RELEVANT INFORMATION

The Care Act and Whole-Family Approaches (Local Government Association et al)

RELATED CHAPTERS

Domestic Abuse

May 2026 – This chapter has been reviewed and updated throughout to reflect the updated LGA Guidance ‘The Care Act and whole family approaches’.

1. Introduction

The Care Act 2014 sets out how councils should identify and work with young carers, and adult carers of disabled children (parent-carers), to plan an effective transition to the adult care and support system using a ‘whole family’ approach.

It is also important for that practitioners working in adult social care and partner agencies consider and include the needs of all family members when carrying out assessments and developing plans for adults with care and support needs. This includes young carers, and adult carers of disabled children and may, therefore, mean that colleagues from children’s social care and other partner agencies will also need to be involved.

There are four steps to the Whole-Family Approach:

  • Step one: Think family;
  • Step two: Get the whole picture;
  • Step three: Make a plan that works for everyone;
  • Step four: Check it is working for the whole family.

This chapter is based on the guidance from the Local Government Association: The Care Act and Whole-Family Approaches – Revised edition), and provides guidance about using the Whole-Family Approach in daily practice.

1.1 Legislative and policy landscape

Under the Care Act, local authorities must identify young carers (who are any children involved in providing care to an adult), including when practitioners are carrying out needs assessments with an adult or their carer. Where a young carer is identified in a family, the local authority must:

  1. offer a needs assessment to the adult requiring care and support; and
  2. consider whether the child / young carer should be referred for a young carer’s assessment or a needs assessment under the Children Act 1989, or a young carer’s assessment under s63 of the Care Act (see Young Carers, Calderdale Children’s Social Care procedures).

As well as identifying any young carer and establishing whether they are a ‘child in need’ under the Children Act 1989, the local authority should assess them using a whole-family approach and ensure that they are not providing ‘inappropriate or excessive’ care. There is also a duty to provide a transition assessment for young carers as well as parent-carers if they (carer) are ‘likely to have needs for support’ after the child turns 18 (see Transition to Adult Care and Support).

Since the first edition of ‘The Care Act and Whole-Family Approaches’ was published in 2015, additional requirements for local authorities have been introduced. The statutory guidance Working Together to Safeguard Children (Department for Education) states that adult services must establish whether there are children in the family providing care for an adult and, if so, whether they need support.

Details of the legislation relating to young carers are covered in detail in the implementation guidance (pages 39-47) for ‘No Wrong Doors for Young Carers’.

As part of the single assessment process, the Care Quality Commission (CQC) will ask local authority staff about their duties towards young carers and parent-carers under the Care Act. ‘The Care Act and Whole Family Approaches’ and ‘No Wrong Doors for Young Carers Memorandum of Understanding’ is explicitly mentioned in the good practice guidance section of its assessment framework; and is, therefore, an essential part of preparation for the CQC assessment. A local authority which has signed the ‘No Wrong Doors for Young Carers’ Memorandum of Understanding may, for example, have to provide evidence that it is committed to whole system support for young carers, parent-carers, and their families. See Toolkit on Unpaid Carers and Care Quality Commission Assurance on the Local Government Association website.

2. Step 1: Think Family – Early Intervention and Prevention

Under the Care Act 2014, a whole system, whole council, whole-family approach must be taken, with services which services and support organised around the adult and their family . It also means that everyone must think about the impact of the care needs of the adult on their wider family, including any children they have, any family members who have caring responsibility for the adult, including any children (who are young carers or young adult carers).

Considering the adult’s needs within the context in which they live helps recognise what is important to them as part of their family, as well as individually, and builds on the collective strengths of the family and their support network. The knowledge and expertise of carers is a crucial part of the assessment and support planning processes. It is also crucial that family roles and responsibilities, including parenting, are discussed, the impact on children is considered, and any caring roles undertaken by children are identified (see Section 2.4, Young carers).

