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Bundle Public Board 25 January 2018 7.1 Carers Update Report / Adroddiad Diweddaru Gofalwyr Presenter: Sarah Jennings Carers Update Report Jan 2018 Board Appendix 1 Carers Annual Report 2016-17 Appendix 2 Investors in Carers Annual Report 2016-17

Transcript of 7.1 Carers Update Report / Adroddiad Diweddaru Gofalwyr ... 7.1 Carers Update Re… · number of...

  • Bundle Public Board 25 January 2018

    7.1 Carers Update Report / Adroddiad Diweddaru GofalwyrPresenter: Sarah Jennings

    Carers Update Report Jan 2018 Board

    Appendix 1 Carers Annual Report 2016-17

    Appendix 2 Investors in Carers Annual Report 2016-17

  • 7.1 Carers Update Report / Adroddiad Diweddaru Gofalwyr

    1 Carers Update Report Jan 2018 Board

    Page 1 of 4

    CYFARFOD BWRDD PRIFYSGOL IECHYD UNIVERSITY HEALTH BOARD MEETING

    DYDDIAD Y CYFARFOD: DATE OF MEETING:

    25 January 2018

    TEITL YR ADRODDIAD: TITLE OF REPORT:

    Carers Update Report

    CYFARWYDDWR ARWEINIOL: LEAD DIRECTOR:

    Sarah Jennings, Director of Partnerships and Corporate Services

    SWYDDOG ADRODD: REPORTING OFFICER:

    Gareth Morgan, Strategic Partnerships Manager and Chair of West Wales Carers Development Group

    Pwrpas yr Adroddiad (dewiswch fel yn addas) Purpose of the Report (select as appropriate)

    Er Gwybodaeth/For Information

    ADRODDIAD SCAA SBAR REPORT Sefyllfa / Situation The Board is asked to note for information two Annual Reports for Carers:

    • Carer’s Annual Report 2016/17

    • Investors in Carer’s Annual Report 2016/17

    Cefndir / Background 2016-2018 represents a transition period as the responsibilities move from the Carers Information and Consultation Strategies Measure 2010 to the Social Services and Well Being (Wales) Act 2014. In West Wales, there are longstanding robust partnership arrangements previously overseen by the Hywel Dda Carers Measure Programme Board. This Board was dissolved at the end of 2016/17 and the responsibilities transferred to the West Wales Regional Partnership Board. The priorities for Carers, which are driving the work of the local partnership, are set out by Welsh Government ,namely:

    • Strengthening the partnership approach at a regional level

    • Enabling third sector partners to fully participate in delivery

    • Working towards delivering increased requirements of the Act

    • Use transition funding to embed and mainstream good practice This Carer’s Annual report is therefore a statement of the work undertaken during 2016/17 which was the first of a two year transition period. The UHB is also continuing to deliver a successful Investors in Carers award programme, which has received Welsh Government recognition as an example of good practice.

    Asesiad / Assessment The Carer’s Annual Report (Appendix 1) documents activity undertaken in 2016/17 by the former Hywel Dda Carers Measure Programme Board to support the transition of the Carers Information and Consultation Strategies Measure 2010 to the Social Services and Well-being

  • Page 2 of 4

    (Wales) Act 2014 (the Act). This report has been endorsed by the West Wales Regional Partnership Board and was submitted to Welsh Government to meet the requirements of the funding conditions. As highlighted in previous annual reports, this work is underpinned throughout by partnership working and illustrates both the diversity of the programme across the three counties as well as some of the challenges that remain to be addressed. The report highlights the importance of driving forward the delivery of services for Carers and responds to the priority areas established by Welsh Government. Unpaid Carers play a vital role in supporting the care of others in the community, whether this is an immediate family member, relative, neighbour or friend. In addition, we know that there is likely to be a lot of unmet need in the community, for example in terms of Young Carers and Young Adult Carers. The Investors in Carers (IiC) Annual Report 2016/17 (Appendix 2) highlights the involvement of a wide range of different organisations who have engaged with an assessment under this programme. This is not only a measure of the success and versatility of the initiative but also shows that unpaid Carers can be supported in a number of settings. The number of Carers being supported has increased, and the report highlights that approximately 700 new Carers were referred by GP surgeries via the IiC scheme during the year. The report acknowledges that whilst this is a considerable achievement, there remain more Carers to identify. The Investors in Carers team collect stories from Carers that have had a referral via the scheme in order to illustrate the type of help and support which is being provided via both the 3rd sector and statutory services.

    Argymhelliad / Recommendation The Board is asked to:

    • Note the Carers Annual Report 2016/17 which has been submitted to Welsh Government and endorse it for publication on the UHB website;

    • Note the Investors in Carers Annual Report 2016/17.

  • Page 3 of 4

    Amcanion: (rhaid cwblhau) Objectives: (must be completed) Cyfeirnod Cofrestr Risg Risk Register Reference:

    Not currently on risk register

    Safon(au) Gofal ac Iechyd: Health and Care Standard(s): Hyperlink to NHS Wales Health & Care Standards

    4. Dignified Care 5. Timely Care 6.1 Planning Care to Promote Independence 7. Staff and Resources

    Amcanion Strategol y BIP: UHB Strategic Objectives: Hyperlink to HDdUHB Strategic Objectives

    All Strategic Objectives are applicable

    Choose an item. Choose an item. Choose an item.

    Amcanion Llesiant BIP: UHB Well-being Objectives: Hyperlink to HDdUHB Well-being Statement

    Support people to live active, happy and healthy lives Improve efficiency and quality of services through collaboration with people, communities and partners Choose an item.

    Deddf Llesiant Cenedlaethau'r Dyfodol (Cymru) 2015 - Pum dull o weithio:

    The Well-being of Future Generations (Wales) Act 2015 - 5 Ways of Working: Hyperlink to Well-being and Future Generations Act 2015 - The Essentials Guide

    Please explain how each of the ‘5 Ways of Working’ will be demonstrated

    Long term – can you evidence that the long term needs of the population and organisation have been considered in this work? Carers provide over one million hours per week of care. The needs of Carers were reflected in the West Wales Population Assessment and specific actions will be developed for inclusion in the West Wales Area Plan.

    Prevention – can you evidence that this work will prevent issues or challenges within, for example, service delivery, finance, workforce, and/or population health? Proactively identifying and supporting the needs of Carers will ensure a preventative approach to future health and social care needs.

    Integration – can you evidence that this work

    supports the objectives and goals of either internal

    or external partners?

    The driving ethos is to ensure integration across the

    health and social care spectrum and the West Wales

    Carers Development Group are part of the governance

    structure of the West Wales Regional Partnership

    Board.

    Collaboration – can you evidence working with

    internal or external partners to produce and deliver

    this piece of work?

    We are working with partners in the Local Authority and

    third sectors across the Hywel Dda area footprint.

  • Page 4 of 4

    Involvement – can you evidence involvement of people with an interest in the service change/development and that this reflects the diversity of our population? At individual county level, there are groups that link with Carers so that their voice is at the core of all we do.

    Gwybodaeth Ychwanegol: Further Information: Ar sail tystiolaeth: Evidence Base:

    West Wales Population Assessment published in March 2017.

    Rhestr Termau: Glossary of Terms:

    Not applicable

    Partïon / Pwyllgorau â ymgynhorwyd ymlaen llaw y Cyfarfod Bwrdd Iechyd Prifysgol: Parties / Committees consulted prior to University Health Board:

    West Wales Regional Partnership Board have approved this Annual Report 2016/17 prior to its submission to Welsh Government.

    Effaith: (rhaid cwblhau) Impact: (must be completed) Ariannol / Gwerth am Arian: Financial / Service:

    Welsh Government provided a transition budget in 2016/17 which is used in conjunction with UHB Core budget to deliver a programme of work to address the needs of Carers.

    Ansawdd / Gofal Claf: Quality / Patient Care:

    The report identifies the important contribution to patient care via unpaid carers.

    Gweithlu: Workforce:

    It is estimated that within HDdUHB alone more than 1,000 staff are unpaid Carers.

    Risg: Risk:

    None to call out at present.

    Cyfreithiol: Legal:

    None to call out at present.

    Enw Da: Reputational:

    The Investors in Carers award has gained Welsh Government recognition.

    Gyfrinachedd: Privacy:

    None to call out at present.

    Cydraddoldeb: Equality:

    The Annual Report highlights that more work is needed around young carers.

