2 - Building Caring Communities Strategy - Final Combined.docx
North Ayrshire Council · 24 August 2023
Back to Integration Joint Board — 24 August 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 Integration Joint Board 24th August 2023 Subject: New Carer Strategy & Investment in Services for Unpaid Carers in North Ayrshire Purpose: To bring forward a new Carer Strategy and update board on the developments in relation to increased investment in support for unpaid carers. Recommendation: Board members are asked to: • Note the new Carer Strategy (2023 – March 2025) • Note the increased investment in services for unpaid carers through the development of a strategic partnership with Unity Enterprise. Direction Required to Council, Health Board or Both Direction to: - 1. No Direction Required X 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran 1. EXECUTIVE SUMMARY 1.1 This paper updates board on progress across two workstreams for unpaid carers. 1. The first is the development of a 2-year carer strategy: Building Caring Communities 2023 – 2025. This strategy is in conjunction with implementation plans to accompany; 2. the reprovisioning of the expanded North Ayrshire carer service following a recent tender award. 1.2 This paper highlights a range of collective priorities be taken forward as a strategic partnership with the successful incumbent supplier of carer services, Unity Enterprise. Both the strategy and implementation plans detail the importance of supporting carers to sustain their caring roles and look after their wellbeing. The commitment to the carer’s agenda with a threefold increase in resource will crucially show how the service will expand its reach and improve carer identification, information, assessment, and support. NAHSCP continues to aspire to involve more carers and key partners in collaborative decision making on services for carers and the people they care for. Ultimately progress ensures NAHSCP continues with the implementation of the Carer (Scotland) Act 2016 and the delivery of statutory responsibilities therein.
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2 2. BACKGROUND 2.1 Duties under the Carer’s (Scotland) Act 2016 came into force in April 2018. The Act sets out responsibilities including the development and publishing of a local carer strategy and the establishment and maintenance of an information and advice service for carers resident or caring for someone in that local authority area. North Ayrshire Council has commissioned carer information and support services for over 20 years. Carer engagement activities had commenced in preparation for the review of the strategy in late 2019 but were postponed due to the COVID19 pandemic. Efforts were redirected to focus on ensuring carers and the people they care for were informed, supported to protect themselves from COVID-19, and when possible, were enabled to safely re-engage in their communities. With the post covid context now clearer and retendering of commissioned carer support service complete attention within the HSCP carer team turned to the carer strategy in Q1 and Q2 of 2023. The strategy must cover the following areas to meet the statutory definition of a carer strategy: 1. Plans for identifying relevant carers and obtaining information about the care they provide to cared-for persons in North Ayrshire. 2. An assessment of the demand for support to relevant carers. 3. Support available to relevant carers in North Ayrshire. 4. An assessment of unmet need for carers. 5. Plans for supporting carers. 6. Plans for putting arrangements in place for the provision of care to the cared- for person in emergencies. 7. As assessment of the extent to which plans in place may reduce any impact of caring on carers’ health & wellbeing. 8. Intended timescales for preparing adult carer support plans and young carer statements. 9. Information relating to the particular needs and circumstances of young carers. We now bring forth our carer strategy – Building Caring Communities 2023 - 2025 and its priorities to be taken forward with the new strategic partner and rebranded – Unity Gateway Carer Service. The intent is to use the 16 month strategy period to work with Unity Gateway Carer Service, our carers and the broader sector to engage in a medium-term strategy to be ready to cover the period 2025 – 2030. Recently, a National Carer Strategy and implementation plan was also published by the Scottish Government (December 2022) which provides guidance on national priorities. The NAHSCP carer strategy has taken this into account when devising our key priorities. Contextually, the carer population is just under 14,000 people in North Ayrshire according to the Scottish Census. 1,607 (1,343 adults & 264 young carers) carers
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3 were known and registered with Unity Gateway Carer Service at the last count on 18th July 2023. This is a 5% increase from July 2022 and reflects some progress based on the messaging and promotion of the carer services partnership. Predominantly increased referrals for carer registration have come from self-referral, NAC Education for young carers or Hospital discharge teams for adult carers. NAHSCP has shared responsibility with NAC Education Services for young carer identification and offers of support. Across our primary and secondary schools 287 young carers under 18 years old were identified in June 2023 prior to the school term finishing. By way of assessment leading to support, for the reporting year 2022/ 2023, Social Work staff have offered 449 Adult Carer Support Plans with 94 accepted and 56 of those following on to completion. In October 2022 capacity was added to NAHSCP carer team with a Carer Support Officer (CSO) to offer an alternative route to early and preventative carer support, mainly for carers who were not already known to Social Work services or were aged 16 - 18 years and not in school. The introduction of this new role has seen the NAHSCP carer team offer retrospective support to 72 adult carers and work is ongoing with 57 young carers and families. There have been 29 new referrals and 7 assessments completed through the new CSO route since February 2023 for light touch support. This has been improved by a Self-referral form launched in carers week (5th - 11th June 2023) to all services, service access and commissioned carer services with release on social media platforms. NAC Education staff report 183 Young Carer Statements offered with 167 accepted and completed in the year 2022/ 2023. Over three times more than in 2021/ 2022. From the young carer statements, it is noted 40% required a break away from their caring role, 34% needed emotional support meaning school staff being aware of caring roles, their anxieties and having someone to talk to. 23% requested practical support with homework, schoolwork or a place to study. And 24% did not need additional support through their carer conversation. 3. PROPOSALS 3.1 A. Carer Strategy ‘Building Caring Communities’ 2023 - 2025 is intended to help deliver consistency of message and approach for all carers. It advises carers of their rights, sets out plans to identify carers, routes for assessment and support, and information about local and national services. The strategy advises carers, those they care for, professional staff and partner agencies of how we currently identify and support carers, and what this will look and feel like in the future through the expanded service. We are continuing with a programme of review, change and growth as to how we work with and involve carers
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4 in and around our communities and in service design to shape and implement better carer services. The aim is that all North Ayrshire carers are identified, supported and valued and are afforded an opportunity to live, work, thrive and stay connected to their communities enjoying a life alongside caring, where they choose to continue to care. It is also our ambition that all unpaid carers have their voices heard and ideas considered in the design and delivery of information and support services provided across NAHSCP through a more collaborative/ network model led by North Ayrshire Carers Gateway, Carer Champion and IJB Carer Representative. We understand that often caring roles are demanding and complex and we hope the strategy offers support and guidance to carers when they need it most. In the development of the strategy priority areas have been identified for growing young and adult carer services. NAHSCP will work closely with North Ayrshire carers, North Ayrshire Carers Gateway. and other key partners to implement and improve information, systems and support options through ensuring: • Priority 1: Carers are actively sought and identified. • Priority 2: Carers are informed, have increased confidence in their caring role and feel supported. • Priority 3: Carers are offered and supported to prepare an Adult Carer Support Plan or Young Carer Statement. • Priority 4: Promotion of variety in breaks from caring. • Priority 5: Carers feel involved as equal partners in care design/ delivery. • Priority 6: Strong partnership working/ engagement. • Priority 7: Improved identification, information and support for Young Carers with a focus on transition periods through to adulthood. The strategy and priorities have been developed over the past 6 months and have been endorsed by our longstanding Carers Advisory Group, which includes the North Ayrshire Council Carers Champion and the HSCP Portfolio Holder/IJB Chair, the Carers Advisory Group endorsed the strategy on 20th July 2023. It has also been endorsed through the Partnership Senior Management Team and the Social Work Governance Board. NAHSCP will fine tune this strategy with a proposed soft launch with carers in September 2023. We will move forward with the content, priorities and associated action plan to ensure all carers in North Ayrshire can experience a good quality of life,
