Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER Case No: UI-2025-005441
First-tier Tribunal No: HU/56192/2024
LH/00696/2025

THE IMMIGRATION ACTS

Decision & Reasons Issued:
On 20 July 2026

Before

DEPUTY UPPER TRIBUNAL JUDGE HOWARTH

Between

ILABEN KAPDI
(NO ANONYMITY ORDER MADE)
Appellant
and

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the Appellant: Mr. M. West, Counsel, instructed by M.P. Solicitors
For the Respondent: Ms. S. Mckenzie, Senior Home Office Presenting Officer

Heard at Field House on 3 June 2026

DECISION AND REASONS

Introduction
1. This is a remaking hearing under section 12(2)(b)(ii) of the Tribunals, Courts and Enforcement Act 2006 of the decision of the First-tier Tribunal judge (“the judge”) promulgated on 4 September 2025, dismissing an appeal against the Entry Clearance Officer’s refusal of the appellant’s application as an adult dependent relative, as well as her human rights appeal under Article 8 ECHR. This remaking follows the setting aside of the judge’s decision for a material error of law, in a decision with reasons issued on 17 March 2026. The error of law decision is attached in an annex to this decision.

Background
2. The appellant is a citizen of India, who is now 75 years old. On 28 February 2024, she applied for entry clearance as the adult dependent relative of her nephew, who is an EU national settled in the United Kingdom. He will be referred to in this Decision as the appellant’s “sponsor”.
3. On 14 May 2024, the respondent refused the appellant’s application. The respondent gave several reasons for the refusal. First, the respondent was not satisfied the appellant met ADR 4.1 because the appellant was not a parent of the sponsor. Secondly, although the respondent was satisfied that ADR 5.1 was met, because the appellant either did, or may soon, require long-term personal care to perform everyday tasks as a result of age, illness or disability, the respondent was not satisfied the appellant had shown pursuant to ADR 5.2 that she would be unable to obtain the required level of care in India. Third, the respondent was not satisfied the appellant could be adequately maintained without recourse to public funds. Fourthly, the respondent concluded the decision to refuse entry clearance would not result in a breach of Article 8 ECHR because there were no exceptional circumstances applicable to the appellant’s case.
4. The appellant appealed against the refusal of her application.
The appeal before the First-tier Tribunal
5. The appeal was heard by the judge on 29 May 2025. The judge made the following findings which were favourable to the appellant:
i. The appellant met the requirements of ADR 4.1 because the evidence demonstrated on the balance of probabilities that the sponsor had been informally adopted by the appellant (and her late husband) and so the appellant satisfied the requirement of being a “parent” of the sponsor for the purposes of ADR 4.1 [34 – 38].
ii. The judge acknowledged the respondent’s concession that the appellant would need long-term care given her age and the medical evidence [39] and described a “complete picture of the conditions” the appellant suffers from, as comprising of hypertension, hyperthyroidism, having suffered from a stroke in 2018 and suffering from stress.
iii. The judge also found the appellant satisfied the necessary maintenance requirements.
6. However, the judge concluded the appellant did not satisfy ADR 5.2 because of a lack of evidence to demonstrate the treatment the appellant required, or that it would not be available in India. In so concluding, the judge relied upon the lack of sufficient medical evidence in relation to the appellant’s mental health. The judge referred to the appellant’s mental health problems as amounting to “stress which is said to be due to the emotional separation from the appellant and the sponsor” [43].
The Error of Law Decision and Preserved Findings
7. Following a hearing on 17 March 2026, I found the judge had made a material error of law by failing to consider relevant evidence in relation to the appellant’s mental health. The judge found the appellant suffered from stress but in assessing whether ADR 5.2 was met, had missed the evidence referring to her more significant mental health problems. As noted in the Error of Law Decision at [19], Dr. Dhawal Patel had referred to the appellant’s persistent low mood, chronic anxiety and recurrent suicidal ideation, which hadn’t improved despite treatment (letter dated 7 May 2025). The appellant’s symptoms were described in similar terms by Dr. Dipesh S. Patel (letter dated 9 May 2025). Dr. Urvishkumar P. Jaganiya, referred to symptoms of mood and behavioural disturbances, irritability, restlessness, anxiety, sleep disturbances, as well as psychotic features like fearfulness and persecutory ideas, noting that full time care may be required (letter dated 21 October 2023). At [20] of the Error of Law Decision, I concluded this was important factual evidence which was relevant to the assessment of whether the appellant was unable to obtain the required level of care in India. The judge had rejected “the evidence from the witnesses that they had approached care homes but none could take her due to her significant mental health concerns” based on a finding that there was “insufficient medical evidence to support the appellant having such significant mental health care concerns” [20]. However, there had been relevant evidence before the judge about significant mental health problems which the judge had not taken into account. Further, the judge had also incorrectly recorded there was “no evidence of it being taboo in India if you have mental health conditions” , whereas the CPIN in fact said the opposite. Recalling, Moses LJ in Detamu v SSHD [2006] EWCA Civ 604 at [14], I concluded that the judge would not have been bound to have reached the same conclusion, notwithstanding the error of law [20]. I therefore set aside the judge’s decision but preserved the findings in relation to ADR 4.1, 4.2 and 5.1.
Re-making Hearing
8. The remaining issues for determination at the remaking hearing were:
a. Whether pursuant to ADR 5.2 the appellant had demonstrated she would be unable to receive the required level of care in India, even with the practical and financial help of her sponsor in the United Kingdom because it is not available and there is no person in that country who can reasonably provide it, or because it is not affordable.
b. Whether Article 8 ECHR was engaged, and if so whether there are exceptional circumstances which would render refusal of entry clearance a breach of Article 8.
9. At the remaking hearing I heard evidence from the sponsor, who did not need to use an interpreter. The sponsor gave evidence about the deterioration in the appellant’s health since her husband passed away, the daily care provided by a family friend, Chandha Singh and why the arrangement with Chanda Singh could not continue and about steps the sponsor had taken to date to approach care homes to see if they would take the appellant. I also admitted some fresh evidence in support of the appellant’s case, which, in summary, comprised of: a letter from a care home, a further statement from Chandha Singh, a letter from a doctor providing an update on the appellant’s health, a letter from a psychiatrist providing an update on the appellant’s mental health and evidence of money transfers from the sponsor to Chandha Singh. The admission of this evidence was not opposed by the respondent. In addition, I had all of the documentary evidence from the Error of Law hearing bundle, which included everything which had been before the First-tier Tribunal. This included witness statements from the appellant, the sponsor, Chanda Singh, the appellant’s daughter in India, as well as medical evidence in relation to the appellant and documents in relation to the sponsor’s finances.
