Every home care agency registered with the Care Quality Commission (CQC) needs a complaints procedure. The legal requirement is Regulation 16 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, headed "Receiving and acting on complaints". It has three paragraphs, and CQC's guidance on Regulation 16 sets out what providers must have regard to under each one.
This guide covers agencies in England. Care services in Scotland, Wales and Northern Ireland answer to different regulators and different regulations, which are compared in home care compliance in the four UK nations.
What Regulation 16 says
The regulation is short enough to read in full:
- Any complaint received must be investigated, and necessary and proportionate action must be taken in response to any failure identified by the complaint or investigation.
- The registered person must establish and operate effectively an accessible system for identifying, receiving, recording, handling and responding to complaints by service users and other persons in relation to the carrying on of the regulated activity.
- The registered person must provide to CQC, when requested and by no later than 28 days beginning on the day after receipt of the request, a summary of complaints made under the system, the responses and any further correspondence with complainants, and any other relevant information CQC requests.
CQC says the intention is to make sure people can complain about their care and treatment. Its guidance describes complaints as coming from people using the service, people acting on their behalf or other stakeholders. In home care that will often include family members, and it can include a commissioner or another professional.
Paragraph 3 is the one with a clock. CQC says it can prosecute a provider for failing to provide information about a complaint within 28 days when asked, and that it can move directly to prosecution without first serving a Warning Notice. It also says it must refuse registration if a provider cannot satisfy it that it can and will continue to comply with the regulation.
Taking the complaint: any member of staff, any format
CQC's guidance on paragraph 1 starts with who can receive a complaint. People must be able to make a complaint to any member of staff, verbally or in writing, and all staff must know how to respond when they receive one.
That matters in home care. A carer on a morning call may be the first person to hear that a client is unhappy, long before anyone in the office does. If the procedure only recognises complaints that arrive in writing at the office, the system is not accessible in the way CQC describes, and the carer has nowhere to put what they heard.
The guidance also says:
- unless they are anonymous, all complaints should be acknowledged, whether written or verbal
- complainants must not be discriminated against or victimised, and a person's care and treatment must not be affected because they complained or someone complained on their behalf
- appropriate action must be taken without delay to respond to any failures identified
- when a complainant does not wish to identify themselves, the provider must still follow its complaints process as far as possible
The second point deserves a line in your policy and in carer training. A client who has complained about a carer may worry about what happens at the next visit. The guidance is clear that the complaint must not change the care they receive.
Making the system accessible
Under paragraph 2, CQC says information about how to complain must be available and accessible to everyone who uses the service, in appropriate languages and formats for the people using it. Providers must tell people how to complain, offer support, and provide the level of support needed, for example through advocates or interpreters.
For a home care agency the practical test is whether a client can find out how to complain without phoning the office they want to complain about. You might put it in the client's home folder or service user guide and on your website. Wherever it sits, the information should name who to contact, how a complaint will be handled, and where to go if the person is not satisfied.
That last point is in CQC's guidance on paragraph 1: information must be available about how to take action if the complainant is not satisfied with how the provider manages or responds to the complaint, including when complaints will be escalated to other bodies. For most people using home care in England, that other body is the Local Government and Social Care Ombudsman, covered below.
Investigating and responding
CQC's guidance says providers must have effective systems to make sure all complaints are investigated without delay. It breaks that down into:
- a review to establish the level of investigation and immediate action required, including referral to appropriate authorities such as professional regulators or the local authority safeguarding team
- investigations that identify what might have caused the complaint and the actions required to prevent similar complaints
- where the complainant has identified themselves, investigating and responding to them, and where relevant their family and carers, without delay
The first review step is where a complaint can turn into something else. A complaint about a missed medication, rough handling or money going missing may also be a safeguarding concern, and the local authority's safeguarding route applies alongside your complaints procedure. Safeguarding adults in home care covers that route. Some incidents also need a statutory notification to CQC, which is covered in CQC notifications for home care agencies.
CQC also says providers must act in accordance with Regulation 20, the duty of candour, for complaints about care and treatment that have resulted in a notifiable safety incident. A complaint does not replace those steps. Duty of candour for home care agencies explains what the duty requires.
Throughout the investigation, CQC's guidance says complainants, and the people complained about, must be kept informed of the status of the complaint and its investigation, and told about any changes made as a result. Consent and confidentiality must not be compromised during the process unless professional or statutory obligations make it necessary, such as safeguarding. Staff who assess and investigate complaints should have the right knowledge and skill, and should understand the provider's process and the current guidance.
Regulation 16 does not set a fixed number of days for acknowledging or answering a complaint. If you choose timescales for your own procedure, write them down, tell the complainant what they are, and keep to them. If you hold a contract with a local authority or the NHS, check whether it sets its own requirements.
Keeping the record
CQC's guidance says providers must maintain a record of all complaints, outcomes and actions taken in response. Where no action is taken, the reasons should be recorded.
