What is a carer?
A carer is anyone, including children and adults who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, a mental health problem or an addiction and cannot cope without their support. The care they give is unpaid.
Are you a carer?
Some people have been looking after family or friends for years and do not recognise themselves as carers. This is why, at Cambridgeshire and Peterborough NHS Foundation Trust, we value the often life-long support carers provide and recognise them as equal care partners. We want to offer as much guidance and reassurance as possible, to help you in your caring role.
Who cares for the carer?
On this page you will find lots of links to very helpful resources, ranging from information about support groups for carers and looking after yourself, through to advice on housing and welfare. Registering as a carer at your GP surgery can help with:
Your GP will monitor your health more closely, as they will be more aware of your commitments as a carer and any associated health problems.
Looking after your self
It's really important that you look after yourself during these difficult times. The Five Ways to Well Being are steps you can take to maintain wellbeing, from keeping active to connecting with others. General information on maintaining your mental wellbeing can be found at Keep your Head and cpslmind, as well as the government website. Cambridgeshire County Council and Peterborough City Council provide information on how to get help or to register your self or others as a vulnerable person
Carers assessments and support
Carers assessments for adults caring for adults
- If the cared for person accessing Cambridgeshire and Peterborough Foundation Trust Mental health services has an allocated Section 75 Social Worker or has a CPFT Adult Social Care arranged package of care, The carers assessment will be completed by an allocated Social Worker employed as a Social Worker with CPFT under the Section 75 Partnership Agreement. If you are a carer please contact the key work or care co ordinator of the cared for person to request a carers assessments.
- If the cared for person doesn’t have an allocated Section 75 social worker or an Adult Social Care arranged package of care, the carer can be referred or can self referr to:
- Peterborough, email@example.com / 01733 747474 option 4
- Cambridgeshire Adult.EarlyHelp@cambridgeshire.gov.uk / 01480 373440 Self-referrals to 0345 045 5202 / firstname.lastname@example.org
Carers assessments for young carers
- All young carers (up to the age of 18) should be referred for a statutory young carers needs assessment to http://centre33.org.uk / 03334141809 / email@example.com
Support for carers
For further information about organisations supporting carers can be found by following these links:
Triangle of Care
We have adopted a national initiative called the ‘Triangle of Care’ which is a therapeutic alliance between service users, staff and carers that promotes safety, supports recovery and sustains wellbeing.
The concept of a triangle has been suggested by many carers and professionals who want to ensure that carers are active and equal partners within the care team. It represents partnership working between the physical or mental health professional, service user and carer. The Triangle of Care brings together many years of research with carers about what they feel will benefit them when involved with physical/mental health and learning disability services.
If the Triangle of Care is used properly and a partnership is developed, it helps to promote safety, support on-going recovery and improve the wellbeing of both the carer and the person they care for. We are working to ensure that the six key elements or standards are embedded into clinical practice. The six standards are:
- Carers and the essential role they play are identified at first contact or as soon as possible afterwards
- Staff are ‘carer aware’ and trained in the best way to engage with you as a carer
- Policy and practice protocols regarding confidentiality and sharing information are in place
- Defined posts responsible for carers are in place
- A carer introduction to the service and staff is available, with a relevant range of information across the care pathway.
- A range of carer support services is available.
For more information about Triangle of Care please email firstname.lastname@example.org.
Consent and confidentiality
The Deparytment for Health and Social Care have recently published and updated their consenous statement on Information sharing and suicide prevention (August 2021). Details of this consenous statement can be found here
Inaddition to this statement the Zero Suicide Alliance, on behalf of DHSC, has also published guidance for frontline staff on how to use the consensus statement, which aims to support staff regarding when and how to share information about patients where this may help prevent suicide.
Consent and confidentiality
AT CPFT we believe that carers and family members should be seen as working in partnership with those who provide clinical services. They provide important information that may help doctors, nurses, social workers and therapists to have a better understanding of the needs of service users. In order to be effective, partners, carers and family members need clear information about the service user’s care and treatment, their medication, potential side effects and any circumstances that may put the service user at risk. Confidential health-related personal information is shared between care professionals, such as doctors and nurses involved in a service user’s care, so that they get the safest and highest possible quality clinical care. In addition, staff need to include carers in the extended care and support team. A carer’s role requires them to be well informed so they can provide the essential support that service users need. Effective care and better clinical outcomes rely on this three-way partnership (Triangle of Care) between people who experience mental health problems, their families and carers, and our staff.
Who is a carer?
‘Carers are people who provide help and (unpaid) support to a family member, friend or neighbour who would otherwise not be able to manage. We use the term ‘carer’ in its broadest sense to include the most significant people in the life of the service user, including spouses, parents and young carers. It is also important to note that the carer is not always the “nearest relative”. The term “nearest relative” is defined in the Mental Health Act. The person they care for may have a physical or learning disability, dementia, mental health problems, may misuse drugs or alcohol or may be ill or frail.’