2.1 Wellbeing

The principle of wellbeing is at the heart of this approach (see Promoting Wellbeing chapter). A vital part of an adult’s wellbeing is the situation they live in, who they live with and family relationships. It is important to achieve a balance between their wellbeing and that of any family or friends caring for them.

A whole-family approach to promoting wellbeing and preventing needs for care and support may include helping the adult and their family to think about changes which may happen in the future, and to plan for these,  for example, if the adult needs more care or if a carer becomes unwell (see Preventing Reducing or Delaying Needs chapter).

2.2 Who is a carer?

The Department of Health and Social Care defines a carer as “anyone who cares for a friend or family member due to illness, disability, a mental health problem or an addiction.” The care provided is unpaid, and support can be emotional as well as practical.

A young carer is under 18 years old, who provides or intends to provide care for another person (of any age); a parent-carer is a person aged 18 or over who provides or intends to provide care for a disabled child for whom the person has parental responsibility. A young adult carer is not defined in legislation but is usually regarded as aged 18-24.

2.3 What is a family?

The government’s Family Test includes a list of some of the relationships at the centre of family life. It is not exhaustive but is useful reminder of the variety of relationships that constitute family:

  • couple relationships (including same-sex couples), married partners, civil partnerships, co habitees and those living apart together (two partners who regard themselves as a couple but are not co-habiting);
  • relationships in separated families, including between children and any parent they may no longer reside with, as well as relationships with extended family, especially grandparents;
  • parent and step-parent to child relationships;
  • relationships with foster children and adopted children;
  • sibling relationships;
  • children’s relationship with their grandparents;
  • kinship carers – relatives or friends looking after children who cannot live with their parents;
  • extended families, particularly where they are playing a role in raising children or caring for older or disabled family members.

It should be remembered that roles and identities in families are not set and can fluctuate and change. Also, people who provide care for both an older person and a child may have conflicting demands on their time and different roles to fulfil. Not all carers live in the same household, and some will provide care and support from a distance.

Recognising the complexity of these relationships is important in order to be able to provide the right support to adults and their families. Many people value their role in providing care and support to a loved one, but caring can have a negative impact on health and wellbeing if a carer’s needs are not addressed and support provided at an early stage. Taking a whole-family approach from the outset means local authorities can identify everyone’s needs and support adults to achieve the outcomes that are important to them whilst maintaining a strong supportive family unit.

2.4 Young carers

The needs of young carers, are referenced in both the Care Act 2014 and in the Children and Families Act 2014.

The local authority must carry out a young carer’s assessment whenever a young carer is identified, and it appears they may need support. The assessment must consider whether the care and support being provided by the child is excessive or inappropriate and how the child’s caring responsibilities affect their wellbeing, education, training, work, recreational activities and development.

Some of the tasks which may be considered inappropriate or excessive caring include:

  • intimate personal care;
  • strenuous physical activity such as lifting;
  • administering medication;
  • financial responsibility;
  • emotional support to the adult.

2.5 Key practice points

‘In a council that thinks family:

  • there is commitment across the council to a whole-family approach with protocols in place across a wide range of local partnerships to enable services to be coordinated;
  • the council and ICB are signed up to their local ‘No Wrong Doors for Young Carers’ memorandum of understanding (MOU);
  • all staff, regardless of service or setting, will establish whether a child or young person is providing care for a family member and understand what the next steps are in arriving at a judgement about what further support, if any, is required by the family;
  • there is an active approach to establishing if there are any significant potential changes in families’ lives and working with them to plan for these;
  • families and carers are an integral part of the design, delivery and evaluation of services and support.’ (The Care Act and Whole Family Approaches)

3. Step Two: Get the Whole Picture – Assessment

Getting the whole picture means seeing each person as an individual, as well as recognising the part they play in their family and community. Everyone has something to contribute to addressing the adult’s needs. The Whole-Family Approach builds on everyone’s strengths and develops their resilience. It also promotes working together with carers as partners, as well as the adult and other members of the family and friends where appropriate.

