A Telling Experience

Understanding the impact of Covid-19 on people who access care and support – a rapid evidence review with recommendations

This report from the TLAP Insight Group aims to identify what worked well, and to highlight areas that people found difficult, both generally and in relation to social care during the first phase of the coronavirus pandemic, seen through the lens of personalisation.

Read a brief summary below or download the full report. (opens new window) 


Members of TLAP Insight Group submitted details of research and/or data collection that explored the impact of Care Act Easements and/or Covid-19 on the lives of people who accessed care and support, and unpaid carers. This highlights the experiences and views of people receiving social care and support. The wider impact of the pandemic on aspects of health care and provision (both physical and mental) was also considered.

The data was analysed as part of a rapid evidence review to inform future practice. Recommendations to take practical action to address health and care inequalities, increase personalisation and embed co-production are included.

General impact of Covid-19

Research pointed to the general confusion and anxiety of the early pandemic on the public and specifically on those with care and support needs, including:

  • loneliness and isolation of social distancing and the impact on mental health
  • financial pressures, particularly on extra costs in food and bills
  • practical issues around food shopping
  • increase in health anxiety
  • changes to the streetscape, particularly affecting visually impaired people

Impact of Covid-19 on those who accessed care and support

Specific findings relating to this group and their unpaid or family carers included:

  • overarching challenge around communications
  • concerns around PPE and testing, including for direct payment holders with personal assistants, as well as the wider workforce and testing in care homes
  • cancellations of respite and day services adding to increased pressures
  • some examples of changes to care packages

Impact of Covid-19 on specific groups

Concerns were raised about the impact on:

  • care home residents, visitors and staff, particularly in terms of stress and mental health
  • direct payment (DP) holders, who reported a very mixed picture ranging from poor to good practice 
  • some of the most at risk and disadvantaged groups in society were impacted by the reduction or withdrawal of mental health staff from face-to-face support 
  • BAME groups, specifically individuals who felt isolated or frightened about how they might be disproportionately impacted by Covid-19
  • individuals experiencing digital exclusion through people’s inability to use technology
  • unpaid/family carers who picked up extra care responsibilities when day care centres closed
  • people who were shielding receiving advice from clinicians/GPs that conflicted with government guidance and messages. 

Impact of Care Act Easements

The Coronavirus Act 2020 provided for Care Act Easements, which gave councils the flexibility to redeploy or retarget capacity to help them respond to the crisis.

It was not possible build up a comprehensive picture of Care Act Easement activity and its impact on people that accessed care and support through this review. Eight local authorities introduced CAE but in different ways over different time frames, and not all did so across the whole of adult social care.

Impact data highlighted the difficulties of attributing change to CAE directly, as opposed to the wider impact of Covid-19. This meant that the majority of the research talked more generally to the broader effect of Covid-19.

The Department of Health and Social Care reconginse the importance of the need for research on the impact of Care Act Easements. 

Areas of good practice or learning

The review identified areas of good practice or learning which might be drawn upon to help build a legacy for future care and support, including:

  • support to shape future communications and advice
  • flexible and agile working, particularly in terms of digital models of provision
  • finding meaningful activities and connectedness
  • potential of personalisation reaffirmed as the cornerstone of future delivery
  • good practice around co-production to build on for future learning
  • innovation and good practice in commissioning to build a new a vision for mental health support and a new vision more widely across health and social care
  • potential of the informal networks of mutual aid groups, neighbourhood support and national networks to share information, good practice and learning at sector leadership level.


This report is intended as a stimulus for change. Some recommendations will require changes to system and process. But at their heart they depend on a willingness to develop and implement policies and practices in co-productive ways that put people front and centre.

Recommendations cover:

  1. Production of guidance
  2. Communications at local level
  3. Co-production
  4. Care Act Easements
  5. Commissioning
  6. Addressing inequality
  7. Support for carers
  8. A better deal for direct payment holders
  9. Addressing mental health
  10. People living in care homes and families
  11. Mobilising communities
  12. Going digital
  13. Developing the workforce
  14. Further research and learning