Care Act boost to carers’ rights did not improve support because of council budget pressures, says study

Volume of carer assessments, numbers receiving support, spending on carers and their satisfaction with services decreased following the implementation of the legislation, finds research

The front cover of the Care Act 2014
Photo: Gary Brigden

The Care Act 2014’s strengthening of carers’  rights did not improve their access to support because of council budget pressures, a study has found.

Though the legislation enhanced carers’ rights to an assessment and gave them, for the first time, an entitlement to support if they met new national eligibility criteria, the research found that volume of carer assessments, the numbers receiving support, council expenditure on carers and carer satisfaction with support all decreased after its implementation in 2015.

While researchers said these reductions were unlikely to be the result of the act, they said they were “most likely related to the fiscal environment during the period in which the Act was implemented, and in particular to reductions in local government budgets since 2009”. This was reflected in reductions in most other aspects of social care provision

The findings come from the end-of-project report of the Carers in Adult Social Care (CASC) study, funded by the government’s National Institute of Health Research (NIHR) and carried out by researchers from the London School of Economics (LSE) and the NIHR Policy Research Unit in Health and Social Care Workforce.

New rights

Under section 10 of the Care Act 2014, councils in England must carry out an assessment of a carer of an adult where it appears that they may have need for support. Previously, carers needed to be providing a substantial amount of care on a regular basis to qualify for an assessment. In addition, section 20 of the act placed a duty on councils to meet carers’ needs in line with national eligibility threshold.

The Care Act was expected to lead to a “substantial increase” in the numbers of carers seeking support from local authorities, with a government impact assessment published during the consultation process estimating the legislation would generate an additional 270,000 carer assessments in the first year, rising to a steady-state increase of 360,000 assessments per year by 2017-18.

However, the research found that a decline in the number of carer assessments that had started before the act’s implementation continued after it,

Decrease in assessments and support

In 2014-15, the year before implementation, 297,000 joint or separate carer assessments were undertaken, declining by 14% to 256,000 in the year of implementation (2015-16), then to 240,000 assessments in 2016-17.

There was a similar trend in the provision of services and information to carers, with analysis of the results of the annual survey of adult carers suggesting that support had become concentrated on carers providing more intensive levels of care. There was also an apparent shift in the provision of support from services to information and advice,

“These changes were predicated on the grounds that information and advice would improve carers’ wellbeing by empowering them to access local universal support services, but also out of a desire to divert growing demand for services away from the financially stretched adult services departments in local authorities,” the report said.

In addition, though the act also aimed to reduce the extent of local variability in access to services by introducing national minimum eligibility criteria, the study found that significant variability remained in the provision of support.

In addition, spending on carer-specific  services fell by the greatest percentage of any client group (14%) in the year following implementation, while there was a “small but significant” fall in carer satisfaction with local authority support following the act’s implementation.

 Care Act ‘constrained by council resources’

Ruby Peacock, head of policy at Carers UK, said the Care Act was a big step forward for carers’ rights, but echoed the report’s findings in saying that implementation had been “constrained by council resources”, a problem that had got worse during the pandemic.

Peacock said the experiences that carers have shared with Carers UK suggested that the implementation of the Care Act and Children and Families Act 2014, which enshrined rights to assessments for young and parent carers, was varied across England and “they are not realising the benefits that were intended by the legislation”.

“Even for those carers who had a positive experience of the assessment itself, often there is not support available locally following on from it to relieve the issues they have raised,” she added.

Peacock urged the government to deliver an “ambitious, sustainable plan for rebuilding our social care system, coupled with substantial funding, so that unpaid carers get the practical support they need and deserve”.

In response to the research findings, a Department of Health and Social Care (DHSC) spokesperson said “We commissioned this London School of Economics research as part of our Care Act evaluation, to ensure local authorities are providing carers with the support that was committed to through the Act”

It said proposals to help improve the adult social care system will be informed by this evaluation, DHSC’s pandemic experience and its ongoing engagement on these issues with carer organisations, local government and stakeholders across the public sector.

4 Responses to Care Act boost to carers’ rights did not improve support because of council budget pressures, says study

  1. Liz February 10, 2021 at 9:09 pm #

    Interesting. The Government insists they have provided funds for carers to local authorities .instead of passing funding on directly they give it to carers charities mostly all have paid staff . It would be useful to audit all carer’s funding streams to establish where and how tax payers money is being spent.

  2. Lorna curran February 11, 2021 at 2:42 pm #

    Despite me having a carers assessment, which in itself is draining I was denied any support due to a personal vandetta from a senior social worker who was on the panel.
    I apparantly did not meet the criteria, which my advocate from caring for carers in Essex was appalled by the decision.
    I was so low I did not have the fight in me to appeal.

  3. A Man Called Horse February 13, 2021 at 8:22 am #

    The Care Act was made in a vacuum with no reference to draconian cuts made to LA budgets by the Tories .Almost feels like the assessments are a waste of time because all you can offer is information and advice, no money in the budgets for carers really. Same in terms of carers allowance an absolute pittance offered to carers.

  4. Chris Sterry February 13, 2021 at 12:08 pm #

    The Care Act 2014 did express rights for carers and did provide a greater definition of carers to allow more persons caring to qualify for a Carers Assessment.

    But it did not go far enough and more rights to carers should have been included, for when a need or needs were identified the outcome was restricted by funding, exactly what the ‘end-of-project report of the Carers in Adult Social Care (CASC) study‘ concluded.

    This was not ‘rocket science’ as the austerity cuts from 2009 were seriously depleting the finances of all Local Authorities, some more than others.

    In Sheffield some 5 years ago when the Carers contract was put out to Tender, the finance for the contract was reduced meaning, whoever, did win the tender would not have sufficient funding to enable all that was done previously would not be able to be maintained in total.

    The contract is again out for tender, but do to a ‘Conflict of Interest‘ I am not able to oversee the tender, so do not know if the funding has been reduced further, increased or stayed the same.

    Hopefully, should the White Paper, ‘Integration and Innovation: working together to improve health and social care for all‘, becomes into law, then the requirement to tender could well be withdrawn, unless the existing organisation was not fulfilling the contract.

    But for anything to succeed then the required finance needs to be provided no matter how good the contents of the resulting Act stipulates.

    Unfortunately providing finances and certainly sufficient finance is not what Governments are good at and by this, I mean any Government, certainly within my current life time of 71 years.

    Even before that when the NHS was created in 1948, the finance was not sufficient for in 1952, a small prescription charge had to be introduced and today you only have to look at the NHS and even more so Social Care.

    Immediately, this Government needs to reverse all the Local Government austerity cuts with increases for the ‘costs of living’ even though that would not be sufficient for Social Care, but it would be a start.

    This Should be a certainty to be included in next budget of the Chancellor of the Exchequer Rishi Sunak MP.

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