Young Carers and Young Adult Carers
SCOPE OF THIS CHAPTER
This chapter provides guidance on identifying and supporting young carers. Since April 2015, local authorities have had a duty to take 'reasonable steps' to identify children in their area who are young carers, and to determine if they need support. Local authorities must carry out an assessment whenever it appears that a young carer has a need for support (this could be either in their capacity as a young carer or in a more general sense as a child or young person). This assessment is called a Young Carer's Needs Assessment.
Carers UK - resources and information on young carers (including assessment tools)
This chapter was added to the manual in November 2021.
1. Background and Definition
The Children and Families Act 2014 amended the Children Act 1989 to make it easier for young carers to get an assessment of their needs by introducing 'whole family' approaches to assessment and support. Local authorities must offer a Young Carer's Needs Assessment where it appears that a child is involved in providing care for a family member and requires support. A similar provision was introduced in the Care Act 2014, requiring local authorities to consider the needs of young carers if, during the assessment of an adult carer or adult with care needs, it appears that a child is providing, or intends to provide, care.
Under the Children and Families Act 2014, a young carer is defined as:
'A person under 18 who provides, or intends to provide, care for another person. The concept of 'care' includes practical or emotional support, and 'another person' means anyone within the same family, be they adult or child'.
The Children and Families Act definition excludes children providing care as part of contracted work or as voluntary work unless the local authority consider that the relationship between the person cared for and the young person under 18 is such that it would be appropriate for him/her to be regarded as a young carer.
A young carer is a child or young person under 18 years old who spends time looking after or helping a family or household member that would find it difficult to cope without this help. The person may require support from a young carer for a range of reasons, including because that person is physically or mentally ill, disabled or misuses alcohol or substances. Most young carers look after a parent or a brother or sister. A young carer may be caring for more than one person, for example, a parent and a sibling.
A young adult carer is a carer 'in transition to adulthood' and aged between 16 and 25. Young adult carers will be included in this guidance as well as transition support. The guidance for 'adult carers' breaks' will also be of relevance for this group.
Young carers and young adult carers, and the people they support, are from all backgrounds, cultures and religions, with a diverse range of needs. A survey of young carers in 2016 found that there was a large overrepresentation of children and young people with disabilities in the young carer population, meaning they also had care and support needs of their own.
Young carers are one and a half times more likely to be from black, Asian and minority ethnic (BAME) communities, and are twice as likely not to speak English as their first language.
2. Support Provided by Young Carers and Young Adult Carers
Young carers and young adult carers provide a range of support. Day-to-day responsibilities may include:
- Practical tasks such as cooking, cleaning and shopping;
- Providing intimate personal care such as helping someone to get out of bed and get dressed;
- Helping to give medicines;
- Supporting with GP or hospital visits;
- Providing emotional support;
- Financial management;
- Communication, for example by being the primary translator in a non-English speaking family.
Action for Children estimates that young carers spend on average 25 hours per week caring for loved ones and that many are effectively 'on call' at night.
3. Impact on Young Carers
A longitudinal survey is a way of researching and finding out what happens to the same people or a situation over a long period of time which could be years or decades. Children's Society used a longitudinal survey and found that:
- Young carers and young adult carers are at risk of poorer educational outcomes than their peers, with significantly lower attainment at GCSE level. They may miss high numbers of days of school per year and are more likely to drop out of college or university;
- They have higher rates of poor mental and physical health and high levels of stress and tiredness;
- They are vulnerable to financial difficulties and are more likely than the national average to be 'not in education, employment or training' as they transition to young adulthood between 16 and 19 years of age;
- Young carers may experience social isolation and a lack of opportunity to take part in typical social and leisure activities alongside their peers. This makes it difficult for them to maintain relationships.
4. Identifying Young Carers
Local authorities are expected to take 'reasonable steps' to identify children in their area who are young carers. The local authority must carry out an assessment if it appears that the young carer may have needs for support and, if so, should identify what those needs are.
A child may come to the notice of agencies as caring responsibilities can significantly affect a child's health and development. A child may present with one or more of the following concerns:
- Social isolation;
- A low level of school attendance and /or educational difficulties including poor concentration;
- Impaired development of their identity and potential;
- Behaviour observed as mature or not "typical" for years;
- Low self-esteem;
- Emotional and physical neglect;
- Conflict between loyalty to their family and their wish to have their own needs met.
