Social care practice with carers: What social care support is provided to family carers? What support do family carers want?

Introduction

Better ways of supporting carers providing unpaid care are needed to help prevent the negative consequences that prolonged intensive caring sometimes has. Otherwise, it will become increasingly hard to support the growing numbers of older adults and people with disabilities needing support.

The Care Act 2014 created a number of new rights for carers. It aims to place carers on an equal footing with those for whom they care in terms of rights to support. Local councils with social services responsibilities (CSSRs):

• have a duty to assess carers’ needs for support (not just those defined as providing regular and substantial care) and to meet those needs if carers are eligible;
• must ensure that carers and service users have information and advice about the support available in their locality; and
• should use the principle of well-being when defining outcomes for carers and people using services.

Objectives

The Care Act 2014 strengthens the rights and recognition of carers in the social care system, including new rights for carers to receive services. In the run-up to implementation of the Act, this study mapped different types of social care support for family carers across England.

The study aimed to ask:

• How do carers access information about social care support?
• What are carers’ experiences of assessment?
• What support is provided by carers’ workers whose tasks involve providing specific support to family carers?

Methods

This was a mixed methods study with four main strands, including in-depth interviews with 24 family carers, 8 commissioners, 16 representatives of voluntary organisations and 38 carers’ workers in four parts of England; 80 responses to an email/postal survey sent to all local authorities with responsibilities for adult social care (50% response rate); a web audit of 50 local authority websites; and secondary analysis of the National Minimum Data Set for Social Care (NMDS-SC) data on carers’ workers.

Findings

• Most social care support for carers is delivered through the voluntary sector, although most councils still directly undertake carer assessments
• Changes in commissioning and contracting arrangements have created additional opportunities for
  the voluntary sector but also some uncertainties
• Carers have mixed views on the extent to which they feel their social care needs are met. However, they are positive about the help provided by carers’ workers with a specific remit to provide them with support
• Activities by carers’ workers are varied and include outreach work, information provision, counselling, advocacy and ongoing support
• Different ways of improving carers’ access to information, such as websites, carers’ cafes and outreach workers, have been developed, although these rarely seem to be evaluated for their effectiveness
• Identifying carers in need of additional support seems mainly to take place when the person for
  whom they care is assessed. This disadvantages those caring for someone who is not eligible for, or
  who refuses, social care support from their local authority
• The Care Act 2014 has implications for the way that social care support to carers is delivered. Currently, carers caring for someone not meeting the eligibility criteria for social care support may have substantial or critical unmet needs of their own
• Carers’ organisations argue that an important part of their role is to encourage carers to complete self-assessments but they are concerned that not enough support is then available to those carers who have been assessed
• Some local councils are working with local clinical commissioning groups on integrating support for carers, though these developments have yet to become established everywhere
• Personalisation has brought mixed benefits; with some positive examples of carers having more control over their support but some concerns that the preferences of carers who simply want a regular and reliable break are not being properly met.

Resources

Journal papers

Manthorpe J, Moriarty J, Cornes M (2015) Parent? carer? mid-lifer? older Person? similarities and diversities across different experiences of caring and their implications for practice, Working with Older People, 19, 2.

Manthorpe J, Moriarty J, Cornes M (2015) Supportive practice with carers of people with substance misuse problems, Practice, 27, 1, 51-65.

Moriarty J, Manthorpe J, Cornes M (2014) Reaching out or missing out: approaches to outreach with family carers in social care organisations, Health & Social Care in the Community, online.

Moriarty J, Manthorpe J (2014) Fragmentation and competition: voluntary organisations’ experiences of support for family carers, Voluntary Sector Review, online.

Moriarty J, Manthorpe J, Cornes M (2014) Skills social care workers need to support personalisation’, Social Care and Neurodisability, 5, 2, 83-90.

Manthorpe J, Moriarty J, Cornes M, Hussein S, Lombard D (2013) On-line information and registration with services: patterns of support for carers in England, Working with Older People, 17, 3, 117-124.

Manthorpe J, Moriarty J, Cornes M (2011) Keeping it in the family? People with learning disabilities and families employing their own care and support workers: Findings from a scoping review of the literature, Journal of Intellectual Disabilities, 15, 3, 195-207.