Agenda item

CARER FRIENDLY Southampton – supporting carers in their caring role

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 – Young carers Alex, Ellie-May, Leah, Zunayrah

·  A vox pop outlining the views of young carers was played to the Panel, and 3 young carers, Leah, Ellie-May and Zunayrah, supported by Jo Payne from No Limits, informed the Panel about their experiences.

·  Additional support in schools; considering the views of young carers during health assessments; an awareness day or a session in a PSHE lesson in school about young carers; support with transitioning to adult services; and, a young carers card were among the issues identified by the young carers as initiatives that would help them.

A carers perspective – Adult carer Claire

·  A vox pop outlining views of adult carers on the support they receive in their caring role was played for the Panel.  In addition, Linda Lawless, Service Manager at Carers in Southampton, interviewed Claire who is a single parent and carer for 2 sons, one who is 26 and is severely autistic, and a 14yr old on the autistic spectrum.

·  The vox pop identified the challenge transitioning to adult services. Most children do not go directly to adult mental health services from CAMHS.  Processes and language simplification was also raised (Re:Minds group develop their own leaflets to help carers and CAMHS have asked for these to be drafted) as was waiting lists, resources, training for carers and assessments.

·  Claire found accessing Social Care to be a challenge.  Knowledge of the system is essential as it is difficult to know where to go to in order to access care.  Claire identified the transition from children’s services to adult services to be a difficult time.  Great Oaks School were helpful but for carers and children the 16-18 age is daunting.

·  Mencap and Rose Road provide paid for support via Direct Payments.  No training has been provided on how to be a carer and Claire would have welcomed peer support, but she now offers this to new carers. 

·  Resources and time limited the City Council’s ability to support her.

Hampshire Young Carers Alliance – Lee Culhane

• A presentation was provided by Lee Culhane. The Hampshire Young Carers Alliance (HYCA) is a consortium of ten Young Carer projects/services within Hampshire.
• Hampshire - 4,109 Young Carers identified in the 2011 Census, 1272 registered as Young Carers on the projects, 1,449 supported over the year 2019-2020.
• The overall aim and vision was to develop a single county-wide voice, advocating and championing Young Carers across the county.
• The consortia has allowed stronger relationships to evolve with key stakeholders, ensuring an overarching aim of ongoing quality, consistency and sustainability moving forward.
• Developed a countywide, consistent approach in managing referrals, reviews and ‘step-down’ process.
• Strong links to Hampshire’s Children’s Services Family Support Service, with appropriate challenge made from both sides.  Stronger links with Hampshire’s Adults’ Health and Care Department ensuring that conversations relating to Carers involve Young Carers.
• Referrals come from numerous sources, including self-referrers and family members.
• HYCA are represented on the newly formed Hampshire Carers Partnership Board.
• Areas of focus include: Encouraging a whole school approach; developing stronger links with health (recognising impact young carers have on reducing NHS costs).
• Covid 19 has changed how HYCA operate.  New ways of working have mitigated transport challenges. Developing a relationship with No Limits.

Personalised Care and how it can help to support young carers and adult carers – AlisonFroude, Delivery Partner, Personalised Care Group, NHS England & Improvement

• A presentation was delivered by Alison Froude.
• The NHS Long Term Plan states that personalised care is one of the five major, practical changes to the NHS that will take place over the next five years.  It states that ‘People will get more control over their own health, and more personalised care when they need it’.  It also states that “Personalised care will become ‘business as usual’ for 2.5 million people across the health and care system by 2024”.

• Personalised Care is a shift in relationships between health and care professionals and people.  The Golden thread is ‘What matters to me’.
• The Personalised Care implementation plan has three actions specifically that focus on carers:

o  Action 2 – take a whole family approach

o  Action 13 - explore new rights to have personal health budgets (PHBs) for carers

o  Action 14 - test, gather best practice and build the evidence for PHBs for carers; Identify actions on how the Personalised care model works for carers, working with relevant representative organisations.