Legal Framework
ADR 5.2
10. ADR 5.2 provides:
Where the application is for entry clearance, the applicant, or if the applicant is applying as a parent or grandparent, the applicant’s partner, must be unable to obtain the required level of care in the country where they are living, even with the financial help of the sponsor because either:
(a) the care is not available and there is no person in that country who can reasonably provide it; or
(b) the care is not affordable.
11. The lawfulness of this part of the Immigration Rules was considered by the Court of Appeal in BritCits v SSHD [2017] 1 W.L.R 3345 where the following observations were made by Sir Terrence Etherington MR at [59]:
“[59] Second, as is apparent from the Rules and Guidance, the focus is on whether the care required by the ADR applicant can be “reasonably” provided “to the required level” in their home country. As Mr Sheldon confirmed in his oral submissions, the provision of care in their home country must be reasonable both from the perspective of the provider and the perspective of the applicant, and the standard of such care must be what is required for that particular applicant. It is possible that insufficient attention has been paid in the past to these considerations, which focus on what care is both necessary and reasonable for the applicant to receive in their home country. Those considerations include issues as to the accessibility and geographical location of the provision of care and the standard of care. They are capable of embracing emotional and psychological requirements verified by expert medical evidence. What is reasonable is, of course, to be objectively assessed.”
12. In Ribeli v Entry Clearance Officer, Pretoria [2018] EWCA Civ 611, the Court of Appeal considered an appeal against the decision of the Upper Tribunal (IAC), setting aside a decision made by the First-tier Tribunal, which had allowed the appellant (Ribeli’s) appeal against a decision of the Entry Clearance Officer to refuse her application as an ADR. The Court of Appeal upheld the decision of the Upper Tribunal (IAC) and concluded the appellant (Ribeli) had not satisfied the ADR Rules. Lord Justice Singh stated as follows:
“[49] I also agree with the second reason that UT Judge Clive Lane gave for setting aside the FTT determination. There was no independent evidence that the Appellant was unable, even with the practical and financial help of her daughter and sponsor in the UK, to obtain the required level of care in the country where she was living. As the UT Judge observed at para 8, that is what the relevant Rules require: see e.g. para. 35 of Appendix FM – SE. The only evidence that was placed before the FTT on behalf of the Appellant (the GP’s letter of 18 December 2013) referred only to the Table View area, where the Appellant lives, not to the larger Cape Town area, still less the whole of South Africa.
[50] On the subject of waiting lists for care homes in South Africa, the FTT had before it two letters. The first, dated 30 January 2015, by Mr Clive van Zil (the manager of the home) said that it did not take in pensioners younger than 65 years old. It also said the home was full and it had a very long waiting list. The second letter, dated 13 February 2015, from Huis Boland said that the home had no openings at that time and there was also a long waiting list. That was insufficient evidence, in my view, to justify the conclusion that there was no care available to the Appellant in the whole of South Africa.
[51] As to the UT’s third reason, again I agree with its reasoning. There was no independent evidence to support the FTT’s assertion that, without the supervision of a close relative, the delivery of care services in South Africa would be wholly unreliable. What the FTT said, for example at para 14, was generalised and far too sweeping about conditions in South Africa”.
13. In upholding the decision of the Upper Tribunal (IAC) and the Entry Clearance Officer, Lord Justice Singh recalled that the burden of proof lies with the appellant to demonstrate she qualifies for entry clearance in accordance with the Rules, which as amended from 2012 are “rigorous and demanding” [56]. The standard of proof is the balance of probabilities.
Article 8 ECHR
14. In relation to Article 8 ECHR, the appellant must first establish on the balance of probabilities the factual circumstances on which they rely and that Article 8(1) is engaged. In SSHD v IA & Others [2025] EWCA Civ 1516; [2026] H.R.L.R 4, Sir Geoffrey Voss, MR, handing down the judgment of the Court of Appeal, recalled at para. 10 that the “consistent jurisprudence of the European Court of Human Rights (the ECtHR) has been that “family life for the purpose of Article 8 is normally limited to the core family and that there will be no family life between parents and adult children or adult siblings unless they can demonstrate “additional elements of dependence, involving more than the normal emotional ties”” (emphasis added). As explained by the ECtHR in Kumari v. The Netherlands 44051/20, 10 December 2024, at para. 43, “the assessment of whether additional elements of dependency, other than normal emotional ties, have been shown to exist, requires an individualised review of the relationship at issue, and other relevant circumstances of the case”.
15. If Article 8(1) is engaged, the appellant must then establish pursuant to Article 8(2) that the respondent’s interference with family life is disproportionate to the public interest, which permits such interference only where it is in accordance with the law and is necessary in a democratic society, in the interests of the economic well-being of the country, or for the protection of the rights and freedoms of others. As noted by Sir Geoffrey Voss, MR, in IA, citing Lord Reed in R (Agyarko) v SSHD [2017] UKSC 11, [2017] 1 WLR 823, the immigration control policies of the respondent and the United Kingdom Government, as reflected in the immigration rules, express what is necessary in the interests of the economic well-being of the United Kingdom and for the protection of the rights of the citizens in the United Kingdom, and should be attributed “considerable weight” when assessing proportionality, and “very exceptional or compelling circumstances” have to be shown for entry clearance to be granted outside of the rules: IA at paras. 12, 158 and 173.
Findings and reasons
The evidence in relation to the appellant’s ill-health
16. I accept the appellant suffers from problems with her health, in relation to which she receives treatment from medical professionals in India. I also accept the appellant requires long-term personal care to perform everyday tasks as a result of her age and ill-health. These finding are based upon the medical evidence, witness statements and the live evidence of the sponsor, summarised below.
