Eastern Region Report – 2016-17

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Personal Social Services Survey of Adult Carers in England (SACE)

Operational Performance & Intelligence Team Southend-on-Sea Borough Council

Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Contents

Page No.

Introduction 3

Executive Summary 4

- Overall Carer Survey Summary 4

- ASCOF Measures Summary 5

- SACE Questions Summary 7

National Survey Data 8

Eastern Region Survey Data 11

ASCOF Measures 14

1D Carer related quality of life 15 1I(2) The proportion of Carers, who reported that they had as much social contact as they 17 would like 3B Overall satisfaction of Carers with social care support services 19 3C Percentage of Carers who report that they have been included or consulted in 21 discussion about the person they care for 3D2 The proportion of Carers, who find it easy to find information about services 23

SACE Questions Analysis 25

Question 1 - How old is the person you care for? 26

Question 2 - Does the person you care for have? (a particular health condition) 27 Question 14 - In the last 12 months, has your health been affected by your caring role in 29 any of the ways listed below? (particular health issues) Question 15 - In the last 12 months, has caring caused you any financial difficulties? 31 Question 22 - About how long do you spend each week looking after or helping the 32 person you care for? Question 24 - Do you have the following? (health conditions) 34

Annex 1 – Includes Source links 36

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Introduction

The Personal Social Services Survey of Adult Carers (SACE) is a biennial survey which was last conducted in 2016-17. It is conducted by Councils with Adult Social Care Responsibilities (CASSRs), and covers carers aged 18 or over. Carers must be caring for a person aged 18 or over who, during the previous 12 months, have been assessed or reviewed by social services; received respite support; received another form of support or carer support.

The main areas the SACE collects data on are: the carer experience of support and information received; the impact on caring on quality of life; the person receiving care.

The SACE seeks carers' opinions on a number of topics that are considered to be indicative of a balanced life alongside their caring role. Similar to the Adult Social Care Survey (ASCS), SACE data is used by:

• The Department of Health (DH) - to inform policy monitoring and speeches, briefings for Ministers and Senior 0.Officials and answering parliamentary questions and Prime Minister's Questions • The Adult Social Care Outcomes Framework (ASCOF),the Towards Excellence in Adult Social Care (TEASC) programme and CASSRs, who use SACE data for purposes such as benchmarking against other councils, policy development and measuring/ monitoring local performance • Academics • The general public

Note: NHS Digital Publications on the 2016-17 Carer’s Survey can be found under Annex A.

The purpose of this report is to look at the 2016-17 Carers Survey results across the Eastern Region. The Eastern region comprises of 52 local authorities of which 11 are upper tier local authorities.

The first part of this report will compare the Eastern Region against other regions nationally. The second part will compare the 11 upper tier local authorities within the Eastern Region.

The report then moves on to compare the ASCOF Measures nationally to the Eastern Region as well as comparing local authorities within the Eastern Region.

The final section of the report looks at six questions asked to carers and compares results across the Eastern Region with comparisons to national data.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Executive Summary

OVERALL CARER SURVEY SUMMARY

National Data 2016-17

Eligible Carers

• The Eastern Region had 576 eligible carers per 100,000 populations, the lowest rate nationally, compared to the England average of 785. The North East (1195) had the highest rate.

Proportion Surveyed of Eligible Carers

• The Eastern Region surveyed 33.5% of their eligible cohort compared to the England average of 40.1%. The region with the lowest proportion was the East Midlands (26.8%) and the region with the highest proportion was London (65.7%)

Proportion of Responses from those Surveyed including Yearly Trend

• Of those surveyed in 2016-17, the Eastern Region had 48.1% of carers respond compared to the England average of 40.7%. This is the second highest response rate nationally. The Eastern Region was the only region to show an improvement in response rate in 2016-17 compared to 2014-15.

Eastern Region Data 2016-17

Eligible Carers • Of 11 Local Authorities in the Eastern Region, Southend had the highest rate of eligible Carers per 100,000 population (1230) compared the Eastern Region average of 576. Proportion Surveyed of Eligible Carers

• The LA with the lowest proportion surveyed was Essex (19.0%) and the region with the highest proportion was Bedford (78.1%)

Proportion of Responses from those Surveyed including Yearly Trend

• Of those surveyed in 2016-17, Suffolk had the highest proportion (58.0%) of carers respond compared to the Eastern Region average of 48.1%. Southend had the lowest (38.0%). When comparing data from the 2014-15 survey, Norfolk had the largest increase in response rate, 29.7% increased to 55.2%.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 ASCOF MEASURES SUMMARY

Five ASCOF measures use data derived from the Social Services Survey of Adult Carers.

The table below shows for each ASCOF measure how the Eastern Region LAs performed compared to the 2016-17 England average and the LA results from 2014-15. The numbers in brackets indicate the number of LA’s.

The Eastern Region results show most LAs scored higher than the England average for ASCOF 1D ,3C and 3D2; most LAs improved performance for ASCOF 3D2. For ASCOF measures; 1D, 1(2), 3B and 3C the majority of LA’s showed a decline in performance compared to 2014- 15. Results shown for 11 Eastern Region local authorities.

