Wellbeing

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Guidance

Protecting the Health and Wellbeing of Young Carers – examples of practice

Being a young carer can often have a severe, significant and long-lasting impact on a young person’s health and wellbeing.
Area of Care: 
Mental Health
Outcomes: 
PreventionWellbeingHealth inequalitiesCarer awareness
I work in: 
Health careMental health careHealth and wellbeingCarers servicesSocial careEducation
I work with: 
Young carers
Location: 
Whole UK
Date Revised: 
Tuesday, November 25, 2014 - 10:15
Body: 

Assessing the health needs of young carers

The initiative aims to undertake comprehensive health assessments of children and young people targeted by the young carers’ service in Oxford City. It supports collaborative working between health, social care and education and ensures a more coordinated pathway of care.

Young carer-led and age-appropriate respite for young carers

PDF iconThe young carers service provides respite breaks and activities for young carers, but with young carers right at the heart of decision making, from choosing what activities they do to educating professionals about young carers’ needs.

Other examples of practice

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PDF icon young carer led and age appropriate respite for young carers
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Guidance

Protecting the Health and Wellbeing of Young Carers

Being a young carer can often have a severe, significant and long-lasting impact on a young person’s health and wellbeing. It is therefore essential that services consider how they will support young carers with regards to their physical and mental health and wellbeing.
Area of Care: 
Mental Health
Outcomes: 
PreventionWellbeingHealth inequalitiesCarer awareness
I work in: 
Health careMental health careHealth and wellbeingCarers servicesSocial careEducation
I work with: 
Young carers
Location: 
Whole UK
Date Revised: 
Tuesday, November 25, 2014 - 17:00
Body: 

Impact of caring

Caring responsibilities can be difficult and stressful at any age. Taking on the physical and emotional demands of supporting a family member or friend with a long term sickness, disability, mental ill health or addiction is a lot for young minds to deal with.

For many young people, particularly those who go unidentified, caring can lead to a significant and long term negative impact on their physical and mental health and wellbeing.

Young carers often talk about feeling tired and under pressure. Many experience traumatic life changes such as bereavement, family break-up, losing income or housing, and seeing the effects of an illness or addiction on the person they care for. All these things alongside the pressures of school or college and the social isolation experienced by many, can lead to stress, anxiety and depression. PDF iconResearch by Carers Trust and the University of Nottingham found that almost a third of young carers surveyed (29%), reported that their own physical health was ‘just OK’, and 38% reported having a mental health problem.

Young carers’ physical health may also suffer. Financial pressures, time pressures, exhaustion as a result of interrupted sleep, physical injuries from repeatedly having to support or move someone with poor mobility.

The health of young carers may be affected for a variety of reasons and might not be addressed if their health appointments are missed, not prioritised or there is a distrust of health services. The 2011 census found that young carers providing between 20 and 49 hours are over 3 times more likely to report their health as not good compared to other children without caring responsibilities.

Assessment, support and services

It is vital that young carers are identified early and that an assessment of their needs includes an assessment of their health and wellbeing.

School nurses are ideally placed to support in the early identification of young carers and ensure that they receive timely, age-appropriate information, by spotting and addressing any emerging health needs. By ensuring that young carers are accessing appropriate health services and other support, school nurses can help reduce the negative impact on the health and wellbeing of young carers.

An annual health and wellbeing needs assessment could be employed to ensure a young carers own health is maintained and to check that young carers are registered and able to access their GP, dentist or optician. In Oxfordshire for example, one initiative aims to undertake comprehensive health assessments by a school nurse of young carers.

The PDF iconManual for Measures of Caring Activities and Outcomes is being increasingly used by young carers’ services across the UK and abroad. It contains a range of tools relevant for assessment and evaluation work with young carers and assesses the impact of caring on a young carer.

Emotional support

Dedicated support for young carers can help to protect the health and wellbeing of young carers. Young carers often say that having someone to talk to, to share their concerns with such as a young carers’ support worker, is hugely important.

Young carers also often say that peer support online or within a young carers’ service for example, where they can relax, be themselves and take part in activities is vital. For others, dedicated emotional support from specialist services may be appropriate.

