news analysis of failure by agencies to assess carers’ support needs

In April 1996, the Carers Recognition and Services Act was
implemented, giving carers a right to an assessment of their needs
providing the people they cared for had also been assessed. Five
years later, all carers became entitled to an assessment in their
own right irrespective of whether the person cared for had refused
an assessment or services, writes Amy
Taylor.

But a survey published by charity Carers UK to coincide with
Carers’ Week 2003 reveals that, despite these legislative
advances, still only a third of carers are being assessed.

The findings show that almost half of carers who have not been
assessed had not been informed of their right to an assessment and
a third were unaware of the reason for being assessed.

Of those who have been assessed, less than half said they had
received services as a result despite two thirds believing they
required them, fuelling the view held by a quarter that the process
was pointless.

In Sutton, south west London, one carer who cares for his
elderly mother told Community Care he had still not received an
assessment from the council despite putting in a request in early
January.

He says that when nothing happened he asked the social worker
again three weeks later only to be told that, although she
recognised it was his right, she could not give him a date for an
assessment because they were “too busy at the moment”. He has heard
nothing since and received no recognition that his request has been
recorded. He says things were very stressful at the time he
requested an assessment, but that the social worker seemed to have
a total lack of regard for the problems his family was
experiencing.

Carers UK chief executive Diana Whitworth believes this
situation is partly due to social workers’ reluctance to
offer an assessment because they know that their councils don’t
have any resources to provide support. She says this negative view
filters into carers’ own opinion of assessments: “They are
deterred by professionals and the council saying how scarce
resources are.”

Whitworth adds that, even when some carers do manage to get an
assessment, many do not get any extra services as a result. “It’s
quite clear that some people that are being assessed are also being
told that there aren’t any services…and their assessments are
being put on the shelf.” She is concerned that this situation
could become even worse once the current ring fencing of the carers
grant ends in 2006.

Simon Latham, executive head of community living at Sutton
council says that if the authority is made aware of any individual
examples, it will always look into them. However, he acknowledges
that Sutton’s assessment figures have not been satisfactory in the
past – as shown in last year’s performance indicator results
– and that social workers’ reluctance to offer
assessments was a contributing factor. “There was a lack of clarity
about the benefit of assessment and what it might lead to,” he
explains. Latham adds that, in terms of raising carers’
awareness of their rights to assessments, “other
pressures” had previously taken priority.

In order to improve the figures, the council is currently
looking at employing an additional member of staff to deal
specifically with improving figures on assessments and run training
courses for staff on the issue.

In neighbouring Surrey council, carers are a priority – a
fact reflected in last year’s positive performance indicator
outcomes. John Bangs, carers’ development manager at Surrey,
explains how the council has been running a self-monitoring process
since last October in which care staff go through files to make
sure carers have been offered assessments.

Another practice involves signs being posted in every social
care office asking staff if they have asked a carer if they want to
be assessed. David Munro, executive council member for adults and
community care, says these are “very cheap and very obvious
measures” which could easily be adopted by other councils.

Leicester council is also among those local authorities
performing well on carers’ assessments. Darsh Chauhan,
carers’ identification officer, explains that the council discusses
what an assessment is and makes carers know that they can ask for
one through leaflets and carers’ practice guidance, which has been
launched twice to raise awareness.

It also has initiatives such as the ‘Carers Home Assistance
Repairs and Maintenance’ service, under which the only prerequisite
for carers to receive help with their house or garden is for them
to have had an assessment. The scheme has been so popular since it
began in January 2000 that two further rounds have taken place, and
it is set to be relaunched again this year with direct
payments.

Leicester also positively promotes carers’ assessments
while assessing the needs of people they care for under the
Community Care Assessment process. Chauhan explains that giving
carers the opportunity to ask for their own assessment at this
point is not complicated and is an example other councils could
easily follow.

In Suffolk, social care manager Joan Carlyon says that past poor
performance on carers’ assessments was partly down to the way
in which data was stored, with carers having their details hidden
within the file of the person they were caring for rather than
having their own separate file. She says that a crisis in staffing
and heavy workloads were also partly to blame, as the needs of
those being cared for were always going to be put ahead of those of
carers.

Carlyon says the council has now experienced a “complete
cultural change”, treating carers as individuals in their own
right. She says it was a case of realising that “if carers put
their heads under the duvet, the whole world would end”.

Croydon council argues that part of the problem with
carers’ assessments is the wording of existing legislation.
Social services director Hannah Miller claims that the separate
assessment of carers introduced under the Carers and Disabled
Children Act 2000 sets a higher threshold for assessment than the
NHS and Community Care Act 1990.

“Needing to be ‘satisfied’ that a person
‘is’ someone for whom the authority may provide
services (under the 2000 Act) is clearly a more stringent test than
it ‘appearing’ that someone ‘may be’ [under
the 1990 Act),” Miller explains.

“It is difficult to see how a local authority could meet
this more stringent test and satisfy itself without having assessed
the individual concerned in some way (not necessarily directly),
and made a determination that the person cared for is eligible for
community care services.”

As a result, Croydon decided to link carers’ assessments
to eligibility criteria under the Fair Access to Care Services
policy. However, this policy has now been amended after concerns
were raised by a local carers’ group.

In general, Whitworth believes the problem of low assessment
levels is a matter of carers being a low priority rather than
councils being unaware of the legislation. Her charity is calling
for legislation to be introduced placing a legal duty on councils
to inform carers of their right to an assessment to bring England
and Wales in line with Scotland and Northern Ireland.

Whitworth is also calling for the government to help push
carers’ needs up the agenda by including an indicator on services
for carers in the 11 key performance indicators that help determine
a social services department’s star rating. An indicator on
assessments alone, she argues, is not enough as assessments are
worth nothing unless they lead to services where required.

“What’s actually helpful to carers is the outcomes,”
agrees Bangs. “If those who access services are getting help
does it really matter if they’ve had an assessment?”

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