If something doesn’t feel right about your loved one’s care, it can be hard to know what to do next. Is it a complaint? A safeguarding concern? Or are you simply worried you’re overreacting? This post explains the real difference between poor care and safeguarding, what the law says, and the practical steps you can take – so you feel confident acting on what you see.
Key Points
- Poor care and safeguarding are different things, but one can quickly become the other
- Under Section 42 of the Care Act 2014, local authorities have a legal duty to act when an adult is at risk of abuse or neglect
- Patterns matter more than single incidents – repeated concerns that go unaddressed are often where the threshold is crossed
- You do not need to prove abuse to raise a safeguarding concern. Reasonable suspicion is enough
- Keeping a simple, dated log of what you see is one of the most useful things you can do
- Independent social work reviews can give families and deputies a clear, neutral picture of what’s happening and what should happen next
The Difference Between Poor Care and a Safeguarding Concern
Poor care and safeguarding are not the same thing, even though they can look similar from the outside.
Poor care is broadly about standards – a care home that is inconsistent, a care worker who is disorganised, or a service that falls short of what a family expects. A single medication error that is promptly reported, apologised for, and learned from is disappointing, but it is unlikely to meet the threshold for a safeguarding referral.
A safeguarding concern is different. It’s about actual or likely abuse or neglect that puts someone at risk of harm – and under Section 42 of the Care Act 2014 opens in a new tab, that triggers a legal duty for the local authority to make enquiries and act.
In my experience, the line between the two is rarely as clear in real life as it is on paper. What begins as poor care can cross into safeguarding territory if the same problems keep happening, concerns are being dismissed, and nothing changes.
What the Law Actually Requires
Under Section 42 of the Care Act 2014 opens in a new tab, a local authority must make enquiries if it has reasonable cause to suspect that an adult has care and support needs, is experiencing or is at risk of abuse or neglect, and as a result of those needs is unable to protect themselves.
That last point is important. It’s not enough for someone to be receiving poor care. The question is whether they are at risk and unable to keep themselves safe. For most people living in a care home or receiving domiciliary care, that threshold is not difficult to reach.
Safeguarding is not a bureaucratic “extra” process. It is the route by which the law’s protection duties are actually delivered.
How to Tell the Difference in Practice
I often invite families to ask themselves two simple questions.
- Has this been an isolated mistake – acknowledged, reported, and put right, with clear evidence of change? If so, it is likely a complaint matter, handled through the provider’s own processes or via the Care Quality Commission (CQC). Or
- are you seeing a pattern – repeated concerns, dismissive responses, and no meaningful change – for someone who cannot protect themselves? If so, you are probably looking at a safeguarding concern, whether or not anyone has used that word yet.
Typical signs that a safeguarding threshold may have been crossed include
- repeated falls,
- recurrent pressure sores,
- missed medication more than once,
- poor continence care that has been raised and ignored,
- unexplained bruising, or
- marked changes in mood or behaviour around certain staff.
SCIE (the Social Care Institute for Excellence) and the CQC both recognise that most safeguarding activity in care settings arises from poor practice rather than deliberate cruelty. But the impact on the person can be just as serious either way.
What You Can Do Right Now
Start a simple log. Write down dates, times, and what you saw or were told. Note who you spoke to and what was agreed. You do not need anything formal – a notebook or a running note on your phone is enough. This is useful both for complaints and for any safeguarding referral.
Raise concerns with the provider first (unless the risk is immediate or severe). Ask for a meeting with the manager. Share specific examples and ask what action will be taken, and by when. Request a written response.
Escalate if you need to. If you are brushed off or see no change, that in itself is important information. At that point, you can raise a concern directly with the local authority adult safeguarding team. You can also contact the CQC, and in serious cases the police.
You do not need to prove abuse. Reasonable suspicion, based on what you have seen and recorded, is enough.
A Note for Deputies and Solicitors
If you are responsible for someone’s welfare or funding their care, this is not just a family concern. It is a professional duty. Good contemporaneous notes show that you identified risks and acted proportionately – and that matters for OPG supervision and any later challenge.
An independent social work review can give you a clear, legally framed picture of whether what you are seeing constitutes poor care or a safeguarding issue, what the local authority should be doing, and what practical steps are needed next. Because I work independently of both providers and local authorities, my assessments are not shaped by internal pressures or budget constraints.
If You Are Not Sure, Get in Touch
If you are worried about a loved one’s care but unsure whether to complain, escalate, or refer to safeguarding, you are not alone. I speak to families in exactly this position regularly. Sometimes a conversation is all it takes to feel clearer about what to do next.
Feel free to get in touch with me at AJH Social Work. There is no obligation – just an honest conversation about your situation and what your options are.
FAQs about Safeguarding
What is the difference between poor care and a safeguarding issue?
Poor care usually refers to substandard or inconsistent practice that affects quality of life but does not yet amount to abuse or neglect. A safeguarding issue arises when there is actual or likely abuse or neglect causing, or risking, significant harm to an adult with care and support needs, which engages the local authority’s duty to consider a Section 42 enquiry under the Care Act 2014.
When should I report a care home or care agency to safeguarding?
You should raise a safeguarding concern if there is clear harm, ongoing risk, or a pattern of neglect, rough treatment, or serious failures that are not resolved when you raise them with the provider. You do not need to prove abuse; reasonable concern based on what you have seen, heard, or recorded is enough for the local authority to decide whether a Section 42 enquiry is required.
Should I complain to the provider first or go straight to safeguarding?
If the situation is not immediately dangerous, it is usually appropriate to raise concerns with the manager and use the provider’s complaints process first. If there is serious harm, clear risk, or you have already tried to resolve issues without improvement, you should contact the local authority safeguarding team and, if needed, the CQC or police alongside the provider’s procedures.
How can an independent social work review help in borderline cases?
An independent social work review can separate isolated poor practice from wider safeguarding concerns by examining records, observing care, and speaking with the person and those involved. The report provides a neutral, legally informed view on whether safeguarding thresholds are met and sets out practical recommendations that families, deputies, and solicitors can use when deciding what to do next.
Is involving safeguarding likely to make things worse for my loved one?
Safeguarding exists to protect adults from abuse and neglect, not to punish families for speaking up. While it can feel uncomfortable to escalate concerns, formal oversight, clear records, and, where needed, independent input usually help to improve safety and accountability for your loved one and others in the same service.
Ashley Holderness is an Independent Social Worker based in Lincolnshire, registered with Social Work England and the British Association of Social Workers. AJH Social Work provides independent care home reviews, safeguarding consultancy, and adult care assessments.
