1) The study aimed to understand how carers' needs are assessed and supported in England following the implementation of the Care Act 2014, which included new duties to provide information and advice to carers. 2) A multi-method study was conducted, including interviews, surveys, and an audit of local authority websites to understand how information is provided to carers digitally. 3) The audit found significant variability between local authority websites in terms of the information provided about carer assessments, processes, and support. Some groups also face digital exclusion.

1. Jo Moriarty
(on behalf of CASC team)
Carers’ access to social
care support in
England

2. Study aims
To understand the processes and
resources for assessing and meeting the
care needs of carers in England, and to
examine the extent to which they
changed following the implementation
of the Care Act 2014
To evaluate the support provided to
carers post-Care Act 2014
Sustainable Care Conference 2021 2

3. The CASC Team
Jose-Luis Fernandez
Joanna Marczak
Tom Snell
Nicola Brimblecombe
Jo Moriarty
Jacqueline Damant
Martin Knapp
Jill Manthorpe
https://www.lse.ac.uk/cpec/assets/docu
ments/cascfinalreport.pdf
Sustainable Care Conference 2021 3

4. Outline
Multi method study
• Included interviews and survey
• Secondary data analysis
• Audit of local authority websites
Focus on website audit
• First need to explain policy on online services and barriers
to digital inclusion
Sustainable Care Conference 2021 4

5. Care Act 2014
Included specific duty
to provide information
and advice
Sustainable Care Conference 2021 5

6. Digital by
default
Government target of delivering
services online since 2010
Sustainable Care Conference 2021 6

7. Office for National Statistics Data
0
5
10
15
20
25
2011 2012 2013 2014 2015 2016 2017 2018
Fewer adults have never used internet or last used it over three months ago
Number of adults (millions) %
Sustainable Care Conference 2021 7

8. Use of the internet
Under-represented groups
Some groups over-represented
among those who have never
used the internet
• Single person households
• Those with lower household
incomes
• Households in which there is
no adult in paid employment
• People with disabilities
Improvements
Some gaps have reduced
• Fewer people aged 75+ have not
used the internet but a gap still
exists
• Proportionally fewer older adults
use smartphones or tablets
• Ethnicity gap has declined
• Technology – e.g. more voice
activated services could make it
more accessible
Sustainable Care Conference 2021 8

9. Cost as a barrier
Cost of broadband per month.
Compare this with Universal
Credit (approx. £400 per month
for single person & £600 for
couple)
Sustainable Care Conference 2021 9

10. Rural areas have less access to high
speed broadband
Croydon Dulverton
Sustainable Care Conference 2021 10

11. Mobile data
Sustainable Care Conference 2021 11

12. ‘Mystery shopping’
What would you see if you were a carer looking
for information?
Method has been used before
• Manthorpe et al (2013)
• Independent Age (2016)
• Lloyd and Jessiman (2017)
9 April 2019 Local authority workshop 12

13. Variability in what’s included
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Definition of
carer
Reference to
young carers
Care Act 2014 Right to
carer's
assessment
Assessment
process
Who
completes
assessment
Waiting times
for
assessment
Direct
payments for
carers
Emergency
support
Welfare rights
& benefits
Self funders
Content checklist
Yes No
Sustainable Care Conference 2021 13

14. Need to look inviting and inclusive
Clear layout http://www.coventry.gov.uk/carers
Sustainable Care Conference 2021 14

15. Does this matter?
Care Act 2014 intended to reduce ‘postcode’
lottery and increase transparency
Websites need to ensure content reflects carers’
concerns
• What happens in an emergency?
• How long will it take to get an assessment?
• Is everything means tested?
Sustainable Care Conference 2021 15

16. Carer Assessments
Limitations to the comparability
of return data before/after April
2014 (especially changes in the
accounting of numbers ‘not
assessed’)
Numbers of assessments have
decreased since around 2010, in
keeping with broad trends in
social care activity
Reductions in assessments
continue following
implementation of the Care Act
in April 2015
Sustainable Care Conference 2021 16
Numbers of carer assessments
Source: RAP, SALT returns

17. Carer Expenditure
Carer expenditure data are available
for ASC-FR years (2014/15 onwards)
only
Decreasing levels of real-term
expenditure on carer services since
2014/15
Over the corresponding period,
overall adult social care expenditure
increased by 0.4% in real terms
between 2016/17 and 2017/18
“Local authorities advised that
expenditure related to carers could
sometimes be captured within a
different category in ASC-FR […] and
so this expenditure should not be
directly compared with the activity
data” (NHS Digital 2018)
Sustainable Care Conference 2021 17
Gross current expenditure on carer support (2017/18 prices)
Source: ASC-FR returns

18. Services for
carers
Sustainable Care Conference 2021 18

19. Carer
satisfaction
Sustainable Care Conference 2021 19

20. Conclusion (from overall study)
Care Act 2014 was expected to lead to significant
increases in the numbers of carer assessments
• Post implementation years were associated with significant
reductions in standardised rates of assessments relative to the
pre-implementation period
• Improved clarity about the roles and responsibilities of the
state towards carers
• Impact of strengthened carer rights appears to have been
limited by the requirement for local authorities to keep within
budget, and as a result these rights have not led to greater
access to support for carers
Sustainable Care Conference 2021 20

21. Taking this forward
Do carers experience a ‘digital divide’?
What are the links between information quality and
use of services?
• Carers often consult organisations for specific conditions (e.g.
Alzheimer’s Society)
• Assumes the person cared for has a diagnosis and there is an organisation for people in their
position
Opportunities for cookies and algorithms
• When do carers look for help and what else do they look at?
Sustainable Care Conference 2021 21

22. Links and references
Slide
number
Link
5 https://www.ons.gov.uk/peoplepopulationandcommunity/householdcharacteristics/homeinter
netandsocialmediausage/articles/exploringtheuksdigitaldivide/2019-03-04#what-is-the-
pattern-of-internet-usage-among-disabled-people
9-11 Quotes from MoneySupermarket.com
11 Acknowledgement to Josie Barnard programme
https://www.bbc.co.uk/programmes/m000823p
Sustainable Care Conference 2021 22

23. Disclaimer
This study was funded by the National
Institute for Health Research (NIHR)
Policy Research programme project
reference PR-R14-1215-
21008/Supporting carers following the
implementation of the Care Act 2014:
eligibility, support and prevention. The
views expressed are those of the
author(s) and not necessarily those of
the NIHR nor the Department of Health
and Social Care
Sustainable Care Conference 2021 23