Carer's Allowance Supplement: evaluation

Findings

This section presents the findings of the evaluation in terms of the achievement of CAS against short-term and medium-term policy objectives. In doing so, it also highlights the likely contribution of CAS to wider long-term government outcomes for carers. It also discusses the policy implications identified through the qualitative research.

Achievement against short-term policy outcomes

This section assesses CAS against the following policy outcomes:

• Payments are made to as many eligible people as possible
• Carers feel that the process of receiving the benefit is user friendly and simple
• Carers understand why the payment was made
• Carers feel they have been treated with dignity and respect and have a positive experience of Scotland's social security system

It uses data from Official Statistics, Experience Panels research and the commissioned research.

Payments made to as many eligible people as possible

Since eligibility for CAS is reliant on receipt of Carer's Allowance, and the payment is automatic, the take-up is by definition 100%. However, this does not mean that all eligible carers in Scotland are receiving Carer's Allowance, and thus, CAS. The DWP do not produce estimates of take-up for Carer's Allowance and identifying the size of the eligible carer population, and then identifying those who do not claim within that, is particularly challenging due to the complexity of the eligibility criteria for Carer's Allowance. Though the Scottish Government has committed to promoting the take-up of Scottish benefits, similar challenges to estimating and measuring the take-up of the Scottish replacement to Carer's Allowance are likely to remain.

DWP runs a scan of the information they hold on those in payment of Carer's Allowance twice a year to identify those eligible for Carer's Allowance Supplement on each of the eligibility dates. Scans are run around six weeks after each CAS eligibility date. DWP then securely transfers the necessary data to Social Security Scotland to allow them to make CAS payments.

Summary statistics for Carer's Allowance at February 2020 and CAS at April eligibility date 2020 are summarised below^[19]:

• Since September 2018, 401,575 CAS payments have been made to 105,795 carers, totalling £108.8 million.
• Of this, £34.9 million was for 2018/19 eligibility dates (£221 for each payment), £36.9 million was for 2019/20 eligibility dates (£226.20 for each payment), and £36.9 million was for the April 2020 eligibility date (including the standard CAS of £230.10 and a one-off Coronavirus Carer's Allowance Supplement of £230.10).
• 80,185 CAS payments have been made to carers who were eligible in April 2020 at the time of publishing. Further payments will be made to carers who receive backdated Carer's Allowance payments from DWP.
• Over two thirds of CAS payments made to those eligible in April 2020 were made to female carers (55,150 payments, 69 per cent), while 31 per cent of payments were made to male carers (24,985 payments).
• Overall the number of CAS payments made to those eligible in April 2020 increased with age band up to age 64, while relatively few payments were made to those aged 65 and over^[20]. Around four times as many CAS payments were made to carers aged over 50 (36,790 payments, 45.9 per cent), compared to those aged under 30 (8,990, 11.2 per cent). The average age of carers in receipt of CAS payments was 46. Only a small proportion of CAS payments were made to carers aged 65 and over (2,595 payments, 3.2 per cent) or under 18 (365 payments, less than one per cent).
• The local authorities with the greatest numbers of carers receiving CAS payments in April were Glasgow City (12,890, 16.1 per cent), North Lanarkshire (6,870, 8.6 per cent), Fife (6,115, 7.6 per cent), South Lanarkshire (5,715, 7.1 per cent) and City of Edinburgh (4,565, 5.7 per cent).
• At each eligibility date from October 2018 onwards, around 89-93% of carers receiving payments had also received a payment at the previous date, and around 7-11% had not received a payment at the previous date. Of those carers eligible in April 2020, the data currently shows that 93.3% (74,830) had received a payment for October 2019. This proportion is likely to decrease once backdated payments for this eligibility date are taken into account.

Carers feel that the process of receiving the benefit is user friendly and simple

There is no application process for CAS. Findings from the Experience Panels survey with 114 CAS recipients showed that most respondents, before receiving the letter confirming the CAS payment, knew that CAS was coming (89 per cent), with most finding out about it through social media, through other organisations, or through family or friends.

More than nine in ten respondents recalled receiving a letter from Social Security Scotland about CAS, and of them, the majority of them found the letter to be very helpful/helpful. Among those who found the letter to be very helpful/helpful they found the letter to be "clear" and "easy to understand".

Respondents were asked if they had received the payment when they had expected to, after receiving the letter. Nearly nine in ten respondents had, while over one in ten said they did not or could not remember.

Respondents were asked if they had any questions about Carer's Allowance Supplement which were not answered by the letter. Among those who did, questions were about the possible effects of CAS on other benefits^[21], and the date it would be paid.

A number of respondents described positive experiences of receiving the Carer's Allowance Supplement letter. Reasons included feeling appreciated and that the letter gave the necessary information.

A few described less positive experiences and highlighted a number of areas where they felt the letter could be improved. This included providing clearer information about the exact dates the Supplement would be paid and that the letter should have arrived before the payment, which was what was intended.

Carers understand why the payment was made

The commissioned qualitative research found that awareness of the existence of CAS was very high. Generally, carers were aware of having received the payment, knew roughly when they had last received it, and had a very good idea of the amount. Carers had typically first heard about the Supplement by letter. With exceptions, participants knew that CAS was paid by the Scottish Government.

Overall, levels of awareness about the purpose of CAS were mixed. Carers were generally able to name at least one objective of the policy, but some participants sometimes had to make a guess and tended to be a little unsure.

Carers feel they have been treated with dignity and respect and have a positive experience of Scotland's social security system

These outcomes relate to carer experience of Scotland's social security system. Research findings from the Experience Panel research and commissioned research suggested that the letter communicating CAS payments had been helpful, that carers felt appreciated when receiving it, and that it went some way to making them feel valued by the Scottish Government.

However, much of the data on carer experience of the Social Security system and of Social Security Scotland is still being collected which, once published, should provide further evidence as to how carers have experienced Scotland's social security system. That said, as CAS is not a benefit which carers apply for, we can expect the delivery process for CAS to be a less determining feature in achieving its policy outcomes than with other Scottish benefits.

Achievement against medium-term policy outcomes

This section assesses CAS against the following policy outcomes:

• Carers feel CAS has had a positive impact on their finances
• Carers feel CAS has had a positive impact on their quality of life (including physical health, mental health and wellbeing and feelings of control and empowerment)
• Carers feel recognised for the role they provide

This section is largely informed by the qualitative research with some evidence from the Experience Panels research. The full qualitative research report from Ipsos MORI can be found in Annex A.

Impact on carer finances

Experience Panels survey findings with 114 CAS recipients showed that the payment had impacted positively on carers' feelings of financial ease - with many respondents reporting that the money had paid for necessities they had needed but could not afford. Respondents mentioned specific items such as wheelchairs, medical essentials, debts, heating for the winter, and household repairs. However, some also reported spending it on Christmas costs or saving it for emergencies.

In terms of the commissioned research, typically, carers liked the current payment schedule (two lump sums per year) as it meant they could spend on bigger things and felt they had more to show for it. Participants used payments in various ways, including spending on Christmas, on general household needs, on home improvements, or on trips and other treats. There was no clear pattern in terms of participants' financial position and how they chose to use the payment.

Carers who were struggling the most financially felt the biggest financial impact – whether they had spent it on treats or trips away, which they would not have otherwise been able to have, or whether they had spent it on essential household expenses, which they would otherwise have struggled to pay for. Carers who were financially comfortable but had spent it on treats also felt a benefit, as they were unlikely to have had those enjoyable experiences without the payment. The least impact was felt by carers who had spent it on general household needs but who already had enough money to pay for these things.

While carers were grateful for the payment and could identify positive impacts, they tended to say that the payment had not helped their day-to-day finances – they felt they only benefitted during the months that CAS arrived. This was the case regardless of their financial circumstances.

Impact on carer quality of life

The Experience Panels survey showed that carers felt that receiving the letter and CAS payment had more of an impact on their mental wellbeing and health rather than their finances. That said, respondents reported how increased financial ease reduced their stress levels which then resulted in increased mental wellbeing.

In general, carers interviewed in the commissioned research reported that their mental health was poor or variable, and had been negatively impacted by their caring responsibilities. Issues commonly raised included the physical and emotional toil of round-the-clock care; anxieties about the health and wellbeing of the person they care for; worries about finances; isolation; and not being able to undertake paid work.

Typically, CAS had helped improve their mental health and wellbeing a little. It had a positive impact on relieving money worries around the months carers received the payment, and had given them "a wee lift".

In some exceptional cases, its impact on mental health and wellbeing had been transformative. This was in cases where it had enabled carers in great financial difficulty to pay off debts or where it had been used towards a trip away when carers felt they were close to breaking point.

There were mixed views on the impact of CAS on carers' sense of control and empowerment. It had made the biggest difference to those who were struggling the most financially by helping them to feel more on top of their finances and more prepared for upcoming expenses. Others thought it had made little difference overall.

CAS had generally not had a big impact on carers' physical health. However, there were a few examples of it being used to support physical health including buying healthier food, affording more heating in winter, facilitating exercise and hobbies, or enabling the purchase of back and knee support items.

Impact on carer feelings of recognition

Overwhelmingly, the feeling among carers interviewed during the qualitative research was that the general public have very little awareness of the work they do and therefore the role is not valued by wider society. Carers thought the public were:

• not aware of the societal contribution they make and how much money they save the Scottish Government in social care costs
• not aware of how much work is involved and how relentless it can often feel
• not aware of the stress and emotional toil that is often involved.

This lack of awareness was attributed to the fact that most caring work is unseen, 'behind closed doors' and not talked about enough. But, more fundamentally, carers felt that it was impossible to understand what was involved unless you were in that situation yourself – and even their close family and friends did not fully appreciate it.

The consensus among participants was that CAS had not raised awareness or the profile of carers among the general public and had not made them feel more recognised or valued by society in general. However, there was a less common view that it may have raised the profile of carers a little – mainly through news stories at the time it was introduced.