17. In relation to her physical health, I accept the medical evidence, which refers to the appellant having suffered from a stroke in 2018 and suffering from hypertension and hypothyroidism. I accept she receives medication in relation to these conditions.
18. In relation to her mental health, there are numerous letters from several different doctors which refer to a deterioration in the appellant’s mental state over recent years. The doctors letters document the following symptoms: low mood and elsewhere persistent low mood, irritability, restlessness, anxiety, sleep disturbance, as well as psychotic features like fearfulness, persecutory ideas and suicidal ideation. I accept that the appellant suffers from these symptoms, which are not only documented in the medical evidence but also variously referred to in the witnesses evidence.
19. However, beyond establishing these mental health symptoms, I do not find that the appellant has provided sufficient evidence to allow me to reach a firm conclusion about what medication, treatment, or regimen she requires. Firstly, the doctors letters do not provide sufficient detail about what medication she takes, or has taken, in relation to her mental health problems. Nor do they detail what types of therapy have been provided, or to what extent the appellant has engaged with therapy to date. The letters skirt over this detail and merely indicate neither medication nor therapy has not resulted in an improvement and suggest the only remedy is for her to be reunited with her son in the United Kingdom. Secondly, the most recent medical evidence including a letter from Dr Dipesh S. Patel of Trident Hospital, dated 14 May 2026, states that the appellant suffers from extreme depression and refers to a new diagnosis of early onset Parkinson’s Disease. However, the letter does not refer to any of the assessments or diagnostic tools used to reach these diagnoses and therefore lacks detail in this important respect. Similarly, beyond recommending the appellant is permitted to come to the United Kingdom, Dr Dipesh S. Patel does not refer to any particular medication, forms of therapy, or regimens which would assist with the appellant’s continued care.
20. The sponsor gave evidence about the deterioration in the appellant’s ill health since the death of her husband. The sponsor explained how both the appellant’s physical and mental health had declined. He said he visited her between approximately every 8 months to a year and for around three and a half weeks each time. During his visits he has observed her deterioration, which had caused him to ask their neighbour, Chanda Singh to assist his mother. This arrangement now involves Chanda Singh going to the appellant’s house several times a day, to make meals, and if she has a nappy on changing it, and providing assistance with her everyday tasks, including washing. The sponsor explained that owing to the appellant’s mental health problems, sometimes she did not recognise Chanda Singh, or she would throw things at her, which made caring for her challenging. The sponsor provides monthly payments to Chanda Singh in relation to his mother’s care. Overall, I found that the sponsor gave credible evidence about all of these matters. His oral evidence was consistent, detailed and supported by the statements from Chanda Singh and the medical evidence.
21. Despite my reservations about some of the medical evidence as explained in [19] above, looking at the evidence as a whole, I accept the appellant has demonstrated she is at a point where she requires long-term personal care to perform everyday tasks.
The availability of care in India
22. Neither the appellant nor the sponsor have pursued an argument that the care required by the appellant is unaffordable. The issue is therefore whether the care the appellant requires is available and can reasonably be provided to her in India.
23. The sponsor gave evidence about the current care regime in his oral evidence, which I have summarised above at [20]. While the arrangement with Chanda Singh began in 2022 and continues at the current time, I accept she does not wish to continue to care for the appellant indefinitely. Consequently, it is necessary to consider whether the appellant has established on the balance of probabilities that there is no other available care in India, which is reasonable both from the perspective of the provider and the appellant. In this regard, I must consider the available evidence in relation to the possibility of the appellant being looked after in a care home.
24. There was no opposition to the admission into evidence of a letter from NEMA Eldercare, dated 13 May 2026. The letter set out the reasons for refusing to admit the appellant to their facility following an assessment as follows:
“The primary reason for this determination is that the Prospective Resident’s current risk profile – specifically the active suicidal ideation in combination with advanced dementia – exceeds the level of specialist psychiatric and clinical care that our facility is registered, staffed, and equipped to provide.
Admitting an individual with this level of psychiatric risk would place the Prospective Resident, existing residents, and our staff in an unacceptable position of risk, contrary to our duty of care”.
The letter from NEMA Eldercare further set out:
“In our professional opinion, the Prospective Resident requires placement in a specialist facility capable of providing all of the following concurrently:
• Specialist dementia nursing care with 24-hour qualified nursing supervision, including structured Active Living programmes designed to support cognitive function and daily engagement for individuals with dementia;
• Active mental health support intervention, including access to psychiatric assessment and ongoing psychiatric support;
• A secure environment designed to mitigate risks associated with suicidal ideation, in compliance with applicable mental health care standards and regulatory requirements”.
Finally, the letter concluded by stating as follows:
“Accordingly, having explored referral options available within our existing partnerships and networks, we have been unable to identify a suitable facility capable of simultaneously meeting the Prospective Resident’s psychiatric needs and her dementia care with Active Living. This underscores the complexity of this case and the genuine clinical barriers to appropriate local placement.
We would respectfully recommend that the Prospective Resident be placed in a specialist facility capable of delivering integrated psychiatric and dementia care with Active Living provision under a single placement arrangement”.
25. During cross-examination, the sponsor was asked about the letter from NEMA Eldercare, including whether he had approached the type of facility which had been recommended by NEMA Eldercare, namely, “a specialist facility capable of delivering integrated psychiatric and dementia care with Active Living provision under a single placement arrangement”. The sponsor confirmed he was yet to make enquiries of any such specialist facilities. The sponsor said he had previously called other care homes but they would not take the appellant because of her psychological issues which also posed a risk to other residents. He referred to a facility called “Helping Hand”, who he said he contacted two or three years ago but they would not provide a letter to confirm their decision not to admit the appellant. In re-examination the sponsor explained he had begun to make enquiries with care homes as far back as 2022, when the appellant’s psychological problems began and he had spoken to between 10 – 15 different care homes, whom had seen the appellant either virtually or in person before determining they could not admit the appellant.
