Agenda Item 9 - Updated CSWO Annual Report
North Ayrshire Council · 22 August 2024
Back to Integration Joint Board — 22 August 2024 and its agenda
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Integration Joint Board 22 August 2024 Subject : Chief Social Work Officer Annual Report 2023/24 Purpose : To present the Integration Joint Board with the annual Chief Social Work Officer report which is required by Scottish Government. Recommendation : IJB are asked to note :- 1. The contents of the report, in particular the successes and challenges; 2. The skilled and compassionate interventions of our practitioners and managers. 3. The worsening financial context and associated impact on all ages within our community both in terms of wellbeing and risk. 4. Ask the CSWO to submit the annual report to the Office of the Chief Social Work Adviser in Scottish Government. Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required X 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership CSWO Chief Social Work Officer SOLACE Society of Local Authority Chief Executives ASP Adult Support and Protection 1. EXECUTIVE SUMMARY 1.1 There is a requirement for every Local Authority to appoint a professionally qualified Chief Social Work Officer (CSWO) and this is contained within Section 3 of the Social Work (Scotland) Act 1968 as amended by Section 45 of the Local Government (Scotland) Act 1994. 1.2 In line with the legislation and guidance, the CSWO is required to prepare an annual report for the Council, on all statutory, governance and leadership functions of the CSWO role.
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1.3 This report will be submitted to NAC Cabinet on 27th August 2024. 2. BACKGROUND 2.1 In 2014, the Office of the Chief Social Work Adviser, following consultation with CSWOs across Scotland, SOLACE and others, identified a more standardised approach to prepare the annual reports. 2.2 The report provides an overview by the CSWO of the partnership structures, governance arrangements and the performance of social services in the context of the demographic landscape of North Ayrshire. It looks more closely at the statutory functions of the service and the quality and workforce development within our services. 2.3 The report highlights the range of Social Work activity throughout the year and places that in the context of the socioeconomic challenges faced locally. Within the report there are four key issues I would like to bring to the attention of IJB :- Practice • Practice generally remains strong. We have a skilled workforce and services have worked hard to support newly qualified workers and those new into management posts. Our work continues to recover Social Work practice back into a person- centred activity. Less of a culture of care management and more of a culture of people and relationships taking primacy. We have indicators that this strategic approach is working through our workforce sufficiency data and crucially through our strategic inspection of adult support and protection which reflected on strong practice and strong governance and leadership. We don’t always get it right and when these circumstances present Social Work services are committed to listening, learning and resolving wherever it can. Public Protection • Our approaches to child protection and our commitment to support families to remain together wherever possible continues to be a key Social Work activity. Our number of child protection concerns continues on the downward trajectory that started in 18/19 as does our number of children subject to Statutory Orders. Finally, in relation to another core Social Work task, it is pleasing to see the number of permanence orders finally recover to pre covid levels. • Our justice services continue to deliver exceptionally high levels of success in relation to the completion of community payback orders while the number of diversion report requests remained on a par with last year.
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• Mental health services have had to manage exceptional rises in demand over the year. There are many medical and socio economic reasons for this but what is clear was our support to communities with worsening mental ill health at the acute end of wellbeing. Short term detentions requests rose to 182 while pre covid this figure was 67. The covid years and the post covid context have seen this intervention rise significantly and in a sustained way. Our Local Authority Guardianship have also increased in the year past to 121 from 85 last year. These two examples quantify the increased demand on services to not only protect from harm but to fulfil the key Social Work task of protecting the rights of individuals who lack capacity. • Our adult support and protection activity has also seen an uplift in activity from last year in relation to ASP referral (915 from 722); ASP investigations (112 from 72) and ASP case conferences (57 from 41). Despite these increased levels of activity the strategic inspection gave us assurance that practice was strong and governance in place. Out of Authority Placements in North Ayrshire • The disruption in the care home sector has seen an increasing number of local providers seeking to offer care to the most complex individuals from across Scotland. This has brought with it real challenges for North Ayrshire HSCP in relation to residents of other authority areas living in North Ayrshire care homes. These challenges have often had at their root either a lack of oversight, namely out of sight out of mind, or sufficient sharing of high-risk information with the provider and NAHSCP. In these circumstances the outcomes for individuals are usually poor and interventions are required under Adult Support and Protection or Adult with Incapacity legislation. Regardless of the intervention pathway, the additional time and resource taken in the year past to manage these situations has been significant across all levels of the organisation. • Human and financial resource to manage risk, to manage relationships, to coordinate responses, to liaise with the regulatory bodies as well as the placing authorities, NHS Boards and Scottish Government. • The inertia in dealing with the representation of this issues tells us much about how difficult it truly is to affect the whole system change on a national level. The Impact of the financial context Our risk exposure is growing with every passing month. In the social work and social care sector the ability to manage services is critically driven by demand and capacity variables. Everything we stop, or reduce, results in a loss that is rarely acceptable. Against this backdrop the professional view has been clear in relation to leaving no one at risk of significant harm, a view supported by the Partnership and IJB.
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We continue to see a growing number of people in our community waiting for services as our system pursues its obsession with delayed discharge. With so much unmet need pent up those residents reach crisis point and enter hospital with more complex needs requiring higher degrees of intervention and support at discharge than may otherwise have been required. Either way reduced resource coupled to increasing complexity is the perfect storm and Social Work services will continue to mitigate as best it can the impact of this on our most vulnerable residents. 3. PROPOSALS 3.1 It is proposed that IJB notes the key themes and challenges detailed in the report and that it endorses the report as set out in Appendix 1 and asks the CSWO to submit this to Scottish Government. 3.2 Anticipated Outcomes That North Ayrshire Council, the Integration Joint Board, and the Scottish Government are made aware of the positive impact of Social Work Services in North Ayrshire as well as the significant challenges that are being faced. 3.3 Measuring Impact Impact will be measured in terms of the direction and support to continue to transform the delivery of Social Work Services. 4. IMPLICATIONS 4.1 Financial None. 4.2 Human Resources None. 4.3 Legal None. 4.4 Equality/Socio-Economic None. 4.5 Risk The delivery of Social Work Services is a statutory duty placed on North Ayrshire Council and delegated to the Integration Joint Board and on to the HSCP. 4.6 Community Wealth Building None.
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4.7 Key Priorities This report covers matters which contribute to the key priorities around vulnerable children and adults within the Council and IJB Strategic Plans. 5. CONSULTATION The Extended Partnership Senior Management Team and operational services have contributed to the contents of this report. Caroline Cameron, Director For further information, please contact Scott Hunter, Chief Social Work Officer on scotthunter@north-ayrshire.gov.uk Appendices • Appendix 1 – Chief Social Work Officer Annual Report 2023-24
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/ Chief Social Work Officer Report 2023 – 2024
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Contents Introduction .............................................................................................................. 1 Demographics .......................................................................................................... 3 Locality Planning...................................................................................................... 4 1. Governance, Accountability and Statutory Functions ................................... 7 1.1 Overview of the North Ayrshire Health and Social Care Partnership ......... 10 Visions, Values and Priorities ............................................................................ 10 2. Service Quality and Performance ................................................................... 11 2.1 Children, Families and Justice Services .................................................... 11 The Promise ...................................................................................................... 11 North Ayrshire Champions Board ...................................................................... 11 CASST ............................................................................................................... 12 Signs of Safety................................................................................................... 12 Child Protection Registrations............................................................................ 13 Breastfeeding..................................................................................................... 13 Rosemount Project ............................................................................................ 13 School Nurse ..................................................................................................... 14 Childhood Immunisations .................................................................................. 15 Key Performance Indicators .............................................................................. 16 2.2 Adults ......................................................................................................... 19 North Ayrshire Drug and Alcohol Service .......................................................... 19 North Ayrshire Model for Enhanced Intermediate Care and Rehabilitation (eICT) ........................................................................................................................... 20 Learning Disabilities ........................................................................................... 21 Care at Home .................................................................................................... 21 Carers ................................................................................................................ 22 Money Matters ................................................................................................... 23 Mental Health..................................................................................................... 24 Suicide Prevention ............................................................................................. 25 Self-Directed Support & Ayrshire Independent Living ........................................ 25 Older Peoples Day Services .............................................................................. 26 Community Link Workers ................................................................................... 27 Trindlemoss Day Opportunities.......................................................................... 27 Alcohol and Drugs ............................................................................................. 28
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Dads’ Support Worker ....................................................................................... 29 Community Wards ............................................................................................. 29 Out of Hours Social Work Service ..................................................................... 30 2.3 Criminal Justice .......................................................................................... 31 Prevent Multi Agency Panel ............................................................................... 31 Recruit with Conviction ...................................................................................... 31 Koestler Awards ................................................................................................. 31 Refugee Support Team ..................................................................................... 32 Community Payback Orders .............................................................................. 32 Drug Treatment and Testing Order .................................................................... 33 Diversion from Prosecution ................................................................................ 34 Key Performance Indicators .............................................................................. 35 3. Resources ........................................................................................................ 38 3.1 Financial Pressures ................................................................................... 38 2024-25 Budget ................................................................................................. 39 3.2 Financial Performance ............................................................................... 40 3.3 Medium Term Financial Outlook ................................................................ 41 4. Workforce ......................................................................................................... 43 4.1 Workforce Planning .................................................................................... 43 4.2 Workforce Support and Development ........................................................ 44
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1 Introduction Welcome It is a pleasure to introduce this year’s annual Chief Social Work Officer report for North Ayrshire which covers the period 1st April 2023 through 31st March 2024. As our policy and professional worlds relentlessly continue to pursue specialisation and centralisation in equal measure, I find myself seeking a common language that unites Social Work in North Ayrshire. I constantly revisit the Social Work (Scotland) Act 1968. Section 12 speaks to the Social Work task – the promotion of social welfare by making available advice, guidance and assistance on such a scale as appropriate for their local authority area and describes the principle of helping at the earliest time to avoid greater expense further down the line. Now, more than ever, North Ayrshire needs a strong Social Work voice. A voice anchored in an understanding and commitment to the values of the social justice and social welfare. This year there are a couple of issues that I would wish to highlight that the report template doesn’t easily lend itself to: Firstly, as we experience diminishing resources and increased levels of need, the year past has seen North Ayrshire beginning to manage increasing service wait lists across the partnership. The cost of this unmet need on a human level plays out every day in our communities as services strive to make the available resource go as far as possible. The other result of the increase in service waits is the requirement to manage the associated increase in risk. This places further demands on front line teams and careful attention is taken by management teams to ensure that thresholds of risk are not diluted. Secondly, the disruption in the care home sector has seen an increasing number of local providers seeking to offer care to the most complex individuals from across Scotland. This has brought with it real challenges for North Ayrshire HSCP in relation to residents of other authority areas living in North Ayrshire care homes. These challenges have often had at their root either a lack of oversight, namely out of sight out of mind, or sufficient sharing of high-risk information with the provider and NAHSCP. In these circumstances the outcomes for individuals are usually poor and interventions are required under Adult Support and Protection or Adult with Incapacity legislation. Regardless of the intervention pathway, the additional time and resource taken in the year past to manage these situations has been significant across all levels of the organisation. Human and financial resource to manage risk, to manage relationships, to coordinate responses, to liaise with the regulatory bodies as well as the placing authorities, NHS Boards and Scottish Government. The inertia in dealing with the representation of this issue tells us much about how difficult it truly is to affect whole system change on a national level. The data tells us that our communities can experience the impact of drug and alcohol use, the lasting impact of enduring poor physical and mental health and our children and young people experience the highest level of child poverty in Scotland
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2 out with of Glasgow City. In this context I hope you will have time to read some, or all, of this report and feel the difference our practitioners and teams are making to strengthen communities and improve life chances in North Ayrshire. There are many examples of hope, inspiration and perspiration described, but they all have in common a belief in the value and potential of the individuals and communities we serve, and most importantly a belief that change and a better future is possible. I am conscious that the need for Social Work and Social Care support today far outstrips the human and financial resources that are available. There are growing numbers of our residents waiting for services and it is the voices of these residents, and all those in our community managing day to day, with family or without, that need to be heard in the context of the challenging situation our society now finds itself in. Finally, I would like to place on record my appreciation for the compassion and commitment displayed day in, day out by our practitioners, managers, business support staff and partners to ensure that Social Work and Social Care services are delivered to the very best of our abilities. Scott Hunter Chief Social Work Officer North Ayrshire Health and Social Care Partnership
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3 Demographics North Ayrshire is home to approximately 133,490 people, (National Records for Scotland, Mid-2022 Population Estimates Scotland) all living in its many towns, villages, and islands, with slightly more females (52.2%) than males (47.8%). 15.9% of the population are aged 0 to 15 years, 9.2% are aged 16 to 24 years, 21.5% are aged 25 to 44, 29.5% are aged 45 to 64 years of age, 13.2% ages between 65 to 74 years of age, with 10.7% of our population aged 75 years and above. The latest update of the Scottish Index of Multiple Deprivation has reconfirmed the deep structural challenges faced by many communities in North Ayrshire, despite steady progress by North Ayrshire Council in its ongoing commitment to eradicate poverty. North Ayrshire is ranked as the fifth most deprived council area in Scotland. Some of the area’s most heavily affected by deprivation are concentrated in the Three Towns and Irvine areas but areas in Kilwinning and the Garnock Valley also have above average deprivation.
