Agenda Document Pack - Adult Care and Social Work Committee - 02/09/2025
North Lanarkshire Council · 2 September 2025
Back to Adult Care and Social Work Committee — 2 September 2025 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Clerk Name: Karen Swan Clerk Telephone: 07919 730272 Clerk Email: committee@northlan.gov.uk 22 August 2025 Members of the Adult Care and Social Work Committee Chief Executive’s Office Rachel Blair Chief Officer (Legal & Democratic) Civic Centre, Windmillhill Street, Motherwell ML1 1AB www.northlanarkshire.gov.uk Notice is given that a Meeting of the Adult Care and Social Work Committee is to be held in the Council Chamber, Civic Centre, Windmillhill Street, Motherwell, ML1 1AB on Tuesday, 02 September 2025 at 14:00 PM which you are requested to attend. The agenda of business is attached. Rachel Blair Chief Officer (Legal & Democratic) Members : M McCulloch, B Baudo, A Ballinger, C Barclay, M Boyd, G Brennan, B Burgess, W Goldie, H Gray, J Jones, P Kelly, J Keltie, K Larson, A McCrory, B McCulloch, R McKendrick, C McManus, C Quigley, N Shevlin, L Stubbs, R Sullivan, J Toner, C Williams, N Wilson, G Woods. Page 1 of 174
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Agenda 1 Declarations of Interest In Terms of the Ethical Standards In Public Life Etc. (Scotland) Act 2000 Operational 2 Discharge without Delay Programme Update & North UHSCP Improvement Plan Submit report by the Chief Officer (Adult Social Work Services) highlighting the progress on the Discharge without Delay process within Lanarkshire. 5 - 12 3 Home Support Service Submit report by the Chief Officer (Adult Social Work Services) highlighting developments in the Home Support Service over the past 12 months in preparation for the implementation of the new operating model for the Health and Social Care Partnership. 13 - 28 4 Supporting Resilience Across our Communities Submit report by the Chief Officer (Performance, Planning and Quality Assurance) setting out the ongoing work and commitment undertaken in supporting resilience across our communities, unpaid carers and supported people. 29 - 38 6 Quality Assurance Annual Report Submit report by the Chief Officer (Planning, Performance and Quality Assurance) providing an update on the Quality Assurance activity over the period from 1 April 2024 to 31 March 2025 39 - 134 Performance 7 Adult Social Care Performance Report – Quarter 4 2024/25 Submit report by the Chief Officer (North Lanarkshire Health and Social Care Partnership) providing an update on the performance of key areas of activity within Adult Health and Social Care for the period 1 January to 31 March 2025 and Quarter 4 2024/25. 135 - 148 Page 3 of 174
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Financial 8 Revenue & Capital Budget Monitoring Report: Adult Social Care Period 03: 01/04/2025 to 20/06/2025 Submit report by Chief Officer (Planning, Performance and Quality Assurance) providing a summary of the revenue financial performance of the Health & Social Care Partnership (H&SCP) – North Lanarkshire (Adult Social Care & Housing) and the financial performance of the Social Work capital programme, for the period 1 April 2024 to 20 June 2025. 149 - 162 9 Sundry Debt Write Off 2025 Submit report by the Chief Officer (Adult Social Work) seeking approval to write of debtor accounts deemed uncollectable following all attempts at recovery or considered uneconomically viable to continue pursuing. 163 - 168 Contracts 10 Contracts awarded below Committee approval threshold Submit report by the Chief Office (Assets and Procurement) advising of the contracts awarded since the last meeting of the Committee. 169 - 174 Page 4 of 174
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref DF/JD Date 12/08/25 Discharge without Delay Programme Update & North UHSCP Improvement Plan From Diane Fraser, Chief Officer (Adult Social Work Services) E-mail FraserDi@northlan.gov.uk Telephone 07583114596 Executive Summary This report highlights the background to, present position and ongoing progress in terms of development within Lanarkshire on the Discharge without Delay (DwD) process. The main components of the process are highlighted in terms of current status and expected outcomes in terms of performance improvement measures are clarified. The report also provides a brief update on North University Health and Social Care Partnerships Improvement Plan to support unscheduled care and frailty, a plan that has been requested of whole system areas this includes University Health and Social Care Partnerships and Acute Division sites by the Executive Flow Oversight Board. This is to improve in-patient flow and promote discharge without delay underpinned by a Home First approach which is supported by evidence that people recover better at home. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Endorse the continued direction and development of DwD in Lanarkshire as it supports and compliments the overarching strategic intentions of Operation flow. The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities Programme of Work Resilient People Item 2 Page 5 of 174
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1. Background 1.1 The Discharge without Delay programme has been in place in Scotland since 2023 supported by Scottish Government DWD Steering Group and improvement teams. The aim is to deliver Discharge without Delay in both acute and community settings. This requires close working between hospital and community teams to ensure positive outcomes for people who have a hospital admission and require supported discharge to facilitate a transfer of care. The programme is built around four co-dependent workstreams: • Acute Frailty Units • Home First / Discharge to Assess/Home Assessment Teams • Planned Date of Discharge (PDD) process and Integrated Discharge Teams • Community hospital and step-down inpatient rehabilitation workstream 1.2 Each workstream has a range of guiding principles (41 in total). 1.3 These 4 Domains and their guiding principles formed the basis of a whole system based self-assessment process which was conducted by colleagued from NHS Lanarkshire, North and South Lanarkshire Health and Social Care Partnerships in March 2025. A record of the assessment containing the then current position of the Board in relation to DwD was produced and an associated Action Plan was drawn from the findings in the self-assessment. 1.4 The Discharge Without Delay programme aligns with the Getting it Right for Everyone programme implemented by North Lanarkshire UHSCP and the Operation Flow Target Operating Model for Optimal Discharge Target. 2. Report Agreed Whole System Outcomes & Anticipated Benefits 2.1 A set of Outcome measures has been agreed and will be adopted as Targets within Lanarkshire, as across Scotland. These are; • Reduce acute Medicine for the Older Adult length of stay (LOS) by >20% by end March 2026. • Reduce community hospital/ step-down LOS by > 20% (ideally less 28 days) by end March 2026. • Reduce respective HSCP delayed discharges by >20% by end March 2026 as a consequence of improved flow. • With improved downstream capacity, the DwD programme aims to improve 4- hour whole system performance by 3-5% points. 2.2 It is anticipated that achieving delivery on some of these positions by December 2025 will be highly beneficial in terms of managing winter pressures faced by the Whole System. Page 6 of 174
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2.3 It is also anticipated that overall acute, health, and social care spending will be more effectively controlled if frail older patients spend less time in hospital and maintain greater independence. This can be achieved by discharging patients without delay, minimising hospital-induced dependency, and preventing the over-prescription of social care services. Present Position In Lanarkshire 2.4 DwD Needs Self-Assessment conducted in March 2025 with an associated Action Plan created. (Appendix 1) 2.5 Lanarkshire (and all Boards) were invited to complete a request for Non-Recurring financial Resource to assist in achieving the principles of DwD. 2.6 This resource has now been agreed to support the further development of frailty pathways, hospital at home and discharge to assess. The financial resource, which is non-recurring will be used exclusively to employ (on a fixed term basis), additional Integrated Discharge Facilitators on each of the Lanarkshire Acute Sites. The rationale for this, is that the recent CFSD visits and report highlighted the role as crucial, and also recent scoping work commissioned by Core FOB concluded that this role would enable greater impact on the Delayed Discharge performance and improved Discharge planning, including a presence on Community Hospital facilities. 2.7 Lanarkshire professional representatives were identified and nominated for National DwD Subgroups, themes in alignment with the 4 main Workstreams and including a Data group. These sub-groups are established and focus on frailty pathways, integrated discharge hubs, discharge to assess and community/ offsite hospitals. There is also a data group which supports the four workstreams. 2.8 Lanarkshire has not created a formal forum for the DwD work, as all aspects are already represented in existing Strategy, Governance and Operational fora. It is also intended for the discharge without delay activity to be delivered through the new established Aging and Frailty Board. 2.9 Local arrangements for communication within Lanarkshire are developing. Progress 2.10 Work within the 4 main workstreams is ongoing and overseen by the Strategic and Governance structures within Lanarkshire. Acute Frailty Units 2.11 All 3 acute sites now have either established or developing Acute Frailty Assessment facilities with the following assessment capacity per site. • University Hospital Hairmyres – 24 Bedded Area • University Hospital Monklands – 24 Bedded Area • University Hospital Wishaw - 12 Bedded Area (in Development) Page 7 of 174
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2.12 Processes and access pathways vary at present, but there is a vision to establish equitable service across the system. Home First/Discharge to Assess/Home Assessment Services 2.13 It is important that people who require support on discharge are assessed in their home environment. The Home Assessment Team (HAT) in North Lanarkshire UHSCP has existed for over 3 years and its capacity and coverage has grown. All locality areas can assess people at home and in the last 12 months, the HAT component of all supported Discharges has risen from 20% to 30%, and often higher. Once people are supported, they may receive time limited, targeted assessments which may determine the need for supports including longer term paid support. It is expected that there will be continued improvement in performance with the changes in home support. 2.14 Ongoing improvement work is being conducted, and it is anticipated that the delivery by Home Assessment will increase significantly as the Operation Flow Target Operating Model for Optimal Discharge is implemented, and Home Assessment will become the default approach for all simple pathways and for the majority of more complex pathway patients. Planned Date of Discharge and Integrated Discharge Teams 2.15 Scoping work was completed by the Lanarkshire Core Flow Oversight Board, leading to a decision to commission a formal review of Planned Date of Discharge (PDD) across the whole system. This will focus on operational, educational and practice elements, which is expected to improve the multi-disciplinary aspect of PDD as well as delivering meaningful patient-centred approaches to discharge planning, avoiding unnecessary prolonged hospital stays and delayed discharges for people who require support on discharge 2.16 Integrated Discharge Teams will similarly be developed as a “One for Lanarkshire” approach and early arrangements to scope and map current processes and develop an optimum model are in place, reporting again to the Core Flow Oversight Board. Community Hospital and Step-Down In-Patient Rehabilitation 2.17 Further to initial work within Operation Flow, a review process is ongoing in this area, with development expected that will enable Lanarkshire to improve the clarity of function of each Community facility, provide clear operational arrangements for the care of patients in appropriate pathways and provide a platform for working towards the expected outcome measures as mentioned at section 2.0 above. 2.18 This Improvement initiative reports to the Core Flow Oversight Board. Delayed Discharge Performance 2025 2.19 Chart 1 – Performance against Target for Lanarkshire and GG&C facilities Page 8 of 174
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2.20 The performance has generally been good throughout 2025, and more obviously from March onwards. The month of July saw some rises in the numbers of delays and there has been some fluctuation in the number of occupied bed days associated with this rise. 2.21 This however has already been met with urgent analysis and action to correct the short- term decline and recover the position as it has been throughout the previous months of the year. 2.22 It is intended that more ambitious trajectories be considered for the year ahead, as we have shown that we can not only achieve improvement but consistency. Improvement Plan 2.23 The Executive Flow Oversight Board (EFOB) and Core Flow Oversight Board (Core FOB) have requested that all component areas of the whole system provide Improvement Plans showing the significant improvement work that each area is doing. 2.24 The North UHSCP Plan has been through several iterations since March 2025, having been submitted to Core FOB. 2.25 More recently (July 2025), the plan was reviewed and amended to exclude improvement actions that are being led upon in other areas, and to include improvement detail and ambitions that we as a partnership have in relation to the ongoing developments across a range of domains. 0 10 20 30 40 50 60 70 80 90 100 05-Jan 12-Jan 19-Jan 26-Jan 02-Feb 09-Feb 16-Feb 23-Feb 02-Mar 09-Mar 16-Mar 23-Mar 30-Mar 06-Apr 13-Apr 20-Apr 27-Apr 04-May 11-May 18-May 25-May 01-Jun 08-Jun 15-Jun 22-Jun 29-Jun 06-Jul 13-Jul 20-Jul 27-Jul Delayed Discharge Performance in Lanarkshire & GG&C Facilities 2025 Total NHSL Delays NHSL Target Total GG&C Delays GG&C Target Target = 75 Target =19 Page 9 of 174
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2.26 The partnership has ensured that the contemporary version of the plan is intrinsic to the work being done not only in Operation Flow, but across other areas such as DwD, Back to Basics, Enabling approach and the Operating model for Health & Social Care services. 2.27 We do not have readily available baseline data for some of our planned improvement areas, and we are compiling this now so that realistic improvement trajectories and targets can be identified. This will be an ongoing piece of work. 3. Measures of success 3.1 DwD is a developing concept with practices and processes beginning to align with the organisational strategies that were already in place in Lanarkshire. 3.2 All domains/workstreams of the DwD agenda are being led and developed in Lanarkshire. 3.3 The Health & Social Care Teams across North Lanarkshire have worked hard to achieve improvement and consistent practice, through a period of change in order to deliver the right care for patients and service users, and to support their families and carers. 3.4 Patient Care and Continuous Improvement is at the heart of North Lanarkshire’s work, and it echoes and underpins the “Getting it Right for Everyone” agenda as well as enabling creative, innovative practice. 4. Supporting documentation 4.1 Appendix 1 Discharge without Delay - There's No Place Like Home Diane Fraser Chief Officer / Head of Service (Adult Social Work Services) Page 10 of 174
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Page 11 of 174
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Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☒ No ☐ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? This is captured in the Home Support Programme Board/Discharge Without Delay Owner is Karen Workman 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. 5.11 Children’s rights and wellbeing impact Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 12 of 174
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1 North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref DF/KW/MF Date 31/07/25 Home Support Service From Diane Fraser, Chief Officer / Head of Service (Adult Social Work Services) E-mail FraserDi@northlan.gov.uk Telephone Executive Summary This report outlines the service developments in the Home Support Service that have been achieved over the past 12 months to implement the new operating model for the Health and Social Care Partnership. In North Lanarkshire, our commitment to delivering high-quality, person-centred care continues to drive change in the Home Support Service. The service is nearing the conclusion of full implementation. This will see the management structure in place to embed the home support workforce in assessment and planning and the Living Well Service providing ongoing long-term support. Over the past 12 months, there has been a focus on four key areas; embedding an enabling approach, realigning and preparing the workforce to focus on home assessment and ongoing paid support, implement a dynamic scheduling tool and continue with the transition of analogue to digital to ensure continuity through community alarms whilst maintaining quality service. The service is promoting an ethos of Home First which is an approach that helps you to remain at home or to return to you home to recover following medical intervention. this will be achieved through an enabling approach providing enhanced rapid, short term reablement, and hospital discharge coordination. The development of a whole system approach to Home First reflects our commitment to a proportionate, strengths-based Locality Enabling Approach, consistent with the Health and Social Care Partnership plan of work. A phased implementation is in progress, with the full implementation of the assessment and planning functions operational by the end of the year. The approach emphasises staff empowerment, collaboration with acute care, and embedding prevention-driven, outcome- focused practice to improve lives of people, family, carers and staff. Recommendations It is recommended that the Adult Care and Social Work Committee. (1) Acknowledge the developments within Home Support Service and the progress being made to implement the approved operating model. Item 3 Page 13 of 174
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2 1. Background 1.1 The Health and Social Care Partnership remains committed to providing services at the right time and place, leveraging a personalised, choice-driven model that enhances wellbeing and independence. 1.2 The plan for the new operating model to deliver Home Support was agreed by the IJB in March 2018. The model was based on the outputs of the Cross−Party Working Group, the advice from support officers and wider officer research, the proposed model focuses on five major elements: • Integrated Model (Discharge to Assess in Localities) • Same Day Response/Reablement/First Support (Intensive and time limited) • Specialist Teams (e.g. supporting people with frequently changing needs and end of life / Palliative Care) • Ongoing Paid Support (allocation of an individual budget to deliver individual outcomes as part of SDS) • Quality Assurance (improving standards of care) 1.3 There has been considerable work undertaken to implement a functional model — through assessment and planning and delivering long-term support via Living Well at Home which is outlined in the Home Support Service report that was presented to Committee on the 3 September 2024. 1.4 It is widely recognised that robust assessment at home which includes direct support can determine more accurately what supports an individual may require longer term. The home support workforce is key to maximising an individual’s independence through practical tasks as well as following a rehabilitation programme to work on specific tasks and confidence. Generally, home support staff will work closely with other members of the multi- disciplinary team such as Occupational Therapists, Physiotherapists and Social Workers and families. The Home Assessment, Reablement, Integrated Rehabilitation and Intensive Teams can support individuals to ensure a thorough assessment is complete to inform any decisions regarding longer term support. This should assist in managing demand and directing resources to those most in need. 1.5 North Lanarkshire continue to have a positive balance of care, a term which is used to refer to the balance of support and care available within the community - based settings compared with support within residential settings. This is supported by the continued investment in community – based supports and a long-standing commitment to self- directed support. This is underpinned by community support which is codesigned with The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities Programme of Work Statutory / corporate / service requirement Page 14 of 174
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3 individuals and their carers/ families. This approach has resulted in a high proportion of individuals remaining at home. The model will support more people being assessed at home and supported to be as independent as possible. This will ensure that people who need short term reablement to reach their full potential receive this. 1.6 This approach is necessary to address the demographic changes and increasing pressure on financial resources including the impact of changes in the cost of living, which means that “more of the same” is not the right response. The 2022 census demonstrates the potential demographic change which supports the case for change. • Between 2011 and 2022 the 25 to 44 age group saw a percentage decrease (- 7.3%), in contrast the 75 and over age group saw a percentage increase (+21%) • Although the population is projected to decrease from 2028 to 2043 by 1.2% there is a forecast increase of 71.4% in the age group 75 years and over across the same timescale • 20% of North Lanarkshire data zones are within the 20% most deprived in Scotland • Individuals who reported themselves ‘in fairly good health’ as opposed to ‘good health’ has grown by 15% (+7036). • Individuals who reported themselves as having ‘long term health conditions’ has grown by 30.6% (+43,943). • Individuals self-reporting mental health issues has grown by 158.6% (+24,903) • Individuals self-reporting as providing informal / unpaid care has grown by 31.6% (+10,877). 1.7 The delivery model required for assessment and planning and Living Well has had to align with the new operating model for the Health and Social Care Partnership which is outlined in the report Back to Basics to Getting it Right for Everyone presented to Committee in May 2025. There has been considerable work to embed the values and principles of Getting it Right for Everyone and an enabling approach into the home support workforce. 1.8 This report will outline the progress made in four key areas; embedding an enabling approach, realigning and preparing the workforce to focus on home first and ongoing paid support, implement a dynamic scheduling tool and continue with the transition of analogue to digital to ensure continuity through community alarms whilst maintaining quality service. Overall, the report confirms our capacity to deliver a flexible and efficient operating model for North Lanarkshire. 2. Report Embedding an enabling approach 2.1 The enabling approach that has been adopted in each locality promotes the following principles: • Do no harm • Home First • Empower People • Focus on prevention Page 15 of 174
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4 • Whole system approach • No waits 2.2 The learning through the Back-to-Basics programme has influenced the home support redesign and staff have been involved in the range of work that has supported new practice and processes to ensure that we can provide a quick and effective response whilst retaining a focus on one of our key principles helping people to help themselves. The delivery model relies on organising the home support workforce to be able to support assessment and planning to identify what long term support is required as well as provide ongoing paid support. The Living Well Service will provide ongoing support. This model promotes the key tasks of assess, plan, intervene and review. 2.3 We have introduced this approach in all six localities however we started the learning process in Wishaw with a focus on all referrals being directed through Home Assessment Team and Reablement. The performance in this area improved and was evidenced through improved waiting times, as outlined below, and importantly feedback from individuals and their families was positive. They reported feeling more included, information and processes were clear, they felt respected and empowered. Professionals also reported feeling optimistic, safe, motivated, and inspired. March 2025 March 2024 2.4 Home support staff have played an important role to proactively supporting a home first ethos. They have supported this by committing to adopting an outcome focused approach to their intervention. There will be ongoing training to refresh the assessment and planning activity undertaken. Through the assessment phase people will receive a period of reablement/ rehabilitation to support their recovery. It is important that longer term support is not decided in environments such as hospital unless in exceptional 0 5 10 15 Jan 2024 Jan 2025 Wishaw HAT Completions July 24 v 25 Ongoing Service Req. No further service req. Readmission to hospital SU refused futher service Death Page 16 of 174
