Case Study - Staffordshire County Council - Support for Carers
Case Study - Staffordshire County Council - Support for Carers
Placing the carers perspectives at the heart of developing carer support systems in Staffordshire and developing a Carer’s Hub
What: Quantitative and Qualitative Research
Why: Co-design of carer support systems in Staffordshire
Where: Staffordshire
Who: Staffordshire Staffordshire County Council
About the Client
Staffordshire County Council
Staffordshire County Council aims to provide high-quality services which deliver high value for money and are tailored to their customers and communities. There are 62 elected county councilors who make decisions for the county and work closely with council officers.
The council works closely with a wide range of organisations including Clinical Commissioning Groups to commission a range of services including community social care, mental health and carer, and wellbeing services. In this role, the County Council supports the commissioning and delivery of services to the 1.1 million residents who live in the county.
Background
Carers are recognised as a key priority for the Department of Health (DH) and Care Quality Commission (CQC) due to their continued contribution to society, health, and social care. The care supplied by family and friends to ill, frail or disabled relatives is valued at £119 billion a year. This figure has risen by more than a third since 2007 when estimates were given of £87 billion. It is also estimated that each carer saves the economy £18,473 a year. Applying this costing to Staffordshire suggests that carers’ contribution is worth £1.825 billion per year.
Like many other UK counties, Staffordshire has an increasingly aging population. With over 25% of people aged over 60, the age demographics are considerably higher than the national average of 22%. On top of this, a lack of adult physical activity and a high level of obesity is among the most prominent public health concerns in Staffordshire.
Around 12% of the population of Staffordshire undertakes unpaid care. Nearly a quarter (23.7%) of these unpaid carers are aged over 65, but the vast majority are in the 50-64 age group (38.3%). Strikingly there are over 1,500 unpaid carers under the age of 15 within the county.
The Carers UK National Carers Survey in 2013 found that almost a third of those caring for 35+ hours a week receive no practical support with caring and that nearly a half (44%) had been in debt as a result of their caring responsibilities. Worryingly, 92% of carers believed that their mental health had been affected by their obligations as a carer. The report highlighted that access to support and information; workplaces ensuring that carers can juggle work and care; acting urgently to prevent carers’ financial hardship; and ensuring carers themselves receive high quality care were amongst the largest challenges to carers.
Staffordshire County Council and Clinical Commissioning Groups work together to commission services to improve outcomes for carers in Staffordshire. Services and support available to carers in Staffordshire have been delivered in the same way for a number of years.
The Staffordshire Carers Partnership was leading engagement and co-production processes with local carers, providers and wider stakeholders to identify the key outcomes, needs and aspirations of carers in Staffordshire to inform the modernisation and re-design of services.
Goals
To understand carer’s priorities and co-design a Carers Hub
The overall aim of this project has been to inform the re-design of the support given to carers in Staffordshire. In undertaking this work we engaged with carers on a meaningful level. With a focus on engagement and involvement, our aim was to identify the priorities that are important to carers.
As well as growing a solid understanding of carer’s priorities, there was also a core aim of determining what carers would like a “Carers Hub” to look like and how it should support them.
Throughout the project the core underlying focus was on brining carers into the heart of the redesign and ensuring that their thoughts, experiences and needs were supported.
Challenges
Engaging with young carers
As with any kind of large scale engagement, especially around health, social care and public services, there is an issue around ensuring a true demographic representation of users.
Because a significant number of carers are young we were aware from the beginning that utilising, engaging or even approaching this age group in a meaningful way would call for special consideration.
We understood that young people are often required to balance a range of pressures from education, social and care responsibilities. Through previously established support groups we were able to find a method by which young carers could be engaged in a familiar and supportive environment.
Utilising our experience of building relationships with organisations across the community, this provided our project with inclusivity of what all ages of carers consider priorities.
Solution
Qualitative and Quantitative approach
The research proposed used a two phase approach, including both qualitative and quantitative methodologies.
Phase 1
In the first phase of this project, the methods focused on establishing initial contact with carers on an individual level and through support groups.
The aim was to achieve an extensive reach within the community and as a result we engaged with 224 carers, 19 professional organisations and 17 additional young carers.
This provided us with an idea of the issues faced by carers of all ages as well as the priorities that are important to them.
Phase 2
For phase 2 we developed a series of focus groups and questionnaires which were utilised to test the Carers Outcome Framework and to identify whether the issues outlined in Phase 1 were both accurate on a wider level and to explore how they could be addressed through the development of a Carers Hub.
