Commissioning for A Better Life for Carers in Dorset 2023 to 2028

Adult Carer

An adult carer is someone who has a caring role over the age of 18 years. There are a high number of adult and older carers living in the rural parts of Dorset. In the rural areas there are less community-based opportunities and less providers. This makes the need for a joined up and responsive service key to their support. Often older carers in rural communities' health and wellbeing are impacted by their caring role as they cope with their own frailties and may not be digitally enabled.

Working Carers

Carers should not have to give up their chosen career due to caring responsibilities, however this is often the case. Many carers will need to return to paid work to supplement income in the years ahead.

Corporately, Dorset Council want working carers to feel supported and able to deliver both their work roles and their responsibilities as carers. The council has an agreed approach to supporting carers in its workforce and seeks to be a best practice exemplar for other employers.

An information page dedicated to working carers employed by Dorset Council has been developed with links to support, advice, and policies to support them. An employee network for Carers was launched 2022 and is growing rapidly. They share information and experiences but also contribute to improving the understanding of Dorset Council as an employer. In early 2023 they coproduced an ‘Employees who are carers’ guidance for managers and carers which was shared with Dorset residents as best practice.

The Pan-Dorset Carers Steering Group have outcomes in relation to this which are to be reported on regarding delivering support for working carers. Two of the outcomes are:

• we will develop workforce training solutions that raise awareness at a local level to enable us to listen to carers ideas and concerns
• we will develop a peer support network for carers (can be workforce group)

Learning can be gained from the NHS employee leaflet, ‘Juggling caring and work’.

Parent carers of adult children

It is also important to recognise parent carers of disabled children or SEND (Special Educational Needs & Disability). Getting information to parents and Carers at the right time regarding what support is available to them when the young person moves from childhood into adulthood, moving from Children’s Services to Adult Social Care support can be challenging. This is a critical part of our work on the Birth to Settled Adulthood pathway (see our wider strategy on A Better Life for Adults).

Young Adult Carers, Young Carers

Strategic plans are being developed in partnership with Children’s Services under the Young and Thriving Strategy to improve young carers service delivery, including the whole family approach. Services are being developed in partnership with Children’s Services, Carer Support Dorset, Health and MYTIME Charity –  see Young Carers section, and Young Carers Project information. The Project Group are committed to providing young carers with good support and protect them from inappropriate caring responsibilities which prevent them from learning and developing to their best potential.

Between adult social care, children’s services and health services we need to agree on consistent age ranges for provision of young carers’ support.

Sibling Carers

Within a family home where there is an Adult with health or social care needs, there children take on caring roles. Sibling Carers are children who care for their sibling to help the parents. Sibling carers who are often missed out of existing service deliveries. Children’s Services are developing their strategy for this area as part of their Young and Thriving strategy.

Occupational Carers

There are also paid carers, also known as occupational carers. This strategy does not include this group.

The population of Dorset is increasing and with that, particularly with the impact of the Covid-19 pandemic, the number of people providing care to another has dramatically increased. There is an assumption that most are not coming forward and identifying as carers. With the increased pressure on the care system, hospitals, and lack of professional care staff in the community, the burden on carers is expected to increase and further preventive support will need to be identified and developed by a system-wide approach including the Health, Social Care and Community networks.

Our vision draws on our learning from engagement with Carers, professionals and providers and the national guidance whilst also making it relevant to local needs. The overarching aim and set of objectives can be used to measure how we deliver better support for carers in Dorset.

Dorset Council want to identify potential carers of the future, register identified carers, support them throughout their caring journey and reach individuals at risk before they reach crisis. We want carers supported across the whole system, and for caring to be acknowledged and recognised as an important role by everyone, not just Adult Social Care.

We will work together so that all carers are empowered to lead their best life, are respected, informed, involved, valued, and receive the right support, at the right time, and in the right place.

The Right Support

An immediate focus will be on further developing our information, advice and guidance offer to be more joined up, clear and easily accessible, including on some priority issues for carers such as planning ahead, financial planning, contingency planning, digital literacy, and end of life planning. This needs to be shared activity with NHS partners, carers organisations and others, and involve carers in the design  work.

