Carers face postcode lottery in support due to variations in thresholds, finds study

Carers face a postcode lottery in access to support because of significant variations in the way councils carry out assessments, determine eligibility and allocate resources, a study has found.

The research identified differences between authorities in thresholds for accessing support, the extent to which councils allowed professionals discretion in the way they determined eligibility and in resource allocation systems for determining the size of carer personal budgets. There was also variation in the extent to which councils outsourced the provision of carers’ assessments to external organisations, such as local carers’ centres.

“It is highly likely that differences between local authorities in eligibility thresholds for carers and levels of carer [personal budgets] will lead to carers with similar levels of need being treated differently in different local authorities,” warned researchers.

The York University paper has been published four months before the Care Act 2014 introduces a new, lowered threshold for accessing carers’ assessments and, for the first time, an entitlement to support for those deemed eligible against new national criteria. This is designed to address the problems revealed by the research by establishing a consistent threshold for support across the country.

Research findings

The study found that some councils determined eligibility according to the assessor’s professional judgement of the impact of the person’s caring role on their health and wellbeing, while others used formal eligibility criteria. However, these criteria differed in their level of detail and in their content and structure. Some specified a minimum number of hours spent caring as the threshold, while others assessed the likelihood of carer breakdown or the impact of their role on the carer’s wellbeing. Some councils used a points-based system to assess carer need – with a certain number of points determining eligibility – while others banded carers according to the extent of their assessed needs.

While half of the councils studied used in-house staff exclusively to assess carers the others outsourced at least some of their assessments, usually to local voluntary organisations such as carers’ centres. While the study did not examine the consistency of assessments between in-house and external staff, it said this issue would need to be addressed by councils outsourcing assessments.

While most councils offered carers variable personal budgets, with the sum based on level of need, others provided standard, fixed sum budgets. The study warned that the latter approach may prove inequitable by not basing personal budget sums on need. Among councils who provided variable personal budgets, most councils had a ceiling on the amount they would give a carer, of £200, £300 or £500 per year. Among those who did not have a limit, budgets of £1000 or above were said to be unusual and require special permission. Payments were usually given as lump sums because this was administratively simple.