Caring Together: The Carers Strategy for Scotland 2010 - 2015

2. INTRODUCTION

Why a Young Carers Strategy?

2.1 This Young Carers Strategy aims to build on progress since the publication in 2005 of the Care 21 Report: The Future of Unpaid Care in Scotland¹.

2.2 The Care 21 Report made 22 recommendations about support for carers and young carers, which the then Scottish Executive responded to in 2006. Most of these recommendations apply to both young carers and to adult carers.

2.3 One recommendation was specific to young carers - the establishment of a Young Carers Forum, supported by a Young Carers Strategy. The Care 21 Report also recommended that the Scottish Government continue to develop policy and strategy for unpaid carers. The Scottish Government and the Convention of Scottish Local Authorities ( COSLA) are producing this Young Carers Strategy in response to these recommendations.

"Being a young carer, there is no time to have a childhood. It's like living in "dog years," you grow up much quicker than everyone else your own age. I feel as if my life has been much longer than it actually has, I have brought up a family from the age of 8."

Siobhan, 19 years

2.4 Our decision to produce this Young Carers Strategy, linked to the Carers Strategy, reflects our commitment to young carers and the importance that we give them. It acknowledges that young carers' needs can be different from adult carers' and that many of the responses also need to be different.

2.5 We also recognise that the caring contribution made by young carers can have a significant impact on their health and well-being. Many young carers face demands that can significantly limit their personal development, relationships and opportunities and their ability to reach their full potential.

2.6 However, many children and young people derive benefits from the caring contribution that they make. But it is essential that this is adequately supported to allow an appropriate balance of caring. Through affection and commitment, very many children and young people are making a positive contribution to supporting a family member affected by illness, disability or addiction.

2.7 The following case studies illustrate what it can mean to be a young carer. The first highlights the positive impact, the second the more negative effects on the young person.

CASE STUDY

Gemma is 11 and helps to look after her mum, who has mobility problems due to severe and progressing arthritis. She has two younger siblings.

Her dad has an early start in the morning, and has to work away from home occasionally. When this happens, Gemma is the main carer for her mum, although her aunt lives nearby and helps out, as her siblings do too. On a normal day, Gemma has to help her mum get up, get washed and dressed, and make breakfast for everyone before she gets her brother and sister organised for school and takes them with her. In the evening, she helps to tidy up and get everyone ready for bed. She doesn't often have to cook or shop, as her dad and her aunt see to that. She has a very close relationship with her mum, and likes to help her.

The family's situation is known to the school, and so she and her siblings are well supported. Gemma has quite a few close friends at school, is a happy individual, and achieves reasonably well. The school referred all 3 children to the local young carers' service about a year ago, and they have all been able to take advantage of activities and trips to get some time away from their caring role. Gemma doesn't go to the group when her dad is away because she feels she needs to be in the house for her mum.

Gemma says she would like to be a vet when she grows up.

CASE STUDY

Luke is 14 and lives with his dad who has depression and drinks heavily on a fairly regular basis. His mum and dad broke up 2 years ago, and his mum and sister went to live in England. Luke wanted to stay as he felt closer to his dad, and was also worried about who would look after his dad.

This year has been very difficult for Luke. His dad was admitted to hospital when he drank himself into unconsciousness, and Luke found himself alone at home overnight as he was afraid to tell anyone. This incident made Luke very anxious about his dad, and he now worries a lot about leaving him alone, believing that the last incident was a failed suicide attempt.

Luke is now regularly missing school, and is becoming increasingly isolated from his friends. Recently, when he did return to school after a 3 week absence, his guidance teacher was quite shocked at the change in his appearance, and his attitude. She made a referral to Child and Adolescent Mental Health Services through the school nurse, and his GP, and he is on a waiting list. Social services are also involved now.

When asked what he would like to do in the future, Luke has said that all he can think of is getting his dad 'off the drink' for good, so that he can have a life again.

2.8 Our policy objective in relation to young carers is that, while recognising the positives that caring can bring, we want to ensure that young carers are relieved of inappropriate caring roles, to enable them to be children and young people first and foremost.

2.9 This Young Carers Strategy has been produced in the context of the development of the Scottish Government's Getting It Right For Every Child²( GIRFEC) approach. GIRFEC is a fundamental way of working across all statutory and Third Sector services and is the delivery mechanism for improving outcomes for children and young people.

