A sufficiency of carers support services
John Bangs OBE[1] reflects on the recent UN carers rights decision and its implications in relation to the duties of local health and social care authorities to provide a sufficiency of carers support services
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The UN Committee on the Rights of Persons with Disabilities (CRPD) has given an important decision concerning the rights of unpaid carers in the case of Maria Simona Bellini v. Italy (2022). For the background to the case and fuller details of the decision click here.[2]
This posting considers the implications of the UN decision for service planning by local authorities and Integrated Care Boards.
Although the CRPD provides no specific rights for family carers, the Committee accepted that in many instances ‘the rights of persons with disabilities cannot be realised without the protection of family caregivers’. In its decision the Committee noted that states had a duty to provide adequate support services to family carers, so that they can in turn support their relatives to live independently in the community. This support required was said to include respite care and other supportive services.
In the UK, these obligations, of course, largely rest with local authorities. Given what the UN decision says about services that should be available to carers, this means that local authorities (and also Integrated Care Boards) need to undertake assessments of the availability of such services and commission appropriate levels of service in order to ensure that carers’ needs can actually be met. The UN decision clearly implies the need for such action in relation to breaks services and carers support more generally. The decision also highlights a need for the availability of counselling services, which may need to be addressed as a health service provision.
These obligations might, perhaps, be thought similar to the requirements in relation to child care where Section 6 of the Childcare Act 2006, places a duty on councils to ensure the availability of child care that is sufficient to meet the requirements of parents in the local authority’s area. Section 11 of this Act also places a duty on all local authorities to undertake a Childcare Sufficiency Assessment as a means to identify the availability of and demand for childcare provision.
There are already a range of systems for local authorities and ICB partners to strategically plan the provision of services to ensure that these meet the needs of their population. The UN decision means that it will be essential to address carers’ needs and ensure there are sufficient services to meet these:
The Care Act 2014 already places a duty on local authorities to shape and maintain an efficient and effective market of services for meeting care and support needs in the local area. There is a duty on the local authorities to ensure that there is adequate capacity on the ‘supply side’ to meet the care and support needs of their populations, including those of carers. This is made explicit in section 5 of the act and imposes on authorities a duty to ‘promote the efficient and effective operation of a market in services for meeting care and support needs’; ensuring that it has a variety of high-quality services to choose from.[3]
The Health and Care Act 2022 also amends section 116A of the Local Government and Public Involvement in Health Act 2007, renames ‘Joint Health and Wellbeing Strategies’ to ‘Joint Local Health and Wellbeing Strategies’ and replaces references to ‘Clinical Commissioning Groups’ with ‘Integrated Care Boards’. Responsible local authorities and each of their partner ICBs need to ensure that Joint Local Health and Wellbeing Strategies sufficiently address how needs of their population will be met. Section 10 of the Act introduced a duty on Integrated Care Boards to consult carers on planning and commissioning policies as wall as on services relating to the patient for prevention, treatment and diagnosis. The Health Care Act provisions applies equally to services to children and adults and therefore the needs of carers of all ages and the UN decision reinforces the requirement that there to be an adequate supply of services to meet carers needs.
Councils must provide a ‘local offer’[4] which sets out the support available for children and young people with special educational needs and disabilities. There are range of duties to assess the needs of their carers (see notes below). These obligation to undertake carers assessments apply regardless of which Children’s Services team is doing the child’s assessment (for example assessments undertaken through the Early Help process). The UN decision reinforces the need for local authorities to have a strategic plan to ensure that there are enough services to support carers of SEND children and young people.
For young carers, local authorities are also under a strategic duty to identify the extent to which there are young carers in their area who have needs for support.[5]
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In conclusion, throughout local authority and ICB planning processes it is essential to ensure carers are consulted, their needs addressed and that there is sufficient supply of services to meet their needs. The Care Quality Commission and Ofsted need to be checking whether this is the case when undertaking inspections of adult and children’s social care services.
Notes re assessments of carers of children
- For parent carers, Children Act 1989, sections 17ZD – ZF).
- For aunts, uncles and Grandparents, Carers Recognition and Services Act 1995, section 1.
- For adults caring for children in transition to adulthood, Care Act 2014, sections 59 – 62.
- For young carers, Children Act 1989, sections 17ZA – ZC.
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[1] John Bangs OBE, Independent Carers Policy Adviser, jbangsuk@icloud.com and Twitter @JohnBangs15.
[2] See A Landmark UN carers decision at https://www.lukeclements.co.uk/a-landmark-un-carers-decision/ posted 6 December 2022.
[3] For further discussion on the duty to ensure support services are actually available see ‘The duty to meet needs’ at https://www.lukeclements.co.uk/the-duty-to-meet-needs/ posted 31 August 2022.
[4] Children and Families Act 2014 s30 and see also the Special Educational Needs (Local Offer) Regulations 2014.
[5] Children Act 1989 s17 ZA(3).
Posted 14 December 2022