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Please use this form for reporting quality concerns that do not meet the criteria for reporting a safeguarding adults concern. For complaints, please refer to Knowsley MBC’s complaints process.

This form replaces the ‘provider-led concern/enquiry’ processes and previous versions of the ‘Quality Concern’ process. It is no longer necessary for you to submit a Provider-Led Enquiry in addition to this form; however if necessary, the Safeguarding Quality Improvement Service may contact you and ask for further enquiries to be made in relation to the concern you are reporting here.

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Provider name and address

Name, role and contact details of person reporting quality concern

Date, time and location of quality concern

Name and address of the person the concern is about

Description of concern/issue - please include how this came to your attention and why the concern occurred/what went wrong

Actions taken to address the concern, including all steps taken to minimise risk of recurrence and how the organisation will ensure and monitor this

Lessons learned and how lessons will be shared

Do you consider this concern to be resolved? Please provide a rationale as to why you consider this to be the case - if further actions are required, please detail these here and state who you expect will complete these actions