Glasgow Health & Social Care Partnership Carer Scotland Act 2016 DRAFT Eligibility Criteria Consultation November 2017 This presentation was prepared for a city wide carer consultation event held on 3 November 2017and we have tried to adapt it for an on line consultation. It should be read in conjunction with the Glasgow Carers Partnership Annual Report attached in the Survey Monkey.

Why do we need eligibility criteria? The Carers (Scotland) Act 2016 requires Health & Social Care Partnerships to have a carers eligibility criteria in place by 1st April 2018. The eligibility criteria will be a public statement on how social work will respond to carer needs by establishing different levels of access to carer supports Local authority resources should be targeted fairly and on those with the greatest need, by using the same criteria for prioritising the needs of everyone who requests or requires a service A carer’s eligible needs are those identified needs for support that cannot be met through support to the cared for person or through accessing services that are generally available, and which meet the threshold for support set by the local eligibility criteria. Point 1 - Not the first piece of legislation significant to carers – 2002 - gave carers providing regular and substantial care the right to an assessment – welcomed as progress, but didn’t come with resources. Distinction - In previous legislation social work had a power to support carers Power is the ability to support – Duty is the obligation to support which means we must provide support Eligibility criteria is a legal requirement and we need to consult with carer to gather their views on our proposals. When completed, any new carers receiving support should have access to the eligibility and be clear on how services will be provided. Point 2 – eligibility criteria – currently have a DRAFT – will finally be a document accessible to public to make them aware of what they can expect as a carer in Glasgow Point 3 - Could view Eligibility Criteria cynically as allowing workers to be gatekeepers to resources. Glasgow carers Partnership isn’t using this to stop people accessing support, but quite the opposite. To ensure that those carers in greatest need are prioritised for support and information. This is evident from the GCP Annual Report. Point 4 – Can’t look at the carer in isolation – both parties have rights – distinct, but interconnected needs. Public funds, accountable for spending appropriately to promote independence and deliver positive outcomes to Glasgow’s citizens. How the decision is made about who is eligible is in completing the carers support plan.

Key Principles that underpin Glasgow’s Eligibility Criteria All unpaid carers in Glasgow are eligible for carer support with a universal offer of information and advice for all as a minimum. The Carers Information Line provides the access point. The Glasgow carer strategy seeks to provide the right level of support at the right time  The underpinning principles are that adult carers are supported as key partners and that the focus for young carer’s should be, where possible to alleviate the caring role.  All caring situations are assessed by Carers Partnership to identify the risk of breakdown of the caring role. The Carers Information booklet and referral form provides the access point to carer assessments and carer support plans. Key to this is identifying carers early in their caring journey focussing on early intervention and prevention to prevent crisis in caring. These are the key principles that underpin the existing Glasgow Carer Eligibility Criteria which have been developed over the last 5 years in partnership with carers and 3rd sector commissioned carer centres. Glasgow model of eligibility previously known as prioritisation system has worked pre legislation, is entirely consistent with the aims of the Carer Act with 11000+ carers having been supported through this model since 2011.

Critical and Substantial risk and need SDS Short Breaks Replacement Break Carers Centres + Cares Support Service Money Advice Emotional Support Community Connections Training Short Breaks Peer Support Emergency Planning Income Maximisation Carer Health Check Universal offer of information and advice – Carers Information line Critical and Substantial risk and need Moderate risk and need Carers Journey Adult Carer Support Plan or Young Carer Statement Low risk and need All carers in Glasgow have had a universal offer of support since 2011. Glasgow carers Partnership will be basing the eligibility criteria on that model and this slide demonstrates this look like in practice. The triangle demonstrates the supports and information that are currently available to improve outcomes for carers and service users. It also demonstrates how the level of support provided would become more intensive as a caring role becomes more intensive. On the right we have the practitioners perspective, where assessments are completed to support carers to access the right services at the right times to support them in their caring role. Assessment takes place in the Young Carer Statement and the Adult Carer Support Plan Key focus with YC is to alleviate and/or remove caring role Key focus with adults is to provide supports to manage their caring role On the left we have the carers journey. Carers can access support and information through the partnerships single point of access at different times and circumstances in their caring role. We acknowledge that carers circumstances can change quickly and any model of support needs to be personalised able to respond quickly to changing circumstances. Some carers may access support close to the point of diagnosis for the looked after person and may have a low level of risk and need. A carer may have been coping well and become overwhelmed and come to the attention of the carers partnership at a time when their level of need and risk is critical. The model is intended to be a flexible, personalised and responsive approach ensuring that practice matches the individual circumstances of carers Effective partnership working between carers, SW Carer Teams and Carer Centres assessing caring situations determines what the right level of support is for individual carers. This partnership working is intended to try and stop caring situations reaching a critical point, or support carers during crisis situations. Ideally, by the provision of support and information, the level of risk and need can be reduced and both carers and the person being cared for experience positive outcomes. There is a £3.2 million annual investment in Glasgow Carers Partnership. In 2011 this was £1.6M. There will be new resources to support the Act and the funding allocations will be known late December 2017/ early January 2018. The level of investment in carers support prior to the introduction of the Carers ( Scotland) Act is an indicator of Glasgow HCSP ongoing commitment to supporting unpaid carers.

