Gwenda Thomas Deputy Minister for Social Services
Members will recall that during the Stage 1 debate on the General Principles of the Social Services and Well-being (Wales) Bill I committed to publish a statement in relation to the resource implications regarding assessing and meeting the needs of carers, and to provide assurances regarding the rights of carers in the Bill.
Throughout the scrutiny of the Bill, you have heard me say that this legislation will introduce a number of gains for carers. I set out here a number of those provisions which will bring the expected benefits. The Bill will give carers rights equivalent to the people they care for. A carer no longer needs to be providing ‘a substantial amount of care on a regular basis’ to be able to have an assessment. The local authority will have a duty under the Bill to undertake a carer’s assessment where it appears they have needs for support. Additionally section 4(2) provides that the person conducting the assessment must have regard to the individual carer’s views, wishes and feelings. This assessment must take into account the ability and willingness of the carer to continue caring as well as their employment, education, training or leisure needs (for adults) and development needs (for children). These are real life issues which matter to carers.
Section 3(4) of the Bill provides a wider definition of carers than that which exists in current legislation to include those who provide, or intend to provide, care. Consultation with, and the involvement of, carers will be required as an integral part of the assessment process for the person cared for subject to the views of the individual. The Code of Practice will set out the expectation of the detailed arrangements that must be in place for consulting and involving carers and the people they care for.
Section 21 of the Bill places a duty on local authorities to meet the needs of carers who themselves have eligible needs. Where the carer has eligible needs they will be entitled to have a statutory support plan which the local authority must regularly review. That duty does not exist in any of the current carers’ legislation and is, in my view, a significant gain.
Section 5 of the Bill provides that the Welsh Ministers must issue a statement relating to the well-being of people who need care and support and carers who need support. The statement must specify outcomes to be achieved in terms of the well-being of these people and measures against which achievement of these outcomes could be measured.
Section 14 places a new duty on local authorities to secure the provision of an Information, Advice and Assistance service, to provide people with information and advice relating to care and support, and with assistance in accessing it. The service will be available to all carers regardless of whether they have support needs. This service will cover the range of local authority functions, not just social services. It also includes assistance and is therefore broader than the current provision in the Carers Strategies (Wales) Measure 2010. Section 14(5) ensures that LHBs and NHS Trusts continue to have a role in relation to the provision of Information, Advice and Assistance.
Members will also be aware of the co-operation and partnership provision in section 152 of the Bill. This provides that a local authority must make arrangements to promote co-operation between the local authority and its relevant partners with a view to improving the well-being of carers within the authority's area. Local Health Boards (LHBs) are relevant partners for the purposes of this provision.
Section 155 provides that a local authority must exercise its social services functions with a view to ensuring the integration of care and support with health provision and health-related provision, where it considers that this would promote the well-being of carers with need for support within the local authority's area.
These are extensive provisions demonstrating the Government’s ongoing commitment to carers and their needs.
I turn now to the issue of resource implications. Annual figures for each of the last two years show that nearly 7,000 carers in Wales had an assessment or review of their needs yet only around 4,000 of those carers received a service as a result of that assessment. It is also worth noting that information provided by a number of local authorities in Wales in 2012 showed that between 18% and 25% of assessments for social care services, across all adult service user groups, resulted in no service being delivered
The Bill opens up access to a wider range of appropriate services in a more flexible way; including access to comprehensive information relating to all types of support and respite services. The provision of Information, Advice and Assistance (IAA) services will play an important role in signposting carers to be able to access support through the universal, preventative and community based services currently available to people whose needs are classified as moderate or low. These types of services are highly valued by carers and are predominantly the types of services the Bill will require local authorities to promote.
The Bill will also require local authorities to provide this type of support to carers either without an assessment or in response to a simple, proportionate assessment. We already have experience of streamlining the assessment process through new guidance on ‘Integrated Assessments, Care planning and Review Arrangements for Older People’ which was issued under existing legislation in December 2013 by the Minister for Health and Social Services; and which provides a solid foundation for the development of the new system that will underpin the Bill.
Finally, I would like to turn to an issue which I know has been of great interest to Members and stakeholders which relates to the Carers Strategies (Wales) Measure 2010 and how its provisions are being dealt with in the Bill. Section 11(1) of the Bill places specific duties on local authorities and LHBs to work together to assess the extent of needs for care and support – which includes the needs of carers in the local authority’s area – and the extent to which these needs for care and support are not being met. The role of NHS Trusts in supporting the formulation of the Strategies is set out in the legal framework that covers the Health and Well-being Strategies. They must assess the range of services required to meet the care and support needs identified, and the range of services required to prevent, delay or reduce needs for care and support. LHBs are also required to exercise their functions to support the purposes of preventative services, including how these cater for carers under section 12.
The Bill requires this local needs assessment provided for in section 11 to be taken into account by local authorities and LHBs as they prepare, or review, their joint health and well-being strategies. In addition to this, and in recognition of the strength of feeling expressed to me in this area, I have tabled an amendment to the Bill for consideration at Stage 3. The effect of which is to amend section 40 of the National Health Services (Wales) Act 2006 to place a duty on LHBs to submit any part of their Health and Well-being Strategy that relates to carers to the Welsh Ministers. This ensures that the current duty on LHBs regarding the leadership role for the submission of strategies to the Welsh Ministers, contained within the Carers Strategies (Wales) Measure 2010, is maintained. It will be imperative that there is clarity regarding the setting of operational and strategic objectives to meet the needs of carers and that these are expressed in detail via the local integrated planning undertaken by local authority and health partners.
Members are aware that transitional funding is available to support the implementation of the whole Bill. In addition to this, I have given a commitment to explore ways in which the funding currently allocated to support the implementation of the Carers Strategies (Wales) Measure 2010 could be used to support the implementation of the enhanced duties in relation to carers. I expect local authorities to use the funding to underpin the costs that will be associated with delivering the transition to prevention and early intervention services that the Bill mandates.
The Carers Strategies (Wales) Measure 2010 will not be repealed until the Social Services and Well-being (Wales) Bill comes into force in 2016. By this time I expect the good practice around identification, information and consultation relating to carers to be well-embedded within the NHS and local authorities; and the experience of developing and implementing the Information and Consultation Strategies provided for via the Carers Strategies (Wales) Regulations 2011 will have led to enduring partnership arrangements being in place. The legal framework for this partnership working will be different under the Bill but is designed to reinforce collaboration across service providers and strengthen the support they provide to carers of all ages. I also hope that the commitment I have given to working with stakeholders in drafting the regulations underpinning the Bill will be responded to positively. I know our stakeholders will have a lot to offer in ensuring the subordinate legislation will secure and extend the provisions in the Measure.
I am grateful for the expert advice that organisations such as Carers Wales, Hafal and Carers Trust have contributed to the development of the carers provisions in the Bill. Their work supports my long and firmly held view that carers provide an invaluable service to those that they care for and this Bill provides significantly for them to support them in their task. I hope therefore that Members will support the further action I am taking in the Bill and onwards through implementation to ensure that carers receive the help they need, in the ways they need it.