Learning & training opportunities report june 2010_final

Understanding the Barriers for Carers in
Accessing Learning and Training
Opportunities

Mapping & Research Project (North West)

Report Published
June 2010

Caring with Confidence, Carrwood Park, Selby Road, Leeds, LS15 4LG
T +44 (0)113 385 4491
E cwc.info@caringwithconfidence.net
W www.caringwithconfidence.net

Caring with Confidence – Mapping & Research Project (North West)

Contents

1. Introduction and background p3
1.1 Aims of this study
1.2 Previous research
1.3 This report

2. Methodology p4

2.1 Desk research
2.2 Supply - Learning and training organisation consultation
2.3 Demand - Carer consultation
2.4 Key stakeholder interviews

3. Caring with Confidence p6
3.1 Background to Caring with Confidence
3.2 Caring with Confidence training/learning programme
3.3 Caring with Confidence target groups
3.4 Caring with Confidence delivery to date
3.5 Learning to date

4. The policy and research context p9

4.1 Policy context
4.2 Research on carers
4.3 Summary

5. Learning and training provision in the North West p14

5.1 North West mapping
5.2 Types of organisations engaging carers across the North West
5.3 Provision across the North West
5.4 Barriers to providing learning and training opportunities in the North West

6. Carers needs p20

6.1 Interest in learning and training opportunities
6.2 Previously accessed learning and training support
6.3 Barriers to accessing learning and training provision
6.4 Outcomes of learning and training

7. Conclusions and recommendations p24

7.1 How current provision needs to adapt in the North West in the short term
7.2 How provision needs to adapt in the North West in the longer term
7.3 What role for Caring with Confidence
7.4 Moving forward and recommendations

2


1. Introduction and background

Caring with Confidence commissioned Equal Access Consultancy in October 2009 to undertake a
mapping and research project in the North West of England in support of their project brief from the
Department of Health on understanding the barriers for carers in accessing learning and training
opportunities.

1.1 Aims of this study

The overall aims of this mapping and research project as outlined in the project brief are as follows:

o to provide a regional mapping/overview of the current learning and training opportunities for
carers living in the North West of England
o to understand the need, quality, relevance and geographical spread of learning and training
opportunities in the North West
o to produce a piece of research focusing on the short and long-term issues of carer related
learning and training opportunities
o to contribute to the continuing discussions surrounding the future of Caring with Confidence and
its role within the carer community
o to feed into the ongoing work being undertaken in support of accreditation.

1.2 Previous research

In spring 2008, Caring with Confidence commissioned an external consultancy, Waves, to conduct a
national mapping exercise, in which a survey was distributed to a database of over 4,500
organisations, compiled from a number of individual databases managed and maintained by carer
organisations. In total 639 questionnaires were completed, with 329 responses gained from
organisations that provided or commissioned training for carers, and the analysis of these formed the
basis of their report. This represented an overall response rate of 7.3%.

1.3 This report

This report presents the research findings from mapping and research in the North West of England,
conducted by Equal Access Consultancy between October 2009 and March 2010. This research
seeks to develop a wider understanding of the learning and training agenda for carers, exploring the
supply and demand sides of the equation.

On the supply side, the research explores the current levels of provision available to carers in the
North West of England, the types of organisations delivering learning and training to carers, from the
voluntary, statutory and private sector, the geographical spread of learning and training opportunities
and the challenges and barriers to providing learning and training to unpaid carers.

On the demand side, this research explores the needs, wants and desires of carers in relation to
learning and training opportunities, specifically related to their caring duties but also wider needs for
training and learning.

3


2. Methodology
The mapping and research project examined both the supply and demand side of the learning and
training equation, mapping and consulting with organisations that provide learning and training
opportunities for unpaid carers. This section of the report presents the methodology adopted.

2.1 Desk research

At the outset of the project, a brief desk review was undertaken to place the work in the emerging
context, examining the emerging policy, the general development of the carers agenda nationally
and examples of research in this field.

2.2 Supply - Learning and training organisation consultation

o North West mapping - Using a blend of research methodologies including desk based research
and telephone interviews, we mapped the geographical spread of learning and training
opportunities in the North West. Using internet research, local authority contacts were developed
for each of the districts in the North West, carers centres were identified, along with further
educational institutions and key support organisations related to the Caring with Confidence
target groups. A snowballing method was then used to reach into key contact networks. A total of
512 contacts were mapped who indicated that they were engaged with learning and training for
unpaid carers in some respect, or plan to be involved in providing learning and training to unpaid
carers in the future. On occasion, multiple individuals from the same organisation were included,
as they operated in either different local geographies or with different target groups.

o North West survey - Working with Caring with Confidence a questionnaire was developed,
which was distributed to learning organisations via email and post. A targeted booster was used
to follow up non responses among those groupings with low response rates.1 The total number
of completed questionnaires returned was 1052, representing a response rate of 20.5%.

o North West interviews - 12 qualitative interviews were undertaken with a range of learning and
training organisations that represented specific types of provider or specific conditions, in the
North West and wider where appropriate, which added qualitative depth to the survey findings.3

2.3 Demand - Carer consultation

o Carers needs survey – Working with Caring with Confidence, a questionnaire was developed
which was sent to a database of over 3,000 carers in the North West to evidence carer need.
The questionnaire was designed to assess the barriers to learning and training.4 The total
number of completed responses to this survey was 544, with 29 partial responses, representing
a response rate of 19.1%. The analysis carried out includes all respondents (5735). In addition,
further questionnaires were sent through local organisations involved in focus groups and
interviews. The questionnaire was also available for completion through the Caring with
Confidence website.

o Focus groups - A series of five focus groups were conducted with carers across the North West
and wider where appropriate, engaging with those carers who have, and have not benefited from
the Caring with Confidence learning and training opportunities, carers in the Caring with
Confidence target groups, and carers from a geographical spread of the region through
Providers of the Caring with Confidence programme in the North West where possible.

