Report of the Director of Legal and Business
Operations requesting that the Panel consider the comments made by
the invited guests and use the information provided as evidence in
the review
Minutes:
The Panel considered the report of the Director of Legal and Business Operations requesting that the Panel consider the comments made by the invited guests and use the information provided as evidence in the review.
Summary of information provided:
A carers perspective – Rebecca Kinge, Alex, Leah, Jasmine and Zunayrah
· Following a vox pop produced by Carers in Southampton that provided view points from a number of adult carers on the impact of caring on their health and wellbeing, Linda Lawless, Service Manager at Carers in Southampton, interviewed Rebecca Kinge, a carer and parent to 3 children, 2 of whom have additional needs.
· Rebecca discussed her serious health condition caused by the stress of her caring responsibilities; the limited free time she has; the impact caring has had on her ability to work; the essential support she receives from friends and family; bouts of depression before working hard on her mental wellbeing; her wish that services had been available to prevent the crisis caused by her neurological disorder; the impact of caring on her job security, pension, financial independence. Rebecca praised the support offered by Re:Minds, a parent led support group for parents with children with mental health issues.
· Emma Jones and Emma Bowley from No Limits supported young carers Alex, Leah, Jasmine and Zunayrah to inform the Panel of the impact of caring on their health and wellbeing. The young carers discussed the impact on their social life; the impact on their emotional, physical and emotional wellbeing; the sense of loss because of their caring role, and; the support they had received.
Carer Wellbeing – Clare Rachwal, Team Manager, Portsmouth Carers Service, Adult Social Care
A presentation was delivered by Clare Rachwal providing an overview of the support for carers provided by the Portsmouth Carers Service. Key points raised in the presentation included the following:
· The NHS GP Patient Survey 2019 showed that carers’ health and wellbeing was worse than the general population, 61% of carers reported a long-term condition, disability, or illness compared with 50% of non-carers.
· Research by Carers UK into carers’ health and wellbeing found that most of those providing substantial care had faced mental ill-health and physical ill-health as a result of caring. Specifically, 6 out of 10 people (61%) say their physical health had worsened as a result of caring, while 7 out of 10 (72%) said they had experienced mental ill health.
· The national policy context in support of carers was strong and, pandemic permitting, getting stronger. This included the NICE Guideline Supporting Adult Carers published in Jan 2020: and the NHS England – GP Quality Markers & NHS England – Commitment to Carers.
· Portsmouth Carers Service is based within Adult Social Care, it was previously based in a joint public health and prevention service.
· It has been responsible for Carers Assessments since 2009. The Carers Centre is a community hub for a range of carer activity including groups, training, cooking activities, events.
· Early intervention and prevention ethos seeking to reduce social isolation, promote physical activity and healthy eating, increase carer knowledge
· Staff are aligned with key community organisations including Positive Minds, Re:Minds, Parent Carer organisations, Learning Disability services, Older Persons Mental Health.
· In 2017/18 they radically redesigned the assessment and support planning process based on what carers wanted. Carers assessments now: Start at first contact, are proportionate and scalable; Barriers are removed – no forms, open conversation in a way that suits the carer; Whole family approach where wanted, combined or joint assessments – work in progress; Focus on what matters - regularly includes health and wellbeing.
· Carers breaks and Personal Health Budgets (PHB) - Where breaks are provided through a prepaid card direct payment they are counted as a PHB.
· Portsmouth offers a wide range of breaks options e.g. weekly coffee, break away, hair/beauty services, sports/crafting/hobby equipment, part payment for gym membership, kindle, TV subscriptions.
· Replacement care includes 6 hours a week sitting service (maximum) or equivalent via direct payment, two block purchased respite beds chargeable at LA rate for self-funders. Telecare/tech-based solutions also available.
· The service benefits from being within Adult Social Care, opportunities for the social care team to help before crisis point is reached. Service still has a lot to do but it offers value for money, invest to save.
· Links with GPs are mixed. Some practices are excellent, some have adopted GP quality markers, some have not engaged. Working with Solent NHS Trust to increase identification of carers.
