Consultation: Impact of the Social Services and Wellbeing (Wales) Act 2014 in relation to Carers

Swansea Council’s response

 

Western Bay (formerly ABMU) Carers Partnership Board comprises representatives from ABMU Health Board; Swansea Council is one of the three local authorities, Third Sector and Carers Service/ Centres.  The Board has been working together since 2012 to increase Carer awareness, engagement and assisting carers by providing information, advice and support. 

 

The number of carers’ assessments undertaken in Wales and how this has changed as a result of the Social Services and Wellbeing (Wales) Act 2014 and whether there is variation between local authorities

There had been some fluctuations in the number of carers assessment recorded within Swansea Council since the introduction of the Social Services and Wellbeing (Wales) Act 2014. 

 

Adult Services

 

Number of Carers identified in assessments of the cared for person

Number of Carers offered an assessment

Number of Carers wanting an assessment

Number of reviews of Carers assessments undertaken

2015

1139

1091

445

445

2016

1364

1314

522

550

2017

547

516

180

629

2018 (1st half)

678

604

232

370

 

 

 

Child & Family Services

 

Number of Young Carer assessments undertaken

2015/16

29

2016/17

2

2017/18

17

 

Swansea Social Services wish to point out that numbers of completed assessments recorded decreased during 2017.  This corresponded withchanges made to the assessment tool created to meet the requirements of the Act.  During the pilot and implementation stages, for technical reasons linked to the development of the database it was not possible to gather the number of assessments completed through the recording system; this was also the case for assessments of young carers in this area. 

This issue has been resolved with indications that there has been an increase in completed assessments.

 

The extent to which local authorities are fulfilling their duties under the Act to provide information, advice and assistance to carers

Information, advice and assistance (IAA) is provided directly. The Adult Common Access Point work to provide the right response at the right time. Anyone can contact the information, advice and assistance services to have a discussion and get help. The teams will listen to whoever calls including carers and let them know what information, advice, or assistance can be provided and who can help from a range of different agencies including council services, third sector, health and the police.

Information is also available on the local authority websites this includes a range of fact sheets and leaflets., During 2017/18, 1,271 people viewed these pages.  We also utilize social media, printed material and the Wales National Dewis website.  

In Swansea, information, advice and assistance can be accessed via Central Children's Information, Advice and Assistance.  Swansea commissions a number of services from third sector organisations for the benefit of carers including a range of respite options and a dedicated service for young carers.

Swansea Social Services commission a number of services from third sector organisations for the benefit of carers including a range of respite options and a dedicated youth club for young carers run by the local YMCA;  the local Carers Centres and Carers Service, to provide a variety of services for carers of all ages including information, advice and support.  In Swansea during 2016/17 there were 5,481 recorded contacts by carers to Swansea Carers centre; of those 1,111 were carers not know to the service.  Two news letters are produced per year, they are distributed to approximately 4000 carers.  Information, advice and assistance is provided to carers over the telephone, home visits, outreach sessions and events.

Transitional funding and Integrated Care Fund alongside other funding has been used to enable local Carers Centres and Carers Service to provide information and support services to carers within hospitals including mental health and palliative care units in the Abertawe Bro Morgannwg University Health Board area.

There were over 2000 carer contacts last year as a result of Hospital Outreach and working with Community Resource Teams.

During 2017-18 carers’ information and awareness raising sessions were delivered at a number of Protected Time for Learning Sessions for staff who work in Primary Care.  All areas ran awareness sessions for GP practice staff and provided signposting and information within GP surgeries including ‘on screen’ messages. Practices received regular information and copies of the local Carers Centres and Carers Service newsletters. This work was funded from a range of sources including Transitional funding. 

 

Whether local authorities and Local Health Boards have sufficient information on the number and needs of carers in their areas

Western Bay in partnership with local authorities and local health board undertook a population assessment, which included ‘Carers who need support’.  Each local authority provided a range of information to inform the regional findings.

Numerous activities have been undertaken for example:

At the Swansea ‘Carers Rights’ event in November 2017 carers were asked:

·        What is going well?

·        What are you worried about?

·        What needs to happen next?

