Commissioning for carers

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Toolkit

Young Carers In Schools - A Toolkit for Local Authorities

Legislation into Practice: Making the Children and Families Act 2014 and the Care Act 2014 a Reality for Young Carers
Area of Care: 
Mental HealthPhysical illnessAlcohol MisuseSubstance MisuseSpecial education needsPrimary CareSecondary Care
Outcomes: 
PreventionWellbeingCarer awarenessIdentifying carers
I work in: 
Information and adviceCommissioning for carersCommissioning for young carersSocial careEducationCommissioning
I work with: 
Young carersParent carersSibling carersFamilies
Caring for: 
Young peopleChildren
Location: 
England
Date Revised: 
Tuesday, November 13, 2018 - 15:45
Body: 

A resource for local  authorities working with schools to identify and support young carers. 

This resource supports the case for the effective and economic ways that local young carers services offer both preventative and responsive support for young carers and their families. 

It sets out the case to include the Young Carers in Schools Programme in all aspects of educational support and how this would support local authorities to ensure they fulfil their statutory duties as set out in the Children and Families Act 2014 and the Care Act 2014. 

Most importantly it will ensure positive outcomes for young carers and their families. 

PDF iconLegislation into practice toolkit pdf

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Guidance

Flu Vaccinations for Carers campaign - useful resources

NHS Employers and Carers Trust produced flu campaign guidance and resources in 2014 which healthcare staff can download .
Area of Care: 
Primary Care
Outcomes: 
PreventionWellbeingCarer awarenessIdentifying carers
I work in: 
Primary careHealth and wellbeingPharmacy ServicesCarers servicesInformation and adviceCommissioning for carersSocial careCommissioning
Location: 
England
Date Revised: 
Friday, May 4, 2018 - 09:15
Body: 

Help reach carers across the whole community

NHS Employers and Carers Trust  produced flu campaign guidance and resources in 2014. Carers Trust also produced a set of resources aimed to be used by a wide range of organisations to as well as individuals to encourage flu vaccination uptake among carers. The resources also encourage carers to get in touch with Carers Trust for details of their local carer service. 

The Word versions of each resource were designed to be customised to include your organisation’s own logo.

Further details

For more information about the Flu Vaccination Campaign for Carers, please email Carers Trust.

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Good Practice

Supporting Carers in Primary Care Learning Event

Carers Trust hosted the Supporting Carers in Primary Care Learning Event in November 2014. The event brought together over 100 professionals from across the sector who work to identify and support carers across primary care.
Area of Care: 
Primary Care
Outcomes: 
PreventionWellbeingIntegrationHealth inequalitiesCarer awarenessIdentifying carers
I work in: 
Health carePrimary careMental health careHealth and wellbeingCarers servicesInformation and adviceCommissioning for carers
I work with: 
Adult carersParent carers
Caring for: 
AdultsOlder adultsYoung peopleChildren
Location: 
England
Date Revised: 
Friday, May 4, 2018 - 09:00
Body: 

Carers Trust hosted the Supporting Carers in Primary Care Learning Event in November 2014. This annual event was funded by the Department of Health as part of the wider Supporting Carers in Primary Care programme. 

The large scale event brought together over 100 professionals from across the sector who work to identify and support carers across primary care. 

The day provided an excellent opportunity for sharing information and good practice and the additional networking hour at the end of the day provided the ideal opportunity for delegates to reflect on what they had learnt together. The  evaluation feedback demonstrates that delegates found the day both informative and useful.

The programme

Rick Bolton, who cares for his four-year-old son led the day, sharing his account of what being a carer means to him. Delegates heard from a variety of expert speakers including Wendy Nicholson, Professional Office for School and Community Nursing at the Department of Health, Jen Kenwood, Head of Patient Experience – Community, Primary and Integrated Care at NHS England and Moira Fraser, former Interim CEO and Director of Policy at Carers Trust, as well as taking part in a selection of workshops. 

View the presentations

The event presentations will be useful for staff from carers services and other organisations who support carers in primary care.  You can also preview what was covered in the workshops. 

