Your social care needs assessment will decide if you are eligible for support. If you do not get the support you hoped for, this can be upsetting. If you believe you should be eligible for more support, you can:
challenge the decision
find other sources of help for things not covered by your care and support package
The support you can get and how long this might take can vary by area. The needs assessment is the first step when applying for social care support. After this comes the means assessment. This will look at how much money you have to pay for your own care.
The Care Act 2014 defines specific eligibility criteria for social care. These cover:
By law, your local authority must provide care to meet the eligible needs in your assessment. But this care may not be what you want.
You might want a carer to prepare meals for you but a meal delivery service could meet these needs too.
You might want a 24-hour carer but your local authority may offer a place in a residential care home.
If you are reassessed, your eligible outcomes might be different and your care could change.
Support for 'ineligible' needs
Some needs may fall outside of your local authority's remit. The authority should tell you about other organisations in your area that may be able to provide support and advice. You can also:
search online for support in your area
talk to your local disability advice service
ask your doctor for information about local support
Challenging your needs assessment
If you had an assessment and you are unhappy with it, ask your local authority about their appeals process.
You could also use an advocate. Advocates are people who speak up on your behalf. They can help you fill in forms and sit with you in meetings and assessments. They're usually free. Find an advocate in your area (NHS).
POhWER can give you more information on how an advocate can help.
1. Have an informal conversation with your assessor
Ask your local authority for a written explanation of the assessment. If you are unhappy with this, tell the assessor what you are unhappy with, either in writing, face to face or over the phone.
For example, you might say: "When considering need x, you need to take y and z factors into account."
If you decide to do this face to face or over the phone, follow this up in writing so that you have a record.
The authority may take this information into account and revise the decision. Or they might explain in greater depth why you are not eligible. If you are still unsatisfied, take your complaint to the next level.
2. Make a formal complaint
All local authorities have a formal complaint procedure. Your assessor should be able to tell you about this.
You can also search online for the name of your local authority and ‘complaints procedure’. This will include:
what should happen and when
This will usually be a written complaint made online, either by email or using a form.
You should get an initial reply within 2 weeks. The local authority may decide to reassess your needs or they may not.
3. Ask for an independent review
Ask your local authority for an independent review if you are unhappy with how they respond to your complaint.
Write to them and explain why you are not happy.
For example, the assessor may have missed something or not considered important information relating to your condition or impairment.
The reviewer will usually be an independent social worker. They will look at the records of your assessment and consider your support needs.
4. Complain to the Local Government Ombudsman
The Local Government Ombudsman investigates complaints from the public about councils and some other bodies providing public services in England. Make a complaint to the Ombudsman if you:
have made a formal complaint, and
had an independent review
can ask your local authority to reconsider a decision or to provide an apology or compensation
has the final say, except in rare cases that raise legal questions that need a judicial review
You can contact the Ombudsman once for each complaint. Make sure you give them all the information you feel that they need to know.
Submit your complaint using an online form or by phone. Keep copies of any information you share. If your condition means that contacting them another way would be more accessible, ask for an adjustment.