people, respond in writing within 20 working days with clear findings and a real apology, say what you are changing, check that it changed, and tell people how to go to the ombudsman if you have not satisfied them. Record it all in one place, review it quarterly, and treat a rising number of complaints as a sign that people trust you rather than a sign of failure. Do that and complaints stop being a threat and start being the cheapest improvement tool you own. If you want to see complaints, incidents and care records in one log, book a demo.

Frequently asked

What must a care home complaints procedure include?

Under Regulation 16 it must be accessible, explain how to complain and to whom, give timescales for acknowledgement and response, say how complaints are investigated and recorded, name an alternative contact for complaints about the manager, and set out the escalation route to the Local Government and Social Care Ombudsman. It should also say clearly that nobody will be treated differently for complaining.

How long does a care home have to respond to a complaint?

There is no single statutory deadline for providers, but good practice, and what the ombudsman expects, is an acknowledgement within three working days and a full written response within 20 working days, or 28 at the outside. If it will take longer you must tell the complainant before your own deadline passes and give a new date.

Who can I complain to about a care home if the home does not resolve it?

In England, the Local Government and Social Care Ombudsman investigates complaints about adult social care, including for people who pay for their own care. Complain to the home first and give it a reasonable chance to respond, normally up to twelve weeks, and go to the ombudsman within twelve months of knowing about the problem.

Does CQC investigate individual complaints about care homes?

No. CQC cannot investigate or resolve an individual complaint or obtain compensation, but it does want to be told about concerns because they feed into its assessment of the service. Your policy should say this plainly, alongside the ombudsman route, so people are not sent to the wrong place.

How do you handle a complaint in a care home step by step?

Listen properly and write down each issue, acknowledge in writing within three working days, agree the points and the timescale with the complainant, gather the records and speak to those involved, reach a finding on each issue, respond in writing with clear findings, a specific apology where due and dated actions, offer a meeting, give the ombudsman details, and check three months later that the actions happened.

What is the difference between a concern and a complaint?

A concern is something that can be resolved the same day by the person who hears it, logged with a one-line outcome. A complaint is anything that cannot be resolved immediately, anything the person asks to be treated as a complaint, and anything involving harm, dignity, money or safeguarding. Review concerns monthly, because a cluster of concerns is a complaint about a system.

What if a complaint suggests abuse or neglect?

Stop and make a safeguarding referral to the local authority the same day, notify CQC where required, and contact the police if a crime may have been committed. Do not run your own investigation in parallel with a section 42 enquiry unless the local authority asks you to, because interviewing staff first can contaminate it. Resume the complaints process afterwards for the parts safeguarding did not cover.

Do we have to tell CQC about complaints we receive?

You do not notify each complaint individually, but Regulation 16 requires you to provide CQC with a summary of complaints, the outcomes and the action taken when it asks, and inspectors routinely ask for the last twelve months. Complaints that involve abuse, serious injury, a death or police involvement are separately notifiable under the registration regulations.

Sources

• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 16: Receiving and acting on complaints
• Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 17: Good governance, and Regulation 20: Duty of candour
• Local Authority Social Services and National Health Service Complaints (England) Regulations 2009
• Local Government and Social Care Ombudsman: published decisions and guidance for care providers
• Care Quality Commission: complaints guidance for providers and the single assessment framework
• Competition and Markets Authority: consumer law advice for care homes
• Consumer Rights Act 2015 and Equality Act 2010
• Care Act 2014, section 42, and the Public Interest Disclosure Act 1998