Improved At or Above England Below England Declined Performance Measure Performance or the Average (2016-17) Average (2016-17) from 2014-15 same from 2014-15

1D 55% (6) 45% (5) 36% (4) 64% (7) 1I(2) 27% (3) 73% (8) 18% (2) 82% (9) 3B 27% (3) 73% (8) 27% (3) 73% (8) 3C 55% (6) 45% (5) 45% (5) 55% (6) 3D2 64% (7) 36% (4) 55% (6) 45% (5)

The England average for all ASCOF measures show a slight decline in performance from the survey’s carried out in 2014-15. For 2016-17, the Eastern Region average is also slightly lower than the England average across all 5 measures.

1D Carer related quality of life - Higher scores are assigned to better outcomes.

National and Eastern Region National Year Comparison Eastern Region Commentary Comparison 2016-17 England Average England Average 4 LAs in the Eastern Region had a 7.9 7.7 2014-15 2016-17 score above the England average, these were; Central Bedfordshire, England Average Eastern Region Average 7.7 7.6 Peterborough, Southend and Suffolk. 2016-17 2016/17 The highest score was Southend (8.2) and the lowest Essex and

Trend Trend Hertfordshire (7.3)

1I(2) The proportion of Carers, who reported that they had as much social contact as they would like Higher percentages indicate better outcomes.

National and Eastern Region National Year Comparison Eastern Region Commentary Comparison 2016-17 England Average England Average 38.0% 35.5% 2014-15 2016-17 2 LA’s improved their percentage England Average Eastern Region Average from 2014-15; Central Bedfordshire 35.5% 31.6% 2016-17 2016/17 (41.0% to 41.6%) and Peterborough (29.7% to 33.2%). Trend Trend

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 3B Overall satisfaction of Carers with social care support services Higher percentages indicate better outcomes.

National and Eastern Region National Year Comparison Eastern Region Commentary Comparison 2016-17 England Average England Average 41.5% 39.0% 2014-15 2016-17 3 LA’s show an improvement from 2014-15; Essex, Cambridgeshire and England Average Eastern Region Average 39.0% 37.3% Bedford. The largest declines were 2016-17 2016/17 seen in Cambridgeshire (-6.5%) and Southend (-6.2%) Trend Trend

3C Percentage of Carers who report that they have been included or consulted in discussion about the person they care for Higher percentages indicate better outcomes.

National and Eastern Region National Year Comparison Eastern Region Commentary Comparison 2016-17 England Average England Average 71.7% 70.6% 2014-15 2016-17 Within the Eastern Region 5 LA’s saw England Average Eastern Region Average an increase compared to 2014-15; 70.6% 70.2% 2016-17 2016/17 Southend, Norfolk, Peterborough, Thurrock and Central Bedfordshire. Trend Trend

3D2 The proportion of Carers, who find it easy to find information about services Higher percentages indicate better outcomes.

National and Eastern Region National Year Comparison Eastern Region Commentary Comparison 2016-17 England Average England Average 66.0% 64.2% 7 LA’s in the Eastern Region saw 2014-15 2016-17 results above the England average. England Average Eastern Region Average Suffolk had the highest percentage 64.2% 63.2% 2016-17 2016/17 (77.5%), 7.4% higher than the closest performing LA. Cambridgeshire had Trend Trend the lowest (59.3%)

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 SACE QUESTIONS SUMMARY

This report also contains SACE questions analysis.

Six questions were chosen to give an understanding about the person the carer is caring for and around the carer themselves. They show if there has there been an impact on the carers health and financial situation due to the amount of time they spend in their caring role and also if the carer themselves have a particular health condition. All these factors can have an impact on caring and the carer’s quality of life.

• Question 1 - How old is the person you care for? • Question 2 - Does the person you care for have? (a particular health condition). • Question 14 - In the last 12 months, has your health been affected by your caring role in any of the ways listed below? (particular health issues). • Question 15 - In the last 12 months, has caring caused you any financial difficulties? • Question 22 - About how long do you spend each week looking after or helping the person you care for? • Question 24 - Do you have the following? (health conditions)

Key Outcomes

Across these 6 questions analysed, there is little variance between National and Eastern Region results. The outcomes show a similar pattern and this is also evident comparing LAs within the Eastern Region.

• The Eastern Region cared for the highest proportion of people over the age of 65 nationally (73.1%). The England average was 67.3% • The most common health condition for cared for persons nationally and in Eastern Region are those with a physical disability, 53.1% and 55.1% respectively. The least common was Alcohol or Drug dependency nation-wide. • Carers in the Eastern Region reported that 79.2% felt tired, above the England average of 76.0%. For all regions the area with highest proportion was also feeling tired. Across all regions the results for the top 5 areas affecting carers show a similar pattern. • The Eastern Region was below the England average (54.4%) by 1.0% for those Carers in financial difficulties at 53.4%. For those carers whose role caused a lot of financial difficulties, the Eastern Region (8.8%) were below the England average (9.6%) • For those carers spending 100 or more hours caring for their cared person, the Eastern Region proportion of 35.7% was above the England average of 35.7% by 2.1%. National results show that most carers spend 100 or more hours caring for their cared person. • Carers in the Eastern Region had a lower percentage of those with a mental health problem, a learning disability or difficultly and a long standing illness than the England average.

