Submission - Jersey Association of Carers - Jersey Care Model Review - 23 September 2020

Letter to Deputy Le Hegarat 22nd September 2020 Dear Deputy Le Hegarat ,

Thankyouforyourletterof8th September regarding the Jersey Care Model.

1. I am unaware of the out of hours social care service establishedinresponsetoCovid19.
2. Any shift of care into the communitywillrequiremorecommunity workers such as social workers.
3. Care homes and Carers do not work together unless residential respite is planned. As there do not seem to be any designated respite beds this cannot be booked for more than 1 or 2 weeks in advance and short breaks of a few days may be charged at a weekly rate. During the recent lockdown many Carers did not see their loved oneforabout12weeks,causinganxietyanddistress.
4. Careathomeispreferredbymany patients and Carers but Carers must feel supported with information, training and flexible respite. Emergency help must also be available if the Carer is unwell.
5. There must be more Primary and community care provided.
6. The JCM has many ideas but no firm suggestions re Carers except increased support, but no details. If more restrictions are necessary due to Covid19 there should be plans to help Carers who have turned to charities and volunteers for support until now. Carers' mental health is at risk.

I have read the JCM and some of the proposals are very interesting and make sense. I am not sure of the financial implications. I have attached a copy of The Carers Strategy written by Carers. The Carers Partnership Group is planning to meet next month.

I hope this reply is of some help.

Yours sincerely

Margaret Bayes

Dr Margaret Bayes MBE ChairmanJerseyAssociationofCarersInc.

The views expressed in this letter reflect the personal opinions of Dr Margaret Bayes MBE

Appendix

JerseyCarersStrategy

Getting things right so Carers thrive not just survive'

Jersey Association of Carers Incorporated and the Carers' Partnership Group

Contents

1.0 Preface

2.0 Introduction

0. Strategy Development
   1. Key strengths in the current system
   2. Key gaps in the system

5.0 The underpinning principles

0. Supporting Jersey Carers to thrive by Getting it Right'
1. Priority Area 1. Getting the right Respite
2. Priority Area 2. Getting the right Emotional and Practical Support
3. Priority Area 3. Getting the right Resources through Legislation
4. Priority 4. Getting the right Information and Advice
5. Priority Area 5. Getting the right Inclusion and Empowerment

0. Key Deliverables we want to achieve
1. Measuring the deliverables

 Carers' strategy preface – Chief Minister

A carer' can be anyone, a child, a parent, a friend or a relative. A carer can also be any age, from the very young to the more mature in our community.

One of the challenges we face is getting people to acknowledge that they are, themselves, carers. People will often say "I'm not a carer, she's my mum. I just pop in to see her a few times a week, do a bit of cleaning and bring her dinner." As our population ages we will see more and more people who say they are "just" looking after their wives, husbands or parents.

Jersey's 2016 Health & Life Opportunities Survey found that one in ten households include a selfidentified carer' and that 1% of households have a young carer who is under the age of 19.

This new Carers' Strategy has seen politicians and government representatives working alongside the voluntary and community sector and carers themselves. Looking after a loved one touches on every aspect of the lives of carers and of the person being cared for. It can affect relationships, finances, family life, career and education opportunities.

50% of carers say they get satisfaction from their caring role, however 51% say it increases their stress levels and 39% say caring can make them feel worn out or exhausted.

This is a comprehensive strategy for our island which has involved all sections of our community in its development. I hope it plays its part in improving the lives of both carers and of those they are caring for.

 Introduction

Our society owes a great deal to the thousands of people who provide unpaid care and support to a family member or friend. The pressure on many Carers is often high and the impact on their lives is significant. Offering the right type and amount of support is crucial, in order to meet theneedsofCarerswhowanttocontinue to care for their loved one and who want to thrive and not just to survive'.

• Jersey's population is ageing and there has been a sharp increase in the numbers of Carers over the age of 75.

• The numbers of people dependent on another in Jersey is growing and this will escalate significantly in the years ahead.

• The numbers of Carers in Jersey aregrowinganditisestimated that one in seven people are currently fulfilling an unpaid caring role.

• Without the right support caring can take its toll, many Carers say that caring has pushed them into the financial hardship andnearlythree quarters said they have suffered mental health problems because of the pressure.