1
See appendix 4 for a full copy of the survey.
2
With a further 90 partially completed. See appendix 1 for a breakdown of responses by geographical region.
3
See appendix 3 for a list of consultees.
4
See appendix 5 for a full copy of the survey.
5
See appendix 2 for a breakdown of responses.
4


o Biographical interviews – Further, detailed biographical interviews were undertaken with four
carers with an interesting journey and experience of learning and training e.g. transition to
employment through gaining skills, civic engagement including volunteering, savings to the state
in avoiding the need for mainstream services.

2.4 Key stakeholder interviews

We conducted 10 key stakeholder interviews to address the emerging issues from the supply and
demand side analysis of learning and training opportunities, holding discussions surrounding the
6
potential future of Caring with Confidence and its role within the carer community.

6
See appendix 3 for a list of consultees.
5


3. Caring with Confidence

3.1 Background to Caring with Confidence

Caring with Confidence (formerly known as the Expert Carers' Programme) started on 1 January
2008 and is part of the New Deal for Carers and the renewed National Carers Strategy. The
Department of Health awarded a contract to a consortium comprising of The Princess Royal Trust for
Carers, Carers UK, Crossroads Care, Partners in Policymaking and the Expert Patients Programme
Community Interest Company (EPP CIC) who are the lead administrative organisation, to lead the
delivery and on-going development of Caring with Confidence. The Department of Health allocated
£4.7 million a year to Caring with Confidence for three years.

3.2 The Caring with Confidence programme

Caring with Confidence is a free, innovative programme of flexible sessions offering support to
carers, empowering and enabling them. It informs them of their rights; the services available to them;
develops their advocacy skills and their ability to network with other carers to support their ongoing
needs. The first programme took place in August 2008 (pilot) and the project was expected to reach
full capacity by June 2009.

The programmes main aim is to:

‘Help carers make a positive difference to their life and that of the person they
care for’.

The programme consists of an introductory session “Finding Your Way” and the following six generic
modules:

• Caring and Coping
• Caring and Communicating
• Caring and Me
• Caring Day-to-Day
• Caring and Life
• Caring and Resources.
7
The programme is available through face-to-face group sessions (led by trained facilitators ),
through self study packs or by accessing online sessions. Carers can mix and match the methods
they use to develop their knowledge, or participate in learning and support.

“Caring with Confidence have put together a high quality and structured programme, they
have done a really good job on working with carer needs, presenting it well.” – Department of
Health

7
Facilitators must achieve their “Passport to Practice” (internal accreditation) from Caring with Confidence. The process
for a fully recognised facilitator is:

• Completion of an application form;
• Interview;
• Three day Facilitator Development Programme (currently residential);
• Two observations of delivery within the first six sessions plus optional additional telephone coaching.

The “Passport to Practice” is awarded providing facilitators have successfully completed each of the above steps.
6


3.3 Caring with Confidence target groups

Caring with Confidence is aimed at adult carers, with particular emphasis on target groups specified
by the Department of Health. The core target groups are carers who are:

• in receipt of Carers Allowance (or care for 35 hours per week or more) – (1/3)
• of black and minority ethnic (BME) heritage
• or lesbian, gay, bisexual or transgender (LGBT) – (1/3 LGBT and/or BME).

And, carers of (1/3):

• disabled children
• adults with complex needs
• people living with mental ill-health
• people with dementia
• people with long-term conditions
• people nearing the end of life.

The generic programme is tailored and supplemented to meet the needs of carers from the target
groups.

3.4 Caring with Confidence delivery to date

Caring with Confidence awarded contracts to 32 organisations to deliver face-to-face group sessions
to carers in England. This followed a thorough procurement process in which 381 organisations
submitted an expression of interest to become a Provider, 128 organisations went on to complete a
prequalification questionnaire and from those submitted, a total of 76 organisations were formally
invited to tender for a contract to deliver the programme, and 32 organisations were selected.

The overall target set for the whole project is to reach 27,000 carers across England over the 3 year
period. To date the programme is not on target to achieve this output level. Positive feedback
received from the end users indicates that the sessions have been received with significantly high
8
proportions of carers rating the sessions as very good .

Caring with Confidence Providers have faced challenges in reaching the target number of carers,
with difficulties in particular being experienced in reaching the Caring with Confidence target groups
e.g. BME, LGBT, which are still relatively little understood. Many of these carers’ groups remain
‘hidden’ from support services, and little best practice exists for reaching them.

In response to these challenges, Caring with Confidence has complimented its programme with a
second tier delivery framework, which involves working through and engaging with grass roots
community organisations which are better placed on the ground to reach carers in the specific target
groups. This new model complements and supplements the existing structure, and early signs are
that ‘hidden’ carers in the Caring with Confidence target groups are more likely to engage through
grass roots organisations with which they identify at the very local level.

3.5 Learning to date

The programme has taken time to establish itself and begin to deliver against its ambitious targets. It
is however a developmental programme, operating on a national scale and it has faced a number of
challenges with its Provider base and the quality and pace of delivery. It is clear, like any national, life
limited (3 year) programme, a significant planning and infrastructure stage is required before any
delivery phase can commence. Evidence from this programme shows that the first half of the project
(18 months) has been concentrated on building that framework and there is evidence that delivery is

8
14,967 feedback forms received of which 9,106 excellent (60.8%), 5,282 good(35.2%) 500 satisfactory (3.3%) poor
(0.06%). 13,825 would recommend a friend (92.3%).
7


now beginning to flow from the work done to establish the programme.

o A key strength of the programme has been developing connections among carers, which has
contributed to the formation of new support groups, and the Caring with Confidence National
Team is currently looking at different ways to sustain these support groups after the programme,
as it is recognised as a significant achievement that needs to be built upon.

o The modular format facilitates carers’ participation and promotes their self determination. Whilst
this has enabled many carers to participate at their own pace and convenience, it has also
impacted on the levels of absence, which have been higher than expected.

o In terms of the outcomes of the Caring with Confidence programme, there is no evaluation data
which picks up the longer term outcomes of participation. However while a national evaluation
carried out by Leeds University is expected to report on this, it seems this would have been more
appropriate to have an action research approach to the evaluation, in order to feed the findings to
the National team for ongoing support.

o As a result of delivery issues to date, some of the wider aspects of the programme have been
under developed, for example work on benchmarking and accreditation. Moreover little progress
has been made at a strategic level with local authorities and Strategic Health Authorities, to
explore sustainable models for long term delivery of learning and training for carers.

