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Introduction

The Carers (Equal Opportunities) Act 2004 commenced on 1 April 2005. The Department of Health and the Department for Education and Skills will shortly produce policy guidance, which sets out the Government’s views of the issues for local authorities in carrying out their functions under the Carers and Disabled Children Act 2000 and the Carers (Equal Opportunities) Act 2004.

Supporting Carers was one of the themes in Round 6 of The Beacon Council Scheme in 2004. The Department of Health Theme Lead was heavily involved in the selection process for this theme and was impressed by the wealth of good practice in supporting carers being demonstrated by the authorities shortlisted in the Beacon process.

The Department of Health is delighted to be able to share some of these examples in the context of the three clauses set out in the Carers (Equal Opportunities) Act 2004. These examples have been extracted from the 9 authorities shortlisted for Beacon status.

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Background

The Beacon Council Scheme is a cross Government initiative to identify and recognise excellence in local government. The scheme is run by the Office of the Deputy Prime Minister (ODPM) in conjunction with the Improvement and Development Agency (IDeA) and entered it’s sixth round in 2004. One of the themes in this round was Supporting Carers.

The 2001 Census shows that of the 5.2 million people providing informal care in England and Wales, just over 1 million provide over 50 hours of care per week. This is a large number of people providing significant levels of care, enabling people to live longer in the community, which is what over three quarters of people say they want.

Studies suggest that caring is likely to be associated with inequalities in mental and emotional health including fatigue and physical health problems, which can result in social exclusion. Carers providing substantial amounts of care are statistically more likely to be working part-time or be out of work. With appropriate support, carers are less likely to become marginalised while they care for someone and will be more able to return to work when their caring role ceases.

By providing services, which promote independence and choice, and by providing flexible, responsive support for carers, the sustainable caring situation can be maintained.

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The Process

An Advisory Panel on Beacon Councils makes the final decisions on which authorities receive the Beacon Council Award. They base their decision on recommendations from Government Theme Leads and Specialist Members appointed for each Theme.

The Government Theme Leads and Specialist Members scrutinize all applications, sift through these to produce a shortlist, visit all shortlisted authorities and attend an event where these authorities give final presentations.

Applications were assessed against the following criteria:

Outcomes

Services are delivered to those who need them and their carers strategically to maximise the wellbeing of the community, particularly the socially excluded who are most likely to benefit from support;
Carers receive an appropriate level of support for them and those they care for, and as far as possible, how and where they choose

User & Community Satisfaction

Carers and partners are involved in the development and delivery of services and feel that their issues and concerns are acknowledged and acted upon;
Services are supported by all sections of the community and there is public confidence in the appropriateness, fairness and responsiveness of services to support carers.
Vision & Strategy

A local carers’ strategy, or evidence of strategic planning for carers in place covering all services, that carers use or might use such as housing, education, transport and leisure;
Evidence that this strategic planning has been developed in consultation with carers themselves as well as other statutory and voluntary sector providers
Consultation

Appropriate mechanisms for direct communication are established with the full range of carers including those who are harder to engage with, such as black and ethnic minority or rural carers;
Evidence that the council is making efforts to reach out to carers who are not known to them (hidden carers) through a variety of means;
Evidence that the contribution of carers who have been involved in the consultation process is acknowledged and their views informed future service planning.
Partnerships

Good working relationships are established with partners providing services for carers and those they support from the statutory, voluntary and private sectors;
Specific evidence of partnership working with the health services;
Partners are involved in developing co-ordinated services both formally, for example through Local Delivery Plans and on a more informal basis.

Actions

The council demonstrates its commitment to delivering carer-focused services by communicating its vision to the staff and public. Staff programmes to promote commitment to the principles of carer-focused services are in place;
Services are planned in a co-ordinated way across the council and;
actively promote independence and choice;
treat carers with dignity, respecting individual cultures and lifestyles;
are fair and consistent;
are accessible to all carers and address the issues of social exclusion;
are sufficiently flexible to meet individual needs;
are capable of adapting quickly to changing circumstances.

The deadline for applications to the scheme was 9 September 2004 and 22 applications were received on the Supporting Carers theme. The standard of applications was very high and all of them demonstrated a commitment to carer’ issues and included innovative approaches to supporting carers.