• Social prescribing - Carers should have access to social prescribing in all areas of England through referral to a social prescribing Link Worker from primary care and other agencies such as local authority social care teams. This includes both adult carers and young carers.
• 2 additional roles in primary care that could help carers:

o  Health & Wellbeing Coach - Can work with a carer to identify what’s important to them, set personal goals and appropriate steps, build skills and confidence to achieve goals, and use problem solving to work through challenges.  They can support carers by working with them to develop their knowledge, confidence and skills to take control of their own health and wellbeing and to do more of the things in life that brings them joy.

o  Care Coordinator - Can work with a carer to ease the potential burden of navigation and coordination across multiple health and care services. These roles will work with the carer to support them and may direct them to one of the recognised supported self-management interventions:  health coaching, peer support and self-management education.

• In Southampton 2 out of the 6 Primary Care Networks (PCNs)are commencing recruitment of care co-ordinators.  Personalised Care increases opportunities for designing creative solutions for improving carers outcomes.
• Continuity of approach with Social Care and consistency of offer is essential as carers move between services and funding streams.

Personalised Care and Strength Based Approach: how it works for carers in Southampton – Moraig Forrest-Charde, Deputy Associate Director, Integrated Commissioning Unit; Louise Ryan, Service Manager for the Social Wellbeing Service, Adults Wellbeing and Health, SCC & Carl Adams - Head of People Participation/ Clinical lead Community Specialist Service, Solent NHS Trust

·  A presentation was delivered by Moraig, Louise and Carl.

·  In Southampton multiple things are happening under each of the 6 key stages for Personalised Care and Support.

·  Moraig - 3 key things getting traction in Southampton are:

·  Louise - Adult Social Care have adopted the 3 Conversations Model, a strengths-based approach for assessment and care planning within Southampton.These conversations are suitable for Adults and Carers.

• The first conversation explores an adult’s strengths, and connects them to personal, family or community resource that can offer support. Within that conversations with family/carers and involvement is key.
• The 2nd conversation is led by the adult to assess risks in their lives and to plan for any crisis that may occur.
• The 3rd conversation is planning for long term needs and outcomes.  Based on what a good life looks like to that person.  Drawing on resources available including personal budgets, personal skills and community assets.
• SCC’s approach is similar to Portsmouth’s with direct payments that focusses on wellbeing activities for the carer.  Uptake for this is increasing each month.
• We need carers to be clear about their support plan; ASC want to increase the number of carers assessments undertaken and recorded by the Council; and joined up care and support plans between adults and carers.
• Carl – Working with a group of health professionals across the local health system to encourage behaviour change and the delivery of personalised care.
• WASP (Wessex Activation and Self-Management Programme) bespoke tool developed to improve personalised care – 12-week tailored programme.
• Real change is happening through the WASP tool in the delivery of personalised care.
• Opportunities for changes to systems driven by the health professionals.  SystmOne template makes it easy to refer to social prescribers to reduce burden.
• Behaviour change is happening with a shift away from the medical model to a collaborative model.  The model can be applied across adult social care and the voluntary sector.

Parent Carers report – Vickey Kowal, Co-ordinator of the Parent Carer Forum

• A presentation was delivered by Vickey Kowal.  There is a statutory obligation for every area to have a Parent-Carer Forum.  Southampton is good at co-production and involving parent carers in proposed changes.
• Significant challenges faced by parent carers in Southampton – Vickey identified the following:

o  Lack of easy access to information

o  Lack of recognition of needs of parent-carers

o  Lack of emotional support

o  Lack of practical support

o  Financial and housing support

o  Breadth of SEND and therefore challenges faced by parent-carers

o  Only small percentage of parents are able to access carers assessment (statutory requirement) those that do access aren’t involved in their own assessment

o  Communication

o  Parents not seen as experts in their child

o  Many families have more than one child with SEND

o  For many this is a lifelong role, different needs at different times

• A new model is being proposed in Southampton called the iThrive Model that puts the child and family at the centre of the model.  Model being used in CAMHS and the Council is considering using this model for families with SEND.  Moving from a referral culture and a service led approach.
• Vickey identified a number of recommendations including:

o  Ensure all parent-carers have access to a carer’s assessment

o  Parent-carers treated equitably with other carers

o  Cultural change from ‘service led and child focused’ to ‘needs led and family focused’

o  Increase the number and variety of parent support groups across different areas of SEND and geographical areas of the city

o  Support proposed changes to adopt iThrive model

o  Provide Parent support for managing children and young people with challenging behaviour

o  Ensure timely access to an increased range of parent training and education courses

o  Improved communication between professionals/agencies as well as with parents.