Carers Legislation - Analysis of Consultation Responses

6 Stages and Transitions

In summary,

Statutory guidance on the Carer's Support Plan

• 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.
• Key advantages cited for this approach were that it would help to identify changing needs and allow for authorities and service providers to respond to changing needs, it would support the development of consistent good practice and consistency in assessments and it would help with cross-border portability. That said, there were comments that this will need to be flexible and responsive to individual and changing needs.
• In terms of young carers specifically, there were requests for a CSP to be carried out well in advance of their transition to an adult carer.
• Of the small number of respondents opposed to this, there were queries as to whether the concept of stages of caring is useful, that this should not be needed by qualified staff or that regular reviews and assessments of carer needs are already conducted.

Young carers becoming adult carers

• A large majority of respondents were supportive of new carers' legislation provided 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 being able to access necessary support services.
• There were calls for planning to be carried out well in advance so that the transition can be as smooth as possible as well as ensuring safeguards are in place to consider the needs of the young carer, for example, education or career options.
• One concern was that young carers without a Child's Plan may be disregarded.
• Some local authorities noted they already provide this service.
• Some respondents - primarily those opposed to the introduction of this legislation - commented that young carers already have their needs assessed and services provided via GIRFEC or the Children and Young People Act.

6.1 This chapter of the consultation examined stages in the experiences of the cared-for person and the carer, the transition from children's services to adult services for young people and the transition from being a young carer to an adult carer. In order to clarify the terminology used, the consultation paper distinguished between stages, which relate to different stages experienced by cared-for people and carers; and transitions, which mean transition of service for cared-for people usually required because of the cared-for person's age.

STATUTORY GUIDANCE ON THE CARER'S SUPPORT PLAN

6.2 Discussions with carers have shown they can experience difficulties and challenges at different stages in their caring role. The Scottish Government is proposing to issue guidance on the Carer's Support Plan (CSP) which will include guidance for those undertaking the CSP on managing stages of caring. Question 14 asked:

Question 14: Should we issue statutory guidance on the Carer's Support Plan which will include guidance for those undertaking the Carer's Support Plan on managing stages of caring? This would apply to adult carers only. (For young carers, practice guidance will be developed to support management of a Child's Plan through the stages of caring).

Table 6.1: Question 14

Respondent group	Yes	No	Other	Nil response
Individuals (32)	27	-	-	5
Carer/ User support (81)	61	1	-	19
Local authority (24)	12	7	-	5
Health (13)	7	1	-	5
CHCP (6)	1	4	-	1
Public body (3)	2	-	-	1
Professional body (3)	-	-	-	3
Representative body (3)	1	1	-	1
TOTAL (165)	111	14	-	40

6.3 As can be seen in the table above, the large majority of those responding to this question (111), said yes while only 14 said no. Disagreement with this proposal came primarily from respondents within local authorities and CHCPs. One hundred and six respondents commented on this question. A number of advantages to the introduction of this proposal were identified by respondents and these included:

• It will help to identify changing needs and allow for responses to changes in circumstances.
• It would support the workforce to achieve consistent good practice across all local authority areas.
• It will mean greater consistency in assessments.
• It will help with cross-border portability.
• It will help those in an advocacy role to help a carer to prepare for assessment.

6.4 A number of respondents, primarily carer/ user support organisations, noted a degree of caution in relation to this proposal, most notably that it will need to be flexible and responsive to individual (and possibly changing) needs, particularly if crises or emergencies arise. A small number of respondents felt that this should be reviewed on a regular basis or that it should be possible for a review to be triggered by a carer if their circumstances change.

6.5 A small number of respondents, all local authorities and carer/ user support organisations commented on young carers specifically. A key theme was the need for a Carers' Support Plan for a young carer to be carried out well in advance of their transition from a young carer to a young adult or adult carer. Another carer/ user support organisation commented that it is essential that there are linkages between plans for children and young people to ensure that vital information is not omitted. Two of these local authorities noted that guidance would be useful.

6.6 Reference to some of the wording was made by a few respondents. For example, a local authority felt that caution is needed in relation to 'managing stages of caring', given that this is not a linear process. A carer/ user support organisation noted "We interpret the reference to "end of caring" as being to the death or institutionalisation of the person being cared for. We think it would be helpful to be explicit about what is meant here".

6.7 A small number of respondents felt that this aligns with the core principles of EPiC (Equal Partners in Care) or those of coproduction and SDS. One carer/ user support organisation felt it would be useful to consider how this will link with the Named Person role within the Children and Young People Act.

6.8 There were calls from a small number of carer/ user support organisations for carers to be involved in the development of guidance.

6.9 For the small number of respondents who were not supportive of this proposal, a few comments were made, each by only two or three respondents:

• Query whether the notion of stages of caring is useful as this process is not ordered or predictable (local authorities).
• We regularly review and adapt assessments and support interventions already (local authorities).
• Guidance is welcomed but it does not need to be statutory (local authorities and a health board).
• Providing examples of good practice may be more useful, for example, to highlight areas to be covered when undertaking an assessment.

