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Complaint Form
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Date of Complaint
*
Complainant's Name
*
Nature of Complaint
Regarding Carer
Regarding Service User
Regarding Staff Member
Other
Nature of Complaint (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
Details of Complaint
The complaint is regarding:
Name of the person(s) which/whom the complaint is filed:
Name of Person
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Actions to take
*
Organise Spotcheck
Conduct Supervision
Increase QA's on Carer's Clients
Send for retraining
Disciplinary Action
None Required
Other
Action to take (other)
Raised as a safeguarding?
*
Yes
No
Information Recorded By:
*
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