CARE ACT SEMINAR

Carers

Correct as at March 2015

Carer…… A definition

Locally under the NEL Carers Strategy carers are defined as….

Under the Care Act 2014, the new definition will be….

“Carer” means an adult who provides or intends to provide care for another adult (an “adult needing care”);

20 Years of History - the Carers Agenda

Key General Points with reference to

carers

Current legislation regarding carers is

consolidated within the Care Act

The following Carers legislation has been repealed:

Carers and Disabled Children Act 2000Carers (Equal Opportunities) Act 2004

Carers (Recognition & Services) Act 1995

Wellbeing principle

Assessments & Support Planning

Eligibility

NEL Carers Strategy

‘Caring for our Carers’ 2013-

2016

Charging Cross Border Placements

Ordinary residence

Parent Carers – not directly covered–

Children and Families Act

Young Carers

Transition

Independent advocacy

National Carers

Strategies

Carers Personal Budgets

New duties Prevent/ reduce/ delay

carer needAdvise & Inform carersCarers & Safeguarding

Market DiversityIntegration

• Local Authorities [LA] currently have a legal duty to inform carers of the right to request a carers assessment

• Carers can request an assessment of need, where they provide/ intend to provide ‘regular and substantial’ care for someone aged 18 or over and the LA (focus/ NAViGO) are satisfied that the person cared for is someone for whom it may provide/ arrange the provision of social care services

• Parent carers of disabled children are the responsibility of Children’s Services

Pre April 2015

• Carers will be entitled to a carer’s assessment where they appear to have needs

• LAs must now actively seek to identify carers and offer them an assessment of need if there is an appearance of need at any level

• Rights under the Children’s & Families Act for Parent Carers to have a carers needs assessment via Children's Services

• Young Carers now have the right to a carers needs assessment

Post April 2015

Identification of key differences: Assessments

Key Principles: Carers Assessments

Must establish the carer’s:• Ability and willingness to continue caring• The impact of the caring situation• Caring role - which includes both the

practical and emotional support provided• The carer’s wishes to participate in

employment, education, training and leisure opportunities

• Future needs for care and support. • Outcomes the carer wants to achieve in

their daily life, their activities beyond their caring responsibilities, and the impact (short, long & cumulative) of caring upon those activities

Carers can refuse an assessment, LA must

offer again when needs appear to

change

Can be separate, combined with the cared for or joint

Collaborative process that is

transparent and understandable

Proportionate

Information should be provided on the

process and questions in advance, and in an

accessible format prior to the assessment

Whole family approach

• LA ‘Power’ to provide services and support to carers• Carers are provided with a universal- prevention and wellbeing offer as well as support via a

commissioned service • Eligibility for commissioned services is based on the carer providing regular and substantial

amounts of care and there being a risk to the caring role becoming unsustainable . The Practice Guidance to the 2000 Act requires the extent of the risk of the caring role to be graded into four risk categories:• Critical - imminent risk of the breakdown of the caring role • Substantial - significant risk of the breakdown of the caring role • Moderate - some risk of the breakdown of the caring role• Low - low risk of the breakdown of the caring role

• Carers are eligible for services within North East Lincolnshire where the assessed risk is critical, substantial or moderate

Pre April 2015

• First time that the LA will be required to meet carer’s unmet needs that meet the national minimum eligibility threshold

• LA’s will still have the option of meeting needs that fall below the national minimum threshold• LA will consider 3 questions when making a decision on eligibility:• Do the carers needs arise because the carer is providing necessary care and support?• Is the carer’s physical and mental health affected or at risk of deteriorating, or is the carer

unable to achieve any of the listed outcomes?• Is there consequently a significant impact on the carer’s wellbeing?

• If carers do not meet the eligibility criteria, the LA is still under a duty to provide carers with advice and information

Post April 2015

Identification of key differences: Eligibility

Key Principles: Eligibility LAs must consider whether

1) the needs arise as a consequence of providing necessary care for an adult

2) the effect of the carer’s needs means the carer is unable to achieve any of the following outcomes:– Carrying out any caring responsibilities the carer has

for a child– Providing care to other persons for whom the carer

provides care– Maintaining a habitable home environment– Managing and maintaining nutrition– Developing and maintaining family or other significant

personal relationships– Engaging in work, training, education or volunteering– Making use of necessary facilities or services in the

local community– Engaging in recreational activities

3) As a consequence of not being able to achieve any of those outcomes there is, or there is likely to be, a significant impact on the carer’s wellbeing

• A carer’s needs are only eligible where they meet all three of these conditions

• The national eligibility threshold for carers is set out in the Care and Support (Eligibility

Criteria) Regulations 2014• Eligibility is based on providing necessary

care, the impact of caring on wellbeing, risk to sustainability of the caring situation and the carers ability to have a life outside of caring

