Caring well

• Help you to remain fit and well, or to improve or maintain your current abilities for longer by making informed choices.
• Encourage you to do as much as you can for yourself as well as the person you care for with support from your family, friends and community networks.
• Promote the use of technology and digital solutions where they can play a role in helping to maintain or improve your well-being and independence.
• Work with other organisations to ensure you can access advice and find out about local support and other services to help you look after both the person you care for and yourself in your community.
• Contribute to making your local places, healthy and safe places that support you in your role. We will work with partners, in particular the NHS, GPs and the Voluntary Sector, to achieve this.
• Help you to find the support that increases your ability to manage the specific care needs of the person you care for and for yourself
• Work with you where the young person you care for is approaching adulthood to prepare for that transition so that it is a positive experience.
• Work with you when you are a young carer approaching adulthood yourself so that experience is positive and contributes towards a healthy and fulfilling future.

• When you are in need of direct support, we ensure you have timely access to health and social care services that meet your needs and are affordable for the County Council.
• If you are referred to Adult Social Care, we ensure that we understand what you really need to support you in the short and longer term to live as independently as you can.
• The support you have focuses on achievement of goals, digital or equipment needs, existing or new community and family connections.
• We support you by commissioning housing and support that promotes and maintains your independence for as long as possible, by developing more modern settings and offering more short-term and goal-focused opportunities.

• a perception that the formal caring system can be unresponsive and that, where there is a lack of service availability this has a detrimental impact on them
• that the caring role is often complex and where different teams are involved with support, there is a risk of an holistic picture not being developed
• a concern about training needed to support people with a learning disability, autistic people, dementia and mental health needs and strokes
• a concern about the availability, accessibility, flexibility and affordability of services, together with concern about the cessation of replacement care for people with a learning disability and for older people
• a concern about poor accessibility in relation to General Practice, where there is often low carer awareness
• that it can be difficult to find a suitable agency or worker with the right skills in some circumstances

The feedback on access to information and advice is reflected in the survey with Devon ranking 19/150 and better than all comparator averages.

When considering how well carers report that they have been included or consulted in discussions about the person they care for, the picture is mixed. Our performance declined, but more slowly than that of our statistical neighbours and England as a whole.

Carers in Devon respond less positively than all comparators to questions about multiple facets of carers’ lived experience.

Carers in Devon do not feel socially connected

The 2021 National Census provided important information about those providing unpaid care in Devon.

• More than 20% of carers in the 2021 census provided 50 or more hours of care a week.
• National estimates of the “value” of carers unpaid work, place the total value of the unpaid work of Carers in Devon as £1.6 billion annually.
• During 2020 the Office of National Statistics suggested that there were 130,000 unpaid Carers in Devon (1 in 6 of the population)..
• During 2022, approximately 42,000 carers are known to Devon County Council, 24,000 carers are registered with Devon Carers.
• Carers of people with substance abuse or addiction issues, male carers, working age carers, carers aged over 75, carers from minority ethnic communities, LGBT+ carers, carers with multiple caring roles are less likely to access support.
• Carers are less likely to work than their peers, and when they do work are more likely to work part-time and/or in lower paid jobs.
• 44% of those caring for more than 50 hours per week are economically inactive, compared with 20% in the wider population.

The COVID-19 pandemic impacted on carers more than most of us, increasing their number and caring commitments, affecting their health, wellbeing and economic circumstances.

While some carers mentioned benefits from working or socialising online, spending more time with their loved one, the significant majority reported only negative effects:

The cost-of-living crisis is exacerbating some of these challenges. Carers UK ‘Heading for Crisis: caught between caring and rising costs’, identifies that nationally, carers are a particularly vulnerable group to the effects of the cost of living crisis, due to their limited ability to earn an income and the extra costs they incur as a result of caring.

Assessing how much we spend on supporting carers relative to our population and comparative to others is made challenging by differences in operating models and accounting between different local authorities but the 2021/22 national returns suggest that we support far more carers than is typical nationally, regionally or in similar authorities because of high carer identification and registration (though more would be desirable). Nationally, the number of carers supported decreased during the COVID-19 pandemic but increased in Devon.

We need to have more timely and proactive conversations with people about how best to support them to develop and maintain independence.

This includes changing the culture and practice of social work in Devon to have conversations with people that focus on the achievement of goals, the home environment, equipment needs, and existing or new community and family connections.

We must improve the frequency and number of strength-based reviews of the support people need to live as independently as possible and increase the use of digital solutions and Technology Enabled Care and Support (TECS).

There are significant workforce challenges in Devon. We need to continue to grow the social care workforce and ensure that new ways of working are adopted, including digital and TECS solutions. Skills for Care estimates that the staff turnover rate for the independent provider market in Devon was 39.9% in 2021, which was higher than the region average of 32.0% and higher than England at 29.5%.

Not all turnover results in workers leaving the sector, as many leave for another role in social care, but this churn can impact on service and provider quality (continuity of care and training or development) and efficiency (indirect spend to recruitment and agency staff).