For information comparing LAs within the Eastern Region, see the full analysis from page 25

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 National Survey Data

These charts which show each region nationally benchmarked against the England average. Regions are shown from North to South:

• Chart 1: The rate of eligible carers per 100,000 populations per region. • Chart 2: Each regions survey sample size. • Chart 3: The proportion of the eligible carer population surveyed per region. • Chart 4: The survey response rate per region for 2014-15 and 2016-17.

Chart 1 - The chart below shows the rate of eligible carers per 100,000 populations. Nationally the average is 785.40 carers per 100,000 of the population The Eastern Region had the lowest rate nationally with 576.18 carers per 100,000 of their population. The highest rate is seen in the North East with 1195.58 carers per 100,000 of their population.

The survey uses answers from a sample of carers to make inference (or estimates) about the whole population. The eligible population is identified from each local authority’s SALT return. Each LA follows government guidance to work out the size of the sample that will be needed to meet the requirement that the survey results have a margin of error of less than +/- 5 per cent. This ensures the results of the survey are representative of all. It is worth noting, that the cost of running the survey may influence the proportion of carers surveyed and response rates may be affected if local authorities have run their own independent surveys.

The guidance states “sending out additional questionnaires can increase the reliability of results and reduce the margin of error; however the use of additional questionnaires will also lead to increased costs. Furthermore, sending out larger numbers of questionnaires may mean that carers are more likely to receive one each time the survey is run, and be more likely to fail to respond as a result of ‘survey fatigue’. So whilst the margins of error will be improved (reduced), response rates may appear to have worsened (reduced)”.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Chart 2 – The chart below shows the number of questionnaires required by each region to meet the margin of error of less than +/- 5%; the number of questionnaires sent and the actual number of completed questionnaires received.

• Each region received completed questionnaires above the requirement. • The Eastern Region needed 3390 surveys and received 4480 surveys.

Receiving more than the requirement, means the survey results are a good representation of the whole population.

Chart 3 – The chart below shows the proportion of carers surveyed by each region in England benchmarked against the England average.

• Nationally 40.1% of the eligible population was surveyed. • The Eastern region surveyed 33.5% of their eligible population – one of the lowest proportions in England • East Midlands surveyed 26.8% of their eligible population – the lowest proportion in England.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Chart 4 – the chart below shows the response rate per region for the past two surveys conducted in 2014-15 and 2016-17, benchmarked against the 2016-17 England Average. All regions apart from Eastern saw lower response rates than the 2014-15 survey.

• Nationally the average response rate was 40.7% a reduction on 2014-15’s rate of 43.8%. • The Eastern Region response rate was 48%, the second highest nationally and the only region to improve its response rate from 2014-15.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Eastern Region Survey Data

The second part of this report looks at the upper tier local authorities in the Eastern Region. The Eastern Region comprises of 52 local authorities of which 11 are upper tier local authorities. Each upper tier local authority identifies their eligible carers through their SALT return. A sample of their eligible carers was sent surveys.

• Chart 5: Proportion of eligible population surveyed by each LA in Eastern Region. • Map 1: Eastern Region map of LA’s carer rate per 100,000 of population. • Chart 6: Eastern Region LA’s carer rate per 100,000 of population. • Map 2: The proportion of the eligible carer population surveyed per region. • Chart 7: The survey response rate per region for 2014-15 and 2016-17.

Chart 5 – The chart below shows the proportion of each LA’s eligible population that was surveyed benchmarked against England and Eastern proportions.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17

Map 1

The Rate of Eligible Carers per 100,000 Population for each Local Authority in the Eastern Region

The darkest colours represent the local authority with the highest rate of eligible carers per 100,000 populations.

Southend has the highest rate of carers per 100,000 at 1229.89

Suffolk the lowest at 232.69.

Chart 6 – The chart below shows the 2016-17 rates of eligible carers per 100,000 of population for each LA in the Eastern Region benchmarked against the England average rate of 785.4 carers per 100,000 population and the Eastern average of 576.18.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17

Map 2

The Proportion of Respondents for each Local Authority in the Eastern Region

The darkest colours represent the local authority with the highest proportion of respondents.

Suffolk had the highest at 58% and Southend the lowest with 38%.

Chart 7 – The chart below shows, for each LA, the trend in response rates over the past two surveys. It shows a mixture of improvement and declines throughout the region. The highest response rate was 58% in Suffolk, the lowest 38% in Southend. The largest improvement was seen in Norfolk from 29.7% in 2014-15 to 55.2% in 2016-17. The largest decline was in Cambridgeshire from 68.2% in 2014-15 to 50.2% in 2016-17.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17

ASCOF Measures

5 indicators are taken from SACE; they are listed below along with their outcomes. Details of each one will follow.

Domain 1 – Enhancing quality of life for people with care and support needs

1D Carer related quality of life: Outcome – Carers can balance their caring roles and maintain their desired quality of life.

1I(2) The proportion of Carers, who reported that they had as much social contact as they would like: Outcome – Enhancing quality of life for people with care and support needs.

Domain 3 – Ensuring people have a positive experience of care and support

3B Overall satisfaction of Carers with social care support services: Outcome - People who use social care and their carers are satisfied with their experience of care and support services.

