Carers (Scotland) Act 2016: statutory guidance - updated July 2021

Part 5: Local Carer Strategies

Chapter 1 – Local Carer Strategies

Summary

Section 31 requires each local authority and relevant health board to prepare a local carer strategy and provides for what that strategy must set out.

Section 32 requires the local authority and relevant health board to have regard to a non-exhaustive list of factors when preparing their local carer strategy.

Section 33 deals with the publication and review of the local carer strategy.

The duty under section 31 applies to local authorities and relevant health boards but is delegated to integration joint boards under the Public Bodies (Joint Working) (Prescribed Local Authority Functions Etc.) (Scotland) Amendment (No. 2) Regulations 2017^[143] and the Public Bodies (Joint Working) (Prescribed Health Board Functions) (Scotland) Amendment Regulations 2017^[144]. As sections 32 and 33 are subsidiary functions of section 31, these will also fall under the delegation of integration joint boards.

For the purpose of this chapter the terminology 'local authorities' and 'relevant health boards' will continue to be used in place of integration joint boards or integration authorities.

Statutory local carer strategy

5.1.1. A local carer strategy which deals specifically with the exercise of all functions relating to carers will allow matters to be dealt with more comprehensively than can be the case in the integration strategic plan or children's services plan.

5.1.2. It will also allow issues relating to the needs of both adult and young carers to be planned in one exercise. This in itself will support planning for the transition of individuals from being young carers to adult carers.

5.1.3. The requirement to prepare a local carer strategy is intended to help deliver consistency of approach. Each local authority and relevant health board must prepare and have regard to the same factors when preparing a strategy (section 32) and each strategy must contain information about the same things (section 31). This will ensure a consistent approach while allowing the content and presentation of local carer strategies to reflect different local circumstances in the planning and delivery of support to carers.

5.1.4. It is a matter for each local authority and relevant health board to consider whether they wish to include further information in the local carer strategy over and above that required by section 31.

5.1.5. The duty under section 27 to involve carers and persons and bodies representative of carers in carer services applies to the preparation of a local carer strategy. Authorities and health boards are strongly recommended to work closely and collaboratively with carers and with the third sector in preparing strategies.

Duty to prepare local carer strategy

Local authority and relevant health board

5.1.6. Section 31(1) provides that each local authority and relevant health board must jointly prepare a local carer strategy.

5.1.7. Section 31(5) defines 'relevant carers', who should be covered by the local carer strategy. Relevant carers include both (a) carers who reside in the area of the local authority (whether or not they provide or intend to provide care for cared-for persons in that area) and (b) carers who do not reside in the authority's area but who provide or intend to provide care to cared-for persons in that area.

5.1.8. This means that the local carer strategy must cover carers:

• living and caring in the local authority area;
• living in the local authority area and caring for people living elsewhere; and
• not living in the local authority area but caring for a person or people who live in the local authority area.

5.1.9. Section 31(6) sets out the meaning of 'relevant health board'. It means a health board with a coterminous boundary with the local authority or the health board within whose area the area of the local authority falls.

5.1.10. Where functions have not been delegated, in particular children's services in some areas, the requirement for health boards and local authorities to work closely together to prepare the local carer strategy still applies.

5.1.11. Section 31(2) sets out what the local carer strategy is and what information it must contain.

Joint working – two or more local authorities and health boards

5.1.12. There may be some local authorities and health boards which will work together to prepare a joint local carer strategy covering two or more local authority areas. Given that the duty is on each local authority and relevant health board to ensure that it has prepared a local carer strategy applicable to its area, the duty will equally be discharged by working together with another authority to have one local carer strategy which applies to each area.

Content of strategy

Local carer strategy checklist

A local carer strategy must cover all of the things listed at section 31 of the Act. A document which doesn't include all of these would not meet the statutory definition of a local carer strategy. The nine things which must be included are:

• plans for identifying relevant carers and obtaining information about the care they provide (or intend to provide) to cared-for persons in the local authority's area,
• an assessment of the demand for support to relevant carers,
• support available to relevant carers in the authority's area from -
  • the authority,
  • the relevant health board,
  • any other organisations that the authority and health board consider appropriate,
• an assessment of the extent to which demand for support to relevant carers is currently not being met,
• plans for supporting relevant carers,
• plans for helping relevant carers put arrangements in place for the provision of care to cared-for persons in emergencies,
• an assessment of the extent to which plans for supporting relevant carers may reduce any impact of caring on relevant carers' health and wellbeing,
• the intended timescales for preparing adult carer support plans and young carer statements.
• information relating to the particular needs and circumstances of young carers.