26. I accept the sponsor made an enquiry with NEMA Eldercare and I accept their letter confirming they cannot admit the appellant into their facilities. However, I am do not find the appellant has established on the balance of probabilities that the care the appellant requires is not reasonably available in India. As the sponsor himself conceded, further to the letter from NEMA Eldercare, he is yet to make enquiries of the type of specialist facility recommended; one providing “integrated psychiatric and dementia care with Active Living provision under a single placement arrangement”. The only documentary evidence of any enquiry having been made with care homes in Indiais the letter from NEMA Eldercare. There was no documentary evidence of internet searches, or of phone calls being made to providers in India. There was no documentary evidence of emails or letters making enquiries of any care homes. Although, I found the sponsor to be a credible witness on the whole, I do not accept his evidence about having made enquires with as many as 10 – 15 care homes. The sponsor said the care homes would not provide letters explaining why they had refused to admit the appellant into their care. However, given NEMA Eldercare provided exactly such a letter, I cannot accept that all of the care homes who he purportedly approached refused to provide any correspondence in writing.
27. Both before the First-tier Tribunal and the Upper Tribunal, Mr. West for the appellant, highlighted passages in the medical evidence indicating that the appellant’s future well-being depended not upon clinical intervention but rather reunification with her son, indicating that her psychological suffering was rooted in the separation from him and therefore she should be permitted to join him in the United Kingdom. I do find this evidence to be persuasive. First because of my reservations about the level of detail in the medical evidence outline above at [19]. Secondly, because the doctors do not sufficiently engage with or consider the suitability of other potential care arrangements in India, such as the type of facility suggested in the letter from NEMA Eldercare. For example, there is no independent evidence suggesting that without the care of a close relative, the provision of such specialist care would not be suitable.
28. As noted by Singh LJ in Ribeli, the requirements under the Rules are “rigorous and demanding“ and the appellant must show a reasonable level of care cannot be provided in the country of origin. At the current time, there is insufficient evidence to demonstrate that a reasonable level of care could not be provided anywhere in India. It may be the case in future that the appellant might meet the requirements of the Rules but I am not satisfied she has sufficiently addressed the concerns of the Entry Clearance Officer in relation to the requirements of ADR 5.2 in the current application and appeal proceedings.
Article 8 ECHR
29. I must first consider whether Article 8(1) family life exists between the sponsor and the appellant. As noted above, for the purpose of Article 8, family life is normally limited to the core family and does not include family life between an adult and their parent unless “additional elements of dependence, involving more than the normal emotional ties” has been established on the facts.
30. Although largely addressed already in the decision, I will highlight the relevant factual matrix, save for the appellant’s medical problems which I have set out at [16 – 21] above. The appellant and the sponsor do not live together. The appellant resides in India. The sponsor lives in the United Kingdom. The sponsor visits the appellant approximately every eight months to a year, for about three and a half weeks on each occasion, including with his immediate family. During these visits the sponsor is able to care for the appellant. Otherwise, the appellant is cared for by Chanda Singh, a neighbour, whom the sponsor sends money every month in respect of his mother’s care. This arrangement continues to date but will not continue indefinitely. The appellant also has a daughter in India, however, she is unable to care for her mother, owing in part to her own mental health difficulties. The cultural expectation is that the sponsor, as the appellant’s son, should care for her in her old age. However, as the sponsor lives in the United Kingdom he is unable to do so. He doesn’t wish to relocate his family to India because his family are settled in the United Kingdom, they have jobs, a mortgage, a lease on a car and two sons, one of whom is at primary school. The appellant’s wife is Indian. Both the sponsor’s wife and sons have British passports. The inability of the sponsor to care for his mother is causing anguish for both the sponsor and the appellant.
31. Whilst I have sympathy for both the appellant and sponsor, I do find Article 8(1) to be engaged on the facts of this appeal. The sponsor provides regular financial support in relation to the appellant’s care. He is also engaged in the provision of care in a practical sense, both by caring for her when visiting India and remotely from the United Kingdom by liaising with Chanda Singh. Although the sponsor certainly supports his mother, I do not find there to be additional elements of dependency which go beyond the normal ties, in the context of a relationship between an adult and an elderly parent who requires provision for their care.
32. Although, I have found Article 8(1) not to be engaged, even if I had found Article 8 family life to exist, I would not have found it disproportionate to refuse the appellant entry to the United Kingdom for the following reasons. As explained by Sir Geoffrey Voss, MR, in IA, at para. 11, during the proportionality stage the “court is looking primarily at the article 8 rights of those persons within the jurisdiction of article 1 of the ECtHR”; thus in this appeal, as in IA, at the sponsor’s Article 8 rights. Considering the proportionality balancing exercise from the sponsor’s perspective, I acknowledge it is his wish for her mother to be permitted to come to the United Kingdom and I accept he will experience emotional hardship if the appellant cannot be cared for by him in accordance with applicable cultural norms. However, the sponsor can make further enquiries about possibilities for alternative care in India, including at specialist facilities. The sponsor is able to continue to visit his mother and care for her directly on those visits. Alternatively, although I accept it would cause them upheaval, the family could relocate to India to care for the appellant on a day to day basis whilst needed. It is significant that the appellant cannot satisfy the requirements of the immigration rules. This is a feature of the case which must be accorded some considerable weight when weighing up proportionality and I do not find exceptional circumstances to exist on the facts of this appeal.