A useful complaint record lets you answer, months later, the questions an inspector or the Ombudsman is likely to ask:
- when the complaint came in, who made it and who received it
- whether it was acknowledged, and when
- what was looked at, and who was spoken to
- what the agency concluded and what it changed, or why it changed nothing
- what the complainant was told, and when, including where to go if they were unhappy
- whether it was also treated as a safeguarding concern, a notification or a duty of candour incident
The 28-day request under paragraph 3 is much easier to meet when that record already exists. CQC says it can ask for details of how the process is administered and reviewed, including whether it has an independent review stage, as well as the complaints themselves.
Looking for patterns
CQC says providers should monitor complaints over time, looking for trends and areas of risk. That includes considering whether the process itself needs revising, such as adding an independent review stage. Providers without an independent review stage should regularly review their process to make sure it does not disadvantage complainants.
In a home care agency, a trend is often about the rota rather than one carer: late calls on a particular run, frequent changes of carer for one client, or visits that are regularly cut short. Complaints that look minor one at a time can point to the same cause when they are read together, and the same records are often relevant to electronic call monitoring data.
When the complainant is still unhappy: the Ombudsman
The Local Government and Social Care Ombudsman investigates complaints about adult care services in England. It says it does not matter whether care is provided by a council or the person pays for it themselves. It can look at care arranged by a council, and care arranged directly with a provider by someone using their own or family money, or money from a council such as a direct payment.
The Ombudsman's how to complain page says the first step is to complain to the organisation and give it a chance to put things right, and that it cannot look into a complaint before that happens. People will usually need to go through all stages of the organisation's complaints process first. They can also go to the Ombudsman if they have complained but not had a response within a reasonable time, which the Ombudsman says in most cases should be up to 16 weeks.
The same page says the Ombudsman cannot normally look into a complaint if more than 12 months have passed since the person first knew about the problem. Its advice on complaining to a care provider says the care provider should explain where the person can go if they are still unhappy.
CQC's guidance on Regulation 16 says that where complainants escalate their complaint externally, the provider should cooperate with any independent review or process.
The Ombudsman and CQC have different jobs. The Ombudsman says it looks at individual complaints when something has gone wrong, while CQC monitors, inspects and regulates services. CQC's page on complaining about a service says it is not able to take forward complaints on someone's behalf, but asks people to tell it about poor care they have seen or experienced.
Where health and social care are both involved, the Ombudsman says it runs a joint working team with the Parliamentary and Health Service Ombudsman so the person does not have to complain to both separately.
Council-arranged care
When a local authority has arranged a person's care, the person may also complain to the council. The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 apply to complaints made to a local authority about its social services functions, including services provided under arrangements it has made with someone else, under regulation 6.
Those regulations set steps for the council, not for your agency. They include acknowledging a complaint within 3 working days under regulation 13, and a written response with a 6-month period for it under regulation 14, unless a longer period is agreed. If the council investigates a complaint about care you deliver, it is likely to ask you for your records, so the same complaint log serves both routes. The regulations also cover independent providers of health care under arrangements with an NHS body. If you deliver NHS-funded care, check with your commissioner which arrangements apply.
What to have in your complaints policy
Drawing the points above together, a complaints policy for a home care agency in England should cover:
- how anyone, including family members, can complain, in person, by phone, in writing or through a carer
- what carers do when a client or relative raises a complaint during a visit
- who acknowledges complaints and who investigates them
- the first review that checks for safeguarding, notification and duty of candour triggers
- the timescales the agency sets itself, and how the complainant is kept updated
- that the person's care will not be affected by complaining
- how anonymous complaints are handled
- support available, such as advocacy, interpreters and accessible formats
- where to go if the person is not satisfied, including the Local Government and Social Care Ombudsman
- how complaints are recorded, reviewed for trends, and summarised for CQC within 28 days of a request
Where homecareOS fits
The homecareOS CQC inspection readiness page describes how complaint response deadlines are tracked with care plan reviews, training expiry, supervisions, audits and incident investigations in one overdue view. The policies library includes nation-specific complaints procedures for each agency to adapt. Neither decides whether a complaint is upheld, writes the response, or replaces the registered manager's judgement. They keep the dates and the record in one place.
Sources
- Regulation 16, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, for the text of the regulation.
- Regulation 16: Receiving and acting on complaints, Care Quality Commission, page last updated 16 May 2025, for the guidance on each paragraph, prosecution, and refusal of registration.
- Complain about a service or provider, Care Quality Commission, for CQC's role in individual complaints.
- What the Ombudsman investigates in adult social care, Local Government and Social Care Ombudsman, for self-funded and council-arranged care, and the difference from CQC.
- How to complain, Local Government and Social Care Ombudsman, for complaining to the provider first, the 16-week guide, and the 12-month limit.
- Top tips for making a complaint to a care provider, Local Government and Social Care Ombudsman, June 2025.
- Complaints about health and social care, Local Government and Social Care Ombudsman, for the joint working team.
- The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009, regulations 6, 13 and 14, for complaints made to a council.