Presentation
Agenda
- The plan
- Challenges
- What we found out
- Community of enquiry
- Action plan
The plan
- Setting the scene: statistics, needs assessment, research and policy landscape
- What are children and young people telling us
- What do services look like now? What’s working well and what needs to be improved?
- Reflect and discuss, community of enquiry (today)
- Share what we’ve learned and what we plan to do
Challenges
- Getting responses to data requests
- Finding suitable dates to attend young carers’ meetings
- Moving from consulting with children and young people to co-production
- What may help? Longer lead times, support from stakeholder group and RPB children’s sub-group members
What we found out
- 5,100 young carers aged 0 to 24 (2020 estimate
- 40% are being supported
Young carers need:
- more carer breaks (respite)
- more awareness and better identification
- more mental health and well-being services
A few years ago when I was in year 9, I happened to be late to school. I missed my bus because I was looking after my mum. I got detention and negative behaviour points.
I once went to get shopping during lockdown and got screamed at by an old lady, that it was teenagers like me going out to meet with our mates that are killing everyone with Covid. I had to get shopping because my mum was really ill and everyone else was high risk. She didn’t even ask.
Young carer from North Wales
Lessons from elsewhere
- Listen to young carers and provide the support they need, including fun
- Work together to raise awareness of issues they face
- Provide a range of support including online
- Transition support to adult services and employers
Information pack
Young carers are children and young people who look after or help look after a family member or friend who has an illness, a disability, or is affected by a mental health condition or addiction
Carers Trust
Key information from the Population Needs Assessment:
- In November 2021 there was an estimated 1,570 young carers in North Wales and those numbers continue to grow.
- Young carers are at higher risk of mental health and wellbeing issues. 40% of young carers and 59% of young adult carers said their mental health is worse since the pandemic (Carers Trust, 2020).
- There are a number of factors for young carers that mean safeguarding issues can arise. Young carers are often difficult to identify, and this can mean their needs only come to light when there is a crisis. The extent of the child’s caring role and the impact that it has on their own development can be a safeguarding concern in itself, which is why it is vital that services quickly recognise and fully assess their needs to ensure the right support is in place at the right time.
- Young carers need more advocacy support so that their voices can be heard.
- In March 2021, all 6 councils, BCUHB and young carers commissioned providers launched the North Wales Young Carers ID Card as a collaborative initiative, ensuring young carers receive the same support from professionals across North Wales. However, there is still a need for more awareness and identification.
- Young carers need more respite care.
These points are reflected and supported by the literature search provided below.
For more information read the section on Unpaid Carers in the Population Needs Assessment.
Demographics
- The 2011 Census suggests there were about 5,475 young carers in North Wales (1,525 aged under 16 and 3,950 aged 16-24). This was a ratio of 12 out of every 1,000 young people aged 0-15 and 52 out of every 1,000 young people aged 16-24.
- Using a simple projection of the same ratios for the latest population estimates, by 2020 we would have expected this number to have fallen slightly to about 5,100 young carers across the region (1,525 aged under 16 and 3,575 aged 16-24). However, as we become better at identifying and registering Young Carers our expected numbers of Young Carers and the support they need could increase.
- Records from organisations supporting young carers across North Wales show that in August 2022, 40% of the predicted number of young carers in the region were being supported by the third sector under service agreements with local authorities (2,104). A slightly larger proportion of young carers accessing support are female, 55% of those supported (1,175), 42% (908) are male.
- Of young carers receiving support, 41% are aged 12-15 years (868), 33% (691) are children under the age of 11, with 26% aged 16-25 years. Compared to the data from the 2011 Census this suggests that young adults are underrepresented within the people we support, but this may be due to the way services and support are targeted.
- Flintshire (615) Denbighshire (545) and Conwy (497) support the highest numbers of young carers, with Wrexham (267), Anglesey (87) and Gwynedd (93) delivering support to fewer individuals. The difference between areas is in part due to the way the providers define and count support, and the way their service is focussed.