The Department of Health awarded the contract to a consortium comprising of The Princess Royal
Trust for Carers, Carers UK, Crossroads Care, Partners in Policymaking and EPP CIC. These expert
carer organisations should have been able to provide greater support with reaching carers and
particularly hidden carers, and more generally with the strategic development of the programme. The
relationship with the board has improved significantly in the last 12 months, with greater engagement
from all parts.

8


4. The policy and research context
The health and social care agenda in the UK is being shaped by demographic change, with the
number of people over 85 (the age group most likely to need care) expected to increase by 50%
over the next decade. By 2026, it is expected that there will be 1.7 million more adults who need
care and support. This demographic change, coupled with rising expectations of choice and control
and tightening of public finances means that the UK will need to take a number of tough decisions on
the direction of social care and support for carers in the medium to long term

4.1 Policy context

Our Health, Our Care, Our Say

The Department of Health’s 2006 White Paper ‘Our Health, Our Care, Our Say’, made a commitment
to launch a New Deal for Carers, recognising the needs of the six million carers in the country. The
New Deal for Carers, as set out in the White Paper, was made up of four constituent parts:

• a major review of the 1999 Carers’ Strategy was promised9 - It was acknowledged that the 1999
strategy did not provide the framework for meeting all of the needs of England’s carers

• a comprehensive national information service - to meet the many and diverse needs and
concerns of carers. Carers Direct, in place by Spring 2009, provides via a single telephone
number and a website, access to the information needed by all carers

• the establishment of Caring with Confidence - a training programme for carers, empowering and
enabling them in their caring role. Caring with Confidence will ‘inform carers of their rights, the
services available to them and provide information and training that will benefit the whole family.
It will also develop their advocacy skills and their ability to network with other carers to support
their needs’

• emergency care cover - £25 million additional funding per year was to be made available from
October 2007 to local authorities, to enable them to develop plans with carers to provide cover
when the carer experiences an emergency that prevents them from caring.

The experience of caring differs according to the circumstances of the person cared for, and the
cultural expectations and family structures within different communities. The White Paper
acknowledged that little was known about a range of carers’ groups, for example those with learning
disabilities, and LGBT carers.

Cultural concepts of caring are not universally shared throughout all communities in Britain; for
example many people from other countries who have not had experience of a welfare state do not
share the same concept of ‘carers’. The National Black Carers and Carers Workers Network
highlighted that they had been unable to find a word in Gujarati, Urdu, Punjabi or Bengali which
translates into ‘carer’. These findings have been reflected in the Caring with Confidence target
groups and highlight the difficulty of engaging with a carer sector that relatively little is known about.
st
Carers at the heart of 21 century families and communities

The revised Carers Strategy was published in June 2008, with a vision ‘that by 2018, carers will be
recognised and valued as being fundamental to strong families and stable communities’. The carers
strategy outlined a number of important issues for the training and support of carers, identifying the
need for more personalised, targeted information which will reduce the difficulties carers face. While
the strategy recognises the family as the cornerstone of the care and support provision, it identifies
the need for additional information, advice and support, for families to undertake their caring roles
effectively, with personalised support both for themselves and for the person for they care for.

9
Carers at the heart of 21st century families and communities - “A caring system on your side. A life of your own” was
published in June 2008.
9


Importantly, the strategy acknowledges that families want recognition for the valued role that they
play.

The strategy states that by 2018, carers will be respected as expert care partners and will have
access to the integrated and personalised services they need to support them in their caring role.
Underlying the approach is a recognition of the need to get the services right for the person being
supported. Carers and their caring role are inextricably linked to the people they care for and if the
support and services are not right for the person being supported then both the individual and the
family will be affected.

Standing Commission on Carers

A Standing Commission on Carers was announced in September 2007 with a long-term remit,
including a key role in the implementation of a carer strategy as well as a responsibility to advise the
Government on matters it feels relevant to carers in the longer term. The Commission is designed to
ensure that the voice of carers is kept ‘at the heart of government’ by being an influential and
powerful advocate for carers, both within government and with external stakeholders working with
carers across the country to ensure that their voice is heard at a local and national level.

The Standing Commission on Carers published its first annual report in October 2009, highlighting
the importance of raising the profile of carers as equal citizens, but in need of more active support –
financial, practical and emotional. Carers need to be understood as the diverse group that they are,
and carers need to be able to receive support in a flexible manner which recognises that those they
care for will not always have a static condition, and the nature and level of support needed will
change over time. Carers have repeatedly told the Commission that they wish to be recognised and
respected as expert partners in care, to have their contribution valued and to be supported in what is
often a very challenging role.

Shaping the future of care together

Published in July 2009, this Green Paper set out the Government’s proposals for ways to reform the
care and support system for adults in England. The key message from the Green Paper is for a need
to share the costs of care between individuals, families and government. The responsibility for
paying for care could be shared between people who need care, and the state, but the Green Paper
encourages an examination of how responsibility for providing care is shared between family
members and the state.

It is acknowledged that the current system can place too much responsibility for care on informal
carers and suggests that people should be able to choose how much of their care and support is
provided by a carer and carers should be able to choose how much care and support they wish to
provide. With improved survival rates, many carers are now providing higher levels of care and
support and performing more complex care tasks than in the past. With people living longer and a
trend for starting families later and later in life; many people find they have a double caring role,
looking after young children and elderly relatives.

While the Green Paper acknowledges it would not be affordable to replace family care with state-
funded care and support, a high amount of care and support can have a big impact on the carer’s
health and wellbeing, which can have economic impacts, both for the family and for wider society, if
people have to drop out of the workforce because of high levels of caring responsibilities.

