Graphical version
SCOTTISH EXECUTIVE
STRATEGY FOR CARERS IN SCOTLAND
Table of Contents
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The Programme for Government launched by the Scottish Executive
on 6 September announced that a Strategy for Carers would be introduced in Scotland in
2000. Before drawing up proposals for our Strategy we discussed carers' priorities
with carers' organisations in Scotland. With them we identified 5 main areas for
action. This document sets out what action the Scottish Executive is taking in relation to
each area.
The Scottish Executive acknowledges the vital contribution made to
society by the many unpaid carers in Scotland who look after relatives or friends who are
frail, sick disabled or vulnerable. That is why we are committed to supporting carers. We
aim to ensure that all carers have access to flexible, quality services at a local
level. This includes those people living in rural and remote communities who face added
difficulties. On a national level we will help raise awareness of the invaluable
contribution that carers make to society. We will discuss the promotion of carer-friendly
employment policies with the Scottish business sector.
Carers need to feel valued and to feel that they are not isolated.
There are many hidden carers in our communities who do not think of themselves as carers
and may not be aware that help and support are available. We need to identify these carers
and the measures outlined in this paper will help achieve this. We have many young carers
looking after parents who are vulnerable, ill or disabled. Young carers can be
particularly disadvantaged through their caring responsibilities. They may face problems
at school with attendance and completing course work. They may feel isolated from other
children because they do not have time to spend with their friends. Young carers have
special needs and we hope that many of them will benefit from our proposals.
The measures set out in this paper are very much a first step towards
addressing carers' needs. The Scottish Executive is committed to ensuring that these
measures translate into real differences to carers' lives. We all may be carers or
need care ourselves at some time in our lives. We all expect to be given help and support
when needed
Carers' issues are now being given a higher profile. That can
largely be attributed to the years of campaigning by carers' organisations. They have
given carers a real voice and we will continue to listen to that voice as we take forward
carers' issues in the years to come.
IAIN GRAY
Deputy Minister for Community Care
24 November 1999
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Under the Scottish Executive's Programme for Government a
commitment was made to introduce a Strategy for Carers in Scotland to help unpaid carers.
This paper sets out the content of the Scottish Executive's
Carers' Strategy, a package of measures aimed at supporting the many carers in
Scotland who look after sick, disabled, vulnerable or frail relatives or friends. In
addition, it looks at action already taken to support carers in Scotland. There are also
relevant UK-wide measures affecting carers on employment, pensions and benefits that are
outlined in the paper. These policies are set out in the wider context of other Programme
for Government commitments, all of which have a bearing on how we aim to improve
services. The Scottish Compact with voluntary organisations has also been a major
factor: we have developed these policies in consultation with the voluntary organisations
representing carers.
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We have placed supporting carers high on our agenda. To ensure that the
priorities of Scottish carers were addressed, we consulted carers' organisations
based in Scotland (principally, Carers National Association, Coalition of Carers in
Scotland, Crossroads Scotland, Princess Royal Trust for Carers and Shared Care Scotland)
to identify priorities for action. Those they identified were:
- The promotion of new and more flexible services for carers, including respite care, at a
local level.
- The introduction of national standards for such services.
- The need for monitoring by the Scottish Executive of the performance of health and
social services in supporting carers.
- The introduction of carers' legislation to allow carers' needs to be met more
directly.
- The provision of better and more targeted and information for carers at a national
level.
- Attention to the specific needs of young carers.
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- We are identifying £10 million of Grant Aided Expenditure from 2000-2001 for
carers' services including respite care. This doubles the £5 million already
notionally allocated for such services in the Grant Aided Expenditure system. We have
already announced that the total GAE for social services will increase by £40 million
next year. It is from these resources that the additional £5 million will be found.
- Each local authority's share of the £10 million will therefore be explicitly
identified and local carers groups will be advised of the resources available to their
authority for developing new services and enhancing existing services. If, to ensure real
improvements, it is necessary to increase that sum, we will consider doing so in future
years by allocating more GAE.
- Local authorities must consult local carers' organisations and Health Boards on
spending plans for these resources with a focus on supporting flexible and quality
services which meet carers' needs. In particular, we expect authorities to take into
account the needs and priorities of carers from ethnic minority communities in accordance
with their statutory obligations under section 71 of the Race Relations Act 1976, those
from remote and rural communities who have special and sometimes distinct needs and,
foreshadowing our learning disability review, those who care for people with learning
difficulties.
- The issues around charging for services, including standardising charges, will be
considered in conjunction with the Royal Commission's report into long-term care and
a recent survey by the Accounts Commission into charging practices.
- We have already set up a National Care Standards Committee to agree national standards
for residential care, day and home care services.
- National standards for residential respite care will be introduced in 2000 and for
home-based care in 2001.
- Carers are represented on the working groups set up to discuss standards across the
services. In addition, carers will be included in focus groups set up to discuss the
emerging proposals.
- Discussions are already taking place between UK-based carers' organisations and the
Department of Health on standards for carers' services. The results will be fed into
the work of the Committee.
