Additional practice examples
These case studies are real-life examples of transition practice. As such, they do not reflect the new rights for young carers enshrined in the Children and Families Act 2014. In future, young carers should receive significantly more support before reaching the point of a transition assessment than is often the case in the examples below. The principles of early identification, personalised assessment and careful planning will be as relevant in the future as they are in these scenarios.
Practice example: Joseph
A young carer in a complex family situation
Joseph (aged 17) provides emotional support and personal care for his mother who has had a stroke. He also takes responsibility for parenting his five younger siblings – a sister aged 15, a brother aged 12 and triplets aged nine. This includes waking them up and getting them ready for school in the morning, travelling with them to and from school, making all meals, shopping, cleaning and helping with homework.
Joseph was referred to the young carers’ project team in his area by his school, where he is currently studying for his ‘A’ levels. The team conducted an assessment with Joseph and his mother. After the assessment the project worker worked with Joseph and his family to alleviate some of Joseph’s caring responsibilities and put mechanisms in place to support the family. This included referring his siblings to a mentoring service, to allow Joseph some personal time and space.
With support from the project worker, Joseph made a successful application to a welfare trust and received a grant to help towards the cost of new bedroom furniture and clothes.
A plan was developed for Joseph to receive support to secure a volunteer placement and a part-time job.
Joseph has said that the project has helped to build his confidence and allow him to truly understand what it means to be a carer and a young adult. He now knows what resources are available to him and how to access them. Significantly, Joseph has reported no longer feeling ashamed of his caring role. He is now able to talk to both his friends and teachers about his caring responsibilities and this has had a positive impact on his life.
Practice example: Carrie
Encouraging aspiration in a young carer
Carrie (aged 17) is a lone carer for her mother who has bipolar disorder. As a young teen, Carrie was placed into care. She has now returned home and is providing emotional and domestic support for her mother. Carrie was referred to a young adult carer service in her area by the children’s home after moving back in with her mother. A young adult carer support worker began working with her to identify her care and support needs.
Following a home visit, the support worker found that Carrie did not recognise herself as a carer. Carrie realised that she had learning needs, having missed most of her GCSE exams due to caring, and was concerned about whether or not she could gain a college place or a job. Her mother wanted parenting advice, domestic support and benefits advice.
A family support worker conducted a transition assessment. The assessment highlighted several care and support needs. These needs included support with housing, their entitlement to benefits and parenting. Carrie’s mother made an appointment with the welfare rights office, which assessed her benefit entitlement.
A transition plan was developed for Carrie to help her secure a place at the local college to study information technology. While waiting for the course to start, Carrie is undertaking a work experience programme during the school holidays. The work experience is giving her a break from her caring role as well as providing educational benefits. Carrie will be able to access support from the young adult carer service at the college drop-in sessions when she starts her course in September.
Practice example: Rachael
The importance of early transition planning in some situations
Rachael (aged 16) cares for her father who has schizophrenia and suffers from blood clots. She sleeps in the living room of a one-bedroom flat in one of the most deprived areas of Salford and is frequently disturbed by her father’s interrupted sleep. Rachael provides domestic and emotional care and accompanies her father to appointments.
A family support worker was allocated to the family after Rachael’s admission to a psychiatric assessment unit after she had taken a drug overdose. On completion of a transition assessment, the main issues facing Rachael were housing, social isolation, poverty and lack of support for her father.
A transition plan was developed to include:
- referring Rachael to a supported tenancy worker to help with applying for her own housing
- inviting Rachael to take part in a social group organised by Young Carers – she quickly forged friendships and was also assigned a mentor through a mentoring scheme
- liaising with the college to make them aware of Rachael’s living and caring situation and requesting that she be assigned a mentor
- making a referral to a local health support service to address her own emotional needs
- arranging an appointment with an employment support worker, who is working towards accessing part-time work for her.
The family support worker encouraged Rachael’s father to seek further help through his GP and he was assigned a community psychiatric nurse.
Rachael reports feeling less isolated. She has made friends with other young adult carers and values this peer support. She is also having more opportunities to leave the home and says that she no longer feels solely responsible for her father’s health.
Rachael’s father feels more supported and relieved that she now has opportunities to socialise and is also receiving support.
Practice example: Sean
A young carer with shared caring responsibility
Sean (aged 16) lives with his parents. His father has spina bifida, a brain tumour, diabetes, heart disease and a faulty heart valve. Due to poor health, he also has depression. Although his mother is the primary carer, she works part time and needs to continue this for her own mental wellbeing. Sean is therefore responsible for dressing and bathing his father and for his emotional care. Caring means that Sean cannot concentrate in school, argues with teachers and constantly worries about his father and lack of finance.
Following an initial assessment, individual support was arranged for Sean in school via a young carer worker to make sure that he had the necessary emotional support. His mother was also assessed to look at the level of care she gave and the impact on her health and wellbeing. His father was supported to join an Active Lifestyles Project and START Art Project to tackle some of his frustration and anger at his situation. The family were referred to the welfare rights office for a full assessment of their benefits and to adult social care to reassess adaptations made to their home to make sure that they were suitable for Sean’s father.
A transition plan was developed with Sean to put his caring in perspective and removed some of his worries. The school provided extra pastoral support and more time within school to have individual sessions with the young carer worker. He is more focused and has an apprenticeship lined up for when he leaves school. His father has started a course in digital photography and is getting out of the house more. The welfare rights office has done a full assessment and there has been an improvement in the family’s finances. Sean’s mother has registered with the Carers Centre as a carer and is now looking at her own needs.
Practice example: Deb
Supporting a young carer into higher education
Deb had been known to Barnardo’s Action with Young Carers for two years. She worked with one of the young carers’ project workers and was assessed using the young carers’ assessment tool. Deb was aged 16 when she was referred to the service and was at sixth form college. Deb lived with her mother and two brothers. Her mother had a diagnosis of bipolar disorder and also alcohol dependency.
Deb’s attendance at school was poor and she was struggling to manage her school work alongside the responsibilities that she had taken on at home. Her caring role included cooking, shopping, checking medication and making sure that her brothers got to school. Work was completed by the young carers’ project worker with Deb and her family. Deb’s mother did not engage with services that could support her with her mental health problems and alcohol use. However, through working with the project worker the impact of caring for Deb was reduced and through close joint work between the project worker and the school there was an improvement in her attendance and attainment at school.
A transition assessment was carried out, which looked at:
- Deb’s current needs for support and the impact they were having on her wellbeing
- whether she was likely to have needs post-18
- which needs would be eligible for support
- what she wanted to achieve in day-to-day life and how care and support could contribute to this
- information and advice on adult social care.
Transition support helped to build Deb’s confidence and aspirations over a period of time to enable her to make choices about what she would like to achieve. She chose to go to a university outside of her area and this meant that her practical caring role would cease although she would continue to give emotional support. Advance planning in relation to her brothers and mother was put in place to help her to make that transition. She was also linked into support services at the university of her choice.
Practice example: Indra
A young carer who wishes to continue caring
Indra, aged 17, was studying for her ‘A’ levels when her mother was diagnosed with early onset dementia. Her father worked long shifts and had decided that Indra, being an only child, should stop attending her course with immediate effect and care for her mother.
The college contacted Indra to find out why she had not been attending her college courses and found out about her situation. The college support worker persuaded Indra to be referred to the local authority for a young carer’s assessment.
Initially, a case worker from children’s services met Indra at her college to discuss her circumstances and what an assessment would entail. The case worker also discussed the need to involve both her parents in the assessment. A young carer’s assessment was arranged when Indra, her father and mother were all able to be at home together to meet the case worker.
The case worker visited the family home to carry out the assessment to better understand Indra’s needs for care and support. Indra had decided that she wanted to help care for her mother. The assessment included an exploration of the whole family circumstances and who else was in the family to support the care of Indra’s mother. It was also attuned to the cultural pressures on Indra to take on the caring role.
The assessment process took a further two follow-up sessions. Indra identified several needs:
- more information about her mother’s condition
- help to juggle education and caring (Indra had considered her options and decided that she wanted to continue her education on a part-time rather than a full-time basis)
- finding someone the family could trust to care for Indra’s mother while she or her father were out of the house.
Following the assessment process:
- children’s services liaised with adult services and allocated a case worker who would be able to work with the family
- the family GP was contacted and arrangements were made for Indra to find out more about early onset dementia and how best to support her mother
- Indra registered herself at the GP surgery as a carer and registered for a carer’s emergency card so that in case of an emergency her mother would not be left without assistance
- the college learning support service was contacted to find out how they could support Indra to complete her studies part time
- benefits advice was given to Indra
- the local Crossroads service was able to find a personal assistant to stay at home with Indra’s mother when both she and her father were out of the house
- the Crossroads service also had a young carers support service where Indra could attend a lunchtime club and meet other young carers.
The case worker provided adult services with an indication of Indra’s carer needs post-18.
Indra’s mother has a degenerative condition and, under the Care Act 2014, it would be appropriate to complete a transition assessment for Indra in order to provide an indication of her likely needs when she becomes an adult carer and whether these needs are eligible. A transition assessment that includes an understanding of the whole family circumstances would consider Indra’s future aspirations, areas of support for the family (as her mother becomes more dependent on care) and any cultural factors that are likely to influence the type of support to be found. It would also mean that Indra’s own care and support needs can be reviewed once she becomes an adult.