3C Percentage of Carers who report that they have been included or consulted in discussion about the person they care for: Outcome: Carers feel that they are respected as equal partners throughout the care process.

3D2 The proportion of Carers, who find it easy to find information about services: Outcome: People know what choices are available to them locally, what they are entitled to, and who to contact when they need help.

The following charts will look at the comparison of the upper tier local authorities in the Eastern Region, benchmarked against National averages.

• Chart 8/9: ASCOF Indicator 1D: carer reported quality of life • Chart 10/11: ASCOF indicator 1|2: Proportion of carers who reported that they had as much social contact as they would like • Chart 12/13: ASCOF indicator 3B: Overall satisfaction of carers with social services • Chart 14/15: ASCOF indicator 3C: Carers included and consulted in decisions • Chart 16/17: ASCOF indicator 3D2: Proportion of carers who find it easy to find information about support

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 ASCOF 1D – Carer-reported quality of life

Outcome – Carers can balance their caring roles and maintain their desired quality of life.

This measure gives an overarching view of the quality of life of carers based on outcomes identified through research by the Personal Social Services Research Unit. This is the only current measure related to quality of life for carers available. It combines individual responses to six questions in the survey which measure different outcomes. These outcomes are mapped to six domains; occupation, control, personal care, safety, social participation and encouragement and support. Higher scores are assigned to better outcomes. The maximum possible score is 12. Only carers who answered all six questions are included in this measure. Each question has three possible answers equated with having:

• No unmet needs - score of 2; some needs met – score of 1; no needs met – score of 0.

Chart 8 - The chart below shows the Carer-reported quality of life score for each of the regions nationally along with their score from the 2014-15 survey benchmarked against the England average for both years. Nationally the score declined by 0.2 from 7.9 in 2014-15 to 7.7 in 2016-17. The 2016-17 Eastern region score of 7.6 was lower than the England average of 7.7. Only the Northwest and Yorkshire and Humber are higher than the England average.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Chart 9 - The chart below shows the Carer-reported quality of life score for each of the Easter Regions upper tier local authorities along with their score from the 2014-15 survey. Nationally the score declined by 0.2 from 7.9 in 2014-15 to 7.7 in 2016-17.

• 2 LA scores improved: Peterborough and Suffolk by 0.5. • 2 LA scores remained the same: Norfolk and Southend. • 7 LA scores declined: Bedford (-0.4); Cambridgeshire(-0.4); Central Bedfordshire(- 0.1); Essex(-0.8); Hertfordshire (-1.1); Luton(-0.5) and Thurrock(-0.4) • 4 LA’s remained above the England average: Central Bedfordshire; Peterborough; Southend and Suffolk. • The highest score across the region was Southend (8.2) and the lowest Essex and Hertfordshire (7.3)

Interpretation:

The measure gives an overall indication of the reported outcomes for carers – it does not, at present, identify the specific contribution of councils’ adult social care services towards these outcomes.

The six questions drawn from SACE are:

• Occupation – Q7: Which of the following statement best describes how you spend your time? • Control – Q8: Which of the following statement best describes how much control you have over your daily life? • Personal Care – Q9: Thinking about how much time you have to look after yourself – in terms of getting enough sleep or eating well – which statement best describes your present situation? • Safety – Q10: Thinking about your personal safety, which of the statements best describes your present situation? • Social participation – Q11: Thinking about how much social contact you’ve had with people you like, which of the following statements best describes your social situation? • Encouragement and support – Q12: Thinking about encouragement and support in your caring role, which of the following statements best describes your present situation?

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 ASCOF 1I(2) – Proportion of carers who reported that they had as much social contact as they would like.

Outcome – Enhancing quality of life for people with care and support needs.

There is a clear link between loneliness and poor mental and physical health. A key element of the Government’s vision for social care is to tackle loneliness and social isolation, supporting people to remain connected to their communities and to develop and maintain connections to their friends and family.

This measure will draw on self-reported levels of social contact as an indicator of social isolation for carers. The measure is determined by carers answering the relevant question (Q11) in the survey indicating they have as much social contact as they want.

Chart 10 - The chart below shows the proportion of carers who answered that they have as much social contact as they want by each region nationally.

• The England average declined from 38.0% in 2014-15 to 35.5% in 2016-17. • The Eastern Region had the lowest proportion nationally of 31.6%, a decline from 2014-15 of 37.5% • The North East had the highest proportion nationally of 44.8% a decline from 2014-15 of 45.7% • London was the only region to improve from 35.4% in 2014-15 to 35.6%.

1I(2) Proportion of carers who reported that they have had as much social contact as they would like by region

2014-15 2016-17 Eng Ave 14-15 (38.0%) Eng Ave 16-17 (35.5%)

50.0% 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0%

10.0% 5.0% 45.7% 44.8% 39.9% 35.8% 41.0% 38.7% 35.0% 32.0% 38.0% 36.9% 37.5% 31.6% 34.4% 35.6% 37.8% 33.2% 35.2% 32.3% 0.0% North East North West Yorkshire East West Eastern London South East South West and the Midlands Midlands Humber

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17

Chart 11 - The chart below shows the proportion of carers who answered that they have as much social contact as they want. The England average declined from 38.5% in 2014-15 to 35.5% in 2016-17.

