Safeguarding: spotting neglect or poor care from a carer

Signs of neglect by a carer include missed or very short visits, weight loss, dehydration, poor hygiene, untreated injuries or sores, medication not given as planned, and a person who becomes withdrawn or anxious. If someone is in immediate danger, call 999. Otherwise, raise it with the care provider and report a safeguarding concern to the adult social care team of the council where the person lives.

At a glance

• Neglect is one of the forms of abuse councils must act on under section 42 of the Care Act 2014.
• Warning signs include weight loss, poor hygiene, untreated injuries, missed medicines, a cold or dirty home, and changes in mood (NHS).
• Not every problem is neglect. Poor care (lateness, rushing) should still be raised with the provider.
• Report concerns to the adult social care team of the council where the person lives. In an emergency, call 999.
• The Hourglass helpline for older people is free and confidential: 0808 808 8141 (listed by the NHS).

What counts as neglect by a carer?

Neglect means failing to meet someone’s basic care needs. The NHS gives examples such as not being given enough food, or not getting proper help with hygiene or medical care (NHS).

Under the Care Act 2014, abuse includes physical, sexual, psychological, financial, discriminatory and organisational abuse, as well as neglect, self-neglect, domestic abuse and modern slavery. A paid carer, an agency, a family member or anyone else can be responsible.

Organisational abuse is worth knowing about. It covers poor care caused by how a service is run, for example rotas that make proper care impossible. It is not only about one carer’s actions.

What are the warning signs of neglect at home?

Some signs are physical. Others are changes in the person or their home. Look for patterns over time rather than one bad day.

Signs in the person

• Weight loss, or signs they are not eating or drinking enough.
• Dirty clothes, unwashed hair or skin, or being left in soiled clothing or bedding.
• Bruises, wounds, fractures or other untreated injuries (NHS).
• Sore or broken skin, especially on the heels, hips or lower back.
• Seeming more confused, drowsy or unwell than usual.
• Becoming quiet and withdrawn, or anxious when the carer is due (NHS).

Signs in the home

• A home that is cold, or unusually dirty or untidy (NHS).
• Out-of-date or no food in the fridge, or meals left uneaten.
• Unused medicine in blister packs, or doses missing from the chart.
• Care records with gaps, very short entries, or times that do not match what you know.
• Aids left out of reach, such as a walking frame, glasses, hearing aids or a call alarm.

Signs in the care itself

• Visits much shorter than booked, or carers regularly very late or not arriving.
• Constant changes of carer, so no one knows the person’s needs.
• Tasks in the care plan not being done.
• The person saying carers are rough, rude or rushed.

If you are concerned about someone’s health, such as a wound, dehydration or sudden confusion, contact their GP or call NHS 111. Call 999 in an emergency.

Is it poor care or neglect?

The line is not always clear. A useful way to think about it:

Poor practice can become neglect if it continues or causes harm. If you are unsure, it is fine to ask the council’s adult social care team for advice. You do not need proof to raise a concern.

What should I do if I suspect neglect?

1. Make sure the person is safe now

If someone is in immediate danger or needs urgent medical help, call 999. If a crime may have been committed, such as assault or theft, contact the police.

2. Write down what you have seen

Note dates, times, what you saw and who was there. Take photos where appropriate, for example of an empty fridge or a missed-medicine chart. Ask to see the care records; the agency should keep a log of each visit and, where it gives medication support, a Medicines Administration Record (NICE NG67).

3. Talk to the person, if you can

Ask them gently what they want to happen. Making Safeguarding Personal is the national approach: the person’s wishes should be central, while still keeping them safe.

4. Raise it with the care provider

For poor practice, contact the registered manager of the agency. Say what happened, what you expect them to do, and ask for a written reply. CQC-registered providers must have a complaints procedure.

If you think a carer is harming the person, you can go straight to the council instead of the agency.

