The Treatment of Informal Care-Related Risks as Social Risks: An Analysis of the English Care Policy System
Caring can significantly affect the wellbeing and quality of life of informal carers and the people they support. It is essential, therefore, that care relationships are adequately supported. In my article ‘The Treatment of Informal Care-related Risks as Social Risks: An Analysis of the English Care Policy System’ I explore the extent to which the English state, through its care policies, seeks to protect the informal carers of older people against the poverty and welfare risks they face. This topic is a key policy issue because care provided by family, friends, and neighbours remains the key source of support for people over the age of 65 who have long-term care needs.
The topic of informal care is one I am personally and professionally familiar with: as an informal carer for members of my own family; and in my previous role as a social worker working in adult services teams in local authorities in England. The decision to conceptualise informal care as a risk-based activity stems from experiencing and witnessing the welfare and poverty risks associated with care-giving first-hand. For example, carers can face financial risks due to being unable to work, or only able to work part-time, while the health and wellbeing of carers can be impacted because they lack time to take a break or access medical care for themselves. The key argument made in the article is that the care-related risks associated with informal care should not be privatised to the individual or care relationship to manage, instead they should be recognised and treated as social risks by states. In practice this means that governments have a responsibility to design and implement care policies which provide adequate levels of protection to the diverse range of people who provide informal care, and require long-term care, against the poverty and welfare risks they face.
To this end, the qualitative research project sought to assess whether the English state recognises and treats care-related risks as social risks by analysing the care policy system in England. To achieve this I designed a methodology which recognises that care takes place within a relationship, and acknowledges the diversity of informal carers’ and older peoples’ characteristics and circumstances in relation to their age, employment status, income status, relational status, living arrangements and the level of care provided. The resulting ‘model care relationship matrix’ was used as a policy simulation tool to assess the extent to which care policies including cash benefits, employment related support, and care services, recognise, and offer protection to, different types of care relationships. Data were obtained from government documents and regulations, and interviews with operational and strategic managers and front-line practitioners, including local authority social workers, benefit agency and Jobcentre Plus administrators, and third sector advisors. The findings reveal the types of carers most likely to be recognised as needing state support, and the types of carers whose risks are privatised to the individual to manage because they remain unrecognised by the state. The state is also shown to create risks for care relationships through the way in which care policies are designed and practiced by practitioners and managers. For example the state is seen to shift the responsibility for care-related risks back onto families and individual care relationships to manage, through the provision of inadequate levels of support. The complexity of the overarching care policy system produces risks for care relationships due to the level of emotional and physical effort required to access the statutory support that is available. Policies can also create conflicts and tensions between informal carers and the older people they support by setting their needs and entitlements in opposition to one another, and failing to recognise that care takes place in the context of a relationship. The article concludes by reflecting on the implications of the major Care Act 2014 reform for the treatment of care relationships in England. It argues that more fundamental changes must be made to the care policy system if the English state is to treat informal care-related risks as social risks in England.
This article is relevant to policy-makers, academics, practitioners, managers and students who work in the field of long-term care and informal care because it reveals the implications of the design and operation of the care policy system in England for carers and the older people they care for.