Commissioning young carers' and young adult carers' breaks
In England, local authorities have a legal duty to identify, assess and consider the impact of caring on the child and family. Most commissioning of breaks and support is undertaken by local authorities, rather than through health services.
Young carers, young adult carers and the people they support will come into contact with different services at different points. Therefore, local authorities, a range of NHS services (including GPs and mental health), education and training providers and third sector organisations need to work together. A good example of this is the Tower Hamlets Hidden Heroes guide for practitioners, which clearly demonstrates the different pathways to identification, assessment and support for different groups.
Funding of support and breaks for young carers is mixed. Local authorities fund some services, others are jointly funded by local authorities and CCGs (for example, to create a grant fund that individuals or groups can apply to). Many services are partially or fully supported by grants, charities, and local donors, or contributions by the parents of young carers.
Commissioners need to consider how they identify young carers and young adult carers, and how they provide them with appropriate support. The main focus of this guidance is on commissioning and providing breaks and support.
Identifying young carers
Local authorities must take ‘reasonable steps’ (Children and Families Act 2016) to identify young carers in their area who have support needs. Identification is the role of both adult and children’s services using pathways such as ‘early help’. This role can be supported by working with educational and health services.
Adult services working with an adult who has care needs have a responsibility to consider whether a child or young person is undertaking a caring role in relation to the adult, and work together with children’s services (including referring for assessment) young carers or those at risk of becoming young carers within the household. This is one aspect of using a whole-family approach.
Local authorities can also support raising awareness or direct commissioning with the following organisations.
Young carers and practitioners both identify schools as being well placed to make a significant difference to the wellbeing and attainment of young carers. Local authorities commissioning ‘schools’ engagement’ reported increased and earlier identification as a benefit.
More information about the Young Carers in Schools Programme.
Colleges and universities Open
Currently there is great reliance on self-identification of students who are young carers or young adult carers, and patchy support for those who do identify themselves. Self-identification amongst this group is more likely with greater awareness of support available (25 per cent of young adult carers did not inform their education provider as they felt there was ‘no point’). Working with colleges and universities, including within commissioning could help identify carers.
Healthcare providers: GPs Open
As the first place that many cared-for people and carers, including young carers, have contact with the NHS, GP surgeries are well placed to identify if someone is or could be about to become a young carer or young adult carer.
General public awareness and self-reporting Open
Young carers and young adult carers will be more likely to self-report or be identified by the wider public if there is more awareness of young carers in general and services available locally, more specifically. Commissioning requirements should include providers having a readily searchable, up to date and easy to understand ‘front door’ to their services.
For further information on identifying young carers, see the Carers Trust report Identification practice of young carers in England.
Principles of commissioning young carers' breaks and support
Commissioning young carers’ breaks and support should be guided by two key principles:
- A whole-family approach, which involves understanding and addressing the needs of the family as a whole.
- Involving young people in planning their breaks and support, in particular by co-producing.
Commissioners should support young carers to take part in the four phases of the commissioning cycle: Understand, Plan, Do and Review. The report from Carers Trust Commissioning Services for Young Carers and their Families provides guidance on enabling young carers’ voices to be heard in service planning and provision, while protecting their own dignity and rights as individual citizens. Key elements of this model are outlined below.
Understand local needs, existing services and potential assets and partners by co-producing with young carers, families and services. A good local understanding of the current and likely future needs of young carers is crucial in developing a strategy that will meet those needs and that is economically efficient and effective. In order to recognise co-production with young carers as ‘core business’, a budget and other sufficient resource – including staff time – will need to be allocated to do it effectively.
Local needs include understanding the local demographics, and which of those groups may be more at risk of becoming a young carer and/or more hidden or less likely to self-report.
Local assets and partners could include existing organisations for young people or carers, schools, colleges, universities and GPs.
Design services that meet young carers’ needs. It is important to consider that young carers predominately want more support for the person they care for and may feel unable to take breaks and activities offered without this. They may also want to take supported breaks with the person they care for and not separately from them. This is where a whole-family approach is essential.
Young carers and their families are experts on their own lives, and as such must be fully informed and involved in co-producing and delivering support services.
Commission services to meet identified needs. When setting contracts and service specifications, commissioners should:
- Involve young carers and families in setting service specifications to ensure that service-level targets and measurements reflect the things that make a direct impact on the lives of young carers and their families, and are valued by them.
- Measure and track wellbeing of young carers and their families and the impact of wellbeing locally.
