People who receive social care ‘left in the dark’ about how to challenge decisions

Adults receiving social care in England and Wales are being failed if they try to challenge decisions made by local authorities, according to an inquiry conducted by the Equality and Human Rights Commission (EHRC).

Evidence published by the equality and human rights regulator finds that local authority processes are confusing and slow and comes with risks that people do not get the care they need.

The EHRC launched its inquiry in July 2021 to understand the experiences of social care users and carers who have challenged decisions made by local authorities. It examined the procedures in place among local authorities across England and Wales, as well as gathering insight from social care professionals.

The inquiry learned that social care users and their loved ones find making complaints difficult and stressful, often at a time when they are in crisis. It also found that some people are deterred from seeking help by a ‘complicated system’ that should instead be upholding their rights to challenge decisions about their care.

Marcial Boo, Chief Executive of the Equality and Human Rights Commission, said that while social care can make ‘an enormous difference’, the current system in England and Wales is ‘struggling’, with people’s needs being balanced against tight budgets.

“While local authorities are facing huge pressures, they must protect people’s rights when making decisions about their care. Effective ways for people to challenge those decisions are crucial to ensuring that good decisions are made and people’s needs are met.”

The inquiry heard that some people are not given crucial information about how to challenge decisions, and under half of the local authorities surveyed always signpost users to independent advice or support. The EHRC said this creates unnecessary barriers for users and fears of negative consequences if complaints are made, including loss of access to the social care needed.

The report found that there is also poor collection and analysis of equality data with the EHRC saying this missing information could help councils to understand how well they meet the social care needs of different groups to improve services.

“People who receive social care should not be left in the dark about how to challenge decisions that affect their wellbeing, dignity and independence so fundamentally,” Marcial Boo continued.

“Our findings demonstrate that improvements must be made to the accessibility of information, the clarity of the complaints process and the availability of support.

The EHRC recommends that complaints in future are considered and resolved within ‘well-defined’ timescales, and that they consider the ‘substance or outcome of decisions, as well as the processes followed’.

It also recommends requiring complaint decision makers to be “robustly and visibly independent, to support trust and accountability”, and to “provide clarity about the different routes of redress available to those using (or trying to use) adult social care, including early signposting to information on legal help, legal aid and legal specialists.”

Currently, complaints can be made to the Local Government and Social Care Ombudsman (LGSCO), with the report arguing this body should be made the statutory complaints standards authority for adult social care in England and given new powers to initiate investigations into areas of concern without the need for individual complaints.

Michael King, Local Government and Social Care Ombudsman, welcomed the report adding that its findings echo the issues the body often finds in its investigations.

“People have a right to good quality care that respects their basic rights to dignity, autonomy and fair treatment. If things go wrong, there should be transparent, effective and accessible procedures in place for people to challenge decisions made by their local councils.

“But we know this is not always the case, which is why we have been calling for statutory signposting to our service.”

Mr King said that as a newly-empowered statutory complaints standards authority, the LGSCO could ensure complaints were dealt with “clearly and consistently across the country, and that lessons from complaints were properly scrutinised and embedded.”

“We have previously highlighted our concerns about the erosion of effective local complaints processes and the particular challenges faced by people with disabilities in accessing the complaints process. The EHRC’s report confirms the problems we are finding with access for people with communication needs as we increasingly look at complaints through the lens of human rights.

“The EHRC has made a number of pragmatic recommendations which support the powers we have been calling on the government to give us, including the ability for us to carry out investigations where we think there is unremedied injustice regardless of whether we have received a complaint.”

BASW England said in a statement that it would be looking at the findings and recommendations and how to take these forward, alongside recommendations contained in other recent social care reports, such as the Church of England’s ‘Care and Support Reimagined’ and the House of Lords Adult Social Care Committee’s report ‘A Gloriously ordinary life’, which proposes an independent review of the Care Act.

The recommendations also include a call for the Welsh Government to work with local authorities and others to improve the collection and analysis of equality data from social care users, including those who challenge decisions. This data should be used to identify and address poor outcomes where they are experienced by people who share particular protected characteristics.

Eryl Besse, Wales Commissioner for the EHRC, said the views and wishes of people who receive social care should be taken into account.

“To ensure good decisions are made and people’s needs are met, there must be effective ways to challenge care decisions. Our findings show that this will require improvements to be made to the accessibility of information, the clarity of the complaints process, and the availability of support.

“Our inquiry sets out several steps that should be taken now to uphold equality and human rights standards. The launch of the new Citizens Voice Body for Health and Social Care in April 2023, and wider social care reforms in Wales, present opportunities to support these improvements”.

Gillian Baranski, Chief Inspector at Care Inspectorate Wales, said: “Ensuring people are at the heart of decision-making and their voices are heard is one of the core principles guiding the CIW’s work.

“I welcome this inquiry and look forward to continuing to work closely with the EHRC to ensure its recommendations are taken forward.”