We want to further develop the range of available support, with an emphasis on flexibly responding to carers needs, including those who work, and with elements of choice, crisis prevention and response. We also want to develop a clearer carer break offer for carers with a significant caring role. Dorset Community Response and Help and Kindness have introduced new community volunteer support for carers which will continue to grow.

Some parts of the support infrastructure could be further developed, with community supporting people to engage, including the Carer Card and a Carer Friendly Community accreditation scheme for organisations/businesses. Technology can provide opportunities to make life easier and relieve some anxiety of caring at home, and assistive technology and equipment should be incorporated into every carers assessment.

We want more people to have a carers’ personal budget and direct payment, and to have the freedom and flexibility to arrange the support that they need, with support from an Individual Service Fund provider for those who need it.

The Right Place

Our Carers Case Workers provide valuable support on a one to one basis where there is complexity, however, there is a need to ensure resources are aligned to different locality need.

As part of developing the range of support available, we are introducing more peer support groups across Dorset to encourage Carers to take part in local community support.

The Right Time

We need to bring more people and organisations into the work of identifying carers and flagging to them that there is support available. This will enable more carers to access the timely support they need, and provide a more immediate response to crisis, as well as identifying those who may soon become carers, and those who are ageing and for whom caring is becoming ever more challenging.

For those young people who take on caring roles so early in life, the right support joined up across children and adult services is critical to their future growth and development.

All of these aspirations are captured in four high-level outcomes that guide our work. These help us to think about what the issues are that get in the way, and what we need to work on to fix them. At the end of this strategy is our action plan for year 1 and, in outline, for future years – the actions are grouped under these four outcomes.

• carers are respected and valued across social care and other council departments, and are included and involved
• carers can find the information that they want, when they want it, and in formats that work for them
• carers have access to a range of support, responsive to their needs both in the community and from the council
• carers receive meaningful assessment, with responsive options for receiving the support that they need

Carers strongly tell us that they deserved recognition for the hard and complex work that they do, and the impact that it has on their lives. This sounds like a simple statement, but behind it is a frustration with the difficulties of navigating not only the care system, but all statutory sources of potential help, finance, and support, including housing, benefits, and other areas.

Carers tell us that too few interactions with council officers gave them confidence that their lives as carers were understood, or that there was appreciation of the stresses and pressures in a carer’s life. They also talk about not feeling trusted in their caring role, including where they are taking financial decisions with their cared-for person. This is a key part of better respecting and recognising carers, and they tell us that culture and behaviours need to change. They say that they want a more ‘human element’ to their support. This ‘relational’ approach is a long-term piece of culture change work, but it is an important journey to take. The importance of ‘walking in our shoes’ cannot be overstated, as well as having insight into life as a carer. And crucially, it should be a whole-council endeavour.

There should be more campaigns about the carer role, which would build awareness, but could also help in identifying carers and improving the levels of carer registration so that support could be offered. We will also implement a wider training programme for council and other organisations’ workforce, including using the high-profile national carer support campaigns (e.g. Carers Week) to maintain visibility.

In all of our work to strengthen the voice of the carer, we must also be careful not to lose the voice of the person with the care needs. This is a delicate balance, and includes issues around privacy and data protection that must be sensitively handled. Carers tell us that they understand that these are issues, but when navigating the issue they want us to be more attentive to their needs as people intimately involved with the care of their friend or family member, and as an active partner in the delivery of care to the cared-for person.

Task-and-finish review of carer support, April 2022

In March 2022 a Task & Finish Group was established to look into the issues facing carers in Dorset, and to produce recommendations for improvements to the support that is available. This was intended to inform this strategy, which was in development at the time.

The group brought together carers, carer representative organisations, and council officers, and was chaired by Cllr Cherry Brooks. It met four times, with a number of carers involved through the process, as well as individuals running organisations providing support to carers, and a number of people who also talked both from their professional perspective and a personal perspective as carers themselves. The recommendations, right, emerging from this process have been instrumental in shaping this strategy. 

