Adult education & social care - Charges too high
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Adult care delivered by your council can include support and care in your home, supported living, care home or nursing home. This guide provides details on how to raise a complaint. You can find additional information from the Local Government Ombudsman or the Care Quality Commission (CQC).
You should know
This guide – which applies to those who live in England – tells you about your choices with regards to the care and support that is paid for by your council. This is known as ‘adult social care’, and provides recipients with personal and practical support to help them live their lives. It also helps individuals maintain their independence and dignity, and ensures that they have as much choice and control over how they live as possible. The Department of Health offers a useful guide to the choices available to you. Plans of care and support After your assessment, your local council might decide that you are eligible for social care. This could mean that the council agrees to pay for some or all of the care and support that you need. If this is the case, the council will agree with you a plan for your care and support. As part of this plan, your council could offer you a personal budget. There are a number ways that this might be managed: If you have eligible needs, the council with responsibility for providing your care and support must ensure that you are provided with direct payments if requested, regardless of whether you have a personal budget. Your council should tell you where you can get independent advice to support you through this process. Caring for someone else When the council is assessing the needs of someone that you care for, it should: Your council must take all reasonable steps to do this. If you provide, or plan to provide, a substantial amount of care on a regular basis, you can ask for a separate assessment of your needs as a carer. Your assessment should consider whether you: Following an assessment of your needs as a carer, your council might offer you a personal budget. Your assessment could show that the best way to help you is to provide care and support for the person that you care for. In that case, the person may be offered a personal budget or direct payment to pay for their own care; this will then give you a break from caring. There are numerous ways that you or the person you care for can manage a personal budget: The council should tell you where you can get independent advice to support you through this process. If you care for someone and are offered support paid for by the council, you have the right to ask for a direct payment instead of receiving services, regardless of whether you have a personal budget. Residential care After your assessment, your local council may decide that you are eligible for social care. This means that the council agrees to pay for some or all of the care and support that you need. Following this assessment, if you require a place in a care home or a care home with nursing care, your council should inform you of your right to: If the best way to have your needs met is to find a place for you in a care home, or a care home providing nursing care, this placement could be permanent or just for a short time. In either case you have the right to choose where to live, subject to certain restrictions. What choices do I have? You can ask your council to: What advice must your council give? Your council must: Who will give me the advice? Some councils pay independent groups to provide information and advice on their behalf. These might include local voluntary organisations, carers centres and community groups. Support information The NHS Choices website can give you general details about social care, including information on direct payments and choosing residential care. It provides tools and resources that can help you consider your options. It also has details of all registered care providers, including nursing and residential care homes, with information on the services and support they offer and how they perform in key areas. It enables you to provide comments and feedback on your experiences, and read reviews that others have left. Raising a complaint Your council must have a clear reason for deciding: It must tell you what decision it has made and why. Should you wish to, you can complain to your council about its decision via Resolver. If your issue is not addressed Bear in mind that, due to the nature and sensitivity of some cases, your council might take longer to reply to your complaint than you would wish. However, if your council does not respond to your complaint at all, or you are dissatisfied with its response, Resolver will tell you to whom you should escalate your issue. Escalating your case If your complaint remains unresolved 12 weeks after you submitted it to the council, you can send the case to the Local Government Ombudsman via Resolver. All communications are recorded in your personal case file in the Resolver system, allowing you to easily submit the details for independent assessment. If you feel that the council has been given sufficient time to respond to your issue, you can escalate your case to the Local Government Ombudsman before the 12 weeks is up. However, the nature and sensitivity of some cases means that you should allow the council reasonable time to reply in the first instance. Ombudsman restrictions If your case has gone to court, or is with the court, your case cannot be raised to the ombudsman. This also applies if the council is taking court action against you. If you fund your own social care If you fund your own social care, you should raise your case to the social care provider. If the issue is not resolved, you can send the case to the Local Government Ombudsman for independent assessment. Time limits Unless there are exceptional circumstances, you should escalate your case to the ombudsman within 12 months of the issue becoming apparent. What can the ombudsman do? The ombudsman’s actions will depend on the issues uncovered, and how it believes that they have affected you. If the ombudsman believes that something the council has done has harmed you, it will ask it to take action to make up for this, as far as is possible. For example, it might ask the council to: If the ombudsman finds fault with the council's procedures, it could ask the council to make changes so that the same problem doesn't happen to anyone in future. Further advice If you need additional advice you can contact the Local Government Ombudsman on 0300 061 0614 (Monday to Friday from 8:30am-5pm).
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