If you disagree with your local council, trust or authority's decision not to pay for your care services – speak out. Two in three complaints that reach the Ombudsman are successful.
Know your rights
Taking on your local authority, or Health and Social Care (HSC) Trust in Northern Ireland, can seem daunting.
But if you’re planning to challenge a decision, it will help your confidence to know a few basic things first:
- You have the legal right to a free care needs assessment to work out how much help you need to live as independently as possible. Your local council can’t simply refuse because they don’t think you’ll qualify for support.
- You can ask for a reassessment if you think your circumstances have changed.
- Every local council has their own eligibility criteria for what support you can and can’t receive. But they still have to follow government guidelines.
- Your local council has a legal duty to meet your eligible care needs – it’s not enough to say they can’t afford them.
How do I challenge my care needs assessment?
You don’t have to stick by the decision of the people who carried out the assessment.
For example, if you have an illness or a disability, they might have assessed you on a ‘good’ day. But the assessment should also take into account fluctuating needs.
If you disagree with a decision not to provide support, or you don’t think the care package being offered is enough to meet your needs, follow the steps below to challenge it.
How do I challenge my financial assessment?
Top tip
Calculating the value of assets and income for means-test purposes can be complex. This is why many people get independent legal or financial advice before challenging a decision.
There are strict rules about how much you should pay for long-term care. Although local councils might have more generous arrangements than the government guidelines.
Still, if you think your assets or income have been overvalued or something’s been included wrongly, and you’re being asked to pay for more than you should, you can ask for your case to be reviewed.
If you’re not sure about what income or capital should be taken into account, a FirstStop adviser might be able to help you. Call them on 0800 377 7070.
For support and free advice on care, contact:
If you live in England, Age UKOpens in a new window
In Wales, Age CymruOpens in a new window
In Northern Ireland, Age NIOpens in a new window
- In Scotland, Age ScotlandOpens in a new window
You can also book an appointment to speak to an adviser at Care Rights UKOpens in a new window
If you need to find a specialist care fees adviser, see our guide Get financial advice on how to fund your long-term care
How to challenge a decision – step by step
Did you know?
You can make the challenge yourself or ask someone else, such as a friend or relative, to do this on your behalf.
Follow these steps to challenge a decision.
Step 1 – Do your research
Find out about the complaints procedure for your local council – or your local Health and Social Care Trust in Northern Ireland.
Find your local authority (council) or trust:
- in England and Wales, go on GOV.UK
- in Scotland, go on mygov.scot
- in Northern Ireland, go on nidirect
The details will be on their website. It’s also worth taking a look at their eligibility criteria for long-term care services, and their charging policy.
You have the right to take someone with you to an appeal or assessment. This could be an advocate. Advocacy services are usually free.
An advocate can be someone who:
helps you to say how things affect you and speak up for what you need
provides emotional support.
Find out more about advocates and how to get one on the NHS websiteOpens in a new window
Step 2 – Contact your local council or trust
Your local council or trust has a legal duty to give you a written explanation of their decision.
Take time to read it. If you think it’s unfair, you can ask for your case to be reassessed.
There might simply have been a failure in communication or a misunderstanding that can be easily fixed.
Step 3 – Get help
If you need help with a complaint, contact your local councillor, Citizens Advice or local disability or support groups to see if they’ll help you put your case forward.
You can get help with legal questions on the Citizens Advice websiteOpens in a new window
Find out more on the Citizens Advice website
Step 4 – Take your complaint to the Ombudsman
If you’re not happy with the response you get from your local council, you can get legal advice or take your complaint to the relevant local government ombudsman:
- in England, contact the Local Government and Social Care Ombudsman
- in Scotland, contact the Scottish Public Service Ombudsman
- in Wales, contact the Public Services Ombudsman for Wales
- in Northern Ireland, contact the Northern Ireland Ombudsman
Complaints about your care
If your complaint is about the care you’re getting, there’s a slightly different process to follow. This is the case even if you’re paying for the care with direct payments from your local council.