Respite activities and sports are also important for young carers. Providing opportunities where young carers can simply be young people and have fun, will help reduce social isolation and protect their health and wellbeing.

Examples of practice

Protecting the Health and Wellbeing of Young Carers – examples of practice

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PDF icon Manual for Measures of Caring Activities and Outcomes
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Guidance

Support for young carers and their families

Targeted support for young carers and families formed part of the vision of the National Strategy for Carers. The value of dedicated support for young carers cannot be underestimated.
Area of Care: 
Specialist services
Outcomes: 
PreventionWellbeingIntegrationIdentifying carers
I work in: 
Health and wellbeingCarers servicesSocial careEducationCommissioning
I work with: 
Young carersFamilies
Location: 
Whole UK
Date Revised: 
Tuesday, November 25, 2014 - 16:15
Body: 

Young carers and families have consistently stated how they value targeted support which recognises and understands their distinct needs.

Not all young carers will wish to access targeted support and for many mainstream or universal activities will meet their needs. Strong links between both targeted and universal support services will mean that young carers have support that meets their needs and circumstances and ensure that any issues are identified early. 

Young carers services - what do they offer?

Young carer’s services deliver a wide range of interventions in their local area including the provision of clubs, respite activities and one-to-one support. Some services will also offer befriending or mentoring schemes, skills programmes, smaller groups where young carers with similar caring roles can support each other and specific support programmes.

Providing transport to activities is a big part of a young carers’ service as few families have transport of their own.

Online support for young carers

Online support is a great alternative to a physical support group which can particularly meet the needs of hidden young carers who are unable to access local services or who do not wish to do so.

It may not provide all the benefits of a physical support group where young carers can meet peers in similar circumstances, however for young adult carers particularly and young carers from rural locations, it can reduce the isolation experienced by young people, provides information and connects them with others and other services when appropriate.

Supporting the health and wellbeing of young carers 

Dedicated support for young carers can help to protect the health and wellbeing of young carers. Young carers often say that having someone to talk to, to share their concerns with such as a young carers’ support worker, is hugely important.

Young carers also often say that peer support online or within a young carers’ service for example, where they can relax, be themselves and take part in activities is vital. For others, dedicated emotional support from specialist services may be appropriate.

Respite activities and sports are also important for young carers. Providing opportunities where young carers can simply be young people and have fun, will help reduce social isolation and protect their health and wellbeing.

Find out more about protecting the health and wellbeing of young carers.

Further information

Support for young carers and their families – supporting the family

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Guidance

Support for young carers and their families – supporting the family

A whole family approach to supporting young carers and their families can significantly help to reduce inappropriate caring roles.
Area of Care: 
Specialist services
Outcomes: 
PreventionWellbeingIntegrationIdentifying carers
I work in: 
Health and wellbeingCarers servicesSocial careEducationCommissioning
I work with: 
Young carersFamilies
Location: 
Whole UK
Date Revised: 
Tuesday, November 25, 2014 - 10:15
Body: 

A whole family approach to supporting young carers and their families can significantly help to reduce inappropriate caring roles.

Whole family working involves understanding and addressing the needs of the family as a whole. This means considering the impact of an individual’s additional needs on the rest of their family and addressing a child’s needs within the context of their family, instead of in isolation.

Respite for family members

Both young carers and their families value the opportunity of trips and activities for the whole family. These provide shared family experiences and support and strengthen family relationships.

A range of family support for young carers of substance misusing adults

The PDF iconproject supports families affected by substance abuse by providing one-to-one support to young carers and parents and a range of group activities for both adults and children.

Partners in identification and support of young carers

Supporting young carers in education 

Schools are vital and ideally positioned to play a collaborative role in identifying young carers and initiating support for young carers and their families. Children are often caring for relatives without their teachers’ knowledge, yet if unidentified and unsupported, their caring roles can seriously affect their educational outcomes and aspirations.

Supporting young carers in youth services 

Mainstream youth services can play an important role in supporting young carers. Not all young carers will wish to access a dedicated young carers service, preferring mainstream universal services instead. 

