EAST SUSSEX CARERS’ FORUM 16th June 2010 The first public meeting of the East Sussex Carers’ Forum was held on 16th June 2010 at Asburnham Place, Battle, as part of a large scale launch event. Care for the Carers (CftC) is commissioned by East Sussex County Council (ESCC) and the NHS to run the Carers Forum, to ensure that carers have an independent voice regarding local services. 178 carers and guests attended and took part in two sessions; the first focussed on Personalisation, and the second was a Carers’ Question Time in the afternoon.
Personalisation The morning session looked at what Personalisation means for carers in East Sussex. Consultation methodology Vicky Smith (Choice, Market Development & Engagement Workstream Manager, ESCC) gave a presentation on how Putting People First is being implemented locally, and carers gave their views through table discussions facilitated by Care for the Carers and ESCC staff. Carers were asked for their views on: • The benefits of Personalisation for carers • Their concerns • What support they will need during the Personalisation process
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The discussions were recorded on a ‘Graffiti wall’, to which carers also added comments and questions. The themes are summarised in this report, and comments have also been recorded in full in Appendix A.
What are the benefits of personalisation for carers? ‘Having the choice is valuable but it is directly related to the extra stress of setting up and managing services’ Carers felt that Personalisation would: • Benefit self funders • Give more choice and control over services • Give greater flexibility What concerns do carers have about Personalisation? ‘What happens if the carer disagrees?’ Carers highlighted several concerns, the most common being: • Carers’ Assessments Carers reported a shortage of information and a delay in accessing carers’ assessments and reviews. ‘You have to ask for it, but you need to know of it to ask!’ •
Carer’s Allowance ‘If you don’t get Carer’s Allowance, how will you get a budget?’
•
The cost ‘‘Will charges be affordable?’
•
Direct Payments
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Carers said that they had limited understanding of direct payments, and were concerned about whether direct payments are means tested or taxed, how would they affect other benefits and whether they could buy equipment with the money. ‘How will we be allowed to self manage the funds?’ •
Employment Concerns about the complexities and stress in finding and employing ‘approved’ staff and uncertainty about how brokerage would work. ‘Do gardeners/cleaners/decorators have to be on an ‘approved’ list in order to be paid for out of the personal budget?’
•
Finances A particular concern was whether the available budget will meet the need. ‘I support the concepts of personal choice and flexibility but I am concerned about the impact of budget cutbacks. How exactly will social services ensure there are services for people to access?’
•
Self-Funders There was an overwhelming concern about the lack of support for people not eligible for support from Adult Social Care ‘How can people who do not meet the eligibility criteria get help to access ‘early intervention’ and ‘low level services’ as described on slides?’
What support will carers need through the Personalisation process? •
Advocacy – ‘someone to speak up for what I want’, and the need to be directed where to go for information and speak with someone face to face.
•
Continued Contact with Care for the Carers – ‘essential and helpful, and always there when needed’
•
Contingency Plans – carers expressed a concern as to the support ‘if it all goes wrong’ and how available resources are likely to be allocated.
•
Respite
Carers’ Question Time Later in the day, Carers Question Time provided an opportunity to quiz a panel of representatives of local carers, ESCC, Sussex Partnership Foundation Trust,
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the NHS, and Care for the Carers. Particular themes included Information, financial hardship, NHS’ expenditure on Carers’ Respite, and recognition of carers as partners in care. The Panel Carers Question Time was chaired by Pam Ferris (Carer and Vice President of the Princess Royal Trust for Carers), and the panel was comprised of: • Roger Strange-Burlong (Carer and Chair of the Carers’ Forum core membership) • Debbie Charman (Carers Commissioning Manager, ESCC) • Sam Chittenden (Director of Strategy and Primary Care/Deputy Chief Executive, NHS East Sussex Downs and Weald & NHS Hastings and Rother) • Andy Porter (Deputy Director Social Inclusion, Sussex Partnership Foundation Trust) • Liz Fenton (Chief Executive, Care for the Carers) The Questions Carers had been invited to submit questions for the panel in advance – the questions used on the day reflected the most common themes from the pool of questions received. Sadly not all the questions could be addressed on the day, so a list of questions not addressed on the day is included at Appendix B. These questions have been put to the relevant organisations, and the answers also included. Some of the questions received related to issues around carers’ individual caring roles – where this was the case, CftC Support Workers are making contact to discuss this personally.