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4 Locality Planning The themes of the strategic plan are how the HSCP will plan services and seek positive outcomes across the whole of North Ayrshire, but each community within North Ayrshire will have unique challenges and different inequalities. As such, the HSCP is required to develop planning in a smaller geographic area for different localities, which in North Ayrshire are: • Arran • Garnock Valley • Irvine • Kilwinning • North Coast and Cumbrae, and • Three Towns A new method for carrying out local planning in these areas has been developed over the last year and is currently being implemented in order to develop priorities and actions in the form of published Locality Plans, to be developed by 2025. This method will analyse local data, engagement, and service information, and ensure continued community feedback and leadership to develop robust, informed plans. Locality Planning is the local mechanism for strategic planning in which local priorities are developed for smaller geographical areas across the local authority. In 2023 it was decided that the framework for carrying out Locality Planning would be revised in order to involve new methods for community engagement and ensuring continued leadership through new Locality Chairs. Throughout late 2023 and early 2024 this new process was further developed in order to collect robust data and information about each locality in order to develop Locality Plans. Engagement: Locality Conversations Twice per year, Locality Conversations will be held within each locality in order to collect information from different people within the communities, and feedback what we are doing with the information. The first set of Locality Conversations are set to take place in April 2024, in the form of 2-hour workshops with local staff and members of the public invited to intend. This will allow us to explain a bit about the new process and collect initial community perceptions and challenges. The next set of Locality Conversations will be held in September 2024 when the focus of the engagement will be groups of shared characteristics, where we will seek the views of targeted groups. Locality Conversations will continue twice a year until locality plans can be developed in each area.
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5 Local data: Locality Profiles The Strategic Commissioning Plan is developed using a Strategic Needs Assessment provided by Public Health Scotland, outlining local health and care data and inequalities across North Ayrshire. Public Health Scotland also provides more local data for each locality, where it is possible to obtain data at that level. These locality profiles will be used to identify key inequalities within each locality in order to understand where targeted effort may be required. Local Services: Review of access There are many health and care services that are carried out within each locality, and there are others that people across the authority would need to travel to another locality to access. In order to understand how services are accessed and where some of the access challenges lie, we will be carrying out a mapping exercises of the health and care services available within each locality. This will include primary care, but also local third sector services and wellbeing in the community. The partnership also began a review of its front door in January 2024. This work has quickly established key issues around the number of networks, duplication of assessment and referral process and the complexity of presenting needs. This work is helping to develop our thinking and approaches based around the concepts of a liberated services model. This is exciting and challenging in equal measure and the work is due to report by December 2024 with recommendations for consideration. Community Priorities: Community Planning The Integration Joint Board is a member of North Ayrshire Community Planning Partnership, which has a separate requirement to carry out Locality Planning with more involvement of the community to develop general community priorities. The established priorities for each area will be considered within the HSCP Locality Planning Process as these were developed alongside the local community. Governance All the above information will be collected, collated, and analysed over the course of 2024 and 2025, which will allow 4 periods of engagement and a greater depth of information and understanding of each area will be developed. Information will be analysed, and plans and actions will be developed by the Locality Planning Review Group for each area, who will also enable delivery and monitoring of the plans. Each Locality Planning Review Group will meet twice per year, following each period of engagement. Group membership will be tailored to the specific needs of each community but will be Chaired by a Head of Service to ensure consistency and continued leadership. Locality Plans will be developed by late 2025. Arran The outlined method for Locality Planning will apply to the five primarily mainland localities of Irvine, Kilwinning, Three Towns, Garnock Valley and North Coast and
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6 Cumbrae, though there are current discussions within the Community Planning Partnership regarding the current arrangements for specific challenges for residents of Cumbrae. Arran has an established locality planning arrangement which has been in place for many years due to the specific and persistent challenges of the Island. These arrangements have a governance that sits under the Island Plan and the Health and Social Care Partnership will develop health and social care priorities for Arran under this existing governance structure, and using engagement that has already been carried out with the islanders. This will occur using the same timescales as our mainland localities.
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7 1. Governance, Accountability and Statutory Functions The Chief Social Work Officer is a statutory appointment by virtue of Section 3 of the Social Work (Scotland) Act 1968. The Chief Social Work Officer is appointed for the purposes of the Council's functions under the 1968 Act and under those other enactments listed in Section 5(1B) of that Act. In broad terms, those functions cover all social work and social care services whether provided directly by the council, in partnership with other agencies, or procured by the council and provided by others on its behalf. Those functions are referred to as “social work services”. The qualifications required for the post are set out in the Qualifications of Chief Social Work Officers (Scotland) Regulations 1996. The Chief Social Work Officer is required by section 5(1) of the 1968 Act to carry out the duties of the post under the general guidance of the Scottish Ministers. The Scottish Ministers issued revised and finalised guidance in January 2010. The overall powers of the Chief Social Work Officer post are:- (a) To oversee the discharge of the council's statutory social work duties; (b) To ensure the provision of effective professional and objective advice to elected members and officers of the Council in the Council's provision of social work services; (c) To secure the effective provision of social work services. The powers of the Chief Social Work Officer fall into two broad categories; service provision and corporate responsibility: Service provision • To establish and develop social work services focussed on the needs of service users, to promote the continuous improvement of those services, and to monitor and raise standards of their delivery; • To ensure the effective governance of the balance of need, risk and civil liberties in the provision of social work services in accordance with professional practice; • To provide advice on all aspects of workforce planning including safe recruitment practice, supervision, monitoring and assessment of social work students, securing of professional qualifications and continuous learning and development for staff, and supporting and advising managers in all aspects of staff supervision; • To ensure the existence of systems to both promote good practice and identify and address poor practice in the provision of social work services; • To ensure that significant case reviews are undertaken of all critical incidents either resulting in, or which may have resulted in, serious harm or death; and
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8 Corporate Responsibilities Corporate responsibility The Chief Social Work Officer has the following corporate powers which require direct access to the Council's Chief Executive’, Elected Members of the Council and the Chief Officer, and the provision of forthright and independent advice to them:- • To ensure compliance with the Council’s statutory duties to prepare, publish and review plans for the provision of social work services. • To promote, communicate, support and review values and standards of professional practice, and to ensure that they are adhered to. • To establish, in conjunction with the Council's Corporate Management Team, appropriate experience and qualified cover for the post of Chief Social Work Officer during the post-holder's absence or incapacity. • To report to the Chief Executive and Chief Officer any failure in the Council's corporate policy or governance arrangements designed to reflect the proper balance amongst need, risk and civil liberties in the provision and management of social work services. • To report to the Chief Executive and Chief Officer any weaknesses and failures in the systems in place to promote good practice and identify and address poor practice in the provision of social work services. • To report and provide independent comment where necessary to the Chief Executive, Elected Members of the Council and the Chief Officer on the findings of significant case reviews and relevant performance reports and on any other social work related issues. • To provide an annual report to the Council on all of the statutory, governance and leadership functions of the role of the Chief Social Work Officer North Ayrshire continues to invest in its oversight of Social Work activity through the provision of a standalone Chief Social Work Officer, further supported by a formal Depute CSWO. The CSWO reports directly to the Director of the NAHSCP and has a direct line to the Chief Executive of the Council. The CSWO represents Social Work within a range of strategic groups including: IJB, IJB Performance and Audit Committee, IJB Strategic Planning Group, NAHSCP Health Care Governance Committee, HSCP Partnership Senior Management Team, Alcohol and Drugs Partnership, Child Protection Committee, Adult Protection Committee, Chief Officers Group, Carers Advisory Group, Children’s Services Strategic Planning Partnership; Corporate Parenting Board, Transitions Strategic Group amongst others. The CSWO also provides professional oversight as a member of the Care Home Oversight Group and the Care at Home Oversight Group. These groups continue to fulfil key governance activity in relation to the Social Care sector. These groups have worked closely in the year past to manage high risk situations in relation to market
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9 failure in the Care at Home Sector and the closure of a residential care home following poor inspection reports. The CSWO has regular contact with the Independent Chair of CPC and APC to ensure public protection oversight. The year past has seen North Ayrshire commission one learning review. As often happens, the timescale for reporting remain unclear as a result of ongoing activity with our Police and Fiscal colleagues. Professional support and guidance over the year has been offered in relation to high- risk justice cases including our first management of a lifelong restriction order, as well as in relation to Prevent activity. The CSWO also sits on the pan Ayrshire Strategic Oversight Group for the implementation of the new Joint Investigative Process. Social Work and Social Care matters are regularly reported to the IJB and Clinical and Care Governance Committee. There is a particular focus on the impact of policy and external scrutiny activity. The CSWO maintains regular calls with our Care Inspectorate strategic link to share developments and hear of national developments that support activity in North Ayrshire. The CSWO also contributes to quarterly calls with the inspectorate and the broader PSMT. The primary governance of practice matters remains the Social Work Governance Board. The board terms of reference and membership have been refreshed in the current year with the support of the professional leadership group. The board has had a full agenda of issues over the year and has provided support and governance in relation to a range of matters including: • The development of a framework for practice where virtual methods are not suitable to promote good quality social work practice • Practice enhancement notices in relation to adult support and protection • Safe Holding and associated Governance • Developing Community Social Work models and discourse • Contextual safeguarding • Guidance to practitioners on the ASP / CP interface for 16 & 17 Year Olds • Practice standards for MHO’s annual accreditation