• respect carers, their work, and their challenges
• make the different support offers clearer
• improve information and support, including accessibility
• remove the operating silos
• take a more “relational” approach to supporting carers
• review and improve the impact of carers’ assessments
• review the rules around short breaks, where possible
• widen the uptake of direct payments or individual service funds
• review the contract of Carer Support Dorset and make the offer clearer
• review the Carer Caseworker service and make the offer clearer
• ensure carers are considered in assessment of future housing demands
• diversify the provision of day opportunities, including virtual contact and addressing digital exclusion

Carers voices, providers and professional carers leads have fed into this strategy, ensuring the right services are commissioned and assumptions are not made. We are very grateful to everyone who has taken part.

Every carers situation is unique however there are some common themes: activities, wellbeing, and pathways.

Activities

• day centres and services are valued and more activities with carer/without carer are wanted
• carers want activities, not just meeting other carers, they want to be distracted of their caring role – although transport is a barrier

Wellbeing

• carers do not get a break from their caring responsibilities (this can describe hours, days, weekends, overnights)
• carers report feeling isolated, lonely, and deteriorated mental health illness
• caring had escalated and become more difficult and challenging throughout the COVID-19 pandemic, with lockdowns making support and activities/respite less available – a situation which has continued
• some of the carers were elderly, had health or practical support needs themselves, or the cared for person didn’t want support, making caring more challenging.
• carers want some or more time off, to see friends, have a weekend away, to have fun separately and together, but didn’t complain and some commented it was their ‘duty’.
• most welcomed more support for their wellbeing, by means of day trips, wellbeing treatments and to be able to eat out and admission tickets to attend events/shows.
• many carers reported they did not have family, friends, or neighbours to ask for support/give them a break/rest.

Pathways

• assessments are not received by all, and some felt it was difficult to get one
• carers are not sure if they are registered with Carer Support Dorset
• carers are not always clear which organisation provides the support they receive, e.g. many register with GPs unaware of other support available
• access to services and care in the rural parts of Dorset are harder to find or don’t exist
• we know at least 30% of the carers are not digitally enabled
• some carers appear not to know what is available to them or how to access it.
• most carers do not access and don’t know how to access the Short Breaks service.

From the work that has taken place we have listened to what carers have told us they need to support them in their caring role. There is lots of work to be undertaken to improve the marketing of the existing offer, making it clearer to understand, and widening access to all groups in the community.

The Summer of Co-Production

A series of events and conversations were convened over the summer of 2021. Members of public and representatives from Dorset Council and providers/partners who participated included some carers, and this is what they told us they wanted:

• go back to what they were doing before COVID-19
• be independent, feel valued and live their life with purpose
• be listened to, trusted, valued and treated with respect
• have support staff who care and know them well
• socialise and make new friends
• get a break/rest from caring responsibilities
• be offered more choice of activities
• get better information about day opportunities
• be helped to access the support they need even if they can pay for it themselves

In particular, people us they want to:

• find work
• volunteer
• learn life skills
• take part in sport
• explore new places
• go on walks and day trips

There are many services or support for adult residents which also benefit Carers.

A ‘Carers tool kit’ was developed during 2020 to detail the universal services provided by the VCSE that was used by Councillors to enable them to sign post Carers to services. This would need to be continuously updated as services change and evolve.

‘If Only I’d Known That’ is a booklet produced by PramaLife and The Leonardo Trust which is based on a carers journey over 20 years ago, which is still very relevant today. The booklet is free to all carers and provides hints and tips on navigating the services and provides a helpful index of contact points at the back. This has been sent to all elected members and is sent to all registered carers. Similarly, 'Angels in Gumboots' was published in 2022 by a Dorset Carer Jennifer, who is looking after her husband who was diagnosed with dementia whilst trying to run a farm and family home. It emphasises the many issues carers face, especially the need for timely support, up to date information and practical help.

Information, advice and guidance offer

Information and advice provision is a critical part of getting carers the support they need, when they need it. With a number of different web offers on information and advice, carers tell us that this causes confusion and, whilst there are links and routes between them, this remains confusing. There is also in some cases easy access to information on the important issues that carers needed to know. For some, they didn’t know some of what they might need to know and therefore didn’t know how to ask for it until too late. However, this was not solely about information on being a carer; it also applied to information about arranging and managing care for their cared-for person. These themes are relevant for the work being undertaken to redesign the council’s information and advice offer, and carers’ work is integral to the project teams established for that work.