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5 circumstances. To support this, we have worked closely with NHS Lanarkshire colleagues to develop a process to request for assistance. Through an enabling approach staff will work on the principles of early intervention and prevention and ensure that people are provided with information, advice, and signposting relevant to their ongoing assessment. Planned interventions will include carers support, use of technology enabled care, as well as being able to use their own resources. Our staff undertaking assessments and providing support and care which promotes self- management and slow stream rehabilitation. 2.5 The ethos of Home First is currently being promoted and whilst this approach is not exclusive to HAT the performance of the team, provides an indicator of the outcomes for people. Key indicators show consistent improvements in response times and service user satisfaction. Staff feedback highlights growing confidence in applying the enabling approach and working across disciplines. These successes have contributed to timely hospital discharges, supported community resilience, and informed best practice. 2.6 The existing Home Assessment Team has supported around 3700 people since its inception, with the ongoing strong focus on rehabilitation and assessment the service continues to deliver strong results as evidenced below. 2.7 Service Users with no ongoing Home Support Needs following HAT Assessment 2.8 The table above identifies that: Page 17 of 174
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6 • 45% of individuals required immediate support from hospital but with support did not require longer term intervention. • 37% of individuals required ongoing service, a high proportion of these individuals were assessed as benefiting from a community alarm hence this being recorded as ongoing service, however, crucially this does not involve ongoing paid supports at home. • 14% of individuals readmitted into hospital. 2.9 Readmission rates appear to be high and relate to premature discharge, general decline in health and new acute episode. This also needs to be considered against the age profile of the service users that are being supported. However, with the focus of early intervention and discharge 86% of those being supported via HAT are not being readmitted. 2.10 The model will support hospital discharge flow, allow early planning, and facilitate a smoother transition from acute care settings to community-based support. Coordination will involve locality-based decision-making, informed by real-time scheduling data. Over the past 6 months there has been an improvement in the number of delays and have consistently remained below target as demonstrated below. However, by improving flow with the new delivery model, Home Support staff will work within a multi- disciplinary way to respond to surges within the system. This will be dependent on a whole system response to improving the persons journey in hospital. Page 18 of 174
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7 2.11 This new way of working reflects the strategic ambition set out in previous committee reports under the Back-to-Basics programme which has evolved into the Getting It Right for Everyone programme. A particular focus will be placed on improving evening and out-of-hours support, recognising historic service gaps identified through consultation and service performance reviews. The aim is to ensure a balanced and resilient service which can respond to both planned and unplanned care needs at all times of day. 2.12 The Living Well at Home service continues to be locality-based, allowing responsive, integrated care aligned to the needs of communities. A new service descriptor for this service has been devised setting out what the service will provide moving forward. 2.13 The aim of the Living Well at Home service is to promote independent living, choice and control, social inclusion, and wellbeing for the adults that it supports. Living Well at Home will do this by providing personalised assistance to meet individual’s identified outcomes. 2.14 The primary focus will be to support individuals where there is significant complexity of need. This may be complex physical and/or complex social need including where there may be public protection issues. Acknowledging that levels of complexity can be difficult to quantify, decision making around this will be determined in line with the outcome of a person’s assessment and a multi-disciplinary team approach to support. Workforce 2.15 The workforce is key to implementing the new delivery model for assessment and planning and Living Well. Staff have participated in a range of engagement sessions and are supportive of change that will lead to an improved quality of service for people who receive support as well as benefit the workforce. There are 1235 Home Support Workers employed in the Service across Reablement, Home Assessment Team, Intensive, Community Alarm and Living Well Service. The worker profile is made up of 94% female and 6% male with over 60% of our workforce over age 50. The management and support roles were previously reviewed. These roles support with scheduling visits, carrying out reviews, supervision, and training. There is no other employment change proposed at the moment other than the Senior Home Support Managers and Service Delivery Manager with the other aligned staff. However, future practice with consideration of demand and capacity could indicate potential further movement required. 2.16 Significant progress has been made in aligning the operational level of the workforce structure to support the assessment and care delivery. Frontline and supervisory roles, including Home Support Workers, Schedulers, and Team Leaders, have now been aligned to the appropriate service and this will be seamless in supporting the models of delivery. 2.17 To fully implement the model and to maximise flow it will be necessary to align key management posts. The proposed management and supervisory structure includes Service Delivery Managers and Senior Home Support Manager roles within both Assessment and Planning and Living Well at Home need to be finalised. There will be an HR process to follow, working with the services HR Business Partner. 2.18 The recruitment and retention of Home Support Workers remains a priority for the service. Between Jan 2024 and May 2025, a total of 55.62 fte (75 head count) new Page 19 of 174
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8 recruits have started since January 2024 however this has been offset against the leavers of 81.82fte (117 headcount) employees within the same period. These figures are reflective of the aging workforce with the service seeing an increase, in retirement and termination through capability. 2.19 To improve this position there have been changes to recruitment practices to attract new people into social care with the format of the interviews taking a value-based approach. This has allowed a wider pool of staff to be recruited successfully allowing investment in those individuals looking for a career change. The latest recruitment campaign seen an increase in the number of successful applicants. 2.20 Participation within the Council’s summer programme has also seen a number of young people come forward with an interest in working in care. This has given us the opportunity to work with these young people to help them achieve their goals through modern apprenticeships in care as well as securing sessional post for those young people still in full time education. 2.21 The model of delivery will provide clearer roles and improved career paths. This will provide staff opportunities for staff to develop skills and confidence in specific elements with the intention of increasing the retention of staff. For example, staff will have the opportunity to work closely with Allied Health Professionals, Social Workers and nursing staff providing intervention based on rehabilitation. In addition, to focusing on recruitment and retention there has been considerable work undertaken to provide training to ensuring that we have a competent, confident workforce as we move into a new delivery model. With support from Learning and Development there has been a targeted approach to ensure staff have appropriate training. Dynamic Scheduling System 2.22 The service has undergone two significant system changes in the past 6 months which have included the introduction of the dynamic scheduling tool and Mosaic the client information system for Social Work. The dynamic scheduling tool will offer a wider range of benefits to service users and staff by improving consistency, reducing missed visits, and incorporating travel time accurately. For the first time, the service will be able to monitor care delivery in real-time as well as improve quality of service which in turn improves the experience for people who receive support. It also has the ability to produce accurate reports which will help to inform future demand upon the service. 2.23 A revised project timeline was devised for the roll out to Home Support Teams and at present Bellshill, Wishaw, Airdrie and Motherwell Home Support Teams are using the new system. There has been significant work undertaken to maintain service delivery whilst implementing a new system. It has been challenging for staff who have gone above and beyond and shown incredible dedication. The project team have worked closely with the provider to deliver this with minimal disruption. The programme for the project is outlined below with a completion date of 1st September 2025. Systems will require to be updated until the interface between Mosaic and the scheduling tool. The service is also preparing for the implementation of the Council’s new telephony system. Page 20 of 174
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9 Home Support Team Back Office Go Live Date Full Go Live Date Bellshill 17/03/2025 24/03/2024 Wishaw 26/05/2025 02/06/2025 Motherwell 23/06/2025 30/06/2025 Airdrie 14/07/2025 21/07/2025 2.24 Service users and their families are registering for the new Client Portal, which will allow service users and/or their family members to view scheduled care visits, including the times and names of Home Support Workers who will be delivered the care and support. The website is being updated to provide users and carers with information on how to register. 2.25 Staff have embraced the new system and are using basic functions to facilitate the implementation across the Home Support Service within a tight timescale. The go live is not the end of the journey; it is only the beginning in terms of introducing the full capabilities of the system and reviewing the information now available on supports being delivered to ensure the right support is being provided to service users at the right time. Community Alarms Update 2.26 The Community Alarm Service currently provides support to 7,859 people in North Lanarkshire with the confidence that they can call for help at any time of the day or night, every day of the year and is an essential service when people experience difficulties such as a fall or sudden illness. Of these individuals, 6,306 people are using dispersed analogue and or digital community alarms and 1,553 people are within sheltered accommodation. The Community Alarm staffing structure is being reviewed to support the outlined changes in the wider service. Improving Quality 2.27 The work that has been undertaken to embed Getting it Right for Everyone has led to improvements in the quality of service being provided. This has been achieved working closely with the Care Inspectorate to address areas identified for improvement through inspection. Staff absence, workforce availability, and recruitment of skilled professionals have previously impacted service consistency, but recent trends indicate a positive shift in performance across all locality teams. Page 21 of 174
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10 2.28 Significant improvement planning has been developed across localities and is actively monitored by the Senior Manager Adult Social Work, in conjunction with Care Inspectorate input and support. 2.29 The Service has been advised that only registered services who are rated 3/ adequate or below will receive a full inspection in the inspection year which commenced April 25. Services sitting on 4/ good or above will be chosen on a random basis to ensure quality grades are maintained. The Airdrie Home Support Team were the first team to receive their full inspection (July 2025) which resulted in an improved grade for the staff team and identified the need for improvement in key performance areas of the job role undertaken by Home Support Team Leaders. 2.30 Monthly improvement plans, and performance data are collated and reviewed for each Home Support Team by the Service Managers and Senior Manager. This supports the registered managers to focus on providing the best quality service. This ensure that any outstanding statutory work required for inspection and provides senior managers with a clear position on the strengths and areas of development within each of the teams. Quality Assurance colleagues have been working with the service to undertake self-evaluation to highlight areas that need immediate improvements to satisfy the regulator and improve outcomes for people. 2.31 Whilst the Service has continued to work in partnership with both the Care Inspectorate and Quality Assurance Team to deliver improvements within the service it should be noted that significant work remains to restore the previously high-level grades. Next Steps 2.32 To operationalise the new operating model there is a need to finalise the management structure. Benchmarking and learning visits to other areas have taken place and the workforce are kept informed throughout the process through regular consultation and updates. 2.33 Working towards full implementation of the new operating model for assessment and planning with Home Support staff already aligned will support the transition to the new Page 22 of 174
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11 way of working. There will be a communication plan and training programme in place over the next 6 -12 months. The progress will be reviewed and evaluated in conjunction with the wider programme of work, Getting it Right for Everyone. 2.34 The dynamic scheduling tool implementation will be complete by September 2025 and will be evaluated. Once this is complete it will be possible to use the data to make further improvements. Conclusions 2.35 The report demonstrates significant progress in transforming the Home Support Service in North Lanarkshire, aligning with the strategic objectives of delivering high- quality, person-centred care. 2.36 The clear functional separation of Assessment and Planning from Living Well at Home marks a pivotal development phase, allowing targeted service delivery and efficiencies. 2.37 Multi-disciplinary Home First Assessment Teams (HATs) have had a measurable positive impact, with the alignment of reablement and intensive support this impact will continue at pace. 2.38 Implementation of the dynamic scheduling system (Access CM) has improved data accuracy, scheduling, and real-time monitoring, though challenges remain regarding system performance and workforce resource demands. 2.39 Note the updated position within the Community Alarm Service as it transitions from analogue to digital and progress made to date. 2.40 Locality-specific improvement plans, and quality assurance processes have contributed to more consistent service quality, with several localities achieving 'Good' inspection ratings. 2.41 The transition plan for full rollout by the end of 2025 is well-structured and supported by training, communication, and workforce engagement. 3. Measures of success The following measures of success have been identified: 3.1 Improved wellbeing of supported peoples’ outcomes. 3.2 Service Quality Improvements - Inspection ratings increased across all localities. 3.3 Technological Integration of the Access CM dynamic scheduling system. 3.5 The technological integration of the digital ARC within the Community Alarms Service. 3.6 The Home First Assessment Model to be implemented across all six localities by 31st October 2025. 3.7 Improved discharge response from Lanarkshire and Glasgow Hospitals. 3.8 Living Well at Home will prioritise ongoing longer-term support. 3.9 Workforce Stability and Engagement. 3.10 Ensure a sustainable financial model. Page 23 of 174
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12 4. Supporting documentation 4.1 N/A Diane Fraser Chief Officer / Head of Service (Adult Social Work Services) Page 24 of 174
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13 5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? Currently working with Finance Business Partners to determine any financial implications to implement the operating model and associated structure, being mindful of the agreed service efficiencies. 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☒ No ☐ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? Currently working with HR business partners to determine any HR implications to implement the operating model and associated structure. There will be an agreed HR process for this and links with relevant trade unions as required. The agreed HR process will be supporting the leadership and management of the model, the wider workforce will be realigned to their current roles and responsibilities within living well at home or assessment and planning, this will require effective communication across the workforce for a fuller understanding. 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ Page 25 of 174
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14 If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☒ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☒☐ No ☒ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? All relevant processes have been followed throughout the implementation of the new digital systems. Yes ☒ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? The communication plan has been devised and will be implemented throughout the changes ensuring full understanding across the service and wider health and social care partnership. 5.9 Risk impact Is there a risk impact? Yes ☒ No ☐ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? Key risks is the delivery of the project; ongoing service risks relate to training and workforce availability to the transferring of information to the DRS. Risks are recorded on the Corporate risk register and project risk register. 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. 5.11 Children’s rights and wellbeing impact Page 26 of 174
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15 Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 27 of 174
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref MD/MW/ Date 19/09/23 Supporting Resilience Across our Communities From Morag Dendy, Chief Officer (Performance, Planning & Quality Assurance) E-mail barrym@northlan.gov.uk Telephone 07939 280915 Executive Summary We have an ongoing commitment to supporting resilience across our communities, unpaid carers and supported people. We have made significant efforts in developing and enhancing partnership working. We have commissioned community and voluntary sector organisations (CVS) to further this. These organisations have a key role in enabling and delivering a resilience-based approach, and in providing the supportive infrastructure that facilitates it. Our local approach continues to be based on promoting resilience through independence, self-help, enablement, choice, and control, using an assets and strengths-based approach. We also seek to ensure that a preventative approach is embedded, and that anticipatory and emergency planning has been considered. The overall intent is that communities, unpaid carers and supported people are resilient, and can influence and shape decisions - from individual care planning to strategic decision making. Our shared approach, involving lived experience, business intelligence and professional knowledge and expertise is a whole system approach to getting it right for everyone. Our approach incorporates the Scottish Government’s pathfinder work promoting a multi-agency approach to designing and delivering public services that focus on people’s needs, to make sure services work well for everyone who uses them. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Endorse the ongoing work to support resilient communities. Item 4 Page 29 of 174
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1. Background 1.1 In defining resilience as: the capacity to withstand or to recover quickly from difficulties, or as supporting individuals to overcome adversity and build resilience: there is recognition that engagement and participation activity is essential in helping define and inform what matters to people, and what support they may need to help withstand or overcome difficulty. 1.1.1 Accordingly, supporting resilience involves: • supporting engagement and participation, • the provision of information, advice, signposting, or campaigning, • help people to help themselves, • providing support as a means of prevention or early intervention, • facilitating anticipatory or emergency planning, thus lessening impact on statutory services. 1.2 This approach also helps meet statutory obligations set out in: • The Carers (Scotland) Act 2016 (which increased carers rights and enshrined these in law.) • The Social Care (Self Directed Support) Scotland Act 2013. (which gave people requiring support significantly greater choice and control around how they chose to be supported and the way in which support is delivered.) • The Community Empowerment (Scotland) Act 2015 (which aimed to empower communities by giving them more control over local decisions, land, and resources, enhancing their ability to influence public services.) • The Equality Act 2010 (specifically the public sector equality duty, where Scottish public authorities must have due regard to the need to: eliminate unlawful discrimination; advance equality of opportunity; foster good relations.) • The Community Wealth Building Bill (aimed at ensuring that wealth is generated, retained, and circulated within communities) (Scottish Govt, March 2025) 1.3 Members will recall previously agreeing investment in CVS organisations at the Adult Care and Social Work Committee on 12 November 2024. These organisations, identified through procurement, has ensured that robust arrangements are in place to further the resilience of communities. Engagement and participation of communities, unpaid carers and supported people is well supported. 1.4 Five organisations were identified, through Tender, to support unpaid carers: • Action For Children Young Carers Support Project • Alzheimer’s Scotland (support around dementia related caring) • Lanarkshire Carers (direct carer support, and Adult Carer Support plans The Plan for North Lanarkshire Priority Enhance participation, capacity, and empowerment across our communities Ambition statement (13) Improve preventative approaches including self-management and giving people information and choice over supports and services Programme of Work Resilient People Page 30 of 174
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• Getting Better together (post discharge support) • North Lanarkshire Carers Together (carer engagement, participation, and campaigning 1.5 A consortium led by North Lanarkshire Disability Forum (NLDF) and involving Lanarkshire Links and Voice of Experience was the successful bidder in the tender aimed at furthering the intent set out in the Engagement and Participation Strategy 2024- 2027. 1.6 Voluntary Action North Lanarkshire (VANL) continue as the third sector interface across North Lanarkshire and manage the Community Solutions programme. Community Solutions has a focus on local activity, through the Community and Voluntary Sector (CVS), aimed at pro-active early interventions and preventative approaches, which in turn promote self-help, independence, choice, and control, and reduce demand and need for statutory service involvement. 1.7 Engagement and participation activity continues to support the development of plans and strategies, inform investment and contribute to supporting resilience, positively impacting on improving equity, reducing reliance and demand on statutory sector provision, and improving health outcomes across North Lanarkshire. 1.8 Alongside this, community hubs, in line with the Council’s approved strategy and programme of work function as a gateway, signposting (where appropriate) offering preventative approaches and facilitating early intervention and targeted approaches, based on local needs. 2. Report 2.1 This report appraises Members on the current position, sets out anticipated challenges, and the suggested next steps and actions to ensure that there is equity of opportunity across the authority area. The report also appraises Members on the progress made on meeting the strategic intent set out in the: • Engagement and Participation Strategy 2024-2027 • North Lanarkshire Carers Strategy 2024 – 2027. 2.1.1 Both these strategies support a culture of engagement and participation with the people of North Lanarkshire and seek to ensure that this is embedded in all aspects of health and social care. The intent was to: • Improve communication and increase connections. • Increase awareness of what matters. • Build capacity for early intervention and prevention. Current Position. 2.2 Each of the commissioned organisations is working in partnership with council services, partners and communities, utilising engagement and participation activity to shape the delivery of a range of needs-based support, information, advice services and activities. 2.3 Carer focused initiatives are in place, including arrangements around Adult Carer Page 31 of 174
