The Department of Health has developed a consultation on reforming adult social care.  This is because the system has a lot of problems including not enough care being available, people waiting too long for care and when someone receives care it often isn't the kind of care they would like.  Social care also needs to change because in the future more people will need care  and support becayse people are living longer and there will be a smaller working age population available to provide paid care.  You can read the full consultation and an easy read version here.

Carers NI have developed this short survey around the 6 key prorities from the Department's consultation to gather carers views about the consultation and what needs to change.  We have sought to provide a short summary of the proposals under each question.  We will use this and the many responses carers have provided to previous surveys including State of Caring alongside what carers told us at our Summit and in groups.

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* 1. Priority One: making the care system sustainable and working well.

This includes:
* Making a new law for adult social care which says what care people should expect and its quality
* Deciding who is best to provide care - a  trust, a private organisation, community or voluntary organisations (or a combination)
* Planning services better including getting support to people earlier
* Considering what charges, if any, should be made for social care incluidng third party top ups for care homes.  There is a review underway and they do not propose any changes until after this review.
* Making sure people with direct payments are provided with enough funds to make it easier to buy their own care

Do you agree or disagree with this priority?

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* 2. Do you have any comments about your experiences of social care, particularly what you think needs to change or be provided sooner to better meet the needs of the person you care for and you as their carer.

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* 3. Priority 2: A Valued Workforce - Staff who work in Social Care will be valued, competent and resilient

The consultation recognises the importance of a valued, supported workforce to ensuring that adult social care is sustainable and improving.  It includes improve the pay, terms and conditions of the lowest paid in the social care workforce and developing a Strategy for improving qualifications, training and career progression in care services, including making care a rewarding and attractive career.  It also proposed providing better support to people who employ Personal Assistants directly themselves including training for PAs and police checks.

Do you agree or disagree that the terms and conditions of care staff should be improved?

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* 4. Do you have any comments on the care workforce and what you think needs to change to either improve the support provided to the person you care for by services or to improve support for individual employers of PAs?

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* 5. Priority 3: Individual Choice and Control to ensure the individual has control over the decisions affecting their social wellbeing and their care and support needs

The Department is proposing the development of a co-produced regional strategic “In Control” action plan to promote individual choice and control. The action plan would be closely aligned to commissioning of services.  This aims to make sure that there are a range of services to choose from, that they are as good as possible, that local community organisations are supported to help people and that more people are able to use direct payments.  This plan also includes making sure that people have the information they need to make decisions about what support they want by developing systems to help service users and carers to navigate social care.

Do you agree that the reform of adult social care should include making it easier for you and the person you care for to have more choice and control over the services you need?

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* 6. Have you or the person you care for used direct payments in the past/use them currently?

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* 7. If yes, do you have any positives or negatives you would like to share to help shape improvements in the future?

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* 8. If no, what were the barriers to you using a direct payment?

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* 9. When you started caring, how easy was it to find the information you needed about getting support?

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* 10. Do you have any more comments about improving your choice and control over the services you and the person you care for receives?

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* 11. Priority 4: Prevention and Early Intervention: a renewed focus on prevention and early intervention to support people to achieve their own social wellbeing. 

Statutory adult social care services are often only triggered when a crisis occurs or when a person has already developed significant needs. A preventive approach to adult social care requires a significant balance shift away from reactive services to one which supports and sustains a whole system of both informal and formal support.

Prevention and earlier intervention services could support people’s independence for longer, reduce the likelihood of more complex needs being developed, help people to take measures to achieve their own social wellbeing.

Eligibility criteria is often so high that only those in critical needs get support.

The Department is proposing:
  • that eligibility criteria for certain services for those with more complex needs must run alongside preventive and early intervention services which have lower access thresholds.
  •  the introduction of the offer of preventive/support visits for anyone aged over exploring and promoting improved support to the community sector
  • engaging service users and services in community planning
  • strengthening the capacity of the social work profession to support community focussed practice 
Do you agree or disagree with these proposals?

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* 12. If you had received support earlier, what impact might it have had e.g. on your health and wellbeing, or on the needs of the person you care for?

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* 13. Priority 5: Supporting Carers: Carers will be supported in their caring duties and entitled to support in their own right.

The Department proposes to conduct an evaluation of the current 2006 Caring for Carers strategy to inform a new approach which includes:
  • Implementation of a HSC carer support pathway
  • Adoption of NICE Quality Standard for supporting adult carers
  • Cross government approaches needed to support family carers
  • Promote recognition of carers as a Section 75 group
  • Include measurements related to family carer wellbeing in the Programme for Government outcomes assessments
  • A Carers’ Register
  • A Carer Navigation System
  • Awareness Raising
  • To fully embed co-production
  • To fully embed Personal and Public Involvement 

Do you agree or disagree with these proposals?

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* 14. What do you think should be included in a new strategic approach for carers?  Is there anything missing from the list above?

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* 15. The Department is proposing a Cross Departmental Senior Officials’ Group which will be guided by the voice of experts with lived experience.  This group would also be responsible for agreeing and implementing cross Departmental responses to the need identified in any new strategic direction.

Do you agree or disagree with this?

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* 16. The Department proposes the introduction of an independent Carers’ Champion role.  This person would be a public advocate for family carers with a particular remit for ensuring the voice of lived experience was heard and bringing that to influence policy and give advice across government departments.  The champion would also have a role to challenge policy makers and service providers.

Do you agree or disagree with this?

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* 17. Do you have further comments on what needs to be done in this reform of adult social care to support carers more effectively?

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* 18. Priority 6:  Primacy of Home: The purpose of adult social care, including group care services, is to support citizens to live well in their own home

The Department proposes a range of actions to make this happen. 

  • a regional, standardised model of domiciliary care
  • improving the quality of care planning including the co-ordination and integration of all aspects of someone’s care 
  • the removal of any set limits on the amount or cost of a service someone may receive. Each situation should be assessed individually.
  • the development of a mental and social wellbeing framework for care homes to enhance that aspect of the care they provide
  • continue the rollout of the “My Home Life” programme
  • expand the availability of the Supported Housing model to more people including those with complex needs who require more intensive support
  • phasing out of shared bedrooms in care homes over a three year period except for the provision of couples who wish to share a room.  There should be enough flexibility in registration to allow for a sufficiently large bedroom to be used as a single or a double that could accommodate couple
  • a phased move in commissioning from larger scale facilities to smaller scale facilities
Do you agree or disagree with these proposals?

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* 19. Do you have any comments on what needs to change to ensure that people, and their carers, are supported so that they can live at home for as long as they wish?

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* 20. Do you have any comments on improving care homes and other supported accommodation including any experience you have on what needs to change?

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