For some the reliance solely on websites was not sufficient, and some carers appreciated printed matter as a source of information that they could retain and refer to at a later time. This is not incompatible with a fundamentally digital offer, and it is possible to facilitate this with, for example, the ability to output webpages as printable PDFs, which professionals and support organisations could then share with carers on demand. Relying on a suite of PDFs uploaded to the site was recognised to be problematic in accessibility terms, and for keeping them updated.

Carers also tell us that the adult social care system is complex and difficult to navigate, and when a carer is in need of information they are also likely to be in a place of distress or anxiety. Therefore, the council needs to give thought to how people can get have a meaningful conversation to get to the answers that they need: in short, a ‘human touch’. This could also apply to the provision of training for carers, to provide spaces for them to more fully explore important themes in their role as a carer.

Discussions on this theme also point to the importance of digital exclusion, and work to tackle it, in supporting carers’ wellbeing. Evidence and survey results have evidenced many Carers are not digital, with a high percentage being older adults. In talking about digital offers, therefore, there was a strong recognition that levels of digital exclusion in Dorset were high, and that therefore carers should be “high up on the list” for any support to get online and overcome this exclusion. Other things to consider when attempting to reach carers is Dorset has a blend of rural and urban settings with a high population of elderly people, including people with disabilities, blindness, sensory impairment, or other difficulties, and this will include carers.

It is a key ambition of this strategy that all services that provide for the communities of Dorset are understanding and supportive of the needs of carers. Supporting carers is everyone’s business, and we will work with statutory and community partners, and with community leaders across the county, to develop this supportive culture.

There is an opportunity to work closer with the VCSE who are already engaged in projects such as the Dorset Community Response. The Weymouth Information Shop has provided a venue to develop services for carers in partnership with the VCSE and our commissioned service Carer Support Dorset. As this partnership is developed it will be reviewed to consider how to mirror the approach in other areas.

There is already an appetite for partnership working with the established provider Forums. This now needs to be developed to the next stage of how to join up the services for Carers regardless of their entry to request for help. We need to consider how best to make it as easy as possible for carers to access services with no wrong front door.

Carer Support Dorset have launched as part of Carers Week a stakeholder event to understand how they can work closer with other organisations. This conversation will be continued at an event in early 2023.

The new Carers Card scheme launched in early 2023, which will also provide an opportunity to explore more community-based support where carers cafes and support groups can become embedded in local businesses signed up to the Carers Card scheme. This can provide opportunity to develop Community Champions and possibly local business awards linked to the work on carer-friendly employers.

The Dementia Friendly Purbeck scheme is a good example of organisations and the community working closely together to make the community a welcoming place for the people with Dementia and their carers. Help and Kindness are already working on further exploration work to understand what other friendly communities are in Dorset and their assets. This will link very nicely to Carers and help us understand what is available and what the gaps are.

By developing the Direct Payment offer (alongside the more supportive individual service fund approach) as part of the Personal Budget, we will create greater flexibility as requested by Carers. A new advocacy contract will also provide more support options for carers. We can also involve the community to respond and support the carers and person they care for with local organisations services, volunteers, friends and family support.

The Carers’ Caseworkers provide the statutory support under the Care Act 2014 where there is complexity or safeguarding concerns, although they do not undertake all Carers Assessments. They are strategically based across Dorset including localities and some hospital sites. The Community Mental Health Teams also have carers leads.

The posts were created to work with carers in more complex situations where there is a need for a formal Carers Assessment under the Care Act 2014, and it is not appropriate for an allocated worker to complete the assessment. This would include the following situations:

1. Safeguarding concerns and complications.
2. Where there is conflict between the carer and the cared for person, or where there are conflicting views between the carer and the cared for person about desired outcomes.
3. Where there are complex inter-relations between the needs of the carer and the needs of the cared for person and there is a need for independent support for the carer.
4. Where there is no allocated worker for the cared for person (private funders where there is no request for an assessment of the cared for person).

Carer Case Workers also offer support to bereaved carers in the short term and signpost to other organisations. There was an increase in welfare calls and sadly bereavement support during the pandemic. It is recognised that they offer valuable support to carers which was made particularly difficult during the Covid-19 pandemic with many Carers shielding and lack of resources to refer them to.