Carer Identification

5.1.13. Section 31(2)(a) requires the local carer strategy to set out plans for identifying relevant carers and obtaining information about the care they provide or intend to provide to cared-for persons in the local authority and relevant health board area.

5.1.14. It will only be possible for the local authority and relevant health board to plan for the delivery of the Act's functions by taking steps to identify carers and determine the extent of caring responsibilities. Local authorities and health boards may already know the number of existing identified carers in their areas. They may also use Scottish Government statistical data obtained through surveys such as the Scottish Health Survey^[145] and the Census^[146] to obtain carer number data.

5.1.15. The plans for identifying relevant carers will be particular to each area but might include identification by different parts of the statutory workforce as well as by the third sector in a number of different ways set out in Annex D.

Assessment of demand for support

5.1.16. Section 31(2)(b) states that the local carer strategy must include an assessment of the demand for support to relevant carers^[147].

5.1.17. It is recognised that assessing current and future demand is not an exact science. The caring population is fluid and carers are constantly moving in and out of the caring role. Many factors will determine demand including:

• the extent to which carers are identified;
• the changing national demographics with the growth in the older population, more adults with complex and multiple care needs and more children with complex needs surviving into adulthood;
• local demographics – age profile and socio-economic make-up of the local population;
• the impact of local publicity and communications regarding support for carers; and
• the extent to which carers are supported by family, friends and neighbours rather than by statutory services.

5.1.18. It should be noted that factors such as complex caring situations and intensive caring in areas of deprivation can exacerbate ill-health and result in increased demand.

Evidence

47% of carers in the most deprived areas care for 35 hours a week or more which is almost double the level in the least deprived areas where 24% of carers care for 35 hours a week or more^[148].

5.1.19. There is evidence of lessening demand from the Community Led Support (CLS) Programme in selected areas of Scotland, England and Wales where CLS assists organisations to work collaboratively with their communities and their staff teams to redesign a service that works for everyone^[149].

5.1.20. An assessment of the demand for both preventative support and support for those with eligible needs will help local authorities with the relevant health board to plan for meeting current and future needs, including unmet need.

Support available to carers

5.1.21. Section 31(2)(c) requires the local carer strategy to set out the support available to relevant carers in the authority's area from: (i) the authority, (ii) the relevant health board, (iii) such other persons and bodies as the authority and relevant health board consider appropriate.

5.1.22. The purpose of this section is for the local carer strategy to set out the support available at the time when the local carer strategy is being prepared.

5.1.23. 'Such other persons and bodies' as at section 31(2)(c)(iii) may include support from the third and independent sectors. The support available across all sectors could include community-based assets such as leisure and recreational facilities, gardening clubs, libraries etc. and people assets and expertise. It may also include support from educational bodies.

Unmet demand

5.1.24. Section 31(2)(d) requires the local carer strategy to set out an assessment of the extent to which demand at a macro level for support to relevant carers is currently not being met. This means that having set out the support available to relevant carers; the next step is to set out an assessment of whether this is sufficient to meet the need.

Plans for supporting relevant carers

5.1.25. Section 31(2)(e) requires the local carer strategy to set out plans for supporting relevant carers. Having assessed demand, considered the existing support available and then assessed the extent to which demand for support is not being met, the final step in this process is to set out the plans for supporting carers.

Emergency planning

5.1.26. Section 31(2)(f) requires the local carer strategy to set out plans for helping relevant carers put arrangements in place for the provision of care to cared-for persons in emergencies.

5.1.27. There is separate provision in sections 9(1)(c) and 15(1)(d) of the Act about emergency planning at an individual level. These sections require adult carer support plans (ACSPs) and young carer statements (YCSs) to contain information about whether the adult or young carer themselves have arrangements in place for the care of the cared-for person in an emergency.

