1. CARE ACT SEMINAR

2. Carer…… A definition Locally under the NEL Carers Strategy carers are defined as…. Under the Care Act 2014, the new definition will be…. “Carer” means an adult who provides or intends to provide care for another adult (an “adult needing care”);

3. 20 Years of History - the Carers Agenda

4. Key General Points with reference to carers Current legislation regarding carers is consolidated within the Care Act The following Carers legislation has been repealed: Carers and Disabled Children Act 2000 Carers (Equal Opportunities) Act 2004 Carers (Recognition & Services) Act 1995 Wellbeing principle Assessments & Support Planning Eligibility NEL Carers Strategy ‘Caring for our Carers’ 2013- 2016 Charging Cross Border Placements Ordinary residence Parent Carers – not directly covered– Children and Families Act Young Carers Transition Independent advocacy National Carers Strategies Carers Personal Budgets New duties Prevent/ reduce/ delay carer need Advise & Inform carers Carers & Safeguarding Market Diversity Integration

5. Local Authorities [LA] currently have a legal duty to inform carers of the right to request a carers assessment Carers can request an assessment of need, where they provide/ intend to provide ‘regular and substantial’ care for someone aged 18 or over and the LA (focus/ NAViGO) are satisfied that the person cared for is someone for whom it may provide/ arrange the provision of social care services Parent carers of disabled children are the responsibility of Children’s Services Pre April 2015 Carers will be entitled to a carer’s assessment where they appear to have needs LAs must now actively seek to identify carers and offer them an assessment of need if there is an appearance of need at any level Rights under the Children’s & Families Act for Parent Carers to have a carers needs assessment via Children's Services Young Carers now have the right to a carers needs assessment Post April 2015 Identification of key differences: Assessments

6. Key Principles: Carers Assessments Must establish the carer’s: Ability and willingness to continue caring The impact of the caring situation Caring role - which includes both the practical and emotional support provided The carer’s wishes to participate in employment, education, training and leisure opportunities Future needs for care and support. Outcomes the carer wants to achieve in their daily life, their activities beyond their caring responsibilities, and the impact (short, long & cumulative) of caring upon those activities Carers can refuse an assessment, LA must offer again when needs appear to change Can be separate, combined with the cared for or joint Collaborative process that is transparent and understandable Proportionate Information should be provided on the process and questions in advance, and in an accessible format prior to the assessment Whole family approach

7. LA ‘Power’ to provide services and support to carers Carers are provided with a universal- prevention and wellbeing offer as well as support via a commissioned service Eligibility for commissioned services is based on the carer providing regular and substantial amounts of care and there being a risk to the caring role becoming unsustainable. The Practice Guidance to the 2000 Act requires the extent of the risk of the caring role to be graded into four risk categories: Critical - imminent risk of the breakdown of the caring role Substantial - significant risk of the breakdown of the caring role Moderate - some risk of the breakdown of the caring role Low - low risk of the breakdown of the caring role C arers are eligible for services within North East Lincolnshire where the assessed risk is critical, substantial or moderate Pre April 2015 First time that the LA will be required to meet carer’s unmet needs that meet the national minimum eligibility threshold LA’s will still have the option of meeting needs that fall below the national minimum threshold LA will consider 3 questions when making a decision on eligibility: Do the carers needs arise because the carer is providing necessary care and support? Is the carer’s physical and mental health affected or at risk of deteriorating, or is the carer unable to achieve any of the listed outcomes? Is there consequently a significant impact on the carer’s wellbeing? If carers do not meet the eligibility criteria, the LA is still under a duty to provide carers with advice and information Post April 2015 Identification of key differences: Eligibility

8. Key Principles: Eligibility LAs must consider whether 1)the needs arise as a consequence of providing necessary care for an adult 2)the effect of the carer’s needs means the carer is unable to achieve any of the following outcomes: – Carrying out any caring responsibilities the carer has for a child – Providing care to other persons for whom the carer provides care – Maintaining a habitable home environment – Managing and maintaining nutrition – Developing and maintaining family or other significant personal relationships – Engaging in work, training, education or volunteering – Making use of necessary facilities or services in the local community – Engaging in recreational activities 3) As a consequence of not being able to achieve any of those outcomes there is, or there is likely to be, a significant impact on the carer’s wellbeing A carer’s needs are only eligible where they meet all three of these conditions The national eligibility threshold for carers is set out in the Care and Support ( Eligibility Criteria ) Regulations 2014 Eligibility is based on providing necessary care, the impact of caring on wellbeing, risk to sustainability of the caring situation and the carers ability to have a life outside of caring LAs must consider whether the carer’s need for support arises because they are providing care to an adult Carers can be eligible for support whether or not the adult for whom they care has eligible needs Consideration should be made regarding ‘fluctuating’ needs Once eligibility has been determined, the LA must provide the carer with a copy of the eligibility decision Where the carer is found to have no eligible needs, LAs must provide information and advice on what can be done to meet or reduce the carers needs