  • 1 Appendix 1 Carers Annual Report 2016-17

    West Wales Carers Annual Report 2016/17 Page 1

    Carers Annual Report 2016–17

    Transitional Funding to support Carers under the

    Social Services and Well-being (Wales) Act 2014

    A partnership approach in West Wales

  • West Wales Carers Annual Report 2016/17 Page 2

    Table of Contents

    Foreword ................................................................................................ 3

    1. Overview: Reflections on a partnership approach during 2016 / 17 .... 5

    a. Population Needs Assessment (PNA) ............................................ 6

    b. Transforming Governance from Measure to Act ............................... 8

    c. Ongoing work streams from the Carers Measure ............................. 8

    Ensure Transitional Funding is used as a means to embed the practice

    of mainstreaming Carers‟ needs ........................................................... 12

    a. Resources Review ......................................................................... 12

    b. Investors in Carers ....................................................................... 13

    c. Carer Leads .................................................................................. 15

    b. LA Plans and delivery of the increased responsibilities under the

    SSWBA .............................................................................................. 16

    Carmarthenshire County Council .................................................... 16

    Ceredigion County Council .............................................................. 19

    Pembrokeshire County Council ....................................................... 22

    Setting out how as partners we planned and delivered the increased

    responsibilities for health and the new responsibilities for local

    authorities ............................................................................................. 26

    Creating Opportunities to enable third sector to fully participate in the

    delivery ................................................................................................. 27

  • West Wales Carers Annual Report 2016/17 Page 3

    Foreword

    This Annual Report documents activity undertaken by the former Hywel Dda Carers

    Measure Programme Board to support the transition of the Carers Information and

    Consultation Strategies Measure 2010 to the Social Services and Well-being (Wales)

    Act 2014 (the Act). As Chair of the West Wales Regional Partnership Board who now

    have responsibility for ensuring the continued collaborative planning and

    commissioning of activities to meet the needs of carers, I must first acknowledge the

    input and leadership provided by the Hywel Dda Carers Measure Programme Board

    which has overseen this work since 2010, and the work of the Carers Measure

    Implementation Group.

    In West Wales, we have been working in partnership to address the framework set

    down by Welsh Government, namely:

    Strengthening the partnership approach at a regional level

    Enabling third sector partners to fully participate in delivery

    Working towards delivering increased requirements of the Act

    Use transition funding to embed and mainstream good practice

    In the sections that follow, we provide evidence on how we have delivered against

    this as a partnership during 2016/17 financial year. Collaboration between the

    partners of the 3 Local Authorities, the Health Board and the Third Sector has been

    essential to underpinning the work. One of the key successes is knowing that the

    number of Carers registered at GP Surgeries in the Hywel Dda area has increased

    from 6,112 in March 2016 to 6,830 in March 2017; this means that there are now a

    further 710 Carers who now receive a range of help and support from newsletters,

    information and appointments with out-reach workers to formal Carers‟ Needs

    Assessments.

    During the reporting period, which we have referred to locally as the first of two

    transition years from „Measure to the Act‟, a lot of commitment has been forthcoming

    from the partners to maintain a diverse work programme - whilst developing our

    strategic aims. At times, this has been challenging yet one of the key outcomes of

    2016/17 has been the way the partnership has maintained a focused and robust

    working relationship. The governance arrangements were reviewed during 2016/17

  • West Wales Carers Annual Report 2016/17 Page 4

    and it was agreed to move away from a dedicated Carers Measure Programme

    Board to embed the Carers partnership arrangements within the West Wales

    Regional Partnership Board. This allows us to advance our ambitions and support

    work to mainstream the care and support needs of Carers in the future and respond

    to the priorities set out in the West Wales Population Needs Assessment published

    at the end of March 2017.

    .

    ………………………………………………………

    Sue Darnbrook

    Chair of West Wales Regional Partnership Board

  • West Wales Carers Annual Report 2016/17 Page 5

    1. Overview: Reflections on a partnership approach during

    2016 / 17

    Transition year 1 from ‘Measure to Act’ presented a number of challenges to

    the partnership between the 3 Local Authorities and Health Board. On the one

    side, there was a need to maintain an already diverse programme of work to

    ensure existing support to carers was continued. On the other side, we found

    ourselves needing to prepare for the Act, requiring additional capacity around

    key areas of work most notably the Population Needs Assessment. The fact

    that the partnership has managed to balance this duality of purpose deserves

    to be recognised, not least as one of the subtle outcomes has been to

    strengthen the professional relationships between individual officers.

    2016/17 was therefore not only about the support given to carers, which has

    increased in many areas of service delivery. It was also about a maturing

    programme, ensuring that the high impact contribution that carers make every

    day is properly described and profiled. One of the breakthroughs during the

    year was constancy of message that was given about carers and the invaluable

    support they provide, not only for the cared for but more widely to health and

    social care services. As an extension of this, a number of discussions were held

    in different settings regarding the impact on health and social care services,

    plus the wider public sector, if carers went on strike. Whilst the likelihood of

    this is low, the impact would be far reaching and service provision would come

    under serious strain within a matter of hours.

    It is not entirely accurate to describe 2016/17 as a foundation year, not least

    because service delivery was still maintained. Yet the foundations that were

    put in place were rock solid, not just in terms of the evidence-base collected

    but also with respect to our ability and ambition to deliver. This will be a two

    levels, first a ‘vertical’ programme which is about a core carers programme.

    Secondly, at a ‘horizontal’ level in which the carers agenda is clearly identified

    and responded to within the other thematic groups of the Population Needs

    Assessments. Again, this sets the carers agenda apart as it is a cross cutting

    theme that needs to be taken into account in the planning and delivery of

    many programmes of work.

  • West Wales Carers Annual Report 2016/17 Page 6

    The annual report that follows will give further details on the successes to date

    plus our ongoing challenges – it is only a partnership approach that can deliver.

    2: Strengthening the partnership approach at a local level

    a. Population Needs Assessment (PNA)

    A significant work programme was undertaken in 2016/17 to establish Carers‟ needs

    across the region in line with the Act‟s requirements. Not only did this further

    demonstrate the strong partnership approach to Carers in West Wales, but it also

    describes the invaluable and immense contribution that unpaid Carers make across

    the three counties.

    The PNA was finalised at the end of 2016 and published in March 2017. The

    assessment provides analysis of:

    The contribution made by carers and the various support needs of Carers,

    including the distinct needs of Young Carers;

    The range and level of services required, including preventative services, that

    can meet those needs;

    The extent to which those needs are not being met and where improvement is

    therefore necessary; and

    How these services will be delivered through the medium of Welsh.

    The PNA was informed by a combination of quantitative and qualitative data,

    including population projections and usage data. Qualitative information was

    captured through a variety of means; specific questions were included in the well-

    being survey conducted on behalf of the Public Service Boards (PSBs) over the

    summer to meet the requirements of the Well-being of Future Generations (Wales)

    Act 2015 and further qualitative data was captured in follow-up engagement events

    in the autumn, including the „Let‟s Talk Health‟ programme run by the Health Board.

    Information from established Carer groups and recent consultations were also fed

    into the assessment.

    Carers are a key thematic group within the PNA and the regional Carers partnership

    undertook the assessment on a county by county basis. From these separate

  • West Wales Carers Annual Report 2016/17 Page 7

    reports a final regional response was prepared and submitted for the Partnership to

    edit the final document. The work of the Carers‟ thematic group was commended by

    the West Wales Regional Partnership Board, demonstrating a sound evidence base

    and further reinforcing the Board‟s view of the need to ensure a robust focus on the

    Carers‟ agenda particularly in preparation for the Population Needs Assessment

    Development Plan.

    Some Key statistics from the PNA

    All of us will have our lives touched by caring at some point: 3 in 5 of us will be

    Carers and many of us will also need care in our lifetime. Carers are vital to

    those they care for and to the foundation of the health and social care system.

    Around 1 in 8 people in West Wales, many of them young people, are providing

    unpaid care with a significant proportion providing between 20 to 50+ hours of

    unpaid care per week.

    The provision of unpaid care is increasing as the population ages, with an

    expectation that the demand for care provided by spouses and adult children will

    more than double over the next thirty years.

    Based on a national calculation conducted by Carers UK and Sheffield University

    in 2015 the cost of replacing unpaid care in West Wales, can be estimated at

    £924m. This exceeds the NHS annual budget for the region which is almost

    £727m.

    Areas identified for improvement

    Chapter 7 paragraph 7.5 of the PNA describes the gaps in services and what

    improvements are needed to address these. Below are some examples of the areas

    that we expect will form the forward work plan set out in the West Wales Area Plan

    over the coming 5 years.

