the carers strategy for scotland 2010 - 2015 - the moray council

26 July 2010

Caring Together The Carers Strategy for Scotland2010 - 2015

ii pp.i-iv

© Crown copyright 2010

ISBN: 978-0-7559-9713-8

The Scottish Government St Andrew’s House Edinburgh EH1 3DG

Produced for the Scottish Government by APS Group ScotlandDPPAS10110 (10/10)

Published by the Scottish Government, October, 2010

This document is also available on the Scottish Governments website: www.scotland.gov.uk

w w w . s c o t l a n d . g o v . u k

All photographs courtesy of the Princess Royal Trust for Carers. Photographs include two taken at Pollok Young Carers Storytelling project, 2010 and one of Amna & Avais.

Further copies of the Executive Summary are available, on request, in alternative formats. Please contact 0131 244 4040.

iii Caring Together

CONTENTSForeword 1-2

GuidetoDesignFeaturesinStrategy 3

Executive Summary 4-14

Chapter1 Action Points and Implementation 13

Chapter2 Introduction 15-30

Chapter3 Profile of Carers 31-35

Chapter4 Prioritising Support to Carers 36-38

Chapter5 EqualitiesEqualityGroupsCaringinRemoteandRuralAreas

39-43

Chapter6 Carers Rights 44-47

Chapter7Carer Involvement in Planning, Shaping and Delivery of Services and Support

48-51

Chapter8 Identification of Carers 52-56

Chapter9 Carers Assessments (Carer Support Plans) 57-60

Chapter10 Range and type of Support 61-65

Chapter11 Information and Advice 66-69

Chapter12 Carer Health and Wellbeing 70-75

Chapter13 Short Breaks 76-82

Chapter14TrainingCarer TrainingWorkforce Training

83–87

Chapter15 Housing and Housing Support 88–91

Chapter16Use of Assistive TechnologyTelecareEquipmentandAdaptations

92–96

Chapter17 Advocacy Support 97–99

Chapter18 Employment and Skills 100–102

Chapter19 Tackling Poverty: Financial Inclusion 103-106

Appendices

Appendix1Appendix2Appendix3Appendix4Appendix5

Appendix6

Appendix7

Appendix8Appendix9

Appendix10Appendix11

Carers Strategy Steering GroupCarers Reference GroupAction Points (consolidated list)ResourcesCare 21 Recommendations and Progress Since 2006Number of Carers by Local Authority AreaRural Transport – Scottish Government PoliciesPathway DiagramFuel Poverty – Energy Assistance PackageGlossary of Terms and DefinitionsReferences

107108109-118119120-131

132

133-135

136137

139-142143-148

iv pp.i-iv

1 Caring Together

ForewordTheScottishGovernmentandCOSLAaredeterminedtoensurethatcarersare

supportedtomanagetheircaringresponsibilitieswithconfidenceandingood

health,andtohavealifeoftheirownoutsideofcaring.

Wearepleasedtohaveworkedtogetherwitharangeofinterests,includingHealth

Boards,thenationalcarerorganisationsandcarersindevelopingthisstrategy.It

willbuildonthesupportalreadyinplaceandtakeforwardtherecommendationsof

thelandmarkreport,Care 21: The Future of Unpaid Care in Scotland.

WerecognisecarersasequalpartnersinthedeliveryofcareinScotlandandfully

acknowledgecarers’expertise,knowledgeandthequalityofcaretheygive.With

appropriatesupport,especiallysupportdeliveredearlytopreventcrisis,caringneed

nothaveanadverseimpactoncarers.

Caring Togethersetsout10keyactionstoimprovesupporttocarersoverthenextfive

years.Thefocusisonimprovedidentificationofcarers,assessment,informationand

advice,healthandwellbeing,carersupport,participationandpartnership.

Insupportofthisagenda,theScottishGovernmentispleasedtoannouncean

investmentofafurther£1millionin2010-11tovoluntarysectororganisationsto

providemoreinnovativeshortbreaksprovisioninScotland.

Thestrategysitswithinawidercontextandreformagenda,withcarersattheheart

ofthisagenda.Inordertoachievelastingchangebothforcarersandthepeople

theycarefor,weneedtodriveforwardarangeofpolicydevelopments,suchas

actiontotacklehealthinequalitiesandhouseholdincome.Weneedtodomoreto

shiftresourcesfrominstitutionalcaretocareathome,includingsupportforcarers.

TheReshapingCareforOlderPeopleStrategicDeliveryPlan,whichisinpreparation,

willarticulatetheextentoftheshiftinresourceswithinthesystem.

WearealsopleasedtohaveproducedGetting it Right for Young Carers,whichwe

believewillresultinbetteroutcomesforyoungcarers.Tothebestofourknowledge,

itisthefirstevernationalyoungcarers’strategyinEurope.

Werecognisethatmanyyoungpeoplecanbenefitfromprovidingcaretoarelative

orfriendaffectedbyillness,disabilityorsubstancemisuse.However,weare

committedtoensuringthatyoungcarersarerelievedofinappropriatecaringroles

andaresupportedtobechildrenandyoungpeoplefirstandforemost.

2 pp.1-12

Wearetakingimportantstepstoimproveyoungcareridentificationandsupport

withinschools,collegesandthehealthservice.Thestrategyalsoendorsesan

approachwhichorganisesservicesaroundthechildoryoungpersonsothatallthe

needsofthechildoryoungpersonwillbeidentifiedandaddressed,includingthe

impactofcaringontheirhealth,wellbeingandeducation.

Insupportofthisagenda,theScottishGovernmentispleasedtoannouncefunding

of£150,000forafourthYoungCarersFestivalin2011.Thiswillbringtogether

youngcarersfromalloverScotlandtosocialise,haveabreakfromcaringandlet

themmeetotheryoungcarers.Youngcarerswillbeabletotellnationalandlocal

decision-makerswhatdifferencethisstrategyismaking(ornot)totheirlivesone

yearonfrompublication.

ThereisanimportantpointrelevanttobothCaring TogetherandGetting it Right

for Young Carers.TheScottishGovernmentgaveHealthBoards£9millionforCarer

InformationStrategiesinthelastthreeyears,with£5millionofthisallocatedthis

year.UntiltheSpendingReviewisconcluded,theScottishGovernmentcannot

confirmtheresourceof£5millionfromApril2011onwards.However,weseethis

asapriorityforthatreview.Also,completionofsomeoftheotheractionsinthis

strategywilldependontheoutcomeofthereview.

WebelievethatCaringTogetherandGetting it Right for Young Carers representan

importantstepforwardincreatingaframeworkforaction.Together,andthrough

implementationofthisstrategyoverthenextfiveyears,wewillimprovethelivesof

carersandyoungcarers.

ShonaRobison,MSPMinister for Public Health and Sport

AdamIngram,MSPMinister for Children and Early YearsCouncillor

DouglasYatesCOSLA Spokesperson forHealth and Wellbeing

CouncillorIsabelHuttonCOSLA Spokesperson for Education, Children and Young People

3 Caring Together

This is a brief guide to the design features within this strategy:

ACTION POINTS

“Quotes from carers to illustrate points made.”

References to good practice – examples of good practice (and carers’ stories) are set out in separate document accompanying this strategy.

Points for emphasis, including useful information which does not form an Action Point because the action is already underway and is not new.

Young carers – reference to young carers within the carers part of the strategy.

Thetextornarrative.

4 pp.1-12

EXECUTIVE SUMMARYHeadline MessageCarersareequalpartnersintheplanninganddeliveryofcareandsupport.There

isastrongcasebasedonhumanrights,economic,efficiencyandqualityofcare

groundsforsupportingcarers.WithoutthevaluablecontributionofScotland’s

carers,thehealthandsocialcaresystemwouldnotbesustained.Activityshould

focusonidentifying,assessingandsupportingcarersinapersonalisedand

outcome-focusedwayandonaconsistentanduniformbasis.

The Government’s Headline ActionsThefollowingaretheheadlineactionsinthisstrategytohelpimproveoutcomesfor

carers:

1. Weacknowledgetheimmensecontributioncarersmaketosocietyand

theneedforappropriatesupport.We will develop a Carers Rights Charter,

consolidatingexistinglegalrightsandsettingoutkeyprinciplesforcarersupport

bothnowandinthefuture.

2. We will put in place measures to help professionals in the health and social care workforce identify carers.Careridentificationopensthedoortoa

carer’sassessmentandtotheprovisionofsupport.Therewillbeastrongemphasis

onworkforcetrainingasmembersoftheworkforcewhoare

‘carer-aware’haveabigroletoplay.

3. We will take steps to improve the uptake and quality of carers assessments/carer support plans.Thiswillbeachievedthroughworkforcetraining

andwidely-disseminatedguidanceaswellasbyinclusionoftheroleofassessments

intheforthcomingNHSinformcarersinformationzone.Carerscentreswillcontinue

theirvitalworkinsupportingthisprocess.

4. We will improve the provision of information and advice to carersthrough

variousmeansincludingworkforcetrainingandoursupportforNHSinform.

5. We will ensure carer representation on Community Health Partnerships. Carerswillbecentraltotheplanning,shapinganddeliveryofservicesforthe

peoplewithcareneedsandinrelationtosupportforthemselves.

5 Caring Together

6. Ascarerscansufferpoorhealthdirectlyasaresultofcaring,carerhealth

andwellbeingisvitallyimportant.We will produce a bespoke resource on issues relating to stress and caringtocomplementthesuccessfulSteps for Stress.We will continue to work with the Royal College of General Practitioners Scotland and the national carer organisations on carer identification and support,including

promotinggoodhealth.We will ensure that carers aged 40-64 have access to health checksunderplanstotargetgroupsofpeople,includingcarers,whomay

notliveinthemostdeprivedareas–thoseeligiblepeopleinthemostdeprived

areaswillalreadyhaveaccesstohealthchecksundertheKeepWellinitiative.

7. Carertrainingpromotescarerconfidenceandenablescarerstocarefor

longer.We will invest £281,000 in carer (and workforce) training this year through a grant to the national carer organisations.Wewillworkwith

NHSBoardstoensurea‘trainingoffer’maybemadetocarersingreatestneed,

contingentontheoutcomeofthenextSpendingReview.

8. Theprovisionofshortbreaksorrespiteishugelyimportanttocarers.We

willworkwitharangeofpartnerstopromotethefurtherdevelopmentofflexible,

personalisedshortbreaks.Localauthoritieswillcontinuetoprovide,andsupport

accessto,shortbreaks.We will invest a further £1 million in 2010-11 to provide more innovative short breaks provision in Scotland to be delivered by the voluntary sector.

9. Itisimportantforcarerstobeabletoremaininemployment,whenthey

wantto,ortotakeupemployment,learningortrainingopportunities.We will encourage and promote carer-friendly employment practices.SkillsDevelopment

Scotlandwillbeworkingwiththenationalcarerorganisationstohelppromote

learningandothercareeropportunities.

10.Thereisaclearneedforbetterstrategicplanningandcollaborativeworking

betweenhealthandsocialcareservicestoensurethedeliveryofco-ordinated

servicesandsupports.We will work to ensure this happens so that carers do not have to negotiate the boundaries of different health and care services.

Appendix 1setsoutthemembershipoftheCarersStrategySteeringGroupwhich

helpedinformstrategydevelopment.Appendix 2setsoutthemembershipofthe

CarersReferenceGroup,comprisingcarersfromdifferentpartsofScotlandandwith

differentcaringexperiences,whichalsohelpedinformstrategydevelopment.

6 pp.1-12

Chapter 1: Action Points and ImplementationChapter 1setsoutthearrangementsforimplementationofthisstrategy.The

consolidatedlistofActionPointsisatAppendix 3.

Chapter 2: IntroductionChapter 2setsoutthesharedvisionforunpaidcarers(carers)inScotlandwhere

carersarerecognisedandvaluedasequalpartnersincare;supportedtomanage

theircaringresponsibilities;fullyengagedintheplanninganddevelopmentof

services;andnotdisadvantagedordiscriminatedagainstbyvirtueofcaring.Weset

outanumberofkeyoutcomeslinkedtothevision.

Carersplayacrucialroleinthedeliveryofthehealthandsocialcaresystemin

Scotland.Thisrolewillbecomemoreimportantasaresultofdemographicand

socialchanges.Carersneedtobeattheheartofareformedhealthandsocialcare

systemwithashiftfromresidential,institutionalandcrisiscaretocommunitycare,

earlyinterventionandpreventativecare.Wemakeclearthatinmakingradical

changestothehealthandsocialcaresystem,carersshouldnotbeburdened,but

supportedandsustainedintheircaringrole.

Wesetouttheeconomicandefficiencyargumentsforsupportingcarers,whilst

recognisingthefundamentalhumanrightsandequalitiesperspective.Wemake

clearthatmuch more needs to be done to achieve practical support on a consistent and uniform basis and in a way which enables carers to have a quality life of their own outside of their caring responsibilities.

Appendix 4setsoutresourcescommittedbytheScottishGovernmenttodate

forsupporttocarers.Thereisafocusonthechallengingeconomicclimate.There

isalsoaclearstatementthatdespitetheextremepressuresonpublicfinances,

local authorities and Health Boards will commit to delivering incremental improvements to support for carers. This recognises that the demand on current statutory health and social care provision is unsustainable without changes in the pattern of service delivery.

ThischaptersetsouttheroleoftheScottishGovernment,COSLA,localauthorities,

HealthBoards,thenationalcarerorganisationsandotherpartnersindeliveringthe

strategy.

Wemakeclearthattherewillbeabaselinepositionagainstwhichtomeasure

progressoverthenext5years.

7 Caring Together

Weoutlineourcommitmenttopublish,atthesametimeasthisstrategy,good

practicetoshowtheinnovationoflocalauthorities,HealthBoards,theThirdSector

andprivatesector.Wearealsopublishingaselectionof‘carerstories’toshowthe

widerangeofcaringexperiences,bothpositiveandnegative.

WehighlighttheimportanceoftheCare21Report,whichcontained

22recommendationsinrelationtocarersandyoungcarers.Wesetoutprogress

sincethepublicationofCare21inAppendix 5.

Chapter 3: Profile of CarersChapter 3 summarisesarangeofdataonthecharacteristicsofcarers,including

age,gender,hoursspentcaringeachweek,whetherworkingornot,and

socio-economicbackground.Appendix 6setsoutthenumberofidentifiedcarersby

localauthorityarea.

WediscussthedifficultiesofcollectingdataonBlackandMinorityEthnic(BME)

carersandstatetheactioninhandtomakeprogressonthisfront.Wediscussthe

diversityofboththecarerandcared-forpopulation.We make clear that support for carers needs to take account of the dynamics of the caring situation and to be tailored accordingly. Weacknowledgethattherearegroupsofcarersweknow

littleabout,suchascarerswithdisabilities,gypsytravellersandrefugeesandthat

weshouldaddressthislackofknowledge.

Chapter 4: Prioritising Support to CarersChapter 4focusesontheneedforstatutoryandThirdSectororganisationsto

prioritisesupporttocarersingreatestneed,accordingtolocalpartnerships’own

definitionsofneed,basedonneedsassessmentwork.Somecaringsituationswillbe

morechallengingthanothersbutwherecaringresponsibilitiesareminimal,plans

shouldbeputinplacetoprepareforanyescalationinthedemandsonthecarer.

Anemphasisonpreventativeactionandearlyinterventionshouldbethedefault

positionratherthancrises-ledresponseswhichhappenafteranescalationofthe

problemsandissues.Smallpackagesofcost-effectivesupportdeliveredinatimely

wayareappropriate.

8 pp.1-12

Chapter 5: Equalities - Equality Groups - Caring in remote and rural areasInadditiontothemanyreferencestoequalitiesissuesthroughoutthestrategy,

Chapter 5focusesontheneedtofullyrecogniseandimplementinameaningful

way,andtofurthermainstream,equalitiesissues.Carersshouldnotbe

discriminatedagainstonthegroundsofage,ethnicity,gender,disability,sexual

orientationorreligion.Therefore,effortsneedtobemadetoidentifyandsupport

carerswhocansometimesbe‘hard-to-reach.’

Thischapterbuildsonthereferencesthroughoutthestrategytotheparticular

needsofcarersinremoteandruralareas,includingaccessibilityofservicesforthe

cared-forperson,thelackofeasy-to-reachrespiteprovision,theadditionalcostsof

caringinremoteandruralareas,difficultiesindeliveringcarertrainingandsoon.

WesetoutinAppendix 7thefullrangeofScottishGovernmentpoliciesdesigned

toimprovetransportationinremoteandruralareas.Wewillworkwithkeypartners

toidentifyinnovativesolutionstohelpaddresssomeoftheissues.

Chapter 6: Carers RightsChapter 6makesclearourintentiontodevelopaCarersRightsCharterwhichwill

consolidateinoneplaceexistingcarersrightsandsetoutkeyprinciplesforthe

future.SubjecttoaSelf-DirectedSupportBillbeingintroducedintoParliament,

andreceivingRoyalAssent,therewillbeafurtherlegalrightforcarerstoreceive

directpaymentsifvariouscriteriaaremet.WewillpromotetheEqualityAct2010.

WemakeclearthatthedeliveryofalltheActionPointsinthestrategyshoulddrive

forwardsupportforcarersoverthenext5years,andbeyond.

Chapter 7: Carer Involvement in Planning, Shaping and Delivering Services and SupportChapter 7makesclearthatservicesandsupportwillonlybeplannedanddelivered

effectivelyandefficientlyifcarerorganisationsandcarersarefullyinvolvedatall

stages.Sincecarerscomprehensivelyoutnumberthepaidworkforce,theyshould

haveacentralroleinplanning,shapinganddeliveringservicesandsupport.

TheScottishGovernmentwillensurecarerrepresentationonCommunityHealth

Partnerships(CHPs).ThereviewofPublicPartnershipForumswillinvolvecarer

representatives.TheHealthcareQualityStrategyforScotlandisalsoensuringcarer

involvementinimportantissuesregardingthequalityofhealthcareservices.There

shouldalsobecarerinvolvementinprocurementprocesses.

9 Caring Together

Chapter 8: Identification of CarersChapter 8 setsoutthemosteffectivewaystoidentifycarersandstressesthe

pivotalroleofpractitionersinthehealthandsocialcareprofessions,whoare

trainedincarers’issues.Carerself-identificationisalsoimportant.Identification

isthefirststeptohavingacarer’sassessmentandaccessingsupport–enabling

carerstobeidentifiedortoself-identifyisthereforecritical.Tothisend,wewill

continuetoworkwiththeRoyalCollegeofGeneralPractitionersScotlandand

thenationalcarerorganisations.NHSBoardsneedtocontinuetosupportcarer

identificationbeyond2011,whencurrentCarerInformationStrategyfunding

comestoanend.WewillworkwithAlcoholandDrugsPartnerships(ADPs)andthe

newScottishDrugsRecoveryConsortium(SDRC)tohelpidentifyandsupportcarers

ofpeoplewithaddictionsandsubstancemisuseproblems.Appendix 8 setsouta

carerpathwayfromidentificationthroughtosupport.

Chapter 9: Carers Assessments (Carer Support Plans)Chapter 9 setsouttherangeofactionstohelpimprovetheuptakeofcarers

assessments/carersupportplans,toenhancethequalityoftheassessmentsbeing

undertakenandtoprovidemoreandbettersupportfollowinganassessment.

TherewillbefurtherworktoensurethattheTalking Pointsapproachtothe

undertakingofassessmentsispursuedrigorously.Thereisanemphasisonthe

needforpractitionerstobefullytrainedinthecarryingoutofassessmentsand

toacquireknowledgeaboutservicesandsupportavailablelocally.Withtheright

focus,theassessmentshouldleadtocarersbeingsignpostedtoappropriate

support.Assessmentsmustberevisitedandreviewedtotakeaccountofchanging

circumstancesandmusttakeaccountofthewiderneedsofcarers.

Chapter 10: Types of SupportChapter 10isalinkchaptertothefollowingchapters,whichsetoutactionto

improvetheplanninganddeliveryofdifferenttypesofsupport.

Chapter 11: Information and AdviceChapter 11setsouttheimportanceofcarershavingaccesstoup-to-date,good

qualityinformationandadvicewhenevertheyneedit.TheCarersInformationZone,

tobelaunchedlaterbyNHSinform,willprovideusefulinformationandadvice

on-line.Informationandadvicewillalsocontinuetobeprovidedbycarerscentres,

HealthBoards,GPpractices,localauthorities,condition-specificorganisationsand

byothers.WewillscopethepotentialforaScotland-widecarershelpline,andthe

optionsforprovidingit.

10 pp.1-12

Chapter 12: Carer Health and WellbeingChapter 12focusesonthemental,emotionalandphysicalhealthofcarers.Early

identificationofcarersandtheprovisionofsupportisthekeytocarerhealthand

wellbeing.Carerscentresplayamajorroleinimprovingcarers’overallhealthand

wellbeing,asdootherorganisations.Wewillcommissionabespokeresourcefor

carers,buildingonCarersScotland’shealthguideforcarerstocomplementSteps

for Stress.WewantNHSBoards,CHPsandlocalauthoritiestoensurecarershave

accesstotrainingonmovingandhandling.Healthcheckswillbeprovidedto

eligiblecarers.Wewillpromotetocarersthehealthbenefitsoftheseasonalflu

vaccine.

Chapter 13: Short Breaks (Respite)Chapter 13 emphasisestheimportanceofprovidingflexible,personalisedshort

breaksprovisiontocarers.Innovativesolutionsarerequiredtohelpmeetdemand.

Suchsolutionscanfocuson,forexample,theuseofvolunteerstogivecarersa

break,buildingcommunitycapacity,ensuringmoreflexibleuseofandaccessto

universalprovisionsuchasplayschemesforchildrenwithdisabilities,morebeds

beingavailableincarehomesforrespiteinsuitablecircumstancesandincreasing

theuseofdirectpaymentstopurchasepersonalisedrespite.Wewillinvest

£1millionin2010-11toprovidecarerswithshortbreaks.

Chapter 14: Training - Carer training - Workforce trainingChapter 14 makesclearthatcarerswhoreceivetraining,iftheyneedit,feelbetter

supportedintheircaringrole,andmoreconfident.Whilstthereisagreatdealof

carertrainingbeingundertakenbyHealthBoards,nationalcarerorganisations,

localauthoritiesandothers,thisneedstobeconsolidatedandcarriedforward.The

granttheScottishGovernmenthasgiventotheNCOsin2010-11of£281,000will

beusedtoexpandcarer(andworkforce)training.TheNCOswillbuildonthegood

practiceintrainingpilotstheScottishGovernmentalsofunded–inLothian,with

BMEcommunitiesandinruralareas.NHSBoardsshouldcontinuetodelivercarer

training.SubjecttotheoutcomeoftheSpendingReview,wewillworkwith

NHSBoardssothattheymaymakeanofferoftrainingtocarersingreatestneed.

Workforcetrainingincarerawarenessandcarersupportisessential.A

well-informed,knowledgeable,trainedandskilledhealthandsocialcareworkforce

canhelpimprovethelivesofcarers.NHSEducationforScotland(NES),withNHS

BoardsandtheNCOs,willbuildoncurrentworkandidentifytrainingmaterials

11 Caring Together

tobeusedwithincoreinduction,educationandtrainingcurricula.NESwill

communicatetotherelevantregulatory,professionalandnationalbodiesthe

crucialimportanceofworkforcetraining.WewillworkwithNHSBoardstoensure

workforcetrainingiscarriedforward.WewillalsoworkwiththeScottishSocial

ServicesCouncil.

Chapter 15: Housing and Housing SupportChapter 15 acknowledgesthathousingisanimportantelementinenablingcarers

tosupportthepersontheycarefortoliveindependently,ifpossible,safelyand

withdignityintheirownhomesandcommunities.Housingmustbesuitablefor

changingneeds.UndertheReshapingCareprogramme,fivemainoutcomeshave

beenidentifiedforolderpeople’shousing.Weneedtodevelopmoreeffectivelinks

betweenhousing,socialcareandhealthpolicies,withcarerinvolvement,andwill

worktowardsachievingthis.

Chapter 16: Use of Assistive Technology - Telecare - Equipment and AdaptationsChapter 16 coversbothtelecareandequipmentandadaptations.Muchhasbeen

achievedoverthelastfewyearstoensuretheavailabilityoftelecarewhichbenefits

carerssignificantly,deliveringgoodoutcomes.Wewanttomaximisetheimpactof

telecareinvestmenttoensurethatthebenefitsandapplicationofnewtechnology

forcarerscontinuesanddevelops.

Werecognisethebenefitsofsuitableequipmentandtheneedforadaptations

tobecarriedoutefficientlyandwhenrequired.Thereisaneedtobuildonthe

existingworktoensurethatcarershaveappropriateinformationonequipmentand

adaptationsservicesandthattheyreceivetrainingontheuseofequipment.

Chapter 17: Advocacy SupportChapter 17 setsoutthebenefitsofadvocacysupporttocarers,especiallythose

whoarethemostvulnerable.Thereareonlythreecareradvocacyorganisationsin

Scotland.Giventhisscarcityofprovision,andtheoutcomesthatcanbeachieved

throughadvocacy,weurgelocalauthorities,NHSBoardsandotherlocalpartnersto

developorexpandcareradvocacyservicesforthoseingreatestneed.

Chapter 18: Employment and SkillsChapter 18 isclearthatpeopleshouldnothavetogiveupworktocareandshould

notfinddifficultyaccessingwork.Carersshouldbesupportedinemployment

12 pp.1-12

throughcarer-friendlypoliciesandpractices.Workprovidescarerswithasense

ofnormality,alifeoutsideofcaringandisthekeytoaddressingcarerpoverty,

includingmaintainingpensionrights.Withchangingdemographics,manycarers

whowanttoworkshouldbehelpedtodoso,astherewillbeashrinking

working-agepopulation.Wewillencourageandpromotecarer-friendlyemployment

practicesandSkillsDevelopmentScotlandwillhelpcarersintotrainingand

employment.Carersshouldalsobesupportedtoenjoylifelonglearning

opportunitiestoimprovetheirownwellbeing.

Chapter 19: Tackling Poverty: Financial InclusionChapter 19focuses onthefinancialconsequencesofcaring,thelowtake-upof

benefitsbycarersandserviceusers,fuelpovertyandlocalauthoritycharging

policiesforservicesandsupport.Appendix 9setsoutthefuelpovertyenergy

assistancepackage.

Increasingly,CommunityPlanningPartnershipsareenhancingmainstreamservices

whichaddressincomemaximisation,debtadviceandfinancialcapability.Carers

centres,nationalcarersorganisationsandothersprovideadviceonbenefitsand

incomemaximisation.WherevoluntaryservicesarelocatedinGPpracticesto

adviseandsupportcarers,therehasbeenatake-upinbenefitsbycarers.

WewillpursuewiththenewUKGovernmenttheleveloftheCarer’sAllowance

andareviewoffinancialsupporttocarers.COSLAalsoprovidesguidancetolocal

authoritiesonchargingpoliciesandisdevelopingabenchmarkingfacilityto

facilitateconsistentapproachesinthisregard.

Chapter5Carers’Rights

Chapter1ActionPointsandImplementation

14 Chapter1 pp.13-14

1.1 TheScottishGovernmentandCOSLAintendtoensurethattheActionPoints

inthisstrategyaretakenforwardandwillkeepthestrategyunderreviewtobeable

torespondquicklytonewpolicy,fiscalandresourcedevelopments.Wewillformally

reviewthisfive-yearstrategybyAugust2013.Wewillscopeoutthenatureofthis

reviewlater.

1.2 TheconsolidatedlistofActionPointsissetoutinAppendix 3.Adetailed

ImplementationPlanwillbefurtherdevelopedoverthecomingmonths.

1.3 TheScottishGovernmentintendstoestablishanImplementationand

MonitoringGroupcomprisingarangeofstakeholderstooverseeimplementationof

thestrategy.ThisGroupwillreporttotheScottishGovernmentandCOSLAHealth

andCommunityCareDeliveryGroup.Therewillbeafurtherlineofaccountability

totheMinisterialStrategicGrouponHealthandCommunityCare.Therewillbe

different(butlinked)arrangementsinrelationtoimplementationoftheyoung

carerspartofthestrategyassetoutinthatpart.

ACTION POINT 1.1The Scottish Government, with COSLA, will keep this strategy under review. An Implementation and Monitoring Group will report annually on progress, with the first report being undertaken by August 2011. A formal review will be concluded by August 2013. As part of the review the Scottish Government, with COSLA, and informed by the views of stakeholders, including carers, will decide whether new or revised Actions would be appropriate.

Chapter5Carers’RightsChapter2Introduction


2. INTRODUCTION

Terminology2.1 Arangeoftermsisusedtodescribeapersonwhocaresforanotherincluding:

‘unpaidcarer,’‘carer,’‘familycarer’and‘informalcarer.’Allpartnersinvolvedinthe

developmentofthisstrategyprefertousetheterm‘unpaidcarer’or‘carer.’Inthis

strategyweabbreviate‘unpaidcarer’to‘carer,’asdomanyorganisationsandcarers

themselves.Itisimportantthatcarersarenotconfusedwithpaidworkers,whoare

sometimesincorrectlycalledcarerstoo:paidworkersarecareworkers.

2.2 Equally,carersarenotvolunteers.Theremaywellbevolunteerssupporting

thecared-forpersonand/orthecarer,buttheyarenotthecarer.

What carers do2.3 Carersprovidecaretofamilymembers,otherrelatives,partners,friendsand

neighboursofanyageaffectedbyphysicalormentalillness(oftenlong-term),

disability,frailtyorsubstancemisuse.Sometimesthecared-forpersonwillhave

morethanonecondition.Somecarerscareintensivelyorarelife-longcarers.Others

careforshorterperiods.Thecarerdoesnotneedtobelivingwiththecared-for

persontobeacarer.Anybodycanbecomeacareratanytime,sometimesformore

thanoneperson.Carersarenow,andwillremain,fundamentaltostrongfamilies

andpartnershipsandtoresilientandcohesivecommunities.The lives of carers and the cared-for are closely intertwined, but they are not the same.

Who this strategy is for2.4 Thisstrategywillbeofinteresttothosewhocanimprovethelivesofcarers,

inpartnershipwithcarers,andwhocaninfluencethesupportprovidedtocarers.It

isfordecision-makers,managersandpractitioners,especiallyinlocalauthorities,

HealthBoards,theNHS,CommunityPlanningPartnerships,CommunityHealth

Partnershipsandinallstatutoryagenciesinvolvedinsupportingcarers.

2.5 ThestrategywillinteresttheNationalandLocalCarerOrganisations,

condition-specificorganisationsandothersintheThirdSector.

17 Carers Rights

2.6 Thosewhosupportmainlyyoung carerswillbeinterestedinCaring

Together.Althoughthereareimportantdistinctionstobedrawnbetweenyoung

carersandcarers,therearesimilaritiesinthecaringexperiences.Therearealso

importanttransitionissues,especiallywithregardtosupportforolder young carers

aged over 18.

2.7 ThestrategywillalsobeofinteresttounpaidcarersinScotland.Wedo

notneedtochangecarers’heartsandmindsbecausetheyareacutelyawareof

whatcaringmeans.However,wedoneedtochangehowservicesandsupportare

plannedanddeliveredandtakeforwardactionwhichwillbenefitcarersnowandin

thefuture.Thisstrategy,togetherwithotherpolicies,willseektoachievethis.

“I am actually quite proud to be a carer. It’s not something I would have

chosen to do but my philosophy has always been, if you are going to do

something, do it well.”

Paul,whoisacarerforhiswifewithMSandforhisdaughterwithcerebralpalsy.

Vision into Action2.8 Toadvancethisstrategyandtobuildonandimprovesupporttocarers,itis

necessarytoarticulateaclearvisionofthefutureforcarers.