• Two local authorities improved their results – Central Bedfordshire by 0.6% and Peterborough by 3.5%. • Hertfordshire saw the largest decline from 46.8% in 2014-15 to 22.9% in 2016-17. • Three local authorities are higher than the England average of 35.5% – Cambridgeshire 36.3%; Central Bedfordshire 41.6% and Southend 44.9%. • The highest proportion was 44.9% in Southend; the lowest was 22.9% in Hertfordshire.

1I(2) Proportion of carers who reported that they have had as much social contact as they would like by LA's in Eastern region

2014-15 2016-17 East Ave 16-17 (31.6%) Eng Ave 16-17 (35.5%)

50.0% 45.0% 40.0% 35.0% 30.0% 25.0% 20.0%

15.0% 10.0%

5.0% 38.6% 31.0% 38.6% 36.6% 41.0% 41.6% 44.3% 26.8% 46.8% 22.9% 39.0% 35.3% 32.2% 32.0% 29.7% 33.2% 45.8% 44.9% 25.6% 24.9% 45.1% 29.7% 0.0%

Interpretation:

The measure focuses on carers – the responses have been chosen to focus the measure on individuals achieving the best outcomes, to allow for better use in benchmarking.

The impact of social isolation and loneliness is much wider that the population who answered this question and all parts of the health and care system have a role to play in preventing, and reducing, social isolation and loneliness in the broader population.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 ASCOF 3B – Overall satisfaction of carers with social services

Outcome – People who use social care and their carers are satisfied with their experience of care and support services.

This measures the satisfaction with services of carers of people using adult social care, which is directly linked to a positive experience of care and support. It is suggested that satisfaction with services is a good predictor of the overall experience of services and quality.

The measure is determined by carers answering the relevant question (Q4) in the survey.

Chart 12 - The chart below shows the proportion of carers who indicated they are extremely or very satisfied with the support and services they received in the last 12 months per region nationally.

• The England average declined from 41.5% to 39.0% in 2016-17. • Eastern Regional declined from 40.5% on 2014-15 to 37.3% in 2016-17 • All other regions results were lower than 2014-15, apart from London whose proportion improved by 0.4%.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Chart 13 - The chart below shows the proportion of carers who indicated they are extremely or very satisfied with the support and services they received in the last 12 months for each LA in the Eastern Region.

• 3 LA’s show improvements in the proportion satisfied with support and services from 2014-15: Essex by 0.8%; Cambridgeshire by 1.6% and Bedford by 0.5%. • The others declined, the largest declines were seen in Cambridgeshire (-6.5%) and Southend (-6.2%). • 3 local authorities’ results are above the England average of 39.0%: Central Bedfordshire (43.0%); Thurrock (40.2%) and Bedford (43.4%). • The highest percentage was Bedford with 43.4%; the lowest was Luton with 33%.

Interpretation:

This measure is defined by determining the percentage of all those responding who identified strong satisfaction by choosing the answer ‘I am extremely satisfied or very satisfied’. Carers are excluded from this measure if they answered that they haven’t received support or services in the last 12 months.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 ASCOF 3C – Carers included and consulted in decisions

Outcome: Carers feel that they are respected as equal partners throughout the care process.

This measure reflects the experience of carers in how they have been consulted by both the NHS and Social Care. It is determined by carers answering the relevant question (Q18) in the survey.

Chart 14 - The chart below shows the proportion of carers who indicated that they always or usually felt involved / consulted for each region nationally for 2014-15 and 2016-17.

• The England average for 2016-17 declined from 71.7% in 2014-15 to 70.6% in 2016-17. • Eastern region declined from 73.1% in 2014-15 to 70.2% in 2016-17 and was slightly below the England average of 70.6% by 0.4%. • The North West, although declined from 78.8% in 2014-15 had the highest proportion of 77.2%. • London declined from 65.0% in 2014-15 and had the lowest proportion of 65.8%.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Chart 15 - The chart below shows the proportion of carers who indicated that they always or usually felt involved / consulted for each LA in the Eastern region benchmarked against the England and Eastern Region averages for 2016- 17.

• 5 LA’s results improved from 2014-15. Southend by 2.2%; Norfolk by 2.4%; Peterborough by 0.7%; Thurrock by 1.4% and Central Bedfordshire by 4.7%. • The other 6 LA’s saw a decline, the largest from Essex by 9.4% • The highest proportion was 77.6% in Central Bedfordshire and the lowest 65.8% in Cambridgeshire.

Interpretation:

This measure is defined by determining the percentage of all those responding who identified they always felt involved or consulted. Carers should be respected as equal partners in service design for those individuals for whom they care - this improves outcomes both for the cared for person and the carer, reducing the chance of breakdown in care.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 ASCOF 3D2 – Proportion of carers who find it easy to find information about support

Outcome: People know what choices are available to them locally, what they are entitled to, and who to contact when they need help.

This measure reflects social services carers’ experience of access to information and advice in the past year. Information is a core universal service and a key factor in early intervention and reducing dependency. It is determined by carers answering the relevant question (Q16) in the survey.