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Support Plans (ACSP) through Lanarkshire Carers, and Young Carer Statements, through Action for Children. There is a well-developed Carer Breaks service and an innovative Carer Breather programme, offering carers time away from the caring routine. Alongside existing engagement and participation opportunities, the first of a number of carers sounding boards has been established by NLCT, with a focus on parent carers, with other sounding boards to follow. 2.4 These are intended to ensure that the focus continues to be on what matters to carers. NLCT also facilitates and manages a much wider Carer Support Network (CSN) involving a diverse range of carer focused organisations. CSN raises awareness of caring related issues, community initiatives, offers a supportive network to carer focused practitioners, and opportunities to share information on best practice. Assurance and oversight are provided through a Carers Oversight Group, which involves representatives from UHSCNL, the commissioned carer organisations and Education and Families. A representative from Health has been identified and will join the group for future meetings. 2.5 Meaningful participation through mechanisms such as the Carer Forum(s), carer representation on the Integration Joint Board (IJB), collaboration with the wider Carer Support Network and through the range of funded Carer Breather and Time for Me organisations and groups, as well as the Public Partnership Forum, ensure that people, including carers, are supported to engage early, access the right information, and influence change. 2.6 Through awards made from a Growth Pot provided by UHSCNL, and managed by NLDF, significantly broadened reach has been achieved, and the voice of previously unheard communities has been amplified. Recipients of Growth Pot funding to date have included organisations facilitating engagement with Global Minority Ethnic communities, library projects, biodiversity and greenspace, food and fuel poverty, benefits advice, displaced communities, and age-related support organisations. 2.7 The Community Solutions Governance Group agreed to consult on a new funding model to allocate thematic funds to Community and Voluntary Sector (CVS) organisations. The intention was that funding was more dynamic and responsive to changing themes and priorities, on an annual basis, including the priorities of the Community Solutions Strategy and Investment Plan, the UHSCNL Strategic Commissioning Plan, Programme of Work, and public health priorities. Funding of £512,000 was disbursed and twenty projects were funded, covering each of the fund’s priority activities. 2.8 Paid support is delivered through in-house services, framework support provider organisations, or through a Direct Payment. Information on these arrangements is reported separately to committee. The majority of community-based support is facilitated through self-help and unpaid care, and within our approach to supporting resilience, UHSCNL continues to develop or enhance place-based initiatives. Two specific examples that serve to enhance community\place-based support are Neighbourhood Networks and Community Connectors. Neighbourhood Networks utilise a peer support approach which focuses on the development of natural networks with an emphasis on helping people achieve outcomes whilst reducing dependence on paid support. Its roots are in early intervention, prevention, and the development of communities in line with the principles first outlined in the Christie Report. Neighbourhood Networks has been delivering services in North Lanarkshire since 2003 and has adapted and flexed to meet local need over the past two decades. More recently, Community Connectors have been employed, managed by NLDF, to ensure Page 32 of 174
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that people, who may otherwise have had to access statutory supports can be connected, or re-connected to local community opportunities. 2.9 We have an effective and impactful engagement, participation, and support (if required) landscape in place through commissioned organisations, augmented by wider CVS organisations, to help promote and develop resilience across communities, carers, and supported people. This is further evidenced by the range and strength of involvement of people from these areas, whether around individual planning, policy, service design, or involvement in tender evaluation. Lived experience has become an increasingly influential and important element of the three-way partnership across business intelligence, professional knowledge, experience, and skill, allied to lived experience. 2.10 We can be confident that an infrastructure is in place to support and promote resilience, and effective early intervention, when required. Preventative, and anticipatory approaches are in place across communities, carers, and supported people, thus alleviating pressure and demand that would otherwise fall to statutory provision, for people aligned to services, whether statutory, or through CVS. 2.11 We are also confident that our approach assists with the requirements set out in the Community Wealth Building Bill (Scottish Govt, March 2025) aimed at ensuring that wealth is generated, retained, and circulated within communities. As an anchor organization, North Lanarkshire Council helps ensure that local employability options, consumer spend, and economic development can be prioritised and supported. This can be achieved by ensuring that local people continue to be consumers, citizens, and users of local services being helped to help themselves and if support is required, are supported by local people, local communities, and local organisations. Challenges 2.12 The landscape set out above helps promote and support resilience for those people currently known to services, whether statutory services, or CVS. Our investment further upstream demonstrates a strong return, irrespective of whether spending to save, deferred spend, or spend avoidance - all three hold true. 2.13 However, the National State of Caring, published March 2025, presents a concerning picture. Locally, NLCT were asked to engage with carers in our area, to get a sense of the local picture around caring, but also with a focus on resilience, inclusion, and any impacts of economic deprivation. Findings demonstrated that the local experience is more positive than the national picture but highlighted that we still have much to do. 2.14 There is, therefore, a wider consideration around supporting resilience. There are many carers and supported people not currently aligned to any services. Demographic information from a range of sources, such as the national census, local carer engagement sessions and other means, all demonstrate the scale of challenge. North Lanarkshire has an ageing population, including unpaid carers, and estimates suggest that three in every four people will have an unpaid caring role at some point in their lives. Doing more of the same as we do now is not a sustainable approach to service delivery. The demographic challenge means that we need to broaden reach- to reach people that are not aligned to services and to identify any unmet need - through whole system efforts. Next Steps 2.15 The challenge we face is how to ensure that people and communities can, and do, make advance plans; to ensure that the needs of people currently unknown to Page 33 of 174
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services, do not become service reliant, but can instead continue to live as independently as possible, with the appropriate community infrastructure in place to facilitate and enable that, through the optimal combination of self-help, preventative approaches, and anticipatory planning. 2.16 It is often the case that people only first present to services when already in crisis, with the costs in financial terms, resources and most importantly, in human terms, then being significant. Often, crisis can be avoided, through the implementation of preventative or anticipatory actions or future planning. However, when the person, or situation, first presents when already in crisis, such opportunities are lost, as the window of opportunity for introducing, options such as enabling approaches, assistive technology, or advance planning, has passed. 2.17 Accordingly, there is a need to ensure that even earlier planning takes place across communities, carers and supported people, as well as across partner organisations. Promoting self-planning, thinking ahead and sustaining resilience will be key elements of our approach. Our aim is to not only get it right for everyone known to services, but to try and ensure that people do not need to become known to services, or, if or when they do, that advance plans, rather than crisis-lead responses, set out what should happen. 2.18 Our aim is also to ensure equitable provision across the authority area and redress any current service provision imbalance in an appropriate and sustainable way. We want to ensure that we maintain our focus on Getting it Right for Everyone, through prevention, early intervention and anticipatory planning, allied to tackling inequality, in a fair, equitable and sustainable way and to ensure that there is no postcode inequality in service provision. Action to rebalance support and services to reflect this will be progressed. Partnership work in this area has already commenced, following the shared VANL thematic review. 2.19 Wider service approaches such as income maximisation, assistive technology, community hubs, ageing well initiatives and other work streams all have a continuing role to play in promoting and sustaining independence, self-help, and self-reliance and is supporting community wealth - to support resilient communities. UHSCNL and partner organisations all have a role and remit in promoting and supporting wider self- planning and individual approaches and solutions to the challenges described above. This will be the priority and area of focus moving forwards. 2.20 We will report to Committee in due course on progressing next steps. 3. Measures of success 3.1 The measures of success have not fundamentally changed since previous reporting. 3.2 All care groups and communities are engaged, included, and represented to the extent they wish to be. 3.3 Creation of better opportunities for under-represented and seldom heard people to participate and have their voices heard. 3.4 Improved opportunities to co-produce and co-design services, our Strategic Commissioning Plan and associated Programmes of Work and a better route to consult and seek feedback. 3.5 Provision of sector, locality and thematic forums that can be influenced and shaped by the engagement and participation activity set out above are delivered, on an equitable basis, across the authority area. Page 34 of 174
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4. Supporting documentation 41. N/A Morag Dendy Chief Officer (Performance, Planning and Quality Assurance) Page 35 of 174
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Page 36 of 174
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Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☐ No ☒ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. 5.11 Children’s rights and wellbeing impact Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 37 of 174
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1 North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☒ No Ref Date 23/07/25 Quality Assurance Annual Report From Morag Dendy, Chief Officer (Planning, Performance, and Quality Assurance) E-mail DendyM@northlan.gov.uk Telephone Executive Summary The role of Quality Assurance includes a broad spectrum of activity both internally across social work services, and, in partnership with our commissioned services. Assurance and Governance underpins our key functions whilst aligning our work to the Council’s Plan for North Lanarkshire and the five-year Programme of Work 2023-2028. Throughout 2024/2025, the Quality Assurance Team have participated in Strategic Planning meetings, influencing and shaping future priorities and approaches aligned with the University Health & Social Care (UHSCNL) Strategic Commissioning Plan 2023 – 2026 and the priorities outlined within the associated Programme of Work. The health and social care environment in which we operate remains challenging and sharing of best practice and solution focused ideas are integral to ensure the people of North Lanarkshire receive good quality support to help meet their outcomes. Our commitment is to provide an annual report on activity carried out in the preceding year. The purpose of this report is to update Committee on our Quality Assurance activity over the annual period of 1 April 24 to 31 March 25. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Note and endorse the contents of the report. (2) Remit the report for information to the Integration Joint Board (3) Remit the report for information to the Audit and Scrutiny Panel (4) Remit the report for information to the Education, Children and Families Committee. Item 6 Page 39 of 174
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2 1. Background 1.1 This report highlights Quality Assurance activity over the period 1 April 2024 to 31 March 2025. It outlines how work has progressed in areas which includes Contracts & Contract Management Framework, Procurement, Back to Basics – Getting it Right for Everyone, Safe Staffing, Market Facilitation, Review of Registered Social Landlords, Duty of Candour, In House Monitoring, Social Work Risk Management, ASW Governance Subgroup for Registered Managers, Participation & Engagement and Carers. 1.2 Full detail of these activities is included in Appendix One. 2. Report Contracts 2.1 The Quality Assurance Team are responsible for coordinating and facilitating all procurement activity across social work. This is in partnership with our corporate procurement colleagues, who provide the framework and legal basis to ensuring that decisions taken are in line with legislation including the Procurement Reform (Scotland) Act 2014. 2.2 Over the past year, Quality Assurance have continued to ensure consistency across purchased services and that contractual arrangements have clearly defined terms and conditions. This has ensured that expectations are clearly outlined and there is a basis for contract monitoring to take place. This enables the quality of services being provided to people to be evaluated. Arrangements range from national frameworks to Individual Placement Agreements which balance quality against cost to achieve overall best value for services purchased to support people. Contract Management Framework 2.3 Adherence with the contract management framework is an integral component of the processes in place to demonstrate commissioned services are adhering to terms and conditions and that outcomes and best value are achieved. Contract monitoring is a means to identify unmet need and inform future strategic planning and commissioning. 2.4 The Contract Management Framework was also the focus of a recent internal audit of Quality Assurance. Findings were positive, with only minor recommendations for improvement. As a result of the audit, feedback from stakeholders and new legislation, further enhancements have been made: The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities Programme of Work Resilient People Page 40 of 174
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3 • Contract Management Framework process has been made clearer with roles & responsibilities outlined for both QA staff and providers • Monitoring prioritisation assessment (MPA) modified to more clearly identify service-related risk • Analysis of quarterly return submission documented, and feedback is now given to providers • Closure date introduced for acceptance of quarterly & annual return submissions to enhance compliance • Information added to capture the principles of safe staffing legislation 2.4.1 We reported last year that we planned to produce a Quarterly Commissioned Services Performance Report. This was implemented as of 1st April 2024, to provide useful information to operational colleagues to assist in supporting people to make a choice of care provider based on the available intelligence. The report also enables the Quality Assurance Team to monitor performance, patterns, themes and trends in relation to areas such as notifications of concern, engagement & participation, Care Inspectorate Grades, Tier Ratings and compliance with annual/quarterly provider returns. 2.4.2 During the reporting period we started to provide information which assists Locality Teams in supporting people to identify their choice of care provider. All providers on the SDS Framework are included within the Performance Benchmark Tool, as are up to date contact details. Alongside each provider on the SDS Framework, we have included performance information which gives indicators to the quality of care being provided to people. We strive to ensure information is up to date. Benchmarks include Care Inspectorate grades, contract monitoring Tier indicating associated risk level and evaluation score at the time of entering the framework. Procurement 2.5 Quality Assurance continued to lead on procurement activity for all social work services in collaboration with colleagues within Corporate Procurement, Service Leads and Locality Social Work Teams, to ensure joined up planning, clear procurement processes and subsequent contract monitoring arrangements. This ensured that all commissioned contract work delivered best value, in accordance with Procurement Reform Scotland Act 2014 and the Procurement (Scotland) Regulations 2016. In House Monitoring Framework 2.6 Throughout 2024 a Test of Change for the newly developed In House Monitoring Framework continued within Home Support (Living Well at Home). The review and evaluation of the In-House Monitoring Framework commenced in December 2024 and those who had been involved in the development of this, and the participants of the Test of Change provided feedback on what worked well and what further developments could be embedded within the approach. Feedback consisted of individual meetings and group workshops. 2.7 The Senior Management Team have agreed the roll out of the revised In-House Monitoring Framework and a programme of activity will commence in April 2025. Market Facilitation 2.8 The health and social care sector continued to experience a variety of challenges. These challenges are expected to continue for some time. The Quality Assurance team continues to promote, stimulate and support market facilitation, and our approach is based on strategic intervention, relationship building, light touch intervention and Page 41 of 174
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4 supporting beneficial new relationships and activities that lead to resilient and sustainable approaches. In turn this leads to continuous improvement, improved ways of working and an active learning cycle, whereby planning impacts on delivery, review and learning. Engagement & Participation 2.9 In September 2024 the University Health and Social Care Engagement and Participation Strategy was launched alongside the Growth Pot Fund. Quality Assurance were involved in both the drafting of, and raising awareness of, the strategy and its ambitions. During the year work to collate examples of best practice to support staff across the service to further engage with those involved in services, was undertaken by Quality Assurance, in partnership with Planning and Performance colleagues. Back-to-basics to getting it right for everyone 2.10 Over the past year within Adult Health & Social Care Services, we have been working on the development of an enabling approach that supports the move from our work on back-to-basics to getting it right for everyone, as we recognise the landscape of health and social care is changing and services, supports and responses need to change to continue to improve the lives of people who live and work in North Lanarkshire. We have sought to adopt a human learning approach by trying different ways to focus more on people and less on systems and processes, and use resources to their best effect, to make the most positive impact on peoples’ lives. 2.11 Over the coming year we will further develop specific plans and service developments: as this is a whole system approach, we anticipate there will be a lot to focus on and much change across services, supports and responses that are needed to achieve and sustain change. Safe Staffing 2.12 The Health and Care (Staffing) (Scotland) Act 2019 (HCSA) came into effect on 1st April 2024. The purpose of this legislation is to establish a statutory framework to ensure appropriate staffing levels in health and care settings. North Lanarkshire Council have responsibilities as a provider of care and support and as a placing authority. 2.13 Quality Assurance supported both commissioned and in-house services with the implementation of the Act throughout the reporting period, by facilitating two dedicated working groups. 2.14 Quality Assurance have devised the Health and Care (Staffing) (Scotland) Act 2019 Annual Report for Social Work Services. Duty of Candour 2.15 All health and social care services in Scotland have an organisational duty of candour. This is a legal requirement which means that when certain types of incidents happen, the people affected understand what has happened, receive an apology, and the organisation learns how to improve for the future. 2.16 North Lanarkshire Council reviewed and modified its Duty of Candour reporting procedures during 2024/25. Throughout January, February & March 2025 Locality Page 42 of 174
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5 Social Work Managers, Senior Social Workers and Registered Managers participated in awareness raising sessions to enhance understanding of the circumstances when Duty of Candour would be considered; and the stages involved in the procedure. 2.17 The Duty of Candour notification procedure now includes two stages, which are: • Part 1 Possible Duty of Candour incident (Initial Notification) • Part 2 Managing the Duty of Candour Process 2.18 The intention underlying the introduction of the two-stage process is to enable internal monitoring and analysis of when Duty of Candour has been considered but not activated. It is envisaged that this data will contribute to organisational learning. Review of Registered Social Landlords 2.19 Since the summer of 2023, Quality Assurance has been leading on the review of five Registered Social Landlords who provided thirteen sheltered & very sheltered developments across North Lanarkshire. These services were funded to provide housing support, using Supporting People funding. This funding stream was discontinued around 2016/17, leading to mainstream social work funding being accessed pending review. This review has now concluded, and North Lanarkshire Council no longer commission or fund these Registered Social Landlords. Adult Social Work Subgroup – Registered Managers 2.20 An Adult Social Work Subgroup for Registered Managers was established in 2025. This group meet eight weekly, and the chair is the Quality Assurance Service Manager or delegated person. This group reports through the ASW Governance Group and its purpose is to ensure robust governance and oversight across Registered Services. Social Work Risk Management 2.21 Quality Assurance have oversight of the social work risk register and are responsible for quarterly & annual reporting, compliance audits and for the facilitation and coordination of the Social Work Risk Forums. Quality Assurance participate in Corporate Risk Management Team meetings, and cascade appropriate information through the correct forums. 2.22 Risk Champions and Facilitators act as points of contact for risk management matters within social work and promote risk awareness across the service. 3. Measures of success 3.1 Measures of success are contained within Appendix One of this report. 4. Supporting documentation 4.1 Appendix 1: Quality Assurance Annual Report 2024/25 Morag Dendy Chief Officer (Planning, Performance, and Quality Assurance) Page 43 of 174
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6 5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☐ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☐ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☐ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☐ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? Page 44 of 174
