Young Carers

1. Introduction

Definition of a Young Carer

A "young carer" means a person under 18 who provides or intends to provide care and support for another person.

A young carer may provide care and support for another child or an adult in the family, who has a disability, life limiting condition, ill health, a mental health condition or substance misuse (Young people who are caring for someone under a contract or as a volunteer are not classified as a "young carer").

See: Young Carers in Hertfordshire (Carers in Hertfordshire Service).

2. Statutory Framework

The Local Authorities Duties under the Children Act (2014) and the Care Act 2014 in relation to Children and Young People under 18 Providing Care and support:

The Children and Families Act 2014 amended the Children Act to make it easier for young carers to get an assessment of their needs and to introduce 'whole family' approaches to assessment and support. The new provisions include:

Identifying Young Carers;
Assessing Young Carers;
Supporting Young Carers.

3. Identifying Young Carers and Their Needs

Identification Duties

Young Carers Under the Age of 18 Local Authorities (LAs) must:

Ensure that young carers are identified, and that consideration is given as to whether they are a 'child in need';
Be proactive about identifying young carers in their area and acting to help take reasonable steps to identify young carers in their area who have support needs (Part 5, Section 96, Children and Families Act 2014);
Identify any children who undertake/ intend to undertake a caring role when assessing adults who may have care needs (Paragraph 6.68 and 6.69 Care Support Statutory Guidance under the Care Act 2014.

Examples of Support Young Carers May Provide

A young carer may provide care and support for another child or an adult in their family who may be:

Physically ill or disabled, or mentally ill or with a learning or sensory disability; or
Dependent on drugs or alcohol; or
Dependent on them for practical and/or emotional support.

Young carers are often significantly disadvantaged in comparison to their peers and have individual needs. Some children and young people who are involved in caring for someone else will not be negatively impacted by the experience - but if the responsibility and expectations placed on them are excessive or inappropriate, they could be significantly harmed and/or disadvantaged.

All young carers should have recognition and support to help them cope and those who are disadvantaged or at risk of harm should receive help aimed at resolving excessive or inappropriate demands on them.

Many children and young people help with daily tasks and share in the care of siblings as part of everyday living within their family household. This is not and should not be an automatic cause for concern. Caring can be a positive and valued experience that strengthens family ties and builds personal skills.

Consideration of when caring responsibilities become too much for a child should be identified when undertaking a young carers assessment. If the caring role and responsibilities are having an adverse effect on the child/young person's education, or ability to form friendships or undertake leisure activities.

Workers should take account of the expectations, commitment and competence of the child or young person involved. Key areas are the emotional pressures and social impacts on young carers providing support or 'looking out' for the person they care for.

Anyone who identifies a young carer should consider the following:

The contribution made by a young carer is important and should be openly recognised, respected and values;
Services should be provided, primarily to parents to enhance their ability to fulfil their parenting responsibilities following assessment;
All professionals who work with dependent adults should positively recognise the contribution of young carers and appropriately include them;
Young carers are entitled to:
- Support;
- Help;
- Access to opportunities;
- Achieve;
- Maintain the same reasonable standards of health and development as their peers.
There may be different expectations placed on young people according to their circumstances, which may add to the problems faced by young carers:
- The needs of young carers can be different from those of adult carers;
- It may be inappropriate for young carers to take on some caring roles, such as personal care;
- Young carer's views should be actively sought and listed to in privacy – and appropriate time and space should be available for this. Professionals should not make assumptions about young carers;
- Some young carers find it difficult to seek or accept help, because they think it might result in difficulties. Professionals need to recognise that children will have a strong sense of loyalty and commitment to their families;
- Young carers from ethnic minority groups may face additional problems. These may include difficulties in contacting or trusting services or a likelihood of school exclusion;
- Professionals may need to involve the services of interpreters. Where possible, and impartial interpreter should be used as the young carer should never, except in exceptional circumstances (emergency/life/death situations) be used in this role;
- Involvement in inappropriate physical tasks may adversely affect a young carer's physical development. Moving and assisting handling may raise specific issues for young carers.

