Complaints procedure in health and social care

A complaints procedure in health and social care is a formal, documented process that sets out how an agency receives, investigates, and responds to expressions of dissatisfaction about the care it provides. For domiciliary care agencies, it is not optional: it is a legal requirement under CQC Regulation 16. A clear procedure gives clients and their families confidence that concerns raised about care in their own home will be taken seriously. It also gives you, as a registered manager or agency owner, a structured, defensible way to handle feedback and demonstrate to inspectors that your service is responsive and well-led.

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What the complaints procedure in health and social care must cover

Under CQC Regulation 16, every registered provider must have an effective, accessible system for identifying, receiving, recording, handling, and responding to complaints. For home care agencies, that means your policy needs to address six core elements.

Accessibility. People must know how to complain and receive support to do so if needed, in appropriate languages and formats. You cannot assume every client or family member will navigate the process unaided.

Acknowledgement. Unless a complaint is anonymous, it must be acknowledged. This signals to the complainant that their concern has been received and is being taken seriously.

Thorough investigation. All complaints must be investigated without delay. That means establishing what level of investigation is required, gathering evidence, and identifying what caused the issue and what needs to change.

Detailed recording. You must keep a record of all complaints, outcomes, and actions taken. Where no action is taken, you must record the reason why.

Clear escalation routes. Complainants must be told what to do if they remain dissatisfied with your response. This may be an internal review stage, the Local Government and Social Care Ombudsman (LGSCO) for publicly funded care, or the CQC directly for regulatory concerns.

Non-victimisation. Anyone who makes a complaint must be protected. Their care and treatment must not be affected because they raised a concern.

These requirements sit within the broader framework of the CQC fundamental standards that all registered providers must meet. Your complaints policy is one of the documents inspectors will ask to see.

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The steps of a compliant home care complaints process

A good policy translates into a clear, reproducible process that any member of your team can follow. Here is what that looks like in practice.

1. Complaint received. A complaint can come through any channel: phone, email, in person, or in writing, and it can be raised with any member of staff. Your whole team needs to know how to recognise a complaint and what to do when they receive one.
2. Acknowledge within three working days. The complaints regulations require you to acknowledge a complaint no later than three working days after you receive it. This can be done orally or in writing, though a written acknowledgement gives you a clear record. Confirm that the complaint has been received, set out what happens next, and agree a reasonable timescale for your response.
3. Assign a named lead. Designate a specific person to investigate the complaint. They must be sufficiently senior and impartial, and should be introduced to the complainant by name.
4. Investigate thoroughly. Gather evidence, review care notes, speak to the relevant carer and coordinator, and establish a clear picture of what happened. Consent and confidentiality must be maintained throughout.
5. Respond within the timescale you agreed. The regulations do not set a fixed deadline for your full response. You agree a reasonable timescale with the complainant when you acknowledge the complaint, and keep them updated on progress. Aim to respond as promptly as you can; a full written response should ordinarily be completed within six months at the latest. If it will take longer, write to the complainant before that point, explain the reason, and give a revised date. Many agencies set their own internal target, often around 20 working days, as good practice, but that is a local standard, not a legal requirement.
6. Record the outcome and actions taken. Log the full complaint record, including what was found, what was resolved, and what changes were made as a result.
7. Explain the escalation route. If the complainant remains unhappy with your response, direct them to the LGSCO for publicly funded care, or advise them that they can raise regulatory concerns directly with the CQC.

For guidance on the communication side of this process, our companion guide on how to respond to a complaint in health and social care covers the conversation and correspondence in more detail.

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How to record and handle complaints properly

Resolving a complaint is only part of the job. Recording it properly is what makes your process defensible at inspection and useful for improving care quality over time.

For every complaint, your records should capture the date it was received, the name of the complainant where consent is given, the nature of the concern, the outcome of the investigation, and the specific actions taken. Where no action was taken, record why. These records must be available to the CQC within 28 days of a request under Regulation 16(3).

Beyond regulatory compliance, your complaints log is a quality improvement tool. When you review complaints over time, patterns emerge. Repeated concerns about a specific carer, a particular visit route, or a type of task are signals that something in your operation needs attention. Addressing the root cause prevents future complaints and improves the consistency of care.