- More intensive support is offered to young carers in Gwynedd. Action for Children prioritise intensive 1-1 (Tier 3) and group activities (Tier 2) due to the complexity of needs of young carers in the county. One or two young carers receive membership and information (Tier 1) in Gwynedd and Anglesey compared with almost a third of all young people supported across Conwy, Denbighshire and Wrexham.
- WCD young carers count young people who have been invited to attend groups and trips in their figures.
Gwynedd and Anglesey
- Action for Children provide the young carers support service, provision is tailored to reflect the needs of children and young people in each local authority area.
- In Gwynedd support is targeted specifically to the most vulnerable young carers who have experienced adverse childhood experiences (ACEs) aged 8-18 years.
- The Blues Programme is being offered directly to young carers. It is a six week intervention designed for young people aged 13-19 to improve emotional resilience, reduce low mood and anxious thoughts.
- A project to identify hidden young carers is funded by the Regional Integration Fund. A project worker was employed to work closely with hospital discharge facilitators to identify hidden young carers. The project was redesigned during the pandemic to focus on community healthcare services including CAMHS, Dietetics and pharmacies.
Conwy, Denbighshire and Wrexham
- Support is provided by WCD Young Carers/Credu to improve emotional/mental wellbeing, resilience and improve family relationships.
- 337 young carers have signed up to receive a Young Carers ID Card across the three local authority areas. In Conwy 30% have signed up compared with an average of 20% across the region.
Flintshire
- NEWCIS are commissioned to support young carers to achieve their wellbeing outcomes:
- Partners are able to identify young carers, understand what that means for the child/ young person and are able to provide information, advice and signpost young carers to appropriate support services.
- Young carers are aware of their rights and what support is available to them.
- Young carers have access to a range of opportunities that support their health, well- being and progression.
- Young carers have opportunities to do the things that they enjoy, giving them a break from their caring role.
- Young carers have the right skills and confidence in undertaking their caring role. Young carers understand their own health and wellbeing needs and how to maintain them.
Other support for young carers:
- Carers Trust North Wales offer 1-1 respite breaks for young carers (funded by the six local authorities).
- Carers Trust North Wales Crossroads Young Adult Carer Service supports those aged 17-25 years In Anglesey and Gwynedd (funded by Lloyds Foundation until October 2022).
- Carers Outreach Service also support young carers in Flintshire (funded by BCUHB via the Welsh Government Annual Carers Grant).
- North Wales Young Carers support young carers through schools (funded privately).
Survey results
We created a survey to distribute to young carers across North Wales. This is a summary of the 37 responses we had:
We asked young carers if they agreed with the following statements based on a survey carried out last year. Below are the percentages that agreed.
- More respite 90%
- More awareness 93%
- More mental health and wellbeing services 97%
Other comments asked for widespread awareness. One young carer commented that ‘often staff in the shop question why we are alone without adults or why we are in a small group shopping and threaten to throw us out’. Another young carer said that they would like ‘someone to talk to’.
Young carers’ ‘Magic’ moments:
A lot of the answers talked about the different activities and trips that the young carer organisations arrange and how fun they are and how they make them happy. There were also comments about the help and support that the organisations give.
One young carer also wrote, ‘getting the recognition of a young carer in school.’
Young carers’ ‘Tragic’ moments:
The majority of the answers to this question were focused on personal tragic moments and weren’t related to young carers services/hospitals/schools. A few young carers did write about having bad experiences with schools and hospitals and not being recognised as a young carer. For example, one young carer wrote ‘not being trusted or respected by medical staff caring for my mum’. Another wrote; ‘being ignored or sent away in scenarios or places like schools/hospitals because simpy put ‘I’m a child’ and people don’t believe I know what I’m talking about.’
Some of their ideas to make services, schools, hospitals better for young carers:
Awareness was a strong suggestion, specifically in schools:
- ‘Put up signs showing the lanyards and what they mean and why we wear them.’
- ‘More awareness at school[s].’
- ‘Maybe have Young Carers groups in school[s].’
- ‘Raising awareness among professionals.’
They also suggested more activities:
- ‘Do fun activities.’
- ‘Do more activities that are aimed at young carers.’
For the full results of the survey please ask to see the full PDF.