Supporting Carers in Primary Care Learning Event – view the presentations

 

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Good Practice

Supporting Carers in Primary Care Learning Event – presentations

View the presentations from the Supporting Carers in Primary Care Learning Event that Carers Trust hosted in November 2014.
Area of Care: 
Primary Care
Outcomes: 
PreventionWellbeingIntegrationHealth inequalitiesCarer awarenessIdentifying carers
I work in: 
Health carePrimary careMental health careHealth and wellbeingCarers servicesInformation and adviceCommissioning for carers
I work with: 
Adult carersParent carers
Caring for: 
AdultsOlder adultsYoung peopleChildren
Location: 
England
Date Revised: 
Friday, May 4, 2018 - 09:00
Body: 

These presentations will be useful for  staff from carers services and other organisations who support carers in primary care.  You can also preview what was covered in the workshops. 

Morning plenary presentations 

Policymaking to primary care practice making it happen at the sharp end (Moira Fraser, former Interim CEO and Head of Policy, Carers Trust)

Moira Fraser explained that much needs to be done to turn the rhetoric into reality and overcome the barriers facing carers organisations working with the NHS to identify carers. 

Cosying up: how CCGs can partner carers (Dr Michael Taylor, Lead GP for Carers Services at Heywood, Middleton and Rochdale CCG)

Find out which strategies Dr Michael Taylor recommends to improve support for carers by working in partnership with CCGs.

RCGPs supporting carers in general practice programme (Dr Nazia Mohammed, Clinical Champion for Carers, RCGP)

Dr Nazia Mohammed provided an overview of the College’s work to improve carer identification and support in general practice.

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Morning workshops 

Delegates were able to choose between the following morning workshops:  

How to network effectively across the health economy to maximise support for carers (Michelle Pilling Lay, Advisor Quality & Patient Experience, East Lancashire CCG)

An overview of the current landscape in health and the opportunities to maximise the impact of the Primary Care Identification Worker.

GP audits and GP investors in carers standard accreditation (Louise Shaw, Primary Care Lead & Carer Assessment Support worker and Hazel Wright, Adult Services Manager, Northampton Carers)  

Outlines the successes and challenges of co-produced primary care Interface work over five years with specific focus on the implementation of annual audits and the launch of Northamptonshire Investors in Carers Standard accreditation.   

Developing and maintaining a carers links network in Salford (Julia Ellis, former Development Manager for Primary Care and Outreach, Carers Trust)

Provides an overview of the successful and well-established Carers Links Network in Salford. Learn how the service that provides 300 referrals per annum from the primary care sector was established, developed and maintained.

Effective monitoring and evaluation tools to assess the impact of emotional support services for carers (Clare Edwards, Carer Health Worker, West Cumbria Carers)

Explores how to effectively assess the impact of services in supporting carers’ mental wellbeing using questionnaires developed by NICE.  

We also held a workshop on young carers which was  led by Rick Bolton, Dr Nazia Mohammed and Daniel Phelps. It was agreed we all need to work together to generate a culture of change and focus on developing good long term relationships to encourage lengthy engagement. Solutions discussed included:

  • A whole family approach - ensuring young carers are identified when parents present with chronic illness for example.
  • GP awareness training - the same read code would be used for young carers as adult carers.
  • Remembering that primary care is much wider than GP surgeries.
  • NHS employees’ awareness training.
  • Continued identification through schools / colleges.
  • Identifying young carers early through health visitors and children’s centres.
  • Importance of relationships such as a long-term relationship between pharmacy staff and families.
  • Professionals having the awareness of young carers and the confidence to ask appropriate questions.
  • Important to find champions with passion to drive work forward in own establishments.

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Afternoon plenary presentations

Community pharmacy - how can it help support carers (Alastair Buxton, Head of NHS Services at PSNC) 

Describes the community pharmacy services which can support carers and the Carers Trust / Pharmaceutical Services Negotiating Committee pilot to test carer identification in community pharmacies in England.