Solent NHS Trust’s Commitment to Carers – Sarah Balchin, Associate Director Patient Experience, Solent NHS Trust
A presentation was delivered by Sarah Balchin providing an overview of Solent NHS Trust’s commitment to carers. Key points raised in the presentation included the following:
· There has been an increase in demand for support from carers, especially during the pandemic.
· The commitment of the Trust to listen to, and hear from, carers.
· Involving carers in decisions about care and treatment.
· The value of early identification of carers in reducing barriers to health prevention activity.
· Improving identification and support for carers working for Solent NHS Trust.
· The need to improve support for people transitioning between services to make it easier and safer. The NHS is poor at this.
Southern Health NHS Foundation Trust’s work with carers – Dawn Buck, Head of Patient and Public Engagement and Patient Experience & Amelia Abbott, Patient and Public Engagement – Southern Health NHS Foundation Trust
A presentation was delivered by Dawn Buck and Amelia Abbott on the work being undertaken by Southern Health to support carers. Key points raised in the presentation included the following:
· Southern Health are improving the support being provided to carers. For example, the Trust is delivering the Joint Carers Strategy for Carers (in partnership with Hampshire County Council); has established a Carers, Families & Friends group; Coproduced an organisation plan for Carers & their Families, and; developed carers webpages.
· Additional support has been provided to carers during the lockdown.
· Southern Health is working towards accreditation for the Triangle of Care initiative. ‘Triangle of Care’ is a national initiative launched by the Carers Trust. This initiative promotes the importance of involving carers, alongside service users and staff. Southern Health is working hard to embed the Triangle of Care standards within its work.
· So far in Southampton 176 members of staffed have been trained in being carer aware and in engaging with carers, and, 27 carers leads have been identified.
· Moving forward the Trust will be coproducing a service model for Patients and Carers Advice, support & Liaison; sending letters to all GP practices regarding registration of carers in order to look after their health & wellbeing; supporting the implementation of the Trust’s Carers Plan; developing toolkits to support staff to collaborate with carers; looking towards co-developing Carer Peer Support Worker roles within our services.
· The Trust needs to work closer with SCC and Carers in Southampton.
Adult Social Care and carers – Sharon Stewart, Head of Service for Adult Social Care & Louise Ryan, Service Manager for Social Well-Being - Southampton City Council
A presentation was delivered by Sharon Stewart and Louise Ryan. Key points raised in the presentation included the following:
· Adult Social Care (ASC) works in partnership with Carers in Southampton to provide assessments and support plans for those who are caring for people who reside in the city.
· The National Carer’s Survey is conducted every two years. The 2018 survey results have not been as we had hoped in Southampton and it shows a need to improve.Overall, only 37 % of respondents were extremely or very satisfied with the support or services that they, and the person they care for, have received from Social Services in the last 12 months.
· An action plan is required to rectify and improve the outcomes for carers in Southampton.
· This cannot be just an ASC or City Council response. It needs to be broader working across the city, including housing, health, employees and the voluntary sector and moving beyond just delivering against our statutory duty.
· There is a need to learn from complaints and to address inconsistencies. To improve information, advice and guidance to carers, reflecting that carers are individuals and a one size fits all approach is not the solution to ensure that help and support is provided when carers need it.
· ASC recognise the need to listen more effectively to carers; To engage them in the development of the service offer; To consider wellbeing as a fundamental part of the Care Act Assessment; To link the Carers assessment with the person receiving support, and; To offer regular planned support and prevention such as telecare and housing to carers.
· ASC enjoy a good relationship with Carers in Southampton, this is enhanced by having an ASC employee working within Carers in Southampton.
· ASC also has strong relationships / partnerships with health colleagues.
· Services can be delivered in different ways by different local authorities. Portsmouth offer hours of free time to carers. In Southampton between 400 to 500 carers receive direct payments of between £15-£45 per month (not means tested) if they meet eligibility criteria and resource allocation requirements, to support their wellbeing in line with the carers support plan.
· This is probably just the tip of the iceberg however, reflecting on the potential 30,000+ unpaid carers in Southampton.
Supporting documents: