Complaints about councils that conduct community care assessments

This fact sheet is aimed primarily at people and their carers who have problems concerning community care assessments and may be considering making a complaint to the Ombudsman.

I am unhappy about the way in which the council has carried out my community care assessment. Can the Ombudsman help me?

• In some cases, yes. The Ombudsman cannot question the merits of decisions, or professional judgements, where they have been reached properly. But we can consider how those decisions are reached and whether they have been implemented properly.
• The law says that where it appears to a council that any person may be in need of any services within its area, the council shall carry out an assessment. The council must then decide whether the person’s needs call for the provision by it of any such services. Councils also have a duty to assess carers if they request it. A carer can be any individual who is over 16 and provides or intends to provide a substantial amount of care on a regular basis.
• There is no guidance on how long it should take for a community care assessment to be carried out. But the Ombudsman normally considers that it is reasonable for this to take between four and six weeks from the date of the initial request, although for individuals with more complex needs we recognise that if can take longer, especially if information is required from other agencies. If there has been a delay by those agencies in providing the information needed, councils should be able to demonstrate that they have taken reasonable steps to obtain that information.
• Councils should take into account the views of the person being assessed and, if appropriate, their carers. Some councils do this by supporting the person to do a self-assessment of their needs. They should also work with other agencies towards a single combined assessment in order to avoid delays and duplication. 
• Government guidance requires councils to adopt eligibility criteria, and to decide at what banding level they will provide services.¹ This policy can vary between councils. Councils should assess against four eligibility bands: critical, substantial, moderate and low. Individuals should be placed in one of these bands in order to prioritise needs. 
• Councils should take into account an individual's assessed needs and the associated risks to their continued independence when deciding on their eligibility for services.
• Once an assessment is completed, the council should share with the service user their written record of what services the person requires, and how these will be provided (the Care Plan or Support Plan). 

1  The Department of Health's Prioritising need in the context of Putting People First: a whole system approach to eligibility for social care. Guidance on Eligibility Criteria for Adult Social Care, England 2010.

How do I complain?

• You should normally complain to the council first. We will not normally consider a social services complaint until the council has had the opportunity to consider and resolve it locally.
• You should normally complain to us within 12 months of hearing what the council’s final decision is. When you make a complaint to social services you should be given information about what will happen to your complaint and how long this will take.
• The council should agree with you a plan for how it will deal with your complaint, including a timescale. You can complain to us if you’re not happy with the outcome, once the council has completed its consideration of your complaint.
• In exceptional cases we will consider complaints even though they haven’t completed the council’s social services complaints procedures, perhaps because of  serious unexplained delays.
• To complain to the Ombudsman phone our Advice Team on 0300 061 0614 (8.30am to 5.00pm, Mondays to Fridays). You will be able to discuss your complaint with one of our advisers. You can text us on 0762 480 4299.
• You can complete an online complaint form.

If you can consider my complaint what will the Ombudsman look for?

We consider whether there is fault in the way the council has dealt with a person’s assessment for community care services and whether they have suffered as a direct result. Some faults we might find are that the council:

• failed to consider properly the complainant's needs and circumstances 
• failed to make an assessment of the carer’s needs or to take a reasonable account of the care a carer is able to provide
• failed to involve the carer in the assessment of the cared for person
• failed to obtain relevant information from other key agencies, or failed to chase up that information, or
• delayed unreasonably in carrying out an assessment.

What happens if the Ombudsman finds that the council was at fault?

It depends on the fault and what the consequences are. We must consider what injustice has been caused to the complainant or service user as a result of what went wrong, and how best that can be put right. So if, for example, there are errors in a care assessment, we first ask the council to reassess the person and think again about the services they may need. We might then ask the council to compensate that person for any injustice caused by the previously inadequate assessment. 

Examples of some complaints we have considered

Other sources of information

• See the Community Legal Advice’s website at www.clsdirect.org.uk or call them on 0845 345 4 345.

Our fact sheets give some general information about the most common type of complaints we receive but they cannot cover every situation. If you are not sure whether we can look into your complaint, please phone 0300 061 0614.

Date Updated: 17/08/11