For some young carers mainstream activities best meet their needs and reduce the social isolation of a caring role. Accreditation schemes often run by youth services are a good way of supporting some young carers at risk of becoming NEET.

Supporting young adult carers into further education and employment 

It is common for young adult carers to face barriers in relation to further learning and employment. Targeted support for young adult carers to address these specific barriers is therefore important to prevent them from becoming NEET and to help them transition smoothly and reach their full potential.

Practice examples

Protecting the Health and Wellbeing of Young Carers – examples of practice

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PDF icon Family support for young carers of substance misusing adults
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Guidance

Young carers and parental substance or alcohol misuse – examples of good practice

Area of Care: 
Alcohol MisuseSubstance Misuse
Outcomes: 
PreventionWellbeingIntegrationHealth inequalitiesCarer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsCarers servicesSocial careEducation
I work with: 
Young carers
Caring for: 
AdultsOlder adults
Location: 
Whole UK
Date Revised: 
Tuesday, November 25, 2014 - 10:15
Body: 

Examples of good practice

Out of hours family support for young carers living with a substance misusing adult

The PDF iconout of hours family project aims to provide a range of emotional and practical support to families in order to improve outcomes for young carers, the substance misusing adults they care for and the wider family.

Support for young people affected by a parent’s drug or alcohol misuse

Time4Us identifies and supports young people with a parent who is misusing drugs or alcohol. The project also supports the wider family by providing information and support to parents to access other available services.

Supporting families affected by drug and alcohol misuses

PDF iconExplore Family in Nottingham delivers both low threshold and structured interventions for anyone affected by the drug or alcohol misuse of someone else in their family. The service works with children within the family (some of whom will be young carers), any non-misusing parent and the misusing parent when appropriate.

Further information

The Association of Directors of Adult Social Services and Association of Directors of Children’s Services produced Signposts, See Me, Hear Me, Talk to Me – Talk to My Family as Well in 2011.

The Office of The Children's Commissioner for England produced the report Silent Voices – Supporting children and young people affected by parental alcohol misuse in 2012.

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PDF icon Explore Family in NottinghamPDF icon Out of hours family project
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Guidance

Young carers and parental substance or alcohol misuse

Children of parents who are addicted to drugs or alcohol may experience chaotic lives which lack routine and may often worry about the safety of their parent.
Area of Care: 
Alcohol MisuseSubstance Misuse
Outcomes: 
PreventionWellbeingIntegrationHealth inequalitiesCarer awarenessIdentifying carers
I work in: 
Health carePrimary careHospitalsCarers servicesSocial careEducation
I work with: 
Young carersFamilies
Caring for: 
AdultsOlder adults
Location: 
Whole UK
Date Revised: 
Tuesday, November 25, 2014 - 10:15
Body: 

The statistics 

  • 22% of young people under 16 in the UK (2.6 million) live with a hazardous drinker.
  • In the UK, 335,000 children live with a drug dependent parent.

How does parental substance or alcohol misuse affect young carers?

Not all young people who live in families where there is drug or alcohol misuse have a caring role or experience difficulties at home. Those who do may undertake physical tasks, such as domestic chores, dealing with bills, or nursing a parent suffering from drug or alcohol withdrawal, but it is often emotional support that is most prevalent in their caring role.

Children of parents who are addicted to drugs or alcohol may also experience very chaotic lives which lack routine and may often worry about the safety of their parent and fear what, or who they will find on returning home from school or college. Young carers from these families may have had to deal with the aftermath of alcohol and substance misuse in their home.

Parents affected by substance misuse may experience impaired patterns of parental care. This in turn may lead to a higher risk of physical neglect or abuse, poor or limited diet, and missed health appointments, such as the dentist or vaccinations.

Research in 2004 found that where children are caring for a relative with drug or alcohol problems, the incidence of missed school and educational difficulties were considerably higher than for other young carers. 34% were missing school (compared to 27% of young carers) and 40% in total were missing school or had other indicators of educational difficulties (source: Dearden C. & Becker S. (2004) - Young Carers in the UK: the 2004 report - Carers UK and The Children’s Society).