The proposed National Care Service would help carers by making the process of getting care and
support easier, supporting carers, particularly people who care for those who would have received
no funding from the state under the current system. This will give people more flexibility in deciding
how much they want to care for a family member.

10


The Big Care Debate

Following the publication of the Green Paper in July 2009, the government launched The Big Care
Debate around the questions raised in the Green Paper. Prime Minister Gordon Brown announced a
commitment to the National Care Service at the end of 2009.

“So we will say in Labour's manifesto that social care for all is not a distant dream, that to provide
security for pensioners for generations to come – we will bring together the National Health Service
and local care provision into a new National Care Service… for those with the highest needs we will
now offer in their own homes free personal care”.

This announcement about social care for the elderly is a move towards adopting the green paper. In
early 2010 the main political parties failed to reach a cross party consensus on funding the future of
social care in the UK. The Princess Royal Trust for Carers is calling on all political parties to include
a series of guarantees for carers in their manifestos. They include: a guarantee that the Carers'
Strategy will continue throughout the next Government; a carers' centre in every area; and a right to
a break for every carer. The charity also wants parties to promise that every carer will receive
financial support if needed.

4.2 Research on carers

Carers in the regions - profiles

A recently published profile of carers in the North West draws much of its understanding of carers
from 2001 Census statistics. Now nine years old, this data set shows that 40% of carers are aged 50
to 59, however it is older carers (65 plus) who provide the highest intensity of care, with
approximately 50% caring for more than 50 hours per week.

11


Examination of ethnicity shows that those with South Asian heritage are most likely to care for more
than 20 hours per week, and that within these ethnic groups, women are disproportionally burdened
with caring responsibilities. The 2001 Census shows the geographical distribution of carers, with a
clear north south divide and urban focus, with a significant concentration of carers in South Wales,
but in largely rural counties of Pembrokeshire and Carmarthenshire.

Carers in the North West are more likely to not have access to a car, providing a further barrier for
them in their caring duty, with 24% of males and 30% of females caring over 50 hours per week with
no access to a car, compared to 19% and 26% of non carers respectively (16% and 23% nationally
for non carers). By 2030, the number of carers will increase by over 96,000 or 11% in the North
10
West, however a larger percentage increase is predicted for England as a whole at 15% .

10
Carers in the Region A profile of the North West, Leeds University for Department of Health.
12


The 2011 Census will give a revised picture of the caring population and will take into account
significant migration that has occurred in the last 10 years, and the increased aging of the
population. It would be expected that the regional carer profiles will be updated at the earliest
opportunity to provide commissioners with a sound evidence base to inform investment decisions.

“If only I'd known that a year ago”

A book titled “If only I'd known that a year ago” which includes an introduction written by a former
carer of a person affected by Parkinson’s disease, contains a directory of every carers organisations
in the county and 20,000 copies have been circulated to date. Subtitled 'A guide for newly disabled
people, their families and friends', the book provides an introduction to relevant services, rights and
facilities, covering areas such as accommodation, aids and equipment, education and employment,
discrimination, health and social services, transport, sport and leisure, benefits and personal
relationships, it gives all the information needed to 'start the ball rolling' and the signposts to gain
more detailed knowledge as required.

Achieving Equality in Health and Social Care - A framework for action

Recent research by the Afiya Trust has highlighted that Bangladeshi (2.4%) and Pakistani (2.4%)
11
groups had the highest rates of spending 50 hours a week or more caring , but many minority ethnic
carers tend to care unaided and in isolation. The report outlines a number of underlying factors for
the continuing health inequalities experienced by BME communities in the UK. These include
individual/community factors such as cultural behaviours and structural explanations such as social
deprivation and exclusion, but also evidence that racism, racist victimisation and discrimination can
affect a person’s and community’s health.

The key message from the research is that race equality matters and needs to be at the centre of all
future policy development in health and social care. While there is an acknowledgement that service
users, carers and communities should be at the centre of policy development, the opportunities for
participation or leadership for people from BME communities have remained minimal and this
situation needs changing if people from BME communities are to have equal and equitable access to
health and social care.

4.3 Summary

While there has not been extensive research specifically on the needs of carers in respect of
learning and training opportunities, the emerging policy context clearly outlines the importance of
support for carers in their caring role and the need to increasingly recognise the role of all carers in
wider society.

11
Afiya Trust citing 2001 Census
13


5. Learning and training provision in the North West

5.1 North West mapping

Within the mapping exercise undertaken for this commission, contacts mapped were categorised by
the five sub regions within the North West region (see figure 1). These were geographically
distributed across the region as follows; 38% of all contacts located within Greater Manchester, 21%
located within Lancashire, 16% in Merseyside, 14% in Cheshire and 11% in Cumbria.

Figure 1 - Learning and training organisations by sub region, North West England

15% 14%

11% Cheshire
Cumbria
Greater Manchester
21%
Lancashire
Merseyside

39%

The number of contacts in each sub region is generally reflective of the extent to which support
networks have developed in a location, its urban nature and the size of the population it serves. This
is reinforced when this mapping is examined at a district level. Figure 2 plots the organisations
mapped and the district population, and the correlation is clear.

14


Figure 2 - Learning and training organisations by district and sub region, North West England

60 500,000
450,000
50
400,000
No of organisations

District population
350,000
40
300,000
30 250,000
200,000
20
150,000
100,000
10
50,000
0 0
Bury

Hyndburn
Fylde
Burnley
Oldham
Eden

Blackburn

South Ribble

Wyre

Wirral
Stockport

Sefton
Halton

Bolton

Wigan
Salford

Trafford

Blackpool

Liverpool

St Helens
Allerdale

Rochdale

Tameside

Pendle
Chorley

Ribble Valley
Warrington

Warrington
Manchester

Lancaster
Carlisle

Knowsley
Preston
South Lakeland
Copeland

West Lancs
Barrow in Furness

Rossendale
Cheshire East
Cheshire West & Chester

Cheshire Cumbria Greater Manchester Lancashire Merseyside

Organisations mapped Mid Year population etimates 2008,

Figure 2 clearly shows the greatest concentration of mapping contacts in the large urban areas of
the North West, with 49 contacts in Manchester and 27 contacts identified in Liverpool. A number of
smaller urban areas appear to be well represented by organisations providing learning and training
support to carers, and these include Carlisle and South Lakeland in Cumbria, and Blackburn,
Burnley and Preston in Lancashire, where contacts mapped are high in relation to overall population.