2.9 Manycarerssaythatitisaprivilegetocareforaloved-oneandthatcaring

bringsrewardsandagreatdealofsatisfaction.However,beingacarermeans

thataloved-one,friendorneighbourisillorfrailorhasadisabilityorasubstance

misuseproblem.Thiscanhaveasignificantimpactoncarers’lives.Sometimes

carerslookafterfamilymembersandothersinverydifficultandchallenging

circumstances,andbecausetheyfeelobligedratherthanbecauseitiswhatthey

wanttodo.StatutoryandThirdSectoragenciesprovidingservicestothecared-for

personshouldneverassumethatpeoplewantorchoosetobecarersandshould

alsonotmakeassumptionsaboutthetimecommitmentpeoplehaveforcaring.

2.10 Carers,whatevertheircircumstances,shouldenjoythesameopportunities

inlifeasotherpeoplewithoutcaringresponsibilitiesandshouldbeabletoachieve

theirfullpotentialascitizens.


2.11 Oursharedvisionisasocietyinwhich:

• carers are recognised and valued as equal partners in care; • carers are supported and empowered to manage their caring

responsibilities with confidence and in good health and to have a life of their own outside of caring;

• carers are fully engaged as participants in the planning and development of their own personalised, high-quality, flexible support and are not shoe-horned into unsuitable support. The same principle applies to carers’ involvement in the services provided to the people they care for; and

• carers are not disadvantaged, or discriminated against, by virtue of being a carer.

2.12 Thevisionisunderpinnedbythemutualhealthandsocialcareapproach.

InitsbroadestsensethismeansaninclusiveScottishsocietyinwhichcarersare

reaffirmedaspartnersandarenotpassiverecipientsofhealth,careandother

supportservices.Theknowledgeandskillsofcarersneedtobeharnessedtomake

decisionsabouttheshapeandstructureofservices.

Outcomes2.13 Thisstrategywillseektoachieveandsustainanumberofkeyoutcomes.

Carers will:

• have improved emotional and physical wellbeing; • have increased confidence in managing the caring role; • have the ability to combine caring responsibilities with work, social,

leisure and learning opportunities and retain a life outside of caring; • not experience disadvantage or discrimination, including financial

hardship, as a result of caring; and • be involved in planning and shaping the services required for the service

user and the support for themselves.

2.14 Theparticularneedsofcertaingroupsofcarers,forexample,carerswhoare

older,BlackandMinorityEthnic(BME)orLesbian,Gay,BisexualandTransgender

(LGBT),andcarerswithdisabilities,willberecognisedandsupported.

2.15 Goodoutcomesforcarersaredependentonanumberofotherfactors

including,crucially,theprovision of good quality services for the person they are caring for.

19 Carers Rights

2.16 ThecareroutcomesabovearedirectlylinkedtotheGovernment’sNational

Outcomes,inparticular:

• we live longer, healthier lives; • we realise our full economic potential and more and better employment

opportunities for our people; • we have tackled the significant inequalities in Scottish society; and • our public services are high quality, continually improving, efficient and

responsive to local people’s needs.

2.17 Keydriversforchangeincludetacklinghealthinequalities,improving

people’smentalhealth,maximisinghouseholdincomeandpromotingemployment

andlifelonglearningopportunities.

Key role of carers: now2.18 Carersplayacrucialroleinthedeliveryofhealthandsocialcareprovision

inScotland.Theidentified657,3001carersinScotland–1in8ofthepopulation-

areanessentialpartoftheworkforce,initsbroadestsense,contributingsavingsto

healthandsocialcareservicesinScotlandofanestimated£7.68billion2everyyear.

“We are a good thing, a fundamental building block of society, and through our

efforts we save the public purse billions of pounds.”

Paul,whoalsoprovidedthefirstquote.

2.19 Carers,asequalpartnersinthedeliveryofcare,enablepeoplewith

illnessesordisabilitiestoremainathomeandintheirowncommunitiessafely,

independentlyandwithdignity.Carerscan,forexample,preventavoidablehospital

admissionsandcontributetopeople’soverallhealthandwellbeing.

Key role of carers: future2.20 Carers’roleandcontributionwillbecriticalinthefutureduetodemographic

andsocialchanges:

• Scotland’s65+populationisprojectedtoriseby21%between2006and

2016andby62%by2031;and

• forthe85+agegroup,a38%riseisprojectedby2016andby2031the

increaseisaprojected144%.

1 http://www.scotland.gov.uk/Topics/Statistics/16002/SurveyDetails2 http://www.sociology.leeds.ac.uk/assets/files/research/circle/valuing-carers.pdf


2.21 By2031therewillbelargernumbersofveryoldpeopleanda

proportionatelysmaller,youngerworkingandtax-payingpopulation.Thisisa

successstoryintermsofhealthandwellbeing,butitcarrieshugeimplicationsfor

thefutureofcareinScotland.Therewillbeanadditional25%demandforhealth

andsocialcareservicesby2031.

2.22 Therewillbemorepeoplelivingalone–anestimated400,000by2031.

Moreolderpeoplewillalsobelivinginremoteandruralareas.

2.23 Olderpeopleprovidefarmorecarethantheyreceiveandareamajor

strengthandresource,contributingmuchtosociety.Withtheageingpopulation,

thenumberofcarersisexpectedtogrowtoanestimated1million3by2037.Three

outoffivepeopleinScotlandwillbecomecarersatsomepointintheirlives.Some

oldercarersmayrequiremoresupportintheirownright.Society as a whole will become even more dependent on carers’ vital contribution to health and social care delivery. Carers are at the heart of the solution.

2.24 Shiftingthebalanceofcarefromresidentialandinstitutionalsettingsto

careathomeandmorepeoplebeingcaredforathomeforlongerhasimplications

forcarers.Carerswillplayanincreasinglyimportantroleinthesupport,careand

treatmentofpeoplewithlong-termand/ormultipleconditions,disabilities,illnesses,

includingdementia,andalcoholanddrugdependency.However, this greater role must not place additional burdens on carers or prevent them from working, learning or having a life outside of caring.

2.25 TheagestructureoftheestablishedBMEcommunitiesismarkedlydifferent

tothewhitepopulation,withamuchyoungerageprofile.However,thiswillchange

withinthenext10yearsasthenumberofBMEolderpeopleincreases.Thisshiftin

theageprofilepresentsanopportunitytoprovidesuitablytailoredandproactive

supporttoBMEcarers.

2.26 Thereareotherchanges,forexample,‘delayedmotherhood’wherean

increaseinbirthstowomenaged40andovermightmeanmoreyoungerpeople

caringforelderlyparentsinfutureyears.

3 CarersUK

21 Carers Rights

2.27 Therearealsomorechildrenwithcomplexandexceptionalneedsbeing

caredforathomebyparentcarers.Thisisdue,inpart,topopulationincreasesbut

alsotomedicaladvancesandtoincreaseddiagnosisandreporting.InScotland

thereareapproximately70,000disabledchildrenundertheageof16.4Forthefirst

time,thereisagenerationofpeoplewithlearningdisabilitiesandcomplexneeds

whoareoutlivingtheirparents.

2.28 Thereisarelativelynewmigrantpopulation,includingasylumseekers.

Updatedfiguresonthenewmigrantpopulationwillbeprovidedinthe2011

Census.ManycarerswhohaverecentlysettledinScotlanddonotgenerallyaccess

supportfortheircaringrole.Identifyingthesecarersandprovidingsupportis

important.

The case for action2.29 Overthelastfewyears,muchhasbeenachievedintakingforwardthe

carers’agendaatapolicylevelbothnationallyandlocally.Therehasalsobeenreal

progressinprovidingpracticalsupporttocarers.However,policydevelopmentshave

notalwaysresultedinrealimprovementsincarersupport,leading-sometimes-to

abreakdownintrustbetweencarersanddecision-makersandserviceplanners.This

strategyisthereforebeingpublishedwithahighexpectationofchange.

Much more needs to be done to achieve practical support on a consistent and uniform basis.

2.30 Providingsupporttocarersmakeseconomic sensebysavingresourcesinthe

longerterm.Withappropriateandtimelysupportcarersareabletocareforlonger,

andenjoybetterhealthandimprovedwellbeing.Carersdonotusually‘down

tools,’butunsupportedtheycanexperiencerealhardshipfinancially,physically

andemotionally.Itismuchmorelikelythatacared-forpersonwillbeadmittedto

hospitalandthecarer’sownhealthdeteriorateifthecarerisunsupported.Carers

caneasilyreachcrisispointwithout appropriate and timely intervention.Such

interventionscan:

• maintain carers’ capacity, reducing the need for paid service delivery to the cared-for person; and

• help keep carers healthy, reducing their own need for support from the health and the social care system.

4 ExtrapolatedfromUKfigureofanestimated700,000children,FamilyResourceSurvey,ONS


2.31 Localpartnershipsbetweenhealthandsocialcare,withcarerinvolvement,

candrive change at local level.Somechangesrequiredcouldbeachievedby

improvements to existing services and supports,ratherthanrequiringthe

developmentofnewinterventions.Forinstance,well-plannedhospitaldischargecan

resultinefficiency savings.

2.32 Ifhospitaldischargeiswell-plannedandtherightservicesputinplacethen

thereisamuchgreaterlikelihoodofthecared-forpersonremainingathomewith

carersupport.Thismeansidentifyingthecareratanearlystagewhenthepersonis

admittedtohospitalandensuringthatthecarerispartofthecareanddischarge

plan.

2.33 Althoughcarersshouldreceivesupporttohelpsustainthemintheircaring

role,they are providers of services, not service users.Thisisanimportant

distinction,andonewhichcarersarekeentomaintain.

2.34 Theimpactofcaringcanbeimmense:5

• intensivecaringcanresultincarersbeingtwiceaslikelytosufferfrom

ill-healthasnoncarers;

• upto70%ofcarerswillhidethefactthattheirhealthissuffering;

• oneinfivegiveupworktocare;

• 46%needtoseeaGPduetotheimpactofcaringontheirownhealth;

• manycarersareisolatedorexperiencepovertyofopportunity;

• sometimes,thefinancialimpactofcaringcanbeacute(forexample,by

requiringadditionalheating,payingforspecialdiets,refurbishingthe

homedamagedbyachildwithautismandspendingmoreontransport,

especiallyinremoteandruralareas);and

• wherespousesorpartnersprovidecaringsupporttoeachotherand

whereonepersoninthepartnershipfallsillorexperiencesanadverse

event,thiscanresultinbothbeingadmittedtohospitalatmuchgreater

costtohealthandsocialcarebudgets.

“Caring for our son was placing a strain on our relationship, our employment

and our health. We were both physically and mentally exhausted. We never had

a holiday without the stress of caring for our son.”

Maryandherhusband,whocarefortheir18year-oldsonwhohasautism,a

learningdisabilityandchallengingbehaviour.

5 http://www.carersuk.org/Professionals/ResearchLibrary/Financialimpactofcaring/1228318101

23 Carers Rights

The evidence2.35 Theavailableevidencebasepointstocurrent and future savings across health and social carearisingfromeffectivecarersupport:

• trainingforcarerscanenablepatients,especiallythosewithchronic

long-termconditions,tobesupportedlongerwithinthecommunity;and

forolderpeopleitcandelayamovetoresidentialcare;6

• improvingskillsofcarersduringtherehabilitationofin-patientsreduces

costsforstrokecareandimprovestheirqualityoflifewithoutincreasing

theburdenofcaretofamiliesortransferringcoststothecommunity;7

• carersprovidedwithtrainingarelesslikelytopresentatGPswiththeir

ownhealthissues;8

• arecentreportinEngland9exploringthesocialandeconomicbenefits

ofshortbreaksprovisionaimedatthosewiththemostcomplexneeds

(familieswithdisabledchildren)estimatedfinancialsavingsforthe

stateof£174millioneachyear.Thiscouldbeachievedthroughthe

effectivedeliveryofshortbreakscombinedwitharangeofactivities,

includingextra-curricularandotheractivitiesinwhichdisabledchildren

canparticipate.Theestimatedfinancialsavingsforthestatefromfull

coverageofshortbreaksprovisionandotheractivityaimedatdisabled

childrenwouldincludesavingsfromlessbeingspentonlong-term

residentialcareandhealthservices.A key message is that families should have regular short breaks to sustain their health and wellbeing and to maintain savings to the state. CarersinScotlandsay

theybenefitmostwhentheyhavegoodquality,flexiblerespiteasand

whenrequired;and

• providingtelecaretopeoplecanresultinsavingstohealthandsocial

carebyreducingpersonalhealthproblemsaswellasreducingunplanned

admissionstohospitalandadmissionstoresidentialcare.10

The personalised approach2.36 Ensuringapersonalised approachcanhelpsupportchange.Eachcaring

situationisunique.However,carers-whatevertheircaringsituation-require

similartypesofsupportbutpersonalisedtothecaringsituationandresponsiveto

particularneedsandindividualcircumstances.

6 CarersUK7 http://www.bmj.com/cgi/content/full/bmj;328/7448/10998 http://www.carersuk.org/Professionals/ResearchLibrary/Healthandcare/12011860519 http://www.actionforchildren.org.uk/uploads/media/36/9163.pdf10 http://www.sociology.leeds.ac.uk/assets/files/research/circle/carers-scotland-report-dec-2009-web.pdf


2.37 BuildingonChanging Lives,11theAssociationofDirectorsofSocialWork

(ADSW)hasgivenaclearcommitmenttoadvancingpersonalisation,recognising

thatmoreofthesamewillnotwork.

2.38 Thepersonalisationapproachisseekingtoinfluencepolicyandlocal

practice,promoteinnovationandempowerfrontlinestaff.ADSWwillbeengaging

withmanagersinlocalauthoritiesinordertoachievewiderchangeinculture,

systemsandprocessesthatwillbenefitbothcarersandthosewithcareneeds.Of

courseadvancingpersonalisation–movingtowardsmorepersonalisedsupports–is

asharedagendarelevanttoallsectorsandacrossallservices.

ACTION POINT 2.1Councils, with partners in NHS Boards, the national carer organisations and other Third Sector organisations, will continue to promote personalisation, working towards a position whereby staff at all levels receive induction training and continuous professional development on this approach, including having specific regard to the personalisation of carers’ support (also see chapter 14 on training).

Resources2.39 Resourcesforservicestopeoplewithcareneedsandforsupporttocarersare

withinlocalauthoritysocialcarebudgets.Otherlocalauthoritybudgetswillalsobe

relevant,especiallyinrelationtohousingandeducation.

2.40 TheNationalHealthService(NHS)inScotlandisalsoresponsiblefor

providinghealthservicestopeoplewithhealthcareneedsandforsupporttocarers.

2.41 Localauthorities’netrevenueexpenditureonsupportforcarers,including

respitecare,was:£100millionin2006-07,£117.034millionin2007-08and

£134.740millionin2008-09.12Inaddition,otherorganisationssuchasAlzheimer

Scotlandhavereceivedgrantstohelpsupportcarers.

11 http://www.scotland.gov.uk/Publications/2006/02/02094408/16

12 Whencomparingrevenueexpenditurelevelsin2008-09topreviousyears,therewasachangetothelocalgovernmentfundingstructurein2008-09,withtheformerring-fencedrevenuegrantsbeingrolledupintoGeneralRevenueFunding.Asaresultofthischange,thefigurein2008-09isnotwhollycomparablewiththepreviousyears’figures.

25 Carers Rights

2.42 SincethisGovernmenttookofficeinMay2007,ithasinvestedatleast

£15.814millioninsupporttocarersandyoungcarers.Someofthiscarriesforward

to2011.ThebreakdownoffinancialsupportfromtheScottishGovernmentisset

outinAppendix 4.Theconsiderablelevelofinvestmentinthetelecareprogramme

(over£20millionsince2006)alsobenefitscarers.

2.43 TheBIGLotteryannouncedinMarch2010that£50millionwouldbe

availablefrom2011tosupportpeoplewithdementiaandtheircarersandyoung

peopleleavingcare.Whilelotteryfundingdecisionsaretakenindependentlyof

Government,theScottishGovernmentisworkingcloselywiththeBIGLotteryFund

onthisinitiative.

Challenges2.44 Thisstrategyisbeingpublishedinadifficulteconomicclimate,with

pressuresonpublicfinancesandatatimewhenthepopulationisageing

significantly.Itisdifficulttopredictwithcertaintythedurationoftheeconomic

difficulties.However,publicspendingwillbeunderconsiderablepressureoverthe

nextfewyears.

2.45 Despite the economic challenges, local authorities and Health Boards will commit to delivering incremental improvements in support for carers, recognising that demand on statutory health and social care provision is unsustainable without changes in the pattern of service delivery.

2.46 Service redesign, while necessary, has the potential to adversely affect the health and wellbeing of carers, if they do not have access to appropriate support.

Opportunities2.47 Supportforcarersisanessentialpartofkeystrategicdevelopmentssuch

astheReshapingCareforOlderPeopleprogramme,ShiftingtheBalanceof

Care,Scotland’sNationalDementiaStrategy13andtheprogrammeofworkon

IndependentLiving,allbeingtakenforwardbytheScottishGovernmentwith

itspartners.TheScottishGovernment,localauthoritiesandHealthBoards,with

keypartners,canoptimisetheuseofresourcesandharnesstheeffortbetterby

strongerstrategicplanningandmorejoined-upapproachestocarersupport.

13 http://www.scotland.gov.uk/Topics/Health/health/mental-health/servicespolicy/Dementia


2.48 Withinexistingfinancialresources,reducingavoidablehospitaladmissions

byprovidingappropriatesupportandservicesinthecommunityisthesingle

mostsignificantareathatcandeliverbetteroutcomesforpeople.Italsohasthe

potentialtoreleaseresourcestouseelsewhereinthehealthandsocialcaresystem.

2.49 Aphilosophyofcarethatpromotespeople’sindependenceandcontrolof

theirsituationbyusingcurrentresourcestooptimumeffectwillreduce,butnot

eliminate,theneedforadditionalresourcestosupportcarers.

Role of Scottish Government, COSLA and partners2.50 TheScottishGovernment’sroleinrespectofsupporttocarersistoset

outthestrategiccontext,aswehavedoneinthisstrategy.Thestrategiccontext

providesthereferencepoint,onaScotland-widebasis,forlocalauthorities,

CommunityPlanningPartnerships,HealthBoards,CommunityHealthPartnerships,

statutoryagenciesandtheThirdSectortolocatetheirplansofaction.The

ScottishGovernment’sleadinthisareawillbeimportanttohelpsupportlocal

implementation.

2.51 COSLAistheScottishGovernment’sformalpartnerinthedevelopmentof

thisstrategy.COSLA’sleadershipwillbeimportanttosupportlocalimplementation.

2.52 Localauthoritiesareresponsiblefordecisionsmadeatlocallevelandthey

arebestplaced,withpartners,todeterminelocalpriorities.

2.53 Giventheevidenceaboutdemographicandsocialchangesandthepivotal

roleofcarersinsustainingcareinthecommunity,theScottishGovernmentand

COSLAexpectlocalauthoritiestohaveregardtothekeymessagesinthisstrategy

andtoimplementtheActionPointsrelevanttothem,aslocalprioritiesdictate.

2.54 AsNHSHealthBoardsareaccountabletoMinisters,itwasnotappropriate

ornecessaryforthemtohavethesameformalpartnerstatusasCOSLAinthe

developmentofthisstrategy.However,theywereofcoursevitalcontributorsto

theworkonthestrategy.TheScottishGovernmentexpectsNHSBoardstosupport

implementationofthestrategyassetoutintheActionPoints.Health Boards are expected to make further progress and to take forward beyond March 2011 the good practice in the Carer Information Strategies (CIS), which the Scottish Government funded to March 2011.

27 Carers Rights

2.55 TheScottishGovernmentcannotdeterminetheprioritiesoftheThird

Sector,althoughwemayinfluencethemthroughScottishGovernmentfunding

tovoluntarysectororganisationstosupportcarers.However,weencouragethe

ThirdSectortoconsiderandtakeforwardtheActionswithinthisstrategyto

supportcarers.Inparticular,thenationalcarerorganisationshaveakeyrolein

implementingthestrategy,andsomeoftheActionPointsarespecificallyaimedat

them.

2.56 TheScottishGovernmentexpectslocalauthorities,HealthBoards,

CommunityPlanningPartnershipsandCommunityHealthPartnershipstodirectly

involveawiderangeofpartners,includingAlcoholandDrugsPartnerships,in

decisionsaboutplanninganddeliveringsupporttocarers.

2.57 The Scottish Government values the work of those statutory and Third Sector organisations which actively support carers. To reinforce and build on that work, across all of the statutory sector and relevant Third Sector agencies, the Scottish Government expects a change in culture so that it is everyone’s job to actively identify and support carers.

Baseline Position2.58 InordertoevaluateprogressinsupportforScotland’scarersoverthenext

5years,itisnecessarytoestablishabaselinepositionasat2010.Nationally,there

isonekeyareawhereinformationiscollectedsystematically.Thisis:

• The number of respite weeks provided each year.

2.59 Thenumberofrespiteweeksprovidedin2008-09was193,65014across

Scotland(withmanylocalauthoritiesusinganewmethodologytocalculatetheir

respiteweeks).The2009-10figureswillbepublishedlaterin2010andwillbe

comparablewiththe2008-09figure.ThereaftertheScottishGovernmentwill

collectthefiguresfromlocalauthoritieseveryyear.The baseline position in 2008-09 is 193,650 respite weeks.

14 RespiteCare,Scotland2009(FinalFigures)


2.60 UndertheCommunityCareOutcomesFramework,localCommunityCare

Partnershipsareencouragedtocollectdataagainst16inter-relatedmeasures.

Theseincludemeasureson:

• the % of carers who feel supported and capable to continue in their role as a carer;

• the % of carers who are satisfied with their involvement in the design of the care package for the person they care for; and

• the % of carers’ assessments completed to national standard.

2.61 Thedataisexaminedandusedforbenchmarkingpurposesbythe

CommunityCareBenchmarkingNetwork.Alargeproportionofpartnerships

arealreadyusingthesemeasuresandothersareintheprocessofintroducing

them.TheScottishGovernmentanticipatesthatsuchreportingwillspreadacross

Scotlandinduecourse.Wherelocalagenciesarealreadycollectingdataagainst

thesemeasures,thiswillbepublishedlocally.

2.62 Inaddition,theCommunityCareBenchmarkingNetworkiscurrentlyrunning

apeer-ledprojectoncareroutcomeswhichincludescollectingdataonthenumber

ofcarersassessmentscarriedoutineachpartnershipareaacrossScotland.Dataon

thisrangeofactivitieswillbepublishedaspartofareportontheprojectinAutumn

2010.

ACTION POINT 2.2The Scottish Government will publish on its website each year the baseline position on respite support to carers and the position in all years up to 2015.

ACTION POINT 2.3Each year, participating local partnerships will collect the relevant data on outcome measures relating to carers in the Community Care Outcomes Framework and will publish progress against the three outcome measures.

Good Practice2.63 TheScottishGovernmenthasreceivedawiderangeofgoodpractice

examples/casestudiesfromthestatutory,voluntaryandprivatesectors.These

goodpracticeexamplesdemonstratethecommitmentoflocalauthorities,

NHSBoards,theThirdSectorandtheprivatesectortoensuringsupportforcarersin

ameaningfulandsustainableway.

29 Carers Rights

2.64 Itisnotpossibletoshowcaseallthegoodpracticeexamplesinthisstrategy.

We are therefore publishing in a separate document the good practice examples received, as well as examples of good practice within the NHS Boards’ Carer Information Strategies.Wemakereferenceinthisstrategytosomeofthe

examples.Thefulltranscriptsareintheseparatedocument.

2.65 Thechallengeistospreadthegoodpractice,recognisingthatlocal

variationissometimesnecessarytoreflectdifferingpopulations,geographical

considerations,theexistenceofservicesalreadyinplaceandsoon.Certainly,some

oftheexamplessuchase-learning modules for NHS staffinoneareacanbe

rolledoutatverylittlecost,andwithhighimpact.A high proportion of healthcare practitioners in Lothian have received training in carer awareness through NHS Lothian’s e-training programme.

2.66 However,toachieveconsistent,highqualitystandardsandapproaches

acrossthecountry,itisnotenoughsimplytocopyaserviceorsupportthatworksin

onearea.Whatisrequiredtoproducegoodoutcomesforcarersisanunderstanding

ofthechangesneededtoexistingservicesandsupportstomakethemmore

effectiveandefficient,andacommitmentbydecision-makerstoimplementthese

changes.

ACTION POINT 2.4Over the next 5 years, councils and Health Boards, with partners, will take account of good practice promoted in local authority and Health Board areas. They will consider how the good practice can be transferred, if appropriate, and/or will consider whether or how existing services and supports can be reconfigured to achieve the best outcomes for carers and for those they care for. As a first step, councils and Health Boards, with partners, will consider the good practice contained in the publication accompanying this strategy.

ACTION POINT 2.5By 2015, the Scottish Government will ensure that the planned acceleration in pace of sharing good practice under Reshaping Care takes account of good practice in supporting carers.


Care 21: The Future of Unpaid Care in Scotland2.67 TheCare21Report15made22recommendationsaboutsupportforcarers

andyoungcarers.ThethenScottishExecutivegavedetailedconsiderationtoeach

recommendationandprovidedaresponseinApril2006.16Thisstrategybuildson

the22recommendationsintheCare21report.The22recommendationsareset

outinAppendix 5, whichalsodetailstheprogressmadesince2006.

15 http://www.scotland.gov.uk/Publications/2006/02/28094157/216 http://www.scotland.gov.uk/Publications/2006/04/20103316/3

Chapter5Carers’RightsChapter5Carers’RightsChapter3ProfileofCarers


The purpose of this chapter is to provide key data on the characteristics of Scotland’s carers. It is necessary to have up-to-date data for planning, shaping and delivering support.

3.1 Thereareanestimated657,300carersinScotland(ScottishHousehold

Survey(SHS)2007-08.Thenumberofcarersbylocalauthorityareaaresetoutin

Appendix 6.

3.2 Caring requirements: TheSHS2007-08estimatesthatthereisaperson

requiringcareinaround14%ofhouseholds.However,33%ofhouseholdsreport

thatthereisapersoninthehouseholdwithalong-termillnessordisability.

3.3 Prevalence of caring: Around10%ofthepopulationprovidescareto

anotherperson.(Census2001).

3.4 Number of carers: 79%ofhouseholdswithcarersinthemhaveonecarer,

17%havetwocarersand4%havethreeormorecarersprovidingcareinthe

household(SHS).

3.5 Who carers care for: Themajorityofcarersprovidecaretoaparent,closely

followedbycaretootherrelatives(spouses,children,siblings)(SHS).

3.6 Time spent caring: Almost halfofScottishcarersprovidingcaretoother

householdmemberswereproviding‘continuouscare.’23%ofallcarersarecaring

for50hoursormore.63%ofcarerswereundertakinglessthan20hoursofcare

eachweek.(Census2001).Forthosecarershelpingorcaringforanotherpersonnot

livingwiththem,79%reportedthattheywereprovidinglessthan20hoursofcare

eachweek(SHS).

3.7 Duration of caring role: Forthoseundertakingacaringrolewithinthe

household,over70%ofcarershavebeenprovidingcareforover5years(SHS).

3.8 Age:Ascarersgetoldertheytakeonmorecaringresponsibility(Census

2001).

3.9 Gender:Thedataindicatesthataround11%ofwomenareundertaking

acaringrole,comparedto8%ofmen.Theoverallprevalenceofwomencarers

tomalecarersisaround60:40(Census2001).Betweentheagesof30and69,

morewomenarecarersbutthegenderbalanceismoreevenforyoung carers

33 Caring Together

andforoldercarersaged70andoverwhenacaringroleisundertakenwithinthe

household(SHS).

3.10 Ethnicity:Allofthedatasuggeststhedifficultyinunderstandingthe

numbersofBMEcarersinsociety.Lowreportednumbersofcarersshouldnotbe

assumedtomeanlowprevalenceofcaring,butratherareflectionofthedifficulties

surveyresearchhasinadequatelyrepresentingthesegroups.

3.11 TheMinorityEthnicCarersOlderPeople’sProject(MECOPP)hasundertaken

asurveyofsupportandservicesprovidedtoBMEcarersbylocalauthoritiesand

HealthBoardsinScotland.Thereportwillprovidedatatosupportthebaselineof

informationcurrentlybeingestablishedbytheScottishGovernment.

3.12 Economic Activity:Forcarersinemployment,part-timeworkersarethe

mostlikelytobecarers.Ofthosewhoundertakeover20hoursofcareeachweek,

part-timeworkersandunemployedpeoplearethepredominantcarergroups

(Census2001).

3.13 Working Status: Theworkingstatusofahouseholdleastlikelytocontaina

carerwhocaresforanotherhouseholdmemberissingleworkingadulthouseholds.

Thestatusofhouseholdsmostlikelytocontainacarerisacouplehouseholdwhere

neitherworks(SHS).

3.14 Social Class: Thesocio-economicclassificationleastlikelytohaveacarer

whocaresforanotherhouseholdmemberisthehighermanagerialandprofessional

occupations,ataround7%ofhouseholds.Householdswithacareraremostlikely

tobeinthelowermanagerialandprofessionaloccupationsclass(26%)(SHS).

3.15 Scottish Index of Multiple Deprivation (SIMD):Thebiggestproportionof

householdswithacarerwhocaresforanotherhouseholdmember(28%)areinthe

20%mostdepriveddatazonesintheSIMD.Theproportionofhouseholdswitha

carerthendecreasessteadilyasdeprivationdecreases,sothattheleastdeprived

20%ofdatazonesalsohasthelowestprevalenceofhouseholdswithcarersin

Scotland(13%)(SHS).

3.16 Housing tenure:Carerswhocareforotherhouseholdmembersaremost

likelytoowntheirpropertyoutright(35%),whichislikelytobelinkedtoatendency

forcarerstobeolderand/orretired.Afurther33%ofhouseholdswithacarer

sociallyrenttheirproperty(SHS).


ACTION POINT 3.1The Scottish Government will make the information on carers and young carers from surveys such as the Scottish Household Survey and Scottish Health Survey accessible to researchers, care providers and the public through its website and publications.

ACTION POINT 3.2In respect of the 2011 Census, the views of carers’ organisations will be taken into account in deciding what analysis tables will be produced for the General Register Office for Scotland 2011 Census website.

Diversity of the caring population3.17 CarersreflectthediversityofScotland’spopulation.Therearecarerswho

work,carerswhocannotworkduetotheirintensivecaringorage,carerswhowant

toworkorpursueopportunitiesinFurtherorHigherEducation,oldercarersand

young carersunder16,loneparentcarers,lifelongcarers,studentcarers,BME

carers,LGBTcarers,carersinremoteandruralareasandmanyothertypesofcarer.

Ofcourse,carersmayfallintomorethanonecategory.

3.18 Kinship carersaredifferentfromcarersinthattheyarethefamilyand

friendsofyoungpeoplewhoarein,orareatriskofcominginto,thecaresystem.

Kinshipcarersaresometimestheparentsofadultswithsubstancemisuseproblems

whocarefortheirgrandchildren.Theyshouldreceiveakinshipcareallowancefrom

thelocalauthority.However,akinshipcarercanalsobeacarerif,forexample,the

grandchildhasadisabilityand/orifthekinshipcarerisalsocaringfortheirpartner,

ownparentorsomeoneelse.Therefore, support for people who are kinship carers through the carers’ route should always be considered if appropriate.

Diversity of the cared-for population3.19 Justascarersarediverse,sotooarethepeopletheycarefor.Itisnot

straightforwardtocategorisecaringsituations.Forexample,apersonwith

dementiamayalsobefrailandelderlyorapersonwithalearningdisabilitymay

alsohaveamentalhealthproblem.Therearemanypeoplebeingcaredforwho

havelong-termconditions.

3.20 TheScottishConsortiumforLearningDisability(SCLD)isworkingwith

localauthoritiestoensurethegatheringofmoreaccuratestatisticsonadultswith

learningdisabilitiesandautism.The200817figuresshowthat7,793adultswith

learningdisabilitiesandautismknowntolocalauthoritiesinScotlandlivedwitha

carer.Thisrepresents48%oftheadultsforwhomthisinformationwasreported.

