Care Home Complaints: How to Complain and Escalate

Complaining about a care home can feel difficult. Families often worry about making things worse, upsetting staff, being labelled “difficult”, or causing problems for a parent who still depends on the home for daily care. But raising concerns is not being difficult. It is part of making sure care is safe, respectful and properly managed.

Some care home problems can be sorted out quickly with a conversation. Others need a written complaint, a care plan review, safeguarding referral, local authority involvement, CQC feedback, an ombudsman complaint or legal advice. The right route depends on the seriousness of the issue, who arranged the care, whether the resident is at risk, and whether the care home responds properly.

This guide explains how to complain about a care home, what to put in writing, what evidence to keep, when to escalate, who to contact, what CQC can and cannot do, when adult safeguarding is relevant, and what families can do if the care home ignores or dismisses concerns.

If your complaint is linked to unsafe care, you may also find our guides to care home red flags, safeguarding adults in care homes, falls in care homes, care plans in care homes and care home staffing levels useful.

When should you complain about a care home?

You should complain if something is wrong, unclear, unsafe, unfair or repeatedly not being addressed. You do not need to wait until serious harm happens. Early complaints can prevent small issues becoming bigger problems.

Common reasons to complain include:

poor personal care;
missed or delayed medication;
falls not being reviewed;
unexplained injuries;
poor food, hydration or weight loss;
staffing concerns;
call bells not answered;
poor continence care;
pressure sore concerns;
poor communication with family;
lost clothes or belongings;
missing money or valuables;
unclear fees or unexpected charges;
problems with the contract;
poor dementia support;
resident distress being ignored;
concerns not being recorded or followed up;
staff being rude, rushed or dismissive;
the care home not following the care plan.

CQC says that if you have experienced or seen poor care, you have the right to complain to the organisation that provided or paid for the care, and health and social care services must have a complaints procedure. CQC’s complaints guidance explains this right.

Not every complaint means the home is unsafe. A single laundry mistake is different from repeated neglect. A delayed reply is different from the home failing to tell family about falls, medication errors or weight loss. But if something matters to the resident’s dignity, safety or wellbeing, it is reasonable to raise it.

Complaint, safeguarding concern or emergency?

Before starting the complaints process, decide how urgent the situation is. Some issues can wait for a manager’s meeting. Others need immediate action.

If there is immediate danger

Call 999 if someone is in immediate danger, has been seriously injured, may have been assaulted, has urgent medical symptoms, or a crime may be happening now.

If urgent medical advice is needed

Contact NHS 111, the GP, district nurse or emergency services depending on the situation. For example, urgent help may be needed after a fall with head injury, severe pain, suspected fracture, sudden confusion, dehydration, chest pain, breathing problems or stroke symptoms.

If there may be abuse or neglect

Contact the local authority adult safeguarding team if you suspect abuse, neglect, unsafe care or serious risk. You do not need to prove neglect yourself. You need to raise a reasonable concern so the right professionals can decide what enquiries are needed.

Examples that may need safeguarding include:

unexplained injuries;
rough handling;
fear of particular staff or residents;
repeated falls with no review;
missed medication causing risk;
weight loss or dehydration being ignored;
pressure sores not being managed;
resident left in soiled clothing;
unsafe staffing causing harm;
financial abuse or missing money;
sexual abuse concerns;
the care home covering up incidents.

For a detailed explanation, read Safeguarding Adults in Care Homes.

If it is a quality or service complaint

If the issue is not an emergency or immediate safeguarding concern, start with the care home’s complaints process. This may include speaking to staff, contacting the manager, writing a formal complaint and asking for a written response.

Start with a clear informal conversation

Some concerns can be resolved quickly by speaking to the right person. This is often worth trying first if the issue is not urgent, serious or repeated.

Speak to the nurse, senior carer, deputy manager or registered manager. Try to be specific and factual. Instead of saying “the care is bad”, describe what happened.

For example:

“Mum’s drink was out of reach during my last three visits, and she has been more confused. Can we check whether staff are prompting fluids and whether this is in her care plan?”

Or:

“Dad fell on Tuesday evening. We were told he was fine, but nobody explained whether his falls risk assessment has been updated. Can we arrange a review?”

After an informal conversation, make a short note of:

date and time;
who you spoke to;
what you raised;
what they said;
what action was promised;
when they said they would update you.

If the issue is resolved, keep the note anyway. If the same problem happens again, you can show it is a pattern.

Informal conversations are useful, but do not rely only on verbal complaints for serious concerns. If the issue affects safety, dignity, medication, falls, nutrition, fees or the care plan, follow up in writing.

