Equal Partners in Care (EPiC)
Core principles for working with carers and young carers
Accessible Word Version
June 2013
Table of Contents
Equal Partners in Care (EPiC) 1
Core principles for working with carers and young carers 1
Table of Contents 2
About the EPiC project 4
What do we mean by ‘carer’? 4
Why equal partners in care? 5
A note on terminology 6
What are the core principles? 6
Figure 1: Core Principles for Working with Carers and Young Carers 7
Figure 2: The three levels of the core principles 8
How the levels work 9
How to use the principles 10
Using the principles to plan workforce learning 12
Equal Partners in Care (EPiC): Core principles for working with carers and young carers 14
Carers are identified 14
Carers are supported and empowered to manage their caring role 16
Carers are enabled to have a life outside of caring 19
Carers are free from disadvantage or discrimination related to their caring role 21
Carers are fully engaged in the planning and shaping of services 23
Carers are recognised and valued as equal partners in care 25
Appendix 1: Glossary of key terms 27
About the EPiC project
Equal Partners in Care (EPiC) is a joint project between NHS Education for Scotland (NES) and the Scottish Social Services Council (SSSC) to implement the workforce education and learning elements of Caring Together 2010-15, the Carers Strategy for Scotland. We aim to support workers from health, social services and other sectors to work in partnership with carers and young carers, and to achieve better outcomes for all involved in the caring relationship. We will do this by providing learning resources to help best practice become universal practice.
What do we mean by ‘carer’?
A carer is someone who provides unpaid support to a family member or friend. They may care for an older person, someone who is disabled, has a long-term illness, mental health problems or is affected by alcohol or drug misuse. Carers can be any age, from children to older people, and from every community and culture. Some carers may be disabled or have care needs themselves. They may be parents, spouses, grandparents, daughters, brothers, same sex partners, friends or neighbours.
A young carer is a child or young person who has a significant role in looking after someone in their family. They may have practical caring responsibilities or be emotionally affected by a family member’s care needs.
Sometimes the word ‘carer’ can cause confusion as people use it to describe care workers or personal assistants. In the Carers Strategy and throughout these principles, we mean unpaid carers. Carers receiving benefits related to their caring role are still considered unpaid. People with a parenting role are often called carers too, but the Strategy specifically refers to parents who care for a child with additional care or support needs.
Carers enable the person they care for to remain at home safely, independently and with dignity. The care they provide saves the Scottish taxpayer more than £10 billion a year – the cost of a second NHS. It’s important to recognise and support carers and enable them to continue caring while ensuring their quality of life is maintained.
Please note: We use the term ‘carer’ throughout the core principles to mean all carers. Where the principles relate to a particular carer group, such as young carers, this is specified.
Why equal partners in care?
Carers have a unique role in the life of the person they care for. When we are planning and delivering care for that person, it’s important that we involve their carer. They have valuable knowledge to contribute and any decision will have an impact on their caring role. Carers, the person they care for, and workers from health and social services should work together as partners to achieve better outcomes for all involved.
Carers have the right to play an equal and active role in care planning and decisions. This does not mean that all carers are the same or that the caring is shared equally. Every carer has a different role, but the same right to have the support and information they need and to be as involved as they choose to be. Equality is about having rights and choices.
It’s important that workers also feel valued as equal partners. This will help create a culture of mutual respect and partnership.
“We recognise carers as equal partners in the delivery of care in Scotland and fully acknowledge the expertise, knowledge and the quality of care they give.” (Caring Together, the Carers Strategy for Scotland 2010-15)
A note on terminology
We are aware that some of the language used in Government policies and strategies may not be understood by every reader, and that different terms are used by health and social services. We have tried to avoid jargon and make these principles as clear as possible. There is a glossary on page 26 to explain some of the terms that are often used in relation to carer and young carers. For example, in your practice you may use the terms personalisation, co-production, personal outcomes or person-centred to describe an approach to working with people that puts them and their carers at the centre of shaping their own support. For clarity, we have used the term ‘person-centred’ but you can read this as the term most understood in your practice.
What are the core principles?
The core principles have been developed in consultation with carers, workers in health and social services, carers organisations, educators and trainers, employers and managers, regulatory and professional bodies, and other stakeholders. They are intended to ensure that workers in different settings have a shared understanding of how to work in partnership with carers and young carers.
The principles are based on six key outcomes for carers and young carers (see figure 1 below). These outcomes are informed by the vision of the Carers Strategy 2010-15. Each outcome is linked to the knowledge and skills workers need to work effectively with carers to achieve this outcome.
Figure 1: Core Principles for Working with Carers and Young Carers
Figure 2: The three levels of the core principles
How the levels work
There are three levels which are designed to work cumulatively (see figure 2). Everyone who may come into contact with carers in any setting should have at least Level 1 awareness of carers. Those with more regular contact with carers should also have Level 2, while those with a leadership role should also have Level 3. Progression through the levels should not be restricted by job role but guided by your level of involvement in working towards a culture where carers are recognised and valued as equal partners. It is possible that your role may link to different levels for each area of work.
