9. 8. Short Debate: Enriching Lives of Carers: Caring for those that Care

– in the Senedd at 6:18 pm on 1 March 2017.

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Photo of Elin Jones Elin Jones Plaid Cymru 6:18, 1 March 2017

(Translated)

The next item on our agenda is the short debate. For those of you who are leaving—

Y rhai ohonoch sy’n gadael, a wnewch chi hynny’n ddistaw ac yn gyflym? Rwy’n pwysleisio ‘yn ddistaw’.

I therefore call on Jayne Bryant to present the debate—Jayne Bryant.

Photo of Jayne Bryant Jayne Bryant Labour

Diolch, Lywydd. Thank you. I’m pleased to be able to raise the issue of carers in the Chamber today. I’m particularly pleased to have the short debate on St David’s Day and on an issue that I believe is so crucial to our society. I’ve agreed to give my colleagues Joyce Watson, Julie Morgan, and Hannah Blythyn a minute of the time allocated.

One of the huge privileges of being an elected representative is the opportunity to meet people and talk with them about their experiences, hopes and ideas. Since being elected, it has struck me how many people in Wales are caring for loved ones at all ages, for different family members, and at different stages in their lives. It has been said that there are four types of people: those who have cared for someone, those who are caring for someone, those who will care for someone, and those who will be cared for. I think this sums up the importance of this issue.

With a growing older population, often with complex care needs, it’s inevitable that we need more carers. Already in 2017, Carers UK estimated that the number of older people needing care will outnumber family members able to meet their need.

(Translated)

Suzy Davies took the Chair.

Photo of Jayne Bryant Jayne Bryant Labour 6:18, 1 March 2017

It’s difficult to get an accurate current figure of the number of people who care for loved ones. Many would not define themselves as carers, but would see it as something you just do. In Wales, there are an estimated 400,000 unpaid carers, which is the highest proportion in the UK. In my own city of Newport alone, there are an estimated 22,000. Many of these people fall into the category of the ‘sandwich generation’, those people who are caring for multiple generations—elderly parents, adult children and grandchildren—at a time in their life that they were expected to still be working, or enjoying their retirement. Unpaid carers in Wales are estimated to provide 96 per cent of all care services in the community, and Carers Wales estimated that they saved £8.1 billion to the Welsh economy per year. They’re an unpaid workforce that underpins our NHS and social care system, and there is no doubt that we could not do without them.

I believe it’s our duty to lead the way in protecting and supporting carers. It’s important to note that the Welsh Government has already made incredible strides. In the Social Services and Well-being (Wales) Act 2015, for the first time the same rights are extended to carers as those they care for. This is an excellent opportunity to support our carers, but today I want to focus on older people who care, and what happens after their time as a carer comes to an end. In particular, how do we support our carers at a time when they feel isolated and like they’ve lost their identity? We need to acknowledge the impact caring has on someone’s health, their future prospects, and the importance of respite. We must recognise the unique expertise carers have, and how valuable they are to our community and society, and, importantly, we need to think about how we can harness these skills, and prepare carers for the future, to ensure that no-one is left behind.

It’s a common feeling that, after caring for an extended period, many carers feel like they’ve lost their own identity. The experience of one of my constituents illustrates this. At the over 50s information event in Newport last year, I met a woman who’d been a full-time carer. She devoted her life after leaving school to caring for her mum, and then afterwards her husband. When I met her, sadly both of her beloved family members had passed away. She felt as though she had nothing. As a full-time carer she found it difficult to maintain a social life, and had never been able to start her own career. After spending most of her life caring for loved ones who depended entirely upon her, being a carer defined her. When those she cared for passed away, she felt that she had no purpose. At 55 she was healthy and keen to be active in society, but with no way to use the skills that she’d gained. This is just one example of many thousands of people who, after doing something that as a society I believe we should value immensely, felt left behind with little to look forward to in the future.