How to write a formal care home complaint

If the informal route does not work, or the issue is serious, put the complaint in writing. Email is often best because it creates a clear record. Ask for the complaint to be handled under the care home’s formal complaints procedure.

Your complaint should include:

resident’s name;
your name and relationship to the resident;
your contact details;
date of the complaint;
clear summary of the issue;
dates and times of incidents if known;
names of staff or witnesses if relevant;
what you have already raised informally;
how the issue has affected the resident;
what outcome you want;
request for written response;
request for timescale.

Keep the tone calm and factual. Strong emotion is understandable, but a clear written complaint is easier to investigate.

You might write:

“I am making a formal complaint about repeated delays in responding to my mother’s call bell and concerns about toileting support. On 4, 7 and 9 March, I found her distressed and waiting for help to use the toilet. On 9 March, she said she had waited so long that she was afraid to drink. I raised this with the senior carer on 7 March, but the issue has continued. I would like this investigated, her care plan reviewed, and a written response explaining what action will be taken.”

Be clear about what you want. Possible outcomes include:

apology;
explanation;
care plan review;
medication review;
falls review;
nutrition or hydration plan;
staff training;
change in communication process;
refund or fee correction;
meeting with manager;
written action plan;
referral to safeguarding or health professionals;
confirmation that CQC or the local authority has been notified where required.

If the complaint is about the care plan not being followed, link it clearly to the care plan. For example: “The care plan says Dad needs two carers for transfers, but on two occasions one carer attempted to move him alone.” Read Care Plans in Care Homes for more on this.

What evidence should you keep?

You do not need to become an investigator, but clear records help. They show patterns, dates, responses and whether concerns are being taken seriously.

Keep:

emails sent and received;
letters;
notes of phone calls;
dates and times of incidents;
names of people spoken to;
photos where appropriate;
copies of invoices;
contract and fee documents;
care plan notes or summaries if shared;
hospital or GP letters if relevant;
weight records if nutrition is an issue;
medication concerns;
falls records if available;
complaint responses;
promised actions and whether they happened.

For visible injuries, poor room conditions, stained clothing, broken equipment or unsafe environments, photos can be useful. Be respectful of the resident’s dignity and privacy.

If money or belongings are missing, keep a list of:

item or amount missing;
when it was last seen;
who had access;
whether it was recorded in the home’s property list;
what the care home said;
whether police or safeguarding may be needed.

Do not secretly record conversations or install cameras without taking advice. Covert recording and surveillance can raise privacy and legal issues, especially in shared care settings.

What response should you expect from the care home?

Every care home should have a complaints procedure. Ask for a copy if you cannot find it. The procedure should explain how to complain, who handles complaints, expected timescales and how to escalate if you are not satisfied.

A good complaint response should:

acknowledge the complaint;
explain how it will be investigated;
confirm timescales;
consider records and staff accounts;
speak to the resident where appropriate;
consider family evidence;
answer the main issues raised;
admit mistakes where appropriate;
explain what action will be taken;
give a review date if changes are needed;
explain how to escalate if you remain unhappy.

Red flags in complaint handling include:

no acknowledgement;
long delays with no explanation;
verbal reassurance but no written response;
defensive or dismissive tone;
blaming the resident or family without investigation;
refusing to discuss serious concerns;
no action plan after repeated issues;
staff becoming hostile after you complain;
threats of eviction after a reasonable complaint;
records appearing inconsistent or missing.

If the complaint is about unsafe care, poor staffing, nutrition, falls or medication, ask how the care plan will be reviewed. Relevant guides include Care Home Staffing Levels, Care Home Food and Nutrition and Falls in Care Homes.

Escalating inside the care provider

If the care home manager does not resolve the issue, check whether the home is part of a larger provider group. There may be a regional manager, operations manager, complaints lead, head office or nominated individual.

Escalate inside the provider if:

the manager does not respond;
the response does not answer the complaint;
the issue continues;
you believe records were not checked;
staff are defensive or hostile;
the complaint involves the manager;
the home is threatening notice or eviction after a complaint;
fees or contract terms are disputed;
you want a senior review before going outside the provider.

When escalating, include your original complaint, the response received, why you are not satisfied, and what you want to happen next.

You might write:

“I am escalating this complaint because the response does not address the main issue: repeated failure to follow my father’s care plan for two-carer transfers. The response says staff are aware of his needs, but it does not explain why the incidents happened, what records were reviewed, or what action will prevent recurrence.”

Give a reasonable deadline for response. If the matter is serious or risk continues, do not wait indefinitely before contacting safeguarding, the council, CQC or the ombudsman.

When to contact the council, CQC or safeguarding

External escalation depends on the type of concern.