2.10 GIRFEC is a partnership approach that puts the child, including those with caring responsibilities, at the centre. It identifies and builds on existing family and community supports to promote all children and young people's well-being and improve outcomes.

2.11 As the GIRFEC approach is adopted by Community Planning Partnerships, support for young carers will be provided earlier and become more integrated and responsive to their needs. There will also be better information gathered about those who are carers.

2.12 GIRFEC has identified eight areas of well-being as areas in which children and young people need to progress in order to do well now and in the future. These are illustrated in the following diagram:

2.13 The impact of caring can significantly reduce children and young people's opportunities and their hopes and dreams for the future. This Young Carers Strategy, together with the implementation of GIRFEC across the Third Sector and statutory services, will combine to help to address the negative impact of caring and to build on the positives.

2.14 Together these developments will make a significant contribution to ensuring that young carers achieve the outcomes that we have outlined in our National Performance Framework:

• our young people are successful learners, confident individuals, effective contributors and responsible citizens.
• our children have the best start in life and are ready to succeed.
• we live longer healthier lives.
• we have tackled the significant inequalities in Scottish society.
• we have improved the life chances for children, young people and families at risk.
• we live our lives safe from crime, disorder and danger.
• we have strong resilient and supportive communities where people take responsibility for their own actions and how they affect others.

2.15 The Care 21 Report also highlighted the need for unpaid carers' issues to be integrated into policy planning. This sought to ensure that young carers feature high on the agendas of policy makers and practitioners and that universal services, such as schools and health services, contribute even more to identifying and supporting young people who provide care.

2.16 In developing this Young Carers Strategy we have therefore made direct links with other Scottish Government policy developments relevant to children and young people. In addition to GIRFEC, we have sought to highlight young carers' issues and interests in the work that is underway on, for example:

Curriculum for Excellence³: Curriculum For Excellence aims to achieve a transformation in education in Scotland by providing a coherent, more flexible and enriched curriculum from 3 to 18. With the full implementation of CfE from August 2010 everyone within a learning community, whatever their contact with children and young people, will share responsibility for creating a positive ethos and climate of respect and trust where attention is given to all pupils' wellbeing. Curriculum for Excellence provides opportunities and support that is tailored to the needs of the individual learner so that every child and young person can develop the attributes, knowledge and skills they will need if they are to flourish in life, learning and work and to be effective contributors, successful learners, confident individuals and responsible citizens.

Additional Support for Learning⁴: The Education (Additional Support for Learning) (Scotland) Act 2004 (as amended) provides a framework for local authorities and other agencies to identify and address the support needs of children and young people who face barriers to their learning. The Act recognises that all children or young people may need additional support, long or short term, to help them make the most of their school education. It also recognises that there are a number of factors which could lead to a child or young person requiring additional support, including being a young carer, not attending school regularly, experiencing a bereavement or are living with parents who are abusing substances or who have mental health problems. The Act recognises that some children, including young carers, need extra support to help them learn. It requires local authorities to identify and support children with additional support needs.

Children Affected by Parental Substance Misuse: This policy work builds on the 'Road to Recovery; A New Approach to Tackling Scotland's Drug Problem ⁵'. It recognises that children who live with parents with drug and/or alcohol problems are amongst the most vulnerable in society. Many young carers are living in these situations and are caring for their parent and/or siblings, or have to look after themselves.

Valuing Young People⁶: The Scottish Government and COSLA jointly produced this practical resource, which identifies the links between policy, national outcomes and children's rights. With particular reference to GIRFEC and the Early Years Framework, it outlines a set of common principles that have been adopted by key agencies who are working together to enable young people to achieve their potential.

More Choices, More Chances⁷: More Choices, More Chances is an action plan to reduce the proportion of young people not in education, employment or training in Scotland. Its actions seek to ensure that young people are able to access the universal services from which they should benefit, whilst catering for young people who need additional support. More Choices, More Chances recognises that young carers are amongst those young people who do not move on to positive and sustained destinations when they leave school.

2.17 Together these policy drivers and the actions resulting from them will make a significant contribution to ensuring that young carers are better identified and supported, that their well-being is improved and that they achieve better outcomes.

