Step one: complain to the care home directly, in writing
When care in a home falls seriously short, most families want a straight answer to one question: who do I take this to, and will it actually change anything? The honest answer is that the correct route depends on how the placement is funded, and this is the single point where families most often go wrong, sending a well-evidenced complaint to the wrong organisation and losing months getting nowhere. None of the bodies below can undo what has already happened, but each has a distinct part to play, and knowing which one to approach, and when, saves families weeks of frustration at an already difficult time. This guide sets out the correct step-by-step complaints route for care homes in England, what to include at each stage, and precisely what the Care Quality Commission (CQC), the Local Government and Social Care Ombudsman (LGSCO) and the Parliamentary and Health Service Ombudsman (PHSO) can and cannot do. If your complaint relates to being asked to leave a home rather than a quality-of-care issue, our separate guide on care home eviction rights covers that specific process.
Every service registered with CQC is required, as a condition of registration, to operate an accessible system for receiving, recording and responding to complaints. This comes from Regulation 16 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and CQC can take regulatory action against a provider that cannot show it meets this requirement. In practice, every care home should be able to point you to a written complaints procedure, and using it is always the right first step, even if you doubt it will produce a satisfactory answer, because both ombudsman services below expect the home to have had a fair opportunity to investigate and respond before they will get involved.
Put your complaint in writing rather than relying on a conversation, and include: the specific dates and times of each incident; the names or job titles of the staff involved; a factual description of what happened, separated from how it made you feel; any previous occasions you raised the same concern informally; and the outcome you are actually asking for, whether that's an apology, a specific change in care practice, a fee adjustment, or a formal investigation. A precise, dated account is far more likely to be acted on than a general complaint about poor care.
There is no single fixed statutory deadline for a care home's response — Regulation 16 requires providers to investigate without delay rather than within a set number of days. Most homes' own complaints policies commit to acknowledging a complaint within a few working days and giving a full written response within around 20 working days, a timescale modelled on wider NHS complaint-handling practice, though genuinely complex cases can reasonably take longer if the home explains why and gives you a new date. Keep a copy of everything you send and receive; you will need this bundle at the next stage.
Why the next step depends on how the care is funded
If the home's response doesn't resolve things, or you don't get a response at all within a reasonable time, the next step is an ombudsman complaint — but which ombudsman depends on who arranged and paid for the placement, not on who you feel ought to be responsible. Broadly: council-arranged or council-funded placements, including those where you now pay some or all of the fees (for example after a means-tested contribution or a deferred payment arrangement, but the council was originally involved in arranging the care), fall to the LGSCO. Placements that are NHS-funded, most commonly under NHS Continuing Healthcare, or that involve care commissioned by an Integrated Care Board (ICB), fall to the PHSO — but only after you have been through the NHS's own complaints process first. Fully self-funded placements, arranged privately with no council or NHS involvement at all, are commonly assumed to have no ombudsman route — this is incorrect, and worth understanding precisely before you complain. A short test that generally works: ask whether the council ever assessed or arranged this placement, even if you now pay all or most of the fees yourself. If yes, start with the LGSCO. If the NHS assessed the person and is paying towards or all of the care under Continuing Healthcare, start with the NHS complaints process instead.
The step-by-step escalation route
- Submit your complaint to the care home in writing, using its own complaints procedure, and give it a reasonable opportunity to respond before escalating.
- Establish exactly how the placement is, or was, funded and arranged: fully by the local authority, self-funded but originally arranged via a council needs assessment, self-funded with no council involvement, or funded in whole or part by the NHS (including NHS Continuing Healthcare). This single fact determines which body you complain to next.
- If the placement is council-arranged or council-funded, complain to the Local Government and Social Care Ombudsman once you have a final response from the care home, or have waited a reasonable time (commonly cited as up to 16 weeks) without one.
- If the placement is NHS-funded, such as under NHS Continuing Healthcare, first raise a formal complaint with the NHS body responsible for funding it (usually the Integrated Care Board, via its PALS or complaints team), following the NHS Complaint Standards, which also apply to independent providers delivering NHS-funded care. Only take this to the Parliamentary and Health Service Ombudsman once that process has run its course.
- If the placement is fully self-funded, with no council or NHS involvement, the LGSCO can still consider your complaint. Its remit was extended in 2010 to cover privately arranged and privately funded adult social care, specifically so self-funding families were not left without an independent route — a point many people are never told, and that leads some to give up wrongly at the CQC stage.
- Submit your complaint to the correct ombudsman within 12 months of becoming aware of the issue, attaching your written complaint to the home, its response (or confirmation of no response), and any supporting evidence such as care plans, incident logs, correspondence, medication records, and photographs where relevant. Independent evidence of the home's track record, such as a compiled inspection and review history report, is also worth having ready alongside your own account.