Local authority adult safeguarding

Contact adult safeguarding if you suspect abuse, neglect or serious risk. This applies whether the resident is council-funded or self-funding. The local authority leads adult safeguarding enquiries.

Safeguarding is especially relevant if concerns involve:

physical abuse;
sexual abuse;
emotional abuse;
financial abuse;
neglect;
organisational abuse;
unsafe restraint;
serious medication failures;
serious dehydration or malnutrition;
pressure sores linked to poor care;
risks affecting other residents.

The council that arranged or funds the care

If the local authority arranged or pays towards the care, contact the council’s adult social care team or complaints team. The council may need to review the placement, funding, care needs, provider quality or safeguarding concerns.

This is particularly important if:

the council arranged the placement;
the resident receives council funding;
top-up fees are disputed;
the home says it can no longer meet needs;
the person needs reassessment;
there are concerns about the council’s decisions;
the complaint is about funding, assessment or care planning.

CQC in England

CQC regulates care homes in England. It wants to hear about poor or unsafe care, but it does not usually investigate individual complaints for you or get compensation for your family. CQC says that to make a formal complaint, you must contact the service itself, and that feedback helps CQC monitor services. CQC’s feedback page explains this distinction.

You should consider telling CQC if:

care is unsafe;
the home is poorly staffed;
there are repeated medication problems;
falls are not reviewed;
nutrition or hydration concerns are ignored;
residents appear neglected;
complaints are not handled properly;
the concern may affect other residents;
the provider appears to be covering up incidents;
management or leadership is weak.

For individual resolution, you may still need to use the care home complaints process, council process or ombudsman route.

Ombudsman, Healthwatch and advocacy support

If the complaint is not resolved by the care home, provider or council, you may be able to take it to an ombudsman or get support from advocacy organisations.

Local Government and Social Care Ombudsman

The Local Government and Social Care Ombudsman, often called the LGSCO, can investigate complaints about councils and adult social care providers, including care homes and home care agencies. It says it can look at adult social care complaints whether the council provides the care or the person pays for it themselves. LGSCO guidance on what it can look at explains this.

The LGSCO may be relevant if:

you have completed the care home’s complaints process but remain unhappy;
the provider has not handled the complaint properly;
the complaint involves council-arranged care;
the complaint involves self-funded care from a registered adult social care provider;
you want an independent review of maladministration, poor service or injustice.

The LGSCO is independent and free. It does not take sides. It looks at whether organisations made decisions properly and whether fault caused injustice.

Parliamentary and Health Service Ombudsman

If the complaint is about NHS care, such as NHS Continuing Healthcare decisions, NHS-funded nursing care, hospital discharge, GP care or NHS services involved in the placement, a different complaints route may apply. NHS England says people can search for NHS complaints advocacy in their area or contact local Healthwatch to find out who provides advocacy. NHS England complaints guidance explains NHS complaint support routes.

If NHS Continuing Healthcare is involved, see NHS Continuing Healthcare: Who Qualifies and How to Apply.

Healthwatch

Healthwatch is the independent champion for people using health and social care services. It can help people share experiences and may signpost to local support. Healthwatch explains that it makes sure health and social care decision-makers hear people’s voices.

Advocacy

An advocate may help if the resident struggles to speak up, has no suitable family support, lacks capacity for certain decisions, or is involved in safeguarding, complaints or assessment processes.

Advocacy may be especially useful if:

the resident disagrees with family;
there are mental capacity concerns;
the resident is afraid to complain;
communication is difficult;
there is no suitable relative to support them;
the complaint is complex or serious.

Complaints about fees, contracts and money

Care home complaints are not always about care quality. Some are about fees, contracts, deposits, notice periods, top-up fees, guarantors, charges after death, property, funding or unexpected extras.

You may need to complain if:

fees were not explained clearly;
the contract is confusing;
you are asked to sign as guarantor without understanding the risk;
top-up fees were not properly explained;
charges appear after death;
fees increase without proper notice;
you are charged for services not provided;
personal allowance or spending money is unclear;
the care home threatens notice because of a funding dispute;
the resident’s money or belongings go missing.

The Competition and Markets Authority has published consumer-law advice for care homes. The advice says care homes must provide important information upfront, treat residents and representatives fairly, and avoid unfair terms. It also says a contract term or consumer notice found to be unfair is not enforceable against a resident. CMA care homes consumer law advice is useful if your complaint is about fees or contract terms.

For related guidance, see:

If a fee complaint involves council funding, contact the council. If it involves a private contract and the care home does not resolve it, the LGSCO may still be able to consider complaints about adult social care providers, including self-funded care. You may also need independent legal or consumer advice for complex contract disputes.