Emotions and thoughts

Young carers who care for a parent affected by substance or alcohol misuse may experience a whole range of differing emotions and thoughts: They may become angry, confused and ashamed or even feel guilty. They may feel like their parent loves drugs and/or drink more than them and they may get teased or bullied because of a family member’s addiction. They may feel very isolated and feel unable to invite friends home.

Support

Fear of stigmatisation and fear of intervention by services can act as barriers to identification and young carers receiving support. Services and support must recognise these particular issues faced by these young people and gain the trust of families and young people in order to encourage openness and engagement.

Like many young carers, this group of young carers need someone to talk to and for their needs to be understood. It helps when they realise that there are other young people in similar circumstances. They also need to understand that they are not responsible for their parents’ choices and that it is not their fault. Early intervention is key.

Dual diagnosis

Some parents may be affected by both substance or alcohol misuse and have a mental health condition. It is, therefore, important to maintain effective links between all agencies involved to provide extra support should they need it.

Further information

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Good Practice

Whole family approach - practice examples

The Department for Education funded Carers Trust between 2010 and 2012 to build a collection of practice examples to support those who commission or develop services think about how to deliver creative and effective services locally.
Area of Care: 
Mental HealthAlcohol MisuseSubstance Misuse
Outcomes: 
PreventionWellbeingCarer awarenessIdentifying carers
I work in: 
Health careCarers servicesSocial careEducationCommissioning
I work with: 
Families
Location: 
Whole UK
Date Revised: 
Tuesday, November 25, 2014 - 10:15
Body: 

Whole family support

The Department for Education funded Carers Trust between 2010 and 2012 to build a collection of practice examples to support those who commission or develop services think about how to deliver creative and effective services locally.

Examples of whole family working

  • Whole family support for at risk families and young carers
    The PDF iconThink Family Project delivers sustained, intensive work with targeted young carers and their families over a period of around 12 months. The work is personalised to each family and addresses the needs of young carers as well as the wider needs of the family through parenting and relationship work, family activities and advocacy.

  • A one-stop holistic service for young carers and their families experiencing multiple challenges 
    Tailored, multi-agency PDF iconsupport to the families of young carers experieincing multiple challenges and who are most at risk of harmful or excessive caring.

  • Using a whole family assessment
    A PDF iconwhole family assessment is initially carried out in order to embed a whole family approach to supporting families. The results of this assessment then inform an intervention plan that is developed and agreed upon by the family.

  • Coordinated meetings to help families write their own care plans
    Barnardo’s in Bolton coordinates meetings Family Group Conferences which aim to bring together everyone who is involved with a young carer, enabling the family to decide what support they need and to make plans that reduce the young person’s caring role.

  • Out of hours support family work
    The Out of Hours project aims to provide a holistic package of support for young carers and their families at times that suit them, which may be outside the existing 9–5 service. Young carers and their families are offered one-to-one support, signposting, advocacy and fun activities for the whole family.

  • Support programme for parents of young carers
    The Triple P System is an evidence-based parenting programme founded on over 30 years of clinical and empirical research. Winchester and District Young Carers uses the model to work with the parents of young carers in order to create improvements in their family lives.

  • Whole family involvement in young carer crisis plans
    Using a child-friendly booklet designed with and for young carers, called "Safe, Sorted and Supported," the PDF iconproject encourages young carers and their families to plan ahead in case of crisis or emergencies.

Mental health problems or addiction

Below are some examples of targeted whole family approaches for families where mental health problems or addiction is present.

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Key Info

Whole family approaches

Young carers exist because someone in their family network requires their support. Caring for a family member or friend can be a positive experience for a young person which can strengthen family relationships and build a young person’s life skills and maturity.
Outcomes: 
PreventionWellbeingCarer awarenessIdentifying carers
I work in: 
Health careCarers servicesSocial careEducationCommissioning
I work with: 
Families
Location: 
Whole UK
Date Revised: 
Tuesday, November 25, 2014 - 10:15
Body: 

Why is whole family working important?