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Results

Nine authorities were shortlisted for Beacon Status (Bury Metropolitan Borough Council, Gloucestershire County Council, Hertfordshire County Council, Rochdale Metropolitan Borough Council, Sefton Metropolitan District Council, Somerset County Council, Sunderland City Council, Surrey County Council and Tameside Metropolitan Borough Council).

From these, four were appointed (Hertfordshire County Council; Rochdale Metropolitan Borough Council; Sefton Metropolitan Borough Council; and Sunderland City Council)

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The Carers (Equal Opportunities) Act 2004

The Carers (Equal Opportunities) Act 2004 (the “2004 Act”) seeks, through clause 1, to give carers more choice and better opportunities to lead a more fulfilling life by ensuring that carers receive information about their rights to an assessment under the 2000 Act. Clause 2 ensures that those assessments now consider the carer’s wishes in relation to leisure, training and work activities. The third clause provides for co-operation between local authorities and other public authorities, including housing, education, transport and health, in relation to the planning and provision of services that may help support the carer in their caring role.

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Examples of Good Practice

Clause 1: Duty to inform - Ways of ensuring that carers receive information about their rights to an assessment under the 2000 Act

All the Authorities demonstrated a variety of innovative ways to reach out and provide information to carers who may not yet identify themselves as such. These include displaying information:

on a giant plasma screen at a local leisure centre (Bury)
via information booklets (Hertfordshire and Somerset)
via a website (Hertfordshire, Somerset, Sunderland, Surrey and Tameside)
on Carers notice boards in GP surgeries (Bury, Hertfordshire, Rochdale, Sefton, Somerset, Sunderland, Surrey and Tameside) on notice boards in hospital wards (Bury, Rochdale and Tameside) in hospital admission and/or discharge packs (Bury, Somerset, Sunderland and Tameside)
in pharmacies (Bury and Sunderland)
in libraries and other opportunistic environments e.g. shops (Somerset, Sunderland, Tameside)
in posters and events for Carers Week (Bury, Hertfordshire, Rochdale, Somerset and Tameside)
in carers articles in Council’s newspaper and Carers magazines (Bury, Rochdale, Somerset and Tameside)
in carer information sent to all households (Rochdale and Sunderland)
on pay slips or e-mails to Council employed staff (Rochdale, Somerset and Tameside)
via carers messages broadcast on local radio (Rochdale, Somerset and Tameside)
via carers messages broadcast on local Asian radio (Rochdale)
via Care radio (web based) (Surrey)
via Council call centres (Somerset and Sunderland)
in Carers newsletters (Bury, Rochdale, Sefton and Somerset)
in Carers newspaper (Gloucestershire)
via Carers Linkworkers Network (Gloucestershire)
Authorities ensured an inclusive approach to providing information - some
examples include:

Making information available in large print, other languages, braille & audio tape (in English & other languages) (Bury, Hertfordshire, Rochdale, Somerset and Tameside)
Undertaking dedicated work to provide language skills to carers in black and minority ethnic groups to facilitate access to information and support (Rochdale and Tameside)

Many Authorities take proactive measures to reach unknown or “hidden” carers via:

Carer awareness training sessions available to all hospital staff (Bury)
Carer awareness training for all frontline staff (Hertfordshire and Somerset)
Carer awareness training with special modules for frontline staff (Gloucestershire)
Carer awareness raising via contacts with voluntary organisations/other authorities (Bury, Somerset and Surrey)
Carer aware benefits advice workers (Rochdale and Sunderland)
GP based Carer Support Workers (Somerset)
Outreach work to employers to raise awareness about staff who are carers (Sunderland, Surrey and Tameside)
Specific campaigns to target carers (including campaigns to target carers from Black and Minority Ethnic Communities (Gloucestershire, Hertfordshire, Rochdale and Sefton)
The inclusion of a target within the PCT Local Delivery Plan to increase the number of people registering as carers (Hertfordshire)
Partnership work with PCTs and local GP practices to develop carers registers (Somerset)
Carer events and conferences (Bury, Somerset and Tameside)
Carer events/outreach in community groups (Rochdale, Somerset, Sunderland, Surrey and Tameside)
Carer awareness raising in schools (Rochdale, Somerset, Sunderland and Surrey)
Carer support Groups (Tameside)
Neighbourhood work and outreach (Sefton)
Events and publicity around Carers Week and Carers Rights Day (Gloucestershire)

