Names: Laraine Marston, Amanda Street and Cate Edmondson
Job titles: School Nurse – Specialist Practitioners and Senior Nursery Nurse
Specialty: School Nursing Service – Young Carers
Organisation: Walsall Healthcare NHS Trust
What is the initiative and or project you are involved in?
School Nurses have a key role in supporting young carers to look after their health and wellbeing. The service has a School Nurse who is a Young Carers Champion (DfE, 2011) and already supports children and young people at the local young carer’s youth group. Engagement work had been undertaken to understand what support these children and young people wanted, where they wanted it delivered and how they wanted to access support. This initiative was developed as a result of the engagement work and involved School Nurses working with young carers to support their emotional health and wellbeing through the delivery of an evidence based resilience programme at their youth club.
What prompted you to do this work?
A young carer is someone under 18 who helps look after someone in their family, or a friend, who is ill, disabled or misuses drugs or alcohol. They take on considerable responsibilities of caring and supporting in the home which might lead to then having higher levels of school absence, missing out on extra curriculum activities and time to socialise with peers. Whilst the caring responsibilities can be rewarding it is recognised that young carers can experience additional stresses that can impact negatively on their emotional wellbeing (Young Minds, 2019/Carers Trust, 2019).
The service delivers interventions to improve the emotional health and wellbeing of children and young people. The evidenced based FRIENDS programme teaches children and young people the skills to help improve their confidence, self-esteem and manage mild anxieties. There are programmes for all age groups, Fun FRIENDS 4-7, FRIENDS for Life 7-13 and Teen FRIENDS 13 - 19. However, it was recognised the timing and venues of the interventions offered might be potential barriers to accessing young carers accessing services, as these conflict with their care responsibilities.
How did you initiate the work?
The themes emerging from the initial engagement were that the children and young people valued their time with peers, to interact and have fun. The FRIENDS programmes seemed to meet these requirements, it is a group intervention which encourages peer interaction and uses a fun approach to learning. It was agreed to pilot two groups, one for young primary age children and a second for teenagers. The delivery of the FRIENDS programme is a commissioned part of our core delivery and supporting vulnerable groups runs as a theme throughout the high impact areas (PHE, 2018) and therefore no additional budget or business case was required.
What have the challenges to implementing the service/intervention been? And what has enabled the implementation of the service/intervention?
The challenges were that young carers only meet with their peers at the youth club fortnightly. So, there was a need to balance the young carers preference to having fun social time with peers with delivering an intervention to support their wellbeing without significantly limiting their social time. Taking time to engage with the group and understand what they wanted from services was key to identifying and providing the appropriate support that the young carers were happy to engage in.
Has the initiative or project made a difference to patients/service users and or staff?
The groups ran fortnightly and consisted of 6 children attending the primary age group and 6 young people attending the teenage group.
The feedback from the children and young people and the support staff was very positive. A qualitative evaluation sheet was used and yielded comments such as they now felt more confident in themselves and that they would implement the strategies taught when dealing with situations out of their comfort zone. However, there was a key difference between the age groups. The teenagers were less engaged and expressed views that they preferred to spend more social time with their peers who they viewed as an important support network as opposed to participating in the programme. They expressed a wish for a ‘drop in’ style of support
What are the long-term aims for the work?
The next steps are to continue running primary FRIENDS because this age group were the ones who found it most beneficial and to explore training young carers to co-deliver groups themselves in the young carer’s settings.
There is a need to develop a better understanding of the role School Nurse might lay in supporting teenage young carers. The plan is to consider delivering a modified version of the School Nurse Champion programme which is provide young people with skills to consult with peers and contribute towards developments in the service leading to an ASDAN award (British Youth Council, 2016).