The Debate 1. How can carers in East Sussex find out what they are entitled to? Whilst there was general agreement on the value of the Carers Assessment as a source of information, not all carers are entitled to the assessment. Eligibility needs to be clarified as some carers may have been in their caring role for many years before they find out their rights and entitlements. Liz proposed that a Carers Charter be developed in East Sussex, to which all agencies could sign up Page 4 of 17
to, and which could enable all agencies to work together to ensure that carers get the information they need. This was welcomed by the panel, who also acknowledged that carers do not always identify themselves as carers. The panel also highlighted the importance of the voluntary sector in supporting carers who do not wish to be labelled, and may therefore not approach the statutory organisations. Comment from Audience: A carer spoke very highly of the carer’s assessment as she accessed the Carers’ Respite Emergency Support Service (CRESS) and received a Carers Support Grant. However, the assessment had been put into action after her mother was admitted to hospital. The carer was concerned that she would not have heard of it otherwise and that other people are not aware of it. 2.
How can we ensure that carers are not financially disadvantaged by their caring role? The financial and emotional realities of caring need to be recognised and the ensuing challenge must not be overlooked. Bodies such as the Princess Royal Trust for Carers and Carers UK lobby Government on a regular basis ensure that financial benefits for carers are high on the agenda. Debbie said that ESCC is working with Job Centre Plus to support carers return to work. It was acknowledged that this will not apply to many carers who cannot return to work and therefore live in a difficult financial position. Comment from Audience: One gentleman added that he had felt that he had a responsibility to his wife to prepare for their retirement; but as a result they are now not entitled to any support. Also added that the term ‘benefits’ was incorrect, should be called ‘entitlements’. 3.
The National Carers Strategy led to £150m being allocated to Primary Care Trusts (PCTs) from 2009 to 2011 for carer’s respite. Can the panel comment on how this has been used in East Sussex? Sam Chittenden advised that last year the East Sussex Primary Care Trusts had a budget of £500,000 for carers. This budget had not been ring fenced, and whilst it had been spent on Continuing Health Care as agreed, this spending had been reactive last year and this year will be more carefully planned. This financial year the Primary Care Trusts will use a more transparent and strategic approach in partnership with Social Services with the money being used as a priority for breaks. Andy Porter said that direct payments could provide carers with the opportunity to pay a support worker to go on holiday with them and the person they care for, which would give the carer the opportunity for some respite. Comment from Audience: One gentleman added that he cares for his son who has special needs. Respite is good, but he has feelings of guilt – it would be beneficial for both carer and the
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person they care for to have opportunity for breaks apart. This would allow parents to have a break, knowing that their child was also having a good time. 4.
What are the barriers to carers being recognised as partners in care and how can these be removed? It was accepted that there were many barriers to carers being recognised as partners in care by NHS services, and that carers are not always recognised due to regulations relating to confidentiality and information sharing. Often barriers exist from prejudice and habit but they can be overcome. There is an awareness of the need for staff training, perhaps involving carers as in the case with social workers. It is possible to respect patients’ and carers’ wishes and not have a one or other approach. Comment from Audience: One carer spoke of how frightening a hospital can be and suggested that hospital staff wear identity badges. Hospital staff had not listened to her about how to prepare her daughter, who has learning difficulties, for an operation. Her daughter had become so frightened that she had to be taken home and the appointment rebooked. 5.
Does the panel believe that there will be sufficient quality services for Putting People First to work efficiently? Debbie Charman stated that there was still much work to be done including ensuring that systems are in place. There is an internet project detailing available services. It is essential to make sure that resources are available and ESCC would like carers to report back when problems are flagged up. The Sussex Partnership Foundation Trust recognises the challenge but it is still in the early stages of self-directed support. This is a new role which will bring new challenges. In the current climate funding is not guaranteed. Comment from Audience: One carer said how grateful he was for the support and help received from Adult Social Care and in particular at Pinehill.
Evaluation The evaluation of the event asked carers to comment on the different sessions, as well as the garden party element of the day. Results show that whilst carers recognised the benefits of Personalisation, there were a number of concerns about potential cuts, information and the complexity of the system. ‘Expert advice particularly in table discussion. More of this please’.
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Carer satisfaction with the Carers Forum and the Garden Party was high with 95% of carers reporting a ‘quite useful’ or ‘very useful’ satisfaction rating for the first session. Carers Question Time achieved an even higher satisfaction with 100% of carers saying it was worthwhile.