In addition, Carers Case Workers are the experts in their locality/specialist team and provide training, advice and support to colleagues undertaking Carers assessments. They hold local peer support groups and lead in their local communities working with the Primary Care Networks, GP surgeries, hospitals, the community and other organisations in the area. They are the primary coordinators of the Provider Forums and work very closely with primary care and other providers in their setting.

The relationships they hold with their local communities, colleagues, Health partners and Primary Care Network enables good outcomes for Carers. The Provider Forums they host provide opportunity to share good practice, hear about risks and gaps and new services for carers in their respective areas. In addition, they hold local peer support groups to keep in touch with the Carers, providing a forum for feedback and change.

Improving services

A good partnership exists between the Operational lead, Carers Case Workers, Commissioner, Commissioned services, and partners that needs to continue to strengthen with clear direction from this strategy taking new opportunities forward to progress the service delivery.

However, some carers told us that there was confusion about whether the carers caseworker service was a universal one, including the provision of carers’ assessments to anyone who came forward for one, or whether it was a targeted service aiming to intervene where carers are in difficulty or crisis. There was a clear sense that people didn’t know what they might get from an assessment, or the support of a Carer Caseworker, and that others had received some substantial support.

Whilst this may, in reality, be needs-led, it was also perceived as inequitable. Alongside the clearer specification and communication about the role of Carer Support Dorset, it was suggested that a similar exercise needs to happen for the Carer Caseworker service, and this has been initiated. This will help to shape the work of the team, bring consistency and improve performance, as well as being linked to the Adult Social Care reform programme, through which an audits approach on Carers assessments is being taken forward.

Carer Support Dorset offers a ‘front door, one stop shop’ approach, for carers of all ages from Dorset Council. This service contributes to the collective model of early intervention and prevention, providing a preventative offer to delay carer breakdown and reduce the need for Adult Social Care intervention. They are the first point of contact offering the information, advice, support, signposting, befriending and guidance. They also hold the Dorset Carers Register on Dorset Councils behalf for Adult Social Care and Children’s Services.

A vast amount of data is available provided by quarterly reports from Carer Support Dorset to understand about Dorset carers. Carer Support Dorset is developing as the lead carer organisation, the front door for Dorset Council resident carers. Their reach and registration of carers and young carers is on an upward trend. They have  positive survey results of carers regarding the services they provide, which include:

• they are recognised by health and partners as the lead carer organisation for Dorset Council, however they are not recognised as the lead carer organisation for Dorset Council by all providers and carers. Carers report there is confusion as to who to contact and how to access an Assessment under the Care Act 2014. Carers want information , respite, replacement care and support for the cared for person but Carer Support Dorset cannot help with this. Part of the resolution will be in Carer Support Dorset recording more information on carer contacts, so targeted help can be provided
• the newly formed Reference group has had two meetings to date (Oct 21) and is likely to develop into a very successful group over time with Carer Support Dorset’s leadership
• newsletters are sent on a regular basis (electronically and by post) to inform carers of training opportunities, news, and information
• there is a Keep In Touch Coordinator post now, which when recruited will (with volunteers) regularly contact Carers to see how things are, to show support and offer more help
• Carer Support Dorset are keen to get involved in community activity which has increased post Covid restrictions and want to meet with carers. They are increasing networking and sharing of universal information to carers of services from across Dorset
• training is very much carer led; however, Carer Support Dorset are developing a training strategy to shape the offer with targeted cohorts and key areas of information
• peer support groups are scattered across Dorset, with some areas (particularly rural) lacking therefore providing opportunities for Carer Support Dorset to start new ones at grass roots and nurture them into self-managed groups
• regular advice and guidance and support for those who have registered

Developing Carer Support Dorset

There is an opportunity to work closer with the community, to allow them to volunteer for Carer Support Dorset, providing the much needed and valued Here to talk befriending service and other areas such as peer support groups. This is an exciting area that is just beginning to flourish. Joint work with Help and Kindness  Community Response will open more doors to Carer Support Dorset to connect with community and voluntary organisations to improve the service and response to  carers at a community local level.

We are aware many citizens are funding their own replacement care so to support them information needs to be developed to inform them what is available and make it easier for them to access it. This should help with decision making and encourage self-management and planning ahead.