Clause 2: Assessments - examples of current practices that ensure assessments consider the carer’s wishes in relation to leisure, training and work activities

A number of Authorities are already ensuring that assessments take account of carers’ needs outside of their caring role via:

A single assessment process to ensure carers’ needs are considered at an early stage (Bury)
Cross-boundary carer assessments (recognising the needs of carers who live in a different borough to that of the person(s) being cared for. These carers would have otherwise been excluded from services. (Bury and Tameside)
Peer network within Council with links to carers information supported through Social Services and Corporate Equality Unit (Gloucestershire)
Councils establishing their own carer friendly working strategies (e.g. flexible working patterns, time off with pay for caring emergencies, opportunities to meet as a group during Carers Week etc) - thereby encouraging more carers into employment (Herfordshire, Sefton, Somerset, Sunderland and Surrey)
Multi-agency People into Employment Project to support people with disabilities and carers back into work (Sunderland)
Participation in the Action for Carers into Employment - a national initiative to enable carers to return to work whilst maintaining their caring role (Sunderland and Surrey)
The purchase of services from leisure providers and the issue of vouchers to carers to enable them to use local leisure facilities (Tameside)
The provision of training opportunities for carers such as IT, language, confidence building and personal development (Bury, Gloucestershire, Rochdale, Sefton, Somerset, Sunderland and Tameside)
Opportunities to volunteer to help other carers (for those who feel confident and able to do so) (Rochdale)
Partnership working with leisure services to develop new ways of respite that are more inclusive within the local community (Sefton)
The provision of a Young Carers ID Card which identifies young people as carers and can explain (without embarrassment)
Their reasons for handing in work late, being late for school etc (Sunderland)
Assisted learning out of school and access to computers for young carers (Sunderland)

Clause 3: Co-operation between authorities

A number of Authorities are already working closely with colleagues within their organisations and with other public authorities such as housing, education, transport and health to help support carers in their caring role by:

The introduction of cross-boundary carer assessments (recognising the needs of carers who live in a different borough to that of the person(s) being cared for. These carers would have otherwise been excluded from services. (Bury)
Establishing joint working arrangements with health staff when conducting carers assessments (Somerset)
Establishing excellent working relationships with health partners to ensure carers needs are met as much as possible (e.g. hospital discharge planning arrangements etc) (Bury, Gloucestershire, Hertfordshire, Somerset, Surrey and Tameside)
Close partnership working with voluntary sector (Bury, Gloucestershire, Hertfordshire, Sefton, Sunderland, Surrey)
Partnership working with Registered Social Landlord in the Borough to look at housing issues from the viewpoint of carers (Tameside)
Establishing Carer Support Workers, which are posts that are jointly funded between Health and Social Services (Somerset)
The existence of Champions in council staff, health partners and social services (Bury, Hertfordshire, Rochdale, Somerset and Tameside)
The inclusion of an objective within the Carers’ Strategy to lever co-operation from colleagues in leisure, housing and transport (Gloucestershire)
Partnership working with Adult Care Services and Children, Schools and Families Services (Hertfordshire and Rochdale)
Partnership working with schools to identify and support young carers (Hertfordshire, Rochdale, Somerset, Sunderland, Surrey)
Establishing links with housing department, law courts, health visitors, local education colleagues and shopmobility (Sefton)
Partnership working with the leisure sector to help meet the needs of young carers (Sefton, Somerset and Tameside)
Partnership working with Young Carers Strategic Planning Group (including education, youth & community services, childrens services, adult services and the young carers organisation) (Gloucestershire)
Establishing partnership arrangements for some specific groups (such as Learning Disabilities, Mental Health) (Sunderland)
Partnership working between Carers Centre, NHS and the Council to share the cost of Carers Week (Sunderland)

Specific innovative examples of good practice

There were many examples of good practice contained within the shortlisted applications but the following were particularly noteworthy and could be adapted to meet the needs within other authorities:

Bury

Cross-Boundary Carers Assessments

Carers living in a different Borough to that of the person(s) being cared for were being excluded from carer services. To address this, Bury held meetings with the authorities that bordered with them and a Cross Boundary Protocol was agreed and published. Carers resident in these areas now have access to services in the most convenient place for them. The protocol has since been published for adoption by other Authorities.

