Title: Supporting carers following the implementation of the Care Act 2014: eligibility, support and prevention
Funder: Department of Health and Social Care

Abstract: Background: The Care Act 2014 enhanced the legal status of carers in England, giving them equal rights to a needs assessment, and clarifying their eligibility for care and support. The Act also required local authorities to adopt an assets-based approach to assessment and care planning, so that services and support are provided as much as possible in a way that prevents, delays or reduces individuals needs for care and support. Aims: The study will investigate whether and how these aspirations are being achieved, and which strategies could facilitate their attainment by addressing two questions: How do English local authorities identify, assess and respond to the needs of carers following implementation of the Care Act 2014? What are the consequences for costs and outcomes of different forms of support for carers with the aim of preventing and/or delaying the development of needs for care and support? Methods: The study will use a mixed-methods approach, combining quantitative and qualitative methods, and will analyse both individual and area-level data. The study will carry out a mapping exercise and evaluation of the strategies and processes used by English authorities for identifying, assessing and supporting carers. For all authorities, the study will collect: Indicators of carer support (e.g. carers offered assessment or review, completed assessments, carers receiving services), other social care activity (e.g. expenditure, coverage, service types) and local socio-economic and other relevant characteristics. A review of local authority websites to extract information about &ldquo;carer&rdquo; definitions, options for carers accessing local services, and types of support offered. In authorities contracting services from Carers Centres or similar organisations, we will also review information provided in these organisations websites. This information will be supplemented by telephone interviews. This mapping exercise will be complemented by quantitative analyses of the relationship between levels of carer support and local characteristics, to explore whether the Act has changed local levels of carer support (e.g. numbers of carer assessments; numbers of carers receiving support). Based on the findings from the mapping exercise and the modelling of patterns of carer support activity, the study will sample purposefully five authorities with different socio-economic backgrounds and patterns of carer support. In partnership with these five authorities, the study will carry out: An in-depth process evaluation of the approaches to and processes for case-finding, needs assessment and care planning for carers. We will interview carers, local authority managers, professionals involved in carers assessment (e.g. first-contact team members, care managers), carer support service providers, and professionals from local Carers Centres and other such organisations. An evaluation of the costs and consequences of key preventative carer interventions. We will examine the relationship between carers needs and types of support provided, and evaluate the outcomes of key carer services based on publicly available data and on data from the selected schemes in the 5 authorities. The study will last 30 months. The process analysis will be completed within 18 months, and the service evaluation component within the full 30 months. Research team The research team has a long-standing track record of successful social care evaluations, significant expertise in qualitative and quantitative methods, and knowledge and understanding of the English social care system, of carers, and of the Care Act 2014. Impact The study will provide key evidence for the implementation of the Care Act 2014. It will help policy makers understand how local authorities are addressing the great expectations of the Act for carers, and will provide evidence to commissioners, managers, and practitioners in different sectors. Ultimately, this should help to improve the quality of life of carers and care users.

Lay abstract: The Care Act 2014 gave carers in England new rights to assessment of their needs and clarified their entitlements to public support. It aimed to make support for carers more consistent and accessible. The proposed study aims to investigate whether and how these aspirations are being achieved. It explores: How do English local authorities identify, assess and respond to the needs of carers? What are the costs and outcomes of different forms of support for carers? The study will use a mixed-methods approach, and analyse individual and area-level data, engaging with carers throughout. First, the study will carry out a mapping exercise and evaluation of the ways local authorities identify, assess and support carers. It will analyse: Local authority returns about carer support (e.g. assessments completed and services delivered), returns on other social care activity (e.g. expenditure, coverage) and information about local characteristics. Information from local authority and contracted services websites about local carer definitions, contacts for carers, and types of support. When required, we will complement this information with telephone interviews. Next, statistical analyses of the relationship between local carer-support patterns and characteristics will explore how the Care Act has affected local levels of carer support. Based on this work, we will work in five different local authorities to acquire more in-depth data about carer services. In partnership with those authorities, we will: explore whether the mechanisms and approaches to case-finding, needs assessment and care planning for carers are effective. This will involve interviews with key staff, carers and their representatives; evaluate the costs and benefits of preventative activities (helping to support carers), examining carers needs and the support provided, drawing on evidence already collected. The study will take place over 30 months, with process analysis to be completed within 18 months, and service evaluation to take the full 30 months of the study. The research team is composed of researchers with considerable experience in social care evaluations. They will engage with key stakeholders throughout the study.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE