How do I complain about a social care means tests assessment?


A dramatic rise in complaints by people who are means tested for social care has emerged in recent months, new figures from the social care ombudsman reveal.

Some 212 challenges to care assessments, which involve needs and means tests, reached the ombudsman between the start of April and early June this year.

That puts complaints on course to reach 1,100 this year – a massive jump on the 725 received in 2017/2018 and 715 the year before – against a backdrop of an aging population with growing care needs and funding pressures on local authorities.

Proposals over-due: The Government's long-postponed plans for social care are pending

Proposals over-due: The Government’s long-postponed plans for social care are pending

The newest figures from this spring were obtained under a Freedom of Information request made by financial services firm Quilter, which said cash-strapped councils could be taking a hard line on social care assessments.

The Local Government and Social Care Ombudsman upheld 61 per cent of complaints in both the previous two years, but the more recent success rate is not yet known.

The relatively high rate could be because only the most determined complainants with serious cases get as far as the ombudsman. 

People who are unhappy with the result of a means test for social care have to challenge their local council first, then get an independent review, before turning to the ombudsman.

The figures only cover English councils, as there are separate social care ombudsmen for Scotland, Wales and Northern Ireland. Find out which councils were the most complained about below.

How is care paid for at present? 

Under the current system someone’s assets – including the family home – is depleted down to £23,250 if they need to go into a care home.

If you need care in your own home, your assets must be depleted to a level set by your local council, which cannot be lower than £23,250, but your home is excluded from this means test. 

The Tories’ plan to revamp this in the last election was to deplete an individual’s assets – including their home – down to a £100,000 floor, no matter whether they need care in their own home or in a residential home.

This proved politically toxic and was swiftly dropped. The party then mooted a cap on bills, promised another consultation on social care and postponed further discussion until the summer of 2018.

The promised green paper, setting out the Government’s plans and putting them up for public discussion, is still awaited.

They indicate a growing level of dissatisfaction with the current means testing system, ahead of the publication of long-postponed plans for social care from the Government.

It says these will be published ‘at the earliest opportunity’, and adds: ‘We are committed to ensuring that everyone has access to the care and support they need.’

The Government’s pending green paper – a consultation document, not a white paper which would be a policy statement – is expected to contain ideas for ‘risk pooling’ to protect people from high and unpredictable costs.

Meanwhile, a House of Lords committee recently demanded an immediate £8billion investment in social care, plus a further £7billion to introduce free personal assistance for people who need help with essentials like eating, washing and going to the toilet. 

Gordon Andrews, tax and financial planning expert at Quilter, said: ‘Navigating the current social care system is overwhelmingly complex, made worse by the fact that the people who have to navigate it are generally already overwhelmed with numerous emotional and financial difficulties.

‘The means test for care has many nuances, for instance the type of assets held by an individual and the type of care needed significantly affect eligibility.

‘If an individual needs care at home, the value of their house is not counted towards their assets. If they need care in a care home, the value of the home is included (unless, for example, a spouse is living in that home).

‘The level of complexity means there is room for interpretation by local authorities and given they are cash-strapped they may be taking a hard line.

Which councils were most complained about between April 1 and June 6 this year (Source: Social care ombudsman and Quilter)

Which councils were most complained about between April 1 and June 6 this year (Source: Social care ombudsman and Quilter)

‘But their assessments are not always right. In fact the figures from the ombudsman show if you challenge their decision there is a high likelihood the decision will go in your favour. Going through the hassle can be time-consuming but it is worth it to get the funding from the state that you deserve.’

How do you challenge a means-test for social care?

There is a three-stage process, but the first step is to complain to your local authority. If you are dissatisfied with the outcome, you can ask for an independent review of your case.

After that you can take your case to your local government ombudsman. Go here for England, here for Scotland, here for Wales and here for Northern Ireland.

The Money Advice service explains the complaints process, and the help available to you when challenging decisions on social care, on its website here. 

What ideas are being floated to overhaul social care?

A dearth of Government proposals in recent years has led members of the House of Lords, former Tory MP Damien Green and the Association of British Insurers to tout their own plans to overhaul the social care system.

Meanwhile, insurer AIG surveyed the public on how they would prefer to pay bills for support as their health declined.

A contingency fund option, where people would fund care needs by saving into a special fund that could be bequeathed to loved ones if it wasn’t used, proved the most popular. 

Which councils were most complained about in 2016/17 and 2017/2018 (Source: Social care ombudsman and Quilter)

Which councils were most complained about in 2016/17 and 2017/2018 (Source: Social care ombudsman and Quilter)

‘Social care funding: Time to end a national scandal’, published by the House of Lords’ economic affairs committee, said some 1.4million people had an unmet care need in 2018, and the number of elderly and working age adults requiring help was increasing rapidly.

My mum suffered from dementia and I found the social care system complex and unsupportive

Find out tips to get the best help for your loved ones from Olivia Kennedy, a financial planner at Quilter Private Client Advisers. Read more here.

It called for the launch of universal free personal care. That means ‘essential help with basic activities of daily living, such as washing and bathing, dressing, continence, mobility and help with eating and drinking’ for people with substantial and critical levels of need. 

It would not cover assistance with housework, laundry or shopping, or accommodation and living costs.

Green’s report said everyone should receive basic care in old age, but fork out individually for extras like a bigger room and better food in a care home. 

The ABI proposed tax breaks, a new Isa, and more opportunities for people to tap the value of their homes to help them pay for social care.

It found nine out of 10 people have no plans to cover their care needs at present, but that money incentives could encourage more to prepare to meet potentially huge bills. 



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