17 ScottishConsortiumforLearningDisability:eSAYproject

35 Caring Together

3.21 Therearesomecommunitiesofcarersweknowverylittleabout,most

notably:refugees,asylumseekers,gypsytravellersandcarerswhothemselveshave

disabilities,includinglearningdisabilities.TheScottishGovernmentwillconsider

theneedforresearchinthisarea.

ACTION POINT 3.3By 2012, the Scottish Government will draw up a specification and seek to commission research on communities of carers we know little about, including refugees, asylum seekers, gypsy travellers and carers with disabilities, including learning disabilities. This is relevant to young carers too.

Chapter5Carers’RightsChapter4PrioritisingSupporttoCarers

37 Caring Together

The purpose of this chapter is to make clear that carers most in need should be prioritised for support. This does not mean delivering support in response to crises. The emphasis should be on early intervention and preventative support. There is a link to chapter 3 on the profile of carers in that some further data is provided on carers’ characteristics. Small packages of cost-effective support are appropriate.

4.1 Therearecarerswhoareparticularlyvulnerableandinneedofsupport,

especiallypreventativeinnature.Theestimatedhalfofcarerswhoprovidecareto

anotherhouseholdmemberandwhoarecaringcontinuouslyeachandeveryday

arecaringintensively.Furthermore,theScottishHouseholdSurvey2007-08shows:

• 18%ofcarersareaged70andover;

• 19%ofcarersareaged60-69;

• 4%ofcarerscarefortwoormorepeople;and

• 70%ofcarershavebeencaringforover5years.

4.2 Anothermeasureof‘need’mightbethosecarerslivingindeprivation,who

willbelessabletopayforservices,morelikelytobeinpovertyandpoorerhealth

andmoresociallyisolated.

4.3 Throughreviewoftheirlocalstrategies,localauthoritieswithpartners

willwishtotakeaccountofthemostvulnerablecarersaccordingtoanobjective

assessmentofneedwhichalsotakesaccountofthenatureandlevelofrisk.The

ScottishGovernmentandCOSLAacknowledgethatauthoritiesmayalreadyhave

donethis.

4.4 Thisdoesnotcontradicttheemphasisonearlyinterventionorthe

preventativeapproach.Whatitdoesmean,forexample,isthatfrailelderlycarers

mightbeconsideredtobeingreatestneed:apreventativeapproachwouldmean

earlyidentificationofthesecarersandtheavailabilityofthenecessarysupportsto

enablequality-of-lifeandinturntopreventcrises.

4.5 Thereneedstobemorefocusonearlyintervention,withcrisissupport

availabletoo.Intimesoffinancialconstrainttheimperativeisusuallytotake

actionwhenthereisacrisisthatneedstackling.However, a greater emphasis on anticipatory and preventative support in relation to both the carer and cared-for person – which does not have to be complex or expensive - can delay or prevent the need for crisis intervention, and is therefore more cost-effective.


4.6 TheReshapingCareProgrammehasastrongemphasisonearlyintervention.

Afocusonanticipatorysupportforcarersisessentialaspartofthisprogramme.

4.7 Carerswhosecaringresponsibilitiesareminimalalsoneedtohaveadequate

informationsothattheyaresupportedshouldtheircaringresponsibilitiesbecome

moredemanding,andpossiblyhave‘emergencyplans’inplaceshouldtheir

circumstanceschangequickly.

4.8 Notwocarersorcaringsituationsareidentical.Carersinasimilarcaring

situation-forexample,caringforagrownupchildwithlearningdisabilities-may

havedifferentneedsduetoarangeofcircumstances,includingtheavailability

ofservicesintheirarea,supportfromfamilyandfriends,supportfromthewider

community,people’slevelofincometopurchaseservicesandsoon.Allthese

considerationsareimportant.

ACTION POINT 4.1By 2012, if they have not already done so, local authorities, with partners, will wish to revisit their local carer strategies to identify and support carers in need according to their own assessment of need. To support this process, the Scottish Government will produce a short list of key points that local carer strategies should address.

ACTION POINT 4.2By 2013, local authorities, with partners, will aim to identify carers in greatest need according to an objective assessment of need, and in line with published indicators, which also takes account of the nature and level of risk. They will aim to provide support or signpost on to support.

ACTION POINT 4.3Over the next five years, local authorities and Health Boards, with partners, should seek to provide preventative support to carers and minimise the need for crisis intervention.

ACTION POINT 4.4Over the next five years the Reshaping Older People’s Care Programme will look to ensure a focus on early intervention for carers. Good practice in this area will be transferred to other care settings.

Chapter5Carers’RightsChapter5Equalities


The purpose of this chapter is to reinforce the importance of the equalities dimension in identifying and supporting carers. It is important to recognise, and to respond to, the particular challenges for some groups of carers. People should be free from disadvantage or discrimination as a consequence of caring.

As discussed in chapter 3 on the profile of carers, the lack of data on hard-to-reach or hidden carers, including BME carers, should not imply that they do not exist. This chapter also links to chapter 4 on prioritising support to carers and to chapter 6 on carers rights. We also include within this equalities chapter support to carers in remote and rural areas which is an equalities issue in terms of the availability of, and access to, services and support in certain geographical areas.

5.1 Thenewcross-cuttinglegislativeframework,The Equality Act 2010,18is

intendedtoprotecttherightsofindividualsandadvanceequalityofopportunity

forall;toupdate,simplifyandstrengthenthepreviouslegislation;andtodeliver

asimple,modernandaccessibleframeworkofdiscriminationlawwhichprotects

individualsfromunfairtreatmentandpromotesafairandmoreequalsociety.

Chapter6oncarers’rightscoversinmoredetailtheprovisionsintheEqualityAct

2010.

Equality Groups5.2 Ensuringequalitiesinraceorethnicity,disability,genderorsexual

orientation,ageorreligionmeansensuring opportunity for all carers to access suitable resources and support. Carersmaybeexcludedfromsupportbecause

thereisnorecognitionoftheirparticularcaringsituation.Theresultmaybelackof

opportunity,difficultyinaccessingprovisionorunresponsiveservices.

5.3 Supportneedstobedeliveredinasensitiveway.So,forexample,carer

trainingmightbedeliveredtoBMEfemalecarersintheirownright.Inrelationto

genderissues,professionalshavetorecognisethatdaughtersmaynotwishtocarry

outpersonalcarefortheirfathers.Carers’centresshoulddeliversupporttopartners

andbecarefulaboutadvertisingthemselvestofamiliesonly,whichmightbe

off-puttingtoLGBTcarers.Healthandsocialcareprofessionalsneedtobesensitive

tocaringrelationshipsandthedifferentformsthesemaytake.

18 FurtherinformationcanbefoundattheEqualityandHumanRightsCommission(EHRC)websiteat: http://www.equalityhumanrights.com/

41 Caring Together

“We were treated differently to heterosexual couples who meet in a private

space during visiting times whereas we had to meet in the dining room of the

hospital ward. One day when I put my arm around Martin to comfort him I was

told to stop by healthcare staff as they thought this may lead to ‘other things.’

As a very private person I was extremely upset and humiliated.”

Brian,whocaresforhispartner,Martinwhohasmentalhealthproblems.

5.4 Thereshouldbegreaterawarenessindeliveringculturallycompetent

services.Culturalcompetence19asaconcepthasevolvedparticularlyinrelationto

BMEgroupsbutitappliesequallytootherequalitygroupsandallformsofsocial

care.

5.5 Culturalcompetencerecognisesthattherearebarrierswhicheffectively

preventBMEcarersandserviceusersaccessingappropriatesupportandservices.

Thesebarriersmaybevisible,suchasproducinginformationinEnglishonly,or

invisible,suchastheassumptionsofindividualworkerswhichmayleadtocultural

stereotyping.

“I look after my wife myself. Our children have grown up and moved away. It

is very difficult and tiring but I have to manage. I do not read or speak English

so I did not know I could get any help until a Chinese worker told me. My life is

easier now but there are still many Chinese who do not know they are a carer.”

MrLimcaresforhiswife,whohashadastrokeandisalsofrailelderly

(translatedintoEnglish).

5.6 ProblemsinidentifyingBMEcarerscanleadproviderstobelievethat

thereisnoneedordemandfortheirservices.Additionally,BMEcommunitiesin

differentpartsofScotlandcanberelativelysmall,withanevensmallerBMEcarer

population.Thismayleadproviderstobelievethata‘criticalmass’doesnotexist

tojustifythedevelopmentofspecificservices.Whilst it may not be practical or appropriate to develop new services, providers must consider whether they are excluding people from support that other carers receive. The‘mainstreaming’

agendarecognisesthatmainstreamserviceshavetochangetoaccommodatethe

needsofadiversepopulation.‘Mainstreaming’isequallyapplicabletoallequality

groups.

19 TheScottishGovernmentdefinesculturalcompetenceas:‘aservicewhichrecognisesandmeetsthediverseneedsofpeopleofdifferentculturalbackgrounds.Akeypartofculturalcompetenceisensuringthediscriminationonthebasisofculture,belief,race,nationalityorcolourhasnoroleinthedeliveryofservices.’


5.7 Therewillbesomecarerswhoarethemselvesdisabled.Theirparticular

needsshouldbefullyaddressedbylocalauthorities,HealthBoardsandother

partners.Thiswillbeinlinewiththeexistingdisabilitypublicsectorequalityduties.

5.8 Equality Impact Assessmentscanprovideanimportantmechanismfor

increasingawarenessofcarers’needsandrightsinthepublicsector.Thepublic

sectorisrequiredtoensurethatequalitydutiesonrace,disabilityandgenderare

integratedintoallthefunctionsandpoliciesofScottishGovernmentDirectorates

andAgenciesandoflocalauthoritiesandHealthBoards.Weallneedtoassessthe

impactofourpoliciestoensurethatwedonotinadvertentlycreateanegative

impactforequalitygroups.

ACTION POINT 5.1The Scottish Government, with COSLA and partners, will ensure that all the Action Points in this strategy are taken forward in ways which fully address the equalities perspective.

Caring in Remote and Rural Areas5.9 Providingsupporttocarersinremoteandruralareashasanequalities

dimensiontotheextentthatcarerslivingintheseareasmaynothaveaccessto

supportthatothercarershave.Werefertotheparticularneedsofcarersinremote

andruralareasthroughoutthisstrategy,especiallyinrelationtotheaccessibilityof

servicesforthecared-forperson,theprovisionofshortbreaks,carertraining,carer

healthandincome.Theaccessibilityofhealthcareservicesforthepersonwithcare

needsisanissue.

5.10 Anotherkeyissueistransport.Manycarersinremoteandruralareashave

totravellongdistancesandthereareissuesaboutthelackofadequatetransport

orthehighcostsoftransportation.Appendix 7 setsoutthefullrangeofScottish

Governmentpoliciesdesigned to improve transportation in remote and rural areas.

“Living in a rural area we rarely go out other than for medical appointments

due to fuel and time costs. Shopping and seeing friends is always squeezed into

these travel arrangements.

Doctor 68 miles return (1 hour 30 minutes), hospital 140 miles return (3 hours).”

Ann,whocaresforherhusbandwithcomplexhealthproblemsandlimitedmobility.

43 Caring Together

5.11 Communitytransportservices20arenormallyoperatedbyvoluntary

organisationsandcantakedifferentformssuchascommunityminibuses,

dial-a-bus,andvoluntarycarschemes.Thesetypesofserviceareveryvaluablein

ruralareaswheretherearenoorverylimited,publictransportservicesandareof

particularbenefittoolderanddisabledpeople.Manyservicesaredemandled,

providingadoor-to-doorserviceatthetimerequestedbythepassenger.Thistype

ofservicemaybeofbenefittocarers,particularlyinruralareas.

5.12 Thereareotherkeyissuesrelevanttocaringinremoteandruralareas.

Asaresultofhavingtotravellongdistances,itcanbedifficulttokeephospital

andGPappointments.Innovativesolutionsareneededtohelpmakelifemore

straightforwardforcarersinruralareas.Telehealthcaresolutionsareveryrelevant

tocaringsituationsinremoteandruralareas.Telephonesupportinrelation

tohealthandwellbeingandcarertrainingshouldbeexploredfurther.The

developmentofruralco-ordinatingnetworks,perhapstofacilitaterespite,canhelp.

Thefurtherdevelopmentofcommunityfacilitatorsorco-ordinatorsofsupportin

remoteandruralareascanbeexploredtoo.

ACTION POINT 5.2From 2010 onwards, the Scottish Government will work with the relevant local authorities, Health Boards and Third Sector organisations to develop plans to help address rural carer issues.

20 Localauthoritiesmaybeabletoprovideinformationoncommunitytransportservicesoperatingintheirarea.Inaddition,theCommunityTransportAssociation,[email protected],maybeabletoprovidedetailsofcommunitytransportservicesinruralpartsofScotland.

Chapter5Carers’RightsChapter6CarersRights

45 Caring Together

The purpose of this chapter is to set out the Scottish Government’s view on the development of carers rights. Once commenced, the Equality Act 2010 will be an important step forward, as will the provisions in the forthcoming Self-Directed Support (Scotland) Bill. We emphasise that existing carers rights (as enshrined in law) should be further enhanced by the development of a Carers Rights Charter, which will consolidate in one place the existing rights and will set out key principles of support to carers and outcomes. The Scottish Government will consider whether further rights should be enshrined in law.

6.1 TheEqualityAct2010willprohibitdirectdiscriminationandharassment

basedonassociationandperceptioninrespectofrace,sex,genderreassignment,

disability,sexualorientation,religionorbeliefandageinrelationtoemployment

andotherareas.Thislegislationwillcovercaseswherethelessfavourable

treatmentisduetothevictim’sassociationwithsomeonewho,forexample,is

disabled.Thediscriminationwillbeunlawfulinrelationtoaperson’semployment

andalsothroughtheprovisionofservicesandhousingandinotherareas.

6.2 ThePatient Rights (Scotland) Billaimstoplacepatientsatthecentre

oftheNHSinScotland.IfapprovedbytheScottishParliament,thishealthcare

legislationwillhelpensurethatpatients’rightsandentitlementsaremorewidely

understoodandused.Aspartoftherequirements,thereareexpectedtobePatient

RightsOfficersforHealthBoardareas.This will have direct relevance to carers.

6.3 TheSelf-Directed Support (Scotland) Billwillseek,amongstotherthings,to

givelocalauthoritiesthepowertoprovidedirectpaymentstocarers.

6.4 Self-directedsupportisoneformofpersonalisedsupportwhichensures

individualscanchoosehowandbywhomtheirsupportisprovided.Evidence

suggeststhatself-directedsupportanddirectpaymentscanleadtoimproved

outcomesforindividuals,familiesandcommunities.

6.5 TheScottishGovernmenthasconsultedonadraftNationalStrategyon

Self-DirectedSupportandisconsultingonproposalsforaSelf-DirectedSupport

(Scotland)Bill.OneoftheaimsintheBillwouldbetoextendeligibilityfordirect

paymentstovariousgroupsthatarecurrentlyexcluded,includingcarers.TheBill

wouldprovidelocalauthoritieswithgreaterflexibilitysothattheycanprovide

supporttocarersintheformofadirectpayment.


6.6 Theaimistoremovebarrierstopeopletakingupself-directedsupport,

includingdirectpayments.Barrierstodirectpaymentsinclude:assumptions

andattitudesaboutthecharacteristicsofpeoplewhomaybenefitfromthem;

limitationsontheuseoftheallocatedbudget;andthechallengesofsustaining

currentserviceswhilstinvestinginnewindividualisedapproaches.

6.7 Theuseofdirectpaymentscanhelpmeettheneedsofcertainsectionsof

thecarerpopulation,includingBMEserviceusersandcarers.The Minority Ethnic Carers Older People’s Project (MECOPP) is supporting a group of BME carers and the people they care for in West Lothian to pool their direct payments together to facilitate support within mainstream daycare services.

6.8 Currentdirectpayments’legislationonlyallowsdirectpaymentstobeused

toemployaclosefamilymemberinexceptionalcircumstances,“…wheresecuring

theservicefromsuchapersonisnecessarytosatisfactorilymeettheserviceusers’

assessedneeds.”Itisimportantthatthisfacilityismadeknowntocarersfromthe

outsetandisusedwherethiscouldprovidebestoutcomes,forexamplewhen:

• apersonrequiresend-of-lifecare;

• therearefewserviceprovidersinruralorremoteareas;

• itisconsideredtobethemostappropriatewayofmeetingan

individual’sculturalneeds;and

• afeatureoftheperson’sdisabilityischallengingbehaviourtowards

strangers.

6.9 Carersrightswhicharenotenshrinedinlawcanbetakenforwardina

numberofdifferentways.Inparticular,aswellastheprovisionsinthisstrategy

relatingto,forexample,theprovisionofinformationandadvice,carertraining,

shortbreaksandtelecare,the Scottish Government will also ensure that carer representatives are members of Community Health Partnerships (CHPs) – see chapter 7 for further details.

6.10 TheScottishGovernmentintendstoraisetheprofileofcarers’issueswidely

throughaCarersRightsChartersettingoutandconsolidatingexistingrights,what

carersneedtohelpachievebetteroutcomesandwhatlocalauthorities,Health

Boardsandothersneedtodotosupportcarers.Aclearsetofprinciplesinsupport

ofcarerswillbeestablished.TheCharterwillbewidelydistributed.

47 Caring Together

ACTION POINT 6.1From 2010 onwards, the Scottish Government will work with the national carer organisations to promote the Equality Act 2010, once commenced, especially the provisions providing protection from discrimination for carers.

ACTION POINT 6.2The Scottish Government will work with COSLA and local authorities to ensure a consistent approach across local authorities to the employment of close family members in exceptional circumstances. The guidance on implementation of the Self-Directed Support Strategy, to be produced by the Scottish Government, will include a section on approaches to the employment of close family members in exceptional circumstances.

ACTION POINT 6.3By December 2011, the Scottish Government will produce, with COSLA and partners, a Carers Rights Charter for wide distribution to local authorities, Health Boards, Community Health Partnerships and other bodies. By July 2013, the Scottish Government will consider whether further rights should be enshrined in law.

Chapter5Carers’Rights

Chapter7CarerInvolvementinPlanning,ShapingandDeliveryofServicesandSupport

49 Caring Together

The purpose of this chapter is to set out how carers will be further involved in the planning, shaping and delivery of services and support. Their involvement is crucial to ensure the best quality services and support, delivered in a personalised way. Carers should be involved in a number of different ways.

7.1 Community Health Partnerships (CHPs),establishedbyNHSBoards,havea

roleindeliveringthechangerequiredtosupportthecared-forpersonandthecarer.

Thisisbecausetheyhavetoensurethatpeopleandcommunitiesareengagedin

thedecisionsmadeonhealthserviceswhichaffectthem.

7.2 CHPsprovideanopportunityforpartnerstoworktogethertoimprovethe

livesoflocalcommunities.CHPsshouldactivelyinvolvethepublic,patientsand

carers.

7.3 SomeCHPshavecarerrepresentationonthem,throughcarerorganisations.

CarersthemselvesarerepresentedonPublicPartnershipForums,whichareoneof

themainlinksbetweencommunitiesandCHPs.MembersofthePublicPartnership

Forums(usuallyChairsand/orVice-Chairs)generallyhaveaplaceonthelocalCHP,

andanumberofcarerscurrentlyfulfilthisfunction.

The Scottish Government believes there should be carer representation on CHPs and will ensure that this happens.

7.4 Public Partnership Forumscontinuetoprovideavaluableinputintothe

planninganddeliveryoflocalservicesanditisimportantthattheirrolecontinues

toevolve.Assuch,theScottishGovernmentwillbeundertakingareviewofPublic

PartnershipForumssothattheirrolecanbestrengthenedanddeveloped.Given the important contribution that carers make to Public Partnership Forums through their expertise and knowledge, we are committed to involving them in the review so that their interests are fully represented.

ACTION POINT 7.1In 2010-11, the Scottish Government will ensure carer representation on CHPs by writing to the Chief Executives of Health Boards to make this happen.

ACTION POINT 7.2In 2010-11, in taking forward a review of Public Partnership Forums, the Scottish Government will ensure that it consults with appropriate carer organisations in order that their interests are fully represented.


ACTION POINT 7.3Local authorities and NHS Boards will ensure they fully involve the national carer organisations, other Third Sector organisations and carers, as appropriate in the planning and shaping of services and support.

7.5 Carerswillcontinuetobeinvolvedininspectionsofserviceswhenthenew

scrutinybodies,SocialCareandSocialWorkImprovementScotland(SCSWIS)and

HealthcareImprovementScotland(HIS),aresetupin2011.

7.6 The Healthcare Quality Strategy for NHSScotland,publishedinMay

2010,21willalsohelpensurethevoiceofcarersisheard.Itisthekeydriver

forfurtherchangeandimprovementsinhealthcare.Thisstrategywillseekto

ensurethathealthcareisofthehighestquality,withimprovedsafetyandclinical

effectivenessbasedonperson-centredsupportandthefullinvolvementofcare

partners.Therewillbeanemphasisondevelopingrelationship-basedcareand

shareddecision-making.Afurtheraimistoensurethatpatientsandcarershave

clearinstructionsandinformationoncare,treatmentandsymptomsandthatthey

arefullyinvolvedintreatmentchoices.Therewillbeaclearemphasisontreating

carersasequalandexpertpartnerswithknowledgeandexperience,especially

aboutthepersontheycarefor.

7.7 TheHealthcareQualityStrategylistsNationalQualityOutcomeMeasures,

someofwhichareofdirectrelevancetocarersandolder young carersandwhich

helpensurecarershaveapivotalroleindecision-making.Inparticular:

• Carers will provide feedback on their experiences of healthcare. The Scottish Government is considering how to capture the experiences of carers; and

• The measure on emergency admissions, relating to supporting patients to remain at home, will reflect improved partnership working with carers.

7.8 Carerinvolvementandparticipationinprocurement processesisessentialto

empowercarers,andtoensurethatservicesproperlytakeaccountofcarers’needs.

7.9 TheScottishGovernmentexpectstoreportontheconsultationonDraft

GuidanceonSocialCareProcurementinsummer2010.TheDraftGuidancesetsout

aframeworkforsocialcareprocurementinScotlandwhichhasasignificantimpact

onpeople’squalityoflifeandwellbeing.

21 http://www.scotland.gov.uk/Publications/2010/05/10102307/8

51 Caring Together

7.10 Localauthorities’commissioningstrategiesshouldsetoutthefutureresponse

tomeetingneedsandimprovingoutcomesandtheplansformajorshifts,suchas

movingcontrolfromorganisationstoindividualsandmovingfrominstitutional/

buildings-basedservicestocommunitysupport,wherethatisappropriate.

7.11 Localauthoritiesshouldadoptaninclusiveapproachandcreatean

environmentwhichinvolvesstakeholders,includingserviceusers,theiradvocates,

carers,serviceprovidersandthosewithastatutoryresponsibilityforservicedelivery,

workingtogethertoimproveoutcomesforserviceusersandcarers.

7.12 Procurementprocesseshave,insomecases,givenserviceusersandcarers

asensethattheyhavelittlecontrolovertheirlivesandnoabilitytoimpactonthe

decisionsmadeinrespectoftheirservices.

7.13 Theinvolvementofserviceusersandcarers,andtheopportunityforthem

tovoicetheirexperiencesandviews,isessentialateverymainstageofthe

procurementprocess,fromtheearlieststagesofanalysisandplanningtothelater

stagesofcontractmonitoring,managementandreview.Serviceusersandtheir

carersmayhaveanopiniononchangestocurrentserviceprovision,mayhave

concernsaboutanexistingproviderwhichmeritachangeofprovider,ormaywant

tosupportthecontinuationofaserviceprovidedbythelocalauthorityorvoluntary

orprivatesector.

ACTION POINT 7.4In 2010 and beyond, the Scottish Government and COSLA will promote the Social Care Procurement Guidance to local authorities so that they are aware of that part of the guidance on carer participation and can act on it as appropriate. Furthermore, the Scottish Government will provide training for procurement staff, establish learning networks and promote good practice to continue to seek improvement in procurement practices across Scotland, which will take account of the need to involve carers.

7.14 Carersshouldbeinvolved,asappropriate,inthecareplansforthepeoplethey

carefor.Forexample,withregardtocarerswhocareforpeoplewithmentalhealth

problems,psychiatricservicesneedtoensurethattheyinvolvethecarerasmuchas

possibleinthecareandtreatmentplansothatthecarercanbefullysupportedand

engaged.Thiscanbeadifficultareaforallconcernediftheadultrefusestogive

consenttosharepersonalinformationwithcarers,asistheirlegalright.Inthese

circumstances,professionalsmustrespecttheneedforprofessionalconfidentiality,

whilstmaintaininganopenprofessionalrelationshipwithcarersasinterestedparties.

Chapter5Carers’RightsChapter8IdentificationofCarers

53 Caring Together

The purpose of this chapter is to set out the measures to take forward effective carer identification by ensuring that the health and social care workforce have the necessary skills. Self-identification is also important. Identification is the precursor to a carer’s assessment and to receipt of support. Appendix 8 sets out a carer pathway from carer identification or self-identification through to support.

8.1 Thereareanumberofdifferentwaystoidentifycarers.Differentmodels

havebeentriedandtestedandtwolessonshaveemergedasthemosteffective

wayofidentifyingcarers:

• itiswidelyrecognisedthatpractitionersintheNHSandsocialcare

professionsarebestplacedtoidentifycarersthroughtheircontactwith

patientsandtheirfamilies;and

• integratingcareridentificationintothecoreprofessionalroleofhealth

andsocialcareprofessionalssupportseffectivecareridentificationand

signpostingtosupport.

8.2 Onceidentified,acarermaynotwanttobeover-burdenedwithinformation.

Astheircaringrolechanges,theymayrequireacertainlevelordifferenttypeof

information.Mentalhealthcarerstellusthatmanyofthemneedinformationat

thepre-diagnosisstage,especiallyiftheirrelativeseemstohavesevereproblems

anderraticbehaviour,butwherethereisnodiagnosisasyet.

8.3 Itisimportanttokeepafocusoncareridentification,asthisisthefirst

importantsteptohavingacarer’sassessmentandalsotoaccessingappropriate

supporttomeetcarers’needs.Aspartofthis,there needs to be a continued emphasis on carer identification within GP practices and in hospital and other settings.PerthCarersCentresaid:

“Usually when someone cares for someone with a long-term condition, the care

professionals are maintaining the cared-for person and they do not always offer

the carer support automatically - this is changing as they are more aware of the

needs of carers through networking meetings, conferences being held and so on.

Also staff working in the GP practices and raising the profile of our carers centre

enables these people to come forward for support and for health care staff to

recognise carers centre staff and how they provide carers with support.”22

22PRTCCarerCentreSurvey,2010


8.4 CarerswereincludedinTheScottishEnhancedServicesProgrammefor

PrimaryandCommunityCare(2007-2009).ThisprogrammewillcontinueuntilApril

2011.Theenhancedservicesaremaximisingtheopportunitiestoidentifycarers

throughtheworkofgeneralpracticeandbyunderstandingthecarers’roleandits

associatedrisks.Thisenablesthepracticeteamtosupportcarersintheircaringrole

andtohelpcarersprotecttheirownhealth.GPpracticesprovidingtheseservices

areexpectedtoestablishastructuretosupporttheoverallneedsofpatientswho

arecarers.

8.5 NHSBoardshavedevelopedstrategiestoidentifycarersandmanyaredoing

so.For example, in South Lanarkshire a Primary Care Co-ordinator works with the 55 GP practices to identify and support carers. A Blood Borne Virus Support Worker identifies BME carers, some of whom are affected by BBV. A GP Liaison Worker in NHS Borders works with GPs to help identify carers.

The Scottish Government expects NHS Boards to maintain a focus on carer identification through the Carer Information Strategies.

8.6 The Princess Royal Trust for Carers has taken forward the Moffat Programme, sponsored by the Moffat Charitable Trust, with four NHS Boards – NHS Lothian, NHS Greater Glasgow and Clyde, NHS Ayrshire and Arran and NHS Borders. The main aim of the Moffat Programme is to promote early identification, intervention and support for carers to prevent unnecessary crisis, including a breakdown in carers’ own health.

8.7 Carers Scotland is continuing to work with GPs and other primary health care personnel to raise awareness of carers, to help staff identify carers and to help carers self-identify. They have produced a resource pack for GP practices which provides a range of tools and a notice board. Carers centres across Scotland are working with GP practices too.

8.8 Theworkforcetraininginitiativesetoutinchapter14oncarerandworkforce

trainingwillhelppromotecareridentification.Theemphasisontrainingsocialcare

staffintheundertakingofcarers’assessmentssetoutinchapter9willbecriticalto

thisprocess.

8.9 ThereisscopefortheScottishGovernmenttoworkwithAlcoholandDrug

Partnerships(ADPs)andwiththenewScottishDrugsRecoveryConsortium(SDRC)

topromotetheneedfortheidentificationof,andsupportto,carersofpeoplewith

55 Caring Together

substancemisuseproblems.TheScottishGovernmentexpectsADPstoengage

withallrelevantaspectsofcommunityplanningtohelpsecurethebestoutcomes

bothforpeoplewithaddictionproblemsandfortheircarersandfamilies.TheSDRC

willbeworkingcloselywithADPsbyassistingserviceusergroups,familysupport

networksandlocalcommunities.Carersofpeoplewithdrugandalcoholproblems

canmakeanimportantcontributiontotherecoveryofthepeopletheyarecaring

for,andthewelfareofcarersisanimportantpartofthisagenda.

ACTION POINT 8.1From 2010 onwards, the Scottish Government will promote this strategy with Alcohol and Drug Partnerships (ADPs) and with the Scottish Drugs Recovery Consortium (SDRC) and will work with ADPs and with the SDRC to help identify and support carers of people with substance misuse problems.

8.10 TheRoyalCollegeofGeneralPractitionersScotland(RCGPS)hasdecidedto

makecarerandyoung careridentificationandsupportoneofitskeyprioritiesin

2010-11throughitsPatientPartnershipinPractice(P3)group.Thismeansthatthe

RCGPSworkingwithothers,willdevelopguidanceforGPpracticesinScotlandon

careridentificationandsupport.

8.11 Inaddition,theRCGPS,inpartnershipwiththePrincessRoyalTrustfor

Carers,islaunchingaUK-wideAwardtorecognisetheexcellentworkofGPpractices

inidentifyingandsupportingcarers.TheseawardswillbepresentedinthefourUK

countries,withanoverallwinnerreceivingtheUKAwardlaterin2010.

ACTION POINT 8.2The Scottish Government will approach all relevant national training and qualification accreditation bodies to agree how they could integrate carer identification and awareness into the curriculum by 2013.

ACTION POINT 8.3In 2011-12 and beyond, local authorities, Health Boards and all carer support organisations are to identify carers and young carers in the hard to reach groups, including BME carers.

ACTION POINT 8.4In 2010-11, the Scottish Government will work with the Royal College of General Practitioners Scotland on its plans to provide guidance to GP practices in Scotland on carer and young carer identification and support.


8.12 Peoplecanidentifythemselvesascarers(self-identification).However,that

isnotstraightforward.Thereisawidespreadviewthatcaringfororlookingafter

someone,particularlyafamilymember,is‘whatyoudo.’

8.13 Itcanalsobedifficulttodeterminewhen‘thecaringjourney’starts,

depending,forexample,ontheconditionofthewould-becarer’srelativeorpartner,

whomayinitiallykeepquitegoodhealth.Aspeoplebecomeolder,frailer,sicker,

and/orincreasinglydisabled,becomeaddictedtoalcoholand/orillegaldrugsor

haveadiagnosedmentalhealthproblem,theroleofcarerbecomesmoreapparent.

“My sister constantly told me that I was a carer and that I should ask for help

and for a long time I ignored her. I didn’t think of myself as a carer and

despite many visits to the GP and workers coming to see mum at home, no one

had ever spoken to me about getting support for myself, so that reinforced my

view that I couldn’t get help.”

Eileen,whocaresforhermother,whohasacombinationofmedicalneeds

andisalsofrail.