    There are challenges to improving outcomes for Carers; caring responsibilities

    can grow over time so there‟s a need to further embed good practices around

    identification, information and consultation as well as raising the public

    understanding of caring.

    There is a need to design and develop preventative services and review

    commissioned service specifications to meet the prevention model.

  • West Wales Carers Annual Report 2016/17 Page 8

    There is a need to improve carer assessments and do more to ensure

    services that support the cared for person are accessible.

    Providing programmes aimed at maintaining general health and well-being of

    carers and build resilience.

    Supporting the development of social enterprises and user-led services to

    ensure that services are commissioned which best meet the needs of Carers.

    b. Transforming Governance from Measure to Act

    During the reporting period a significant amount of work was undertaken by the West

    Wales Regional Carers Measure Implementation Group to transform the governance

    structure ensuring that the repeal of the Measure and the introduction of the Act

    would not distract from or devalue the Carers‟ agenda.

    The working group developed a plan for transition to include a programme of delivery

    and the associated staffing issues which were mapped for compliance with the WG

    transition directive. This was submitted to WG and agreed.

    The work of the Carers Measure Programme Board continued until the end of March

    2017, when responsibility was transferred to the West Wales Regional Partnership

    Board; and the regional Carers work is now being taken forward by the West Wales

    Carers Development Group.

    c. Ongoing work streams from the Carers Measure

    c.1 Communication and Awareness

    Communication remains a priority area and the partnership has continued to develop

    themes on a regional basis with localised information included. The maintenance

    and upkeep of the Carers Boards in hospitals is invaluable as is the distinct presence

    of dedicated information boards at GP surgeries across the region – (an outcome

    from the Investors in Carers scheme). The partnership has developed a catalogue of

    information to ensure that the messages on Carers Boards project commonality

    across West Wales.

    Further communication initiatives were developed to promote Carers through social

    media. All organisations actively utilise a variety of social media to get messages

  • West Wales Carers Annual Report 2016/17 Page 9

    and information out to Carers. Again, themes and specific promotions are shared

    and agreed so that Carers around the region receive the same news.

    All four organisations and a variety of third sector partners have actively promoted

    Carers Week and Carers Rights Day. These are two significant calendar markers for

    Carers and each county has actively sought hidden Carers by holding events and

    getting out and about in communities. Newsletters continue to be produced and

    shared whilst events to support Carers are collectively discussed and planned on a

    joint basis if appropriate (see Young Carer Training below).

    The Outreach model of delivering information to Carers is proving invaluable with so

    many Carers, rural and urban, being isolated at home and as yet not connected to

    social media or the internet. The Act states that information should be available on a

    face to face basis if required and the creation of the Outreach services in the three

    counties fulfils this requirement and satisfies Carers‟ requests for someone to

    support them, someone to speak to and share issues with.

    c.2 Training: Workforce development and Carer Awareness e-learning

    Training has been an important regional driver for the way we worked in partnership

    during 2016/17.

    A key element of the Training sub-group‟s work focused on improving and

    developing the knowledge and understanding of the Carer agenda across the

    regional workforce. The e-learning packages, Carer Aware and Young Carer Aware

    have been the key learning tool across the region during the Carers Measure

    implementation and the Carers Measure Programme Board endorsed the

    development and continuity of both courses. The courses include the important

    changes under the Act for deployment across the region, in partnership with

    Authorities‟ learning and development teams, in Health and Social Care. The

    courses are still the cornerstone training package as part of the Investors in Carers

    accreditation, and provide not just knowledge, but relevant and updated links for

    each County, giving staff the tools to advise Carers directly with accurate information

    on the range of support available in their locality.

    The courses were updated to reflect the new legislation and guidance and are now

    being actively promoted across the regional workforce, including availability for third

  • West Wales Carers Annual Report 2016/17 Page 10

    sector and community organisations, free of charge until December 2017, in both

    Welsh and English language versions.

    Importantly, the courses provide links to Social Care Wales information, in particular

    the Learning Hub, encouraging the workforce to review other aspects of the

    legislation, guidance and strategy across the Social Care spectrum.

    During 2016/17, the key developments have been:

    Review course licences with Cylix and establish an extended licence until

    December 2017

    Work directly with SSWBA Train the Trainers to review and update the

    course content for Carer Aware and Young Carer Aware to incorporate

    legislation and guidance covering Social Services and Well-being (Wales) Act

    2014 ready for relaunch Update all course information links to reflect changes

    to services and websites across the regional authorities

    Develop links with Learning & Development (L&D) teams to host the courses

    on the All Wales web platform

    During 2017, there will be a major promotion of the course across the West Wales

    region providing access, particularly to Community Groups and partnerships, to

    widen the knowledge and understanding of the Carers‟ agenda. Further work is also

    planned to:

    Further develop hosting on the All Wales platform to improve access and

    availability for Health Staff

    Review the current suite of Carer training in partnership with Authority L&D

    teams

    Develop viable, long term solutions to succeed the current e-Learning from

    January 2018

    Encourage Carer modules as a standard element of wider Health and Social

    Care training courses, including “train the trainer”.

    Targeted specific teams across Health such as Health Care Support workers,

    where roles have a high degree of contact with families and Carers.

  • West Wales Carers Annual Report 2016/17 Page 11

    c.3 Investors in Carers

    Since 2013/14 the Investors in Carers award scheme has been regionally

    coordinated by the Health Board. The Health Board has dedicated a resource to

    support this and the WG transition funding (formerly the Carers Measure Monies)

    has been utilised across organisations including social services and the third sector

    to employ dedicated staff. These will promote and facilitate participation by the wider

    community of interested parties including: primary and secondary care, social

    services departments, community pharmacies, schools and relevant third sector

    providers. Essentially, the resource has been targeted at creating a network of Carer

    aware organisations and individuals who, through participation and awareness, have

    galvanised a stronger partnership ethos around unpaid Carers. See a more detailed

    report below.

    c.4 Young Carers

    The dedicated resource for Young Carers (YC) within the transformation budget was

    utilized to continue the support provided through the Health Board. One day a week

    and school holiday periods were ring fenced to progress the work around

    coordination and collaboration between partners. We prioritised the work programme

    to include working with partners from the 3 Local Authorities and respective

    commissioned YC Services, as well as internal groups such as Public Health Wales

    and Occupational Health, and national agencies such as Children in Wales and

    Marie Curie to advance awareness and promote knowledge.

    Some of our key activities included:

    YC subgroup Terms of Reference updated, distributed and agreed.

    Ensured Young Carers are reflected within the Integrated Medium Term

    Plan document for the Health Board.

    Planning the budget spend in relation to the Young Carers‟ element of the

    transition fund.

    Supported and promoted the IiC bronze level award within the region‟s

    schools and colleges.

    Lead the development and trial of a YC resource pack for Professionals in

    HDUHB including the resource reading list, referral pathway and local

    support service.

  • West Wales Carers Annual Report 2016/17 Page 12

    Children in Wales approached the regional partnership group to offer a

    free training session to Young Carers in the region on their rights as

    Young Carers under the Social Services and Well Being Act. This offer

    came late in the year so the planning took place in 2016/17 whilst the

    event took place in the new financial year..

    Conducted consultation with Young Carers about what they want from a

    service. These were done usually in half term with an activity making up

    part of the day.

    The development of a YC Lesson Plan (in conjunction with the IiC

    scheme) to be used by school staff/ Public Health Wales to help

    professionals and children identify YC and signpost to support services.

    Introduced a YC board game to help young people, young Carers and

    teachers to recognize the difficulties and challenges experienced by

    Young Carers.

    Ensure Transitional Funding is used as a means to embed

    the practice of mainstreaming Carers’ needs

    a. Resources Review

    As a follow on from the PNA, evaluating and reviewing resources and potential gaps

    between current need and provision has been crucial in planning for 17/18.

    Welsh Government (WG) supported the implementation of the Carers Measure

    Information and Consultation Strategy over a 4 year period from 2012 to 2016, and

    the Health Board received the allocated funding on behalf of the Hywel Dda Carers

    Measure Programme Board, who oversaw the expenditure. WG provided further

    funding to support the transition from Carers Measure to the Social Services and

    Well-being (Wales) Act 2014 which came into existence on 1 April 2016.

    The regional partnership was allocated a total of £119,543 for 2016/17, which

    included a ring-fenced amount of £10,411 for Young Carers.