- During the investigation, the ombudsman's caseworker will typically request the care home's or NHS body's records, ask both sides for comment, and produce a draft statement of reasons before reaching a final decision. Straightforward cases are often decided within around six months of acceptance; more complex ones, especially where health and social care overlap, can take a year or longer — LGSCO and PHSO run a joint working team for cases that involve both.
- Read the final decision carefully. It will state whether fault (sometimes called maladministration) was found, whether it caused injustice, and what the ombudsman recommends the organisation does to put things right.
What CQC can, and can't, do with your complaint
It's worth being precise about CQC's role, because misunderstanding it is one of the most common ways families end up feeling let down. CQC is the regulator of health and social care providers in England: it registers, inspects and rates services, and can take enforcement action, up to suspending or cancelling a provider's registration, where standards fall below what is required. What CQC does not do is investigate or resolve individual complaints on your behalf, and it cannot award you compensation, an apology, or any other personal remedy — CQC's own guidance is explicit that you should complain to the provider first for exactly this reason. Where a concern is serious enough to suggest a resident is at risk of harm, you can also raise it with the local authority's safeguarding adults team at the same time — safeguarding referrals sit alongside the complaints process rather than replacing it.
What CQC does do with the information you give it is use it as regulatory intelligence: patterns across multiple complaints about the same home can trigger an earlier inspection, inform a rating, or support wider enforcement action that protects future residents. That's valuable, but it's a different thing from getting your own complaint resolved, so submit feedback to CQC alongside, not instead of, the care home and ombudsman routes above. If you want an independent read on a home's regulatory history before or during a complaint, checking its inspection ratings, enforcement notices and review pattern can help you judge whether what happened looks like an isolated incident or part of a wider pattern worth flagging.
What an ombudsman can, and can't, deliver
Both LGSCO and PHSO exist to investigate maladministration — essentially, whether a public body or a provider acting on its behalf got the process wrong — and whether that caused you a genuine injustice. Where they find fault, they can recommend a range of remedies: a formal apology, a change to the home's or NHS body's policies or procedures, staff training, a review of similar cases, and in some circumstances a financial remedy. That financial remedy is usually a modest, quantifiable amount — reimbursing fees that were wrongly charged, or a symbolic payment recognising the distress and time caused by the fault — rather than a court-style damages award.
What they can't do is discipline an individual member of staff (that sits with the employer, or a professional regulator such as the Nursing and Midwifery Council for a registered nurse), and they don't award compensation for personal injury, pain and suffering, or loss of the kind a civil court can order following a negligence claim. Ombudsman decisions are also not legally binding in the way a court judgment is, though organisations very rarely refuse to implement their recommendations, and decisions are published, which adds a level of public accountability.
When to consider a solicitor instead of, or alongside, an ombudsman complaint
If what happened caused real physical or psychological harm — a serious pressure sore, a fall linked to inadequate supervision, or a medication error with lasting consequences — this may amount to negligence, and an ombudsman complaint alone won't secure compensation for that harm the way a clinical or care negligence claim could. Many families pursue both routes in parallel: the ombudsman complaint for accountability, an apology and systemic change, and a solicitor for compensation where genuine harm has occurred. Personal injury claims are also subject to strict time limits, generally three years under the Limitation Act 1980, so take advice promptly rather than waiting for an ombudsman decision first. For guidance on recognising the signs of neglect and building the evidence a claim like this needs, see our guide on gathering evidence of care home negligence, which covers that side in detail.
Frequently Asked Questions
Do I have to complain to the care home before going to an ombudsman?
Yes. Both the LGSCO and the PHSO expect you to have used the care home's or NHS body's own complaints procedure first and given it a reasonable chance to respond, unless there are exceptional circumstances.
Which ombudsman covers a fully self-funded care home place?
The Local Government and Social Care Ombudsman. Its jurisdiction was extended in 2010 to cover privately arranged and privately funded adult social care, so self-funding families do have an independent ombudsman route, even with no council involvement.
Can CQC investigate my individual complaint about a care home?
No. CQC regulates providers and can take enforcement action based on patterns of concern, but it does not resolve individual complaints or award you compensation or an apology. Complain to the care home, then the relevant ombudsman, and copy CQC in for its regulatory records.
How long does an ombudsman investigation into a care home complaint take?
Straightforward cases are often decided within around six months of the complaint being accepted; complex cases, particularly where NHS and social care funding overlap, can take a year or longer.
Can an ombudsman award compensation for what happened to my relative?
It can recommend a financial remedy in some cases, such as reimbursing wrongly charged fees or a symbolic payment for distress, but this is not the same as a court damages award for injury, pain and suffering. Where genuine harm has occurred, a solicitor and a negligence claim may be the more appropriate route.
What if the placement involves both council and NHS funding?
The LGSCO and PHSO run a joint working team for complaints that span both health and social care and cannot be fairly investigated by either body alone, so a mixed-funding complaint can still be considered — just tell whichever ombudsman you contact first that both council and NHS funding were involved.