- Breaks make a real difference. Carers value breaks for many reasons and view them as essential to continue caring and maintaining their own health and wellbeing. They help prevent stress, crisis and breakdown. Carers who don’t get a break are more likely to suffer mental ill health or worsening of their physical health. Breaks can enable the carer (and the cared for) to stay connected to family, friends and things they enjoy – helping to reduce loneliness and isolation. Whole family approaches can support relationships – offering a break from the caring routine rather than time away from the person.
- Many carers don’t get a break. Forty per cent hadn’t had a day off for more than a year – so it is important to remove any barriers. Reasons for carers not having a break include:
- Cost – 38 per cent of carers said they couldn’t afford replacement care.
- The person they care for isn’t willing to accept care and support from others.
- Arranging breaks – the effort, time and bureaucracy involved can be off-putting.
- Concerns about quality of care stops some, as do lack of availability or suitability.
- Co-production and collaboration are essential to developing breaks that are wanted and that work for people. Carers know what is important to them and many have great ideas. Facilitating the right climate for co-production, that is inclusive of all carers, is key. Shared conversations and platforms can help bring together carers with providers that want to improve or adjust their offer to really respond to what’s needed and local businesses that want to play a positive role in their communities.
Carers have clear ideas of what constitutes a good break. Whilst this will be different for everyone, there are some key features. Breaks should:
Support to enable carers to sleep or attend medical appointments is not a break.
- be planned, meaningful and positive
- offer a positive experience for the people they care for
- be flexible, accessible and personalised
- take whole-family approaches and be considered as part of a range of support for the carer and the person they care for to live well.
Empowering carers is important for them to get the breaks they need. What helps?
- Information and advice about what breaks are available and what is possible including non-traditional options. This needs to reach all carers and communities – including self-funders.
- Clear information about funding and any charging arrangements.
- Peer support can give confidence by sharing ideas about what works well.
- Personal budgets offer a great way for carers to tailor breaks that work for them, but carers may need some help in managing the detail.
- Assessments should help people understand their needs and the outcomes they want but breaks are often not discussed, so this needs to be improved.
- Effective strategic commissioning needs to be co-produced with local people and join up across a range of services. Understanding the role that carers play and impact, including financial, if they stopped helps align priorities for breaks across wider agendas. Strategic needs assessments can help identify where targeted approaches could improve equalities and access. Decommissioning of some services may be the right thing to do if there is not demand or they are unable to adapt.
- There needs to be a genuine choice of breaks. Commissioners, through market shaping, and providers need to develop a wide range of provision and types of provision available at different times. That may include residential respite, sitting services, through to holidays and support around shared activities. This range needs to address equalities and specific needs that may require particular skills or approaches. Commissioners should support outcomes, investing in quality and what works.
- Support innovation. There are excellent examples of innovative breaks that are highly valued by carers and families. Some draw on community assets and local business bringing a more inclusive and flexible option to a wider range of carers and their loved ones. Good commissioning and funding arrangements will ensure small charities and social enterprises that may be put off by formal tendering processes are able to deliver tailored, innovative solutions.
In offering effective breaks, good providers have shown what helps:
- Quality systems. This includes workforce development for the right skills and approach; involving carers and community members in checking services; knowing how they make a difference; building on what they do well.
- Clear information to make breaks easy to arrange and access. This enables carers to take a view on the skills, approach, environments and whether it’s right for them and their loved one. Carers need to know what to expect.
- Co-production – being flexible about this and really listening to and acting on what people say. Are carers involved in the board, training, recruitment?
- Carers want providers to deliver good personalised approaches. They want good communication – getting to know the whole family and giving time to adjust to a new service. Carers need to be able to trust staff, knowing their loved one will have a good experience and they as carers won’t have to pick up the pieces afterwards. A key message was make the break enjoyable.