Young Carers' Views

2.18 In developing this strategy we have taken into account the views of young carers themselves. These have been gathered through direct contact with young carers, through representations from the Scottish Young Carer Services Alliance and, in particular, through consultation with the 800 young carers who participated in the Scottish Young Carers Festivals in 2008 and 2009.

2.19 At the festivals, young carers highlighted many positives about the support they receive, particularly from dedicated young carers' services. However, they also identified a number of priority areas for improvement. These included the need for: sustained funding for young carer services; increased awareness and understanding of young carers and the support they need, by teachers, GPs and social workers; national recognition, respect and understanding of young carers; increased support for young carers aged 18-25 years; and more awareness-raising training about caring for people with mental health issues.

2.20 This Young Carers Strategy aims to promote actions that will help to address these priorities. Young carers' comments and experiences are included throughout the strategy.

2.21 As young carers have informed the development of this strategy, it is important that they also provide feedback on its implementation. The Scottish Government intends to support this through funding a further festival.

ACTION POINT 2.1

The Scottish Government will provide the Princess Royal Trust For Carers with funding of £150,000 to deliver a Scottish Young Carers' Festival in 2011. As well as achieving the aims of earlier festivals, this fourth festival will give young carers an opportunity to provide feedback, from their own perspective, on the implementation and impact of this strategy and Getting It Right For Every Child.

Defining Young Carers

2.22 There are a number of definitions of a 'young carer', which are consistent and share common themes (see for example; Social Care Institute of Excellence ⁸; Princess Royal Trust For Carers ⁹).

"A young carer is a young person who looks after someone who is ill, and cannot manage to look after themselves and is sometimes in hospital."

Sandra, 11 years

"As a young carer I know that I have to look after my Mum and help her to get better and I know that she is not able to do things for herself.''

Fiona, 9 years

2.23 Saul Becker's ¹⁰ definition of young carers has been adopted by The Blackwell Encyclopaedia of Social Work as:

" children and young people under 18 who provide or intend to provide care, assistance or support to another family member. They carry out, often on a regular basis, significant or substantial caring tasks and assume a level of responsibility which would usually be associated with an adult."

"The person receiving care is often a parent but can be a sibling or other relative who is disabled, has chronic illness, mental health problems or other condition connected with a need for care, support or supervision."

2.24 The Care 21 Report ¹¹ provided a more succinct definition of a young carer "as a child or young person aged under 18 who has a significant role in looking after someone else who is experiencing illness or disability."

2.25 These definitions convey the essence of what it means to be a young carer: as a child or young person, a young carer has more significant responsibilities and demands than are appropriate for their age. The definitions also help to understand more about the young people with whom this strategy is concerned.

2.26 However, we also need to be aware that young carers are individuals. They come from different social, economic and ethnic backgrounds and with a range of experiences. They live in urban and rural areas, with siblings or alone, in two parent and lone parent families. Although young carers have 'caring' in common, the amount and type of care that they provide may vary greatly, as will its impact on their health and well-being.

2.27 All partners must also acknowledge that caring is not necessarily static and constant. Family circumstances can change and other adults can begin to contribute or can withdraw support. The effects of a parent's or sibling's illness or disability, or of a parent's misuse of alcohol or drugs, can also change over time, or dramatically, affecting the time and intensity of care given by the young carer. The services that support young carers need to be flexible and responsive to address these changes.

2.28 Further, it is also important to recognise that many young carers do not identify themselves as carers. Instead, they see what they are doing as a natural extension of family relations and as their responsibility as a son, daughter, brother or sister. Many are happy to make this contribution and it can often be beneficial. However, in many situations the impact of the young carer's contribution can be to their detriment.

2.29 If young people do not recognise themselves as young carers or do not want to be seen as such they will not necessarily know where to get the information or support that can help to meet their own needs. This is a challenge for this strategy and for services working with and supporting young people who are providing care. However, in placing the child at the centre, GIRFEC focuses on the well-being indicators rather than whether or not a child is identified or defined as a 'young carer' and so helps to address this challenge.

Who this strategy is for

2.30 The Young Carers Strategy will be of interest to identified young carers themselves. It will provide them with information on what support is available and on what the Scottish Government and COSLA intend should be done in order to improve this support.