Supporting the health and wellbeing of carers (Wendy Nicholson, Professional Officer for School and Community Nursing at the Department of Health)

Demonstrates that community nurses are keen to extend their understanding of carers’ needs and to ensure carers’ wellbeing needs are met.

Further guidance on supporting adult carers through community nursing can be found on the Supporting adult carers through community nursing page.

NHS England commitment to carers - can it make a difference (Jen Kenwood, Head of Patient Experience – Community, Primary and Integrated Care, NHS England)

Described NHS England’s commitment to carers, which comprises 37 commitments spread across eight key priorities, from raising the profile of carers to person-centred coordinated care. 

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Afternoon workshops

Delegates were able to choose between the following afternoon workshops:

The carers health team: a methodology to prevent carers falling between the gaps in our systems (Geoff Coleman, Chief Executive, Crossroads Care South Central)

Explored using a collaborative approach to support carers involving a partnership between Crossroads Care, Carers Health Team (NHS) and Carers Support West Sussex.

Carer awareness training for pharmacies (Anne Cole, Regional Manager South West, CPPE)

A guide to the new carer-awareness training resources for pharmacy teams co-produced by the Centre For Pharmacy Postgraduate Education (CPPE) and Carers Trust to improve the identification and referral of carers and how this fits into the Carer Friendly Pharmacy Pilot.

Supporting carers through integrated care (Helen Brown, Health Development Lead Carers Resource, Harrogate) 

Evidences the value of providing support for carers by establishing a service for carers within Integrated Care Teams. It highlights the success of the service in identifying and reaching out to ‘hidden’ carers and the benefits to all the multi-disciplinary professionals involved.

Supporting carers through e-learning for community nurses (Jennie Whitford – Carers Project Manager, QNI) 

Explores the digital Carers Resource for community nurses which has been developed by The Queen's Nursing Institute in collaboration with nurses working in the community.

 

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Good Practice

Supporting carers of people with dementia in black, Asian and minority ethnic communities

A good practice example of working with carers of people with dementia from diverse communities by the Dementia Information and Support for Carers (DISC) service hosted by Sandwell Crossroads Birmingham
Area of Care: 
Mental HealthPhysical illnessSpecial education needsSpecialist servicesDay centreRehab CentreHospitalCare homesDementia care
Outcomes: 
Carer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsMental health careHealth and wellbeingPharmacy ServicesCarers servicesCarers involvementCarers breaksInformation and adviceCommissioning for carersCommissioning
I work with: 
Adult carersFamilies
Caring for: 
AdultsOlder adults
Location: 
Whole UK
Date Revised: 
Monday, April 30, 2018 - 13:45
Body: 

DISC Dementia information and support for carers

The Disc Service was launched 11 years ago, it is hosted by Sandwell Crossroads and funded by Sandwell and West Birmingham, Cross City, South Central CCG’s, and Birmingham City Council through the Birmingham Bettercare Fund

The service originally operated in West Birmingham, but had funding extended to cover the entire Birmingham City Council area.

The service is focused on supporting carers from the diverse communities in the Birmingham area. The DISC service prides itself on being proactive in recruiting staff from local black, Asian and minority ethnic (BAME) communities who have both the language skills and understand the cultural sensitivities.

The service supports over 400 carers and offers Iiformation, advocacy and support for carers, though one-to-one contact and successful weekly information and support groups.

It also offers a signposting and referral service into other local statutory and voluntary sector services.

Examples of the type of help and support carers have receive:

  • Accessing respite
  • Liaising with district nurses, occupational therapists and social workers.
  • Continence advice and support.
  • Advice in managing changing and unusual behaviours.
  • Finding the right care such as day centres, care homes and care agencies.
  • Talking to the wider family.
  • Advice on benefits and carers' rights.
  • Information on the Mental Capacity Act.
  • Information on lasting power of attorney

DISC's strengths

  • Building relationships with carers over a long period of time.
  • Stepping in to offer support before a crisis develops.
  • Bridging the gap between clinical diagnosis and families coping alone.
  • Making carers feel welcome – 14 of them formally volunteer in supporting other carers.
  • Being led by carers, listening to carers and developing services to meet need.
  • Feeling passionate about the service.

