Assessments

When social services carry out a carer’s assessment, they should not make any assumptions about your willingness to be a carer. This can be a very sensitive area because many of us feel that we have a duty to those we care for. We sometimes rule out other options because we feel we have no choice. You have the right to choose:

• whether to be a carer at all,
• how much care you are willing to provide, and
• the type of care you are wiling to provide.

Their needs

If you are unable or do not wish to meet all the care needs of the person you are looking after, social services must consider what services and support they can provide. There may be some parts of the role that you find more difficult than others. For example, this may be intimate physical care such as helping someone to wash. It is important to explain to social services exactly what aspects of your caring role you find upsetting or worrying.

Take a step back and think about your role as a carer. This can be useful in the discussion you have during a carer’s assessment. Ask in advance for the assessment to happen in private so that you can speak freely.

Example

Tina has a flourishing career as an IT consultant. Her mother has early dementia and has just come out of hospital after breaking a hip. Tina has two married brothers who are busy with their own careers and families and they live a long way away from their mother.

Tina loves her mother deeply and does not want to see her go into residential care because she feels her mother would be unhappy there. However, she is not sure that she wants to care for her mother full-time. She is very anxious about the consequences for her way of life, both social and financial. She is also worried about whether or not she can cope emotionally with her mother’s increasing frailty and dementia.

Tina has a carer’s assessment as part of the plans made to discharge her mother from hospital. She arranges to speak privately to a social worker and is frank about her worries. They discuss Tina’s feelings of pressure and her sense of duty towards her mother.

She finds out about the variety of residential care schemes that may suit her mother, as well as the possibility of her mother going into a care home on a trial basis. She also has the chance to hear about various services available if she does become her mother’s carer, such as daycare services, respite breaks and support so that she can continue working.

When you have a carer’s assessment, it is vital that it considers whether the role of carer is affecting your health or safety.

Many carers take on physical tasks, such as lifting and carrying, which can cause long-term health problems. Others find that the stress of the role can lead to depression or other mental health problems. In some cases, safety can be an issue, e.g. because of the behaviour of the person they look after. Some carers may have pre-existing health problems, such as a bad back, which is made worse by their caring role.

Your health and ability

During your assessment, explain any mental or physical health problems you are experiencing. Social services must consider all aspects of your health and safety, including:

• Whether you have any specific health problems.
• If so, whether you are receiving treatment.
• Whether you are carrying out any tasks that put you at risk.
• Whether you're stressed, anxious or depressed.
• Whether your sleep is affected.
• If there is anything about your home (or where the person you care for lives) that presents a risk to your safety.

There are many ways in which social services may be able to improve the situation for you. They should focus on the outcome you want, rather than simply look at what services they have available. Examples of focusing on the outcomes might include:

• Helping to ensure that you are able to attend any medical appointments for yourself. You may need someone to look after the person you care for while you're out.
• Making arrangements so that you are free to have treatment, e.g. an operation that you might have been putting off.
• Assessing whether there are any aids or adaptations that could make it easier to lift or carry the person you look after. For example, you may need some adaptations to a bath or shower.
• Arranging some training for you, such as training how to safely and efficiently lift and move the person you look after.
• Assess what you do as a carer, examining whether it is right for you to continue this role or what support would make it easier for you to continue.

Example

Linda is looking after her severely disabled son, Richard. Richard is 24 and is very heavy to lift or move. He frequently wakes during the night and needs attention from his mother before he can go back to sleep.

Linda is suffering from a number of health problems. She has sharp pains in her back and realises that she should not be trying to lift Richard but there is no one else available to help her. After years of caring for Richard, she is extremely tired. She has a few hours break during the day while he is at a day centre but she has not been on holiday for years. She often feels depressed because she cannot see the situation improving and is on antidepressants.

A carer’s assessment gives Linda the opportunity to discuss her physical and mental health problems. She discusses her role as a carer and makes it clear to the social worker that she does not want to stop being Richard’s carer but she needs more help and some respite.

Linda focuses on the problem with her back, which she feels is the most urgent issue. She and the social worker discuss possible solutions, such as care workers for Richard at key times of the day, a hoist system so that he can be lifted more easily, and training for Linda in lifting techniques.

