Carers Legislation - Analysis of Consultation Responses

8 Planning and Delivery

In summary,

Involvement in the development of local carers' strategies

• 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.
• A significant minority of respondents noted they already involve carers and carer organisations in the development of carer strategies; some local authorities presented this as an argument against this proposal.
• Key advantages to the introduction of this were that it would help to identify unmet needs for support, it will help to provide parity of services across Scotland or that it will be critical in helping to review progress and monitor outcomes.
• There were some calls from respondents for the need to consider a Young Carers' Strategy, either in its own right or as part of a carers' strategy.
• There were some calls for the period of review to be flexible to meet changing needs, rather than every three years.

Range of services

• 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. Once again, opposition came primarily from local authorities and CHCPs.
• A significant number of respondents noted the need to be able to offer a range of services to carers in order to meet their needs; for example, access to advice or training.
• There were comments that this would allow for consistent provision across Scotland.
• Some respondents noted that they already collaborate with other organisations in relation to service delivery.
• There were some concerns over the wording of this question with calls for clarification of 'sufficient range of services' and 'reasonably practical'.
• A key reason for opposition to this proposal was that SDS legislation already allows for this.

8.1 This chapter of the consultation set out proposals for statutory provision for the development and publication of local carers' strategies which would, among other things, address issues of need and demand for support.

INVOLVEMENT IN THE DEVELOPMENT OF LOCAL CARERS STRATEGIES

8.2 In order to ensure a good focus by local authorities and Health Boards on strategic planning, the Scottish Government is proposing 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.

8.3 The Scottish Government is not proposing statutory provision for the preparation of young carer strategies given the provisions in the Children and Young People (Scotland) Act for the preparation of a children's services plan. Question 20 asked:

Question 20: Should we 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?

Table 8.1: Question 20

Respondent group	Yes	No	Other	Nil response
Individuals (32)	26	1	-	5
Carer/ User support (81)	62	-	-	19
Local authority (24)	12	10	1	1
Health (13)	8	2	-	3
CHCP (6)	3	2	-	1
Public body (3)	1	-	-	2
Professional body (3)	-	-	-	3
Representative body (3)	1	-	-	2
TOTAL (165)	113	15	1	36

8.4 One hundred and thirteen respondents said yes while 15, mainly from the local authority group, said no and a further local authority respondent said perhaps. One hundred and twelve respondents commented on this question. A number of respondents, mainly carer/ user organisations or individuals noted the need to include carer organisations and carers in the development of local carers' strategies, with some specifying particular groups of individuals such as young carers or organisations with a national remit who are involved in delivery of services.

8.5 A significant minority of respondents noted that they already involve carers and carer organisations in the development of carer strategies. Many of these respondents were local authorities and views from these were polarised in terms of whether statutory provision should be introduced. Those disagreeing with the need for statutory provision noted that as they already involve carers and carer organisations, there is no need for further legislation. One CHCP noted,

"At a local level, the Carers Joint Planning and Performance Implementation Group (JPPIG) which involves health and social care professionals, the local carers' centre and carers' representatives, has developed a strategy every three years with the most recent strategy being published in 2013. The outcomes in the local strategy have clear links to national outcomes and are informed by consultation with local carers. A work plan is in place which is driven forward by the local partnership to address and promote carers issues."

8.6 Some carer/ user organisations outlined advantages to the introduction of statutory legislation. These advantages included that legislation will help to identify unmet needs and demands for support to carers, that it will help to provide parity of services across Scotland, that it will be critical in helping to review progress and monitoring the outcomes or that it will embed a more consistent and strategic approach to the development of carer services. A public body also noted that this reinforces the importance of collaboration between services and carers to ensure improved outcomes.

8.7 A number of respondents, most notably carer/ user organisations, commented on the need to give consideration to a Young Carers' Strategy, either in its own right or as part of a carers' strategy. As noted by one carer/ user organisation,

"We believe that Young Carers' strategies should also be developed. This could be a distinct part of the Carers' Strategy or a separate document, but the needs of young carers should be considered alongside adult carers in a local area. Not all young carers will be accessing children's services and therefore may not be covered by a Children's Services Plan."