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5 sustain or improve their wellbeing and realise their goals by accessing information and support closer to home that enables them to continue caring, where they wish to do so. As a final point the strategy acknowledges the challenges currently faced across Health and Social Care Partnership services and systems, but we also recognise that often means rising pressure for many carers. Carers are paramount to the wealth and sustainability of our communities and the health and social care system. This is why carers needs are of priority across North Ayrshire. B. North Ayrshire Carers Gateway – Implementation Plans Strategy preparation has been in conjunction with the retender and reprovision of the North Ayrshire carer service for young and adult carers. Unity Enterprise was awarded the contract for 3 years commencing 3rd July 2023 with the option to extend for up to 24 months. The total value of the overall contract delivers a threefold increase in the resource to support carers. Due thought and diligence have gone into considering the options available, risks, resource/ best value implications and crucially the right result for North Ayrshire carers. Tender process timescales were stretched to the fullest and the outcome was not concluded lightly. A prior interest notice for unpaid carer services was issued in October 2022 to test the market and seek a dynamic and creative strategic partner to be more present and visible within our communities to develop, deliver and expand the reach of information, and support services to young and adult unpaid carers across all North Ayrshire localities. NAHSCP invited suitable applicants to tender for the reprovision in March 2023 with 11 expressions of interest. Interviews were held with all suitable applicants. Tender scoring weighed favourably with Unity Enterprise. As stated, there is considerable investment in improving carer services. This will see an increase from 4.5FTE to 14FTE carer support staff to develop and resource an outreach model. Carer identification, information, activities and support will be closer to carers homes, in their communities. This includes a fourfold increase to ensure sufficient coverage to all primary and secondary school clusters. There will be specialist posts for carer wellbeing and to promote variety in breaks from caring. A specialist recruitment consultant has been appointed to support the upscale of staff. Interviews for the Service Manager and Locality Co-ordinator roles are scheduled for August. The success of this expansion relies heavily on these key posts having the skills to deliver organisational and service planning and to be prepared to drive change forward with our carers. Consistent messaging for carers and professionals on the newly branded and expanded outreach service and what it offers is also crucial and this will be the role of the new Marketing and Evaluation Officer. The service will be operational from 8am – 8pm with some weekend provision. This is supported by investment in localised digital resource/ platforms to support and inform all carers 24/7, 365 days per year. Caring is not a Monday – Friday, 9 – 5
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6 commitment and we understand caring for loved ones can have pressure points or the need to reach out for information and support at various junctures or times. We also understand carers need options to suit how they identify in their caring role and how they wish to seek support. Moving forward with Unity Enterprise the broad requirements for the delivery of the service mirror the 7 priorities noted above under the strategy. A Project Initiation Document has been agreed and an implementation plan and risk register set for the first 6 months with the immediate establishment of a small strategic project board having met weekly since award. Primary areas for focus are under the following streams: • Continuity and monitoring of current carer service as the service grows • Phased Recruitment & HR responsibilities • Partnership mapping & establishment to promote the new service • Marketing of the rebranded ‘Gateway’ carer service • Digital developments, scoping the right resource and market testing for young and adult carers • Property discussions with possible colocation and establishing a new administrative base • Financial planning and oversight 3.2 Anticipated Outcomes The results we hope to achieve through the strategy and expansion programme for carers are: Priority 1: Carers are actively sought and identified. Carer staff will be more present and visible across all localities to seek out carers who are currently unreached or not engaging with carer services. North Ayrshire Carers Gateway will consist of dedicated and knowledgeable staff within each locality and across schools. We will see: • An increase in the number of carers identified, registered and supported, year on year. • A proportion of the carers identified will be new young and adult carers who are not known to services or in receipt of carer support as well as from diverse groups (minority communities such as BAME, LGBTQIA+, the travelling community at Redburn and those seeking refuge or asylum). • Improved reporting of carer referrals and registrations.
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7 Priority 2: Carers are informed, have increased confidence in their caring role and feel supported. Carers, professionals and partner agencies will know North Ayrshire Carers Gateway as the first point of contact for carer information, advice and support when they need it. We will see: • Carers being aware of carers rights and where to go to access good quality information and support closer to carers homes and community. • Good response times for carers from the first point of contact to information and support received. • Carers having understood, used and acted upon the information, advice and guidance to support their caring role. • Service and partner agencies staff having increased carer awareness/ knowledge. Priority 3: Carers are offered and supported to prepare an Adult Carer Support Plan or Young Carer Statement Until now carer assessment was only available through NAC/ NAHSCP services. North Ayrshire Carers Gateway. will offer alternative routes for young and adult carers to flexibly be offered or request a carer conversation and access to support. We will see: • All carers identified through the Gateway service offered the opportunity to prepare an ACSP or YCS. • Good recording and reporting of ACSP, YCS information and support received, personal carer outcomes being met and better information for statutory annual returns. • Good recording and reporting of reviews of each ACSP and YCS completed. Priority 4: Promoting variety in breaks from caring. A break from caring is any form of support which can be taken in several ways to enable a carer to have time away from their caring routines and responsibilities. The purpose is for carers to have a life outside or alongside the caring role. The short break will support the carer and often the cared-for, the caring relationship and promote sustained or improved health & wellbeing. It can provide a change of scenery, improve carer confidence, increase ability to cope or succeed, reduce isolation, improve emotional wellbeing, improve general quality of life and increase the ability to sustain the caring role. We will see: • All breaks and funding payments logged, recorded and reported appropriately within agreed, reasonable timeframes with appropriate paperwork for the purpose of audit.
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8 • Published best practice examples of carer short breaks for young and adult carers showcasing the options available for carers. • Carers reporting they have time for themselves and feel that they have a life outside caring. • Carers having an improved ability to manage and enjoy a changing relationship with the person they care for. • Carers reporting improved wellbeing. Priority 5: Carers feel involved as equal partners in care design/ delivery. NAHSCP has always been committed to the principle of carer involvement with our nominated Carer Representative on IJB and Carer Champion role. Both help widen the pool of views being represented locally for carers. The longstanding Carers Advisory Group has been active for 11 years and carers represent all localities, care groups and conditions. Moving forward this group will expand to form a Carers Collaborative. This approach gives carers a stronger voice in future service design and planning and encourages the principles of community engagement to be embedded more widely. To support this aspiration further North Ayrshire Carers Gateway will host an annual North Ayrshire Carers Conference. We will see: • Evidence of carers feeling they are involved, listened to and opinions valued - treated as equal and expert partners in care. • Engagement/ consultation activities reported quarterly under contract management. • Carers reporting an improved confidence in their caring role and in their wider life circumstances. • Carers having a greater say and control over the support and services they receive as well as those provided to those being cared-for. Priority 6: Strong partnership working/ engagement. NAHSCP seek and encourage effective relationships and partnerships with carers, professional staff and partner agencies to achieve better opportunities and outcomes for carers. We will: • Demonstrate carers and professionals’ knowledge and skills are developed due to working in partnership with the service. • Develop and undertake outreach across the 6 localities of North Ayrshire. • Report attendance and learning at different networking sessions/ events/ groups annually. • Evidence an increase in carer referrals and registrations from all pathways including Social Care, Health and Education, third sector and independent providers. • Produce and publish a range of resources/ materials/ links for use by all professionals and agencies to improve the early identification, recognition of caring and delivery of communication and support available for carers.
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9 Priority 7: Improved identification, information and support for Young Carers with a focus on transition periods through to adulthood. NAHSCP take a whole family approach and want to ensure young carers are recognised and supported as early as possible and enabled to be children and young people first and foremost. This is especially important at transitional ages and stages for young people who should be supported to manage and prepare for changes moving into adulthood and becoming an adult carer. We will: • Evidence the whole family have been considered in each young carers needs. • Demonstrate how young carers statements identify strengths, aspirations and support to overcome possible barriers created by caring. • Ensure young carers know the service and what information and support is available in their community. • Ensure strategic partners and universal services such as HSCP, education and primary/ acute care are aware of the specific needs of young carers. • Have information and support available/ accessible in digital formats that appeal to younger carers. • Demonstrate how young carers are involved in developing information, resources and support opportunities. 3.3 Measuring Impact We will demonstrate what good carer support looks like through governance and performance monitoring of the strategy, implementation plans and above anticipated outcomes. The carer service and its associated developments remain accountable to the IJB. Scheduled updates will be tabled through PSMT for continued oversight and direction with escalation to SWGB where required. Adjustments to the carer engagement model will also provide a robust measure of impact/ success. Carers Advisory Group will continue to assist whilst we move to a more inclusive and collaborative engagement model. Developments will be monitored through the voices, wisdom and experiences of our carers. North Ayrshire Carers Gateway also work with Evaluation Support Scotland who support organisations to measure, monitor and report on their impact for improvement. The appointment of an Administration & Evaluation Officer to the Gateway will also enhance the services ability to capture better, quality data to interrogate for service design and improvement. Quality assurance will further be measured through NAC quarterly contract monitoring and agreed KPI’s again linked to the anticipated outcomes.
