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Complaints about privately arranged adult social care

We can investigate complaints about adult social care which is arranged privately with a care provider, whether paid for with private money or Direct Payments from a council. This fact sheet deals with complaints to care providers about privately arranged adult social care. We have a separate fact sheet for complaints about adult care services generally and one like this for council arranged services.

I want to complain to the Ombudsman, so why do I need to go to the care provider?

Before investigating a complaint we must be sure the care provider knows about the complaint and has had a reasonable chance to investigate and reply to it.

What is the care provider’s complaints procedure?

By law care providers have to operate complaints procedures according to the Care Quality Commission’s regulations

Where can I get details of the care provider’s complaints procedure?

If the care provider has a website, this is the best place to look, or you can telephone it and ask for a copy. 

How long will the care provider’s procedure take?

We usually give the provider 12 weeks to try to resolve your complaint. It may ask you to agree to more time and should explain why that is needed. It may be in your interests to agree to this as long as progress is being made. If you are unsure, please contact us.   

Six weeks have passed and I have heard nothing from the care provider. What should I do?

You should contact the care provider and ask them to explain what is happening with your complaint.

What if the care provider doesn’t progress the complaint in a reasonable time?

The care provider should have agreed an extension of time with you if it intends to take longer than 12 weeks to investigate your complaint. If it has not, and no progress is being made, please contact us. We may decide the care provider has had enough time to deal with your complaint and that we should consider it for investigation.

I complained to the care provider before it decided the issue I am concerned about – is this not enough?

No, because until the care provider made a decision affecting you, there would have been no cause for a complaint. 

Why must I allow the care provider to put my complaint through the complaints procedure when I know it will not change its decision?

Care providers are generally committed to trying to resolve complaints through their own complaints procedures and may reconsider earlier decisions. We must be fair to both sides.

I think I will suffer lasting harm if the care provider is allowed time to deal fully with the complaint. Why can’t the Ombudsman investigate the complaint now?

We can investigate some urgent complaints without giving the care provider the chance to put the complaint through its complaints procedures first. But we only do this in exceptional cases. If you think we should treat your complaint as an exception, and you have not asked us already, please discuss it with us when we contact you.

My complaint is about the care provider’s plan to stop my place in the care home and I will have to move somewhere else. The care provider has told me this will happen soon, so if I have to wait some months before the Ombudsman investigates it’s likely I’ll have moved by then. 

Making a complaint to the care provider or to us won’t in itself stop the care provider from going ahead with its plans. we don’t have the power to stop that from happening, but we may be able to ask. If this would help, please call us.

What happens if I am still unhappy after the care provider has completed its response to my complaint?

Please call our helpline on 0300 061 0614. It would help if you have the care provider’s written or email response to your complaint (if it has sent one) when you call, as our Adviser will ask you some questions about what the letter or email says. The complaint will go to our Assessment team to consider. We aim to telephone or write to you within 20 working days but this may be affected by the volume of cases we are handling.

December 2020