Recurring concern
Failure to ensure people are placed in care settings suitable for their needs
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Request correctionFirst reported 23 May 2014•Latest report 10 Oct 2025
What this concern includes
Includes failures of the care-placement process to assess needs, identify suitable settings, match people to placements, or move them when an existing setting cannot safely meet their needs, including residential and nursing placements and comparable care settings.
Not included
- Excludes generic discharge, transfer or care-coordination failures where placement suitability is not the identified unsafe condition.
- Excludes shortages or unavailability of placements unless they directly result in a person being placed or left in a setting unsuitable for their needs.
- Excludes inappropriate hospital, mental-health or custodial placements unless the assertion specifically concerns the suitability of a care placement for the person's needs.
- Excludes failures limited to care quality after a placement is suitable, where the placement decision or suitability assessment is not deficient.
- Reports
- 19
- Individual concerns
- 20
- Date range
- 2014–2025
- Stated actions
- 12
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
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Concerns raised1
Inappropriate care-home placement for patient needs
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Discuss professional curiosity with teams, remind staff to review care-home paperwork and consult carers, and provide support sessions on asking appropriate questions.
Stated by Essex Partnership University NHS Foundation Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
Essex County Council is responsible for responding to concerns about placement appropriateness and updating the section 117 care plan.
Stated by Essex Partnership University NHS Foundation Trust
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Concerns raised1
Lack of a step-down community rehabilitation facility for patients unsuitable for inpatient rehabilitation but unsafe at home
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
Integrated Care Boards are responsible for commissioning stroke services, including rehabilitation.
Stated by Department of Health and Social Care
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Concerns raised1
Failure to ensure that discharge to a non-nursing care home is appropriate for a patient's condition and care needs
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure to ensure resident suitability for care home placement
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Send providers learning from the case on robust pre-admission risk assessments and personalised care planning that considers impacts on other residents, families and staff.
Stated by NHS Greater Manchester Integrated Care Board -
Action
Present the case learning to Tameside care home managers and deliver a further session on discharge and transfers between community and acute settings.
Stated by NHS Greater Manchester Integrated Care Board
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Concerns raised1
Continuation of care in a home unable to safely meet complex care needs
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
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Action
Review safe and appropriate discharge arrangements for people with complex needs across Greater Manchester with localities.
Stated by NHS Greater Manchester Integrated Care Board -
Action
Continue complex-needs and discharge scoping through the Learning Disabilities Complex Needs Programme.
Stated by NHS Greater Manchester Integrated Care Board
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
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Position
Existing reassessment and review arrangements are relied upon to address changes in patients’ care needs and placement suitability.
Stated by NHS Greater Manchester Integrated Care Board
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Position
Cases where registered-service staff cannot safely meet someone’s needs are referred to the Local Authority under safeguarding protocols.
Stated by Care Quality Commission
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Concerns raised1
Placement of people in unsuitable and unsafe residential settings
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
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Position
Adult Social Services cannot place someone in nursing care without a health professional’s nursing needs assessment.
Stated by Norfolk County Council
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Position
Adult Social Care cannot source higher-level specialist placement until the CCG agrees to fund it.
Stated by Norfolk County Council -
Position
The letter was escalated through the community response team and senior management, so no escalation to the Director was considered necessary.
Stated by Norfolk County Council
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Concerns raised1
Failure to provide appropriate places of safety for autistic patients with additional mental health problems
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure to provide suitable ward placement due to capacity and flow constraints
This report raised 9 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
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Action
Review the Patient Outlier Policy with stakeholders to clarify guidance for minimising risks to patients cared for outside their specialty wards.
Stated by Bolton NHS Foundation Trust -
Action
Provide the Integrated Discharge Team across all assessment wards and the Emergency Department, assigning a lead care coordinator from admission through discharge.
Stated by Bolton Borough Council and Bolton NHS Foundation Trust and Greater Manchester Mental Health NHS Foundation Trust -
Action
Require wards to escalate patients with complex needs to the Integrated Discharge Team for a full multidisciplinary meeting before considering transfer of care.
Stated by Bolton Borough Council and Bolton NHS Foundation Trust and Greater Manchester Mental Health NHS Foundation Trust
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
Local authorities, service providers and the Care Quality Commission are responsible for acting on allegations of poor care, neglect or abuse.
Stated by Department of Health and Social Care
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Concerns raised1
Failure to provide a care placement able to cope with complex care needs
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure to identify a suitable nursing home placement when the care home no longer met residents’ needs
This report raised 9 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
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Position
Nursing-home placement is not the District Nursing Team's responsibility, so the concern should be addressed by the CCG's Funded Nursing Care team.
Stated by Stockport NHS Foundation Trust
Data last updated 7 September 2026