Next steps An important outcome of this meeting is that the views that carers expressed influence local services. To ensure that this happens, CftC will provide this report to: • • •
All participating organisations, and any other statutory organisations with a responsibility for supporting carers in East Sussex All core members of the Carers Forum, including member organisations All carers who attended
The next public meeting of the Carers Forum will take place in October and will focus on Respite – please contact Care for the Carers on 01323 738 390 if you are interested in taking part.
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Appendix A TRANSCRIPT OF CARERS’ COMMENTS PRESENTATION Jargonistic and too statutory in formation. Not balanced and accessible. Couldn’t hear couldn’t see the screen Presentation was clear No input from Children’s Services – totally disregarded as a carer.
BENEFITS Better for self-funders Choice Flexibility
Control
CONCERNS Cuts
I think support with ‘Confidence’ will be excellent for self funders Sounds like a good idea as it allows for more control Gives Choice Greater flexibility. Assist cared for on occasional shopping trip – easier to arrange with personal budget Service users will benefit from flexibility of their own care worker – especially if paid through A4E Complete benefit check/financial assessment. Gives control and better support for individuals which is what they want. Son with LD get an allocation of hours with staff from Avery which works well
The new Government is going to cut some L.G. grants . The will probably be: Supporting people Carers Grant LD Development Fund Mental Health Mental Capacity Act Training Will this have a knock on effect on service users and carers in Susex? I support the concepts of personal choice and flexibility but I am concerned about the impact of budget cutbacks. What guarantees +/or contingency plans are in place How exactly will social services ensure there are services for people to access? Does ASC provide the service or do they rely on private companies to provide. Not enough services for carers + support re SDS process
Resources
Choice
Lack of clarity around system How will resources be allocated In an ideal word we must all agree these changes BUT we have to talk money – what ceilings are in place? Will the money be there to meet need? Happy with current system and what support is in place P.A.s are not for everyone Choices around respite limited
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Flexibility
Quality
Employment
Cost
Direct Payments
Carer’s Allowance
Assessments
Having the choice is valuable but it is directly related to the extra stress of setting up and managing services How does the personal budget meet individual need. Even if needs are similar in some ways to other people’s needs they may require different support. How will we get the flexibility we need? Increasing concerns about the standards, quality and training of individuals and organisations How will you assure the quality of services to purchase? How do I know what/who to choose and the quality of service I will get? How will brokerage work? The new arrangement are linked to financial and employment issues that are too complex i.e. managing/opening new bank accounts/employing p.a.s Employing someone direct is troublesome without support How will people be ‘approved’ for recommendation as workers? Carers are too busy to deal with the complexity of budgets and employment How will we be allowed to self manage the funds Do gardeners/cleaners/decorators have to be on an ‘approved’ list in order to be paid for out of the personal budget? Too stressful – paperwork, responsibility of employment etc. Good paid carers are hard to find. Caring profession isn’t highly regarded, isn’t well paid, so hard to recruit your own carers. Grant if you get good ones that stay with you. Will a payment level be put on charges for services? Will it cost more to use external providers? Charges – will they be affordable? Can DP’s be made to carers who live with the service users? Will it be means tested. Will it be taxed? When will payment be made – annually or monthly? Does a PB replace my benefits? Will DLA be taken away? Could S.D.S effect benefits? Too many constraints around benefits e.g. state pension, Carers Allowance etc. Carers might lose out on benefits they currently get Will it include equipment e.g. rising chairs, massage equipment? If you don’t get a Carer’s Allowance how will you get a budget Carers Allowance should not be means tested and available after retirement My 20 year old so has had an assessment form S/Services. He doesn’t receive any money or help. My husband and myself care for him. We occasionally get a Carers Grant to help with taking him on a family holiday. If the Carer’s Grant is cut we will struggle to have any sort of family time away. How long does the assessment process take and how often reviewed? Waiting/delay for reviews Concern about when and how reviews will be taken Carer’s Assessments vital! But need to be reviewed regularly – carer should be contacted Must be given a separate Carers Assessment to SDS process – Have a voice?