5.1.28. Section 31(2)(f) is intended to be more strategic, reflecting the importance of emergency planning to provide carers with an agreed plan and peace of mind. Emergency planning (sometimes called contingency planning) includes planning for unplanned emergencies. For example a carer not being able to care due to:

• ill health;
• a family emergency; or
• the impact of adverse weather conditions (heavy snow, flooding, etc.)

5.1.29. Some areas already use resources^[150] to offer carers emergency plans or discuss emergency planning with them whilst other areas offer carers an emergency card.

5.1.30. An emergency card lets the emergency services or social care services know that a person is a carer. Carrying the card at all times can help services to put other support in place in a crisis.

Reduce impact of caring on health and wellbeing

5.1.31. Section 31(2)(g) requires the local carer strategy to set out an assessment of the extent to which plans for supporting relevant carers may reduce any impact of caring on relevant carers' health and wellbeing.

5.1.32. This reinforces the preventative approach underpinning the Act. This requires the local authority and the relevant health board to assess how effective their plans for supporting carers are on a preventative basis.

5.1.33. This provision means that the local authority and the relevant health board will assess the extent to which support may meet carers identified needs in order to achieve their personal outcomes. It also means authorities and health boards will assess the extent to which preventative support may prevent, delay or reduce carers' needs, or potential needs, for support.

5.1.34. There are Audit Scotland reports which focus on the need for transformation in health and social care to take forward preventative approaches to supporting people, including carers, in order to reduce costs and promote health and wellbeing^[151].

Examples of preventative support to carers:

• proactive and comprehensive use of the information and advice service for carers, ensuring that carers are provided with the right information and advice at the right time and in the right way;
• providing early support such as a short break to carers who have moderate needs but whose needs might become substantial without such support;
• promoting carers' resilience; and
• carers' health checks.

Intended timescales for preparing adult carer support plans and young carer statements

5.1.35. Section 31(2)(h) requires the local carer strategy to set out the intended timescales for preparing ACSPs and YCSs.

5.1.36. There are no set timescales in the Act for preparing these except for carers of terminally-ill persons. Part 2 of this guidance provides more information on the timescales for preparing individual ACSPs and YCSs, including specific timescales for carers of terminally-ill persons.

5.1.37. The intention of section 31(2)(h) is to give carers an indication of the maximum time for preparation of the ACSP or YCS.

5.1.38. There may be different timescales for completion of ACSPs and YCSs. Local authorities may have their own guidance for timescales based on urgency or risk. There may also be factors in individual cases which can result in ACSPs and YCSs taking longer to complete. For example where the carer's needs are complex and require more than one contact to prepare and complete the ACSP or YCS or where support required is specialised and not readily available.

5.1.39. Local authorities are recommended to prepare each ACSP or YCS as quickly as possible and without delay but to focus on achieving the right outcomes for the carer rather than allowing set timescales to become a de facto target.

Other information

5.1.40. Section 31(2)(i) also allows a local carer strategy to include such other information as each local authority and relevant health board consider appropriate. This enables each local carer strategy to reflect and take into account local circumstances.

5.1.41. This would enable a local authority and health board to include information about, for example:

• achievements and successes from previous non-statutory local carer strategies; and
• an overview of caring situations in relation to different types of conditions of cared-for persons.

Financial Information

5.1.42. Section 31(2)(i) would also allow the strategy to include relevant financial information about how money will be spent in the area on supporting adult and young carers. It will be a matter for the local authority and relevant health board to decide if they wish to include financial information.

5.1.43. It is recognised that carers can be supported indirectly by support put in place for cared-for persons. For various reasons, it may be challenging to identify the total resource supporting carers indirectly^[152]. Self-directed support has also made it more difficult to disaggregate individual budgets.

5.1.44. The performance management framework for integration authorities under the Public Bodies (Joint Working) (Scotland) Act 2014 requires integration authorities to publish certain financial information on an annual basis. The detail of this is set out in The Public Bodies (Joint Working) (Content of Performance Reports) (Scotland) Regulations 2014^[153]. Regulation 4(1), read with regulation 4(2)(d) of those regulations requires an integration authority to publish, in an Annual Financial Statement, the total amount and proportion of funds which have been spent in each reporting year on 'social care services provided in pursuance of integration functions to support unpaid carers in relation to needs arising from their caring role'.