Further information

For more information on the service contact Jo.Moon@sandwellcrossroads.org or visit the Sandwell Crossroads website.

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Research

A survey of the experiences and needs of male carers

Husband, Partner, Dad, Son, Carer? is the report of a survey of the experiences and needs of male carers, carried out by Carers Trust and the Men’s Health Forum at the start of 2014.
Area of Care: 
Mental HealthPhysical illnessSecondary CareAcute Care
Outcomes: 
WellbeingCarer awarenessCarers in employment
I work in: 
Carers servicesCarers involvementCarers breaksInformation and adviceCommissioning for carersCommissioning
I work with: 
Adult carersParent carersFamilies
Caring for: 
Young peopleChildren
Location: 
Whole UK
Date Revised: 
Monday, April 30, 2018 - 10:15
Body: 

Caring is often seen as a ‘female’ issue but it is something that affects a large number of men too. The 2011 Census found that in England and Wales more than four in ten carers are male (42.3%) - amounting to 2.44 million men providing care, unpaid, for a friend or family member who due to illness, disability, a mental health problem or an addiction.

Despite their vast number, there has been little research to understand the experiences of these men or the vital role that they play in their families.

Carers Trust and the Men’s Health Forum sought to learn more about men’s experiences of caring, the impact it has on their lives and the support services they feel would be helpful to them. A total of 609 male carers from across the UK took part in a survey which included 119 fathers, all of whom were caring for a child or children with a disability, long term conditions or mental health or addiction issue. PDF iconDads care too: A survey of the experiences of fathers who are carers showcases the experiences of these dads.

Key findings

  • 119 dads responded, of all ages.
  • The highest proportion (72%) care for a son or daughter with a learning disability or autism.
  •  Nearly 20% had been caring for 21 years or more.
  • 35% cared alongside being in employment. 40% of those spent 60 or more hours caring per week.
  • A third of dads reported that they never get a break.
  • 46% said caring had a negative impact on their mental health, and 43% said it had a negative impact on their physical health.
  • Almost three quarters said they missed out on spending time with friends and family members as a result of being a carer.
  • The most common support wanted but not received was breaks from their caring role.
  • 55% said they felt the needs of male carers were different from female carers.
  • Many felt their role as a carer was not recognised, or that services were not designed in a way which met their needs.

Further information

Download Dads Care too.

Read the reportPDF iconHusband, Partner, Dad, Son, Carer: A Survey of the Experiences and Needs of Male Carers

Exexutive Summary (PDF iconEnglish language version(PDF, 1,728KB).

Executive Summary (PDF iconWelsh_language version(PDF, 728KB).

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Research

A Road Less Rocky Supporting Carers of People with Dementia

A Road Less Rocky is a report from Carers Trust that found that carers of people with dementia are not getting the support and advice they often desperately need.
Area of Care: 
Mental HealthDay centreRehab CentreHospitalCare homesPrimary CareSecondary CareAcute CareDementia care
Outcomes: 
PreventionWellbeingCarer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsMental health careHealth and wellbeingPharmacy ServicesCarers servicesInformation and adviceCommissioning for carersSocial careCommissioning
I work with: 
Adult carersYoung adult carers
Caring for: 
AdultsOlder adults
Location: 
Whole UK
Date Revised: 
Friday, April 27, 2018 - 14:00
Body: 

The report found that there were a number of critical points along a carer’s journey where they would most value information and support. These critical points include:

  1. When dementia is diagnosed.
  2. When the carer takes on an 'active' caring role.
  3. When the capacity of the person with dementia declines.
  4. When the carer needs emotional support and/or a break from caring.
  5. When the person with dementia loses their mobility.
  6. When the person with dementia has other health problems.
  7. When the carer has to cope with behavioural problems.
  8. When the carer's own circumstances change.
  9. When the person with dementia becomes incontinent.
  10. When decisions about residential care and end of life care have to be made

We have designed a toolkit around these ten points,the issues carers face at these points and what will make a positive difference. It has been produced to sit alongside A Road Less Rocky and gives guidance to professionals who come in contact with carers. The toolkit is useful for anyone who works with or treats patients with dementia and is therefore likely to come into contact with carers. 