Notice of Decision

1. The appellant’s appeal against the decision of the Entry Clearance Officer under the adult dependent relative rules is dismissed.
2. The appellant’s Article 8 human rights appeal is dismissed.

K. Howarth

Deputy Judge of the Upper Tribunal
Immigration and Asylum Chamber

7 July 2026

ANNEX

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER Case No: UI-2025-005441
First-tier Tribunal No: HU/56192/2024

THE IMMIGRATION ACTS

Decision & Reasons Issued:

…………………………………

Before

DEPUTY UPPER TRIBUNAL JUDGE HOWARTH

Between

ILABEN KAPDI
(NO ANONYMITY ORDER MADE)
Appellant
and

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the Appellant: Mr. M. West, Counsel, instructed by M.P. Solicitors
For the Respondent: Ms. L. Clewley, Senior Home Office Presenting Officer

Heard at Field House on 17 March 2026

DECISION AND REASONS
Introduction
1. The appellant appeals with permission against the decision of the First-tier Tribunal, dated 4 September 2025, dismissing her appeal in relation to her application as an adult dependent relative and her human rights appeal under Article 8 ECHR.
Background
2. The appellant is a citizen of India, who is now 75 years old. On 28 February 2024, she applied for entry clearance as the adult dependent relative of her nephew, who is an EU national settled in the United Kingdom. He will be referred to in this Decision as the appellant’s “sponsor”.
3. On 14 May 2024, the respondent refused the appellant’s application. The respondent gave several reasons for the refusal. First, the respondent was not satisfied that the appellant met ADR 4.1 because the appellant was not a parent of the sponsor. Secondly, although the respondent was satisfied that ADR 5.1 was met, because the appellant either did, or may soon, require long-term personal care to perform everyday tasks as a result of age, illness or disability, the respondent was not satisfied that the appellant had shown pursuant to ADR 5.2 that she would be unable to obtain the required level of care in India. Third, the respondent was not satisfied the appellant could be adequately maintained without recourse to public funds. Fourthly, the respondent concluded that the decision to refuse entry clearance would not result in a breach of Article 8 ECHR because there were no exceptional circumstances applicable to the appellant’s case.
4. The appellant appealed against the respondent’s refusal of her application.
The appeal before the First-tier Tribunal
5. The appellant’s appeal against the refusal was heard by a judge of the First-tier Tribunal (“the judge”) on 29 May 2025. The judge made the following findings which were favourable to the appellant:
i. The appellant met the requirements of ADR 4.1 because the evidence demonstrated on the balance of probabilities that the sponsor had been informally adopted by the appellant (and her late husband) and so the appellant satisfied the requirement of being a “parent” of the sponsor for the purposes of ADR 4.1 [34 – 38].
ii. The judge acknowledged the respondent’s concession that the appellant would need long-term care given her age and the medical evidence [39] and described a “complete picture of the conditions” the appellant suffers from as comprising of hypertension, hyperthyroidism, having suffered from a stroke in 2018 and suffering from stress.
iii. The judge also found that the appellant satisfied the necessary maintenance requirements.
6. However, the judge concluded that the appellant did not satisfy ADR5.2 because of a lack of evidence to demonstrate the treatment the appellant required, or that it would not be available in India. In so concluding, the judge emphasised the lack of sufficient medical evidence in relation to the appellant’s mental health [43]. In rejecting the appeal on this basis, the judge relied on the following factual findings:
i. “the evidence as to the appellant suffering from mental health issues due to separation from the appellant” was “lacking” [41];
ii. there was a lack of evidence in relation to the treatment the appellant required for her physical conditions, how this was impacted by her mental health and why the only treatment for her mental health was being reunited with her son [42];
iii. there was insufficient medical evidence about the appellant’s mental health to support the evidence from the witnesses that they had approached care homes but none could take her due to her significant mental health concerns [43];
iv. further, there was no evidence “of it being taboo in India if you have mental health conditions”.
Grounds
7. The appellant raised three grounds of appeal. First, that the judge erred in law by failing to give proper consideration to the evidence concerning the appellant’s mental health conditions because the judge only referred to the appellant suffering from stress but missed the other medical evidence referring to more significant mental health problems. Specifically, the judge did not refer to a letter dated 7 May 2025 from Dr. Patel of Silva Care, which referred to the appellant as suffering from significant psychiatric challenges including persistent low mood chronic anxiety and recurrent suicidal ideations. Those mental health issues were not noted in the judge’s determination.
8. Second, the judge erred in law by failing to consider the appellant’s mental health issues in conjunction with the country background information. Specifically, the respondents CPIN stated that people consider mental health issues as taboo in India and try to hide them. However, at [43] the judge found that there was no evidence of it being taboo in India if you have mental health conditions. The appellant submitted that the judge was wrong about this, which was important because it was relevant to the judge’s consideration of the Immigration Rules and Article 8 outside of the Immigration Rules.