Young carers exist because someone in their family network requires their support. Caring for a family member or friend can be a positive experience for a young person which can strengthen family relationships and build a young person’s life skills and maturity. However, children must not be relied on to take on inappropriate or excessive caring roles that impact on their health, wellbeing, development or life opportunities.

Many young carers are providing caring roles that negatively impact on their own lives. Whole family working is essential to identify young carers early, address the root causes of why any child is undertaking a caring role and ensure the family have the right support in place.

What is whole family working for young carers?

Whole family working involves understanding and addressing the needs of the family as a whole.

This means:

  • considering the impact of an individual’s additional needs on the rest of their family
  • Addressing a child’s needs within the context of their family, instead of in isolation.

Evidence in practice highlights the particular benefits of supporting a young carer in the context of their family. By addressing the reasons why a young person is caring and providing support to the person who needs care and support and the wider family, the role and well-being of the young carer can be significantly changed.

In England, The Care Act 2014 enshrines in law the importance of a whole family approach as an effective way to understand and address the needs of an individual in the context of their family. See what the Care Act Says about whole family approaches and young carers in England.

What constitutes a ‘whole family approach’?

There are a number of different components that make a ‘whole family approach’ including:

  • whole family assessments   
  • support for adults and other family members within the family, such as parenting support; provision of practical and emotional support
  • building support networks including engaging the wider family through for example, family group conferences
  • relationship building within the family, such as support with building roles, routines and responsibilities and engaging families in positive activities (such as planning a menu, cooking together or a family picnic).

Get tips on how to start whole family working with our Whole Family Practice examples

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Young carers and their education

Young carers are a particularly vulnerable group of pupils, specifically mentioned in Ofsted’s evaluation inspection schedule.
Outcomes: 
PreventionWellbeingIntegrationHealth inequalitiesCarer awarenessIdentifying carersCarers in employment
I work in: 
Health careCarers servicesSocial careEducation
I work with: 
Young adult carersYoung carers
Location: 
Whole UK
Date Revised: 
Tuesday, November 25, 2014 - 16:30
Body: 

Young carers’ experiences in education

Young carers are a particularly vulnerable group of pupils, specifically mentioned in Ofsted’s evaluation inspection schedule.  Often, these children are caring for relatives without their teachers’ knowledge, yet if unidentified and unsupported, their caring roles can seriously affect their future wellbeing, life chances and levels of aspiration. 

Research shows that:

  • Around one in 20 young carers miss school because of their caring responsibilities, affecting not just their education but their chances of longer term employment.
  • They have significantly lower educational attainment at GCSE level, the equivalent to nine grades lower overall than their peers (i.e. the difference between nine B’s and nine C’s).
  • They are more likely than the national average not to be in education, employment or training (NEET) between the ages of 16 and 19, which reduces their future life chances.
  • Although young carers need extra support, they are no more likely find it from statutory agencies than other children.
  • A quarter of young carers said they were bullied at school because of their caring role. Only half had received additional support from a member of school staff.

Source: 1-4 Hidden from View: the experiences of young carers in England (The Children’s Society 2013) / 5 Young Adult Carers at School: Experiences and Perceptions of Caring and Education (Carers Trust 2013).

Young adult carers at transition

Transitions from school are particularly complex and challenging for young adult carers.  Research shows that:

  • Around 1 in 5 young adult carers become NEET when they leave school.
  • Over half of young adult carers at college or university said they experienced difficulties because of their caring role and 16% were concerned they might have to drop out.
  • Less than half of young adult carers thought they had received good careers advice and only 19% though that it took their caring role into account.
  • Over three quarters of young adult carers at college or university had communicated their caring role to their college or university but nearly half still felt there was no one there who recognised them as a carer and helped them.

Source: 1 Young Adult Carers and Employment (Carers Trust 2014) / 2 & 4 Young Adult Carers at College and University (Carers Trust 2014) / 3 Young Adult Carers at School: Experiences and Perceptions of Caring and Education (Carers Trust 2013). 