8.14 Manypeoplewhosupportfamilymemberswithmentalhealthproblemsor

drugoralcoholaddictiondonotseektoidentifythemselvesascarersasthereisstill

astigmaattachedtothisrole.Inaddition,thepersonwithcareneedsmaydeny

thattheyneedoraregettingsupportfromafamilymemberorpartner.

8.15 Therearehard-to-reachorhiddencarers,includingBMEandLGBTcarers.For

BMEcarers,problemsoflanguageandcommunicationmaymakeselfidentification

moredifficult.Professionalattitudesandbeliefssuchas‘theylookaftertheirown’

canalsoimpactonhowBMEcarersareidentifiedbypractitioners.

Chapter5Carers’RightsChapter9CarersAssessments(CarerSupportPlans)


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 Carerswhoprovidesubstantialandregularcarehaveastatutoryrightto

assessment.23Thestrategyrecognisesthatthereneedstobeimproveduptakeand

deliveryofqualityassessments.Inaddition,thosecarerswhoarenoteligiblefora

carer’sassessmentshould,asfaraspossible,beprovidedwithinformation,advice

andpointerstowardsavailablecommunitysupports.

9.2 TheScottishGovernment,localauthoritiesandHealthBoardsneedto:

• beproactiveinensuringthatcarersknowabouttherighttorequesta

carer’sassessmentandthatup-to-dateinformationoncarers’supportis

available;

• articulateandpromotethevalueandbenefitsofacarer’sassessments;

• developawiderunderstandingoftheneedforthecarer’sassessment,

anditsreachinconsideringallaspectsofcarers’lives;

• increaseaccesstocarersassessmentsandmonitortheup-take;

• ensurethatthereisanoutcomes-basedapproachwhichdoesnot

shoehornpeopleintoexistingservicesifthoseservicesarenotsuitable;

and

• ensurethatassessedneedsaremetandtheimpactandoutcomes

monitored.

9.3 Everypersonwhoisentitledtorequestanassessmentoftheirabilitytocare,

andwhowantsanassessment,shouldhaveacomprehensiveassessmentcarried

outquicklyafterrequestingtheassessment.Theassessmentshouldbereviewed

systematicallytotakeaccountofchangingcircumstancesaffectingthecarer,

cared-forpersonandotherrelevantpeople.Theassessmentshouldcovertheneed

foremergencyplanningsocarershaveaplantocoveremergencysituations.Those

23 UndertheSocialWork(Scotland)Act1968,asamendedbytheCommunityCareandHealth(Scotland)Act2002,carerswhoprovide“asubstantialamountofcareonaregularbasis”areentitledtoanassessment.

59 Caring Together

carryingouttheassessmentshouldbeknowledgeableabouttheavailabilityof

supportstothecarerandservicesforthecared-forandotherrelevantpeople.The

carershouldhaveanamedpersontheycancontactfollowingonfromthecarer’s

assessment.Carerscentreshaveakeyroleinpromotingtheassessmentandin

helpingcarerstomakethemostoftheprocess.

9.4 Theoutcomesapproachtocommunitycareseekstoembeduserandcarer

experienceattheheartofallcommunitycareservicesandsupport.Oneofitskey

principlesisdirectengagementwithpeopleusingthoseservicesandtheircarers

throughtheTalking Pointsapproachtoassessment,careplanningandreview.

9.5 TheScottishGovernment’sreviewofTalking Pointstodateshowsthatmany

frontlinepractitionersareenthusiasticexponentsoftheapproach.However,there

isgreaterresistanceamongstmiddlemanagers,whoareconcernedaboutraising

carers’expectations,thetimecommitmentrequiredforthedevelopmentofcare

plans,theneedforcontinuousreviewofthecareplans,lackofservicestosignpost

carersontoandlackofresources.Thesearelegitimateconcerns.

9.6 Nevertheless,investingtimeinthecarer’sassessmentwillreapbenefits.

Thosecarryingoutthecarer’sassessmentandtheirmanagersneedtobefully

awareoftherangeofexistingservicesinlocalareasandtohavetheabilitytotake

forwardpersonalisedandflexibleapproachestomeettheneedsofthecarer.A

stagedapproachtomeetingcarers’needsmightbeappropriate,andifthisisthe

caseitshouldbefullyexplainedtothecarer,withthecarergiventheopportunityto

comment.

9.7 ThereisguidanceonthetraininganddevelopmentofstaffontheScottish

Government’sJointImprovementTeamwebsiteat:

http://www.jitscotland.org.uk/action-areas/talking-points-user-and-carer-

involvement/staff-development-materials/

9.8 ThepreviousScottishExecutiveissuedGuidanceonSections8-12ofthe

CommunityCareandHealth(Scotland)Act2002(ScottishExecutiveCircularCCD

2/2003).Theguidancecovered,amongstotherissues,informingcarersoftheir

righttoassessmentandtheassessmentofcarers.Itisstillrelevant,butwecould

usefullycomplementitwithpracticalguidancetoundertakingcarersassessments.


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,theassessmentprocessalsopresentsanopportunitytodocument

whereresources,supportsorservicesarenotavailable.Assessorscoulddothisto

assistwithstrategicplanning.Itwouldhelptoidentifyunmetneed.

ACTION POINT 9.1On 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 9.2On 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 9.3In 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 NHSScotland and will be informed by stakeholders and carers.

ACTION POINT 9.4On 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.

Chapter5Carers’RightsChapter10RangeandTypeofSupport


The purpose of this chapter is to act as a link to the subsequent chapters on the range and type of personalised support to be made available to carers. The key issues raised at engagement events with stakeholders are set out here.

10.1 Thecarer’sassessment/carersupportplanshouldbethegatewaytosupport

andservices.However,carerswhodonothaveacarer’sassessment/planshould

alsobeabletoaccesssupportevenifthecarer’sassessmentisthepreferredroute

tosupport.

10.2 Therearemanyformsofsupportavailabletocarersoverandabovethat

provided,insomecases,byotherfamilymembers,friendsandneighbours.Carers

whoarenewtocaringoftensaythatthepriorityforthemistohaveinformation

and adviceabouttheconditionorillnessofthepersontheyarecaringfor.They

mayrequireadifferenttypeofinformationastheillnessorconditionchanges.

10.3 Inthedeliveryofsupport,itisimportanttotakeintoaccountthataperson’s

caringsituationcanchangequitedramatically,eveninashortspaceoftime.

Peoplecancontinuetobecarers,inadifferentway,forexample,whentheperson

theyarecaringformovesontoindependentlivingorintoacarehome.Caring

atend-of-lifeisparticularlydifficultandthecarermayneedsupportaftertheir

relativedies.

“I felt alone and in the dark when mum died. I loved caring for mum. But a

carer’s life starts to move on when their caring journey ends. I have now found

my own identity as this can be lost when caring. My carers’ centre supported me

to see the light. I am carrying on using my voice and experience in supporting

carers.”

Rosemary,whocaredforhermotherwithdementia.Rosemary’smother

sadlydiedinFebruary2010.

10.4 Carersfrequentlyreportthedifficultiestheyencounterandthebarriersthey

faceintheirday-to-daycaringrole.Somesaytheyhavebenefitedfromsupport

whichisthenwithdrawnorthatthereisadisjointedapproachtothedeliveryof

supportfromdifferentprofessionals.Carersthemselvesoftenhavetousetheir

limitedandprecioustimeandenergytofacilitatetheconnectionstobemade

amongstthevariousprofessionals.

63 Caring Together

“Our daughter has complex health and developmental needs. We had to come

to terms with the fact that life was going to be very different for her and for us

as a family. Services became disjointed when she was four years old. Getting

assessment and support was an uphill struggle. We co-ordinate our daughter’s

support and we want the disjointed approach to end. The battle is exhausting

for both sides.”

BrettandMaggie,whocarefortheiryoungdaughterwithararegenetic

syndrome(CorneliadeLangeSyndrome).

10.5 Carersoftenexperiencedisjointedapproachesandalackofjointworking

attimesoftransitionforexample,whentheirchildwithalearningdisabilityleaves

nurseryorschool.Thetransitionfromchildren’stoadultsocialcareservicescanbe

particularlytraumatic.Somecarershavedescribedthislike“fallingofftheendofa

cliff.”

“Planning for transition can be spectacularly pointless if there is no

follow-through. A multi-disciplinary group agreed that all of my daughter’s

support should continue as her needs would not change. But after transition to

adult services, nothing continued and I was left to start things up again as

best I could.”

Anne,aloneparentwhocaresforheradultdaughterwithprofound

learningdisabilitiesandwhoisphysicallydependent.

10.6 Equally,changecanbemanagedwell.Anne,above,alsosaid:

“The move into supported accommodation was managed very well. I was

consulted about my daughter’s care plan and social activities, equipment and

furnishings. We met her flat mate and new care workers well before the move.

A difficult and anxious time was made less so by a sensitive response to my

concerns and a clear and continuing commitment to my daughter’s wellbeing.”

Anne.

10.7 Early diagnosisofacondition,syndromeorillnesshelpswould-becarersto

accessinformationandadviceattheearliestopportunity.Forexample,theScottish

Government’scontinuingnationalhealthtargetonimprovingearlydiagnosisof

dementiarecognisesthatthisiskeytothosewithdementiaandtheircarersin

accessingthegatewaytoearlypost-diagnosticsupport.


10.8 Caringcanimpactheavilyonacarer’sphysicaland/ormentalhealthand

wellbeing.Accesstoemotional supportthroughacarerscentreorprovidedbya

condition-specificorganisationorthroughtheGPcanhelp.Somecarersneedmore

intensiveinterventionssuchascounselling.

10.9 Goodadviceandperson-centredtrainingonmoving and handlingcanhelp

withthephysical aspects of caring.Sotoocanhavingtherightservicesinplace

forthecared-forpersontolessenthephysicalburden,whichcansometimesbe

extreme.

10.10 Manycarersbenefitfromshort breaks or respite.Thisislinkedto

emergency planning–arapidresponseservice–whenthereisaneedforsuch

aservice.Carersshouldbesupportedinproactiveplanningforemergenciesand

unexpectedevents.

10.11 Carer trainingisimportant.Ifcarershaveaccesstogoodqualitytraining,

theyarebetterequippedtodealwithmanydifferentaspectsofcaringandto

continueintheircaringrole.

10.12 Housingandhousingsupportisanimportantissueforsomecarers,

especiallyinensuringtheyhavetherighttypeofaccommodationtosuittheneeds

ofthefamily.Accesstotherightequipment and adaptationswhenneededis

necessary.

10.13 Accesstotelecare servicesforthecared-forpersoncanalsoprovidepeaceof

mind,reducestressandlessenthephysicalaspectsofcaring.

10.14 Somecarers,especiallythemostvulnerable,benefitfromindependent

advocacy supporttohelptheminmanydifferentways,includingsupportingthem

intheirdealingswithhealthandsocialcareandotherprofessionals.

10.15 Manycarerswantsupporttoremaininwork asworkprovidesanincomeand

itiswhatpeoplegenerallydo,orwanttodo.Otherswanttoaccesswork,trainingor

FurtherorHigherEducation.Othercarerswhocannotworkduetoageand/orlevel

ofcaringresponsibilitywouldlikesupporttohaveagood standard of livingand

notexperiencefinancialchallengesduedirectlytothecostsofcaring.

65 Caring Together

10.16 Carers want to have an identity beyond caring which can be found in employment, volunteering and leisure opportunities.

10.17Carersappreciatethesupportprovidedbycarers centresandbyawiderange

ofvoluntaryorganisationsandoftensaytheywouldlikethemtobebetterfunded

andresourced.The sustainability of these services and ability to cope with an increasing demand is an important issue, and one which should be addressed by funding provided, where possible, by local authorities, Health Boards and others.

Chapter5Carers’RightsChapter11InformationandAdvice

67 Caring Together

The purpose of this chapter is to show why it is important for carers to have the right information and advice at the right time and to set out actions to improve provision in this area.

11.1 Carersfrequentlysaythattheywouldliketherighttypeofinformationat

therighttime,dependingontheirparticularcircumstances.Theyalsowant

up-to-dateinformation,assometimestheyareprovidedwithinformationon

servicesthatisout-of-date.Specialisthealthprofessionalscanplayanimportant

roleinprovidingcondition-specificinformationthatcanhelpcarerstounderstand

anddealwithdifficultorchallengingsymptoms.

11.2 Carersoftenneedassistancetonavigateinandaroundbothstatutoryand

nonstatutoryservicesandorganisations.

“I would like to urge other carers to get support for themselves although it was

years before I realised I was a ‘carer.’ Never be discouraged or disheartened. If

you’re determined and look ahead, there is help and plenty of information out

there. I have found that the National Schizophrenia Fellowship (Scotland) has

been a great support and I would urge others to pluck up the courage to go to a

carers’ group.”

Thispersoncaresforhersonwithschizophrenia.

11.3 The national carer organisations and other organisations, including condition-specific organisations, provide a lot of information for carers through their publications and websites. Local carers centres have a crucial role in providing a wide range of comprehensive information and advice, including carer information packs tailored to different caring situations, benefits advice and advice on health and wellbeing.

11.4 Moreover, many other Third Sector organisations such as Alzheimer Scotland, Chest Heart and Stroke Scotland, the Stroke Association and the Parkinson’s Disease Society are providing a wide range of information and advice to carers. MECOPP (Minority Ethnic Carers of Older People’s Project) is the lead agency for the joint NHS 24, Health Scotland and NES website ‘Health in my Language’ which offers patients and carers access to information in community languages.


11.5 Itisnecessarytomaintainafocusontheprovisionoftimely,accurateand

goodqualityinformationandadvicenotonlywhensomeoneisnewtocaringbut

alsowheneverinformationandadviceisneeded.Wehavealreadydiscussedthe

roleofhealthcareandsocialcareprofessionalsinidentifyingandsupportingcarers

andhavesetoutactionsinpreviouschapters.Theseprofessionalshaveakeyrole

tooinprovidinginformationandadvice.

11.6 Moreover,theCarers Information ZonebeingestablishedbyNHS inform

willhaveanimportantroleinprovidinginformationtocarers.

11.7 Thiszone,whichisdrivenbytheneedsofcarers,will:

• provideacentralaccessibleonlineresourceofspecificinformationfor

carers,rangingfrompracticalsupportforlookingaftersomeoneto

caringfortheirownhealthandwellbeing;and

• signpostcarerstothemostappropriatesourceforfurtherinformation,

supportandguidance.

ACTION POINT 11.1In 2010, the Scottish Government will continue to work with NHS inform on the development of its Carer Information Zone. Once fully developed, NHS inform will continually review the online service to ensure that it remains up-to-date, accurate and relevant to carers’ and young carers’ needs.

11.8 TheScottishGovernmentlaunchedCare Information Scotland (CIS)earlier

thisyear.Thisservice,managedbyNHS24,consistsofawebsiteserviceand

confidentialtelephonehelpline,24providingcomprehensiveup-to-dateinformation

onallaspectsofcommunitycareforolderpeople.CIScoversissuessuchas:howto

getacareneedsassessment;careoptions,includingcareathomeandcarehomes;

andhowmuchcarecosts.CISalsoprovidesinformationonlocalservicesandhow

toaccessthem,andlinkstoadviceandsupportservices.Thereisa‘Supportfor

Carers’sectioninthewebsite,providinggeneralinformationandcontactdetailsfor

localservicesandsupportorganisations.

11.9 CISisavailabletoallandismainlybeingusedbythefriends,familyand

carersofolderpeople.Carersareadvisedofthehelpavailabletothem,inaddition

tothepossibleserviceoptionsforthosetheycarefor.

24 Thehelplinenumberis:08456001001andthewebsiteaddressiswww.careinfoscotland.co.uk.

69 Caring Together

11.10 AsNHS24operatestheCISandwillruntheCarersInformationZoneinNHS

inform,theappropriatelinksareinplace.BothCISandNHSinformarenewand

willneedtofirmlyestablishtheoperationoftheircoreservicesbeforeconsidering

developments.Thepotentialforextendingtheservicesinordertoprovidea

comprehensivehelplineforallcarerswillbeconsidered,alongwithpossible

alternativeoptions.

ACTION POINT 11.2By December 2011, the Scottish Government will gather and review the available evidence and scope the potential for a Scotland-wide carers’ helpline and the options for providing it, including extending the service for carers offered by Care Information Scotland.

11.11 ManycarerssaythattoreceiveinformationfromGPsandotherhealthcare

staffontheconditionofthepersontheycareforwouldhelpthemintheircaring

role.Theybelievethattheywouldbebetterequippedtocarefortheirrelativeif,for

example,theGPinvolvedthemintheconsultationorappointmentwiththe

cared-forperson.

11.12 Familymembersdohavetherighttobeinvolvedindecisionsabout

thehealthcareofpeoplewholackcapacity,balancingthepatient’srightto

confidentialitywiththeprincipleofcarerinvolvement.Thereareanumberofuseful

sourcesofinformationonthisimportantethicalissue,afewofwhicharelisted

below.25

11.13 Withregardtopatientswhodonotlackcapacity,orwhodonothave

amentaldisorder,orwhoarenotachild,thereareethicalissuesaboutcarer

involvementandtherightofthepatienttoconfidentiality.Nooneelsecanmake

adecisiononbehalfofanadultwhohascapacity. However, it is good practice for a GP or other healthcare professional to check whether a patient needs any additional support to understand information, to communicate their wishes or to make a decision. This may include support from a relative, partner or carer or another person close to them. There is evidence to suggest that when carers are provided with appropriate information and engaged in the care planning, the outcomes for the patient and carer are enhanced. The overriding principle is the need to consider the best interests of the patient and carer.25 http://www.rcpsych.ac.uk/PDF/Carersandconfidentiality.pdf http://www.bma.org.uk/healthcare_policy/community_care/Workingwithcarers.jsp http://www.gmc-uk.org/guidance/ethical_guidance/confidentiality_64_66_sharing_information.asp http://www.gmc-uk.org/guidance/good_medical_practice/relationships_with_patients_people.asp, http://www.bma.org.uk/images/confidentialitytoolkitdec2009_tcm41-193140.pdf

Chapter5Carers’RightsChapter12CarerHealthandWellbeing

71 Caring Together

The purpose of this chapter is to set out the issues about the emotional impact of caring and the physical demands, both of which can impact adversely on carers’ health. The aim is to prevent a deterioration in health as a result of caring and to promote good health, recognising that carers – like anyone else - can experience poor health unconnected with caring. Carers’ health can be protected if the range of support discussed in this strategy is delivered according to individual needs. Even a sensitive and supportive carer’s assessment/carer support plan can reduce stress and anxiety. This chapter also sets out plans for health checks for eligible carers.

12.1 The emotional impact of caring for a relative or friend can be immense.Caring,forexample,forapartnerorrelativewithdementiaorotherneurological

conditions,orwithaseveredisabilityorlong-termorfluctuatingcondition,orfora

childwithspecialneeds,canoftenaffectacarer’semotionalwellbeingmorethan

theirphysicalhealth.

12.2 Themajorhealthconcernsarerelatedtostress,anxiety,emotional

healthandwellbeinggenerallyandthephysicalstrainsofcaring,especiallyback

problemsthroughliftingandhandling.Earlyidentificationandsupportofcarers

hasapositiveimpactontheiroverallhealth.Agoodserviceresponsetochanged

circumstancesincaringisalsobeneficialtocarers’health.

12.3 Manycarersareconcernedthattheycannotaffordtobeill,andsomefeel

unabletocontinuewiththeircaringrole.Carerswhodosaytheyareabletocope

oftenraiseconcernsaboutincreasingageandtheirownpersonalhealthproblems.

12.4 Carerscanbecomesociallyisolatedandgrounddownbytryingtoget

servicesinplaceforthepersontheycarefor.Moreover,disability,illness,and

long-termconditionsoftenchangefamilyrelationships. Being a life-long or long-term carer is challenging.Asacaringroleintensifies,manycarersreport

howpreviousmarital,partnerorparentalrelationshipschangeintopatient-nurse

relationships.Therecanbestrongfeelingsofguiltand/orangerandaninabilityto

copeattimes.

12.5 Carerscentresprovidecarerandpeersupportgroupswithinasafe,listening

environment.Thisisextremelyvaluabletomanycarers.Withtheincreaseinmore

intensiveandlong-lastingcaringsituations,thereissomeadditionaldemandfor

professionaltherapeuticandcounsellingservices.


12.6 Theservicesandresourcesinplacetothegeneralpopulationsuchas

Breathing SpaceandSteps for Stressareavailabletocarers.Inaddition,the

ScottishGovernment,withpartners,willproduceabespokeresourceforcarerson

stressandcaring.Weacknowledgeindoingsothatsomepeoplewillnotrecognise

themselvesascarersandmaythereforeuseSteps for Stressonly.

12.7 ThenewWellness Recovery Action Planning (WRAP)promotedbythe

ScottishRecoveryNetwork,whoarefundedbytheScottishGovernment,isamodel

withpotentialtohelpimprovethementalhealthandwellbeingofthegeneral

population,includingcarers.TheGovernmentwillworkwithpartnerstoexplorethis

further.

12.8 TheScottishGovernmentisworkingcloselywithNHSBoardsandothersto

expandandimproveaccesstopsychological therapiesforpeopleofallages,as

analternativetodrugtreatments.Thiswillbenefitcarerswhoneedthistypeof

supportandwhoareconcernedaboutthewaitingtimesforsuchservices.Thereisa

specificcommitmenttoenhancecapacityandtotraincurrentNHSstafftodelivera

rangeofevidence-basedinterventions.

12.9 In 2010-11, the Scottish Government is developing an access target for psychological therapies (relevant to carers as part of the general population) which will complement the existing access target for those assessed as needing specialist support through the Child and Adolescent Mental Health Services (CAMHS).

12.10 There are other innovative approaches being taken forward at local level, such as the Carers’ Counselling and Groupwork Service developed by the Voice of Carers Across Lothian (VOCAL).

12.11 Information prescriptionisbeingtakenforwardinsomeareasinScotland.

Approvedinformation(forexample,books,DVDs,CDsandwebsites)canbe

‘prescribed’topatientsandcarerstoenablethemtolearnmoreaboutthedifferent

aspectsofaconditionanditstreatment,personalandemotionalhealth,dealing

withstress,dietandsoon.Theseinitiativesshouldensurethatmaterialsare

availablethroughawiderangeofdistributionpoints,includinglibrariesandcarer

supportcentres.

73 Caring Together

ACTION POINT 12.1In 2011-12, the Scottish Government will continue to provide and raise awareness amongst both professionals and the general public (including carers) of Breathing Space. The Steps for Stress booklet will be available, on request.

ACTION POINT 12.2The Scottish Government with partners, including Health Scotland and the national carer organisations, will produce a bespoke resource on issues relating to stress and caring, building on Carers Scotland publication, Finding the Balance: Promoting Good Health – A Carers’ Resource Guide to Health and Wellbeing26and linking in to the NHS informCarers Information Zone and to Steps for Stress.The resource will be widely disseminated.

12.12 Thephysical demands of caringcanbeimmense,leadingtoexhaustionand

havinganimpactonemotionalwellbeing.Thisisespeciallysowhereboththecarer

andcared-forareelderly,orwherethecareriscaringforsomeonerequiringalotof

movingandhandlingduetolimitedornomobility.

12.13 Itisimportantforcarerswhoareableandwilling,tohavetrainingon

movingandhandlingandonthesafeuseofequipment.Ifthisiscarriedoutinthe

homethenthetrainingismuchmoreeffective.

12.14 ThroughNHSBoardCarerInformationStrategiessomeBoardshave

undertakentrainingonmovingandhandling.

12.15 TheScottishGovernmentwillpromotethebenefitsoftheseasonalflu

vaccinetocarers.Itisimportantforcarerstoprotectboththemselvesandthe

peopletheycareforfromtheeffectsofseasonalflu.

ACTION POINT 12.3In 2010-11, the Scottish Government will encourage NHS Boards, Community Health Partnerships and local authorities to introduce programmes of training for carers on person-centred moving and handling and on the safe use of equipment. This should be linked to an assessment at the point of hospital discharge planning.

26 http://www.carersscotland.org/Information/Takingcareofyourself/NewHealthResourceGuideforCarers


ACTION POINT 12.4From 2010 onwards, the Scottish Government will promote to carers the benefits of the seasonal flu vaccine to help protect themselves and the people they care for.

12.16 High-riskprimarypreventiontargetedonhealthinequalitiesissupported

throughtheKeep Well and Well North programmes.Theseweredevelopedto

tacklehealthinequalitiesthroughincreasedinvestmentinprimarycare.The

programmehasbeentargetedatthoseaged45-64livinginthemostdeprived15%

ofareasaccordingtotheScottishIndexofMultipleDeprivation(SIMD),andalsoat

othersatriskwhowouldnotbeidentifiedthroughthisapproach.Theintervention

involves:

• identifyingandengagingwiththosepeopleatparticularriskof

preventableseriousill-health(includingthosewithundetectedchronic

disease);

• givingthesepeopleaholistichealthcheck,whichfocusesonriskfactors

forcardiovasculardiseaseanddiabetes;

• offeringappropriateinterventionsandservices;and

• providingmonitoringandfollow-up.

12.17Thecurrenttargetpopulationisaround160,000,ofwhomaround70,000

havebeenchecked.Thiswillhaveincludedcarersaged45-64livingintheareas

servedbyKeepWell.

12.18Itisnotknownhowmanycarershavecomeforwardforthehealthchecks

intheKeepWellareas.However,NHS Scotland is updating its training for practitioners in the Keep Well areas, and that will include training on carer awareness and support.

12.19TheScottishGovernmentisalsoconsultingontheextensionofhighrisk

primarypreventiontargetedoninequalities.Theintentiontoextendthehealth

checksincludemakingthecheckfive-yearly,extendingtoallthe15%most

deprivedareasandloweringthe‘qualifying’ageto40fromthecurrent45.Health

Boardsarealsobeingaskedtoconsiderhowtotarget,reach,assessandsupport

thoseatincreasedriskwhodonotliveinthe15%mostdeprivedareas,including

offenders,gypsytravellersandthosefromBMEcommunities.Carerswillnowbe

addedtothatlist.

75 Caring Together

12.20TheScottishGovernmentseesmeritincarersintherelevantagebracket

havingaccessto,andbeingenabledtotakeadvantageof,thesesortsofhealth

checks,wheretheyarealsoatincreasedriskofdevelopingcardiovasculardisease

anddiabetes.However,creativeandflexiblesolutionswillberequiredtofacilitate

suchcheckswhencarerscannoteasilyattendappointments.

12.21TheScottishGovernmentwillalsoconsidertheevaluation,whenavailable,of

thehealthcheckpilotsinEngland,whichareunderwayinsixdemonstrationareas.

ACTION POINT 12.5In 2010-11, the Scottish Government will work with NHS Board Chief Executives to ensure the inclusion of eligible carers (ie those aged 40-64) in the list of those to be considered in the mainstreaming of Keep Well and Well North.

Chapter5Carers’RightsChapter13ShortBreaks

77 Caring Together

The purpose of this chapter is to be clear about the importance of flexible, personalised short breaks provision, leading to better outcomes for carers and the people they care for. We set out actions in support of the further development and sustainability of short breaks, including the allocation of a £1 million grant to the voluntary sector.

13.1 Theterms ‘short break’ and ‘respite’tendtobeusedinterchangeably.

Somecarersandserviceusersprefertheterm‘shortbreak’or‘breakfromcaring,’

signifyingabreakfromtheroutine.

13.2 Theterm‘respite,’ontheotherhand,canimplythe‘relieffromaburden,’

therebygivingthewrongimpressionofthecaringrelationship.Itcanalsobe

associatedwithinstitutionalformsofsupportorhospital-basedstays.

13.3 Whilstmanypeopleprefertousetheterm‘shortbreak’or‘breakfrom

caring,’theterm‘respite’shouldnotbedisregardedjustyetasthismore

traditionaltermisstillverymuchusedandrecognised.Indeed,somecarersusethe

termthemselves.

13.4 Carerssaythataccess to personalised, flexible short breaksprovisionis

crucial.Shortbreakshelptorechargebatteriesandsustaincarersintheircaring

role.Theycanbealifesaverforsome.Carerscanhavealifeoftheirownthrough

theprovisionofsuitableshortbreaks.

13.5 Manycarerswantplannedbreaksfromcaring.Carersalsoneedtobeableto

mixandmatchdifferentoptions,atdifferenttimesandfordifferentreasons.There

shouldatalltimesbeanemphasisonchoice,flexibilityandavailabilityofbreak

whenneeded.

13.6 Itisalsoimportanttorecognisethatsomegroupsofcarers,suchasBME

carers,mayhaveparticulardifficultiesinusingmainstreamshortbreakservices.

13.7 Manycarersdobenefitfromshortbreakswhichmeettheirneedsentirely.It

givesthemagood-qualitybreakfromthestressfuldemandsofsupportingsomeone

withadisabilityorlong-termconditionordementiaoranotherconditionorillness.

Itmakeslifeeasierforthecarer(andalsoforthepersonwithcareneeds).


13.8 Thebreakmightbeduringthedaytimeorovernight.Thebreakmightbe

foracoupleofhoursorformuchlonger.Itmightinvolvethecared-forperson

havingabreakawayfromhome,thusbenefittingthecarerinthattheyhavetime

forthemselves.Orthecarermighthaveabreakaway,withservicesbeingputin

placetosupportthecared-forperson.Somepeoplewanttohaveabreaktogether,

withadditionalsupporttomakethishappen.Sometimestheserviceisprovided

inthehomeforthecared-forperson,withthecarerhavingtimetodosomething

themselvesforacoupleofhoursduringtheday.Thislattertypeofsupportis

providedbyCrossroadsCaringScotlandandotherorganisationsandbylocal

authorities.

“We have two kinds of short breaks for our young daughter. She goes to an

activity group once a week at Sense Scotland Touchbase and has great fun.

She has planned overnight short breaks at Quarriers Countryview which is a big

adventure for her. Both services have well-designed facilities with workers who

have the expertise to support our daughter. We found out what was on offer

ourselves and are delighted with the way things have worked out over the last

two years. Short breaks can change as she gets older but we always want them

to be enjoyable for her. We can relax knowing that she is happy.”

BrettandMaggie,whocarefortheiryoungdaughterwithararegenetic

syndrome.

13.9TheScottishGovernmentandCOSLArecognisethattherearesomeverygood

initiativesanddevelopmentsatlocallevelintheprovisionofshortbreaks.There

areexamplesofimprovedconsultationwithcarersonshortbreaksprovision,better

allocationssystemsresultinginimprovedequityofaccessbasedonassessedneed,

andtheprovisionofnewfacilities.Someshortbreaksprovisionprovidesearly

interventionandwillresultincostsavingstothehealthandsocialcaresystem.

13.10Overthelastfewyearstherehasbeenprogressbutthereneedstobemore–

theprovisionofshortbreaksishighonthelistofcarers’priorities.Itisnotpossible

toknowexactlyhowmuchneedisunmet.Thismaybedueinparttoalackof

systematicdatacollectionandanalysisofthisinformation.Butitisalsodueto

thefactthatcarerscanalreadybenefitfrombreaks,forexample,duetoadirect

paymentpaidtothecared-forperson,butwithnorequirementtorecordthebreak

provisioninanysystem.Carersmayalsobenefitfromvoluntarysectorservicessuch

asbefriendingprovidedtothecared-forperson,butagainthismightnotbeknown

tothelocalauthority.

79 Caring Together

13.11 Concernsaboutshortbreaksprovision,include:

• onlybeingofferedafew hoursshortbreakeachweek,withpeoplein

similarsituationsinotherareasbeingprovidedwithmorehours;and

• lack of accessible respite in rural areas,withtherespitehoursbeing

reducedbecauseoftimespenttravellingtotheservice;

“I was very grateful to get 3 hours per week from a care provider (Crossroads)

to look after my husband whilst I travelled a round trip of 68 miles to enjoy a

swim or a coffee and chat with a friend.”

Ann,whocaresforherhusbandwithcomplexhealthproblemsand

limitedmobility.

