THE CITY

OF EDINBURGH

COUNCil

Kezia Dugdale MSP The Scottish Parliament Holyrood Road Edinburgh EH991SP

27 October 2011

Dear Kezia, Change Fund - Carers Thank you for your letter dated 4 October in relation to support for carers as part of the Change Fund. The Change Fund has been a welcome commitment from the Scottish Government to enable health and social care partners to implement local plans for making better use of their combined resources for older people's services. Supporting carers has been a key principle of the Change Fund in 2011/12 and I note that this has been strengthened by the announcement as part of the Spending Review that at least 20% of the Fund should be allocated to support carers from 2012/13. This is not a 20% increase in national funding, it is simply asking partnerships to ensure that they commit 20% of their overall Change Fund allocation to support carers. Whilst the Change Fund applies to older people, the Spending Review makes further references to carers and it is welcomed that in 2012-13, Scottish Government priorities will include continued funding to support carers and young carers. The Local Authority will continue to work in partnership with Health Boards to help deliver these priorities. We await clarification by the Scottish Government in relation to the envelope of funding for this ring-fenced support for carers to implement the commitments in the National Carers and Young Carers Strategy. We also welcome that the Scottish Government has outlined that they would ensure carers' experience and knowledge is fully taken into account so that there are improvements in the treatment and care of those who are cared for. Support to young carers and parent carers (parents of children with disabilities) are addressed within our local carers' strategy and children's service plans. Any additional service provision to these groups would be considered by the relevant committees within agreed budgets. In response to your concern that resources available through the Change Fund are not being allocated to the third sector, I feel that these concerns have been taken on board in Edinburgh. The Edinburgh Change Fund plan allocates 20% of 2011/12 monies (1.2m) to Community Capacity and Co-production work streams which is substantially more than other partnerships, with most allocating around 10% to this theme. This allocation will be made to fund innovative projects and marks a significant commitment to change the focus of current models of care to include more preventative, community based services. Whilst the shifting of resource from statutory services to developing community capacity is a positive move, we need to ensure that we have a rigorous evaluation and evidence base on which to make these decisions and I know that partnerships are working to develop these.

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Within Edinburgh, 500k has been allocated to an Innovation Fund which will allow voluntary sector organisations to apply for funding for short term, innovative projects to meet the criteria of the Change Fund. The process for allocating this funding is being developed in partnership with Edinburgh Voluntary Organisations Council and will be open and transparent. A further 400k will be used to develop a Community Connecting model in the city and this will be tendered for following the Council's procurement processes. Support for carers is a key objective of the Edinburgh Plan and all work streams are being asked to demonstrate a positive impact on carers. I have attached a summary which provides further detail of this. In addition, 100,000 has been allocated directly to carer support for 2011/12. Lastly, you make reference to councils using the Change Fund to shore up statutory services. Under this Administration, over the last four years, the Health and Social Care Department has received significant additional investment and we have a very strong track record in achieving better value for that investment. To that end we allocated significant new monies to address demographic pressures in the councils budget set in February. Had that budget not been passed and had the Oppositions proposals been successful then the Health and Social Care budget would have been short by 1.387M for demographics equating to some 106, 692 care hours. Perhaps that is a topic you might like to raise with the Labour Group on this council.

I hope that this provides a useful response to the points raised in your letter.

Yours sincerley

fvJ~
Councillor Paul Edie

Supporting

Unpaid

Carers in Shifting

the Balance

of Care for Older

People

Change Fund Proposals The Change Fund submission Edinburgh proposals Edinburgh. Day Services The proposal suggests would provide (134k) is to extend the opening of day services to the weekend. for service Feedback respite from consultation carers at a on services at weekends a positive within impact is a priority users and carers. This proposal provide for their also aims to develop impact a life as possible. being developed to the Scottish Government unpaid impact clearly states the commitment carers. This document summarises of the how the in

Change Fund Partnership

to support

will have a positive

on older carers and carers of older people

that providing having approach

an additional

service to 15 service in reducing day services.

users and would service

the weekend, re-ablement

carer stress. The proposal as independent

The re-ablement

can have a positive

carers by helping Overnight their

older people to regain life skills and maintain Service (BOOk) service is key to enabling or a care home. increase the capacity people

Homecare

The Homecare admission The proposal provide

Overnight to hospital

to come home from valuable

hospital

or to prevent for carers. of visits they

The service

provides

overnight the number

respite

is to significantly

of team, to increase

each week from Support Support strategies supported

less than 400 to over 1100. Carers are Assets (400k) as part of a wider and managing The proposal redesign of older people's preventative to informal development with lived Behaviour Support and care of 'Carers carers, services, including dementia. The BSS will provide behaviour also includes

Behaviour A Behaviour mental homes, education are Assets', experience Service. Telecare! Proposals adaptation leading people people

Service!