5. Report a safeguarding concern to the council

Contact the adult social care team of the council where the person lives and say you want to raise a safeguarding concern. Every council has a safeguarding route and an out-of-hours emergency duty team. In London, our directory of London borough adult social care contacts links to every borough council.

Under section 42 of the Care Act, the council must make enquiries if it has reasonable cause to suspect that an adult:

• has needs for care and support;
• is experiencing, or at risk of, abuse or neglect; and
• because of those needs, cannot protect themselves.

This applies even if the council does not fund the care. Councils follow local multi-agency safeguarding procedures; in London, for example, boroughs follow the London Multi-Agency Adult Safeguarding Policy (London ADASS, November 2025).

6. Tell the Care Quality Commission

The CQC regulates home care agencies that provide personal care. It does not investigate individual complaints, but it uses feedback to decide where to inspect. You can use its Give feedback on care service online.

7. Get support

The Hourglass helpline offers free, confidential support about the abuse of older people: 0808 808 8141 (as listed on the NHS website).

What happens after a safeguarding concern is raised?

The council decides whether the concern meets the section 42 test. If it does, it will make enquiries, or ask another organisation such as the care provider to do so. It will usually talk to the person, and to you if they agree.

The outcome might be changes to the care plan, a new provider, extra training, police involvement, or no further action if the concern is not upheld. The council should tell you what it can, while respecting the person’s privacy.

If the concern relates to the quality of care rather than harm, the council may pass it to the provider’s complaints process instead. Our guide on how to complain about home care explains the steps.

How can I reduce the risk of neglect when choosing care?

Prevention starts with choosing the right provider and setting clear expectations.

• Check the CQC rating and latest report. Look closely at the “Safe” key question. Our guide to CQC ratings for home care explains what each rating means.
• Understand who is responsible. A self-employed carer or an introductory agency may not be CQC-regulated. See our guide to care agency vs private carer.
• Agree a detailed care plan that lists each task, the visit length and the medication support needed.
• Ask how visits are monitored, including how the agency spots late or missed calls.
• Stay involved. Visit at different times, read the care log and get to know the carers.

For more on your rights when arranging and paying for care, see our guide to paying for home care.

Our printable questions to ask a home care agency includes safeguarding questions you can use at the first meeting.

Frequently asked questions

What are the most common signs of neglect by a carer?

The NHS lists signs such as being quiet and withdrawn, untreated injuries, an unkempt appearance, weight loss and a home that is cold or unusually dirty. In home care, also watch for missed or very short visits, gaps in care records, unused medicines and tasks in the care plan not being done.

Who do I report a carer to?

For urgent danger, call 999. For a safeguarding concern, contact the adult social care team of the council where the person lives. For quality problems, raise it with the agency’s registered manager. You can also give feedback to the Care Quality Commission, which regulates home care agencies.

Do I need proof before I raise a safeguarding concern?

No. You only need a genuine concern. The council decides whether to make enquiries under section 42 of the Care Act. It is better to raise a concern that turns out to be unfounded than to wait. Write down what you have seen, with dates and times, to help the council.

Will the carer find out I reported them?

The council and provider will handle the concern sensitively, but they may need to share some information to investigate properly. You can ask the council how your details will be used. If you fear retaliation, or the person you care for does, tell the council when you report.

What if my parent doesn’t want me to report it?

If your parent has mental capacity, their wishes matter and should be central. But you can still ask the council for advice, and the council can act where others are at risk or a crime may have been committed. If someone is in immediate danger, call 999.

Sources

• Abuse and neglect of adults at risk (safeguarding) – NHS
• Care Act 2014, section 42 – legislation.gov.uk
• Care and support statutory guidance – GOV.UK
• London Multi-Agency Adult Safeguarding Policy, November 2025 – London ADASS
• Give feedback on care – Care Quality Commission
• Managing medicines for adults receiving social care in the community (NG67) – NICE
• Personal care and introductory agencies – Care Quality Commission

This guide is general information, not financial, legal or medical advice. Last reviewed September 2026.

Reviewed by The Care Panel team on 15 October 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.