Carers and caring

What does substantial or critical mean?

The focus is on the impact of care on the carer. As such, the definition of carer does not include any threshold for the level of care provided. In every situation, a proportionate approach to the preparation of the adult carer support plan or young carer statement is adopted, taking into account the impact of the caring role on the carer.

**Examples of substantial or critical needs**
Category of caring role	Caring has substantial impact Substantial Risk	Caring has critical impact Critical Risk
Health and wellbeing	Carer has health needs that requires attention. Significant impact on carer's emotional wellbeing.	Carer's health is breaking /has broken down. Carer's emotional wellbeing is breaking/has broken down.
Relationships	The carer's relationship with the person they care for is in danger of breaking down and/or they no longer are able to maintain relationships with other key people in their life.	The carer's relationship with the person they care for has broken down and their caring role is no longer sustainable and/or they have lost touch with other key people in their life.
Living environment	Carer's living environment is unsuitable and poses an immediate risk to the health and safety of the carer and/or cared for person.	Carer's living environment is unsuitable and there are immediate and critical risks to the health and safety of the carer and/or cared for person.
Employment and training	Carer has significant difficulty managing caring and employment and there is a risk to sustaining employment and/or education in the short term. Carer is not in paid work or education but would like to be soon.	Carer has significant difficulty managing caring and employment and/or education and there is an imminent risk of giving up work or education. Carer is not in paid work or education but would like to be now.
Finance	Caring is having a significant impact on finances e.g. difficulty meeting housing costs and utilities.	Caring is causing severe financial hardship e.g. carer cannot afford household essentials and utilities, not meeting housing payments.
Life balance	Due to their caring role, the carer has few and irregular opportunities to achieve the balance they want in their life. They have little access to breaks and activities which promote physical, mental, emotional wellbeing.	Due to their caring role, the carer has no opportunities to achieve the balance they want in their life. They have no access to breaks and activities which promote physical, mental, emotional wellbeing.
Future planning	Carer is anxious about planning for the future and has significant concerns about managing caring.	Carer is very anxious about planning for the future and has severe concerns about managing caring.

The pandemic continues to be challenging for many parts of the social care system and for people in receipt of Self-directed Support. In response to these pressures, the Scottish Government expects local authorities to exercise maximum flexibility in the provision of support through SDS. Local authorities and Health and Social Care Partnerships will adapt to meet changing circumstances. This may be done by continuing to maintain their welfare function, by:

carrying out regular reviews
holding good conversations and co-producing support plans with individuals and their support networks
organising social care support to meet personal outcomes, including making use of community supports and assets.

This will help to ensure everyone understands what matters to the individual and how their personal outcomes can be met. There remains a requirement to demonstrate a clear link between items and services purchased and the personal outcomes identified and agreed in an individual’s support plan, adult carer support plan, or young carer statement.