LIVERPOOL
SUPPORTING
CARERS
STRATEGY
2008 – 11
Contentspage
Foreword3
Section 1– Introduction, Vision and Aims4
Section 2 - Carers in Context5
Section 3 – Analysis of Need10
Section 4 – Policy Context12
Section 5 – The Carers Compact14
Section 6 – Current and Anticipated Financial Resources16
Section 7 – Other Resources17
Section 8 – Eligibility and Charging17
Section 9 – Priority Areas18
Section 10 – Reviewing the Strategy25
Appendix 1 – Short Breaks and Carers Services27
Appendix 2 – Carers Grant28
Foreword
Welcome to the Liverpool Supporting Carers Strategy. For some considerable time, carers, local carer organisations, Liverpool City Council and Liverpool PCT have worked together to achieve positive changes in the lives of the many carers in Liverpool who provide unpaid support and or help to relatives, partners, friends and neighbours.
Carers dedicate large parts of their own lives to helping loved ones – often in addition to working or studying. Carers receive no payment for the invaluable work they do, yet our community could not manage without them.
Significant legislative changes relating to carers have taken place over the past few years. This has resulted in a significant cultural shift in the way carers are viewed: carers are now explicitly recognised as key partners in the provision of care and as people who have the right to work and have the same life chances that are available to everyone else.
In Liverpool, considerable progress has been made to improve the lives of carers, including young carers. In particular, a comprehensive support service for carers is in place and an active Carers Forum is successfully promoting the involvement of carers, representing their views and ensuring carers have a voice and genuinely influence how services are planned and provided. A wide range of organisations and groups are providing direct support to carers (such as training, alternative therapies and so on) and others are providing support through short break schemes. Funding from the Carers Grant and contributions from the Neighbourhood Renewal Fund and Liverpool Primary Care Trust has provided the required resources to make these and other developments possible.
However, further work is required to ensure ever improving support for the many carers in Liverpool who every day make personal sacrifices to care for a relative or friend. With the demand for care rising, it is critical that we all recognise the invaluable contribution that carers make to our community and understand how best we can support them and the people they care for. This document sets out our priorities for how we plan to support, inform and involve carers in Liverpool over the next three years.
Tony Hunter Dave Antrobus
Executive Director Executive Member
Community services Portfolio Health and Adult Social Care
- Introduction
The Liverpool Supporting Carers Strategy recognises the essential role that carers play in our community. That they are key partners in the task of enabling people to remain living at home and that there has never been a more important time to focus all available resources on ensuring that carers are acknowledged and supported.
It further recognises both the cost of caring to carers themselves and also the degree to which tasks undertaken by carers prevent or reduce the need for intervention by the statutory sector.
This strategy builds upon previous Carers Strategies further reinforcing the City Councils commitment to identifying and supporting the needs of carers in Liverpool. It provides a strategic framework for delivering on the Carers Agenda in Liverpool and sets out the ‘commissioning intentions’ for carers’ services over the next three years.
1.1. Our vision for carers in Liverpool
Our vision is for carers in Liverpool to be recognised and valued for the positive contribution that they make to our community. That they are enabled and empowered to take control of their own lives by identifying their own needs; through increased choice; high-quality, flexible support and services; improved information and advice.
1.2. Purpose of the strategy
The Liverpool Supporting Carers Strategy provides a strategic framework for delivering on the Carers Agenda in Liverpoolover the next three years. It establishes a set of key standards in the form of a Carers Compactthat provide organisations (both statutory and third sector) with a framework against which they can measure how well they are meeting the needs of carers locally.
It also sets out the ‘commissioning intentions’ for carers’ services over the next three years. It makes explicit our plans for commissioning services from resources (mainly Carers Grant) that have been identified as directly for carers’ services.
2. Carers in Context
2.1Who is a carer?
The Government defines a carer as a person that ‘provides a substantial amount of care on a regular basis for a relevant person’. It is therefore important to make the following distinction:
The role of ‘carer’ should not be confused with ‘care worker’ or ‘care staff’ who are either paid to provide care as part of a contract of employment, or volunteer attached to a voluntary organisation.
This distinction is made in law through the Carers’ (Recognition and Services) Act (1995).
For the purpose of this strategy:
A carer is someone who provides unpaid care to a spouse, partner, parent, child, sibling, other relative or friend who due to illness or disability would not be able to live in the community without their help.
A parent carer is a parent or guardian who is likely to provide more support than other parents because their child is ill or disabled. Parent carers will often view themselves as parents rather than carers, but their child will have considerable additional care needs.