Chart 16 - The chart below shows the proportion of carers who indicated that they found it very or fairly easy to find information. Results are benchmarked against England averages for 2014-15 and 2016-17.

• The England average declined from 66.0% in 2014-15 to 64.2% in 2016-17. • The Eastern region declined from 64.8% in 2014-15 to 63.2% in 2016-17. • The North East had the highest proportion at 70.2%, a decline from 72.5% in 2014-15. • The West Midlands had the lowest proportion at 61.0%, a decline from 63.2% in 2014-15. • Only the East Midlands and London saw an improvement from 2014-15.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Chart 17 - The chart below shows the proportion of carers who indicated that they found it very or fairly easy to find information by each LA in the Eastern region. Results are benchmarked against 2016-17 England and Eastern Region averages.

• 6 LA’s improved their results from 2014-15. Bedford by 2.1%; Essex by 0.1%; Luton by 7.5%; Southend by 1.2%; Suffolk by 13.0% and Thurrock by 1.9%. • Suffolk had the largest improvement by 13% from 64.5% in 2014-15 to 77.5% in 2016-17. • 5 LA’s results declined: Cambridgeshire (-7.1%); Central Bedfordshire (-1.2%), Hertfordshire (-3.5%), Norfolk (-4.4%) and Peterborough (-0.4%) • 7 LA’s were above the England average of 64.2%. • Suffolk has the highest proportion of 77.5% and Essex the lowest at 59.0%

Interpretation:

This measure is defined by determining the percentage of all those responding who identified they found it very easy or fairly easy to find information and advice.

Improved and/or more information benefits carers and the people they support by helping them to have greater choice and control over their lives. This may help to sustain caring relationships through, for example, reduction in stress, improved welfare and physical health improvements. These benefits accrue only where information is accessed that would not otherwise have been accessed, or in those cases where the same information is obtained more easily.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 SACE Questions Analysis

The 2016-17 SACE consisted of 29 different questions, which apart from gathering information about the cared for person also asks questions on how the carer feels; how easy they can find information and advice and questions on the support the carer and the cared for person receive.

The main areas the SACE collects data on are:

• the carer; • their experience of support and information received; • the impact on caring on their quality of life; • the person receiving care.

The following section of this report will look at some of these questions in more detail and show comparisons nationally and regionally with the aim being to support discussions around ASCOF indicators and give an insight into the carer’s role.

• Question 1 - How old is the person you care for? • Question 2 - Does the person you care for have? (A particular health condition). • Question 14 - In the last 12 months, has your health been affected by your caring role in any of the ways listed below? (Particular health issues). • Question 15 - In the last 12 months, has caring caused you any financial difficulties? • Question 22 - About how long do you spend each week looking after or helping the person you care for? • Question 24 - Do you have the following? (Health conditions).

Each question contains charts which show:

• A comparison of England and Eastern Region where multiple criteria apply. • A comparison of all regions nationally. • A comparison of all upper tier local authorities in the Eastern Region.

Note: As some of the Eastern Region LA charts contain multiple criteria’s, the England and Eastern Region averages are displayed as bars and not lines as on previous charts in this report.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Question 1 – Asks how old is the person the Carer cares for?

Question 1 of SACE asked how old the person the carer cared for is. The ages have been put into two age bands: 18- 64 and 65+.

Chart 18 – The chart below shows that carers in the Eastern Region cared for the highest proportion of people over the age of 65 nationally (73.1%). This was 5.8% higher than the England average of 67.3%. The lowest proportion was in London (63.8%), who in turn had the highest proportion of people aged 18-64 being cared for.

Chart 19 – The chart below shows that Carers in Essex and Southend cared for the highest proportion of people over the age of 65 across the Eastern Region. Essex at 84.2% was 16.9% higher than England average of 67.3% and Southend at 79.1% was higher by 11.8%. Both had the highest proportion across the Eastern Region. Suffolk had the lowest proportion at 61.1%. Carers in Suffolk cared for 38.9% of people aged between 18-64, which was the highest proportion across the Eastern Region, 6.3% higher than the England average of 32.6% and 12.0% higher than the Eastern Region average.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Question 2 – Asks about the health conditions of the person being cared for.

Question 2 of SACE asked the carer to say which health condition the person they cared for had. Respondents could select more than one answer. The charts below show the proportion of cared for persons with these conditions.

Chart 20 shows the comparison between England and the Eastern region on the range of health conditions that the cared for persons had. The highest proportion in the Eastern region was for cared for people with a physical disability (55.1%), which was higher than the national average of 53.1% by 2.0%.

Health conditions of cared for persons - 2016-17 60.0%

50.0%

40.0%

30.0%

20.0%

% of cared for person % for of cared 10.0%

0.0% Alcohol or Sight or A mental Problems A learning Long- A physical Terminal drug Dementia hearing health connected disability or standing disability illness dependenc loss problem to ageing difficulty illness y England 35.1% 53.1% 30.2% 20.5% 35.2% 19.3% 40.0% 5.2% 1.6% East 39.1% 55.1% 29.3% 17.8% 37.3% 15.7% 40.9% 5.9% 1.1%

The next two charts will look at the top 5 health conditions nationally and show a comparison for each region nationally and for each LA in the Eastern Region.

