Regulation 16: Receiving and acting on complaints

“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.” (Regulation 16(1))

Reg 16(2) requires the registered person to establish and operate effectively an accessible system for identifying, receiving, recording, handling and responding to complaints. Reg 16(3) requires the provider, when CQC asks, to give a summary of complaints, the responses and any further correspondence, by no later than 28 days after the request.

Note what Reg 16 does not set: a statutory deadline for responding to an individual complaint. The 28-day limit is only for the summary sent to CQC on request. Where care is NHS-funded or local-authority-funded, separate complaint-handling timescales apply under the 2009 Complaints Regulations; those are a funding-dependent layer on top of Reg 16, not part of it.

CQC looks for a complaints system people can actually use: a clear, accessible route to complain, complaints recorded whether they arrive in writing or in passing, each one investigated, and proportionate action taken on what it reveals. The inspector samples recent complaints and tests the loop on each: was it logged, looked into, responded to, and did anything change as a result.

The standard that separates a compliant service is learning. Complaints reviewed for themes, a recurring issue turned into a change, and that change evidenced, read as a well-led service. Complaints closed one by one with no pattern ever drawn out read as a system that receives complaints but does not act on them.

The most common gap is the informal complaint handled in the moment and never logged, so it cannot be evidenced and cannot feed learning. Next is the absence of trend analysis: each complaint closed on its own, with no one asking what three of them together are saying. Then there is the accessibility requirement, missed when the only route to complain assumes a confident, English-reading complainant. And where care is NHS-funded or local-authority-funded, the separate 2009 timescales are sometimes missed because the provider is working only to Reg 16.

Verivius records every complaint in one place, runs it through to a response with action, and surfaces the themes across complaints so a recurring issue becomes a single finding and a change rather than a series of closed cases. The trail at inspection shows the complaint, the investigation, the action and the learning.

Sample policy template: Complaints. Procedure checklist: Complaints handling.