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Please complete the form below for your complaints.
Date of Issue/Complaint
*
/
Day
/
Month
Year
Date
Complainant's Name
*
Nature of Issue/Complaint
*
Regarding Carer
Regarding Service User
Regarding Staff Member
Other
Service User Name
Service User Postcode
Service User Type
Please Select
Adult Service User
Child Service User
Private
Service User Region
Please Select
Manchester
Stockport
Rochdale
Trafford
Liverpool
Details of Issue/Complaint
Where did Issue/Complaint Come from?
*
QA
Phone call
Email
Spot-check
Other
The Issue/Complaint is regarding:
*
Name of the person(s) against which/whom the Issue/Complaint is filed:
Actions to take
*
Organise Spotcheck
Conduct Supervision
Increase QA's on Carer's Clients
Send for retraining
Disciplinary Action
None Required
Other
Raised as a safeguarding?
*
Yes
No
Information Recorded By
*
Send
Should be Empty: