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Unsatisfactory care can cover a wide range of issues and so it is helpful to know what standards you can expect from a care home, care agency or the NHS and how to identify potential problems. 

On this page you can find the following information

1. Standards to expect
2. National standards for care homes 
3. Identifying problems
4. Abuse in care homes or at home

Standards to expect

You might think that a care home, care agency or NHS hospital is not providing the level of service that they should; there might be a specific incident that you are unhappy with; or your relative might seem unhappy, but you’re not sure of the exact reason. In extremely rare cases, you might have concerns about neglect or abuse.

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If you are concerned about unsatisfactory care of your relative, knowing your rights is a good starting point. Care homes, home care agencies and NHS hospitals must all be registered with their national regulatory body and meet the minimum standards that they set. The national watchdog in each country is:

In England: the Care Quality Commission (CQC)
In Northern Ireland: the Regulation and Quality Improvement Authority (RQIA)
In Scotland: the Care Inspectorate
In Wales: the Care and Social Services Inspectorate Wales (CSSIW)

They are responsible for:

  • setting national minimum standards for care homes, home care agencies and NHS services (hospitals and GPs)
  • monitoring and inspecting care homes to make sure that the services they provide come up to scratch.

National standards for care homes

If your relative is receiving care services they have five basic rights:

  • To be respected, involved in their care and support and told what’s happening at every stage.
  • To expect care, treatment and support that meets their needs.
  • To be safe.
  • To be cared for by staff with the right skills to do their jobs properly.
  • To expect the care provider to routinely check the quality of their services.

Note: These standards are for care services in England. For more information about standards in Scotland, Wales and Northern Ireland please check the regulators’ websites, as given in the links above.

Identifying problems

Your relative might tell you about problems themselves. If not and you think they are unhappy, or you suspect a problem, try to talk to them about it.

In addition to your relative’s views, use your own observations to judge how the care is going. If you are unable to visit while the carer is present, is there someone else (a neighbour or friend) who could?

If your relative is not able to communicate problems to you or you have further worries, there are some common problems that you can look out for: see our Checklist for common problems to look out for.

Abuse in care homes or at home

Cases of abuse in care homes or by an agency carer at home are extremely rare, but if you suspect that anyone is being abused by their carer, or witness an incident, it can help to know what action to take. Abuse can be psychological, financial or physical.

If you suspect abuse

If your relative seems frightened or unhappy, talk to them somewhere in private, get as much detail as possible and suggest that you report the matter to the care manager together. Ask for an explanation or an investigation. 

If you are not satisfied with the answer, then contact the social care registration authority in your country. 

If you are still unsatisfied, you can contact the local council (regardless of whether they fund your relative’s care). All councils have procedures in place to deal with the protection of vulnerable adults and have the authority to intervene. 

To find your relative's local authority website, use the Local authority services tab in our Care services directory.

If you witness abuse

If you see your relative or another person being abused by a carer, challenge the abuser immediately and tell them to stop. Write down exactly what happened and speak to the care manager in private to report what you have seen. In serious cases, report the incident to the registration authority and/or local council immediately.

If you want independent advice or support, contact the Relatives and Residents Association, a charity that supports older people in residential care and their families.

More information

Page last reviewed: September 2017