The Care Act - two years on
The recent report on adult social care sets out starkly what many carers knew already, that; “support for carers which could prevent them from becoming unwell, such as respite care, is being reduced or is simply not on offer".
The recent report on adult social care from the cross party Parliamentary committee that scrutinises local government policy and practice sets out starkly what many carers knew already, that; “support for carers which could prevent them from becoming unwell, such as respite care, is being reduced or is simply not on offer, despite duties in the Care Act which require councils to consider carers’ health and wellbeing and meet their needs for support.”
Two years on, the reality is not yet living up to the Care Act’s positive spirit and the vision it set out of promoting wellbeing in its broadest sense and putting individuals at the heart of decisions about their care and support.
On a more promising note, the Act has brought carers higher up the agenda of local authorities. A local authority strategy for carers has become the norm not the exception. Some have also used the emphasis on wellbeing in the Act to think more creatively about what they offer. We’re working with increasing numbers of local authorities to help them reach and support more carers - a lot can be achieved by working better together despite the constraints on spending.
But this is little comfort to those struggling today without enough support or access to the services that would enable them to have a break, look after their own health condition, foster relationships with those they love or take away the constant money worries.
Our research with over 4000 carers in England carried out a year after the Care Act came into force found that many faced long waits for assessments. It also pointed to significant variations between those in different caring scenarios with those caring for someone with a mental health condition and those caring for a disabled child under 18 waiting longer than other carers.
When they had an assessment we heard from carers that it often didn’t look at their needs holistically; failing to look across the impacts a caring role can have their own health, the impact on relationships, on their ability to work, to parent etc. Few of those responding to our survey felt that these different aspects were addressed sufficiently or at all in their assessment.
This was particularly stark in the case of considering a carer’s wishes to remain in or enter work alongside caring - something highlighted by MPs in the Committee’s report. Nearly three quarters of working age carers felt that support to combine work and care was not properly considered as part of their assessment. The demographic and economic imperatives for enabling more of us to combine work and care were prominent not just in the Committee’s report but also in the Government’s recent Fuller Working Lives report where caring responsibilities are highlighted as a major reason people leave work before state pension age.
Those who have found it too difficult to juggle work and care are clear about what would have made a difference; more support from care workers, access to low level support with household chores and more support with managing or coordinating the care of the person they care for. These are all areas which access to quality, affordable services should make possible. Yet, shaping a care market that can deliver these services for self funders and those in receipt of statutory services alike remains on the ‘to do’ list for some local authorities. It’s not surprising that local authorities struggling to afford services for those with the greatest need and the least recourse to finance have not been able to create a flourishing care market in their areas. The challenges to overcome are great; high workforce turnover, low wages, and a knowledge gap in the numbers and needs of the self funding population.
To tackle some of these challenges and give local authorities resources to deliver on the Care Act, national Government needs to recognise and fund social care as part of its new industrial strategy – seeing it as a part of the essential infrastructure of our society.