Level 1 – Carer Aware – is intended for all workers and volunteers who may come into contact with carers – from cooks and porters, receptionists and healthcare assistants, GPs, nurses and consultants, care workers and social workers, educators and managers, carer support, housing and emergency services. This basic training will ensure that any worker will be able to:
· identify carers and young carers,
· provide information, and
· signpost them to support and a carers assessment.
Workers who have more regular or specific contact with carers, for example with a role in care planning, carers assessments, or other roles with a focus on carers should also have level 2 training.
Level 2 – Caring Together – is for any worker who wants to improve their understanding of carers and improve their practice should be able to progress to level 2. At this level, you should be able to:
· work with carers in a person-centred way to achieve better outcomes,
· be aware of equality and diversity issues (cultural competence), and
· sensitively manage conflict in the caring relationship, such as around areas of confidentiality and short breaks.
Level 3 – Planning with Carers as Equal Partners – is for anyone with a leadership role in involving carers in planning and shaping services and has already completed at least level 1. This includes people who plan or commission services, managers who support staff who work with carers, educators and trainers who plan and deliver workforce training, members of Community Health and Care Partnerships, or any worker who has taken a leadership role such as carers champion or ambassador. This level will ensure that:
· carers are embedded throughout your practice as equal partners in care,
· your service is person-centred and culturally competent,
· workers are supported and trained to work effectively with carers and the person they care for to achieve better outcomes, and
· you understand current policy and strategy drivers in relation to carers and the need for a culture change in how services are delivered.
How to use the principles
The health and social services workforce are very diverse and we recognise that learning can take place in many different settings. The core principles are intended to underpin workforce education and learning and ensure that workers in health, social services and other services (such as housing, emergency services, carer support) that work with carers have a shared understanding of how to work effectively with carers and young carers.
The principles have been developed at a time of significant change in the public sector in Scotland. With the Integration of Health and Social Care, the principles will help ensure a consistent approach to working with carers and young carers among workers in the public services. Other major changes include personalisation and Self-Directed Support, the Promoting Excellence framework for working with people with dementia and their carers and Person-centred Health and Care, which all promote a focus on personal outcomes for people using services and their carers. The principles have been designed to complement and link to these areas. Rather than add to the list, the principles will support these existing programmes and help ensure that we are all working in a consistent way to achieve better outcomes for all.
You can use the principles to inform the design and delivery of workforce education and learning in relation to carers, such as:
• Reflecting on your own practice
• Induction and Continuous Professional Development modules for staff
• Curricula for health, social work and social care courses in higher and further education
• Managers and employers can use the principles to support staff to improve their practice with carers
The principles are linked to existing skills and career development frameworks - the NHS Knowledge and Skills Framework (KSF) and the Continuous Learning Framework (CLF), and to the National Occupational Standards (NOS) and relevant codes of practice. You can use the principles to evidence your progress towards your professional development objectives.
Visit www.knowledge.scot.nhs.uk/equalpartnersincare for links to related information and learning resources to help you reflect on and improve your practice.
Using the principles to plan workforce learning
The EPiC portal hosts a number of online learning resources but people learn in different ways and many workers prefer face to face training to online learning. If you have a role in planning and delivering workforce training on carers and young carers, you can use the EPiC principles at different stages of the process. You may find level 3 relevant to your role in relation to involving carers in planning and delivering workforce training. You will find some practical guidance on this at www.knowledge.scot.nhs.uk/equalpartnersincare.
Initially, you can assess the need for training and link it to the different levels of the principles. For example, do you need to deliver carer awareness (level 1) training to a large number of workers? Some health boards and local authorities have made this a mandatory part of induction training. Others have included carer awareness as a module within other training being delivered such as Dementia, Adult or Child Protection.
You can use the principles to plan the learning outcomes for the training and to ensure the content is appropriate to the level. You can link this to the job role, the level of engagement with carers and young carers, or the leadership demonstrated in relation to carers. For example, a receptionist or care at home worker may begin with level 1 and determine that they regularly engage with carers. They can choose to enhance their practice by accessing level 2 training. As their confidence builds, they may then decide to take on a leadership role, for example as a carers lead or ambassador within their workplace, and may be interested in level 3 training. The resources on www.stepintoleadership.info can support them to develop their leadership skills. If you are planning training in partnership with carers, you may find level 3 relevant to your role.
You can also use the principles to measure the impact of the training. When you are planning your learning outcomes, think about how you will measure them. For example, workers feel more confident identifying carers. Consider taking a baseline before the training is delivered and then monitor any increase in referrals for carer support or uptake of carers assessments.
Equal Partners in Care (EPiC): Core principles for working with carers and young carers
Carer and young carer outcome / What you know / What you are able to do / Link to CLF /KSF / NOS /
Carers are identified
Level 1: Carer Aware / Understand the definition of ‘carer’Be aware of key signs that someone may be a carer, and understand that these will vary according to the individual and their caring role
Be aware that a child or young person may be the main carer
Understand the range of reasons why some carers, and in particular young carers, have difficulty identifying themselves as carers / Recognise that anybody can be a carer
Be able to identify the main carer(s) in the life of the cared for person
Be able to raise the issue with a person if you suspect they have a caring role, in a sensitive and empathic manner / NOS:
SCDHSC0021
SCDHSC0227