Carers’ assessments

Dr Nick Hervey: Local authorities and trusts have an overall obligation to provide assessments for carers.

It is essentially about sitting down with a carer and asking them, ‘what’s working for you, what isn’t working?’, ‘how are you yourself?’, ‘are there stresses to do with your role as a carer that we can help you look at?’, and obviously some of the services – things like carers’ breaks – give people an opportunity for a break from their caring situation.

Nikki Smith: One would be looking for the impact that the caring role has upon the carer’s well-being. That might be in relation to their own mental state, or their own emotional or psychological well-being, the impact it has on the carer's vocational occupational activity – for example if you’re spending an awful lot of time caring for or supporting a relative you might not be able to work full-time yourself, and in turn that may well have financial implications and other practical implications – housing implications and so on.

Dr Nick Hervey: A lot of carers give up work in order to look after a loved one and as a result, they lose out financially even if they may be able to claim benefits. And there are points in time when they may be able to go back to work and therefore the carers’ needs assessment should pick up that and offer to help people with support to go back to work or to get into education or training.

Nikki Smith: Also we quite often find that the burden of caring places a strain on the carer’s own relationships with family, friends, their employers and so on.

Dr Nick Hervey: A lot of carers don’t fully recognise or understand that they are carers and can be quite surprised when you suggest that to them. And I think what is very common for carers of people with mental health problems is that they feel very isolated. Often even within their own families, they may be the only person who’s really trying hard to look after the relative who’s got a mental health problem. So I think in the first instance, one thing that a carer’s assessment can do is actually help the carer think about their own needs as an individual, whilst at the same time helping them look at their role as a carer and whether there are problems that they’re having with that, and whether there is advice or information or services that they can access as a result of having a carer’s needs assessment.

Nikki Smith: In the event of an episode of acute distress, that can be a real pressure cooker environment. If people are living together at home, it can be very difficult and stressful to manage. Sometimes the pressure of caring can make people frankly exhausted, and so respite is a service or a resource that is often provided to carers. Sometimes what happens is, a carer can receive funding to take a holiday, effectively, to take a break and then, if the person they care for – if they live with that person – has to stay at home, then we might have to arrange for and fund support staff to go in to help the person who’s left at home.

Dr Nick Hervey: If your relative is a part of a community mental health team, then the suggestion would be usually that a nurse or a social worker would offer that assessment, but a lot of trusts now do have specialist mental health carers’ workers and some of those workers will also carry out carers’ assessments.

Nikki Smith: So we very much have a duty in community mental health teams as care coordinators to be very mindful of carers’ needs, to undertake assessments of those needs where requested or indicated, to review a carer’s needs periodically and review their care plan, and to refer to resources to help to meet a carer’s need if not directly provide resources to carers ourselves.

Dr Nick Hervey: The assessment really involves the worker trying to understand and have a conversation with a carer about how is their situation for them. Are there issues that they’re struggling with? Would they like more information about things like diagnosis or treatment? – but also giving them an idea of what services are available in the local area that they could access.