If you disagree with your local authority’s decision not to pay for your care services – speak out. Two in three complaints that reach the Ombudsman are successful.
Know your rights
Taking on your local council can seem daunting. But if you’re planning to challenge a decision, it will help your confidence to know a few basic things first.
- You have the legal right to a free care needs assessment to work out how much help you need to live as independently as possible. Your local authority can’t simply refuse because they don’t think you’ll qualify for support.
- You can ask for a reassessment if you think your circumstances have changed.
- Every local authority has their own eligibility criteria for what support you can and can’t receive. But they still have to follow government guidelines.
- Your local authority has a legal duty to meet your eligible care needs – it’s not enough to say they can’t afford them.
How do I challenge my care needs assessment?
You don’t have to stick by the decision of the people who carried out the assessment.
For example, if you have an illness or a disability, they might have assessed you on a ‘good’ day. But the assessment should also take into account fluctuating needs.
If you disagree with a decision not to provide support, or you don’t think the care package being offered is enough to meet your needs, follow the steps below to challenge it.
How do I challenge my financial assessment?
Calculating the value of assets and income for means-test purposes can be complex. This is why many people get independent legal or financial advice before challenging a decision..
There are very strict rules about how much you should pay for long-term care. Although local authorities may have more generous arrangements than the government guidelines.
Still, if you think your assets or income have been overvalued or something’s been included wrongly, and you’re being asked to pay for more than you should, you can ask for your case to be reviewed.
If you’re not sure about what income or capital should be taken into account, a FirstStop Adviser might be able to help you. Call them on 0800 377 7070 (Monday to Friday, 9am – 5pm).
To find out more about FirstStop, see their website.
How to challenge a decision – step by step
Did you know?
You can make the challenge yourself or ask someone else, such as a friend or relative, to do this on your behalf.
Follow these steps to challenge a decision:
Step 1 – Do your research
Find out about the complaints procedure for your local authority (or your local Health and Social Care Trust in Northern Ireland).
The details will be on their website. It’s also worth taking a look at their eligibility criteria for long-term care services, and their charging policy.
Your local authority or trust has a legal duty to give you a written explanation of their decision.
Take time to read it. If you think it’s unfair you can ask for your case to be reassessed.
There might simply have been a failure in communication or a misunderstanding that can be easily fixed.
Step 3 – Get help
If you need help with a complaint, contact your local councillor, the Citizens Advice Bureau or local disability or support groups to see if they’ll help you put your case forward.
Step 4 – Take your complaint to the Ombudsman
Did you know?
In England, the Ombudsman finds in favour of the person bringing the complaint in two out of every three social care cases it looks at.
If you’re not happy with the response you get from your local authority, you can get legal advice or take your complaint to the relevant local government ombudsman:
Complaints about your care
If your complaint is about the care you’re getting, there’s a slightly different process to follow. This is the case even if you’re paying for the care with direct payments from your local authority.
Find out more in our What if you’re unhappy with the care you receiveopens in new window guide.
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