Regulation 16 Receiving and Acting on Complaints

The CQC look at this as part of the Responsive KLOE. 

The intention of this regulation is to make sure that people can make a complaint about their care and treatment. To meet this regulation providers must have an effective and accessible system for identifying, receiving, handling, and responding to complaints from people using the service, people acting on their behalf or other stakeholders. All complaints must be investigated thoroughly and any necessary action taken where failures have been identified.

When requested to do so, providers must provide CQC with a summary of complaints, responses and other related correspondence or information.

CQC can prosecute providers for a breach of the part of this regulation (16(3)) that relates to the provision of information to CQC about a complaint within 28 days when requested to do so. CQC can move directly to prosecution without first serving a Warning Notice.

16.—(1) 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.

(2) 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.

(3) The registered person must provide to the Commission, when requested to do so and by no later than 28 days beginning on the day after receipt of

the request, a summary of—

(a) complaints made under such complaints system,

(b) responses made by the registered person to such complaints and any further correspondence with the complainants in relation to such

complaints, and

(c) any other relevant information in relation to such complaints as the Commission may request.

Point 1   

People must be able to make a complaint to any member of staff, either verbally or in writing.

• All staff must know how to respond when they receive a complaint.

• Unless they are anonymous, all complaints should be acknowledged whether they are written or verbal.

• Complainants must not be discriminated against or victimised. In particular, people’s care and treatment must

not be affected if they make a complaint, or if somebody complains on their behalf.

• Appropriate action must be taken without delay to respond to any failures identified by a complaint or the

investigation of a complaint.

• Information must be available to a complainant about how to take action if they are not satisfied with how the

provider manages and/or responds to their complaint. Information should include the internal procedures that

the provider must follow and should explain when complaints should/will be escalated to other appropriate


• Where complainants escalate their complaint externally because they are dissatisfied with the local outcome, the

provider should cooperate with any independent review or process.


Point 2 

Information and guidance about how to complain must be available and accessible to everyone who uses the

service. It should be available in appropriate languages and formats to meet the needs of the people using the


• Providers must tell people how to complain, offer support and provide the level of support needed to help them

make a complaint. This may be through advocates, interpreter services and any other support identified or


• When complainants do not wish to identify themselves, the provider must still follow its complaints process as far

as possible.

• Providers must have effective systems to make sure that all complaints are investigated without delay. This

includes: Undertaking a review to establish the level of investigation and immediate action required, including referral

to appropriate authorities for investigation. This may include professional regulators or local authority

safeguarding teams.

o Making sure appropriate investigations are carried out to identify what might have caused the complaint and

the actions required to prevent similar complaints.

o When the complainant has identified themselves, investigating and responding to them and where relevant

their family and carers without delay.

Providers should monitor complaints over time, looking for trends and areas of risk that may be addressed.

• Staff and others who are involved in the assessment and investigation of complaints must have the right level of

knowledge and skill. They should understand the provider’s complaints process and be knowledgeable about

current related guidance.

• Consent and confidentiality must not be compromised during the complaints process unless there are

professional or statutory obligations that make this necessary, such as safeguarding.

• Complainants, and those about whom complaints are made, must be kept informed of the status of their

complaint and its investigation, and be advised of any changes made as a result.

• Providers must maintain a record of all complaints, outcomes and actions taken in response to complaints. Where

no action is taken, the reasons for this should be recorded.

• Providers must act in accordance with Regulation 20: Duty of Candour in respect of complaints about care and

treatment that have resulted in a notifiable safety incident.


Point 3  

CQC can ask providers for information about a complaint; if this is not provided within 28 days of our request, it

may be seen as preventing CQC from taking appropriate action in relation to a complaint or putting people who

use the service at risk of harm, or of receiving care and treatment that has, or is, causing harm.

• The 28-day period starts the day after the request is received.

Point 4

If complainants are not satisfied with the way the organisation has dealt with the complaint they can go to the Parliamentary and Healthcare Ombudsman for a Healthcare related complaint or the LGO Local Government and Social Care  if it is a Social care complaint. About a council or a social care provider.

In their Complaints policy either of these should be mentioned. And how to contact them  The CQC do not actually handle complaints they pass them to these 2 bodies.

Point 5

Make it a smooth process for people to make a complaint. A compliant should be seen as a way to make improvements in your processes to highlight areas of poor training etc. See them as a learning experience rather than a negative. You will not always get things right we as humans do make errors , we make have equipment malfunction. Its  how we handle them that makes a difference. I know when I have complained either in a restaurant or for goods purchased the times where I have been dealt with respect and dignity and respect have been the time when the organisation has been able to make an improvement in their process.

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