Draft Guidance on Supporting Carers
The UNISON Scotland Submission
To the Health Department, Scottish Executive
Consultation Paper on Community Care and Health (Scotland) Act
2002: Draft Guidance on Section 8-12: Carers
UNISON is Scotland's largest trade union
representing 150,000 members working in the public sector.
UNISON members include workers in both the health service
and local authorities.
UNISON Scotland welcomes the consultation
paper as an important step in raising awareness of the
change in legislation affecting carers in Scotland.
UNISON Scotland would hope that sufficient
resources would be put in place to ensure that the legislative
changes are properly implemented. This would include both
staff training and the implementation of suitable procedures.
There should be a clearer definition of
what is meant by the term - ‘substantial and regular'.
This should be clarified both in relation to adult and
This document aims to provide draft guidance
on the implementation of the Community Care and Health (Scotland)
Act 2002. This paper relates to unpaid or informal carers, such
as parents and children etc who may be caring for a family member.
It highlights that supporting carers and involving them in the
partnership of care is an integral part of the Scottish Executive's
social and health agenda.
The aim of the legislation is to ensure that
carers are not excluded from a wide range of activities and
opportunities because of their time and personal commitment
to their caring role. The legislation also envisages local authorities
and other statutory agencies ensuring that support for carers
is designed to empower carers to make the most of their potential.
The legislative changes now mean that carers,
under certain conditions, can have an assessment of their ability
to care when they request it, irrespective of whether an assessment
is provided for the cared for person. The right to an assessment
is enshrined in the changes and applies equally to adult carers
and carers aged under 18.
The guidance paper also highlights the need
for local authorities and other agencies (principally NHS Health
Boards) to inform carers of these changes including allowing
Scottish Executive Ministers to require NHS Health Boards to
draw up carer information strategies.
The main issues of concern in the paper are:
Assessment of Carers
From 1 September 2002 local authorities were
required to inform any carer they are aware of who appears to
be ‘providing a substantial amount of care on a regular basis'
that they may be entitled to an assessment. Once an authority
has decided that a carer does qualify as ‘substantial and regular',
the carer is entitled to an assessment, not just the ‘main'
or ‘primary' carer.
There is some concern over the lack of a clear
definition on what is meant by ‘substantial and regular'. This
could exclude some carers from receiving assessments which could
help improve not only their quality of life but also that of
the cared for person. There needs to be clarification on this
Assessment however is a means, not an end in
itself. Assessment acts as the gateway to the provision of services
or other support. They are also meant to ensure that the carer
can provide a sustainable level of care.
However, all local authority staff have a responsibility
to inform a carer of these new rights to assessment and this
may involve a variety of methods such as verbal or printed information.
This may help identify carers who are caring for people who
are not known to local authorities or cared for people who are
refusing their own care assessment. Although the majority of
staff that come into contact with carers will be social work
staff, it may also include staff in other departments such as
This leads to a concern that carers may be
overloaded with information about their assessment rights from
all local authority members of staff that they come into contact
with. For this reason clear procedures should be in place to
ensure that each carer receives the information they require
and that other staff members are aware that this information
has been passed on. The use of Single Shared Assessments allays
this concern to some extent. This will allow the most relevant
professional to co-ordinate an assessment and disseminate the
findings to the carer as well as related professionals. In disseminating
such information the staff member responsible for co-ordinating
the assessment must be aware of data protection legislation
regarding the transmission of private information.
This assessment procedure raises further training
and procedural requirements to ensure that these legislative
changes can be fully implemented. Of particular concern are
is the need to ensure that staff are sufficiently trained not
only in legislation affecting carers but also on data protection.
Staff will also need to be aware of carers' cultural and personal
backgrounds and their relationships with the person they are
caring for. This may be a problem when dealing with a cared
for person who refuses the services that may be offered to them
and some level of mediation must be attempted. If this were
to be attempted by staff then they would have to be sufficiently
trained or at least made aware of suitable family mediation
services that could intervene.
For carers of children with disabilities, staff
would also need to be aware that if the carers are the parents
of these children then they have specific legal obligations
that need to be taken into account during the carer assessment.
The legislative changes will provide young
carers (those under 18 years of age) with the same right of
assessment as adult carers. However there will be a different
interpretation of the ‘substantial and regular' definition in
respect to their caring responsibilities. The impact on young
carers' current and future development is to be taken into account
during any assessment. The primary objective of young carer
assessments is to safeguard their interests and promote their
All of these issues will have to be taken into
account in the training of local authority staff who come into
contact with young carers, whether in providing them with information
on the new legislative changes or in caring out their assessments.
Further resources such as access to family mediation services
etc will also have to be available in order to ensure this legislation
is fully implemented.
NHS Carer Information Strategies
The legislation provides Scottish Ministers
with a new power to require NHS Boards to prepare and submit
to them a ‘carer information strategy', setting out how the
Board will inform carers who appear to them to be ‘substantial
and regular' of their potential right to an assessment. Scottish
Ministers may specify the date for submitting the strategy,
the form and extent of the strategy, and the consultation that
the Board must undertake in preparing it. NHS Boards must also
provide a copy of their carer information strategy to any person
who requests it.
The introduction of these strategies will place
similar requirements on staff working in the NHS as those in
local authorities. It is also important to note that carers
are more likely to present themselves in a health care setting
before they make contact with local authority departments. As
with local authority staff, there will have to be sufficient
training and procedures put in place. It will also be important
that NHS Boards develop strategies in close co-operation with
local authorities and other agencies, in order to minimise duplication