Implications of the Care Act 2014 for Carers in Lincolnshire

Transcription

1 APPENDIX B Implications of the Care Act 2014 for Carers in Lincolnshire Presentation by Lincolnshire Carers and Young Carers Partnership to LCC Adult Scrutiny Committee 1 April 2015 Report Authors: Peta Hill, Barry Earnshaw and Clive Yates Page 19

2 Contents 1.0 Purpose Lincolnshire Carers and Young Carers Partnership (LCYCP) Care Act 2014 & Implications for Carers Engagement with Carers Assessment & Support Planning Support Services Charging & Financial Assessments Young Carers Adults Caring For Children Conclusion...4 NOTES...5 Note A - Assessments...5 Note B - Care Act Support Planning - Summary...5 Note C - Personal Budgets Summary...6 Note D Young Carers /Parent Carers...6 Carers Case Studies 6-9 Page 20 LCYCP/LCC Scrutiny Briefing 1 April Page 1 of 10

3 Implications of the Care Act 2014 for Carers in Lincolnshire LCC Adult Scrutiny Committee 1 April Purpose This is a summary briefing paper to promote debate and discussion relating to the impact of the Care Act on the unpaid Family Carers of Lincolnshire. According to the 2011 census Adult Carers, Parent Carers make up 79,000 plus Carers (in addition 6000 Young/Young Adult Carers) in Lincolnshire. Approximately 5,000 Carers are currently supported, a number of which have reported on issues raised as a result of their caring role: Social isolation Stigma Poor mental health Lack of knowledge of how to access services/support, often accessing these too late to avoid carer breakdown. (Note - If a Carer becomes ill or cannot cope with caring responsibilities any longer, resulting in carer breakdown and hospital admission; the related costs are approx per week PLUS the same or similar costs to support the cared for, whilst the carer is ill) 2.0 Lincolnshire Carers and Young Carers Partnership (LCYCP) Grant aided by LCC to raise awareness and promote carer engagement, and informs and influences the shaping of services. In reality this results in: Support for Carers in terms of referral to services Distribution of advice and information Acting as interpreters between Sectors and Carers Supports Carers and organisations to identify, (or self-identify) that they are providing a caring role Informs and influences future commissioning decisions 3.0 Care Act 2014 & Implications for Carers 3.1 Local Authority responsibility for overseeing Carers needs for support. Gives carers an equal right to an assessment, regardless of whether the person they are supporting receives services from LCC 3.2 Eligibility Criteria (See Note A attached) health at risk; unable to meet daily, hourly outcomes; impact on Carers Well-being. 3.3 Holistic approach to whole family caring, recognising the importance of networks of caring e.g. Freda looks after Bill, but Freda s daughter, Ann, supports Freda. Ann also may need support in order to ensure her Mum can carry on caring. 3.4 Promotes prevention and a good sense of wellbeing. Carers tell us that joining support groups, and having peer support makes a significant difference in coping with caring. The Care Act places a significant emphasis on the well-being of the carer. 3.5 Promotes the importance of advice and information. Carers tell us that they struggle to find WHERE to find information. They also report that they are often overwhelmed by their caring Page 21 LCYCP/LCC Scrutiny Briefing 1 April Page 2 of 10

4 role that responding to a leaflet is not a priority. They tell us they would like to be referred into services, not signposted. 3.6 Care Act promotes a diverse market, which will potentially give carers more choice, therefore enhancing their sense of wellbeing 3.7 Embeds personal budgets giving more choice and flexibility 4.0 Engagement with Carers 4.1 LCYCP hosted local forums inviting Carers, Partners, and Carer s Groups from other agencies. 4.2 Carers mixed responses on the Care Act, ranges from little/no knowledge or understanding to recognition of the Act and its implications. 4.3 Carers report a concern that their level of need goes unrecognised in many cases - example of Carers comments:- The Care Act won t make a difference to me Who will actually help us access support? 4.4 LCYCP mainstream work focusses on advice and information. Carers tell us that knowing where to find and how to access good quality advice is the most important factor that affects whether or not they can maintain their caring role. 5.0 Assessment & Support Planning 5.1 Assessment process considers how the person can be best supported. The Care Act emphasises the need to take a holistic approach to caring, recognising the importance of family-wide networks 5.2 Support plans set out how the Carers needs will be met, direct practical and emotional support for the Carers and replacement care to give the carer a break. The skill, knowledge and understanding of recognising and responding to the Carer s needs will impact on outcomes. 6.0 Support Services 6.1 This can include information and advice, access to systems; education, training & employment; practical and emotional support. The Wellbeing Service, Carers Breaks, Domiciliary Services, Residential Care, Circles/Networks of Support, Carers Groups, - Specialist support for people with Dementia, Learning Difficulties, Mental Health etc. Carers report that transition between services, at any age can be difficult. 6.1 Carers report that peer support networks are often more valuable than professional support, with knowledge of hints and tips enabling the carer to be better equipped to care. Carers report that good information and advice, and appropriate support, has the most impact during the first year of caring. 6.2 Carers report that retaining employment is often difficult - 1 in 5 carers gives up work to care full time. Businesses lose experienced staff, as most carers fall into the age range at the peak of their careers. The Care Act aims to ensure that carers are economically and socially independent, as this has an impact on wellbeing and reduces carer breakdown. Page 22 LCYCP/LCC Scrutiny Briefing 1 April Page 3 of 10

