Perth and Kinross Joint Adult and Young Carers Strategy 2023-2026

Carer support in Perth and Kinross

At the time of writing, National Census for Scotland statistics have not yet been published. Link to Carer statistics on Carers Pages on pkc.gov.uk when available.

Identifying carers

We estimate that approximately 2,800 adult carers are registered across PKAVS, Perth and Kinross Health and Social Care Partnership and at the Perth and Kinross Carers Support Project at Change Mental Health (formerly Support in Mind), which is an increase since our last Strategy. This suggests that up to 80% of adult carers might be missing out on preventative support, information and advice that might assist them in reducing the impact of their caring role. Whilst this likely includes a proportion of carers who do not feel they need or want support, there is still a disparity between the number of carers in the 2011 census and the number of carers registered for support in Perth and Kinross. At the time of writing, we do not have information from the most recent National Census, but we anticipate that there will be a greater number of carers identified, not least following the COVID-19 pandemic where many people took on caring roles or increased the amount of unpaid care they provided. Statistics will be available on the Supporting Unpaid Carers pages of pkc.gov.uk when published.

Timescales for completing Young Carer Statements and Adult Carer Support Plans

When we receive a referral from a carer or third party on behalf of the carer to receive information, advice and/or support, we will consider the priority and urgency of each situation. When it is brought to our attention that urgent support is required, we will prioritise this. Demand for services is generally high and may be subject to external factors which are out of our control. However, we aim to provide carers with:

• Young Carer Statements within 12 weeks of their request
• Adult Carer Support Plans within 10 weeks of their request

These timelines will be kept under review to ensure that we are meeting needs appropriately.

Current support available in the local area

Short Breaks Services Statement

Perth and Kinross HSCP's Short Breaks Services Statement contains a more extensive list of the short breaks services available for carers locally and nationally. This has been reviewed as part of the refresh of the Strategy. The list below provides information about support currently available to carers from commissioned services and other agencies.

Local resources for young and adult carers

• PKAVS Carers Centre has three separate services to support carers from school age upwards. It provides a range of information, advice, and support to carers. Types of support include respite and activity groups for young and young adult carers, social (massage) therapies, carer cafes, training opportunities, short breaks, day services for people with long-term conditions or disabilities, telephone befriending service, one-to-one support from dedicated carer support workers, Self-Directed Support advice, and up-to-date information about different resources available in their local community. Information and support in completing emergency plans can also be provided, as well as peer support for unpaid carers whose role has changed due to bereavement or when the cared-for person enters long-term residential care (the 'Bridge Project').
• Crossroads primarily aims to provide respite care for carers in the community, with home- based respite and domiciliary care service for adults with any of the following: mental health issues, dementia, physical disabilities, learning disabilities, or other serious health conditions.
• MECOPP (Minority Ethnic Carers of People Project) works with Gypsy/Traveller carers of any age across Perth and Kinross who live in housing, on sites and in roadside camps. The support includes outreach work, community-led research, filmmaking, limited case work and training.
• Change Mental Health is a Mental Health Organisation providing information and support for people who have mental health problems or mental illness and for their families and carers. It runs a Carer Support Project in Perth and Kinross, providing individual support, as well as a range of information and advice.
• Alzheimer Scotland is the local point of contact for people living with dementia, family members, carers, and communities.
• Independent Advocacy Perth and Kinross provides information and advocacy support when needed by carers.

There is also a range of universal services available such as leisure centres, libraries, support groups and emotional support.

Statutory services support for young and adult carers

Perth and Kinross Health and Social Care Partnership can provide a range of services to meet the carer's identified needs in their Support Plans. Perth and Kinross Council's Education and Children's Services can support with access through the Carers Centre for young carers with a Young Carers Statement and access to appropriate services. These include arranging care for the cared-for person, day care services, short breaks/respite, telecare support, emergency carers card, and rapid response.

Health Services will provide support at the point of diagnosis, along a health pathway, for the ongoing care and treatment and with discharge from hospital. Hospital discharge planning is also supported by a dedicated hospital link worker, social care officer and palliative carer support worker.

Social Prescribers offer signposting and support for people to access and use community- based activities, to help address influences which contribute to health problems, with the aim of improving health and wellbeing.

Perth and Kinross Council Welfare Rights Service offers advice and information on benefit entitlements when circumstances change, when carers are struggling financially or when they have been turned down for a benefit or are unhappy about a benefits decision. Under Carers (Scotland) Act, carers have a right to information about income maximisation to ensure they receive the benefits they are entitled to. Carers may also find it helpful to speak to Citizens Advice who can help with form filling as well as providing advice on benefit entitlement and any other help they may be able to receive locally.