5.1.45. The figure in the integration performance report may well be different from that which might be included in the local carer strategy at the discretion of the local authority and relevant health board for the following reasons:

• it will be a retrospective account of sums actually spent rather than potentially a projection of sums to be spent;
• it may not cover exactly the same services - in particular if the local authority has chosen not to include the function of supporting young carers in the integration scheme; and
• the performance management obligation relates specifically to money that the integration authority has spent, and so would not cover funding from charitable or other sources.

Young carers

5.1.46. Section 31(3) requires a local carer strategy to contain information relating to the particular needs and circumstances of young carers as defined at section 2 of the Act. This information must include in relation to young carers all the issues covered by section 31(2)(a) to 31(2)(i) of the Act.

5.1.47. The Act does not specify how this information is to be included in the local carer strategy. There is therefore local discretion on whether such information is contained in a single local carer strategy document covering both adult carers and young carers or whether a the local carer strategy consists of two documents, one in relation to adult carers and a separate document covering young carers.

Consultation before preparing strategy

5.1.48. Before preparing a local carer strategy,section 31(4) requires the local authority and the relevant health board to jointly (a) consult such persons and bodies representative of carers as they consider appropriate and (b) take such steps as they consider appropriate to involve relevant carers.

5.1.49. Persons and bodies representative of carers may include, for example:

• local adult and young carer organisations;
• condition-specific organisations which work with carers;
• disability or age-focused organisations which do not support carers directly but who have an interest in issues such as short breaks; and
• education bodies.

5.1.50. In order to involve relevant carers, it will be important to consult with carers in different caring situations and with those carers with whom agencies cannot easily interact. Carer centres, young carer projects and other local carer services may be able to help support this engagement with carers.

Links between local carer strategy and other plans and strategies

5.1.51. In preparing a local carer strategy, section 32 requires local authorities and relevant health boards to take account of a range of statutory criteria and planning obligations, including under integration and children's services planning.

Children's Services Plans

5.1.52. Section 32(a) requires the local authority and the relevant health board to have regard to any plans for the provision of services relevant to young carers which are set out in the children's services plan prepared for area of the local authority under section 8 of the Children and Young People (Scotland) Act 2014. Section 32(b) also requires the local authority and relevant health board to have regard to the aims of children's services plans under section 9 of the 2014 Act.

5.1.53. Statutory guidance on Part 3 (Children's Services Planning) of the Children and Young People (Scotland) Act 2014 was published in December 2016^[154]. Paragraphs 205 to 208 of that guidance refer to the local carer strategy and to supporting young carers.

Wellbeing of children

5.1.54. Section 32(c) requires the local authority and the relevant health board to have regard to the criteria for assessing the wellbeing of children and young people set out in section 96 of the Children and Young People (Scotland) Act 2014.

5.1.55. This means that the wellbeing indicators set out in section 96^[155] of the 2014 Act must be used in considering the particular circumstances of young carers in the area.

For Information

The wellbeing indicators are:

Safe, Healthy, Achieving, Nurtured, Active, Respected, Responsible and Included.

National Health and Wellbeing Outcomes

5.1.56. Section 32(d) requires the local authority and the relevant health board to have regard to any national health and wellbeing outcomes prescribed under section 5 of the Public Bodies (Joint Working) (Scotland) Act 2014^[156].

5.1.57. These prescribed outcomes include the following as outcome 6:

'People who provide unpaid care are supported to look after their own health and wellbeing, including reducing any negative impact of their caring role on their own health and wellbeing'.

5.1.58. There are a number of questions in the Scottish Health and Care Experience Survey^[157] which provide evidence in support of this outcome. This survey is run every two years and the results are published by individual Health and Social Care Partnerships as well as for Scotland as a whole. It would be useful to consider these results when preparing the local carer strategy, alongside any local data collections, such as local indicators, and to consider the change every two years.