It is important that special consideration is given to specific groups to ensure inclusive practice, especially when undertaking an assessment of needs-for example:
- Black and minority ethnic groups;
- Refugees and Asylum Seekers;
- Very young carers;
- Families in rural areas.
The duty to assess applies where there is an appearance of need i.e. there does not have to be a specific 'request'.
Identifying young carers is not always easy. Research has found that a significant proportion of young carers do not disclose their caring responsibilities to their school, and that often young people (and their families) do not recognise themselves as 'young carers'. Furthermore, parents and carers can be reluctant to disclose information about caring responsibilities for fear of repercussions, including children's social care involvement and potential family separations.
Adopting a whole family approach is recommended as the best way to identify young people who are caring for a family member. This means that whenever an adult is receiving social care or support, any assessments undertaken should always include discussions about children in the household to identify if they have caring responsibilities and may, therefore, require support as a young carer. Providing the right care to adult family members at the right time is vital, and helps to ensure that children do not take on inappropriate caring tasks. The need for children to provide care is increased when services to ill or disabled adults (or other family members) are inadequate, inappropriate or missing and when family-based interventions are not provided.Schools also have a vital role to play in identifying and supporting young people who are helping to care for family members.
5. Assessing Need and Providing Support
The local authority must carry out a Young Carer's Needs Assessment whenever a young carer is identified and it appears they may need support. The assessment must consider whether the care being provided by the child is excessive or inappropriate and how the child's caring responsibilities affect their wellbeing, education and development.
Clear communication between professionals and families at the start of the assessment process is important to allay any concerns parents and young people may have about the assessment and its likely consequences.
Local authority adults' and children's services should work together to offer young carers and their families an effective service which avoids the need for multiple assessments. The Needs Assessment should be carried out in a manner which is appropriate and proportionate to the needs and circumstances of the young carer to whom it relates.Assessments of young carers and the people they care for are intrinsically linked, and the regulations allow local authorities to combine assessments. Whoever carries out the assessment must:
- Be appropriately trained;
- Have sufficient knowledge and skill to be able to carry out the assessment; and
- Be an appropriate person to carry out the assessment having regard to the young carer's circumstances, in particular the young carer's age, sex and understanding.
Ideally assessments should be carried out promptly following identification or disclosure of a young person's caring responsibilities.In carrying out the assessment, the local authority must, in particular, have regard to:
- The young carer's age, understanding and family circumstances;
- The wishes, feelings and preferences of the young carer;
- Any differences of opinion between the young carer, the young carer's parents and the person cared for, with respect to the care which the young carer provides (or intends to provide); and
- The outcomes the young carer seeks from the assessment.
In order to ensure full and meaningful participation in the assessment process, the following people must be provided with age appropriate information about the manner and form of the assessment prior to the start of the assessment:
- The young carer;
- The person cared for;
- The young carer's parents; and
- Any other person whom the young carer or a parent of the young carer requests should participate in the assessment.
- a parent of the young carer who does not have parental responsibility; and
- a person who is not a parent, but has parental responsibility.)
Overall, the Young Carer's Needs Assessment must consider the impact of the needs of the young carer's family on the well-being of the young carer and any child in that family and, in particular, on their education and personal and emotional development. The assessment should take into account the strengths of a family, as well as identifying any challenges faced by its members.
The local authority must consult with persons with expertise and knowledge in relation to the young carer as part of the assessment process, including teachers, health workers and other relevant adults. It is important to speak to the child alone, wherever possible, and to observe how they relate with their parents and siblings.
The assessment must consider the following:
- The amount, nature and type of care which the young carer provides (or intends to provide); the extent to which this care is (or will be) relied upon by the family, including the wider family, to maintain the well-being of the person cared for;
- Whether any of the tasks which the young carer is performing (or intends to perform) when providing care are excessive or inappropriate having regard to all the circumstances, and in particular, the carer's age, sex, wishes and feelings. Inappropriate tasks could include:
- Personal care such as bathing and toileting;
- Strenuous physical tasks such as lifting;
- Administering medication;
- Maintaining the family budget;
- Offering precociously mature, emotional support to the adult.