Progress summary

External context

COVID-19
Progress on our Carers Strategy 2019-2022, which was approved by our Integration Joint Board and Lifelong Learning Committee on 6 November 2019, was soon impacted by the COVID-19 pandemic and the restrictions placed on all of us to reduce the spread of the virus.

These restrictions had an immediate effect on carers and the people they care for, from the reduction in availability of support for the people they care for, access for medical appointments, and the requirements around protective coverings. Many carers were rightly worried about the risks of introducing COVID-19 to the home of the person they care for and there continue to be concerns around this. Some people who had not been carers prior to the pandemic became carers as they looked to support more vulnerable members of their families, during the initial lockdowns when normal activities like shopping and moving outdoors were restricted.

In partnership with the Carers Centre, we initially responded by increasing the telephone contact with unpaid carers, following this, the Carers Centre was a point of contact for PPE (Personal Protective Equipment) for unpaid carers including deliveries to carers who could not travel. We also set up a short-term sitting service to enable carers to have a break from caring whilst their loved ones were looked after. This service ended in September 2020 as commissioned services were able to re-establish cover.

We appreciate that some carers remain concerned about COVID-19 as it continues to circulate in the wider community, and whilst most of the population have received vaccination cover, vaccinations may not be available to all due to health conditions. Ongoing support is available to carers from Scottish Government and through Scottish National Health Service.

Cost-of-living crisis
The cost-of-living crisis is an ongoing concern to many carers. Prior to this, carers were still subject to financial insecurity due to the costs associated with looking after someone with a disability, such as heating, power for equipment, special dietary needs etc. This may also have been exacerbated by restrictions on carers' earning if they are in receipt of Carer Allowance and the likelihood of them having to reduce hours of work or stopping work due to their caring responsibilities. Some of the costs have been mitigated by government interventions however, carers have recently reported taking out loans and getting into debt due to the increased costs of daily living. Scottish Government funds through Shared Care Scotland were made available through a hardship fund in early 2022 which was administered by the Carers Centre locally.

Progress on our Outcomes

Despite the challenges we faced due to the COVID-19 pandemic, and the many challenges faced by carers we were able to make good progress on our Joint Carers Strategy 2019-2022.

• Outcome 1: Provide clear, reliable, accessible information about local and national support which is available across a wide range of locations in Perth and Kinross
  We used a variety of methods to provide information to carers about the support that is available for them. The restrictions brought about by the pandemic made it necessary for us to provide information in new and innovative ways including online and hybrid presentations for Carers Connect and Carers Weeks. We also promoted support for carers with banners and advertising at the Vaccination Centres set up in Perth and Kinross throughout the pandemic. We used digital advertising, podcasts and had a takeover of the Perth and Kinross Council's Facebook page for Carers Weeks. We also revised our core information with assistance from Carers Voice to create a single booklet which we promoted across Perth and Kinross, working with CulturePK. We also worked with Perthshire Welfare Society to improve the support available to carers from the global ethnic majority. All this work is ongoing to ensure that as many carers from all backgrounds and communities as possible know how to access support to enable them to continue caring.
• Outcome 2: Promote awareness about the Carers Act in the local community and workplaces to improve early identification and support of carers
  We developed training materials for professionals about carers' rights and the support which is available which we commenced in November 2021, investing in a dedicated Learning and Development Officer in 2022 to embed and progress this training. Individual locality and community support teams and our volunteer support agencies are all carer champions.

We worked with Carer Positive to engage with employers in the area however, we were unable to increase the number of employers with Carer Positive accreditation. We will however continue to engage with local employer groups and individual employers to promote Carer Positive to ensure the early identification of working carers, and provide better support to working carers, in line with the Scottish Government's Fair Work agenda.

• Outcome 3: Ensure carers are listened to and have their opinions valued by professionals
  We have worked to provide support to carers looking after someone in hospital with our Hospital Link Worker and invested in a Palliative Carer Support Worker and Social Care Officer to improve the identification of carers to involve them in the discharge process and provide support to them. Our investment in a dedicated Palliative Carer Support Worker has enabled us to meet the timelines for carers who support people with a terminal diagnosis in accordance with the Terminal Illness Regulations, introduced in July 2021 to provide immediate support for the carer when facing a life-changing situation. Alongside our locality Carer Support Workers, we also have dedicated Carers Support Workers in i-Dart, Older People's Services and in the SCOPE team supporting families as young people with complex needs transition from school.

Training has been provided to Social Work professionals in both the Health and Social Care Partnership and Education and Children's Services to ensure that they involve carers as much as possible in planning the support for those who they care for. We will further develop this training to widen the scope and include healthcare professionals. We developed the Carer Experience Survey so that we can be sure that the health and wellbeing of carers is supported and to highlight areas for improvement.

