Equality and Human Rights Commission reveals social care users find making complaints difficult
A report 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.
The Challenging adult social care decisions needs in England and Wales study, published by the equality and human rights regulator, 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 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.
Many regarded complaining as pointless and were reluctant to do so, according to the State of Caring report, the main barrier to carers raising a complaint or concern was the perception that doing so would make little difference, reported by 47 per cent 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. 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 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.
The survey found that nine out of 10 local authorities in England and Wales would, in at least some cases, signpost someone wishing to challenge a decision to advice or support to a body that is independent of the local authority. Over two fifths of local authorities reported that they do this in every case.
“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.
Findings revealed that 89 per cent of local authorities in England, and 100 per cent in Wales, have procedures to tell social care users and carers how to challenge a decision by informal or formal complaint or appeal. However, only 90 per cent of local authorities in England and Wales make information on how to challenge a decision in accessible formats.
Additionally, just over a third of local authorities in England and Wales have some sort of appeals process as well as formal complaint processes. This means that people in many local authority areas do not have access to this option.
Michael continues: “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.
According to the study, few local authorities collect and analyse data on the protected characteristics of individuals who make either informal or formal complaints. When they do, it’s mostly about age, sex and race.
Between 3 per cent and 8 per cent of local authorities collect and analyse data on the protected characteristics of people making informal complaints, and between 7 per cent to 26 per cent do the same for formal complaints.
Only 20 per cent of local authorities said they developed action plans to monitor whether learning from challenges was acted on, and just 16 per cent cited reviews of lessons learnt.
Two-thirds of those responding to the survey said that, even when challenges are withdrawn, or resolved outside the formal complaints process, they review records to identify improvements needed.
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”.
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.
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.”
https://thiis.co.uk/equality-and-human-rights-commission-reveals-social-care-users-find-making-complaints-difficult/https://thiis.co.uk/wp-content/uploads/2023/03/Ageing-Better-Adult-Social-Care-at-home-900x599-1.jpghttps://thiis.co.uk/wp-content/uploads/2023/03/Ageing-Better-Adult-Social-Care-at-home-900x599-1-150x150.jpgNewsroomReports & ResearchSector Newsadult social care,adult social care and health,Care Act,complaints process,Equality and Human Rights Commission,local authoritiesA report 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. The Challenging adult social care decisions needs in England and Wales study, published by the equality...Millie YorkMillie Yorkmillie.york@bhta.comEditorTHIIS Magazine