The impact that caring can have on both physical and mental health can be debilitating and long lasting. This can be particularly damaging to older carers. Conditions like arthritis, high blood pressure, back problems, are common amongst older carers, and, if left without the right support, the physical process of caring can exacerbate this even further. Carers can feel mentally exhausted, which is often worsened by worry, anxiety, and lack of sleep caused by the challenges of caring. In a survey conducted by Age UK of older carers, 75 per cent of those between 60 and 69 said caring had a negative impact on their mental health. We do not want to see anybody in a position where they’re sacrificing their own health, and if the health of the carer fails then it often puts the cared for in a crisis situation.

The physical and mental impact caring can have is demonstrated by another constituent of mine who was working abroad as a secondary school teacher when she came home to care for her 85-year-old mother who has dementia. Her 86-year-old father had previously cared for his wife until he fell and broke his ribs. Her father sadly died. My constituent gave up her job, moved in with her mother, and became a full-time carer. The physical challenges of caring had an impact, and she began to lose her confidence and became isolated, struggling to take part in social events as she would need to pay someone to look after her mother. Although she had some carers on some days, she had very little respite. Her mother did not sleep because of the dementia, which meant that they were both up all night, making it incredibly difficult to cope. My constituent’s mother died just before her ninetieth birthday, after nearly five years of being full-time cared for. Her isolation increased as care workers stopped visiting; the house was empty. She no longer had caring tasks and her allowance stopped. She was expected to go onto jobseeker’s allowance. Being a full-time carer changed my constituent’s life. After a successful career as a teacher, my constituent felt there was no way to get back on track again due to her age. She’d applied for several jobs, but had been unsuccessful, and this is heartbreaking, as she gave up a bright career to care for her mum when she needed her the most. Again, this is just one example of many.

Carers know the importance of respite. It can be a lifeline to give the carer space and time to continue to be able to look after them in their own home. It’s a big step for many people to feel that they can leave their loved one with someone else, but, once the first step is taken, it’s an essential way of supporting the carer. Respite cannot be a one-size-fits-all model. Flexible forms of respite have to be looked at to ensure that it works for each individual carer and situation.

I also think that it’s important that we do all we can to support those who have a caring responsibility to stay in their jobs for as long as possible. Initiatives to reward employers that support carers and recognise the importance of retaining experienced staff members must be looked at.

In my constituency, Aneurin Bevan health board have launched a new initiative, Ffrind i mi, which is looking for volunteers to match with anyone who’s feeling lonely and isolated. The idea is to say, ‘Let me introduce you to a friend of mine’. Working with Newport City Council community connectors and other befriending services, they want to get to as many people as possible. Initiatives like these can make a huge difference to carers, who can be isolated.

Now, more than ever, it’s vital that we harness the expertise of these highly skilled carers, while simultaneously providing for carers once their cared for has passed away. The Open University in Wales developed a free online course last year designed specifically for carers called, ‘What about me?’ The point of the course was to help carers identify the skills they have and help them to return to education or employment. Again, this is something that I feel needs to be supported and promoted. Indeed, I feel we need to go further to explore potential training opportunities and qualifications for our unpaid carers. I wholeheartedly believe that, after years of devoting their lives to others, carers deserve the recognition and future prospects that a qualification can give. They deserve respite, they deserve recognition, but, most of all, they deserve our unwavering support.

Photo of Joyce Watson Joyce Watson Labour 6:28, 1 March 2017

Thank you very much for bringing this extremely important debate forward here today. I’m going to focus my minute on young carers, those under 18 years of age, who, according to the 2011 census—it identified over 11,500 young carers in Wales offering ongoing care and emotional support to their family members. Young carers often experience isolation, bullying, and they struggle educationally, and they can miss out on those opportunities that other children enjoy when it comes to play and learning. They’re often too frightened to ask for help, as they’re worried about letting their family down, and, consequently, being taken into care. That is why it’s so imperative that all schools, health professionals and other organisations that do come into contact with young carers are appropriately trained to identify and engage with them to ensure that their needs are met. The young carers online toolkit that was commissioned by the Welsh Government does help tackle that very issue, but organisations like Action for Children are critically important in supporting those carers. They have nine young carers projects in Wales, they offer a range of services, and work with schools. They have outings for young carers, advocacy, and there are several in Pembrokeshire, and there is one in Ceredigion in my area.

