How unpaid carers are still not supported by the Care Act

The Care Act, which came into act in April 2015, has been widely welcomed. However implementation of the act is far from complete.

After replacing the 1948 National Assistance Act and 60 years of piecemeal amending legislation, the Care Act both consolidated and simplified care law in England. It set in place a new organising principle for decision makers, the promotion of individual wellbeing, and placed the rights of informal carers on an equal footing to those with care needs.

Over the past six months a commission established by the Carers Trust has been examining the impact the Act has had on the lives of carers, so far. 

The results of the inquiry, led by Professor Paul Burstow, were published in the House of Commons on 4 July. 

A key finding from the inquiry found that 69 per cent of carers responding to the survey noticed no difference since its introduction. Many expressed frustration and anger at the lack of support they received in their caring role.

The survey of carers found that too many carers were unaware of their rights. Sixty-five per cent of carers who responded had not received assessments under the new Care Act. The review made some carers aware of their rights for the first time.

One area of concern identified in the review is around the Quality of Care Act Assessments. Thirty-four per cent of carers responding to the survey felt that their carers’ assessment was not helpful.

The Care Act and the accompanying statutory guidance make clear that carers’ eligibility for support is independent of the person they care for. The review found evidence to suggest that practitioners are not always clear on this point.

It also appears that not all local authorities are complying with the letter of the law in the way they assess and respond to carers’ needs. The review recommended further study in relation to this.

Many carers continue to find engagement with health services problematic for them and the person they care for, yet there are many opportunities for the NHS to support carers, particularly with identification. The new NHS England Carers Toolkit is welcome in this regard.

There was little evidence that the Act’s market-shaping duty has benefited carers and promoted innovation. Local authorities could do more to develop their offer to carers.

The Act introduced a transition planning duty for young carers and parent carers. Some local authorities have adopted a narrow interpretation of this duty, limiting it to those with care needs, to the exclusion of carers with support needs.

There is still good reason to be optimistic about the transformative potential of the Care Act. Implementation support is still required however, and further study and evaluation should be put in place.

In all the commission makes 22 recommendations addressed to government, directors of Adult Social Services, directors of Children’s Services, directors of Public Health, the Care Quality Commission, Public Health England and NHS England.

The Commission has called on national and local government, together with the NHS, to urgently invest in the support needed to ensure that the new legal rights for carers are fully introduced in all areas, so that carers receive the assessment, support and breaks they need to be able to choose how and when they care.

The report argues that it is essential that local authorities ensure that all social workers and assessors are appropriately trained, and are able to reflect the wellbeing principle in assessment and care and support planning.

Local authorities, with the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS), should review their systems for monitoring progress in implementing the Act. The Short- and Long-Term (SALT) return should be reviewed, so that it captures all assessment and support activity for carers, including prevention.

The full report, details of the commission members and methodology are available at the Carers Trust website.

Professor Paul Burstow

Professor of Mental Health Policy,

Department of Social Policy and Social Work, University of Birmingham