Annex B

City of York Council

Equalities Impact Assessment

Who is submitting the proposal?

Directorate:			People
Service Area:			Adults Commissioning Team
Name of the proposal :			Carers Support Service
Lead officer:			Craig Waugh
Date assessment completed:			03/11/2021
Names of those who contributed to the assessment :
Name	Job title	Organisation		Area of expertise
Craig Waugh	Commissioning Manager	City of York Council		Commissioning portfolio covering unpaid carers
		York Carers Centre		Provision of support and services for unpaid carers
		York Carers Strategy Group		Unpaid carers and cross-sector providers of support and services for unpaid carers.

Step 1 – Aims and intended outcomes 

1.1	What is the purpose of the proposal? Please explain your proposal in Plain English avoiding acronyms and jargon.
	To deliver a sustainable, integrated support model for unpaid carers, delivered by a competent and professional external provider who fully understands the needs of carers of all ages and from all backgrounds.

1.2

Are there any external considerations? (Legislation/government directive/codes of practice etc.)

The main external considerations are to ensure delivery of the local authority’s statutory duties under The Care Act 2014 in an equitable and fair manner. Considerations are in line with current legislation, initiatives and directives within Adult Social Care (driven by the Care Act 2014) to place emphasis on prevention, early intervention and the maximisation of self-care. The Carers Support Service and Carers Hub model will deliver strongly against the strategic priorities set out in the Operating Model for Adult Social Care.

1.3	Who are the stakeholders and what are their interests?
	Main stakeholders are unpaid carers, their families and the cared for. Further stakeholders include the local authority, health partners and VCSE organisations providing support and services for unpaid carers and their families.

1.4

What results/outcomes do we want to achieve and for whom?  This section should explain what outcomes you want to achieve for service users, staff and/or the wider community. Demonstrate how the proposal links to the Council Plan (2019- 2023) and other corporate strategies and plans.

Major outcome to significantly reduce the call on long term care, welfare and other benefits and physical and mental health services through recommissioning of the Carers Support Service under the Carers Hub model. Avoidance of carer breakdown and improved quality of life for carers, the cared for and their families. Outcomes associated with the Carers Support Service include: - Consistent growth in new carer registrations. - Targets for carer referrals being met and often exceeded. - Targets for Carers Assessments of Need being met and often exceeded. - Increase in the number of outreach hubs available to carers. - Preventing the complete breakdown of the care giving role and associated longer term benefits. - Prevention in admissions to residential care / reduction in the take up of domiciliary care packages. - Prevention of a significant deterioration in carer mental health. - Prevention of a significant deterioration in carer physical health. - Sustaining carers in employment and alleviating financial hardship. The proposals are fully aligned with the Council Plan 2019 – 2023 and its corporate priorities, particularly: - good health and wellbeing o The carers support service and carers hub model supports carers to undertake their carer role. This approach is aligned to early intervention and prevention to avoid carer breakdown and improve the physical and mental health of carers across the city enabling them to undertake their carer role. - well paid jobs and an inclusive economy o The carers support service supports carers and their employers to recognise and adapt to carers needs, allowing them to gain and remain in employment alongside their carer role. - a better start for children and young people o The carers support service supports young carers and very young carers in their carer role, giving them a better start and sustained support to enable them to live a life of their own and have their own voice. The current York Carers Strategy 2019 – 2024 and accompanying action plan was introduced following extensive consultation with carers across the city. Continuous feed-in and delivery of the strategy and action plan takes place with the oversight of the York Carers Strategy Group attended by carers, health and social care providers and voluntary sector partners crucial to the delivery of carers support services. The York Carers Action Group have direct feed-in to the strategy group through carer representatives. The agreed vision of the York Carers Strategy is to create a carer friendly city. One where all carers in York will be able to say: · I know who to turn to for help · I can cope · I can live a life of my own · My voice is heard – my views make a difference The Carers Support Service aligns directly with the York Carers Strategy.