Photo of Julie Morgan Julie Morgan Labour

Thank you, and thanks very much to Jayne Bryant for holding this very important debate. I think Jayne has illustrated the huge toll that caring can take on the carers, especially when they’re elderly themselves. I think it’s very important to remember that, however great the toll is, the carers want to care because it’s often their most loved person that they are caring for.

I just wanted to illustrate the real problems that can come from a caring situation with the very sad events that happened in my constituency last year. My 86-year-old constituent had been caring for his wife, also 86, who had been suffering from dementia for many years. Their children had left home. My constituent wanted to remain independent, and his wife had begged him not to put her in a home. Sadly, in July last year, everything became too much. My constituent killed his wife and threw himself under a train at Cardiff Central. He died in hospital seven weeks later. This is a very extreme case, but in the inquest, the inquest was told that my constituent had been caught in the fog of fatigue and he had given up. I think it is an illustration—an extreme illustration—of the state that you can get in, because this was a loving family: a carer who loved his wife but was driven to extreme measures because of the great toll that it had taken on him. So, I’d like to thank Jayne very much for highlighting these issues today.

Photo of Hannah Blythyn Hannah Blythyn Labour 6:31, 1 March 2017

I too want to thank Jayne Bryant for bringing this most important issue of our time, I believe, to the floor of the Assembly today. I just wanted to briefly contribute, because, like many others, this is an issue that is very close to my heart, because, like many others in this Chamber and across the country, my family has first-hand experience of the challenges faced by unpaid carers. I know that the Member for Newport West is an incredibly strong advocate in this area.

At my local level, in the local authority, I know, to my knowledge, that there is a lot more that’s being done to help unpaid carers through the local authority and the voluntary sector working together, but I think what we need to do now is build on this work to develop innovative and sustainable solutions to plug that gap that still exists sometimes between the acute hospital setting, community hospitals and other means of respite step-up and step-down care, as well as homecare, but these need to fit, be tailored and be flexible to fit the family and the circumstances. So, we all know that the pressures are growing and that people are living longer, which obviously is a positive, but we need to actually deal with how we meet those challenges, both financial and demographic. So, I’ll just finish by saying that I think that we need to see how all partners can work together to develop new models of public sector provision that have both those needing care and those providing care at their core.

Photo of Suzy Davies Suzy Davies Conservative 6:32, 1 March 2017

(Translated)

I call on the Minister for Social Services and Public Health to reply to the debate.

Photo of Rebecca Evans Rebecca Evans Labour

Thank you. As a Government, we recognise the vital role that carers undertake on a daily basis, and these include husbands, wives, parents, children, relatives, friends and neighbours, who provide unpaid but invaluable care for some of the most vulnerable people in our communities. In Wales, there are around 385,000 carers, accounting for more than 10 per cent of our population, and it’s estimated that that number will double over the next 15 years. Given the outstanding and selfless work that carers do, we have to ensure that they’re not taken for granted and are provided with the appropriate help and support that they need.

The Welsh Government has long sought to improve the lives of carers. In 2000, we published our carers strategy for Wales, which provided a framework for delivering services and support for carers. This was followed 10 years later with the Carers Strategies (Wales) Measure 2010 and, more recently, the Social Services and Well-being (Wales) Act 2014 has enabled us to build on the progress and strengthen our commitment to carers.

As Jayne recognised in her opening speech, the Act, which came into force in April of last year, significantly strengthens the rights of carers. Now, for the first time, carers have an equal right to assessment and support as the people they care for. They no longer need to demonstrate that they provide significant care in order to have their needs assessed. Whilst previously the onus was on the carer to request an assessment, the Act now places a statutory duty on local authorities to proactively inform carers of their right to be assessed. Once an assessment has been undertaken, and if it’s confirmed that the carer is eligible, then the local authority is required to put in place a statutory care plan to meet the needs that have been identified.