- From April 2000 local authorities will be required to report in detail on the use of the
resources allocated to them for carers' services and respite services through
Community Care Plans and annual updates.
- Community Care Plans will be submitted to the Scottish Executive for scrutiny. From now
on we will require them to be accompanied by a letter from local carers' groups
confirming that they have been consulted in the planning and development of services and
that they are satisfied that each authority's share of the £10 million has been used
appropriately. Further guidance will be issued shortly.
- In addition, our Community Care Implementation Unit will review practice in involving
carers in service planning and provision. The Unit will identify and promote good practice
both in relation to the planning process and in the development of new services. It will
also report to Ministers on any barriers to the development of good quality services for
carers.
As part of the monitoring process, we need to obtain more information
on the level and quality of services provided to carers.
- Carers' needs have therefore been included as part of the existing statutory
performance indicator on assessment currently required by the Accounts Commission from
local authorities. It is our intention that the new national dataset currently being
devised by the Scottish Executive, COSLA and the Accounts Commission to monitor social
care on a national basis should include information on carers' assessments and
respite care.
- Carers who provide substantial care on a regular basis are currently entitled to request
an assessment of their need under the Carers (Recognition and Services) Act 1995 when the
person they care for is being assessed or re-assessed. We are committed to drawing up
legislative proposals as soon as possible to enable carers, including young carers, to
have their needs directly assessed and to extend the Act's provisions to young
carers.
- Carers' organisations do not want this to be rushed. We have therefore decided to set up
a Carers' Legislation Working Group by the end of 1999. This Group will consist of
representatives from the Scottish Executive, service users and carers, carers'
organisations and local authorities. The Group will draw up legislative proposals for
public consultation in 2000.
- Early in 2000, we are proposing to provide further information on our Strategy and the
services available to carers. We will be promoting this through leaflets which will be
widely available as well as through local radio campaigns.
- By Spring 2000 the NHS Helpline will be extended to provide information on access to
social services and support for carers. This will also be covered by NHS Direct when it
comes on line.
- The Scottish Health Service already makes use of the Internet to provide information to
patients, carers and the public through web pages such as Scottish Health on the Web
(SHOW) and the Health Education Board for Scotland's website. Relevant social care
information will be made available through the SHOW site as well as through the NHS
Helpline and NHS Direct.
These changes will be of particular benefit to carers in remote and
rural areas.
But we also need to gather better information on carers:
- In an attempt to help identify hidden carers our intention is that the Census in 2001
should include for the first time ever a question on carers, seeking information on the
time people spend on unpaid caring. Details will be announced with the Census information
shortly.
- We will consider options for identifying hidden carers, including the potential use of
GP databases. We will also consider whether elements of the Princess Royal Trust Focus
on Carers pilot project to identify hidden carers can be extended on a national basis.
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The NHS has an important role in supporting carers.
- The next Scottish Executive's Planning and Priorities Guidance for the NHS will
require Health Boards and Trusts to give appropriate recognition to the needs of carers
and the NHS's response will be monitored by the Scottish Executive in the normal way.
- We will take the needs of carers into account in the training of GPs, primary care teams
and social workers. In addition, we currently fund the Carers' National
Association's training unit which from January 2000 will provide a range of courses
for health, social care and other professionals.
Young carers are a particularly disadvantaged group and we are
committed to addressing their specific needs.
- We want legislation to enable carers under 16 to have for the first time a direct
assessment of their needs
- In planning to spend the increased resources allocated for carers' services we
expect local authorities to pay particular attention to young carers' services. The
Scottish Executive and carers' groups will monitor their response in this area.
- We are making available around £2 million pa to the Family Fund Trust which in turn
provides grants to families who have a severely disabled child (or children) living at
home.
- Through the Dundee social inclusion partnership scheme we are providing £210,000 over
three years 2000-2003 to a project aimed at identifying and supporting young carers.
- We will work up proposals for research on what support is available to young carers in
Scotland and what guidance is needed for professionals in health, education and social
care. Information about this will be placed on the Scottish Executive website so that
young carers themselves have the opportunity to contribute towards what the research
should examine.
- The Scottish Household Survey will provide information on how many young carers there
are in Scotland, details on the level of care they are providing and to whom. Information
from the Survey will provide a basis for conducting the research referred to above..
- Schools, usually through the guidance system, are very aware of the needs of young
people who face the additional burdens of caring for family members. They offer pastoral care, seeking to provide for social and emotional and
general welfare needs and to respond to a range of individual needs for counselling and/or
action related to personal problems. The Carers National Association have produced a young
carers' pack which we will be making freely available to Directors of Education for
use in their schools to support teachers in their work with these young people.
- We have asked Teacher Education Institutions to include training of the needs of young
carers in the initial training of teachers.
- As an employer, the Scottish Executive will be providing information on carers'
issues to all its staff through information packs and its Intranet. An informal Staff
Network to support carers will be launched in January 2000, and we will involve
carers' organisations in this as appropriate. Our career break scheme enables people
to take time out to care. We have had discussions with the carers' organisations to
obtain their advice on our policies.