    The regional budget profile supported extensions to the employment of key fixed

    term staff in order to ensure there was continuity across the Region. The plan also

    included support for the Investors in Carers scheme across Health and Education

    settings, in order to further improve identification and support of Carers and Young

  • West Wales Carers Annual Report 2016/17 Page 13

    Carers. During the reporting period and indeed throughout the course of the Carers‟

    Measure the implementation and transition of the legislation has been further

    complemented by the resources allocated from both the Heath Board and local

    authorities across the region. The West Wales Carers Measure Implementation

    Group consisting of lead officers from each organisation have committed to the

    consultation, planning, implementation and review processes necessary to deliver

    the workstream and all have done so from within their current job descriptions,

    ensuring the funding has been targeted on service development.

    At the time of writing this report, confirmation of the allocation of funding for 2017/18

    has been received (Table 1). The Health Board area has received a further 3.5% cut

    in funding, which follows a 10% reduction in the previous year. This creates a

    challenging financial landscape and will require collaboration and creativity in order

    minimise any detrimental effect on the work that has been planned across the region

    for 2017/18.

    Table 1: Summary of financial position

    Allocation Main Allocation Young Carers

    2016-17 £119,543 £109,132 £10,411

    2017-18 £115,469 £105,429 £10,041

    Local authorities also face financial pressures with reduced funding that may impact

    upon support for third sector services which constitutes further risk to the support

    available for Carers in future years.

    b. Investors in Carers

    The Investors in Carers (IiC) programme is designed to help health and social care

    settings, such as GP practices, hospital wards and social care teams to improve

    Carer awareness and enhance the help and support they give Carers. Three levels

    of achievement are available: Bronze, Silver and Gold and it is delivered in

    partnership with local authorities and third sector organisations in Carmarthenshire,

    Ceredigion and Pembrokeshire.

    Bronze Awards attained in 2016/17:

    St Non Ward, Bro Cerwyn, Haverfordwest

    Boots pharmacy, Fishguard

  • West Wales Carers Annual Report 2016/17 Page 14

    Newport Pharmacy, Pembrokeshire

    Cohens Pharmacy, Milford Haven

    Cardigan Out Patients and Minor Injuries

    Ceredigion Community Mental Health Team

    Cea Bryn Community Mental Health Team, Prince Philip Hospital

    Boots Pharmacy, Whitland Bronze revalidations attained in 2016/17 (bronze certificate last for 2 years):

    Tenby surgery

    Charles Street surgery, Neyland

    Robert Street surgery, Milford Haven

    Amman Valley surgery

    Coalbrook surgery, Pontyberem

    Meddygfa Gelli-onn

    Penygroes surgery, Llanelli

    Morfa Lane surgery, Carmarthen

    Llanilar surgery, Aberystwyth

    Padarn surgery, Aberystwyth

    Newcastle Emlyn surgery

    All other surgeries are working on their revalidations.

    Silver Awards in 2016/17: Margaret Street Surgery, Ammanford

    In 2016/17 53 of the 54 GP surgeries in the Hywel Dda area are at the Bronze level

    of the scheme. A total of 4 were at Silver level with a further 8 surgeries working on

    this level in 2017/18. In addition, 12 Community Pharmacies and 3 Secondary

    Schools are at Bronze with a further 6 Secondary Schools working towards this.

    Eight Hospital Settings are at the Bronze level with another 10 settings working on

    their award for 2017/18; a lot of these are in the Adult Mental Health and Learning

    Disabilities teams and wards.

    A comprehensive annual report for IiC has been produced and can be accessed via

    the Hywel Dda University Health Board web pages.

  • West Wales Carers Annual Report 2016/17 Page 15

    Other developments.

    The scheme has now been developed for other settings that have contact with

    Carers. Some Social Services departments in local authorities, libraries and

    community projects are examples. There has been an IiC scheme for Secondary

    Schools for some time and this has now been embraced by two colleges in the

    region with submissions to be made in 2017/18.

    Other Successes attained in 2016/17:

    Team Around the Family (TAF) in Pembrokeshire

    Workways+ Community Project in Pembrokeshire As a result of the pilot in the above two areas the other two counties are being

    approach to roll out the scheme there in 2017/18.

    c. Carer Leads

    Each setting that engages with the IiC scheme are appointing a Carer Lead to be the

    settings contact for Carers and professionals. Their role is to ensure Carer notice

    boards are kept up to date, help Carers complete the registration/referral form,

    signpost them to other services etc. This role was evaluated earlier in the year and

    key finding was that 65% said they are more aware of the needs of Carers at their

    surgery/health setting.

    We also ran a Carer Lead event in each county during the year whereby Carer

    Leads from any setting engaged with the scheme came together to network, learn

    what is available for Carers and to share best practice. A quote from an event:

    “I have been able to pass on information to patients and colleagues in the

    surgery and advise patients of the benefits of registering as a Carer.” Carer Lead

    Using the consistent Carer registration and referral process within the IiC scheme we

    can report a number of findings. The number of Carers registered at their GP

    Surgery has increased from 6112 in March 2016 to 6830 in March 2017. GP

    surgeries have referred Carers for further help and support in each county as

    summarised below:

    Carmarthenshire 300

    Ceredigion 181

    Pembrokeshire 229

  • West Wales Carers Annual Report 2016/17 Page 16

    This means that a further 710 Carers now receive a range of help and support from

    newsletters, information and appointments with out-reach workers to formal Carers‟

    Needs Assessments.

    In March 2017 an „abstract‟ was submitted for the Inspiring Innovation conference

    which was hosted by the Hywel Dda University Partnership Board. There were 4

    themes: Innovation in Community Interventions, Service Delivery, Cancer Care and

    Science. Oral presentations and poster presentations were to showcase Clinical

    Research, Social Care and Wellbeing Research, Audit and Innovation.

    The IiC was one of 35 posters submitted and was Highly Commended.

    b. LA Plans and delivery of the increased responsibilities under the

    SSWBA

    Carmarthenshire County Council

    Through its commissioned services, Carmarthenshire County Council has developed

    a cohort of providers (including some who are not commissioned) who collectively

    make up a „provider forum‟. The forum membership consists of „Carer focused‟

    services and some whose services are less focused but nevertheless touch unpaid

    Carers and families. Through this network Carmarthenshire has been able to sustain

  • West Wales Carers Annual Report 2016/17 Page 17

    communication around the transition and developments related to the legislative

    frameworks and maintain the momentum around Carers that will effectively ensure

    the embedding of practice.

    Further to this the introduction of the Act in April 2016 has seen new and inclusive

    practices introduced that firmly uphold Carers‟ rights and entitlements at the service

    entry level. Information, Advice and Assistance (IAA) for Carers is being developed

    through the Carers Information Service and a relatively new outreach service model

    which has demonstrated resounding examples of efficiency and compliance with the

    Act.is now established and providing an appropriate next step for Carers referred

    through the Investors in Carers programme. Carers, who self-refer, can be

    signposted to the specialist IAA provided through a third sector organisation who are

    jointly contracted by health and social care. Targeted advice and assistance of a

    comprehensive nature ensures that Carers receive appropriate levels of support to

    meet their individual needs. For Carers whose circumstances present a less than

    clear picture the service employs the Carers Outcomes Star to establish levels of

    Carer stress which can be measured with further referral for formal assessment

    made as required.

    New processes to guide compliant social services practice have been developed and

    introduced following scrutiny and ratification by the Department‟s Practice and

    Process Board who oversee and authorise new or revised initiatives. Several

    process maps are available to guide practitioners on a step basis to ensure that

    Carers receive recognition and appropriate support in a timely way, whichever route

    they have arrived from. These processes are accessible to all practitioners via the

    department‟s „Just ASC‟ (Adult Social Care) web pages.

    Carmarthenshire Carers action Plan 2014–2017 has been implemented with

    additional benefits for Carers through the Carers Extenuating Circumstances Direct

    Payments scheme and the Carers Card scheme. Both initiatives have been reviewed

    and redesigned to extend service provision for Carers and ensure compliance with

    the Act. The Card scheme will be promoted extensively and offered to all Carers as a

    matter of course.

    Working Carers also feature in the Plan and a bi-annual campaign and award

    scheme are being launched for the second time during Carers Week. The scheme

  • West Wales Carers Annual Report 2016/17 Page 18

    allows Carers who have been supported at work by their boss or manager to

    nominate them for an award. The scheme raises the profile of working carers and

    promotes examples of best practice where working carers are supported to sustain

    work and a caring role at home. The Awards will be made during Carers Rights Day

    in November.