Registration of Young Carers

In Hertfordshire, all identified young carers are offered an assessment. A young carer assessment is offered to all children and young people identified as a young carer in the county and can only be completed with family consent (or where applicable using Frazer /Gillick competent). A young carer assessment can be completed at any time for a young carer. Registration is a means of identifying young carers, ensuring they are supported, obtaining a view of the needs of young carers in Hertfordshire and monitoring their caring roles, which may change from time to time, to ensure their caring role is not having a detrimental impact on their health and well-being, education, or their ability to thrive as a young person.

Where a young carer is not registered, any practitioner working with the young person and their family may complete a young carer assessment with consent from family or young person (see above).

Please contact the Carers in Herts Young Carers Service by phone on 01992 586959 to advise of the family wish, and they will check if child/young person is already registered and if not, they will accept a referral for the young person as a young carer. You must have the following information when you call Carers in Herts Young Carers Service:

Consent from the parent and young adult carer (aged 16 or 17);
Name of child/young person;
Date of Birth(s);
Home address including postcode;
Your contact details.

If the child/young person is not registered – You will be asked to complete the registration form on the Families First Portal and email this using the secure email system HertsFX only to young.carers@carersinherts.org.uk
Or to carersinhertfordshire@nhs.net.

Alternatively, you can make a referral via the website – see Register or Refer - Carers In Herts.

Referring Young Carers

Professionals

Carers in Hertfordshire Young Carers Service is commissioned by Hertfordshire County Council to offer a range of support to young carers on behalf of the County Council, including:

Raising awareness and early identification of young carers through campaigns, including delivery of training to schools and supporting schools to adopt a whole school approach to identifying and supporting young carers, awareness and training to other professionals;
Young Carers assessments of identified young carers on EHM and proportionate reviews of the young carers caring role and the emotional impact it has on them;
Undertaking a Families First Assessment where there is a negative impact of caring requiring multi agency support and no other agencies are working with the family. Where other agencies are involved, Carers in Herts will support their work;
Transitional assessment and support for young carers through key transitions, including school transitions or transitioning into adult carer where a young carer wish to continue providing care;
Offering the opportunity to meet other Young Carers through a range of activities in the school holidays;
Coordination of a countywide young carers Council to ensure young carers have a voice and contribute to service development and improvements;
Access to mentoring support for young carers provided by Safe Space.

Further guidance for professionals can be found via the Carers in Herts Website.

Young Carers

Do you help to look after a member of your family, who is ill or disabled, or who uses drugs or alcohol?

Do you take on responsibility for things that would normally be done by an adult?

For young people over 16 years old, or families who would like to refer themselves, click here to download a self-referral form.

4. Assessing Young Carers

Assessment Duties – Young Carers under 18

Local Authorities (LAs) must:

Ensure the right to an assessment of needs for support will be extended to all young carers under the age of 18 regardless of who they care for, what type of care they provide or how often they provide care;
Assess whether young carers in their area have support needs and, if so, what those needs are. (Part 5, Section 96, Children and Families Act 2014). A local authority must offer an assessment where it appears that a child is involved in providing care and has a need for support. This legislation is aligned with similar provision in the Care Act 2014, requiring local authorities to consider the needs of young carers if, during the assessment of an adult with care needs, or an adult carer, it appears that a child is providing, or intends to provide care;
Carry out a transition assessment for a young carer if they are likely to continue to care and have needs once, they turn 18 (Paragraph 16.8 Care and Support Statutory Guidance. Issued under the Care Act. DH 2014). The Act requires Local Authorities to undertake an assessment for a young carer if it considers that she/he is likely to have needs for support after turning 18, and that the assessment would be of significant benefit to her/him. If a Local Authority decides not to undertake such an assessment, it must give reasons for its refusal;
A young carer needs assessment must include an assessment of whether it is appropriate for the young carer to provide, or continue to provide, care for the person in question, considering the young carer's needs for support and wishes.