Chart 21 shows the top 5 heath conditions carers reported people they cared for had, for each region nationally. The highest proportion for each region was those with a physical disability. The Eastern region had the highest percentage out of all regions for dementia (39.1%) and physical disability (55.1%). All regions had the top condition as physical disability, followed by a long standing illness.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17

Chart 22 shows the top 5 heath conditions carers reported people they care for had, by each LA in the Eastern Region. Carers across all LA’s showed they cared for more people with a physical disability than any other health condition.

• Dementia – Essex had the highest proportion at 51.7% which was 16.6% above the England average (35.1%) and 12.6% above the Eastern Region average (39.1%). • Physical disability – Essex had the highest proportion at 59.4% which was 6.3% above the England average (53.1%) and 4.3% above the Eastern Region average (55.1%). • Sight of hearing loss – Luton had the highest proportion at 33.7% which was 3.5% above the England average (30.2%) and 4.4% above the Eastern Region average (29.3%). • Long standing illness – Essex had the highest proportion at 44.9% which was 4.9% above the England average (40.0%) and 4% above the Eastern Region average (40.9%). • Problems connected to ageing – Southend had the highest proportion at 50.3% which was 15.1% above England average (35.2%) and 13% above the Eastern Region average (37.3%).

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Question 14 – Asks the carer if their health has been affected by their caring role

Question 14 of SACE asked the carer if their health had been affected by their caring role in a number of ways. Respondents could select more than one answer. The tables below show the proportion of carers who felt their health had been affected.

Chart 23 shows the comparison between England and the Eastern region. Nationally and in the Eastern region, carers reported they felt tired, followed next by disturbed sleep. The Eastern region was above the England average in 7 of the 12 areas.

Areas affecting carers health - 2016-17 90.0% 80.0%

70.0% 60.0% 50.0% 40.0% 30.0% % of carers % of 20.0% 10.0% 0.0% Develop Physical Short ed my Made an Feeling General Had to Feeling Loss of Disturbe strain tempere own existing No, none depresse feeling see own Other tired appetite d sleep (e.g. d/ health conditio of these d of stress GP back) irritable conditio n worse ns England 76.0% 43.4% 13.0% 64.0% 58.7% 32.8% 41.8% 29.3% 23.3% 19.7% 3.3% 9.7% East 79.2% 45.7% 11.9% 66.3% 60.7% 36.1% 44.3% 30.6% 23.3% 19.5% 3.0% 7.3%

Chart 24 shows the top 5 ways carers felt their health was being affected for each region in England. All regions have a similar pattern with feeling tired as the highest proportion, followed by disturbed sleep. The third was general feeling of stress, followed by close proportions of feeling depressed and short tempered/irritable.

The Eastern region had the highest proportion of carers feeling tired (79.2%), which was 3.2% above England average. Nearly every region had the highest proportion as feeling tired, followed by disturbed sleep, then general feeling of stress, followed by feeling depressed and lastly short tempered/irritable.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Chart 25 shows the top 5 ways carers felt their health was being affected for each LA in the Eastern region.

• Feeling tired – Suffolk had the highest proportion at 85.8% which was 9.8% above the England average (76.0%) and 6.6% above the Eastern Region average (79.2%). • Feeling depressed – Suffolk had the highest proportion at 50.3% which was 6.9% above England average (43.4%) and 4.6% above the Eastern Region average (45.7%). • General feeling of stress – Suffolk had the highest proportion at 67.8% which was 9.1% above the England average (58.7%) and 7.1% above Eastern Region average (60.7%). • Disturbed sleep – Suffolk had the highest proportion at 75.3% which was 11% above the England average (64.0%) and 9% above the Eastern Region average (66.3%). • Short tempered / irritable – Hertfordshire had the highest proportion at 50.2% which was 8.4% above the England average (41.8%) and 5.9% above the Eastern Region average (44.3%).

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Question 15 – Asks the carer if caring has caused them any financial difficulties

Question 15 of SACE asked the carer if their caring role had caused them any financial difficulties with three categories of answers.

Chart 26 below shows the proportion of carers who answered each of these categories by each region nationally. On average over 50% of carers in England and across all regions reported their caring role had not caused any financial difficulties. The Eastern Region percentage of 53.4% was lower than the England average of 54.4% by 1%. The proportion who felt it had caused some difficulties was 37.8%, which was higher than the England average of 36.0% by 1.8%, and the proportion who felt it had caused a lot of financial difficulty was 8.8%, which was lower than the England average of 9.6% by 0.8%.

Chart 27 below shows the proportion of carers who answered each of these categories by each LA in the Eastern region.

• No, not at all – Southend had the highest proportion of carers who feel their caring had not caused any financial difficulties at 63.5%, which was 9.1% above England average (54.4%) and 10% above the Eastern Region average (53.4%). • Yes, to some extent – Suffolk had the highest proportion of carers who felt their caring had to some extent caused financial difficulties at 41.2%, which was 5.2% above England average (36.0%) and 3.4% above the Eastern Region average (37.8%). • Yes, a lot – Luton had the highest proportion of carers who felt their caring role had caused a lot of financial difficulties at 11.7%, which was 2.1% above England average (9.6%) and 2.9% above Eastern Region average (8.8%).

