Archived decisions

HAMPSHIRE COUNTY COUNCIL

Decision Report :

EXECUTIVE SUMMARY

1) Summary of Decision Area:

1.1. To approve the special grants programme for carers' support for 2008/9.

Carers play a vital role within our communities and we recognise the enormous contribution they make in Hampshire, often in very difficult and stressful circumstances.

Over the past two years, Hampshire Adult Services Department has been working closely with carers and key partners in the third sector to develop our strategic approach and response to supporting carers. This work resulted in a new strategy for carers in Hampshire which both reflects local need and supports national policy.

This work acts as a basis for the recommendations in this report, focusing on meeting the support needs of carers in Hampshire and national policy objectives regarding the improvement of carers' support.

2) Issues Covered in Report:

2.1. The grants allocation of carers' resource (of those grants over £5,000)

In recognition of the vital role that carers play in our communities, national government allocated additional resources in 2008/9 to support the development of additional support services, in particular respite services. In line with partnership working and within the new strategic approach, we have developed a grants programme using the additional resource to meet local respite needs across a range of caring roles.

2.2. Policy context for carers (locally and nationally)

The new Carers' Strategy promotes the development of respite services for carers and an increase in the availability, accessibility and affordability of such services. Therefore, this grants programme recommends the placement of resources where carers have ease of access, for example, directly with Hospices and care agencies.

The recommendations support the Hampshire Model, developing multi-sector partnerships to `put carers first' and to develop practical services for all carers. Two of the grants recommended in this paper are directly to support the increased involvement of carers in decision-making and service development, promoting choice and empowerment through service options and improved accessibility.

Although the grants are specifically for adult carers, partnership work is ongoing with Children's Services to ensure that the needs of young carers are taken into account and that carers in transition continue to be supported.

2.3 Supporting outcomes for carers, making a difference

The grants will support the range of outcomes for carers that have been developed through the increase in self-directed support (SDS) options (the Basingstoke SDS project and work related to Direct Payments).

Carers will be supported to:

· Manage the day-to-day running of their home life

· Get new relationships or maintain the existing relationships they already have

· Be able to take part in activities in their local area

· Be able to learn new things or get a job

· Feel safe at home and have the right support/equipment to stay safe

· Get help so they don't hurt themselves or others

· Get help to make decisions when they need it

· Be able to get support when they need it

For example, a carer may be able to access respite support from the Alzheimer's Society programmes to enable them to attend a college course.

2.4 Supporting the voice of local carers

Through consultation work relating to the Strategy, carers and stakeholders have

asked that resources be allocated to respite services and that Adult Services

investigates ways in which services might be developed.

2.5 Promoting the independence of carers

Following feedback from the Carers' Strategy and Basingstoke SDS project, the grant initiatives have been designed to increase the independence of carers by

increasing the range, flexibility and accessibility of respite care. Carers will have

more choice and control with self-directed options and direct access. The

initiatives have been targeted towards carers in Hampshire with identified priority

needs, for example, carers of people at the end of life where grants will be

located with the Hospices.

2.6 Working with partners

Adult Services has worked in partnership with the third sector in developing the strategic priorities for local carers. This is in line with the Hampshire Compact: working together to improve mutual understanding, collaboration, trust and respect in the true spirit of partnership to the benefit of the people of Hampshire.

3) Recommendations:

It is recommended:

3.1 That £235,396 of the carers' resource be allocated as a grants programme within the central grants process.

3.2 That individual grants are supported as proposed in the plan set out at

Appendix C.

3.3 That a small grants programme of a total value of £75,000 be supported in 2009/10. This will be a small grants programme for carers' projects and support which will be managed locally. The value of each grant will be less than £5,000 and so will not require Executive Member approval on an individual basis.

MAIN REPORT

1) Contextual Information:

1.1 The new Hampshire Carers' Strategy was launched at the end of 2008 following successful partnership working with the local community. This document establishes the local strategic response to carers' support and priorities for the next two years. It also outlines intentions for developments in local services.

1.2 2008 also saw the publication of a new National Carers' Strategy which outlined the national government approach and priorities for the next 10 years.

1.3 Both strategies acknowledge the importance of carers in our communities and establish that carers require a range of quality support services and interventions which offer support both within, and outside of, caring roles.