    Carers‟ Lead roles have been taken up by a cross section of social services staff

    who have declared an interest in supporting carers by providing a team focal point

    that offers direction and guidance on compliance and good practice related to the

    new processes implemented to uphold the Act.

    An inspection of Carmarthenshire Social Services conducted by the Care and Social

    Services Inspectorate Wales under their „Key Lines of Enquiry - Carers‟ programme

    found very positive outcomes, stating “Carers reported they value the support

    received from the Carer‟s Information Service provided by Crossroads Carers Trust.

    Carers reported that they have a wide range of resources and information available

    and they welcomed being involved in the production of the documentation”

    CSSIW Performance Review of Carmarthenshire County Council Social Services 2016/17.

    Consultation with Carers to gain views and opinions regarding outcomes, new or

    existing service design, pressures and desirables is important to ensure Carers have

    voice and control over services and service development. Carmarthenshire Carers

    Forum are commissioned via a small budget to facilitate bi-monthly meetings around

    the county where carers are invited to attend and speak freely. The Carers Forum

    are tasked with reporting issues and trends to inform service development, report

    poor performance or good performance and ensure that Carers feel included.

    “Carmarthenshire has strong carer representations on the Carers Partnership board

    and the Regional Strategic carer‟s board. Discussions board members confirm they

    are influential in shaping services; they have a strong voice and hold the local

    authority to account in ensuring that carer‟s needs are effectively met”.

    CSSIW Performance Review of Carmarthenshire County Council Social Services 2016/17.

    The Carers Information Service, during 2016/17 has conducted its first annual Carer

    survey. With over 1500 Carers registered on their data base (most of whom are

    familiar with IT), they have undertaken a survey to establish the service satisfaction

  • West Wales Carers Annual Report 2016/17 Page 19

    levels and any stressors that Carers want to report. A report will be produced

    annually to support commissioning and offer general feedback to the department.

    During the year Carers Rights Day and Carers Week were successfully promoted.

    The annual Carers Rights day was influenced by carers who requested more „fun‟

    and ‟interactive‟ activities. A successful event at the Ffos Las Race Ground in

    Trimsaron saw over a hundred carers attend who benefited from a wide range of

    information from over 20 third sector organisations, take part in taster activities and

    workshops and enjoy a social event with old and new friends. The event also

    launched the inaugural Above and Beyond Awards which recognise the contributions

    made by volunteers to support carers. Two of the award winners represented

    Carmarthenshire at a Royal Garden Party.

    Ceredigion County Council

    CSSIW undertook a Key Lines of Enquiry Carer Focus Inspection between October

    2016 and January 2017 relating to the Act. This was a new process undertaken

    across all 22 local authorities. CSSIW Inspection noted “The role of the local

    authority‟s carers unit was exemplary and received universal praise from all of its

    partners and carers. The awareness of the Act and the importance of the „what

    matters‟ conversations with Carers is clearly established within the Unit”. The

    Inspection further noted “The „added value‟ that the Carers Unit brings to both

    Carers, the 3rd sector and the council, and its unique ability to oversee, co-ordinate

    and drive the work with and support of Carers cannot be underestimated”.

    In response to the new Act duties to provide Information, Advice and Assistance

    (IAA), Carer feedback has been collected through a variety of means throughout the

    year. A feedback log is being established to record all feedback received from

    Carers. A system has been established to record enquires from Carers and

    professionals. Carer feedback is collected via the Carers Forum newsletters that are

    sent out every other month (feedback is submitted by Carers that complete and

    return the „pull out page‟. Feedback from Carers is also collected from Carers at

    Carers Forum meetings and following Carer events. All positive feedback is recorded

    on the compliments log. Monthly reports are forwarded to the corporate complaints/

    compliments team to log. CSSIW noted: “The Carers Unit has a well-developed and

    detailed communications plan which sets out the engagement plan for the year,

  • West Wales Carers Annual Report 2016/17 Page 20

    feedback is sought from Carers and partners as to the effectiveness of these events.

    There is a good amount of reflection and conversation surrounding the work carried

    out. This is an essential way to evidence the work and scope of the Unit”.

    In addition to the mandatory training for staff on the modules of the Act, the Carers

    Unit delivered written guidance and individual training sessions across social care to

    embed the new procedures in supporting Carers in practice, and supported health

    and social care practitioners in the implementation of the new Porth Gofal Triage

    team within the Social Care single point of access, to assist staff in developing

    knowledge in meeting the requirements of the Act. Articles have been included in the

    Carers magazine to make Carers aware of changes in rights and process. CSSIW

    noted: “The Unit has produced a very useful guide to the changes regarding the

    response to carers brought about by the SSWB Act”.

    Since the implementation of the Act in April 2016, the Carers Unit has been working

    to develop and enhance the Carers Information Service provided by the team. In line

    with the Act, the Carers Information Service aims to support Carers through

    providing information that may help or support them in their caring role thus

    preventing or delaying their needs from escalating. The Carers Information Service

    provides a means for Carers to receive support without receiving formal Social

    Services support. Two Carers Unit Officers were the first to achieve the Level 4

    Information Advice and Guidance qualification within Ceredigion County Council.

    CSSIW noted: “The Council offer direct contact with carers via the Carers

    Information Service (CIS). The Unit demonstrates flexibility and innovation in

    responding to what matters to carers and live examples were presented to CSSIW.

    There is a good awareness of services locally and nationally, available to support

    and advise”. The core service is enhanced through a joint partnership Service Level

    Agreement with Hywel Dda University Health Board. This enables the Carers Unit to

    expand the range and reach of printed information into more health environments

    and extend the delivery of core Carers Week and Carers Rights Day activities.

    The Unit is further supported by the Ceredigion Carers Alliance network. The

    CSSIW Inspection noted: “The Ceredigion Carers Alliance is an effective forum

    bringing together a wide range of 3rd sector and health representatives. The purpose

  • West Wales Carers Annual Report 2016/17 Page 21

    of which is to ensure consistent development and information sharing for those

    organisations who support carers throughout Ceredigion. The Alliance is coordinated

    and driven by the Carers Unit. CSSIW sought feedback from all members of the

    CCA as to; the quality of the information provided by the council, carers views as to

    the quality, effectiveness and accessibility of this information , the support the

    alliance receives from the council and any suggestions for improvements. It is clear

    from all of these responses the high regard the Carers Unit and its staff are held in

    by the Alliance and the carers they support. Specifically; The accessibility of staff for

    advice, and support. Its role in coordinating the work needed to support carers. The

    awareness raising of carers issues and developments. The knowledge hub. Plays a

    vital role in keeping carers services and rights prominent in health and social care.”

    The Carers Unit worked with partners to deliver a series of events for Carers during

    Carers Week in June 2016, the events were organised in partnership with

    commissioned service providers: British Red Cross, Hafal and Crossroads Mid &

    West Wales with support from Marie Curie. Successful partnership working was

    demonstrated and positive outcome achieved for Carers who reported that it was

    good to have opportunity to talk and be recognised and there was plenty of

    information available. Carers Rights Day saw a hugely successful public event for

    100 Carers and a very successful first speed networking learning event for Third

    sector organisations was facilitated by the Carers Unit to inform Health and Social

    Care professionals with the support of the Carers Alliance as part of Carers Rights

    Day in implementing the principles of the SSWBA in partnership working.

    The Jigsaw magazine produced by the Carers Unit was produced twice in 2016 with

    2000 copies printed and distributed in in June 2016 and 1500 copies printed and

    distributed November 2016. Following feedback received from Carers and

    professionals, the Jigsaw magazine has since been rebranded to „Carers Information

    Service magazine‟ and the new logo mentioned above is incorporated in to the

    publication. CSSIW noted: “The Jigsaw publication received universal praise from

    carers and partners, and serves as a single source of information and directory of

    support, clearly something that is welcomed by carers.”

    CSSIW noted: “Feedback from Carers is extremely positive about the support given

    by the Carers Unit and its staff. The Forums are supported by a good range of

  • West Wales Carers Annual Report 2016/17 Page 22

    Carers events throughout the year with excellent attendance. The Forums are

    professionally and compassionately chaired”. The new Ceredigion Carers Forum has

    now been running for 1 year and membership continues to grow month on month.