8.8 There were also calls from a small number of respondents for this to be linked into the national carers' strategy.

8.9 Some respondents referred in some way to the integration agenda; some of these noted that there is no need for the introduction of statutory provision as this will be covered as part of the integration of Social Care and Health. For example, two health organisations commented that this responsibility should sit with Health & Social Care Partnerships. There were also a small number of comments that any legislation needs to take account of the structure of integrated bodies and the provision of any services that do not fall under the integration agenda.

8.10 Some respondents referred specifically to the period of review, with views split as to the necessary frequency of this. While there was some agreement that a three yearly review would suffice, there were also some requests for review to be an ongoing process in order to meet changing needs, for example, if an individual is suffering from a degenerative condition.

RANGE OF SERVICES

8.11 The consultation paper noted that there is not currently a legal duty in social care law to provide support to carers. As such, there is an under-developed market of providers to provide carers with support such as advocacy, short breaks, counselling and so on.

8.12 The consultation paper went on to note that there may be merit in legislative provision so that local authorities with Health Boards have to take steps to ensure, as reasonably as is practicable, that support services are available to meet the needs of support to carers and young carers. Question 21 went onto ask,

Question 21: Should we introduce statutory provision to the effect that local authorities with Health Boards must take steps to ensure, in so far as is reasonably practicable, that a sufficient range of services is available for meeting the needs for support to carers and young carers in the area?

Table 8.2: Question 21

Respondent group	Yes	No	Other	Nil response
Individuals (32)	26	-	-	6
Carer/ User support (81)	58	-	-	23
Local authority (24)	12	10	1	1
Health (13)	6	1	1	5
CHCP (6)	2	4	-	-
Public body (3)	1	1	-	1
Professional body (3)	-	-	-	3
Representative body (3)	1	-	-	2
TOTAL (165)	106	16	2	41

8.13 As shown in the table above, the majority of respondents (106) providing an answer at this question said yes; these were primarily from carer/ user support organisations, individuals and local authorities. Sixteen gave an answer of 'no', and these were mainly from the local authority group and CHCPs. Two gave other answers (perhaps and undecided). Ninety-four respondents provided further commentary and explanation in support of their response.

8.14 A significant minority, mostly carer/ user support organisations, noted the need to be able to offer a range of services to carers in order to meet their needs. A small number of these respondents noted specific types of service this needs to include, such as access to advice, training and education, and person-centred support and advocacy. A small number of respondents noted that there is already collaboration between different organisations in relation to service delivery. There were also a small number of suggestions that these services could be provided by third sector or voluntary organisations and funded by local authorities and health boards.

8.15 A small number of respondents, mainly carer/ user support organisations, noted the need to have minimum standards of services across Scotland or that there should be a universal list of what is available across Scotland and how to access these services.

8.16 Additional comments from those in support of this statutory provision noted that this would be fairer and consistent for carers, or that there is a need for consistency in provision across the whole of Scotland, including the more rural areas. There were also comments on the need to include carers in decision-making.

8.17 While many comments referred to the need to provide a range of services, a small number of respondents also pointed to the need to ensure that the quality of services and outcomes achieved were also important considerations.

8.18 The wording of the question raised concerns from some respondents (mostly local authorities and carer/ user support organisations), with calls for clarification of 'sufficient range of services' or 'reasonably practicable'. One organisation in the health sector noted that without a clear definition, it is difficult to assess resource requirements.

8.19 Another concern from a number of respondents related to resources, with some calls for greater levels of funding to ensure capacity, or ring-fenced funding being made available in order to be able to make local authorities and health boards accountable.

8.20 Of the respondents not supporting this statutory provision, a small number, mostly CHCPs noted that SDS will bring about changes to services or that SDS legislation focuses on this issue. As one noted,

"As self directed supports develop, the means to access supports for carers and young carers will become increasingly diverse. It is anticipated the market will grow to reflect the demand. The demand for appropriate support will be driven by individuals as opposed to statutory bodies in time, however, there should be a means within each partnership to monitor demand and ensure there is sufficient ease of access to relevant identified support provision such as independent advocacy."

8.21 A small number of respondents also noted that this should be the responsibility of HSCPs or that this is considered under the provision of the Children and Young People (Scotland) Act 2014.

8.22 Another issue raised by a small number of respondents was a request for more consultation and/ or research to look at the specific needs of carers and/ or a review of what is currently available.