9. CARERS ASSESSMENTS (CARER SUPPORT PLANS)
The purpose of this chapter is to set out what the Scottish Government, local authorities and Health Boards need to do to improve the uptake and quality of carers assessments. These assessments can be called carer support plans, terminology which will enhance their accessibility to carers and reinforce the participatory and collaborative approach. All partners need to respond proactively to the concern that carers are often critical of their experience of professionals as assessors and gatekeepers to services. Carers want to have more control over the services developed and delivered to the person they care for, and over support for themselves.
9.1 Carers who provide substantial and regular care have a statutory right to assessment. 23 The strategy recognises that there needs to be improved uptake and delivery of quality assessments. In addition, those carers who are not eligible for a carer's assessment should, as far as possible, be provided with information, advice and pointers towards available community supports.
9.2 The Scottish Government, local authorities and Health Boards need to:
- Be proactive in ensuring that carers know about the right to request a carer's assessment and that up-to-date information on carers' support is available;
- Articulate and promote the value and benefits of a carer's assessment;
- Develop a wider understanding of the need for the carer's assessment, and its reach in considering all aspects of carers' lives;
- Increase access to carers' assessments and monitor the up-take;
- Ensure that there is an outcomes-based approach which does not shoehorn people into existing services if those services are not suitable; and
- Ensure that assessed needs are met and the impact and outcomes monitored.
9.3 Every person who is entitled to request an assessment of their ability to care, and who wants an assessment, should have a comprehensive assessment carried out quickly after requesting the assessment. The assessment should be reviewed systematically to take account of changing circumstances affecting the carer, cared-for person and other relevant people. The assessment should cover the need for emergency planning so carers have a plan to cover emergency situations. Those carrying out the assessment should be knowledgeable about the availability of supports to the carer and services for the cared-for and other relevant people. The carer should have a named person they can contact following on from the carer's assessment. Carers centres have a key role in promoting the assessment and in helping carers to make the most of the process.
9.4 The outcomes approach to community care seeks to embed user and carer experience at the heart of all community care services and support. One of its key principles is direct engagement with people using those services and their carers through the Talking Points approach to assessment, care planning and review.
9.5 The Scottish Government's review of Talking Points to date shows that many frontline practitioners are enthusiastic exponents of the approach. However, there is greater resistance amongst middle managers, who are concerned about raising carers' expectations, the time commitment required for the development of care plans, the need for continuous review of the care plans, lack of services to signpost carers on to and lack of resources. These are legitimate concerns.
9.6 Nevertheless, investing time in the carer's assessment will reap benefits. Those carrying out the carer's assessment and their managers need to be fully aware of the range of existing services in local areas and to have the ability to take forward personalised and flexible approaches to meet the needs of the carer. A staged approach to meeting the carer's needs might be appropriate, and if this is the case it should be fully explained to the carer, with the carer given the opportunity to comment.
9.7 There is guidance on the training and development of staff on the Scottish Government's Joint Improvement Team website at: http://www.jitscotland.org.uk/action-areas/talking-points-user-and-carer-involvement/staff-development-materials/
9.8 The previous Scottish Executive issued Guidance on Sections 8-12 of the Community Care and Health (Scotland) Act 2002 (Scottish Executive Circular CCD 2/2003). The guidance covered, amongst other issues, informing carers of their right to assessment and the assessment of carers. It is still relevant, but we could usefully complement it with practical guidance to undertaking carers' assessments.
9.9 Glasgow City Council has developed self-assessment for carers in partnership with a wide range of statutory and voluntary agencies. Edinburgh City Council has developed a new carers' assessment tool based on effective partnership working between the statutory and voluntary sectors. It is outcomes focused and meets the national minimum information standards. This is an electronic tool hosted on the single shared assessment platform, eAssess.
9.10 Those carrying out assessments and their managers must recognise that there are wider resources across a range of agencies, and the wider public sector, which can support carers following an assessment. With a wider focus, the assessment can lead to carers being signposted to services other than those traditionally within the remit of social services.
9.11 However, the assessment process also presents an opportunity to document where resources, supports or services are not available. Assessors could do this to assist with strategic planning. It would help to identify unmet need.
ACTION POINT 9.1
On an ongoing basis, in order to fully engage carers and deliver improved outcomes for carers, the Scottish Government will continue to promote and monitor the use of carer outcome evaluations through Talking Points.
ACTION POINT 9.2
On an ongoing basis, in order to improve the knowledge and skills of the social care and health workforce in undertaking carers' assessments, the Scottish Government, in partnership with local authorities, will continue to encourage and promote the further training and development of staff. (Also refer to chapter 14 on training).
ACTION POINT 9.3
In order to improve the carrying out of carers' assessments with the aim of delivering improved carer support, the Scottish Government will, by 2012, commission the production of practical guidance on the undertaking of carers' assessments. This will include guidance on how to conduct culturally competent assessments. This will be done in partnership with COSLA and NHS Scotland and will be informed by stakeholders and carers.
ACTION POINT 9.4
On an ongoing basis, local authorities will monitor the impact and outcomes of carers' assessments. If any resources, supports and services are not available to meet need, local authorities will use the carer assessment process (and other initiatives) to record what is currently unavailable. This will assist strategic planning with respect to carers' support.