Undertaking Caring roles can have a wideranging impact on individuals in a number of areas of their lives, including physical health,education, training, employment, financial,emotional health and relationships with family and friends. Carersare people of all ages and cultural backgrounds and the pressures are even more intense for Carers who are very young, in their later years or have an additional vulnerability themselves.

Work has already been undertaken to improve and develop support services and training for Carers in Jersey. However, addressing the impact of undertaking an unpaid caring role and recognising the contribution individuals make for local people and for the economy of the island, continues to be a priority.

This strategy sets out our vision and new model for meeting the needs of Carers. It highlights a growing a culture of inclusion and empowerment that will most effectively meet the needs of Carers and the people they support and care for. It identifies the areas for change needed in Jersey, so we can ensure that local Carers thrive in their roles and their lives.

Strategy Development

A whole system event was held on the 23rd March 2017 and over 70 local people attended from all walks of life. In attendance were a high proportion of people with caring responsibilities, as well as staff from Charities, Voluntary Organisations, the Parishes and many Statutory Departments.

The day was chaired by an independent facilitator Amy Hobson from The Wellbeing Collective and focused on the strengths locally as well as the gaps. During the event people were able to describe the things that worked well for Carers currently and the things that they would like to see changed, improved or enhanced in some way. The day enabled the identification of key themes and ideas that would improve the future for Carers. A final part of the day involved voting using coloured stickers, to give a sense of where the priorities were and what would have the biggest impact.

The Now

• What we want to keep and change

The Future

• What ideas we have about a better future

The priorities

• what we think are the most importnt areas for change

1. Key strengths in the current system

1. The charity and voluntary sector are considered valuable to thesystemandtoindividualCarers. The range of charity and voluntaryprovisionisgood, however there are ongoing resourcing and coordinationissuesthat limit the reach and impact.
2. The Disability Strategy is welcomed by local people; however, it does not cover all Carers or those being cared for. It also doesn't go far enough to meet the holistic needs of Carers in order to help them thrive in their role and lives.
3. Collaborative work between professionals, Carers, Charities and Voluntary Services was cited as areallocal strength and one of the biggest opportunities for development. This collaborative work needs further embedding, as it is not currently universal or totally consistent.
4. The levelandqualityoflocalexpertise isseenasafantasticresource. Ensuring consistent access for Carers to people with expertise and knowledge, was considered of high importance.
5. The implementation of the TriangleofCare asaphilosophyandpractical model is a local strength. There was a strong desire to see this adapted and offered to individualsandCarersinallsituations.

2. Key gaps in the system

1. The lack of Carers and Care Legislation is seen as a real weakness in the current system and one of the opportunities to make the biggest impact.
2. The level and range of practical and emotional support was seen as one of the biggest gaps locally. Many detailed examples were cited from Carers across all scenarios and age groups
3. Theneedforenoughappropriateandhigh quality respite is considered a significant issue currently and there is a very powerful message from Carers that flexibility and personalisation are key to bridging this gap.
4. With regards to communication and navigating the system although there were examples of good practice in this area the gaps and inconsistencies mean that overall this is a deficit currently.Theneedforjoinedupcommunicationanda simplesystem to navigate was described by local Carers as a recurring need.
5. The Triangle of Care is consideredastrengthinthe Adult Mental HealthSector. The gap is around other groups in the population who also would welcome this model to be developed, in order to support collaboration and good practice.
6. Many people described the cultural stigma and perception of Carers as a longstanding weakness. The need to promote a positive culture being identified as an overarching issue worthy of prioritisation.

5.0 The underpinning principles

The following principles are based on the information gathered from people with lived experience of caring roles before, during and after the Whole System Event. These principles underpin the strategy and support the development of the key actions required to achieve the future state.

That Jersey Carers' needs are identified and responded to appropriately.

That Jersey Carers areprovidedwithsuitableadviceandinformation throughout theircaringjourney. That they are recognised as expert partners, are involved in careandsupportplanningforthosetheycarefor. That Jersey Carers areinvolvedinthedesign,deliveryandmonitoringofservices.

That Jersey Carers are supported appropriately practically and emotionally.

That Jersey Carers are supported to thrive as a Carer and as an individual beyond their caring role. That Jersey celebrates Carers and their contribution to the health and wellbeing of the Island's population.