5 6.3 Work with NHS & Social Care to develop and deliver Carer Support services LCYCP are working with a number of surgeries in Lincolnshire to expand the RCGPs model of Carer Friendly surgeries, to include a Carers Register, good carer pathways and referral to appropriate support. The Care Act emphasises self-care management, but it is important to note that carers need to know how and where to access that support, before they can truly self-direct. 7.0 Charging & Financial Assessments 7.1 In most cases the Local Authority do not charge, for carer s services. The Care Act gives the Local Authority the discretion to charge for services. LCYCP has some anxiety about this because this could result in the very vulnerable carers not accessing much needed support. LCYCP will be facilitating some task and finish groups later in the year, to look at this issue, and will make recommendations for the future. 7.2 Local Authority would need to carry out financial assessments for each case. 7.3 Many carers who already self-fund do not have the advantage of being signposted to services by LCC and therefore do not know how to access low level support. The LCYCP Carers Charter will help support this process. 7.4 Income maximisation schemes will support carers if charging is introduced, BUT current schemes will need better support, AND these will need to better promoted. Personal Budgets 7.5 Carers may receive a personal budget as part of support plan, which includes the amount Carer will pay and the amount Local Authority pay. Currently, those carers receiving a Personal Budget report that this enables them to access respite opportunities that they may not otherwise do. The Care Act gives opportunities to change this. (See Note C). 8.0 Young Carers 8.1 The Care Act does not deal with assessment of people under 18 years old who care for others. 8.2 The Children & Families Act gives Young Carers similar rights to assessments as other Carers have with the Care Act. Summary at (See Note D attached). 9.0 Adults Caring For Children 9.1 Carers receive support from Children s Services, not from Adult Services but they can ask for assessment under the Care Act in advance of a child reaching 18 to support transition to Adult Care Services. 9.2 The ongoing S.E.N.D reforms present additional challenges, with a significant number of parent carers lacking in knowledge and skills of how to be included in educational decisions, or feeling disenfranchised. Page 23 LCYCP/LCC Scrutiny Briefing 1 April Page 4 of 10

6 10.0 Conclusion For the first time, carers will be recognised in the law in the same way as those they care for below is an extract of a comment from Dame Philippa Russell, Chair of Standing Commission on Carers. The Care Bill in many respects marks a quiet revolution in attitudes towards, and expectations, of carers. At last, carers will be given the same recognition, respect and parity of esteem with those they support. Historically, many carers have felt that their roles and their own well-being have been undervalued and under-supported. Now we have a once in a lifetime opportunity to be truly acknowledged and valued as expert partners in care. NOTES Note A - Assessments Local Authorities will have a responsibility to assess a carer s needs for support, where the carer appears to have such needs. (This replaces the existing law, which says that the carer must be providing a substantial amount of care on a regular basis in order to qualify for an assessment.) More carers will be able to have an assessment, comparable to the right of the people they care for. Local Authorities will be required to assess whether the carer has needs and what those needs may be. The Care Act considers the impact on the wellbeing of the carer. Assessments will consider the impact of caring on the carer and what the carer wants to achieve in their own day-to-day life. For some, providing 10 hours a week of extensive caring, has a greater impact that providing care for 25 hours a week Assessments must also consider other important issues, such as whether the carer is able or willing to carry on caring, whether they work or want to work, and whether they want to study or be more socially connected. If both the carer and the person they care for agree, a combined assessment of both their needs can be undertaken. Carer Act Eligibility Summary When the assessment is complete, the Local Authority must decide whether the Carer s needs are eligible for support from the Local Authority. In the case of Carers, eligibility depends on the Carer s situation. The Carer will be entitled to support if: they are assessed as having needs that meet the eligibility criteria; the person they care for lives in the Local Authority area (which means their established home is in that Local Authority area); Page 24 LCYCP/LCC Scrutiny Briefing 1 April Page 5 of 10