• LAs must consider whether the carer’s need for support arises because they are providing care to an adult

• Carers can be eligible for support whether or not the adult for whom they care has eligible needs

• Consideration should be made regarding ‘fluctuating’ needs

• Once eligibility has been determined, the LA must provide the carer with a copy of the eligibility decision

• Where the carer is found to have no eligible needs, LAs must provide information and advice on what can be done to meet or reduce the carers needs

Key Principles: Support PlanningIf the carer has some eligible needs, the LA must:

Establish ordinary residence requirements – in the case of carers the person for whom they care must have ordinary residence in the LA’s area

Agree with the carer which of their needs they would like the LA to meet

Ensure the carer is informed of their indicative personal budget

Consider how the LA/ carer/ others may meet the carer’s needs

Prepare a support plan in conjunction with the carer

Inform the carer of their actual personal budget and support the carer’s decision making on how to organise their care package – commissioned services, direct payment….other

Review the carer’s needs annually as a minimum or when the carer’s needs change

Young Carers

Definition - “Young carer” [YC] means a person

under 18 who provides or intends to provide care

for an adult

A YC becomes vulnerable when their caring role risks

impacting upon their emotional or physical

wellbeing and their prospects in education and life

The LA must consider whether the YC should be

referred for a young carer’s assessment or a

needs assessment

Identification of a YC in the family should result in

an offer of a needs assessment for the adult requiring care & support

YC assessments should include an indication of how

any care and support plan for the person(s) they care for would change as a result of the young carer’s change in circumstances

If the LA thinks a YC is likely to have needs for support after

becoming 18 and it is of benefit to the YC who has consented, the LA

must assess the YC’s need for support now and in the future

Where a LA decides not to comply with a request for a YC assessment ,

it must give: (a) written reasons for its decision, and

(b) advice & Info about what can be done to prevent or delay the YC needs for

support in the future

Where a YC refuses a YC’s assessment and the consent condition is accordingly not

met, the LA must nonetheless carry out the assessment if the YC is experiencing, or is at risk

of, abuse or neglect

Considerations in the adults needs assessment:• When carrying out an adult’s or carer’s assessment, if it appears that a child is involved in providing care the LA must:

1) Consider the impact of the person’s needs on the YC’s wellbeing, welfare, education and development;

2) Consider whether any of the caring responsibilities the YC is undertaking are inappropriate.• An assessment should take into account the parenting responsibilities of the person as well as the impact of the

adult’s needs for care and support on the YC.• A LA should consider how supporting the adult with needs for care and support can prevent the young carer

from under taking excessive or inappropriate care and support responsibilities

Update on progress so far

Modelling of potential increased

carers activity

Robust Adult Carers Action Plan & Young Carers Action

PlanEmbedding of the Care Act in business as usual - NEL Carers

Strategy Action Plan is Care Act Complaint

Planning is underway to launch Carers

Personal Budgets

Planning an Information &

Advice event for Carers Strategy

Group stakeholders

The eligibility threshold has

been reviewed and implications

assessed

Carers policies and procedures

are being re-developed

Launched a Carers

Personal Budgets Work

stream in 2012-2013

Analysis and options appraisal developed for carers charging –

recommendation not to charge

Attendance at Regional/ National

Care Act sessions to ensure a consistent

approach to supporting carers

Assessment & Care Planning Task & Finish

Groups

Challenges / Barriers

• Short timescale between guidance released and 01.04.2015!

• Shear scope of requirements affecting carers across the whole Care Act– Over 1,000 references to carers

• Development of Service User Care Act compliance process required prior to/ alongside carer processes

• Capacity in social care services to meet demand of assessments and reviews

• Financial resource required to meet carers’ needs in the future

• Carers are and will continue to be reluctant to be identified and assessed for the care they provide

Carers Animation DVD

So what does this mean for carers in NEL?

A significant shift in legislation… however very little change in

practice as we are already ahead of the game – the main exception

being the launch of Carers Personal Budgets.

Here in NEL, we already have:

Significant suite of carers’ information–

Carers Guide, Local Employers Guide to

supporting Carers, Carers Assessment Guide

Carers Emergency Alert Card

Carer led model - carer involvement in the

development, design and planning of carers

support and services (NEL Carers Centre re-procurement)

A recently established NEL Carers Support Service providing a

hub and spoke model of carers advice,

information, support and services

Carers Support Worker Service

Carers Breaks – sitting &

respite services

Carers Health

Checks trial

Robust NEL carers Strategy which has driven the carers agenda

since 2007

Questions

For further information or advice, please contact:

Nicola PullmanService Lead: Carers & Communities

nicola.pullman@nhs.net0300 3000 546

Presented by:Nicola Pullman

Service Lead - Carers and Communities, Care & Independence Team (NELCCG)

For further comments / queries:NELCCG.workforce-FAQ@nhs.net