Integration functions in Strategic Plan

5.1.59. Section 32(e) requires the local authority and the relevant health board to have regard to any arrangements for the carrying out of integration functions relevant to carers which are set out in the strategic plan prepared for the area of the local authority under section 29 of the Public Bodies (Joint Working) (Scotland) Act 2014.

Other local or national plans

5.1.60. Section 32(f) requires the local authority and the relevant health board to have regard to any other local or national plans relating to the provision of social work services and health services as the authority and relevant health board consider appropriate.

5.1.61. The local authority and relevant health board may consider it appropriate to take into account the National Health and Social Care Standards: 'My support, my life^[158]'. These aim to ensure that people across Scotland receive the same high standard of care and support, delivered in a way which reflects their own personal needs and circumstances. The Standards sit beneath five overarching principles (dignity and respect; compassion; included; responsive care and support; and wellbeing). They set out what people should experience every time they use health and/or social care services.

5.1.62. In terms of local plans there are likely to be other, non-statutory, planning processes in the area which may be relevant to assessing the needs of carers and the support to be provided to them. An integration authority may, for example, have detailed planning processes in relation to dementia, mental health, learning disabilities, autism, sensory impairment, augmentative and alternative communication and/or substance misuse. Where such planning processes exist, they may be taken into account when preparing the local carer strategy.

Publication and Review of Local Carer Strategy

5.1.63. Sections 33 sets requirements for publication and review of the local carer strategy.

Publication

5.1.64. Section 33(1)requires each local authority and relevant health board to jointly publish their local carer strategy. There is no statutory provision for the form or method of publication. This could however be on websites and/or made public in other ways. The Scottish Government would however find it useful to have notification of publication and a link to any web based local carer strategy.

Timescales

5.1.65. Section 33(2) means that the first local carer strategy must be published by the next date after 1 April 2018 when the corresponding integration authority is required to review its strategic plan under section 37 of the Public Bodies (Joint Working) (Scotland) Act 2014. Such reviews are required three years after:

• the integration start date;
• the date a replacement strategic plan takes effect after a strategic plan has been reviewed; or
• the date the integration authority has decided not to prepare a replacement strategic plan following such a review.

5.1.66. Before preparing a local carer strategy, the local authority and the relevant health board must carry out consultation under section 31(4), as outlined above. Because of these statutory consultation requirements, it is not expected that the first statutory local carer strategy would be in place in April 2018.

5.1.67. The timing of local carer strategies and integration strategic plans may not synchronise with that of children's services plans under Part 3 of the Children and Young People (Scotland) Act 2014. Under section 8 of that Act, the local authority and health board must prepare a children's services plan in respect of each three year period. The first three year period will start on 1 April 2017 and subsequent periods will start on each 3 year anniversary of that date. Secondary legislation on Part 3 came into force on 7 October 2016 and requires that a children's services plan, prepared in accordance with the provisions of Part 3 of that Act, should be in place by 1 April 2017. This date will apply consistently to all local authorities and health boards across Scotland.

5.1.68. Section 32(a) and (b) of the Act is intended to ensure that, although timescales may not synchronise, the local carer strategy is prepared in a way which takes proper account of children's services plans. Likewise the guidance in relation to children's services planning takes account of local carer strategies as highlighted above.

Review

5.1.69. Section 33(3) and (4) requires the local authority and relevant health board jointly to review their statutory local carer strategy at least every three years. This should enable local authorities and relevant health boards to keep the review of their statutory local carer strategy in line with the integration strategic plans if they wish to do so, or to allow the statutory local carer strategy to run for a full three years even if the integration strategic plan is reviewed sooner if they feel that is more appropriate.

5.1.70. In conducting the review, section 33(5) requires the local authority and relevant health board to comply with the consultation requirements in section 31(4) Guidance on these requirements is set out above.

5.1.71. Following the review, section 33(6) and (7) requires the local authority and relevant health board to revise and publish the revised strategy or to publish a statement that they have not revised it. Section 33(7) also requires the local authority to comply with section 32 (duty to have regard to other statutory plans, aims, criteria and outcomes) into account in preparing a revised strategy. Guidance on section 32 is set out above.