• lackofsuitablerespite,choiceandflexibility;

• inconsistencyintheapproachtoaneedsassessment;

• poorlymanagedservicetransitions,particularlyduringthetransition

fromchildren’stoadultservices,oftenresultinginalossofsupportata

criticaltime;

• lackofinvolvementwithcarersandserviceusersinplanningand

preparingfortheirshortbreaks;and

• concernsaboutreplacementcareintimesofemergency.

13.12 Therearemanychallengingissuesaroundtheprovisionofshortbreaks.

People,quiterightly,wouldliketobeabletoaccessavarietyofshortbreaks

provisiontosuittheirneeds.

13.13 Someprovision,forexampleresidentialandovernight,isexpensivetorun,but

somepeoplerequirethis.Verytoughdecisionsarebeingmadeatlocallevelabout

howbesttoprovideandfundshortbreaksinlightofresourcingandotherpressures.

TheScottishGovernmenttoo,inexperiencingthesepressures,stillaspirestotake

forwardtheManifestocommitmentofaminimumentitlementtorespiteforthosein

greatestneed,butwillreassessthetimescalefordelivery.Progressisbeingmadewith

theConcordatcommitmenttodeliveranadditional10,000respiteweeksby2011.

13.14 Inlightofthesechallenges,all partners need to consider how best they can support carers to have time out from caring, and develop innovative solutions based on a better understanding of people’s different needs and circumstances.Forexample,childrenwithdisabilitiescanbenefitfromparticipation

inyouthclubs,after-schoolclubs,sportsclubsandholidayactivityprogrammes.


13.15 Localauthorities,withpartnersincludingNHSBoards,thevoluntarysector

andcarers,shouldusetheircombinedresourcesandexpertiseincreativewaysto

planforthedevelopmentofmoreflexible,personalisedshortbreaksprovision.

13.16 TheScottishGovernmentreceivedanumberofgoodpracticeexamplesof

innovativeshortbreaksprovisionTheseincludedtheShort Breaks Bureau operated by Falkirk Council which benefits service users and their carers with an assessed need for short breaks. This may consist of a rolling programme of short breaks in a preferred facility, occasional breaks, or emergency placement if and when required. Falkirk Council can target service user groups, for example, mental health users, to increase the uptake by this group. North Ayrshire Council runs a short break and holiday service for people with learning disabilities, complex needs, challenging behaviour, physical disabilities or autism. Theseexamplesand

othersareincludedintheseparateGoodPracticedocument.

13.17 Somecarerswhosecaringresponsibilitieshavereducedmayvolunteerby

helpingoutinanothercarer’shometogivethemabreakfromcaring.Peoplewho

havenocaringresponsibilitiesvolunteerinthiswaytoo.Thistypeofvolunteering

supportisusuallyprovidedtoafriendorrelative.

13.18 Therearealsoexamplesofvolunteerssupportingpeopletheydonotknow

initially.Thistypeofvolunteeringisusuallyfacilitatedbyorganisationssuchas

VolunteerDevelopmentScotland,CommunityServiceVolunteersandBefriending

NetworkScotland.Thelatterwilllaunchitsdementiatrainingtoolkitlaterthisyear

toenablevolunteerstotailortheirbefriendingsupporttotheneedsofthosewith

dementiaandtheircarers.

13.19 Therearedifferingviewsonwhethervolunteeringbypeoplewhoarenotthe

carers’relativeorfriend,shouldbepromotedtohelpproviderespite.Oneviewis

thatvolunteerscanusefullysupportpeoplewhodonothaveintensivecareneeds

inordertoallowthecarerabreak,whilstothersbelievethereareissuesaround

training,support,trust,disclosureandsoon.

13.20 The Scottish Government, Shared Care Scotland and others believe there is merit in exploring the volunteering options further as part of citizenship and community capacity building, and will build on the initial discussions we have had with a range of organisations.

81 Caring Together

13.21 TheScottishGovernmenthasrecentlyapprovedaPublic Social Partnership

pilotinpartofArgyllandButetosetuparespitebureauforcarersofferingamenu

ofrespiteservices.Thebureauwillcommissionadultrespitecareservicesand

provideabrokerageserviceconnectingtheneedsofcarersandserviceuserswith

themenuofrespiteservicesavailable.

13.22 Thisisoneof10two-yearpilotprojectsacrossScotlandseekinganewway

ofworkingbetweenthepublicsectorandtheThirdSector.ArgyllandButeCouncil

andArgyllandButeSocialEnterpriseNetwork,thetwopartnersintheproject,

haveappointedtheBritishRedCrossasThirdSectorPartnerandPreferredProvider.

SharedCareScotlandisalsosupportingthispilot.

13.23 Therearefurtherexamplesofshortbreaksbureaus(seetheFalkirkexample).

SharedCareScotlandhassetupanActionLearningSetcurrentlyworkingwith

ninelocalauthoritiestohelptakeforwardshortbreakbureaudevelopments.Ideas

aresharedtoseeifsomeoftheadministrativeandfundingchallengesofsettingup

abureaucanbetackled.Thebureauhelpstoconnectpeoplewithservicesthatbest

meettheirparticularneedsandsituation.

13.24 Itisveryimportantthatemergencyrespitecareisavailablewhere,for

example,acarerhastodealwithanemergencyandneedsrespiteatshortnotice.

Therearevariousmeanstoprovidesuchsupport.Inverclyde Council is using Concordat monies to fund the local carers’ centre to provide sitter services either on a one-off or ongoing basis. This service is widely publicised in order to target ‘hidden carers’ as well as those already in touch with the carers centre. The Council also has a Rapid Response Team, which has a home care team to provide emergency respite.

13.25 ThereareanumberofActionPointsasbelow,allrelevanttoyoung carers

too:

ACTION 13.1The Scottish Government, in allocating £1 million to the national carer organisations in 2010-11 for short breaks provision, will monitor progress towards the provision of innovative, personalised, flexible provision which meets the needs of carers.


ACTION POINT 13.2In 2010-11 the Scottish Government will work with Shared Care Scotland and others to disseminate the findings of the short breaks research and to consider the development of further actions in light of the findings. In particular, Shared Care Scotland seeks to use the research findings to support partners to improve the local strategic planning and commissioning of short break provision.

ACTION POINT 13.3For the duration of this strategy, the Scottish Government will undertake to strengthen the NHS role as a strategic partner in supporting the provision of respite care. The Scottish Government will facilitate a high level meeting with NHS Boards to consider current practice, with a view to identifying factors which would help promote/support joint working in this area.

ACTION POINT 13.4For the duration of this strategy, the Scottish Government with Shared Care Scotland and other partners will encourage and support the continued development of more effective ways of providing short breaks through learning networks and, where possible, the setting up of demonstration projects.

ACTION POINT 13.5From 2011, the Scottish Government will work with a range of organisations to explore the potential to develop short breaks provision through volunteers.

ACTION POINT 13.6For the duration of this strategy, the Scottish Government will work with a range of organisations to explore the potential to develop emergency respite and to support carers with emergency planning.

ACTION POINT 13.7The Scottish Government will continue to publish beyond 2011 official statistics on respite provision and will work to improve the quality and consistency of this information, in order to achieve National Statistics status for this data source and publication.

ACTION POINT 13.8By July 2012, the Scottish Government will reassess the timescale for delivery of the Manifesto commitment to a guaranteed annual entitlement to breaks from caring for those in greatest need, taking account of progress in the delivery of short breaks through the other Action Points in this chapter.

Chapter5Carers’RightsChapter14CarerandWorkforceTraining


The purpose of this chapter is to set out the positive outcomes from training provided to carers and the need for a skilled and knowledgeable health and social care workforce. Various actions are set out to help roll out carer training and to provide training to the paid workforce.

Carer Training14.1 inrecognitionofthekeyroletheyplayinprovidingcare,carersshouldget

similaropportunitiesfortrainingasthepaidworkforce.Carerswhoreceivetraining

feelbettersupportedintheircaringroleandmoreconfident.Trainingshould

addressthebroadspectrumoftheemotionalimpactandpracticaldemandsof

caring.Itshouldincludemovingandhandling,managingmedication,managing

carers’ownhealthandwellbeing,andpersonaldevelopment.

14.2 Considerationneedstobegiventohowbesttomeetthetrainingneedsof

specificgroupsofcarerssuchasBMEcarers.

“The trainer helped me to better understand how I could deal with the

difficulties I have coping with the way my son behaves because of his problems.

It helped to be given some good ideas and the way these were explained in

Punjabi afterwards made them easier to understand.”

APakistanicarerinGlasgow.

14.3 NHSBoards,localauthoritiesandvoluntarysectororganisationsneedto

supportimprovedoutcomesforcarersachievedthroughcarertraining,including:

beingmorepositiveaboutcaring,beingmoreconfidentinthecaringroleand

havingamorepositiveimpactonthecarer’shealth.

14.4 Alotofvaluableandoutcomes-focusedcarertrainingisbeingundertaken. NHS Fife, with the local carers centre, has used Carer Information Strategy funding to run training sessions for carers caring for people who have had a stroke or who have chronic obstructive pulmonary disease (COPD), and for carers who care for people with autism. The Lothian carer training pilot, Caring with

Confidence, run by NHS Lothian and the VOCAL Carers Centre, provided training to carers on manual handling. VOCAL has since introduced spot-purchasing of manual handling training in order to fast-track support for carers in greatest need.

85 Caring Together

14.5 Therearelessonstobelearned,suchashavinglearningpathwayssothat

carerscanseethewayforwardtomeettheirknowledge,skillandsupportneeds.

One-offtrainingisnotenoughinmostcases.Thereisalsosomeduplicationof

effortintheprovisionoftrainingtocarers,aswellasgaps.Moreconsideration

needstobegiventoe-trainingandtomeetingthetrainingneedsofcarersinrural and remotelocations.

14.6 TheScottishGovernmenthasprovidedagrantof£281,000tothenational

carerorganisationsin2010-11tohelppromoteandprovidecarer(andworkforce)

training.Theproposalhasthefollowingthreestrands:

• carryingoutafullauditofcarerandworkforcetrainingprovision

acrossScotlandtogetanaccurateandup-to-datepictureinorderto

enableastrategicviewtobetakenandtodevelopplansandfunding

requirementstoaddressneeds;

• developingaCarerTrainingConsortiumtosupportworkatlocallevel

andtodevelopaqualityassuranceframeworkpromotinghighstandards

oftraining,withsystematiccareroutcomeevaluation;and

• deliveryanddevelopmentofcarerandworkforcetrainingbyinviting

applicationsfromacrossthesectors,andfundingcarerandworkforce

trainingthroughtheallocationoffundsinatransparentway.

14.7 SubjecttotheoutcomeoftheSpendingReview,wewillalsoworkwith

NHSBoardssothattheywillmakeacarertrainingoffertocarers.

ACTION POINT 14.1The National Carers Organisations will use the £281,000 grant from the Scottish Government to allocate grants to a range of organisations for carer and workforce training in a transparent and outcome-focused way. The NCOs will ensure dovetailing with the NHS Board Carer Information Strategies.

ACTION POINT 14.2NHS Boards will build on the carer training provided under the Carer Information Strategies and continue to train carers beyond 2011. Subject to the outcome of the Spending Review, the Scottish Government will also work with NHS Boards so that they will make a training offer to carers.


Workforce Training14.8 Awell-informed,knowledgeable,trainedandskilledhealthandsocialcare

workforceisessentialtohelpimprovethelivesofcarersandyoungcarers.

14.9 Healthandsocialcarestaffshouldhaveaproperappreciationoftherole

ofcarersandyoung carersandcommittoengagewithcarersasequalandexpert

partnersinthedesignanddeliveryofhealthandsocialcareservices.

14.10NHSBoardsandlocalauthoritiesneedtocontinuetotakeforwardworkforce

trainingthroughinductiontrainingandcontinuousprofessionaldevelopment.

Relevant good practice includes Glasgow City Council’s mandatory training module for health and social work staff and NHS Lothian’s e-training for the workforce.

14.11 TheScottishGovernmentwilltakeforwardworkforcetrainingissueswiththe

ScottishSocialServicesCouncil(SSSC),withNHSEducationforScotland(NES)and

withothers.

14.12 Thenationalcarerorganisationswillbeusingpartofthe£281,000

grantfromtheScottishGovernmenttoallocategrantsin2010-11toarangeof

organisationsforworkforcetraining.TheNCOswillensuredovetailingwithallother

workforcetraining,includingthatbeingtakenforwardbyNHSBoards.

ACTION POINT 14.3In 2010-12, NHS Education for Scotland (NES), in collaboration with NHS Boards and the national carer organisations, will review existing training, education and learning modules for working with carers and young carers; identify core competencies for NHS staff in identifying and supporting carers and young carers; and identify packages and materials to be incorporated within core induction, education and training curricula.

ACTION POINT 14.4NES will communicate to the relevant regulatory, professional and national bodies the importance of identifying and supporting carers and young carers in workforce training and education.

ACTION POINT 14.5From 2010 onwards, the Scottish Government will work with NHS Boards to ensure that identifying and supporting carers and young carersis embedded inworkforce training.

87 Caring Together

ACTION POINT 14.6From 2010 onwards, the Scottish Government will continue to promote the benefits of workforce training through the Scottish Social Services Council (SSSC), the national carer organisations and others.

ACTION POINT 14.7In 2011-12, NHS Education for Scotland (NES), and the national carer organisations will produce a good practice guide to workforce training. This will be widely distributed.

Chapter5Carers’RightsChapter15HousingandHousingSupport

89 Caring Together

The purpose of this chapter is to indicate the importance to carers of having suitable housing and to set the necessary action within the context of housing reform and Reshaping Care.

15.1 ThereisnospecificCare21recommendationinrelationtohousingor

housingsupport.However,overthepastfewyearscarershaveraisedanumberof

concernsabouthousing,primarilythesuitabilityofhousingforchangingneeds,

andhousingforadultswithlearningdisabilitieswhooutlivetheirparents.Issues

aboutequipmentandadaptationsarecoveredinchapter16ontheuseofassistive

technology.However,itisimportanttonoteherethataidsandadaptationscan

helppeopletoremainintheirownhomewhichcanresultinlesspressureonsocial

housing.

15.2 Someofthespecificconcernsraisedinclude:

• peoplewithlearningdisabilitiescanbeallocatedahousebutthenthere

isnofundingtoputthesupportservicesinplace.Weshouldexplore

waysofpredictingdemand(forhousingandsupport)thatlinkperson-

centredplanningwithcapacity;

• housesareinthewronglocationforindividuals;

• peoplewithlearningdisabilitieswantandshouldbeabletoaccess

thesameopportunitiesforhavingtheirownhomeaspeoplewithout

disabilities;

• muchofshelteredhousingissingleroomorbedsitanddoesnotallowfor

visitingcarersandotherfamilymembers,andsupportedaccommodation

doesnotallowforpartnerstoberesidentandtocontinueintheircaring

role;and

• equipmentandadaptationsshouldbeprovidedquickly(seechapter16

onAssistiveTechnology).

15.3 Housingisanimportantelementinenablingcarerstosupporttheperson

theycarefortoliveindependently,safelyandwithdignityintheirownhomesand

communities.

15.4 TheissuesraisedbycarershavebeenrecognisedaspartofthejointScottish

Government/COSLAReshapingCareprogramme.Thehousingworkstreamknown


as’WiderPlanningforanAgeingPopulation’hasbeentakenforwardthrougha

stakeholderworkinggroup.Thegrouphasidentifiedfivemainoutcomesforolder

people’shousing:

• clearstrategicleadershipisinplaceatnationalandlocallevelaboutthe

housingoutcomestobedeliveredforolderpeople;

• olderpeoplearebetterassistedtoremainin,andmakebestuseof,

existinghousingstock;

• investmentinnewhousingprovisionacrossthesectorsmeetsthefuture

needsofolderpeople;

• theneedsofolderpeopleforlowlevel,preventativesupportaremet;and

• theinfrastructuretosupporttheseoutcomesisimproved.

15.5 Theworkstreamalsoconsideredarangeofoptionstoachievethese

outcomes.Itsreport27proposes27suggestedactionsforspecificmeasures,

coveringpolicy,evidence,standards,guidance,deliveryandinfrastructure.

15.6 TheScottishGovernmenthaslaunchedadiscussionpaperonthefuture

shapeofhousingpolicyinthelightoftheactiontakentorespondtothe

economicdownturn,thefutureconstraintsonpublicexpenditure,andthemany

otherchallengesfacingScottishhousingoverthenextfewyears.Oneofthese

isrespondingtotheincreaseinthenumberofpeopleaged75andover.The

discussionpaperthereforehighlightstheimportanceofsupportingindependent

living,andmoreeffectivelinksbetweenhousing,socialcareandhealthpoliciesand

servicesinthefuture.Thisshouldassistthosecaringforolderordisabledpeople.

15.7 Glasgow City Council has recently demonstrated how allocations policies can be adapted to support families in difficult circumstances. With a range of partners the Council produced in March 2010 ‘A Practical Guide for Registered

Social Landlords: Housing and Autism Spectrum Disorder (ASD).’ These guidelines are a reminder of what registered social landlords need to do to fulfil their duties and to assist people with ASD to get access to appropriate living conditions. It is helpful to the carers of people with ASD. For example, a single mother of two children, one with Asperger’s Syndrome, lived in a two-bedroom property in multi-storey flats. The son with Asperger’s Syndrome needed his own bedroom. The allocations policy did not take account of her son’s need for his own space, as it only took account of physical disability. The Autism Resource Centre worked closely with the Registered Social Landlord to amend the policy so as to award a medical priority for applicants affected by ASD.

27 http://www.jitscotland.org.uk/action-areas/reshaping-care-for-older-people/workstream-e---wider-planning-for-an-ageing-population---housing-and-communities/

91 Caring Together

ACTION POINT 15.1For the duration of this strategy, the Scottish Government and COSLA will work with local authorities, housing associations, the independent rented sector, Health Boards and other partners to ensure that the needs and views of carers are taken into account in developing more effective links between housing, social care and health policies and services.

ACTION POINT 15.2Carers views will be taken into account during public engagement events in 2010 on the Reshaping Care for Older People programme. These views will help shape the development of that programme.

Chapter5Carers’RightsChapter16UseofAssistiveTechnology

93 Caring Together

The purpose of this chapter is to set out action to extend the use of telecare and to ensure that carers have access to information and training on the use of equipment.

Telecare16.1 Telecareistheremoteorenhanceddeliveryofcareservicestopeople

intheirownhomeoracommunitysettingbymeansoftelecommunications

andcomputerisedservices.Thetermusuallyreferstosensorsandalertswhich

provideautomaticandremotemonitoringofcareemergenciesandlifestyle

changes,totriggerhumanresponsesorshutdownequipmenttoprevent

hazards.All32localpartnershipsinScotlandhavedevelopedtelecareservices.

16.2 Averybroadrangeoftechnologiestosupporthealthandcareneedshas

beendeveloped.Theterm‘telehealthcare’isnowbeingusedtodescribethe

widerpackageofservices.

Case studyJoyce has dementia and lives with her husband in Edinburgh. Joyce

tends to walk about during the night. Recently Joyce was admitted to

hospital, unlikely to return home due to her health situation and lack of

management of her night walking. However, Joyce was provided with a

telecare solution, including a property exit sensor and a pager system.

Should Joyce try to leave the house during the night, the property exit

sensor automatically raises a call to her husband’s pager and gradually

turns on the bedside light. This allows Joyce’s husband to get to the

front door or street to assist his wife to return home. It also helps him to

get a better sleep knowing he will be alerted if needed.

16.3 InanindependentreviewoftheTelecareProgrammein2008,2874%of

carersreportedreducedstressand93%ofthosebeingcaredforfeltsaferat

home.Morerecentresearch29furtherreinforcesthesefindings,andidentifies

thatcarerscanbenefitsignificantlyfromusingtelecareservices.

28 TheYorkHealthEconomicsConsortium(YHEC)29 http://www.sociology.leeds.ac.uk/assets/files/research/circle/carers-scotland-report-dec-2009-web.pdf


16.4 Carershavesaid:

“When you have a vulnerable person to care for in your house, it feels like you’re

on duty 24/7. So it was wonderful, it allowed me to relax, gave me chill out time.

I wasn’t on alert throughout the night.”

“I can sleep easier and work easier knowing that a call-out will happen if

something is wrong.”

16.5 Theappropriateandtargeteduseoftelecarecanhelpcarersby:providing

affordableaccesstosupportandassistanceroundtheclock;supportingindividual,

personalisedservices;achievingfewerdaysinhospitalandcarehomesandless

AccidentandEmergencyadmissions;reducingstressandprovidingpeaceofmind;

enablingagoodnight’ssleep;helpingsomecarerstocombineworkandcare;

providingsomewithanopportunityforalifeoutsideofcaring;andprovidingearly

intervention.

16.6 TheScottishGovernmentwillworkwithpartners,includinglocalauthorities,

toensurethattelecarefullybenefitscarersinScotland,enablesmorepeopletolive

independentlyandimprovesthequalityoflifeforcarers.

ACTION POINT 16.1In 2010-11 the Scottish Government, with local authority and other partners, will raise awareness of telecare amongst carers nationally and locally and will ensure that carers have better access to appropriate information on services.

ACTION POINT 16.2The Scottish Government, with Carers Scotland, will ensure that carers’ training is included as part of a national approach to telecare education and training, with a specific workstream developed to address this over 2010-12.

ACTION POINT 16.3In 2010-12, the Scottish Government will ensure that telecare is included in the practical guide to undertaking carers assessments and will promote its further integration within Single Assessment and Care Management/Review protocols and processes.

ACTION POINT 16.4By 2015, the Scottish Government will further maximise the impact of its telecare investment to ensure that the benefits and applications of the new technology for carers continues and develops.

95 Caring Together

ACTION POINT 16.5In 2010-2015 the Scottish Government will further explore the innovative use of new technologies in support of carers living in remote and rural areas, and identify mechanisms which may be more accessible to young carers.

Equipment and Adaptations16.7 Equipmentandadaptationscanplayanimportantpartinsupportingthe

roleofcarers.Havingtherightequipmentoradaptationsinthehomewillallowthe

cared-forpersontoremainathomeforlonger.Itwillalsoreducethepressureon,

andrisksto,thecareranditcanhelppreventhospitaladmissions.

16.8 Research30hasshownthatmanycarersandotherfamilymembersare

puttingtheirhealthatrisk,orsufferingactualshortorlong-terminjury,through

liftingorcarryingtheirchildrenorotherrelatives,becauseofthelackofsuitable

facilities.

“His mother had back problems and had to have an emergency operation after

lifting him onto the toilet one day. She has seen X-rays of her spine which have

convinced her that she cannot risk further damage by trying to help him in

these areas.”

16.9 Itisclearthattheprovisionofequipmentandadaptationscanprovide

physicalrelief,particularlywithregardtobackstrain.Therearealsofinancialand

economicimplications,asadamagedbackcancostthestateinmedicaltreatment

andlostemployment.

16.10 Theissueofcompatibilityofequipmentisoftenraisedbycarers,including

parentcarers,youngpeopleandpractitioners.Parentsinparticularfeelthat

manufacturersshouldworktogethertoensureequipmentiscompatible.

16.11 Anyunnecessarydelayintheprovisionofequipmentandadaptationscan

causefrustrationandputcarersandthepeopletheycareforatrisk.

30 http://www.jrf.org.uk/publications/effectiveness-housing-adaptations


16.12 It is essential therefore that assessments are carried out as early as possible and that the views and experience of the carer are taken into account. The assessment should take into account how needs will change over time, especially when providing adaptations. Where delays are unavoidable, carers and the people they care for need to be kept informed, advised of the reasons for any delay and given a realistic timescale for delivery of equipment or completion of the adaptation.

16.13 Itisalsovitalthatcarers receive adequate trainingontheuseofthe

equipmentprovided.TheHandlewithCareReport31publishedin2008byScotland’s

CommissionerforChildrenandYoungPeoplehighlightedthisasamajorissue.

16.14 Thereportstatedthatthevastmajorityoftheparentsandcarershad

receivednomovingandhandlingtraining.Onecarerstated:

“We never get offered moving and handling training. Our hoist was put in at

home but no training was offered regarding the hoists and slings. They didn’t

even guide us to where we could get training.”

ACTION POINT 16.6In 2011-15 the Scottish Government, with local authorities, Health Boards and other partners, will raise awareness of equipment and adaptations amongst carers and ensure that carers have better access to appropriate information and training on equipment.

31 http://www.sccyp.org.uk/webpages/Handle_with_care_lr.pdf

Chapter5Carers’RightsChapter17AdvocacySupport


The purpose of this chapter is to confirm the importance and value of advocacy for carers in their own right and to encourage support for the development of carer advocacy.

17.1 ThreededicatedcareradvocacyinitiativesoperateinScotland.Carer

advocacyprovidesanimportantsupporttothemostvulnerablecarerstohelp

themtocommunicatetheirviewsclearlyandtosupportthemoncomplexissues

relatingtothecaringsituation.Oftenthesecanrequiretheco-ordinationofaction

byseveralagenciesorcoversituationswherecarersseektoaccessmainstream

provisionforpeoplewithsupportneeds.Theremaybesituationswherepersistence

isrequiredoveralongperiodoftimetoreachasolution,forexample,withhousing

issuessuchasrelocationormajorhousingadaptationstoprovideforindependent

living.

17.2 Inadditiontotheircaringresponsibilities,carerscanbeswampedbyalarge

volumeofpaperworkfromarangeofagenciesinvolvedwiththecareoftheservice

user.Theymayalsoberequiredtoproduceasignificantamountofcorrespondence

themselves.Careradvocacyservicessupportcarerstofillinvariousformsand

applications,writeappealsubmissions,draftformalcomplaintletters,write

specialisteducationplacementrequestsandwritetoMSPs,MPsandcouncillors.

17.3 Careradvocacyorganisationsreportpositiveoutcomesforcarersonawide

rangeofissues,forinstance,one-offinterventions,multi-disciplinaryhearingsand

longcampaignsforre-housingorhousingextensionstoaccommodatepeoplewith

complexdisabilities.Manyofthebeneficiariesarethemselvesdisabledorelderly,or

havementalhealthproblemsorlearningdisabilities.Providingcareradvocacycan

helprestorefamilyandpartnerrelationships.

17.4 Careradvocacyshouldnotgenerallybeprovidedbyindependentadvocacy

workerswhoalsorepresentusersofservices,asthismayleadtoaconflictof

interestandunderminenationalguidanceonprinciplesandstandardsofadvocacy.

Carerscentresarewellplacedtoprovidecareradvocacyasmostlocalcarer

organisationsalreadyfulfiltheroleascollectivecareradvocacyorganisations.

99 Caring Together

“I am the sole carer for my son who has Autistic Spectrum Disorder. His

condition was not diagnosed and he was excluded from school for nearly

4 years. I was judged by many professionals to be the cause of his behaviour.

He was violent and abusive towards me and I became depressed and suicidal.

Having been informed of the existence of the local Advocacy Service I now have

a trained and sympathetic advocate who has, after a 3 year battle, got my son

diagnosed and starting to be integrated into mainstream education. Advocacy

has been my lifeline. I can rely on her support and advice at any time. She is

both mine and my son’s voice at meetings.”

Allison,whoisthesolecarerforherson,whohasAutisticSpectrumDisorder.

17.5 TheScottishGovernmentandCOSLArecognisethevalueandbenefit

ofrepresentationforcarersandwillconsiderthescopeforguidanceabout

careradvocacy.Inviewofthefactthatthemostvulnerablecarerscanbenefit

enormouslyfromadvocacysupportrelatingtotheirabilitytocareandthesupport

theyreceivefortheircaringrole,wewillalsoencouragelocalpartnerstodevelopor

expandcareradvocacy.

ACTION POINT 17.1The Scottish Government and COSLA acknowledge the value and benefit of carer advocacy. From 2011 onwards we will encourage local authorities, NHS Boards and other local partners to develop or expand carer advocacy services for those in greatest need. We will also in 2011-12 examine the scope for producing guidelines on carer advocacy.

Chapter5Carers’RightsChapter18EmploymentandSkills

101 Caring Together

The purpose of this chapter is to confirm the importance of carer employment, skills development and lifelong learning, recognising the important role of carer-friendly and flexible working practices and to set out actions in support of this.

18.1 Takingonacaringroleshouldnotmeanthatpeoplehavetogiveupworkto

care.Ifpeoplehavetoleavepaidemployment,reducehoursofworkormoveinto

alowerskilledjob,theycanexperiencefinancialhardshipthroughlossofearnings

(estimatedat£11,822eachyear32)andpensionrights.

18.2 Thebenefitsofemploymenttoindividualsinsociety(forexample,income,

responsibilityandrespect)shouldextendtocarers.Carerswhowantandareable

toworkshouldbeenabledtodoso,andshouldnotbediscriminatedagainst.They

shouldbesupportedintheworkplacetomaintaintheiremploymentstatus.

18.3 TheparticularchallengesfacedbyBMEcarerswhosecommunitiesare

characterisedbyveryhighlevelsofselfemployment,(forexample,retailand

catering)needtobetackledsothatBMEcarersarenotexcludedfromemployment

opportunities.

18.4 Carersshouldhaveaccesstolifelonglearningopportunities,furtherand

highereducationandskillsdevelopmentinwayswhichtakeaccountoftheircaring

responsibilities.

18.5 Thereisagoodeconomicandbusinesscaseforsupportingcarersthrough

introducingandextendingflexibleworkingpractices.33

18.6 EmploymentisreservedtotheUKParliament.However,theScottish

Government,throughskillsdevelopmentandeconomicpolicies,andthepromotion

ofcarer-friendlyworkingpractices,cansupportcarerstoremainin,orreturnto,

employmentortotakeuplifelonglearningopportunities.Whereworkingagecarers

havetogiveupemploymenttocare,thereneedstobeaccesstoongoingsupport.

18.7 Itisimportanttosupportcarersastheybegintoplantheirroutebackinto

workorlearningoncecaringends.

18.8 TheJobCentrePlusprogrammeinScotland,WorkFocusedSupportforCarers,

isinplace.

32 http://www.carersuk.org/Professionals/ResearchLibrary/Financialimpactofcaring/120110902333 http://www.carersuk.org/Professionals/ResearchLibrary/Employmentandcaring/1201869157

102 Chapter18 pp.100-102

18.9 Manyemployershavedevelopedcarer-friendlypoliciesandeffective

workplacepractices,enablingcarerstoremainin,ortoreturnto,work.34

18.10 ThereisaclearmessageandvisionintheSkillsforScotlandStrategyand

theScottishGovernment’seconomicpoliciesthatwehavethepotentialtodo

morewiththeskillsavailabletous.TherefreshedSkillsStrategyforScotlandwill

emphasisetheimportanceofskillsdevelopmentforcarersandyoung carersand

theskillsthatcarersandyoungcarersbringtoemployment.

18.11 TheScottishGovernmentispleasedthatSkillsDevelopmentScotland35has

undertakentosupportcarersandyoungcarersinboththeshortandlongerterm.

SkillsDevelopmentScotlandhascommittedtoanumberofActionPoints.Thosein

relationtoyoung carersareincludedintheyoungcarers’partofthestrategy.

ACTION POINT 18.1In 2010 and beyond, the Scottish Government will: - encourage public bodies,36 through identifying and building on good

practice, to promote carer friendly employment practices; and- i dentify ways in which the Scottish Government can work with employers

and others to promote carer friendly employment practices. The Scottish Government’s Employability Learning Network (ELN) will help with this, including consultation with employability stakeholders.

ACTION POINT 18.2By September 2011, Skills Development Scotland will increase awareness of its services and resources with carers’ centres in Scotland, facilitated by the PRTC.

ACTION POINT 18.3By December 2011, Skills Development Scotland will explore the opportunities afforded to carers by its partnership with JobCentre Plus, to develop an Integrated Employment and Skills service.

ACTION POINT 18.4By March 2012, Skills Development Scotland (SDS), the national carer organisations and the network of carers centres will work together to build on good practice to: - identify the learning, career aspirations and employability requirements

of carers; and - i dentify ways in which SDS services can be more effectively targeted to

help carers into training and employment.

