Prevention in practice? 

Friday 30 November saw groups and organisations across the UK come together to celebrate Carers’ Rights Day. And despite the grey, autumnal day outside, the mood in Cardiff Council’s County Hall – where I was invited to attend the Council’s Carers Staff Network event – was anything but gloomy.

Carers’ Rights Day is all about raising awareness of the help and support that carers have a right to, and the life they’re entitled to live.

Being a carer can be a fulfilling and rewarding role, but it can also be hugely demanding and often results in carers putting their own well-being on the back burner. Despite knowing this, I was still shocked to read that a staggering 70% of carers in Wales said they suffered from mental health problems.

For the first time, the Social Services and Well-being (Wales) Act 2014 gives carers a right to be assessed for their own support needs, equal to those who they care for. The assessment can be jointly, alongside the person(s) who they care for, or an individual, separate assessment.

Across Wales there are 370,000 carers who support a loved one who is older, disabled or seriously ill, without being paid to do so. However, national figures show that up until April 2018 only a tiny fraction of these (less than 4%) had been assessed by local authorities to see what help they needed.

One of the most telling stats published by Carers Wales in their latest Track the Act Briefing is that 65% of people with a caring responsibility did not identify themselves as a carer in the first year of caring. It is in our human nature to care for others. Friends, sons, daughters; brothers or sisters; mums and dads; a parent, partner or relative – for many, the line between this and becoming a ‘carer’ simply doesn’t exist. This illustrates part of the challenge that local and central government in Wales face in ensuring more carers are informed, engaged and/or assessed, to prevent their needs from deteriorating.

It is projected that there will be a 107% increase of those aged 85 and over in Wales by 2035.

Meeting people’s needs preventatively is crucial if Wales’ public services face any chance of effectively dealing with the rapidly increasing demand. Successfully providing a ‘prevention solution’ means intervening with the right support at the right time for service users and carers; even if that intervention simply means signposting people to the right information.

Why we’re talking about this…

Preventative approaches within the front door to adult social care is the focus of one of our local government national studies for 2018-19 – a fascinating and eye-opening project that’s taken up a lot of my time over the last few months. It involves reviewing progress made by local authorities in delivering their new duties under the Act and implementing the associated culture change in shifting the focus from what people can’t do to what they can do, in order to promote their independence.

With its focus on prevention, the Act also requires local authorities to provide a bilingual and accessible Information, Advice and Assistance (IAA) service, perhaps taking the form of a one-stop-shop where people can access help to help themselves or be referred for a further assessment of their needs.

So far, we’ve undertaken detailed fieldwork in five councils in different parts of Wales and this has involved mapping the pathways that service users must follow should they enter their council’s social care system. Social Care Wales has published a clear flowchart showing what the process might look like. For many councils, their IAA service is becoming the ‘front door’ and it has been fascinating to spend time with front line officers working in these teams and seeing how they make prevention a reality.

The study is part of the Auditor General for Wales’ annual programme of national local government studies. Our overall question is: ‘Are local authority first point of contact assessment and processes better meeting the needs of service users and carers in line with the commitments of the Act?’

Coming up with a ‘yes’ or ‘no’ answer to this question is a challenge that will no doubt give us a few headaches over the coming months, but all being well and good (and with plenty of coffee and cake), we want our national report to help drive further improvement for people in Wales.

We will be publishing our report in 2019, so watch this space!

About the author

Euros Lake is a Performance Auditor working in the Local Government National Studies Team. He has worked for the Wales Audit Office for five years in a variety of roles, including Welsh language policy and communications. Outside of work, Euros enjoys cycling and following the ups and downs of Cardiff Blues rugby.