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As a carer you need the opportunity to talk separately during the SDS process Concerns around financial assessment and paying top up’s for respite What will happen if I disagree with SDS Assessment Accountability Self-Funders
Self-funders
Mental Health
Contingency Plans Lack of Information
Sustainability Social Services
SUPPORT Employing staff Advocacy Advice Feedback from others Mutual Support Contact with CftX
Who is ultimately accountable if the SDS package breaks down Will self-funders still be eligible for Carers Grants? How will self-funding people be supported to get support services? Self Funding people do not get enough support now to access the services they need. How can PPF service support these people? How can people who do not meet the eligibility criteria get help to access ‘early intervention’ and ‘low level services’ as described on slides Postcode lottery for self-funders Retired Self-Funders not eligible for Carers Personal Budgets – not recognised for their caring role How can self-directed support adequately help with people with Mental Health care needs to access appropriate services. Carers are not treated as experts in mental health Self-direction won’t work if the cared for person lacks mental capacity or chooses not to. What if SDS breaks Down Complicated if it all goes wrong Lack of information – Personalisation not widely known about – not mentioned by ADSC workers during review. A lot of carers don’t know what they are entitled to. How well promoted is Carers Assessment? You have to ask for it…but you need to know of it to ask! Should it be offered more systematically? How do people hear of CftC and other support networks? Particularly if you are someone who ’drifts’ into the carers’ role – no financial needs, no hospital, events etc. So Many people don’t know where to go for help/support/advice /information I didn’t realize that Adult Social Care has even an option – cared for has been seen by MH team but no care discussed Notes not always up to date on CareFirst so hard to find out what’s happening Are carers personal budgets going to continue? At the end of the day are Social Services no longer going to provide care themselves? Carers services should be kept separate Where will we get help to find care workers How do we get help to employ staff? Support for employing staff Advocacy – someone to speak up for what I want Would like to discuss things with someone face to face Need advice – don’t know where to go Feedback from other service users about quality of services Mutual support - carers to met each other – carers groups geographical Regular contact with CftC and information Support from CftC – essential and helpful and always there when needed Knowing where to get information
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Good information in lots of places. Need help to understand the system. Lack of information – Personalisation not widely known bout – not mentioned by ADSC workers during review. Not sure what things can be done- cared for needs encouragement Reliance on carer to support cared for in self-assessment. Carer may need support Respite is important and needed Need a break Barriers
Attitudes of ASC towards carers needs to change ASC a law unto themselves Needs more crosscutting work with health
General Continuity of Care
Minority Groups Young Carers Recognition as a carer Advice to other Carers Social Services Grant Advice Daycare
Respite
Continuity of support through ADSC – open/shut cases Continuity of carers Would really like to find a way of having the same carer more often – high value to find a carer that truly works well with the person being cared for. ‘Not many BME people are represented here today’! Why can’t children get any help for looking after a parent? I would like to be recognised as a carer not only as wife/mother Always Appeal! – Carers Advice about ASC When you finally get the right person, it works (ASC) Now that we have run out of money are we eligible for support and a motorized wheelchair? Day Centres Shutting Down, or won’t take Self-Funders. These types of services are seen to be valuable to meet my family member desires! Insufficient day care – carers want Day Care Respite away from home. Do not want people in their own home.
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Appendix B
CARERS’ QUESTION TIME – ADDITIONAL QUESTIONS QUESTIONS ANSWERED BY THE PRINCESS ROYAL TRUST FOR CARERS Why can't we be given an income for our caring like paid carers? The Trust believes it is wrong that carers are effectively penalised for taking on care on behalf of the state. During the Big Care Debate it put forward a proposal "Crediting Carers" which suggested a way of compensating carers financially for the care they provide. We intend to continue exploring new approaches like this which give more recognition to the role carers play in society. Paying carers in the same way that paid carers are paid remains a controversial issue. It seems right and fair for carers to be recognised for what they do. However, paying a carer as an "employee" of the person cared for could completely change the relationship with the cared for person. Many carers would not want this as they could see it upsetting the balance of give and take in the relationship. The direct payments legislation allowed payment "in exceptional circumstances" although it was never clear what these would be. Another very strong barrier to payment would obviously be the cost to the public purse which would be prohibitive. Would it be ever possible to up the carers allowance slightly if caring for two people? Carers Allowance does not work very well as a benefit for anyone. It is not particularly fair or helpful. We would prefer to see a major change which improved financial support to carers generally. The Department of Work and Pensions would say Carers Allowance is an income replacement benefit so whether you are caring for one or two people, the carer could only have one income to be replaced. However, we support MPs recommendation for a Costs of Caring payment which would be on top of benefits and it is conceivable that this could be higher if caring for two people rather than one – but this is only a proposal and the Government has not shown signs of adopting a Costs of Caring payment How can the government pay me £94 per week and say I can earn another £100 a week, yet they class me as being in full time employment? Is this fair over 35 hours? Carers Allowance does not work very well as a benefit for anyone. It is not particularly fair or helpful. We would prefer to see a major change which improved financial support to carers generally If ‘full time employment’ here refers to having to care for more than 35hrs p/w before receiving Carers Allowance (CA) then from the Government’s point of