1.4 Additional resource was made available through the new National Carers' Strategy via the Carers' Grant to support the following strategic priorities:

· `the doubling of respite provision' over the next 10 years;

· involving carers in service development; and

· increasing self-directed support options.

1.5 Overall, the 2008/9 allocation was an additional 24% at £625,700. The total recommended grants spend in this paper is £235,396, with the remainder allocated to a range of small grants.

1.6 From 2009/10, there is potential to work in partnership with Hampshire Primary Care Trust enabling joint projects to be developed. As such, this paper outlines how it is proposed that the majority of the current resource is allocated to support carers in the next 12 months.

1.7 Carers involved with the development of the new Hampshire Strategy and those continuing to support the Carers' Strategic Partnership have recommended that Adult Services support local carers and organisations via a grants programme.

1.8 Therefore, this report details the range of grants proposed for 2008/9, supporting

local and national priorities to ensure better outcomes for carers and supporting

Adult Services in delivering the range of services and initiatives expected in the future.

1.9 The report also recommends that £75,000 is allocated from carers' resources in

2009/10 for the provision of a small grants programme for carers' support. This small grants programme will focus on supporting innovative third sector breaks for carers and building diversity in the local market, less than £5,000 per grant:

· Supporting self-directed support

· Remit of small community projects and services

· No criteria around client groups or service type

2) Key Issues:

2.1 The recommended grants support the development of respite opportunities for carers in all care groups and in a number of caring situations and roles. This supports the policy aims of the new National and Hampshire Carers' Strategies and supports joined-up approaches with other strategic work. It links with the Older Persons' Mental Health, Care at the End of Life and Hampshire Sustainable Community Strategies. An overview of the National Strategy and the implications for Hampshire can be found in Appendix D.

2.2 The range of agencies has been selected to enable the development of support for carers which is tailored to meet individual need and improve accessibility, supporting the priorities of carers in Hampshire. For example, respite resources for carers undertaking a caring role for someone at the end of life have been directed to Hospices to assist access and response times. Resources for carers of people with dementia have been allocated to the Alzheimer's Society and the development of local Alzheimer's Cafés.

2.3 This grants programme develops support for carers in partnership with carers and local organisations. The grants enable a range of local organisations to respond innovatively with bespoke respite solutions for carers, supporting personalisation and third sector development and the involvement of carers in decision-making (in line with the Hampshire Model).

2.4 In line with local and national policy on respite services, this grants programme

supports the expansion of the range and availability of support services for carers.

2.5 The grants represent contributions to the work of the organisations listed. In the

cases of the Alzheimer Cafés in Gosport and Andover the grant will contribute to the start-up costs for these new projects and is seen as pump-priming funding.

2.6 The long-term aim is to co-ordinate our grant programme with Hampshire PCT.

The additional carers' money in 2008/9 represents an early opportunity to deliver improved outcomes for carers in advance of establishing the joint arrangements.

2.7 The availability of the resource was signalled late in the year which limited options

for deployment. This did not fit with the central grants programme timetable and so the carers' grants have been proposed through a parallel and complementary process. This has involved close working with colleagues who look after the main Grants Programme so that there is linkage between the programmes.

2.8 The rationale for grant-making was based on matching local providers with identified priority issues for local carers, those people caring for someone at the end of life (hospices) , those caring for older people with mental health needs (Alzheimer Society and Cafés) and those who could promote the involvement of carers on a Hampshire wide basis (Carers Together in Hampshire for carers of older people and people with physical disabilities and The Princess Royal Trust for Carers for carers of people with mental health needs).

3) Risk Assessment

3.1 Services have been developed using the Adult Services grants framework to enable use of an existing framework for resource allocation which has built in quality and monitoring processes. Local providers (voluntary sector organisations that provide services in Hampshire) with strong track records have been identified to deliver services. Monitoring grant agreements will be prioritised to ensure value, quality and accessibility. Service outcomes will be monitored to ensure value for carers.

3.2 Assessments will be undertaken with small, local providers accessing the grants programme to ensure that they are able to deliver locally-based support.

3.3 Government has committed to a `doubling of respite provision' over the next 10 years. Increases in the Carers' Grant have been delivered (so far) to support this. There is no long-term certainty that this funding will be continued given the length of time and the possibility of a change in Government.