Children should not undertake inappropriate or excessive caring roles that may have an impact on their well-being, education and development.

These duties are underpinned by 'The Young Carers Needs Assessment Regulations 2015'.

The Assessment Process

Professionals who undertake assessment of children and adults need to be alerted to the possibility of ''young carer'' issues, and ensure they are specifically identified and addressed. Children Services, Health and Community Services are required to work in partnership to ensure to ensure services for the family are identified.

Assessing young carers may be completed:

Early Help Services

Families First Assessment and Early Help Module;
Utilising a whole family approach and Team Around the Family by gathering information from other relevant professionals;
Module may be used before, or in conjunction with a young carers assessment to identify the full range of needs;
Young Carer Advisors within Carers in Herts Young Carers Service undertake young carers assessments, offer universal support, assess needs for targeted, intensive, transition and provide support.

Children's Services

As part of the Child and Family Assessment process.

Adult Social Care

As part of the Adult Social Care Assessment Process or Adult Mental Health Services Assessments.

The Continuum of Need Threshold document sets out the 'Levels of Needs' that might be experienced by children, young people and families in Hertfordshire, and the level of intervention that may be most appropriate to respond to identified needs.

Considerations During the Assessment (Families First Assessment)

When assessing the needs of a young carer, the following should also be considered:

A young carer's education may be adversely affected in that their attendance may be poor, or they may be regularly late for school, bullied or thy may not be able to satisfactorily complete homework. They may also be too tired or concerned about their home situation to concentrate properly at school;
Young carers may be unable to get on with the sort of life they would like for themselves, including establishing relationships outside the family, moving away from home, and getting a job;
Isolation from members or family members;
Young carers may not always be aware of the impact their caring role has on their daily life. i.e. unable to socialise as a family, or the frustration; or
Anger they experience from being in that situation;
Feeling and possibly actually being different form their peers;
The contribution made by a young carer is important and should be openly recognised, respected and valued;
Services should be provided, as with under 16's, primarily to parents to enhance their ability to fulfil their parenting responsibilities following assessment under the Framework for the Assessment of Children in Need and Their Families;
All professionals who work with dependent adults should positively recognise the contribution of young carers and appropriately include them;
The needs of young carers can be very different from those of adult carers. Young carers should not be taking on the same responsibilities as an adult;
It may be inappropriate for young carers to take on some caring roles;
Inappropriate responsibility for caring can pass unnoticed;
Young carers views should be actively sought and listened to in privacy, appropriate time and space should be available for this. Professionals should not make assumptions about young carers;
Some young carers find it difficult to seek or accept help because they think it might result in difficulties. Professionals need to recognise that children will have a strong sense of loyalty and commitment to their families;
Young carers from ethnic minority groups may face additional problems. These may include difficulties in contacting or trusting professionals, or a likelihood of school exclusion;
Professionals may need to involve the services of interpreters. Where possible an impartial interpreter should be used and the young carer should never, except in exceptional circumstances (emergency/life/death situations) be used in this role;
Involvement in inappropriate physical tasks may adversely affect a young carer's physical development. Moving and handling may raise specific issues for young cares.

Where the child requiring a young carer's assessment is under the age of 16 and is not competent to consent, a person with parental responsibility will need to be involved in their assessment wherever possible. If there is no person with parental responsibility available, consideration should be given to whether there is another person who could facilitate the young carer’s involvement in the assessment. If not, an independent advocate must be provided.

