To approve a new joint carers strategy for Herefordshire and  agree consequent commissioning intentions for carers and procurement arrangements for commissioned services.

The cabinet member for young people and children’s wellbeing introduced the item.

He thanked all those who had contributed to the strategy and noted the following points:

·         there were barriers to the way in which carers could maintain their own wellbeing and that of the individuals they cared for;

·         in view of resources the council had to deploy smarter ways of working, enhance what it had and promote greater awareness;

·         the strategy recognised the massive contribution made by carers;

·         the strategy included a focus on young carers;

·         the council was proposing to invest in the carers strategy to ensure that carers had access to the best services;

·         there was a focus on strategic change rather than specialist services, due to the high number of carers – estimated to be about 34,000 in Herefordshire.

The strategic wellbeing and housing manager set out further detail on the report. He explained that:

·         the strategy had been prepared in consultation with the clinical commissioning group (CCG) and other partners;

·         the carers strategy formed part of an emerging wider strategic approach to wellbeing and prevention;

·         carers played a key role in preventing and delaying the onset of significant health and care need by supporting the most vulnerable people in society;

·         there had been engagement with carers during production of the draft strategy which would continue during the implementation and commissioning phases;

·         the carers strategy was a medium to long term document which set out the broad direction of travel, vision and priorities and the headline outcomes which were being pursued; details of how outcomes would be achieved, over what timescale and by what means would be set out in the implementation plan;

·         with limited and reducing financial resource to invest in services for carers the council could not focus on providing and funding specialist services for individual carers, the focus had to be on strategic change such as making universal services more effective and accessible and helping carers navigate the system;

·         consultation had highlighted that the most important thing for carers was that the person they were caring for got the services they needed at the right time  and in the right way;

·         need to recognise that carers are individuals with many other roles who may not choose to be defined primarily as carers, the strategy seeks to take a whole person and whole system approach;

·         carers may themselves be vulnerable being either older people or young carers, or have other needs;

·         the strategy focussed on six priorities, some were ongoing from previous strategies, others were new or had new emphasis such as the focus on universal services, information advice and mutual support and networking;

·         there were now statutory duties to assess the needs of carers;

·         needs would be assessed on a strengths basis by identifying what the carer could do, what the person they were caring for could do and what support was available in the local community;

·         there was a need to recommission and re-procure services for carers from April 2018, the fine details of what was to be commissioned were being worked through with a focus group of 10 carers with the competitive tendering process due to begin in mid September 2017.

Group leaders were asked to make comments on behalf of their group.

The representative of the Herefordshire Independent’s group welcomed the document as comprehensive and the result of a great deal of work that had been carried out in the previous few years. He stressed the importance of identifying young carers and making sure that carers were known to their GPs.

The leader of the Liberal Democrat group queried what the definition of a carer was. He noted that many people would provide some measure of care or support to another person but that resources needed to be focussed on those most in need of support.

The strategic wellbeing and housing manager responded that there were various definitions of carer but no particular definition was used in the strategy. The number of people undertaking substantial caring duties would be smaller than the 34,000 figure referred to but an individual’s need for support as a carer may not correlate with the amount or complexity of care they provide. The fact remained that even if the council could clearly define a narrower group providing a high level of care resources would be insufficient to provide individual support to all of those people, the strategic approach would still be required.

The leader of the It’s Our County! group welcomed the draft strategy. He thanked the strategic wellbeing and housing manager for considering the proposals put forward by his group as set out in paragraph 32 of the report. He noted the value of unpaid work done by carers and stated that it should be recognised and rewarded. He asked that the voucher and/or discount scheme proposed by his group be fully explored and reported on.

The strategic wellbeing and housing manager responded that voucher and discount would be considered as part of the implementation of the strategy but that the possible financial implications for the council and partner organisations would have to be carefully reviewed.

The group leader asked if the 34,200 carers identified in the strategy included young carers and whether the figure was in line with national norms and expectations for Herefordshire as a county.

The manager confirmed that the estimates did include young carers in principle but the council could not be certain that the estimates accurately captured the number of carers in the county. Certain groups such as young carers were particularly likely not to recognise themselves to be carers.

The group leader asked when the figures on places and spend on short breaks and respite as mentioned in paragraph 2.4 of the strategy would be available.

The strategic wellbeing and housing manager responded that these figures were being finalised and would be added before the strategy was published. There was a difficulty in that children’s social care, adult’s social care and health used different terminology. The manager offered to write to the group leader when these figures were available.

The leader of the green group noted that respite and short breaks services were seen as support for the cared for person and not the carer. She stated that the worth to the carer of respite and short breaks should be captured.

The group leader commented on the pressure on community based services and concerns that providers were increasing prices which led to those funding their own care being unable to access the services. Lower take up of these services might then lead to them being seen as failing. The group leader asked what monitoring would be undertaken to ensure that community based services were able to meet the needs of carers and that individuals were not falling through the gaps.

The strategic wellbeing and housing manager acknowledged that with reducing resources there was a shift toward neighbourhood and family support. The council was investing a lot of time and some resource to build community capacity to support vulnerable people and to prevent and delay the onset of more significant needs. There had been a shift nationally over the previous few years for respite and short break services to be seen as services for those being cared for. There was inevitably a benefit for carers as well but the focus was on meeting the needs of the person being cared for.

The cabinet member for young people and children’s wellbeing stated that statistics prepared for a speech in January 2017 referenced 700,000 young carers nationally which equated to 1 in every 12 secondary age pupils. This would give an idea of the potential number of young carers in the county.

The vice chairman of the adults and wellbeing scrutiny committee welcomed the new strategy. He asked what part WISH would be playing. He noted that recent outreach sessions in market towns had been successful and asked if this could be expanded to more rural areas through village halls etc.

The strategic wellbeing and housing manager responded that WISH was seen as essential in the provision of information and advice for carers and that plans were being finalised to commission some additional focussed information for carers which would integral with the WISH service. The manager reported that take up of outreach support information and advice had been limited where it had been operating in village halls and the like. As part of the new adult social care pathway a new service called ‘let’s talk community’ would be introduced in the autumn where members of the public, including carers, could talk to a member of adult social care staff with an in-depth knowledge of community and neighbourhood services in that area.

It was resolved that:

(a)  the draft joint carers strategy for Herefordshire be approved;

(b)  the commissioning intentions at appendix 2 and the timetable for procurement of services for carers set out in paragraph 13 be approved; and

(c)  the director for adults and wellbeing be authorised to award contracts for carers services for a period of up to five years and a maximum combined value not exceeding £1.23m