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.
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.