Caring Together: The Carers Strategy for Scotland 2010 - 2015

5. IDENTIFYING YOUNG CARERS

5.1 Many children and young people do not see themselves as 'carers' and many are not identified as such by the universal services they are in contact with. However, when Getting It Right For Every Child and Curriculum for Excellence are fully implemented they will enhance health, education and social care agencies' existing commitment to identifying and meeting the support needs of all Scotland's children. This will be achieved irrespective of whether the young person is defined as being a young carer, a child with disabilities, a 'looked after child', etc.

5.2 However, this is not yet the situation across Scotland and, as the previous chapter indicated, young carers can face specific and significant risks and encounter barriers to normal opportunities. It is therefore necessary to consider what more can be done to identify young carers and to make it safe for them to self-identify and disclose that they are young carers.

5.3 One of the most consistent messages that young carers conveyed at the Scottish Young Carers Festivals in 2008 and 2009 was that professionals could do much more to identify them, in order then to provide them with they support they need but otherwise don't receive. Young carers particularly cited teachers, GPs and social workers.

Identification of Young Carers in Schools

5.4 School staff are often provided with the opportunity to identify young carers early, through their day-to-day contact, the support and pastoral care they offer, or their concern about underlying reasons for problems with attendance, achievement, attainment and behaviour. The opportunity may arise through their awareness of the child's wider family circumstances, their partnership working with parents or because professionals in other agencies have shared information about the young person's caring responsibilities.

5.5 Young carers may require additional support to help them make the most of their school education and be included fully in their learning. Local authorities have a duty to provide this.

5.6 Across Scotland there are some excellent examples of agencies working in partnership to ensure that young carers are identified and supported in their access to education. See, for example, Skye and Lochalsh Young Carers Project, Stirling Schools Project and Action for Children North Lanarkshire in Good Practice Examples.

ACTION POINT 5.1

By 2012, if they have not already done so, local authority Education Services will wish to revisit their policies, procedures and approaches for identifying young carers in schools, to reflect the impact of current policy and legislation, including Curriculum for Excellence and the Supporting Children's Learning Code of Practice.

ACTION POINT 5.2

By 2012, if they have not already done so, local authority Education Services will wish to explore opportunities for developing partnership working with their local schools, parents and the third sector, including young carers' services in order to improve identification of and support for young carers.

ACTION POINT 5.3

The Scottish Government will work with the Scottish Young Carers Services Alliance to produce a practice guide on young carers for teachers and schools.

5.7 The Scottish Government has provided funding to the Princess Royal Trust for Carers to commission a toolkit to assist primary school staff to identify young carers. In keeping with COSLA and the Scottish Government's commitment to early intervention and the early years¹⁹, this recognises that these younger carers may be particularly vulnerable and may require more intensive support to achieve positive outcomes.

5.8 This toolkit will also highlight the importance of ensuring that relevant information about a pupil's role as a young carer is conveyed at times of transition between schools, including between primary and secondary school.

ACTION POINT 5.4

The Scottish Government and COSLA will promote the use of the toolkit that is currently being developed to assist primary school teachers to identify and support young carers.

Identification of Young Carers in the NHS

5.9 The potential for General Practitioners to identify unpaid carers is recognised in the Quality and Outcome Framework ²⁰, which was introduced in 2004 as a system for managing the performance and payment of GPs across the UK. It requires GP practices to have "a protocol for the identification of carers and a mechanism for referral of carers for a social services assessment."

5.10 In providing support to a child or adult with a disability or illness, or to an adult affected by substance misuse, NHS staff are well placed to consider how this disability, illness or addiction might affect other children in the household. They can consider whether they are young carers and assess the impact this has on their health, to then provide advice and support. See for example, Skye and Lochalsh Young Carers Project (in Good Practice Examples).

5.11 Young carers sometimes express frustration that they are assumed to be mature enough to carry out a caring role, but when it comes to consultations with GPs and Consultants regarding the cared-for person, they may be excluded - even although they may have an important contribution to make.

" GPs and doctors haven't taken any consideration into my point of view of the illness despite the fact I help my parent with this illness 24/7. It's frustrating."

Rachel B, 17 years

"I'm 17 yet when my mum was in hospital no one would discuss my mum's situation with me. I'm her main carer and have been since I can remember. It's humiliating and frustrating not being involved in decisions about my mum yet I am considered old enough to care for her."

Rachel O, 17 years

5.12 A range of measures are in place, or being developed, to help improve identification of young carers by NHS staff. For example, the Scottish Government has provided NHS Boards with £9m funding over three years to implement their Carer Information Strategies ( CIS), which require them to:

• involve young carers and the organisations that support them
• address identification and information needs of young carers
• train staff on issues relating to young carers.

5.13 See, for example, NHS Lothian's e-Learning modules, NHS Borders consultation forum and NHS Fife's Information and Liaison Worker (in Good Practice Examples).

5.14 Further, the Royal College of General Practitioners in Scotland has decided to make carer and young carer identification and support a priority in 2010-11 and to develop and promote guidance for all GP practices in Scotland.

