The Care Act and the ‘visibility’ of unpaid carers

Coming into effect today the Care Act, with its widening of eligibility for unpaid carers to be assessed and for support to be provided to meet carers’ needs, is an important step forward

No end of care?: informal care for older parents in Britain between 1985 and 2000

This study is concerned with the issue of substitution between formal and informal care in Britain between 1985 and 2000. This period provides the conditions for a ‘natural experiment’ in social policy. During the late 1980s/early 1990s, there was a rapid increase in long-stay residential care for older people, which came to an end around the mid-1990s. The key issues examined here are whether this increase in formal services led to a decline in provision of informal care, and whether this was subsequently reversed. For reasons identified in the literature review, the focus is on provision of intense informal care by adult children to their older parents, trends in which are identified using General Household Survey data. The study shows that there was a significant decline in provision of intense and very intense co-resident care for older parents between 1985 and 1995, which came to an end in the mid-1990s. A number of potential explanations for these trends are explored, including supply-side explanations in terms of changes in socio-demographic factors and employment rates, and an alternative demand-side explanation in terms of changes in ‘spouse care’. The study finds that, under certain circumstances, key trends in intergenerational care were negatively related to changes in long-stay residential care. In particular, the study finds evidence of substitution effects between nursing home/hospital care and very intense co-resident care for older parents provided by adult children for 50 hours a week or more. A key policy implication is that an expansion of very intense formal services for older people could bring about a decline in some of the most intense forms of intergenerational care for older people. The study relates these conclusions to options around reform of the long-term care system currently under consultation in England following the recent Green Paper on social care

Financing Long-Term Care for Elderly People

Last year’s report of the Royal Commission on Long Term Care (1) and the expected Government response have prompted fresh interest in the debate on how to fund long-term care. To inform this debate the Personal Social Services Research Unit (PSSRU) has conducted a study, funded by the Department of Health, of long-term care demand and finance. This has involved the construction of a computer model to make projections of likely demand and expenditures to 2031. This article describes the model of long-term care demand and expenditure developed by the PSSRU. It then presents some of the results obtained and sensitivity analysis around them

The ‘visibility’ of unpaid care in England

Summary: Social work practice is increasingly concerned with support not just for service users but also for unpaid carers. A key aspect of practice is the assessment of carers’ needs. The Government has recently passed legislation that will widen eligibility for carers’ assessments and remove the requirement that carers must be providing a substantial amount of care on a regular basis. This article examines which carers are currently ‘visible’ or known to councils and which are not, and uses the results to examine the likely effects of the new legislation. In order to identify the characteristics of carers known to councils, the article uses large-scale surveys, comparing the 2009/10 Personal Social Services Survey of Adult Carers in England and the 2009/10 Survey of Carers in Households in England. Findings: Carers who are known to councils provide extremely long hours of care. Among carers providing substantial care who are known to councils, the majority care for 100 or more hours a week. The focus of councils on carers providing long hours of care is associated with a number of other carer characteristics, such as poor health. Applications: Councils' emphasis on the most intense carers is unlikely to be attributable solely to the current legislation. Therefore, dropping the substantial and regular clauses alone will not necessarily broaden access to carers' assessments and, in order to achieve this, considerable new resources may be needed. How far these resources are available will determine the extent to which practitioners can broaden access to carers' assessments

Future demand for long-term care, 2002 to 2041: projections of demand for long-term care for older people in England

The financing of long-term care raises a great many questions. How many older people are likely to require long-term care services in the coming decades? How much are these services likely to cost? Will the cost to public funds prove affordable? Who should pay? How should costs be divided between public expenditure and private sources of finance? In order to address these issues, reliable projections are needed of future demand for long-term care and future long-term care expenditure. This paper presents projections of demand for long-term care for older people in England to 2041 and associated future expenditure. The projections were produced using an updated and expanded version of the Personal Social Services Research Unit’s (PSSRU) long-term care projections model. The version of the model used here has a base year of 2002 and incorporates the 2004-based official population projections. The first part of the paper describes the PSSRU long-term care finance research programme and recent associated projects. The second part of the paper describes the updated and expanded PSSRU long-term care projections model, including details of the data used in this updated version. The third part presents a set of base case assumptions and the projections obtained using those assumptions. The fourth part investigates the sensitivity of the projections to changes in those assumptions. Section five discusses the findings. A final section sets out some conclusions

Barriers to receipt of social care services for working carers and the people they care for in times of austerity

Reconciliation of unpaid care and employment is an increasingly important societal, economic and policy issue, both in the UK and internationally. Previous research shows the effectiveness of formal social care services in enabling carers to remain in employment. Using quantitative and qualitative data collected from carers and the person they care for in 2013 and 2015, during a period of cuts to adult social care in England, we explore barriers experienced to receipt of social care services. The main barriers to receipt of services identified in our study were availability, characteristics of services such as quality, and attitudes of carer and care-recipient to receiving services. These barriers have particular implications for carers' ability to reconcile care and employment

Perceptions of unmet needs for community social care services in England. A comparison of working carers and the people they care for

Previous UK research has found expressed unmet need for services by unpaid working carers and among disabled and older people. There are, however, suggestions from research that views on unmet needs for services differ between carers and care-recipients. Working carers in the UK say that the care-recipient is sometimes reluctant to accept services and the few international comparative dyad studies that have been carried out find that carers perceive higher unmet need than care-recipients. Recent policy discussions in England have also recognised that there may be differences of opinion. We collected data in 2013 from working carer/care-recipient dyads in England about perceived need for services for the care-recipient, disability, unpaid care hour provision and individual and socio-demographic characteristics. We find that care-recipients as well as their carers perceive high unmet need for services, although carers perceive higher unmet need. For carers, unmet need is associated with the disability of the carer-recipient and being the daughter or son of the care-recipient; for care recipients it is associated with unpaid care hours, carers’ employment status and carers’ health. The majority of dyads agree on need for services, and agreement is higher when the working carer provides care for 10 hours or more hours a week. Services for care-recipients may enable working carers to remain in employment so agreement on needs for services supports the implementation of legislation, policy and practice that has a duty to, or aims to, support carer’s employment

Numbers of working carers whose employment is 'at risk' in England

Recent evidence suggests that a key threshold at which carers in England are at risk of leaving employment occurs when unpaid care is provided for 10 or more hours a week, a lower threshold than previously thought. Previous studies had shown that providing care for 20 or more hours a week had a negative effect on employment. One implication is that there are more working carers whose employment is at risk than previously thought. This paper aims to estimate the numbers of working carers whose employment is at risk because they provide care for 10 or more hours a week. A subsidiary aim is to estimate the numbers of working carers providing care for 10 or more hours a week to someone in a private household. Using the 2011 Population Census, Understanding Society (2010/11) and the Survey of Carers in Households (2009/10), we find that there are approximately 790,000 working carers aged 16-64 whose employment is at risk because they provide care for 10 or more hours a week. Of these, approximately 735,000 provide care to someone in a private household. There are nearly a quarter of a million more carers whose employment is at risk than previously thought