It shouldn’t be a surprise to anyone that breaks are essential to carers and those that they care for, and that it’s in everyone’s interests to ensure carers get the support they need. We know that problems with the carer contribute to readmission into hospital in 62% of cases where there is a carer. We know that for every £1 invest in support for carers, up to £4 is returned. We know that carers with good support are likely to be healthier both physically and mentally.
We also know that one in three carers have never had a break of any kind.
The environment in which services for carers operate becomes more difficult every single year. The costs and responsibilities placed on services that provide breaks and replacement care continue to increase while the amount of funding available from local authorities is continually squeezed. According to the UK Homecare Association, the minimum rate of funding needed an hour for a care provider to meet all of its responsibilities and deliver care is £16.20. In Wales, the average rate paid an hour is £13.
Last month I travelled to the International Short Breaks Conference, this year held in Edinburgh, in part to try and glean what we can learn from approaches to replacement care and breaks from elsewhere in the world. The International Short Breaks conference is held biennially at different places around the world, this year it was hosted in Edinburgh. Eighteen countries were represented from as far away as Iceland, the USA, Canada and India.
There’s lots we can and should be doing in Wales. Take something like respitality – a confusing word that isn’t immediately apparent as a portmanteau of respite and hospitality. At its simplest, respitality is taking advantage of unused capacity at places like hotels and bed and breakfasts to provide affordable respite to those who need it. This already happens in places in Wales, but we’re a good few steps behind the structured approach in place in Scotland where companies can easily make a ‘respitality gift’ online. The Scottish model is itself based on work that was done previously in the USA.
And quite rightly, Scotland took the opportunity of hosting the conference to flag up a lot what is widely seen as positive work taking place there, for example their online breaks portal and their Young Carers Festival which has been consistently funded by the Scottish Government and is now in its ninth year.
The conference itself didn’t just look at different models used to provide short breaks but how you measure the success and impact of those breaks. One presentation by ARCH Respite in the US outlined their efforts to put together a research framework for measuring the impact of respite for individuals and society. It was during that session that a presenter said:
‘We are scrapping for money all the time in our country’
And this was the unfortunate truth with almost everyone that I spoke to at the event from across the world. Breaks, replacement care, respite – it remains chronically underfunded.
During the run-up to the National Assembly for Wales election this year, and since, we’ve been calling for the introduction of a Carer Well-being fund. A national fund to help increase the availability of breaks and replacement care to Wales’ carers. Similar funds exist across the world, including in Scotland where their Short Breaks Fund has provided over 23,000 breaks. We were pleased when Welsh Labour committed to ‘investing the benefits of establishing’ such a fund in their manifesto, but we’re still waiting to know what that investigation will look like and the commitment doesn’t appear in the new Programme for Government.
And while the event provided a valuable insight into the different ways that countries across the world are tackling the challenge of providing breaks, what was troubling was how little Wales seemed to be involved in the wider international effort to promote breaks. Despite the rare luxury of having the event on our doorstep in Edinburgh, as opposed to Germany where it was two years ago, there were only four people from Wales in attendance, including myself. To put that in perspective there were seven from Northern Ireland and dozens from Scotland and England.
This is not to denigrate the good work that is carried out by the third sector, local authorities, local health boards and others in Wales. There is a lot of innovative practice out there and our own publication ‘Investing in Carers, Investing to Save’ includes a number of case studies that show this. But it seems clearer than ever that there needs to be immediate and innovative action taken to improve how short breaks and replacement care are funded and delivered in Wales.
Wales has the highest proportion of carers in the UK and relies hugely on the contribution that carers make, providing 96% of care in the community. But support for carers is on a precipice. Without action the impact will not only be felt in health and social services, but by carers themselves, many of whom need support now. Wales is lagging behind both in investment and innovation of support for carers.
A Carer Well-being Fund will not solve all the challenges we face, but will be a step in the right direction. That’s why Carers Trust Wales has continued to call for the introduction of such a fund, most recently with our ‘What about the rest?’ campaign, asking carers across Wales to write to their Assembly Members, asking them to support our call for a Carer Well-being Fund.
And unless steps are taken now, we risk a future where carers’ services are far and few between, where carers are unable to get the support they need and deserve, and where health and social services are buckling under ballooning demand. Wales is the country with the biggest caring population in the UK, and we have one of the highest proportions of older people accessing social care services in the world. We shouldn’t be playing catch-up when it comes to breaks, and with a committed effort to improve support for carers, we won’t have to be.