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10 4. IMPLICATIONS 4.1 Financial 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 revised annual budget for 2023/24 currently is £1,185,623. Following the award of the contract the funding distribution is summarised below: Planned/ Proposed Annual Spend 23/ 24 £ Carer Service Contract (part year cost) 566,065 Staffing Carer Support Team (2 further posts are under SDS) 54,659 Light touch breaks for adult carers 100,000 Young Carers Wellbeing through Education 20,000 Young Carer KA Payment 28,784 Digital Resource (Carers UK) 2,500 Business Contingency for Emergent Needs 20,000 TOTAL SPEND 792,008 TOTAL BUDGET 1,185, 623 It is important to note there are other workstreams that relate to carer activity which have yet to be finalised but will impact on spend, for example work ongoing in relation to Self Directed Support. A conscious decision has also been taken to retain resources to allow capacity to respond to any emergent issues. 4.2 Human Resources Recruitment of the expanded service is underway and as previously stated people will be the bedrock for success of the service moving forward. HR requirements have been adhered to with the incumbent supplier Unity Enterprise matching necessary posts and offering internal opportunities. A recruitment consultant is guiding the process to upscale from 4.5FTE to 14FTE to find suitable quality candidates. External recruitment commenced week beginning 31/07/23. This process is in true partnership with a mixed Unity and HSCP recruitment panel. 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 in relation to possible carers ‘Rights to Breaks from Caring’. 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,
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11 relationships & social opportunities, finances, appropriate housing, ability to retain education or employment. It is also known that carers predominantly are female and in the mid – older stages of life. The strategy and plans for service growth contained in the report bring together a range of priorities, new approaches and better routes for information and support to ensure carers are equally recognised, informed and supported whilst trying to reduce any negative impacts caring may have on people’s lives. 4.5 Risk Board should note the risks if this work does not continue to be a key priority: • Carers will not be aware of their rights or how to access information and support at the right time on their caring journey. • More carers will not be identified, informed and supported resulting in carer roles/ relationship breakdown and carers experiencing further impact on their own physical and emotional wellbeing. • Carers and HSCP services will be further overwhelmed and experience increasing pressure, leading the carer into crisis and resulting in higher demand and cost for health and social care services. • Current messaging and approaches to carer identification and support through adult carer support plans are not sufficient. Opening the routes further through our strategic partner Unity Enterprise can support those carers who do not want to or need to be supported through the social work front door. • 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 should be a priority. (Moderate) 4.6 Community Wealth Building Community benefits are a contractual requirement within the reprovision of the carer service. The growing investment leads to an increase in the local workforce and supports available locally for carers with a shift to a locality approach to support. 4.7 Key Priorities For carers service expansion the primary areas for focus are under the following streams: • Continuity and monitoring of current carer service as the service grows • Phased Recruitment & HR responsibilities • Partnership mapping & establishment to promote the new service • Marketing of the rebranded ‘Gateway’ carer service • Digital developments, scoping the right resource and market testing • Property with possible colocation and establishing a new base • Financial planning and oversight
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12 For ‘Building Caring Communities’ 2023 – 2025, the strategy will be minimally adjusted and designed to allow for a soft launch with a special Carer Advisory Group mid- September 2023. Focus will then turn to fuller carer engagement to begin to explore, imagine, shape and realise medium term goals for carer information and support. The new strategy is fully in alignment with the IJBs Strategic Plan “Caring Together” ambitions. 5. CONSULTATION 5.1 As noted earlier the collective priorities and expansion plans within this update have been discussed and agreed through appropriate governance routes including Carers Advisory Group, PSMT, SWGB and with our strategic partner Unity Enterprise. Carer involvement and collaborative working is a key principle in all our ambitions for carers and we recognise they are equal and expert partners in caring. It is our priority moving forward with the renewed service and new medium – term strategy to ensure carers and those partners responsible for supporting carers are at the core of everything we design and deliver through the remodelled Carer Collaborative Network. There are also plans to host an inaugural North Ayrshire Carers Conference in line with celebrations in Carers Week – June 2024 inviting carers from across North Ayrshire localities to share information, insight, knowledge, ideas and routes for improvement for carer services. Lead: Scott Hunter, Chief Social Worker Prepared by - Kimberley Mroz, Manager – Professional Standards (SDS/ Carers), kmroz@north-ayrshire.gov.uk
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Priorities & Actions Building Caring Communities: Interim Carer Strategy for 2023 – 2025
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2 Version Control Document Version V4 Version date 21st July 2023 Document Controller Kerryanne Owens - Carers Development Officer Document Owner Caroline Cameron – Chief Officer North Ayrshire HSCP Latest Changes 21.07.23: Added Priority 6 & adjusted Content Page PSMT Approved Date: IJB Approved Date:
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3 Table of Contents FOREWORD ....................................................................................................................... 4 INTRODUCTION ................................................................................................................. 5 WHAT DO WE MEAN BY ‘CARER’ .................................................................................... 5 WHAT ARE YOUR RIGHTS AS A CARER ......................................................................... 6 NORTH AYRSHIRE CARING PROFILE ............................................................................. 7 NORTH AYRSHIRE CARERS INDEPENDENT ADVICE & SUPPORT SERVICE ............. 7 WHAT ARE OUR CARER PRIORITIES FOR DEVELOPMENT ......................................... 8 Priority 1: Carers are actively sought and identified. ....................................................... 9 Priority 2: Carers are informed, have increased confidence in their caring role and feel supported. ...................................................................................................................... 10 Priority 3: Carers are offered and supported to prepare an Adult Carer Support Plan or Young Carer Statement ................................................................................................. 11 Priority 4: Promoting variety in breaks from caring. ....................................................... 14 Priority 5: Carers feel involved as equal partners in care design/ delivery. ................... 16 Priority 6: Strong partnership working/ engagement ………………………………………17 Priority 7: Improved identification, information and support for Young Carers with a focus on transition periods through to adulthood. ................................................................... 18 WHAT WILL GOOD SUPPORT LOOK LIKE FOR CARERS ............................................ 20 APPENDICES ................................................................................................................... 21 ACTION PLAN .................................................................................................................. 24 Priority 1: Carers are actively sought and identified. ..................................................... 24 Priority 2: Carers are informed, have increased confidence in their caring role and feel supported. ...................................................................................................................... 24 Priority 3: Carers are offered and supported to prepare an Adult Carer Support Plan or Young Carer Statement. ................................................................................................ 24 Priority 4: Promoting variety in breaks from caring. ....................................................... 25 Priority 5: Carers feel involved as equal partners in care design/ delivery. ................... 25 Priority 6: Strong partnership working/ engagement. ..................................................... 25 Priority 7: Improved identification, information and support for Young Carers with a focus on transition periods through to adulthood. ................................................................... 26
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4 FOREWORD Welcome to Building Caring Communities: 2023 – 2025, an interim strategy for young and adult unpaid carers in North Ayrshire. This strategy is one of the North Ayrshire Health and Social Care Partnership’s priorities under the Carers (Scotland) Act 2016 (the Act), which extends and enhances the rights of unpaid carers. The strategy has been written with and is supported by North Ayrshire carers, strategic partner – Unity Gateway Carer Service and key stakeholders who want our aims and ambitions for carers to be clear with information and support offered to all carers, which includes those who are adults, parents, working, retired, young and at school or moving into adulthood. North Ayrshire Health and Social Care Partnership acknowledge and give thanks for the substantial contribution that unpaid carers make in caring for loved ones and friends’ health and wellbeing and recognise the value carers add throughout our communities. There are around 14,000 carers in North Ayrshire,1 yet many do not identify in their caring role and are not accessing key carer information and support. This strategy is in place to help reach more carers and provide vital information and links to support to be accessed at a time that is right for each individual carer and their circumstances. Our aim is that all North Ayrshire carers are identified, supported and valued and are afforded an opportunity to live, work, thrive and stay connected to their communities enjoying a life alongside caring, where they choose to continue to care. Our ambition is that all unpaid carers have their voices heard and ideas considered in the design and delivery of information and support services provided across North Ayrshire Health and Social Care Partnership. We understand that often caring roles are demanding and complex and we hope that this strategy offers support and guidance to carers when they need it most. We acknowledge the challenges that we currently face across Health and Social Care Partnership services and systems, but we also recognise that often means rising pressure for many carers. Carers are paramount to the wealth and sustainability of our communities and the health and social care system. This is why carers needs are of priority across North Ayrshire. 1 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjSherN4fT_Ah XizgIHHVYvC- EQFnoECCAQAQ&url=https%3A%2F%2Fwww.ons.gov.uk%2Ffile%3Furi%3D%2Fpeoplepopulationa ndcommunity%2Fpopulationandmigration%2Fpopulationestimates%2Fdatasets%2F2011censuskeyst atisticsandquickstatisticsforlocalauthoritiesintheunitedkingdompart1%2Fr21ukrttableqs301ukladv1_tc m77-330517.xls&usg=AOvVaw3e55wWR8PtTnPd2Rey95lR&opi=89978449
