Ombudsman Wales: An Own Initiative investigation into the administration of carer’s needs assessments in Wales (October 2024)

Summary

The Public Services Ombudsman for Wales has powers under the Public Services Ombudsman (Wales) Act 2019 to undertake ‘Own Initiative’ investigations, where evidence suggests that there may be systemic service failure or maladministration.

Four local authorities were included in the investigation: Caerphilly County Borough Council, Ceredigion County Council, Flintshire County Council and Neath Port Talbot Council. The investigation considered:

• Whether the local authorities being investigated were meeting their statutory duties under the Social Services and Well-being (Wales) Act 2014 and its Code of Practice and The Care and Support (Assessment) (Wales) Regulations 2015.
• Whether those entitled to a carer’s needs assessment were being made aware and understand their right to request a carer’s needs assessment.
• Where carers’ needs assessments are commissioned, whether those assessment services are being delivered appropriately and whether local authorities appropriately monitor the contracting arrangements.
• Whether carers’ needs assessments, including those completed by commissioned service providers, are undertaken in accordance with the Social Services and Well being (Wales) Act 2014.

The investigation considered evidence provided by each of the Investigated Authorities, in the form of documentary evidence and evidence from staff, evidence from commissioned service providers and their staff, evidence from those with lived experience of having their needs as carers assessed and evidence from other organisations. Advice was also sought from one of the Ombudsman’s professional advisers

Content

The investigation found:

• Between 10% and 12% of the population (over 5 years old) in the Investigated Authorities identified as a carer in the 2021 Census.
• Only 2.8% of the carer population in the Investigated Authorities had their needs assessed.
• Only 1.5% of the carer population in the Investigated Authorities had an assessment that led to a support plan.
• Many carers are not aware of their rights and are unaware of the support that may be available to them. There was evidence of carers not being fully informed of their rights by the Investigated Authorities. In some instances, carers were signposted to commissioned service providers without being informed of their rights.
• Carers’ needs assessments are referred to by different names, which caused confusion amongst carers and carers were sometimes unaware that their needs had been assessed. There needs to be consistency in the language used.
• There is lack of clear information about the process of assessment, the role of commissioned service providers (where applicable), what carers may expect from the assessment and how carers may be supported following an assessment. This would enable carers to make an informed decision about whether to have their needs assessed.
• Where they are undertaken, carers’ needs assessments at the Investigated Authorities are generally being completed appropriately, with the exception of young carers’ needs assessments in Ceredigion and Neath Port Talbot.
• Some improvements could be made to the recording of carers’ needs assessments, including the involvement of the cared for person (where feasible), the extent the carer is able and willing to provide care and the carer’s wishes in terms of work, education, training and leisure.
• There is a need to implement quality assurance audit processes for completed carers’ needs assessments in Caerphilly, Ceredigion and Neath Port Talbot council areas.
• There are discrepancies between the Investigated Authorities in the way that support provided to carers is recorded.
• Improved, consistent and comparable data collection could enable better analysis to drive improvement, monitor progress and identify areas in which further improvements are necessary.
• Carers must be offered advocacy – the decision on whether an advocate is needed is not one for the staff completing assessments to make, nor is it appropriate for the staff member to consider themself to be the advocate.
• The appropriateness of Direct Payments for carers is variable and 3 of the Investigated Authorities need to ensure that Direct Payments are something the carer is able to manage, with this being reviewed if circumstances change.
• The SSWB Act places a duty on both local authorities and health services in respect of carers. Collaboration and joint working between health services and local authorities in relation to carers and their rights is essential and should be strengthened.
• The recording of equality data relating to carers is limited and inconsistent at the Investigated Authorities.