5.2 Types of organisations engaging carers across the North West

A broad range of organisations were found to be engaged in providing learning and training
opportunities to unpaid carers. In mapping the organisations providing these learning and training
opportunities to unpaid carers, the following typology has been developed, breaking down a number
of key groups to reflect the Caring with Confidence target groups. The typology of organisations is as
follows:

• academic • condition specific- Disability
• colleges & FE • condition specific - End of life
• community specific – BME • general carer
• community specific – LGBT • local authority
• condition specific – Dementia • NHS & PCT
• condition specific – Mental health • training organisation.

Figure 3 demonstrates the number of organisational contacts mapped under this typology in the
North West, with the ‘condition specific’ group the largest grouping (199), which is unsurprising given
the diverse range of conditions people can suffer from that would lead to a requirement for carer
support. These organisations have developed specialist approaches to supporting carers which
address the very specific needs of their target community (e.g. Age Concern, Mind, British Heart
Foundation).

15


The second largest grouping of contacts is found in the general carer grouping (102), which includes
organisations which address the needs of all carers and would include organisations such as
Crossroads Care and The Princess Royal Trust for Carers.

Figure 3 - North West organisations providing learning and training opportunities

200
180
160
140
120
o

100
N

80
60
40
20
0
Academ

Colleges & F

Com unity specific

Com unity specific- BM

Com unity specific- LGBT

Condition specific

Condition specific - Dem

Condition specific- M

Condition specific- Disability

Condition specific - End of life

General carer

Local authority

N S & PCT

Training Organisation
H
m

m

m
ic

E

ental health
E

entia

A low number of contacts were found providing learning and training opportunities in the academic
grouping (1), community specific – LGBT grouping (5), condition specific - disability grouping (3) and
condition specific – end of life grouping (10). The academic grouping can be largely discounted,
given that we discovered only 1 contact, Deputy Head of Department, Professional Development at
the University of Chester. It is clear that academic and university departments on the whole are not
providing learning and training support to unpaid carers. It is surprising however that such a low
number of contacts were mapped in the condition specific – disability grouping, given that both
physical and mental disabilities are likely to require specific learning and training for those who care
for disabled people.

5.3 Provision across the North West
12
The survey of learning and training providers for unpaid carers examined the operating
geographies of organisations. Sixty per cent of all respondents operate at the level of their district,
with 14% operating at county levels, 11% operating at a regional scale and 15% operating nationally
or as part of a national group or organisation. So while the number of carer organisations are
generally reflective of their urban location and the population served, the majority operate within the
politically defined geography of the district.

12
See appendix 2 for details of survey response rates and a detailed breakdown of respondents by geography and typology.
16


Figure 4 - Organisational operating geographies

15%

11% National
Regional
County wide
Local Authority

14%
60%

The operating geography of organisations is largely influenced by the funding sources provided to
these organisations, with the vast majority of organisations drawing a substantial share of their funds
from the Local Authority. Other significant funders include the PCT and the National Lottery, but more
frequently organisations used their own resources to provide learning and training opportunities.

Figure 5 - Funding by source and county

25

20
No of organisations

15

10

5

0
C heshire C umbria Greater Lancashire Merseyside
Manchester

Own organisation Local Authority PCT Lottery LSC

5.4 Barriers to providing learning and training opportunities in the North West

The main barrier to providing learning and training opportunities in the North West is funding, with
52% of all providers citing this as the biggest challenge. The two, joint second, largest challenges
faced by providers, are engaging carers, and providing the financial support to enable carers to
partake in the learning and training offer (e.g. to cover travel costs and respite care). Organisational
capacity and the existence of local provision were less likely to be barriers, although almost one third
(29%) of organisations felt that their organisational capacity provided a big obstacle to providing
learning and training opportunities to their carers. This demonstrates the need for support both
financially and organisationally for providers of learning and training for unpaid carers.

17


Figure 6 - Main obstacles13 in providing learning and training opportunities to carers

Existence of local provision

Organisation capacity

Uptake: carers time

Funding to enable carers to participate

Funding to provide training

0 10 20 30 40 50 60
%

Providers of learning and training opportunities perceive carers to need learning and training in the
following areas; stress management - 87% of organisations stated that carers had a very significant
need for stress management, 84% stated the significant need for support around carers health, 80%
of organisations stated that carers had a very significant need for confidence building and 77% felt
that there was significant need for support around finances, 71% condition specific training and a
lesser extent (49%) felt there is significant need to support carers with training to get them back to
work.

Figure 7 - Perceived carers' needs from providers

100
90
80
70
60
%

50
40
30
20
10
0
Finances

get back into
Condition

Carers
Confidence

Management

health
specific

Training to
training
building

Stress

work

There is a strong correlation between perceived needs and the learning and training opportunities
provided, but also a number of discrepancies which need to be considered. From the North West
mapping the most frequently provided learning and training opportunities are confidence building
(from 19% of providers) and stress management (from 18% of providers) with 50 and 48 (of the total
195) responding organisations providing this type of training respectively, which reflects providers
perceptions of carers needs.

13
Big obstacle includes all those respondents who have chosen to score their responses between 7 and 10; whilst
'obstacle' corresponds to the range 4 to 6 and 'no obstacle' to the 1 to 3 range, where 1 = no obstacle and 10 = big
obstacle.
18


A total of 40 providers (15%) offered training in moving and handling, which surprisingly was not
listed as a significant need of carers. There were 39 providers (15%) of condition specific skills,
reflecting a highly perceived need. Thirty four providers (13%) offered support around finances and
benefits, another highly perceived need and a lower percentage of providers offer support in getting
back into work (11%), which is reflective of the lower perceived need. Carers health, the second
most highly perceived need does not appear to be addressed specifically in the learning and training
offer in the North West, and this needs to be explored in more detail.