2.31 This Young Carers Strategy is important and relevant to anyone concerned with the care, protection, welfare and development of Scotland's children and young people. As so many young carers have not been identified, this strategy is not just for those working with young people who are known to provide care. It is also for many others who are supporting Scotland's young people more generally.

2.32 This is a strategy for practitioners, managers and planners in statutory services and the Third Sector. It will be of interest and relevance to those working with children and young people in education, health, youth and community work and in social work services. It is relevant to those partners who have committed to adopting the principles outlined in 'Valuing Young People'.

2.33 By presenting the issues faced by young people who provide care, and by highlighting positive responses, this strategy aims to increase awareness of young carers. With greater awareness, those who are involved in supporting young people generally will be better able to identify which of them are carers. That will enable them to respond sensitively to the challenges and issues that affect the young carers' lives, that impact on their health and well-being and that limit their childhood.

2.34 One of the most effective ways of relieving young carers of detrimental caring responsibilities is for health and social work services to provide adequate support to meet the cared-for person's needs - support that does not rely on inappropriate caring by a child or young person.

2.35 This strategy is therefore also for those providing care and support to adults or children affected by disability. These practitioners and professionals have a crucial role in considering the impact of the disability, illness or addiction on children and young people in the household.

2.36 This strategy is also for the dedicated young carer services across Scotland. There are nearly 50 such services providing emotional support, group work, information, school-based work and training. They also provide opportunities for young carers to have social contact, enjoy activities, to have fun and to enjoy breaks from caring.

"The Young Carers' Project means so much to me and I have met loads of new people and have become involved in many new things I may not have had the opportunity to do so otherwise. Most importantly people at the project listen to me and understand me."

Alexander, 16 years

2.37 Workers in these services understand and are responding with great commitment to the issues affecting young carers. However, this strategy will provide them with other ideas and opportunities to enable them to work more effectively, particularly in partnership with school staff, nurses, GPs, social workers and others, to identify and support young carers.

Resources

2.38 Since this Government assumed office in May 2007 it has invested over £15m in support to carers. Some of this benefits young carers, for example, in respect of NHS Carer Information Strategies and in the provision of additional short breaks from caring. Some of this funding carries forward to 2011.

2.39 In addition, the Scottish Government has given over £800,000 to support specific work with young carers. This includes the funding of three Scottish Young Carers festivals; a Mapping Exercise to identify the level of services to young carers across Scotland; specific young carers' projects; a national Mental Health Development Worker; the development of a toolkit to help identify young carers in primary schools; and support for young carers into employment/training.

2.40 Furthermore, local authorities provide funding to support young carers. Some local authorities directly provide support to young carers, while others support carer centres, dedicated young carer services and other Third Sector providers through grants and contracts.

Challenges

2.41 This strategy is being published in a difficult economic climate, with pressures on public finances, and at a time when the population is aging significantly. It is difficult to predict with certainty the duration of the economic difficulties. However, it is clear that public spending will be under considerable pressure over the next few years.

2.42 Despite the economic challenges, local authorities and Health Boards will commit to delivering incremental improvements in support for carers, recognising that on the present patterns of service delivery demand on statutory health and social care provision is unsustainable.

Opportunities

2.43 Acknowledging these realities and challenges invites us to think about new approaches and ways of working. We need to consider approaches that enable existing resources to be used differently and to go further, by improving partnership working, removing bureaucracy, reducing duplication and focussing on front-line delivery.

2.44 Many of the responses that young carers themselves ask for are not resource-intensive. While many practitioners are supportive, young carers tell us that if greater awareness and sensitivity were shown by education, health and social services staff more widely, as well as by colleges and employers, young carers' situations could be improved significantly.

2.45 Any new approaches to identifying and supporting young carers should also reflect the Scottish Government and COSLA's joint policy commitment ¹² to earlier and preventative interventions, as promoted by GIRFEC and in 'Valuing Young People'.

2.46 The need for earlier intervention is apparent if we recognise that relieving young carers of inappropriate demands that place them at risk and deny them their childhood, is a child protection issue, a children's right issue and a child health issue - and should thus be a high priority for all agencies working with children and young people.