Policy background
The Social Services and Well-being (Wales) Act defines a carer as ‘someone who provides unpaid care to an adult or disabled child’. ‘Young carers are children or young people who take a main caring role for a family member’ and ‘young people aged 18-25 are called young adult carers’.
The Social Services and Well-being (Wales) Act provides the legal framework for improving the wellbeing of carers including; rights to an assessment and support, if eligible receiving a ‘Carer’s Support Plan’ and local authorities must ensure any needs are met.
The Welsh Government Strategy for unpaid carers prioritises; identifying and valuing carers, information/support, respite and support in education/work. Respite is in the short breaks scheme statement and Carers Trust set out a vision for respite care for carers and young carers.
The North Wales Carers Strategy engaged with carers to identify their needs and any gaps in implementing the Social Services and Well-being Act, to develop a series of standards for partners across North Wales to work towards to improve services and consistency.
An inquiry into the impact of the Social Services and Well-being Act highlighted areas requiring improvement for young carers including; recognition, assessment/support and respite. The Mind Over Matter report looked at changes needed for children and young people’s mental health support, young carers were highlighted as being particularly vulnerable. A report from Estyn sets out recommendations for education settings around supporting young carers.
Further examples of support from Welsh Government for young carers included; funding the further roll-out of the national ID card scheme and funding a young carers festival.
Literature search
Please ask to see a fully referenced version.
What is the impact of caring for children/young people?
- Low self-esteem/confidence. Lack of protective factors.
- Feel unable to cope/overwhelmed.
- Education (Absent, late, struggle school work, bullying, behaviour, lower attainment, drop out, prevented further study, tired, anxious).
- Mental health & wellbeing (anxiety, stress, anger, frustration, isolated).
- Often tired, not enough rest.
- Finances (earn less, lower income, poverty).
- Positive impacts: caring, proud, confident, maturity, strong, determined, satisfaction, self-esteem, empathy, practical caring skills, close family, self-motivated, multi-task.
- Friendship/socialising (hard make/keep friends, different, leisure time, stigma). Physical health (disability/long-term illness/special education needs).
- Worry about person caring for while away. Embarrassed and guilty.
- Positive carer identity and support mitigates negative impacts of caring. Work (balancing work-care, work-life balance, life chances).
- Intersectional inequalities; race, class, gender, disability, class and sexuality.
What do young carers need?
- Early identification and provision carers under 8 and under 5 and over 18. Opportunity to meet/safe space other young carers.
- Respite/time off/time with friends (fun activities).
- Mental/emotional support (counselling, someone to talk to, no judgement). Getting help for whole family, prevent inappropriate care (whole family approach). Support school/college/work (someone talk to, balance work) 39% school unaware. School nurse (knowledge/skill to support, contact, partnership working school/health).
- Recognition impact caring on health and wellbeing (mental, physical, social, education).
- Be able to contact parent.
- Support with non-intrusive tailored help with caring/support/signposting. Recognised, valued and understood.
- Treated like other children/young people but remember have additional needs. Collaborative/multi-disciplinary working for joined up support.
- Other needs: SEND, exploitation, abuse, substance misuse (child), bullying, bereavement.
- Other things that help: listening to music.
- Transition adulthood (housing, education, work, finances, relationships, future plans). Voices are heard, involved to plan/develop services.
What do parents/families of young carers need?
- Help with own mental health affecting the child. Help with routines at home.
- Quality family time. Conflict resolution.
Why are young carers hard to identify?
- Reluctant self-declare (fear consequences, believe nothing will change). Term ‘young carer’, don’t always recognise selves as carers.
- Don’t want to be identified (stigma, shame, fear, embarrassed, lack of understanding. Adult services still focus on the adult with needs not the child.
- Young carers and wider community unaware of services or don’t see benefit/need. Seldom heard (rural, BAME, LGBT, migrants, own health issues, mental illness, substance misuse, HIV/AIDS, Roma/Gypsy/travellers, out of education, adolescent/young adults).
- Professionals need training on how to identify young carers. Capacity to self-refer.
- Previous poor experience.
- Lack of acceptance of health condition.
