Carers Legislation - Analysis of Consultation Responses

Executive Summary

BACKGROUND

1.1 In October 2013, Alex Salmond MSP, the then First Minister of Scotland announced that the Scottish Government would bring forward specific legislation to promote, defend and extend the rights of carers and young carers. The aim is to further support unpaid adult carers and young carers who care for family members, friends or neighbours.

1.2 Between 22 January 2014 and 16 April 2014, the Scottish Government conducted a consultation on proposals to improve outcomes for carers and young carers. The consultation contained 27 questions relating to new carers' legislation.

MAIN FINDINGS

1.3 In total, 1,587 responses (1,422 of which were generated by surveys distributed by two stakeholder organisations) were submitted to the Scottish Government. The remainder (165) were standard written responses to the consultation paper; 32 from individuals and 133 from organisations. Full copies of the standard written responses can be found at http://www.gov.scot/Publications/2014/05/8784/0^[1].

1.4 Of the 1,422 responding to stakeholder surveys, 513 respondents submitted their response using a template produced and distributed by the Coalition of Carers in Scotland (COCIS). The remainder (909 responses) were based on a questionnaire distributed by the Scottish Youth Parliament. The Scottish Government also ran a series of 16 consultation events across the country.

1.5 Similar themes emerged from the consultation responses and in the consultation events. The main themes to emerge from consultation responses are discussed in the following paragraphs.

The Carer's Assessment: Carer's Support Plan

1.6 A large majority of those who addressed the question of whether the name should change from Carer's Assessment to Carer's Support Plan supported the change of name. The main reasons given for this support were that the current name can act as a barrier to take-up as it has negative connotations and can discourage carers, as it can appear judgemental (Question 1).

1.7 Most respondents agreed with the removal of the substantial and regular test and welcomed the fact that this would increase eligibility for an assessment (Question 2).

1.8 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 Carer's Support Plan for every carer (Question 3).

1.9 Almost all respondents who replied supported the introduction of two routes through to the Carer's Support Plan. A main theme to emerge was that this proposal should improve access to support (Question 4).

1.10 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 (Question 5).

1.11 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 (Question 6).

1.12 Many respondents felt that portability of assessment is a significant issue for service users and carers. A variety of reasons were given and these included that carers should not have to go through a reassessment, issues with differences across local authority areas and the need for consistency and standardisation (Question 7).

1.13 Almost all of those who replied agreed that the Scottish Government and COSLA with relevant interests work together to take forward improvements to the portability of assessment, some for the reasons given in the paragraph above (Question 8).

Information and Advice

1.14 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 area with information and advice relating to the Carer's Support Plan, support for carers and the Carers Rights Charter. A majority of those opposed to this proposal were local authorities (Question 9).

1.15 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 (Question 10).

Support to Carers (other than information and advice)

1.16 A majority of respondents supported the proposal to introduce 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. Respondents felt that a key advantage is that this might create a consistent approach across Scotland, improving access to services. The views of local authorities were split, with equal numbers in favour and against. Some local authorities wanted to set their own eligibility criteria (Question 11).

1.17 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 CHCPs (Question 12).

1.18 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 (Question 13).

Stages and Transitions

1.19 A majority of respondents supported the proposal to issue statutory guidance on the Carer's Support Plan (CSP) which will include guidance for those undertaking the Carer's Support Plan on managing stages of caring. Disagreement with this proposal came primarily from local authorities and CHCPs (Question 14).

1.20 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 of this approach are that it would help to ease the difficulties of transition and mean a more integrated approach with all agencies working together, as well as preventing potentially long delays in young carers becoming adult carers being able to access the necessary support services (Question 15).

Carer Involvement

1.21 All respondents answering this question agreed that 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 of respondents commenting that carers are in the best position to know what services are required (Question 16).

1.22 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 (Question 17).

1.23 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 (Question 18).

1.24 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 (Question 19).

Planning and Delivery

1.25 Almost all respondents answering this question 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 (Question 20).

Range of services

1.26 A majority of respondents 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 needs for support to carers and young carers in the area. Opposition came primarily from local authorities and CHCPs (Question 21).

Identification

1.27 There was majority support amongst carers organisations and individuals for legislative provision for GPs or local authorities to maintain a Carers' Register in order to support the identification of carers. However, a number of respondents perceived the wording of this question to be confusing and the results of this question should be treated with a degree of caution (Question 22).

1.28 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 equity and consistency across Scotland and offer a joined up approach towards the provision of services to carers (Question 23).

1.29 Almost all those responding to this question were supportive of the Scottish Government asking Health Boards to monitor compliance with the core contractual elements of the GP contract (Question 24).

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

1.30 Views on the lead local 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 (where the cared-for person lives) (Question 25).

1.31 Again, views were split as to which local authority should cover the costs of support to the carer. As with the previous question, there were also some requests for collaboration between local authorities and for costs to be shared (Question 26).

1.32 Almost all respondents answering this question supported the Scottish Government and COSLA producing guidance for local authorities, although there were some comments that any guidance produced needs to be for all local authorities (Question 27).

Responses submitted on Coalition of Carers in Scotland template

1.33 The majority of these respondents said that they support the Carers Bill and wanted to see the following:

• 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.
• A duty on local authorities to provide and promote short breaks.
• A duty on local authorities to offer all carers, including young carers who are about to turn 18, a carers support plan
• A duty on local authorities to establish and maintain a service for providing carers with information and advice on their rights, support, and access to a carers support plan.
• A duty on health agencies to inform and involve carers in hospital admission and discharge procedures.
• The inclusion of emergency planning in carers support plans.
• A named person in each health practice, responsible for managing a GP carer register, identifying carers, supporting them and signposting them to other services.

The Scottish Government did not consult on the last three bullet points. These were included by the Coalition of Carers in Scotland (COCIS) in their template.

Scottish Youth Parliament responses

1.34 Responses from the Care Fair Share questionnaire distributed by the Scottish Youth Parliament to young people aged under 25 years generated 909 responses. Just over one in five (22%) of those who responded to this questionnaire said they have caring responsibilities at present.

1.35 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:
  • duty to support young carers, allowing them to participate in leisure and recreational activities without financial burden.
  • duty to hold information centrally about young carers and younger 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.
  • to meet minimum national expectations about providing services and support for young carers.
• Carers legislation should specifically mention the needs of young adult carers as they move into adulthood in order to highlight the different challenges they face at this point in their lives, including the possibility for increased financial strain.
• All young carers moving into adulthood should be automatically offered a new support plan by their local authority to consider their changing needs.

SUMMARY

1.36 There was a good response to this consultation, with many respondents welcoming the opportunity to provide their comments on the proposals outlined. Across the consultation as a whole there was support for specific legislation that will support carers and their rights, with many respondents 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.

1.37 In general, respondents were supportive of the proposals outlined in the consultation paper.