Understanding the needs of the whole family and getting them to think about the outcomes they want to achieve individually, as well as a family is vital. It means the practitioner can then provide the right guidance, information and services.

Appropriate and proportionate assessments are a critical intervention; it is not just a gateway to receiving care and support. At this stage practitioners can provide guidance and information to help the family understand their situation; their needs and strengths, how they can reduce or delay the onset of greater needs (see Preventing, Reducing or Delaying Needs chapter) and how to access support when they require it. The aim of assessment is to get a full picture of the person and their needs and goals, so any carers must be consulted (see Assessment and Eligibility chapter which also includes information about different types of assessment). Carers are recognised in the Care Act, in the same way as those they care for.

3.1 Key practice points

‘In a council that gets the whole picture:

  • there are joint working agreements in place between children’s and adult services that makes clear where responsibilities lie and how services work together;
  • information on the assessments and care and support plans family members have with other organisations is routinely identified;
  • where possible and appropriate, assessments are coordinated or combined;
  • proportionate assessments are undertaken in a way that’s most appropriate to each family;
  • people providing care and support are identified and involved in the assessment to provide their expertise and knowledge and views of what works and what does not;
  • any risks to carers of sustaining their caring role are always considered;
  • carers’ willingness and ability to continue caring is always established, for example with questions such as:
    • who else lives in your house?
    • who helps with your support and who else is important in your life?
    • is there anyone that you provide support or care for?
    • is there a child in the family (including step-children, children of partners or extended family)?
    • do you need support in your parenting role?
  • carers, including young carers, are provided with an assessment on the appearance of need and carers’ eligibility for support independent of the person they support understood by practitioners;
  • in all instances, even when a person can achieve an outcome independently, consideration is given to any impact on others and whether they might be adversely impacting on the health or safety of others, particularly family members and including children;
  • at assessment, all eligible needs are identified regardless of whether such needs are being met by any carer;
  • when looking at eligible needs, consideration of the ability to maintain family or other significant relationships, including with any children, and the impact of these not being maintained on the adult’s wellbeing is always considered. This applies to both the person in need of care and support and their carer;
  • when a child may be a young carer, consideration is always given as to whether to provide them with services to support them under section 17 of the Children Act 1989;
  • assessments of an adult identify any potential child in need who does not have any caring responsibilities’. (The Care Act and Whole Family Approaches)

4. Step Three: Make a Plan that Works for Everyone – Support Planning

Adopting a whole-family approach to developing a plan can offer new opportunities to achieve the best outcomes for the whole family. Sometimes a plan for an individual adult can have unintended consequences for other members of the family. This may be particularly so for carers, but often small changes can support better outcomes for everyone. A whole family approach can also make better use of resources.

Sometimes more than one member of the family has plans and there may also be plans from different organisations. Using the whole-family approach, plans should not be developed in isolation from one another but in a coordinated way. If everyone involved agrees, plans for different family members can be combined into a single plan in which there may be components for individuals as well as collectively. This can be key in ensuring that everyone’s wellbeing is promoted. It can also be useful in resolving any conflict and ensuring negotiations are a balanced way of achieving everyone’s desired outcomes. Where it is not appropriate to combine plans, they should be coordinated, at least.

Examples of possible combined plans are:

  • carers (including young carers) and the adult with care and support needs;
  • mutual caring where adults involved have both care and support needs and caring responsibilities;
  • children with Education and Health and Care plans and parent carers;
  • people in receipt of local authority and NHS healthcare; and,
  • where budgets are pooled.

Plans can only be combined if everyone involved agrees; combination of plans should be in the best interests of all. Where one of the plans is for a child (under 18 years old), the child must have mental capacity to agree to combining and plans. If the child does not have mental capacity to make the decision themselves, the local authority must be satisfied that the combining plans would be in their best interests. This applies to children who are young carers as well as children with care and support needs.

Where plans are combined or integrated across services / organisations, a named worker should be identified to lead on monitoring and assurance of the plan, that here is clarity for all concerned about exactly when the plan will be reviewed and by whom.