Carers who are no longer caring or would like to enhance their learning or develop as a volunteer need information to understand what is available to them. Some joint work with organisations such as the Dorset Volunteer Centre, local educational settings and Adult Education will enable this area to be developed.

Rethink – Dorset Carers Service

Rethink is the Commissioned service provider for Carers of all ages who live in Dorset Council area who care for people aged 18 or over with Mental Health Illness. They have recently developed an offer for parents of teenagers with mental ill health. They work collaboratively with Carer Support Dorset to promote and enable the early identification, carer recognition, support, and training for carers. They provide joint sessions with Carer Support Dorset to support carers living from mental health illness themselves and of those who they care for.

The support offer can include a personalised payment of up to £300 to support Carers wellbeing administered through the Breakaway Fund. This is recognised as a model that can be used in addition to being awarded Short Breaks by Adult Social Care.

Young carer support

Children’s Services are keen to explore opportunities to access mental health services for young carers. This is a possible development as part of the Young and Thriving Strategy. Opportunities are being explored to develop the Rethink support for young carers and young adult carers as part of all ages contract in place, joining up the mental health support services for young.

Developing Rethink

The links with Rethink varies across CMHT depending on their staffing hierarchy. Most Carers assessments are being completed by CMHT (Health staff). Some have Carers Lead Officers or equivalent employed by Dorset Council, some do not. The pathway to access Rethink needs improvement and there is an opportunity to review it with an aim to apply a consistent approach in respect of pathway and workforce across Dorset Council area. However, resources would need to be identified to support this exploration work across Adult Social Care and Health including CMHT.

This contract expired in January 2023 and therefore work is underway to understand how best to commission a new service to meet the needs of Carers, whilst being mindful of the detrimental effects Covid-19 pandemic has had on carers.

Time to Talk – mental wellbeing for carers

The Time to Talk contract is a bespoke demand led counselling service jointly shared with BCP Council offering counselling services to carers for up to 6 sessions, with an optional additional 6 sessions if required. In June 2022 the  service moved over to the Leonardo Trust and a carers assessment was no longer required to access it. We will work with this organisation as it develops the new provision.

Direct payments

For all of these possible community-led options and breaks, personal budgets and Direct Payments for carers is key to unlocking the flexibility that carers say they want. Currently, Dorset is performing poorly compared to the rest of the country in the provision of carers’ direct payments, albeit that there is steady improvement. At 25.9% this compares to 68% across the South West and 77.6% across England.

A Direct Payment would mean that a carer could “buy in” the support that worked for them and met the identified priorities of the support plan and, together with provision of Individual Service Funds for those who want someone else to make the arrangements, is critical to improving choice and control for carers. It also opens up the possibility of a range of flexible and responsive brokerage support options, so that community-based organisations could start to offer assistance to get the support in place that the carer wanted.

Individual service funds

The option of an ‘individual service fund’ would provide similar flexibility but also involve a support organisation to provide the assistance that some carers are asking for to make the arrangements for the support that they need.

Carers’ Assessments

There are delays in the social care system to obtain a strengths-based Carers Assessment under the Care Act 2014. Reporting shows this has increased during the Coronavirus pandemic with levels of assessment being lower than previous years. As Carers Assessments are undertaken by all Adult Social Care Staff to help prevent delays and not just the Carers Case Workers who undertake the complex ones it is possible to reduce the delay if more Carers Case Workers were employed to undertake the assessments or commissioned to another organisation to undertake.

In the Carers’ Task and Finish Group work undertaken in 2022, there were mixed views expressed about whether carers’ assessments that members of the group had undertaken had been impactful. Some felt very strongly that they were a “box ticking exercise”, whilst others had found them helpful for exploring ways that they could manage the impact of their caring upon them. Some carers are fearful that an Assessment is 'a check of how they are caring' so they don’t welcome it. The language needs to be clear and friendly and simple to understand. The actual process of the assessment also needs to be simpler, quicker to remove the stress and time for the carer & ASC to improve turnover/support more people.

Improving uptake of carers’ assessments and direct payments

Our wider strategy has a fuller discussion of our ambitions to increase uptake of direct payments, and this applies equally to carers as with others with whom adult social care works. We need to make the system more understood and higher profile, creating a clearer sense of what people could access if they had a direct payment to pay for it.