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7 Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☐ No ☐ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☐ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. 5.11 Children’s rights and wellbeing impact Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 45 of 174
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Quality Assurance Annual Report 2024/2025 APPENDIX 1 Page 47 of 174
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1 1. Introduction The role of Quality Assurance includes a broad spectrum of activity both internally across social work services, and, in partnership with our commissioned services. Assurance and Governance underpins our key functions whilst aligning our work to the Council’s Plan for North Lanarkshire and the five-year Programme of Work 2023-2028. Throughout 2024/2025, the Quality Assurance Team have participated in Strategic Planning meetings, influencing and shaping future priorities and approaches aligned with the University Health & Social Care (UHSCNL) Strategic Commissioning Plan 2023 – 2026 and the priorities outlined within the associated Programme of Work. Quality Assurance have strengthened the governance structure and reporting arrangements around the Strategic Commissioning Plan Programme of Work. These sit alongside and compliment structures already in place across UHSCNL. The purpose of the structure is to ensure oversight of inter-related programmes, projects and activities. Last year we reported on the expanded remit of Quality Assurance and the additional staffing resource that had been aligned. We believe that we met our key deliverables. Our achievements include the evaluation of the In-House Monitoring Framework and subsequent roll out; a review of Duty of Candour Procedures and delivery of training across Locality Teams; completion of a review of Registered Social Landlords, collation of information for inclusion in the CSWO report; development of a care opinion newsletter; the launch of the Engagement & Participation Strategy; and the organisation of the annual Committed to Carers Event. The bigger part of our work focuses on social work procurement and contract monitoring. The range of contracts that have been procured, and further development of our contract management framework are detailed within this report. Some key functions of the Quality Assurance Team were subject to audit and the findings shared. We are delighted to report that the areas of work audited reflected compliance with good practice principles and defined expectations. Much of the focus of Quality Assurance during this reporting period has been supporting our Registered Services and an Adult Social Work Subgroup for Registered Managers commenced. A safe staffing working group continues to explore best practice and develop standardised tools to evidence compliance with the Guiding Principles of the newly implemented Health and Care (Staffing) (Scotland) Act 2019. The Quality Assurance Team supported Home Support (Living Well at Home) to introduce a performance monitoring framework to ensure accountability across all grades of staff. The team also facilitated workshops and briefings to assist in expanding the knowledge of Care Inspectorate Quality Frameworks and self-evaluation tools. In line with the principles of self-directed support, people can exercise as much choice and control as they wish, around their support arrangements. Quality Assurance support this through ensuring that teams are equipped to facilitate discussions around choice of support options. Performance is now being captured through the introduction of a Quarterly Performance Report and Benchmark Tool for commissioned services. We have progressed new social work induction processes, social work self-evaluation, the reframing of risks and policy development has commenced. Test of change sites have been identified for social work self-evaluation, prior to roll out. Page 48 of 174
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2 Extensive work was carried out in relation to new legislation around reporting requirements under the Health and Care (Staffing) (Scotland) Act 2019 Act. We also supported Housing and Early Years colleagues with the aim of ensuring a consistent approach across North Lanarkshire Council to safe staffing reporting. Over the past year Quality Assurance have supported the work around our transformational change programme, Phase One Back to Basics, which is now embedded across our locality teams. As we enter Phase 2 Getting it Right for Everyone, we remain engaged and connected to the principles underlying the approach. The activities reported in this annual report reflect our commitment to on-going improvement and that people can influence and shape decision making. 2. Contracts The Quality Assurance Team are responsible for coordinating and facilitating all procurement activity across social work. This is in partnership with our corporate procurement colleagues, who provide the framework and legal basis to ensuring that decisions taken are in line with legislation including the Procurement Reform (Scotland) Act 2014. Our approach to procurement activity reflects Scottish Government best practice guidance including Procurement of Care and Support Services, and the Public Procurement Strategy for Scotland 2023 to 2028. We seek to ensure that we are acting in accordance with the principles of ethical commissioning. As a learning organisation, we continue to modify and adapt our procurement journeys to inform and secure best value, to provide care and support to people across North Lanarkshire. Following the awarding of contracts throughout 2024/2025, our internal procurement end to end process has been revised and modified to reflect what worked well and what improvements and enhancements could be made to ensure that future services are influenced, shaped and aligned to the Plan for North Lanarkshire, the Strategic Commissioning Plan and other key health and social care priorities and ambitions. The Quality Assurance Team have participated in additional procurement awareness training during this reporting period and more bespoke training is planned for August 2025. An invite will be extended to operational colleagues to take part in this training, in response to feedback from previous tendering activity. It is envisaged that the modifications made to the end-to-end procurement journey and the involvement in bespoke procurement training will assist operational colleagues to devise service specifications, which describe the service required and the outcomes to be achieved. We continued to work closely with our partners at Scotland Excel. Through Scotland Excel, we operate the National Care Home Contract, the Children's Residential Care and Education including Short Break, Services and Fostering & Continuing Care contracts from Scotland Excel. Scotland Excel have committed to redesigning the National Care Home Contract, as since its development in 2013 there have been significant changes to the social care environment. It is envisaged that redesign will be more reflective of the current social care landscape, which includes challenges such as the inexperience of the workforce, staff recruitment and retention, cost of living impacts and changing demographics/more complex needs of the care home population at the time of admission. Page 49 of 174
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3 Over the past year, Quality Assurance have continued to try and ensure consistency across purchased services and that contractual arrangements have clearly defined terms and conditions. This has ensured that expectations are clearly outlined and there is a basis for contract monitoring to take place. This enables the quality of services being provided to people to be evaluated. Arrangements range from national frameworks to Individual Placement Agreements which balance quality against cost to achieve overall best value for services purchased to support people. Tables 2a and 2b below illustrate that as of 31 March 25, 98% of all social work spend had a formal contracting arrangement in place. This figure remained consistent with 2023/2024, when we reported 98%. Two organisations are currently out of contract and subject to review during the reporting period. The review findings are under consideration and previous funding agreements are being honoured during this time. Quality Assurance continue to progress with arrangements to ensure all spend has contractual and legal agreements in place; however, it should be noted that due to the fluidity of contracting and commissioning, achievement of 100% compliance may not always be possible. Table 2a 98% 2% No of Contracts 2024/2025 Contracts in Place In Development 98% 2% No of Contracts 2023/2024 Contracts in Place In Development Page 50 of 174
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4 Table 2b There are currently 310 contracted provider organisations, a decrease of seven from the figure reported last year and as highlighted above. The number of out of authority care homes being utilised has increased by 7 and it can be determined that this is not due to lack of availability within North Lanarkshire, as there have been no capacity issues throughout the reporting period. People accessing care homes out of authority are doing so due to their choice to locate close to family. There has been a reduction in the cross-border provider organisations we contract with. It can be seen from the graphs above that non framework self-directed support has increased, and non-traditional respite packages have decreased. 3rd sector and voluntary providers have increased by 1. We encourage these providers to join our SDS Framework. The number of care homes within North Lanarkshire we contract with remains unchanged since last year and this is also the case with Self Directed Support (SDS Framework). 10 4 27 12 141 3 10 2 7 4 9 9 4 61 0 20 40 60 80 100 120 140 160 3rd Sector / Voluntary Advocacy Care Home (NLC) Care Home Cross Border Care Home Out of Authority Carers Network Fostering & Continuing Care Mental Health Misc Non Framework Self Directed Support Non Traditional Respite Residential Schools Secure Services Self Directed Support Spread of Providers 2023/2024 11 4 27 3 148 10 10 2 7 5 8 10 4 61 0 20 40 60 80 100 120 140 160 3rd Sector / Voluntary Advocacy Care Home (NLC) Carers Network Care Home (Out of Authority) Care Home (Cross Border) Fostering & Continuing Care Mental Health Misc Non Framework Self Directed Support Non Traditional Respite Residential Schools Secure Services Self Directed Support Spread of Providers -2024/2025 Page 51 of 174
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5 3. Contract Management Framework (CMF) The two most recent Quality Assurance Annual Reports (2022/23 & 2023/2024) provided updates on developments and enhancements to the contract management framework. From the cyclical changes implemented, and throughout the 2023/24 reporting period, the Quality Assurance team evaluated the impact of the changes. Various methods of evaluation were utilised, including an on-line meeting with commissioned services. Other methods included a Quality Assurance presentation at one of the SDS Provider Development Sessions, feedback from Internal Audit, on-going discussions at team meetings and through the findings of senior officers’ use of the framework, findings from service manager sampling and compliance checks. This approach reflects one of a learning organisation and focuses on our overarching aims, which include monitoring our commissioned services to enable effective partnership working, early intervention and the targeting of resources to improve the experience of people. Adherence with the contract management framework is an integral component of the processes in place to demonstrate commissioned services are adhering to terms and conditions and that outcomes and best value are achieved. Contract monitoring is a means to identify unmet need and inform future strategic planning and commissioning. The main changes made to the contract management framework and as highlighted in 2022/2023 & 2023/2024 annual reports are as follows: - - Introduction of an Engagement & Participation Toolkit - Quarterly & annual returns being specific to the model of service - Monitoring Visit report template introduced to improve on consistency and the impact from monitoring In January 2025 Quality Assurance arranged a feedback session focusing on the changes made to the contract management framework. Over 40 providers attended. Feedback was used to further build on developments to avoid duplication of reporting or collation of unnecessary information. The outcome was an improved and more relevant framework. In March 2025 Quality Assurance facilitated a further session on the contract management framework at one of the SDS Provider Development Days. Feedback was positive and promoted enhanced understanding and awareness. The Contract Management Framework was also the focus of a recent internal audit of Quality Assurance. Findings were positive, with only minor recommendations for improvement. As a result of the audit, feedback from stakeholders and new legislation, further enhancements have been made: • Contract Management Framework process has been made clearer with roles & responsibilities outlined for both QA staff and providers • Monitoring prioritisation assessment (MPA) modified to more clearly identify service-related risk • Analysis of quarterly return submission documented, and feedback is now given to providers • Closure date introduced for acceptance of quarterly & annual return submissions to enhance compliance • Information added to capture the principles of safe staffing legislation The revised MPA can be seen below in two parts (Table 3a & 3B) It is based on a confidence rating and focuses on assessment areas which indicate the potential risk of lower-than- Page 52 of 174
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6 expected standards of care and support being provided. Outcomes are nuanced and determined based on narrative provided by Senior Officers who have additional context as to circumstances, as well as established relationships with providers. This approach is balanced with an element of standardisation. Table 3a Table 3b Page 53 of 174
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7 The MPA outcome indicates the tier level and associated frequency of monitoring required by Quality Assurance Senior Officers. See below: - Each Tier suggests a minimum monitoring frequency as set out in Table 3c below Table 3c STATUS INDICATED MONITORING LEVEL Red Significant concerns in relation to service performance, contract compliance. TIER 4 Contract monitoring visit frequency – 1 to 4 weekly. Amber Moderate concerns in relation to service performance, contract Compliance TIER 3 Contract monitoring visit frequency – variable, at least quarterly but no more than monthly. Yellow Minor concerns identified in relation to service performance and contract compliance TIER 2 Contract monitoring visit frequency – variable, at least bi-annually but no more than quarterly. Green Service performance, contract compliance and engagement are satisfactory. TIER 1 Contract monitoring visit frequency – annually in most cases. Page 54 of 174
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8 Table 3c The on-going improvements to our contract management framework ensure that due diligence is consistently and clearly documented and decisions are based on facts and evidence. This safeguards North Lanarkshire Council from potential reputational or financial consequences. Table 3c highlights Tier Levels as reported at the end of 2023/2024 and for the same time in 2024/2025. Tier 4 services have increased in this reporting period from 0% to 5%. However, it is positive that the risks are known to the team, as this ensures these can be mitigated with the appropriate interventions. When comparing the lower tier ratings (1 & 2) across both reporting periods, there was a 3% reduction from 2023/2024 and for Tiers 3&4 there was a 2% increase from 2023/2024. Overall, most providers were tiered within the lower Tier rating categories. This is positive as the intensity and frequency of Care Inspections, and our monitoring activity has been enhanced. Quality Assurance are mindful of the challenges being experienced within the sector and are pleased to report that in spite of the challenges evidence highlights an improved quality of care from 2023/24. Tier 1 Tier 2 Tier 3 Tier 4 Q4 2024 to 2025 74% 16% 5% 5% Q4 2023 to 2024 68% 25% 8% 0% 0% 10% 20% 30% 40% 50% 60% 70% 80% Commissioned Services Q4 Tier Ratings 2023/2024 & 2024/2025 Q4 2024 to 2025 Q4 2023 to 2024 Page 55 of 174
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9 Commissioned Services Quarterly Performance Report – We reported last year that we planned to produce a Quarterly Commissioned Services Performance Report. This was implemented as of 1st April 2024, and it is intended to provide useful information to operational colleagues to assist in supporting people to make a choice of care provider based on the available intelligence. The report also enables the Quality Assurance Team to monitor performance, patterns, themes and trends in relation to areas such as notifications of concern, engagement & participation, Care Inspectorate Grades, Tier Ratings and compliance with annual/quarterly provider returns. The format of the Commissioned Services Quarterly Performance Report has continued to change and develop in response to feedback from Localities. Feedback indicated it would be helpful for Localities to receive updates following submission of Notifications of Concern about provider performance. We introduced a feedback section within the Notification of Concern Form. We also track the timescales for feedback to be provided. Levels of Engagement and Participation have continuously increased. Over the reporting period we engaged with the following: Table 3d Supported people Staff Relatives/ carers Other Amount 146 276 134 48 0 50 100 150 200 250 300 No of people engaged with as at 31/03/2025 Supported people Staff Relatives/ carers Other Q1 3 11 2 0 Q2 43 80 32 18 Q3 68 109 60 20 Q4 32 76 40 10 0 20 40 60 80 100 120 No of people engaged with during each quarter 2024/2025 Page 56 of 174
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10 We continue to measure the impact of this engagement. Some examples are shown below: - Table 3e GP is now based within the Care Home one day a week. Provider ensured consistency and improvement in staffing arrangements. Manager arranged a meeting with the family to outline the staffing arrangements and to provide reassurance around their concerns The need to provide information about people’s likes and dislikes in Agency staff induction and handovers was agreed. This has been added to the service development plan. Previous concerns around prearranged GP appointments. Discussed concerns with the management team Concerns around inadequate staffing levels at night raised by family Discussion took place with the manager who confirmed safe staffing levels were in place Some carers are better than others Senior Officer discussed with manager and asked for follow up Agency staff who do not know the residents Information relayed to the manager Page 57 of 174
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11 Performance Benchmark Tool – During the reporting period we started to provide information which we hope will assist Locality Teams in supporting people to identify their choice of care provider. All providers on the SDS Framework are included within the Performance Benchmark Tool, as are up to date contact details. Alongside each provider on the SDS Framework, we have included performance information which gives indicators to the quality of care being provided to people. We strive to ensure information is up to date. Benchmarks include Care Inspectorate grades, contract monitoring Tier indicating associated risk level and evaluation score at the time of entering the framework. 4. Regulatory Activity Table 4a below details an analysis of the key question “How well do we support people’s wellbeing?”. The data has been extracted from Tables 4b and 4c below. North Lanarkshire Care Homes performance measures lower than Scotland wide care homes, in that 72% of grades of 4 and above were awarded. Scotland wide care homes achieved 76.6% of grades of 4 and above. From the figures below it would appear that North Lanarkshire care homes seem to have an overall average of grades ranging between adequate and good. An improvement area would be to start to focus on why very few care homes are achieving good or above grades. 132 Scotland wide care inspections are reported below for the period 1st April 2024 – 31st March 2025. Please note some care homes have not been inspected or have not been inspected under this key question. Table 4a - Please note North Lanarkshire care homes are not included in the overall Scotland wide figures. How well do we support people’s wellbeing Number of Care Homes Assessed Grades Awarded Percentage North Lanarkshire Care Homes (Table 4b) 25 0 x Excellent 5 x Very Good 13 x Good 4 x Adequate 0 x Weak 0 x Unsatisfactory 3 x Not Assessed 0% 20% 52% 16% 0% 0% 12% Scotland Wide Care Homes (Table 4c) 107 3 x Excellent 38 x Very Good 41 x Good 17 x Adequate 1 x Weak 0 x Unsatisfactory 3% 35% 38% 16% 1% 0% Page 58 of 174
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12 7 x Not Assessed 7% Table 4b As of 31st March 2025, there were 27 care homes within North Lanarkshire. 24 of the care homes had been assessed by the Care Inspectorate against their key question of, ‘How well do we support people’s wellbeing?’. None of the care homes assessed achieved the highest grade of ‘Excellent’, however 29.1% of care homes achieved ‘Very Good’. How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Very Good 3 2 1 2 0 Good 15 13 9 6 9 Adequate 5 7 3 5 2 Weak 4 3 0 3 2 Unsatisfactory 0 1 1 0 0 0246810121416 Care Inspectorate Grades -North Lanarkshire based Care Home as at 31/03/2024 How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Very Good 7 4 4 1 0 Good 13 7 14 13 11 Adequate 4 7 3 2 4 Not assessed 3 9 6 11 12 0 2 4 6 8 10 12 14 16 Care Inspectorate Grades -North Lanarkshire based Care Home as at 31/03/2025 Page 59 of 174
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13 The majority of care homes were assessed as ‘Good’ or better against this question, totalling 54.1%. It is positive to note that the number of care homes assessed as Very Good has increased from 11.1% in 2023/2024. The care homes who were assessed as ‘Very Good’ were Blair House, Carrickstone, Darroch, Highgate, Kirknowe, Rosepark and Summerlee. Of the 27 care homes within North Lanarkshire, 15 were assessed under key question ‘How well is care and support planned?’ Of the 15 assessed, 73% received a grade of ‘Good’. During the reporting period, no care homes within North Lanarkshire were subject to Large Scale Investigations. From 1st April 2024 to 31st March 2025 there were a total of six care homes within North Lanarkshire, who at periods, had a voluntary moratorium applied to all new admissions. These were Avondale, Darroch, Carrickstone, Milbrae, Parksprings and Woodside. Out with Avondale, whose moratorium was applied due to a change in contract, the remaining five care homes were for reasons of weak Care Inspectorate grades and the findings from monitoring carried out by Quality Assurance. The duration of these moratoriums was a maximum of three months with some being removed with one or two months. Cumbernauld Care Home had an enforced moratorium due to weak Care Inspectorate grades. Improvements were quickly embedded by the Provider and the moratorium to new admissions was removed within three months. It is important to note the application of a moratorium to new admissions is to enable the care homes to focus on progressing identified improvement areas. Page 60 of 174
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14 Table 4c Care Homes in Scotland (excluding North Lanarkshire): North Lanarkshire Council currently has 313 people placed within 122 care homes that are located elsewhere in Scotland. Contract Monitoring activity is carried out by the host authority where the care home is geographically located, although care management responsibilities remain with North Lanarkshire Council for the individuals placed. Individual Placement Agreements are implemented for individuals and these agreements detail the basis for care and support. North Lanarkshire Council are notified of any Large-Scale Investigation activity or potential scenarios which may lead to the closure of the home e.g. Care Inspection Enforcement Action, Liquidation etc. How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Excellent 0 1 0 1 0 Very Good 39 40 15 9 13 Good 56 44 34 37 38 Adequate 30 27 19 12 25 Weak 2 2 1 2 1 0 10 20 30 40 50 60 Care Inspectorate Grades -Care Home as at 31/03/2024 (excluding NLC) How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Excellent 4 2 0 1 0 Very Good 58 36 45 20 22 Good 58 44 50 49 41 Adequate 18 25 17 15 23 Weak 1 2 2 0 0 Not assessed 9 39 34 63 62 0 10 20 30 40 50 60 70 Care Inspectorate Grades -Care Home as at 31/03/2025 (excluding NLC) Page 61 of 174
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15 Table 4d How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? How well do we support Children and Young People's Rights and Well-Being Care and Support Environment Staffing Management and Leadership Excellent 3 0 2 0 0 0 0 0 0 0 Very Good 32 21 21 1 12 1 2 0 2 1 Good 12 15 10 1 10 1 0 0 0 1 Adequate 7 6 6 0 6 0 0 0 0 0 Weak 1 1 2 0 1 0 0 0 0 0 Not assessed 6 18 20 59 32 0 0 2 0 0 0 10 20 30 40 50 60 70 Care Inspectorate Grades -Self Directed Support including Care at Home as at 31/03/2025 Page 62 of 174
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16 Table 4e Self-Directed Support (SDS) including Care at Home: Across the services on the SDS Framework a total of 38 Care Inspections took place using the current inspection methodology. There remain two services whose last inspections were carried out in accordance with a previous inspection approach. How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Excellent 1 0 0 0 0 Very Good 27 16 7 1 7 Good 16 20 9 2 9 Adequate 3 8 1 0 3 Weak 2 2 2 0 2 0 5 10 15 20 25 30 Care Inspectorate Grades -Self Directed Support including Care at Home as at 31/03/2024 Page 63 of 174
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17 The table above outlines 61 services with their current grades under each Key Questions as of 31st March 2025. This table highlights that for Key Question 1 ‘How well do we support people’s wellbeing?’ Three services received a grade of ‘Excellent’. These services were Active Care and Support Services, Potential Living (VAMW) and Support for Ordinary Living (SOL). A grade of ‘Very Good’ was received by 58.1% of services and 21.8% of services inspected received grades of ‘Good’ or above. For the key question ‘How well do we support people’s wellbeing?’, one service received a grade of ‘Weak’. This service was Aspire West Support Service Care at Home. Of the 61 services, 29 were inspected by the Care Inspectorate against the key question ‘How well is care and support planned?’. Of these, 41.3% received grades of ‘Very Good’ and 34.5% received grades of ‘Good’, or above. It should however be taken into consideration that a further two services have grades of ‘Very Good’ under Quality of Care and Support from the previous Care Inspectorate approach. This means that 45.1% of services inspected received grades of ‘Very Good’. During the reporting period no SDS Framework services were subject to Large Scale Investigations. From 1st April 2024 to 31st March 2025 there were a total of six SDS Framework services within North Lanarkshire, at periods, that had a voluntary moratorium applied to supporting any new people. These were Aspire, Ayrshire Children’s Service, Cera Care, Enable, Invercare and Home Instead. Out with Home Instead, whose moratorium was applied due to a change in contract, the remaining five SDS Framework services were for reasons of weak Care Inspectorate grades and findings from monitoring carried out by Quality Assurance. Care 1 Professional had an enforced moratorium due to weak Care Inspectorate grades. When taking into consideration timescales for moratoriums being applied, SDS Framework services were in place for considerably longer than care homes with an average period being approximately six months. Page 64 of 174
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18 5. In-house Monitoring Framework Throughout 2024 a Test of Change for the newly developed In House Monitoring Framework continued within Home Support (Living Well at Home). The review and evaluation of the In-House Monitoring Framework commenced in December 2024 and those who had been involved in the development of this, and the participants of the Test of Change provided feedback on what worked well and what further developments could be embedded within the approach. Feedback consisted of individual meetings and group workshops. The evaluation highlighted the need for a greater focus on engaging with people to inform self-evaluation improvement plans during Stage One of the process. Furthermore, the timescales and documentation/tools have benefited from slight modifications in response to what people told us during the engagement and evaluation. The Senior Management Team have agreed the roll out of the revised In-House Monitoring Framework and a programme of activity will commence in April 2025. Prior to roll out, briefing sessions will be facilitated by Quality Assurance for Registered Managers and Service Managers/Locality Social Work Managers, who are scheduled to participate in the process throughout 2025/26. Services in scope are Locality Support Services, Integrated Day Services and the Children’s Residential Houses. Two localities from Home Support (Living Well at Home) will recommence the cycle as of April 2025 as they achieved Tier 1 status. The remaining four localities continue to engage with Quality Assurance six weekly, to monitor progress of improvement plans, due to them being assessed as Tier 2 status. Prior to roll out of the In-House Monitoring Framework, the Quality Assurance Team will facilitate Improvement workshops for Registered Page 65 of 174
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19 Managers and their teams, which will focus on self-evaluation, quality frameworks and the tools to assist in this process. Page 66 of 174
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20 6. Market Facilitation The health and social care sector continued to experience a variety of challenges, which have been mentioned throughout this report. These challenges are expected to continue for some time. The Quality Assurance team continues to promote, stimulate and support market facilitation, and our approach is based on strategic intervention, relationship building, light touch intervention and supporting beneficial new relationships and activities that lead to resilient and sustainable approaches. In turn this leads to continuous improvement, improved ways of working and an active learning cycle, whereby planning impacts on delivery, review and learning. Work with Enterprise & Communities Team - The Quality Assurance Team continued to liaise with colleagues across the council to identify and support initiatives to assist providers to flourish, remain sustainable and deliver excellent care and support to people across North Lanarkshire. There is a plan for Quality Assurance and Enterprise & Communities to jointly visit a variety of care homes and SDS Framework providers supporting people at home. The aim of these visits will be to hear directly from providers what the challenges are and to identify ways in which the council can support long term sustainability and growth. A report will be made available following the programme of visits which will take place throughout 2025/26. Care Academy - Quality Assurance continued to participate in the work activity of the Care Academy which consists of representatives from North Lanarkshire Council, South Lanarkshire Council and NHS Lanarkshire. The overall vision for the Care Academy is to: Develop a robust, sustained, vibrant Care Academy attracting and developing a diverse workforce for health and care services in Lanarkshire and promoting the sector as a rewarding choice for careers. Increase awareness and engagement about the Care Academy across all partners and organisations, to support people from our communities, working in our communities. The aims of the Care Academy are to: 1. Create the health and social care workforce for the future that best serves the needs of people living in Lanarkshire. 2. Contribute to addressing deprivation and inequalities across Lanarkshire to help people live their lives to the fullest. 3. Provide pathways to fair work, meaningful employment, and progression across the breadth of health and social care. Page 67 of 174
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21 4. Build a strong talent pipeline to meet future demand and reduce skills shortages within the health and social care sector across Lanarkshire. Further Roll Out of Funding to Support Workplace Scheme- Quality Assurance are currently planning, through the Care Academy to further build on an initiative whereby funding was provided by North Lanarkshire Council to Lanarkshire Care Partners, who deliver care at home services to people across North Lanarkshire. This workplace scheme has already achieved the following: - • 8 North Lanarkshire jobseekers secured paid work. • Over 500 hours of work were paid at a rate above SLW. • Approx.152 CPD points accrued. • SCQF level 5 qualifications gained in Emergency First Aid at Work and Moving and Assisting People. • 7 people finished the placement scheme and are qualified to fill gaps in the Health and Social Care workforce. • 5 offers of employment were made by us to people who would not have been on our recruitment radar without the work-placement scheme. • Approximately £1000 increase in revenue to local businesses contracted to deliver some of the scheme training. Other Care Academy Priorities - Quality Assurance have also been involved in a variety of other deliverables identified by the Care Academy, including the development of micro businesses within Adult Health & Social Care, development of local market facilitation plans, engagement with the principles of the Community Wealth Building and exploring options for funding to support training and wellbeing across the sector Impact of Increase in Employer National Insurance Contributions - Adult service colleagues liaised with providers to consider individual, unique and collaborative ways of minimising the impact of the increase in employer national insurance contributions. Meetings have taken place to ensure a solution focused approach to this. Provider Capacity Portal – Last year we reported that we would be rolling out a new portal whereby SDS Framework Providers would be able to report their capacity to deliver work. This roll out took place following an initial test of change. Feedback has been positive from providers and locality teams, in that the original aim to minimise the time impact for all, has been achieved through this reporting system. 7. Carer and carer focused organisations The Quality Assurance team participated in a range of carer focused work over the year, including a large-scale procurement exercise, monitoring of the commissioned carer focused organisations, engagement and participation focused activity, involvement in Carers Week and development work with the wider carer support network. The second annual Commitment to Carers event in North Lanarkshire was also organised and Page 68 of 174
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22 facilitated by Quality Assurance and supported by the commissioned carer organisations, again demonstrating the excellent partnership ethos to support carers locally. The Quality Assurance team continued to be influential in ensuring that North Lanarkshire maintained and further developed the long-standing positive record of engagement and participation and strong relationships with carers, and carer focused organisations. Over the reporting year Quality Assurance continued to engage with unpaid carers and carer focused organisations, to build on progress to date, and upon the intent set out in both the national Carers Strategy and the North Lanarkshire Carers Strategy 2024-2027. Quality Assurance led in certain areas of this work, offered support and guidance in other areas, and had an assurance overview throughout. Carers in North Lanarkshire are subject to the many challenges faced by unpaid carers nationally – around accessing breaks from caring, the hidden costs of caring, and issues with accessing replacement care are widely known and recognised, but solutions can be harder to identify. National Census information confirms that more people are having to provide unpaid care. In North Lanarkshire there is an ageing population of unpaid carers, and resources remain limited, whilst needs are infinite. Quality Assurance were involved in influencing and shaping how to best meet these challenges in a sustainable and innovative way, and the local carer experience over the past year continues to be significantly more positive than the findings and statistics reported nationally. This was evidenced through Quality Assurance monitoring and engagement with carers. In line with legislative requirements, a Procurement Exercise, led by Quality Assurance took place in late 2024 to identify carer focused organisations who would work in close partnership with UHSCNL to meet the needs and outcomes of unpaid carers locally. The UHSCNL financial commitment to support carers within this Tender was £18 million and involved significant engagement with carers and other stakeholders, resulting in key areas identified as being: • Adult Carer Support and Adult Carer Support Plans • Carer Information, Advice, Campaigning, Engagement and Participation • Dementia specific caring • Hospital Discharge related caring. • Support for Young Carers The successful bidders were: • Lanarkshire Carers • North Lanarkshire Carers Together (NLCT) Page 69 of 174
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23 • Alzheimer’s Scotland • Getting Better Together • Action for Children Young Carers Support Project Funding was also provided for: PAMIS – to offer a Family Support Service for families caring for individuals with profound, complex, and multiple disabilities, where specialist knowledge was required. HOPE for Autism - to support children, adults, and family carers, where Autism or Neurodivergence is a feature. Quality Assurance monitoring ensured continued strategic fit, best value, positive impact, and an outcome focused approach. Quality Assurance were also involved in the commissioning of North Lanarkshire Disability Forum (NLDF) - to deliver on the Engagement and Participation Strategy 2024 -2027. Engagement across seldom heard communities and organisations resulted in the voices of previously “hidden” carers also coming to the fore. Through a separate Tender led by Quality Assurance, the Adult Carer Advocacy remit was re-aligned to an Advocacy provider organisation, having previously been hosted by NLCT. Quality Assurance continued to be involved in both governance and operational activity around the Community Solutions programme, facilitated by Voluntary Action North Lanarkshire (VANL). A range of engagement and participation activities aimed at all carers, but with a focus on underrepresented individuals, groups, or communities, including carers from minority ethnic communities and LGBTQI+ communities and involving Quality Assurance, was progressed throughout the year. Funding was made available by Quality Assurance, for an Equalities post within NLCT, and this augmented a similar existing post within Lanarkshire Carers. Quality Assurance were involved in assessing funding applications across a variety of funding streams, including Carer Breather, VANL Community Mental and Well Being Fund, NLDF Growth Pot, and NLC Grant Awards Programme. The range of CVS organisations, including those with an age-related, or condition specific focus, continue to have a role in direct, or indirect, support to carers as well as supported people. Monitoring and quality evaluation regarding carer support across these organisations took place throughout the year to ensure that we continue to have a strong focus on approaches that are carer and supported people led. Page 70 of 174
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24 Quality Assurance continued to be involved in governance structures and strategic forums, involvement in improvement areas, consultation, and co- production, with identified actions that further engagement and participation in our day-to-day practice. 8. Commitment to Carers Event The 2nd annual Commitment to Carers Event took place in Motherwell in May 2024, following on from the inaugural event in Bellshill in 2023. The event saw a number of carers and young carers delivering keynote addresses on various caring related topics. The event, hosted by UHSCNL also served as the official launch of the North Lanarkshire Carers Strategy 2024 -2027. As part of the movement towards ever greater carer engagement and participation, responsibility for the annual Commitment to Carers Event has now passed from UHSCNL to NLCT, with the 3rd annual event continuing to have a focus on celebrating the impact of caring and carer focused activity, and is scheduled for November 2025, at the Chryston Community Hub. 9. Participation and Engagement Quality Assurance were instrumental in the progress made over the year to increase the capacity to enhance engagement and participation, across our communities, and amongst supported people and unpaid carers. This work continued over the year, in line with Ambition Statement 19, in the Plan for North Lanarkshire (Improve engagement with communities and develop their capacity to help themselves.) This is also priority within UHSCNL Strategic Commissioning Plan and is critical to ensuring: • We involve people in the decisions that affect their wellbeing. • Improvement comes from feedback on the experiences of services and supports. • Our services and supports continue to be based on what matters to people. • We have a continued focus on person centred approaches to embed the wider approach to Getting it Right for Everyone. The key ambitions of our continued investment to engage supported people, unpaid carers and communities is to: • Improve communication and increase connections • Increase awareness of what matters to people Page 71 of 174
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25 • Increase capacity for early intervention and prevention During 2024-25 the investment and focus to ensure that the voices of supported people were strengthened, gathered pace. The consortium of North Lanarkshire Disability Forum (NLDF), Lanarkshire Links (LL) and Voice of Experience Forum (VoEF), worked together to engage with supported people and support active participation. To help facilitate this, Quality Assurance provided a Growth Pot managed by NLDF. Across 2024-25 there were two rounds of Growth Pot funding that generated 55 applications and 20 awards totalling just over £80,000 to community organisations. The fund reached minority ethnic groups, rural communities and those who experience disability, mental health issues and addictions. The North Public Partnership Forum comprises 3 local forums in North Lanarkshire: Cumbernauld; Kilsyth and Villages; Northern Corridor. During the calendar year the forum decided to change their name to Lanarkshire North Partnership Forum to better represent the areas in North Lanarkshire in which they operate and as part of a review of their core functions. Over the last 12 months the forum’s views have been sought on a range of topics from health colleagues including Effective Prescribing, Pharmacotherapy and Treatment Escalation Plans. Quality Assurance participated in the forum and acted as a conduit to help facilitate progress, resolve issues and link to operational colleagues. In September 2024 the University Health and Social Care Engagement and Participation Strategy was launched alongside the Growth Pot Fund mentioned above. Quality Assurance were involved in both the drafting of, and raising awareness of, the strategy and its ambitions. During the year work to collate examples of best practice to support staff across the service to further engagement with those involved in services and supports was undertaken by Quality Assurance, in partnership with Planning and Performance colleagues. The Strategy for Carers 2024 – 27 was developed with carers and carer organisations and led by Quality Assurance. Carer related work is reported on in a previous section. Similarly, Quality Assurance support to Voluntary Action North Lanarkshire, (VANL) who oversee the Community Solutions programme, and the Children, Young People and Family Network is contained in another section of this report. Quality Assurance helps facilitate a broader reach within communities and supports opportunities for people to engage in what matters to them in North Lanarkshire. Engagement with localities builds community capacity, through anchor organisations and Community Consortia provide leadership and co-ordination of activities. The commissioning of Care Opinion in adult health and social care sought to ensure that there were opportunities online for adults, children and young people to feedback on their experiences and raise any concerns across the commissioned and funded services in North Lanarkshire. Quality Assurance has a coordination role in relation to Care Opinion. Page 72 of 174
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26 Care Opinion - Care Opinion is an independent, non-profit, web-based feedback platform where people can submit their experiences of health and social care services whether positive or negative. Comments are moderated and forwarded to the relevant service who can respond directly. 2024/2025 saw the introduction of a Care Opinion Newsletter produced by Quality Assurance. This has enabled feedback to be shared across networks and promotes the use of Care Opinion. The Care Opinion Newsletter celebrates positive feedback, highlights any lessons learned and is published quarterly. 10. Communications Quality Assurance have a key function within the area of communication. This includes the following responsibilities: - • Overseeing and updating North Lanarkshire Council (Social Work) and UHSCNL websites • Governing social work resources, policies and procedures held on our SharePoint site • Owners and administrators of Viva Engage – which includes responding to queries and sharing updates in relation to Subject Access Requests and Resources, Policies & Procedures • Quality Assurance Newsletter • Care Opinion Newsletter and administration of the stories received by UHSCNL Quality Assurance Newsletter During the reporting period the newsletter was refreshed and published three times. Having reviewed our Quality Assurance communications and the number of views from social work staff it was decided that a Quarterly Commissioned Services Report would be published. More information is available about this report under Contract Management Framework. Social Work Induction Talent and Organisational Development (TOD) initially developed a Social Work Induction Platform. Quality Assurance have continued to expand this with a specific focus on how we practice within North Lanarkshire. Various social work representatives have contributed to the development of this. Quality Assurance will continue to host a forum for ensuring on-going review. The current Social Work Induction Platform has been shared with IT Leads who will update accordingly. This work will progress during 2025/26. The focus from Quality Assurance will be to develop a standardised and localised induction programme which will concentrate on learning, development and reflective practice at key points, following commencement in a new post. Page 73 of 174
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27 11. Information Governance Quality Assurance had oversight to ensure that information was dealt with to the highest standards, ensuring fairness, consistency, and security. The Information Governance Framework supports in fulfilling these responsibilities. The team coordinate: • Subject Access Requests (SARs), including reviews, complaints from the Information Commissioner’s Office (ICO). • Quarterly SAR statistics. • Freedom of Information (FOISA) requests, including reviews and complaints from the Scottish Information Commissioner. • Data Protection Impact Assessments (DPIAs). • Data Protection Act (DPA) or Schedule 2 requests. • Annual ICO statistics. • Quarterly Corporate Key Performance Indicators (KPIs). The benefits of Information Governance for the council includes but is not limited to, enhanced data security, regulatory compliance, improved data quality, risk management, cost reduction, efficiency and accountability. Quality Assurance consult with the Freedom of Information Team and Data Protection Team, who guide internal processes in accordance with legislation. There was a continued focus on coaching, mentoring and training of locality administrative staff and field workers, in relation to SARs and SARs recording. This followed from the review and update of SAR’s recording systems. SARS statistics 2024/2025 The upcoming focus and development within Social Work Information Governance will focus on monitoring and tracking across all social work teams. 114 63 290 341 208 0 50 100 150 200 250 300 350 400 CASES AT START OF APRIL 2024 CASES AT END OF FEBRUARY 2025 TOTAL NUMBER OF SARS RECEIVED: TOTAL NUMBER OF SARS CLOSED: TOTAL NUMBER CLOSED ON TIME: SAR Information as at 31/03/2025 Page 74 of 174
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28 12. Procurement Quality Assurance continued to lead on procurement activity for all social work services in collaboration with colleagues within Corporate Procurement, Service Leads and Locality Social Work Teams, to ensure joined up planning, clear procurement processes and subsequent contract monitoring arrangements. This ensured that all commissioned contract work delivered best value, in accordance with Procurement Reform Scotland Act 2014 and the Procurement (Scotland) Regulations 2016. Quality Assurance support individual’s rights to determine the way they receive support, and this includes the right to select a provider who is not on any of our contract frameworks. On these occasions, and following due diligence checks of the preferred provider, Individual Placement Agreements (IPA’s) are created to ensure there is a shared basis between North Lanarkshire Council and the Provider for the delivery and manner of support. In the past year, 56 citizens of North Lanarkshire chose this route for support. Table 12a - Procurement activity for contracts under £50,000 undertaken in 2024/2025. Provider Contract Overview Service Area / Procurement Category Total Value of Contract (Excl VAT) Contract Start Date Contract End Date Commercial Strategy Sourcing Route Disabled Enabled Ltd: Access Panel North Lanarkshire Provision of advice and guidance in supporting and ensuring accessibility across North Lanarkshire buildings and the built environments Adult Social Work Services £4,684 01/04/2024 31/04/25 Re-Procurement Proposal for Funding SACRO Provision of an individual service using a mentoring Children, Families and Justice Social £49,995.00 01/06/2024 30/06/2025 Re-Procurement Proposal for Funding Page 75 of 174
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29 approach, which is a way of helping and supporting individuals with issues they might be facing both practically and emotionally. Work Services Ten for Zen Provision of the mindfulness sessions online and in person service users could develop skills, which is a way of helping and supporting individuals with issues they might be facing both practically and emotionally Children, Families and Justice Social Work Services £32,850.00 01/04/2024 31/03/2026 Re-Procurement Proposal for Funding Lanarkshire Counselling &CBT Centre (LCCC Scotland Ltd) Provision of counselling services, in person, virtually and by telephone, service users have the opportunity to Adult Social Work Services £33,600.00 01/04/2024 31/03/2025 New Requirement Proposal for Funding Page 76 of 174
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30 address problematic areas in their lives with a trained counselling professional. Yoga Through the provision of the yoga and breath work in person sessions, service users have the opportunity to reduce stress, improve mental and physical health and improve coping skills. Children, Families and Justice Social Work Services £5,190 01/04/2024 31/03/2025 New Requirement Proposal for Funding Wise Group An on-line service that assists people to develop life skills. It is a secure flexible service for people being supported by a range of Justice Services and can count Children, Families and Justice Social Work Services £31,506 01/04/2024 31/03/2025 Re-Procurement Proposal for Funding Page 77 of 174
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31 towards the other activity element of a community payback order Families Outside A support service for families in North Lanarkshire who are affected by imprisonment Children, Families and Justice Social Work Services £56,188 01/04/2024 31/03/2025 New Requirement Proposal for Funding PAMIS Family information, advice, and support service for families in situations where a family member has a significant level of disability - profound and multiple learning disability (PMLD). Adult Social Work Services £36,500.00 01/04/2024 31/03/2025 Re-Procurement Proposal for Funding Shelter Scotland Provision of Specialist Housing Advocacy Service Adult Social Work Services £25,000.00 01/07/2024 31/03/2025 Re-Procurement Proposal for Funding Page 78 of 174
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32 Improvement Service Provision of independent support from the improvement service to offer workshops, consultation and engagement to help direct a review of family support. Children, Families and Justice Social Work Services £5,000.00 09/09/2024 01/06/2026 New Requirement Proposal for Funding Deaf Services Lanarkshire Provision of support to reduce inequalities for people with a sensory impairment Adult Social Work Services £10,000 01/02/2025 31/07/2025 Re-Procurement Proposal for Funding Barnardo’s Scotland To provide a Missing Persons Service across the North Lanarkshire to children and young people who have been reported missing to Police Scotland. Children, Families and Justice Social Work Services £50,000 16/02/2024 15/02/2025 Re-Procurement Proposal for Funding Page 79 of 174
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33 Care Opinion The purpose of the Care Opinion Subscription is to: • Provide an innovative model which assists and enables the Subscriber to fulfil their public engagement involvement responsibilities; • Enables the Subscriber to compare feedback on the Care Opinion website across local services using alerts and push reporting to provide access to performance management information for staff, managers, partnership, elected officials and key Social Work £35,936 01/11/2024 31/10/2027 Re-Procurement SLA Page 80 of 174
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34 stakeholders including public partners; • Provide evidence about the quality of services provision which can be used to support relevant standards in relation to quality and participation of people who use services. Table 12b - Procurement activity for Contracts over £50,000 undertaken in 2024/2025. Contract Title Contract Overview Total Value of Contract (Excl VAT) Service Area Contract Start Date Contract End Date (Excl Extensions) Advocacy Services for Children & Young People Due to new legislation to be introduced by Scottish Government during the early part of 2025, it is necessary to grant a direct award for 12 months to the current provider. This will enable the service to develop and take cognisance of the new legislation. A subsequent open tender will take place in 2025/2026. Provision of advocacy services to children and young people is in support of their rights as individuals as set out in the United Nations Convention on the Rights of the Child (UNCRC), which aims to support children in all areas of their lives. £241,000.00 Children, Families and Justice Social Work Services 03/03/2025 28/02/2026 Page 81 of 174
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35 Befriending Service The aim of this support is to provide additional resource to Children’s Services Planning Partnerships to provide the right support at the earliest time to children, young people and families. This also supports the ambitions of the Promise; to provide flexible and responsive support, enabling more children to remain loved and supported within their own families and develop resilience, self-esteem, address isolation and build effective relationships. £361,591.80 Children, Families and Justice Social Work Services 01/10/2024 30/09/2025 plus 2 one- year extensions available Community Alarm replacement - Analogue to Digital UHSCNL and NLC have invested significantly in early intervention and supported self-management for over a decade, with support for change and investment across all sectors which focus on wellbeing. The Community Alarm Service is a key part of supporting self-management with technological advancements creating the opportunity to move from a crisis response service to being more proactive and preventative. Telephone lines in the UK are being upgraded to digital technology. The process of migrating to digital telephone lines has already started. The rollout was scheduled to be completed by the end of 2025, when analogue telephone services in the UK will be switched off and replaced by digital systems using internet protocol (IP) technology £495,000.00 Social Work 17/02/2025 31/03/2025 Community Alarms Individuals who have been provided with telecare equipment from NLC, Social Work, such as community alarm and assistive technology must have their equipment updated to continue to receive a safe and reliable service. £249,970.00 Adult Social Work Services 20/05/2024 16/11/2024 Community Living Support The service helps to ensure those residents of North Lanarkshire, who require support to maintain their tenancy, are enabled to do so. The low-level support available contributes to good health and wellbeing and can reduce any need for higher level support. £1,209,960.00 Adult Social Work Services 01/06/2024 31/05/2027 Page 82 of 174
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36 Direct Payment Support Services The service will provide independent support and advice for people wishing to consider or actively employ staff directly to meet their social work budget using a direct payment option 1. £415,788.00 Adult Social Work Services 06/01/2025 05/01/2028 Distress Brief Intervention (DBI) The overarching aim of the DBI service is to provide a framework for improved inter-agency co-ordination, collaboration and co-operation across a wide range of care, settings, interventions and community supports, towards the shared goal of providing a compassionate and effective response to people in distress improving experience and outcomes for those experiencing distress and those providing support. Pan Lanarkshire with North Lanarkshire as the lead procuring partner. £1,917,960.00 Adult Social Work Services 01/04/2024 31/03/2026 Domestic Abuse An inclusive domestic abuse service for any person affected by abuse aligned too Equally Safe £1,384,492.00 Social Work 01/06/2025 30/05/2029 Early Help & Family Support To provide early help and take a preventative approach to providing support to families who need it. This is an opportunity to connect services locally and improve access to family support through earlier and more effective response to need. £4,080,000.00 Education 01/04/2024 31/03/2026 plus 1 year extension available Flexible Framework for Self-Directed Support - Entry Point 4 Flexible Framework with Providers to support the critical Service Delivery to Children, Young People and Adults who have been assessed as requiring support to design, develop and achieve real lives in line with the Social Care (Self Directed Support) (Scotland) Act 2013 £820,000,000.00 Adult Social Work Services 01/04/2025 31/03/2031 Independent Advocacy Services (Adults) Independent advocacy supports people to have their voices heard and their rights and interests protected. Independent advocacy is a positive force in influencing social change, with the work and ethos of advocacy underpinned by a person-focused and human rights framework. The importance and benefits of independent advocacy are now widely recognised and woven into the fabric of health and social care provision and legislation in Scotland. Advocacy for carers and for people affected by drug and alcohol £3,507,405 Adult Social Work Services 01/03/2025 28/02/2028 plus 2 one- year extensions available Page 83 of 174
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37 misuse are now also incorporated into the requirements of the contract. Multi Agency Risk Assessment Conferences (MARAC) Provision of effective management, co-ordination and administration of Multi Agency Risk Assessment Conferences (MARAC), on behalf of North Lanarkshire Council and North Lanarkshire Health and Social Care Partnership £253,325.00 Children, Families and Justice Social Work Services 01/07/2024 30/06/2026 plus 2 one- year extensions available Mental Health Peer Support and Short-Term Mental Health Support Service Mental health and wellbeing service that provides support to residents of North Lanarkshire experiencing mental health challenges. Lot 1 – Peer Support Service with Info Service Lot 2 – Short-Term Support Service. £3,081,204 Adult Social Work Services 01/03/2025 28/02/2029 Support for Unpaid Carers and Young Carers To provide support to unpaid adult carers and \ or young carers, across North Lanarkshire. The service(s) procured will be instrumental in helping North Lanarkshire Council meet statutory requirements and duties as outlines in the Carers (Scotland) Act 2016 and Self-Directed Support (Scotland) Act 2013, specifically around support to carers. Lot 1: Direct Carer Support and breaks from caring, Lot 2: Carer Information, Advice and Campaigning Services and breaks from routine from routine, Lot 3: Condition specific Carer support (Dementia), Lot 4: Post Discharge Carer Support, Lot 5: Young Carers £16,380,000.00 Adult Social Work Services 01/03/2025 28/02/2028 plus 3 one- year extensions available. National Shared Alarm Receiving Centre (ARC) Framework is a single supplier framework and will provide the participating members a mechanism to procure a technology solution to contribute to a smooth transition from the current analogue connections to digital connections within their Alarm Receiving Centres. £412,183.00 03/03/2025 02/03/2027 plus 2 one- year extensions available Page 84 of 174
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38 Bairns Hoose Underpinned by the UNCRC, Bairns Hoose promotes a child-centred, trauma-informed and multi-agency approach that supports children recover from abuse. £102,640.00 Children, Families and Justice Social Work Services 01/10/2024 30/09/2025 Missing Persons To provide a Missing Persons Service across the North Lanarkshire to children and young people who have been reported missing to Police Scotland. £290,000 Children, Families and Justice Social Work Services 15/02/2025 14/02/2027 plus 2 one- year extensions available Provision of information and advice service for (Autism) To provide a bespoke service to persons, families, communities and professionals who are affected by or work with Autism. £62,500.00 Adult Social Work Services 01/04/2025 30/09/2025 Provision of support for people affected by Huntington’s Disease A bespoke service to persons, families, communities and professionals who are affected by or work with Huntington’s Disease. Tripartite agreement with North Lanarkshire Council, South Lanarkshire Council and NHS Lanarkshire. North Lanarkshire Council is the lead. £398,898 Adult Social Work Services 01/04/2025 31/03/2028 Page 85 of 174
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39 13. Ethical Commissioning The Scottish Government’s Adult Social Care Ethical Commissioning policy team commissioned the Institute for Research and Innovation in Social Services (Iriss) to work with a range of partners, on developing an implementation plan with priorities, to ensure that ethical commissioning and procurement principles became a reality. One of the priorities identified by the group was for better support for commissioners and to work on developing training and a qualification for commissioners. As part of the project, Iriss ran an Action Learning Set for commissioners. The aim was to develop support for commissioners and others involved in implementing ethical commissioning and procurement. A group of 15 local authority commissioners were invited to meet monthly from August 2024 to January 2025 for discussions with input from expert speakers. Quality Assurance were part of this group. Local commissioners shared their experiences, challenges and priorities for support and any training needs. The group provided a space for learning, development and support with the move to ethical commissioning, and for commissioners to hear about current developments and improvements in commissioning policy and practice, working together on identifying priorities for future support. The outcomes were: • Commissioners have increased knowledge, skills and confidence in their commissioning practice. • The Scottish Government Adult Social Care Ethical Commissioning team and partners have a clearer sense of commissioning as a distinct profession and the skills and knowledge required to commission ethically. • Scottish Government and partners have a foundation on which to build future and more formalised training in partnership with larger training focussed organisations. Scottish Living Wage Last year we reported that most Providers had indicated they were either already accredited as or were willing to become Scottish Living Wage employers. This trend continues, with 96% of 96% 4% Providers Paying Scottish Living Wage at at 31/03/2025 YES % N/A % 96% 4% Providers Paying Scottish Living Wage as at 31/03/2024 YES % N/A % Page 86 of 174
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40 Providers who deliver a direct care & support service paying the Scottish Living Wage. The remaining 4% of Providers provide non-care related services (such as domestic & catering staff) or are within the cross-border category, whereby the Scottish Living Wage does not apply. 14. Adult Support & Protection (ASP) Quality Assurance have a remit across social work in supporting commissioned services to respond in accordance with Adult Support & Protection legislation and North Lanarkshire Council policies and procedures. Quality Assurance also have a role in the identification of any patterns and themes which may indicate wider systemic concern. As a direct link to commissioned services, Quality Assurance promote best practice in relation to Adult Support & Protection. Over the reporting period, Quality Assurance continued to maintain links with adult services colleagues to ensure ASP activity was considered in day-to-day practice. Quality Assurance continue to have representation in the following ASP forums and contribute to: • Learning & Development • Monitoring & Reporting • Lanarkshire Wide Care Home Task Force Group • Weekly Care Home ASP Review Quality Assurance were also involved in a National Learning Review involving the closure of a Care Home. Representation will continue within a focus group driving forward local recommendations that arose from the Learning Review. 15. Social Work Risk Management Quality Assurance have oversight of the social work risk register and are responsible for quarterly & annual reporting, compliance audits and for the facilitation and coordination of the Social Work Risk Forums. Quality Assurance participate in Corporate Risk Management Team meetings, and cascade appropriate information through the correct forums. Risk Champions and Facilitators act as points of contact for risk management matters within social work and promote risk awareness across the service. Representatives from the Quality Assurance Team participated in a two-day accredited Institute of Risk Management (IRM), Essentials of Enterprise Risk Management Course. Participation assisted Quality Assurance to continue to progress the reframing of social work risks, to ensure that these are fluid, dynamic, specific and relevant to the current environmental context. Risk Champions and Facilitators continue to engage with risk owners to provide awareness and support to reframe risks. This approach ensures that our work priorities are focused on the correct areas. Risk continues as a standing agenda item at the ASW Governance and Social Work Leadership meetings and there is a plan for live risks to be discussed and reviewed by leadership teams within these forums. 16. Registered Social Landlords Since the summer of 2023, Quality Assurance has been leading on the review of five Registered Social Landlords who provided thirteen sheltered & very sheltered developments across North Lanarkshire. These services were funded to provide housing support, using Supporting People Page 87 of 174
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41 funding. This funding stream was discontinued around 2016/17, leading to mainstream social work funding being accessed pending review. Quality Assurance engaged with all stakeholders during 2024/2025 to hear their views in relation to the proposal to discontinue housing support services and move to Retirement Housing. Advocacy were involved to ensure representation for those who required this. Following the engagement sessions, it was agreed that NLC would no longer commission or fund the staffing associated with the legacy model. This was to ensure that all those living within the services under consideration could have choice and control over who delivered their care and support in line with SDS principles. Two of the five Registered Social Landlords (RSL’s) involved transitioned from sheltered/very sheltered housing to other models in April and July 2024 respectively, and positive outcomes were reported following the change. The remaining three RSL’s continued to finalise their transition plans and in early 2025 one moved to a new model. For the remaining two RSL’s direct funding from NLC has ceased. However, one of these RSL’s elected to join NLC’s Self-Directed Support including Care at Home Framework to enable them to provide care and support utilising individual budgets should people chose them as a provider. We will continue to engage through monitoring activity. Following the conclusion of this review there is confidence that individuals are receiving the right support at the right time. 17. Care Home Governance & Assurance Following review of the enhanced clinical and care oversight arrangements for care homes reported last year, there has been continued support commissioned through the Care Home Assurance and Support Board and the Care Home Collaborative Group. The Collaborative Group combined what was previously two separate subgroups - the Care Home Governance Group and the Care Home Healthcare Framework Implementation Group. An initial gap analysis of the implementation of the Healthcare Framework and follow up review have been progressed meaning that the separate Implementation Group was disbanded. The Safety Huddle Multi-Disciplinary Forum which has continued to build on good practice embedded during the pandemic, has been further stepped down to fortnightly meetings. The focus of work has been reviewed and refined to include the ratings for each Care Home within North Lanarkshire. Adult Support and Protection escalations have also been included in discussions. These further enhancements maximise the effectiveness of the arrangements in place, to ensure systems and processes enable intelligence to be shared between agencies, to identify and allow support to be provided to care homes at risk. Actions are agreed collaboratively to provide an immediate response to safeguard residents. Quality Assurance participate in the Collaborative Group and the Safety Huddle and play a part in influencing the assurance and governance arrangements through a social work lens. Quality Assurance have been involved in the on-going review of the Healthcare Framework Gap Analysis, and it is envisaged that enhanced awareness raising across care homes of the framework and what providers and people can expect, will be a focus of activity throughout 2025/26. Quality Assurance introduced a working group with providers, to understand the Healthcare Framework. The meetings were initially beneficial, as historically Care home managers did not always engage with opportunities to participate in formal governance meetings. However, with consensus, these meetings have since been disbanded as the group felt it had achieved its purpose. Page 88 of 174
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42 18. Care Home Managers Meeting Quality Assurance continued to co-ordinate Care Home Managers Meetings as a support for Care Home Managers. Meetings, hosted in a local care home setting, have continued, with the aim to have them quarterly. The meetings give the opportunity to share ideas, good practice initiatives and common provider concerns. There is an ongoing input and update from a range of professionals involved in supporting care homes. Meetings over the reporting period have included topics such as Adult Support & Protection, promoting continence care, promotion and use of care opinion, pharmaceutical updates, the healthcare framework and safe staffing legislation. The Associate Medical Director, attended the meeting in August 2024 to brief the group on the Serious Adverse Event Review (SAER) 19. Complaints Quality Assurance retains an overview role in terms of complaints regarding Social Work service provision. Quarterly reports on complaints activity are reported through our governance structures. The annual summary and analysis of complaints received over the period 2024/2025 is attached as Appendix 1. 20. Duty of Candour All health and social care services in Scotland have an organisational duty of candour. This is a legal requirement which means that when certain types of incidents happen, the people affected understand what has happened, receive an apology, and the organisation learns how to improve for the future. An annual report capturing Duty of Candour activity is a requirement of the Council and the report for 2024/2025 is attached as Appendix 2. 21. Safe Staffing The Health and Care (Staffing) (Scotland) Act 2019 (HCSA) came into effect on 1st April 2024. The purpose of this legislation is to establish a statutory framework to ensure appropriate staffing levels in health and care settings. A review of procurement, contracts and contract monitoring processes took place prior to the implementation of the Act. There has been recognition from Scottish Government, Care Inspectorate and all Local Authorities that the reporting requirements for Local Authorities are currently vague and therefore in the lead up to the first annual report, there remained new and emerging guidance being shared. Reassurance has been provided, that due to the lack of clarity, the Care Inspectorate on behalf of the Scottish Government, will carry out an analysis of reports following receipt, with clearer guidance and a reporting template to be made available for annual reports due in 2026. Quality Assurance worked collaboratively with the Care Inspectorate throughout the year, participating in the HCSA Implementation Group, which is facilitated by the Safe Staffing Programme and was launched in August 2024. This group meets every two months and provides a forum for stakeholders to share experiences, good practices, and areas for improvement. Whilst the group is ongoing, discussions are underway about its future direction after the current reporting period. Page 89 of 174