7 Note B - Care Act Support Planning - Summary The Local Authority and the Carer will agree a support plan, which sets out how the needs of the Carer will be met. This might include help with housework, buying a laptop to keep in touch with family and friends, or becoming a member of a gym so that the Carer can look after their own physical and mental health and wellbeing. It may be that the best way to meet a Carer s needs is to provide care and support directly to the person that they care for, for example, by providing replacement care to allow the Carer to take a break. It is possible to do this as long as the person needing care agree. Note C - Personal Budgets Summary Carers should receive a personal budget, which is a statement showing the cost of meeting their needs, as part of their support plan. It will include the amount the Carer will pay, if any, and the amount the Local Authority is going to pay. Carers have a right to request that the Local Authority meets some or all of such needs by giving them a direct payment, which will give them greater control over how their support is provided. Note D Young Carers /Parent Carers The Care Act relates mostly to adult carers people over 18 who are caring for another adult. Young carers (aged under 18) and adults who care for disabled children can be assessed and supported under children s legislation. The regulations under the Act allow for rules about looking at family circumstances when assessing an adult s need for care, and making sure that the position of a young carer within a family would not be overlooked. The Act makes new rules about working with young carers, or adult carers of disabled children, to plan an effective and timely move to adult care and support Page 25 LCYCP/LCC Scrutiny Briefing 1 April Page 6 of 10

8 Carers Case Studies November 2014 Adult Carer Annie has been caring for her husband for 14 years and has recently moved into the area and therefore has a limited social network, this has been compounded by the fact her caring role has increased. Annie attended an LCYCP Roadshow at Mablethorpe after hearing from her neighbour that there might be something useful there for her. When Annie came into the room she was very diffident, and through the skilled support of the LCYCP and appropriate encouragement of the LCYCP staff team Annie was persuaded to stay and participate. At the roadshow, the Director of Adult Care led the carer conversation. Annie needed permission to ask questions and had the confidence to respond to the encouragement by the LCYCP staff. By the end of the carer conversation session Annie said she had a lot more knowledge of how the Care Act would affect her and had been able to put her point of view across, even though at times it was at odds with what was being said. As a result of this first attendance Annie made a self-referral for a benefits check with Carers Connect and asked to be referred for a Carers Assessment. An additional benefit of that event was that Annie spoke to other carers in the room, and arranged to meet up with them socially subsequently. Following on from the Roadshow Annie had indicated that she did not want other carers to have the same experience as she did; no information, lack of access to services and becoming socially isolated. Annie was motivated to become involved with LCYCP to take on the role of a carer champion in her local community. Annie understands that the benefits of this are two fold; supporting other carers and through social contact and a sense of giving something back results in her feeling valued, recognised more confident. She is now engaged in her local community, has a sense of belonging resulting in an improvement in her emotional wellbeing. January Carer in Employment I care for my father who has dementia and my mother who is physically disabled. I work full-time. I live 20mins drive away from my parents. I am spending more and more time going round to make sure they have at least a cooked meal and that they are alright. My father used to care for my mother (he used to do all the cooking, but this has now stopped) and I can see that my mother does not want to worry me. This pressure is making me very anxious I am unable to give up work and I have young children. I am finding it increasingly frustrating that they will not ask for help. If they got home help it would make me feel less stressed as I do worry constantly and I am finding it difficult to juggle my life balance. I feel isolated and stuck. I can see this making me ill. Fortunately my partner is understanding, but how long will people put up with me worrying and jumpy every time my mobile rings. But I really cannot afford to have time off work. *An assessment under The Care Act approach would consider the impact that the caring role has on this young lady. Page 26 LCYCP/LCC Scrutiny Briefing 1 April Page 7 of 10

