Procuring of Carers Services

1. Procuring of Carers Services Judd Skelton – Integrated Commissioning Manager July 2015

2. Structure of Event • Presentation: • Carers in Salford • Carers pathway to services • Current thinking on scope of tender • Next Steps • Group questions and discussion • Individual opportunity to ask questions and provide feedback

3. Carers in Salford • 2011 census identified 23,400 carers in Salford • 6,400 identified themselves as caring for more than 50 hours per week • JSNA on carers completed in 2012 • Carers strategy in place covering period 2013-2016 • Current core carers services contracts end March 31st 2016 • Carers funding contained in Better Care Fund managed by Alliance agreement • City Council acts as Lead Commissioner

4. Salford has a long established Carers Centre, registered with the Carers Trust Current Centre operates out of a building located in Central Salford and provides a full range of carers services Current thinking is we would wish to commission a Carers Centre with a strong emphasis on ensuring delivery within local communities Carers Services in Salford

5. Carers Pathway • Aims to identify where we see responsibilities lying for: • - Identification • - Assessments • - Advocacy • - Provision of advice and information • - Generic and specialist support lie • Would welcome views on alternative pathways and models of delivery

6. Carers Pathway

7. Carer Identification • All organisations responsibility to identify carers and have effective policies and processes in place to support carers • Commission a service to: • - Maintain a database of carers in the City • - Deliver a Primary Care liaison and development service • - Support neighbourhoods and communities to identify and support carers • - Support the creation of carers groups

8. Carers Market Development Assessments Alison Antrobus – Principal Manager 

9. Assessment • For the first time Carers will be recognised in the law in the same way as the person they care for • The Care Act places responsibility on the Local Authority to: • Assess carers need for support where the carer “appears” to have such need • The assessment has to consider the impact of the caring on the carer • Must consider issues such as whether the carer is willing to carry on caring, whether they want to work, undertake study or do more socially

10. Assessment Process Done in two ways: • Joint assessment: complete as part of the assessment for the cared for person • Carers Assessments: Assessments focused on the carer and developed in line with the Independence Led Assessment • Assessments are completed by workers across all adult teams; mental health services. • We have Specialist carer development workers based on teams across the City. • Outcomes are identified from the assessment and a support plan then developed with the carer

11. Carers Market Development Advocacy; Advice & Information; Generic Support & Health Checks Judd Skelton – Integrated Commissioning Manager

12. Advocacy • Care Act 2014 - new statutory requirements regarding independent advocacy • Local Authorities must arrange Independent Advocates for people who have: • ‘substantial difficulty’ in being fully involved • and • b) where there is no one appropriate available to support • Includes support and representation during a carers assessment • 'Appropriate'? “It is not sufficient to know the person well or to love them deeply; the role of the advocate is to support the person’s active involvement with the local authority processes” • Training for carers

13. Provision of Advice & Guidance • Provide comprehensive information to all carers in Salford • Support other organisations to provide information for carers • Maximise use of Social Media and Internet

14. Interdependencies • Range of organisations are commissioned to provide carers support, generally as part of a holistic service offer: • - Age UK • - Stroke Association • - GMW • Role of commissioned service to work in partnership to support delivery of outcomes for carers • This will also include developing relationships with City Council, SRFT, GMW and employing organisations

15. Generic Support • Role of commissioned service to provide generic support to carers • Expectation is that this will be delivered by: • - the advice and information offer including short term carers support • - more comprehensive support packages will be delivered to carers referred to the service

16. Carers Market Development Drug & Alcohol Support Mark Knight – Public Health Strategic Manager

17. Drugs & Alcohol There are an estimated 11,000 ‘higher risk drinkers’ in the city although the true figure could be as low as 4,000 or as high as 39,000 (PHE 2014). How many adults in Salford live with some who has a drink problem is anyone’s guess! In 2014, there were around 300 problem drug users and 150 problem drinkers in treatment living with children under the age of 18 (Salford NDTMS data). Children with heroin using parents are the cohort most likely to become problem drug users themselves and end up in prison (PwC / MoJ 2008). Nationally, 1.5 million people are ‘significantly affected’ by a relative’s drug use (UK Drug Policy Commission 2009). ACMD (2003) estimate that 2-3% of all children are affected by parental drug misuse. This equates to between 1000 and 1,500 in Salford. National Psychiatric Morbidity Study (NPMS) estimates applied to the Salford population suggest 10,300 children live with hazardous drinkers and 1,200 live with harmful drinkers. UKDPC (2009) estimates suggest there are at least 2,500 adults (e.g. parents and partners) in Salford who are living with someone who has a drug problem.

18. Drugs & Alcohol We know that children supporting a family member with a drug or alcohol problem are much more likely to miss school and experience educational difficulties (e.g. 40% of Dearden and Becker’s 2004 sample). We know that carers use alcohol as a coping mechanism: - a survey of unpaid carers in Wales found that 20% of respondents used alcohol to cope with the pressures of caring (Alcohol Concern Cymru & Carers Trust, 2012). - 34% of spousal caregivers reported using alcohol as a coping strategy (Connell 1994). SERVICE IMPLICATIONS An effective partnerships with Achieve (drug and alcohol services) is essential. But drugs and particularly alcohol need to be everyone’s business. So it’s not just about having a substance post in a carer’s service It’s about screening, providing brief interventions and knowing when an onward referral to specialist services is required.