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43 Quality Assurance continued to support both commissioned and in-house services with the implementation of the Act throughout the reporting period, by facilitating two dedicated working groups. North Lanarkshire Council have responsibilities as a provider of care and support and as a placing authority. • Commissioned Services Working Group This group was established prior to the Act’s implementation. Its aim was to share best practices and discuss potential risks. Feedback from participants indicated that attending the group was beneficial and helped them feel more prepared. Following the implementation of the Act, the group continued to meet for several months, creating a collaborative platform where services could share experiences, including examples of good practice and areas for improvement. • In-House Registered Services Working Group This group was formed in November 2024 and initially met monthly, before transitioning to a bi-monthly schedule. It continues to be well attended by registered managers, and feedback indicates that the group is valuable in supporting ongoing learning, knowledge exchange, and the sharing of best practices. • The group has developed an assurance tool which is based on the guiding principles of the Act, and it is intended to document evidence of how the principles of the Act influence staffing arrangements. This tool is being used across all NLC registered services. • Throughout 2025/2026 staffing contingency plans and staffing level tools will continue to be developed. The Health and Care (Staffing) (Scotland) Act 2019: Annual Report for Social Work Services is attached as Appendix 3. 22. North Lanarkshire Registered Services Care Inspectorate Activity: Annual Report 2024/2025 Quality Assurance have oversight of Care Inspectorate activity, and this enables the monitoring of individual services and organisational patterns, themes and trends. An annual report has been produced capturing findings over the reporting period see Appendix 4. 23. Getting it Right for Everyone (GIRFE) Quality Assurance were represented on the GIRFE Facilitation Group, which is tasked with ensuring that the wider principles of the national approach to GIRFE were embedded within day-to-day practice across North Lanarkshire. GIRFE is about providing a more personalised way to access help and support when it is needed. GIRFE places the person at the centre of all the decision making that affects them, with a joined-up consistent approach, regardless of the support needed at any stage of life. GIRFE is intended to inform the future practice model of all health, social care and public sector professionals, and shape the design and delivery of services, ensuring that people’s needs are met. Work to embed the 5 GIRFE principles, as noted below is ongoing and the GIRFE Facilitation Group had a lead role in raising awareness of these and seeking to ensure that these are reflected in operation day to day. Page 90 of 174
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44 • I have the information I need to make decisions about my life, in a way that works for me, and I am supported to understand what options are available to me, and trusted to know what is right for me • the people who support me take the time to listen and understand me as a person and we consider my whole life when making decisions about my life • I know that I can be clear about what matters to me, and I trust that my choices will be respected and understood by the people who support me • if I need to access services or support, I am treated with kindness, dignity and respect at all times. • the people I am involved with work together with me and each other to share information, in a way that is accessible to me and develop a clear understanding of how to support my wellbeing The GIRFE approach applies equally to existing supports and services, as well as to innovation, with some exciting innovations underway. A Getting it Right for Everyone Approach has now been embedded within North Lanarkshire as our local means of meeting the aspirations of the national approach. 24. Back-to-basics to getting it right for everyone Over the past year within Adult Health & Social Care Services, we have been working on the development of an enabling approach that supports the move from our work on back-to-basics to getting it right for everyone, as we recognise the landscape of health and social care is changing and services, supports and responses need to change to continue to improve the lives of people who live and work in North Lanarkshire. We have sought to adopt a human learning approach by trying different ways to focus more on people and less on systems and processes, and use resources to their best effect, to make the most positive impact on peoples’ lives. Through the learning as management strategy (also known as Human Learning System) approach, we have been working with academic and national partners, including Healthcare Improvement Scotland, to make learning and experimentation a key driver in our work. A key element of the learning approach has been the development of a Whole System Enabling Approach strongly embedded within each of the six localities, which supports a place-based model. Overarching this work has been making sure that when people contact our services the response is quick and effective, with a focus on helping people to help themselves first. Our Enabling Approach has helped us understand and consider how all parts of the Health & Social Care system interact and influence each other. Our desire is to continue to support people to thrive by providing targeted services that are tailored to reflect their diverse needs. Keeping people central to the decisions that affect them is key and has helped us plan actions that support positive outcomes for those who access our services. Over the coming year we will further develop specific plans and service developments: as this is a whole system approach, we anticipate there will be a lot to focus on and much change across services, supports and responses that are needed to achieve and sustain change. 25. Trauma Informed Practice There is a Scotland wide vision of a trauma informed and responsive workforce and services. This approach recognises the impact of trauma and adversity on individuals and seeks to prevent further harm, support recovery, address inequalities and improve life chances. Within Page 91 of 174
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45 North Lanarkshire, a Trauma Informed Practice Oversight Group was established, with representatives drawn from across the wider Health and Social Care service, including Quality Assurance. The remit of the group is focused on ensuring that the principles of Trauma Informed Practice are embedded in day-to-day practice, and that our buildings and spaces also reflect and support a Trauma informed approach. Examples of the role of Quality Assurance in supporting this approach include, but are not limited to: Three recently concluded adult Tenders (Adult Advocacy, Support for unpaid Carers, and Peer Support, Mental Health) were all developed in line with Trauma Informed Practice. The services commissioned through these Tenders, as well as other local CVS organisations who provide information\ advice \ support to citizens of North Lanarkshire, were, for the most part, involved in an initial Trauma Informed Awareness session, facilitated by the Trauma informed Practice Lead. The overall intention is that Trauma Informed Practice becomes embedded into everyday practice, not just within Health and Social Care, but across partner organisations also. The next step in this process will be to link with framework support provider organisations and promote the opportunity to participate in Trauma Informed Practice awareness raising sessions, again with the expectation, that Trauma Informed Practice is further embedded within these organisations also. Work will also continue to embed Trauma Informed Practice across the services delivered by UHSCNL. 26. Policies and Procedures Work has continued to progress in relation to Social Work Policies and Procedures. Quality Assurance are the SharePoint site owners for these, and editing rights are restricted to the team. During the reporting period there has been a Policies & Procedures Working Group established with representatives from across social work. The aim of this group was to agree the file path for central storage and easy access. Furthermore, policy control documents would be attached to ensure that policy owners, review dates and version control were available and up to date. Thereafter the plan was for Quality Assurance to host a Policy Review Group to ensure social work policies remain consistent with changes in legislation and practice. This work was paused due to a variety of findings which made it difficult to establish a suitable file path due to use of language and gaps and duplication in policies and procedures. Several discussions and presentations have taken place with the Senior Leadership Team and colleagues in Legal Services and Corporate and there is now a plan to progress with the devising and implementing of policy statements, rather than working directly from National Guidance. These policy statements will guide and govern all safe operating procedures for local services. This work will be carried out in phases commencing with Registered Services. 27. Care Home Physical Activity Initiative UHSCNL funded an initiative with the Burns Gym which has meant that over the reporting period, Burns Gym has successfully expanded and enhanced its virtual fitness programme, delivered weekly via Zoom, for care homes across North Lanarkshire. 23 out of 27 homes participated in this imitative. Joe and Tony Burns have effectively engaged residents, significantly improving their physical, social, and mental well-being. Participation has increased, and feedback continues to highlight the programme’s positive impact. Page 92 of 174
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46 From the latest evaluation report some of the key Statistics have been identified and these include: Physical Health Improvements: Mobility improved in 50% of participating homes. Strength and balance improved in 40% of homes. Falls reduced in 20% of homes. Social Engagement: 72% of homes reported increased social interactions. Emotional Well-being: Improved mood reported in 80% of homes. The link to the report is below for more information. NLC 12 Month Evaluation Report.docx 28. Adult Social Work Subgroup – Registered Managers An Adult Social Work Subgroup for Registered Managers was established in 2025. This group meet 8 weekly, and the chair is the Quality Assurance Service Manager or delegated person. This group reports through the ASW Governance Group and its purpose is to ensure robust governance and oversight across Registered Services. The group aims are to: • Ensure good governance and oversight across service delivery • Work collaboratively as registered managers team • Source/agree solutions that promote good outcomes • Identify and agree actions that improve the quality of care and support and reduce the risk of harm • Ensure robust systems and processes are in place to reporting through various governance routes • Support a culture of self-evaluation; refection; shared learning; improved practice • Plan and support the inspection process through the development of improvement plans Initial feedback is that this forum is well received and Registered Managers feels that it gives them focused time to discuss and plan improvement work with their peers. There are plans in place for Duty of Candour, Engagement & Participation & Infection Control to be future focus sessions. 29. Social Work Scotland Contracts & Commissioning Practice Network Quality Assurance participate in quarterly Social Work Scotland Contracts & Commissioning Practice Network. The team lead on a Care Home subgroup which explores some of the national issues, initiatives and best practice. This group feed back to the main membership. Page 93 of 174
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47 Quality Assurance also facilitated a session on VAT Holding Companies as requested by the Chair. 30. Quality Assurance Planned Developments This report has covered Quality Assurance activity undertaken during the period 1 April 2024 to 31 March 2025 and highlights progress made in key activities noted in the last reporting period. Several developments outlined below are in progress or planned for the period 2025/2026 and we will provide updates in future reports. Quality Assurance Planned Developments • Work with operational colleagues to influence and shape future procurement and service specifications • Establish clearer end to end procurement processes • Revamp contract mobilisation procedures • Working with commissioned services to support/mitigate the impact of the NI changes. • Finalise Social Work Induction • Further develop support for Carers • Progress with Policy Statements/ Policy Review Group/File Path • Roll out of Social Work Self Evaluation following test of change • Complete programme of In-House Monitoring • Build on engagement and participation toolkit to embed throughout all aspects of our work • Embed Programme of Work Governance Structure & Reporting Procedures • Oversight and support in relation to Care Inspectorate complaints for registered services • Sampling/Quality check/Feedback relating to Elected Members/Parliamentary enquiries • Complete reframing of risks on social work risk register. Change the ethos of review. • Participate in National Care Home Learning Review/Progress Recommendations for Quality Assurance • Establish quarterly reporting structure for expressions of dissatisfaction & Care Inspectorate activity for Registered Services • Progress Care Academy deliverables Page 94 of 174
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48 Annual Complaints Report 2024-2025 Social Work [Adults and Education, Families & Justice] Introduction This report provides an overview of Social Work’s performance in terms of handling complaints received between 1 April 2024 and 31 March 2025 which covers both Adults and Education, Families & Justice services. This report describes how complaints have been managed by social work services, details the number and nature of complaints received during the year and demonstrates our commitment to learning and improvement. Complaint Process We always aim to provide the highest possible quality of service to all members of our communities and are committed to ensuring accountability and transparency. We recognise there are times when we get things wrong and fail to meet the expectations of those who use our services. We welcome feedback as it provides information that helps us to learn from complaints and shape and improve the way services are delivered. Complaints are viewed as a positive communication tool and are actively encouraged. As per the Scottish Public Services Ombudsman [SPSO] definition, we regard a complaint as any expression of dissatisfaction, by one or more members of the public, about our action or lack of action, or about the standard of service provided by us or on our behalf. Anyone can make a complaint, either verbally or in writing, face to-face, by phone, letter or email. People are directed and encouraged to use the North Lanarkshire Council online portal to make a complaint but retain the right to use any of the aforesaid options. A two-stage statutory social work complaints process was introduced on 1 April 2017, which harmonised complaint handling processes across all council services. The process is as follows: • Stage one – ‘frontline resolution’: we will always try to resolve complaints quickly, within five working days, and in exceptional circumstances extend for a further five days. • Stage two – ‘investigation’: if people remain dissatisfied with our stage one response, they can escalate their complaint to stage two. Complaints that are complex or need detailed investigation from the outset can be looked at immediately at stage two. These complaints will be acknowledged within three working days and a written response provided within twenty working days; this can be extended in exceptional circumstances. Appendix 1 Page 95 of 174
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49 Following completion of the complaints process, if the person remains dissatisfied, they can ask the SPSO to consider their complaint further. We always advise of this entitlement and provide contact details. Complaint activity [overall] Overall, 263 complaints were received in the reporting period, an increase of 58 [28%] from 2023-2024 when 205 complaints were recorded. Notably, 34% of all adult services complaints were in relation to home support services. A breakdown of locality complaints is undernoted: Education, Families & Justice 103 complaints were received in relation to Education, Families and Justice services across 2024-25, an increase of five [6%] from last year. The undernoted summarises locality complaint activity for Education, Families and Justice services across 2024-2025. Adult Social Work Services 160 complaints were received in relation to adult services across 2024-25, an increase of 59 [54%] from 2023-2024. The undernoted summarises locality complaint activity for Adult Social Work Services in 2024-25. 14 18 21 16 7 17 10 Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw H.Q. Education, Families & Justice Services 57 16 9 19 19 28 12 Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw H.Q. Adult Social Work Services Page 96 of 174
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50 All localities had increased complaint activity in the reporting period. However, Airdrie and Bellshill recorded notably high increases over 2024-2025 – Airdrie, a 62% increase, Bellshill, a 100% increase. Increased complaints were attributable to dissatisfaction about home support services in the areas. However, Bellshill complaints are still relatively low – they recorded eight in 2023-2024 and 16 2024-2025. Management actions were deployed to consider this increase more fully, and consequently, home support complaints decreased in quarter four. Performance Indicators The Complaints Standard Authority, in conjunction with the Scottish Public Services Ombudsman developed a suite of four mandatory performance indicators in association with the Local Authority Complaint Handlers Network on which we are represented. These indicators [undernoted] are a valuable source of information as they help to identify recurring or underlying issues, derive/drive learning from complaints and highlight potential areas for improvement. • Indicator One: the total number of complaints received. • Indicator Two: the number and percentage of complaints at each stage that were closed in full within the set timescales of five and 20 working days. • Indicator Three: the average time in working days for a full response to complaints at each stage. • Indicator Four: the outcome of complaints at each stage. Education, Families & Justice – Performance Information Indicator One - 103 complaints were received in relation to Education, Families and Justice services across 2024-25 Indicator Two/Three: Compliance with target statutory timeframes to complete complaint. Undernoted graphics depict adherance to statutory timeframes. At Stage 1, 57% were met within 5 working days, a further 38% were met with an agreed extension [within 10 working days], and 5% were outwith response target time. Average number of days to issue response: 6 working days. At Stage 2, 56% were met within 20 working days, a further 24% required an agreed extension, and 20% were outwith reponse target time. Average number of days to issue response: 34 working days. Page 97 of 174
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51 Indicator four - Complaint Outcomes “Outcome” refers to whether a complaint was upheld, not upheld, partially upheld or resolved. At Stage One, 33% of all complaints were not upheld, with the remaining 66% recording a positive outcome for the complainant. At Stage 2, 36% were not upheld, 64% recording a positive outcome. The volume of Education, Families and Justice complaints since 2020-2021 has remained stable, with little variation in the number of complaints between 2021-2022 and 2024-2025. Cause of Complaints [Stage 1 Cause of Complaints [Stage 2] Page 98 of 174
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52 Adult Social Work Services – Performance Information Indicator One - 160 complaints were received in relation to adult services across 2024-25. Indicator Two/Three - Compliance with target statutory timeframes to complete complaint. Undernoted graphic depicts adherance to statutory timeframes: At Stage 1, 53% met statutory response times, 26% met statutory timeframes within 10 days, 21% breached target timeframe. Average number of days to issue response: 6 working days. At Stage 2, 72% were met within 20 working days, a further 18% required an agreed extension, and 10% breached target timeframe. Average number of days to issue response: 23 working days. Indicator 4 - Complaint Outcomes “Outcome” refers to whether a complaint was upheld, not upheld, partially upheld or resolved. 54% of complaints at Stage 1 were not upheld, with the remaining 46% recording a positive outcome for the complainant. At Stage 2, 37% of complaints were not upheld, 63% had a positive outcome. 35 53 11 Stage 1 Upheld Not upheld Partially upheld 7 148 9 Stage 2 Upheld Not upheld Page 99 of 174
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53 Adult Social Work Service complaints show variation in the number received between 2021- 2022 and 2024-2025. The increase in complaints throughout 2024-2025 are commensurate with increased home support complaints. Cause of Complaints Stage 1 Stage 2 Learning from Complaints [Both Services] The learning from all social work complaints this year have highlighted: • The importance of good communication and mutually respectful interactions. • The need to ensuring that those who use our services and their carers have appropriate information. • Ensure that service quality is met. • The need to improve information and advice for those who need to contact and seek support from social work services. • Importance of reviews carried out regularly. • Ensure that we comply with Human Rights. Page 100 of 174
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54 • Update support plans accurately. • Confirm social work planned intervention with person. • Adherence to timeframes. • Assure that all staff are appraised of procedural/process change. Outcomes are often specific to the complaint and complainant, but when there are organisational learning points that influence policy or procedure, it is necessary to ensure that learning outcomes are cascaded and acted upon. Individual learning points are handled directly with the complainant and through supervision with members of staff. More general learning points are cascaded through supervision with team members and discussion at team meetings. 31% of all social work complaints indicated that there were no learning outcomes, whilst 34% were attributed to communication/staff attitude as the principal cause of complaints. 19% related to other issues as mentioned above, with 16% unrecorded on the system. 54 [34%] of Adult Social Work Services were in relation to home support services in this reporting period. We recognise the importance of learning from complaints and acknowledge that having a learning outcome recorded is an area that requires attention. We understand that complaints help organisations learn more about the experiences of people who use their services, and that complaints can be helpful to enable us to provide a person-focused service. While learning from complaints remains a non-mandatory performance indicator by the Scottish Public Services Ombudsman, they are interested in any systemic changes that are made following a complaint. Going forward, we will work directly with our locality teams to ensure that accurate recording and learning from complaints is embedded in practice to ensure quality services are delivered. Scottish Public Services Ombudsman The SPSO considered nine complaints throughout 2024-2025 six of which they decided not to follow up, with one complaint withdrawn by the complainant. One complaint awaits a decision, whilst the final complaint, the Council were instructed to issue a new stage two response. Child Friendly Complaints Procedure The SPSO launched the Child Friendly Complaints Procedure in July 2024. This procedure aims to ensure that children’s rights, under the United Nations on the Rights of the Child, [UNCRC] are met through a child-centred complaint process. Their principal aim was to co- 74, 34% 67, 31% 40, 19% 35, 16% Learning from Complaints Communication No learning Service Improvement Outcome unrecorded Page 101 of 174