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view there are 2.9m people who do combine work and care. Their policy of allowing carers to earn up to £100 (after tax and replacement care costs) and still receive CA tries to recognise that for some carers, caring for 35 hrs p/w and doing some part time work is realistic and desirable on behalf of the carer. The carer is expected to look for a job as soon as the patient dies or goes into care: ICA stops immediately. Could ICA be extended for three months assisting the carer greatly? This does seem a reasonable thing to ask for. It is very difficult to adjust from a life of caring into work so quickly. We will take your comment on board to help inform our policy work on behalf of carers. Should the carers allowance be means tested? My costs in being a carer comes out of my wages. Should they? Carers Allowance is a taxable benefit (not means tested) so if you earn over £5k plus Carers Allowance then you may have to pay tax on your total income. Regarding the costs of caring we support MPs recommendation for a Costs of Caring payment which would be on top of benefits – but this is only a proposal and the Government has not shown signs of adopting a Costs of Caring payment See response to previous question (question 4) regarding carers' allowance not working. In the future will the Government ever give out extra funding and pensions to US CARERS? As of April 2010, carers caring for more than 20 hours a week will have their contribution to State Pensions paid for them by the Government. On greater financial benefits, the Government is proposing welfare reform and we will campaign for increasing benefits for carers to be a part of that. We will continue to try to influence Government to improve financial support for carers of all ages. QUESTIONS ANSWERED BY CARE FOR THE CARERS Are more social groups being set up in the future? i.e. social get ups and social evening events? Through our Carers in Touch Programme we have ten Carers Groups throughout the county which provide information and an element of socialising. Certainly friendships can and do develop, and carers put a strong emphasis on the importance of talking with other carers at these groups. Carers asked us for such a group in Uckfield which started in March and we are now looking for a venue for a new Eastbourne Group, which again has been requested by Carers.
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We have recently started twilight sessions which gives our support workers the opportunity to contact carers who otherwise could not be contacted. These sessions have proven to be very successful. In response to this question, we will ask carers whether they would like to have evening events in an edition of Careline. How can Care for the Carers become more inclusive of carers who have sensory impairments? We believe that our service should be accessible to all carers in East Sussex, and work hard to achieve this. Measures we have taken to render the service inclusive of carers who have sensory impairments include supplying CareLine magazine in tape and CD format and raising funds to enable us to employ signers at events. We ask every carer we work with how they would like us to communicate with them and when organizing meetings and events, we ask whether people have accessibility requirements, and we do everything that we can to meet these. We also welcome feedback on how we have done, and by responding to this we hope to continue to improve our service. QUESTIONS ANSWERED BY THE NHS Why are health care costs a lottery? Each Primary Care Trust has a defined budget, which is allocated to it from the Department of Health. As you would expect, the actual healthcare needs of a local population can vary significantly from place to place, and each PCT will use public health information to determine the healthcare needs of its local population and therefore, how it should spend its money to provide for this need. A PCT can only use the money it has been allocated and unfortunately this means that difficult decisions have to be made to fund some services over others – in making these decisions, the PCT will consider where the outcomes and benefits to its population would be greatest. QUESTIONS ROLES ANSWERED BY ESCC Could you please confirm if any grants for respite are available to someone who provides 24/7 care to a disabled person who also pays them as a P.A through the direct payments? If you provide regular and substantial care to someone on an unpaid basis, on top of any care you provide when you’re paid as a PA, you may be entitled to a Carers Assessment in your own right. The Carers Assessment provides you with an opportunity to discuss your respite and other service needs. This would then be considered as part of the support plan for you and the person you care for. I live with Mum. What happens to our house if she needs to go into a home? - Where do I live? The answer to this very much depends on your individual circumstances. In the first instance it would be useful for you to look on our website www.eastsussex.gov.uk that provides full information about residential and Page 14 of 17