9. Third, the judge erred in law by failing to give proper consideration to Article 8 ECHR. Specifically, there was no reference at all TO117B of the Nationality Immigration and Asylum Act 2002, as amended. The judge failed to refer to section 55 of the Borders Citizenship and Immigration Act 2009. The judge relied on the same reasoning for finding that the Immigration Rules were not met in order to dismiss the appeal outside of the Immigration Rules. Also, to the extent that ground one or two were made out, the Article 8 ECHR assessment was also arguably flawed because it was predicated upon these findings being found sound.
10. Permission to appeal was granted on all grounds by Upper Tribunal Judge Hoffman, whom commented that ground one was at least arguable, ground two was “weak” and that it was difficulty to identify any arguable error in relation to ground three.
Rule 24 Response
11. The respondent submitted a Rule 24 Response. No challenge was made to the judge’s findings in relation to ADR 4.1 and the maintenance requirements. However, the respondent submitted that the judge had properly considered the evidence in relation to the appellant’s mental health and there was nothing materially incorrect with the judge’s assessment. With respect to the second ground, the respondent submitted that stigma which may exist in relation to mental health in India had not prevented the appellant from receiving treatment and the judge had not made a material error in assessing Article 8 ECHR.
Hearing before the Upper Tribunal
12. A Rule 25 Reply was received by the Tribunal the day prior to the error of law hearing. Although it was late, Ms. Clewley did not object to its admission and I decided to admit it because it helpfully narrowed the issues to be determined by withdrawing the third ground of appeal. At the hearing, Mr. West confirmed ground three was no longer pursued and described the second ground as parasitic on the first ground, meaning it should be considered in conjunction with the first ground, rather than a stand-alone ground of appeal.
13. Mr. West highlighted the respondent’s acceptance that the appellant required long term care with the issue in dispute being whether the appellant had demonstrated there was no alternative care available to her in India. Mr. West emphasised that the issue in the case concerned emotional deprivation, and referred to para [59] of the judgment of the Court of Appeal in Britcits v SSHD [2017] EWCA Civ 368, in which Sir Terence Etherton, MR had stated that a consideration of whether “care is not available and no person can reasonably provide it” under ADR5.2, is “capable of embracing emotional and psychological requirements verified by expert medical evidence”.
14. Mr. West explained that the case had been put in terms of a combination of both the appellant’s physical and mental health issues but that when referring to a “complete picture” of the appellant’s health, the judge had only referred to stress but had missed her other significant mental health problems. Specifically, evidence in the bundle had described her suffering from “persistent low mood, chronic anxiety and suicidal ideation” and that “[d]espite medication and supportive therapy, her mental health had shown little to no improvement, primarily due to the profound emotional trauma stemming from her separation from her only son” (letter from Dr. Patel of Silva Care dated 7 May 2025, at page 55 of the bundle).
15. Mr. West submitted that the judge had erred by failing to take into account highly relevant evidence in relation to the appellant’s mental health and had been wrong to find at [41] that “the evidence as to the appellant suffering from mental health issues due to separation from the appellant to be lacking” because there was evidence to this effect from Dr. Patel. Mr. West submitted the judge had erred in finding at [43] that there “was insufficient medical evidence to support the appellant having such significant mental health concerns” to support the “evidence from the witnesses […] that they have approached care homes but none can take her due to her significant mental health concerns” because evidence of significant mental health concerns had been before the judge. Mr. West referred to Detamu [2006] EWCA Civ 604 at [14 and 18] and submitted that another judge considering the evidence that had been presented in relation to mental health would not have been bound to come to the same conclusion.
16. Ms. Clewley relied upon the Rule 24 Response and submitted that the judge had properly understood the appellant’s case in relation to her mental health, including that it had been put in terms of emotional deprivation, and the judge was not required to rehearse all of the evidence. Ms. Clewley submitted that the judge had not been wrong to use the term stress in conjunction with the suggestion she was suffering from emotional deprivation and highlighted that at [31] the judge had referred to the letter from Silva Care and had stated that “the appellant is exhibiting signs of chronic stress and that there has been no improvement of her emotional trauma from the separation from her son who resides abroad”; albeit Ms. Clewley rightly conceded this was in the context of the judge summarising the submissions made by the appellant’s legal representative. Ms. Clewley submitted that the judge had been correct to characterise the evidence addressing why the only solution for her mental health problems was for the appellant to be reunited with her son “as lacking”.
17. In reply, Mr. West emphasised that the only finding the judge had made in relation to the appellant’s mental health related to her suffering from stress at [39]. This was significant, given the judge’s finding at [43] regarding insufficient of evidence in relation to the appellant “having such significant mental health concerns” to have resulted in care homes having refused to take her was premised on the evidence “set out above”, which could only be read by way of a reference to the finding about stress at [39]. Mr. West also referred to Gurdeep Kaur [2023] EWCA Civ 1353 at [23] to support the submission that a reference made by a judge in their review of the evidence does not mean it has been taken account in their findings. Further, Mr. West submitted that the evidence showed that medication and treatment to date had had little effect in improving the appellant’s mental health because the underlying issue concerned the effect upon her mental health of the separation from her son.
