Some adults receiving social care in Scotland are unsure of how to challenge decisions about their care, according to new research published by the Equality and Human Rights Commission (EHRC) yesterday.

An accompanying survey of local authorities, also published yesterday by Britain’s equality regulator, uncovers inconsistencies in the complaints process across Scotland.

The EHRC commissioned the research to explore how well the current system works for people who want to challenge decisions about the social care they receive in Scotland.

In depth interviews with eighteen social care users, carers, personal assistants and advocates revealed broadly negative experiences of a system that does not always provide an effective way to challenge decisions about their care.

Current processes are found to add to the mental, physical and intellectual burden of those receiving social care, and some users also fear negative consequences if they challenge a decision or make a complaint.

The research identifies potential improvements to the current process of challenging decisions. However, learning from this work will also help inform the EHRC’s approach to ensuring equality is embedded in the development of Scotland’s new National Care Service (NCS) and the NCS Charter, which will set out the rights of service users and responsibilities of service providers. 

Scotland Commissioner for the EHRC, Dr Lesley Sawers OBE, said:

“There are currently significant reforms underway in Scotland, including the establishment of a National Care Service and the reform of equality duties for public bodies. These present particular opportunities to address the issues highlighted by our research, including through the co-production of the National Care Service Charter.

“We know people want control over the services provided to them, and we heard fresh evidence of the barriers currently faced by those receiving social care when challenging local authority decisions about their or their loved one’s care.”

The research found that none of the local authorities that participated made accessible information on the right to challenge a social care decision available publicly. Almost all required those receiving social care, their family members or someone advocating for them, to request that information.

Once someone enters the complaints process, the majority of local authorities surveyed either signpost service users to independent advocacy or commission advocacy support on their behalf. Those social care users with experience of working with an advocate reported benefiting from their knowledge of the process, emotional detachment and energy to persist in making a complaint.

The research also demonstrates failings in relation to the gathering of equality data and its use to improve social care provision. Few of the local authorities that responded knew whether they collected data from complainants on characteristics protected under the Equality Act 2010. Such data is critical to ensuring local authorities provide their services equally, do not discriminate and comply with their obligations under the Public Sector Equality Duty.

Dr Sawers added:

“People who receive social care should not be left in the dark about how to challenge decisions that affect them.

“Our research highlights the need for an accessible, clear and consistent complaints process, for guaranteed access to independent advocacy and for all local authorities to gather equality data.

“With health and social care systems struggling to meet demand in the wake of the COVID-19 pandemic, there is a greater risk that older and disabled people’s rights may be breached. A more robust and transparent link between decision making, user complaints and efforts to improve care quality will help local authorities tackle the inequalities that persist in social care.”

The EHRC will continue to work with partners to ensure the right to independent living is recognised in the systems that support older and disabled people, and respected in practice by all social care services in Scotland.

Read the reports:

• Challenging decisions about adult social care, which describes the experiences of a group of service users; and
• Challenging social care decisions: Survey of local authorities, which presents findings from a survey of Scottish local authorities. ​

Notes to Editors

• Eighteen in depth interviews were undertaken between October 2021 and January 2022 (ten with social care users and carers, four with personal assistants and four with advocates). The research represents a valuable insight into the experiences of social care users, but findings may not be generalisable due to sample size and sampling approach.
• All 32 local authorities in Scotland were invited to participate in the online survey. Eight local authorities responded between December 2021 and February 2022. The research adds to the current evidence base, while accepting there may be other local authority processes not captured and represented in the research.
• This research is specific to Scotland and was undertaken separately from the EHRC’s statutory inquiry into challenging decision-making in adult social care in England and Wales, which is due to be published this year.