When evaluating the impact of services, commissioners should:
- Check whether the service has improved the lives of the young carer, the person they care for and their family.
- Include aspects that are specifically relevant to services or partners. For example, schools may be interested in academic achievement, class attendance and Ofsted.
Market shaping is central to ensuring a diverse, high-quality market from which local people can choose. This should be based on locally identified needs, demographics, trends and aspirations. Local authorities are expected to use a wide range of approaches to meet the needs of all young people in their area who need care and support, whether arranged or funded by the state, by the individual themselves, or by the third sector. Local authorities need to ensure a variety of different service providers, including a variety of types of provider, and should always encourage innovation.
Many of the issues included in the guidance in the adult carers’ breaks resource are relevant to young carers and young adult carers. For example, it is important to talk to carers about what they want: whilst some may want organised activities, others may just want time to themselves. A whole-family approach should see a range of options available for carers and their families to choose from.
Commissioners can support shaping the market for young carers’ support services. This could involve:
- Mapping local need and existing services across the county or local authority area to identify any gaps and areas where there might be potential for services to join up or work in different ways.
- Being aware of local and national funds and grants that could contribute towards short breaks and discounts on activities for young carers and publicise them.
- Considering sources of funding and programmes that could be used to support the provision of young carers’ activities. For example, the Council’s Stronger Communities programme could be used to help develop a community asset-based approach to market development of more short breaks and activities.
- Including counselling services as part of the offer to carers to help them cope through times of stress and these could link to schools, colleges and universities.
- Looking at different sources of income and for in-kind support which may include free use of venues, materials or equipment, spaces to work, transport or professional time.
- Considering how volunteers, both trained and untrained, can help support young carers. For example, transport is identified as a barrier to young carers being able to participate in activities and breaks, and this could be supported by volunteers.
Types of breaks and support
There are some key differences between the breaks and support for young carers and young adult cares, and those for adults as well as some overlap, particularly for those in transition. For example, using residential or nursing care for the person being cared for is not on its own a break for a young person unless there is an adult available to support the young carer at home, or another activity put in place. The following focus is on breaks and activities for the young carer or young adult carer rather than for the cared for person.
Support for young carers and young adult carers can be considered as four general themes:
- Residential breaks, short breaks and replacement care
- Employment, education and training
- Emotional support and engagement
- Grants for young carers and/or their families
Residential breaks, short breaks and replacement care
These included holidays and activity weekends. There are numerous types of holiday options:
- for the young carer while the person is cared for at home or a residential setting
- a shared holiday for the carer and the person they care for
- a family holiday – the key element is that there must be support available for the caring tasks.
Residential breaks and holidays for the carer only are often with other young carers or other young people in need of support. Activities can include adventure or ‘challenge’ activities such as zip-wire or canoeing, as well as emotional support and engagement activities and elements or education or training. For example, learning about first aid or sessions to help young carers think about what they are good at.
These are often leisure or group activities for young carers or those in transition held regularly after school, at the weekend or during school holidays. These could be as a group, or service providers can help young carers to start or continue an activity they enjoy, independently or with a family member – for example supporting family swimming once a week. As with longer breaks, these can include training, employment and education elements, as well as emotional support and engagement.
Employment, education and training
Support for young and young adult carers can come from within their school, college, training provider or university. For example, drop-ins, lunchtime groups, information on noticeboards about accessing support, homework clubs and support accessing school-linked activities such as sports clubs. Young carers may need support out with of their education or training institution. This could include support for their caring role such as first aid, nutrition or moving and handling training. For teenagers and young adult carers, sessions around careers or education/training advice can be helpful.
Practice examples on employment, education and training
Emotional support and engagement
This can include one-to-one support, counselling, group work with other young carers and young adult carers, and family work to support the whole family together. Befriending services and buddy schemes can provide a means of peer support for the young carer or young adult carer, allowing them to connect with others in a similar situation or to give them support when they join a new group or activity. Peer support can also be in the form of social media or online groups.
Practice examples on emotional support and engagement
- Youth Development Service - Children, Young People and Family Services (Hull City Council)
- Young carers’ break and holiday activities (Sheffield Young Carers Project)
Grants for young carers and/or their families
These can include social prescriptions through GPs or primary care, and grants through local or national charities including carer and children’s charities and those for specific illnesses or conditions. Grants are usually for providing a holiday or short break or support to design a break as a family and make it happen. Young people and their families require support in identifying and applying for grants.