Figure 8 - Learning & training offer in the North West

20
18
16
14
12
10
%

8
6
4
2
0

m a na ge m e nt
Finances /
Medica tio n

Mo v ing a nd

ge t ba ck into
C o nditio n

C o nfide nce
spe cific

be ne fits

Tra ining to
ha ndling

building
S tre ss

work

19


6. Carers needs

6.1 Interest in learning and training opportunities

The respondents to the carer survey, when asked about their interest in learning and training
opportunities to support them in their caring role, were almost evenly split, between those who are
interested in accessing learning and training opportunities relating to the caring role (53.4% or 252
out of 472) and those who are not (46.2% or 218 out of 472).

Figure 9 - Are carers interested in learning and training?

46%
Yes
No
54%

Exploring this in more detail, there is a clear age differential in relation to carers interest in learning
and training, with younger age groups more interested than those in older age brackets. The age
bracket most interested in learning and training (50-64) is however also the age bracket least
interested, with half of respondents in this bracket both interested and not interested in learning and
training opportunities to support them in their caring role. Carers under the age of 50 are much more
likely to be interested in learning and training provision compared to those aged over 65 who are
much less likely to be interested.

Qualitative research has supported this finding, with carers on the whole more concerned with their
support needs being met than learning or training, for many just getting together with carers provides
that support and links them into networks where they can access further support. Learning and
training opportunities provide a frame for carers to reach the wider support they need.

Figure 10 - Interested by age

100%

80%

60%
%

40%

20%

0%
18 to 25 26 to 34 35 to 49 50 - 64 65 - 74 75 - 84 85 +
years years years years years years years

Yes No

20


Exploring carers needs in terms of learning and training, those responding to the survey are most
interested in learning and training opportunities around stress management (68% or 123 out of 181),
condition specific training (e.g. stroke, dementia) (55.6% or 85 out of 153), and first aid (53.7% or 88
out of 164), with confidence building in 4th place. The topics in which the respondents are not at all
interested include back into work training (48.4% or 61 out of 126) and moving and handling (27% or
38 out of 141).

Figure 11 - Rated interest in learning and training topics

80
70
60
50
%

40
30
20
10
0

management
Medication
Basic caring

First aid

Moving and

specific (e.g

work training
Finances

Confidence
dementia)
Condition
handling

building

Back into
stroke,

Stress
skills

A lot A little Not at all

6.2 Previously accessed learning and training support

Of those surveyed, 24% had accessed Caring with Confidence previously, those consulted in focus
groups who had been on the Caring for Confidence training found it very useful, the programme
provided lots of useful local information which professional bodies had not been providing to carers.

”It’s only when you meet other carers that you get this level
of information.” - Carer

Other types of training accessed included condition specific training (11%) around dementia,
Alzheimer’s and Dyspraxia. Seventy five had attended formal NVQ training in Health Care and a
number of others had accessed non caring specific training through care providers in IT and cookery.

Figure 12 -Type of learning and training accessed by respondents

C wC

C ondition specific: dementia

NVQ Health C are

Emergency First Aid

IT

C ookery

C ondition specific: ASD and Dyspraxia

C ondition specific: Alzheimers

0 5 10 15 20 25
%

21


6.3 Barriers to accessing learning and training provision

The main obstacle to accessing learning and training opportunities for those interested is time, with
48% (159 out of 331) respondents identifying it as a major obstacle. The second largest obstacle is
the availability of transport to get to a learning or training venue, which 41% (119 out of 291)
consider an obstacle. Respite care is a large obstacle for over 30% of carers responding to the
survey.

Figure 13 - Main obstacles in accessing learning and training

60

50

40
%

30

20

10

0
Time (length of Transport to get to a Needing someone to C ost
session) venue look after the person /
people you care for

A lot A little Not at all

14
In understanding carers demand in more detail we asked carers what the biggest barriers for them
taking part in learning and training were. Almost 80% said that the provision of respite care was ‘very’
important for them to access learning and training. The responsibility of their role makes it difficult for
them to engage without this external support. A further significant factor, with 54% of carers stating
this to be ‘very’ important, are travel costs, to and from the learning or training on offer. As
demonstrated in section 4 of this report, those with significant caring duties are less likely to have
access to a car, and even less likely in the North West compared to England as a whole. Location,
especially in rural areas highlights specific transport and accessibility issues and has an impact on
carer resources. While only 8% of respondents categorised themselves as other than white British,
however translation was cited as ‘very’ important for more than 20% of carers.

Figure 14 - What is 'very important' for carers to access learning and training

90

80

70

60

50
%

40

30

20

10

0
Respite care Travel costs Translation

14
See appendix 3 for details of survey response and breakdown of responses by age, gender, ethnicity, employment status etc.
22


The timeliness of sessions is important and can act as a barrier to engagement and therefore it is
important to make training available at different times. Organisations such as St John Ambulance run
their courses during the day and during the week, because they mainly serve an elderly community,
however this is obviously an issue for working carers who need support at more convenient times
such as weekends and evenings.

6.4 Outcomes of learning and training

Once the carer has been to a group session or a series of group sessions, there is often then an
appetite developed to meet again for mutual and peer support. Often carers want some continuity
and support, however not all providers have the capacity or resource to support a group of trainees
who wishing to continue to meet for mutual support.

Case Study (case study names have been changed to protect identities)

John cares for his mother who is 102 years old! He is her full time carer and has attended
training sessions with St John Ambulance which he found very beneficial, in particular John
valued the information on financial management and as a consequence he is now claiming a
council tax rebate.

John has really benefitted from the support provided by St John Ambulance, meeting other
carers has been uplifting for him. He is an older person himself and at times feels very lonely
looking after his elderly mother, but he is totally devoted to her care. He feels undervalued and
will need continued ‘support’ when he stops being a full time carer.

