How to Handle a Complaint in a Care Home: A CQC Regulation 16 Guide for Managers
What Regulation 16 actually requires, a step-by-step process from first contact to lessons learned, and the records that show inspectors your complaints system works.
To handle a care home complaint the way CQC expects, make it easy to complain to any member of staff, acknowledge and record every complaint, investigate it without delay, respond to the complainant, act on any failure found, and tell them how to escalate if they are unhappy. Regulation 16 requires an effective, accessible complaints system, and CQC can ask to see a summary of your complaints within 28 days.
Most searches for care home complaints are from families who want to complain. This guide is for the other side: registered managers and provider staff who have to receive, investigate and answer a complaint properly. It follows Regulation 16 and CQC’s guidance, and it is honest about where the rules stop and your own policy begins.
Key takeaways
- People must be able to complain to any member of staff, verbally or in writing, and all staff must know how to respond.
- Unless anonymous, every complaint should be acknowledged, and every complaint must be investigated with proportionate action taken.
- Complainants must not be discriminated against or victimised, and their care must not be affected.
- You must tell complainants how to take it further if they are not satisfied.
- CQC can request a summary of complaints and responses, and you must provide it within 28 days.
In this guide
What Regulation 16 Requires
Regulation 16 says providers must have “an effective and accessible system for identifying, receiving, handling and responding to complaints” from people using the service, those acting for them and other stakeholders. CQC’s guidance adds that providers must tell people how to complain, offer support to make a complaint, for example through advocates or interpreters, and still follow the process where a complaint is anonymous (CQC: Regulation 16).
The regulation does not set response timescales. Those come from your complaints policy, which you should publish to residents and families.
A Step-by-Step Complaints Process
| Step | What to do | Record |
|---|---|---|
| 1. Receive | Accept it from anyone, in any form. Do not require a written letter. Reassure the person their care will not be affected. | Date, who raised it, how, and what was said in their words |
| 2. Acknowledge | Confirm receipt and explain the process and timescale in your policy. | Date and method of acknowledgement |
| 3. Triage | Decide the level of investigation needed. Check whether it raises a safeguarding concern, a notifiable event or a clinical risk needing immediate action. | Triage decision and any referrals made |
| 4. Investigate | Assign someone with the right skills who was not involved. Gather records, speak to staff and, where appropriate, the person and family. | Investigation notes, evidence reviewed, interviews |
| 5. Respond | Give a clear written outcome: what you found, what you will change, and an apology where it is due. | Response letter and date sent |
| 6. Escalate information | Tell them how to take it further if unhappy, including any internal review and external bodies. | Confirmation of the information given |
| 7. Act and learn | Complete any actions, share learning and review the complaint in your trends. | Actions with owners, dates and outcome |
Suggested timescales are for you to set. A common approach is to acknowledge within a few working days and respond within a fixed number of weeks, with a short holding update if an investigation takes longer. State yours in the policy and meet it every time.
How Inspectors Judge Your Complaints Handling
CQC’s published key lines of enquiry for the Responsive key question ask how effectively complaints are handled, “including ensuring openness and transparency, confidentiality, regular updates for the complainant, a timely response and explanation of the outcome, and a formal record”, and how far complaints are used as an opportunity to learn and drive improvement (CQC: Concerns and complaints). CQC is currently replacing its assessment framework (see the new framework explained), but the regulation itself has not changed.
Inspectors typically look at:
- Whether residents and families know how to complain and feel safe doing so.
- Whether staff at every level can say what they would do if someone complained to them.
- A sample of complaint files, from receipt to outcome.
- Whether trends are analysed and led to changes.
Telling People How to Take It Further
Regulation 16 guidance requires information for the complainant on what to do if they are not satisfied, including your internal procedure and when complaints will be escalated to other appropriate bodies. In adult social care that commonly means the local authority and the Local Government and Social Care Ombudsman, and, for concerns about safety or quality, CQC. CQC says where complainants go externally, providers should cooperate with any independent review. Providers without an independent review stage should regularly check their process is not disadvantaging complainants.
Remember that a complaint can also be a safeguarding concern. If so, follow the safeguarding referral process in parallel, not after.
Common Mistakes
- Treating verbal complaints as informal and not recording them.
- Missing the acknowledgement or going quiet during a long investigation.
- Investigating by the person complained about or closing ranks.
- A defensive response with no apology and no learning.
- Victimisation, even unintended, such as an awkward atmosphere towards a family that complained.
- No analysis of trends, so the same issue returns as separate complaints.
The Records to Keep
For each complaint, keep the original wording, the acknowledgement, the investigation, the outcome letter, the actions arising and the date they closed. Add compliments too, because they show what is working. Use our complaints log template for the fields, and review the log at every governance meeting.
CQCLogic’s complaints log records complaints and compliments with response deadlines, so overdue responses are visible before they become a problem, and its governance meeting manager keeps the resulting actions with owners.
Keep every complaint on track
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Frequently Asked Questions
How should a care home handle a complaint?
Receive it from anyone in any form, acknowledge and record it, decide the level of investigation, investigate without delay, respond in writing with the outcome and actions, tell the person how to escalate, and use the learning to improve.
What does CQC Regulation 16 require?
An effective, accessible system for identifying, receiving, recording, handling and responding to complaints. Every complaint must be investigated and necessary, proportionate action taken. Providers must give CQC a summary when asked, within 28 days.
Do complaints have to be in writing?
No. Regulation 16 guidance says people must be able to complain to any member of staff, either verbally or in writing.
How long do you have to respond to a care home complaint?
Regulation 16 sets no fixed timescale. Your complaints policy sets it, and you should tell complainants what it is. Investigate without delay and keep the person updated.
What if the complainant wants to remain anonymous?
You must still follow your complaints process as far as possible. Anonymous complaints do not need an acknowledgement, but they still need to be looked into.
Can CQC ask to see our complaints?
Yes. When requested, providers must give CQC a summary of complaints, responses and related correspondence within 28 days. Failing to provide it can lead to prosecution without a prior Warning Notice.
Where can someone go if they are unhappy with the outcome?
You must tell them. Typical routes are your internal review, the local authority, the Local Government and Social Care Ombudsman and, for safety or quality concerns, CQC.
Sources: CQC: Regulation 16, Receiving and acting on complaints · CQC: Concerns and complaints (KLOE R2)