ACTION POINT 5.5

In 2010-11, the Scottish Government will work with the RCGP (Scotland) on its plans to provide guidance to all GP practices in Scotland on carer and young carer identification and support.

5.15 The needs of young carers will also be better identified and addressed through young carer issues being a focus of in-service training for NHS staff.

ACTION POINT 5.6

In 2010-12, NHS Education for Scotland ( NES), in collaboration with NHS Boards and the national carer organisations, will review existing training, education, and learning modules for working with young carers; identify core competencies for NHS staff in identifying and supporting carers and young carers; and identify packages and materials to be incorporated within core induction, education and training curricula.

ACTION POINT 5.7

NES will communicate to the relevant regulatory, professional and national bodies the importance of identifying and supporting young carers in workforce training and education.

ACTION POINT 5.8

From 2010 onwards, the Scottish Government will work with NHS Boards to ensure that identifying and supporting young carers is embedded in workforce training.

Identification of Young Carers by Social Work

5.16 In supporting people affected by disability, illness, mental health or substance misuse difficulties, social work practitioners - social workers, Occupational Therapists, Home Care Managers and social care staff - are all well placed to identify and support young carers. In some cases, where they are involved because of child protection issues, these practitioners have not only an opportunity but also an obligation to support and safeguard young people.

5.17 In carrying out assessments and reviews and in providing care and support, social work practitioners can look beyond the social or functional needs of the person with the disability, illness or addiction. They can take a more holistic view of how this impacts on their quality of life and their opportunities, and that of other family members. They can involve any young carer in the assessment and review process and can ensure that the care package does not rely on any young person carrying out detrimental caring roles.

"'It feels like I'm invisible when people (agencies) come into the house. They don't talk to me. I care for my mum all the time, but they don't think they should be telling me anything. It makes me really angry."

Andy, 17 years

5.18 Social work practitioners supporting children with disabilities will also wish to be sensitive to the likelihood that many of those children's siblings will be young carers.

ACTION POINT 5.9

In 2010-2011, the Scottish Government will work with the Scottish Social Services Council to identify opportunities to raise awareness of young carers' needs in Social Work qualifying training.

Identification of Young Carers by Others

5.19 With some estimates suggesting that there may be over 100,000 young carers in Scotland, and with only a small percentage being supported by dedicated services, it is important that other agencies who engage with young people recognise that a number will be young carers.

"Make more people aware of young carers so they know who we are."

Young Carer, Scottish Young Carers Festival 2009

5.20 Youth and community groups, wider third sector organisations, after-school clubs and other child care organisations, as well as churches, and the emergency services should all be aware of the potential that young people they are in contact with may be young carers. For example, see Skye and Lochalsh Young Carers' Project work with the Fire and Police Services in Good Practice Examples.

5.21 Those agencies who have committed to the principles outlined in 'Valuing Young People' will be working in partnership to support young people to achieve their potential. 'Valuing Young People' recognises that some young people, including many young carers, benefit from earlier intervention and more intensive support to become successful learners, confident individuals, effective contributors and responsible citizens.

5.22 Alcohol and Drug Partnerships ( ADPs) and the new Scottish Drugs Recovery Consortium ( SDRC) can also contribute to raising awareness about young carers affected by parental substance misuse. The Scottish Government expects ADPs to engage with all relevant aspects of community planning to help secure the best outcomes both for people with addiction problems and for their carers, including young carers and families.

ACTION POINT 5.10

From 2010 onwards, the Scottish Government will promote this strategy with Alcohol and Drug Partnerships ( ADPs) and with the Scottish Drugs Recovery Consortium ( SDRC) and will work with ADPs and with the SDRC to help identify and support young carers affected by parental substance misuse.

5.23 With greater awareness of the existence and plight of young carers, adults working in these settings and agencies are better able to identify and support young carers who they come into contact with.

Public Awareness

5.24 Many young people providing care and support to family members affected by disability, or by mental health or substance misuse problems, will be doing so without the local community or local services being aware of this. This may be a natural feature of families enjoying their privacy, without any external intrusion and interference. However, it may also be a reaction to the stigma associated with some conditions, an awareness that children are over-burdened and a fear of what might happen if services become involved.

5.25 Increased public awareness of the existence of young carers, the role they carry out and the demands they face, may be to their benefit as a "hidden population" and as individual young people. Young carers have highlighted the need for this.

"Everyone should be told how to recognise a young carer as this is the only way we can get help."

Dean, 14 years

5.26 Raised awareness of the existence of young carers, their role and contribution could also help to challenge negative attitudes about young people, about disability and particularly around some conditions. This could make it safer, more acceptable and easier for young carers to disclose the extent of their caring role. It could enable young carers to be identified sooner and to be provided with more timely support, including support that relieves them of inappropriate caring roles.

"I think it is a good idea to try and raise awareness about the things we have to do as young carers, although sometimes young carers do not want everyone to know."

Jayne, 13 years