However, key to this is to increase the numbers of carers’ assessments undertaken. This is challenging, given the pressure that exists on the whole adult social care assessment system. Nevertheless, we remain committed to expanding access to an assessment and to the support that will help people to continue to care whilst remaining well and healthy. The provision of an assessment and support would be less costly in the long-run than the breakdown of a caring relationship; this doesn’t, however, remove the workforce challenges of providing both of the assessment and the support.

As part of our new information and advice approaches we will explore how to help people start a self-assessment online, and thereby reserve our capacity for the more complex cases. Similarly, the digital approaches that we are taking will make managing a direct payment easier for people.

Short Break services have traditionally been an offer of support to Carers following a Care Act Assessment. These have taken the form of a replacement care service and the provision is not subject to a financial assessment.

The current offer is care-based and as such is subject to availability within the care market. The experience of Covid 19, where carers have been unable to access the provision, coupled with engagement feedback, demonstrated the need to revisit what constitutes a ‘short break’ offer. A more personalised offer is seen as a way of carers securing goods or services that support them more individually in their caring role.

Examples of some of the wider provision that could benefit a carer could include:

• a course of relaxation classes
• training on stress management
• gym or leisure membership
• adult learning
• development of new work skills or refreshing existing skills
• pursuit of hobbies such as purchasing a garden shed, or laptop to stay in touch with friends and family

Eligibility for Carers to access services is clear and agreed support is detailed in a Support Plan. Whether or not there is a need for replacement care, carers may need support to help them to look after their own wellbeing. Currently, Dorset Council does not consistently provide carers with a personal budget, however they do provide Direct Payments.

This is an area for development under this strategy. The only direct funding a Carer receives from Dorset Council is used for the Short Breaks Service, for counselling, or for equipment (usually provided to the cared-for person). In some cases funding is provided by Rethink under the title ‘Breakaway Fund’.

Addressing issues with Short Breaks

Key to our improvement ambitions are the actions we will take to improve the uptake of carers assessments and direct payments, so that people have the flexibility to make their own arrangements for their support. Workforce commissioning is essential to improve the choice for Carers to access replacement care services. The Carers Strategy links with micro-provider, community response and workforce development opportunities in the overarching Commissioning Strategy, to encourage people to come forward to volunteer or start their own business as a paid or occupational carer. Higher incentives have to be given to encourage more people into caring employment.

Day services and day opportunities

Our commissioning strategy contains ambitions to increase the flexibility of day opportunities. In some cases, these are beneficial to carers as an alternative to organising replacement care. Activities should be available to both the carer and the cared for person. This is subject to availability, cost, accessibility and funding, but it is useful to remember carers told us that a distraction from their caring role can improve their wellbeing. A ‘Memorable Moments’ pilot was successful and was welcomed by those who participated.

The ‘Zoom’ and ‘safe places’ offer that was created by a number of providers through the pandemic was appreciated. It was felt that this should be an integral part of the on-going offer into the future, for both a cared-for person and carer. Online activities for the cared for person also enable a small break for the carer while their loved one was online.

In general, carers have spoken of day opportunities as being really important for creating small spaces in the day in which they could do other things in their lives. There was support for diversity of provision, and this will be something that Care Dorset will be thinking about as it evolves and rebuilds an offer post-pandemic.

Carers Cards

The Dorset Carers Card is a joint contract with BCP funded by the Better Care Fund. It gives access to a card that can be used as Carer identification and provides discounts across Dorset (and nationally) including at cafes, shops, attractions and with some professional services. There are hundreds of opportunities across Dorset to use the card. The Carers Card website includes printable information and helps Carers to discover the offers available. Carers will be able to use the photo ID credit card style printed professional looking card or digital version. The QR code can be scanned by the business to verify the carer is active (no personal information shared) and also sign up to the scheme if not already a member.

The Carers Card scheme distributed to registered Carers - including adults, young carers and Parent carers of children who are disabled or with SEND (Special Educational Needs & Disability) - by Carer Support Dorset and CRISP (Carers Resource Information and Support) for BCP Council, although the scheme is currently coordinated by “Forward Carers”.