The social worker also discusses Linda’s general feelings of exhaustion and depression. The conversation ranges from respite breaks to leisure classes and a weekly coffee morning to provide her with more social contacts. Linda will consider whether these would be helpful for her and then get back to the social worker so a care plan can be drawn up.

As well as being a carer, you will probably also have other commitments to members of your family, friends, your work, or involvement in particular interests and activities. Balancing all these can be difficult.

A carer’s assessment looks at your own interests and commitments to see if and how they are disrupted by your role as a carer. If they are disrupted, a social worker could discuss with you whether or not some support or services could improve matters for you.

What to consider

The assessment should include discussion about:

• Whether you are a parent, and if so, whether there are any difficulties in meeting your children’s needs because of your role as a carer.
• Whether you are married or in a relationship, and whether you have sufficient time and energy to give your partner, or if the nature of the relationship is affected in some way because you're a carer.
• Whether your other relationships with friends or the wider community are affected.
• The effect of your caring role on your paid employment or voluntary work.
• The effect of your caring role on your other interests, such as sport and leisure activities.
• Whether you get any regular breaks to have some time for yourself.

If any of these matters are a problem for you, discuss with social services the type of support or services that may be available. They could include:

• Help with respite or short breaks to give you more time to relax and spend time with family or friends.
• Information about support from social services or local resources for yourself and the person you are looking after.
• Any support available to help you with your paid employment or voluntary work.

If social services agree to provide you with services to meet your needs, you may decide on a direct payment to buy in your own support or services.

This type of discussion may have a knock-on effect and lead to social services considering what extra support or services the person you look after needs. They may carry out a community care assessment or review an existing assessment of the person you are looking after.

Example

Jonny is a widower and a carer for his elderly mother who lives nearby. He is retired and has two married children with families of their own. He used to do voluntary work for a local community service but in the last few months has found he hasn’t had the time or energy to do it.

He also regrets the fact that he no longer has the time to take his grandchildren out for the day. He is a keen angler but again, finds it difficult to make time for this and has lost touch with some of his friends in the local angling club.

Jonny has a carer’s assessment where he discusses the changes in his life since he started caring for his mother. He tells the social worker about his children and grandchildren as well as his hobbies and interest in voluntary work.

They discuss the impact his caring role has had on his life and whether or not he wants some support to re-establish relationships and activities he used to enjoy. Jonny is given information about respite, local sitting services and a possible voluntary 'befriender' for his mother.

One of the most important parts of your carer’s assessment will be a discussion about your wishes concerning paid work, training or leisure activities.

Social services must consider the support you may need if you want to stay in your paid job or return to paid work. They must also consider the support you may need if you want to continue or start studying or training. They should also recognise that you will need some time for yourself and that leisure activities, such as hobbies or sport, can help relieve stress.

Common questions

If I work, do I still qualify as a carer?

Many carers combine paid work, even full-time paid work, with being a carer. Just because you spend time in paid employment does not make you any less of a carer. If you are still caring on a 'regular' and 'substantial' basis, which could be in the evening or weekends for example, you would still be entitled to a carer’s assessment.

As a parent carer, must I stay at home?

No, you should not be treated differently from any other carer. Your wishes about paid employment should be respected.

Is support available for paid work, studying or leisure?

This will depend on your individual circumstances. It could include:

• Care for the person you normally look after while you are unavailable. This would be regarded as a community care service for the person you are looking after.
• Information about training and job opportunities.
• Information about the social security benefits available to you.
• Information about your right to request flexible working arrangements.
• Emergency planning in case there are problems while you're at not available.
• Possibly funding for specific training courses, leisure classes or items you need such as a computer.

Example

Dipti has been caring for her uncle, who has Parkinson’s disease, and she has not been in paid employment for two years. She would like to work at least part-time so that she can contribute to the family finances and keep her skills as a dental hygienist up to date. To start with she will need to do a refresher course and needs information about care for her uncle while she is on the course.

During a carer’s assessment Dipti makes it clear that she wants to continue being her uncle’s carer but that she also wants to return to paid work. She needs advice about combining the two roles. She and the social worker discuss the length of the course and how much and what type of care her uncle would need. They look at different options such as other family members taking on the role of carer, telecare or daycare services.