The Social Services and Well-being Act defines a carer as “a person who provides or intends to provide care for an adult or child”.

The Act further states that “in general, professional carers who receive payment should not be regarded as carers for the purpose of the act, nor should people who provide care as voluntary work. However, a local authority can treat a person as a carer even if they would not otherwise be regarded as a carer if they consider that, in the context of the caring relationship, it would be appropriate to do so. A local authority can treat a person as a carer in cases where the caring relationship is not principally a commercial one”

This definition includes carers of all ages, young carers are carers who are under the age of 18 and young adult carers are aged 18 to 25. Unpaid carers often do not see themselves as carers. They will describe themselves as parent, husband, wife, partner, son, daughter, brother, sister, friend or neighbour, but not always as a carer. A carer is someone who provides unpaid support and/or care to one or more people because they are older, ill, vulnerable or have a disability, Unpaid care is commonly provided by family members, friends or neighbours, it can be provided at home, at someone else’s home or from a distance. Unpaid carers may provide care on a temporary or permanent basis and caring can include physical, practical, emotional and mental health support.

The North Wales Population Needs Assessment provides more detailed information about duties under the Act.

Unpaid carers are the single largest provider of care to people with support needs in our communities, and they save the NHS and social services millions of pounds a year. One estimate puts the value of unpaid care in the UK at £132 billion per year – almost twice what it was in 2001, and close to the annual UK health spend. ^[1]

In recent decades the number and proportion of people born with disabilities and surviving into adulthood and later life has increased significantly. Improvements in health care and general health also mean more people are surviving serious illnesses like cancer or stroke. The increase in the number of people living with long-term conditions creates new and more complex demands on our health and social care services which are under pressure from already stretched NHS and social care budgets. Unpaid care provided by family, friends and neighbours is increasingly helping to meet growing demand and plugging gaps in services.

However, the UK’s rapidly ageing population structure and longer life expectancies mean that the numbers of those in need of care and support is beginning to exceed the numbers of working age family members able to provide it. The high proportion of elderly residents in the area has led to the two counties having some of the highest dependency ratios in Wales. Conwy County Borough in particular has a dependency ratio that is one of the highest in the UK, comparable only to seaside retirement areas such as those found on the south coast of England. Though a dependency ratio is not a direct measure of care need or provision (it is mainly an economic measure), it can, when coupled with information about the age structure of our population, be a useful indicator of the requirement for unpaid care amongst older age groups.

Caring for someone else can be demanding, and can lead to physical health problems for carers themselves (from physical exertion such as lifting or carrying, and from general fatigue). Carers can also be faced with pressures on their mental health such as dealing with stress and worry about the person being cared for and the impact of their illness; social isolation and lack time to focus on themselves; money worries due to reduced household income and/or increasing care costs; and feelings of frustration and anger with the person they are caring for and with the situation they find themselves in.

Until such time the 2021 Census is available we continue to use 2011 Census data. According to the 2011 Census, over 13,600 people in Conwy County Borough (11.8% of the County’s population) and over 11,600 people in Denbighshire (12.4% of the County’s population) provide unpaid care. Almost 30% of these carers (nearly 4,000 people in Conwy County Borough and 3,400 in Denbighshire) provide 50 or more hours of care a week. Such high levels of unpaid care provision will have a huge impact on the economic and social well-being of the carers as well as those being cared for. There will also be a toll on both carers’ physical and mental health.  Those providing over 50 hours of care each week are twice as likely to be in bad health as non-carers.^[2] About two thirds of all unpaid carers are aged 50 or over – in Conwy County Borough 30% are aged 65+; 27% in Denbighshire.

Generally speaking, the proportion of people providing unpaid care increases with age until the 65 and over age group. In the 65 and over age group 14% of people provide unpaid care, which is the same proportion as in the 35 to 49 age group. The majority of the of carers who are in employment work full time and around 30% of carers are retired.^[3]

Carers’ Allowance

In November 2020, there were 18,250 people in North Wales claiming Carers’ Allowance. This has increased from 15,750 in February 2011. This number is much lower than the estimated 73,000 who provide unpaid care reported in the 2011 Census. However, this allowance is only available for those under pension age, unpaid carers may be eligible for Pension Credit once they are in receipt of their State Retirement Pension.

It will not be available to the majority of people in employment who make up about 50% of unpaid carers. The increase in the numbers claiming is probably due to a combination of an increase in the total number of carers and better awareness of the allowance. These numbers still suggest that there is an issue of carers not claiming the benefits they are entitled to and highlights the importance of welfare rights services for carers. There is also a drive from the Welsh Government to get carers to register with their local authorities. North Wales LA’s work closely with Citizens Advice and NEWCIS to support unpaid carers, specifically those in rural areas who can be more isolated, to maximise income and check entitlements for welfare.

