Timescales for adult carer support plans and young carer statements: consultation analysis

Consultation Paper Question 6

Question 6a: Adult carer support plans - Please give your views on the pros and cons of requiring the ACSP to be completed within the following alternative timescales:

2 weeks; 3 weeks; 4 weeks; other.

We received 46 responses to this question.

Response	Total	% of all	Breakdown
			Individuals	Statutory organisations	Non-statutory organisations
Immediately	1	2%	1	0	0
2 weeks	15	32%	9	0	6[3]
3 weeks	10	22%	5	4	1
4 weeks*	11	24%	2	9	0
No time limit or case by case**	9	20%	6	3	0

* Includes one statutory organisation which replied: Other, one month.
** Includes two which were left unanswered but indicated no time limit in comments.

The pros and cons identified most frequently for each category were as follows:

2 weeks

Pros:

• Good for quick intervention and support.
• Realistic given nature of caring for palliative illness and potential rapid changing circumstances.
• Achievable for non-complex cases.

Cons:

• Too short for complex cases involving multiple agencies.
• Carer doesn't have sufficient time to consider their own needs.
• Cared-for person's care needs may not be determined.
• Not enough time to gather all information required.
• Carers/services under pressure to rush a plan which may compromise quality and effectiveness.
• Carer may not be able to cope emotionally.

2 weeks was mainly favoured by individuals and non-statutory organisations. Most individuals provided limited comments on the pros and cons of this timescale, comments focussed on early intervention and quick support, due to the potential speed of decline.

Non statutory organisations felt 2 weeks would be preferred and enough time to complete plan. Some raised concerns of plans potentially being rushed and the need to take account of individual circumstances, with one suggestion of 'ideally 2 / 3' weeks.

No statutory organisation felt that 2 weeks was an appropriate timescale for completion of the full plan. Comments said that it was too short for carers to reflect on their needs and come to terms with the situation. Pressure to complete plan in this timescale could compromise quality, putting carers under pressure, particularly in complex cases. Most preferred either 3 or 4 weeks.

3 weeks

Pros:

• Not as driven by timescale and a better pace for carer.
• Enough time to build a relationship with the carer and family and identify issues.
• Realistic timescale to complete a thorough plan of support.

Cons:

• Carers might find this quite long without support.
• Difficulties may arise due to the changing nature of caring for someone with a terminal illness.
• Potential challenge for complex, multi-agency cases.
• Insufficient time for carer to reflect on their needs fully.

3 weeks was preferred by a significant minority of individuals and statutory organisations. Many saw 3 weeks as a compromise, with 2 weeks feeling rushed and 4 weeks too long without support. Some statutory organisation reflected this could provide enough time to identify need, start to put support in place and be undertaken at the carer's pace.

4 weeks

Pros:

• Allows time for comprehensive assessment.
• Allows time for carers to be flexible.
• Some precedents at local level for 28 days for an assessment.
• Allows time for resources to be targeted correctly.
• More complex cases could be completed.

Cons:

• Situation may decline rapidly with palliative illness and needs change significantly.
• Carer finds process too lengthy at a difficult time.
• Carer without support for too long.

The majority of statutory organisations favoured 4 weeks. Their comments focussed on allowing time to build relationship with carer, carers having time to reflect on their needs and comprehensive plans leading to getting the right support.

Non-statutory organisations felt 4 weeks would be too long due to the potential rapid decline of cared-for person and changing circumstances.

Other

A significant minority of individuals and statutory organisations were in this category. The majority of these responses argued that there should be no time limit either because it does not recognise the nature of palliative illness or it would put undue pressure on carers.

Issues about overall quality of support with any timescale still remain.

Question 6b: Young carer statements - Please give your views on the pros and cons of requiring the YCS to be completed within the following alternative timescales:

2 weeks; 3 weeks; 4 weeks; other

We received 36 responses to the question on the preferred time limit, with 10 people declining/unable to give a preferred option.

Response	Total	% of all	Breakdown
			Individual	Statutory organisation	Non-statutory organisation
Immediately	1	3%	1	0	0
2 weeks*	15	42%	7	2	6[4]
3 weeks	6	16%	3	3	0
4 weeks	10	28%	2	8	0
No time limit / case by case	4	11%	2	2	0

* Includes one left unanswered but indicated the same as adult carers in comment.

2 weeks

Pros:

• good for quick intervention
• realistic given nature of caring for palliative illness
• more essential for young carers due to their age

Cons:

• too short for complex cases involving multiple agencies
• young carer doesn't have sufficient time to consider their own needs
• services under pressure to rush a statement
• too rushed for a young carer
• school holidays may mean workers are off

2 weeks was mainly favoured by individuals and non-statutory organisations, however 2 statutory organisations also preferred 2 weeks. Comments were similar to ACSP and also focussed on the vulnerability of young carers and the need for quick support. One individual commented that children often need longer to reflect and process what change means for them, so this may be too quick.

3 weeks

Pros:

• Not as driven by timescale and a better pace for young carer
• Enough time to build a relationship with the young carer and family

Cons:

• Young carers might find this quite lengthy
• Difficulties may arise due to the changing nature of caring for someone with a terminal illness
• Potential challenge (i.e. too quick) for complex, multi-agency cases

3 weeks was preferred by a significant minority of individuals and statutory organisations. One said a complex YCS could be completed within this time. Other comments highlighted time for young carers to collect their thoughts and more time to gather information.

4 weeks

Pros:

• Allows time for comprehensive assessment
• Allows time for young carers to be flexible and fully supported

Cons:

• Young carers may feel under-supported
• Situation may decline rapidly with a palliative illness

4 weeks was the most popular option among statutory organisations. Comments focussed on allowing time to build relationships with young carers and potentially wider family members to ensure YCS is right. Also ensuring the right professionals are involved in supporting young carers and planning process. With plans being able to reflect views and opinions of different teams/agencies; and allowing time to properly consider more complex needs of youngsters.

Some comments also noted that issues about overall quality of support with any timescale still remain.

Other

A significant minority of individuals and statutory organisations were in this category. The majority of these responses argued that that there should be no time limit either because it does not recognise the nature of palliative illness or it would put undue pressure on young carers. Some said immediately and some did not give any explanation or substantive comments for choosing "other".

Suggestion that 4 weeks is preferable to allow young carers to consider their needs but that guidance should stipulate the YCS should be completed as soon as possible (i.e. as soon as the young carer is ready).

Some specific issues raised about school holidays.