What can we do? Good practice examples/recommendations:
- Kidstime – (formal support service for children of parents with mental illness) helps parents and children communicate and discover joint understanding mental illness. Uses drama, awareness in schools, separate parent and child groups, joint groups, monthly with 10 to 20 families.
- Young Carers’ Festivals – young carers have fun, relax, socialize, voices heard about issues affecting them.
- Barnardo’s Action with young carers – up to the age of 25 provides assessments, specialist one-to-one support, out-of-school and out-of-home activities, counselling and group work. Emphasizes indirect work with local agencies includes; strategy plan, development, training, promotion.
- NHS England Young Carer Health Champion Programme – improve health literacy, promote health/ well-being, young carers participate plan/develop young carer friendly services, service change through young carers voices.
- Edinburgh Young Carers Project Forum – consult young people and involve them with project. Encourages leadership and self-advocacy skills for young carers.
- Recommendations: support in education integrated, priority access mental health support, free/ discounted leisure/transport, financial support young adult carers, sustainably fund social care.
- Next Steps Southampton specialist support service for young adult carers, part of wider organisation supporting young people with complex needs. Assess and tailor to needs and monitor progress.
- Camden’s Minding the Gap Transitions team with young people’s board developed transitions protocol and training programme for CAMHS workers, developed ‘transition champion’ roles in adult services, fortnightly multi-agency panel to improve transition to adulthood.
- Lincolnshire – Transition assessment to develop support plan. Services collaborate and age for young carers and adult carers overlap to aid transition. Also, Carers First Lincolnshire ‘Employers for Carers’ project asking employers to sign up to charter to become ‘carer aware.’ Service emphasises attributes carers have to employers.
- Support workers link with employers and carer champions in local businesses to provide information to carers.
- Move on up (London) supported shared housing scheme.
Statutory Services Identification young carers – Health child programme use engagement tools to help young carers self-identify; the county ‘movement in’ letter, and chat health and health passport.
Health services Identification young carers- Link GP surgeries with young carers services, raise awareness, information to identify/refer.
Schools Identification young carers – Create schools network: increase awareness/referral, share good practice.
Voluntary Sector Identification young carers- Early help tool – multi agency approach with clear pathway to identify/support young carers.
Common barriers: unclear roles, capacity, ineffective systems, knowledge/skills gap, vague/non-existent duties, financial constraints.
Common enablers: senior strategic leadership, transformed services/systems, upskilling staff.
- The Brighter Futures Project Devon – Mentor-led bespoke transition programme to support young carers; improve resilience, engage learning, have a voice and reduce negative outcomes caring.
- Recommendations: funding, promote voice young carers, consolidate transition worker roles, mentoring, family work, steering group, colleges/universities awareness.
- Hampshire YCs Alliance (HYCA) – ‘3-pronged’ support model (respite, family support, school support) Support included; respite, day trips, residential trips, dedicated YC clubs, individual/group emotional support, support in schools. Used ‘whole family approach’ and referred to other agencies.
Recommendations
- Services/workforce: prevention work, specialist knowledge/support, staff skills, stable workforce, training/development, collaborative working schools, aware/understand YCs services school.
- Supporting young carers: consult/listen young carers regularly, respond to needs, diverse activities/ opportunities, combine structured activities and space to ‘chill out’ with peers ‘be children’, regular/ range opportunities talk (adults, peers), regular/range opportunities mutual support with other young carers.
- Provision of county-wide support for young carers: high staff/volunteer to young carer ratio, age appropriate activities and have fun, improve understanding their situation (information or discussion groups), develop/improve engagement young carers with disabilities, support carers under 8, ‘home-visits’.
- Supporting families: maintain/develop family support, develop reporting/measuring support and impact, strengthen relations, maintain/develop opportunities parents meet for mutual support, activities that enable families to have fun together.
- Young carer clubs and activities: young carers/families activities look forward to, establish clear/consistent guidelines clubs/group work behaviour, staff interacting with young carers at clubs/activities, regular clubs/ activities, maintain/develop regular clubs/activities, consistent/focussed messages about services based on what important/benefits young carers, promotion ensure aware/clear what services offer. Liverpool Young Carers’ Service – Services included; transition assessment at 16, can stay up to 25, support plan, multiple services collaborate to provide support, if go to university out of area can still be referred back, YCs involved in design/development services.