- How parental health impacts on their capacity to meet the child's needs;
- Whether any of the young carer's needs for support could be prevented by providing services to:
- The person cared for; or
- Another member of the young carer's family.
- Whether the young carer's needs for support could be prevented if the carer were relieved of part or all of the tasks the young carer performs (or intends to perform) when providing care;
- Whether any other assessment of the needs for support of the young carer or the person cared for has been carried out (and if it has, to take this into account);
- Whether the young carer is a child in need;
- Any actions to be taken as a result of the assessment; and
- The arrangements for a future review.
Also to be taken into consideration is the impact of the needs of the young carer's family on the well-being of the young carer and any child in that family and, in particular, on their educational and personal development. For example:
- Whether the young person's caring role limits their educational opportunities, perhaps because it means they have more absences from school; or
- Whether caring prevents the child from building relationships and friendships; or
- How caring affects the child's physical and emotional wellbeing.
Throughout the assessment process, the professional responsible must identify the impact on the child of what is happening in the family.
A copy of the written record of the assessment must be given to:
- The young carer;
- The young carer's parents; and
- Any person to whom the young carer or a parent requests the authority to give a copy, e.g. the Young Carers Service. The support plan should be reviewed at regular intervals as set out in the Assessment of Need.
An assessment can be refused if:
- The young carer does not appear to have needs for support (It is important to ensure the child is Gillick Competent, using Fraser Guidelines);
- The local authority has already carried out an assessment of the young carer's need for support connected with their care for a particular person and circumstances have not changed;
- There are no concerns in relation to the child/ren being at risk of significant harm themselves.
Where the assessment identifies that the young carer is suffering or likely to suffer significant harm, Bedford Borough, Central Bedfordshire and Luton Safeguarding Children Boards Procedures must be followed immediately.
Sections 63 - 64 of the Care Act 2014 introduced duties towards young carers making the transition to adulthood. The Act requires local authorities to seek the agreement of the young carer to undertake an assessment if they are likely to have needs for support when they reach eighteen, and if the timing of the assessment offers 'significant benefit'.
The timing of any assessment should be discussed with the young carer and their family. Much of the information necessary to complete a transition assessment may have already been collected as part of the Young Carer's Needs Assessment.Transition assessments for young carers must also specifically consider whether the carer is able to care now and whether they are prepared and willing to continue to be a carer after they reach adulthood at eighteen.
7. Further Reading
- The Lives of Young Carers in England Research Brief (DfE, February 2016);
- No Wrong Doors Working Together to Support Young Carers and their Families – Young Carers' Needs Assessment Supporting Information (ADCS, 2015);
- Supporting good practice with young carers and their families - The Care Act 2014 and Children and Families Act 2014 (section 96) places expectations on children's and adult social care to identify carers, assess their needs and provide support for this dedicated workforce;
- Research in Practice (RiP) have brought together learning resources to build the knowledge, skills and confidence of professionals working with young carers and their families. This includes a Practice Tool on young carers and their families, highlighting common concerns and challenges, as well as recommended strategies to help build positive relationships;
- Research in Practice for Adults has also updated a social work practice with carers website, providing open access case studies, films, guidance and tools to use in direct work. Commissioned by the Department of Health and Social Care and co-produced with carers, the learning resources aim to build the knowledge, skills and confidence of professionals working with both young and adult carers and their families;
- Resources available to support good practice with young carers and their families include:
- Adolescent mental health: Front-line Briefing and Tool
- Defragmenting CAMHS – commissioning the children and young people's mental health system
- Promoting resilience in children, young people and families: Front-line Briefing
- Social work practice with carers website (open access)
- Transitional safeguarding – adolescence to adulthood: Strategic Briefing
- Young carers and their families: Confident assessment practice.
- The Whole Family Pathway Tool is a resource for all practitioners who have contact with young carers and their families. The Whole Family Pathway, to ensure that however a family (parent or child) in need of support first makes contact with an agency, the same key points are followed.
- Supporting young carers and their families: An introductory guide for professionals;
- The Children's Society's General Practice Pack - A guide for supporting, identifying and signposting young carers in your practice. This includes a poster for the GP waiting room, two posters for the staff room and an information leaflet for young people with a family member with an illness or disability.