As well as considering everyone’s wellbeing, plans need to cover any identified needs in relation to work, education, training or recreation. For carers, this should consider how they can be supported to look after their own health and wellbeing and to have a life of their own alongside caring.

Some people become more isolated because of older age, ill health, disability or caring responsibilities and do not have a network of support or would benefit from a more extended network. It can be helpful to work with people to develop their circles of support; this may include engaging more with family, friends and community members and help them do things they would like to do.

The Care Act gives people with eligible needs, including, carers the right to a personal budget. A personal budget is a clear statement of the cost to the local authority (and the individual’s contribution towards) of meeting all eligible needs. It will be built around the carer’s desired outcomes and securing the best possible value for the carer from their personal budget (see Personal Budgets chapter). Some people may also have a personal health budget.

4.1 Key practice points

‘In a council that makes plans that work for everyone:

  • support planning takes account of the wellbeing of all the family and the impact of any services and support on other family members. This includes identifying and responding to situations such as mutual caring, carers living at a distance or outside of the council area;
  • support planning always involves any carer and consideration is given to the involvement of other family members;
  • support planning considers how carers can be supported to look after their own health and wellbeing and have a life alongside caring;
  • plans include consideration of support to ensure a carer can fulfil any parenting role;
  • consideration is given to how a person’s circle of support can be developed, where this might benefit them;
  • where the council is going to meet the needs of multiple people in the same family, consideration is given to producing a combined plan with a joint personal budget (where this is appropriate and all involved agree);
  • plans from different organisations for any family members are identified and consideration given as to whether these can be aligned, coordinated or integrated into a single plan (where all involved agree);
  • where plans are integrated, a lead organisation is established to undertake monitoring and assurance, and it is clear about when the plan will be reviewed and by whom’.

5. Step Four: Check it is Working for the Whole Family – Review

As with assessment and care planning, wherever possible a whole-family approach to review should be taken. An outcome-focused review focuses on the results being achieved by the adult and the family. A review that considers the whole family would need to consider many of the same factors as a whole-family assessment discussed in Step Two (see Section 3, Step Two: Get the Whole Picture – Assessment). The local authority would provide assurance and sign off in all instances.

Sometimes an early ‘light touch’ approach to review is useful, which can include a telephone call or ‘self-review’ to see how things are going. Whatever approach is used, the review should always include consideration of any impact of the care and support plan on other family members.

Following review, the plan may need to be revised, which should include the adult, their carer and anyone else they would like to be involved. The benefits of a whole-family approach to reviewing the plan are to ensure that everyone’s needs and wellbeing, including any children, have been considered, that there are no unintended consequences for anyone, and that there is agreement around implementation of the plan.

5.1 Key practice points

‘In a council that knows its approach is working for the whole family:

  • the impact of the plan and results being achieved are reviewed in relation to both the individual and the whole family. This includes consideration of any unintended consequences for other members of the family;
  • consideration is given to any changes that can be made to maximise the benefit to the whole family’
  • carers’ needs are routinely reviewed and the support they are willing and able to provide, as well as the outcomes they want to achieve, is re-established;
  • any anticipated changes in the family that may impact on needs and support are identified and considered in any revised plan.
  • the plan is checked to see that it is providing adequate support to prevent children caring at inappropriate or excessive levels’.

6. Tools to use with the Whole-Family Approach

Practical tools for use with families and Further reading and resources (The Care Act and whole family approaches, Local Government Association).

7. Further Reading

7.1 Relevant information

The Care Act and Whole-Family Approaches (Local Government Association et al)

Was this helpful?
Yes
No
Thanks for your feedback!
– End –
Reading Confirmation
  • This field is for validation purposes and should be left unchanged.

  • This form allows Adult Social Care staff to confirm they have read chapters in this APPP. This can be useful for newly employed staff as part of their induction, supervision, CPD and for team discussions for example.

    When you complete and submit the form, the confirmation will be emailed to you at the address provided.

  • This field is hidden when viewing the form