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10 1.1 Overview of the North Ayrshire Health and Social Care Partnership Visions, Values and Priorities Our Partnership includes health and social care services within Health and Community Care Services (H&CC), Mental Health and Learning Disability Services and Children, Families and Justice Services. In this report, we look back on the progress we have made, share some of our successes and reflect on some areas that have proved challenging. This report aligns with our “Caring Together” Strategic Commissioning Plan 2022- 2030. This is the first time the Health and Social Care Partnership has set out such a long-term plan for how we intend to improve services and the health and wellbeing of the local community. The plan set out our pandemic recovery intentions, as well as offering a longer-term vision for local health and social care services. Over the period of this strategic plan, the Health and Social Care Partnership will seek to: We see these priorities as interlinked, and we expect that where we see success against one priority, it’s effect will positively impact against others. People who use our services and North Ayrshire residents will experience our Partnership values in the way our staff and volunteers engage with you and how we behave. We will treat you with:
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11 2. Service Quality and Performance 2.1 Children, Families and Justice Services The Promise The Promise is a large-scale, complex 10-year change programme with multiple objectives and interlinked activities, across multiple partners that sets out a clear commitment for all corporate parents to have an enhanced understanding of the experiences of those who have spent time in care. Progress continued this year focusing on: Social Media A new North Ayrshire Will Keep The Promise Instagram Channel is now created and growing to reinforce that The Promise is a shared duty between corporate parents but to also share relevant information to our care experienced young people in a trending way. Care Experienced Youth Groups Formed a Care Experienced Youth Group within all Secondary Schools within North Ayrshire to give care experienced young people a platform to use their voice to initiate real change as well as having a safe space to communicate with staff and one another. The young people involved will help to support the rights of fellow care experienced young people in North Ayrshire. Awareness Raising and Training The Corporate Parenting team have worked alongside young people to create a presentation that will be delivered within secondary schools and colleges to raise basic awareness of care experience and provide an insight into what rights and entitlements are out there. North Ayrshire Champions Board Our North Ayrshire Champions Board have created a Care Experienced App named "CE4U". The app has lots of tips, advice, and information that we believe will help Care Experienced young people throughout their journey and beyond. The app has a little bit about everything from housing support, learning how to cook using recipes, tips on how to look after yourself physically and mentally, travel support as well as key contacts and events happening in your area. North Ayrshire Champions Board used their own experiences and journeys to produce the idea for an app as they often found they didn't know a lot of the information that was out there or they simply didn't know who or what to ask to find it for them, and so Scotland's very first Care Experienced app was created.
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12 CASST Our Children and Adolescent Specialist Support team (CASST) were able to create a modern apprentice opportunity thanks to CORRA foundation funding, It was agreed that the team would benefit hugely from recruiting someone with lived experience of substance use in order to support the team in their endeavours to deliver positive interventions to children and young people who are either involved directly in substance use themselves or live within a household where there is problematic substance use. Our modern apprentice has only been in post for a short period of time; however, they have been able to capitalise on their previous adversities and utilise them in a positive way to assist our young people who are currently being supported by the CASST team. In fact, during the recruitment process for the Modern Apprentice, a number of candidates showed wonderful potential, and our Learning and Development team engaged with them in order to help them seek other opportunities within the HSCP and wider Council. Signs of Safety Health and Social Care have begun the implementation of the ‘Signs of Safety’ assessment and planning model. This model places parents, children and everyone naturally connected to the child at the centre of the assessment, decision-making and planning and is a significant paradigm shift for children’s services, where the dominant culture is for professionals to define the problems and what is required to solve them. The Signs of Safety practice principles support our vision that the best place for children and young people to grow up is within their families and networks where they have the potential to care for them safely. When this is not possible, we will provide a secure, stable home, and help them achieve their full potential. We went fully live with Signs of Safety for all new cases in September for Children and Families Locality teams and the Child Protection team. Prior to then we had a period from June where we used the approach with a small amount of practice in order to build workforce confidence and knowledge. Since then, we have utilised this practice framework with over 300 children and young people This is great progress, but we recognise there is ongoing work to build all our confidence in establishing the approach. The focus is on recognising and acknowledging families’ strengths and encouraging them to identify solutions to any identified worries or to assist them to reduce harm, alongside the support of services. We are moving into our second year of a 5-year implementation plan to fully embed the model in practice. Over the next year we will transition all work with families over to a Signs of Safety model approach. Social Work Children and Families Teams will be working to ensure this support model is implemented for all children and young people receiving a service.
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13 Child Protection Registrations In 2023/24 there were 187 Child Protection registrations and 140 De-registrations. The greatest number of registrations were found in December, when there were 27 registrations within the month. The lowest number of registrations occurred in March, when there were 8 registrations within the month. The median number of registrations per month across the year was 15. Breastfeeding Breastfeeding has been a longstanding priority for staff working in North Ayrshire. The integrated community infant feeding team which includes midwives, health visitors, Family Nurses, support staff, Community Infant Feeding Nurse, and Support Nurse, as well as colleagues from the Breastfeeding Network (BfN) work closely with families to help them make an informed choice about feeding. Staff have all received regular high-quality training to ensure they are knowledgeable and skilled in relation to infant feeding. In North Ayrshire our rates of exclusive breastfeeding have decreased slightly, with exclusive breastfeeding rates at the first health visitor contact dropping from 22.7% in 2022, to 21.2% in 2023, and at the 6-8 review exclusive breastfeeding has dropped from 20.1% in 2022 to 17.8% in 2023. However, our overall breastfeeding rates (mixed breast and formula) have increased from 40.6% in 2022 to 41% in 2023 at the first health visitor contact and at the 6-8 week review our overall breastfeeding rates have increased from 31% in 2022, to 31.7% in 2023. This means that more babies in North Ayrshire are receiving breastmilk that at any time since the start of tracking this data. Rosemount Project From 1st April 2023 to 31st March 2024, the Rosemount Project received referrals to work with 127 families across North Ayrshire. There were nine referral sources,
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14 with the Three Towns Children & Families (C&F) locality the most prolific referral source (28%). This was followed by the Families for Children team (25%), and then by the Irvine C&F locality team (20%). The varied referral sources out with this were – the Garnock Valley/North Coast C&F team (14%), Kilwinning C&F team (5%), Service Access/MAASH (4%), Kinship (2%), the Children and Families Disabilities Team (1%), and the Programmes Approach Team (1%). This gives an indication of the diverse needs and complex difficulties that the Rosemount team encounters, working alongside colleagues across our services to support children, young adults, and parents/carers in different settings, each with their own challenging circumstances. There has been a significant uplift in referrals from the Families for Children team from the previous year, which is partly due to Rosemount having ongoing access to a Family Wellbeing Support Worker, whose post is funded via The Promise. The need for this post has been influenced by both the findings from the independent care review in Scotland, and lobbying by sibling’s rights groups, which has informed amendments to the Children (Scotland) Act 1995. The service will continue to work towards the implementation of Signs of Safety, with a focus on how we can work even more effectively with colleagues, parents/carers, and wider family networks to ensure as many children as possible are supported to remain within their communities and at home with their families. School Nurse All school clusters in North Ayrshire have at least one school nurse aligned to them offering support to children and young people in line with the national pathway. School nurses can offer support in relation to: • Child protection • Looked after children and young people • Low level mental and emotional wellbeing • Domestic violence • Sexual health and relationships • Justice • Homelessness • Transitions • Young carers • Substance use The school nursing team has responsibility for offering all school-aged children and young people who are looked after, either at home or away from home, an initial health assessment which is followed up with an annual review. During 2023/24, 75% of looked after young people in North Ayrshire had been offered a health assessment, a significant improvement on previous years. The service has also been developing innovative ways to improve accessibility for young people including
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15 the use of QR codes for self-referrals, and the testing of a podcast to share health and wellbeing information for care experienced young people Childhood Immunisations Throughout 2023/24, the team continued to fully deliver the routine childhood immunisation schedule to eligible children and young people in North Ayrshire. Whilst our uptake rates are good, we continued to see differences in rates between communities. The team is implementing some new approaches, including offering weekend appointments to try and address this. In the last 12 months European countries saw a resurgence of measles. As a preventative measure, additional clinics were delivered in March for North Ayrshire families where children had not received the Measles, Mumps and Rubella (MMR) vaccines in line with the schedule. This was supplemented with a large-scale media campaign to promote MMR uptake. The seasonal flu programme for children and young people was delivered during September and December and vaccination uptake in North Ayrshire was higher than the Scottish average.