The views of carers at this event will help inform the co-production of a Swansea Carers Action Plan. This will be developed during 2018/19 and as well as addressing feedback provided by local carers will also address local and regional priorities identified via the population assessments and via the Western Bay Carers Partnership Board. 

A series of Parent Carer events and workshops have been held to explore what a new parent carer forum in Swansea could look like.  Parent carers have been involved throughout the whole process to create a new forum. This resulted in a tendering exercise to commission an organisation to facilitate an independent parent carer forum.  The future service is expected to provide parent carers with information, advice and assistance as well as acting as a voice for their views.

The Young Carers Project in Swansea has received additional funding via the Integrated Care Fund to undertake work in schools. One of the objectives of this work is to secure a better understanding of the needs of young carers in Swansea. 

Swansea Council also fulfils its statutory requirements with regards to reporting carers’ information in the form of performance indicators and the annual Welsh Government carers citizen survey.

 

Other changes since the Act came into force which may impact on carers, for example changes to the services provided to people who are cared for

Swansea Carers Centres and Carers Service providing information, advice and assistance (IAA) to carers at hospitals in the area and work with Patient Advice and Liaison Service (PALS) and Patient Experience and Advice Service (PEAS) Teams.  Collaborative working and integration is proving to have a positive impact on carers.

In Swansea, there has been a number of changes including the development of an overarching service model for adult social care to deliver requirements of the Social Services and Wellbeing (Wales) Act 2014. The Sustainable Swansea programme and the local authority’s corporate priorities were agreed in June 2017.  The needs of carers are considered within the model to ensure they have appropriate levels of support. This includes:

·                    Access to Information & advice

·                    Peer support

·                    Flexible and accessible sitting services

·                    respite care

Other changes that has happened in Swansea since the Act include:

·        Development of new assessment tools to capture the ‘What matters to me’ conversation

·        Introduction of charges to ensure future services are available and sustainable i.e. respite at home, day services

·        Carer Champions have been established within the Adult Services Hubs

·        Commencement of a review of commissioned carers services to establish best value and ensure services continue to be fit for purpose.

·        A review of commissioning arrangements for carers services with a view to establishing a commissioning structure, priorities and action plan for carers services during 2018/19.

Child and Family Services in Swansea has undertaken a commissioning review of services delivered for children with a disability and their families. This made a series of recommendations which we are in the process of implementing, e.g.:

·        Increase the capacity of in-house home support service

·        develop an early help service for children with additional needs

·        move additional resources into service areas responsible for early intervention

 

Support and Respite Service for Carers

Adult Services understand that respite care and short breaks have an important role in maintaining the well-being of both the carer and the person with care needs.  Supporting carers helps prevent crisis, improves their physical and mental health and ensures the well-being of carers and those they care for.  These principles underpin the local authority’s model of care by enabling people to live as independently as possible, preventing escalation and avoidable crisis and optimising use of limited resources.

 

Swansea Social Services delivers a range of respite care to support carers (including young carers) through:

·        Direct Payments

·        Day care - a service provided outside the home without any elements of overnight stay for the carer or recipient of care

·        In home respite - a (paid) care worker coming into the family home to ‘sit’ with the care recipient

·        Host-family respite - the carer and care recipient take a break together, staying with a ‘host family’

·        Institutional/overnight respite - allows breaks away from the family home for the care recipient for one or more nights

 

Findings of Support and Respite for Carers 2017/18

Our findings and conclusion were as follows:

·        The majority of current services provided for respite care are directed at the ‘cared for person’, this provides an opportunity for the carer to receive a break.  Some carers have commented that services make assumptions that carers need a break from the people they care for but that some carers have commented that they would like support to attend events or activities with people they care for or that they may be interested in attending support groups with other carers, both with and without the people they care for.  Thus it has been identified there may be gaps within the service to support the carer directly in alternative ways.

·        Respite care for older people within day services has slightly decreased throughout this financial year by 3% and residential overnight respite by 7.5%, this may be due to the  range of alternative types of support that are now available and the increased take up of other opportunities which has resulted from awareness raising.