Findings
Support carers in ways they need to be supported
The findings from this project fell into three key areas: (1) priority of issues for carers; (2) issues underpinning support services; and (3) the design and delivery of a Carers Hub.
The main themes emerging from these strands can be broadly summarised as follows:
Carers considered that issues relating to their “physical health”, “caring role”, “managing at home” and “a life outside of caring” were of importance and were a priority that required addressing by support services in Staffordshire.
Carers noted that there were a number of issues that required attention, including respite care; information and advice; and one-to-one support for carers who are having difficulty coping.
Access to GP appointments when needed, gaining respite care and access to alternative and holistic therapies was essential to improve the health and wellbeing of carers and a life outside of caring;
Peer support networks were viewed as essential to improve carers ability to manage at home with their caring role.
Carers suggested that a Carers Hub should be an accessible contact centre that individuals can visit. Rather than a centre open 24 hours, carers suggested that it was more important that a Carers Hub be open 7 days a week, specifically at the weekends and in the evenings.
Participants suggested that whilst the Carers Hub is closed, other support could be offered that could be provided such as ringing up an emergency after hours Freephone line.
The Carers Hub should be delivered through a multitude of approaches: a physical contact centre that is delivered locally to enhance accessibility; through a Freephone support system; provision of online information and face-to-face drip ins.
Recommendations
Aligning services with carer priorities
A Carers Hub should offer services which address the issues concerning physical health, the caring role, managing at home and “ life outside of caring”. Respite care in particular should be a key focus and exploring the use of holistic therapies to support carers continued physical health and wellbeing.
Support services should offer activities that alleviate the stress and pressure from caring and provide a space for carers to meet to share information, experiences and an area where they can receive face-to-face support. Commissioners should engage with more young carers to seek their views and experiences of caring and the systems in place to explore the ways in which support services can be tailored to them.
Re-designing the Carers Hub
The Carers Hub should have a physical presence that is accessible to carers in Staffordshire, and be open 7 days a week with cover over weekends and evenings so that carers can contact the Hub when it is needed most.
Whilst the proposed services should be delivered via a Hub, they should also be distributed in local areas through the use of community assets as well as online information; telephone support services; face-to-face drop in sessions; and support groups.
The Carers Hub should seek to actively communicate and promote its activities and services to carers. Within this, the Carers Hub should offer a friendly and reassuring service that acts as a “one stop shop” that can provide tailored and precise information.
Commissioners should continuously engage with carers to seek their views and experiences of using the Carers Hub. Developing such co-design and co-production panels of users of a Carers Hub would allow for the continued improvement of services offered and resulted in a “best practice” approach.
Impact
The recommendations from both Phases of the Support for Carers Project have been taken forward by Staffordshire County Council. The incorporation of the findings and recommendations from the project into the final specification of the Carers Outcome Framework and the Carers Hub represents the biggest change in carer services locally for over 20 years. Carers have been placed at the heart of the re-design of services and the decision-making process of what a Carers Hub should ‘look’ like and the support it needs to offer.
The Carers Hub will provide a range of support services for carers that gives them easy access to advice, information and guidance in one place. The commissioning of the new services is currently under way, and the Carers Hub model is also being mirrored across Stoke-on-Trent to ensure consistency of approach and delivery. Carers will also be involved in the ongoing evaluation and performance monitoring of the new services.
The feedback we received from carers, carer support groups and our partner organisations was very positive in terms of ongoing dialogue and sustained engagement around support services for carers.
Following the creation of the Carers Hub model in Staffordshire, a third phase of research and engagement will evaluate the service and the experiences of carers who have used the Hub.
Testimonial by Shelley Brough, Commissioning Manager Staffordshire County Council
“ECS designed robust Carers engagement methodologies across two separate phases of engagement and have produced two subsequent reports presenting their findings. The results of the engagement activities has enabled Carers across Staffordshire to be involved, to have their say, to identify the most important issues that they face and explain how they want to be supported.
The results of the engagement has enabled Carers across Staffordshire to co-produce the Carers Outcomes Framework and also inform the development of the Service Specification for the re-designed ‘Carers Hub’, With the support of ECS, the commissioning approach undertaken for the Carers Hub, in terms of the level of Carer engagement and co-production has been commended within the County Council as an example of best practice in commissioning”
About Engaging Communities Solutions CIC (ECS)
Engaging Communities is an independent, not for profit, community interest company that works to give the public a voice in the way services are delivered.
To do this we bring together public engagement, consultation and consumer advice services within a central organisation.
We work to support the voice of the community and to offer an effective way for people to be involved in the services that provide for their health and social care needs.
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