It is now eight years since the launch of the landmark Care 21 Report5 which guided the Scottish Government's approach to supporting Scotland's carers. Many of the forward-thinking recommendations about carers as equal partners, training for health and social care staff and ensuring a focus on the health and wellbeing of carers were pursued.
Caring Together and Getting it Right for Young Carers
However, we had to take stock again as it was apparent that more needed to be done. In 2010 we published, with COSLA, a comprehensive Strategy for carers and young carers, Caring Together and Getting it Right for Young Carers6. This Strategy has a five year lifespan until 2015.
The Strategy has nine key strands which are important to supporting adult carers to be able to care in good health and to have a life outside of caring. These are:
- carers assessments;
- information and advice;
- health and wellbeing;
- support (including short breaks, advocacy, telecare and training);
- employment and skills and financial inclusion;
- equalities; and
- carers as equal partners.
There is a similar approach with regard to young carers although the emphasis is on maintaining a childhood.
The Scottish Government is encouraged by the progress which has been made over the last few years in supporting carers and young carers.
Local authorities, with partners, are implementing local carers strategies, many based on the key principles in the national Strategy. Using Carer Information Strategy funding of almost £29 million since 2008, Health Boards are working with partners to identify and support carers and young carers. The voluntary sector, including national organisations and smaller community-based bodies, is supporting carers and young carers in many different ways. The voluntary sector in particular has a strong emphasis on providing preventative support to sustain carers and to help avert crisis. Since its launch in 2010, the voluntary sector Short Breaks Fund of over £13 million has helped support over 15,000 carers, cared-for persons and young carers to enjoy flexible, person-centred and fun breaks.
In May of this year the Scottish Government with COSLA published a report on progress with implementing both Caring Together and Getting it Right for Young Carers7. This report illustrates progress with national initiatives as well as locally and provides some very good examples of local initiatives and developments.
There are also ten Manifesto commitments in support of carers and young carers. This includes the commitment that at least 20% of the Reshaping Care for Older People Programme Change Fund, or almost £50 million over three years to 2015, is dedicated to supporting carers of older people. The complete list of Manifesto commitments is attached.
There is a wide range of initiatives in other strategies and developments to support carers. These include Scotland's National Dementia Strategy8 , the Mental Health Strategy for Scotland,9 the Learning Disabilities Strategy, The Keys to Life - Improving Quality of Life for People with Learning Disabilities10 , The Scottish Strategy for Autism11 and See Hear: A Strategic Framework for Meeting the Needs of People with a Sensory Impairment12 which all have recommendations to support carers. Likewise, initiatives to support disabled children, people with many long-term conditions and at end-of-life all recognise the role of carers. Some of the initiatives in the strategies which support carers include:
- the guarantee that everyone diagnosed with dementia from April 2013 will receive a minimum of one year of dedicated post-diagnostic support. This will help carers of people with dementia to adjust to a diagnosis;
- increasing the involvement of carers and families in policy development and service delivery in relation to mental health; and
- improving the availability of short breaks for people with learning disabilities and their families and carers to provide opportunities to develop skills and confidence.
Social Care (Self-directed Support) (Scotland) Act 2013
The 2013 Act13 builds on the Self-directed Support Strategy14 to give individuals greater choice and control over their support. The aim is also to ensure that services and support become more flexible and responsive to people's needs. When the Act comes into force next year it will require councils to offer four choices to individuals on how they will get their social care. Moreover, the Act also gives a discretionary power to local authorities to provide support to adult carers following a carer's assessment and if the local authority decides that the carer has needs which could be met by the provision of support. Young carers too can also be provided with support by similar means.
The Scottish Government has also consulted on draft regulations to accompany the 2013 Act about the waiving of charges for support to carers15. We are considering the consultation responses before the regulations are laid before Parliament.
Public Bodies (Joint Working) (Scotland) Bill
The Public Bodies (Joint Working) (Scotland) Bill16 has been introduced into Parliament.
The Bill provides the framework which will support improvement of the quality and consistency of health and social care services through the integration of health and social care in Scotland. Ministers intend to use the framework to integrate adult health and social care services as a minimum, and for statutory partners to decide locally whether to include other functions in their integrated arrangements.
The policy ambition for integrating health and social care services is to improve the quality and consistency of services for patients, carers, service users and their families; to provide seamless, joined-up quality health and social care services in order to care for people in their homes or a homely setting where it is safe to do so; and to ensure resources are used effectively and efficiently to deliver services that meet the increasing number of people with longer term and often complex needs, many of whom are older.
Joined-up, seamless, high-quality, appropriate and consistent services for cared-for persons will help carers. This is because much of the effort and challenge for carers now is about them using up their valuable energy and time to make the joins themselves in order to ensure the best possible care for the people they are caring for.
The work on joint strategic commissioning plans encourages the full involvement of carers. The Bill will enable, through secondary legislation, the involvement of carers in all aspects of the integrated arrangements for health and social care.
Children and Young People (Scotland) Bill
The Children and Young People (Scotland) Bill17 is now being considered in Parliament. The aim of the Bill is to put children and young people at the heart of planning and delivery of services and to ensure that their rights are respected and upheld. Amongst other things the Bill aims to improve the way that services support children and families by promoting co-operation between services, with the child at the centre. This provides a legislative basis for Getting it Right for Every Child (GIRFEC).
The requirement for local authorities with Health Boards to prepare, implement and report on children's services plans; the named person service; and the requirement to produce a child's plan if the child has a wellbeing need, which can only be met by a targeted intervention, will benefit all children including disabled and sick children and their parent-carers. The provisions will also benefit young carers if they have a wellbeing need.
Manifesto Commitments 2011
Annual Carers Parliament: carers themselves are to have a more direct voice in the decision-making processes. The Carers Parliament will allow carers to raise the issues that impact most on their lives with MSPs and Scottish Government Ministers.
Employers Kitemark: create a new Caring for Carers Employers Kite-mark. This will recognise those employers who offer the best support to carers, allowing them the flexibility they often need to deliver care at home.
Energy Assistance Package: extend the EAP to people on carer's allowance.
Short breaks: continue to fund short breaks - provide £3 million over the next four years.
10,000 respite weeks: funding to maintain commitment to an extra 10,000 weeks respite provision per year.
Carer Information Strategies: will continue with £5 million investment each year in the CIS delivered through the NHS. This provides much needed support to local carer centres and training for carers.
20% Change Fund: want to see the third sector and carers play a key role as partners in the process given their important role in the lives of those cared for. To that end we will ensure that from 2012-13 onwards at least 20% of the Change Fund spend is dedicated to supporting carers to continue to care.
Carers as partners in the health service: will work to make sure that unpaid carers are treated as partners in the health service, the treatment for those cared for can and will be improved when the knowledge and experience of their carers is fully taken into account.
Education Maintenance Allowance: will work to ensure the EMA takes account of the needs of young carers, with more flexibility to recognise the particular pressures that some youngsters face balancing school and caring responsibilities.
Young carers in schools: will work to ensure that the particular circumstances of young carers are better recognised in our schools.
All of the commitments have been met or are in progress.
Email: Carers Policy