Complaint letter template and escalation checklist

You can adapt this template for most care home complaints.

Care home complaint template

Dear [Manager name],

I am writing to make a formal complaint about the care provided to [resident name] at [care home name].

My concern is about [brief summary of issue]. The main incidents are:

[Date/time: what happened]

[Date/time: what happened]

[Date/time: what happened]

I have already raised this with [name/role] on [date], but [explain what happened next or why you remain concerned].

I am concerned because [explain impact on resident: safety, dignity, distress, health, finances, family communication].

Please investigate this under your formal complaints procedure and provide a written response. I would like the response to explain:

what records were reviewed;

who was spoken to;

whether the complaint is upheld;

what action will be taken;

whether the care plan will be reviewed;

how recurrence will be prevented;

how and when we will receive an update.

The outcome I am seeking is [explain what you want: apology, care plan review, refund, meeting, action plan, safeguarding referral, staff training, clearer communication].

Please confirm receipt of this complaint and the timescale for your response.

Yours sincerely,
[Your name]

Escalation checklist

Is anyone in immediate danger? If yes, call 999.
Is urgent medical help needed? Contact NHS 111, GP or emergency services.
Could this be abuse or neglect? Contact adult safeguarding.
Have you raised it with the care home manager?
Have you put the complaint in writing?
Have you asked for the complaints procedure?
Have you kept evidence and dates?
Have you escalated to head office or provider management?
Is the council involved in funding or arranging care?
Should CQC be told about unsafe or poor care?
Have you completed the provider complaints process?
Should you contact the LGSCO?
Do you need advocacy or legal advice?

Keep your escalation focused. The strongest complaints are specific, evidenced and clear about the outcome requested.

Frequently asked questions

How do I complain about a care home?

Start by speaking to the manager if the issue is not urgent. If it is not resolved, make a written complaint under the home’s complaints procedure. Include dates, examples, impact on the resident and what outcome you want.

Who regulates care homes in England?

The Care Quality Commission regulates care homes in England. CQC uses feedback to monitor services, but it does not usually resolve individual complaints or get compensation for families.

Can I complain to CQC about a care home?

You can tell CQC about poor or unsafe care. However, for a formal complaint and individual resolution, you usually need to complain to the care provider or the organisation that arranged or paid for the care.

When should I contact adult safeguarding?

Contact adult safeguarding if you suspect abuse, neglect, unsafe care or serious risk. Examples include unexplained injuries, rough handling, serious medication failures, dehydration, pressure sores, financial abuse or neglect.

What if the care home ignores my complaint?

Escalate to the provider’s head office or senior management. If the issue continues, contact the council if it arranged or funds the care, tell CQC about unsafe care, or consider the Local Government and Social Care Ombudsman.

Can self-funders complain to the ombudsman?

Yes. The Local Government and Social Care Ombudsman can consider complaints about adult social care providers, including care homes, whether the council arranged the care or the person pays for it themselves.

What should I put in a care home complaint?

Include the resident’s name, your relationship, what happened, dates and times, who was involved, what you have already done, how it affected the resident and what outcome you want.

Should I complain verbally or in writing?

Minor concerns may be raised verbally first, but serious or repeated concerns should be put in writing. Written complaints create a clear record and make escalation easier.

Can a care home evict someone because family complained?

A care home may give notice if it genuinely cannot meet needs or there is another contractual reason, but it should not use eviction threats to silence reasonable complaints. Ask for reasons in writing and seek advice if this happens.

Can poor staffing be a complaint?

Yes. Poor staffing can affect call bells, personal care, medication, meals, falls, continence and safety. If staffing creates serious risk or neglect, it may also be a safeguarding concern.

What if my parent is afraid I will complain?

Listen carefully and consider whether they fear retaliation. If they have capacity, their wishes matter. If there is serious risk or others may be at risk, you may still need advice from safeguarding or an advocate.

Can I complain if I do not have power of attorney?

You can usually raise concerns, especially about safety, but access to detailed personal information may depend on the resident’s consent, mental capacity and your legal authority. The home should still take genuine concerns seriously.

What if the complaint is about fees?

Ask for the contract, invoices and written explanation. Raise the issue with the manager or provider. If council funding is involved, contact the council. For unresolved adult social care complaints, the LGSCO may be relevant.

What if the care home says everything is in the care plan but staff do not follow it?

Record examples and ask for a care plan review. Ask how staff are briefed, how agency staff are informed and how managers check the plan is followed. Escalate if there is risk of harm.

What is the best way to make a complaint stronger?

Use specific dates, facts and examples. Explain the impact on the resident. Attach relevant evidence. State what outcome you want. Keep the tone calm and ask for a written response.