Carers Legislation - Analysis of Consultation Responses - Research Findings

Carers Legislation: Analysis of consultation responses

In October 2013 the Scottish Government announced that it would bring forward specific legislation to extend the rights of carers and young carers. The aim was to further support unpaid adult carers and young carers who care for family members, friends or neighbours.

Between 22 January 2014 and 16 April 2014, the Scottish Government conducted a consultation on proposals to improve outcomes for carers and young carers. In total, 1,587 responses were submitted (of which 1,422 were generated by surveys distributed by two stakeholder organisations) to the Scottish Government. Key findings from the analysis of these responses are summarised below.

Main Findings

• There was majority support for the name of the carer's assessment to change to the carer support plan (CSP) (now adult carer support plan), agreement for the removal of the substantial and regular test and for removal of the part of the existing carer assessment process where the local authority must or may provide community care services/ children's services for the cared-for person.
• Most respondents supported the introduction of a duty for local authorities to establish and maintain a service for providing information and advice; for the proposal to introduce a duty to support carers and young carers, linked to an eligibility framework; and limited support for the retention of the existing discretionary power. There was majority support, mainly from carers and carers organisation, for a duty to provide short breaks.
• There was majority support for statutory guidance on the CSP and for the new legislation to provide for young carers to have a CSP if they are likely to become an adult carer.
• There was support for carer and young carer involvement in the planning, shaping and delivery of services; and for the involvement of carer organisations.
• Most respondents agreed with the introduction of statutory provision for collaboration and involvement of relevant organisations and carers in development of local carers' strategies, as well as regular review periods; and for the provision of a range of services to meet needs.
• There was support for good practice across Health Boards, such as the proactive use of Registers of Carers within GP practices, or in monitoring compliance with the core contractual elements of the GP contract.
• Views were split as to which local authority should be the lead for undertaking the CSP and for covering the costs of support.

Background overview

Figures from the 2013 Scottish Health Survey suggest that 16% of adults aged 16+ in Scotland provide some form of regular unpaid care. Carers play a crucial role in providing support to others but until relatively recently there has been little acknowledgement of the adverse impact that caring can have on an individual and little or no support provided.

Consultation paper

In January 2014, the Scottish Government published a consultation paper on proposals to improve outcomes for carers and young carers. The consultation contained 27 questions relating to new carers' legislation. In total, 1,587 responses (1,422 of which were generated by surveys distributed by two stakeholder organisations) were submitted. The remainder (165) were standard written responses; 32 from individuals and 133 from organisations. Sixteen consultation events also took place across Scotland.

The Carer's Assessment: Carer's Support Plan

A large majority of those who addressed the question of whether the name should change from Carer's Assessment to carer support plan (CSP) supported the change of name. Key reasons were that the current name can act as a barrier to take-up as it has negative connotations and can discourage carers, and can appear judgemental.

Most respondents agreed with the removal of the substantial and regular test and welcomed the fact that this would increase eligibility for an assessment.

Most agreed with the removal of the part of the existing carer assessment process whereby the cared-for person is a person for whom the local authority must or may provide community care services/ children's services. Reasons for support included that current requirements can act as a barrier to accessing support and the need for a CSP for every carer.

Almost all respondents who replied supported the introduction of two routes through to the carer support plan. A main theme to emerge was that this proposal should improve access to support.

Most respondents agreed with the removal from statute of the wording about the carer's ability to provide care. Many said this has negative connotations and acts as another barrier to carers accessing support. There was also widespread support for a move to an outcomes-based approach.

Most respondents agreed with a duty for local authorities to inform the carer of the length of time it is likely to take to receive the Carer's Support Plan and if it exceeds this time, to be advised of the reasons. Some commented on informing the carer of the length of time being an administrative and bureaucratic process.

Many respondents felt that portability of assessment is a significant issue for service users and carers. A variety of reasons were given, including that carers should not have to go through a reassessment, issues with differences across local authority areas, and the need for consistency and standardisation.

Almost all of those who replied agreed with the proposal that the Scottish Government and COSLA with relevant interests should work together to take forward improvements to the portability of assessment.

Information and advice

A majority of respondents supported the proposal to introduce a duty for local authorities to establish and maintain a service for providing people in its care with information and advice relating to the carer support plan, support for carers and carers rights. A majority of those opposed to this proposal were local authorities.

More respondents agreed than disagreed with the proposal to repeal section 12 of the Community Care and Health (Scotland) Act 2002 about the submission of Carer Information Strategies to Scottish Ministers, subject to reassurances, which are subject in turn to Spending Review decisions, about the continuation of funding to Health Boards for support to carers and young carers. However, opinions were mixed and some respondents found this question hard to understand and difficult to answer.

Support to Carers (other than information and advice)

A majority of respondents supported the introduction of a duty to support carers and young carers, linked to an eligibility framework. Greatest levels of support came from carer/ user support organisations and individuals. The views of local authorities were split, with equal numbers in favour and against, with some wanting to set their own eligibility criteria.

There was majority support that the existing discretionary power to support carers and young carers should not be retained. This was the view primarily from carer/ user support organisations and individuals. Support for retaining the existing discretionary power came primarily from local authorities and Community Health and Care Partnerships (CHCPs).

There was majority support for the introduction of a duty to provide short breaks. Greatest levels of support came from carer/ user support organisations and individuals. Least support came from local authorities, health organisations and CHCPs.

