Together for Carers
A Memorandum of Understanding between Health and Social Care partners within Surrey and local Carers organisations:
Supporting an integrated approach to the identifying, assessment and meeting of Carers' health and wellbeing needs.
"CARERS look after family, partners or friends in need of help because they are ill, frail or have a disability. The care they provide is unpaid." - Carers UK definition
This includes adults looking after other adults, parent carers looking after disabled children and young carers under 18 years of age. Many carers combine caring with other responsibilities; for example combining work with caring or looking after their children and older or disabled relatives.
This overarching Memorandum of Understanding (MOU) sets out an agreed approach to supporting the implementation of an integrated approach to the identification, assessment and meeting of carers' health and wellbeing needs across Surrey. The document has been developed from a national template published by NHS England and others. It has been supported by key partners in the health and social care system who are committed to working together for carers and young carers.
There are more than 108.000 carers in Surrey who contribute a crucial part of the health and social care system within Surrey. The 2011 Census showed in Surrey:
- 108,433 carers
- 29,364 of them care for more than 20 hours a week
- 64,884 of Surrey carers juggle work with caring
- There are also 14,000 young carers under the age of 18 (Source research for BBC "Kids who Care" 2010)
Research by Carers UK & Leeds University shows that Carers in Surrey save the nation £1.8 Billion a year (Valuing Carers 2015)
For more information on the numbers of carers in Surrey see the Joint Strategic Needs Assessment chapter on Carers.
The Care Act 2014 was designed to improve support for carers; as were amendments to the Children Act relating to young carers and parent carers. These strengthened carers' rights to an assessment and also created new duties to provide information and preventative support to carers and young carers. The legislation also includes a duty for the NHS to cooperate with local authorities in implementing these duties.
There are several key NHS policy documents that highlight a need to improve support for carers including the NHS Constitution, the NHS 5 Year Forward Plan as well NHS England's "Commitment to Carers" and "Commissioning for Carers" guidance.
However, the 'State of Caring 2016' report by Carers UK showed many carers are still struggling to get the support they need to maintain their own health, balance work and caring and have a life of their own outside caring. As well as supporting people with a wide range of needs, carers themselves have multiple needs, not all of which are being consistently met within Surrey. This agreement is designed to help improve this through enhanced joint working.
3. What carers can expect
Surrey should be a place where carers are recognised, valued and supported, both in their caring role and as an individual. Carers in Surrey should be able to expect to:
- Be identified as a carer as early as possible, be informed, respected and included by health and social care professionals,
- Have choice and control about their caring role,
- Be able to stay healthy and well themselves,
- Have their own needs and wishes as an individual recognised and supported,
- Be socially connected and not isolated,
- Have support in accessing education and employment or help to remain in work.
- Have their religious and cultural needs respected
Young carers and young adult carers should be able to thrive and develop educationally, personally and socially, and be protected from excessive or inappropriate caring roles.
This support should be available equally to all carers. Partners will therefore endeavour to reach out to hard to reach carers including those from Black and Minority Ethnic Communities, traveller groups and military families.
4. Working together to support Carers
By signing this MOU, Partners have agreed to co-operate with each other, to promote the wellbeing of individual carers, to adopt a whole family approach in their work and to support carers of all ages, in order to:
- maintain the independence and physical and mental health of carers and their families
- empower and support carers to manage their caring roles and have a life outside of caring
- ensure that carers receive the right support, at the right time and in the right place
- identify hidden carers and those who are seldom heard such as those from Black and Minority Ethnic groups, armed forces, gypsy and traveller, veterans etc.
- respect carers' decisions about how much care they will provide and about not providing care at all
- ensure that staff working with carers are appropriately trained and are "carer aware"
- ensure that young carers are recognised and protected from undertaking inappropriate care
5. Key principles
The integrated approach to identifying, assessing and supporting carers' health and wellbeing needs rests on a number of supporting principles.
Partners to this Memorandum of Understanding agree that:
5.1 Principle 1
We will support the identification, recognition and registration of carers and young carers in all organisations including primary care.
5.2 Principle 2
Carers will have their support needs assessed and will receive an integrated package of support in order to maintain and/or improve their physical and mental health.
5.3 Principle 3
Carers will be empowered to make choices about their caring role and access appropriate services and support for them and the person they look after.