Service (BSS) is to be developed and support on understanding facilities.

health

and wellbeing housing

and inpatient

an innovative

and transformative

approach

which will employ

people

of caring as Carer Mentors

as part of the multi-professional

Edinburgh

Telehealth! services

Equipment which

and adaptations forfurther

(675k) in telecare, services telehealth in their and equipment own homes. and is to older people Edinburgh

have been developed

investment of telecare

can be crucial in maintaining in the provision manage which

the way in Scotland with long term

and telehealth

is being used to help are available them that the older

conditions

in the community. the burden

A wide range of devices on carers by assuring

suit the needs of individuals

can reduce

that they care for are safe or can get help when they need it. Connecting Connecting (4001c) is a very recent

Community CommunitY people from ablement through increased

project

which

recruits

and trains volunteers groups benefit. across the city, linking

to support

older

in West and South Central Fund would to identify provided, teams respite

Edinburgh

to access local services, this service carers who would

and activities. Carers would

Funding benefit

the Change

be used to expand attending

closely with rethe

service users and their through

new groups connect

and activities,

and also through

independence

and confidence

of the people

they care for. Many

users of the service go on

to be volunteers

to help other

older people

with activities.

Community Transport (150k) Access to transport was a key issue identified health result travel and wellbeing. reducing A volunteer transport available, the risk of older people

through service becoming

the workshops would housebound, This service shopping

as affecting and suffering

older people's from depression as a

help to address the gap in services would support carers who might the burden on carers

of not being able to join in social interactions. with the older person to hospital transport appointments,

etc or reduce

who need to provide

for those they care for with little support.

Training, Development and Cultural Change (600k) The engagement sessions and workshops held to date have highlighted the importance of training, communication and culture change to support the strategic shift required. This activity will involve all sectors, including carers. Information for Older People and their Carers (part of the Training, Development and Cultural Change theme above) Communication with older people and their carers and the availability of information about services is recognised to be an essential element of the Change Fund work. Work will be undertaken to improve the availability of information and communicating with carers will be a key aspect ofthis work. The funding for this will come from the allocation to workshop 3 - training, communication and culture change. Innovation Fund (553k) It is proposed that a significant proportion of the Change Fund budget for Community Capacity Building and Co-production should be allocated to investment in low-intensity services with high impact for older people. These services will contribute to the overall Change Fund objectives by focusing on preventative and anticipatory care, adopting an asset based approach, and using principles of co-production and volunteering. Proposals will be evaluated based on the impact against key objectives of the Change Fund and this will include support for carers. Re-ablement Services (1m) The home care re-ablement service will be a crucial part of delivering a shift in the balance of care from institutional to community based settings. It has been agreed to expand the re-ablement service as part of the Change Fund programme with an initial recruitment of 26 additional staff, to be considered further as detailed plans develop. Feedback from evaluation of re-ablement services note the support it can provide to carers, a recent briefi ng by the Social Care Institute for Excellence reported that "some carers report that re-ablement increased their confidence with their own caring responsi biliti es" . Intermediate Carel Community Therapy and Community Nursing services (Um) These services are key to supporting people in the community. Proposals are to increase the capacity of these services to ensure older people can access the services they need, supporting older people and their carers. Home Carel Care at Home (600k) This investment is to develop additional capacity for home carel care at home to meet the demand from shifting the balance of care. Delays. lack of availability or breakdown of home carel care at home support is a key area of carer stress and providing additional capacity in this area is essential to supporting older people and their carers at home. Joint Medication Procedure for Home Care and Care at Home Services (2251<) This allocation is to support independent sector care at home providers to implement Council medication training and procedures. Improvements to medication procedures will increase the confidence and safety of service users and their carers, and will ensure better co-ordination across inhouse and externally provided home care services. Medications Review (60k) Appropriate, effective medication is essential to enable many older people to stay safely at home. Improving the review of medication for older people at home will be a benefit to older people and their carers.