Caring Matters

A joint contract in partnership with BCP Council, funded by the Better Care Fund. This bi-annual (6 monthly) magazines have previously been prepared by Pan-Dorset system-wide partners for all Dorset carers.

Produced by Dorset Council and BCP Council in partnership with the NHS, around 16,000 copies were printed to be given to GP surgeries, pharmacies, and professional carers leads, to distribute to carers across Dorset. It was also published on internet sites, including Dorset Council and BCP Council including CRISP websites, Carer Support Dorset's website and others of interest to carers.

It offered the opportunity to someone who has not yet identified as a carer to access information, but also an interesting read with real life stories to registered carers. In 2023, planning is underway on how to relaunch in a more modern way, working in partnership with VCSE. 

Improving Carers Cards

A review with businesses registered indicated the scope to improve this service with:

• improved marketing
• making the information more accessible (paper based or App development)
• having 1 card design rather than the 3 current cards to improve trust in the scheme, and
• developing the offer to be more attractive to younger carers

This contract will therefore be expanded to include advertising of day opportunities, activities in the local community, any free or discounted theatres/cinemas opportunities that can be negotiated, as well as any other opportunities identifying as a carer can bring.

Improving Caring Matters Magazine

There is opportunity to modernise the format and content responding to the wishes of carers. Carer Reference Groups have been consulted for their views and to guide the refresh. Opportunities to coproduce the magazine with partners, and carers will be a priority.

Responses to surveys in the magazine have been low, and so we will need to find further ways to find out what carers value about it.

Recovering from the pandemic

Covid hit people hard from all backgrounds, and carers struggled to manage additional hours of providing care without support, which negatively impacted on their health and wellbeing. Whilst the community support response was enormous, and many services provided digital options, for carers there remains a legacy that we need to be aware of.

In June 2020 Carers Trust asked children and young people aged between 12 and 25 about their experiences of caring during the pandemic. Even amongst everything else they must do, 961 found the time to reply.

• 67% of young carers and 78% of young adult carers are more worried about their future since coronavirus
• 11% of young carers and 20% of young adult carers said the amount of time they spend caring per week increased by more than 30 hours. That is around 1 in 5 young adult carers
• a shocking 8% of young carers and 15% of young adult carers cared for over 90 hours per week during the pandemic
• 30% of young carers and 31% young adult carers are now caring for more people

Domestic abuse

The Dorset Safeguarding Adult Board have completed a Safeguarding Adults Review which focuses on domestic abuse in later life, including a multi-agency action plan to consider how older people can be more effectively supported when they are victims of domestic abuse. This will include Carers.

Paragon (formally You Trust), Dorset Council’s commissioned Integrated Domestic Abuse Service has a free awareness workshop for people in the community and organisations. The aim is to increase awareness across our most hard to reach communities by creating ‘champions’ who can act as a link to specialist support services.

Cross-border working

It is not unusual for carers, especially in urban areas, to live in a different local authority area to the person they support. They have tended to be known as “cross border” carers. Carers have expressed their confusion in relation to borders and why services differ across them. Dorset PCN’s also do not relate to Dorset Adult Social Care borders which adds to confusion as to where to register. The (Association of Directors of Adult Social Services) Carers Leads in South East England have developed a cross border protocol, which is being considered for adoption in the South West.

Themes for further exploration

This strategy will continue to develop, and there are a number of themes around carer experience and support that we will need to explore further as we deliver the priorities outlined here. We will continue to work with carers to co-produce the solutions, but some of the points include:

• inconsistent offer between Dorset Council and BCP Council for Dorset Residents
• workforce capacity for replacement care
• specific workforce training on carers services and assessments
• sharing of information between social care, health, CMHT, providers
• social prescribing
• Carers Case Worker links with the NHS Carer Support and Patient Information Advisers based in the Acute Hospitals and some hospital wards
• digital exclusion, digital solutions including online assessments, e-marketplace, etc
• emergency response or contingency planning
• resources and advice to plan ahead for parent carers and for potential future carers
• working carers support including guidance for employers
• training options for carers on, for example, resilience, employment support; training on conditions (e.g. dementia)

This strategy was last reviewed in 2023. 

The next expected review date is 2027.