34 NationalFrameworkforCarersandEmployment,CarersScotland(2007)35 Setupin2007,SkillsDevelopmentScotlandisanon-departmentalpublicbody,accountabletoScottishMinisters36 ExecutiveNonDepartmentalPublicBodies(NDPBs),AdvisoryNDPBs,Tribunals,NHSBodiesandothersignificantnationalbodies

Chapter5Carers’RightsChapter19TacklingPoverty:FinancialInclusion

104 Chapter19 pp.103-106

The purpose of this chapter is to summarise the issues which have an impact on carers’ level of income and to set out actions to help carers maximise their income. Policy on, and administration of, all benefits and tax credits, including the Carer’s Allowance, is the responsibility of the UK Government.

19.1 Povertyandworriesaboutfinancescanhaveanadverseimpactoncarers’

health,wellbeingandqualityoflife.

19.2 Awiderangeofissuesimpactsoncarers’levelofincome.Carerscan

experiencesignificantfinancialhardshipasaconsequenceoftheircaringrole.They

areoftenfacedwithadditionalcosts,includingfuelcosts,37asaresultoftheillness

ordisabilityofthepersontheycarefor,andtheircaringresponsibilitiescanactasa

barriertoenteringpaidemployment.

“Because the house is used 24/7, gas and electricity consumption is higher than

for those who go out to work. I estimate at least double that of working people.”

19.3 Manycarers,boththoseagedover60andyoungercarers,donotclaimthe

fullrangeofbenefitstowhichtheyareentitled.Theymissoutonpensioncredits,

theCarer’sAllowanceandotherbenefits.38

19.4 WhiletheScottishGovernmentdoesnothaveresponsibilityforthewelfare

system,itdoeshavesomeimportantleverstoinfluencetheuptakeofbenefits.Ithas

madeclearstatementsabouttheimportanceofthebenefitandtaxcreditsystem

workinginpartnershipwithlocalwelfarerightsinformationandadviceservices

tomaximiseincomeandpromotefinancialcapability.TheScottishGovernment

andCOSLAframeworkfortacklingpovertyandincomeinequality,Achieving our

Potential,39setsoutthewiderapproachtoaddressingpovertyanddisadvantage.

19.5 Income maximisation support is vital at points of transition in people’s lives, and should be integrated with holistic services that address all aspects of financial and social exclusion and health and wellbeing. It is important to ensure that people claim all of the financial support to which they are entitled but the work on income maximisation is wider than that. It includes reducing expenditure by, for example, providing advice on the best fuel tariffs or on home insulation, or helping people to manage their debts. It involves a wide range of partners in addition to the named agency.37 http://www.carersuk.org/Professionals/ResearchLibrary/Financialimpactofcaring/122831810138 http://www.carersuk.org/Professionals/ResearchLibrary/Financialimpactofcaring/1207235156 http://www.carersuk.org/Professionals/ResearchLibrary/Financialimpactofcaring/122831810139 http://www.scotland.gov.uk/Publications/2008/11/20103815/0

105 Caring Together

19.6 Arangeofsupportexiststohelpthosewithcaringresponsibilitiestoaccess

allofthebenefits,taxcreditsandgrantsthattheyareentitledto.Welfarerights

servicesarecentraltolocalcitizensadvicebureaux.Manyotherlocally-basedservices

alsofocusonthosecommunitiesandhouseholdswhicharemostvulnerableto

pooroutcomes.Increasingly, Community Planning Partnerships are enhancing established mainstream services to provide holistic and responsive care which addresses all aspects of life circumstances, such as income maximisation, debt advice, access to affordable credit and supporting financial capability. The Scottish Government plans to explore the role of Single Shared Assessments in ensuring that carers are aware of, and receiving all of, the benefits and tax credits to which they are entitled, and in referring individuals for benefit checks where appropriate.

19.7 Arrangementsforsupportingfinancialcapabilitylocallyvaryacrossthe

country,withservicesprovidedby,amongstothers,localauthorities,community

andvoluntarygroups,creditunionsandCitizensAdviceBureaux.Nationwide

servicesareprovidedbyhelplinessuchasCitizensAdviceDirect,CareInformation

ScotlandandtheNationalDebtline.TheConsumerFinancialEducationBody’s

service,Moneymadeclear,offersinformationandguidanceonfinancialmatters,

tailoredtoanindividual’sneedsandcircumstances.Itisaproactive,early

interventionserviceaimingtohelppeoplemakeconfident,informeddecisionsand

makethemostoftheirmoney,withouttryingtosellthemfinancialproducts.

19.8 Moneymadeclearisavailableonthephone,onthewebandcurrently

face-to-faceintheGlasgowarea.The face-to-face service will be available across Scotland from the end of 2010.40

19.9 Intermediariesthatdeliveradviceandsupporttocarersareencouraged

toaccesstrainingwhichincreasesthecapacityoffrontlineagenciestoprovide

accurate,highqualityandeffectiveadviceandinformationontaxcreditsandother

welfarebenefitstoeligibleclaimants.Thiswillhelpmaximisethepotentialincome

availabletofamiliesandindividuals.TheChildPovertyActionGroupSecondTier

AdviceProjectdeliverssuchtraining,fundedbytheScottishGovernment.41

19.10SinceApril2009,incomemaximisationcheckshavebeenundertakenaspart

oftheEnergyAssistancePackage.ThesearecarriedoutbythePensionsServicefor

peopleaged60andover,andbyCitizensAdviceDirectforthoseagedunder60.

Appendix9providesbackgroundontheEnergyAssistancePackage.

40 Moreinformationisavailableat:http://www.moneymadeclear.fsa.gov.uk/41 http://www.cpag.org.uk/scotland/

106 Chapter19 pp.103-106

19.11 Carerorganisations,otherThirdSectorandstatutorybodiesshouldcontinue

toraiseawarenessofthebenefitstowhichcarers,andthosetheycarefor,maybe

entitledto.

ACTION POINT 19.1The Scottish Government will pursue with the new UK Government, as it did with the previous administration, the level of the Carer’s Allowance and a review of financial support to carers.

ACTION POINT 19.2The Scottish Government will work with local authorities and the NHS to enhance the role of Single Shared Assessments and Carers Assessments (Carer Support Plans) as opportunities to promote financial inclusion for carers.

19.12Carerscanbeconcernedaboutlocalauthoritychargingpoliciesforarange

ofsocialcareservicesandsupports.Theycitearangeofissues,includinglackof

consultationonincreasedcharging,sharpmeanstestingtapersonrespitecharges

anddifferencesinapproachindifferentareas.

19.13Localauthoritieswillcontinuetochargeserviceusersandcarersforservices

andsupport.However,COSLApromotestheuseofconsistentandtransparent

chargingpoliciesacrossthecountryandrefreshesitschargingguidanceonan

annualbasis.COSLA is also moving to an online facility, whereby every council’s charging policy will be available to view online. A benchmarking facility is also planned for practitioners in local authorities in order to achieve consistency in the way charging policies are formulated.

ACTION POINT 19.3COSLA will create a benchmarking network to facilitate consistent approaches to charging for non-residential social care services across local authorities. Work will be undertaken annually to assess levels of consistency across Scotland. As part of this process COSLA will engage with national carers organisations to listen and respond to any concerns.

107 Caring Together

Appendix 1Carers Strategy Steering Group

Name Organisation

PatBegley CarersScotland

SueBrace CityofEdinburghCouncil/ADSW

FlorenceBurke PrincessRoyalTrustforCarers(PRTC)

ClaireCairns CoalitionofCarersinScotland(COCIS)

FionaCollie CarersScotland

AnneConlin CarersScotland

SamCoope ScottishGovernment

RonCulley COSLA

SharonDuncan NHSGrampian

SebastianFischer COCISandVoiceofCarersAcrossLothian(VOCAL)

LornaKelly NHSGreaterGlasgowandClyde

SuzanneMunday MinorityEthnicCarersofOlderPeopleProject(MECOPP)

MoiraOliphant ScottishGovernment

CatherinePaterson CarersReferenceGroup

GordonPaterson ScottishGovernment(secondedfromFifeCouncil)

AdamRennie ScottishGovernment(Chair)

JulieRintoul ScottishGovernment

FionaRoberts AlzheimerScotland

JackRyan CrossroadsCaringScotland

MarthaShortreed SocialWorkInspectionAgency(SWIA)

JulieWebster ScottishGovernment(Minutes)

LynnWilliams PRTC

DonWilliamson SharedCareScotland

108 Appendices pp.107-148

Appendix 2Carers Reference Group

Name Area Caring Situation

TonyFitzpatrick(resigned)

NorthLanarkshire

Adultdaughterwithseverelearningdifficulties

AlanGow Glasgow Adultsonwithmentalhealthproblems

AnneHenderson(resigned)

Highland Dualcaringrole

RosemaryKennedy

Glasgow Motherwithdementia,whosadlydied

AnneMacleod EdinburghAdultdaughterwithcomplexdisabilitiesasaresultofRettSyndrome

BrettMillett GlasgowYoungdaughterwithraregeneticsyndrome,CorneliaDeLangeSyndrome

AnnOliver HighlandHusbandwhohascomplexhealthneeds,includinglimitedmobilityandbonestructureproblems

CatherinePaterson

ArgyllandButeFormercarerforhusbandwithmotorneurondisease.Nowcaringforparentsintheir80s,onewithdementia

EleanorRobertson

Renfrewshire Adultsonwithdrugaddictionsinceage17

SamarSheikh

Lanarkshire Adultsonwithdisabilities(similartocerebralpalsy)

PaulWeddell WestLothianWifehasmultiplesclerosisandadultdaughterhaslearningdifficulties

109 Caring Together

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and

Hea

lthB

oard

s-

wit

hpa

rtne

rs

2.5

By2

015,

the

Sco

ttis

hG

over

nmen

tw

ille

nsur

eth

att

hein

tent

ions

to

acce

lera

tet

hep

ace

ofs

harin

ggo

odp

ract

ice

unde

rRe

shap

ing

Care

take

acc

ount

of

good

pra

ctic

ein

sup

port

ing

care

rs.

Scot

tish

Gov

ernm

ent

3.PR

OFI

LE O

F CA

RERS

3.1

The

Scot

tish

Gov

ernm

ent

will

mak

eth

ein

form

atio

nco

llect

edo

nca

rers

an

dy

oun

g c

are

rst

hrou

ghs

urve

yss

uch

ast

he

Scot

tish

Hou

seho

ldS

urve

yan

dSc

otti

shH

ealth

Sur

vey

acce

ssib

let

ore

sear

cher

s,c

are

prov

ider

san

dth

epu

blic

thr

ough

its

web

site

and

pub

licat

ions

.

Scot

tish

Gov

ernm

ent

-w

ith

loca

laut

horit

ies

3.2

Inre

spec

tof

the

201

1Ce

nsus

,the

vie

ws

ofc

arer

s’o

rgan

isat

ions

will

be

take

nin

toa

ccou

ntin

dec

idin

gw

hat

anal

ysis

tabl

es

will

be

prod

uced

fort

heG

ener

alR

egis

terO

ffic

efo

rSco

tland

201

1Ce

nsus

web

site

.Sc

otti

shG

over

nmen

t-

wit

hG

RO(s

)

3.3

In2

011-

12,t

heS

cott

ish

Gov

ernm

ent

will

dra

wu

pa

spec

ific

atio

nan

dse

ekt

oco

mm

issi

onre

sear

cho

nco

mm

unit

ies

of

care

rsw

ekn

owli

ttle

abo

utin

clud

ing

refu

gees

,asy

lum

see

kers

,gyp

syt

rave

llers

and

car

ers

wit

hdi

sabi

litie

s,in

clud

ing

lear

ning

dis

abili

ties

.(R

elev

ant

to

you

ng

ca

rers

too

).

Scot

tish

Gov

ernm

ent

-w

ith

NCO

s

4.PR

IORI

TISI

NG

SU

PPO

RT F

OR

CARE

RS

4.1

By2

012,

ift

hey

have

not

alre

ady

done

so,

loca

laut

horit

ies

wit

hpa

rtne

rs,w

illw

ish

tore

visi

tth

eirl

ocal

car

ers

trat

egie

sto

iden

tify

and

sup

port

car

ers

inn

eed

acco

rdin

gto

the

irow

nas

sess

men

tof

nee

d.T

osu

ppor

tth

isp

roce

ss,t

heS

cott

ish

Gov

ernm

ent

will

pro

duce

as

hort

list

of

key

poin

tst

hat

loca

lcar

ers

trat

egie

ssh

ould

add

ress

.

Coun

cils

Scot

tish

Gov

ernm

ent

111 Caring Together

4.2

By2

013,

loca

laut

horit

ies,

wit

hpa

rtne

rs,w

illa

imt

oid

enti

fyc

arer

sin

gre

ates

tne

eda

ccor

ding

to

ano

bjec

tive

ass

essm

ent

ofn

eed,

and

inli

new

ith

publ

ishe

din

dica

tors

,whi

cha

lso

take

sac

coun

tof

the

nat

ure

and

leve

lof

risk.

The

yw

illa

imt

opr

ovid

esu

ppor

t,or

sig

npos

ton

to

supp

ort.

Coun

cils

4.3

Ove

rthe

nex

tfi

vey

ears

,loc

ala

utho

ritie

san

dH

ealth

Boa

rds,

wit

hpa

rtne

rs,s

houl

dse

ekt

opr

ovid

epr

even

tati

ves

uppo

rtt

oca

rers

and

min

imis

eth

ene

edfo

rcris

isin

terv

enti

on.

Coun

cils

and

Hea

lthB

oard

s

4.4

Ove

rthe

nex

tfi

vey

ears

the

Res

hapi

ngO

lder

Peo

ple’

sCa

reP

rogr

amm

ew

illlo

okt

oen

sure

afo

cus

one

arly

inte

rven

tion

for

care

rs.G

ood

prac

tice

int

his

area

will

be

tran

sfer

red

too

ther

car

ese

ttin

gs.

Scot

tish

Gov

ernm

ent

-w

ith

part

ners

5.EQ

UA

LITI

ES –

EQ

UA

LITY

GRO

UPS

AN

D C

ARI

NG

IN

REM

OTE

AN

D R

URA

L A

REA

S

5.1

The

Scot

tish

Gov

ernm

ent,

wit

hCO

SLA

and

par

tner

s,w

ille

nsur

eth

ata

llth

eA

ctio

nPo

ints

int

his

stra

tegy

are

take

nfo

rwar

din

way

sw

hich

fully

add

ress

the

equ

alit

ies

pers

pect

ive.

Scot

tish

Gov

ernm

ent

and

COSL

A-

wit

hpa

rtne

rs

5.2

From

201

0on

war

ds,t

heS

cott

ish

Gov

ernm

ent

will

wor

kw

ith

the

rele

vant

loca

laut

horit

ies,

Hea

lthB

oard

san

dTh

irdS

ecto

ror

gani

sati

ons

tod

evel

opp

lans

to

help

add

ress

rura

lcar

eris

sues

.

Scot

tish

Gov

ernm

ent

-w

ith

coun

cils

and

Hea

lth

Boar

dsa

ndo

ther

par

tner

s

6.CA

RERS

RIG

HTS

6.1

From

201

0on

war

ds,t

heS

cott

ish

Gov

ernm

ent

will

wor

kw

ith

the

nati

onal

car

ero

rgan

isat

ions

to

prom

ote

the

Equa

lity

Act

20

10,o

nce

com

men

ced,

esp

ecia

llyt

hep

rovi

sion

spr

ovid

ing

prot

ecti

onfr

omd

iscr

imin

atio

nfo

rcar

ers.

Scot

tish

Gov

ernm

ent

-w

ith

NCO

s

6.2

The

Scot

tish

Gov

ernm

ent

will

wor

kw

ith

COSL

Aa

ndlo

cala

utho

ritie

sto

ens

ure

aco

nsis

tent

app

roac

hac

ross

loca

lau

thor

itie

sto

the

em

ploy

men

tof

clo

sefa

mily

mem

bers

ine

xcep

tion

alc

ircum

stan

ces.

The

gui

danc

eon

impl

emen

tati

ono

fth

eSe

lf-D

irect

edS

uppo

rtS

trat

egy,

to

bep

rodu

ced

byt

heS

cott

ish

Gov

ernm

ent,

will

incl

ude

ase

ctio

non

app

roac

hes

tot

he

empl

oym

ent

ofc

lose

fam

ilym

embe

rsin

exc

epti

onal

circ

umst

ance

s.

Scot

tish

Gov

ernm

ent

and

COSL

A-

wit

hco

unci

ls

6.3

ByD

ecem

ber2

011,

the

Sco

ttis

hG

over

nmen

tw

illp

rodu

ce,w

ith

COSL

Aa

ndp

artn

ers,

aC

arer

sRi

ghts

Cha

rter

forw

ide

dist

ribut

ion

tolo

cala

utho

ritie

s,H

ealth

Boa

rds,

Com

mun

ity

Hea

lthP

artn

ersh

ips

and

othe

rbod

ies.

By

Dec

embe

r201

3,t

he

Scot

tish

Gov

ernm

ent

will

con

side

rwhe

ther

furt

herr

ight

ssh

ould

be

ensh

rined

inla

w.

Scot

tish

Gov

ernm

ent

-w

ith

coun

cils

,NH

SBo

ards

,N

COs

and

othe

rpar

tner

s


7.CA

RER

INV

OLV

EMEN

T IN

PLA

NN

ING

, SH

API

NG

AN

D D

ELIV

ERY

OF

SERV

ICES

AN

D S

UPP

ORT

7.1

In2

010-

11,t

heS

cott

ish

Gov

ernm

ent

will

ens

ure

care

rrep

rese

ntat

ion

onC

HPs

by

writ

ing

tot

heC

hief

Exe

cuti

ves

ofH

ealth

Bo

ards

to

mak

eth

ish

appe

n.Sc

otti

shG

over

nmen

t

7.2

In2

010-

11,i

nta

king

forw

ard

are

view

of

Publ

icP

artn

ersh

ipF

orum

s,t

heS

cott

ish

Gov

ernm

ent

will

ens

ure

that

itc

onsu

lts

wit

hap

prop

riate

car

ero

rgan

isat

ions

ino

rder

tha

tth

eiri

nter

ests

are

fully

repr

esen

ted.

Scot

tish

Gov

ernm

ent

7.3

Loca

laut

horit

ies

and

NH

SBo

ards

will

ens

ure

they

fully

invo

lve

the

nati

onal

car

ero

rgan

isat

ions

,oth

erT

hird

Sec

tor

orga

nisa

tion

san

dca

rers

,as

appr

opria

tein

the

pla

nnin

gan

dsh

apin

gof

ser

vice

san

dsu

ppor

t.

Coun

cils

NH

SBo

ards

-w

ith

part

ners

7.4

In2

010

and

beyo

nd,t

heS

cott

ish

Gov

ernm

ent

and

COSL

Aw

illp

rom

ote

the

Soci

alC

are

Proc

urem

ent

Gui

danc

eto

loca

lau

thor

itie

sso

tha

tth

eya

rea

war

eof

tha

tpa

rto

fth

egu

idan

ceo

nca

rerp

arti

cipa

tion

and

can

act

on

ita

sap

prop

riate

.Fu

rthe

rmor

e,t

heS

cott

ish

Gov

ernm

ent

will

pro

vide

tra

inin

gfo

rpro

cure

men

tst

aff,

esta

blis

hle

arni

ngn

etw

orks

,and

pro

mot

ego

odp

ract

ice

toc

onti

nue

tos

eek

impr

ovem

ent

inp

rocu

rem

ent

prac

tice

sac

ross

Sco

tland

,whi

chw

illta

kea

ccou

nto

fth

ene

edt

oin

volv

eca

rers

.

Scot

tish

Gov

ernm

ent

COSL

A

8.ID

ENTI

FICA

TIO

N O

F CA

RERS

8.1

From

201

0on

war

ds,t

heS

cott

ish

Gov

ernm

ent

will

pro

mot

eth

iss

trat

egy

wit

hA

lcoh

ola

ndD

rug

Part

ners

hips

(AD

Ps)a

nd

wit

hth

eSc

otti

shD

rugs

Rec

over

yCo

nsor

tium

(SD

RC)a

ndw

illw

ork

wit

h A

DPs

and

wit

hth

eSD

RCt

ohe

lpid

enti

fya

nd

supp

ort

care

rso

fpe

ople

wit

hsu

bsta

nce

mis

use

prob

lem

s.

Scot

tish

Gov

ernm

ent

-w

ith

AD

Psa

ndS

DRC

8.2

The

Scot

tish

Gov

ernm

ent

will

app

roac

hal

lrel

evan

tna

tion

alt

rain

ing

and

qual

ific

atio

nac

cred

itati

onb

odie

sto

agr

eeh

ow

they

cou

ldin

tegr

ate

care

ride

ntif

icat

ion

and

awar

enes

sin

tot

hec

urric

ulum

by

2013

.Sc

otti

shG

over

nmen

t

8.3

In2

011-

12a

ndb

eyon

d,lo

cala

utho

ritie

s,H

ealth

Boa

rds

and

allc

arer

sup

port

org

anis

atio

nsa

ret

oid

enti

fyc

arer

san

dyo

un

g c

are

rsin

the

har

d-to

-rea

chg

roup

s,in

clud

ing

BME

care

rs.

Coun

cils

Hea

lthB

oard

sCa

rerS

uppo

rtO

rgan

isat

ions

8.4

In2

010-

11,t

heS

cott

ish

Gov

ernm

ent

will

wor

kw

ith

the

Roya

lCol

lege

of

Gen

eral

Pra

ctit

ione

rsS

cotla

ndo

nit

spl

ans

to

prov

ide

guid

ance

to

GP

prac

tice

sin

Sco

tland

on

care

ran

d y

oun

g c

are

r id

enti

fica

tion

an

d s

up

por

t.Sc

otti

shG

over

nmen

t-

wit

hRC

GPS

and

NCO

s

113 Caring Together

9.CA

RERS

ASS

ESSM

ENTS

(CA

RER

SUPP

ORT

PLA

NS)

9.1

On

ano

ngoi

ngb

asis

,in

orde

rto

fully

eng

age

care

rsa

ndd

eliv

erim

prov

edo

utco

mes

forc

arer

s,t

heS

cott

ish

Gov

ernm

ent

will

co

ntin

uet

opr

omot

ean

dm

onit

ort

heu

seo

fca

rero

utco

me

eval

uati

ons

thro

ugh

Talk

ing

Poin

ts.

Scot

tish

Gov

ernm

ent

9.2

On

ano

ngoi

ngb

asis

,in

orde

rto

impr

ove

the

know

ledg

ean

dsk

ills

oft

hes

ocia

lcar

ean

dhe

alth

wor

kfor

cein

und

erta

king

ca

rers

’ass

essm

ents

,the

Sco

ttis

hG

over

nmen

t,in

par

tner

ship

wit

hlo

cala

utho

ritie

s,w

illc

onti

nue

toe

ncou

rage

and

pro

mot

eth

efu

rthe

rtra

inin

gan

dde

velo

pmen

tof

sta

ff.(

Als

ore

fert

och

apte

r14

ont

rain

ing)

.

Scot

tish

Gov

ernm

ent

-w

ith

loca

laut

horit

ies

9.3

Ino

rder

to

impr

ove

the

carr

ying

out

of

care

rs’a

sses

smen

tsw

ith

the

aim

of

deliv

erin

gim

prov

edc

arer

sup

port

,the

Sco

ttis

hG

over

nmen

tw

ill,b

y20

12,c

omm

issi

ont

hep

rodu

ctio

nof

pra

ctic

alg

uida

nce

ont

heu

nder

taki

ngo

fca

rers

’ass

essm

ents

.Thi

sw

illin

clud

egu

idan

ceo

nho

wt

oco

nduc

tcu

ltura

llyc

ompe

tent

ass

essm

ents

.Thi

sw

illb

edo

nein

par

tner

ship

wit

hCO

SLA

and

N

HS

Scot

land

and

will

be

info

rmed

by

stak

ehol

ders

and

car

ers.

Scot

tish

Gov

ernm

ent

-w

ith

COSL

Aa

ndN

HS

Scot

land

and

oth

erp

artn

ers

9.4

On

ano

ngoi

ngb

asis

,loc

ala

utho

ritie

sw

illm

onit

ort

heim

pact

and

out

com

eso

fca

rers

’ass

essm

ents

.If

any

reso

urce

s,su

ppor

tsa

nds

ervi

ces

are

not

avai

labl

eto

mee

tne

ed,l

ocal

aut

horit

ies

will

use

the

car

era

sses

smen

t pr

oces

s(a

ndo

ther

in

itia

tive

s)t

ore

cord

wha

tis

cur

rent

lyu

nava

ilabl

e.T

his

will

ass

ist

stra

tegi

cpl

anni

ngw

ith

resp

ect

toc

arer

s’s

uppo

rt.

Loca

laut

horit

ies

10.

RAN

GE

AN

D T

YPE

OF

SUPP

ORT

– N

O A

CTIO

N P

OIN

TS I

N C

HA

PTER

10

11.

INFO

RMAT

ION

AN

D A

DV

ICE

11.1

In2

010,

the

Sco

ttis

hG

over

nmen

tw

illc

onti

nue

tow

ork

wit

hN

HS

info

rmo

nth

ede

velo

pmen

tof

its

Care

rInf

orm

atio

nZo

ne.

Onc

efu

llyd

evel

oped

,NH

S in

form

will

con

tinu

ally

revi

ewt

heo

nlin

ese

rvic

eto

ens

ure

that

itre

mai

nsu

p-to

-dat

e,a

ccur

ate

and

rele

vant

to

care

rs’a

ndy

oun

g c

are

rs’

need

s.

NH

S in

form

Scot

tish

Gov

ernm

ent

11.2

ByD

ecem

ber2

011

the

Scot

tish

Gov

ernm

ent

will

gat

hera

ndre

view

the

ava

ilabl

eev

iden

cea

nds

cope

the

pot

enti

alfo

ra

Scot

land

-wid

eca

rers

’hel

plin

ean

dth

eop

tion

sfo

rpro

vidi

ngit

,inc

ludi

nge

xten

ding

the

ser

vice

forc

arer

sof

fere

dby

Car

eIn

form

atio

nSc

otla

nd.

Scot

tish

Gov

ernm

ent


12.

CARE

R H

EALT

H a

nd W

ELLB

EIN

G

12.1

In2

011-

12,t

heS

cott

ish

Gov

ernm

ent

will

con

tinu

eto

pro

vide

and

rais

eaw

aren

ess

amon

gst

both

pro

fess

iona

lsa

ndt

he

gene

ralp

ublic

(inc

ludi

ngc

arer

s)o

fBr

eath

ing

Spac

e.T

heS

teps

forS

tres

sbo

okle

tw

illb

eav

aila

ble

onre

ques

t.Sc

otti

shG

over

nmen

t

12.2

The

Scot

tish

Gov

ernm

ent

wit

hpa

rtne

rs,i

nclu

ding

Hea

lthS

cotla

nda

ndt

heN

COs,

will

pro

duce

ab

espo

kere

sour

ceo

nis

sues

re

lati

ngt

ost

ress

and

car

ing,

incl

udin

gbu

ildin

gon

Car

ers

Scot

land

pub

licat

ion,

Fin

ding

the

Bala

nce:

Pro

mot

ing

Goo

d H

ealth

– A

Car

ers’

Res

ourc

e G

uide

to H

ealth

and

Wel

lbei

nga

ndli

nkin

gin

to

the

NH

Sin

form

Car

ers

Info

rmat

ion

Zone

and

to

Ste

ps fo

r Str

ess.

The

reso

urce

will

be

wid

ely

diss

emin

ated

.

Scot

tish

Gov

ernm

ent

-w

ith

Hea

lthS

cotla

nda

nd

the

NCO

s

12.3

In2

010-

11,t

heS

cott

ish

Gov

ernm

ent

will

enc

oura

geN

HS

Boar

ds,C

omm

unit

yH

ealth

Par

tner

ship

san

dlo

cala

utho

ritie

sto

in

trod

uce

prog

ram

mes

of

trai

ning

forc

arer

son

per

son-

cent

red

mov

ing

and

hand

ling

and

ont

hes

afe

use

ofe

quip

men

t.Th

iss

houl

dbe

link

edt

oan

ass

essm

ent

att

hep

oint

of

hosp

itald

isch

arge

pla

nnin

g.

Scot

tish

Gov

ernm

ent

NH

SBo

ards

CHPs

Coun

cils

12.4

From

201

0on

war

ds,t

heS

cott

ish

Gov

ernm

ent

will

pro

mot

eto

car

ers

the

bene

fits

of

the

seas

onal

flu

vac

cine

to

help

pro

tect

th

emse

lves

and

the

peo

ple

they

car

efo

r.Sc

otti

shG

over

nmen

t

12.5

In2

010-

11,t

heS

cott

ish

Gov

ernm

ent

will

wor

kw

ith

NH

SBo

ard

Chie

fEx

ecut

ives

to

ensu

ret

hein

clus

ion

ofe

ligib

lec

arer

s(ie

th

ose

aged

40-

64)i

nth

elis

t of

tho

set

obe

con

side

red

int

hem

ains

trea

min

gof

Kee

pW

ella

ndW

ellN

orth

.Sc

otti

shG

over

nmen

t

13.

SHO

RT B

REA

KS (a

ll re

leva

nt t

o yo

un

g c

are

rs)

13.1

The

Scot

tish

Gov

ernm

ent,

ina

lloca

ting

£1

mill

ion

tot

hen

atio

nalc

arer

org

anis

atio

nsin

201

0-11

fors

hort

bre

aks

prov

isio

n,

will

mon

itor

pro

gres

sto

war

dst

hep

rovi

sion

of

inno

vati

ve,p

erso

nalis

ed,f

lexi

ble

prov

isio

nw

hich

mee

tst

hen

eeds

of

care

rs.

Scot

tish

Gov

ernm

ent

-w

ith

NCO

s

13.2

In2

010-

11t

heS

cott

ish

Gov

ernm

ent

will

wor

kw

ith

Shar

edC

are

Scot

land

and

oth

ers

tod

isse

min

ate

the

find

ings

of

the

shor

tbr

eaks

rese

arch

and

to

cons

ider

the

dev

elop

men

tof

furt

hera

ctio

nsin

ligh

tof

the

fin

ding

s.I

npa

rtic

ular

,the

re

sear

chf

indi

ngs

will

be

used

to

supp

ort

part

ners

to

impr

ove

the

loca

lstr

ateg

icp

lann

ing

and

com

mis

sion

ing

ofs

hort

bre

ak

prov

isio

n.

Scot

tish

Gov

ernm

ent

Shar

edC

are

Scot

land

13.3

Fort

hed

urat

ion

oft

his

stra

tegy

,the

Sco

ttis

hG

over

nmen

tw

illu

nder

take

to

stre

ngth

ent

heN

HS

role

as

ast

rate

gic

part

ner

ins

uppo

rtin

gth

epr

ovis

ion

ofre

spit

eca

re.T

heS

cott

ish

Gov

ernm

ent

will

faci

litat

ea

high

leve

lmee

ting

wit

hN

HS

Boar

dst

oco

nsid

erc

urre

ntp

ract

ice,

wit

ha

view

to

iden

tify

ing

fact

ors

whi

chw

ould

hel

ppr

omot

e/su

ppor

tjo

int

wor

king

int

his

area

.

Scot

tish

Gov

ernm

ent

NH

SBo

ards

Shar

edC

are

Scot

land

115 Caring Together

13.4

Fort

hed

urat

ion

oft

his

stra

tegy

,the

Sco

ttis

hG

over

nmen

tw

ith

Shar

edC

are

Scot

land

and

oth

erp

artn

ers

will

enc

oura

gea

nd

supp

ort

the

cont

inue

dde

velo

pmen

tof

mor

eef

fect

ive

way

sof

pro

vidi

ngs

hort

bre

aks

thro

ugh

lear

ning

net

wor

ksa

nd,w

here

po

ssib

le,t

hes

etti

ngu

pof

dem

onst

rati

onp

roje

cts.