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Question 22 – Asks how long the carer spends each week looking after or helping the person they care for

Question 22 of SACE asked the carer how many hours a week they spent in their caring role. There are 10 categories.

Chart 28 below shows the proportion of carers who answered each of these categories nationally and in the Eastern Region. It is clear that most carers responding to SACE spent over 100 or more hours per week caring for their cared for person. The Eastern regions proportion of 35.7% was above the England average of 35.7% by 2.1%.

Chart 29 will look at the proportion of carers that spent over 50 hours per week looking after or helping the person they cared for by each region in England.

The Eastern region had 7.2% of carers that spent between 50-74 hours per week caring, which is 0.3% higher than the England average (6.9%); 7.9% of carers spent between 75-99 hours per week caring, which is 0.3% higher the England average (7.6%) and 37.8% of carers spent 100 or more hours per week caring, which is 2.1% higher than the England average (35.7%).

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Chart 30 shows the proportion of carers spending over 50 hours per week looking after or helping the person they care for by each LA in the Eastern region.

• 50-74 hours per week – Hertfordshire had the highest proportion of carers spending between 50-74 hours per caring at 8.2%, which was 1.3% higher than England average (6.9%) and 1% higher than the Eastern Region average (7.2%). • 75-99 hours per week – Bedford had the highest proportion of carers spending between 75-99 hours per week caring at 11.4%, which was 3.8% higher than England average (7.6%) and 3.5% higher than the Eastern Region average (7.9%). • 100 or more hours per week – Essex had the highest proportion of carers spending over 100 hours per week caring at 51.8% which was 16.1% higher than England average (35.7%) and 14% higher than the Eastern Region average (37.8%).

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Question 24 – Asks if the carer themselves have any health conditions

Question 24 of SACE asks the carer if they had any health conditions. There are 6 options to choose. A carer could choose more than 1 option.

Chart 14 shows the comparison between England and the Eastern region. The highest percentage of carers, for both National and Eastern region, reported they had a long standing illness, followed next by a physical impairment or disability.

Chart 15 shows the percentage of carers that answered they have a health condition by each region nationally. In the Eastern regions, the health condition that the highest proportion of carers had was a long standing illness at 27.8%, which was lower than the England average by 0.8%. Those with a health condition of physical impairment or disability was 21.3%, which was higher than the England average by 0.7% and sight or hearing loss is 17.5%, which was higher than the England average by 0.8%.

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Chart 16 shows the percentage of carers that answered they have a health condition by each LA in the Eastern region.

Note: Thurrock had only one category with reported figures so will be excluded from this comparison.

• A Physical impairment or disability – Essex had the highest proportion of carers with this condition at 24.2%, which was 3.6% higher than England average (20.6%) and 2.9% higher than the Eastern Region average (21.3%). • Sight or hearing loss – Essex had the highest proportion of carers with this condition at 20.2%, which was 3.5% higher than England average (16.7%) and 2.7% higher than the Eastern Region average (17.5%). • A mental health problem or illness – Norfolk had the highest proportion of carers with this condition at 12.1%, which was 3.2% higher than England average (8.9%) and 3.4% higher than the Eastern Region average (8.7%). • A learning disability or difficulty – Central Bedfordshire had the highest proportion of carers with this condition at 3.2%, which was 0.5% higher than England average (2.7%) and 1.1% higher than the Eastern Region average (2.1%). • A long- standing illness - Bedford had the highest proportion of carers with this condition at 34.3%, which was 5.7% higher than England average (28.6%) and 6.5% higher than the Eastern Region average (27.8%).

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Personal Social Services Survey of Adult Carers in England (SACE) - Eastern Region Report – 2016-17 Annex A

The following documents are available on NHS Digital site: Personal Social Services Survey of Adult Carers in England, 2016-17 - NHS Digital

• Personal Social Services Survey of Adult Carers in England, 2016-17: Report [1.34MB] • Personal Social Services Survey of Adult Carers in England, 2016-17: Methodology and further information [1.03MB] • Personal Social Services Survey of Adult Carers in England, 2016-17: Understanding surveys [127.91KB] • Personal Social Services Survey of Adult Carers in England, 2016-17: Data quality statement [394.13KB] • Personal Social Services Survey of Adult Carers in England, 2016-17: Data quality annex [520.8KB] • Personal Social Services Survey of Adult Carers in England, 2016-17: Annex tables [5.23MB] • Personal Social Services Survey of Adult Carers in England, 2016-17: CSV data [16.64MB] • Personal Social Services Survey of Adult Carers in England, 2016-17: Data dictionary [71.22KB] • Personal Social Services Survey of Adult Carers in England, 2016-17: Time series annex [112.67KB] • Personal Social Services Survey of Adult Carers in England, 2016-17: Carer quality of life scores by health condition of the cared-for person [114.7KB] • Personal Social Services Survey of Adult Carers in England, 2016-17: Tables for report charts [181.53KB] • Personal Social Services Survey of Adult Carers in England, 2016-17: SACE ASCOF CSV data [2.77MB] • Personal Social Services Survey of Adult Carers in England, 2016-17: SACE ASCOF CSV guide [224.85KB] • Personal Social Services Survey of Adult Carers in England, 2016/17 [135.76KB]

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