- We will also discuss the promotion of carer-friendly employment policies with the
Scottish business sector.
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- Encourages joint working between care providers, to provide quicker and better decision
making for service users and carers.
- Emphasises the need to include service users and carers in the planning and purchasing
of services.
- Encourages the development of more flexible home care services and respite care.
- Emphasises that carers' needs should be properly addressed and met.
- £5 million targeted towards local authorities in 1999-2000 for implementing the Plan
recommendations – Scottish Executive are monitoring how these resources are being
spent.
- It is standard practice for carers to be consulted on all community care policy
developments. This is consistent with our Scottish Compact with voluntary
organisations. For example, the review of services for people with a learning disability
sought carers' views through a variety of methods - conferences, roadshows,
representation on focus groups, Ministerial link through the Internet.
- This Bulletin included a communication to all GPs in Scotland emphasising the need to
inform carers about the health and treatment of the cared-for person (with the cared-for
person's consent and to consider on a case-by-case basis divulging information
without that consent) and to help carers maintain their health. The Bulletin also stressed
the need to train carers in basic healthcare skills such as lifting.
- The Programme for Government promised that we will strengthen the patient's
voice and patient's worth to ensure that they and their carers and families get the
response and support they need through every stage of their care.
- This requires the involvement and participation of users and carers in the planning and
delivery of care services
-
Advocacy - A Guide To Good Practice provides guidance on the effective commissioning
of advocacy services by health and social services. The guide is aimed at promoting the
development of advocacy services by these agencies to enable users and carers to make
informed choices about their care needs.
- As indicated in the Programme for Government, we are committed to delivering
person-centred health and community care, recognising the need for partnership with those
who receive care and support and with those who provide care. The Scottish Executive works
closely with the Scottish Consumer Council, the Scottish Association of Health Councils
and other agencies at a local and national level.
- We recognise that patients and their carers need more information about all aspects of
the NHS and its services. We are working to establish a Patients' Project which will
develop a strategy for communicating effectively. We are also addressing this through
extension of the NHS Helpline to include information on health and social care and through
NHS Direct when it comes on line.
- As part of commitment in Health White Paper Designed to Care,guidance was issued
in April 1999 to Chief Executives of NHS Trusts in Scotland setting standards for
patient's discharge information. The guidance specified that information should be
disclosed to a carer or relative where the patient's understanding of written English
is limited for any reason. It also requires the signature of a patient/carer/relative upon
discharge.
- New regulatory framework to improve protection and standards of care.
- New independent Scottish Commission for the Regulation of Care to be responsible for
registration, inspection and enforcement of care standards.
- New Scottish Social Services Council to regulate care staff.
- We have introduced a Bill to make provision for the management of the affairs and
personal welfare of adults who are incapable by reason of mental disorder or inability to
communicate.
- The Bill requires that the views of the nearest relative and primary carer of the adult
with incapacity be taken into account in all interventions relating to that person.
- Measures for managing an adult's finances will be of great assistance to carers.
- We have published guidance on housing and community care to housing, health and social
work agencies on how to improve the planning and delivery of housing to people with
special needs. The guidance highlights the need to involve carers in the planning process
and a requirement to assess the housing needs of carers.
- There are care and repair projects in most parts of Scotland. In 1999-2000, £7 million
has been made available across Scotland for these projects. This will rise to £10million
by 2001-2002. Guidance by Scottish Homes to local authorities, housing associations and
public and private sector housing providers asks that the views of carers be taken into
account in the provision of adaptations to houses.
- A reduction in Council tax levels is available for carers of people with disabilities
who need extra living space to accommodate the needs of the cared-for person. Further
information is contained in the leaflet Council Tax – A Guide for People with
Special Needs and Their Carers.
- We are supporting volunteering through the Giving Age and Millennium
Volunteers initiatives.
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- Extra funding provided for Carers' National Association Helpline to provide
information to carers.
- Carers are eligible for the New Deal 50+ following the introduction of pathfinders in
November 1999. Criteria for entering the 50 + programme includes those who have been in
receipt of benefits such as Invalid Care Allowance (ICA), Bereavement Allowance (BA) and
Widowed Parent's Allowance (WPA). The time spent in receipt of these allowances will
count towards the 6 months out of work eligibility condition for the programme.
- Carers to be helped to remain in touch with work through ONE (previously Single Wrk
Focused Gateway) where all new benefit claimants will have access to a personal advisor
and support from the Employment Service, Benefits Agency and local authorities at a single
point of contact. This will help carers whose caring role has ended to return to work if
that is what they want. One pilot is Scotland. Pilots will be assessed before extending
the scheme more widely.
- An on-going review of financial support to carers including Invalid Care Allowance.
- A second pension for carers by 2050 and the protection of pension entitlements of carers
who have given up paid work to care.
Scottish Executive
Health Department
24 November 1999
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