Young carers are children and young people who often take on practical and/or emotional caring responsibilities that would normally be expected of an adult. Informal carers must be given enough knowledge to enable them to provide effective care from an early stage. Carers should be given the opportunity to talk to staff about any difficulties they are experiencing in their caring role.
Duty of confidentiality
Service users have a right to expect that information about them will be held in confidence. Carers can expect that the information they provide will be held in confidence by the professional care team. Crucial to this process is the building and maintaining of trust between service users, professionals and carers. This is the foundation of good care.
Duty to share information
Doctors, nurses and other members of the care team have a duty to share information about the care, treatment, medication and other important information about a person’s health, in order to provide the safest and best clinical care possible. This means that sharing information must be discussed with service users early on in their care. If there are difficulties in sharing information that is crucial to care, this should be seen as a major problem that requires intensive work. Even when there are problems with confidentiality, this should not be used as a reason for not listening to carers or for not discussing fully with patients the need for their carers to receive information and support. Furthermore, this must be done when service users do give consent for information to be shared.
Consent to share information
Confidential information about a service user should only be shared with their explicit permission. If the service user doesn’t give permission, confidential information can only be disclosed in exceptional situations, such as where the health and wellbeing of the service user, or another person, is at serious risk. Confidential information might also be disclosed where there is a public interest or legal reason for disclosure without consent. In the absence of consent, it is good to share non-confidential information with carers. The care team should always revisit a service user’s refusal to share information with their carers. The support carers can offer is invaluable in supporting an individual’s recovery.
The care team should seek to understand the reasons why a service user may be declining to share information. The best outcome is always that they do agree to share at least some information. Detailed documentation of any conversation relating to consent and family or carers is imperative. Many service users often agree to share information with carers when their condition improves. Any decision made must always be in the best interest of the service user and to achieve the best possible outcome for them. The provision of general information about mental illness, emotional and practical support does not breach confidentiality. General information can include information about the condition and behaviour it may cause, advice on managing it, particularly in a crisis, and contact details of the team responsible for the service user / patient’s care.
Principles of Best Practice
Staff should seek a service user's views on sharing information with informal carers / family as early as possible. This will usually be during assessment or admission. This is the time when it is most likely the service user will refuse permission. This may be because they are very unwell, feel betrayed by their carer, or are angry about the carer’s role in their assessment or possible detention.
There needs to be a clear understanding that sharing information will need to be re-visited during the care episode. Regular review of the situation by the care team is essential. The care team should always seek to understand the reasons why a service user may be declining to share information.
Even if permission to share information is refused at this point, staff must still give general information about mental illness and treatment options, discuss the carer’s concerns or fears and signpost them to carer support services. If permission is given to share information with the carer, it is essential that it is shared.
Any decision made must be in the best interest of the service user and to achieve the best possible outcome for them. It is essential that staff explain how and why the decision to breach consent is in their best interest.
The carer may need help and support to understand their relative’s decision to exclude them. Deciding what information is general and what is personal will be a clinical judgement in each case.
The same principle of confidentiality applies to information given by carers. Staff must clarify the carer’s expectations as to who the information can be shared with.
Where the service user withholds consent or lacks capacity and cannot express their wishes clearly, personal information will only be shared on a strictly ‘need to know’ basis.
The upfront tool is a great resource for carers who are new to the maze of information, benefits and entitlements relevant to caring.
Working carers. The Carers Trust have a dedicated page for carers who are working
What to do in an emergency
The "What if" service operates 24 hours a day, seven days a week, every day of the year and is available to family carers in Cambridgeshire. It can provide urgent support in the event that your carer is unable to be there for you because of a sudden illness, accident or other unplanned event. This is done by getting in touch with your nominated contacts. It can provide back-up support available, if needed. In Cambridgeshire and Peterborough this service is provided by Caring Together.
Lifeline is available 11am-11pm, 7 days a week. T: 0808 808 2121
If there is any information that you would like included or if you find a link that needs updating, please contact us by sending an e-mail to email@example.com
Are you carer? Take this chance to provide us with your views and experiences. Click on this link to complete the survey or talk to a member of staff. It’s completely anonymous and will only take a couple of minutes to complete. Your responses will help to inform our work in engaging with carers.
Please help us to help you and other carers
Carers are the most valuable resource people can have. Because we recognise this, we are committed to listening and learning from you. We particularly value your feedback about the services you receive. If you are interested, or have comments or concerns to raise, please contact our Patient Advice and Liaison Service (PALS).
If you have any queries about the Carers Programme/Triangle of Care please email TriangleofCare@cpft.nhs.uk
Carers for people using adult mental health services:
If you are a family member or carer for someone receiving adult mental health services, you can contact us directly with any questions or concerns you have by emailing the team at ASMHfeedback@cpft.nhs.uk