Stages and Transitions

A majority of respondents supported the proposal to issue statutory guidance on the carer support plan (CSP) which will include guidance for those undertaking the carer support plan on managing stages of caring. Disagreement with this proposal came primarily from local authorities and CHCPs.

A large majority of respondents were supportive of new carers' legislation providing for young carers to have a CSP if they seem likely to become an adult carer. The key advantages are that it would help ease the difficulties of transition and mean a more integrated approach with all agencies working together, and preventing potentially long delays in young carers becoming adult carers being able to access necessary support services.

Carer Involvement

All respondents agreed there should be carer involvement in the planning, shaping and delivery of services for the people they care for and support for carers in areas outwith the scope of integration, with a number commenting that carers are in the best position to know what services are required.

Many respondents noted the importance of involving carer organisations in the planning, shaping and delivery of services and support falling outwith the scope of integration.

Almost all respondents supported the establishment of a principle about carer and young carer involvement in care planning for service users (subject to consent) and support for themselves in areas not covered in existing legislation.

There was support for making provision for young carer involvement in the planning, shaping and delivery of services for cared-for people and support for young carers. There was also recognition that the needs of young carers will differ significantly from those of adult carers.

Planning and Delivery

Almost all respondents agreed with the proposal to introduce statutory provision to the effect that a local authority and each relevant health board must collaborate and involve relevant organisations and carers in the development of local carers' strategies which must be kept under review and updated every three years. Opposition to this came primarily from local authorities, health organisations and CHCPs.

Range of Services

A majority were supportive of the introduction of statutory provision to the effect that local authorities with Health Boards must take steps to ensure, in so far as is reasonably practical, that a sufficient range of services is available for meeting the support needs of carers and young carers in the area.

Identification

There was majority support amongst carer organisations and individuals for legislative provision for GPs or local authorities to maintain a Carers' Register to support the identification of carers. However, a number perceived the wording of this question to be confusing and the results of this question should be treated with a degree of caution.

Almost all respondents were supportive of the Scottish Government ensuring that good practice is widely spread amongst Health Boards about the proactive use of Registers of Carers within GP practices. A key advantage is that this would promote equality and consistency across Scotland and offer a joined up approach towards the provision of services to carers.

Almost all respondents were supportive of the Scottish Government asking Health Boards to monitor compliance with the core contractual elements of the GP contract.

Carer and Cared-for Person(s) in Different Local Authority Areas

Views on the lead authority for undertaking the Carer's Support Plan and agreeing support to the carer where the carer lives in a different local authority area to the cared-for person were polarised. Broadly equal numbers of respondents supported the lead authority being the authority where the carer lives or the authority where the cared-for person lives. A higher number of local authorities were supportive of the latter.

Views were split as to which authority should cover the costs of support to the carer; and there were requests for collaboration between local authorities and for the sharing of costs.

Almost all respondents supported the Scottish Government and COSLA producing guidance for local authorities.

Responses submitted on Coalition of Carers in Scotland (COCIS) template

513 respondents submitted their response using a template distributed by COCIS and local carer centres. The majority supported the Carers Bill and wanted to see a duty on local authorities to:

• Support carers according to an eligibility framework and a discretionary power to support carers who do not meet eligibility.
• Provide and promote short breaks.
• Offer all carers, including young carers who are about to turn 18, a CSP.
• Establish and maintain a service for providing carers with information and advice on their rights, support, and access to a carers support plan.
• (Not included in the consultation paper) There were also requests for:
• A duty on health agencies to inform and involve carers in hospital admission and discharge procedures.
• The inclusion of emergency planning in carer support plans.
• A named person in each health practice, responsible for managing a GP carer register, identifying carers, supporting and signposting them to other services.

Responses submitted by Scottish Youth Parliament (SYP)

909 responses submitted were based on a questionnaire distributed by the SYP; 22% of those responding had caring responsibilities.

The majority of respondents supported the following proposals, most of which the Scottish Government did not consult on.

• Involving young carers in the planning, shaping and delivery of services both for cared-for people and young carers.
• More flexibility for young carers in how they spend direct payments for support they receive from local authorities, rather than receiving a care package.
• All local authorities to have a duty to support young carers, allowing them to participate in leisure and recreational activities without financial burden; and a duty to hold information centrally about young carers and young adult carers in schools, colleges and universities.
• All local authorities should be required to keep information about young adult carers aged 18-25 specifically, separate from information about all adult carers over 18; and to meet minimum national expectations about providing services and support for young carers.
• Legislation should specifically mention the needs of young adult carers as they move into adulthood.
• All young carers moving into adulthood should be automatically offered a new support plan by their local authority to consider their changing needs.

Conclusions

Across the consultation as a whole, there was endorsement for specific legislation that will support carers and their rights, with many commenting on the adverse impact that caring for another can have and the need for support to be available to all carers to help them in their caring role. In general, respondents were supportive of the main proposals outlined in the consultation paper to varying degrees.

This document, along with full research report of the project, and further information about social and policy research commissioned and published on behalf of the Scottish Government, can be viewed on the Internet at:
http://www.scotland.gov.uk/socialresearch. If you have any further queries about social research, please contact us at socialresearch@scotland.gsi.gov.uk or on 0131-244 2111.