5. Support for Young Carers

5.1 The Care Act and Young Carers

The amendment to Section 17 of the Children Act will work with the provisions in the Care Act 2014 so as to apply equally both to children's and adult services. The Care Act Regulations and Guidance link to this in several ways including:

Eligibility Regulations for the Care Act require local authorities to consider the support disabled parents and carers may need in carrying out their responsibilities to care for a child (who may potentially be a young carer);
The statutory Guidance highlights that when carrying out an adult's or carer's assessment, if it appears that a child is involved in providing care, the local authorities must consider:
1. The impact of the person's needs on the young carer's wellbeing, welfare, education and development;
2. Whether any of the caring responsibilities the young carer is undertaking are inappropriate.
The Guidance stresses that young carers should not be left with inappropriate levels of caring and describes this as "anything which is likely to have an impact on the child's health, wellbeing or education, or which can be considered unsuitable in light of the child's circumstance and may include:
1. Personal care such as bathing and toileting;
2. Carrying out strenuous physical tasks such as lifting;
3. Administering medication;
4. Maintaining the family budget;
5. Emotional support to the adult".
The Guidance also says that: "when a local authority is determining whether the tasks a child carries out are inappropriate, it should also take into account the child's own views whenever appropriate";
The Guidance also specifies that adult services must identify children in the household, consider whether they are young carers and if so, whether they are children in need (see also: Section 5.2, When is a Young Carer a 'Child in Need?);
The Guidance also says "a young carer becomes vulnerable when their caring role risks impacting upon their emotional or physical wellbeing or their prospects in education and life. This might include:
1. Preventing the young carer from accessing education, or example because the adult's needs for care and support result in the young carer's regular absence from school or impacts upon their learning;
2. Preventing the young carer from building relationships and friendships;
3. Impacting upon any other aspects of the young carer's wellbeing.
Councils should address the risks of such negative impacts either through support for the adult or through support for the young carer. There will be need for young carers to either have a young carer assessment (Families First Assessment in Hertfordshire) or for the care assessment of the adult they look after to identify support needed to prevent inappropriate care.

5.2 When is a Young Carer a 'Child in Need'?

Not all young carers will be a 'Child in Need', however a child is in need if their health or development is being, or is likely to be, significantly impaired. They should be able to participate in and benefit from the childhood experiences that are normal for someone of their age and ability. This includes educational, recreational and social opportunities.

A young carer in need is therefore a child or young person whose responsibilities for caring for someone else has serious implications for their wellbeing.

5.3 Types of Support for Young Carers

The types of interventions available to young carers to either help reduce or manage their caring responsibilities and ensure their well-being includes:

Individual support;
Referral of child/young person to services/support;
Referral of adult to services/support;
Support to access activities;
Direct and indirect family support.

6. Transition

Sections 63 - 64 of the Care Act 2014 introduced duties towards young carers making the transition to adulthood. This is called a Young Carers’ Assessment (YCA) in transition. The Act requires local authorities to seek the agreement of the young carer to undertake an assessment if they are likely to have needs for support when they reach eighteen, and if the timing of the assessment offers 'significant benefit'.

The timing of any assessment should be discussed with the young carer and their family. Much of the information necessary to complete a transition assessment may have already been collected as part of the Young Carer's Needs Assessment.

Transition assessments for young carers must also consider whether the carer is able to offer care and support now and whether they are prepared and willing to continue to be a carer after they reach adulthood at eighteen. This transition assessment should consider the outcome, desires and goals the young person wants to achieve in adulthood such as employment, further education, friends, relationships and independent living.

From the age of 18, the Care Act allows for the charging of carers. It makes clear that a local authority must not charge a carer for care and support provided directly to the person they care for. Those charges, if they apply, must be levied on the person to whom the support is delivered (even if that person does not have eligible needs). Local authorities should consider how to align personal budgets where they are meeting the needs of both the young carer and the adult needing care concurrently.

7. Moving Areas

If the person with care and support needs moves, there are provisions in the Care Act to make sure that there are no gaps in care and support when the move happens. The person with care and support needs should inform the second local authority of their intention to move and of their wish to be assessed along with their carer.

If the second local authority does not make a decision about care and support before the move takes place, they must meet the needs that the first local authority had previously identified until they have made their own decision. If they then make a different decision about eligible needs to the first local authority, they must explain why. The first local authority is responsible for making any arrangements needed on the day of the move itself.