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Young Carers and School

Young carers are a vulnerable and disadvantaged group, who often experience difficulties in their education.
Outcomes: 
PreventionWellbeingIntegrationHealth inequalitiesCarer awarenessIdentifying carers
I work in: 
Health careCarers servicesSocial careEducation
I work with: 
Young carers
Location: 
England
Date Revised: 
Sunday, October 8, 2017 - 09:00
Body: 

Why do young carers need support from school?  

Young carers are a vulnerable and disadvantaged group, who often experience difficulties in their education. Without support, they can struggle to attend school and make good progress and a quarter of young carers have said they are bullied because of their caring role

Identifying and supporting young carers is an effective way of improving the attainment and attendance of this pupil group; who are specifically mentioned in Ofsted and Estyn evaluation inspection schedules and frequently eligible for free school meals and pupil premium/development grant funding.

Will there be young carers in all schools?

It is likely that there will be young carers at every school in England and Wales:

  • A survey by the BBC in 2010 estimated that about 1 in 12 secondary aged pupils have caring responsibilities.
  • The number of 5-7 year olds providing care increased by 83% between 2001 and 2011.
  • 39% of young carers have said that nobody in their school was aware of their caring role (Carers Trust, 2010).
"Schools have a key role in identifying and supporting all young carers.…. Ofsted take particular interest in the experiences of more vulnerable children, including young carers, during inspections."
Edward Timpson, the Minister for Children and Families, October 2012

What support is available to schools?

In England

Young Carers in Schools is an exciting England-wide programme that equips schools to support young carers and awards effective practice. Led by Carers Trust and The Children’s Society's Young Carers in Focus partnership, this programme has been developed with teachers and school staff to make it as easy as possible for schools to support young carers and rewards good practice. It is funded by The Queen’s Trust and the Big Lottery Fund.

The programme is open to all schools in England and to sign up, schools just need to register online

By taking part, schools can show that they are meeting the needs of a particularly vulnerable group of pupils (specifically mentioned in Ofsted’s School Inspection Handbook) and access:

Supporting Young Carers in Schools: A Step-by-step Guide for Leaders, Teachers and Non-teaching Staff

Written in association with teachers and school staff, who understand the pressures that schools face to deliver the very wide range of demands placed upon them, this Step-by-step Guide helps you step-by-step and includes templates, tools and guidance.

Expert regional networks 

Bringing together schools, young carer services, and health and social care professionals for peer-to-peer learning and training. Opportunities will be available online and face-to-face to make sure everyone can get the best from these networks. 

Young Carers in Schools Award

Schools can provide evidence to showcase how they adhere to five Young Carers’ Standards created by young carers and apply online for a Bronze, Silver or Gold Award. This will enable schools to gain recognition from several leading charities for their effective practice. 

Young Carers in Schools: Information for schools and those working with them

Sign up today to receive this termly enewsletter which will highlight relevant policy developments, spotlight good practice and give updates on the programme’s successes.  Additional Resources

In Wales

Young Carers in Schools Wales programme  is now available for schools in Wales and is currently being rolled out via school clusters. Use the link to find out more including what’s available, access to bilingual resources and details on how to apply.

Supporting Young Carers: A resource for schools (Archive)

PDF iconSupporting young carers: a resource for schools
An extended resource for schools. This resource was developed in 2010 in partnership with The Children’s Society: Phelps, D, Leadbitter H, Manzi, D (2010), Supporting Young Carers: A Resource for Schools (The Princess Royal Trust for Carers and The Children’s Society) (Archive)

Supporting Young Carers in Schools: An Introduction for Primary and Secondary School Staff

PDF iconsupporting young carers in schools
An introductory resource helping schools to set up systems to identify and support pupils who are young carers.

Pupil Premium: Support for Young Carers - primary school resource and secondary school resource

PDF iconpupil premium - primary school resource
Guidance showing how targeted use of the Pupil Premium can support pupils with caring responsibilities.

 

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PDF icon Pupil Premium: Support for Young Carers - primary school resourcePDF icon Pupil Premium: Support for Young Carers – secondary school resource
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