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5 INTRODUCTION Carers help their families and friends across our communities every day to live their lives. Carers and those they care for are at the heart of everything we do and deliver across North Ayrshire health and social care services. Through understanding and building on the strengths and experiences of carers, North Ayrshire Health and Social Care Partnership will continue to co-produce local information and support services which meet the needs of all carers to help make routes to information and support easier and quicker to achieve a better quality of life whilst caring. The Carers (Scotland) Act 2016 came into effect on April 1st, 2018. The duties therein extend and enhances the rights of carers to help improve wellbeing. It enables carers to continue to provide care to friends or family, if able and willing in good health. The Act works alongside other initiatives to support carers and the people they care for, including transforming primary care, reforming adult social care, and improving choice and control. In Scotland, there are an estimated 800,000 carers which includes 30,000 young carers under the age of 18 2. This accounts for almost 15% of the population. In North Ayrshire, the number of unpaid carers is estimated at 14,000 carers but not everyone recognises themselves in a caring role and are often not seeking the information and help available. Carers need time and support to look after their own health and wellbeing, achieve their educational, employment and life ambitions and ensure they stay connected to friends and communities alongside caring. This strategy details the priorities and actions North Ayrshire Health and Social Care Partnership will work towards to help carers realise their ambitions. WHAT DO WE MEAN BY ‘CARER’ Many people do not relate to the term ‘carer’. People often see the help and support they offer as the natural thing to do for family and friends. What becomes a caring role, they see simply as a natural extension of those relationships. The Carers (Scotland) Act 2016 recognises the importance of identifying and supporting caring roles and defines a carer as an individual who: • provides (or intends to provide) care for another person, and this refers to young and adult carers. • An adult carer is someone over the age of 18. • A young carer is someone under the age of 18 or has reached 18 and is still in school. 2 Unpaid carers - Social care - gov.scot (www.gov.scot)
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6 In North Ayrshire carers are defined as: • someone who looks after a family member or friend who needs support due to illness, disability, mental health, addiction issues or needs extra help as they grow older. It is not a caring role if this is only because of the person’s age (where they are under 18). This is parental duties unless the dependent child has additional care and support needs. It is not caring if care is being provided as voluntary work or under a contract of employment. There is also the exclusion of foster care due to the agreement in place and fees paid. Caring roles can vary, some may be for a short time whilst someone recovers from an illness, operation or injury, or it can be a part of everyday life due to a long-term condition, disability or diagnosis. A carer can provide care for one or more people, and they do not need to live in the same household or town. The help carers provide is also varied, it can be practical such as personal care i.e., washing or dressing, housework, finances, shopping, transport to appointments and picking up and administering medication. It can also be providing company and emotional support. For many carers there are positive and rewarding aspects but there are also lots of reasons why caring leaves carers needing support. WHAT ARE YOUR RIGHTS AS A CARER Many carers are unaware of their rights and miss out on information, practical, emotional and financial support available to them. The Carers Charter has been published by the Scottish Government and sets out the rights of adult and young carers. Those rights include: • Being offered or requesting an Adult Carer Support Plan or Young Carer Statement and receiving support to complete them. The plan or statement should also contain information on any emergency plans if the carer is not able or willing to care and/ or circumstances change. • Support based on any needs identified in the plan or statement which meet local eligibility criteria for carer support. NAHSCP publish North Ayrshire Carers Eligibility Criteria. • Support which may be in the form of a break from caring. NAHSCP publish North Ayrshire’s Short Breaks Statement which explains more. • Access to an information and advice service for carers. In North Ayrshire the local authority deliver services in partnership with Unity Gateway Carer Service. • Being involved in the planning of support for the person being cared-for at the point of hospital discharge. • Being involved in the planning of services for carers more generally, including the preparation of this local North Ayrshire Carers Interim Strategy.
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7 We want as many carers as possible across North Ayrshire to understand and realise their rights. For more information, please contact Unity Gateway Carer Service on 01294 311333 or email northayrshire.carers@unity-enterprise.com or visit Coalition of Carers in Scotland, Carers Trust Scotland, Carers UK or Care Information Scotland. NORTH AYRSHIRE CARING PROFILE Around 133,806 people currently live in North Ayrshire across 6 localities with an expectation that this will fall over the next 8 years. By 2030 it is expected that the population will fall to 129,987 with those 65 and over accounting for more than 27%. In addition, it is expected that the number of people over 75 will grow by 16%, from 14,546 in 2022 to approximately 16,905 by 2030, with those 65 to 74 increasing by 11% to 19,207. Currently, 27% of local people are known to have some form of long-term condition with it being recognised that the prevalence of people with a long-term condition increases by age. Just over 10% of the North Ayrshire population recognise they are carers according to the Scottish Census. 1,777 (1,543 adults & 234 young carers) carers were known and registered with Unity gateway Carer Service on 30th June 2023. This is a 16% increase from May 2022 and reflects progress based on the messaging of the carer services partnership. Predominantly referrals for carer registration come from self- referral, Education Services for young carers or acute settings - hospital discharge for adult carers. North Ayrshire Health & Social Care Partnership has delegated equal responsibility to North Ayrshire Education Services for young carer identification and offers of support. Across our primary and secondary schools 287 young carers under 18 years old were identified at June 2023. Some of those young carers in schools will be known to Unity Gateway Carer Service but not all as it is the young person’s choice to be recognised in their caring role. Similarly, those young carers identified by Unity Gateway Carer Service may not wish to be identified as a carer in school. It is imperative that all carers have multiple routes to identification enabling them to access information and support at the right time. These figures do not account for anyone living out with the local authority area but caring for someone who resides in our North Ayrshire communities. NORTH AYRSHIRE CARERS INDEPENDENT ADVICE & SUPPORT SERVICE North Ayrshire Health and Social Care Partnership recently retendered the information and support service for carers. Significant resource is being invested to seek a dynamic and creative strategic partner to help build and deliver an expanded outreach service for key advice, information and support for young and adult unpaid carers in all North Ayrshire localities.
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8 Unity the incumbent carer service was successful in the award with plans to expand the team more than threefold with more outreach and specialist roles to reach more carers and offer alternative supports. Alongside this positive growth they will continue to ensure continuity of carer services for a term of 3 years commencing 3rd July 2023. Due thought and diligence went in to considering the options available, risks, and best value implications but it was crucial to achieve the right result for North Ayrshire carers. Moving forward with Unity Gateway Carer Service the broad requirements for the delivery of the service are as follows: • Carers are actively sought and identified as we extend the reach of the service through outreach & community-based models. • Carers are informed, have increased confidence in their caring role and feel supported with carers knowing the service well and how to access it. • Carers are offered and supported to prepare an Adult Carer Support Plan or Young Carer Statement through expanding the routes threefold for carer access to assessment and support. • Promoting variety in breaks from caring with the expansion of wellbeing and short break support in preparation for the National Carer Service ‘right to breaks’ regulations. • Carers feel involved as equal partner in care design/ delivery with development of the carer collaborative/ network and hospital discharge as priorities for carer engagement and carer voices to be heard. • Stronger partnership working and engagement by establishing effective relationships to increase co-production with carers and key agencies to achieve continuous service improvement. • Improved identification, information and support for young carers with a focus on transition stages in particular into adulthood. An implementation plan has been set with the immediate establishment of a strategic project board. Initial areas for focus whilst ensuring continuity of carer services are: • Recruitment & HR • Partnership mapping & establishment of an expanded service • Consideration of colocation with partners • Digital developments • Marketing of the rebranded ‘Gateway’ carer service • Financial planning WHAT ARE OUR CARER PRIORITIES FOR DEVELOPMENT Priority areas and actions have been identified for growing young and adult carer services. North Ayrshire Health and Social Care Partnership will work closely with North Ayrshire carers, Unity Gateway Carer Service and other key partners to implement and improve information, systems and support.