Proactive quality auditing can surface the same patterns before a complaint arrives. Many registered managers treat their audit programme and their complaints log as two sides of the same quality-assurance picture.

This documentation forms part of building your CQC evidence base. When an inspector arrives, your complaints record should show not just that complaints were resolved, but that they drove real change in how care is delivered.

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Response timescales: what the regulations actually say

The regulations set fewer fixed deadlines than most people assume. Here is what they require, and where you have discretion.

Acknowledge within three working days. You must acknowledge a complaint no later than three working days after you receive it, either orally or in writing.

There is no fixed deadline for your full response. This is the point most complaints policies get wrong. The regulations do not set a specific number of days for your response. Instead, you agree a reasonable timescale with the complainant at the acknowledgement stage and keep them informed of progress. A full response should ordinarily be completed within six months. If it will take longer, you must write to the complainant to explain the delay and give a new expected date.

Provide information to the CQC within 28 days if requested. Under Regulation 16(3), if the CQC asks for a summary of complaints and your responses, you must supply it no later than 28 days beginning the day after the request. The CQC can prosecute a failure to do this and can move straight to prosecution without first issuing a warning notice.

State clearly in your complaints policy the timescales you commit to, so that staff and complainants both know what to expect.

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How a good complaints process protects your CQC rating

How your agency handles feedback directly affects how the CQC assesses your service. Complaints handling sits within the Responsive key question under the CQC single assessment framework, which asks whether people's experiences are listened to and acted on.

A well-run process tells inspectors several things at once: that your service is accessible, that concerns are taken seriously, that investigations are thorough, and that outcomes lead to change. Each of these supports the difference between a Good service and one rated Outstanding.

Poor complaints handling, by contrast, is a consistent finding in Requires Improvement and Inadequate inspection reports. Complaints that are not logged, not investigated, or not acted on signal to inspectors that the service lacks the oversight needed to keep people safe.

Agencies that treat their complaints process as an ongoing quality tool, reviewing trends, acting on findings, and documenting everything, are better placed to evidence responsiveness at any point in the inspection cycle, not only in the weeks before a scheduled visit.

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Frequently asked questions

What is a complaints procedure in health and social care?

A complaints procedure in health and social care is a formal, documented system that care providers use to receive, investigate, and respond to concerns or dissatisfaction raised about their services. It sets out who handles complaints, how they are logged, what timescales apply, and what escalation routes are available. For home care agencies, it is a legal requirement under CQC Regulation 16.

Why do complaints procedures matter in home care?

Care delivered in people's own homes is often less visible than care in a residential setting. A clear complaints procedure ensures that clients and their families have a safe, structured way to raise concerns about what happens during visits. For managers, it provides the oversight needed to spot problems early, act quickly, and demonstrate to the CQC that the service is responsive and accountable.

What does CQC Regulation 16 require?

Regulation 16 requires all registered care providers to have an effective, accessible system for identifying, receiving, handling, and responding to complaints. All complaints must be investigated thoroughly and proportionate action taken. Providers must also supply the CQC with a summary of complaints and responses within 28 days of a request. For the broader regulatory context, see our guide to the CQC fundamental standards.

How long does a home care agency have to respond to a complaint?

You must acknowledge a complaint within three working days, orally or in writing. There is no fixed legal deadline for the full response. You agree a reasonable timescale with the complainant when you acknowledge the complaint, keep them updated, and complete a full written response within six months at the latest, explaining any delay in writing. If the CQC requests information about a complaint, you must provide it within 28 days.

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Building a well-documented, consistently applied complaints process is one of the most practical things a home care agency can do to protect its CQC rating and improve the quality of care it delivers. It needs to be clear, accessible, and followed consistently by everyone in your team.

If you are putting in place the systems and evidence needed to demonstrate care quality to the CQC, Birdie's quality and compliance tools for home care agencies help you keep clear audit trails, spot issues early, and evidence care quality to inspectors. Book a demo to see how it works in practice.

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