What do we know about the young carer population

The identified number of young carers in North Wales has grown in the last few years due to an increase in referrals through successful awareness raising and positive relationships with partner agencies. At time of writing 1,752 young carers are being supported across North Wales (November 2021). The 2011 census identified 1,500 young carers aged 0 to 15 and 4,000 aged 16 to 24 in North Wales. The 2021 census data will be published in 2022 and reviewed.

Funding for young carers only allows organisations such as Action for Children to support young carers who have a moderate to high caring role / impact of caring. This means that there are a number of young carers in North Wales that will not be captured in the data above and therefore the data should be treated as a conservative estimate.

Young carers in particular are more likely to achieve poorer educational outcomes – which is a key determinant of later well-being – missing an average of 48 school days per year due to caring responsibilities (Welsh NHS Confederation, 2018). Carers aged 16–18 are twice as likely not to be in education, employment or training (NEET) compared to their peers.^[4]

As with adult carers, a number of factors influences the relationship between being a young carer and well-being outcomes. In addition to the type, frequency and duration of the care being provided, mediating factors include the family’s socioeconomic situation and the extent of support being provided. Other intersectional factors also have an effect – for example, while nearly half (45%) of young adult carers report having suffered from mental health problems, this increases to 88% for lesbian, gay, bisexual and transgender carers.^[5]

Equality and caring

The Equality Act 2010 gives protection for unpaid carers in relation to disability discrimination. For example, carers of a disabled person are protected due to being associated with a disabled person. They are also protected under the Act if they experience prohibited conduct such as victimisation. Carers can also experience significant multi-layer disadvantages due to intersectionality (the overlap of social identities such as carer status, race, sex and socio-economic status). This can affect confidence in accessing services wellbeing and impacting on the outcomes of carers and those they provide care for.

There are still often societal expectations of women as caregivers. The 2011 census showed that women make up the majority of unpaid carers – 57% of carers in Wales are women and women of working age (25 to 64) are significantly more likely than men to be providing unpaid care to someone with a disability or illness or who is older. A higher percentage of unpaid carers than non-carers reported that they were disable (32%) compared with 23%, with unpaid carers aged 16 to 34 years and 45 to 54 years more likely to be disabled than non-carers of the same age groups (ONS, 2021).

As our society ages, the number of people living with complex needs is increasing. It is therefore inevitable that older people will take on a caring role. Most older carers live alone with the person they care for and many also live with life limiting conditions. There is also likely to be an increase in mutual carers as older couples provide care and support for each other.

Financial hardship

We know from the 2011 Census that the majority of all unpaid carers are of working age and surveys and consultations completed by third sector carer organisations show that the majority wish to work, but many are unable to because of caring. Financial hardship can also disproportionately affect women because they are more likely to be providing care and providing more hours of care while at the same time balancing work or their own health conditions.

An Oxfam report states that prior to the pandemic more than one in three unpaid carers of people with additional needs providing over 20 hours of care per week were in poverty (Care, Poverty and Coronavirus Across Britain, 2020). The report states that it is often the case that unpaid cares can lose income due to leaving or reducing paid work to undertake their caring duties. Research by Carers UK (State of Caring, 2019) stated that 12% of unpaid carers took a less qualified role or turned down promotion at work. 11% of carers retired early to become a carer.

The report further found that 21% of unpaid carers are or have been in debt as a result of their caring responsibilities, 8% cannot afford utility costs and 4% are struggling with housing payments.

Covid-19 impact

Covid-19 has had a significant impact on carers, this is represented in the consultation responses highlighted in the North Wales Population Needs Assessment. One of the most significant impacts has been the effect on the mental health and wellbeing of unpaid carers. Services closed completely or offered a reduced service leaving unpaid carers to cope.  Unpaid carers have told us how stressed they were about keeping the person they care for safe and also worrying about what would happen if they were unable to continue caring Friends neighbours, communities and Third Sector all helped to avert crisis.  Key issues reported across the region were the availability of PPE, access to GP and medical appointments and hospital discharge procedures, and being separated from family and friends.

Since the start of the pandemic there has been an increase in the numbers of carers in Wales, the National Survey for Wales found that that by June 2020 35% of people looked after or provided help and support to family, friends or neighbours. This had increased from 29% in the 2019 -2020 full year survey (Unpaid Carers Strategy Wales, 2021). The Office for National Statistics collated key statistics relating to the impact the coronavirus pandemic has had on unpaid carers:

• A larger number of unpaid carers than non-carers were worried about the effects that the coronavirus pandemic was having on their life (63% of unpaid carers compared with 56% of non-carers)
• Unpaid carers were more likely to avoid physical contact with others when outside their household (92% compared with 88%)
• Unpaid carers indicated that the pandemic impacted life events such as work, access to healthcare and treatment, their overall health, access to groceries, medications and essentials

[1] Valuing carers 2015; the rising values of carers’ support, CareUK

[2] State of Caring 2017, Carers Wales

[3] North Wales Population Needs Assessment

[4] Wales Centre for Public Policy (2021). Well-being and equalities briefing.

[5] Wales Centre for Public Policy (2021). Well-being and equalities briefing.