Caring Together: The Carers Strategy for Scotland 2010 - 2015

4. PRIORITISING SUPPORT FOR CARERS

The purpose of this chapter is to make clear that carers most in need should be prioritised for support. This does not mean delivering support in response to crises. The emphasis should be on early intervention and preventative support. There is a link to chapter 3 on the profile of carers in that some further data is provided on carers' characteristics. Small packages of cost-effective support are appropriate.

4.1 There are carers who are particularly vulnerable and in need of support, especially preventative in nature. The estimated half of carers who provide care to another household member and who are caring continuously each and every day are caring intensively. Furthermore, the Scottish Household Survey 2007-08 shows:

• 18% of carers are aged 70 and over.
• 19% of carers are aged 60-69.
• 4% of carers care for two or more people.
• 70% of carers have been caring for over 5 years.

4.2 Another measure of 'need' might be those carers living in deprivation, who will be less able to pay for services, more likely to be in poverty and poorer health and more socially isolated.

4.3 Through review of their local strategies, local authorities with partners will wish to take account of the most vulnerable carers according to an objective assessment of need which also takes account of the nature and level of risk. The Scottish Government and COSLA acknowledge that authorities may already have done this.

4.4 This does not contradict the emphasis on early intervention or the preventative approach. What it does mean, for example, is that frail elderly carers might be considered to be in greatest need: a preventative approach would mean early identification of these carers and the availability of the necessary supports to enable quality-of-life and in turn to prevent crises.

4.5 There needs to be more focus on early intervention, with crisis support available too. In times of financial constraint the imperative is usually to take action when there is a crisis that needs tackling. However, a greater emphasis on anticipatory and preventative support in relation to both the carer and cared-for person - which does not have to be complex or expensive - can delay or prevent the need for crisis intervention, and is therefore more cost-effective.

4.6 The Reshaping Care Programme has a strong emphasis on early intervention. A focus on anticipatory support for carers is essential as part of this programme.

4.7 Carers whose caring responsibilities are minimal also need to have adequate information so that they are supported should their caring responsibilities become more demanding, and possibly have 'emergency plans' in place should their circumstances change quickly.

4.8 No two carers or caring situations are identical. Carers in a similar caring situation - for example, caring for a grown up child with learning disabilities - may have different needs due to a range of circumstances, including the availability of services in their area, support from family and friends, support from the wider community, people's level of income to purchase services and so on. All these considerations are important.

ACTION POINT 4.1

By 2012, if they have not already done so, local authorities, with partners, will wish to revisit their local carer strategies to identify and support carers in need according to their own assessment of need. To support this process, the Scottish Government will produce a short list of key points that local carer strategies should address.

ACTION POINT 4.2

By 2013, local authorities, with partners, will aim to identify carers in greatest need according to an objective assessment of need, and in line with published indicators, which also takes account of the nature and level of risk. They will aim to provide support or signpost on to support.

ACTION POINT 4.3

Over the next five years, local authorities and Health Boards, with partners, should seek to provide preventative support to carers and minimise the need for crisis intervention.

ACTION POINT 4.4

Over the next 5 years the Reshaping Older People's Care Programme will look to ensure a focus on early intervention for carers. Good practice in this area will be transferred to other care settings.