A Road Less Rocky – Supporting Carers of People with Dementia complements the Triangle of Care Carers included: A Guide to best Practice for Dementia Care. This document describes how meaningful involvement and inclusion of carers can lead to better care for people with dementia, identifying six key standards required to achieve better collaboration and partnership with carers.

Although the terminology and legislation referred to in this toolkit applies to England the standards and rationale are applicable across the whole of the UK.

Further information

Find further information and download the full report A Road Less Rocky – Supporting Carers of People with Dementia (PDF, 962KB).

Download the toolkit PDF iconA Road Less Rocky: Making the Road Less Rocky for Carers, A Guide on how to Support Carers of People with dementia

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Educational

About Time Grant Evaluations

Following the successful delivery of two About Time Grant programmes, Time for Change and Take Action and Support which addressed issues that can lead to young adult carers becoming disengaged from society, independent evaluations of the two programmes have been produced.
Area of Care: 
Mental HealthPhysical illness
Outcomes: 
PreventionWellbeingIntegrationCarer awarenessIdentifying carersCarers in employment
I work in: 
Primary careMental health careHealth and wellbeingCarers involvementCarers breaksInformation and adviceCommissioning for carersEmploymentSocial careEducationCommissioning
I work with: 
Young adult carers
Caring for: 
AdultsOlder adultsYoung peopleChildren
Location: 
Whole UK
Date Revised: 
Monday, February 12, 2018 - 10:00
Body: 

Key points: 

The objectives of the evaluations were to:
  • Provide an overall evaluation of all data to assess the progress of funded projects against the aims and objectives of the About Time grant programmes and of the wider About Time programme.
  • Conduct a qualitative study with funded projects to identify effective strategies and approaches for supporting and enabling young adult carers.
  • Provide a focused evaluation of data derived from outcomes measurement tools designed to measure the extent of care undertaken, the positive and negative impacts of caring for young adult carers and changes in their lives because of taking part in the funded intervention.
  • Evaluate the impacts of programme delivery and Carers Trust grant making processes on funded organisations.

About Time evaluations

The evaluations of the Time for Change and Take Action and Support grant programmes were structured in three phases and each had its own evaluation report with an overview of the whole programme also produced.

Phase one: February–October 2015

 

Phase two: November 2015–November 2016

PDF iconAbout Time Grant Programmes Evaluation Report Phase 2 November 2015 to November 2016 Executive Summary PDF (177 KB)

PDF iconAbout Time Grant Programmes Evaluation Report Phase 2 November 2015  to November 2016 PDF (323 KB)

Phase three: December 2016–October 2017

PDF icon About Time Grant Programme Evaluation Report Phase 3 December 2016 to October 2017 Executive Summary PDF (251 KB)

PDF icon About Time Grant Programme Evaluation Report Phase 3 December 2016 to October 2017 PDF (483 KB)

Overview Report

PDF icon About Time Grant Programme Evaluation Overview Report PDF (519 KB)

Key achievements and learning from the programmes include:

  • Around 7,200 young adult carers have benefited from 114 projects delivered by Carers Trust Network Partners, exceeding the original target of 6,200 young adult carers.
  • Programmes provided support to significant numbers of young adult carers for the first time, with over half of the young people participating being new to Carers Trust Network Partners.
  • Programmes developed a flexible response to the needs of young adult carers, including individual support, group activities and access to small grants for individuals, alongside the development of partnerships.
  • The programme design involved young adult carers and Network Partners, ensuring programmes reflected specific needs across UK.
  • Projects have been successful in reaching a representative group of young adult carers and there was a good geographic spread of projects across the UK.
  • Carers Trust has enabled Network Partners to deliver effective projects by being flexible about delivery approaches and providing good quality support, information and training.
  • The Carers Trust Network has a unique role in supporting the needs of young adult carers.
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Children and young people’s mental health can be affected by their caring role, whether the condition of the person they care is related to physical health, mental health, an addiction or frailty in old age. 

