SCIE Practice guide 5: Implementing the Carers (Equal Opportunities) Act 2004

Assessment of carers - Developing local resources

Key research and policy findings

• Support is needed for community groups to develop their skills, knowledge and abilities to enable them to get involved in local service development (47).
• Local and health authorities have limited capacity to respond to emergency situations and arrange short-term support (29).
• Some reasons for carers' inability to take up community care services are: lack of availability, poor quality services, waiting lists, charges and lack of service flexibility (17).
• Many carers have said that they need help with managing direct payments and with their responsibilities as employers (17).

Practice points

• Gather information on the numbers of carers in the locality. Where possible, include information on their employment status, ethnicity, age, sexuality, etc.
• Carry out an audit of local provision.
• Identify gaps in provision, particularly where there is inequality between groups.
• Develop a commissioning strategy with local partners to meet the identified gaps in service.
• Encourage participation from diverse community groups in developing services to meet the specific needs of their communities.
• Ensure - through partnerships and the role of the carers' lead - that mainstream services are accessible to carers.
• Develop, with the voluntary sector, a carers' emergency scheme.
• To inform future development, record circumstances where desired outcomes cannot be met.
• Promote direct payments by providing a support service.

Research and policy

If services are to focus on outcomes, and flexibility is to be made available to carers to sustain their caring role, services need to be developed locally to meet identified needs. This will necessitate not only the identification of local needs and gaps in service, but also the development of community involvement in meeting those needs. Services cannot hope to meet the needs of carers unless all stages of planning and development have active participants with a carer perspective.

Carers exist in all communities, and their needs will be different depending on certain characteristics - for example, cultural diversity, sexuality, age. It is important that they are included in the development of local services to meet their own needs and that they are empowered to become fully participative citizens.

Independence, well-being and choice (28) emphasises the need to use the wider resources of the community when planning care. Early intervention and prevention are also key to the new vision for social care outlined in Our health, our care, our say. Participation on a local level, in developing services to target local need, may address many of the issues associated with social exclusion.

The government is clear that the involvement of members of the community with public bodies is vital to the implementation of its policies. Local authorities need to mobilise local communities into active participation. Firm foundations (48), a government report on capacity building, sets out a framework for development. The report defines community capacity building as:

activities, resources and support that strengthen the skills, abilities and confidence of people and community groups to take effective action and leading roles in the development of their communities.

Local authorities need to ensure that support is available to local communities to enable individuals and groups to develop the skills and confidence to facilitate active participation (47). Community involvement in decision-making and the setting of local priorities is essential to the implementation of policy at a local level. Communities across the country differ greatly in terms of geography and the diversity of the local population, and such differences are key to the development of appropriate local implementation plans.

Richardson and Sefton (47) offer the basis for a tool for the assessment of capacity-building schemes. They have identified four elements of a successful community group:

• shared vision
• the internal dynamics of the group (including strong leadership, good balance of skills, commitment, enjoying working together and good teamwork)
• relations with the local community
• external support.

They have also ascertained the characteristics of a favourable external environment necessary for the success of community groups:

• financial and other resources - including support with accessing grants
• networking - sharing of skills, contacts and information
• participation in wider activities and projects
• capacity building - i.e. support from external bodies.

Resources need to be evaluated by carers in terms of their outcomes for carers.

Direct payments have, for many disabled people, offered increased independence and choice. If direct payments are to be successful, it is important that people have the support they need to cope with the administrative and human resource management aspects.

Information on direct payments is available from local authorities and from the Department of Health. The main source of direct payments guidance is: Community Care, Services for Carers and Children's Services (Direct Payments) Guidance England 2003 (PDF) .

Ideas from practice

Practice examples are self-reported and have not been evaluated.

• Good practice examples of capacity building are to be found in the housing sector where residents/tenants associations have been central to successful regeneration projects. Housing partners in the locality may be able to contribute experience of such projects to the multi-agency strategy.
• Carers' emergency schemes (55) - Each carer participating in an emergency scheme will be issued with a card carrying a central office contact number and an identification number. The ID number will relate to records held at the central office, which contain details of the cared-for person, their needs and other appropriate contacts. The office should also have a copy of an emergency plan that has been prepared previously with the carer.
  
  Carers UK (46) stresses the importance of a pre-arranged plan and a coordinated 24-hour back-up service. This is far preferable to an emergency card scheme that simply issues carers with a card with contact phone numbers on it. It is also important that people who are offered emergency care are made aware in advance of any likely service charges. Following on from the commitment in Our health, our care, our say, and as part of the new carer's strategy, councils will be expected to develop local schemes to support carers in emergencies.
• Torbay's 'Safely Home' scheme aims to give peace of mind and support to the carers of people with dementia.
  Download the Safely Home Leaflet (217kb PDF)
  
• The London Borough of Camden have established a project with Camden Crossroads to support Bangladeshi carers. It involves training local Sylheti-speaking residents to be employed as care workers so that Bangladeshi carers are able to take breaks. In this way, it offers a source of employment within the local community as well as providing a service for carers. 
• In the Birmingham area, there is a large Somali population. Members of this community, although offered direct payments to purchase care, have had difficulty in accessing culturally appropriate services. Birmingham Crossroads is offering support by training two members of the community to become NVQ assessors, and by employing staff from the community to work at the scheme and become professional carer-support workers.
  
  Local leaders believe that the community has the capacity, dedication and enthusiasm to develop its own domiciliary care service. This would be for the community itself initially but would also, in the longer term, have the potential to provide a service for other minority groups in Birmingham. Such a service would be better equipped to make available culturally appropriate services.
  
  Crossroads aims to support this venture to ensure that it is able to meet the challenges required by regulation and modernisation. The Crossroads Association has applied for funding to facilitate the employment of a dedicated development worker to work alongside the community, the association and the Birmingham Crossroads scheme.
• In the East Riding of Yorkshire a unit of students on placement was set up to carry out carer assessments. The aims of the project were to encourage work with carers at an early stage whilst addressing capacity issues in care management teams and improving performance indicators. Students were given a two-week induction and the opportunity to observe a carer being assessed. Students were regularly supervised and attended team meetings. They also worked on the duty rota. Monthly meetings were held to review the care plans produced by the students and practice issues were discussed with individual students. The project was evaluated and aims were achieved.