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16 Key Performance Indicators Child Protection 2018–19 2019–20 2020-21 2021–22 2022-23 2023-24 Child Protection Concerns 920 849 885 756 570 361 Child Protection Investigations (CP1s) 374 447 443 432 375 197 Child Protection Initial Conferences 126 123 121 119 76 83 Pre – Birth Conferences 43 41 29 34 17 22 CP Initial/Pre-Birth Conferences 4 7 4 9 1 Looked after Children 2018–19 2019–20 2020-21 2021–22 2022-23 2023-24 Children newly accommodated in North Ayrshire 69 84 63 49 61 46 ** Where the number of children accommodated = the number of children either admitted into any placement type except “At Home with Parents”/”With Friends/Relatives” OR moved from “At Home with Parents”/”With Friends/Relatives” to any other placement type 2018–19 2019–20 2020-21 2021–22 2022-23 2023-24 Foster Carers 104 98 103 99 96 105
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17 Permanency Planning 2018–19 2019–20 2020-21 2021–22 2022-23 2023-24 Number of permanency plans approved - 30 10 21 19 15 Adoption – approved and placed 10 3 8 5 7 4 Adoptions granted 7 8 4 5 5 7 Permanence orders approved 7 11 3 7 7 7 Permanence orders granted 9 8 0 1 2 9 2018–19 2019–20 2020-21 2021–22 2022-23 2023-24 Children Subject to Compulsory Supervision Orders 395 393 351 342 298 271 2018–19 2019–20 2020-21 2021–22 2022-23 2023-24 Children with Compulsory Supervision Orders Terminated 157 140 102 101 102 117 Emergency Placements 2018–19 2019–20 2020-21 2021–22 2022-23 2023-24 Child Protection Orders 25 32 39 11 18 14 Secure Placements 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022-23 2023-24 Number of secure placements 1 4 1 2 0 2
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18 Justice Services 2018–19 2019–20 2020-21 2021–22 2022-23 2023-24 Number of reports submitted to the courts (CJSW reports, Section 203, Short Notice CJSW & Supplementary CJSW) 754 763 430 606 606 668 Number of home leave and background reports submitted 114 (49 leave reports, 65 background reports) 151 (66 leave reports, 85 background reports) 114 (39 leave reports, 75 background reports) 93 (30 leave reports, 63 background reports) 91 (28 leave reports, 63 background reports) 112 (41 leave reports, 71 background reports) Unpaid Work Requirements 403 360 94 172 313 310 2018–19 2019–20 2020-21 2021–22 2022-23 2023-24 Level 1 Mappa 181 163 152 172 190 174 Level 2 Mappa 2 7 10 14 27 11 Level 3 Mappa 1 5 3 7 2 2
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19 2.2 Adults North Ayrshire Drug and Alcohol Service The North Ayrshire Drug and Alcohol Service (NADARS) has continued to demonstrate high levels of performance by meeting national and local standards and targets, such as access to treatment waiting times, provision of alcohol brief interventions (ABIs), the roll-out of Naloxone supplies and increasing patient choice regarding Opiate Substitution Therapy (OST) medications. The team continues to identify new ways of working to provide a more agile and streamlined service and further improve performance. This work has been evidenced by the delivery of early intervention services in the delivery of Alcohol Brief Interventions (ABI) in both priority (Primary Care, A&E and Antenatal) and wider settings.
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20 North Ayrshire Model for Enhanced Intermediate Care and Rehabilitation (eICT) The North Ayrshire Model for Enhanced Intermediate Care and Rehabilitation (eICT) utilises multidisciplinary holistic interventions to focus on providing high-quality care and support, through proactive early intervention and preventative action. They aim to assist patients presenting with falls, frailty, low grade infections and general functional decline to avoid hospital admission where possible and facilitating early discharge home from hospitals. The North Ayrshire Enhanced Intermediate Care Team brings together the expertise of dedicated Physiotherapists, Occupational Therapists, Technical Instructors, Dieticians, Community Psychiatric Nurses, Pharmacists, Admin workers, Rehabilitation Nurses, Advanced Nurse Practitioners, and Intermediate Care GP with special interest into one single multidisciplinary and interdisciplinary team; focused on problem-solving for patients in their own homes across all of mainland North Ayrshire. The seven-day rehabilitation service facilitates early discharge from hospital and provides a rapid Indicator 2021-22 2022-23 2023-24 Target set by Scottish Government – Priority Settings 3,420 3,420 3,420 Total ABI delivery in Priority Settings (Ayrshire & Arran) 5,776 4,933 6,398 Indicator 2021-22 2022-23 2023-24 Target set by Scottish Government in Wider Settings 856 856 856 Total ABI delivery in Wider Settings (Ayrshire & Arran) 1,027 1,207 1,210
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21 alternative to acute hospital admissions. The Enhanced part of the team addresses medical and clinical issues that limit a patient’s ability to engage in rehabilitation via a shared care model with the patients registered GP. Learning Disabilities Trindlemoss Day Opportunities continues to make good progress with regard to furthering the diversity of opportunities it can link its customers to, including the opening of its Community Café and Baristamoss, as well as the Glam Hideaway, all of which provide opportunities for skill development and enjoyment for individuals. Trindlemoss Day Opportunities has also been a contributor to the successful delivery of the How We See Ourselves poetry/art animation project, within a project led by Neighbourhood Networks. Following a successful run of the associated exhibition within the Harbour Arts Centre, the animations and interview linked to that work are now viewable on the NAHSCP’s Youtube channel. Ward 7A has also successfully completed its collaboration with the Glasgow School of Art around the implementation of an internship within the ward for 2 students, focused around the theme of connected transitions. The Learning Disability service continues to experience workforce pressures across a number of its elements, in particular Trindlemoss House: within that setting, a number of vacancies are currently unfilled, including 3 Band 5 posts. Recruitment and retention issues are also evident within Ward 7A. While 2 newly qualified nurses started in November, this still leaves 1.86WTE vacancies, as well as creating a new balance with regard to skills/experience mix which will need accommodated. Further fragility is introduced by the need to cover maternity leave as well as the departure of 2 experienced Support Workers to join Foxgrove. Care at Home The Partnership’s Care at Home Team continue to offer exceptional support to the people of North Ayrshire. The Care at Home service has registrations split over two areas on a locality basis. In November 2023, The Irvine, Kilwinning, Garnock Valley and Community Alarm localities were inspected by the Care Inspectorate, receiving very positive feedback that staff demonstrated “passion and commitment to providing the best
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22 care possible” noting service users and their families spoke “warmly and gratefully for the services they received and the difference [it] made to their lives”. The inspector also recognised the good partnership working between the team and District Nurses, GP's, the Hospice, and many others – all with the goal of supporting and meeting the needs of our service users. The inspection found that staff spoke of their pride in being part of the service, of job satisfaction and of making a difference to service users’ daily lives, recognising the guidance, training, and development they received to help them do so. Staff were invited along to an open day at Castleview Hub in Ardrossan in June to have a look around NAHSCP’s newly refurbished training hub for Care at Home staff. Housed in the former Castleview Day Services building in Glasgow Street, the facility will act as a hub for staff working within the service to learn the essential moving and handling skills they require in their day-to-day role, allowing them to move and position clients safely, respectfully, and in a way that promotes their independence, dignity and functional mobility. Carers On Carers Rights Day, a fantastic event was held at West Kilbride Village Hall to launch the expanded North Ayrshire Carers Gateway service. Attended by carers, staff of the Carers Gateway and NAHSCP, representatives from Third Sector organisations, North Ayrshire Provost Anthea Dickson and North Ayrshire Carers Champion Councillor Nairn McDonald, the event offered a chance to network, hear more about the service and find out more about additional sources of support locally. Having delivered services to North Ayrshire’s unpaid carers for over 20 years, Unity’s wealth of experience in supporting those caring for family members and friends has led to them successfully being awarded the contract to deliver support for a further period of three years, with significant resources being provided by NAHSCP to expand, improve and rebrand the services offered to both adult and young unpaid carers. This substantial investment will see a number of positive changes, including a three-fold increase in the number of support staff, increased routes to carers assessments and support, and the development of more community-based outreach services. This will see
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23 unpaid carers being able to access support closer to home in places they already visit and includes a dedicated worker for residents on the Isle of Arran. With an estimated 14,000 unpaid carers in North Ayrshire, the new outreach service will provide extended opportunities for Unity to reach more carers, in more places, in more ways and actively seek to connect with carers not yet known to them. Money Matters Our Money Matters Team once again supported the most vulnerable people in our communities, accessing entitled benefits to the incredible sum of £20,081,590.91, an increase of over £1.5 million pounds from 2022-23. In total 5,739 referrals were received in 2023/24.
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24 Mental Health NHS Ayrshire and Arran Child and Adolescent mental Health Services (CAMHS) fully implemented the NHS Scotland National CAMHS Service Specification published in February 2020 on the 1st August 2023 after papers going to each of the 3 IJB’s (Integrated Joint Boards) between March and May 2023. The specification describes the role of CAMHS as providing access to multi-disciplinary teams that provide: • Assessment and treatment/interventions in the context of emotional, developmental, environmental, and social factors for children and young people experiencing mental health problems. • Training, consultation, advice, and support to professionals working with children, young people, and their families. As a Tier 3 service CAMHS will see young people who present with mental health problems that are causing significant impairments in their day-to-day lives. Prior to the implementation of the specification CAMHS saw an all-time high number of referrals in June 2023 of 330 and 69% of these were requesting a Neuro assessment. All these young people needed to be seen within 18 weeks and involved additional assessments by all clinicians and even some of the Team Leaders and Service Managers did assessments. CAMHS in Ayrshire Referral to Treatment is the best in Scotland sitting at between 3-4 weeks to be seen for initial assessment and the teams are continuing to work on all the waiting lists within the service. N-CAMHS specifically see those children and young people whose Neurodevelopmental Disorder co-exists with a clearly defined and treatable mental–illness. This service offers specialist clinical support, assessment and diagnosis for children and young people experiencing the combined challenges of mental ill-health with conditions such as Autism or Attention Deficit Hyperactivity Disorder (ADHD). CAMHS are working alongside health, social care, education and NEST (Neurodevelopmental Empowerment & Strategy Team) in the 3 Ayrshire’s to ensure young people who are referred for a Neuro assessment, that do not meet the CAMHS Specification, are sign posted to the relevant services and supports. CAMHS Urgent Assessment & Intensive Treatment service operates across seven days which complements our more traditional service model. CAMHS workforce continues to evolve to meet the service need and the employment of Advanced Clinical Nurse Specialists, Pharmacy Prescribers and Nurse prescribers have significantly helped CAMHS over the last year when there have been a shortage of psychiatry staff and medication.