5.4 Principle 4
The staff of partners to this agreement will be aware of the needs of carers and of their value to our communities.
5.5 Principle 5
Carers will be supported by information sharing (with their consent) between health, social care, carer support organisations and other partners to this agreement.
5.6 Principle 6
Carers will be respected and listened to as expert care partners, and will be actively involved in care planning, shared decision- making and reviewing services.
5.7 Principle 7
The support needs of carers who are more vulnerable or at key transition points will be identified early.
5.8 Principle 8
Young Carers will be identified, supported and protected from inappropriate care.
6. Thinking Carer
Implementation of this agreement will be linked to delivery of our multi agency Carers Commissioning Strategy. This is "co-designed" and links together the views of Surrey carers with legislation and national policies that underpin carers' rights.
The strategy promotes a whole family, whole system approach to supporting carers. Shared mechanisms for achieving this will include a Carers Care Pathway and Young Carers Pathway. These are now delivered through a "Carers Prescription"
Health and social care also promote the recognition and support of young carers. Other partners including schools and colleges have a key role in identification and support of young carers and their families and this is coordinated through a complementary Surrey Young Carers Strategy
As health and social care work together to achieve more integrated approaches to delivering care and support we will work to ensure data and information sharing processes between agencies are developed. This is so that information follows the carer across their own care and support pathway without them constantly having to re-tell their story.
Carers friendly employment practice will be promoted within partners own services, within health and social care provider services and within the wider community.
Where there are shared assessment processes between health and social care agencies, the systems adopted will ensure that carers:
- Are identified and given information including about community based and preventative or universal services
- Have access to carers assessments in line with the requirements of the Care Act 2014 and Section 17 of the Children Act
- That children and young people within households are identified and consideration given as to whether they are young carers, triggering an assessment or referral as appropriate
7. Outcomes for carers and young carers
The partners who are signatories will work together to monitor outcomes for carers so that we know what difference support given has made to carers lives. The outcomes for carers promoted through the Carers Commissioning Strategy are attached as Annex 1. A "Young Carers Wish list" is attached as Annex 2.
The statutory assessment processes for young carers is underpinned by "No wrong doors" a complementary Memorandum of Understanding between Adult and Children's Social Care and Mental Health services designed to ensure joined up processes. Partners to this agreement will support this process by effective identification of young carers and making appropriate referrals.
8. Our Commitment to Carers
This Memorandum of Understanding "Together for Carers" is designed to complement the Surrey Carers Commissioning Strategy and Surrey young carers strategy. It has been supported by the following organisations:
- East Surrey Clinical Commissioning Group
- Guildford and Waverley Clinical Commissioning Group
- North East Hampshire and Farnham Clinical Commissioning Group
- North West Surrey Clinical Commissioning Group
- Surrey Downs Clinical Commissioning Group
- Surrey Heath Clinical Commissioning Group
- Surrey County Council
- Action for Carers Surrey
- Surrey Health and Wellbeing Board
Outcomes for Carers
Partners will work together to achieve positive outcomes for carers and evidence how this is being achieved within their Quality Assurance programmes.
These are key things that carers say make a difference to their lives This is about how services have actually helped people. For example, organising a carers group is not an outcome. However, carers feeling less isolated or more in control of their lives as a result of attending are outcomes.
- Carers feel that they can remain part of their community
- Carers have a break from caring
- Carers have more choice and control over day to day life whilst choosing to continue to care
- Carers are able to maintain / make friendships and relationships
- Carers are able to undertake leisure activities
- Carers are able to access educational/ learning activities - whether recreational (for fun/interest) or vocational (employment related and/or leading to a qualification. This also includes support to young carers taking GCSE's and NVQ's.
- Carers able to carry on caring where this is their choice
- Carers helped to maintain their health and wellbeing e.g., exercise, complementary therapies, stress reduction activities.
- Carers are able to remain in or return to employment.
- Carers are supported to remain safe
Young Carers "Wish List"
- Tell me what to expect
- Listen to me
- Talk to me in a way I'll understand
- Talk to me about being a carer
- Give me more support
- Recognise that I am a carer
- Give me the right info so it's easier for me to care
- Remember I am still young
- Make it easier to get an appointment
- Tell me about any changes I don't know about