Voucher Scheme

Bury have developed a flexible and effective voucher scheme which has attracted more carers year on year. Vouchers are used to purchase hours of care from a range of ten independent providers. A database to help administer vouchers was purchased in 2001 using prize money from Health and Social Care Awards which has since been “sold” on to other authorities. Over 27 authorities have visited or been visited by carers officers from Bury for advice and guidance.
Gloucestershire

Share with a Carer Scheme

This unique scheme is run entirely by volunteer carers. Share with a Carer puts carers in touch with others at any time of the day or night, 365 days per year. Carers find this scheme invaluable and the ability to speak to someone who really understands how they are feeling is often key to defusing a moment of great crisis.

Working with carers from Black and Minority Ethnic Communities

Gloucestershire employ a Black Carers Development Worker whose role it is to identify hidden carers and engage with BME communities. She has established carers groups for Asian women and the Afro-Caribbean community and is working toward establishing groups for Hindu and Bangladeshi carers.

Hertfordshire

Carewise

The Council includes Carewise as a strand of its work/life balance policy. Carewise facilitates a wide range of flexible working options to support those combining caring with their work for the Council. The Council has in place arrangements to monitor the experiences of carers in employment and shows that 90% of requests for flexible working asked for by staff in 2003/04 actually delivered. EU funding has been attracted for developing Carers in Employment work.

Money Advice Carers’ Project

This project provides benefits advice, training, talks and information to people working with carers. Improved information about availability of and eligibility criteria for benefits had reaped verified benefit outcomes for 2003-04 of £241,232 for 81 clients.

Rochdale

Carers Resource/Social Enterprise

Rochdale’s carers centre is currently controlled by the Council but is being moved into a carer-run and controlled Social Enterprise. It includes facilities to train for employment and personal development, a raft of counselling, advocacy and social support services, outreach beyond the town centre, benefits advice, special groups/services for male/female/BME carers but also many mixed social events.

Working with carers from Black and Ethnic Minority Communities

The very strong BEM programme ensures that carers issues are brought up in small community meetings. These allow carers not normally in touch with services to identify the barriers they face and introduce them to services that are available to them in a culturally sensitive way. Introduction to the Carers Resource is often to access training. This allows carers to come gradually into contact with those that can offer sensitive personal support once a relationship of trust has been built up. The Carers Resource also hosts fun events such as the Multi-cultural “Ready, Steady Cook” evenings and parties to celebrate Eid, Christmas and Diwali which celebrate different ethnic communities and harness positive relationships between them.

Sefton

Carers Emergency Respite Team (CERT)

This unique service offers instant response for when a carer faces an emergency, which would prevent them from being able to continue caring. Within 1 hour, a pre-briefed member of the team will appear and take over the caring role. Carers spoke very warmly of how valuable this scheme had been to help them cope with major emergencies such as their own health failing.

Telematics

Sefton is investigating telematics as a means of allowing carers to juggle their other responsibilities with their caring role.

Social Enterprise

Sefton are looking at investing in Social Enterprises such as a hotel for the training of carers who want to get into employment whilst producing an extended respite and pampering environment for carers.

Somerset

Carer Support Workers (CSWs)

Somerset have put in place 15 Carers Support Workers (CSWs) based in 13 GP practices to work across the health and social care boundary to identify and support carers including those in hard to reach rural areas. These workers have developed links with their nearest hospitals to encourage early identification of carers in the discharge planning process. As well as advising carers on support they can access, they can also act as an advocate for carers to ensure their concerns are handled sensitively and effectively.

Carers of Adults with Mental Health problems

Somerset received feedback from carers of adults with mental health problems that they were not always receiving the needs assessment as required by the National Service Framework for Mental Health (Standard 6). To rectify this, Social Services and Somerset Partnership NHS Trust seconded a project team member into the Trust to raise the profile of carers needs and developed specific support. Four Carers Assessment Workers (CAWs) were appointed to work alongside Care Coordinators in Community Mental Health Teams. CAWs undertake a Carers Needs Assessment as part of the integrated care programme approach providing information, advice and support to carers whilst working with the Care Co-ordinators to ensure the delivery of appropriate and responsive services.

