Before you start

The information you tell us can help us understand the quality of care the service provides. It can help us decide if we need to take action such as carrying out an inspection. We can’t always tell you what action we’ve taken.

If you think someone’s immediate safety is at risk, you should contact the police by calling 999 or contacting the adult safeguarding team at your local council.

You can also read more about What we want to know and why or look at our Easy to read instructions on using this form.

Time your feedback covers
Have you complained directly to the service?
Please note: We cannot handle formal complaints about services - find out How to make a complaint about services.
About you...
Please choose the option that best describes you or leave blank if you prefer
Your contact details...
How did you hear about this form?
Sharing your information
Tick below to indicate if you do not want us to share your information with other organisations

We will use the information you give us to help us assess the quality and safety of the service. Whenever possible, and always when we publish survey results, we will do this in a way that doesn't identify you or any organisation.

In some cases we may have to share your information with other organisations, for example if someone vulnerable is at risk of abuse, harm or neglect. But aside from these situations, you can choose how we share information that may identify you by using the boxes above. Find out more about Confidentiality.