“Anyone who is a carer should be visibly identified and they should be valued and
recognised” - John


Anne cares for her husband who suffers from Multiple Sclerosis and has been a carer for more
than 10 years. Her husband’s needs have steadily increased over the past six months as his
condition deteriorates. Caring is a full time responsibility for Anne. Her husband used to be an
active member of the Baptist Church and as his wife Anne was always busy with work in the
parish and community. Anne was also a nursery nurse by profession and previously worked for
five years on the children’s ward of Barnstable Hospital. Anne stopped work and took early
retirement to look after her husband as he needed full time care. She attended the St John
Ambulance course for carers and was so delighted with it, she found she grew in confidence
and was able to make time for herself.

“My confidence gave me permission to leave him... and have a little time to myself”
- Anne

Commissioners would however be keen to support those providers who can make provision for
these add-ons and develop these types of softer outcomes. The training at St John Ambulance has
lead to a group of carers being established that meets regularly for coffee at a local cafe and one of
the carers does the coordination of this.

23


7. Conclusions & recommendations

7.1 How current provision needs to adapt in the North West in the short term

Understanding the intricacies of carer demand is extremely difficult as the grouping of people who
are identified as carers is vast and diverse and carers’ needs and views are spread over a broad
span and are shaped by a number of variables such as age, gender, culture, ethnicity, sexuality and
language. There is significant demand for support of any type, including learning and training,
however this is poorly expressed, with many carers unaware that support exists and unaware of the
difference it can make to the quality of their lives. There is a particular lack of understanding amongst
BME carers of services available for example.

Intelligence about carers needs to be developed and shared with local providers, including the
findings of this report. There are many hidden carers and reaching these is a key challenge,
particularly for Caring with Confidence and their Provider base as many of the Caring with
Confidence target groups are disproportionally ‘hidden’ groups.

Publicity and promotional work could be more creative and literature needs to be more targeted, and
from the experience of carers groups consulted, DVD’s are considered an effective and efficient tool.
Copies can be made available at GP surgeries and places of worship for example, helping to reach
hidden carers.

Carers in the North West need learning and training opportunities around stress management,
condition specific training, first aid and confidence building amongst others. Providers of learning and
training opportunities perceive carers to need learning and training in stress management, support
around carers health, confidence building and finances. There is a discrepancy here between the
demand expressed by carers and the perception of learning and training providers around carers
health. This may be that carers themselves are failing to identify their own needs to examine their
own health, instead prioritising the health of the cared for, however this fails to explain why carers
health, the second most highly perceived need, does not appear to be addressed specifically in the
learning and training offer in the North West.

The topics in which the respondents are not at all interested include back into work training (48%)
and moving and handling (27%), however a significant number of providers offer moving and
handling courses. Funding is a key driver and in the short term the environment for developing and
funding adult education is going to be difficult. The year 2010/11 maybe transient with the funding
environment undergoing a major overhaul, and the LSC being replaced with the Skills Funding
Agency.

Transport and respite care are barriers that can be overcome with sufficient support structures built
around training, however this requires funding which is often in short supply. Training needs to be
scheduled at suitable times and venues and carers need support with travel arrangements and
arranging sitting services. Improved intelligence about carers groups can only support more
evidence based decision making which can translate into more effective delivery approaches.

7.2 How provision needs to adapt in the North West in the longer term

Carers lack trust and confidence in the system, as it does not fully understand their needs. In
accessing hidden carers, providers need to be culturally aware, e.g. not holding training during
religious or cultural festivals, Caring with Confidence also need to use language which is
appropriate, with the current approaches considered euro-centric.

Caring with Confidence can support the development of approaches to reaching hidden carers, with
a grass roots, community based approach (e.g. through community groups, GPs, housing
associations) which can offer a route to engagement that carers are comfortable with as a first step
engagement and can play a role in reaching a wide range of carers through a wide marketing
campaign.

24



Susan has been the primary carer for her mother-in–law for the last 15 years and she also
looks after her husband who is unwell with arthritis and her three children. Susan herself
became ill and she was desperate for support When in hospital with her mother-in-law she
talked to the social worker about her needs and the social worker signposted her to Manchester
Carers Centre after an internet search. Susan went along to a coffee morning and was
introduced to the Caring with Confidence programme which she signed up for.

“It has given me a lot of confidence… got me motivated… and made me feel less guilty
about leaving my mother in law alone” - Susan

Susan has really enjoyed the course and found it a life changing experience She now has
caring support for her mother–in-law and is thinking that she would like to get back to some
form of work. The Caring with Confidence programme has given her the boost and confidence
she needed.

Providers also need to be more condition aware. The Caring with Confidence model sometimes
utilises carers to facilitate, but this does not build the condition specific knowledge (for instance,
carers of dementia sufferers have expressed the need for anger management training, an area not
covered but important for them and their role).

There is a mismatch and inconsistency in services and support across the country Supply of learning
and training is often incoherent with not enough joined up working and with little evidence of any lead
or coordination of provision. Many providers are delivering because a need has been expressed, but
there is a need to address provision with a more strategic approach. Local authorities and Strategic
Health Authorities should be playing this role and are increasingly doing so, however there is no
national body to act as a bridge or support for all those interested in the agenda.

7.3 Caring with Confidence recommendations

The following recommendations are specific for the current Caring with Confidence programme:

• Caring with Confidence need to measure the impact of their North West marketing and
assess the extent to which it reaches carers who have not previously engaged with carer
specific organisations

• Caring with Confidence needs to clearly articulate the impact of its training Evaluation
findings from the national evaluation by Leeds University needs to be distilled into core
messages that will appeal to commissioners of services

• the programme needs to respond to and evolve to better address the needs of the Caring
with Confidence target groups. The current programme is very prescriptive and would benefit
from a greater degree of community and locality tailoring

• the Caring with Confidence programme has not been previously available in minority
15
languages . Bi-lingual training is important not just for those who do not speak English but
also for those who speak English as a second language. Where English is not first language,
individuals when challenged with learning new concepts, utilise their mother tongue as their
‘thinking language’

15
Despite the programme requiring a third of its carers engaged to be from BME groups.
25


• while it has been encouraging and positive to recruit facilitators who are carers, there also
needs to cover for specialist fields. The mapping has highlighted that condition specific
organisations are the largest deliverers of training and support for carers, and the Caring for
Confidence programme should look to develop delivery partnerships with more conditions
specific organisations who could add value to the generic modules

• carers regard professional advice highly and in particular Caring with Confidence sessions
around medication and first aid would benefit from the advice of trained professionals and
relationships could be developed with condition specific agencies or professional bodies at a
local level (e.g. St John Ambulance, Red Cross). Working with these organisations would be
complimentary and encourage could encourage more carers to attend Caring with Confidence
sessions.