- See, Hear, Respond – Support delivered: mental health/well-being support, COVID guidance, routines, activities, signpost/link further support, liaise school, practical/financial support.
- Sheffield Young Carers Family Project – Group and 1-2-1 support, family holiday/activities, parent networking. Reduce inappropriate care, increase educational opportunities, improve mental health, increase social opportunities, better housing, improve finances, improve relationships.
- Recommendations: fund more 1-2-1, barriers to attendance, target men/boys. EPYC – provision of information resources and toolkit (checklist, questionnaire, guidelines of good practice etc) to help professionals recognise and support young carers.
- Young Carers in Schools Programme – guide on implementing whole school approach to identify/ support young carers. Awards bronze, silver and gold standard for young carer services offered by school.
- Danish Buddy programme 5-15 – created free space for children to play undisturbed and temporarily keep concerns/guilt at a distance. By offering friendship, Buddies provided opportunities to feel special, seen, acknowledged and taken seriously as a child with valid specific needs/interests.
- Trailblazer step change – recommendations: collaborative whole family approach, identify carers, assessment/support services, transition, measures to assess impact, collaborate schools, collaborate health (goes into further detail for each of these recommendations).
Further recommendations from Step Change:
- Co-ordinate awareness and issues young carers face in communities, pre-schools, leisure centres, youth clubs, religious places, all schools.
- Funding not just for identifying and assessment but also sustainable worthwhile support.
- Specialist support BAME; accessible services, visible, overcome language/cultural barriers.
- Clear embedded pathways and partnership working between children and adult services.
- Designated officer (point of contact) adult social care responsible young carers and transitions.
- Outcome focussed follow-up approach rather than referring young carers on then closing case.
- On-line support is preferred method for many young people.
- More young carer councils to bring young carers together and empower them. Adult social care prioritise additional support for families with young carers.
- Training impact adult’s condition/situation has and ask right questions to identify young carers.
- Young carers consulted/involved in decisions impacting them (care plans). Hospital discharge, question who will support at home, recorded/shared other agencies.
- GP, drug/alcohol and adult mental health service train spot signs, ask right questions Primary, secondary and college application forms need young carer tick box. With transition in place.
- Schools designated member of staff for young carers and their name on website. Schools young carers policy review regularly.
- Partnerships schools and young carer services ensure communication/support improves.
- Schools should sign up ‘young carers in schools programme’. Support/understanding in school (extra time homework, exams at home, mobile phone, understand if late/miss school, identity card).
- Schools outreach work, get to know families and their issues to fully support the young carer.
- Schools peer support in school to give young carers a chance to meet with each other.
- Career’s advisors trained in challenges young carers face and able to offer relevant advice/support.
- Schools counsellor time allocated for young carers particularly in times of stress (exams).
- Carers’ Alert Thermometer for Young Carers (CAT-YC) – Pilot evidence identifying and monitoring needs, is expected to be useful for young carers, range professionals, and organisations supporting young carers.
- Young Carers’ Toolkit – aims: informed staff, effective identification young carers, carer friendly ethos, personalised plan for individual needs and effective multi-agency partnerships.
- Luton Adult and Childrens’ Services – adult social workers playing active role identifying and assessing young carers alongside childrens’ services.
- Salford Gaddum Centre – Working to narrow inequalities by working with local businesses, schools and voluntary sector to support young carers stay in education/employment and reach potential.
- Nottingham Young Carers’ App – for advise and support and finding out about activities.
- Sandwell Young Carers’ work with GPs – staff from over 60 local practices given training, information and advice how to identify/support young carers. So successful expanded to pharmacies and hospices.
- Stockton ID cards – used schools, shops, GP to identify themselves prevent need to explain.
- Surrey Wider Workforce Training – team trains wider workforce understand how they can help young carers. Over 4000 staff from schools, NHS and council trained.
- Includes multiagency co-designed projects (Because Carers Count, Think Carer Think Family, customised training and school staff training).
- Wiltshire Helping Military Families – more likely to become carers, provide dedicated support