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In the UK, there are around 1.5 million carers of people with mental health problems providing substantial amounts of free care. Despite having a legal right to a ‘carer's assessment’, only a minority of mental health carers have had such an assessment. To try and understand why the uptake is so low, we undertook a small (n = 8) qualitative study exploring what mental health staff acting as ‘care co‐ordinators’ thought the barriers to, and facilitators of, carers' assessments might be, and how subsequent practice might be improved.We found that there was some confusion over the definition of ‘carer’ and over who should take responsibility for carer assessments. The main barriers to carers' assessments were the documentation used, the attitudes of staff (especially managers) and the fact that the needs of mental health carers often differed from those caring for people with a physical disability. Practice could be improved through: clarifying the definition of ‘carer’; education and training; redesigning the documentation; dovetailing service user and carer needs assessments; and through offering a wider choice of evidence‐based services as assessment outcomes. Improvements are unlikely to be successful, however, without the active support, expertise and engagement of carers.

This paper presents some of the key findings from a study about supporting carers in employment. It describes the qualitative experiences of family carers for older people who are in paid employment, paying particular attention to their views on assessment and service provision. The perspectives of other key stakeholders, including staff from statutory and independent sector agencies, are also considered. Support for carers in employment is one of the five priority action areas underpinning the National Strategy for Carers (DoH, 1999). However, the findings from this study reveal that carers in employment have a limited profile at strategic level and their specific needs are rarely addressed in mainstream health and social care planning processes. The findings also suggest that assessment and care management practices are failing to support carers in relation to their employment aspirations. The effectiveness of health and social care assessments in identifying and exploring the needs of carers in employment is limited and very few separate carer assessments are completed. Carers' first‐hand experiences of service provision are described. Deficits in current services are identified and examples of good practice are highlighted. The paper concludes by outlining the implications for policy and practice. It is suggested that flexible support, underpinned by partnerships between employers and staff from statutory and independent sector agencies, is the key to supporting carers in employment.

Amongst other actions the Care Act 2014 emphasised the duties of local authorities (LA) to assess the needs of carers, as well as those they care for and to meet all eligible needs for support. This paper aims to report the findings of a study which explored the experiences of older carers of people with learning disabilities as they navigated LA assessment processes and personnel.

Using an explorative design, 21 older carers were interviewed about their experiences. Interview transcripts were qualitatively analysed.

Three main themes were identified, namely, needs assessments as ambitions, not outcomes; the effects of funding-cuts projected onto carers; and challenges with social care personnel.

The study findings attracted a high level of engagement with public awareness and mainstream news and social media. The LA also immediately responded with interventions to address some of the findings, including carer “drop-in” sessions. They are also adapting their carer’s needs assessment processes as a result of the study. It is hoped that the issues raised will be of interest to other social care providers and practitioners.

The purpose of this paper is to establish the outcome of wheelchair prescription procedures for carers supporting a wheelchair user with special reference to their health and well‐being.

A postal questionnaire was used in conjunction with analysis of policy and practice documents in wheelchair prescription and carers' needs.

The majority of carers reported a wide range of health problems. A relationship between wheel chair type and reported carer pain was noted. Only a minority of carers considered that they had received an adequate carer's assessment, and few had received training in wheel chair management; such training where it had been carried out, led to reduced reports of pain.

The study invites more detailed analysis of both the conditions under which wheelchair prescribing takes place and the impact of assessment and training on carers' health. The study is based on a relatively small, local sample and a more extensive study is called for.

Procedures for prescription of wheelchairs should be reviewed and steps taken to ensure that adequate consideration is given to the health needs of carers and the circumstances under which they will push the wheelchair.

More thoughtful prescription of wheelchairs will lead to increased health of carers improving their quality of life and reduce demands on health services and the accompanying risk to their capacity to carry on caring.

The study addresses a neglected topic, which clearly identifies the consequences of inadequate prescription of wheelchairs for the health of carers, a topic generally neglected in the literature.

The purpose of this paper is to explore the role of carers as coordinators of care in their own right. It outlines how statutory and voluntary agencies can work together to support carers in this role, yet also help them work towards personal outcomes to sustain their own quality of life. It also proposes that approaches to working with carers can reveal lessons for integration.

