Missed care visit: what to do when a carer does not arrive

Try to contact the person if you are not with them. Ask what support has been missed and whether they can manage while the agency responds. If you cannot reach them, tell the agency that clearly and use the agreed welfare and access arrangements. Do not assume silence means everything is fine.

NHS guidance says to call 999 for life threatening emergencies. NHS 111 can advise on urgent medical needs where it is not a life threatening emergency. A missed care call is not itself a reason for an ambulance, but a serious medical situation should not wait for the agency to answer.

Give the call handler the actual situation, location and relevant information. Follow their instructions. If there is an essential care need without an immediate medical emergency, make that clear to the agency and, where needed, the council's adult social care or emergency duty service.

Use the urgent number in the care plan or the provider's out of hours arrangements. Explain the scheduled visit time, how late it is, the task missed and the person's current situation. State whether they are alone and whether there is anybody able and willing to help.

Ask who is taking responsibility, who will attend and the expected arrival time. Ask what happens if that replacement is delayed too. Write down the person's name and the time of the conversation. If the response is only that somebody will call back, ask when and which number to use if that does not happen.

Be clear when a relative cannot provide the care. Being an emergency contact does not mean being trained, nearby or available to perform every task. Ask the agency to activate its contingency plan rather than assuming the family will absorb the failed visit.

This original record separates the missing visit from the response to it. Keep it factual and private. It can help the manager investigate and prevent the same problem being explained differently in several conversations.

Record the person's experience in their own words where possible, without adding a diagnosis or motive. Keep messages and the relevant schedule. Avoid sharing names or care details publicly as a substitute for the complaint process.

A delayed visit can create pressure to do something quickly. If the person needs an assessed moving method, equipment or two workers, do not assume a neighbour or relative can safely substitute. Explain the unmet task and ask the provider or relevant professional what arrangement is needed.

If medicine support has been missed, contact the appropriate clinician or pharmacist for advice about that medicine and situation. Do not guess a replacement dose, double a dose or change the schedule to make up for the delay. Tell the replacement carer about any advice received.

Also check what happened before the missed call. Another person may already have helped, or the visit record may be unclear. Replacement workers need accurate information to avoid repeating something that has already happened. Ask the agency to reconcile the record rather than leaving different people to assume.

NHS medicines guidance for carers explains why questions about timing, missed doses or refusal should be discussed with the relevant health professional.

NHS moving and handling guidance explains the importance of suitable training and advice before using equipment.

Ask whether the worker is delayed, the rota contains an error, the person cancelled or the worker attended but could not gain entry. These situations need different investigation. None should be resolved simply by changing the label in a record.

If there was failed entry, ask what attempts were made, who was contacted and whether the agreed welfare procedure was followed. If care was declined, ask how the person was supported to understand the offer and what escalation the care plan required. Do not describe a refusal as proof that no further attention was needed.

Check whether the next visit also needs changing. A very late meal or personal care call can affect the rest of the day. Ask the provider and relevant professional to agree the remaining schedule where necessary, rather than compressing visits without considering their purpose.

Once immediate support is arranged, send the manager a concise account. Ask why the visit failed, when the agency became aware, whether its contingency process worked and what it will change. Request a date for the response and a separate date to check the agreed action.

NICE home care guidance recommends individual contingency planning for missed or late visits and prompt action on the risks. Ask the manager to review the person's plan with them. A general apology or assurance that it will not happen again is less useful than a specific change with an owner.

Examples to clarify include how unstarted visits are detected, which manager responds outside office hours and how staff shortages are covered. Do not ask for private employment details about an individual worker. The important issue is whether the service can deliver and respond reliably.

Use the agency's formal complaints procedure and involve the council if it arranges the care. The NHS explains home care complaint routes, including the Local Government and Social Care Ombudsman when the local response does not resolve matters. You can also share concerns about regulated services with CQC; that is separate from arranging immediate replacement support.

Tell the council safeguarding team if you suspect abuse or neglect, and use emergency services where the immediate situation requires them. Keep the distinction between a scheduling problem, a continuing care risk and an allegation requiring safeguarding consideration. Describe the evidence and let the responsible service assess it.

Repeated failures may mean the arrangement needs reviewing. Ask who will ensure essential care continues during that process. You do not need to wait for a complaint outcome before reporting that the current plan leaves needs unmet.

GOV.UK explains how to report concerns about abuse or neglect, including contacting the council and calling 999 for immediate danger.

Query the charge for the missed or shortened visit against the contract and the actual record. Ask how a credit or adjustment will appear. A billing correction does not resolve the care issue, so keep the investigation and payment questions visible separately.

Review the contact numbers and contingency plan with the person. Use the visit planning guide if the schedule itself is no longer adequate. If confidence in the service has broken down, our guide to changing agencies explains how to avoid a new gap during the change.

For future enquiries, use the agency comparison checklist to test the provider's actual response arrangements. The aim is a service that recognises a problem promptly and takes responsibility for the next practical action.