    The Ceredigion Carers Forum meets every other month in Penmorfa, Aberaeron. For

    those who are not able to reach Aberaeron, Video Conferencing facilities at council

    offices, Aberystwyth have been made available so that Carers can still participate in

    the forum from Aberystwyth. In recognition that Carers have a multitude of

    commitments to balance, the Carers Forum is open to Carers who can attend the

    physical meeting in Aberaeron and the linked meeting in Aberystwyth as well as

    those that can‟t be at the meetings. Carers are welcome to contribute via telephone,

    email or written correspondence if they wish to and in between meetings all Carers

    Forum members are sent a newsletter giving regular updates on Carer related

    issues and consultations. Membership has doubled during 2016/17.

    The Ceredigion County Council Carers Unit worked in partnership with the Mid

    Wales Healthcare Collaborative and Hywel Dda University Health Board and

    partners within the Investors in Carers Team to deliver the highly successful Carers

    Resilience and Well-being Programme pilot to 21 Carers. Reported outcomes for

    Carers were excellent. The resulting report was delivered to the penultimate Hywel

    Dda Carers Measure Programme Board and included as part of the West Wales

    Population Needs Assessment Carers thematic report.

    The CSSIW Inspector noted during the Ceredigion Carer Focus Inspection: “Raising

    awareness of the needs of Carers and recognising those who are fulfilling the role of

    carers, including young carers, is being developed and promoted throughout the

    county. One example of this is the Investors in Carers scheme, a health led initiative

    which works with GP surgeries and is now being rolled out to schools and

    pharmacies. This is raising awareness of Carers both young and adult and the

    importance of identification and referral if appropriate. The effectiveness of this

    initiative is monitored via quarterly monitoring of the number of requests for a service

    and the tracking of referrals that originate from GP‟s”.

    Pembrokeshire County Council

    The Pembrokeshire Carers Strategy, published in 2015 is a joint strategy and sets

    out a five year vision for supporting the health and well-being of Carers and is firmly

  • West Wales Carers Annual Report 2016/17 Page 23

    rooted in a strong foundation of partnership working in the county. The Strategy sets

    out the strategic direction, led by Pembrokeshire County Council, but in partnership

    with the Health Board for support and advice to all Carers in Pembrokeshire,

    including young carers and young adult carers. This is in line with the national

    strategies set by Welsh Government, and links into the overall aim and vision for

    Pembrokeshire that Pembrokeshire people are healthier.

    Following the repeal of the Carers Measure in April 2016, Pembrokeshire County

    Council and Hywel Dda University Health Board have continued to work in

    partnership for Carers as we transition from the Measure to Act. During the 2016/17

    year members of the Carers Strategy Partnership Board have continued to

    implement the work that supports unpaid carers and our priorities identified for

    2016/17 in the Pembrokeshire Joint Carers Strategy.

    The new Pembrokeshire Carers‟ Information and Support Service (PCISS) was

    launched on 4 July 2016 to provide information, advice and assistance for carers in

    Pembrokeshire. The free service based at Crossroads House in Haverfordwest is

    available to anyone in Pembrokeshire, aged 18+, who identifies themselves as being

    a Carer. The new Carers Information Support Service aims to take time to listen to

    carers‟ needs and help them access relevant support in the community through:

    A Walk-In Centre for Carers.

    Information, Advice and Assistance

    Carers Recognition Card

    Carers Emergency Back-up Scheme

    During their first 9 months of service, PCISS have supported 355 carers and of those

    carers, only 42 have required referral to the Local Authority for a formal carer‟s

    assessment.

    Carers Week 2016 saw another successful collaboration, Pembrokeshire County

    Council worked with colleagues from Action for Children, Alzheimer‟s, Crossroads

    Mid & West Wales, Hafal, Hywel Dda University Health Board, Pembrokeshire Coast

    National Park and Volunteering Matters again this year. There were information

  • West Wales Carers Annual Report 2016/17 Page 24

    stands in Newport, Hubberston, St Dogmaels, Crymych, St David‟s, Fishguard,

    Pembroke Dock, Haverfordwest and Tenby throughout the week where carers could

    speak to staff. The main event was at Carew Castle, where a barbecue was held for

    young carers after school, which was attended by 30 people, including 15 young

    carers. They had great fun making catapults and firing water balloons. One young

    carer described it as “awesome time, great place” and another said “I had lots of fun,

    if I had the opportunity, I would do it again”.

    In June 2016, Team around the Family (TAF) became the first Local Authority team

    across Hywel Dda to complete the Investors in Carers Bronze Level award. The

    award is in recognition of the excellent work undertaken with young carers to help

    them understand and cope with the challenges they and their families face. A wide

    range of information and support is available for young carers and TAF have worked

    hard to ensure families understand how to get support that can make all the

    difference for them and the person they care for.

    Pembrokeshire Young Carers continues to operate to the need of the service user

    and their family. Support groups are well attended with an additional group now

    being run in Pembroke Dock for the older age group. The October and February

    Half Term and Christmas activities were a great success with feedback from

    attendees stating that they enjoyed the activities and parents felt they were well

    organised with a good choice of what to do.

    The Act places a duty on the local authority to offer assessments to all carers where

    it appears to the authority that they may have needs for support. The Act imposes a

    further duty on the local authority to meet the eligible needs of carers, both adult and

    young carers. In order for Pembrokeshire County Council to meet their duties,

    extensive training has been provided to social care staff in respect of assessing

    need, eligibility, direct payments and continuing health care.

    On Carers Rights Day 2016, social care staff were invited to a conference which aimed

    to raise awareness of carers, from identifying carers, to referring carers for information,

    advice and assistance, and ensuring that carers are made aware of their rights and are

  • West Wales Carers Annual Report 2016/17 Page 25

    able to access appropriate support to help them continue with their caring role. They

    heard directly from Carers Services about what services they are able to offer Carers to

    support them in their caring role, including the new “Community Connector Project.” As

    well as having the opportunity to ask questions as well as the chance to network and

    browse the information stands.

    In January 2017, a briefing paper was sent to all Chairs of Governors and circulated

    to governing bodies, providing them with information on how to access the on-line

    courses, and how to access further information and advice to enable our schools to

    better support young carers.

    Pembrokeshire County Council's Workways+ team became the second team within

    the Authority to be recognised for their commitment to providing appropriate support

    and consideration to Carers. The Workways+ team has been awarded the Investors

    in Carers bronze level award by the Hywel Dda University Health Board Carers

    Partnership. Some of the actions undertaken by Workways+ have included helping

    carers to access local support, liaising with external agencies to improve their

    support, and providing promotional material on how to access services. Workways+

    is a major EU-funded project which works with long term unemployed and

    economically inactive people to help them overcome barriers to employment and

    volunteering.

    Ellie Brick, Performance and Quality Manager at Workways+, said taking part in the

    Investors in Carers scheme had proved very beneficial. "It has definitely helped us to

    support carers," she said. "We have found out about the extra support that we didn't

    realise was there."

    Project Manager Karen Davies added: "This is a fantastic achievement for the team

    in Pembrokeshire and recognises their hard work in engaging with and improving the

    skills and employment opportunities for carers."

  • West Wales Carers Annual Report 2016/17 Page 26

    Setting out how as partners we planned and delivered the

    increased responsibilities for health and the new

    responsibilities for local authorities

    Whilst acknowledging the challenging financial position and also the partnership

    approach, there is still a need to recognise organisational duties and responsibilities.

    The Health Board has given consideration to the internal transformation needed

    across a large organisation. During 2016/17 a Carers Advisory Team was formed.

    The Carers Advisory Team (CAT) is a small cohort of Health Board personnel whose

    remit is the promotion of unpaid Carers within health settings, predominantly at

    secondary care sights to complement and support the work of Investors in Carers.

    Targeted internal campaigns that rein in support from existing groups such as senior

    nurse forums and communities of practice will assist in the dissemination of

    information and responsibility, reinforcing resilience amongst Carers who need to be

    perceived as partners in care provision. Greater awareness and earlier intervention

    will improve outcomes for Carers and patients, particularly during transfer of care

    planning and elective procedures. The CAT, whilst actively promoting the Carers

    agenda, is developing an internal strategy to address the required recognition and

    engagement of Carers to build on the momentum generated by the Carers Measure

    and to reflect best practice in line with the Act.

    The main drive for our work during year 2 will be centred on four themes, Workforce,

    Partnership, Service Delivery and Communication and Engagement.

    Pages on the Health Board‟s intranet web site to inform Health Board staff who have

    a caring role at home have been created. By having their own needs recognised the

    workforce‟s appreciation for other unpaid Carers will improve resulting in a

    contribution to the cultural change so necessary if Carers are to be regarded with

    respect for their role and contribution.

