Knowing when something is wrong isn’t always straightforward. Changes can be gradual, easy to dismiss, or difficult to put into words.
But when it comes to the health and well-being of someone receiving care at home, acting on a concern early can make a significant difference to outcomes.
Knowing when and how to escalate concerns is not about overreacting. It’s about making sure the right people are informed at the right time.
In this article, we cover the signs that something may not be right. We also look at what families can do when a concern arises, how care workers support the escalation process, and what to do next, including when to call 999.
Are you concerned about your loved one? Our team at myCare is here to help. Get in touch with us today for personalised advice and support.
Signs That Something Isn't Right
Changes in a person’s condition or behaviour are often the first indicator that something needs attention. These changes aren’t always dramatic; in fact, the most important ones are often subtle.
A person who seems quieter than usual, less interested in food, or more confused than normal may be showing early signs of a health change that warrants a closer look.
Some of the most common signs to watch for include:
• Unexplained changes in mood, behaviour, or alertness
• Refusing medication or struggling to manage it independently
• Increased falls, new bruising, or declining mobility
• Expressing that something feels wrong, even without being specific
• Withdrawing from conversation or usual routines
• Noticeable weight loss or changes in appetite
No single sign should be dismissed as ‘just a bad day.’ Patterns matter, and so does what you know about your loved one. If something feels different, it probably is.
What Families Should do When They Have a Concern
Families are often the first to notice that something has changed. You know your loved one, their routines, their personality, their baseline. That knowledge is valuable, and it should never be underestimated.
Trust Your Instincts
If something doesn’t feel right, trust that instinct. You don’t need to wait for a formal report or rely on a written note from a carer to raise a concern. A direct conversation with the care team is always the right first step.
Look for Specific Changes
When raising a concern, it helps to be as specific as possible. Rather than saying ‘they seem off,’ try to identify what has changed and when. Consider:
• When did you first notice the change?
• Is it consistent, or does it come and go?
• Has the person said anything that concerned you?
• Have there been any recent changes in medication, routine, or environment?
Don't Stay Silent
Research by the Care Quality Commission found that the most common reasons for staying silent were not knowing who to raise a concern with (33%), not wanting to be seen as a ‘troublemaker’ (33%), and worrying they wouldn’t be taken seriously (28%).
The encouraging news is that when people did raise a concern, 66% found their issue was resolved quickly and were happy with the outcome. Speaking up works.
If you feel your concern isn’t being taken seriously, don’t let it go. Follow up, escalate, and if necessary, put it in writing.
At myCare, we encourage families to contact the office directly, not just leave a message through a care worker. A phone call ensures your concern is logged, heard, and addressed promptly.
How Care Workers Help
For care workers, escalating a concern isn’t an optional extra; it’s a core part of the role. Every visit is, in effect, an informal risk assessment. Care workers are often the people who know the client best and may be the first to notice that something has changed.
Document, Then Escalate it
When a change is noticed, however small it may seem, it should be recorded clearly and promptly in the care notes. Good documentation creates a timeline that supports any further action taken. But documentation alone is not enough.
Care notes are an internal record; they are not a substitute for direct communication. If something is a cause for concern, care workers will make a direct phone call to the office to ensure nothing is misread or left sitting in a system until the next review.
Speak up Promptly
Delays in escalation can have serious consequences. Timely reporting of concerns is one of the most important factors in preventing harm to vulnerable adults.
If there is any uncertainty about whether something warrants escalation, it almost always does. It is far better to raise a concern that turns out to be minor than to delay on something that isn’t.
At myCare, care workers are supported to speak up. Raising a concern is never seen as overstepping; it is exactly what good care looks like.
How the Escalation Process Works
When a concern is raised, whether by a family member or a care worker, the response doesn’t rest on one person. At myCare, escalation triggers a coordinated, wraparound response designed to ensure nothing is missed and that the right people are involved from the outset.
A Staged Approach
Escalation follows a clear sequence. The concern is first raised with the immediate care team, who assess the situation and determine what action is needed.
If further attention is required, it moves to line management and then to senior management. This staged approach ensures concerns are handled proportionately and that more serious issues reach the right level of the organisation without delay.
The Wrap-Around Response
Once the office is notified, a broader response is initiated where appropriate. Depending on the nature of the concern, this can involve care managers, GPs, district nurses, social workers, and other relevant specialists.
Keeping Families Informed
Throughout the process, communication with the family remains important. At myCare, families are kept up to date at every stage because knowing a concern has been heard and is being addressed can make an enormously difficult situation feel more manageable.
When it Can't Wait
Most concerns can be managed through the staged escalation process. But some situations require immediate action, and it’s important to know when that line has been crossed.
If someone is in immediate danger, whether from a fall, a sudden change in condition, signs of abuse, or any other acute risk, the first call should always be to 999.
Do not wait to contact the care provider first. Emergency services should be the immediate priority.
Once the emergency has been attended to, notify your care provider’s office as soon as possible. This allows the care team to respond, update the care plan, and coordinate with any other professionals involved in the person’s care.
If there is any doubt about whether a situation is an emergency, treat it as one. It is always better to call and not need help than to need help and not have called.
If Your Concern Remains Unresolved
Raising a concern should always result in a response. If it doesn’t, follow up with the care provider in writing to create a formal record.
If the issue remains unresolved, contact the local authority adult safeguarding team directly. Complaints can be made confidentially and without first raising them with the provider.
Research shows that 1.6 million older people already have unmet care needs. Don’t let your loved one become part of that statistic. If something doesn’t feel right, keep raising it. There are independent bodies with the power to investigate and take action.
At myCare, concerns are never left unanswered. From the first phone call through to the wraparound response, our approach is built around ensuring every concern is heard, logged, and acted on promptly.
Escalate Your Concerns With Confidence
Knowing when something isn’t right with a loved one, and feeling confident enough to act on it, can make all the difference. You don’t need to have all the answers before you raise a concern. You just need to trust what you’re seeing and know that there are people who will listen.
At myCare, families are never left to navigate concerns alone. Our team is experienced, approachable, and committed to making sure every concern is heard and acted on promptly, however big or small.
If something doesn’t feel right with your loved one’s care, contact our friendly team today.
