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School for Social Care Research
Improving the evidence base for adult social care practice
Involving Carers in Personalised Adult Social Care Practice
Wendy Mitchell, Jenni Brooks and Caroline Glendinning
SSCR Personalisation Workshop, 12 June 2013
School for Social Care Research
Study Aim
Explore how English adult social care practice balances the interests of older and disabled people and their carers in personal budget processes.
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Study Structure Stage 1:
Survey of LA policy and practice in two English regions Stage 2:
Three LAs Interviews - carers and personalisation lead officers Focus groups - frontline staff in older people’s and learning
disability teams Stage 3:
Interviews with pairs of service users (with cognitive or communication impairments) and carers
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Department of Health Guidance (2010) Service user assessment: covers ‘willingness
and ability’ to continue providing support
Separate carer assessment: important, co-ordinated with service user assessment
Resource allocation: care provided by carer taken into account after separate carer assessment
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Department of Health Guidance (2010) Service user support planning: carer needs
taken into account
Managing personal budgets: avoid assumptions about what carer will do
Reviews: consider carer needs during service user review
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Assessment Carers often present
Carers and service users happy with this Important role to play (explain needs, remember things)
Asked about willingness and ability to provide support A ‘mini carers assessment’? Not all carers remember being asked Many carers do not recall being asked about own needs
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Carers AssessmentStaff: Carers informed of right
to own assessment Some refused Unclear how service
user and carer assessments linked
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Carers: Experiences varied Many not had carer
assessment Some had refused Small number could not
remember being offered assessment
Confirmed inconsistent practice
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Allocating Resources: Staff Reports Help given by carers reduces service
user budget
Funding for carers’ breaks included in service user budget
Carers infrequently received other support
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Support Planning: Staff Views Guidance brief and unclear
Led by staff as part of service user assessment Before budget is calculated
Carers involved in planning service user support But carers assessments often after support planning Unclear how carers’ needs incorporated into
support plan
Inconsistent practice and provision of carer support9
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Support Planning: Carer and Service User Views
Support planning staff led Carers involved but happy for staff to lead Carers had little knowledge of process Most service users happy with how decisions made Carers role valued
Limited support for carers themselves in support plans Few carers had own support plans
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Ongoing Management Most service users had direct payments
Mainly managed by carers with some support Carers mostly happy with their role
Carers can access direct payment support service But no carer-specific advice
Assumption that carer will manage direct payment if service user cannot
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Reviews Carers usually present in service user reviews,
but format inconsistent
Confusion around reviews of carers’ own needs Managers said service user reviews should
include review of carer needs Few carers had reviews of own needs
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Issues Raised by Research Is carer inclusion in service user assessments enough?
Are questions about ‘willingness and ability’ adequate to assess carer needs?
Is it appropriate to expect LAs to do separate carer assessments?
What happens if carer needs change independently?
Are carers really treated equally? The future? Care and Support Bill (2013)
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Further Information
SPRU website:
bit.ly/perCare
This presentation presents independent research commissioned by the NIHR SSCR. The views expressed are those of the authors and not necessarily those of the NIHR SSCR or the DH, NIHR or NHS.
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