Replacement paper - IJB Carer Update
North Ayrshire Council · 15 December 2022
Back to Integration Joint Board — 15 December 2022 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
Page 1
1 Integration Joint Board 15th December 2022 Subject : Support for Unpaid Carers in North Ayrshire Purpose : For information and to provide Integration Joint Board members with an update on developments to improve support for unpaid carers in North Ayrshire. Recommendation : Integration Joint Board members are asked to: • Note and support the work ongoing for unpaid carers • Endorse the routes for resource release Direction Required to Council, Health Board or Both (where Directions are required please complete Directions Template) Direction to :- 1. No Direction Required X 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership PSMT Partnership Senior Management Team IJB Integration Joint Board ACSP Adult Carers Support Plan YCS Young Carers Statement 1. EXECUTIVE SUMMARY 1.1 This update headlines some of the progress for improving carer identification, information and support services. This fits our ambitions and strategic priorities in ‘Caring together’ 2022-30 of engaging the carer community, early and effective ‘upstream’ support, improving carer mental, emotional and physical health & wellbeing and strengthens partnerships. 1.2 The paper highlights a range of actions and collective decisions on how to expand the reach of carer information, assessment and support, how to involve more carers in collaborative decision making and get resources (both personnel and financial) to carers quickly. It ensures North Ayrshire Health & Social Care Partnership (NAHSCP) continues with the implementation of the Carer (Scotland) Act 2016 and the statutory responsibilities therein. 2. BACKGROUND
Page 2
2 2.1 Duties under the Carer’s (Scotland) Act 2016 came into force in April 2018. The Act sets out several responsibilities for carer assessment and provision of support to identify and sustain caring roles as well as a key principle of carer involvement, among others. NAHSCP have been awarded Carer’s Act Implementation funds from the Scottish Government since 2018. The use of this funding is not ringfenced or stipulated but should enable and support the implementation of duties under the Act. The recurring revised annual budget for 2022/23 is £1,959k. 3. PROPOSALS 3.1 The Carers Team and Advisory Group have developed a range of proposals to further develop the positive supports for carers in North Ayrshire. This programme of work has oversight and sponsorship by Scott Hunter our Chief Social Work Officer. Alongside the range of supports in place for all unpaid carers and their loved ones, the Carers Act is underpinned by the ability for unpaid Carers to have an assessment of their own individual needs and supported provided in line with this. There is a particular challenge with the promotion and uptake of carers assessments both to request and to accept a support plan. In North Ayrshire HSCP during 2021-22 there were a total of 360 adult carer assessments offered with 80 leading to a carers assessment (22%) and 55 of those agreeing with care assessment and support plan put in place (15% of those offered). A number of proposals have been developed to ensure carers are identified and supported to take up the options available. The undernoted proposals were discussed and approved by the Partnership Senior Management Team (PSMT) on 17th November 2022 and detailed throughout the paper. • Increased staff capacity Recruitment of three carer posts have been supported to enable the Carers team to increase workload and improve timescales for change. Two posts (Carer Support Worker – Social Work Assistant & Project Delivery Officer) commenced in October 2022 with plans to recruit the third (Short Breaks Co- ordinator) in 2023 as we develop a short break service and increase the variety and offer of breaks in line with the upcoming National Care Service directive of ‘rights to breaks from caring’ for unpaid carers. • Provision of Support A retrospective one-off payment of £300 for each completed ACSP (55) and YCS (52) in 2021/22 will be issued to the carer/ family/ guardian for the purpose of meeting identified carer support needs. The carers support worker will work with the service and care manager to ensure this resource is still required and there remains an identified need, the deployment of this resource will also support those flexibility if they are waiting for their service or support to commence.
Page 3
3 • Provision of Support (Adult Carer) Resource and processes are now in place to offer a softer approach to access assessment and support for adult carers by way of: - Self-Referral Form - Carer Team Inbox for receiving referrals and enquiries - Carer Support Worker to offer and complete ACSP and arrange support - Carer Funding paperwork - Agreed recurring resource for the provision of low level support - Finance administration support • Provision of Support (Young Carer) In partnership with KA Leisure, NAHSCP will offer one year’s subscription to help support positive and active lives for young carers currently registered with the carer service. KA Leisure also included an offer of 10 young carer subscriptions free of charge for 3 months. Active Schools have offered a two- day residential placement for 20 young carers free of charge scheduled for January/ February 2023. The pathway for young carers to be identified, offered their YCS and provided support is both through HSCP Services and North Ayrshire Council Education. For the year 2021/22, 52 YCS were completed through schools. Education services will receive recurring resource to support young carers to meet identified outcomes through the YCS. This will cover all 63 schools and allow staff to provide a break from caring or support young people to have a life alongside their caring role whilst maintaining their wellbeing. • Reprovision of North Ayrshire commissioned Carers Service Work is ongoing to seek a strategic partner and commission a sustainable and expanded carer service. NAHSCP have engaged with the market, assessed our neighbouring HSCP provision and conducted prior interest procurement activities. The current contract ends in June 2023, the successful provider will commence the new contract April 2023 allowing for any handover/ lead in or recruitment time that may be required. The provision for carer support services will cover 3 years with the option of 24 months extension. The service being commissioned will be a broader offering reflecting the need for a Carers service to take a more active role in supporting the completion of carer assessments, particularly those who may not want to seek support from statutory services. • Carers Collaborative (Review of Carer Engagement Model) The remodelling of the longstanding Carers Advisory Group and more recent staff Carer Support Development Group to a Carers Collaborative/ Network approach for local carers, organisations, professionals who work with carers and volunteers will help extend the HSCP reach and ensure carers voices are heard and included. Core Carers Advisory Group members, including IJB Carers Representative Pamela Jardine and the North Ayrshire Council Carers
