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THE CITY OF EDINBURGH COUNCil
Kezia Dugdale MSP
The Scottish Parliament
Holyrood RoadEdinburgh
EH991SP
Dear Kezia,
Change Fund - Carers
27 October 2011
Thank you for your letter dated 4 October in relation to support for carers as part of
the Change Fund.
The Change Fund has been a welcome commitment from the Scottish Government
to enable health and social care partners to implement local plans for making better
use of their combined resources for older people's services. Supporting carers has
been a key principle of the Change Fund in 2011/12 and I note that this has been
strengthened by the announcement as part of the Spending Review that at least 20%
of the Fund should be allocated to support carers from 2012/13. This is not a 20%
increase in national funding, it is simply asking partnerships to ensure that they
commit 20% of their overall Change Fund allocation to support carers.
Whilst the Change Fund applies to older people, the Spending Review makes further
references to carers and it is welcomed that in 2012-13, Scottish Government
priorities will include continued funding to support carers and young carers. TheLocal Authority will continue to work in partnership with Health Boards to help deliver
these priorities. We await clarification by the Scottish Government in relation to the
envelope of funding for this ring-fenced support for carers to implement the
commitments in the National Carers and Young Carers Strategy.
We also welcome that the Scottish Government has outlined that they would ensure
carers' experience and knowledge is fully taken into account so that there are
improvements in the treatment and care of those who are cared for.
Support to young carers and parent carers (parents of children with disabilities) are
addressed within our local carers' strategy and children's service plans. Any
additional service provision to these groups would be considered by the relevant
committees within agreed budgets.
In response to your concern that resources available through the Change Fund are
not being allocated to the third sector, I feel that these concerns have been taken on
board in Edinburgh. The Edinburgh Change Fund plan allocates 20% of 2011/12
monies (£1.2m) to Community Capacity and Co-production work streams which is
substantially more than other partnerships, with most allocating around 10% to this
theme. This allocation will be made to fund innovative projects and marks a
significant commitment to change the focus of current models of care to include more
preventative, community based services. Whilst the shifting of resource from
statutory services to developing community capacity is a positive move, we need toensure that we have a rigorous evaluation and evidence base on which to make
these decisions and I know that partnerships are working to develop these.
(-) filQ .>----~
l:.,,"VESTOR L~ PEOrLE
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Within Edinburgh, £500k has been allocated to an Innovation Fund which will allow
voluntary sector organisations to apply for funding for short term, innovative projects
to meet the criteria of the Change Fund. The process for allocating this funding is
being developed in partnership with Edinburgh Voluntary Organisations Council and
will be open and transparent. A further £400k will be used to develop a Community
Connecting model in the city and this will be tendered for following the Council's
procurement processes.
Support for carers is a key objective of the Edinburgh Plan and all work streams are
being asked to demonstrate a positive impact on carers. I have attached a summary
which provides further detail of this. In addition, £100,000 has been allocated directly
to carer support for 2011/12.
Lastly, you make reference to councils using the Change Fund to shore up statutory
services. Under this Administration, over the last four years, the Health and Social
Care Department has received significant additional investment and we have a very
strong track record in achieving better value for that investment. To that end we
allocated significant new monies to address demographic pressures in the councils
budget set in February. Had that budget not been passed and had the Oppositions
proposals been successful then the Health and Social Care budget would have been
short by £1.387M for demographics equating to some 106, 692 care hours. Perhaps
that is a topic you might like to raise with the Labour Group on this council.
I hope that this provides a useful response to the points raised in your letter.
Yours sincerley
fvJ~Councillor Paul Edie
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Supporting Unpaid Carers in Shifting the Balance of Care for Older People
Change Fund Proposals
The Change Fund submission to the Scottish Government clearly states the commitment of the
Edinburgh Change Fund Partnership to support unpaid carers. This document summarises how the
proposals being developed will have a positive impact on older carers and carers of older people in
Edinburgh.
Day Services (£134k)
The proposal is to extend the opening of day services to the weekend. Feedback from consultation
suggests that providing services at weekends is a priority for service users and carers. This proposal
would provide an additional service to 15 service users and would provide respite for their carers at
the weekend, having a positive impact in reducing carer stress. The proposal also aims to develop a
re-ablement approach within day services. The re-ablement service can have a positive impact on
carers by helping older people to regain life skills and maintain as independent a life as possible.
Overnight Homecare Service (BOOk)
The Homecare Overnight service is key to enabling people to come home from hospital or to prevent
their admission to hospital or a care home. The service provides valuable overnight respite for carers.
