System for challenging social care decisions ‘failing those who need it’

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 today by the equality and human rights regulator reveals local authority processes are confusing and slow, with risks that people do not get 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 too.  

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. 

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. This missing information could help councils to understand how well they meet the social care needs of different groups, so services can be improved. 

Marcial Boo 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.”

The EHRC makes recommendations for local authorities in England and Wales, the UK and Welsh governments and other bodies with a role in the care system.  

The 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.

Michael King, Local Government and Social Care Ombudsman, said:  

“We welcome the Equality and Human Rights Commission’s inquiry report which echoes the issues we regularly find in our investigations about adult care services, of which we uphold more than two thirds. 

“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. As the newly-empowered statutory complaints standards authority, we would 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.”

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.” 

Notes to Editors:

• 153 local authorities out of an eligible 174 with responsibility for adult social care responded to our survey (133 in England and 20 in Wales). In-depth interviews were conducted with 12 councils spread across different regions, to understand the processes and practices of local authorities (2 in Wales).  

• 332 individuals accessing adult social care, their representatives and carers responded to a survey of people’s experiences of challenging decisions (59 from Wales). In-depth interviews were carried out with 41 people seeking or accessing care and carers (10 from Wales).  

• 54 in-depth interviews (23 with Wales stakeholders) and 12 focus group discussions (3 in Wales) were held with a wide range of individuals and organisations, including professionals working within social care, advocacy providers, older and disabled people’s organisations, statutory bodies, professional associations and legal experts. 15 written submissions were received from organisations and experts.