We know that, sometimes, it can be difficult for carers to find the right information and advice, and this is why the Act requires local authorities to ensure that carers can readily access information, advice and assistance about the type of support and services available in their communities. As well as ensuring that services and support are available, we also need to ensure that there’s effective working across health and local authorities, as well as with the third sector and other partners. Seven statutory regional partnership boards have therefore been established. The boards must work together to ensure the provision of integrated services, care and support. A number of priority areas have been set out in statutory guidance, one of which relates to carers. There’s also a requirement to have a carer representative on the board to ensure that the carer’s perspective is always at the heart of the agenda. I hope that this level of partnership working and innovative approach will meet some of those challenges that Hannah Blythyn set out in her speech.

The Act will be evaluated to determine progress and whether or not it’s delivering what we set out to achieve. This will be undertaken in three phases. Policies under the Act will be monitored during the initial year of implementation to understand whether they’re being implemented as intended and whether they have supported improvements. There’ll be ongoing evaluation through the national outcomes framework and the local authority performance measurement framework. Reporting will be undertaken annually and will provide information on whether well-being is improving nationally. An independent, external piece of research will be commissioned. We will work with stakeholders to ensure that the sector continues to be involved and provides guidance for this important work.

Whilst the Act provides significant gains for carers, it is important that we recognise the progress already made by local authorities, health boards and the third sector under the carers Measure. This has included work to mainstream carers’ issues, improve early identification of carers and empower carers in decision making. To support transition from the requirements in the carers Measure to the enhanced duties in the Act, £1 million-worth of funding was allocated for 2016-17 and there will also be a further £1 million for 2017-18. This spending is to provide support for health, local authorities and the third sector to work in partnership and support carers. The funding has been provided to strengthen the partnership approach at a regional level and create opportunities to enable the third sector to fully participate in delivery. It has also been provided to enable existing good practice to be embedded and mainstreamed so that it becomes common practice.

We’re currently refreshing our carers strategy and this will reflect the enhancement of carers’ rights in the Act and will set out the key priority areas and actions that will be taken forward to support carers. This will be developed in partnership with carers’ networks and organisations and with carers themselves to ensure there is joint ownership and action taken to address the issues that really matter to carers. I met with the Wales Carers Alliance in December so that I could hear directly from them the issues that they think we need to be considering when developing the plan.

The strategic action plan will set out what we’ve done, what we’ve been told by carers and what actions we will take in response to that. Carers have told us that they want to be recognised for the work that they do. They want easy access to the right information and assistance and they want support for their lives outside of the caring role, including access to respite care and short breaks. We know the importance of people being able to remain in their jobs when they’re caring for others. We also know how difficult it can be for carers when their caring role comes to an end, and Jayne referred earlier to the loneliness and isolation that carers can experience. Along with Jayne I attended the launch of Ffrind i Mi—Friend of Mine—in Newport, and recognise the importance of befriending schemes and the valuable role of volunteers. As I said in the recent debate on loneliness and isolation, as a Government we’re committed to doing all we can to address this issue, and this will include looking at what we can do to support carers. Therefore, in order to respond to what carers say is important to them, initial discussions with stakeholders have identified three key themes, which include identification and recognition of carers; information, advice and assistance; and life outside the caring role. Further discussions will be held over the coming months to identify the priority actions for delivery under each of these themes. This will be followed by formal public consultation over the summer. We have, however, already committed to exploring the provision of ID cards for young carers and we are also examining a national approach to respite care.

We’re also working as part of the British-Irish Council on a number of priority areas in relation to carers, and these include specific work streams on young carers—and certainly, I’ll be taking on board the comments that Joyce Watson has raised—and the carers of older people, including older carers. Julie’s very sad story illustrates the specific and very special pressures that are on older carers. Also, the identification of carers, and telecare and telehealth services and assistive technologies. This work will be used to inform the development of our strategic action plan for carers.

Finally, on behalf of the Welsh Government, I’d like to thank carers across Wales for their dedication and commitment to improving the lives of the people they care for. I’d also encourage them to exercise their rights and take up the support to which they’re entitled. We want carers to be actively involved in the work we’re undertaking to refresh the carers strategy so that we and other partners can ensure that we take action to address the issues that are really important to them. Thank you.

Photo of Suzy Davies Suzy Davies Conservative 6:40, 1 March 2017

(Translated)

Thank you. That brings today’s proceedings to a close.

(Translated)

The meeting ended at 18:40.