The mental health of young carers, aged 17 or under

The evidence shows that young carers have worse mental health than their peers:

  • A survey of 348 young carers found 48% said being a young carer made them feel stressed and 44% said it made them feel tired. 
  • A survey of 61 young carers in school found that 38% had mental health problems. 
  • The 2011 Census showed that young carers providing 50+ hours of care a week were up to five times more likely to report their general health as ‘Not good’. 

The mental health of young adult carers, aged 16-25 

Young adults with caring roles report higher rates of anxiety and depression. The GP Patient Survey finds that a third more young adult carers report anxiety or depression than other young people- 39% for young adult carers, in contrast with 28% of young people without caring responsibilities.  

A Carers Trust survey of young adult carers found that 45% reported mental health problems. 

Improving the mental health of young carers and young adult carers

The Time to be Heard campaign calls for better support for young adult carers and their families to address caring roles that have a negative impact on their health, including mental health. We are also calling for local plans to improve children’s mental health services, sometimes called Local Transformation Plans, to include measures that improve the mental health of young carers and young adult carers.

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How-to Guide

Triangle of Care Toolkit - A Resource for Mental Health Service Providers

This resource is designed for services implementing the Triangle of Care, it is based on what has worked and what has prevented successful implementation in other organisations. It includes guidance, tips and good practice to guide professionals and carers.
Area of Care: 
Mental HealthAlcohol MisuseSubstance MisuseSpecialist servicesSecondary CareAcute CareDementia care
Outcomes: 
PreventionWellbeingCarer awarenessIdentifying carers
I work in: 
Health careHospitalsMental health careCarers servicesCommissioning for carersCommissioning for young carers
I work with: 
Adult carersYoung adult carersYoung carersParent carersSibling carersFamilies
Caring for: 
AdultsOlder adultsYoung peopleChildren
Location: 
England
Date Revised: 
Monday, November 9, 2015 - 15:30
Body: 

Introduction

The Triangle of Care was launched in 2010 and was developed by carers who were supporting someone who regularly needed acute inpatient mental health services. It identified six key standards that if in place would mean that the carer would be better involved and supported by mental health services.

Since the launch, Carers Trust has led on the programme in England developing the original guide so that it can be implemented across all mental health services including specialist, forensic, children’s, older people’s and community.

In 2013 the Triangle of Care membership scheme was launched to enable mental health providers to receive formal recognition of their commitment to cultural change and carer involvement. Since its launch, 31 NHS trusts have joined the scheme and their experience, knowledge, good practice and pitfalls have been identified to help develop a toolkit for implementation of the Triangle of Care.

You can download the full toolkit here, or review the appropriate section online: PDF iconTriangle of Care Toolkit

The Triangle of Care Toolkit – A Resource for Mental Health Service Providers

The experiences of the 31 trusts who have joined the Triangle of Care membership scheme between 2013 and April 2015 have been extensive. Carers Trust has been able to identify good practice where it has been implemented which has ensured a more successful implementation of the Triangle of Care. These experiences have been collated to develop a toolkit. This toolkit aims to support trusts who are at the beginning of their Triangle of Care journey, those who are yet to begin and those who are already well progressed but want to learn from their peers and ensure a legacy of cultural change.

The toolkit focuses on the different elements that trusts should consider when implementing the Triangle of Care across their services and more information on each area can be found in the toolkit:

  • Strategic buy-in and support
  • Commissioning and reporting levers including Care Act 2014
  • Staff promotion and buy-in
  • Carer partners and Service user partners
  • Carer champions
  • What good looks like and celebrating good practice
  • A willingness to be honest and encouraging the value of honesty and frequently asked questions

These elements have been identified as important to successful implementation if they are in place. While not all the elements are in place in all trusts many trusts do have a majority in place and this has helped their journey be more successful.

Downloads: 
PDF icon The Triangle of Care Toolkit – A Resource for Mental Health Service Providers
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