Equipment and adaptations: guidance on provision

Unpaid Carers

Unpaid carers are at the heart of health and social care policy and should be considered as key partners in care. We need to also acknowledge that this is not a role that can be taken on by everyone, and any assessment needs to be based on open and frank discussions to clarify all support needs.

We noted earlier in the document that, although the term, 'unpaid carer' is used throughout this document, it is important to acknowledge that the same approach must apply to family members providing the support and care, but who may not identify with this label.

We recognise the important role unpaid carers play in supporting people with disabilities to remain at home. Therefore, providing these carers and the person they care for with self-management care skills, and effective rehabilitation services is essential. A holistic approach with early engagement/assessment is essential to ensure appropriate support is in place, particularly where end of life palliative needs are to be addressed in a dignified way.

The timely provision of equipment and adaptations, and/or housing solutions, are critical to supporting the person being cared for, and the person who is caring, to live safely within their home environment, optimising well-being, and avoiding admittance to hospital, falls, and supporting effective discharge home.

To help unpaid carers, we also need to ensure effective hospital discharge policies are in place for the provision of equipment & adaptations/housing support. Leaving hospital can be a difficult experience, especially if the person leaving hospital is unable to function as they did before. It can also be a difficult time for their carers and family too.

Under the Carers Act, unpaid carers have the right to be involved in the hospital discharge process of the person they are or are going to be caring for. They also have the right to have their views taken into account in assessing the needs of the person being cared for. (See sections 5 and 6 of the Carers' charter).

Health boards must take appropriate steps to: inform carers as soon as they can about when the person they care for is to be discharged from hospital; invite their views about the discharge; and take their views into account when planning the discharge (as far as 'reasonable and practical'). This must include the carer's views about the suitability of the current home environment for the service users longer term needs, and proactively support the exploration of alternative housing options, as well as any equipment and adaptations that might be needed. A good practice guide on discharge planning has been developed to provide practical support in involving carers.

Any subsequent support, help, housing advice, equipment or adaptations will play a key part in this process. Having this support in place allows the cared for person and the carer to remain at home for longer, reduces the pressure on the family and importantly helps avoid hospital readmission.

• Assessors must take account of the views and contribution of carers when assessing the person in need.
• Carers must be informed of their right to an adult carer support plan or young carer statement, to determine what is important to them and their own support needs, independent of any assessment of the person for whom they care.
• An adult carer support plan or young carer statement must be offered to anyone who provides care for a disabled or older person, or someone with a long-term health condition (sections 2 and 3 of the Carers' charter), and they should be encouraged to have one.
• The plan or statement must cover a number of issues, including identifying the unpaid carer's needs for support. That can include the carer's need for equipment or adaptations to enable them to support the cared-for person successfully. It must also include their need for advice and training on safe operation of equipment, and the need for ongoing training support as required.

The carer themselves may require information in an alternative format or language to that of the cared for person.

Key Actions

• Assessors must take account of the views and contribution of carers when assessing the person in need, and fully engage them in discussions about future housing needs, and any associated equipment and adaptations which may support the service user to remain safely in the community. The outcomes should be clearly recorded and reviewed as required.
• Carers must be informed of their right to an adult carer support plan or young carer statement to determine what is important to them and their own support needs, independent of any assessment of the person for whom they care.
• An adult carer support plan or young carer statement must be offered to anyone who provides care for a disabled or older person, or a disabled child.
• Carers should be fully involved in assessment and discharge planning from hospital, with agreed outcomes clearly recorded for the provision of any equipment and adaptation and housing solutions, and relevant support identified as required.