19. Carers Market Development Mental Health Judd Skelton – Integrated Commissioning Manager

20. Mental Health • Redesign of the Salford Acute Care Pathway • Carer support in Acute Inpatient and Home Based Treatment • NHS Forward View Access Standards for Early Intervention in Psychosis (EIP) • Increased need for effective Carer support in EIP • Specialist interventions – to complement generic support to carers of people with mental health problems from the core carers service

21. Carers Market Development Young Carers Emily Edwards – Senior Commissioning Manager

22. Young Carers • What is a young carer? • A young carer is a child or young person under the age of 18 carrying out significant caring tasks and assuming a level of responsibility for another person, which would normally be taken by an adult. • The caring role may be long-term, range from a few hours a week, for example checking on someone or keeping someone company, to 24 hours a day every day • Young adult carers (aged 16-25) are often a ‘hidden’ group of carers • What do we know about young carers? • In Salford 1.5% of young people are carers compared to 1.3% nationally. Likely to be an underestimate due to an unknown number of “hidden carers”. • A BBC study estimates that 8% of young people are carers - an estimate of 3759 young carers in Salford • 55% of young carers are female and 45% of young carers are male. • Just under one in ten young carers provide over 50 hours care per week. • Young carers care mostly for people who have a physical disability or mental health problem. • The majority of young carers care for their mother. • 56% of young carers live in lone parent families

23. Young Carers • Impacts and challenges for young carers • Substantial numbers of young carers report stress, anxiety, low self-esteem or depression. • A survey carried out by VOCAL – The forum for young carers in Salford found that 44% of Salford young carers feel their education is affected due to being a carer and 33% would like more support in school. • Young carers are far more likely to be not in education, employment or training (NEET) than their peers. • Young carers experience a range of difficulties and disadvantages, including poverty, isolation, physical and mental health difficulties which have consequences for them, and their families, throughout their lives. • The transition between primary and secondary schools, school to college and into work are identified as difficult points. • What Salford Young Carers have told us… • 58% identified that being a young carer had affected their education • 46% of those who took part in the survey had ignored their own health issues due to caring • 76% identified that they had experienced bullying with over half suggesting it was because of their caring role or being different • Source: Survey conducted by the Salford Carers Centre (49% of those registered participated)

24. Young Carers • Service Implications • Children and Families Act 2014 sets out new rights for young carers • Young carers have a right to an assessment of need • Local Authority must consider needs and wishes of young carers • In Salford, referrals for young carers aged under 18 will go through ‘The Bridge’ • Need for a targeted service for young carers aged up to 25 years, to provide improved outcomes for young carers in Salford through: • - Raising awareness of young carers’/ young adult carers’ issues across a range of organisations, and contribute to training programmes • - Information, advice and advocacy • - Targeted support schools and colleges, health services and employers • - Advice on the development and implementation of young carers’ policies • - Participation in Team around the Child, Family Group Conferences, Child in Need meetings, and Child Protection

25. Social Value Andy Roberts Client Manager – Shared Legal Services

26. Social Value Social Value is defined as: “A process whereby organisations meet their needs for good, services, works and utilities in a way that achieves value for money on a whole life basis in terms of generating benefits not only to the organisation, but also to society and economy, whilst minimising damage to the environment.” Sustainable Procurement Taskforce (2006) Social value asks the question: If £1 is spent on the delivery of services, can that same £1 be used to also produce a wider benefit to the community?"

27. Social Value • It is a mandatory requirement to include a reference to social value within a contract specification, and can be defined as, economic, social and environmental. • Social value should be “Relevant” and Proportionate” to the subject matter. • This may include: • Using long term unemployed citizens to carry out the contract • Creating training places or apprenticeships for young people not in education, employment or training • Making full use of Salford companies • Using sustainable or recycled products

28. Social Value developments The City Mayor’s employment charter will be referred to within contract documentation. We are encouraging providers to work towards or seek accreditation to the charter. The charter refers to good employment practices such as not using zero hours contracts and paying staff the Living Wage. Many organisations have already gained charter accreditation.

29. Salford CVS Marie Wilson Salford Third Sector - Consortium Hub Manager

30. Salford CVS • Established in Salford in 1973 • The city-wide infrastructure organisation for the voluntary, community and social enterprise sector • A membership organisation with over 500 local member organisations • Providing specialist information, advice, development support and opportunities for influence and collaboration Vision A robust voluntary, community and social enterprise sector that meets the diverse needs and aspirations of the people of Salford

31. How we can help • Utilise our networks & forums to communicate opportunities and identify potentially interested partners. • Facilitate briefings and events to empower organisations & enable networking opportunities. • Provide expertise and experience where required to ensure fit for purpose applications.

32. Contact Us Tel: 0161 787 7795 Email: marie.wilson@salfordcvs.co.uk www.salfordcvs.co.uk

33. We will post questions and answers from today on Chest and will be asking for any further contributions by 30th July Total value of tender expected to be in the region of £375-400k p.a. In addition, result of bid for an additional £120k p.a. is awaited Tender process will commence in September and contract start date is April 1st 2016 Next Steps