Decision
18. I am mindful that judicial caution and restraint is required when considering whether to set aside a decision of the First-tier Tribunal, which is a specialist fact finding tribunal who, unlike the Upper Tribunal considering whether there has been an error of law, will have had the benefit of hearing the entirety of the evidence: Yalcin v SSHD [2024] EWCA Civ 74, (Underhill LJ at [50] referring to Lord Hamblen in HA (Iraq) [2022] UKSC 22, [2022] 1 WLR 3784). However, in this case, for the reasons set out below, I am satisfied that the judge has made a material error of law in relation to the assessment of the evidence concerning the appellant’s mental health.
19. The evidence contained in the bundle before the judge demonstrated that the appellant had mental health problems beyond merely stress. However, in setting out the factual findings about the appellant’s state of ill-health, the judge only referred to “stress which is said to be due to the emotional separation from the appellant and the sponsor” [43], and did not make any reference to her other mental health problems. The appellant’s other mental health problems are described in the medical evidence as including persistent low mood, chronic anxiety and recurrent suicidal ideation and it is stated that medication and supportive therapy had not resulted in any improvement (letter from Dr. Dhawal Patel of Silva Care, dated 7 May 2025 at page 55 of the bundle, and in similar terms in the letter from Dr. Dipesh S. Patel of Trident Hospital, dated 9 May 2025, at page 60 of the bundle). Another example is a letter from Dr. Urvishkumar P. Jaganiya, a consultant psychiatrist at Nivan Clinic, dated 21 October 2023, referring to “symptoms of mood and behavioural disturbances, irritability, restlessness, anxiety, sleep disturbance and also psychotic features like fearfulness, persecutory ideas” and noting that “her symptoms seem to be progressive even with treatment and may require full time care” (page 56 of the bundle).
20. The evidence regarding the appellant’s deteriorating mental health was a significant part of her case before the First-tier Tribunal, which was relevant to the assessment of whether she was unable to obtain the required level of care in India. However, the judge did not include the evidence referred to in the paragraph above in the assessment of this issue, which was a significant issue in dispute in the case. At [43] the judge rejected “the evidence from the witnesses that they had approached care homes but none could take her due to her significant mental health concerns” based on a finding that there was “insufficient medical evidence to support the appellant having such significant mental health care concerns” [43]. However, it is possible that a different conclusion on this point might have been made had all of the relevant evidence about the appellant’s mental health. I agree to some extent with Ms. Clewley’s submission that the judge was justified in reaching a finding that the evidence surrounding “why the treatment for her mental health is only being reunited with one of her children” was lacking, because this is not elaborated upon in the medical evidence. However, the only reference made by the judge to the Silva Care letter is in the context of the judge setting out the submissions made by the appellant and not in the factual findings. I am not persuaded that the judge took into account the evidence referred to in paragraph 19 above, including that medication and supportive therapy had not made a difference. I cannot conclude that another Tribunal considering the evidence in relation to the appellant’s mental health would have been bound to come to the same overall conclusion at the judge and therefore I find there has been a material error of law. In that regard, I recall that Moses LJ in Detamu v SSHD [2006] EWCA Civ 604 stated at [14] that “it is a high burden, falling upon the Secretary of State, to persuade anyone that the adjudicator would have been bound to have reached the same conclusion, notwithstanding an error of law, in relation to the approach to and conclusions about an important piece of factual evidence”.
21. Regarding ground two, at [43] the judge incorrectly stated that “there was no evidence of it being taboo in India if you have mental health conditions”. This was contrary to the evidence in the CPIN, which in fact said the opposite. In isolation, this error would not have given rise to a material error of law. However, taken together with ground one and for the reasons already set out above, I am satisfied that the judge erred in approaching the evidence in relation to the appellant’s mental health. The evidence concerning the appellant’s mental health and whether the appellant has demonstrated to the requisite standard that care is unavailable in India will need to be assessed afresh.
22. Having considered and applied the guidance in paragraph 7 of the Senior President's Practice Statement as well as the guidance in AEB v Secretary of State for the Home Department [2022] EWCA Civ 1512 and Begum (Remaking or remittal) [2023] UKUT 46 (IAC), I am satisfied that retaining the appeal for re-making in this Tribunal is appropriate considering the remaining fact-finding that is limited to a consideration of the evidence in relation to the appellant’s ill health, including her mental health, and as assessment of whether the appellant has shown that the care she requires is unavailable in India.

