Carers (Scotland) Act 2016: implementation plan 2021-2023 (March 2021)

Context

Carers in Scotland^[1]

1 in 6 adults have unpaid caring responsibilities for someone with a longstanding illness or disability. Caring responsibilities affect many carers' physical and mental health. Nearly half of carers have long-term conditions themselves.

Many carers are looking after people with complex needs. There are more older carers and a higher number of carers looking after more than one person. The time individuals spend caring is also increasing. Almost half of carers in the most deprived areas care for 35 hours a week or more. This is almost double the level in the least deprived areas where 24% of carers care for 35 hours a week or more.

The number of carers in Scotland appears to have increased significantly as a result of the 2020 Covid 19 pandemic. The actual number of unpaid carers living in Scotland is not known but it was estimated that there were around 700,000 to 800,000 before the Covid-19 pandemic. Recent polling suggests that number could have since grown to over a million.^[2]

Rationale for carer support

Prevention is pivotal in supporting carers and the people that they care for. Intervention and support (including by providing information) at an early stage in a carer's journey can promote quality of life, independence and engagement with their communities and prevent deterioration in their situation – sustaining caring relationships.

The social, human rights and economic case for supporting carers can be summarised as follows:

1. Sustain carer in caring role including by having a life alongside caring

2. Reduce strain and stress on carer

3. Reduce likelihood of carer health problems and breakdown

4. (a) Better outcomes for carer(s)

4. (b) Better outcomes for cared-for person(s)

5. Reduce costs to NHS of meeting health needs

6. Reduce cost to local authorities of replacing care by carer with paid care

Scotland's National Health and Wellbeing Outcomes recognise the importance of supporting carers. These outcomes are set in legislation and provide a high level statement of what health and social care partners are seeking to achieve through integration and quality improvement across health and social care. National health and wellbeing outcome 6 states:

People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and well-being.

Carers (Scotland) Act 2016

The Act extends and enhances the rights of carers. The aim is to better support carers on a more consistent basis so that they can continue to care, if they so wish, in good health and to have a life alongside caring. In relation to young carers, the intention is similar to that for adult carers but also that young carers should have a childhood similar to their non-carer peers.

The Act gives all carers rights to an adult carer support plan or young carer statement to identify each carer's personal outcomes and needs for support. This reflects a general preventative approach, which also underpins the duty on local authorities to provide information and advice services to carers.

The Act also seeks to ensure more personalised delivery of carer support in order to improve wellbeing and deliver positive outcomes for carers. The Act requires local eligibility criteria to be set in each local authority area. These frameworks will help local authorities determine the level of support to provide to carers, based on their identified needs.

Carer involvement is a key principle of the Act. It is intended to recognise carers as equal partners in care, to empower them with more useful information about the support that may be available to them and to ensure that they can share their caring experiences and knowledge with those responsible for providing support or services. Carers should be involved in individual level decisions which affect them, including in hospital discharge processes. They should also be involved in strategic decision making, including in setting local eligibility criteria, in preparing local carer strategies and short breaks services statements and in planning carer services.

Wider context

Shared Principles

The Carers (Scotland) Act 2016 contributes to a wider effort to build a fairer Scotland and a strong, sustainable economy; tackle inequalities; deliver public services with communities; and build systems based on dignity and human rights. It is closely related to and is underpinned by the same principles as other public service reforms, notably integration of health and social care and reform of adult social care, which incorporates work to embed Self-directed Support.

Early intervention and prevention underpins the integration of health and social care and the effort to shift the balance of care from residential settings to support at home and in the community enabling people to be supported at home and in the community for longer.

Impacts beyond health and social care

Carers play a vital role in supporting the individuals they care for and, collectively, their support is vital to the sustainability of the health and social care system. Caring roles can affect many other aspects of carers' wellbeing including social and financial inclusion and the ability to participate in education and employment. Improved support for carers under the Carers Act can therefore improve outcomes beyond health and social care.

The consultation draft Carers Strategic Policy Statement set out the Scottish Government's priorities and the overall outcomes it is working to achieve for unpaid carers across all policy areas, including social security, fair work and social inclusion. Work on the CSPS is currently paused due to the pandemic.

Need for Social Care Reform

Carers are both partners in care and users of social care support. Demand for adult social care support continues to grow faster than traditional services were designed for. Reform is needed to ensure people have access to high quality, person-centred care and support when they need it. It's also important to attract and retain the right people to work in social care support and social work, and raise the status of social care as a profession. As part of the reform of adult social care programme, people who use social care support, carers, and the social care sector worked together with Scottish Government and COSLA to develop a shared vision of what adult social care will look like in future, and a set of priorities for making the changes required to achieve that.

COVID-19 Response and Recovery

The 2020 Covid-19 pandemic brought and continues to present unprecedented challenges which demand co-ordinated effort across Scottish society to respond and recover. The pandemic has highlighted both the vital role played by carers and the importance of social care in ensuring that the needs of some of Scotland's most at risk people are met.

Independent Review & Reform

On the 3 February 2021 the Independent Review of Adult Social Care published its report, making 53 recommendations for improvement of adult social care in order to provide better support for people who use adult social care support, their families, their carers and the workforce.

The report includes a chapter on carers and recommendations which affect the Carers Act. Many of the wider recommendations in the report are under further consideration. Alongside that consideration, the shared outcomes and actions in this plan can make an immediate contribution to delivering some of the recommendations, particularly recommendations 11 and 13. Recommendation 11 is for better and more consistent carer support and recommendation 13 is about better involvement of carers in planning support. Both of these recommendations are also aims of the Carers Act and will be supported by the actions set out in this plan.