Carers Assessment

The Carer's (Recognition and Services) Act 1995 gives people aged 16 and over who provide "substantial care on a regular basis" the right to request an assessment from Social Services.

In addition, standard six of the National Service Framework for Mental Health states that "all individuals who provide regular and substantial care for a person on CPA should:

  • have an assessment of their caring, physical and mental health needs, repeated on an annual basis; and
  • have their own written care plan which is given to them and implemented in discussion with them

There is no definition of "substantial and regular" care. Whether you are a carer providing substantial care on a regular basis depends upon the impact of the caring upon the carer – not whether you live with the person you are caring for, of caring for a set number of hours per week, so the impact of caring is the crucial part: such as a risk of the caring breaking down if no help is put in, especially hospital admission.

How do I get carers assessment?
It is your legal right to be assessed as a carer. The Carers and Disabled Children’s Act (2000) enables carers who provide (or intent to provide) a substantial amount of care on a regular basis to someone aged over 18 to apply for a carers assessment. This applies whether or not the person they care for has had an assessment under CPA or receiving services from a local authority.

The care coordinator of the person you care for should inform you of your right to request an assessment. Often this does not happen and you should ring or write to your local community mental health team to request a carers assessment.

The Carers plan does not become active until it has been read, agreed and counter-signed by yourself and the assessor’s manager. It then becomes part of the CPA.

The assessment

Once you have requested a carer’s assessment the care coordinator should contact you to arrange an appointment in which the assessment will take place. If there is a conflict of interests, another member of the community mental health team may contact you instead. The assessment will look at three areas:

  • information about yourself
  • information about the person you are caring for
  • your needs as a carer

The first part of the assessment form you will need to fill out yourself. You should ask if you need help, don't understand anything or need a translator. For the rest of the form sometimes a carer support worker or another person can be helpful. For the second part of the assessment you will have to tell the assessor what role you play in caring and about the amount of caring you do. Caring for someone includes giving them support and encouragement as well as practical or physical help. Think about which parts of caring you find rewarding or positive, as well as what you find a burden or hassle.

For the final part you should think about what you need to begin, continue, restart or stop care giving. For example, older carers may have concerns about what will happen after their own deaths to the person they care for.

If you have significant long-term health problems or a disability, you should be offered a Community Care Assessment in your own right. The assessment does not assume that you wish to carry on caring. Although you may continue to care deeply about a person, you may be unable or reluctant to continue caring. Carers do not always want to care.

Confidentiality
Carers can declare any information they give as confidential. In practice, this means noting on the assessment form wishes about who information can and cannot be shared with. The risk of self or public harm may over-ride this.

The Care Plan
The Carers' Plan is a written document which aims to list what action should be taken to meet your needs, to provide the services to meet your recognised needs, and to agree on what is achievable.

Carers should be aware that the Carers' Plan is not a legally binding contract.

The Carers' Plan should include:

  • information about the mental health needs of the person for whom you are caring, including information about medication and any side-effects which can be predicted, and services available to support them
  • action to meet your needs
  • information on what to do and who to contact in a crisis
  • what will be provided to meet you own mental and physical health needs, and how it will be provided
  • action needed to secure advice on income, housing, educational and employment matters
  • arrangement for short breaks
  • arrangements for social support, including access to carers' support groups
  • information about appeals or complaints procedure

The plan should be reviewed at least annually. More frequent reviews may be necessary if either the service user or your health or circumstances change significantly.

Problems with care plans

If you are unhappy with the way your assessment was carried out or with the care plan itself, you should contact the assessor and discuss your concerns. If they seem unsympathetic or unable to change your plan you could contact the assessor’s manager. The most common problem with the Carers' Assessment is that needs are identified but there are insufficient resources to meet these needs. Many people feel they would benefit from a carer support worker or carers' group but there are few available throughout the UK.

Because of poor implementation of the National Service Framework for Mental Health and in particular standard six which involves services for carers, few Trusts have much experience with the Carers Assessment. If you are unhappy with the service you are receiving you could consider writing a complaint to the Trust. The Rethink National Advice Service has experience in this field and may be able to help.