As coronavirus restrictions reduce in Wales and society continues to open up, many of us are starting to feel a greater sense of normality.
But this is not the case for many unpaid carers in Wales, as enduring demands, exacerbated by the pandemic, continue to increase. The ongoing challenges for unpaid carers was one of the key issues identified by academic experts as we move forward towards ‘living with COVID-19’.
Unpaid carers are now said to be feeling “overwhelming pressure”; being asked to take on even more care with little (or no) support. This article shines a spotlight on the latest situation faced by unpaid carers.
A “national care crisis”
Before the pandemic it was estimated that around 96% of care in Wales is provided by unpaid carers. Six months into the pandemic, 80% of unpaid carers said they were having to provide more care, and this may have increased following recent developments.
From summer to winter 2021, six of the seven health boards in Wales (all except Powys) and their local authority partners announced that due to the “national care crisis”, they had to prioritise care for those with the greatest needs. The health boards and local authorities explained they would not be able to honour all previously agreed care packages, and were asking families and unpaid carers to step in and provide more care.
This care crisis is attributed to severe workforce shortages, alongside unprecedented demand for services. The Association of Directors of Social Services Cymru told the Health and Social Care (HSC) Committee in February that they had a number of independent providers “hand back” packages of care towards the end of last year as a direct result of staff shortages. ADSS Cymru said social services are having to focus on covering individuals who are at very high risk, and are “relying very, very heavily on family and friends – those informal carers”.
Increasing demands on unpaid carers
Carers Trust Wales told the HSC Committee in February that unpaid carers are currently under pressure to provide prolonged and unsustainable levels of care at home, without support from statutory services. It said:
We have heard of delays of upwards of three months and carers faced with the choice of leaving their loved one in hospital to wait for the care package, visibly deteriorating in hospital, or to shoulder the care burden themselves at home.
Stakeholders including Alzheimer’s Society Cymru are very concerned that health boards are asking even more of unpaid carers at this point in time. Charities have also noted these public statements didn't give any timescales or reassurance of when care packages would be reinstated, “it feels like an open-ended situation”.
Carers Wales says Carers Wales saysthat legal obligations under the Social Services and Well-being (Wales) Act 2014 are being undermined. The charity stressed that the law has a very strong focus on carers only caring if they are “willing and able” to do so, but the pressures around hospital discharge are forcing carers to go beyond this. It believes that local authorities and the Welsh Government should explore creative solutions to lessen the additional burden on carers, such as a fast-tracked direct payments system for carers to try and arrange alternative support.
When asked about this proposal of fast-tracked direct payments last year, the Deputy Minister for Social Services told the HSC Committee:
[…] we are prepared to discuss any proposals that come forward because we recognise the huge strain that there has been on carers, unpaid carers, and what a huge contribution they've made.
Lack of carer support services
Respite care services (which were already in short supply) were severely disrupted by the pandemic. Last summer, 72% of carers said they had been unable to take any breaks at all since the start of the pandemic.
A recent review by ADSS Cymru concluded that the pandemic has demonstrated that respite support is an essential service. However, many of these services had to close or reduce capacity dramatically. The review notes that the pandemic will have financially stretched many services, and for some providers, “may make business continuity impossible”. ADSS says commissioners need to take stock of the impact of the pandemic on respite services, reflecting on their importance as a component of the strategic recovery from the pandemic as a “whole system”.
Carers are reporting that there is still widespread disruption to the services they rely on to provide care; only 8% of carers said day centres providing respite had fully re-opened and only 40% said that support from paid care workers had fully resumed.
While other aspects of society have started to open up, Carers Wales have said they “just haven't seen that with unpaid carers”. The charity stressed that the Welsh Government must commit to work with local authorities to fully re-instate disrupted carer services across Wales.
How is the Welsh Government responding?
In November 2021 the Welsh Government announced funding for a package of support for unpaid carers. The Deputy Minister for Social Services said the funding shows how much the “army” of unpaid carers in Wales are appreciated and:
We share concerns that many are at breaking point due to the additional pressures put upon them from the pandemic.
The Welsh Government also updated its Strategy for unpaid carers delivery plan in January 2022. One of the priorities in the delivery plan is “improving access to short breaks and expanding the range of breaks options available”. The Welsh Government says it will prioritise the increased demand for day centres and more traditional sitting and replacement care services, alongside more innovative models of delivering breaks over the coming year.
In January 2022 the Deputy Minister also told the HSC Committee that the Welsh Government will deliver its programme for government commitment to fund a short break respite scheme. She said “I hope we will be able to transform respite provision in Wales”.
The Welsh Government will be giving evidence to the Health and Social Care Committee on its hospital discharge inquiry on 24 March. The pressure on unpaid carers is a key theme in the evidence received, and is likely to be a strong feature in the discussion.
Article by Amy Clifton, Senedd Research, Welsh Parliament