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9 Priority 1: Carers are actively sought and identified. The question often asked in relation to carers is ‘how do you start to look for those that don’t know they need to be found?’ Carers are often referred to as ‘hidden’ and in North Ayrshire this includes carers in employment, parent carers, young adult carers, those caring for loved ones living with addiction or mental health. We would also include our minority communities such as BAME, LGBTQIA+, the travelling community at Redburn and those seeking refuge or asylum. The move to a community-based outreach service will be central to achieving this priority. An increase to the workforce both in the Health & Social Care Partnership and within Unity Gateway Carer Service means there are now 17.5 staff to develop and support the carers agenda. Carer staff will be more present and visible across all localities to seek out carers who are currently unreached or not engaging with the service. The team will consist of dedicated and knowledgeable specialists within each locality and across schools. They will engage with carers, build networks and use the strengths within our communities to help identify many more carers at the earliest possible opportunity, ensuring Information, signposting and support can be offered directly at a time and place that suits each carer. Innovative marketing, including a service rebrand, and a new digital portal will be established to make identification and registering for support easier. There are plans to include carer identification via GP practices across North Ayrshire. Specific strategies for reaching more young and young adult carers include working with both secondary and their feeder primary schools. This will allow us to support the youngest carers and ensure they are identified earlier. We will also work with local higher and further education establishments across the whole of Ayrshire (and beyond) to identify and support young adult carers. North Ayrshire Health and Social Care Partnership introduced the Carers Appreciation Card in 2016 to work towards ‘building a caring community’ where carers can use the card to be identified and recognised across the community, at hospital, in pharmacies or at school, to name a few. Over 970 carers have registered for their free card and over 30 North Ayrshire businesses recognise the value in caring and offer discounts and concessions for carers. Work already started within North Ayrshire Drugs & Alcohol Recovery Service and the Adult Learning Disability health and social care teams will continue. A programme of carer awareness and improvement will increase staff confidence and capacity to improve the level of carer interaction and identification with information and services offered equally to all carers. “I care for my elderly Father, and I am currently supported by the North Ayrshire Drug and Alcohol Recovery Service. My worker identified that I provide a caring role and
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10 reached out with the offer of an Adult Carers Support Plan. Through conversations it was identified that I would benefit from more support in the community to talk to other carers. I began to attend a local Carer Support Group and I have now gained the support I needed, I have been days out and feel I can also manage my caring role much better now. The support group has helped me manage my mental health and get out of the house more and I am thankful that I was able to be connected with them”. (Adult Carer) Priority 2: Carers are informed, have increased confidence in their caring role and feel supported. The aim is for North Ayrshire carers, professionals and partner agencies to know the Unity Gateway Carer Service as the first point of contact for carer information, advice and support when they need it. The service will: • Raise awareness of and support carers to understand their rights. • Develop and publish relevant local and national carer information, news, and updates on carer developments and support using a variety of appropriate digital/ non digital methods and accessible formats. • Build and maintain effective relationships with other partners to offer and supply co-ordinated carer information and support. • Signpost and support carers to navigate and access local and national health, social care, housing, benefits and grants, education and employment systems in the best way and at the right time. • Implement a workforce development programme for awareness and training and improving staff competence, confidence and capacity to improve the quality of information and service offered. • Implement systems and pathways for effective easy access and delivery of support. North Ayrshire Health and Social Care Partnership currently purchase the Carers UK Digital Resource for Carers. This is designed to bring together several digital products and online resources including e-learning, factsheets, guides and tools to help carers manage their caring responsibilities. It covers areas such as health and wellbeing, practical support with caring including short breaks, help with finances, and information on carers’ rights including rights at work. Access is also free for the care coordination app, Jointly to organise care. This resource helps provide 24/7 support and comprehensive guidance for carers. Find out more by visiting the Carers Digital website and creating an account using the following free access code: DGTL4110 A dedicated page: Support for Carers is available on the North Ayrshire Health and Social Care Partnership website. Unity Gateway Carer Service will introduce a new digital portal to replace the current resource. The portal will provide local and national information, advice and
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11 signposting tailored to meet each individual carer’s needs. The digital portal will be managed by a Marketing & Engagement Officer in the service, who will also deliver ongoing communication via monthly e-newsletters and social media. The digital platform will be available 24/7, and the team will be accessible via email, telephone, video call and online chat between 8am and 8pm, seven days a week. The service will develop a triage process operated by Locality Carer Support Officers. It will be more responsive ensuring that carers are quickly directed to the appropriate pathways and are guided towards the support that is relevant to them. Carers will also be offered flexibility in accessing the support in a manner and at a time that suits them. There will also be a focus on providing awareness and training for carers, both to aid their caring responsibilities and in other life skills as suggested by North Ayrshire carers. North Ayrshire Health and Social Care Partnership and North Ayrshire Council Education have worked in partnership to identify a key Young Carers Co-ordinator in every school across North Ayrshire. In partnership ‘Young Carer Statement’ workshops were delivered with the aim of raising awareness of young carers, promoting good conversations, how to offer and complete Young Carers Statements and recording of identified support needs. This workshop was also delivered to School Inclusion Workers along with a separate ‘Young Carer Awareness’ session. Between October 2022 and March 2023 young carers recorded on seemis increased by 50% and the number of young carers statements offered more than trebled in the reporting period 2022/ 2023 compared to the 2021/ 2022. All information, resources, toolkits and support are available on GLOW for Education staff. Young Carer Support Officers will deliver their programme of information and support to fit around the needs of young carers under the age of 18 years, whether that be within school or on evenings/ weekends. The Young Carer Support Officers work in line with the Team Around the Child (TAC) model to ensure a joined-up approach with other agencies with regards to the welfare of the young person. The multitude of ways in which carers can engage with the new partnership carer service will ensure a flexible, responsive and fully accessible service, which will be a key driver in building their confidence in caring roles and ensuring carers feel informed and supported. Priority 3: Carers are offered and supported to prepare an Adult Carer Support Plan or Young Carer Statement Until now all Adult Carer Support Plans were offered and prepared by North Ayrshire Health and Social Care Partnership Social Work staff. For the reporting year 2022/ 2023, Social Work staff have offered 449 Adult Carer Support Plans with 94 accepted and only 12% (56) of those offered following on to completion.
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12 In October 2022 capacity was added to the carer team with a Carer Support Officer to offer an alternative route to early and preventative carer support, more so for carers who were not already known to Social Work services or were aged 16 - 18 years and not in school. The introduction of this new role has seen the carer team offer retrospective support and funds to all 72 carers. 20 plans are completed, 1 in progress, 24 carers are no longer caring, 3 carers have been passed back to the appropriate service for follow up with the remainder declined, not responding or having moved out with North Ayrshire. There have been 29 referrals and 7 assessments completed through the new route since February 2023 for light touch support. This has been improved by a Self- referral form launched in carers week (5th - 11th June 2023) to all services, service access and commissioned carer services with release on social media platforms. These routes allow carers the opportunity to be involved in good and equal conversations to identify their personal goals and need for support, which if achieved, will enable the carer to provide or continue to provide care for someone. The route for young carers to be offered or request and prepare a Young Carer Statement is through both our Social Work teams and North Ayrshire Council Education. NAC Education staff report 183 Young Carer Statements offered with 167 accepted and completed in the year 2022/ 2023. Over three times more than in 2021/ 2022. From the young carer statements, it is noted 40% required a break away from their caring role, 34% needed emotional support meaning school staff being aware of caring roles, their anxieties and having someone to talk to. 23% requested practical support with homework, schoolwork or a place to study. And 24% did not need additional support through their carer conversation. Also 40% identified as having 2 or more (multiple) needs. 57 young carers and families are being contacted regards an agreed retrospective provision from reviewing Young Carer Statements completed in 2021/ 2022. 46 young carers are entitled to an offer of support and the remainder have left school or moved out of the area. 21 payments for support have been issued and 5 in progress. During preparation of a plan or statement, there is an opportunity to discuss the caring role and consider the impact caring has on several areas in a carer’s life, identifying any risk that may impact on the carer’s own health and wellbeing or ability to have a quality of life. To determine the level of support carers receive fairly and consistently North Ayrshire Health and Social Care Partnership are required to publish a framework for eligibility for adult carers based on national health and wellbeing outcomes and young carers based on GIRFEC indicators to access services. Every carer is entitled to information, advice and universal support. Our Integrated Joint Board agreed in June 2022 to extend the eligibility threshold to include those individuals with low and moderate need as per the Strategic Commissioning Plan – Caring Together 2022 – 2030 ambitions meaning lower levels of support will be