Scot

tish

Gov

ernm

ent

Shar

edC

are

Scot

land

-w

ith

part

ners

13.5

From

201

1,t

heS

cott

ish

Gov

ernm

ent

will

wor

kw

ith

ara

nge

ofo

rgan

isat

ions

to

expl

ore

the

pote

ntia

lto

deve

lop

shor

tbr

eaks

pro

visi

ont

hrou

ghv

olun

teer

s.Sc

otti

shG

over

nmen

t-

wit

hpa

rtne

rs

13.6

Fort

hed

urat

ion

oft

his

stra

tegy

,the

Sco

ttis

hG

over

nmen

tw

illw

ork

wit

ha

rang

eof

par

tner

sto

exp

lore

the

pot

enti

alt

ode

velo

pem

erge

ncy

resp

ite

and

tos

uppo

rtc

arer

sw

ith

emer

genc

ypl

anni

ng.

Scot

tish

Gov

ernm

ent

-w

ith

part

ners

13.7

The

Scot

tish

Gov

ernm

ent

will

con

tinu

eto

pub

lish

offi

cial

sta

tist

ics

onre

spit

epr

ovis

ion

and

will

wor

kto

impr

ove

the

qual

ity

and

cons

iste

ncy

oft

his

info

rmat

ion,

ino

rder

to

achi

eve

Nat

iona

lSta

tist

ics

stat

usfo

rthi

sda

tas

ourc

ean

dpu

blic

atio

n.

Scot

tish

Gov

ernm

ent

Shar

edC

are

Scot

land

-w

ith

part

ners

13.8

ByJ

uly

2012

,the

Sco

ttis

hG

over

nmen

tw

illre

asse

sst

het

imes

cale

ford

eliv

ery

oft

heM

anife

sto

com

mit

men

tto

a

guar

ante

eda

nnua

lent

itle

men

tto

bre

aks

from

car

ing

fort

hose

ing

reat

est

need

,tak

ing

acco

unt

ofp

rogr

ess

int

hed

eliv

ery

ofs

hort

bre

aks

thro

ugh

the

othe

rAct

ion

Poin

tsin

thi

sch

apte

r.

14.

TRA

ININ

G –

CA

RERS

AN

D W

ORK

FORC

E

14.1

The

Nat

iona

lCar

ers

Org

anis

atio

nsw

illu

set

he£

281,

000

gran

tfr

omt

heS

cott

ish

Gov

ernm

ent

toa

lloca

teg

rant

sto

a

rang

eof

org

anis

atio

nsfo

rcar

era

ndw

orkf

orce

tra

inin

gin

at

rans

pare

nta

ndo

utco

me-

focu

sed

way

.The

NCO

sw

ille

nsur

edo

veta

iling

wit

hth

eN

HS

Boar

dCa

rerI

nfor

mat

ion

Stra

tegi

es.

NCO

sN

HS

Boar

ds

14.2

NH

SBo

ards

will

bui

ldo

nth

eca

rert

rain

ing

prov

ided

und

ert

heC

arer

Inf

orm

atio

nSt

rate

gies

and

con

tinu

eto

tra

inc

arer

sbe

yond

201

1.S

ubje

ctt

oth

eou

tcom

eof

the

Spe

ndin

gRe

view

,the

Sco

ttis

hG

over

nmen

tw

illw

ork

wit

hN

HS

Boar

dss

oth

at

they

will

mak

ea

trai

ning

off

ert

oca

rers

.N

HS

Boar

ds

14.3

In2

010-

12,N

HS

Educ

atio

nfo

rSco

tland

(NES

),in

col

labo

rati

onw

ith

NH

SBo

ards

and

the

nat

iona

lcar

ero

rgan

isat

ions

,w

illre

view

exi

stin

gtr

aini

ng,e

duca

tion

and

lear

ning

mod

ules

forw

orki

ngw

ith

care

rsa

ndy

oun

g c

are

rs;i

dent

ify

core

co

mpe

tenc

ies

forN

HS

staf

fin

iden

tify

ing

and

supp

orti

ngc

arer

san

dyo

un

g c

are

rs;a

ndid

enti

fyp

acka

ges

and

mat

eria

lst

obe

inco

rpor

ated

wit

hin

core

indu

ctio

n,e

duca

tion

and

tra

inin

gcu

rric

ula.

NH

SEd

ucat

ion

forS

cotla

nd-

wit

hN

HS

Boar

ds,N

COs,

and

coun

cils


14.4

NES

will

com

mun

icat

eto

the

rele

vant

regu

lato

ry,p

rofe

ssio

nala

ndn

atio

nalb

odie

sth

eim

port

ance

of

iden

tify

ing

and

supp

orti

ngc

arer

san

dyo

un

g c

are

rsin

wor

kfor

cet

rain

ing

and

educ

atio

n.N

ES

14.5

From

201

0on

war

ds,t

heS

cott

ish

Gov

ernm

ent

will

wor

kw

ith

NH

SBo

ards

to

ensu

ret

hat

iden

tify

ing

and

supp

orti

ngc

arer

san

dyo

un

g c

are

rsis

em

bedd

edin

wor

kfor

cet

rain

ing.

Scot

tish

Gov

ernm

ent

-w

ith

NH

SBo

ards

14.6

In2

009-

10,t

heS

cott

ish

Gov

ernm

ent

will

con

tinu

eto

pro

mot

eth

ebe

nefi

tso

fw

orkf

orce

tra

inin

gth

roug

hth

eSc

otti

sh

Soci

alS

ervi

ces

Coun

cil(

SSSC

),th

ena

tion

alc

arer

org

anis

atio

nsa

ndo

ther

s.Sc

otti

shG

over

nmen

t

14.7

In2

011-

12,N

ESa

ndt

heN

COs

will

pro

duce

ag

ood

prac

tice

gui

det

ow

orkf

orce

tra

inin

g.T

his

will

be

wid

ely

dist

ribut

ed.

NES

NCO

s

15.

HO

USI

NG

AN

D H

OU

SIN

G S

UPP

ORT

15.1

Fort

hed

urat

ion

oft

his

stra

tegy

,the

Sco

ttis

hG

over

nmen

tan

dCO

SLA

will

wor

kw

ith

loca

laut

horit

ies,

hou

sing

ass

ocia

tion

s,th

ein

depe

nden

tre

nted

sec

tor,

Hea

lthB

oard

san

dot

herp

artn

ers

toe

nsur

eth

att

hen

eeds

and

vie

ws

ofc

arer

sar

eta

ken

into

acc

ount

ind

evel

opin

gm

ore

effe

ctiv

elin

ksb

etw

een

hous

ing,

soc

ialc

are

and

heal

thp

olic

ies

and

serv

ices

.

Scot

tish

Gov

ernm

ent

COSL

A-

wit

hpa

rtne

rs

13.2

Care

rs’v

iew

sw

illb

eta

ken

into

acc

ount

dur

ing

publ

ice

ngag

emen

tev

ents

in2

010

ont

heR

esha

ping

Car

efo

rOld

erP

eopl

epr

ogra

mm

e.T

hese

vie

ws

will

hel

psh

ape

the

deve

lopm

ent

oft

hat

prog

ram

me.

Scot

tish

Gov

ernm

ent

16U

SE O

F A

SSIS

TIV

E TE

CHN

OLO

GY

– TE

LECA

RE a

nd E

QU

IPM

ENT

& A

DA

PTAT

ION

S

16.1

In2

010-

11t

heS

cott

ish

Gov

ernm

ent,

wit

hlo

cala

utho

rity

and

othe

rpar

tner

s,w

illra

ise

awar

enes

sof

tele

care

am

ongs

tca

rers

nat

iona

llya

ndlo

cally

and

will

ens

ure

that

car

ers

have

bet

tera

cces

sto

app

ropr

iate

info

rmat

ion

ons

ervi

ces.

Scot

tish

Gov

ernm

ent

-w

ith

coun

cils

and

oth

er

part

ners

16.2

The

Scot

tish

Gov

ernm

ent,

wit

hCa

rers

Sco

tland

,will

ens

ure

that

car

ers’

tra

inin

gis

incl

uded

as

part

of

ana

tion

ala

ppro

ach

tote

leca

ree

duca

tion

and

tra

inin

g,w

ith

asp

ecif

icw

orks

trea

md

evel

oped

to

addr

ess

this

ove

r201

0-12

.Sc

otti

shG

over

nmen

t-

wit

hCa

rers

Sco

tland

16.3

In2

010-

12,t

heS

cott

ish

Gov

ernm

ent

will

ens

ure

that

tele

care

isin

clud

edin

the

pra

ctic

alg

uide

to

unde

rtak

ing

care

rs’

asse

ssm

ents

and

will

pro

mot

eit

sfu

rthe

rint

egra

tion

wit

hin

Sing

leA

sses

smen

tan

dCa

reM

anag

emen

t/Re

view

pro

toco

lsa

nd

proc

esse

s.

Scot

tish

Gov

ernm

ent

117 Caring Together

16.4

By2

015,

the

Sco

ttis

hG

over

nmen

tw

illh

ave

furt

herm

axim

ised

the

impa

cto

fit

ste

leca

rein

vest

men

tto

ens

ure

that

the

be

nefi

tsa

nda

pplic

atio

nso

fth

ene

wte

chno

logy

forc

arer

sco

ntin

ues

and

deve

lops

.Sc

otti

shG

over

nmen

t

16.5

In2

010-

2015

the

Sco

ttis

hG

over

nmen

tw

illfu

rthe

rexp

lore

the

inno

vati

veu

seo

fne

wte

chno

logi

esin

sup

port

of

care

rs

livin

gin

rem

ote

and

rura

lare

as,a

ndw

illid

enti

fym

echa

nism

sw

hich

may

be

mor

eac

cess

ible

to

you

ng

ca

rers

.Sc

otti

shG

over

nmen

t

16.6

In2

010-

15,t

heS

cott

ish

Gov

ernm

ent,

wit

hlo

cala

utho

ritie

s,H

ealth

Boa

rds

and

othe

rpar

tner

s,w

illra

ise

awar

enes

sof

eq

uipm

ent

and

adap

tati

ons

amon

gst

care

rsa

nde

nsur

eth

atc

arer

sha

veb

ette

racc

ess

toa

ppro

pria

tein

form

atio

nan

dtr

aini

ngo

neq

uipm

ent.

Scot

tish

Gov

ernm

ent

Coun

cils

Hea

lthB

oard

s

17.

AD

VO

CACY

SU

PPO

RT

17.1

The

Scot

tish

Gov

ernm

ent

and

COSL

Aa

ckno

wle

dge

the

valu

ean

dbe

nefi

tof

car

era

dvoc

acy.

Fro

m2

011

onw

ards

,we

will

en

cour

age

loca

laut

horit

ies,

NH

SBo

ards

and

oth

erlo

calp

artn

ers

tod

evel

opo

rexp

and

care

radv

ocac

yse

rvic

esfo

rtho

sein

gr

eate

stn

eed.

We

will

als

oex

amin

ein

201

1-12

the

sco

pefo

rpro

duci

ngg

uide

lines

on

care

radv

ocac

y.

Scot

tish

Gov

ernm

ent

-w

ith

coun

cils

,NH

SBo

ards

an

dot

herp

artn

ers.

18.

EMPL

OYM

ENT

AN

D S

KILL

S

18.1

In2

010

and

beyo

nd,t

heS

cott

ish

Gov

ernm

ent

will

: -

enco

urag

epu

blic

bod

ies,

42t

hrou

ghid

enti

fyin

ggo

odp

ract

ice,

to

prom

ote

care

rfrie

ndly

em

ploy

men

tpr

acti

ces;

-ide

ntif

yw

ays

inw

hich

the

Sco

ttis

hG

over

nmen

tca

nw

ork

wit

hem

ploy

ers

and

othe

rst

opr

omot

eca

rerf

riend

ly

empl

oym

ent

prac

tice

s.T

heS

cott

ish

Gov

ernm

ent’

sEm

ploy

abili

tyL

earn

ing

Net

wor

k(E

LN)w

illh

elp

wit

hth

is,i

nclu

ding

co

nsul

tati

onw

ith

empl

oyab

ility

sta

keho

lder

s.

Scot

tish

Gov

ernm

ent

-w

ith

Care

rsS

cotla

nd

18.2

ByS

epte

mbe

r201

1,S

kills

Dev

elop

men

tSc

otla

ndw

illin

crea

sea

war

enes

sof

its

serv

ices

and

reso

urce

sw

ith

care

rs’c

entr

es

inS

cotla

nd,f

acili

tate

dby

the

Prin

cess

Roy

alT

rust

forC

arer

s(P

RTC)

.Sk

ills

Dev

elop

men

tSc

otla

nd-

wit

hPR

TC

18.3

ByD

ecem

ber2

011,

Ski

llsD

evel

opm

ent

Scot

land

will

exp

lore

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119 Caring Together

Appendix 4Resources

Recipient Purpose Amount

NHSBoardsandScottishAmbulanceService

CarerInformationStrategies(CIS)2008-09toMarch2011

£9millionoverthreeyears(£1m/£3m/£5m)

LocalauthoritiesDeliveryof10,000additionalrespiteweeksby2011

£4.19millionin2009-10and2010-11aspartofthelocalgovernmentsettlement

Nationalcarerorganisations(NCO)corefunding

SustainabilityofNCOs£1.275millionbetween2007and2011

NCOprojectfunding–todifferentNCOs

Anumberofdifferentprojects:1)Carertrainingpilots(BME,

rural,Lothian)2)Useofdirectpaymentsin

ruralareas3)LearningforLiving4)Shortbreaksresearch5)Carerandworkforcetraining6)Miscellaneous(Eurocarers,

EngagementEvents)7)Threeyoungcarerinitiatives

(primary-agedyoungcarers/mentalhealthandwellbeing/transitions)

8)Threeyoungcarerfestivals9)Youngcarermappingproject10)Youngcarerproject

sustainabilityfunding

£1.349millionbetween2007and2011


Appendix 5Care 21 Recommendations and Progress Since 2006

Recommendation 1

We recommend that the Scottish Executive should develop a Carers Rights Charter in Scotland.

1. TheCare21Reportcontainedavisionstatementarticulatingarights-based

visionforcarers.Therightssetoutincludedtherighttowork,therighttorest

andleisure,includingreasonablelimitationofworkinghours,therighttotraining

andeducation,therighttoaccessservicesandtherighttoastandardofliving

adequateforhealthandwellbeing.

2. ThethenScottishExecutivestatedinitsresponsethataCarersRights

Charterwasnotoneofitsimmediatepriorities.

3. TheWorkandFamiliesAct2006givescarersinemploymenttherightto

requestflexibleworkingpatterns.TheEqualityAct2010(tobecommenced)

enshrinesfurtherrightsinlaw.

Recommendation 2

We recommend that a national forum representing the views of young carers be established and supported by a separate Young Carers Strategy.

4. SeeGetting it Right for Young Carers.

Recommendation 3

We recommend that a range of measures to enable greater control and choice (including shifting the balance of ‘purchasing power’ to carers and users) be fully explored by the Scottish Executive.

5. TheScottishGovernmentintendstointroduceaSelf-DirectedSupport

(Scotland)Bill.Thiswouldextenddirectpaymentstocarers.

Recommendation 4

We recommend the development of a national ‘expert carer’ programme. This should include training for people to develop their own caring skills, knowledge and expertise.

121 Caring Together

6. TheScottishGovernmentmadecarertraininganimportantpartofits

guidanceonNHSCarerInformationStrategies.ManyNHSBoards,withpartners,

arefundingcarertraining,includingtrainingrelatedtospecificconditions.

7. TheScottishGovernmentfundedtheonlinecarertraining‘Learningfor

Living,’whichprovidesanintroductiontocaringandameansofenablingcarersto

considertheirfutureplans.

8. TheScottishGovernmentfundedthenationalcarerorganisationstotake

forwardcarertrainingpilotswithBMEcarersandwithcarersinruralareas.Wealso

fundedaCaring with ConfidenceLothianExpertCarerTrainingPilot.

Recommendation 5

We recommend that all frontline staff with direct responsibilities for supporting the needs of carers in ‘first contact’ agencies (local authorities, health and voluntary organisations) are properly equipped to advise unpaid carers about their rights, entitlements and available services.

9. WhilstthereisnospecificrecommendationinCare21aboutthe

identificationofcarers,itisimplicitinrecommendation5.Itisalsopartof

recommendation6abouttheimplementationofNHSCarerInformationStrategies

inalllocalities.

10. Therehasbeenconsiderableprogressoverthelastfewyearsincarer

identificationandself-identification.Thisinturnhasresultedinnewlyidentified

carersaccessingsupport,includingthatprovidedthroughthenetworkofcarers’

centresinScotland.42

11. NHSCarerInformationStrategiesarebeingimplementedinallHealth

Boardareas.MinimumrequirementsandguidancetoHealthBoardsissuedinApril

200643madeclearthatNHSBoardsmustdevelopproposalstoidentifycarers

anddemonstratethatNHSstaffareawareoftheneedtoidentifycarersandto

signpostthemtosourcesofsupport.AllNHSBoardssubmittedprogressreports

for2008-09,withfurtherreportsfor2009-10duelaterin2010.Morecarersare

beingprovidedwithinformationandadvice,orarebeingsignpostedorreferredto

relevantsourcesofadvice.

43 NHSCarerInformationStrategies:MinimumRequirementsandGuidanceonImplementation,NHSHDL(2006)22,24April2006-http://www.sehd.scot.nhs.uk/mels/HDL2006_22.pdf


12. TheCarerInformationStrategiesbeingtakenforwardbyNHSBoardsare

helpingtotrainhealthandsocialcarestaffincarerandyoung carerawareness

andcarerandyoung carer support.Manyhealthandsocialcarestaffdorecognise

carers’andyoung carers’needsandareworkingwithcarersaspartnersincare.

Recommendation 6

We recommend NHS Carer Information Strategies should be implemented as an early priority in all localities and that the requirements are extended to include local authorities.

13. Seerecommendation5.

14. Localauthoritiesareidentifyingandsupportingcarers.TheScottish

GovernmenthasnocurrentplanstoformallyextendtheCISrequirementstolocal

authorities.

Recommendation 7

We recommend that professional training for all health and social care staff should include a substantial component which relates to unpaid carers as partners in care, carers’ needs and the diversity of the unpaid caring experience.

15. TheNHSBoardCarerInformationStrategies,nationalcarerorganisations

andothershavetakenforwardworkforcetraining.

Recommendation 8

We recommend a greater role for carer representative organisations in the joint planning and development of care and other services (especially housing, leisure and transport) at a national and local level.

16. Nationalcarerorganisationsandcarersareinvolvedinawiderangeof

strategicdevelopmentsatnationallevel,includingengagementinChangingLives,

ShiftingtheBalanceofCare,ReshapingCareandthedevelopmentoftelecare

services.

17. Atlocallevel,NCOsandcarersareinvolvedintheplanninganddevelopment

ofshortbreaks’servicesandotherformsofsupport.

123 Caring Together

Recommendation 9

We recommend that the Scottish Executive and other policy makers integrate the issues facing unpaid carers into their policy development and planning processes.

18. AtScottishGovernmentlevel,thishasbeentakenforwardthroughvarious

policydevelopments,includingthoseinrelationtohealthinequalities,mental

health,dementia,learningdisabilities,independentliving,ReshapingCareand

ShiftingtheBalanceofCare.

Recommendation 10

We recommend that service providers ensure they meet the needs of the whole caring community, taking account of carers with special needs and the specific cultural and language needs of minority ethnic groups.

19. Thisrecommendationisprimarilyforserviceproviders.However,thisstrategy

encouragesserviceproviderstomeettheneedsofallcarers,especiallycarersin

greatestneedandthosecarerswhoareinthehard-to-reachgroups.

Recommendation 11

We recommend that the Scottish Executive continues to update the Carers Strategy to incorporate the impact of demographic and social change and to plan for resourcing of future need.

20. Seerecommendation22.Also,thisstrategysetsoutthefullimplicationsof

demographicandsocialchangeinrelationtosupportforcarers.

Recommendation 12

We recommend that carers’ organisations should have a greater role in the inspection of local services that support unpaid carers and users.

21. CarersarerepresentedontheCareCommissionBoard,andareappointed

aslaymemberstotheScottishSocialServicesCouncilRegistrationandConduct

Committees.AllofSWIA’sperformanceinspectionsofcouncilsinvolvecarersas

inspectors.SWIA,inpartnershipwithCarersScotland,recruitedabankof18carers

employedasinspectorsandruntrainingforcarerinspectorswithGlasgowCollege

forNauticalStudies.


Recommendation 13

We recommend that local authorities should work with unpaid carers to develop person-centred life plans alongside the established carers’ assessment process.

22. TheGovernment’sframeworkofoutcomesforcarersandserviceusers,

Talking Points,focusesontheoutcomesthatcarerswishtoachievefromthe

assessmentprocess.TheNationalMinimumInformationStandards(NMIS)

reiteratethisposition.

23. Carer’sAssessmentGuidanceforNationalStandardsisavailableasan

AnnextoNMIS.Theemphasisisonimprovingoutcomesforcarers.

24. Theguidanceisalsoclearthatassessmentsmustbe‘culturallycompetent’

inrelationtoBMEcarers.Theideaof‘culturalcompetence’haswiderapplicability

toothergroupsofcarers.

25. TheScottishGovernmentisworkingwithpartnerssothattheybetter

understandtheimportanceofthecarer’sassessment(carersupportplan).Theaim

istoincreaseuptakeandtoadvancethisasameansofensuringbetteroutcomes

forunpaidcarersinScotland.

Recommendation 14

We recommend that the UK Government complete an early review on carers’ benefit entitlements, tax credit and pensions with a particular focus on removing the barriers to work which are inherent in the way current financial arrangements are constructed.

26. TheearningsthresholdforreceiptoftheCarer’sAllowanceincreasedfrom

£95aweekto£100aweekfromApril2010.ThisistheresponsibilityoftheUK

Government.

27. ThePensionsAct2008introducedanewCarer’sCredit(fromApril2010)

whichawardscarerswithNationalInsurancecontributionsinordertoprotecttheir

statepensioneveniftheyarenotinpaidwork.

28. TheScottishGovernmentincludedfamilieswithachildunder16asagroup

whichqualifiesforenhancedmeasuresundertheScottishEnergyAssistance

Package.Thishelpsparentcarersofdisabledchildren.

125 Caring Together

Recommendation 15

We recommend that the UK Government should develop a national awareness campaign to ensure that employers of all sizes are made more aware of both their roles and their responsibilities towards carers, and the overall contribution of unpaid carers.

29. TheActionforCarersandEmploymentinitiative44hasraisedawarenessof

thepersonalandeconomicimplicationsofcarersleavingthepaidworkforceandis

lobbyingforchange.

30. TheWorkandFamiliesAct2006providescarerswiththerighttorequest

flexibleworkingpatternsifcertainconditionsaremet.Employersareexpected

tocomplyandtoagreetotherequestsforflexibleworkingunlesstherearegood

reasonsfornotdoingso.

31. JobCentrePlusintroducedWorkFocusedSupportforCarers(WFSC)in

December2009aspartofacarer-specificprogrammetoimprovethehelpand

adviceavailabletocarerswhowishtore-enterthejobmarket.Theserviceisentirely

voluntaryandcarersarefreetoleaveatanytime.CarePartnershipManagersarein

placeinallJobCentredistrictsinScotland(andtherestoftheUK)andadvisersare

inplaceinlocalJobcentres.

32. CarersUK,supportedbypartnersandCarersScotland,havepromotedgood

practiceonflexibleworkingandhavehighlightedtoemployerstheskillswhich

carersbringtotheworkforce.

33. CityandGuilds,inpartnershipwithCarersScotland,hasdevelopeda

personaldevelopmentandlearningtoolforcarers,Learning for Living,45 consisting

ofonlinelearningresourcesforcarersandaqualification.Thisqualificationis

designedtohelpcarerstoremainin,orreturnto,paidemploymentortoprogress

ontofurtherlearning.

Recommendation 16

We recommend that the Scottish Executive, local authorities and NHS agencies along with partner agencies, focus strongly on the health and wellbeing of unpaid carers.

44 ActionforCarersandEmployment2003-2008,CarersUKandCarersScotlandwithpartnershttp://www.carersuk.org/Profes-sionals/ResearchLibrary/Employmentandcaring/1253636966

45 LearningforLivinghttp://www.carerscotland.org/Policyandpractice/Traininganddevelopmentforcarers/LearningforLiving


34. TheoverarchingaimoftheCarer Information Strategiesistoenablecarers

tocontinueintheircaringrole,whilstprotectingtheirownhealthandwellbeing.

35. TheScottishEnhancedServicesSchemeforcarersisinplaceineightArea

HealthBoards.GPpracticesintheseareas,oftenwithin situworkersfromtheThird

Sector,aresupportingcarers,andsometimesyoung carers,inanumberofdifferent

ways.Theseincludeprovidinginformationandadviceoncarers’healthand

wellbeing,signpostingoncarerstosourcesofsupportandprovidingadviceon

benefits.Somepracticeshavesetupcarers’registerstoensuretheyareawareof

theircarerpopulationandalsotoidentifypeopleascarers.

36. TheScottishGovernmentcontinuestofundBreathing Space,thefree,

confidential,out-of-hourstelephoneadviceandsignpostingserviceforpeople

experiencinglowmood,depressionoranxiety.Itisavailabletoall,includingcarers.

ItisrunbyNHS24andthenumberis0800 83 85 87.

37. InAugust2008NHS24launchedLiving Life,apilottelephonecognitive

behaviouraltherapyserviceforpeoplewhoarefeelinglow,depressedoranxious.It

isavailablebyreferralfromselectedGPsurgeriesand,byself-referral,infivehealth

boardareas.ItispartoftheScottishGovernment’scommitmenttoincreasethe

availabilityofevidence-basedpsychologicaltherapiesinarangeofsettingsand

througharangeofproviders.In2009anadditionalpilotprojectwaslaunchedto

supportthecommitmenttoincreaseavailabilityofevidence-basedpsychological

therapies–the‘WISH’pilotishostedbyNHSGreaterGlasgowandClyde,and

involvesthreeotherBoards.

38. TheScottishGovernment,workingwitharangeofpartners,hasdeveloped

anationalmentalhealthimprovementcampaigncalledSteps for Stress.This

formspartoftheGovernment’smentalhealthimprovementpolicyandaction

planTowards a Mentally Flourishing Scotland.Theprintedbookletisavailablein

communitysettingssuchasGPsurgeries,libraries,pharmaciesandCitizensAdvice

Bureaus.

39. The Life Begins at 40pilot,whichstartedinMay2010,isalsorelevant.

Itisnowavailabletoallpeople,includingcarersapproachingtheageof40in

Grampian.Itaimsto:

• provideaccesstoasetofhealthrelatedquestionsforallpeople

reachingtheageof40inordertoassesstheircurrentstateofhealth

127 Caring Together

and,onthebasisoftheiranswers,toprovidethemwithhealth

informationand/oranykeyareasforactionwhichmighthelpimprove

theircurrentandfuturehealth;

• beavailablethroughaninteractiveonlinequestionnaireorbycalling

theNHSHelplinenumberwhereanNHS24HealthInformation

Advisorwilltakethecallerthroughthequestionnaire;and

• beavailabletoandforthatpartoftheentireScottishpopulationwho

areeitherapproachingorattheir40thbirthday.

40. InresponsetotheChildren’sCommissioner’sreport‘HandlewithCare,’

Ministersapprovedin2009anumberofproposedactionsaddressingissues

surroundingthemanualmovingandhandlingofchildrenandyoungpeoplewith

disabilities.

Recommendation 17

We recommend that issues facing unpaid carers are given proper consideration when new technology is applied to caring situations.

41. Over25,000peopleinScotlandhavereceivedatelecareserviceasaresult

oftheNationalTelecareDevelopmentProgramme.TheScottishGovernment

launchedthisprogrammein2006withsubstantialinvestmentofover£20million

tohelplocalauthoritiesacceleratetheadoptionofsupportivetechnologieswithin

mainstreamcareprovision.

42. Newguidanceontheprovisionofequipmentandadaptationswasissued

bytheScottishGovernmentinDecember2009.46Theguidanceaimstoassistlocal

authoritiesandtheirNHSpartnerstomoderniseandintegratetheirequipmentand

adaptationsserviceswithinthewidercommunitycarecontext.

Recommendation 18

We recommend that Scotland’s existing network of local carer support organisations is strengthened (carer training and peer support; emotional support and counselling; breaks from caring; advocacy).

43. TheScottishGovernmentprovidescoreandprojectfundingtothenational

carerorganisations.SomelocalauthoritiesandHealthBoardsfundlocalcarer

centres.TheLotteryprogrammeshavealsofundedcentres.

46 CCD5/2009:GuidanceontheProvisionofEquipmentandAdaptations


44. Seeresponsesunderrecommendationsoncarertraining,healthand

wellbeingandbreaksfromcaring.

Advocacy45. Since2000,theScottishGovernmentandScottishIndependentAdvocacy

Alliance(SIAA)haveledthedevelopmentofindependentadvocacyinScotland.

46. TheScottishGovernmentiscommittedtoensuringthatthereisappropriate

provisionacrossScotlandofadvocacyforpeoplewhoneedit.Oneofthe

achievementshasbeentheinclusionofarightofaccesstoindependentadvocacy

intheMental Health (Care and Treatment) (Scotland) Act 2003.TheIndependent

LivingSharedVisionlookstowardsdisabledpeoplehavingaccesstoarangeof

structured,valuedandaccessibleadvocacyservicestosupporttheiraccessto

independentlivinginallaspectsofdaytodaylife.

47. Earlierthisyear,SIAAproducedAGuidetoCommissionersandPrinciplesand

Standards47andanEvaluationFrameworkToolkit.48Someadditionalworkisplanned

aroundthedevelopmentofguidanceonadvocacyforchildrenandyoungpeople.

In2008theSIAApublishedupdatedPrinciplesandStandardsforIndependent

Advocacy49andanassociatedCodeofPracticeforIndependentAdvocacy.50TheSIAA

hasalsodevelopedaleafletwhichgivesadviceonAdvocacyforFamiliesandCarers.51

48. TheSIAAiscurrentlyreviewingandupdatingtheMapofAdvocacyprovision

acrossScotland.Whencompletedthisshouldhelpidentifygapsinprovisionof

advocacyservices.

49. ThePatientRights(Scotland)Billaimstoplacepatientsatthecentreofthe

NHSinScotland.Thishealthcarelegislation,ifapprovedbytheScottishParliament,

willhelpensurethatpatients’rightsandentitlementsaremorewidelyunderstood

andused.

50. OneofthekeyaspectsoftheBillisthecreationofanewPatientAdviceand

SupportService(PASS)withinHealthBoardareas.ThiswillbestaffedbyPatient

RightsOfficerswhowillhelpandsupportpatientsandmembersofthepublicto

makecomplaints,willprovideinformationabouthealthservices,andwilldirect

themtootherusefultypesofsupport,includingadvocacy.

47 http://www.siaa.org.uk/documents/guide-for-commissioners/siaa_guide_for_commissioners.pdf48 http://www.siaa.org.uk/documents/evaluation-framework/Evaluation_framework_complete.pdf49 http://www.siaa.org.uk/images/stories/siaaprinciples%26standardsforweb.pdf50 http://www.siaa.org.uk/images/stories/siaacodeofpracticeforweb.pdf51 http://siaa.org.uk/images/leaflets/guide-to-advocacy-for-families-and-carers.pdf

129 Caring Together

51. TheScottishGovernmentisprovidingfundingof£1.5milliontoassess

needandprovideadditionaladvocacyservicesoverthreeyearsinordertoimprove

access.

52. TheIndependentAdviceandSupportService(IASS)fundedbyNHSBoards

isavailableinallNHSBoardareastoprovidesupportforpeoplewhohaveconcerns

orwishtomakeacomplaintaboutNHSservices.ItisproposedunderthePatient

Rights(Scotland)BilltoenhanceandreplaceIASSwithanewPatientAdviceand

SupportService.