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25 Accommodation West Road in Irvine will be the new Specialist CAMHS Assessment & Treatment Centre for Ayrshire as well as the operational base for the Community Eating Disorders Services by September 2024. Open seven days per week specialist CAMHS Neuro, ADHD, play Therapy and other Clinical Interventions will be delivered from this re-fitted facility. Hosting flexible working space for staff with 5 clinic rooms and two large meeting rooms, it is envisaged that the facility will become a centre of excellence in the care and treatment of child and adolescent mental ill-health and eating disorders. Accommodation for the Unscheduled Care Service remains a challenge. The wider CAMHS Service will also require a review of accommodation in due course and the service aspires to a specific facility for the care and treatment for moderate to complex mental ill-health. CAMHS continue to explore the feasibility of providing in-patient care for children and young people closer to home in Ayrshire. Suicide Prevention Preventing Suicide in North Ayrshire: ‘Creating Hope Together: Scotland’s Suicide Prevention Strategy 2022-2032’ Staff from across North Ayrshire HSCP were joined by colleagues from NHS A&A, East and South HSCPs and Third Sector partners for a suicide prevention event at Saltcoats Town Hall in October. The theme of the event was ‘Creating Hope Together’, recognising that suicide prevention is everybody’s business and that we can all take action - no matter how big or small - to prevent suicide. The aims of the day were to encourage discussion and generate ideas for taking action to prevent suicide in North Ayrshire; share our knowledge so far about suicide prevention and highlight areas of good practice; inspire a call to action across all sectors to work and learn together to drive change in North Ayrshire, and consider what more can be done to prevent suicide and identify the support needed to ensure everyone can play their part. As well as staff from NAHSCP/NAC/NHS A&A, representatives of Arran CVS, Dalry Men’s Shed and dsm-firmenich also delivered thought-provoking presentations on the day, with attendees taking part in two workshop sessions that will help to shape our next steps. Self-Directed Support & Ayrshire Independent Living Self-Directed Support (SDS) & Ayrshire Independent Living: For the reporting year 2023/24, the following information indicates how people have arranged and directed their support in North Ayrshire. Self-Directed Support offers 4 options. These are: • Option 1 – a direct payment, which is a payment to you or third party to pay for your own support
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26 • Option 2 – you direct the available support • Option 3 – the local council arranges the support • Option 4 – a mix of the above This continues to demonstrate that traditional support options are offered and accessed most with 87% of people receiving Option 3, where little choice and control is exercised and support is chosen, arranged and directed by the Health and Social Care Partnership. North Ayrshire Health & Social Care Partnership has awarded a final contract extension year on a pan Ayrshire basis to continue to commission independent SDS advice and information services from Ayrshire Independent Living Network (AILN). In the calendar year 2023 AILN reported supporting 457 people with 30% resident in North Ayrshire. Almost 180 new referrals were received across Ayrshire from people seeking information and guidance on how to direct their care. AILN have also continued to support partners such as social care teams as well as student and new workers, dementia services, attended jobs fairs at Lockart Campus and hosted a Transitions Event with Equal Employment. The service development work of AILN has been framed into a Business Action Plan 2023 – 2025 which has been shared with the 3 Local Authorities to work in partnership. Older Peoples Day Services Alzheimer’s Scotland commenced a new agreement for the delivery of day services from its Ardrossan service and, with an increase in staffing and the introduction of transport to the service; is able to operate at full capacity offering day services provision across 7 days per week. This compliments the development of a revised model of Older People’s day services which commenced in Quarter 1 to fully recruit to deliver an enhanced outreach model of
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27 day opportunities. This also includes a day services pilot on the island of Arran, offering an outreach day service in the more remote villages. Community Link Workers Community Link Workers continue to support people age 16+ on a wide range of issues affecting health and well-being, such as money worries, unemployment, social isolation, bereavement, alcohol, and drug use, managing stress, low mood and anxiety and living a healthier lifestyle. Over 2,000 clinics were provided in North Ayrshire GP Surgeries with over 6,000 patient contacts made. Community Link Workers have increased their reach by being involved in the roll out of North Ayrshire Council’s No Wrong Door policy, this policy builds on existing efforts to ensure that residents can access the funding or support that they need during the cost-of-living crisis. Residents can now access advice and support from a number of key services including, financial inclusion, employability, homelessness, digital access/skills and community link workers, by completing a simple online form. As part of for this initiative the team worked closely with the NAHSCP communications officer to create an online A-Z list of services that can assist with a wide range of wellbeing, emotional and practical support services. This addition to the NAHSCP has been well received and is now one of the most viewed pages. The webpage can be found here. Trindlemoss Day Opportunities A group from Trindlemoss Day Opportunities achieved a Gold Award as part of the RSPB’s Wild Challenge Awards programme. Stewart Baird, Mark Stevenson, Darren Cousar and Elaine Rae have been busy taking part in the scheme, which has seen them discovering, learning about, and helping wildlife in its natural habitat.
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28 Having already completed the Bronze and Silver levels, the team worked extremely hard over a number of weeks to achieve the highest accolade in the Gold award, with each level of the programme requiring the completion of a total of six activities. Each award level is split into two categories, a ‘Help Nature’ section that involves making our outdoor spaces wildlife friendly, and an ‘Experience Nature’ section, where participants get up close and personal with wildlife and explore the amazing world of nature on our doorsteps. The group took part in a host of activities throughout the challenge, including building bat boxes, bird boxes and bee houses, local plant and mini-beast safaris, and creating a fantastic mini-pond within the garden area at Trindlemoss. They’ve also enjoyed a visit to Eglinton Park, where they tried pond dipping and discovered some newts, as well as RSPB Lochwinnoch to explore the various wildlife habitats there. Alcohol and Drugs A report from North Ayrshire Drug and Alcohol Recovery Service (NADARS) and North Ayrshire Alcohol and Drug Partnership (NAADP) has highlighted some of the positive work being undertaken to prevent drug and alcohol related deaths locally. The report details some of the work carried out over the past year, including the ongoing implementation of the Scottish Government’s Medication Assisted Treatment (MAT) Standards, providing additional support to individuals following a non-fatal overdose, increasing access to residential rehabilitation programmes, and the continued roll-out of the life-saving medication Naloxone across North Ayrshire, which reverses the effects of an opioid overdose. In addition, the report outlines local and national drug and alcohol related targets and standards, all of which were met in North Ayrshire during 2022-23. In March 2023, 96 percent of clients commenced treatment to support their recovery within 3 weeks of being referred (against a national target of 90 percent), with100 per cent of clients waiting less than six weeks, again meeting the national target. North Ayrshire had also been set a target of increasing the number of individuals in treatment from 882 in 2020 to 959 by March 2024, with 2023 figures (1011) already exceeding the 2024 target. An additional target of supplying 420 Naloxone kits in North Ayrshire during 2022-23 was also exceeded, with 846 kits distributed. 31 lives were reported to have been saved in North Ayrshire due to the use of Naloxone during that period, however this number could be significantly higher, as lives saved via the use of Naloxone often go unreported.
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29 Medication Assisted Treatment availability, where individuals have the option to start a treatment of their choosing from the day of presentation – as well as receiving psychological and social support – was expanded during 2022-23 to include all six North Ayrshire localities. National and NAADP funding has allowed the recruitment of additional staff to help deliver this, including addiction workers, additional prescribing capacity and recovery development workers with lived experience. Access to local residential rehabilitation is provided by Ward 5 at Woodland View in Irvine, which has ten beds for residential care for anyone who has an alcohol and/or other drug problem and mental health issues. Ward 5 provides access to residential detoxification, rehabilitation and day attendance support, with seamless pathways of support in place for individuals before, during and after their placement via local community alcohol and drug services. In addition, North Ayrshire Health and Social Care Partnership was instrumental in supporting Phoenix Futures to open Harper House in Saltcoats in 2022, which provides additional residential rehabilitation support for vulnerable families, who can stay together at the facility. The past year has also seen a focus on providing access to external residential rehabilitation, with national funding having been made available to NAADP. Individuals wishing to access this can now do so through NADARS, who will support the development of a care plan, identify a suitable provider, seek funding and support individuals into, throughout and after their placement. Dads’ Support Worker The recruitment of a Dads’ Support Worker within the integrated Universal Early Years’ team will allow an expansion of the offer of early help for children under the age of 5 and their families, which has been recognised by the Scottish Government as an example of good practice. The post will be responsible for developing and delivering specific programmes for Dads, including practical parenting workshops; working in partnership with Dads Rock and learning from the established programmes and approaches they have developed. The post will aim to test how, from an early years’ perspective, we can better engage with dads and other male caregivers to encourage a more active parenting role. Community Wards The Community Wards continue to embark on a number of initiatives to improve the experience of their patients. The efforts of the Ward 2 team (Ayrshire Central Hospital) has been so successful their work has secured a ‘Greatix Award’ – a network which celebrates excellence. The award recognises that having identified that the number of acquired pressure ulcers was well above the normal, interventions were put in place, which over a period of only 6 months not only reversed the trend, but reduced incidents to below previous levels. The team has now also appointed ‘Pressure Ulcer Champions’ to continue this excellent work.
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30 Out of Hours Social Work Service The Ayrshire Out of Hours Social Work Service has now been operational for 12 years. Despite another challenging year with increased and more complexed referrals, as well as ongoing issues with recruitment and absence, the team have continued to provide uninterrupted service throughout this period. Recruitment for vacant posts was concluded in March 2024, and there is now full complement of staff, with 18 sessional staff members supporting service delivery. During the period from 1st April 2023 to 31st March 2024 there were a total of 9,094 referrals made to the service. These are broken down as below: Date Period North Ayrshire South Ayrshire East Ayrshire Total 2019-2020 4219 2460 2955 9634 2020-2021 4165 2337 2800 9302 2021-2022 4000 2202 2613 8815 2022-2023 3185 1783 2366 7334 2023-2024 3832 2103 3159 9094 During the same period in 2023 there were a total of 7334 referrals from Out of Hours to Day Services. These were as below: North Ayrshire 3185 South Ayrshire 1783 East Ayrshire 2366
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31 2.3 Criminal Justice Prevent Multi Agency Panel As a result of having an established Prevent Multi Agency Panel (PMAP) process North Ayrshire are one of only 3 HSCP’s in Scotland to be selected to participate in the PMAP Hydra training sessions that the Home Office and College of Policing run nationally for PMAP Chairs, their Prevent Police colleagues and standing panel members. Training has been well received and is a key element of their response to the Parsons Green findings. As part of a national training programme, and as part of professional development, the HYDRA training has been redesigned this year incorporating much of the feedback received from practitioners. The Hydra training took place in Glasgow in March and is a training platform originally developed for the Police, providing decision-making training for Police functions ranging from investigations to child protection to kidnap situations. The Home Office and College of Policing developed a one-day PMAP-specific training package. The training was a great opportunity to upskill and maintain the focus of colleagues from partner agencies and remind colleagues across the authority of the importance of engaging with PMAP. Recruit with Conviction North Ayrshire Council has received Recruit with Conviction Ambassador status. Working in collaboration with the organisation, ‘Recruit with Conviction’, North Ayrshire Council’s new Ambassador status recognises efforts to offer safe and sustainable employment for individuals with current/historical convictions, ensuring that our internal policies and practices are both current and proportionate. Koestler Awards A group of six clients of North Ayrshire’s Unpaid Work team have received recognition certificates from the Koestler Awards for their original artworks, with one participant also receiving a Highly Commended certificate for a unique wooden birdhouse. The Koestler Awards for arts in criminal justice started in 1962. Each year, over 3,500 people in custody and in the community share their creative work by taking part. The Koestler Awards provide feedback and encouragement to entrants of all abilities in visual art, design, writing and music.