Step 2 – Gathering the information and feedback 

2.1	What sources of data, evidence and consultation feedback do we have to help us understand the impact of the proposal on equality rights and human rights? Please consider a range of sources, including: consultation exercises, surveys, feedback from staff, stakeholders, participants, research reports, the views of equality groups, as well your own experience of working in this area etc.
Source of data/supporting evidence		Reason for using
Carers Support Service contract monitoring arrangements Case management system National Carers Survey York Carers Strategy Carers UK National research and consultation		Consultation and customer feedback has been sought on a continual basis by York Carers Centre as part of their contract monitoring arrangements and annual review process, through focus groups, surveys and interviews with carers of all ages from a wide variety of backgrounds. Consultation feedback through customer satisfaction surveys has been consistent - customers see significant value in the alignment of carers support services through the existing Carers Hub model and are strongly in favour of its continuation. Case notes from the York Carers Centre case management system and from Carers Assessments also point to customer satisfaction with existing support arrangements - particularly the co-ordination of all services through a single point of contact. The emphasis on early intervention and prevention through community outreach provision has been particularly valued. The ability to access Carers Assessments simply and easily within a community setting has also been widely appreciated. The data supports the provision of a fair and equitable service highly valued by customers.

Step 3 – Gaps in data and knowledge

3.1	What are the main gaps in information and understanding of the impact of your proposal?  Please indicate how any gaps will be dealt with.
Gaps in data or knowledge		Action to deal with this
Updated national and local analysis of the impact of the pandemic on carers is due in the coming weeks and months.		Where consultation, stakeholder feed-in and local intelligence can be used to predict the impact of the pandemic on carers this has been used to inform the service specification. Any updated analysis of the impact of the pandemic can be implemented through the contract monitoring and review process.

Step 4 – Analysing the impacts or effects.