In Devon, the pandemic has highlighted the limitations of building-based day services and short break or replacement care models. Many people want to access outreach support in the community.

We need to invest in a more diverse set of opportunities for enabling and independence in communities that is short-term and goal focused, to allow people to regain independence. We also need to develop replacement care models alongside this.

Poor mental health and wellbeing has a considerable impact on quality of life and is a major contributor to premature death. Mental and physical health needs are closely linked. Loneliness is often a precursor for mental health needs and is seen in people of all ages.

People in many Devon communities have a high risk of loneliness. Younger renters with little sense of belonging to their area, unmarried middle-agers with long-term conditions and widowed older people living alone with long-term conditions are at increased risk.

The COVID-19 pandemic has led to an increase in the number of people aged 50-64 who are out of work. Many more people in their 50s and 60s are not working nor looking for work: they have left the workforce altogether.

Some might have stopped working for health reasons or because they need to care for someone else. Others may want to work but are struggling to find a job that fits their needs.

Research from before the pandemic shows that older workers who lose their jobs are more than twice as likely as other age groups to be unemployed for at least two years.

How we will achieve our vision

The priority areas that we will focus on over the next five years are set within the context of our vision, aims and outcomes for people across Devon.

The actions that we will take over the next five years to achieve our vision are described below.

AIM: Encourage you to stay well and support you to help yourself

Prevention – we will:

• Identify carers as early as possible in their caring journey.
• Act across the Health and Care system to connect carers to preventive, universal services.
• Work with partners to improve carer identification and recognition in Primary and Secondary healthcare.
• Seek effective means to tackle carer isolation and improve their quality of life.
• Continue to develop our carer offer to be sharply focussed on prevention, reducing and delaying needs arising for carers.
• Improve ‘front door’ information so carers who are seeking support for the people they care for can find appropriate support easily.
• Make best use of digital and other technological solutions, while recognising these do not work for everyone.
• Take account of wider determinants of health in promoting carers’ wellbeing and resilience, including the need for breaks.
• Focus on carers issues and support through Local Care Partnerships.
• Optimise the independence of the people carers are supporting.
• Continue to work with GP Practices so that carers known by services are also identified as such by their primary care team.
• Continue to develop the applications and functionality of Carers Passports.

2. Community – ‘Carer Friendly Devon’ – we will:

• Enable carers to find support where they live by encouraging ‘Carer Friendly Communities’ which are carer aware and supportive.
• Enable carers to enter or remain in employment if they wish to do so by supporting the development of ‘Carer Friendly Employers’.
• Encourage colleges and universities to identify and support young adult carers, working alongside services on transitions to adulthood as appropriate, and encouraging carers in Education and Training.
• Promote the ‘Carer Confident Employer’ scheme and use the County Council’s community leadership role as an exemplar to support these objectives.

AIM: Work with you when you need help through personalised, strength-based support to keep you connected to your community

Effective support for carers – we will:

• Take a whole family approach, so carers’ mental and physical health is maintained or improved.
• Support carers to have effective and informed choice about their lives and caring role.
• Link carers into effective support, including training, to care confidently, ‘future proofing’ planning for contingencies and awareness of out of hours support.
• Offer carer friendly services, always aware of the challenges carers face.
• Build on the success of our Carers Hospital Scheme in early identification, effective reduction of needs in a brief intervention, and seek to apply learning in other areas of the carers’ support service.
• Develop Shared Lives schemes to support people with high levels of needs as short-term replacement care and alternative to residential care, or to develop independent living skills.
• Act upon carers’ needs in relation to hospital admission or re-admission and discharge.

4. Employers – “Carer Friendly Devon” – we will:

• Enable carers to enter or remain in employment if they wish to do so by supporting the development of “Carer Friendly Employers”.
• Promote the “Carer Confident Employer” scheme and use the County Council’s community leadership role as an exemplar to support these objectives.

5. Replacement care – we will:

• Publish a new vision for replacement care which is focussed on outcomes for carers and personalised to enable carers to take the breaks they need and the person they care for to have a positive experience.
• Publish a needs assessment for replacement care to guide development including locality Replacement Care profiles and data.
• Promote new ways of providing replacement care, test and spread innovative and complementary services meeting need informally, and work to overcome workforce and market issues to achieve the vision.
• Implement practice improvements to deliver on these recommendations. 

6.     Strengths-based and personalised practice – we will ensure that:

• Staff working with people with social care needs recognise, positively engage and respect carers, and are supported in their practice.
• When they are needed, Carers Assessments are always a helpful and useful opportunity, supporting carers’ wellbeing and resilience and achieving outcomes.
• We implement in all services the principles of the ‘Triangle of Care’ so that carers are involved in assessments, care planning, decision making and reviews, are universally recognised as ‘Expert Partners in Care’ and are supported in this role.
• Parity of esteem is achieved for the quality of practice with carers as for the people for whom they care.