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32 Refugee Support Team North Ayrshire continues to welcome New Scots into our local communities. Our Refugee Support Team, alongside multi agency partners continue in their endeavours to help all integrate into their local communities, making everyone feel safe and included. During August we hosted two events to support our families from Syria and Ukraine to become more familiar with their local community and local attractions, in order to support their health and wellbeing. 20 Ukrainian families and 16 Syrian families attended. Please click on the link for more detail in relation to these events. New Scots Summer Fun Community Payback Orders The latest Government statistics on Community Payback Orders (CPOs) (2022-23) show that North Ayrshire had the highest of the Ayrshires with 490 CPOs however was the median of the Ayrshires at 47.3 per 10,000 population. In comparison, East Ayrshire had 488 CPOs and sits at 51.4 per 10,000 population and South Ayrshire had 399 CPOs and sits at 46.2 per 10,000 population. The Scottish average is 33.0 per 10,000 population. There was a significant decline in the number of Criminal Justice Social Work Reports (CJSWs) in 2020-21 thought largely to be due to the result of COVID-19, however numbers rose by 40% from the previous year in 2021-22 and continued to rise in 2023- 24, albeit at a lesser rate of 15% from the previous year. The latest Government statistics on CJSWs for 2022-23 reveal North Ayrshire to continue to be the lowest of the Ayrshires at 75.7 per 10,000 population. In comparison, East Ayrshire sits at 81.9 and South Ayrshire sits at 85.2. The Scottish average is 68.6 per 10,000 population. Our Justice Services continue to have a positive impact on the local community through the Community Payback Order (CPO) unpaid work scheme. For over a decade, the eleventh year in fact we have continuously over-achieved against targets for CPO level 1 and level 2. 2023-24 saw 73 out of 75 level 1 CPO’s completing within timescales and 146 out of 152 level 2 CPO’s completing within timescales. The targets set for unpaid work are pan-Ayrshire targets.
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33 Drug Treatment and Testing Order Following a slight ‘dip’ in Drug Treatment and Testing Order (DTTO) Assessments in 2022-2023, the following chart illustrates a marked increase in the recent financial year, with sentencers at both Ayr and Kilmarnock Sheriff Court requesting these reports more regularly due to recent successes and the service adapting to incorporate changes in recent drug trends from depressant substances to stimulant, thus taking into consideration a host of differing offence-types and the focus of therapeutic interventions to promote change. Of the 66 individuals assessed, 47 Orders were imposed across Ayrshire. Due to the nature of the Order, rigorous supervision and much support is provided to all and more recently through the employment of two Recovery Development Workers from CORRA Funding, we have now incorporated active outreach, additional practical supports and community reintegration to complement our existing service. Success is not only measured through an absence of offending behaviour but also progress being made in several areas of life to ensure resilience and to promote longer- term lifestyle changes.
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34 Diversion from Prosecution Diversion from Prosecution (Diversion) has been available since 1997, within this past year we have experienced a further increase across Ayrshire in assessment referrals from the Procurator Fiscal. Referrals have increased at a significant rate from 2018. Although this disposal is early intervention and low-level offending, the presenting need of service users is extremely high, thus resulting in more staff time being allocated and closer partnership working with other agencies to provide identified services. The number of assessment reports submitted are relatively lower than the number requested due to limited resources, which has resulted in waiting lists within each local authority area. In comparison with last year, 2023-2024 notes a decrease in the number of Diversion cases imposed. This is due to delays from the time that the offence was committed until the individual is referred to and assessed by the Diversion team. In this time many positive changes could have taken place and individuals are actively seeking and engaging with services to address any issues which they may have, thus reducing their risk of further offending. In these instances, no interventions are required due to positive reasons.
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35 Key Performance Indicators MHO Service Mental Health (Care and Treatments) 2003 2018–19 2019–20 2020–21 2021-22 2022-23 2023-24 Emergency Detentions 54 54 81 96 92 99 Short Term Detentions 74 67 134 There have been a total of 171 requests (of which consent was given to 134, with the other 37 being assessed but consent not given) There have been a total of 127 requests (of which consent was given to 108, with the other 19 being assessed but consent not given) There have been a total of 182 requests (of which consent was given to 151, with the other 31 being assessed and consent not given)
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36 Compulsory Treatment 38 51 59 There have been a total of 70 new CTOs granted (of which 27 had been Interim CTOs, with 14 of these moving to full CTO following a further Mental Health Tribunal) There have been a total of 60 new CTOs granted (of which 17 had been Interim CTOs, with 12 of these moving to full CTO following a further Mental Health Tribunal) There have been a total of 47 new CTOs granted (of which 10 had been Interim CTOs, with 4 of these moving to full CTO following a further Mental Health Tribunal) Warrants Undertaken 1 6 6 4 4 3 Criminal Justice Act Scotland 1995 2018–19 2019–20 2020–21 2021-22 2022-23 2023-24 Compulsion Order and Restriction Order 4 3 3 2 0 0 Compulsion Orders 2 6 6 3 3 3 Hospital Directions 1 1 1 0 0 0 Assessment Orders 2 2 2 6 5 6 Treatment Orders 4 2 2 6 2 3 Transfer for Treatment 2 1 3 1 1 1
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37 Adults with Incapacity Act (Scotland) 2000 2018–19 2019–20 2020–21 2021-22 2022-23 2023-24 Private Welfare Guardianships 411 (58 new) 272 (67 new) 314 (57 new) 402 (102 new) 371 (99 new) 422 (125 new) CSWO Guardianships 40 (16 new) 64 (24) 71 (24) 91 (26) 85 (27 new) 121 (54 new) Financial Intervention Order (LAG) 26 31 n/a n/a n/a n/a MHO Report PWG Application 38 104 75 156 139 141 Adult Protection 2018–19 2019–20 2020–21 2021-22 2022-23 2023-24 ASP Referrals (AP1) 457 568 558 643 722 915 ASP Investigations (AP2) 88 108 132 102 72 112 ASP Case Conferences 47 66 64 40 41 57 Protection Orders 1 0 3 1 0 1 Adult Concern Reports 1838 2335 2215 2070 2370 2103
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38 3. Resources 3.1 Financial Pressures The Scottish Government published an updated Medium-Term Financial Strategy (MTFS) in May 2023 which covers the period to 2027-28. It compares the funding and spending scenarios to assess the scale of the challenge. The role of the MTFS is to set out Scotland's fiscal outlook over the coming years, including financial opportunities and risks that may impact on the fiscal position. In line with the recommendations of the Budget Process Review Group, the document does not set out new spending plans or explain how prioritisation decisions will be made to meet policy objectives. These decisions are made in the Scottish Government budget. The Scottish Government’s funding is comprised of five high level categories: 1. The Block Grant – this is the single largest source of funding for the Scottish Government. The Barnett Formula determines the Block Grant and annual growth is dependent on the UK Government’s overall fiscal plans and its spending priorities. 2. Devolved taxes – the Scottish Government receives the revenue from these taxes, the largest of which is Scottish Income Tax. The Scottish Budget is then reduced based on how quickly revenues of the corresponding tax have grown in the rest of the UK (rUK) on a per head basis. 3. Non-domestic rates (NDR) – this revenue is raised by Local Authorities on non- domestic properties. All revenue raised is ultimately returned to Local Government via the Local Government Settlement. 4. Social Security Block Grant Adjustments – this is funding provided by the UK Government for devolved social security payments, based on the growth in expenditure on the corresponding payment in UK on a per head basis. 5. Other income and expenses – other revenue and costs including resource borrowing and associated costs as well as revenues from the Scottish Crown Estate The MTFS notes that the funding available to Scottish Government is expected to grow steadily from £45,260 million in 2023-24 to £50,971 million by 2027-28, an overall cash increase of 12.6% and real terms increase of 6.8%. This is due to increases in the Block Grant and significant growth in the net tax position over this period. However, these increases will vary significantly between years. Pressures on funding will be most severe in 2024-25 when overall resource funding (including NDR) is forecast to grow by only 1.2% in real terms. The Scottish Government MTFS models three scenarios (a central resource funding outlook and an upside and downside scenario, indicating plausible alternative funding paths) and outlines the immediate and longer-term pressures on public spending which need to be considered when developing spending plans to ensure that they meet the needs of a changing population and build resilience for the future.
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39 The Scottish Government intends to publish an updated Medium-Term Financial Strategy during 2024, alongside a refreshed Medium-Term Financial Framework for Health and Social Care. These documents were scheduled for publication in June but have been delayed due to the General Election in July. These will form the basis of the funding assumptions in the next update of our Medium-Term Financial Outlook which will cover the period 2025-2028. 2024-25 Budget As part of the Scottish Government budget and finance settlement funding letters were issued to NHS Boards and Councils, these detailed the requirements in relation to the level of funding to be delegated to IJBs in 2024-25. The specific requirements are as follows: • Compared to 2023-24 budgets, territorial NHS Boards will receive a total increase of 4.3% for 2024-25 to cover costs related to the 2023-24 pay deals, as well as the baselining of £100 million sustainability and NRAC funding provided in 2023-24. • The Partnership receives an appropriate share of the pay award funding, and this is already included in our base budget calculation; the sustainability and NRAC funding is not shared with the IJB. • The funding letter also notes that additional funding is expected to be provided when the 2024-25 pay award is settled and the expectation is that the IJB will receive an appropriate share of any pay award funding. • The Health and Social Care Portfolio will transfer net additional funding of £241.5 million to Local Government to support social care and integration. The overall transfer to Local Government includes additional funding of £230 million to deliver a £12 per hour minimum pay settlement for adult social care workers in private and third sectors, in line with the Real Living Wage Foundation rate. In addition, an inflationary uplift on Free Personal Nursing Care rates (£11.5 million) is provided. These amounts are reflected in the North Ayrshire Council figures. • The funding allocated to Integration Authorities for Free Personal and Nursing Care and adult social care pay in third and private sectors should be additional and not substitutional to each Council's 2023-24 recurring budgets for adult social care services that are delegated. Where there is evidence funding is not passed across to be used for the policy intent, the Scottish Government reserves the right to look at reclaiming funding allocated. • In previous years territorial health boards have received a baseline uplift on core budgets, for example in 2023-24 this was 2%, and on that basis, there was a specific directive from Scottish Government that payments to IJBs for delegated functions delivered the same uplift. As noted, for 2024-25 the Scottish Government has committed the £100 million sustainability funding for non-pay costs, but beyond this and the NRAC funding provided in 2023-24, Boards will be expected to manage pressures within existing envelopes and there will be no new baseline funding uplift. On this basis, there is no funding uplift from NHS Ayrshire and Arran for 2024-25.