A young careris a child or young person under the age of 18, who provides care to another family member usually an adult, who has a physical illness/disability; mental ill health; sensory disability; has problematic use of drugs or alcohol or is HIV positive. The level of care they provide would usually be undertaken by an adult and as a result of this has a significant impact on their normal childhood (North West Quality Protects, 2002).
2.2 What do carers do?
The General Household Survey 1995 found that providing care ranged from regularly helping with practical and physical needs to emotional support. 60% of carers looking after someone in their own home provided personal care, such as washing, bathing, dressing and toileting. A similar percentage provided physical help with getting in and out of bed, walking and using the stairs.
The support provided by carers is unpaid, brings no status, contract of employment or record of learning and skills acquired. Caring responsibilities may vary over time and may be unpredictable. Missing out on job opportunities, giving up work or being unable to undertake paid work because of caring responsibilities leads to many carers facing social exclusion and financial hardship.
2.3 Carers in Britain
For the first time, the 2001 Census, asked a question about whether people provided unpaid care for a family member or friend and for how many hours. This revealed that across England and Wales 10 per cent of the population – almost 5.2 million people – provide unpaid care. And almost 3.9 million of those are of working age.
Fig. 1: Carers by age and sex, April 2001, EnglandWales
More than one-in-five people aged 50-59 are providing some unpaid care. A greater proportion of women than men are carers, both in the population as a whole and in age groups up to 64 years (Fig 1).
Nationally 21 per cent of carers spend 50 or more hours a week caring (Fig 2), almost half – 48 per cent - are not in paid employment (Fig 3) and 11 per cent consider themselves to be in poor health.
Fig 2: Carers by time spent caring per week, April 2001, UK
Fig 3:, Carers by employment status April 2001, UK
The 2001 Census also identified that there are approximately 174,995 Young Carers in the UK. Of these, around 18 000provided 20 hours of care or more a week, and nearly 9000 providedat least 50 hours. Indian, Bangladeshi and Pakistani children were most likely to be carers, around 1.5 per cent of each group.
Fig 4: Carers by ethnic group and time spent caring per week, April 2001, UK
1 in 10 White British and Indian people provide unpaid care to relatives, friends or neighbours. The amount of time that people spend caring differs by ethnic origin (Fig 4). The White Irish, Bangladeshi, Pakistani and White British groups provide the highest rates of unpaid care spending 50 hours a week or more caring.
A high proportion of young Pakistani and Bangladeshi men and women combine paid work and unpaid care - one in eight men and one in seven women from these ethnic groups as compared with just one in twenty five of their White British counterparts.
2.4 Carers in Liverpool
Based on the 2001 Census there are 48,123adult carers in Liverpool. Of these carers 29 per cent spend 50 hours or more a week caring (Fig 5), over half are not in paid employment (Fig 6) and 15 per cent consider themselves to be in poor health. What these statistics demonstrate is that there are a greater number of carers in Liverpool providing 50 or more hours per week caring than carers nationally. Also they are less financially ‘well off’ and consider themselves to be in poorer healththan their national counterparts.
Fig 5: Carers by time spent caring per week, April 2001, Liverpool LA Area
1 – Not in paid employment, 2 – full time work, 3 – part time work
Fig 6: Carers by employment status, April 2001, Liverpool LA Area
There are estimated to be over 2000 Young Carers in Liverpool, many of whom will not be reaching their full potential because of the impact of caring on their lives.
Liverpool City Council works in partnership with a local voluntary organisation to ensure a database of carers in Liverpool is managed, maintained and developed. Currently there are 3163 carers registered on the database. The database enables statutory, voluntary and community organisations to consult and communicate with carers more effectively. It also enables us to gain a picture of where registered carers are located across the city and match service provision to demand.
The maps below (Fig 7) illustrate the spread of carers throughout the city across ward boundaries. The maps are accurate in so far that the information that we canplot. We are continuing to improve the data that we keep (see section 9.10) and will revise map in line with reviewing the strategy (section 10).
Fig 7: Registered Carers by Ward Area, April 2005, Liverpool
This map is reproduced from Ordnance Survey material with the permission of Ordnance Survey on behalf of the controller of Her Majesty's Stationery Office © Crown copyright. Unauthorised reproduction infringes © Crown copyright. All rights reserved 100018351, 2008
3. Analysis of Need
A major new study from the University of Leeds, commissioned by Carers UK, has provided detailed evidence based on analysis of the 2001 census and findings from questionnaires and interviews with carers and professionalsin 10 councils across England, Scotland and Wales. The Carer, Employment and Services (2007) series of reports shows that in return for the massive contribution carers make to the social economy and to the well-being, independence and security of those they care for, they receive penalties rather than rewards.