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13 provided for carers with a view to supporting carers at an early stage in the caring journey. Unity Gateway Carer Service will offer a third route for young and adult carers to flexibly be offered or request a carer conversation and access to support. It will be the equal responsibility of the Locality Carer Support Officers and Young Carer Support Officers to increase both the total volume of Support Plans/Statements, and the proportion of registered carers who do so. The benefits of completing Support Plans/Statements will be incorporated by the Marketing & Engagement Officer through marketing messaging and embedded as a key feature of the new digital portal. There are no set timescales for the offer or preparation of Adult Carer Support Plans or Young Carer Statements from identification. It is expected that all carers who want one should be able to benefit in an efficient and timely manner and ‘ought to be offered and prepared within reasonable timescales taking into account the urgency of need for support and any fluctuation in those needs’. Due to the urgency of supporting carers looking after someone who is terminally ill, the Act sets out time limits for preparing plans of support for these carers. Diagnosis of a terminal illness affects the person and their family or friends who support or intend to support them in very different ways. Carers in this situation often do not have time to think about and discuss their own needs or are ready to recognise their role of becoming a carer. Many carers are already known to North Ayrshire Health and Social Care Partnership services and can approach the team already involved with the person they care for. Alternatively, carers can contact their local area office Service Access Team as the route to all formal assessment and support. Carers may also ask for a referral from Hospital, GP, District Nurse, Carer Centre, hospice care or other sources through our local office Service Access Team. All carers of people who are terminally ill will be offered an adult carer support plan or young carer statement within 2 days of them being identified as a carer, if this is not possible, as soon as is practical thereafter, and as soon as the local authority becomes aware the person is caring for someone with a terminal illness. An initial carer conversation should then cover immediate or urgent outcomes and need for support and should be had within 5 working days of the carer accepting the offer to complete an adult carer support plan or young carer statement. Based on the substantive conversation a light touch adult carer support plan or young carer statement is completed. If the conversation takes place within 5 working days, then the adult carer support plan or young carer statement must be completed within 10 working days of the date when the carer originally requested or accepted the offer of the plan/ statement. If the conversation takes place at a later date, as requested by the carer, the adult carer support plan or young carer statement must be prepared within 10 ‘qualifying working days’ from the original request or acceptance. The timeframe is paused so
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14 that any working days between the delayed date and the conversation taking place are not counted as qualifying days and still allows for 10 working days. The light touch adult carer support plan or young carer statement addresses immediate and urgent carer need and support but may not cover all information required. The carer and North Ayrshire Health and Social Care Partnership appropriate team or Education staff will agree when the plan should be reviewed to include full carer information and a plan/ statement finalised with direction on when all identified carer needs will be met. It is expected that the review would be proportionate to the carer’s circumstances. Where there is a terminal illness diagnosis it may require more regular contact, communication and review of support provision. Priority 4: Promoting variety in breaks from caring. There are many terms used to describe breaks from caring, including respite, short breaks, relief or replacement care. Respite often refers to more traditional forms of building based or residential services which can be beneficial for many carers and families and indeed, have their place. North Ayrshire Health and Social Care Partnership offers day care, residential and nursing care home services. The idea of a short break, taken often, as a means of supporting carers helps sustain caring relationships, and for some is more acceptable to the carer and the people they care for. Short breaks focus on improving the quality of life for both the carer and the person they help, potentially including a break taken together. Short breaks align with the development of personalised approaches and options under the Social Care (Self-directed Support) (Scotland) Act 2013. A short break can mean different things to different people. A break from caring is … any form of support which can be taken in several ways to enable a carer to have time away from their caring routines and responsibilities. The purpose is for carers to have a life outside or alongside the caring role. The short break will support the carer and often the cared-for, the caring relationship and promote sustained or improved health & wellbeing. It can provide a change of scenery, improve carer confidence, increase ability to cope or succeed, reduce isolation, improve emotional wellbeing, improve general quality of life and increase the ability to sustain the caring role. North Ayrshire Health and Social Care Partnership have prepared and published a Short Breaks Services Statement along with local carers and the people they care for, the longstanding Carers Advisory Group, Unity Gateway Carer Service, as well as staff and other third sector partners. The Short Break Statement is to inform and advise young and adult carers, staff and the wider community of planned, short break (often referred to as respite) opportunities for carers who care for someone living in North Ayrshire. The
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15 Statement provides useful links and ideas, what is available regardless of level of support needed, and how to access a break from caring. Collaboratively the carer services will develop, resource and deliver a Short Breaks Bureau. This will include statutory and voluntary offers and will increase the choice and variety of carer breaks. The Bureau will offer advice and practical support to carers seeking and planning a short break from caring along with accessing funding for the cost of carer breaks, detailing any contribution or costs that may apply. Resource by way of a Wellbeing and Breaks Officer specialist role will strengthen the promotion and arranging of breaks from caring. ‘I provide care for elderly grandparents who have a number of medical conditions. I help with shopping, preparing meals, and doing housework. I recently applied for the ‘Time to Live Fund’ via the local Carers Centre. I volunteer at local stables and use this time as a break from my caring role. The fund allowed me to purchase the proper equipment for horse riding and I have now increased the number of days I volunteer which has had a positive impact on my health and wellbeing.’ (Adult Carer) A Short Breaks Bureau as defined by Shared Care Scotland is … “a single point of contact through which carers, and those requiring care, can be supported to access personalised, overnight, short breaks. The bureau helps to connect people with services that best meet their particular needs and situation. The bureau gives people the support they need to plan what they want and to organise it through the bureau or, if they prefer, through family and friends or advocate”. Unity Gateway Carer Services receive funding from the Scottish Government through Shared Care Scotland to distribute across North Ayrshire communities. Carers can access Better Breaks, Creative Breaks and Time to Live funding programmes. For the year 2023/ 24 Unity have been awarded £70k with the proposal to target certain carer groups and locality areas which do not normally access breaks. North Ayrshire Health and Social Care Partnership have initiated several routes recently to support young carers wellbeing and offer short breaks from caring. Young carers identified have been supported via the Young Carers Education Fund. The fund has been used to deliver a variety of creative breaks for young carers to enable them to take time out from their caring responsibilities. This has included overnight stays, family activities, days out, clothing for the gym and personal pieces of equipment such as goal posts, footballs and football boots, ice skates and paddle boards. ‘I bought a paddleboard which I love. I am now able to go out with friends and do something I enjoy and not have to think about caring.’ (Young carer, age 15)
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16 Carer partners along with KA Leisure have offered all registered young carers a one- year subscription to help support positive and active lives. This opportunity offers young carers the ability to access swimming, ice-skating, the gym and activities across all KA Leisure facilities for all ages. ‘I love being able to go ice-skating on a Friday night with my friends, it’s expensive but I don’t need to worry about missing out anymore as I have my KA Card.’ (Young carer, age 14) Carer partners along with Active Schools helped 19 young carers enjoy a free two- day residential trip where young carers enjoyed a variety of activities and the opportunity to make friends. Active Schools will continue to work with young carers to ensure their identified needs to remain active and healthy are met. ‘This was my first residential and I met new friends and had a great time’. (Young carer, age 10) It was good to get a break away from caring and spend time with my friends doing new activities. I did find it hard being away from home overnight, but I am proud of myself for doing it.’ (Young carer, age 11) For young carers aged 16 - 18 who are eligible and meet the criteria the Young Carers Grant offers a one of annual payment of £359.65. Young Scot offers a special bundle of treats available to all young carers who are aged 11 to 18 years old (inclusive) in Scotland - Young Carers Package. The Scottish Young Carers Festival takes place every year and provides a chance for young carers to have a break from their caring role, meet other young carers, take part in consultation and most importantly, have fun. Priority 5: Carers feel involved as equal partners in care design/ delivery. North Ayrshire Health and Social Care Partnership believe carers should be included and involved as much as possible in key decisions about their support and the support of their loved ones. We recognise carers feel heard, seen and empowered by having their views and feelings considered by others in relation to support planning and care decisions. North Ayrshire Health and Social Care Partnership use the Equal Partners in Care principles which set out the right for carers to play an equal and active role and are intended to ensure that workers in different settings have a shared understanding of how to work in partnership with all carers including young carers. We understand carers have a unique role in the life of the person they care for. Each carer and their own circumstances mean not all caring roles are the same, but all carers have valuable skills and knowledge to contribute to decisions for support. More often the carer is the expert in their loved one’s life. Encouraging this input
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17 from carers on key decisions at transition stages in life, on discharge from hospital, at the beginning of the support journey or when there are changes to care needs is key to true partnership working. Involvement of carers in the design and development of local services at strategic level through policy and practice developments, and with Unity Gateway Carer Service is equally important to ensure carer services in North Ayrshire are developed with carers for carers. The North Ayrshire Health and Social Care Partnership Integrated Joint Board (IJB) is the main decision-making body. A nominated Carer Representative has been part of the group membership for around 8 years along with the Carer Champion for over 10 years to widen the pool of views being represented locally for carers. The longstanding Carers Advisory Group has been active for 11 years and carers represent all localities, care groups and conditions. Moving forward the advisory group will expand to form a Carers Collaborative or network for carers, professionals, organisations or volunteers who have a shared aim of improving carer services. This will be established and led by the Carers Champion, Carer IJB Representative and Unity Gateway Carer Service. This approach gives carers a stronger voice in future service design and planning and encourages the principles of community engagement to be embedded more widely. To support this aspiration further Unity Gateway Carer Service will introduce an annual North Ayrshire Carers Conference. There are also carer involvement duties for NHS Ayrshire & Arran Health Board under 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 and supported by Health Improvement Scotland have made good progress over the past year as part of the intensive support to 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 into Unity Gateway Carer Service. The Carer Team will bring forward the learning from this approach for North Ayrshire Community Hospital settings. Priority 6: Strong partnership working/ engagement. North Ayrshire Health and Social Care Partnership seek and encourage effective relationships with carers, professional staff and partner agencies to achieve better outcomes and opportunities for carers as set out in this strategy. The carer service altogether will actively engage to support earlier carer identification through delivering core information about the role of carers and support available to them.