Page 4
4 Champion Nairn MacDonald will help lead on this development supported by the Carers Team and Michael McLennan – The HSCP’s Engagement Officer. • Involving Carers in Discharge Planning (Section 28 Carers Act) Each Health Board must ensure before a person is discharged from hospital, they involve any carer of that person in the discharge plan and process. Section 28 of the Act is key to the Discharge without Delay agenda to improve pathways through hospital settings and reduce inpatient stay. Working with carers from admission ensures people and their families can make informed decisions and are as prepared as possible for loved ones to return home or to a homely setting. A pan Ayrshire team, led by East Ayrshire HSCP/ Carers Service and supported by HIS have made good progress over the past few weeks as part of the intensive support to the acute hospitals. East Ayrshire have recruited 2 carer support staff based at Crosshouse and Ayr acute sites, to work with staff, to identify carers, and support in delivering the right information and support at the right time for carers. A referral process is also implemented for workers to signpost onto appropriate local carer services. 3.2 Anticipated Outcomes The key objectives through this programme of carers development work are both statutory and because it is the right thing to do so that: • Carers are Identified • Carers are supported and empowered to manage their caring role • Carers are enabled to have a life outside caring • Carers are free from disadvantage or discrimination related to their caring role • Carers are fully engaged in the planning and shaping of services • Carers are recognised and valued as equal partners in care 3.3 Measuring Impact Plans and timescales have been agreed by PSMT. This work will be progressed through current carer and governance groups. Developments will be composite to the learning and overarching change taking place through the Self-directed Support Learning Review Board. Quarterly reporting is presented to PSMT (commenced August 22) and IJB updates are agreed as bi-annual (commenced June 2022). Impact will further be measured through carer contract monitoring and financial reporting. Adjustments to the carer engagement model will also provide a robust measure of impact/ success.
Page 5
5 4. IMPLICATIONS 4.1 Financial The recurring revised annual budget for 2022/23 is £1,959k, although additional funding has been received in line with the Carers Act implementation the resource is not earmarked nor ringfenced for this purpose. The proposals outlined do not fully utilise all of the available funding for Carers. The funding is now in the final year of 5 of implementation where there was an expectation of an incremental increase in demand. Where funding is not required to support the delivery of the Carers programme, the commissioned Carers Service and the uptake and completion of carers assessments and those supports provided it has been utilised for a number of years to offset the cost of other services which support carers, this includes the waiving of charges, respite provision for adults and young people and day services. The proposals outlined will place North Ayrshire in a strong position to fully meet the requirements of the Act. 4.2 Human Resources Recruitment of three carer posts is underway. It should be noted also that North Ayrshire Council is a Carer Positive employer and holds Level 2: Accomplished in providing carer support meaning we provide a range of practical support for carers in the workplace. Communicate support available for carers throughout the organisation. Enable carers to feel comfortable in accessing available support both from within and outside the organisation. 4.3 Legal North Ayrshire Council and NHS Ayrshire & Arran must meet their duties under the Carers (Waiving of Charges for Support) 2014 Regulations, Carers (Scotland) Act 2016, Terminal Illness Regulations (July 2021) and upcoming National Care Service Bill. This legislation should be held in the same regard as any other directive pertaining to professional assessment of need and provision of support. 4.4 Equality/Socio-Economic Under the Fairer Scotland agenda, it is commonly noted that unpaid care places added strain on multiple areas of a person’s life including personal health, relationships & social opportunities, finances, appropriate housing, ability to retain education or employment. Having less access to resources can mean carers fare worse. Carers living in more deprived areas also tend to care more and/ or for longer (North Ayrshire was 5th in the deprivation index at 2020). The carer population also tends to be predominantly female. These are all factors for consideration to justify and support the proposals contained in the paper and to continue to develop better routes for carer support.
Page 6
6 4.5 Risk The integrated joint board should note the risks if this work does not continue to be a key priority. • Carers will not be identified, informed and supported resulting in carer roles/ relationship breakdown. • Carers and services will feel more overwhelmed and experience increasing pressure, leading the carer into crisis and resulting in higher demand and cost for health and social care services. • Current approaches to carer support are not working or are not sufficient to sustain caring roles. • Statutory carer duties will not be met. • Fiscally conditions are not going to improve immediately for citizens, carers, local government or the care sector. Mobilising resources to mitigate some of the pressure’s carers are experiencing is the right thing to do. (Moderate) 4.6 Community Wealth Building This work is centred on carers being equal partners in care design and delivery. It focuses on the wellbeing of carers and increases their involvement and inclusion to build resilience and confidence. It encourages a much-needed shift to citizen & community based/ led approaches. 4.7 Key Priorities The vision for North Ayrshire ‘Caring Together’ 2022- 2030’ is ‘People who live in North Ayrshire are able to have a safe, healthy and active life’. To help realise this vision for carers NAHSCP must engage the carer community, provide early and effective ‘upstream’ support, sustain/ improve carer wellbeing but most importantly strengthen partnerships with carers, community and third sector services to develop and deliver these changes together. 5. CONSULTATION 5.1 As noted earlier the range of actions and collective decisions within this report have been discussed and agreed through appropriate governance routes including Carers Advisory Group, Carer Support Development Group, PSMT and Transformation Board. Carer involvement and collaborative working is a key principle in all our ambitions for carers and we recognise they are equal partners and experts in caring. Scott Hunter, Chief Social Worker Prepared by - Kimberley Mroz, Manager – Professional Standards (SDS/ Carers), kmroz@north-ayrshire.gov.uk