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1 APPENDIX 3 Agreed 11/02/04 ELIGIBILITY FOR CARERS ASSESSMENTS UNDER CPA Towards a definition of ‘Regular and Substantial’ care ‘Regular’ Usually ‘living with’, if not at least weekly, face-to-face contact Increased levels of contact during periods of acute distress. ‘Substantial’ The carer is providing a level of care which is integral to the care plan and which directly enables the service user to remain independent in the community and achieve a reasonable quality of life (e.g. help with daily living - shopping, cooking, housework, personal hygiene/care, help to socialise, help to maintain the mental health condition, prompting to take medication, alerting professionals if there is a deterioration, etc.) If the carer was unable to continue to provide the support outlined in the care plan, the service user would be at risk and/or the care co-ordinator would have to provide alternative sources of care to substitute. [N.B. These guidelines will require some interpretation and therefore some discretion on the part of Care Co-ordinators]. Notes There is a distinction between ‘caring about’ someone and ‘caring for’ them. Most relatives care about their family, but not all are providing direct care. Carers’ assessments are designed to be offered to those relatives who are carrying a substantial level of care. Carers need not be ‘next of kin’, they may not even be a relative, as long as they meet the criteria set out above. Carers’ assessments should focus on those problems (health, practical, social, etc.) which arise directly from the process of care and are most appropriately dealt with the users’ care team. These are set out in the assessment proforma. If the carer has mental or physical health needs which require intervention in their own right the team should support an independent referral to the relevant specialist (e.g. G.P, psychiatrist). 2 In general, the carers of users who are on Enhanced CPA should be prioritised. The needs of young carers should also be given special consideration. Where there is more than one carer at home, a decision should be taken as to whether a joint assessment should be offered, or whether there is a ‘main carer’. Carers’ assessments will usually be undertaken by a qualified member of staff, however they may be undertaken by non-qualified staff (e.g. support workers) providing they are working under appropriate professional supervision. If a carer meets the criteria described above, and is offered an assessment, the user cannot ‘veto’ this. User’s views must be discussed and an explanation given by the care co-ordinator as to why the carers assessment is being undertaken. If the user remains dissatisfied their objections should be recorded in the notes. Carers’ assessments should be offered in private (i.e. the service user should not be present unless both parties wish it). Carers assessments should be stored in the patient’s notes, in a separate section, clearly marked ‘Not be shared with the patient without consent’. Carers who decline the offer of an assessment can review their decision at any point in the future. Carers who wish to dispute their eligibility for a formal assessment (i.e. they feel they meet the criteria, but the care co-ordinator does not) should approach the team leader (manager) for that team. If they remain dissatisfied, they should approach PALS for advice on how to pursue their concerns further. If carers do not the criteria described above, or decline a formal assessment, they should still be kept regularly informed of non-confidential information relating to their relatives’ care and be given information and advice about how families can best cope with a mentally ill relative (e.g. general information about illness, service structures, responsibilities of different professionals, how to contact services, general advice about management, etc.). This activity should also be recorded in the care plan.
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