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18 Unity Gateway Carer Service will reach locality community groups both face to face and through strong digital, social media and virtual engagement to achieve greater presence, raise awareness, provide an important opportunity to network and enhance the ability to signpost carers to appropriate and new services. Unity Gateway Carer Service has a solid foundation and reputation. The service will be responsible for growing partnerships at a strategic level, establishing a North Ayrshire-wide framework that will then be activated by the Carer Support Officers/ Young Carer Support Officers in each locality. Carer staff will have autonomy to implement and expand these relationships locally to best meet the needs of carers in their area. North Ayrshire Health and Social Care Partnership seek and encourage effective relationships with carers, professional staff and partner agencies to achieve better outcomes and opportunities for carers as set out in this strategy. The carer service altogether will actively engage to support earlier carer identification through delivering core information about the role of carers and support available to them. Unity Gateway Carer Service will reach locality community groups both face to face and through strong digital, social media and virtual engagement to achieve greater presence, raise awareness, provide an important opportunity to network and enhance the ability to signpost carers to appropriate and new services. Unity Gateway Carer Service has a solid foundation and reputation. The service will be responsible for growing partnerships at a strategic level, establishing a North Ayrshire-wide framework that will then be activated by the Carer Support Officers/ Young Carer Support Officers in each locality. Carer staff will have autonomy to implement and expand these relationships locally to best meet the needs of carers in their area. Priority 7: Improved identification, information and support for Young Carers with a focus on transition periods through to adulthood. Carer rights, opportunities and developments laid out in the preceding sections of the strategy also apply to young carers. North Ayrshire Health and Social Care Partnership take a whole family approach and want to ensure that young carers are recognised and supported as early as possible and enabled to be children and young people first and foremost. This includes relieving them of any inappropriate caring roles to allow them to have a quality for life and a childhood like their peers. A Jargon Buster for Young Carers has been developed to help young carers understand some of the key points within the Act that matter to them most. Unity Gateway Carer Service currently supports 234 young carers across North Ayrshire. The expanded service will have a four-fold increase in the staff resource to support young and young adult carers, such is the importance being placed on supporting young people with caring responsibilities. Young Carer Support Workers
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19 will be split across North Ayrshire school clusters, with each worker being aligned to 3 secondary schools and the feeder primaries in these clusters. The impact from young caring responsibilities often can be reflected in school attendance, academic progress and opportunities, social or financial prospects and in some cases physical, emotional and mental wellbeing. The main area for focus is earlier identification of young carers to ensure support can be put in place when moving through primary to secondary school or onto further education or employment. There will be additional responsibility for young adult carers who are persistently hard to reach. Staff will build stronger partnerships with West College Scotland, the University of the West of Scotland and higher and further education establishments Scotland wide, all of whom receive young adult carers from North Ayrshire. North Ayrshire Council Education service have supported and delivered on the young carer agenda immensely. Young Carer Co-ordinators have been nominated in every school across North Ayrshire. In partnership, Young Carer Statement workshops were delivered in 2022 with the aim of raising awareness of young carers, promoting good conversations, equal offering and preparation of Young Carer Statements and recording of identified young carer support needs. The workshop and other sessions were also delivered to School Inclusion Workers. The result of the targeted work between October 2022 and March 2023 saw young carers identified increase by 50% and the number of young carers statements offered more than treble in the reporting period 2022/2023 compared to the 2021/2022. A Young Carers Statement begins with a conversation that helps young carers to think about their caring role and what is important to them in their life. This gives young carers the opportunity to think about their own health and wellbeing, what goals or aims they want to achieve, and it helps to find out what help young carers might need to do the things they enjoy when they are not caring (going to after school clubs, enjoying sports or hobbies or hanging out with friends). It helps professionals such as teachers, school nurses, social care services and Unity Gateway Carer Service to establish if young carers are carrying out caring tasks, they feel comfortable with and not helping with those that are inappropriate. The key points of the conversation along with identified needs and support are written down and this becomes the child/ young person’s Young Carer Statement. *** TRANSITION PLANNING FOR CARERS Transitions can mean any significant change in circumstances for young and adult carers or the people they care for. Life can be full of change, during which we transition or move from one stage to another. This can be an anxious or stressful, unknown time, so the correct information and support being available at the right time is crucial. Some examples of transitions for carers can include:
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20 • Moving from being a young carer to an adult carer • Changing or giving up employment • Changes to financial benefits • Declining health or a new diagnosis • Hospital admission or discharge • Moving from the family home to a care home Any change in circumstances for the people we care for may require a level of information, advice or extra support. The role of emergency and future planning is important to manage change well. *** Young carers should have a smooth transition pathway to support them entering different ages and stages of life more so from the age of 16 years to manage and prepare for changes to the caring role when they reach the age of 18 years and become adult carers. Changes in life/ education/ home/ work/ caring circumstances trigger specific advice and support. Some young carers also have their own health difficulties, disabilities or impairments. The ILF Transition Fund can help young disabled people, between the ages of 16 and 25, with transition after leaving school or children’s services to be more independent, more active and engage in their community and to build and maintain relationships with other people. WHAT WILL GOOD SUPPORT LOOK LIKE FOR CARERS North Ayrshire Health & Social Care Partnership will promote and provide consistency of information and support and create a culture of mutual respect and partnership with carers, cared-for persons, Unity Gateway Carer Service and partner services altogether. North Ayrshire Health & Social Care Partnership have adopted and expanded the Equal Partners in Care Principles which align with our responsibilities under the Act ensuring: • Carers are identified as early as possible across all communities. • Carers are supported and empowered to manage their caring role. • Carers are enabled to live fulfilled lives and have a quality of life alongside caring. • Carers have equal and easy access to good information, good conversations and support to enable them to maintain their own wellbeing. • 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 expert partners in care. North Ayrshire Health and Social care Partnership will move forward with the content of this strategy and associated action plan (see appendices) to ensure all carers in North Ayrshire can experience a good quality of life, sustain or improve their
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21 wellbeing and realise their goals by accessing information and support closer to home that enables them to continue caring where they wish to do so. We will demonstrate what good carer support looks through governance and performance monitoring of the action plan. The Carer Service and its associated developments remain accountable to the Integrated Joint Board (IJB) and North Ayrshire Council. Scheduled updates will be tabled at Partnership Senior Management Team meetings for continued oversight and direction with escalation to the Social Work Governance Board where required. Developments will be further monitored through the voices, wisdom and experiences of our carers. The extended Carer Collaborative will be more inclusive with the shared aim of real change for carers. Members will share information, insight, knowledge, ideas and routes for improvement as well as identify implementation gaps. Unity Gateway Carer Service will also have responsibility for greater engagement in partnership with the Carers Champions and create a programme of engagement with carers to ensure the Champions are able to represent the interests of local carers within their networks. These opportunities will form the key building blocks of our caring communities. Unity Gateway Carer Service also work with Evaluation Support Scotland who support organisations to measure, monitor and report on their impact. They have a proven track record of supporting third sector organisations to improve and enhance their existing processes for evaluation and impact monitoring. Unity have worked with ESS previously within other service areas with success in analysis and learning for improving quality of services. APPENDICES North Ayrshire National & Local Policy Context for Carers It is the intention of the Carers (Scotland) Act 2016 to ensure all carers are better supported on a more consistent basis so that they can continue to care, where willing, able and if they so wish, in good health and wellbeing, allowing them to have a life alongside caring. The overriding intention for young carers is that they should have a childhood like their non-carer peers by ensuring young carers are enabled to be children and young people first and foremost and relieved of any inappropriate caring roles to allow them to have a quality of life. The Act makes real this ambition by furthering the rights of both adult and young carers instructing North Ayrshire Council/ Health & Social Care Partnership to: • Actively identify unpaid carers. • Provide information and advice services to carers, which must be accessible and proportionate to the needs of carers who use these services. • Offer and complete Adult Carer Support Plans or Young Carer Statements to identify personal outcomes and need for support. As well as the provision of that support, which may include access to breaks from caring.
