The Care Act assessment process is more than a form. It should identify needs, their impact on wellbeing, desired outcomes and whether needs meet the national eligibility criteria. Disputes may concern failure to assess, the content of the assessment, eligibility, the care and support plan or actual delivery.
Key points
- Ask for the written assessment, eligibility decision and reasons.
- Separate disputed facts from professional judgement and unmet delivery from the original assessment.
- Carers may have their own assessment rights.
- Use the statutory adult social-care complaint route and LGSCO where local resolution does not resolve fault and injustice.
Assessment route
Track assessment, eligibility, planning and delivery separately
| Stage | Question to ask |
|---|---|
| Assessment | Were all needs, outcomes, risks and wellbeing effects identified with the person involved? |
| Eligibility | Which national eligibility criteria were found met or not met, and why? |
| Planning | Does the plan specify how eligible needs will be met, personal budget and arrangements? |
| Delivery | Was the agreed support actually provided and reviewed? |
| Review | Have changed needs or risks triggered reassessment or plan review? |
Evidence
Describe need in functional and outcome terms
Explain what the person cannot do, can do only with assistance, can do only with significant pain, distress or risk, or cannot do reliably. Connect each need to wellbeing and the outcome sought. Use daily records, care-provider notes, occupational-therapy material, medical evidence and carer evidence where relevant.
Challenge
Audit the written decision rather than starting again
- needs or risks omitted from the assessment
- factual inaccuracies
- eligibility outcomes not addressed
- evidence rejected without reasons
- care plan too vague to be enforceable or monitored
- personal budget not explained
- support not delivered as planned
- delay causing avoidable deterioration or carer strain
Complaint route
Ask for practical correction as well as findings
Request correction of factual errors, reassessment where material information was missed, a reasoned eligibility decision, an updated care plan, interim support where appropriate and a remedy for evidenced injustice. Safeguarding concerns or urgent unmet needs should be raised through the operational route immediately rather than waiting for the complaint process.
External review
Frame LGSCO escalation around fault, injustice and remedy
LGSCO does not ordinarily replace professional judgement merely because another view is possible. Focus on failures to assess relevant needs, apply the framework, involve the person, give reasons, plan support, review change or deliver agreed provision.
Official sources
Check the current rules behind this guide
- Care Act 2014
Primary legislation for adult care and support in England. - Care and Support Statutory Guidance
Official guidance on assessment, eligibility, planning, safeguarding and charging. - Care and Support (Eligibility Criteria) Regulations 2015
The national minimum eligibility criteria. - Local Authority Social Services and NHS Complaints Regulations 2009
The statutory complaints framework relevant to adult social care.
These are official or primary sources. Local policies, statutory guidance, legislation and deadlines can change. Check the live source and the decision notice before acting.