3.4 All services will therefore be developed as part of self-directed support to increase sustainability.

4) Finance

4.1 The additional carers' grant allocation for 2008/9 is £625,700. The grants

recommended in this report total £235,396. £300,000 will be carried forward as

agreed and the rest of the grant for 2008/09 (£90,304) is fully committed on smaller

grants for carers' support and respite services dependent on local situations and to

promote diversity. These small grants (less than £5,000 each) will be managed

locally to develop markets for carers' self-directed support.

4.2 The resource to be allocated on grants in this paper does not include the carry forward amount for carers' respite care from 2007/8 which was £298,000. This amount has been spent under a separate, specific spending plan (the Emergency Respite Project).

4.3 Funding for these grants has been identified within the Commissioning Directorate and will be allocated via the main Adult Services Grant programme.

5) Conclusions

5.1 The grants programme offers a range of accessible, self-directed options together with the roll-out of successful, existing Hampshire projects which will increase service levels, access for carers and which will assist in the diversification and development of the market for future (current) need.

The use of grants reflects and supports the involvement of carers and local organisations in the deployment of respite resources.

5.2 The recommendations will:

· support Adult Services' performance and ease of measurement;

· limit bureaucracy/administration costs due to use of grants;

· support the Carers' Strategy implementation (national and local);

· increase access for carers;

· support the self-directed model; and



· deliver economies of scale balancing this with local response by enabling the local discretion to provide appropriate services in each area and supporting diversity.

6) Recommendations:

Please see Executive Summary for recommendations.

Appendix A

CORPORATE OR LEGAL INFORMATION:

Appendix B

IMPACT ASSESSMENTS:

1. Equalities Impact Assessment:

Appendix C

Grants Programme 2008/9

Appendix D

Summary of New National Strategy for Carers

This appendix gives an overview of the new National Carers' Strategy, `Carers at the heart of 21st century families and communities: a caring system on your side, a life of your own',

and of areas of implementation, impact and spending for Adult Services.

1 Introduction

The Carers' Strategy sets out the Government's short-term agenda and long-term vision (to 2018) for the future care and support of carers.

The Carers' Strategy is underpinned nationally by increases in the Carers' Grant to implement some immediate steps alongside medium- and long-term plans:

· £150 million towards planned short breaks for carers (paid to PCTs)

· £38 million towards supporting carers to enter or re-enter the job market

A more integrated and personalised support service for carers will be offered through easily accessible information, targeted training for key professionals to support carers, and pilots to examine how the NHS can better support carers.

2 Policy aims

The policy aims are:

· To develop support for carers which is tailored to meet individual need

· That the best environment for a person with support needs is often their own home

· That carers are respected and enabled to have a life of their own

· That carers are supported and not forced into financial hardship

· That carers are enabled and supported to stay well

· The promotion of social inclusion

· The promotion of partnership and integration at all levels

· Support for third sector innovation

There is an `unambiguous signal' to health (PCT, GPs) that it should take a greater responsibility for supporting carers.

3 Governance and performance

The Government is developing:

· A Standing Commission on Carers

· A Programme board

· Performance frameworks

· A New National Indicator Set

A consideration of new indicators from the Strategy and development of outcome-focused indicators based on carers' experiences. In the short term, better use will be made of National Indicator 127 (self-reported experience of social care use) to gather carer views.

Overall, there is a move towards measuring carers' experience of service, part of which will be a national survey for carers 2009/10 (voluntary).

4.1 Impact on Hampshire County Council

The new Hampshire Carers' Strategy addresses the same priorities as those identified at national level. Progressing the local Strategy will enable both to be delivered including work on partnerships, respite breaks, and assessments.

4.1.1 Partnerships

The strategy emphasises that supporting carers is not a job for one agency. Adult Services has a well-established partnership framework with community leaders and carers. Work now needs to be undertaken to extend this with statutory partners.

Partnership work will be undertaken across care groups to support carers, specifically in the areas of Older Persons' Mental Health and Care at the End of Life.

4.1.2 Respite breaks

Emergency planning and respite breaks have been developed. Joint plans with the PCT must be developed and (all) spending on breaks will need to be publicised. Innovation and the development of more flexible breaks with multiple points of access for carers.

The Adult Services spending plan focuses on improving the provision of respite.

4.1.3 Assessments

There will be further development to meet carers' needs (holistic, joint, separate and the potential for self-assessment).