Implementing the Carers (Equal Opportunities) Act 2004
Many of the recommendations in this guide rely on a framework for implementation. The following essential steps, which have emerged as necessary to facilitate implementation, would need to be addressed at a strategic level within local authorities. They are not required by the Act but would form the basis of a model of good practice.
Carers should participate at all levels in local arrangements, including planning, implementation, service development, recruitment, training and evaluation. The development of participation, as opposed to consultation or involvement, is still in its infancy and there is much debate about the value of current approaches (5).
- Position paper 09: Developing measures for effective service user and carer participation (2007)
- Position paper 05: Working together: Carer participation in England, Wales and Northern Ireland (2006)
For any strategy to be effective, carers must agree with the method of implementation. Good practice includes:
- ensuring that carers are supported to participate (e.g. through training, peer support, preparation for meetings)
- having meetings at times that are convenient to carers
- providing appropriate replacement support to the cared-for person
- providing (or funding) transport to meetings
- ensuring that material is accessible and understandable
- avoiding the use of jargon and acronyms
- allowing carers to opt in and out of participation in line with the demands on them as carers
- agency staff attendance at carers' meetings (6)
- ensuring that more than one carer is involved in meetings, to provide moral support (6)
- support from a staff mentor (6)
- making information available about staff members and other attendees at meetings (6)
- paying carers for their work.
A number of organisations, both local and national, are now paying carers for their work, either by the day or at an hourly rate for attendance at meetings. When making payments, organisations should ensure that carers have specialist advice to help them assess the impact of any income on their benefits. In Sunderland, for instance, some carers have raised concerns about this issue and prefer subsistence payments, reimbursement for travel and funding for replacement care.
It is important that each social services department has a named person with responsibility for taking forward the implementation of the Act in conjunction with previous legislation relating to carers. This post should facilitate the implementation of the Act across boundaries, organisations and services for children and adults. It does not remove the responsibility of other workers to address the needs of carers, but should offer leadership and a coordinated approach to carers' issues.
The role of the carers' lead comprises:
- liaising with other public bodies (local authorities, education, children's services, housing and health)
- being aware of the responsibilities of other public bodies towards carers
- ensuring that other public bodies are aware of the requirement for 'due consideration' to be given to local authority requests for help in supporting carers (for example, by circulating a letter to the heads of organisations)
- engaging with local organisations and non-statutory agencies (e.g. voluntary organisations and carers' groups, leisure facilities, local shops and businesses)
- engaging with local employers to raise awareness about carers' issues and promote the 'business case' for employing carers
- working with local community groups to develop services to meet local needs
- promoting the participation of carers at all levels including planning, implementation, service development, recruitment, training and evaluation
- identifying and addressing the support needs of participant carers
- identifying sources of funding to support carers' services
- ensuring that the quality of support to carers is evaluated.
The Princess Royal Trust for Carers offer information to support professionals working with carers.
The local authority is responsible for determining eligibility for services. All other agencies, as well as carers themselves, need to have access to this information.
Services to carers are discretionary. Although a carer's assessment uses the same grading system as the Department of Health's 'fair access to care services' (FACS) - i.e. 'critical', 'substantial', 'moderate', 'low' (7) - to assess risk to the sustainability of the caring role (2), there is no duty to provide services to carers (4). However, 'identification of a critical risk in a Carers' Act assessment triggers a local authority obligation to make an appropriate response to address this risk' (4).
A practitioner's guide to carers' assessments (point 17) (8) suggests a list of key questions to ask when assessing the sustainability of the caring role.
The FACS guidance (7) states that disabled parents should be supported in their parenting role and that this may be beneficial for children, some of whom are young carers. Supporting disabled parents is the responsibility of adult services.
Clements (4) (pp 30-31) provides a full explanation of the application of eligibility criteria in carers' assessment.
In Wales, a person's needs are assessed from the point of first contact under the Unified Assessment Process. It is also mandatory to include a carer's assessment as part of every community care assessment. The guidance (PDF) integrates FACS and an adapted version of the English Single Assessment Process.
As part of the implementation of the Act, each locality should have a multi-agency strategy for carers. This should be agreed by the relevant agencies, including health, housing, education, carers' groups, leisure facilities, Jobcentre Plus and local employers. The strategy should include planning for staff awareness training, the development of an information strategy and methods for monitoring the impact of the various aspects of implementation.
There are many situations where both adults' and children's services will be involved in supporting people who are either caring for or receiving care from family members. A holistic, family approach is essential to providing a seamless service to carers.
Each locality needs to have information about the local population and local needs. The information should be based on available data (e.g. from the Census) and on consultation with local people.
Arrangements for the joint commissioning and funding of projects need to be in place.