4.1	Please consider what the evidence tells you about the likely impact (positive or negative) on people sharing a protected characteristic, i.e. how significant could the impacts be if we did not make any adjustments? Remember the duty is also positive – so please identify where the proposal offers opportunities to promote equality and/or foster good relations.
Equality Groups and Human Rights.		Key Findings/Impacts	Positive (+) Negative (-) Neutral (0)	High (H) Medium (M) Low (L)
Age		Caring responsibilities can affect people of all ages but children and young adults are particularly affected and their life chances disadvantaged as a result of their caring duties. Through various dedicated support mechanisms the service will impact positively on this age group. Older people are another age group that the project will benefit from tailored support packages - many older people face disproportionate caring responsibilities at a time when their own health may be deteriorating.	+	H
Disability		Many of the adults in need who people care for will possess some form of physical or mental disability. By supporting and sustaining their carers the project will impact positively on this client group - ensuring that their existing care arrangements are maintained and enhanced, thereby preventing their conditions from deteriorating or worsening. The service also aims to support and promote the avoidance of carer breakdown.	+	H
Gender		In total more women are carers than men in York, the same trend as nationally. The re-commissioned service will continue reaching out to female carers through a variety of channels that have already proved effective e.g. outreach / pop-up hubs at community events, social clubs and support groups with a high female attendance, through family support networks and by having a presence in GP surgeries etc. However, it should be noted that while more women than men under 65 are carers, men aged in the 50-64 age group provide a higher percentage of unpaid care than women aged 25-49. Among the over 65s, more men provide care (15%) than women (13%). Many older men who care for spouses, partners or family can become isolated and unwilling to ask for help, or even ignored by GPs who focus on the person needing care. From the general to the very individual, older male carers experience loss in many areas of their lives and experiences. Similar challenges are faced by female carers – but a significant problem for men is the lack of support networks, and a reluctance to discuss these problems. Overall, older men are less likely and less forthcoming generally in asking for help and support than older female carers; they tend to reach crisis point before asking for support from care services. Family support, for example, isn’t necessarily something that older male carers feel they can rely on. This suggests that male carers – older and perhaps younger – can have a different kind of experience and need different kinds of support than older women carers. The re-tendered service provision will therefore give careful consideration as to the issues affecting carers as a result of gender (and in some cases a combination of age and gender).	+	H
Gender Reassignment		The service will not impact positively or negatively on gender reassignment.	0	L
Marriage and civil partnership		The project will not impact positively or negatively on marriage and civil partnership.	0	L
Pregnancy and maternity		The project will not impact positively or negatively on pregnancy and maternity.	0	L
Race		The re-commissioned service will demonstrate that all communities of identity use / feel welcome to use the service. The service will engage meaningfully over the longer term with carers from all communities of identity in York. Raising awareness of services and support within these communities is a key element to improving levels of take-up. Making specific, tailored support packages available to a range of communities is also critical. (Levels of take-up will be carefully tracked as part of the monitoring arrangements for the new service).	+	M
Religion and belief		The re-commissioned service will demonstrate that carers of all religions and beliefs will use / feel welcome to use the service. The service will engage meaningfully over the longer term with carers from all religions and beliefs. Raising awareness of services and support within these communities is a key element to improving levels of take-up. Making specific, tailored support packages available to carers of all religions and beliefs is also critical. (Levels of take-up will be carefully tracked as part of the monitoring arrangements for the new service).	+	M
Sexual orientation		The re-commissioned service will demonstrate that carers of all sexual orientations will use / feel welcome to use the service. The service will engage meaningfully over the longer term with carers of every sexual orientation. Raising awareness of services and support within these communities is a key element to improving levels of take-up. Making specific, tailored support packages available to carers of all sexual orientations is also critical. (Levels of take-up will be carefully tracked as part of the monitoring arrangements for the new service).	+	M
Other Socio-economic groups including :		Could other socio-economic groups be affected e.g. carers, ex-offenders, low incomes?
Carer		The primary intention of the service is to support carers of all ages and from all backgrounds.	+	H
Low income groups		In the Carers UK “State of Caring” 2021 report 31% of respondents said that they are struggling to make ends meet, and over two-thirds reported that they regularly use their own income or savings to pay for care or support services, equipment or products for the person they care for. The report found that nationally the average carer looking after someone outside of residential care faces a financial penalty of over £114 a month. Carers are amongst some of the lowest income groups in the city. Support with income maximisation will be one of the specific strands of the service.	+	H
Veterans, Armed Forces Community		Many families from armed forces backgrounds have substantial caring responsibilities therefore the service will work with the veterans and armed forces community in York.	+	M
Other
Impact on human rights:
List any human rights impacted.		Right to education The service will impact positively on the right to education. The existing Carers Support Service works closely with schools across York to identify young carers that may be invisible to them, and school liaison will form a crucial part of the re-commissioned service along with appropriate contract monitoring in this area. As with existing provision the new service will provide drop ins / talks in local schools to raise awareness of the challenges faced by young carers and to support young carers attending these schools. The service will equip schools with a range of techniques to identify young carers and ensure that they receive the same access to education as other children. The re-commissioned service will ensure that young carers have a voice that influences and informs the planning and delivery of education services by ensuring young carer representation on appropriate partnership forums / boards. Right not to be subjected to torture and inhuman or degrading treatment The service will have a positive impact in this area. Staff and partners involved in the service will be trained to recognise degrading treatment and protect people from it. Staff will have a very clear understanding on when and how to report and/or escalate issues if they suspect people are not being treated with respect, or being treated in a humiliating and degrading way.   Freedom of expression The project will have a positive impact in this area. Freedom of expression gives children the right to learn and get information on what they want, which means that young carers have the right to be told about the support and benefits that are available to them. The re-commissioned service will be monitored to ensure that outcomes for young cares are being achieved in this respect. Protection from discrimination The service will support carers and ensure that they are not discriminated against or treated in a manner which makes it difficult for them to fulfil their caring responsibilities, particularly carers in the workplace.	+ + + +	H H M H

Use the following guidance to inform your responses:

Indicate:

- Where you think that the proposal could have a POSITIVE impact on any of the equality groups like promoting equality and equal opportunities or improving relations within equality groups

- Where you think that the proposal could have a NEGATIVE impact on any of the equality groups, i.e. it could disadvantage them

- Where you think that this proposal has a NEUTRAL effect on any of the equality groups listed below i.e. it has no effect currently on equality groups.

It is important to remember that a proposal may be highly relevant to one aspect of equality and not relevant to another.