The proposal is to significantly increase the capacity of team, to increase the number of visits they
provide each week from less than 400 to over 1100.
Behaviour Support Service! Carers are Assets (£400k)
A Behaviour Support Service (BSS) is to be developed as part of a wider redesign of older people's
mental health and wellbeing services, including dementia. The BSSwill provide preventative and
education strategies and support on understanding and managing behaviour to informal carers, care
homes, supported housing and inpatient facilities. The proposal also includes development of 'Carers
are Assets', an innovative and transformative approach which will employ people with lived
experience of caring as Carer Mentors as part of the multi-professional Edinburgh Behaviour Support
Service.
Telecare! Telehealth! Equipment and adaptations (£675k)
Proposals have been developed forfurther investment in telecare, telehealth and equipment and
adaptation services which can be crucial in maintaining older people in their own homes. Edinburgh is
leading the way in Scotland in the provision of telecare services and telehealth is being used to help
people with long term conditions manage in the community. A wide range of devices are available to
suit the needs of individuals which can reduce the burden on carers by assuring them that the older
people that they care for are safe or can get help when they need it.
Community Connecting (£4001c)
CommunitY Connecting is a very recent project which recruits and trains volunteers to support older
people in West and South Central Edinburgh to access local services, groups and activities. Funding
from the Change Fund would be used to expand this service across the city, linking closely with re-
ablement teams to identify service users and their carers who would benefit. Carers would benefit
through respite provided, through attending new groups and activities, and also through the
increased independence and confidence of the people they care for. Many users of the service go on
to be volunteers to help other older people connect with activities.
Community Transport (£150k)
Access to transport was a key issue identified through the workshops as affecting older people's
health and wellbeing. A volunteer transport service would help to address the gap in services
available, reducing the risk of older people becoming housebound, and suffering from depression as a
result of not being able to join in social interactions. This service would support carers who might
travel with the older person to hospital appointments, shopping etc or reduce the burden on carers
who need to provide transport for those they care for with l ittle support.
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Training, Development and Cultural Change (£600k)
The engagement sessions and workshops held to date have highlighted the importance of training,
communication and culture change to support the strategic shift required. This activity will involve all
sectors, including carers.
Information for Older People and their Carers (part of the Training, Development and Cultural
Change theme above)
Communication with older people and their carers and the availability of information about services is
recognised to be an essential element of the Change Fund work. Work will be undertaken to improve
the availability of information and communicating with carers will be a key aspect ofthis work. The
funding for this will come from the allocation to workshop 3 - training, communication and culture
change.
Innovation Fund (£553k)
It is proposed that a significant proportion of the Change Fund budget for Community Capacity
Building and Co-production should be allocated to investment in low-intensity services with high
impact for older people. These services will contribute to the overall Change Fund objectives by
focusing on preventative and anticipatory care, adopting an asset based approach, and usingprinciples of co-production and volunteering. Proposals will be evaluated based on the impact against
key objectives of the Change Fund and this will include support for carers.
Re-ablement Services (£1m)
The home care re-ablement service will be a crucial part of delivering a shift in the balance of care
from institutional to community based settings. It has been agreed to expand the re-ablement service
as part of the Change Fund programme with an initial recruitment of 26 additional staff, to be
considered further as detailed plans develop. Feedback from evaluation of re-ablement services note
the support it can provide to carers, a recent briefi ng by the Social Care Institute for Excellence
reported that "some carers report that re-ablement increased their confidence with their own caring
responsi biliti es" .
Intermediate Carel Community Therapy and Community Nursing services (Um)These services are key to supporting people in the community. Proposals are to increase the capacity
of these services to ensure older people can access the services they need, supporting older people
and their carers.
Home Carel Care at Home (£600k)
This investment is to develop additional capacity for home carel care at home to meet the demand
from shifting the balance of care. Delays. lack of availability or breakdown of home carel care at
home support is a key area of carer stress and providing additional capacity in this area is essential to
supporting older people and their carers at home.
Joint Medication Procedure for Home Care and Care at Home Services (£2251<)
This allocation is to support independent sector care at home providers to implement Council
medication training and procedures. Improvements to medication procedures will increase theconfidence and safety of service users and their carers, and will ensure better co-ordination across in-
house and externally provided home care services.
Medications Review (£60k)
Appropriate, effective medication is essential to enable many older people to stay safely at home.
Improving the review of medication for older people at home will be a benefit to older people and
their carers.
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