Safeguarding an Elderly Parent with Dementia in England

When to Raise a Safeguarding Concern

Safeguarding isn't just for cases of obvious abuse. Under the Care Act 2014, the local authority has a statutory duty to investigate when an adult with care and support needs is experiencing — or at risk of — abuse or neglect and cannot protect themselves because of those needs. For someone with dementia, that includes situations many families aren't sure whether to report:

• Unexplained bruises, weight loss, or deterioration in condition
• Medication being given incorrectly or inconsistently
• Being left in soiled clothing or bedding for extended periods
• Staff speaking to your parent dismissively, impatiently, or aggressively
• Financial irregularities — money going missing, unexplained withdrawals, pressure to change a will
• Being isolated from family contact or having visits restricted without clear reason
• Falls that aren't properly documented or followed up

You don't need to prove abuse has occurred. The threshold for raising a concern is "reasonable cause to suspect" — if something doesn't look right, report it.

How to Raise a Safeguarding Alert

Step 1: Contact the local authority's Adult Safeguarding Team. Every council has one. You can find the number on the council's website or call the main switchboard and ask to be put through. In an emergency, call 999.

Step 2: Describe what you've observed. Be specific — dates, times, what you saw, who was involved. "Mum had bruises on her arms when I visited on Tuesday" is actionable. "Something seems wrong" is harder to investigate.

Step 3: The council decides whether to investigate. Under Section 42 of the Care Act, if the person has care and support needs, is experiencing or at risk of abuse or neglect, and cannot protect themselves because of those needs, the council must launch a formal safeguarding enquiry.

Step 4: Multi-agency investigation. The enquiry may involve the council, police, CQC, and healthcare professionals. The aim is to determine what happened, whether the person is safe, and what actions are needed.

You can raise a concern anonymously, though providing your details helps the council follow up and keep you informed of the outcome.

Deprivation of Liberty Safeguards (DoLS)

DoLS exist to protect people who lack capacity to consent to their care arrangements. If your parent is in a care home or hospital and is under continuous supervision and control — and is not free to leave — that amounts to a deprivation of liberty, which is only lawful if it has been formally authorised.

When DoLS should be in place:

A care home must apply for a DoLS authorisation from the local authority whenever a resident who lacks mental capacity is being deprived of their liberty. This is assessed through:

• A mental health assessment
• A mental capacity assessment
• A best interests assessment
• An eligibility assessment
• An age assessment (the person must be 18 or over)
• A "no refusals" assessment (checking that the arrangement doesn't conflict with a valid LPA or advance decision)

Why this matters for families:

DoLS authorisation gives your parent a legal representative — a Relevant Person's Representative (RPR) — who monitors whether the deprivation remains necessary and proportionate. If you're appointed as RPR, you have formal standing to challenge the care arrangements.

If a care home is restricting your parent's liberty without a DoLS authorisation in place, that is unlawful. Raise this with the care home manager first, then with the local authority if they don't act.

Complaining to the CQC

The Care Quality Commission regulates care homes in England but doesn't investigate individual complaints about care quality. Instead, CQC uses information from families to inform its inspection priorities.

Report concerns about a care home to CQC when:

• The care home isn't addressing your complaint
• You believe the issues are systemic (affecting multiple residents, not just your parent)
• You want CQC to be aware before their next inspection

For individual care failures, use the care home's own complaints procedure first. If the local authority arranged or funds the care and the council does not resolve the issue, use its complaints process and then consider the Local Government and Social Care Ombudsman.

Protecting Your Parent's Interests

If you hold a Health and Welfare LPA, you have legal authority to challenge care decisions and demand information about your parent's care. Without an LPA, your ability to intervene is limited — care homes can refuse to discuss care details with family members who don't have formal legal standing.

This is another reason why setting up LPAs early in a dementia diagnosis is critical. Safeguarding concerns are far easier to pursue when you have documented legal authority to act on your parent's behalf.

Our Dementia Care in England guide includes template letters for raising formal safeguarding concerns, a checklist for monitoring care home quality, and guidance on escalation routes when initial complaints don't produce results.

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