Supporting Jersey Carers to thrive by Getting it Right'

Our vision for Jersey is to ensure that all unpaid carers are valued, recognised and supported to care and to thrive within and beyond their caring role. Through collaboration as a community, we will raise the profile of Carers and the caring role to influence Society, with the goal of improving the lives of carers. We will work with Carers and local partners to develop stronger networks and to reduce the impact of caring on Carers' wellbeing, by providing access to quality information, support and care when needed. We will purposefully challenge inequality and ensurethatCarersofallagesandbackgroundshavetheopportunity to have their voice heard'. We have linked the principles and the vision

together to create a holistic model of support for Carers, whatever their circumstances

Getting the right Respite

Getting the right Getting the right Resources through Information and Legislation Advice

Individual

andCarer

Getting the right Getting the right Inclusion and Emotional and

Empowerment Practical Support

6.1 Priority Area 1 Getting the right Respite

The current criteria to be reviewed and for it to be more accessible for all who need it.

Provide responsive, flexible respite including emergency care availability at short notice, for all ages.

Offeranenhancedchoiceofrespite,includingactivitybreaks and social group respite. Block booking of respite beds in Residential Care Homes.

Offerpersonalisedbudgetingfor respite and short care.

Introduction of new ways to complete Long Term Care Benefit application and support to do so.

Priority Area 2 Getting the right Emotional and Practical Support

Secure a physical drop in hub for Carers within the new hospitaldevelopment.Offer access to emergency help, with transport and short break support.

Give Carers meaningful opportunities to promote their own health and wellbeing through activities.

Parish Volunteers to help with driving, picking up emergency supplies and practical support.

Offer places for social events where Carers and Patients can be supported together.

6.3 Priority Area 3 Getting the right Resources through Legislation

Definecaringandthecaring role incluidng parttime, shared care and extended families.

Design flexible legislation that recognises changes in requirements and circumstances. Implement legislation that gives Carers the right to an assessment of needs.

Introduce the option of personalisation of packages of care and support routinely.

Design support for the specific needs of Carers who are vulnerable or have additional needs. Include employment rights for Carersandoutlinethepotentialresponsibility of employers in

the legislation.

Cross reference the Carers legislation with Mental Health & Capacity Law, Disability Strategy and Disability Discrimination.

Priority 4 Getting the right Information and Advice

Implement the Triangle of Care asaframeworkforeveryone,notjustAdultMentalHealth.

Routinely seek feedback and engageUsersandCarersindesigning and reviewing services. MakethemostofJerseyOnlineDirectoryforhelp,supportandservices.

Offeradviceandinformationatkeytimesinlife,suchastransition into adulthood or discharge from hospital.

Ensurethatinformationisculturally sensitive and available in a range of languages and forms. IntroduceCarers'Championsasa key point of contact and positiverolemodel.

Build on and extend Carer trainingofferingtomaximiseuptake.

Grow a peer support model through a Carers network.

6.5 Priority Area 5 Getting the right Inclusion and listening to Carers

Actively celebrate the role of the Carer in the media and acrossallsectors.

All Services to routinely engage with and consult Carers.

Provide training for Carers about what they can expect and how to navigate the system successfully.

Undertake direct work with employers to support employement opportunities and sustainability.

1. Key deliverables we want to achieve

Carers legislation to be enacted.

Carers feeling included, listened to and heard.

Carers have access to the right information and are given advice that is relevant to their needs.

Carers describe getting the right type and level of practical and emotional support.

Carers describe having time for themselves and a break from their caring role.

Carers are actively supported to access or remain in education, employment or training where possible.

Carers are tangibly supported to maintain their health and wellbeing, alongside that of the person they care for. Young Carers are encouraged to engage with community activities of their choice, to pursue their interests. Young Carers are appropriately supported to achieve full attendance and engagement in education.

Carers' voices are heard during theassessmentofthepersonfor whom they care and the Carer's own needs are assessed

2. Measuring the deliverables

Detailed measurements and targets will be designed with Carers and other key stakeholders and we will measure these outcomes using a variety of methods including;

Routine Carer • Carer Assessments to determine need and support.

Contact • Carer Reviews to measure impact and outcomes. Specific Carer • Carer Surveys and questionnaires.

• Carer Focus Groups and collation of 'Carer

Consultation Stories'.