Inquiry finds adults receiving social care are failed if they try to challenge councils’ decisions

An inquiry conducted by the Equality and Human Rights Commission (EHRC) has found that adults receiving social care in England and Wales are being failed if they try to challenge decisions made by local authorities.

‘Challenging adult social care decisions in England and Wales‘ reveals local authority processes are confusing and slow and risks people not receiving the care they need. Social care users, and their loved ones, find making complaints difficult and stressful, often at a time when they are in crisis.

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 and gathered insight from social care professionals.

The inquiry 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.

Many regarded complaining as pointless and were reluctant to do so. The main barrier to carers raising a complaint or concern was the perception that doing so would make little difference, reported by 47 percent of respondents.

The paper states that local authorities are legally required under the Care Act 2014 in England and the Social Services and Well-being (Wales) Act 2014 in Wales to commission advocacy services to help people be involved in decisions about their care and challenge them.

Marcial Boo, Chief Executive of the Equality and Human Rights Commission, said: “When social care works well it makes an enormous difference, helping people live their lives as they choose. But the social care 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. This creates unnecessary barriers for users and fears of negative consequences if complaints are made, including loss of access to the social care needed.

There is also poor collection and analysis of equality data, according to the inquiry. This missing information could help councils to understand how well they meet the social care needs of different groups, so services can be improved.

Eryl Besse, Wales Commissioner for the EHRC, commented: “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”.

Recommendations in the paper include the UK and Welsh governments and relevant stakeholders should work with local authorities to improve the collection, analysis, and reporting of social care users’ equality data, including those who complain about or challenge decisions.

This should be considered alongside other data around user satisfaction and used to identify and address poor outcomes experienced by people who share protected characteristics.

Marcial added: “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.

“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 need for reform and additional funding for local authorities to deliver social care is widely acknowledged. Our inquiry sets out a number of steps that should be taken now to uphold equality and human rights standards when people challenge decisions about their care.”

Other recommendations include a call for the UK Government to make the Local Government and Social Care Ombudsman (LGSCO) the statutory complaints standards authority for adult social care in England and for the LGSCO to receive new powers to initiate investigations into areas of concern without the need for individual complaints.

Following the publication of the Care Quality Commission’s (CQC’s) annual State of Care report, leaders from the Parliamentary and Health Service Ombudsman, Association of Directors of Adult Social Services (ADASS), Healthwatch England, and NHS Confederation shared their views on the current health and social care landscape in England.