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40 The IJB approved a one-year balanced budget for 2024-25 on 14 March 2024. More information about the 2024-25 Budget. This budget included new budget pressures for health and social care services totalling £16.131m. These were developed in partnership, with Finance supporting front line services to identify current and emerging financial pressures considering historic demand and costs and potential future variations. The provision of funding for pressures has the impact of increasing the budget gap to be addressed through savings, therefore the pressures are only included in budget plans where these are absolutely unavoidable. The new cost and demand pressures resulted in a requirement to identify and approve additional savings of £10.290m 3.2 Financial Performance Strong financial planning and management is paramount to ensure our limited resources are targeted to maximise the contribution to our objectives. Delivery of services in the same way is not financially sustainable. The updated strategic plan approved for 2022-30 is underpinned by the need to learn from the pandemic and ensure opportunities are maximised to transform care models and find new solutions to ensure the future sustainability of high-quality heath and care services. The ability to plan based on the totality of resources across the health and care system to meet the needs of local people is one of the hallmarks of integrated care. Medium term financial planning is key to supporting this process and identifying the transformation and planned shift in resources to provide sustainable services to the local community over the medium term. In 2023-24 the IJB agreed a one-year balanced budget which included an overall savings requirement of £6.215m. Financial information is part of the performance management framework with regular reporting of financial performance to the IJB. This included an integrated approach to financial monitoring, reporting on progress with savings delivery, financial risks and any variations and changes to the delegated budget. There were significant financial challenges during the period. The main challenges during the year were residential placements for children, care at home, supplementary staff in wards and Unplanned Activities (UnPACs) within the lead partnership for mental health. From the initial budget monitoring report in month 3 the projected position has been an overspend. The Integration Scheme requires the preparation of a recovery plan if an overspend position is being projected to plan to bring overall service delivery back into line with the available resource. Heads of Service have closely reviewed expenditure and have implemented actions which have reduced some areas of overspend, however these areas of improvement have been countered by adverse movements in Care at Home, Integrated Island Services, Wards 1 and 2 at Woodland View, UNPACS and intervention services.
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41 As a contingency there was provision of £2m non-recurring funding set aside in the reserves contribute towards the 2023-24 position and this has been applied. The overall financial performance against budget for the financial period 2023-24 (after adjusting for new earmarked reserves) was an overall overspend of £7.464m. This consisted of £6.634m of overspend in social care services and £0.830m overspend in health services. Our health and social care services should reflect and respond to the needs of local people. To support this, we will help to build greater capacity in our communities and provide more ways for service users and local people to share their views with us to help shape services. We are fully committed to planning and designing services together with local people, our staff and our key partners including acute health services, housing, community planning and the third and independent sectors. Growing evidence suggests that the pandemic has had negative socio-economic effects that have led to increased health inequalities and contributed to an increase in both poor mental wellbeing and mental health. The IJB, through the refreshed Strategic Plan, outlines the belief that together we can transform health and social care services to achieve the joint vision for the future “all people who live in North Ayrshire are able to have a safe, healthy and active life.” Moving into 2023-24, we are working proactively to address the financial challenges, while at the same time, providing high-quality and sustainable health and social care services for the communities in North Ayrshire. 3.3 Medium Term Financial Outlook A Medium-Term Financial Outlook (MTFO) is a critical part of the strategic planning process. The financial context for public services remains very challenging and so it is vital that the IJB’s strategic ambitions are set against the financial resources which are anticipated to be available. The MTFO provides key information on the possible financial position of the IJB over future years. It identifies the financial challenges which will be faced by the IJB enabling the IJB to see the impact of current and future decisions on its medium-term financial health. The MTFO will also be used to identify pressure points and inform decisions which are required to ensure the Partnership remains financially sustainable. There are a range of factors which influence the financial planning of the IJB. These are considered through the MTFO and include the following: • Demographic changes. • Local priorities. • Workforce challenges. • The UK and Scottish Economy.
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42 • Policy and Legislation. • Cost and demand pressures. • Available funding. As in previous years, a Medium-Term Financial Outlook has been prepared to identify what the financial position may look like moving into 2025-26 and 2026-27. The Integration Joint Board, in common with most Public Sector bodies, is facing a period of significant financial challenge with cost and demand pressures. The most significant financial pressures continue to be pay awards for staff, inflationary cost increases for contracted services and demographic changes driving increased demand for services - funding these unavoidable pressures year-on-year drives our savings requirement. There are a number of highlighted financial risk areas that may impact on the 2024-25 budget during the year, these include: • Care at Home overspend. • Current overspend areas, especially in low volume / high-cost services e.g. Children’s residential placements, UNPACs, and supplementary staffing across community, mental health and learning disability wards. • High levels of inflation over several years which have impacted on costs incurred directly by the Partnership and on our partner providers. • Growing demand for services. • Staff recruitment and retention challenges across a number of service areas. • The provider market and the ongoing ability to source packages of care for service users. • The expectation that performance will continue to be maintained or improved despite the significant resource challenges. • Ongoing delivery costs of Scottish Government policy directives, particularly where these are not fully funded or inflation proofed. • The Local Government and NHS pay awards are not settled for 2024-25; as outlined in the report, a 3% increase has been assumed for the social care workforce and for NHS it is anticipated that additional funding will be allocated once the pay award has been settled. If the pay awards are not fully funded then this will present an in-year cost pressure. • Unearmarked reserve balances do not meet the recommended threshold of 2% of annual spend and this reduces the ability to absorb in-year variances. • The ongoing review of the Integration Scheme. • Progress with the work to develop set aside arrangements and the risk sharing arrangements agreed as part of this. • The wider system financial challenges and impact across the whole system, for example the financial position of NHS AA and the decisions taken to reduce the Board’s deficit may have impacts on other parts of the health and care system. These risks will be monitored during 2024-25 and the financial impact reported to the IJB
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43 4. Workforce 4.1 Workforce Planning Following the launch of the HSCP “ Be the Best You Can Be” Learning & Development Strategy (Social Work and Social Care) in September 2023 there has been a clear indicator of the HSCP organisational offer and expectations in relation to professional development for the social work and social care workforce. The strategy outlines our approach to articulating to our practitioners how much we are investing in their development and begins to articulate in broader terms the development of leadership and management capabilities. The issues in relation to professional staff sufficiency remain across all areas of social work both locally and nationally. It is recognised and highlighted most recently by the Social Work Scotland ‘Setting the Bar’ report, which is impacting on the pressure being experienced across all the health and social care systems. The strategy outlines how we can continue to offer annual sponsorship opportunities for the Undergraduate Social Work Degree and widen the sponsorship offer to include Traineeship Programmes and “fast track” routes including the Post Graduate Diploma in Social work. As a direct result of the “Growing Our Own” programme we have 12 employees undertaking a social Work qualification and a further 2 employees who have completed a social work qualification and will graduate in the autumn. To further support the “Growing Our Own” programme we have included opportunities for practitioner to undertake the Practice Development Award in Practice Learning which has resulted in the HSCP having 5 more qualified Practice Educators. As part of the strategy and the Growing Our Own programme there is a visual pathway which demonstrates from school leavers to senior levels what is on offer including the opportunity to undertake an HNC in Social Services & Healthcare and 12 employees were supported to begin this qualification. Following the decision to reshape our strategic approach to the professional development of the workforce with the withdrawal from the Learning Network West on 31st March 2024 there has been an encouraging response from universities and colleges around a more direct way of working. From building relationships, we will ensure SVQ, degree level, post graduate and post qualification contexts continue to be on offer and practice learning opportunities is one of our optimum responsibilities. Our commitment to the provision of Mental Health Officers within the organisation is another key component of the Learning & Development Strategy and with the delivery of the mental health qualification from a different HEI the aim is to offer a more bespoke and flexible qualification with a local context for 4 employees who will be sponsored on this course. The strategy seeks to strengthen the newly qualified first year for Social Workers in cognisance of the directive from the implementation of SSSC Newly Qualified Workers Supported Year. This is critical as the first year greatly influences professional autonomy
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44 and authority which are key to good social work practice. With the introduction of mentoring training and support for teams who will have NQSW’s and an offer to extend our support to NQSW’s from 12 months to 18 months with a monthly planned programme delivered by the social work practice team this will nourish new social workers. Leadership & Role Modelling has been seen as one of the key areas where managers and supervisors can influence professional standards and practice and promote a leadership culture. With Aspiring Leaders Programmes for aspiring/new managers and Systems Management Programmes for senior managers these programmes offer reflective space and coaching to allow practitioners to explore complex systems and leadership at all levels within an organisation. Both of these courses have been delivered with extremely successful outcomes in the development of practitioners. In relation to the key area of Good reflective Supervision outlined in the document “Supervision Standards” have been developed following the ongoing work in relation to supervision practice being undertaken by external consultant Bridget Rothwell. The standards are contained in the “Be The Best You Can Be” Learning and Development Strategy. The Supervision Standards outline expectations in relation to good reflective supervision, values and conduct which can be used to develop bespoke service specific supervision guidance and there is clear guidance around expectations and usefulness of face to supervision provision. The strategy includes an overarching focus on the wellbeing of the workforce and is included as a key component of the supervision standards. In relation to ongoing in house training we have been able to increase the number of courses on offer by more than 100% . The variation of courses on offer has increased following consultation with the workforce and driven by other national agendas including Trauma Informed Practice which has been given considerable consideration and a full training programme being implemented in the Autumn. Following the launch of the strategy the “appetite” for development from the workforce is evident with the participation at events and information sessions. 4.2 Workforce Support and Development The HSCP has recognised the value of employees with lived experience in areas such as drug and alcohol recovery. In November 2023, we held our first peer mentor meeting for our recovery development workers within the organisation. The partnership recognises the impact that individuals with lived experiences bring to our workforce when we are trying to make a difference and reach individuals who are impacted by addiction. Whilst our recovery development workers have had a positive impact on those who require support with alcohol and drug use, we also recognise that we have created a sense of hope, direction and achievement for individuals who previously were very much removed from the labour market due to their history with addiction. We have recovery development workers within our Justice Services and Service Access teams. The following is an extract from a recovery development worker currently employed within Justice Services.