Recommendation 19

We recommend that national carer organisations focus on their collective role as the ‘voice of carers’ and coordinate effectively their capacity in the planning, development and monitoring of carer policy and support services.

53. Thisisamatterprimarilyforthenationalcarerorganisations,whowork

togetheronvariousinitiatives.TheScottishGovernmentencouragessuchjoint

workingandwillbeencouragingthisfurtherintheyearsahead.

Recommendation 20

We recommend that as an urgent priority the Scottish Executive develops a national strategic framework with service providers to ensure unpaid carers are given a statutory entitlement to appropriate short breaks and breaks from caring.

54. Thereisnostatutoryentitlementtoshortbreaks.

55. TheScottishGovernment,withCOSLAandpartners,issuedguidance

inDecember2008onshortbreaks(respite).http://www.scotland.gov.uk/

Publications/2008/11/20094716/0.ScottishGovernmentMinistershavepublicised

thisguidance,whichsetsoutkeyissuesaboutshortbreaksincludingthepurposeof

shortbreaks,choiceandpersonalisationandstrategicplanning.Itcontainsgood

practiceexamples.

56. UnderitsConcordatagreementwithlocalgovernment,theScottish

Governmenthascommittedfundingof£4.19millionin2009-10and2010-11so

thatlocalauthoritiescandeliveranadditional10,000respiteweeksby2011in

comparisonwith2007-08.


57. In2008-09,localauthoritiesincreasedrespiteweeksacrossScotlandby

1,150weeks.The2009-10figuresaredueintheAutumn.

58. TheScottishGovernmentisproactivelyworkingwithSharedCareScotland

andotherorganisationstoconsiderandtakeforwardinnovativesolutionsaround

shortbreaksprovision.

59. Thefindingsoftheresearch,fundedbytheScottishGovernmentand

commissionedbySharedCareScotland,whichwillbeavailablelaterinthesummer,

willbewidelydisseminated.TheScottishGovernmentandSharedCareScotland

expectsthisresearchtohelpinformdecisionsatnationalandlocallevelaboutshort

breaks’provision.

Recommendation 21

We recommend that the report’s recommendations are incorporated into providers’ performance management systems and progress monitored by the Scottish Executive and, where appropriate, relevant regulatory and inspection bodies.

60. ManystatutoryandvoluntarysectorproviderswillbeawareofCare21’s

recommendations.SWIAtakesaccountoftherecommendationsinitsinspection

ofservicesforserviceusersandtakescarers’viewsintoaccount.Theprovision

ofrespiteweeks(10,000weeksby2011)ismonitoredundertheConcordat

agreement.TheScottishGovernment’sresponsetothisrecommendationwill

befurtherdevelopedthroughthisstrategy.Localauthorities,do,however,have

responsibilityfordeterminingprioritiesatlocallevel.

Recommendation 22

We recommend that good policy must continue to be based on good research including reliable statistical evidence with attention to the diverse experiences of unpaid carers.

61. TheScottishGovernmentispublishingatthesametimeasthisstrategya

researchpublication,‘Caring in Scotland: Analysis of Existing Data Sources on

Unpaid Carers in Scotland.’Forthefirsttimethisbringstogetherinoneplaceall

thestatisticaldataoncarers.

131 Caring Together

62. Themainsourcesofinformationontheprevalence,intensityandtrendsin

caringupuntilnowhavebeenthe2001CensusandtheScottishHouseholdSurvey.

TheScottishHouseholdSurveyquestionshavebeenrefinedovertheyearstoget

betterinformationoncarers.

63. The2011Censuswillcontainaquestiononcaringsimilartothatinthe

2001Census.Therewillbeafurtherbreakdownonhoursofcaring:the20-49hours

perweekcategorywillbesplit20-34hoursand35-49hoursperweek,tobring

theCensusinlinewiththeScottishHouseholdSurveyandalsotodeterminethe

numberofcarersproviding35ormorehoursperweek,thecurrentthresholdfor

Carer’sAllowance.

64. TheScottishHealthSurveyprovidesadetailedpictureofthehealthof

theScottishpopulation.In2008,theScottishHealthSurveybegantocollect

informationoncarersforthefirsttimeandsomeresultsarepublishedinthe

researchpublicationnotedabove.

65. TheScottishGovernmentisnowpublishing,asOfficialStatistics,information

onrespiteservicesprovidedbyeachcouncilinScotland.Thisdatawillbeused

tomonitortheConcordatCommitmenttoincreaserespiteservicesby10,000

weeksby2011.Thelatestpublicationisavailableat:http://www.scotland.gov.uk/

Publications/2010/02/22113516/0TheScottishGovernmentisworkingwithlocal

authoritiestoimprovethequalityandconsistencyofthisinformation.

66. Aspartofitsperformanceinspectionofsocialworkservicesbetween2005

and2009theSocialWorkInspectionAgency(SWIA)carriedoutasurveyofcarers

whoareincontactwithsocialworkservices.Therewere3,599questionnaires

returnedacrossScotland.TheresultsofthesurveycanbefoundontheSWIA

websiteat:

http://www.swia.gov.uk/swia/findstatsdocument.htm?message=blank


Appendix 6Number of Unpaid Carers by Local Authority Area

Local Authority Number of Unpaid Carers

AberdeenCity 25,111

Aberdeenshire 29,036

Angus 12,133

ArgyllandBute 10,790

Clackmannanshire 8,690

DumfriesandGalloway 22,216

DundeeCity 14,027

EastAyrshire 21,844

EastDunbartonshire 12,862

EastLothian 13,095

EastRenfrewshire 9,772

EdinburghCity 47,404

EileanSiar 2,933

Falkirk 21,929

Fife 49,522

GlasgowCity 66,371

Highland 29,523

Inverclyde 9,892

Midlothian 14,192

Moray 11,628

NorthAyrshire 18,921

NorthLanarkshire 48,957

OrkneyIslands 1,989

PerthandKinross 19,082

Renfrewshire 24,087

ScottishBorders 12,502

ShetlandIslands 2,246

SouthAyrshire 15,283

SouthLanarkshire 38,023

Stirling 12,050

WestDunbartonshire 13,132

WestLothian 18,086

AllScotland 657,328

Source: ScottishHouseholdSurvey,2007-08

133 Caring Together

Appendix 7Rural Transport – Scottish Government PoliciesThe National Transport Strategy (NTS)InDecember2006,theScottishGovernmentpublishedaNationalTransport

Strategy(NTS)whichsetsa20yearvisionfortransportinScotland.Toensurewe

arecontinuingtoreflecttheGovernment’sprioritiesfortransport,wearecurrently

refreshingtheNTS.

TheScottishGovernmentiscommittedtosustainingtheviabilityofremoteand

fragilecommunitiesthroughensuringaccesstolifelineairandferryservices.

WearealsocommittedtomaintainingandimprovingaccessforruralScotland.This

involvesensuringahighqualitypublictransportsystemaswellassupportingthe

developmentofcommunitytransportsolutions.

Smarter Choices, Smarter PlacesTheSmarterChoices,SmarterPlacesprogrammeisa£15mthree-yearprogramme

insevenlocalprojectareas,supportedbyScottishGovernmentandCOSLA.Ithas

tworuralprojects,DumfriesandKirkwall.Theyaredoingsomeveryinterestingand

worthwhileworkonencouraginglocalsustainabletransportsolutions.

Scottish Ferries ReviewTheScottishFerriesReviewwillinformtheScottishGovernment’slongterm

strategyforlifelineferryservicesinScotlandto2022.Thereviewincludesadetailed

appraisalofroutestodeterminewhetherabetterconfigurationcouldbedeveloped

tobetterserveourislandcommunitieswhilecontributingtoouroverallpurposeof

increasingsustainableeconomicgrowth.Afurtherroundofconsultationeventson

theDraftConsultationDocumentwilltakeplaceinthesummerof2010.

Road Equivalent Tariff (RET)TheScottishGovernmentiscommittedtoensuringthatallremoteandfragile

communitieshavedirectlinkstothegreaterScottisheconomy.Weunderstand

thegenuineconcernsfromScotland’sremoteandfragilecommunitiesaboutthe

affordabilityofferrytravelandtheimpactthathasonislandcommunities.That

iswhywehavelaunchedapilotexercisewhichseekstoestablishthebenefitsofa

roadequivalenttariff(RET)asabasisforfutureferryfares.Thepilotwhichrunson

allWesternIslestomainlandroutesbeganinOctober2008andwillrununtilspring

of2011.AninterimevaluationoftheRETpilotwillfeedintotheScottishFerries

Review.


Lifeline Air ServicesTheScottishGovernmentsubsidisesthreePublicServiceObligation(PSO)

routesfromGlasgowInternationalAirporttoCampbeltown,TireeandBarra

underEuropeanrules.Inaddition,thereareanumberofPSOsimposedbylocal

authorities.TheselifelinePSOroutesrecognisetheimportanceofairserviceswhich

wouldnototherwisebecommerciallyviablebutareessentialforsocialcohesion

andsustainabilityofScotland’sremotestcommunities.

Air Discount SchemeTheAirDiscountSchemeisdesignedtofacilitateabetterlevelofsocialinclusion

forthoseresidentinsomeofthemostperipheralpartsofScotland.Residents

benefitfroma40%reductiononthecorefareforairtravel.TheSchemehasproved

popularwithresidentssinceitwasintroduced.Aswellasreducingthecostofair

travel,itimprovesconnectivityandreducesjourneytimesintheHighlandsand

Islands.

Rural Transport Fund FromApril2008,thefundingfortheRuralPublicTransportGrantSchemeand

theRuralCommunityTransportInitiative,twoelementsoftheRuralTransport

Fund,wasabsorbedintotheblocklocalgovernmentsettlement.Itisnowforlocal

authoritiestodeterminetheirprioritiesandtoallocatefundingaccordinglyfor

communitytransportservicesinmoreremoteareasofScotlandwherethereareno

scheduledorlimitedpublictransportservices.

Rural Petrol Stations Grant SchemeThethirdelementoftheRuralTransportFundistheRuralPetrolStationsGrant

Scheme,whichrecognisedtheimportanceofcaruseinremoterareasand

supportedruralfillingstations.FromApril2008itbecametheresponsibilityof

HighlandsandIslandsEnterpriseandScottishEnterprise.HIEAreaOfficesareable

toprovidefinancialassistancetofillingstationslocatedinHIE’sFragileAreas,as

partoftheir‘GrowthattheEdge’initiative.

135 Caring Together

Rural Fuel PricesTheScottishGovernmenthasconcernsabouttherelativelyhighpriceoffuelin

remoteruralandislandcommunitiesandthedisproportionateburdenthatthis

placesonhouseholdsandbusinessesintheseareas.Fueldutyisareservedarea.

However,wehavewrittenanumberoftimestosuggesttotheUKGovernmentthat

ScotlandcouldpresstheEuropeanUnionforaderogationtoapplyalowerrateof

fueldutyinruralareas,recognisingtheaccessibilityandpricedisadvantagesfaced

byScotland’sremoteandislandcommunities.

Strategic Transport Projects ReviewTheStrategicTransportProjectsReview(STPR)isamulti-modalapproachto

achievingabalancedandsustainablestrategictransportnetworkwhichprovides

betterconnectionsacrossScotland.TheReviewrecommendsanumberof

improvementstoScotland’srailnetwork,includingrurallinesintheHighlands,such

astheconstructionofnewrailstationsatDalcrossandpossiblyKintore.However,

theSTPRdoesnotprecludeRegionalTransportPartnershipsandlocalauthorities

fromconsideringthevalueofregionalandlocaltransportinterventions.

Public Transport - BusTheScottishGovernmentiscommittedtosupportingourbusindustry.Therecently

announcedthreeyearagreementwiththeConfederationofPassengerTransporton

theBusServiceOperatorsGrantandConcessionaryfarereimbursementwilldeliver

another£740mofsignificantinvestment.ThiswillhelpdeliverbenefitstoScottish

buspassengers,enablingthemtotravelonalargebusnetworkforareasonable

fare.ConcessionarypassengerscancontinuetoenjoyfreetravelalloverScotland

includingresidentsoftheWesternIsles,OrkneyandShetlandwhoareentitled

totwofreereturnferryjourneystothemainlandeachyear.Fundingthroughthe

Concordatprovideslocalgovernmentwiththeauthoritytoinvestinlocalpriorities,

suchasdemandresponsivetransportandthedevelopmentofnewsustainablebus

routes,andtosupportbusserviceswhererequired.Lateststatisticsindicatethat

publictransportsupportoflocalbusservicesbylocalgovernmentwas£53millionin

2008-9.


Appendix 8Carer Pathway

1. Under the Social Work (Scotland) Act 1968, as amended by the Community Care and Health (Scotland) Act 2002, carers who provide a “substantial amount of care on a regular basis” are entitled to an assessment.

2. Carers who provide substantial and regular care who choose not to have a carer’s assessment can nonetheless access support. However the preferred route to support is via a good quality carer’s assessment.

IdentificationAs carer by health or socialcare professional, or by others

Self-Identification

Self Assessment(where available)

Carer’s Assessmentfor carers who provide

substantial and regular care1.(carer support plan)

Carer chooses not tohave a carer’sassessment (carersupport plan)2.

OR

Access to SupportNo support required

Re-assess or review ifcircumstances change When

Early intervention/preventativeapproachEmergency supportHospital discharge

Culturallycompetent andresponsive to

diversity of carersituations

Impact review andre-assessment as

circumstanceschange

(eg transitions)

Local authority torecord unmet need.

Future planning

Return to work/learningRemain in work/learning

Peer Support/Befriending

Person CentredPlanning;Life or future plans

Education/Training/Lifelong Learning

Self-DirectedSupport

Telecare

Rights

Information

Advice

Carer Training

Advocacy

Short Breaks/Respite

Income Maximisation

Housing Support

Equipment/Applications

Emotional Support

137 Caring Together

Appendix 9Fuel Poverty - Energy Assistance Package

1. TheEnergyAssistancePackage(EAP),launchedon6April2009,aimsto

tacklefuelpovertybyprovidingafour-stagepackageofhelptargetedatthose

mostinneed:

• Stage1energyadviceisavailabletoallwhocontactthemanaging

agentforthescheme.

• Stage2provideshelpwithimprovingincomesthroughbenefitchecks

and,reducingenergybillsbymovingapplicants,whereappropriate,on

totheirenergyproviderssocialtariff.

• Stage3providesaeligiblehouseholdswithloftandcavityinsulation,

wherethisisneeded.

• Stage4canprovideenhancedenergyefficiencymeasuressuchas

centralheating,airsourceheatpumps,externalandinternalwall

insulation.

2. Ahouseholdiseligibleforassistanceifthehousehasanenergyrating

ofbandsE,FandGandtheyareinreceiptofaqualifyingbenefit.Helpisalso

availableforpeopleover60wholiveinahousethatdoesn’thaveacentralheating

systemandforthoseover75wholiveinanenergyinefficientdwelling.

3. Thepackageisavailabletopropertyownersandprivatesectortenants.

SociallandlordshaveaprogrammetoimprovetheirpropertiestomeettheScottish

HousingQualityStandardandsoarenoteligible.

4. EAPistacklingruralfuelpovertybyincludingawiderangeofmeasuressuch

asexternalandinternalwallinsulationandairsourceheatpumpsforhard-to-treat

homes.

5. Adviceonincomemaximisationisavailabletoeveryonewhocallsthe

freephonenumber.

6. From10May2010newRegulationscameintoforceextendingtheeligibility

criteriatoincludeallchildrenundertheageof16wherefamiliesreceivea

qualifyingbenefitandliveinanenergyinefficienthome.Priortothis,theeligibility

criteriaincludedfamilieswithdisabledchildrenundertheageof16.TheScottish

Governmentmonitorstheuptakeoftheenergyassistancepackage.


7. InformationontheEnergyAssistancePackageisavailablebycallingthe

freephonenumber0800512012orbyaccessingwww.energyassistancepackage.

139 Caring Together

Alcohol and Drug Partnerships (ADPs)

AlcoholandDrugPartnerships(ADPs)havebeensetupforeverylocalcouncilareatotransformtheprovisionofservicestotacklesubstancemisuse.ADPsaredevelopingandimplementinglocalalcoholanddrugsstrategiestoreducethenumbersofpeoplewithsubstancemisuseproblems.

Association of Directors of Social Work (ADSW)

ADSWistheprofessionalassociationrepresentingseniorsocialworkmanagersinlocalgovernmentinScotland.

Black and Minority Ethnic (BME)

Anyminoritygroupwhohasasharedrace,nationality,languageandculture.HouseofLordsdefinitionofanethnicgroup–“Essentialfeaturesarealongsharedhistoryandacommonculturaltradition.Theremayalsobesomeofthefollowingpresent:commongeographicallocationfromasmallnumberofancestors;acommonlanguage;acommonliterature;acommonreligion;and,beingaminoritywithinalargercommunity.”Analternativedefinitionis:”Agroupofpeoplewhosharecertainbackgroundcharacteristicssuchascommonancestors,geographicalorigin,language,cultureandreligion.Thisprovidesthemwithadistinctidentityasseenbyboththemselvesandothers.”

Community Health Partnerships (CHPs)

CommunityHealthPartnershipswereestablishedbyNHSBoardsaskeybuildingblocksinthemodernisationoftheNHSandjointservices,withavitalroleinpartnership,integrationandserviceredesign.

Concordat TheagreementinNovember2007betweentheScottishGovernmentandlocalgovernment,basedonmutualrespectandpartnership.ItunderpinsthefundingtobeprovidedtolocalgovernmenttoMarch2011.

Convention of Scottish Local Authorities (COSLA)

TherepresentativevoiceofScottishlocalgovernmentandtheemployers’associationonbehalfofallScottishcouncils.

Direct payments Paymentsfromcouncilsinlieuofservicesprovideddirectlytoindividualsassessedasbeinginneedofcommunitycareservices.Theamountofmoneyreceiveddependsontheassessedneeds.ThelegalprovisionsrelatingtodirectpaymentsarecontainedwithinanumberofActsandRegulations.ThemaindutiesaresetoutinSection12Band12CoftheSocialWork(Scotland)Act1968andtheaccompanyingRegulationsfrom2003.However,thesehavebeenupdatedoveranumberofyears.

Independent Living Promotesindependentlivingfordisabledpeoplewithchoice,controlandqualityattheheartoftheprovision.

Appendix 10Glossary of Terms and Definitions


Keep Well and Well North KeepWellandWellNorthprogrammesprovidehealthchecksinsomeofthemostdeprivedareasofScotland.Theyweresetuptoreducehealthinequalitiesbyidentifyingpeopleagedbetween45and64indeprivedcommunitieswhoareatriskofcardiovasculardiseaseandofferinginterventionstoreducetheirrisk.Theupperlimitof64reflectstheobjectiveofpreventingprematuremortalityandmorbidity,prematurebeingdefinedasbeforeage75.

Lesbian, Gay, Bisexual and Transgender (LGBT)

Lesbian,gay,bisexualandtransgenderpeople.

National Carer Organisations (NCOs)

Thefivevoluntaryorganisationsrepresentingcarersissuesonanationalbasis:-CarersScotland-CoalitionofCarersinScotland(COCIS)-CrossroadsCaringScotland-PrincessRoyalTrustforCarers-SharedCareScotland

NHS inform AsinglegatewayprovidedbyNHS24fortheprovisionofqualityassuredhealthinformationforthepopulationofScotland.

Personalisation Personalisationfundamentallymovesthelocationofpower,decision-makingandexpertisefromthesystemtothepeoplewhomayneedsupport.Itisthepracticalapplicationofprinciplesandvaluesthataimtosupport,encourageandassistindividualstoretain,reclaimordiscoverelementsofthemselvesthatareessentialtotheirhumanity.Inthisnewenvironment,morepeoplewillnotrequireformalservices.A‘onesizefitsall’approachisnotwhatwewantforourselves,butcanbewhatwedeliver.(ADSW–Personalisation2009)

Public Partnership Forums (PPFs)

PublicPartnershipForums(PPFs)arethemainstructurebywhichtheCommunityHealthPartnerships(CHPs)linkwiththepeopleofthecommunitiesthattheyserve,sothatthereisameaningfulandcontinuingdialoguewithlocalpeople.

Reshaping Care for Older People

Thereshapingcareforolderpeopleprogrammeisbeingdevelopedascurrentserviceconfigurationforcareforolderpeopleisnotsustainablegiventhedemographicandfinancialpressurewefaceoverthenext20years.TheScottishGovernment,NHSandCOSLAhaveembarkedonamajorprogrammetoengageallinterestsinreshapingcareandsupportservicessothatwemeetpolicyobjectivesinwaysthataresustainable.Thereisaneedtolookcarefullyathowwellcurrentserviceshelpolderpeopletooptimisetheirindependenceandwellbeingandtomakethenecessarychanges.

141 Caring Together

Scottish Drugs Recovery Consortium (SDRC)

Thenewlyestablishedconsortiumwaslaunchedon1June2010.TheSDRCisanindependentnationalmembershiporganisationestablishedtodriveandpromoterecoveryforindividuals,familymembersandcommunitiesaffectedbydrugsacrossScotland.TheconsortiumisfundedbytheScottishGovernmenttosupporttheimplementationanddeliveryofthe‘RoadtoRecovery’nationaldrugsstrategy.SDRCisacompanylimitedbyguaranteeandisregisteredasaScottishcharity.TheSDRCwillbeanopenandaccessiblevehicleforallofthekeystakeholders–individualswhowanttosharetheirexperienceofrecovery,mutualaidandcommunitygroups;treatmentprovidersinstatutoryandnonstatutorysettings;housingagencies;employmentandtrainingorganisations;primaryhealthproviders;andspecialistagencies.Theywillworktogetherwithpeopleinrecoveryandtheirfamiliestodeveloppathwaystomeaningfulandsustainedrecovery.FormoreinformationaboutSDRCvisitwww.sdrconsortium.org.

Scottish Social Services Council (SSSC)

TheScottishSocialServicesCouncil(SSSC)wasestablishedinOctober2001bytheRegulationofCare(Scotland)Act.TheSSSCisresponsibleforregisteringpeoplewhoworkinthesocialservicesandregulatingtheireducationandtraining.

Self-directed support Thedefinitionofself-directedsupportiswiderthanthedefinitionofdirectpayments.Itreferstothemethodbywhichindividualsandfamiliescanhaveinformedchoiceaboutthewaythatsupportisprovidedtothem.Individualbudgetsareanallocationoffundinggiventousersafteranassessmentforsupport.

Shifting the Balance of Care

ShiftingtheBalanceofCaredescribeschangesatdifferentlevelsacrosshealthandsocialcare,allofwhichareintendedtobringaboutimprovementsinhealthandwellbeingandbetterserviceoutcomes.Thisistobeachievedbyprovidingcarewhichisearlierinthecourseofadisease,aquickerdiagnosisandatreatmentprocesstailoredmorecloselytoeachperson’sneedsandisdeliveredclosertohome.

Social Work Inspection Agency (SWIA)

TheSocialWorkInspectionAgency(SWIA)isanindependentGovernmentagencyformedtoimprovethequalityofsocialworkservicesacrossScotland.

In2011,therewillbeasinglebodyforhealthcareservicesandanotherbodyforsocialworkandsocialcareservices,includingchildprotectionandtheintegrationofchildren’sservices.Thenewbodieswilltakeonworkintheseareascurrentlydoneby:HerMajesty’sInspectorateofEducation(HMIE);NHSQualityImprovementScotland(NHSQIS);SocialWorkInspectionAgency(SWIA);andtheCareCommission.


Third Sector TheThirdSectorcomprisessocialenterprises,voluntaryorganisations,co-operativesandmutuals.IthasanimportantroleinhelpingtheScottishGovernmentachieveitspurposeofcreatingamoresuccessfulcountrywithopportunitiesforalltoflourish,throughachievingsustainableeconomicgrowth.

143 Caring Together

Appendix 11

References1. ScottishGovernment(2007-08):Scottish Household Survey 2007-08

http://www.scotland.gov.uk/Topics/Statistics/16002/SurveyDetails

2. CarersUKandtheUniversityofLeeds(2007):Valuing Carers

http://www.sociology.leeds.ac.uk/assets/files/research/circle/valuing-carers.pdf

3. CarersUK

http://www.carersuk.org/Home

4. OfficeforNationalStatistics:Extrapolated from UK figures of an estimated

700,000 children, Family Resource Survey

5. CarersUK(2008):Carers In Crisis

http://www.carersuk.org/Professionals/ResearchLibrary/

Financialimpactofcaring/1228318101

6. CarersUK

http://www.carersuk.org/Home

7. BritishMedicalJournal:Training Care Givers of Stroke Patients: Economic

Evaluation, 2004

http://www.bmj.com/cgi/content/full/bmj;328/7448/1099

8. Hirst,Michael,Hearts and Minds: The Health Effects of Caring (2004):

UniversityofYorkandCarersScotland

http://www.carersuk.org/Professionals/ResearchLibrary/Healthandcare/1201186051

9. NefConsultation,December2009The Social and Economic Value of Short

Breaks

http://www.actionforchildren.org.uk/uploads/media/36/9163.pdf

10 UniversityofLeedsandCarersScotland(2009):A Weight off My Mind:

Exploring the Potential Impact and Benefits of Telecare for Carers

http://www.sociology.leeds.ac.uk/assets/files/research/circle/carers-scotland-report-

dec-2009-web.pdf


11. ScottishGovernment(2006):ChangingLives:Report on the 21st Century

Social Work Review

http://www.scotland.gov.uk/publications/2006/02/02094408/16

12. Noweblink.

13. ScottishGovernment,June2010:Scotland’s National Dementia Strategy

http://www.scotland.gov.uk/Topics/Health/health/mental-health/servicespolicy/

Strategy

14. ScottishGovernment,February2010:Respite Care, Scotland 2009

http://www.scotland.gov.uk/Resource/Doc/924/0100863.pdf

15. ScottishExecutive,2006:The Future of Unpaid Care in Scotland

http://www.scotland.gov.uk/Publications/2006/02/28094157/2

16. ScottishExecutive2006:Response to the Care 21 Report: The future of

Unpaid Care in Scotland


17. ScottishConsortiumforLearningDisability:eSay Project

ScottishConsortiumforLearningDisability:eSAYproject

18. EqualityandHumanRightsCommission(EHRC):TheEqualityAct2010

http://www.equalityhumanrights.com/legislative-framework/equality-bill/

20. TheCommunityTransportAssociation

http://www.ctauk.org/

21. ScottishGovernment(2010):The Healthcare Quality Strategy for NHS

Scotland


22. ThePrincessRoyalTrustforCarers(2010):The Carers Centre Survey

23. SocialWork(Scotland)Act1968–asamendedbytheCommunityCareand

Health(Scotland)Act2002:Carers who provide “a substantial amount of care on a

regular basis” are entitled to an assessment

http://www.scotland.gov.uk/Topics/Health/care/17655/guidance-profesionals/9803

145 Caring Together

24. CareInformationScotland

http://www.careinfoscotland.co.uk/home.aspx

25. RoyalCollegeofPsychiatrists(2004):Carers and Confidentiality in Mental

Health, issues involved in sharing information

http://www.rcpsych.ac.uk/pdf/carersandconfidentiality.pdf

BritishMedicalAssociation(2009):Working With Carers: Guideline for Good

Practice.

http://www.bma.org.uk/healthcare_policy/community_care/Workingwithcarers.jsp

GeneralMedicalCouncil:Confidentiality Guidance: Sharing Information with a

Patient’s Partner, Carers, Relatives or Friends.

http://www.gmc-uk.org/guidance/ethical_guidance/confidentiality_64_66_sharing_

information.asp

GeneralMedicalCouncil:Good Medical Practice: Relatives, Carers and Partners

http://www.gmc-uk.org/guidance/good_medical_practice/relationships_with_

patients_people.asp,

BritishMedicalAssociation(2009):Confidentiality and Disclosure of Health

Information Toolkit

http://www.bma.org.uk/images/confidentialitytoolkitdec2009_tcm41-193140.pdf

26. CarersScotland(2008):Finding The Balance, Promoting Positive Health: A

Carers Resource Guide to Health and Wellbeing

http://www.carerscotland.org/Information/Takingcareofyourself/

NewHealthResourceGuideforCarers

27. JointImprovementTeam,ReshapingCareforOlderPeople2010:Wider

PlanningforanAgeingPopulation

http://www.jitscotland.org.uk/action-areas/reshaping-care-for-older-people/

workstream-e---wider-planning-for-an-ageing-population---housing-and-

communities/

28. TheYorkHealthEconomicsConsortium

http://php.york.ac.uk/inst/yhec/


29. CarersScotland2009:A Weight off My Mind – Exploring the Impact and

Potential Benefits of Telecare for Unpaid Carers in Scotland

http://www.sociology.leeds.ac.uk/assets/files/research/circle/carers-scotland-report-

dec-2009-web.pdf

30. TheJosephRowntreeFoundation(2001):Money Well Spent – The

Effectiveness and Value of Housing Adaptations

http://www.jrf.org.uk/publications/effectiveness-housing-adaptations

31. Scotland’sCommissionerforChildrenandYoungPeople(2008):Handle with

Care – A Report on the Moving and Handling of children and Young People with

Disabilities

http://www.sccyp.org.uk/webpages/Handle_with_care_lr.pdf

32. CarersUK(2007):Out of Pocket – A Survey of Carers’ Lost Earnings



33. BuckerLandYendleS,CarersUK2006:Who Cares Wins – the Social and

Business Benefits of Supporting Working Carers


Employmentandcaring/1201869157

34. CarersScotland(2007): National Framework for Carers and Employment

http://www.carersscotland.org/Policyandpractice/Workingforcarersandemployment/

Outcomesandresearch

35. SkillsDevelopmentScotland2007anon-departmentalpublicbody

accountabletoScottishMinisters

http://www.skillsdevelopmentscotland.co.uk/

36. ExecutiveNondepartmentalPublicBodies(NDPBs),AdvisoryNDPBs,

Tribunals,NHSBodiesandothersignificantnationalbodies

37. CarersScotland(2008):Carers in Crisis



147 Caring Together

38. CarersUK(2005):Caring and Pensioner Poverty: A Report on Older Carers,

Employment and Benefits



CarersUK(2008):Carers in Crisis



39. ScottishGovernment(2008):AchievingOurPotential:AFrameworktoTackle

PovertyandIncomeInequalityinScotland


40. MoneyMadeClear

http://moneymadeclear.fsa.org.uk/

41. TheChildPovertyActionGroup

http://www.cpag.org.uk/scotland/

42. BodiesfundbytheScottishGovernment(whichexcludestheFurtherand

HigherEducationsectorsandlocalauthorities)

43. ScottishExecutive2006:NHS Carer Information Strategies: Minimum

Requirements and Guidance on Implementation

http://www.sehd.scot.nhs.uk/mels/HDL2006_22.pdf

44. CarersUKandCarersScotland2003-2007:Action for Carers and

Employment


Employmentandcaring/1253636966

45. CarersScotland(2006):Learning for Living

http://www.carerscotland.org/Policyandpractice/Traininganddevelopmentforcarers/

LearningforLiving

46. ScottishGovernment(2009):Guidance on the Provision of Equipment and

Adaptations

http://www.scotland.gov.uk/Topics/Health/care/EandA


47. ScottishIndependentAdvocacyAlliance(2008):Principles and Standards

http://www.siaa.org.uk/content/view/63/46/

48. ScottishIndependentAdvocacyAlliance:Evaluation Framework Toolkit

http://www.siaa.org.uk/documents/evaluationframework/Evaluation_framework_

complete.pdf

49. ScottishIndependentAdvocacyAlliance:UpdatedPrinciplesandStandards

http://www.siaa.org.uk/content/view/19/36/

50. ScottishIndependentAdvocacyAlliance,2008:Code of Practice for

Independent Advocacy

http://www.siaa.org.uk/images/stories/siaacodeofpracticeforweb.pdf

51. ScottishIndependentAdvocacyAlliance:Independent Advocacy for Families

and Carers

http://siaa.org.uk/images/leaflets/guide-to-advocacy-for-families-and-carers.pdf

the carers strategy for scotland 2010 - 2015 - the moray council

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