High impact (The proposal or process is very equality relevant)	There is significant potential for or evidence of adverse impact The proposal is institution wide or public facing The proposal has consequences for or affects significant numbers of people The proposal has the potential to make a significant contribution to promoting equality and the exercise of human rights.
Medium impact (The proposal or process is somewhat equality relevant)	There is some evidence to suggest potential for or evidence of adverse impact The proposal is institution wide or across services, but mainly internal The proposal has consequences for or affects some people The proposal has the potential to make a contribution to promoting equality and the exercise of human rights
Low impact (The proposal or process might be equality relevant)	There is little evidence to suggest that the proposal could result in adverse impact The proposal operates in a limited way The proposal has consequences for or affects few people The proposal may have the potential to contribute to promoting equality and the exercise of human rights

Step 5 - Mitigating adverse impacts and maximising positive impacts

5.1

Based on your findings, explain ways you plan to mitigate any unlawful prohibited conduct or unwanted adverse impact. Where positive impacts have been identified, what is been done to optimise opportunities to advance equality or foster good relations?

There has been ongoing, significant consultation with service users and other stakeholders which has been undertaken through regular project monitoring (quarterly review meetings and an intensive Annual Project Review).This process of stakeholder and service user engagement combined with regular monitoring of project outputs and outcomes will be sustained and enhanced through the re-commissioning procedures.  In addition to regular monitoring of outputs and outcomes, continuous feedback is provided through the York Carers Strategy Group and Carers Action Groups alongside regular reviews and monitoring of the service.

Step 6 – Recommendations and conclusions of the assessment

6.1	Having considered the potential or actual impacts you should be in a position to make an informed judgement on what should be done. In all cases, document your reasoning that justifies your decision. There are four main options you can take:
- No major change to the proposal – the EIA demonstrates the proposal is robust.  There is no                         potential  for unlawful discrimination or adverse impact and you have taken all opportunities to    advance equality and foster good relations, subject to continuing monitor and review.
- Adjust the proposal – the EIA identifies potential problems or missed opportunities. This involves taking steps to remove any barriers, to better advance quality or to foster good relations. - Continue with the proposal (despite the potential for adverse impact) – you should clearly set out the justifications for doing this and how you believe the decision is compatible with our obligations under the duty - Stop and remove the proposal – if there are adverse effects that are not justified and cannot be mitigated, you should consider stopping the proposal altogether. If a proposal leads to unlawful discrimination it should be removed or changed. Important: If there are any adverse impacts you cannot mitigate, please provide a compelling reason in the justification column.
Option selected		Conclusions/justification
No major change to the proposal		Through a combination of early intervention, proportionate assessment and triage for more complex cases of need the Carers Support Service will provide a highly responsive, integrated and flexible carers support model - one which will prove effective in sustaining carers in their care giving role thereby reducing the demand for permanent, long-term care. This in turn will also lead to measurable cost savings across the health and social care system. The service also impacts positively on One Planet York principles of creating strong communities, a vibrant and inclusive economy and a healthy environment. The intention is to maximise the existing positive impacts by extending the service reach and influence and impact within these specific themes. This is not a new project, rather than the re-commissioning of an existing successful scheme. If there is one area that could potentially be improved through the re-commissioning process it is around the setting of clear, measurable outputs and outcomes that directly support the One Planet Principles - ensuring that there are robust monitoring procedures in place to ensure that the outcomes are being delivered. The existing service’s impacts on equalities and human rights have been highly positive, particularly in the areas of age, disability, supporting the lowest income groups and carers (the primary beneficiaries of this project). The recommissioning of the service will build on these positive impacts.

Step 7 – Summary of agreed actions resulting from the assessment

7.1	What action, by whom, will be undertaken as a result of the impact assessment.
Impact/issue		Action to be taken	Person responsible	Timescale
		Ensure the Carers Support Service contains clear, measurable outputs and outcomes that support the One Planet Principles	Craig Waugh	Throughout the recommissioned service duration.
		Ensure the Carers Support Service contains clear, measurable outputs and outcomes that support Equalities and Human Rights Principles	Craig Waugh	Throughout the recommissioned service duration.

Step 8 - Monitor, review and improve

8. 1

How will the impact of your proposal be monitored and improved upon going forward?   Consider how will you identify the impact of activities on protected characteristics and other marginalised groups going forward? How will any learning and enhancements be capitalised on and embedded?

As part of the re-tendering arrangements expectations around innovation, added value and impact upon the One Planet and Equalities & Human Rights Principles will be built into the service specification and carefully measured through contract monitoring arrangements. Whilst the existing provider has delivered a highly valued service the service specification will be reviewed and outcomes clearly defined for an enhanced service approach through the re-tendering process.   Any learning and enhancements can be captured, considered and implemented through the contract monitoring and review procedures.