The research analysed data from focus groups and document analysis to examine how carers and professionals experienced two different approaches to engaging with carers: the Midlothian carer ' s assessment and VOCAL ' s outcomes focused approach. From this, several themes emerged which are relevant to the current debate on integration.

Carers were found to be key co-ordinators of care who play a role in the integration of services. Approaches to working with carers can better enable personal outcomes, and integrate carers as equal partners. In addition, improved integration between services can also improve outcomes for carers.

Approaches to working with carers should be carer and outcome focused, and partnership working can mean that carers feel more empowered and included. This helps to achieve personal outcomes, as well as enhance integrated working between other services. However, differentiation between services might, in places, contribute to better outcomes for people.

This paper shifts the focus of integration to look the role of carers as equal partners, and also illustrates how statutory and voluntary services can work better together, while preserving their distinct identities.

The purpose of this study is to evaluate the efficacy of providing health and well‐being checks and six months support to unpaid carers. Changes in carer stress will be measured between baseline and final assessment.

This is a cross‐sectional, correlational study of the 394 carers recruited and the sub‐group of 348 carers who received support for six months. A T‐test measured change in the carers’ GHQ‐12 scores between baseline and final assessment. A chi‐squared test was used to measure movement in the GHQ‐12 scoring quartiles between baseline and final assessment.

The 348 carers receiving support for six months reported a statistically significant small reduction in their baseline and final assessment scores. The carers identified by the GHQ as having less severe stress scores did better than those with more severe stress levels.

As there was no control group, it was not possible to compare the outcomes of the intervention group with the outcomes of a group of carers receiving care as usual. It is therefore possible that there may be some other factors at play for the intervention group over the six‐month period of support, other than the intervention itself, which have influenced the change in carer stress.

Financial pressures on health and social care budgets can lead to carers’ support services being under‐resourced in some areas. However, the draft Care and Support Bill (July 2012) and the introduction of new mandatory duties may help to ensure that local authorities and health and wellbeing boards meet their obligations to provide services for carers.

There is limited research available on the outcomes of carers’ interventions, particularly those which involve holistic interventions, such as health and well‐being checks being delivered by a multi‐agency partnership.

The purpose of this paper is to provide a commentary on “Older carers of people with learning disabilities: their experiences with local authority assessment processes and personnel” written by Rachel Forrester-Jones.

This commentary considers the experiences of older carers in the context of research, legislative and policy changes over the past 30+ years.

The needs of older carers of adults with learning disabilities are well recognised within the (limited) literature. Less attention has been given to practical strategies to identify and support such carers or to their broader family context.

This commentary highlights that assessors carrying out carers’ needs assessments should consider whether adults with learning disabilities are providing care to their older relative. The recognition of possible mutual or reciprocal care needs to be acknowledged and appropriate support offered.

Short breaks enable unpaid carers to have a life alongside caring, supporting their physical and emotional well-being. In the UK, short breaks are usually explored during a Carers Assessment. The conversations underpinning these assessments require considerable skill and presently there are few tools to support the exploration of short break needs, desired outcomes and options. Images are used in other conversations to enhance communication, help people consider options and broaden thinking. This study aims to explore whether and how stakeholders thought images might support short break conversations.

To improve access to meaningful short breaks, we need to be guided by the insights of unpaid carers, those they support, practitioners, commissioners and policymakers. We hosted two online involvement events, designed to facilitate the exchange of perspectives and ideas amongst diverse stakeholders. The events explored the acceptability, facilitators and challenges of using images to enhance unpaid carer short break conversations.

The online events were attended by 47 short break stakeholders. These stakeholders saw merit in using images to support short break conversations. They identified several facilitators and challenges to introducing images into practice. The paper highlights how this learning can inform future research and practice development.

Supporting the well-being of older unpaid carers is a pertinent concern as the number of older unpaid carers continues to grow. This paper reports on how stakeholders have informed the earliest stages of practice and research development in a relevant area and provides a model of involvement that others can emulate.