Despite the Care Act 2014, carers’ position remains ambiguous and austerity has exacerbated problems they face
The research found that despite their rights being enshrined in the Care Act 2014, carers’ status remains poorly defined.
Researchers from the University of Bristol discovered that data systems at some councils are still unable to recognise that a person can be both carer and service user.
In addition, a lack of clarity over whether some support – such as ‘sitting’ services – is for a service user or their carer, and therefore how it should be paid for, can create disincentives for carers to seek support, the study found.
“Older carers of older people are likely to live together and pool resources – and if a carer wants to take a break the person they care for must pay for a replacement,” said Professor Liz Lloyd, who led the research team.
“Such costs affect the carer too – and can deter them for asking for help.”
The study, which focused on local authority support for older co-resident carers, was based on in-depth case studies at four English councils. Researchers undertook documentary analysis as well as interviews with senior and frontline staff, carers and service users.
It also examined 150 local authority websites to identify their priorities and support for carers. Most had updated them to provide clear information for carers in line with the Care Act, though a significant minority could have benefited from being more accessible, accurate and user-friendly.
Staff told researchers they had made “strenuous efforts” to improve their understanding of the local carer population in the wake of the Care Act.
But interviews revealed some councils’ had no facility to record an individual as both a carer and a service user – meaning that if they received their own package of care, their carer role went unrecognised by IT systems.
“Older carers, caring for older people, are more likely to have their own health problems and might be placed on local authority records as a service user, disregarding their caring role,” Professor Lloyd said.
“This affects the support an individual receives, as well as the accuracy of local authority data.”
Two of the case-study authorities had outsourced carer assessments to third-sector organisations (TSOs) in the wake of the Care Act, both to increase awareness of carer support and to reduce costs.
The study found this approach had had some success, and was often better able to respond to carers’ distinctive needs.
But assessors’ level of training and experience varied considerably, and there were also uncertainties as to whether assessors’ specialist knowledge was being fully drawn on once people were referred on to adult social care teams.
The study found that older co-resident carers could benefit from a more integrated approach that focuses jointly on the needs of carer and service user.
At the one case-study council that had implemented such an approach, multi-disciplinary teams were better able to develop holistic care plans that benefited both parties. In the absence of these, there was a risk that interrelated needs – a particular issue for older carers – could go unmet.
The impact of austerity cuts could be felt in all four locations, with participants raising questions about assessments that “led nowhere”, the research found.
Reduced budgets had led to the closure of independent support organisations, longer waiting lists for services, reduced supply of dementia care staff and tighter eligibility criteria for direct payments and vouchers.
Assessors expressed concern that if older carers were refused help at any point they might not reapply when their situations worsened, the study report said.
Shrinking budgets had, however, driven a focus on boosting carers’ resilience and skills and on developing partnerships and networks of support between different service providers, researchers found.
Where strong partnerships existed – such as between local authorities, clinical commissioning groups, GPs and health trusts – outcomes for carers were more positive, the study concluded.
Full summary findings
NIHR SSCR (2019) Support for Older Carers of Older People: The Impact of the 2014 Care Act, Research Findings 81, NIHR School for Social Care Research, London.
This study funded by the NIHR School for Social Care Research and led by Professor Liz Lloyd within the School of Policy Studies at the University of Bristol.