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45 “Just a wee email to say thank you for your patience with me, my jobs amazing and the privileged nature of the roles not lost on me. It has been a life changing thing for me. I’m grateful for the people around me and the good guidance. In all fairness I do absolutely love my job and my role, it has been a total game changer for me. Having a really supportive team around me and good management is the biggest thing I think that has seen me settle and slot into the team as well as I have. It’s a real privilege to work in the place that helped me so much to change my life, I hope to do the same for the people who I come into contact within the role. The fact I’ve got an amazing management who trust me, encourage me, and value my input makes it all the better.” A pilot scheme was set up by the Council’s Your Next Move employability team in partnership with NAHSCP and supported by We Work for Families and Community Enterprise In Scotland (CEIS) Ayrshire. Throughout the six-month-long pilot project – believed to be the first of its kind in Scotland – a group of five young women, who had either never worked or had not been in employment for a long time, completed a five-week course that covered writing a CV, interview practise and an introduction to the care sector. The candidates involved in the innovative scheme, which ended earlier this year, then went on to undertake paid, mentored, vocational placements with North Ayrshire Health and Social Care Partnership, before attending interviews to join the Care at Home team. After success at interview, the group have all now taken up permanent employment within the team, where they have undergone accredited training and are now working shifts for Care at Home that fit in with their childcare needs and other family commitments. A mother of one from Dalry completed the pilot project and said it has been a “life- changing” experience. “It has made a big difference to my life. Before, when I was unemployed and on benefits, I was very stressed about money quite a lot. Now I am not worrying about it anywhere near as much. This scheme is based around my needs, so I work during my wee girls’ nursery hours which has really helped with my confidence because before I felt really isolated being in the house.” All candidates have continued to thrive in their new roles and have become valued members of their teams. A mother of three from Irvine completed the project and reflected on her experience since joining the Irvine Care at Home Team saying: “I have really enjoyed the opportunity I was given as part of the scheme; It really has changed not only my life but also my children’s lives for the better. As a single parent it has given me better financial stability which allows me to enjoy more quality time doing things with my children. I was given all the training and induction to the service that I required, and I felt fully supported throughout the training period, the support I have received since gaining my permanent position from my team mates and care at home
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46 manager has been amazing, they are always there to help me when needed. I have gained valuable experience that I am still building on by undertaking further training opportunities offered to me. I felt welcomed into the team and I now class my colleagues as friends.” Marlene Fleming, Care at Home Manager for The Three Towns, said the pilot has worked brilliantly for everyone involved – the trainees, the service and most importantly those we support in our community. She explained: “Their confidence has been boosted, they are excited to go to work and they go to work with a smile on their face. This has been extremely valuable to the service, supporting the care at home workforce and giving these women much needed experience and skills to help with their future careers. The pilot went extremely well and has really supported the Care at Home team.” North Ayrshire Council’s top priorities include tackling child poverty and supporting residents through the Cost-of-living Crisis. The three key drivers of child poverty are income from employment, income from social security and the cost of living. Councillor Tony Gurney, Cabinet Member for Economy and Climate Change, said: “It is fantastic to see how successful this pilot scheme has been, and I would like to congratulate everyone involved, and wish the candidates well for the future.” The Partnership has experienced significant workforce challenges across the Health and Social Care sector, including and probably the most challenging of these being on the island of Arran. There are a number of plans underway to address current vacancies on the island including specific targeted recruitment campaigns for a number of health and social care vacancies. The new health and social care accommodation, Glenartney, opened its doors in 2023 and has already been a huge benefit in being able to provide high quality accommodation for staff who commute to work on the island. Several managers within the Health and Social Care Partnership successfully completed our Systems Leadership course during 2023/24. There is considerable change and reflection ongoing with regards to how we transform the services we deliver, to ensure we maximise outcomes for services users, whilst working within a very challenging financial climate. The course has been designed to introduce social work and social care professionals to system leadership. The training combines theoretical learning, practical application, and collaborative experiences to equip participants with the tools and strategies needed to work and progress in complex human systems. Programme objectives include creating whole system awareness within the organisation, the creation of a peer learning environment, connecting system leadership ideas and practices, offering a range of practical tools and mental models to work with complex systems and to finally provide
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47 space for personal reflections and for facilitated support to help progress personal and group change objectives. Our commitment to high quality services is underpinned by our excellent workforce. We understand the importance of ensuring our team of dedicated staff are supported and provided with mechanisms that support their health and wellbeing. Our Community Nursing staff were provided with ‘well-being’ experiences, with staff from the Irvine, Kilwinning, Garnock Valley, Ballot Road and Bourtreehill teams all being given the opportunity to benefit from the HSPC Primary & Social Care Grants Scheme. Staff commented that this was "a fantastic team reward for the effort they put in during COVID19…team morale got a real lift from it." Over the last 3 years our Staff Wellbeing Programme has delivered several successful wellbeing initiatives/activities to support the wellbeing of Primary Care & Social Care staff, GPs, Third & Independent Sector providers who are commissioned by HSCP, Personal Assistants, Volunteers and Unpaid Carers. This work was initially funded by the Scottish Government in 2021/22 and has been funded solely by North Ayrshire’s Integrated Joint Board (NAIJB) for the last 2 financial years. In conjunction with North Ayrshire Leisure, we have delivered online weight management, physical activity and yoga sessions, as well as staff health checks and free gym passes. In addition, staff have had access to Mindfulness sessions, Trauma Release Exercises and a whole host of online sessions delivered by Optima Health, designed to support the health and wellbeing of staff across the above sectors. Feedback from a recent staff survey has recognised the value of teams coming together to undertake team development days and building resilience. Taking into account the feedback from the staff survey, the Staff Wellbeing Programme will continue to provide a range of opportunities to support physical and mental wellbeing by engaging with KA Leisure and Optima Health.
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48 Independent Care Providers who provide care services on our behalf Where we commission care and support from independent and 3rd sector Providers services based within the North Ayrshire area, we monitor these services via the Contract Management Framework. The Framework focusses on ensuring a joint approach to evaluating the quality of care and where appropriate provides an approach to supporting Providers to progress improvements. We use a range of methods to monitor performance, including: • Formal Contract Management meetings on a 6 monthly basis and an Annual Joint Evaluation of Contract to ensure that services are safe, effective and most of all, that they meet people’s needs • Review of compliments, complaints and feedback from staff, carers and people who use services • Information that we collect, before visits, from the provider or from our records • Local and national information, for example, Care Inspectorate reports • Visits to providers, including observing care and support and looking at records and documents The information below represents how those service which are registered with Care Inspectorate and are based in North Ayrshire are currently performing. Registered Services – Minimum Grades across all themes – Care Service Subtype 2 Weak 3 Adequate 4 Good 5 Very Good 6 Excellent Grand Total Adoption Service Not applicable 0 0 0 1 0 1 Adult Placement Service Not applicable 0 0 0 2 0 2 Care Home Service Older People 0 4 10 2 0 16 Care Home Service Children & Young People 1 0 3 6 3 13
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49 Care Service Subtype 2 Weak 3 Adequate 4 Good 5 Very Good 6 Excellent Grand Total Care Home Service Alcohol & Drug Misuse 0 0 1 0 0 1 Care Home Service Learning Disabilities 0 1 2 0 0 3 Care Home Service Mental Health Problems 0 0 1 0 0 1 Care Home Service Respite Care and Short Breaks 0 0 2 0 0 2 Child Minding Not applicable 1 6 61 44 2 114 Day Care of Children Not applicable 1 8 42 16 0 67 Fostering Service Not applicable 0 0 1 0 0 1 Housing Support Service Not applicable 0 2 7 6 2 17 School Care Accommodation Service Not applicable 0 0 2 5 0 7 Support Service Care at Home 0 2 12 7 0 21 Support Service Other than Care at home 0 0 7 0 1 8 Grand Total Not applicable 3 23 151 89 8 274
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50 Inspection of Local Services Throughout 2023/2024, a total of nine inspections took place by the Care Inspectorate, all nine were unannounced. There was also one joint inspection of Adult Support and Protection. • Health & Community Care - 3 inspections with 2 follow up inspections. • Children & Families & Justice Services - 3 inspections • Adult Services - 1 inspection Within Health & Community Care 2 follow up inspections took place at Montrose House after an initial inspection in June 2023. The first of these took place on the 15th of September 2023 and examined the requirements listed in the June inspection. Of these requirements, 2 were met, 2 unmet and 4 not assessed. A further follow up inspection took place on the 14th February 2024 examining the outstanding 6 requirements for the facility. Of these requirements 2 were met and 4 unmet. A further inspection within Health & Community Care related to Dementia Support Service (Core Assurance Inspection – Pilot). This was a pilot inspection known as Core Assurance Inspection – No gradings were provided, therefore previous gradings remain. Previous grading from February 2020 were: • Quality of Care and Support – 4 Very Good • Quality of Staffing – 4 Very Good A joint inspection of Adult Support and Protection was published in February 2024. The joint inspection took place between September and December 2023, scrutinising the records of adults at risk of harm for the preceding two-year period, September 2021 to September 2023. While no gradings were given, the report does provide Priority areas for Improvement. Two priorities for improvement were noted, they are: • Access to independent advocacy was limited. The partnership aimed to address this through their refreshed advocacy strategy. This should be a priority area for improvement. • Police Scotland inconsistently applied policy and practice across several areas, which when combined weakened the operational effectiveness of the partnership’s adult support and protection activity. These require to be promptly addressed to ensure parity of service levels across the partnership. Gradings for the 6 further inspections the Partnership also received can be found below. Inspection reports can be found on the Care Inspectorate website - Inspection Reports.
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51 Inspection Date Service/Unit Wellbeing Leadership Staffing Environment Care & Support 19 - June - 23 Montrose House 3 3 3 4 3 18 - August - 23 The Meadows Children’s House 2 0 0 0 0 29- September - 23 Abbeycroft Children’s House 5 0 0 0 0 03 - November - 23 Irvine, Garnock Valley & Community Alarm 5 5 4 0 4 27 - February - 24 Canmore Children’s House 2 0 0 0 0 13 - March - 24 Trindlemoss House 4 4 0 0 0 The Care Inspectorate use a six-point scale to grade inspections: 1 Unsatisfactory Major weaknesses – urgent remedial action required 2 Weak Important weaknesses – priority action required 3 Adequate Strengths just outweigh weaknesses 4 Good Important strengths, with some areas for improvement 5 Very Good Major strengths 6 Excellent Outstanding or sector leading