A Study of the Carers Strategy (2000): Supporting Carers in Wales

Seddon, Diane; Robinson, Catherine; Tommis, Y.; Woods, Bob; Perry, Jenny; Russell, Ian

doi:10.1093/bjsw/bcp081

Cited by 11 publications

(9 citation statements)

References 9 publications

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“…However, even when carers are known to professionals, they are often unaware of available support. [ 6 , 9 ] Caring for someone with a terminal illness is particularly challenging [ 5 , 10 – 12 ], therefore it is all the more important that such carers are identified early and signposted to support – recognising the importance of a preventative approach for carers at an early stage of caring when the demands may be less intensive.…”

Section: Introductionmentioning

confidence: 99%

Piloting a new approach in primary care to identify, assess and support carers of people with terminal illnesses: a feasibility study

Carduff¹,

Jarvis²,

Highet³

et al. 2016

BMC Fam Pract

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BackgroundGeneral practices in the United Kingdom are encouraged to have a protocol for the identification of carers and a mechanism for social care referral. However, a minority of carers are identified and those caring for someone with a terminal illness often cope until the situation becomes overwhelming. Earlier identification could enable more timely support.The aim of this project was to model and pilot a systematic approach to identify, assess and support carers of people with supportive and palliative care needs in primary care.MethodThe intervention was modelled on the Medical Research Council complex intervention framework with a preliminary theoretical phase, which has been reported elsewhere. In this study, which lasted 12 months, four general practices were recruited. Each practice identified a ‘carer liaison’ person to take the lead in identifying carers, followed by assessment and support using a toolkit modelled from the earlier phase. Qualitative evaluation interviews were conducted with carers who had received the intervention and the carer liaisons and general practitioners in the pilot practices. A stakeholder event was held to disseminate and deliberate the findings.ResultsThe practices’ populations ranged from 5840 to 10832 patients and across the four practices, 83 carers were identified. Thirty six carers were identified from practice registers (disease - 16; palliative care - 9; carer - 11; advanced care plan - 12), whilst 28 were identified opportunistically by practice staff at appointments or at home. Seven carers self-identified. Overall, 81 carers received the carer pack and 25 returned the Carer Support Needs Assessment Tool (CSNAT) form. Eleven carers received a follow up call from the practice to discuss support and 12 were also referred/signposted for support. Qualitative interviews suggest carers valued connection with their practices but the paperwork in the toolkit was onerous.ConclusionThis approach to identifying and supporting carers was acceptable, but success was dependent on engagement within the whole practice. Carers did not tend to self-identify, nor ask for help. Practices need to proactively identify carers using existing opportunities, resources and computer systems, and also adopt a public health approach to raise carer awareness and perceived support within their communities.

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Section: Introductionmentioning

confidence: 99%

Piloting a new approach in primary care to identify, assess and support carers of people with terminal illnesses: a feasibility study

Carduff¹,

Jarvis²,

Highet³

et al. 2016

BMC Fam Pract

View full text Add to dashboard Cite

show abstract

“…We have previously reported on the limited number of carers who are in receipt of these services and highlighted problems relating to service organisation and delivery (Seddon et al . ). Clearly, there is a vicious circle, as current limitations in the carer assessment process mean that the evidence base to inform future service development is far from robust, which in turn perpetuates practitioner ambivalence.…”

Section: Discussionmentioning

confidence: 97%

Carer assessment: continuing tensions and dilemmas for social care practice

Seddon

Robinson

2014

Health Soc Care Community

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Since the early 1990s, UK social care policy has committed to supporting carers. Legislation (England and Wales) over this time period has recognised the importance of separate carer assessments that take into account an individual's ability and willingness to care. This paper considers carer assessment from the perspective of social care practitioners. It reports on qualitative data from a carer research programme that spans over 20 years (1993 to present) and includes 383 in-depth interviews with social care practitioners across England and Wales. Offering unique longitudinal insights, we identify some persistent tensions associated with the translation of UK carer assessment policy into social care practice. We explore practitioners' long-standing ambivalence towards carer assessment and their reluctance to evidence carer need via a separate assessment process. Deficits relating to the conduct of carer assessment are identified. For example, the reliance on structured, problem-focused assessment protocols that restrict discussions to the personal care aspects of caring and fail to capture the complex, diverse lives that carers lead. Carer assessments do not reflect the reciprocal nature of many caring relationships, as a one-way direction of care is assumed. They do not take into account the broader support network of individuals who may be involved in helping someone with complex care needs. Carer willingness to care continues to be taken for granted and planning for the future is a significant gap in carer assessment practice. The proposed changes to the social care systems across England and Wales provide a timely opportunity to review the process and conduct of carer assessment. Policy guidance needs to clarify the links between service user and carer assessments and the way these align within broader assessment and care management frameworks. Assessment tools that encourage a narrative approach to carer assessment and capture the affective aspects of care-giving could benefit future practice.

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“…Despite complaints about too much top–down pressure, coercion does ‘work’ and transactional interventions are needed to unblock traditional ways of working and to introduce new systems that can reflect changing social and political values. For example, the study on the implementation of the National Strategy for Carers (Seddon et al ., 2007) found no significant improvement for carers over the three years of the study; the absence of carers from the local government performance management framework was one reason for this. Consequently, the authors called for performance indicators for the NHS as well as local authorities relating specifically to carer support and the implementation of local carer strategies.…”

Section: The Modernisation Of Adult Social Care Research Programmementioning

confidence: 91%

Beyond Modernisation? Social Care and the Transformation of Welfare Governance

2008

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This article reflects on the process and outcomes of modernisation in adult social care in England and Wales, drawing particularly on the recently completed Modernising Adult Social Care (MASC) research programme commissioned by the Department of Health. We begin by exploring the contested status of 'modernisation' as a descriptor of reform. We then outline some of the distinctive features of adult social care services and suggest that these features introduce dynamics likely to shape both the experiences and outcomes of policy ambitions for modernisation. We then reflect on the evidence emerging from the MASC studies and develop a model for illuminating some of the dynamics of welfare governance. Finally, we highlight the emerging focus on individualisation and on user-directed and controlled services. We argue that the current focus of modernisation involves a reduced emphasis on structural and institutional approaches to change and an increased emphasis on changes in the behaviours and roles of adult social care service users. This focus has implications for both the future dynamics of welfare governance and for conceptions of citizenship.

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A Study of the Carers Strategy (2000): Supporting Carers in Wales

Cited by 11 publications

References 9 publications

Piloting a new approach in primary care to identify, assess and support carers of people with terminal illnesses: a feasibility study

Piloting a new approach in primary care to identify, assess and support carers of people with terminal illnesses: a feasibility study

Carer assessment: continuing tensions and dilemmas for social care practice

Beyond Modernisation? Social Care and the Transformation of Welfare Governance

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