Carers

Overview and key messages

All of us will have our lives touched by caring at some point: 3 in 5 of us will be carers and many of us will also need care in our lifetime (George, 2001). Carers are the mothers, fathers, sons, daughters, siblings, spouses, friends and neighbours who provide unpaid care, caring at home, picking up prescriptions, changing dressings, providing much needed emotional support and much more, and often neglecting their own health and wellbeing needs. Carers are vital to those they care for and to the foundation of the health and social care system.
 
  • Around 1 in 8 people in West Wales, many of them young people, are providing unpaid care with a significant proportion providing between 20 to 50+ hours of unpaid care per week.
  • The provision of unpaid care is becoming increasingly common as the population ages, with an expectation that the demand for care provided by spouses and adult children will more than double over the next thirty years (See for example Pickard, 2008).
  • Based on a national calculation conducted by carers UK and Sheffield University in 2015 (Buckner and Yeandle, 2015), the cost of replacing unpaid care in West Wales, can be estimated at £924m. This exceeds the NHS annual budget for the region which is almost £727m (Hywel Dda University Health Board 2016a).

 

 

 

 

 

 

 

 

 

 

Demographics and trends

  • More than 47,000 unpaid carers representing 12.5% of residents in West Wales (ONS, Census 2011):
  • The age range that provided the greatest share of care were women aged 50-64
  • 7.2% of the population provide 1-19 hours unpaid care per week
  • 1.7% provide 20-49 hours unpaid care per week
  • 3.5% provide more than 50 hours of unpaid care per week

Current and future care and support needs

  • Providing more than 50 hours of unpaid care can increase the likelihood of self-reported poor health (Census data)
  • The short and long-term impact of carer collapse can be devastating. Carers can end up in a double admission alongside their ill or disabled loved one, (Carers UK, 2014)
  • Caring for someone with dementia or mental health needs can have an even greater impact leading to stress and frustration and a detrimental impact on carers’ physical and mental health
  • Carers frequently report that their involvement in care is not adequately recognised and their expert knowledge of the ‘cared for person’ is not taken into account. A disconnected model of involvement like this can lead to carers being excluded at important points (Worthington et al, 2013); and this issue contributed to readmission of the cared for person into hospital in 62% of cases (Carers Trust Wales, 2016)
  • It can be difficult for working-age carers to combine paid work with caring duties and carers may choose to quit paid work or reduce their work hours (OECD, 2011)
  • Around 5% or 1 in 20 people of working age combine paid work with their role as an unpaid carer (Carers UK, 2013b) and yet across the region the percentage of working age people claiming Carer’s Allowance is around 2.0%. Whilst this is comparable to the Wales percentage (2.1%) in Ceredigion the uptake is lower (1.4%) (Data Unit Wales, 2015). Direct Payments to carers in their own right is also low which could be linked to the take up of assessment offers. More than a third of carers miss out on state benefits because they didn’t know they could claim for them (Carers Trust, 2016)


“A carer confided in the GP surgery receptionist that she was not coping at home due to the stress of being a carer to her husband who had been diagnosed with Dementia. She was alone, and nobody understood how her husband could be a handful as his friends and family knew him as this kind caring man”

Source: Hywel Dda Regional IiC (2016)

Current support provision

Carers’ needs are currently met in the region through a range of services that are delivered by or commissioned by the local authorities, health, the third sector and other local community groups. These can be broadly broken down in to services that support:
  • Identification and recognition
  • Advice and information
  • Assessment of carers needs
  • Practical support (for example replacement care, help around the home, shopping)
  • Advocacy
  • Condition specific support for the carer and the person they care for
Evidence of improvements include:
  • An increase in the percentage of carers identified from 10.2% in 2013 to 20.6% in 2016
  • An increase in the number of carers registered with GP surgeries in the region from 5,871 in 2015 to over 6,138 in June 2016. GP Surgeries also made 635 carer referrals for further help and support (almost a 40% increase since 2015)
  • Positive feedback for example

 

 

 

“I realised that I was a carer and could register with my GP after seeing the notices on the board in my Surgery”

Source: Hywel Dda Regional IiC (2016)

 

 

Gaps and Areas for Improvement

There are challenges to improving experience and outcomes for carers including:
 
  • Raising the profile and public understanding of carers and embedding good practices around identification, information, consultation and benefits advice
  • Developing appropriate access to a range of information, advice and assistance, including carers information services and training, which supports all the key stages in the caring journey
  • Ensuring that carers and their families are able to access services through their language of choice and that the offer through the medium of Welsh is available
  • Enhancing assessment and care planning processes to ensure carers are involved in decisions about the cared for person including discharge planning
  • Developing consistent, integrated commissioning and procurement processes that are based on co-production principles, which involve user-led community-based groups and fora in the design and delivery of services
  • Increasing use of direct payments by developing community based supply chains that co-produce new models of service delivery such as carer co-operatives
  • Developing integrated Community Transport Schemes and other concessions on a regional footprint to provide a more consistent service that is aligned with Direct Payments, Voucher schemes and other community schemes
  • Addressing accommodation issues for those caring for older people or people with learning disabilities needing to move home from an inappropriate property, or needing support with adaptations, equipment, repairs and improvements, lettings policies, alarms and telecare technologies
  • Integrating carers impact assessment into planning processes for infrastructure programmes such as transport, housing, and technology developments and other relevant community programmes