Role of Scottish Government, COSLA and Partners

2.47 The Scottish Government's role in respect of support to young carers is to set out the strategic context, as we have done in this strategy. The strategic context provides the reference point, on a Scotland-wide basis, for local authorities, Health Boards, other statutory agencies and the Third Sector to locate their plans of action. The Scottish Government's lead in this area will be important to help support local implementation.

2.48 Local authorities are responsible for decisions made at local level and they are best placed, with partners, to determine local priorities. COSLA's leadership will be important to support local implementation.

2.49 The Scottish Government and COSLA expect local authorities to have regard to the key messages in this strategy and to implement the Action Points relevant to them, as local priorities dictate.

2.50 As NHS Health Boards are accountable to Ministers, it was not appropriate or necessary for them to have the same formal partner status as COSLA in the development of this strategy. However, they were of course vital contributors to the work on the strategy.

2.51 The Scottish Government expects NHS Boards to support implementation of this strategy as set out in the Action Points. The Scottish Government expects NHS Boards to build on the progress made through their Carer Information Strategies ( CIS), which the Scottish Government has provided funding to support over the three years to March 2011.

2.52 The Scottish Government cannot determine the priorities of the Third Sector, although we may influence them through Scottish Government funding to voluntary sector organisations to support carers. However, we encourage the Third Sector to consider and take forward the Actions within this strategy to support young carers.

Good Practice

2.53 To help address the challenges we are currently facing we also need to consider and learn from the examples of good practice that exist. The Scottish Government has received a wide range of good practice examples which demonstrate the commitment of local authorities, NHS Boards, the Third Sector and the private sector to ensuring support for carers in a meaningful and sustainable way.

2.54 It is not possible to showcase all the good practice examples in this strategy. We are therefore publishing in a separate document the good practice examples received, as well as examples of good practice within the NHS Boards' Carer Information Strategies. Within this strategy we make reference to some of these examples. The full transcripts are in the separate document.

ACTION POINT 2.2

Over the next 5 years, local authorities and Health Boards, with partners, will take account of good practice promoted in local authority and Health Board areas and will consider how to adopt or adapt the good practice in their area. As a first step, councils and Health Boards, with partners, will consider the good practice contained in the publication accompanying this strategy.

Duration of the strategy

2.55 The strategy spans 5 years from 2010 to 2015. We have set short and medium term priorities with clear timescales for action. We intend to keep the strategy under review to quickly take advantage of new policy, fiscal and resource developments. We will formally review the strategy in 2013. We will decide nearer the time the nature of that formal review.

Vision into Action

2.56 The Scottish Government is committed to supporting and promoting children's rights and the UN Convention on the Rights of the Child ( UNCRC). This is a key strand underpinning our activity to improve outcomes for all Scotland's children and young people, including young carers. It is important that all agencies that have an impact on the lives of young carers promote and protect their rights, taking into account:

Article 2 - All rights apply to all children without discrimination and children should be protected from discrimination.

Article 3 - In all actions concerning children, the best interests of the child shall be a primary consideration.

Article 6 - Every child has the right to life, survival and development.

Article 12 - Every child who is capable of forming their own views has the right to express those views freely.

2.57 The demands made on young carers can deny them some of their UNCRC rights. Their caring responsibilities can impact on their right to enjoy appropriate leisure, recreational and play activities (Article 31), can restrict opportunities to join groups and clubs or spend time with friends (Article 15) and can have a detrimental effect on their education (Articles 28 and 29).

2.58 To help identify and address these barriers it is vital for young carers that the key principles outlined above and any other relevant rights, including their right to information (Article 17), are promoted by those agencies that have an impact on their lives.

2.59 Our vision is that:

By 2015, increasing numbers of young carers will be effectively identified and supported by statutory and Third Sector services using the GIRFEC approach. This will include the provision of an assessment, information, advice and a range of supports. These will combine to relieve young carers of inappropriate caring roles, to promote their rights under the UNCRC and enable them to be children and young people first and foremost.

2.60 The vision also means that young carers will:

• Have their rights respected and promoted
• Be treated at all times with respect and dignity
• Be treated as individuals and have any particular or special needs recognised
• Be relieved of inappropriate caring roles and able to enjoy their childhood
• Have a life outside of their caring role
• Be supported to stay physically and mentally well
• Be informed through having access to information, advice and support
• Be involved and empowered in making an age-appropriate contribution to caring.