These ‘penalties’ can be grouped into three main categories - first, carers pay a significant health penalty for caring and there is now strong evidence to suggest that the longer you provide care and the more of it you give, the more likely you are to be in poor health yourself.
Second, the research shows financial penalties hit new carers quickly, which is related to giving up work or reducing working hours, as well as the cost associated with caring for someone who is ill or disabled. It is a problem that worsens as caring continues, and many carers will still suffer a financial penalty when they are drawing their pension, too.
Third, carers become socially excluded. The research shows that carers frequently feel isolated and lonely. Due to their caring responsibilities carers have difficulty in continuing with the life they led before – work, education, leisure and community participation. All were difficult to sustain as caring continued and most worried about this, feeling it damaged family relationships and personal life as well as preventing them from contributing to wider society.
Local research undertaken by The Carers Project at Local Solutions on behalf of Liverpool City Council bears out many of the issues highlighted above but also drills down to carers’ individual and collective experiences on a local level. The Consultation with Carers and Professionals Report (2007)contains the findings of consultation with carers and professionals in Liverpool, which took place from April to June 2007.
The aim of the consultation was to find outfromcarers their opinions about current services to ensure future developments are based upon need. In doing that four specific areas were considered:
- Carers health
- Carers in employment
- An emergency care scheme for carers
- Advocacy services
The Consultation with Carers and Professionals Report (2007)sets out recommendations and other data that underpins this strategy. The full document is available on the Carers Strategy page of the Liverpool City Council website www.liverpool.gov.uk.
The main demographic factor affecting future need is the anticipated growth of the number of older people in Liverpool – currently at 63,500 with an anticipated growth of 18% by 2025. However, it is the over 85 population that presents a particular challenge with a projected increase of 37% by 2025. This will mean an increase in the number of older people needing support to live independently and more older carers providing much of it. The known correlation between age of carer and issues of ill health will mean an increase of elderly carers in poor health which presents a considerable challenge
This needs data suggests the following direction of travel for the Carers Agenda in Liverpool over the next three years:
- Active work to identify and, where appropriate, assess the needs of a greater proportion of the estimated 47,711 adult carers and 2000 young carers in city;
- Address the health needs of carers particularly those of older carers;
- Address the needs of carers within health settings particularly in respect of support through GP surgeries and the discharge of the cared for person from hospital;
- Ensure adequate provision of short break and carers support services including training to support carers in their caring role;
- Establish an accessible, responsive and reliable Carers Emergency Support Service that meets the needs of both the carer and cared for person;
- Address issues of service suitability and equity of access to carers support services for all carers but particularly those from Black and Minority Ethnic (BME) and other communities;
- Address the challenge of the large number of carers of working age who need support to access work, remain in work or return to work;
- Use all possible sources of funding together with efficiency savings to increase the volume and range of services for carers.
4. Policy Context
The Liverpool Supporting Carers Strategy is informed by Government legislation relating to carers:
The NHS and Community Care Act (1990) ensures that Local Authorities must involve families and carers when making plans for helping vulnerable people in the community.
The Carers (Recognition and Services) Act 1995was the first major piece of legislation that related solely to carers. It recognises their role and gives carers the right to request an assessment in their own right. The Act gives Local Authorities the duty to take into account the carers assessment when deciding what services are needed to support the person being cared for.
The Carers and Disabled Children Act (2000) reinforces carers rights to request an assessment of their own needs, even when the person they care for has refused a community care assessment or services. It also gave Local Authorities the power to provide some services direct to carers, including direct payments. The Act recognises individuals with parental responsibility for a disabled child.
The Children Act (1989) states that the child’s safety and well being are paramount and stresses the importance of helping families that are in need.
The Carers (Equal Opportunities) Act (2004) places a duty on Local Authorities to inform carers of their rights to an assessment. The Act sought to ensure that carers are enabled to participate fully in society by ensuring when assessing carers needs their leisure, learning and employment needs are also considered. It also gave Local Authorities new powers to call on the assistance of other bodies in providing support to carers.
Our Health, Our Care, Our Say (2006) sets out a new direction of travel for health and social care services. It proposes further support for carers including a national information service or helpline, short-term, home based respite support for carers in crisis or emergency situations and funding to provide training for carers. It also sets out plans to update and extend the National Carers Strategy 1999.
The Work and Families Act (2006)gives carers the right to request flexible working. Parents of children under six and disabled children under 18 already have this right - now carers join them.
The Strategy is also informed by:
The National Strategy for Carers: Caring about Carers 1999 which is currently being reviewed and updated highlights the importance for universal services to work together to ensure carers’ needs are recognised and address. It also addresses issues specifically relating to young carers and the need to ensure their educational and general development are not affected due to their caring responsibilities.