·         Overnight respite care at one in house service (Ty Cila ) has increased by 10% during the financial year.  Some remodelling of existing capacity to increase access to respite where services are at full capacity will be considered.

·        In Home Respite has increased during 2017-18, delivering an additional 1460 hours.  The busiest months being March, May and June.

·        Respite care through our Direct Payment Service has seen a slight increase throughout the year with an average of 2 younger adults and 7 older people receiving short term respite, and an average of 15 older people and 11 younger adults receiving day care respite at any point in time throughout the year. Demand for short term direct payments for  respite is greaterfor carers who look after elderly people than it is for carers who look after younger adults.

 

·        Residential overnight respite for all Learning Disabilities and Physical Disabilities at in house and external provision has increased with a total of 438 clients receiving this service during 2017/18

·        Feedback from carers indicates that the Carers Rights Event was extremely beneficial by raising awareness of services and   by bringing carers in similar situations together, which provided an opportunity for mutual help and support.

·        Carers Champions (a role adopted by selected Social Services Care Management Officers) continue to develop their own specialist knowledge in order to continue to provide ongoing help and support to carers and their families.

·        Overall, there has been a general increase in Respite Care across the services listed above in 2017-18.  The additional costs of providing additional respite care, over and beyond the grant allowance, have been met by the City and County of Swansea.

 

Swansea’s Recommendations

Swansea Council will continue to evaluate carers’ services as part of ongoing business as usual arrangements and will develop and improve options for meeting carers’ needs where appropriate.  The following have been highlighted as areas for potential development and will be considered for inclusion within a carers commissioning action plan to be developed in partnership with key stakeholders during 2018/19:

·        Availability and affordability of transport to and from respite care, as this is a recognised barrier to many people who provide care

·        Establishing carers self-support groups

·        Access to training courses for carers which help to manage caring responsibilities

 

·        Use of in-house overnight respite to increase access where certain services are at full capacity, and possible development of additional respite and short stay provision for people with complex needs

·        Continue to improve networking with key stakeholders to promote carers rights and opportunities, engage support staff around carers’ rights, identify carers earlier and promote access to services so that prevention and early intervention objectives are achieved

·        Continue to raise awareness of the Carers Act and assist carers to understand what is available to them

·        Continue to promote awareness amongst other commissioned service providers of their duties as an employer in relation to carers and promote awareness and understanding of issues affecting carers

·        Evaluation of breakdown of carer / cared for arrangements and impact on hospital admissions and other forms of more intensive managed care

 

In respect of Children’s Services, we are currently in the process of implementing a commissioning review of child disability services. This includes the following actions:

 

·        Re-tender of the residential overnight short break service with greater capacity to deliver day care sessions from the home

·        Expansion of our in-house Home Support Service (Flexible Support Service)

·        Co-production of a Parent Carer Forum

·        Joint commissioning of play and leisure opportunities, including service offering respite during the day

·        Pilot of a designated early help service (key worker team) to support families with a child with a disability

The City and County of Swansea will continue to strive towards promoting respite care services throughout Swansea, building ‘ A life for carers’ as the people ‘they care for’ will also have a better quality of life.

 

Broader Welsh Government policy on carers and how it should be developed.

Suggestions on how Welsh Government policy on carers maybe developed include

•        co-producing policy in partnership with a wide range of carers of all ages

•        recognising the challenges that come with short term funding at very short notice and consider 3 to 5 years funding which would enable more effective planning of services resulting in sustained and consistently delivered services.

•        have one large grant for carers rather than a number of individual grants. One larger grant for carers would be easier to administer and monitor and would support more strategic commissioning.

•        a commitment from Welsh Government to continue funding specifically for carers so that services for carers are more security and stability.

•        The religious and non-religious spiritual needs of people, and the resources which support them should be given consideration on the refreshing of the 2010 Spiritual Care Standards as well as updating the supporting guidance within the 2015 Health and Care Standards on spirituality that includes carers to realign with the Act in addition to improving the health and wellbeing of the citizens of Wales

•        A seamless service for young carers to adult carers. Young carers should have access to the same services as adults for support. young carers services can be time limited, adults are not.