6.10 One local authority felt that each local authority or partner organisation should have responsibility for developing their own guidance to reflect local practice in line with national legislation. Another local authority noted concerns over the issue of portability and the potential for cross-border issues when the carer lives in one local authority and the cared-for person in another.

YOUNG CARERS BECOMING ADULT CARERS

6.11 In order to ensure that young carers approaching the age of 18 who are likely to become adult carers receive a Carer's Support Plan to determine any need for support, the Scottish Government intends to make provision in law for dealing with this transition to adult carer. Question 15 asked:

Question 15: Should new carers' legislation provide for young carers to have a Carer's Support Plan if they seem likely to become an adult carer? Any agreed support recorded in the Carer's Support Plan would be put in place after the young carer becomes a (young) adult carer.

Table 6.2: Question 15

Respondent group	Yes	No	Other	Nil response
Individuals (32)	26	-	-	6
Carer/ User support (81)	57	-	-	24
Local authority (24)	16	5	-	3
Health (13)	8	-	-	5
CHCP (6)	3	2	-	1
Public body (3)	1	-	-	2
Professional body (3)	-	-	-	3
Representative body (3)	2	-	-	1
TOTAL (165)	113	7	-	45

6.12 A large majority (113) of those who replied to this question were in favour of this proposal, with only seven in disagreement. Disagreement came from local authorities and CHCPs. Eighty-three respondents commented on this question and many of the key themes emerging echoed those seen at the previous question.

6.13 Respondents across all sub-groups noted a number of advantages to this proposal. Key was that this would help to ease the difficulties of transition, that it would mean a more integrated approach to planning with all agencies working together to help the young carer, or that it could prevent potentially long delays in young carers accessing appropriate support when they become an adult carer. There were also some comments that transition from being a young carer to an adult carer should be made as easy as possible. A typical comment from a carer/ user support organisation was:

"The transition from Children's to Adults Services for a young carer is often not a smooth and stress-free one. From experience, many young adult carers find themselves in a position where the support they once received is no longer available to them due to this transition. Therefore by ensuring that young carers have a Carer's Support Plan if they seem likely to become an adult carer, will hopefully address this."

6.14 A significant number of respondents noted that planning should be carried out in advance in order for the transition to be as smooth as possible; some of these respondents noted specific ages at which transition planning should commence. Of these respondents, some suggested that planning should start at the age of 14, which is the same time as planning for transitions for children with disabilities starts; others suggested the age of 16 would be a suitable point in time. There were also a small number of concerns about the need to ensure that safeguards should be in place so that career or education options for the young carer can be considered in line with their caring role.

6.15 A concern noted by a small number of respondents was that young carers who do not have a Child's Plan may be disregarded. One carer/ user support organisation commented:

"[We are] concerned that the current proposals mean that young carers are not able to receive a Carer's Support Plan until they become adult carers. As highlighted by YouthLink Scotland, young carers who do not have a Child's Plan may fall between the gaps. The consultation document states that not all young carers will be deemed to have a wellbeing need and so may not have a Child's Plan. It may therefore be difficult to identify young carers who do not have a Child's Plan but who need support through a Carers Support Plan. In line with the recommendation made by YouthLink Scotland, the creation of a Young Carer's Support Plan/ eligibility for a Carer's Support Plan could help to resolve the current issues concerning transition from children to adult services."

6.16 A few local authorities noted that they already provide this service. Small numbers of respondents also made reference to this being consistent with the core principles of EPiC (Equal Partners in Care), or SDS which offers young people choice and control during the process.

6.17 Some respondents - primarily but not solely among those who disagreed with this proposal - referred to GIRFEC specifically, with comments that young carers should have their needs assessed and responded to under the GIRFEC (Getting it Right for Every Child) approach and that the Child's Plan should consider the transition to adulthood. One CHCP commented on this, as well as raising issues over the need for multi-agency working and links with the named person role within the Children and Young People Act. They noted:

"Young carers should have their needs assessed and responded to under the GIRFEC approach and it is important that a Child's Plan considers the transition to adulthood. It is important that any additional responsibilities for young carers do not rest only with the local authority but extends to health, the further education service and Skills Development Scotland. It would be helpful to consider how this will link with the 'named person' role within the C&YP Act. Any plans from the Scottish Government for young carers need to address their rights to seek employment or enter further education. There also needs to be recognition that young carers will possibly want to move to their own accommodation and as such this might reduce their availability to care for the cared for person."

6.18 Other reasons for disagreement with this proposal included,

• This is already carried out and covered in transitions planning (local authorities).
• Existing legislation should be used more effectively.
• Effective integrated services should already be doing this.
• This is not needed (local authority).

6.19 A small number of respondents raised concerns in relation to this proposal. There were some calls for more detail or clarity, for example, in relation to where responsibility lies under the integration agenda or having a clear definition of what constitutes 'adult'.

6.20 The issue of resources was raised by a small number of respondents, for example, that these need to be effectively targeted and providers need to ensure they are age and stage appropriate. One carer/ user support organisation suggested this needs to take place in a multi-disciplinary framework using pooled budgets.