  • West Wales Carers Annual Report 2016/17 Page 27

    Creating Opportunities to enable third sector to fully

    participate in the delivery

    The Act was introduced in April 2016 and a wide range of training has been

    delivered for statutory providers (Social Services Departments).. Training featured

    throughout the year with the workforce completing a range of courses to learn about

    sections of the Act including how unpaid Carers now have equal rights to

    assessment and support if eligible. Third sector partners have been included in the

    training programme so that collectively there is a common knowledge base to

    support the Act.

    Investors in Carers is being delivered at county level through funding from the WG‟s

    Transition Fund. Each county has a dedicated IiC lead facilitator whose role is to

    promote and support a variety of appropriate settings to employ the IiC scheme.

    These lead officers are commissioned through the third sector with Ceredigion

    Association of Voluntary Organisations (CAVO), Pembrokeshire Association of

    Voluntary Services (PAVS) and Crossroads Sir Gar Carers Trust hosting the posts.

    A board game helping young people to appreciate what being a Young Carer means

    was introduced by Marie Curie and has been actively promoted across the region

    where partnerships between statutory and third sector representatives have

    collaborated in delivery. For example; in Pembrokeshire Action for Children, who

    host the county‟s Young Carers‟ project, the council‟s Team around the Family,

    Marie Curie, PAVS and the Health Board all collaborated to deliver the board game

    experience to over 400 7, 8 and 9 year old pupils in a Pembrokeshire school.

    In Ceredigion and Carmarthenshire the Alzheimer‟s Society is actively supporting GP

    surgeries to achieve the Silver level award of the IiC programme and Crossroads

    Carers Trust in Carmarthenshire, through its outreach team, are supporting both

    primary and secondary care services to attain awards.

    County engagement plans have been designed to ensure that carers and carers‟

    issues are included within consultations focusing on the SSWBA and the Well Being

    of Future Generations Act. During the year the region conducted a population needs

    assessment (PNA) to comprehensively establish what levels of help and support are

  • West Wales Carers Annual Report 2016/17 Page 28

    available or required. In working towards a delivery plan the third sector will feature

    strongly through the commissioning and contracting of new or revised services to

    meet the aspirations made in the plan.

    Commissioned delivery summary - in addition to the Transition Funding from WG

    third sector participation to support carers is being commissioned from a variety of

    local and national providers. Many of the national organisations operate in each

    county, offering a similar type of service with many delivering services for a number

    of years. The local organisations tend to specialize and target delivery within their

    counties or even within areas of the counties.

    During the year there has been a great deal of deliberation over the new Act and a

    getting to grips with the direction we are required to follow. During the reporting

    period there has been dialogue on a regional and a local basis to explore how third

    sector partners are going to be able to deliver on the Act. Mapping of organisations

    and community groups has been a key feature of the Information Advice and

    Assistance (IAA) services to date with a growing number of potential partners and

    providers now forming a comprehensive data base to inform practitioners and

    citizens generally. IAA services will maintain and monitor the data to ensure

    information given is up to date and support remains available.

    Commissioned services have been explored to see whether their present service

    specifications meet criteria to facilitate delivery of the Act. In Carmarthenshire a

    series of engagement workshops with third sector providers are planned to explore

    ways that we can collectively deliver the Act through a revision of service

    specifications and other ideas. Further discussion around social enterprises and co-

    operatives has been undertaken and will form part of the agenda for forthcoming

    workshops when third sector partners and other community groups will be

    encouraged to foster these models of delivery.

  • 1 Appendix 2 Investors in Carers Annual Report 2016-17

    Investors in Carers

    Annual Report 2016/17

  • 2

    Contents Foreword by Dr Gareth Morgan..............................................3 GP Surgeries...........................................................................4 Community Pharmacies..........................................................4 Hospital Settings ...................................................................5 Secondary Schools.................................................................6 Other settings.........................................................................6 Carer Leads............................................................................8 Carer Stories...........................................................................9 A Carers’ Journey.................................................................10 The Way Forward..................................................................11 Further results.......................................................................12 Tables and graphs.............................................................12 - 19 The team...............................................................................20

  • 3

    Foreword When reflecting upon the year 2016/17, I look back on a progressive year in which we are putting in strong foundations to deliver the Social Services and Wellbeing Act (Wales) 2014. In particular, the publication of the population needs assessment shows the invaluable and sometimes unappreciated role that unpaid Carers have in our communities every day. Although this is positive in itself in raising the profile of unpaid Carers, it also sets down the challenge for health and social care services to continually keep our work under review. With those comments in mind, I’m delighted to offer this foreword on one of the key programmes for unpaid Carers in the region, Investors in Carers (IiC). First and foremost, I would like to pay tribute to all of the partners who have contributed to the ongoing success of the programme. Within the report examples of these partnerships are presented although this is illustrative rather than exhaustive. Yet the underpinning foundation of IiC is based on partnership, and the positive consequences from relationship building have a wider benefit in the region. Last year was my first foreword as the Carers Lead. 12 months on, I’m delighted to review another report which puts forward further evidence of success of the programme. This success is demonstrated in a range of healthcare settings and beyond, which deserves recognition. Furthermore, the ongoing and indeed increased contact with unpaid Carers is a key measure of success. With all that said, now is the time to redouble our efforts to continue our work, especially to identify and support hidden Carers who may have unmet needs. With respect to these two drivers of both successful continuity and further expansion, there appears to be wide ranging agreement across the region. Whilst the task ahead will thus still have challenges, the common goals we all seek will drive us forward. I would particularly like to thank Pennie Muir and the dedicated team of Investors in Carers staff, which has had personnel turnover last year. One of the measures of success of the programme is that it has not only continued to deliver but arguably has more strength as fresh energy and new perspectives arrive. Pennie deserves huge credit for this and, whilst this programme is certainly not about one individual, this foreword would not be complete with putting down a record of this. In closing, I would therefore like to commend this report to you and thank you all for your interest, support and ongoing encouragement to this programme. Dr Gareth P. Morgan. FRSPH. Hywel Dda University Health Board Carers Lead.

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    Boots in Fishguard achieving the

    Bronze Award in March 2017

    Margaret Street Surgery staff, Ammanford

    receiving their IiC Silver Award in

    December 2016. Also in the photo

    members of the Health Board and Local Authority.

    IiC and GP surgeries. The IiC Scheme continues to be utilised by all GP surgeries within the Hywel Dda University Health Board region. The IiC team have been supporting surgeries to meet their objectives on the Carer agenda with the great majority of surgeries (98%) having gained the Bronze level standard. Whilst there is one remaining surgery yet to engage in the standard there is clear evidence all are supporting Carers in a number of different ways. The IiC Bronze award accreditation is only valid for two years, so the team are now supporting surgeries in the process of re-validation. We have also updated this level to ensure that it is still fit for purpose 10 years after its introduction. This exercise has eliminated duplication of areas and made the process easier to manage for the GP Surgery in an increasingly busy environment. Silver Level A number of surgeries are now working on the Silver level; a more advanced level that demonstrates new (or more effective) ways of working to support Carers. This level is about what differences surgeries can make to a Carer’s life and concentrates on ‘outcomes’ and ‘results’. Teifi and Llynyfran surgeries both in Llandysul and Llwynhendy surgery in Llanelli who achieved Silver in the previous year continue to support their Carers at this level. A number of other surgeries in each county are working toward this level in the 2017/18 financial year and being supported by the team.

    IiC and Community Pharmacies. The role out of the IiC scheme into community pharmacies has proven to be more of a challenge this year. However, work to support this continues, and pharmacies already at Bronze level are now working towards their revalidation.

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    Ceredigion Community Mental

    Health Team for Older Adults achieving the

    Bronze Award in July 2016

    Cardigan Out-patients and Minor

    Injuries team receiving their

    Bronze certificate in August 2016

    IiC and Hospital Settings. The IiC scheme is gaining momentum within hospital settings thanks to the support of senior managers. Community Hospitals in Carmarthenshire are embracing the scheme and teaming up with the Carmarthenshire Carers Outreach Workers who help maintain and refresh Carers Notice boards within the locations. Nearly all Older Adult Mental Health teams and wards are at Bronze level with many areas offering extra support for Carers. For example St Non ward in Haverfordwest have been running Carers Support training sessions, whilst Community Mental Health Team and the Alzheimer’s’ Society run a regular ‘Cake and Clonc’ sessions for both the person affected by dementia and their Carers and have recently raised £300.