7.4 Future role for Caring with Confidence

Caring with Confidence has a strong product which carers require. Carer feedback has been
overwhelmingly positive and the programme offers learning and training which can make a real
difference to carers and those they care for. Learning and training can have added value in engaging
hidden carers, acting as a first step engagement route for carers and subsequently linking them into
wider support structures. These are the types of outcomes that commissioners would be interested
to see evidenced. The Department of Health has invested significantly in supporting carers under the
revised carer strategy with both Caring with Confidence and Carers Direct established as new
services.

A number of key roles have been identified for Caring with Confidence moving forward, these are as
follows:

• Strategic body for the sector – Managing delivery nationally is an extensive role, the National
Team are heavily engaged and this is an unsustainable approach. Caring with Confidence
should move away from its current delivery focus and adopt a more strategic role. It should be
seeking to encourage carer learning and training to be funded, managed and delivered at a
local level. It should be seeking to engage strategic partners with a view to developing buy in
and partnership approaches, influencing carer strategies as they are developed and
implemented by Local Authorities, NHS trusts, Primary Care Trusts and Strategic Health
Authorities

• Champion for carer learning – Caring with Confidence should be the nationally recognised
body for carers learning and training. Caring with Confidence should set the standard for carers
learning, collate intelligence about carers, and understand and advise how to reach hidden
carer groups. As a learning champion, Caring with Confidence should signpost and advise
carers who wish to pursue further training opportunities. Caring with Confidence has developed
experience of learning and training at a national level which is not held by any other
organisation and this knowledge should be retained wherever possible

• Brokerage role – Caring with Confidence, as a nationally recognised organisation and
learning champion should act as a broker in bringing together learners, trainers and providers
in all their diversity. Caring with Confidence should act as a bridge between the various types of
providers of learning and training for carers, providers from sectors or backgrounds where the
level of partnership working with the strategic leads for carers are under developed. This role
does not exist nationally and Caring with Confidence should be the expert body to support
those who have evidenced carer needs in their locality or with their own organisations client
group (e.g. condition specific organisations, colleges etc.) with those who can support and fund
training provision which can clearly demonstrate desirable outcomes (e.g. Local Authorities,
NHS trusts, Primary Care Trusts, Strategic Health Authorities). Synergy also needs to be
developed with Carers Direct, the national body providing information to carers

26


• Research and evidence role – Learning and training can have a significant impact on carers
and those they care for. This commission has highlighted there is insufficient research nationally,
particular around the Caring with Confidence target groups. Caring with Confidence can
continue to develop the evidence base and intelligence around engaging hidden carers in
learning and training and robustly evidence outcomes and impacts through the national
evaluation.

27


Appendix 1 - Learning and Training Organisation Consultation Survey Breakdown

Figure A - Breakdown of survey respondents from the North West

21%

Greater Manchester
36%
Lancashire

Cumbria

Merseyside
10%
Cheshire

8%

25%

Figure B - Type of organisations (number of respondents)

200 25
180
160 20
140
120 15
100
80 10
60
40 5
20
0 0
Training Organisation
Academic

General carer

Local authority
Colleges & FE

Community specific- BME

Condition specific- Mental health
Community specific- LGBT

NHS & PCT
Community specific

Condition specific

Condition specific - Dementia

Condition specific - End of life
Condition specific- Disability

Mapped contacts Survey responses

These carer organisations have an extensive reach into their local communities, holding databases of carers
in their local areas, or carers who have registered a specific interest in the offer of that organisation. Over
35% of organisations hold databases with an excess of 900 contacts, and 15% of these hold a database of
more than 2,000 carers.

28


Figure C - Reach of carer organisations

40
35
30
25
No

20
15
10
5
0
under 100 100 - 900 900 - 2000 2000 plus

No of carer contacts

Figure D - Identification of carers need

4%
8%

2%
Informal conversation with unpaid
carers

In-house survey

External consultant survey
23%
One off research

Regional plan
63%

29


Appendix 2 – Carers Survey Breakdown
The total number of completed responses to this survey is 544 and 29 partial responses. The analysis
carried out includes all the respondents (573). 74% of respondents are female (404 out of 546) and 26%
male respondents (142).

Figure A - Gender of respondents

450

400

350

300

250
No

200

150

100

50

0
Female Male

Forty one per cent of respondents are between 50 to 64 years of age (224 out of 547), and 22% between 35
and 49 years of age (121 out of 547). There are also few young carers among the respondents, some under
18 years old (2 out of 547) and other between 18 and 25 years of age (7). Finally, two of the carers
responding to this survey are 85 plus years old.

Figure B - Age of respondents

250

200

150
No

100

50

0
Under 18 to 26 to 34 35 to 49 50 to 65 to 74 75 to 84 85 +
18 25 years years 64 years years years
years years

92% (492 out of 537) of respondents is white British and the second highest proportion is 3.4% (18)
Pakistani, but the sample is ethnically varied.

30

Learning & training opportunities report june 2010_final

Learning & training opportunities report june 2010_final

Empfohlen

Empfohlen

Weitere ähnliche Inhalte

Andere mochten auch

Andere mochten auch (8)

Ähnlich wie Learning & training opportunities report june 2010_final

Ähnlich wie Learning & training opportunities report june 2010_final (20)

Learning & training opportunities report june 2010_final