9 January Carer/ Volunteer KO is recovering from cancer treatment which resulted in her unable to work as a manager and trainer. She cannot leave the house due to a severe lack of confidence and depression. KO was looking for a volunteering activity to utilise her training, research and coaching skills and was attracted to the opportunity of supporting the LCYCP action based research project around the most efficient category of support to unpaid carers. Since KO first began volunteering she has reported that she now feels alive again. The impact that volunteering has had is that her confidence levels have increased, as has her self-worth and sense of purpose. Through attending the carers peer support and information research group KO now has an increased understanding of the issues surrounding carers, both physical and emotional. This means that KO is able to empathise with other carers she knows in her local community. KO also enriches the delivery of the group through her experience and skills with coaching. This coaching is empowering the carers to self-manage and as a group work towards solving issues that are as a result of their caring role. As a result of attending the volunteer induction KO feels fully informed and equipped to signpost carers to the appropriate support both for LCYCP and within her social network, increasing the impact of the support from LCYCP to a previously untapped audience. February 2015 Parent Carer EH is a parent carer attending the support group as a relatively new member. Following an LCYCP overview presentation he approached the facilitator to express his thanks for an informative presentation and went on to explain he and his partner had never thought of themselves as carers. The definition of carer was a poignant moment to EH who cares for his 9 year old child diagnosed with ASD. EH had not previously been clear about what support they could ask for, or expect since the recent NHS diagnosis. As parents they had not had the confidence to challenge their own GP nor had they been referred to any services by the GP. The presentation had provided EH with a renewed confidence as a Carer, who will subsequently approach the GP, and in the wake of the LCYCP GP Carer Aware initiative and forthcoming Care Act will ask to be flagged on the practice carers register and ask what information is available. Although on the 4ALL mailing list and just starting to attend meetings and conferences to make contact with support services, EH asked to be added to the LCYCP newsletter distribution list, and will follow up on a referral to the Carers Support Team February 2015 Adult Carer Retired & Undervalued I am an Adult Carer and I look after my wife. We are both retired. We do not get Carers Allowance now it was taken from us when we hit pension age. This has made me feel very under-valued as a Carer, and has an impact on my wellbeing. Page 27 LCYCP/LCC Scrutiny Briefing 1 April Page 8 of 10

10 The pension is an income, but now we are classed the same as any other person over 60 - Carers and non-carers. But I am still a Carer. I would like to be recognised as a Carer, just like I was before I was 60. I want to feel valued and financially informed at my age, and I do not feel either. I am also worried about not knowing enough. Forms are ridiculous it takes up too much time, which I do not have. The pressure of caring is great A Volunteers Perspective This is a summary of the impact that volunteering for the Lincolnshire Carers and Young Carers Partnership (LCYCP) has had on my life over the last three and a half months. I care for my son and my wife and stopped work due to the pressure of caring, the demanding nature of the work I was doing and suffering from depression. I have used the opportunity of volunteering for LCYCP to help reintroduce myself into the working environment and help discover the balance between home and work life. I have volunteered part time for the past three and a half months for up to three days a week. The work is office based, carrying out research, data analysis and writing reports, which suited my needs and working background. LCYCP have been very supportive and regularly ask for feedback on the work they have given me and have been flexible in how I deliver the work. Volunteering has helped me to develop a physical working routine which I have missed for a period of time. It has provided me with a broader purpose in life and enriched my understanding of caring, which is an area I had no formal background. This in itself is useful as it has helped me realise how the whole caring system operates within Lincolnshire. One unexpected benefit of volunteering is the altruistic nature of giving and not having any expectation of getting anything back in return. I can only describe it as giving a very warm, positive feeling. This is accentuated when you get praise for the work you have undertaken. This has helped to lift my depression. In addition, the social aspect of working is something I have missed greatly. It has been lovely to develop relationships again and talk to people on a regular basis. This also has had a positive impact on my depression. Whilst the volunteering for LCYCP has been very supportive, I have found this a challenge, coming from a working background where I have had to manage a very heavy workload where I have had to manage conflicting priorities myself, to having an organisation who is regularly assessing the workload and giving me enough to meet my needs at a particular time. It has made me realise that I need to be flexible in terms or how a particular business operate and their culture. Most of all the volunteering has improved my confidence of working and helped me make decisions of what I would like to do next in my life and most importantly determine the balance I need to have between work and home life. This has made me feel happier in the challenges I face next in developing my future career. The whole experience of volunteering has been very positive and enriched my life. Page 28 LCYCP/LCC Scrutiny Briefing 1 April Page 9 of 10