While we all hope that we won’t ever have to complain about medical or personal care that we or a loved one receive, sometimes things go wrong and it’s important to speak up about it.
If you, a family member or a friend, have received care that you are unhappy with, this guide will help you to understand the complaints process and what your rights are.
Know your rights
No matter where you are receiving care, whether at home, in hospital or in a care home, your service provider is legally obliged to make sure you are safe, comfortable, treated with respect, and have a say in your treatment.
If you are unhappy in any way with your care, It’s important to flag this with your care provider so they put things right. Feedback can also help them understand exactly how they are performing and improve their services in line with your needs.
If you want to learn about the exact standards your care provider must meet, you can find out more from the regulator for your region:
- England – Care Quality Commission
- Scotland – Care Inspectorate
- Wales – Care Inspectorate Wales (CIW)
- Northern Ireland – Regulation and Quality Improvement Authority
Some key things to know before you start your complaint
The complaints process can feel confusing and overwhelming at times, so it’s helpful to know some key tips to help make the process as smooth as possible:
- Don’t wait to make a complaint – In the majority of cases, the issue that you are complaining about needs to have happened in the last 12 months, or it won’t be considered as valid. So if something has happened and you aren’t happy about it, it’s important not to wait too long to flag it.
- Document your conversations throughout – While you would hope that your complaint is dealt with quickly and efficiently, it may take some time to be resolved. It’s a good idea to document your conversations and any verbal agreements with dates and names of those involved to create your own paper trail of the process, as this can help speed any investigation along.
- Gather your information in advance – this includes any evidence or examples of any complaint you intend to make, as well as specific dates and names of anyone involved in your complaint. If your complaint relates to any NHS services, you may also need to provide your NHS number, so it’ll be useful if you have this readily available.
- Keep any written complaints short – make your complaint as concise as possible, as presenting reams of paperwork could delay the process. It may be worth getting someone to read over your complaint to make sure everything is clear and easy to understand before you submit it.
- Be aware that there are different processes depending on how you receive your care – If you receive care from the NHS, you will need to follow this process. If you have your care arranged or delivered by your local authority, you will need to follow this process.
- Know what you want – It’s good to have an outline of what you are trying to achieve with your complaint, for example, do you want an explanation, compensation or a change of service provider?
- Do not withhold payment – If you are really unhappy with the services you have been provided with, it may be tempting to say you do not want to pay and withhold your money. However, in the majority of situations, there is likely to be a contractual agreement in place, so it’s best not to withhold payments unless you have had legal advice suggesting you do otherwise.
How to complain
Whether it’s you or a loved one experiencing issues with care, complaining about it can be difficult, especially if you are feeling angry or upset about the treatment you or they have received. There is, however, a right way and a wrong way to complain, and so it’s useful to understand each step of the process so you don’t feel like you’ve wasted your time on top of everything else.
Broadly speaking, there are three main steps in the complaints process: informal conversation, escalation to either the local authority or service provider, and then if the issue still hasn’t been resolved, taking your case to the Ombudsman.
1. Start with an informal conversation
The very first step of a complaints process is to have an informal chat about the problems you are experiencing. Depending on the type of issue and the severity of it you can either speak to the person you’re making the complaint against directly, their manager or the senior management team of your care provider.
Having this conversation can feel a little intimidating, so before speaking to anyone it is worth taking the time to gather your thoughts and write down exactly what you are complaining about and what you would like to happen to resolve the issue. If the complaint is about specific incidents, make a note of the dates that these happened on and the names of who was involved, just so it’s clear in your mind.
After you’ve had the conversation, it’s good to share your notes, along with any agreed resolutions or actions in writing with the manager of the person you talked to or the management team of your service provider. This means you will have a clear paper trail documenting the complaint and the agreed remedy should you need it. If you want to escalate your complaint to the council or an Ombudsman later on, you may need evidence that you have already tried to resolve the issue directly with your provider, so it’s even more important to do this if you think you may need to take things further.
If you can’t sort things out with an informal chat, the route you take next will be different depending on who provides your care and how you receive it. Legally anyone providing care has to have a documented complaints procedure, but generally care falls into one of two groups – care provided by or through your local authority, or care you have sourced and paid for yourself.
2. Complaining to your local authority or another provider
If the care you or a loved one receives is organised, delivered or funded by your local authority, the next step in the complaints process is to complain to them directly.
Each local authority will have their own documented complaints procedure which you will be able to find on their website. If you need help in identifying who your local authority is, have a look here.
While each authority’s complaints process will be slightly different, generally once you have complained to them, they will:
- Send you a response confirming the local authority has received your complaint, and arrange any conversations they might need with you to further understand the issues.
- Investigate the complaint within a set time span – this is often around 25 working days, but it could be longer or shorter, depending on the complexity of your complaint.
- Once they have completed their investigation, and taken any necessary action, you will be sent a written response of their findings and their suggested next steps. If there are any changes being made as a result of your complaint, such as learnings, additional training or other improvements, you will also be notified of this in this letter.
- If you aren’t happy with the outcome, your local authority will usually provide an outline of your next steps.
If you are not satisfied with the resolution offered by your local authority and are not able to come to an agreement with them, then you may want to escalate this further, which may mean going to your local Ombudsman.
If you fund your own care and you want to escalate your complaint, you will need to follow your provider’s complaints procedure. It’s a legal requirement for all care service providers to have a documented complaints process, so if you aren’t sure what yours is, then you can ask your provider and they need to give it to you.
If you live in Scotland, and you feel it is necessary, you can also report your complaint to The Care Inspectorate or to the Scottish Social Services Council, however it is recommended that you go through your provider’s complaints process before contacting them.
Your provider’s complaints process will usually involve a similar investigation, action and resolution process as local authorities use, but their timelines may be slightly different.
3. Complaints to the Ombudsman
If your complaint has not been resolved by either of the first two steps, then your next option is to take it to the relevant Ombudsman. There are different Ombudsmen for different areas in the UK:
- England – Local Government and Social Care Ombudsman – 0300 061 0614
- Northern Ireland – Northern Ireland Public Services Ombudsman – 0800 34 34 24
- Scotland – Scottish Public Services Ombudsman – 0800 377 7330
- Wales – Public Services Ombudsman for Wales – 0300 790 0203
The Ombudsman is an independent and impartial individual, so they do not take sides. They will look at all of the evidence from both sides and will form a judgement about what should be done, and make recommendations to put things right. An Ombudsman’s decision can take a long time, so be prepared for a bit of a wait.
If it is a private company providing your care services, the Ombudsman’s recommendation may be legally binding, but this is not always certain. If the company is in the public sector, the Ombudsman can’t make the organisation follow their recommendations, but they usually do.
If you are unhappy with the decision the Ombudsman has made then you may be able to take legal action, and you will need to hire a solicitor to do so. It’s worth bearing in mind though that any court proceeding is likely to take the Ombudsman’s investigation and recommendations into account, so it’s important to consider whether it is worth your time and energy.
Getting help and advice to complain
Making a complaint of any sort can be daunting and can feel difficult to navigate, so it can be a good idea to get some help with it. Even just talking things through with a family member or friend can help you to clarify what you want to say, but if you want more professional advice, the following charities, businesses and services might be useful:
- The Citizens Advice Bureau
- Age UK Advice Line: 0800 678 1602
- Hourglass
Rest Less Money is on Instagram! Check out our account and give us a follow @rest_less_uk_money for all the latest Money News, updated daily.