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22 • Set local eligibility criteria frameworks for all carers. In North Ayrshire it was agreed at IJB dated 16th June 2022 to amend the eligibility thresholds to include those individuals with low and moderate need for carer support. This extended the parameters of support to include early and effective support as per the Strategic Commissioning Plan (Caring Together 2022 – 2030) ambitions meaning lower levels of support are provided for carers with a view to supporting carers at an earlier stage and preventing the breakdown of carer relationship and support. • Involve and engage effectively with carers about their own potential support needs, that of the person(s) they care for, in general around service design and delivery as well as relating to hospital discharge processes. • Develop, implement and publish a Carer Strategy to detail plans for how carers are identified and how they receive information about local support in their area. A separate Carers’ Charter was also published by Scottish Government setting out the rights of carers as provided for under the Act. The National Carer Strategy in Scotland aims to support unpaid carers whilst recognising and valuing their contributions. It sets out a range of priorities and actions to ensure carers are supported fully in a joined up and cohesive way. The Act and National Strategy are a few of the directives that sit within the broader context of local and national policies and plans that guide carer developments and support in North Ayrshire. Others are: Caring Together Strategic Commissioning Plan 2022 - 2030 NAHSCP’s strategic vision from the commissioning plan ‘Caring Together’ 2022- 2030’ iis ‘People who live in North Ayrshire are able to have a safe, healthy and active life’. To help realise this NAHSCP have five strategic priority areas for action: • Engaging Communities • Prevention & Early Intervention • Improve Mental Health & Wellbeing • Tackling Inequalities, and • Bringing Services Together North Ayrshire Council Plan 2023 - 2028 North Ayrshire Council’s Plan is a contract with the communities and contains priorities for its residents. The vision of the plan is ‘A North Ayrshire that is fair for all’. The strategic aims of the plan focus on four areas which aspire to: • Transition to a wellbeing economy, delivering prosperity, wellbeing and resilience for local people. • Have active inclusive and resilient communities. • Achieve net-zero by 2030. • Be a community wealth building Council that is efficient and accessible, maximising investment and focusing resources on our priorities.
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23 Independent Review of Adult Social Care The review is a request to recommend improvements to adult social care support in Scotland. It proposes to: 1. Shift the paradigm or thinking. 2. Strengthen the foundations. 3. Redesign the system. For carers there are four specific recommendations (11 – 14) to improve involvement in planning and support and increase the recognition of carers and caring roles: 11. Carers need better, more consistent support to carry out their caring role well and to take a break from caring with regular access to quality respite provision. Carers should be given a right to respite with an amendment to the Carers Act as required, and a range of options for respite and short breaks should be developed. 12. A new National Care Service should prioritise improved information and advice for carers, and an improved complaints process. It should take a human rights based approach to the support of carers. 13. Local assessment of carers’ needs must, in common with assessment of the needs of people using social care support services and supports, better involve the person themselves in planning support. 14. Carers must be represented as full partners on the Integration Joint Boards and on the Board of the National Care Service. GIRFEC Principles Getting it Right for Every Child (GIRFEC) is a strengths-based approach and puts the interests and rights of the child at the heart of decision making for their wellbeing, attainments and development. The young carer eligibility criteria for North Ayrshire is based on GIRFEC’s wellbeing indicators – Safe, Health, Active, Nurtured, Achieving, Respected, Responsible, and Included. This promotes the preventative work and early intervention to support young carers to enable them to be children and young people first and foremost. The Promise Scotland The Promise aims to ensure that care experienced children and young people will grow up loved, safe and respected. Carer Positive North Ayrshire Council achieved Carer Positive Exemplary accreditation in March 2023. North Ayrshire Council aspires to be an employer of choice and are committed to valuing, supporting and retaining employees in the workplace who have caring responsibilities. Associated Legislation • Social Work (Scotland) Act 1968 • NHS Community Care Act 1990 • Adult Support and Protection (Scotland) Act 2017 • Mental Health (Care and Treatment) (Scotland) Act 2003
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24 • Adults with Incapacity (Scotland) Act 2000 • Children (Scotland) Act 1995 • Children and Social Work Act 2017 • The Social Care (Self Directed Support) (Scotland) Act 2012 • Public Bodies (Joint Working) (Scotland) Act 2014 • Community Care and Health (Scotland) Act 2022 • Equality Act 2010 ACTION PLAN Priority 1: Carers are actively sought and identified. Performance Indicators • Evidence an increase in the number of carers identified, registered and supported, year on year. • A proportion of the carers identified will be new young and adult carers who are not known to services or in receipt of carer support. • A proportion of new carers should be from diverse groups as noted in point iii above. • Satisfactory administration and reporting of carer referrals and registrations. Priority 2: Carers are informed, have increased confidence in their caring role and feel supported. Performance Indicators • Evidence that carers and partner agencies know where to go and have options on how to access good quality information and support closer to their home/ in their community. • Evidence of response times to carers from the first point of contact to information and support received. • Evidence that carers have understood, used and acted upon the information, advice and guidance to support their caring role. • Demonstrate service and partner agencies staff increased awareness/ knowledge. Priority 3: Carers are offered and supported to prepare an Adult Carer Support Plan or Young Carer Statement. Performance Indicators • Evidence that all carers identified through the service have been offered the opportunity to prepare an ACSP or YCS. • Reporting and recording to confirm ACSP and YCS accepted and declined with the reasons for decline and signposting to universal or alternative support.
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25 • Reporting and recording of information and support received and the personal carer outcomes met. • Reporting and recording of reviews of each ACSP and YCS completed, at least, within 12 months of the original assessment being completed. Any new identified carer needs at the point of review should be considered for the correct level of support. NB: Reporting of ACSP & YCS inform the statutory annual Scottish Government Carer Census return required to be submitted by Local Authorities and Carer Support Services. Priority 4: Promoting variety in breaks from caring. Performance Indicators • Evidence that all carers planning and receiving a short break have been offered an ACSP or YCS. • Evidence that funding payments are logged, recorded and reported appropriately within agreed, reasonable timeframes of making the payment/ purchase. • All funding payments will have an invoice or receipt for the purpose of audit. • Publish best practice examples of carer short breaks for young and adult carers, with permission of the carer/ recipient(s). • Carers report they have time for themselves and feel that they have a life outside caring (collected at review or survey). • Carers have an improved ability to manage and enjoy a changing relationship with the person they care for (collected at review or survey). • Carers report improved wellbeing (collected at review or survey). Priority 5: Carers feel involved as equal partners in care design/ delivery. Performance Indicators • Evidence of carers feeling they were involved, listened to and opinions valued - treated as equal and expert partners in care (collected at referral, review or survey or through the Carer Collaborative) • Engagement/ consultation activities reported 1/4ly under contract management. • Carers report improved confidence in their caring role and in their wider life circumstances (collected at review or survey). • Carers report having a greater say and control over the support and services they receive as well as those provided to those being cared-for (collected at referral, review or survey). Priority 6: Strong partnership working/ engagement. Performance Indicators • Demonstrate carers and professionals’ knowledge and skills are developed due to working in partnership with the service. • Develop and undertake outreach across the 6 localities of North Ayrshire. • Report attendance and learning at different networking sessions/ events/ groups annually.
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26 • Evidence an increase in carer referrals and registrations from all pathways including Social Care, Health and Education, third sector and independent providers. • Produce and publish a range of resources/ materials/ links for use by all professionals and agencies to improve the early identification, recognition of caring and delivery of communication and support available for carers. Priority 7: Improved identification, information and support for Young Carers with a focus on transition periods through to adulthood. Performance Indicators • Evidence the whole family have been considered in each young carers needs. • Demonstrate how young carers statements identify strengths, aspirations and support to overcome possible barriers created by caring. • Young carers know the service and what information and support is available in their community. • Strategic partners and universal services such as HSCP, education and primary/ acute care are aware of the specific needs of young carers. • Information and support are available/ accessible in digital formats. • Demonstrate how young carers are involved in developing information, resources and support opportunities. i Caring Together: NAHSCP Strategic Commissioning Plan 2022-2030