Notice of Decision
1. The Decision of the First-tier Tribunal dated 4 September 2025 contained a material error of law and is set aside.
2. The appeal will be retained in the Upper Tribunal for re-making.
Directions
3. This matter is retained in the Upper Tribunal with the following preserved findings of fact:
(i) The appellant met the requirements of ADR 4.1 [35, 37-38].
(ii) The respondent has accepted that ADR 5.1 is met [39].
(iii) The appellant has satisfied the necessary maintenance requirements pursuant to ADR 6.1 [45].
4. The issues that remain to be determined by this Tribunal include whether ADR 5.2 is satisfied and Article 8 ECHR.
5. The re-making hearing should be listed on the first available beginning 28 days after the promulgation of this Decision and also taking into account Mr. West’s availability.
6. The re-making hearing will have a time estimate of 4 hours. The parties are to inform the Tribunal if they disagree with this time estimate.
7. A Gujarati interpreter should be booked for the re-making hearing, with the appellant’s solicitor’s to notify the Tribunal within 14 days of the promulgation of this Decision if an interpreter is not required or if a different language is needed.
8. The appellant should serve a Skeleton Argument on the Upper Tribunal and the respondent, 14 days before the re-making hearing.
9. If the respondent intends to rely on a Skeleton Argument, this should be served on the Upper Tribunal and the appellant, 7 days before the re-making hearing.
K. Howarth

Deputy Judge of the Upper Tribunal
Immigration and Asylum Chamber

30 March 2026