Dundee Carers Centre Short Breaks Service - the journey to brokerage

Introduction

Dundee Carers Centre Short Breaks Service aims to ensure that unpaid carers have access to a break that is personalised and meets their needs. This service is delivered using a brokerage model following the testing and learning from various methods of service delivery. This story shares this journey. 

Background

Dundee Carers Centre tried several approaches to delivering a short breaks service, capturing ongoing learning from staff and carers, identifying strengths and limitations of each approach, and using this to inform improvement. These models of delivery include: 

  • Carers Time 4 You Respite Service (respite vouchers): a voucher service that provided respite care (up to 3 hours every 90 days) for the cared for person to enable the carer to get a break. There was no assessment to qualify but the cared for person had to be over 65 and not in receipt of social work services, except for community alarm, meals service and/or shopping service. Uptake to the service was low due to tight criteria and there was a lack of care providers on the approved list. It was not as effective as carers wanted it to be. 
  • On the Spot (therapy vouchers): a complementary therapy service that provided one-off vouchers to access a range of therapies from a list of approved providers. This was admin intensive for staff who were responsible for recruiting therapists, coordinating insurances and processing vouchers. Uptake was slow and a therapy wasn’t always suitable for every carer e.g. some male carers were not comfortable taking up massage services. 
  • Micro-grants: through an application and panel process. This approach had reasonable success, in most cases a short-term solution with many one-off overnight stays provided. Significant back and forth with the carer was often required to ensure enough information on the application form to approve funding. This approach did improve access to breaks, but it was still quite restrictive, admin heavy and not personalised. 

In 2014 Dundee Carers Centre, on behalf of Dundee Carers Partnership, commissioned independent research to explore the current and future provision of short breaks/respite for adults in Dundee. Carers were involved as key partners in this activity. A more preventative approach was recommended with a one stop shop model to provide information, source support and enable access to a wider range of short breaks/respite options. 

Approach

Brokerage is a personalised approach which supports carers through good conversations to identify a short break that meets their needs. This might include awarding micro-grants, donated breaks and signposting to community resources. The Short Breaks brokerage model is delivered by a team of experienced support brokers. The team is supported by a team leader who reviews and approves all breaks and a part time admin assistant.  The pathway for carers to access a short break is:

  1. Referral by the Centre’s Carer Support Team, other organisations, or carers can self-refer.
  2. Service contacts carers within one week to triage. Where necessary, carers will be seen on an urgent basis.
  3. A ‘Good Conversation’ with the broker to identify personal outcomes and what the carer hopes to achieve from a break. This normally takes around one hour.
  4. A personal outcome plan is completed looking at health, lifestyle, finances and managing the caring role. Carers may be signposted or referred to additional services where required.
  5. Identification of a break that is personalised, achievable and meets the carer's needs. This can take several meetings and the carer may want space to go away and think about what would work, or they may already have an idea of what would benefit them.
  6. Support can be provided to book or purchase items.
  7. Information on the outcomes and break are recorded on the case management system.
  8. The broker will contact carer after their break to complete a review and measure the impact of the break.

A Continuous Improvement Group is held every three months for carers who recently had a break to share their views and experience of the service, with the HSCP also attending. This feedback is used to identify further ways to improve. For example, during COVID brokerage meetings were held over the phone or online, with carers reporting that this offered choice and made it easier to balance other caring/family/work commitments, so this option has continued to be offered post-pandemic.

Impact

The variety and creativity of breaks identified through the brokerage model has ensured that the service being delivered is truly personalised and meets the needs of individual carers. Previously when completing applications carers would default to ‘breaks away’ as they were not aware of other possibilities. The conversation allows brokers to raise awareness of the creativity of short breaks and encourage carers to think outside of the norm. Examples of breaks delivered include driving lessons, overnight stays, gym memberships, cameras and magazine subscriptions.

Enablers

   
Independent Research Having good quality, independent research provided objective analysis and a different perspective.
Involving and learning from carers Carers were at the centre of planning, sharing feedback about previous approaches with learning then applied in the development/testing of different models.
Dedicated roles and well-trained staff Ensures that brokers have the time to listen to carers and identify a break that is truly personalised and meets individual needs.
Data and stories to demonstrate impact This includes a good level of record keeping (outcome plan, explanation of the decision made) and is key to ensuring sustainable funding from the HSCP for the support broker roles.
Access to Short Breaks funds Additional funding through Shared Care Scotland’s Time to Live Fund is essential to delivering the scale of service required to meet needs.

 

Opportunities for improvement

Introduction of ‘right to a break’ will increase demand on the service, will require additional staff and resources, and it will be important to manage expectation and waiting times. Most carers are happy to wait as they know there will be a quick decision once they are seen, but it will be essential that carers who are struggling are seen quickly.

Diversifying short break options and continuing to raise awareness of Respitality to encourage local businesses to donate short break opportunities for carers, for example including information for businesses on service webpages and Let’s Talk video series.

Further information

To find out more about Dundee's approach to supporting unpaid carers, please contact the team at: centre@dundeecarerscentre.org.uk

Read more about the work of the Unpaid Carers Improvement Programme including further impact stories here.