    All of the Mental Health inpatients settings are now working on their Bronze level. This is supported by regular lunchtime sessions where staff can come along and find out more about the scheme, bring their evidence folders for feedback, and network with colleagues and the third sector. As a result of this engagement many settings were planning events to support this year’s Carers Week in June.

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    Specialist Child and Adolescent Mental Health (S-CAMHS) areas in all three counties are also working on their Bronze level, and are due to submit their files for assessment at some point during the coming year.

    IiC and Secondary Schools. Whilst there has been no secondary school achieving their bronze level in this financial year, a number of schools continue to work on the scheme, and training sessions have been run for both pupils and staff using the Young Carer Board game, I care do you....? For example Ysgol Y Preseli, in Crymych, Pembrokeshire, has seen the Young Carer board game being played by year 7, 8 and 9 pupils with support from Action for Children, Team Around the Family (TAF) the Health Board and Pembrokeshire Association of Voluntary Services. A total number of 423 pupils played the game and some stated that they felt more Carer aware as a result of these sessions. Quotes from pupils include: The game has also been used by teaching assistants, in Coedcae School, Llanelli and by pupils in Penglais School in Aberystwyth, Ysgol Gwaun in Fishguard and Newcastle Emlyn school.

    IiC and other settings. As a result of the success of the IiC scheme in health settings other areas have enquired if they too can participate in the scheme. Therefore the basic framework has been adjusted to suit others areas such as Local Authority departments/teams. This has been embraced in areas within Pembrokeshire with the support of the Carers Strategy Coordinator It is anticipated that other teams, departments and projects in the partner counties will follow

    Pupils at Penglais School playing the Young Carer Board

    game in Carers Week 2016

    “I learnt that it would be quite hard to be a

    young carer.”

    “I enjoyed learning about young carers and have leant they have a much harder life than

    non young carers.

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    suit. Some examples are libraries, community project called Workways+, and a Care Factory in Pembrokeshire.

    Workways+ (left), a European funded project, and Team Around the Family (TAF) (right) have both been successful in achieving their bronze level. Some feedback includes The community of Newport in Pembrokeshire has undertaken some innovative work around the Carer agenda during 2016-17. The GP surgery is working towards their IiC silver level and working in partnership with Newport Community library to support their Carers. Two Carer events were held in March which included short presentations from organisations that support Carers, including Pembrokeshire Carers Information & Support Service, the Community Connectors programme, and the Education Programmes for Patients (EPP). As a result of these events the Carers now want to meet on a regular basis and have set up their own Carers Support Group, which they plan to launch during Carers Week in June. In July EPP will be holding their course “An Introduction to Looking After Me” to help Carers maintain their own good health and wellbeing. A full evaluation of these events is currently underway. This has been an exciting development of the scheme and clearly shows that it can be used flexibly and innovatively to raise awareness of Carers to staff and ultimately the Carer can gain some help and support that may not have evolved for sometime.

    Carer Leads Another positive outcome of the IiC scheme has been the development of the Carer Lead role and recommend that all settings participating in the scheme to have at least one. However, whilst the scheme works very well having a Carer Lead, it needs to be remembered that it is everyone’s responsibility to identify Carers.

    “It has made a big difference to the project and

    to the carers we support”

    “The members of the team do seem to be highlighting more young carers”

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    This person’s role is to be a point of contact for the IiC Team, receive Carers’ information and cascade this to the rest of the staff. Other duties include keeping their Carer notice board up to date, supporting national and local events, speaking with Carers about their circumstances and signposting them as appropriate. Carer Lead events now take place on an annual basis in each of the three Counties. The workshops provide learning and development for attendees on a range of Carer related topics, encourage best practice and ensure Carers are supported to best effect at the surgery/pharmacy and other settings. Topics covered at events over the last 12 months have included:

    Sharing best practice

    Increasing knowledge of third sector Carer specific organisations

    A Carer telling their story

    Considering what would happen if Carers went on a 24 hour strike

    The events have proved to be very popular in terms of encouraging networking across a range of health care providers. Carer Leads from other settings have been encouraged to attend as well. Contributions from other Carer Professionals and the Third Sector organisations that support Carers have been well received at a number of the events and have increased Carer Leads’ knowledge. We have also been able to evaluate the Carer Lead role by asking them to complete a Survey Monkey survey during the year. Some key findings from the survey shows:

    65% said they are more aware of the needs of Carers at their surgery/health setting.

    Over 50% said that they have been able to give Carers at their surgery/health setting relevant information on a regular basis.

    Over half also said that they have identified Carers that their surgery/health setting were not otherwise aware of.

    Some quotes from Carer Leads:

    “I have been able to pass on information to patients and colleagues in the surgery and advise patients of the benefits of

    registering as a Carer.”

    “Overall we have positive feedback; mainly Carers feeling better that there is someone available to talk to who understands their role.”

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    Carer Stories With the support from each county’s Carer Information services (different organisations in each county) we were able to obtain case studies/scenarios detailing the types of help and support Carers receivied as a result of the registration/referral process at their GP surgery. Below is one example of the ongoing support that a Carer now receives. We are able to feedback these to the surgeries in general terms so they can see the type of things that can better understand their part in the process and how this has improved the outcomes for the Carer Case Study – Carers Outreach Worker A Carer is 81 years of age and has been caring for his wife for 2 years. She is 83 years and has been diagnosed with Alzheimer’s disease. We received a referral from his GP surgery, via the Investors in Carers scheme. A Carers Information Pack was sent out and an outreach appointment arranged promptly as the Carer became quite emotional during telephone triage. He was adamant that he wanted to continue to care for his wife at home as they had been married for over 50 years. His wife had provided excellent support for him during a period of ill health and he wanted to reciprocate the care and support she had provided him. He had some support from his sister but she had her own health issues so he was providing most of the care for his wife. He did not want to be referred for a Carers Needs Assessment although he is finding it extremely tiring as he was concerned about disclosing his finances. Reassurance was provided that the financial assessment is optional, but he would have to pay the charges if he didn’t have the assessment. Through the Outreach Service, additional information was provided to the Carer on Carers Needs Assessments, Telecare, replacement care, foot care clinics, carers support groups, Council Tax exemptions. A referral was made to Catch Up for benefits advice. The Carer continued to receive support through the Outreach Service until the issues identified during the first appointment had been resolved. We are considering the best way to use these case studies/scenarios and any other anecdotal feedback that relates to the IiC scheme. Figures and quantitative methods are informative as a means of evaluating the scheme, however the qualitative data and softer outcomes are equally important, and arguably demonstrate the true impact of the scheme. The following diagram of a Carer’s journey illustrates the help and support that is available. This diagram will be used as a training tool during the following year.

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    A real life Carer’s journey resulting from a GP Surgery referral

    Carer completes registration/referral form with the

    help of their surgery.

    Form is sent to Carers Information and Support Service.

    Carer has ticked box for an

    outreach worker to get in touch so a phone call is made.

    Outreach worker meets the Carer at their house and talks through

    their situation.

    Carer cares for her husband who has arthritis and memory

    problems. Carer also has hip pain. Carer worries about her

    husband falling, she is fed up and feels trapped at home, she does all household tasks and never gets time to do anything she

    enjoys. Husband does not go to any day centre or do any

    activities.

    Out reach worker makes some referrals with other relevant

    agencies to help. Also by talking the Carer is helped to off load

    what is on her mind.

    Outcomes: 3 hours replacement care with

    Crossroads so Carer can go out knowing husband is safe.

    Husband now goes to a local day centre once a week so he has

    some interaction, whilst the Carer is able to go shopping and

    meet friends for coffee.

    Outcomes: Carer gets Carer Magazine by

    post. Age Cymru has helped apply for attendance allowance which is being used for a cleaner once a

    week.

    Overall. Carer feels that with this help and support she is able to cope better

    with her caring role.

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    The Way Forward The IiC scheme will continue to be developed within health, in both primary and secondary care, along with social services as the Social Services and Well Being Act 2014 (SSWBA) starts to make an impact. The Welsh Government and the SSWBA places an emphasis on partnership working and this is embedded within the workings of the IiC Scheme. Three members of staff who support the IiC scheme in each county are currently funded through transitional monies from Welsh Government and we are currently reviewing the three counties Carers Programme to look at ways to sustain the IiC scheme at ground level, as well as funding opportunities to ensure continuity of posts and work is considered. Under the Ac