• Outcome 4: Provide opportunities for carers to participate as active partners to the planning and shaping of carers' services in their local areas including services for the people they care for
  We have listened to carers' suggestions on how to improve support for carers over the lifetime of the previous Strategy, involving carer representatives as equal strategic members in our Strategy Group, working groups, and in the Strategic Planning Group. Carer representatives are also non-voting members of the Integration Joint Board, ensuring carers' perspectives are represented across the Partnership. Carers and their representatives have been involved in the development of the refreshed Strategy.

We were also part of the Carers Trust pilot training programme to give carers an insight in to how they can represent the views of carers in their area to improve services. We have identified Parent Carers as a care group who are often overlooked and have engaged with local Parent Carers as part of the Promoting Variety project to improve the support they use through co-production. We have listened to carers through consultations and working together alongside national initiatives through the lifetime of the Strategy, however we will continue to explore better ways of supporting carers.

• Outcome 5: Develop wider carer networks to enrich peer support
  We have worked with Richmond Community in Crieff from June 2021 and Dementia Friendly Aberfeldy from February 2022 to establish local carer cafés and enable improved peer support. Our café in Blairgowrie in partnership with Elder Voice commenced in April 2023. We have continued to support PKAVS in developing online and offline peer support for carers across the area including the establishment of a Carers' Choir 'Gie it Laldy', which meets weekly at Perth Theatre and is open to carers and those they care for. We worked with Carers Voice to listen to the concerns of carers and to ensure those concerns are addressed with information and support.
• Outcome 6: Improve provision of flexible and personalised support, to support the emotional/physical wellbeing of carers and to support them to have a life alongside caring
  The wellbeing of carers is supported through the Carers Centre which provides Social and Complementary therapies, Time for Me grants which enable carers to have a short break and the telephone befriending service in which we further invested in from 2021 to provide out of hours support. Training opportunities, which give carers the skills and tools to support themselves and those they care for, are provided through services commissioned from the Carers Centre and at New Rannoch Older People's services. These were delivered as in-person and online sessions to cover a wide range of topics including Legal Must-Dos and Power of Attorney, Adult Support and Protection, Moving and Handling, Self-Directed Support and Technology-Enabled Care. Self-Directed Support is key to improving personalisation of support to carers and we have been working with other local authority areas to see how we can improve to make this easier for carers.

Based on feedback from carers we have supported the introduction of the Community Tipi - a large mobile Tepee with a wood-burning stove, which is available for use by community groups supporting carers. This will continue to be rolled out in the next few months. We are also seeking to establish volunteer befriending interventions to improve support where regulated services are, or are not involved.

Through the Carers Centre and our Social Prescribers, we are involved in supporting community groups to ensure that our services and support are sensitive to cultural differences. Through provision of support in the community we have reduced the percentage of admissions to long term care due to carer breakdown from 30% to 16%. We have reviewed current supports to assess their adequacy for support to carers and we will continue to look for ways to improve the support for carers, particularly in rural areas, through the life of this strategy.

• Outcome 7: Young carers will have the best start in life and will be supported to achieve their potential irrespective of their caring responsibilities
  As at March 2023 there are 613 registered young carers with the Young Carers Service. During 2022, 172 Young Carers Statements, which identify the young carers' needs outcomes, were completed for newly identified young carers, enabling us to signpost them to the appropriate agencies for support. There is, however, a backlog of Young Carers Statement Reviews as completion of Statements have had to be prioritised.

173 young carers accessed the Education Attainment Service, with tutors delivering 1,231 individual tutoring sessions. There have been 30 weekly primary tutor groups with an average of 15 young carers in attendance and 30 weekly nurture groups provided.

All 11 secondary schools and 48 feeder primary schools have a designated young carers champion who have quarterly meetings with PKAVS/Young Carers Social Worker to discuss issues, challenges, share information and best practice.

150 young carers have accessed alternative respite funds for respite opportunities within their communities and 50 young carers applied for Time4me funding for short breaks through Shared Care Scotland. We also supported day trips, drop-in sessions and outcome focussed groups. Over 250 young carers and their families attended the PKAVS Christmas Extravaganza.

Mental wellbeing support has been provided through partnership working with Mindspace, Saints in the Community and All-Strong Scotland.

Preschool-age young carers are the responsibility of the NHS for young carers support.

Young Carers Voice forum meets every 2 weeks to discuss challenges being faced by young carers and any additional support they may require. The Young Carers Voice Forum will be establishing a sub-group around mental health for young carers.

The Young Carers' Social Worker is available for advice and guidance to the Social Work teams and has attended Team Meetings to share information. More widely, the PKAVS Young Carers' Service is first point of contact for all agencies who have enquiries or wish to discuss referrals.