Universal Offer of Support Critical and substantial level of need and risk Moderate level of need and risk Low level of need and risk Employment and Training – Health and Wellbeing – Finance – Future Planning – Life Balance – Relationships – Living Environment - By way of demonstrating what a personalised offer of support looks like, there are very few carers lives are similar. The factors round the outside of circle influence how we make decisions about allocating responses. Employment and training, etc… Our support plans take account of these individual issues and how they are impacting on the carers lives. This allows us to respond in personalised and measured way, where the level of response is relevant to identified outcomes, risk and need. Critical and Substantial Risk - Carer has major difficulties due to the impact of their role as a carer causing life threatening harm or danger to themselves or others. Seen within 1 x working day by SWS Moderate level of need and risk - Carer able to manage some aspects of the caring. Potential risk to breakdown of caring role. Seen within 28 days by SWS – average waiting time 12 days Low level of need and risk - Carer able to manage most aspects; has difficulty undertaking one or two aspects of their caring / domestic role but with low risk of caring role breaking down. Seen within 28 days by third sector – average waiting time 12 days It would be our intention to use this tried and tested model of support as the basis for Glasgow’s eligibility criteria. The duty to provide support and information would apply to those carers with Critical and substantial levels of risk and need. The power to support would apply to those carers with moderate or low level of risk and need. All carers remain eligible for support. This support model works best when we are able to identify carers early in their caring role. This is when our health colleagues diagnose a family member or friend with a long term health condition. The following slide will demonstrate the work of the partnership in trying to identify carers at the onset of their caring role.

GLASGOW CITY CARERS PARTNERSHIP in context The aim of the Carers partnership is to bridge the gap between - Social Work Services who are tasked with providing high quality services that protect children and adults from harm, promote independence and deliver positive outcomes for Glasgow citizens and the NHSGGC who “Deliver effective and high quality health services, to act to improve the health of our population and to do everything we can to address the wider social determinants of health which cause health inequalities”. The Gap between our services is where we found carers – falling between the services leaves carers without support, and when carers are not fully supported they are often turn up at duty Social Work services in distress making it hard to engage positively with carers to deliver better outcomes. The gap between diagnosis and presenting in crisis can be 6 months or even 10 years without support. By providing the Glasgow City carers Partnership, we can prevent crisis interventions through anticipatory and preventative working, aimed at supporting carers from the point of diagnosis. Its hoped that longer term lower level support may reduce the need for people to turn to social work in a crisis or see their GP or even attend A&E in the worst cases. Our guiding principle is to extend the length of time people are able to live well supporting their loved one in the community. Working in Partnership – Bridging the Gap  The Glasgow City Carers Partnership was formed in Dec 201 bridging the gap for carers between health and social work.  The partnership consists of Glasgow City Community Health Partnership (CHP), Social Work Services and Third Sector organisations.   Model of support An anticipatory / preventative approach may reduce the need for people to come to duty Social Work Services, or extend the length of time people are able to live well with their condition in the community. This in turn will reduce the impact on social work services; primary care and residential or hospital care.

Glasgow Carers Partnership Universal offer of information & advice to all carers Carers Information & Support Line In consultation with carers they highlighted the need to be recognised and identified at the beginning of their caring journey. They also requested a single point of access for smooth easy access to service. As such the Carers Information Line was established and a Carer Information booklet which includes a self referral form and stamp addressed envelope. 3 Adult Carers Information Worker posts have been created to outreach the partners in primary care raising awareness of carers through for GPs, District Nurses and secondary care through dementia and autism diagnostic services, to promote the single point of access to supports. Additionally, for young carers, 3 Young Carer Information posts have been created to work in partnership with Glasgow City Council Education Services to raise awareness of young carers and develop clear pathways for teaching and pastoral staff to identify and refer young carers into services. We feel that our approach of targeting a range of health professionals, and GPs offers carers the best chance of an early referral and as a result, access to the right support at the right time. We recognise that perhaps giving a carer a booklet and encouraging to self-refer can be a barrier, many cares don’t know they are carer and many are proud and decline support. As such we recognise the importance of the relationship and trust that the professional builds with the carer and the conversation that takes place.

Small Group Discussion Do you agree that we should provide the right level of support at the right time to carers ? What are your views on how we allocate resources to carers ? Should all carers get equal share or should we give those with most need where impact of caring role is high more supports to prevent crisis ? Local authorities now have a duty to support eligible carers – would you want to organise services yourself or would you want us to do that for you ? What are your views on working with GPs and others to identify carers earlier on their journey / close to point of diagnosis ? Is this a good idea ?