Challenging local authority and NHS assessments
If you or your relative are unhappy
with a decision made by the local authority or NHS relating to their care
needs, you may decide to challenge the decision. We explain how to challenge a
local authority needs assessment or financial assessment, or an NHS decision
that is affecting your relative.
On this page, we give information
about:
1. Reasons why you might want to make a
challenge
2. Making a complaint
3. Tips for making a successful complaint
4. Taking the matter to an ombudsman: your final option
2. Making a complaint
3. Tips for making a successful complaint
4. Taking the matter to an ombudsman: your final option
Reasons why you might want to challenge a decision
If you, or your relative, have had a
care assessment, financial assessment or carer’s assessment and are unhappy
with:
·
its content
·
the way it was conducted
·
or the outcomes
you have a right to appeal or
complain. Possible reasons for dissatisfaction include:
·
Your relative has not seen the assessment or
has not had a chance to comment or sign.
·
The assessment didn't cover all of your
relative’s needs. There should be a record of all presenting needs, not just
those classed as ‘eligible’.
·
Your relative is unhappy with the decision
following a financial assessment and can’t afford what the council is asking
for.
·
The local authority didn't offer any feasible
options for meeting non-eligible needs. Local authorities are supposed to
signpost people to other services that could meet non-eligible needs.
·
You don’t agree with the judgements about
which needs were ‘eligible’.
·
You don't agree with the way your relative's
needs are described.
·
The assessment failed to offer clear outcomes
(the difference the service is meant to make to your relative’s life) or the
outcomes are not appropriate or not of your choice.
·
The choice of service suggested by the care
plan won't meet your relative’s eligible needs/won't deliver the intended
outcome.
·
The amount of service offered will not meet
your relative’s eligible needs.
·
There have been unacceptable delays in
carrying out the assessment or making decisions.
·
Poor customer service or rude staff.
Making a complaint
If you want to challenge a local authority decision, you
should first complain to the relevant local authority itself.
All councils are legally obliged to have a formal complaints
procedure in place. They should publish information to make it clear to users
that they are entitled to a review; explain how to request a review; and
explain how to make a complaint.
This information should be available on all local
authority websites and given to you or your relative at the time of the
assessment.
Tips for making a successful complaint
·
Make it clear that your letter or email is a
formal complaint by stating this at the top.
·
Include all relevant facts (plus dates, times
and names).
·
Attach copies of all relevant documents.
·
Keep your complaint as brief and to the point as
possible.
·
Say what you would like to happen - for example,
you would like an apology or a review.
·
Be polite.
·
Keep a copy for your own records.
Take the matter to an ombudsman: your final option
If you are not satisfied with the local authority’s
response and you believe the fault is down to a service or administrative
error, your final option is to take the matter to an ombudsman.
Once the ombudsman has decided whether it can legally
deal with your complaint, it will then have up to 12 months to provide you with
a resolution.
In Northern Ireland: Northern Ireland Ombudsman
In Scotland: Scottish Public Services Ombudsman
In Wales: Public Services Ombudsman for Wales
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