Now that CQC has published its assessment framework for the next round of local authority inspections, one thing is clear: support for unpaid carers will be central to how councils are judged, not a footnote. The good news is that the evidence already shows what good practice looks like.
CQC’s own numbers make the point. The Social Care Institute for Excellence’s independent analysis of published assessments found support for unpaid carers needed improvement in 62% of cases. Chris Badger, CQC’s Chief Inspector of Adult Social Care, told the National Children and Adult Services Conference last November that more support for carers was needed, the first finding in his summary of the whole programme.
A universal duty
The new framework, published in April, backs that up: unpaid carers are named explicitly in all nine quality statements, across all four themes, from assessing needs through to leadership and governance. It is threaded through every judgement CQC will make. There is a reason for that. For most social care, statutory duty is triggered by eligible need, a threshold someone must meet before a council owes them anything.
For carers, the duty is different: any carer who appears to have any level of need is entitled to an assessment. It is a universal duty, not a means-tested one. Councils that treat carer support as an add-on for the small number who ask for it are working against the grain of their own statutory obligations, and CQC’s new framework will notice.
Key insights
If we look at the evidence, there are some hints as to what local authorities can prioritise:
- Get the data right: The Survey of Adult Carers in England (SACE) is central to any assessment, but by its nature it only reaches a fairly narrow, already-engaged cohort. Councils need to show they understand the needs of carers beyond that group and those who meet eligible-need thresholds. An evidence base that is just SACE is not broad enough.
- Push co-production past the strategy document: Plenty of councils co-produce a carers’ strategy and stop there. The evidence shows the real gains come when carers help shape the services and support on offer, not just the paperwork above them. Far from slowing things down, this tends to accelerate the more creative and effective approaches to support.
- Treat identification as a priority: It is the theme driving CQC ratings hardest, and the carers still missing are usually the ones not showing up anywhere: working carers, carers who do not identify with the label. Integration with primary care works. One GP text-messaging programme we have seen reached 18,500 patients and identified more than 250 new carers a week. That is the kind of reach a leaflet in a GP waiting room never gets close to.
- Think beyond the commissioned service to the wider ecosystem: In Buckinghamshire, new commissioning practice and the Carers Partnership Board are increasingly focused on a ‘carer friendly Buckinghamshire’, working with schools, employers, GPs and a wide range of VCSE organisations to get carers identified and supported well outside the walls of any one commissioned service. It is still in progress, but the principle is the right one, and the direction of travel is clear: a commissioned service should be shaping the system around carers, not just delivering to the carers who find their way to it.
- Use digital to extend reach and hold the line on cost: Done well, digital tools reach carers who would otherwise go unsupported, improve accessibility and lower the cost of supporting each carer. That combination matters more than usual right now, because it lets councils increase the volume and quality of carer support without a proportionate increase in budget.
That is the real challenge every council is facing: demand for carer support is rising while budgets are shrinking. Carer support has long been the Cinderella of social care, and CQC’s new framework is finally giving it its rightful place. The councils that treat these five areas as this year’s priority will have a genuinely strong story to tell when assessors arrive.
CQC has since shared the findings of its first national assessment programme of local authorities in England; read more here. Then, share your thoughts on this Straight Talk by leaving a comment below.
James Townsend is Co-Founder and Chief Executive Officer at Mobilise.
Email: [email protected] Linkedin: @James-Townsend