9. Key Principles: Support Planning If the carer has some eligible needs, the LA must: Establish ordinary residence requirements – in the case of carers the person for whom they care must have ordinary residence in the LA’s area Agree with the carer which of their needs they would like the LA to meet Ensure the carer is informed of their indicative personal budget Consider how the LA/ carer/ others may meet the carer’s needs Prepare a support plan in conjunction with the carer Inform the carer of their actual personal budget and support the carer’s decision making on how to organise their care package – commissioned services, direct payment….other Review the carer’s needs annually as a minimum or when the carer’s needs change

10. Young Carers Definition - “Young carer” [YC] means a person under 18 who provides or intends to provide care for an adult A YC becomes vulnerable when their caring role risks impacting upon their emotional or physical wellbeing and their prospects in education and life The LA must consider whether the YC should be referred for a young carer’s assessment or a needs assessment Identification of a YC in the family should result in an offer of a needs assessment for the adult requiring care & support YC assessments should include an indication of how any care and support plan for the person(s) they care for would change as a result of the young carer’s change in circumstances If the LA thinks a YC is likely to have needs for support after becoming 18 and it is of benefit to the YC who has consented, the LA must assess the YC’s need for support now and in the future Where a LA decides not to comply with a request for a YC assessment, it must give: (a) written reasons for its decision, and (b) advice & Info about what can be done to prevent or delay the YC needs for support in the future Where a YC refuses a YC’s assessment and the consent condition is accordingly not met, the LA must nonetheless carry out the assessment if the YC is experiencing, or is at risk of, abuse or neglect Considerations in the adults needs assessment: When carrying out an adult’s or carer’s assessment, if it appears that a child is involved in providing care the LA must: 1) Consider the impact of the person’s needs on the YC’s wellbeing, welfare, education and development; 2) Consider whether any of the caring responsibilities the YC is undertaking are inappropriate. An assessment should take into account the parenting responsibilities of the person as well as the impact of the adult’s needs for care and support on the YC. A LA should consider how supporting the adult with needs for care and support can prevent the young carer from under taking excessive or inappropriate care and support responsibilities

11. Update on progress so far Modelling of potential increased carers activity Robust Adult Carers Action Plan & Young Carers Action Plan Embedding of the Care Act in business as usual - NEL Carers Strategy Action Plan is Care Act Complaint Planning is underway to launch Carers Personal Budgets Planning an Information & Advice event for Carers Strategy Group stakeholders The eligibility threshold has been reviewed and implications assessed Carers policies and procedures are being re-developed Launched a Carers Personal Budgets Work stream in 2012-2013 Analysis and options appraisal developed for carers charging – recommendation not to charge Attendance at Regional/ National Care Act sessions to ensure a consistent approach to supporting carers Assessment & Care Planning Task & Finish Groups

12. Challenges / Barriers Short timescale between guidance released and 01.04.2015! Shear scope of requirements affecting carers across the whole Care Act – Over 1,000 references to carers Development of Service User Care Act compliance process required prior to/ alongside carer processes Capacity in social care services to meet demand of assessments and reviews Financial resource required to meet carers’ needs in the future Carers are and will continue to be reluctant to be identified and assessed for the care they provide

13. Carers Animation DVD

14. So what does this mean for carers in NEL? A significant shift in legislation… however very little change in practice as we are already ahead of the game – the main exception being the launch of Carers Personal Budgets. Here in NEL, we already have: Significant suite of carers’ information– Carers Guide, Local Employers Guide to supporting Carers, Carers Assessment Guide Carers Emergency Alert Card Carer led model - carer involvement in the development, design and planning of carers support and services (NEL Carers Centre re- procurement) A recently established NEL Carers Support Service providing a hub and spoke model of carers advice, information, support and services Carers Support Worker Service Carers Breaks – sitting & respite services Carers Health Checks trial Robust NEL carers Strategy which has driven the carers agenda since 2007

15. Questions For further information or advice, please contact: Nicola Pullman Service Lead: Carers & Communities nicola.pullman@nhs.net 0300 3000 546

16. Presented by: Nicola Pullman Service Lead - Carers and Communities, Care & Independence Team (NELCCG) For further comments / queries: NELCCG.workforce-FAQ@nhs.net NELCCG.workforce-FAQ@nhs.net