nursing home care, including the financial implications. Or, you can call Social Care Direct for our fact sheet on ‘Financial assessments for residential care’. If there is any question of eligibility for social care it would be worth getting your mother assessed by ASC to consider all of the options available. When are carers going to be able to get more breaks/respite? This is one of the main priorities of the joint carers’ strategy for East Sussex, and we are working hard with our health colleagues to ensure that respite services are more easily available and accessible to carers right across the county. Why is there no way of ensuring that someone is properly cared for on a care home? There is no valid way of ensuring a proper complaint procedure. National minimum standards and new regulations are clear and explicit, which say that there should be a proper complaints procedure in all care homes, so you should be able to get this from the home concerned. In addition to this, the Care Quality Commission inspect homes regularly, and Adult Social Care become involved in site audits of care homes, typically in response to other areas of concern e.g. a ‘poor’ or ‘adequate’ overall rating from CQC, or a safeguarding concern, at which point we do look at the evidence for complaints and how they are handled. Hastings Crossroads are a brilliant caring organisation and I would like to retain their services which means, I will have to pay £10.14 each week for 3 hours respite care but surely this is supposed to be free at the point of delivery? Yes, services for carers are currently free in East Sussex. We offer free respite support from a framework of approved providers who have been chosen following a rigorous tender process. If you want to get respite care from an agency which is not on our framework, then we will give you the agreed amount of money for your area to pay for the respite you need. You may need to top this up if the agency you choose is unable to deliver the number of hours for the funding we can provide. Would it be possible for mature carers, i.e. well into retirement, to have access to, for instance physiotherapy, aromatherapy at a reasonable price? As part of a Carers Assessment you can discuss your needs, and it may be agreed that you would benefit from some therapy for which you could receive a contribution towards the cost by means of a Carers Personal Budget. We are also looking at how we can work with Borough and District Councils to encourage them to introduce discounts for carers for leisure and other activities in their areas.
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Why do Social Services appear to be unhelpful and at times down right obstruct in relation to adult social care? We do not intend in any way to be unhelpful or obstructive, and I am very sorry that this has obviously been your experience. If you have a complaint I would encourage you to contact our Complaints Unit and let them know the situation so that we can investigate the matter for you. Their telephone number is 01273481242. You can email them on asccommentscomplaints@eastsussex.gov.uk, or write to: Complaints Unit Adult Social Care St.Annes Crescent County Hall Lewes BN7 1SW We want our services to be as accessible and responsive as possible and so we would want to hear about all instances where this was not the case. Are there any places that provide fun/learning activities for teens with autism? We have some activities specifically designed young adults with learning difficulties (over 18s), notably the Saturday Clubs provided by Circles Network in various areas of East Sussex. However, it is true to say that there are limited activities that are designed specifically around the needs of young adults with autism. This reflects the general direction of national service development (i.e. inclusion, not separation) which has a focus on giving young people support to access community services, not necessarily services exclusively for disabled people. Young people under 18 would need to contact our Children’s Services Department, who do have other options. Being over 70 with a learning disability daughter, 51 years, I am finding it difficult to cope with a small garden - are there any volunteer gardeners or similar available? You might be able to access our Handyperson scheme which provides grants for the cost of small jobs around the home. There is also the Anchor Staying Put service operating in East Sussex, which may be able to provide a gardening service for you. As a carer you may also be entitled to a Carers Personal Budget to help you with the cost of a gardener or gardening service. Being as carers contribute so much to society and save taxpayers money, can it be guaranteed that carers grants will be continued through the tough times ahead? As I am sure you can appreciate, nothing can be guaranteed in the current financial climate. However, here in East Sussex we are very conscious of the value that carers bring to the community and will prioritise their needs as far as possible into the future.
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My point is: If you are a paid, live-in carer you are entitled to a 3 hour break each day. Relative carers who do the same job don't get this and the carers allowance is pitiful! The support that family carers provide is vital, and in recognition of this we have established the system of funding some respite every week for those in most need, as well as the opportunity to access other services, including support from the voluntary sector. Locally we are unable to influence the amount of Carers Allowance, but there are national campaigns that you can join to try to increase this. Define what a carer is. (e.g. what is eligibility criteria‌.) A carer spends a significant proportion of their life providing unpaid support to family or potentially friends. This could be caring for a relative, partner or friend who is ill, frail, disabled or has mental health or substance misuse problems. This is the definition provided in the latest national carers strategy [Carers at the Heart of 21st Century Families and Communities, 2008] and reflects national legislation.
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