Sunderland

Modernisation and Reform Groups (MaRGs)

Modernisation and Reform Groups look at all aspects of Social and Health Services and redesign service provision using an inclusive and multi-agency approach. They are partnership led with strong inputs from carers and there is a specific MaRG on user and carer involvement. Through them the Council is able to get detailed feedback and ideas for amending services and creating strategy by ensuring that samples are representative and input facilitated through training and pre-briefings.

Young Carers Scheme

The Young Carers Project in Sunderland is well developed and demonstrates a comprehensive approach to meeting the different needs of young carers. Whilst providing stimulating and exciting trips and activities for young carers e.g. trips to the local ice rink, it also recognises that not all young carers wish to be supported in this way. A young carers ID card which identifies them as carers without embarrassment or breach of confidentiality, specific intervention in school as required by the Young Carers Team; assisted learning out of school and access to computers are all excellent examples of appropriate and responsive support that is available.
Surrey

Back Care Projects

Innovative Back Care Projects have been developed by Action for Carers (Surrey) funded by the County Council and East Surrey PCT. These provide a carers service - providing advice to carers in their own home and have been found to be highly effective. New schemes are being set up to cover other areas in Surrey.

Young Carers Video

The Young Carers project (in conjunction with Young Carers) has developed a very professional video to be shown in schools which has attracted interest from the BBC. The video was developed as a result of consultation with young carers and was edited by them. It deals with wider issues relevant to young carers e.g. bullying.
Tameside

Investors in Carers - GP Scheme

The Investors in Carers certificate is designed to raise awareness of carers needs and rights amongst primary care workers. The project aims to encourage GPs to refer carers to the Carers Centre and to make them aware that they are entitled to an individual needs assessment. As a result of this training package delivered by Carers Centre staff, participating surgeries provide carers information on a designated noticeboard and stock leaflets specific to carer services.

RED Team

Tameside’s Race Equality and Diversity Team provides access to co-workers with language skills so that carers from Black and Ethnic Minority communities may contribute fully to support groups and forum meetings. The Asian Carers Group meets monthly and the RED team co-facilitates these and contributes to the translation of Carers Centre publications into community languages.

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Dissemination of Good Practice

All of the authorities shortlisted for the Beacon award have agreed to the use
of their examples of good practice to appear in the Carers section of the
Department of Health website. They are willing to receive queries about any
of these in order to share good practice with other authorities and their contact
details are below:

Authority Contact Name E-mail address Telephone Number
Bury Gwen Lucas g.lucas@bury.gov.uk 0161 253 5431
Gloucestershire Louise West louise.west@gloucestershire.gov.uk 01452 426502
Hertfordshire Tim Anfilogoff Tim_Anfilogoff@hertscc.gov.uk 01707 280 761
(Mob) 07747 564 837
Rochdale Phil Pearson phil.pearson@rochdale.gov.uk 01706 865621
Sefton Shirley Parker Beacon.carers@sefton.gov.uk 0151 934 3689
Somerset Sue Sheppard smsheppard@somerset.gov.uk 01278 431111
Sunderland Graham Burt Graham.Burt@ssd.sunderland.gov.uk 0191 566 1829
Surrey John Bangs john.bangs@surreycc.gov.uk 020 8541 9675
Tameside Ray Slamon ray.slamon@tameside.gov.uk 0161 371 8963

The Improvement and Development Agency (IDeA) are working with the successful Beacon Authorities to highlight good practice in the Supporting Carers theme. The anticipated outcomes from this programme will take time to accomplish. The learning style for the Supporting Carers Beacon theme will be about working with partners and sharing problems, experiences and innovative approaches to achieve desired outcomes.

More information about the excellent and innovative practices from the successful Beacon Authorities and information on how to book a place on the the learning exchange on Supporting Carers are outlined in the IDeA Beacons Website.

The website also includes various case studies from the Beacons and toolkits to help councils to focus their attention on the specific issues that they need to develop, and where they can go to build upon their existing understanding. The case studies and toolkits will be added to throughout the year and councils are encouraged to visit frequently.

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