The dominant view was that government did not generally recognise the role of carers. Where participants made distinctions between the UK Government and the Scottish Government, they tended to feel that the Scottish Government recognised carers more – and this was largely due to the provision of CAS.

CAS has therefore gone some way to making carers feel more recognised and valued by the Scottish Government. They thought the introduction of CAS:

• showed the government had thought about them
• felt like an acknowledgement and a 'thank you'
• showed their work had value and was a recognition that the level of Carer's Allowance was low

However, it was generally judged to have had 'a little' impact, rather than a big impact, on feelings of recognition and value – and, more exceptionally, there were respondents who had a view that it had made no difference.

Evidence of positive development against wider long-term outcomes for carers

This section will focus on the following wider government outcomes for carers:

• Carers feel supported to look after their own health and wellbeing
• Carers feel supported to improve their own quality of life
• Carers have an increased sense of control and empowerment over their lives
• Society recognises and values the role that carers fulfil

These outcomes relate to the way in which wider government support has impacted on the lives of carers. As outlined in the Methods section, it is difficult to evaluate the impact of CAS on these outcomes. Not only will these long-term outcomes take time to determine, but the contribution of CAS is difficult to measure and attribute given wider factors feeding in to achievement against these outcomes.

Financial assistance through the social security system is thought to be one way to contribute to achieving the above aims. Financial wellbeing can also be one indicator of the outcomes above (though is not the only indicator).

Data from the Scottish Household Survey was examined to see if there had been any change in household income between 2017 and 2019 amongst households with a recipient of Carer's Allowance in them. Though there had been some movement across the income bands, proportions have remained largely consistent over the years. It may be that combining multiple years data in the future will allow measurement of change with statistical certainty, however, no change will be able to be attributed to CAS.

The findings from the qualitative research indicated that CAS has impacted positively on carer finances and quality of life and that it has provided greater recognition of the essential societal contribution that carers make. It was clear from the research that carers appreciated the payments and thought they should continue. In exceptional cases, the research suggested that CAS had a transformative impact on carer mental health and wellbeing.

However, they also indicated that the impact of CAS against these wider outcomes may be necessarily modest given the amount of financial support the payment provided (around £450 per year), and given that other interventions, other than financial support, would be necessary in order to meet them in the longer term.

Implications of evaluation findings

The commissioned research findings acknowledge that CAS has gone some way to meeting its overall aims: to improve outcomes for carers by providing extra financial support and to provide greater recognition of the essential societal contribution that carers make. However it concluded that more significant impact on the wider governmental outcomes of improving carer quality of life and feelings of recognition would require different, additional actions to supplement financial support for carers and/or higher levels of financial support.

As part of the commissioned qualitative research, Ipsos MORI were asked to outline any implications that their research findings may have for future policy development. These are available in the full qualitative report in Annex A and are also outlined below.

The three considerations below relate to the wider government outcomes for carers and how these may be achieved in the long-term. Though relevant context to the research findings, these considerations do not relate to social security interventions generally, or CAS or Carer's Allowance specifically, but rather broader carer policy. Therefore, a discussion of these considerations has not been included in the main body of this evaluation report, but is available in Annex B, along with an outline of how wider governmental support for carers is designed to address some of these considerations.

1. It was suggested that improvements in quality of life and reducing the negative impacts of caring may require increased access to respite care. This would enable those carers who reported feeling the mental and physical stresses of providing round-the-clock care more frequent and regular breaks, and some opportunity to pursue other activities.

2. It was proposed that providing carers with advice and support on reducing the sense of isolation that respondents faced would also help in regard to improving carer quality of life. It was suggested that this might be achieved by taking advantage, of some of the initiatives and technological solutions that have been developed across the wider community during the COVID-19 crisis

3. It was also indicated that increasing recognition of the role of carers among the general public might also require a different approach. Suggestions from participants included carers talking more about the role – one said that they should 'open up about it' as people have done more recently with mental health issues – and increased representation on television and in the media.

Beyond the overall level of support for carers, the findings pointed to a further two issues which might be considered in the development of the Scottish replacement for Carer's Allowance:

4. CAS was introduced as a temporary measure and its payment in two lump sums was a relatively simple and pragmatic way of delivering the payments. However, amongst those interviewed, there was a strong preference for this – rather than including it with the weekly CA payment – as carers felt it allowed them to spend on bigger expenses and they felt they subsequently had more to show for it. However, there were carers (among those who spent the payments on general, on-going expenses) who would have preferred more regular payments which would help them budget throughout the year.

5. The findings suggest that there are issues relating to the conditionality of the current Carer's Allowance benefit. It effectively inhibits more than a small amount of part-time work which would be very beneficial for the wellbeing of some carers who would be able to undertake it. In particular, these carers felt work outside the home would provide a sense of identity outwith the caring role and help reduce their sense of isolation.

These considerations will be taken into account in developing policy for Scottish Carer's Assistance, the replacement to Carer's Allowance in Scotland.