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55 design this alongside children and young people and implement a public sector complaints procedure that meets children’s rights and needs. The SPSO continue to work in collaboration with local authorities to develop good practice guidance through the national complaint handlers’ group, of which officers from Quality Assurance are members. Within North Lanarkshire, a core group meets to co-design and trial our Child Friendly Complaint Process, which is modelled on national guidance. Quality Assurance officers have met with senior managers from Education, Families and Justice to discuss and to distribute draft guidance and FAQs from the SPSO. Care Opinion Care Opinion is a non-profit organisation, web-based feedback platform funded mainly through subscriptions from health and care organisations. At present, 500 health and social care organisations use Care Opinion across the UK. People submit stories to share their experiences of health and social care services. These can be both positive and negative, are moderated by Care Opinion staff, and quickly forwarded to the relevant area of service who can respond directly to the story. We recognise the importance of feedback; it is considered integral to quality improvement. For staff, it gives an opportunity to see the system and the service provided through the person’s eyes. Care Opinion – Key statistics • 471 stories were shared on Care Opinion 1 April 2024 – 31 March 2025 • 84% of stories received a response from the service within 7 working days, with circa 60% within one working day. • 80% of all stories shared have a zero-criticality rating, whilst 1% have a strongly critical rating. 18% have a low to moderate criticality rating. • Circa 83% of stories posted refer to NHS Lanarkshire services, whilst the remaining 17% refer to social care and third sector partners that are included in the UHSCPs subscription. To further support the use of Care Opinion as a vehicle to promote feedback on services, our revised Contract Management Framework asks all contracted providers, through their quarterly monitoring return, to report on their use and promotion of Care Opinion as a method of seeking feedback. We are also expanding the service tree to incorporate commissioned organisations if they wish to be included within the UHSCP subscription. Over the course of the past year, several third sector organisations, mainly those specific to our partnership with Voluntary Action North Lanarkshire, have been added to the subscription. Training Training on the system, where complaints are recorded continues to be delivered virtually through a video. This is a helpful aide memoire, but we recognise that additional support around recording and managing complaints is required and have agreed a programme of learning events to support locality teams to further enhance their approach to complaint handling. Page 102 of 174
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56 Quality Assurance Quality Assurance senior officers provide training and support to social work managers and teams in relation to the complaint handling process. A suite of letter templates is available, which provide guidance on model answers, trauma informed and best practice when engaging with complainants. Complaints are often routed directly through the Quality Assurance team who acknowledge receipt and assign complaints to the relevant service manager. New guidance was recently issued that instructs that all Stage 2 responses are routed through the social work complaints mailbox prior to issue, with all being sense checked by the Quality Assurance Senior Officer. In doing so, we ensure that all stage 2 complaints are compliant with the Complaint Handling Procedure. A single agency learning review was commissioned to consider a serious complaint. The outcome and findings are still be determined. Complaints that relate to both health and social work/social care services are routed through the relevant lead organisations complaints process, but there is an integrated approach to resolution and any joint learning outcomes are shared. Conclusion The principal cause of complaints continues to identify poor staff communication, staff attitudes and quality of service. This is further reflected within the learning outcomes, which indicate the need to improve communication, practice and approach to those using social work services. As a service we are committed to improving learning from complaints, which is also one of the key performance indicators, which in the future may be reportable to the SPSO. We will place further emphasis on the need to ensure that all complaints are dealt within identified timeframes, with clear communication of outcomes. Although 100% of complaints that were sent directly to social work were acknowledged by the due dates, only 58% overall were completed within statutory timeframes, with no need for an extension. Complexity of issues, new processes, staffing, IT systems and very tight time frames for resolution were the contributory factors in failure to complete all complaints within time. Improvement in these areas is expected in 2025-2026. Further actions – 2025-2026 Several key actions have been identified to strengthen our approach whilst dealing with complaints including using the learning to improve the quality of experience for those who use our services. Many are continuing or legacy commitments made in former years but remain valid objectives. The key actions are: 1. We will, over the course of 2025 -2026, sense check and proof-read all stage 2 complaints to ensure that the procedures are understood and followed. Legacy action that is on-going. 2. We aspire to ensure that logging actions and learning from complaints is done consistently to support the improvement of services that support people across our communities. 3. We develop a programme of reflective learning sessions across teams - Complaint activity and learning remain an agenda item in team meetings and links across services and localities are maintained with Quality Assurance who will review complaint activity as required. Learning sessions were delivered as requested in 2024-2025 and will continue in 2025-2026. Page 103 of 174
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57 4. We will continue to promote Care Opinion as one of the key mechanisms for engaging with members of the public and to generate meaningful feedback. Further resources have been deployed to assist with this activity – a one-page newsletter/precis of Care Opinion will be drafted and circulated to all social work staff to support further usage and promotion of Care Opinion. 5. Where possible, we will secure system training to all members of management support teams who now have responsibility for logging and tracking complaints. 6. We will offer complaint handling training as a refresher session, or for training for new staff. Training sessions are offered on an ad hoc basis, and as required by individual teams. 7. A further legacy action from 2023-2024 is the roll out and implementation of Child Friendly Complaints Handling Procedures. The SPSO have now indicated that Child Friendly Complaint Handling will not be a separate procedure, but practice guidance is necessary to ensure that the rights of children and young people, conferred by the UNCRC, are protected. Page 104 of 174
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58 Duty of Candour Report: 2024-2025 All health and social care services in Scotland have an organisational duty of candour. This is a legal requirement which means that when certain types of incidents happen, the people affected understand what has happened, receive an apology, and the organisation learns how to improve for the future. An important part of this duty is that we provide an annual report about the organisational duty of candour in our services. This report describes how our organisation, North Lanarkshire Council, has operated the organisational Duty of Candour during the time between 01 April 2024 and 31 March 2025. If you have any questions or would like more information about North Lanarkshire Council, please feel free to contact us at: barrym@northlan.gov.uk When Must Duty of Candour be Activated? Duty of Candour must be activated as soon as reasonably practicable after becoming aware that an unintended or unexpected incident occurred in the provision of the health, care or social work service were, in the reasonable opinion of a registered health professional (not involved in the incident) that: (a) the incident appears to have resulted in or could result in any of the outcomes mentioned below (b) the outcome relates directly to the incident rather than to the natural course of the person’s illness or underlying condition. The relevant outcomes are as follows: • the death of the person. • permanent lessening of bodily, sensory, motor, physiologic or intellectual functions(including removal of the wrong limb or organ or brain damage) (“severe harm”). Harm which is not severe harm, but which results in one or more of the following: • an increase in the person’s treatment. • changes to the structure of the person’s body. • the shortening of the life expectancy of the person. • an impairment of the sensory, motor, or intellectual functions of the person which has lasted, or is likely to last, for a continuous period of at least 28 days. • the person experiencing pain or psychological harm which has been, or is likely to be, experienced by the person for a continuous period of at least 28 days. The person requires treatment by a registered health professional to prevent: Appendix 2 Page 105 of 174
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59 • the death of the person. • any injury to the person which, if left untreated, would lead to one or more of the outcomes mentioned above. How many incidents happened to which the organisational duty of candour applies? In the last year, there have been no incidents notified to Quality Assurance, where the organisational duty of candour applied. Information About Our Policies and Procedures North Lanarkshire Council reviewed and modified its Duty of Candour reporting procedures during 2024/25. Throughout January, February & March 2025 Locality Social Work Managers, Senior Social Workers and Registered Managers participated in awareness raising sessions to enhance understanding of the circumstances when Duty of Candour would be considered; and the stages involved in the procedure. The Duty of Candour notification procedure now includes two stages, which are: / Part 1 Possible Duty of Candour incident (Initial Notification) / Part 2 Managing the Duty of Candour Process The intention underlying the introduction of the two-stage process is to enable internal monitoring and analysis of when Duty of Candour has been considered but not activated. It is envisaged that this data will contribute to organisational learning. Duty of Candour Reporting procedures and awareness raising sessions have been added to the North Lanarkshire Council Social Work Induction that all social work staff complete within the first four weeks of employment. Duty of Candour training and information is available to North Lanarkshire Council staff on-line at Duty of candour | Turas | Learn Where something has happened that may trigger the organisational Duty of Candour, our staff report this to Social Work Quality Assurance. Quality Assurance initiate contact with the reporter to plan, guide and support the process Duty of Candour Procedure. What have we learned? Duty of Candour discussions and reflections have taken place during the awareness raising sessions and have demonstrated the benefits of interactive learning and peer discussion when considering whether the Duty of Candour criteria has been met. North Lanarkshire Council Social Work will embed a refresher Duty of Candour training programme utilising this method, in turn complementing and enhancing e-learning. We believe that our modified Duty of Candour reporting process provides operational social work staff with the opportunity to explore and consider in full, improvement actions from unintended incidents. Furthermore, it enables North Lanarkshire Council Senior Managers to have confidence that we are fulfilling our legal and morale responsibilities as defined within the Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016 (The Act) and The Duty of Candour Procedure (Scotland) Regulations 2018. Training and Support for staff All new social work & social care staff within North Lanarkshire Council learn about the organisational Duty of Candour at induction and subsequent refresher sessions. Page 106 of 174
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60 We know that serious mistakes can be distressing for staff as well as people who receive care and support and their families. We therefore promote access to North Lanarkshire Council Employee Assistance Programme for those who have been affected by an organisational Duty of Candour incident. Support for relevant persons Where a relevant person (i.e., children, adults, families, etc.) is affected by the incident that activated the organisational duty of candour, we provide links to wellbeing support services. Page 107 of 174
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61 Appendix 3 Health and Care (Staffing) (Scotland) Act 2019: Annual Report for Social Work Services Under section 3(2) of the Health and Care (Staffing) (Scotland) Act 2019 (“the Act”), every local authority and integration authority must have regard to a number of listed factors when planning or securing the provision of a care service from a third party: • the guiding principles in the Act (section 1 of the Act); • the requirement on care service providers to have regard to the guiding principles (section 3(1) of the Act); • the duty on care service providers to ensure appropriate staffing (section 7 of the Act); • the requirement on care service providers with regard to training of staff (section 8 of the Act); • the requirement on care service providers to have regard to guidance issued by the Scottish Ministers (section 10 of the Act); • the duties on care service providers under Chapter 3 of Part 5 of the Public Services Reform (Scotland) Act 2010, for example with regard to registration of care services; and • the duties on care service providers under Chapter 3A of Part 5 of the Public Services Reform (Scotland) Act 2010, for example with regard to the use of any prescribed staffing methods or staffing tools. Note that the Health and Care (Staffing) (Scotland) Act 2019 inserted chapter 3A into the Public Services Reform (Scotland) Act. Section 3(6) of the Act states that relevant organisations must publish information annually on the steps they have taken to comply with the requirement in section 3(2) regarding the planning and securing of care services and any ongoing risks that may affect their ability to comply with this requirement. The information in this report relates to the financial year, 01 April 24 to 31 March 25, and will be published by 30 June 25. Page 108 of 174
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62 To enable the collation of the information published, a copy of the report has been sent to the Scottish Government hcsa@gov.scot. Page 109 of 174
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63 Declaration Name of local authority / integration authority: North Lanarkshire Council Report authorised by: Name Alison Gordon Designation Chief Social Work Officer (Children, Families, Justice and Integrated Services) Date: 23 June 2025 Details of where the report will be published: NLC and UHSCP website(s). Information Required 1. Please detail the steps you have taken as an organisation to comply with section 3(2) of the Health and Care (Staffing) (Scotland) Act 2019: 3(2) In planning or securing the provision of a care service from another person under a contract, agreement or other arrangements, every local authority and every integration authority (within the meaning of section 59 of the Public Bodies (Joint Working) (Scotland) Act 2014) must have regard to— (a) the guiding principles for health and care staffing, and (b) the duties relating to staffing imposed on persons who provide care services— (i) by virtue of subsection (1) and sections 7 to 10, and (ii) by virtue of Chapters 3 and 3A of Part 5 of the Public Services Reform (Scotland) Act 2010. To comply with section 3 (2) of the Health and Care (Staffing) (Scotland) Act 2019 North Lanarkshire Council worked closely with the Care Inspectorate, the Scottish Government, our commissioned Registered Services and key social work staff. Education, training, scoping roles & responsibilities Prior to the enactment of the legislation in April 2024 our Social Work Quality Assurance team led on the research around the requirements of the act, focusing on the impact to Commissioned Services and to North Lanarkshire Council in meeting the responsibilities outlined for Local Authorities. Our engagement activities included: Page 110 of 174
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64 - North Lanarkshire were one of ten authorities involved in the Scottish Government pilot – HSCP Chapter Testing Summary Report - Focus Groups & Peer Learning for Commissioned Registered Services. Sessions included education and the sharing of best practice evidence sources surrounding the 8 Guiding Principles, wellbeing of staff, staff training and the Staffing Method Framework. - Hosted Care Inspectorate Face to Face & On-line Education Sessions for Social Work staff. This raised awareness of the act to ensure social work staff were aware of the responsibilities of providers and Local Authorities. - Introduced as a standing agenda item at Adult Social Work Governance, Senior and Social Work Leadership Team Meetings and our (cross care group) Social Work Workforce Meeting. In doing so preparation and implementation of the legislation was given strategic priority. - Quality Assurance Newsletter. Quarterly updates were provided across social work in relation to the new legislation and how we were preparing for its implementation. Links to the Care Inspectorate Safer Staffing Hub were shared as was training available through the SSSC Open Badge route or alternatively Turas. Procurement & Contracting Our Social Work Quality Assurance Team, in partnership with operational colleagues, are responsible for procuring and contracting of Registered Commissioned Services. Prior to 1st April 2024 they liaised with our Corporate Procurement Team to review contracts which for Registered Services includes: - National Care Home Contract (NCHC) – 25 Care Homes with nursing and 1 Care Home Residential are commissioned within North Lanarkshire. Scotland Excel own and manage this contract through the National Care Home Contract. - North Lanarkshire Council did not plan or secure care homes between 1st April 2024 to 31st March 2025. - Self-Directed Support (SDS) Framework including Care at Home Services – This framework is owned by North Lanarkshire Council. It is a ten-year framework effective from 2021, and it will expire in 2031. There are annual entry points for tender submissions from organisations meeting the criteria however in 2024 tender submissions were invited from December 2024 with the contract being effective as of 1st April 2025. We will report on new services added to the SDS Framework in 2025/2026. Page 111 of 174
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65 - As of 31st March 2025, the SDS Framework for Care at Home Services included 58 services. These services are accessed by Adult Health & Social Care, Children & Families & Justice. Breakdown below of the number of services available to support adults, children and older adults. Adults Children Older Adults 49 19 38 - Children's Residential Care and Education, including Short Break, Services – 2 different organisations from the framework are provide services within North Lanarkshire. This contract is owned and managed by Scotland Excel. - North Lanarkshire Council did not plan or secure any services under this contract between 1st April 2024 to 31st March 2025. - Fostering and continuing Care - 2 services are commissioned within North Lanarkshire. This contract is owned and managed by Scotland Excel. - North Lanarkshire Council did not plan or secure any services under this contract between 1st April 2024 to 31st March 2025. - Individual Placement Agreements – Where an individual chooses to be supported by a non-commissioned service or out of authority/cross borders, placements are agreed through North Lanarkshire Council by utilising an Individual Placement Agreement. The findings from the review of the National Care Home Contract, the SDS Framework for Care at Home services and Individual Placement Agreements, all of which are utilised when planning and securing services, confirmed that no modifications were required to legislative requirements. This was due to the Health and Care (Staffing) (Scotland) Act 2019 legislation/guidance stating that there is no requirement to stipulate the actual name of the legislation. The need to comply with the Care Inspectorate Standards and all legislation relevant to social care form part of our contract monitoring approach. As part of the procurement journey and overall evaluations the guiding principles of the act and person specific training plans are considered in reference to meeting people’s unique outcomes. Care Inspectorate registration details and current grades awarded for each of the Key Questions are also taken into consideration. Contract Monitoring The Social Work Quality Assurance Team have oversight of all commissioned Registered Services for Adult Social Work, Children & Families and Justice services. Page 112 of 174
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66 Monitoring arrangements are in place, and these have been modified to include information around staffing arrangements and the key components of the staffing method framework, the guiding principles of the act including staff wellbeing and stakeholder feedback. During monitoring visits, the Quality Assurance Team engage directly with stakeholders to ensure that their views are being taken into consideration when decisions are made about staffing. A request is made to the Care Inspectorate to extend an invitation to a representative from the Quality Assurance Team to enable them to participate in the feedback session. This approach ensures information about staffing is known timeously. Care Inspectorate grades, requirements and areas for improvement are monitored and taken into consideration when risk assessing the commissioned services and the level of monitoring required. When a placement is being made in a non-commissioned service including out of authority and cross borders, due diligence processes are in place that includes liaison with the host authority and the appropriate regulator e.g. Care Inspectorate. This enables oversight of safer staffing compliance issues. 2. Please detail any ongoing risks that may affect your ability to comply with the duty set out in section 3(2). North Lanarkshire Council have a Self-Directed Support (SDS) Framework including Care at Home Services. This is a 10-year framework with annual entry points, as referenced above. This framework has been live since 2021 and will continue until 2031. Exploration and consideration are in process to make changes to the tendering evaluation process to evidence inclusion of the provider’s responsibilities under the Act. This will feature within future entry points. Subsequent modifications arising will be informed in collaboration with procurement legislation and best practice, which may result in limitations to the scope of change applied throughout this period. The Care Inspectorate do not define training requirements for a provider at the time of registration. Staff training is determined by the needs of the people being supported which is a fluid and dynamic process. To include training requirements as part of any competitive tendering process may not achieve the desired outcome as a result. North Lanarkshire Council take a person-centered approach to the expectations of providers to update their training plans as and when the needs and aspirations or people change. Monitoring visits carried out by our Social Work Quality Assurance Team capture any gaps as defined by the population at that time. Page 113 of 174
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67 North Lanarkshire Registered Services Care Inspectorate Activity: Annual Report 2024/2025 Appendix 4 Page 114 of 174
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68 Annual Report for North Lanarkshire Adult Services Care Inspectorate Activity for 2024/2025 Introduction North Lanarkshire Council currently operate a range of registered services, namely Locality Support Service (Disability), Home Support Service and Integrated Day Services and Residential Children’s Houses. All are delivered over the six localities: Motherwell, Wishaw, Coatbridge, Airdrie, Bellshill and Cumbernauld. These services are regulated by the Care Inspectorate and inspection frequency is determined by risk rating based on the Care Inspectorate scrutiny tool. Purpose of Report The purpose of this report is to provide an overview of care inspection activity for NLC in- house services during the reporting period 1st April 2024 and 31st March 2025. This report provides details of the most recent care inspection activity, including grades awarded, requirements, areas for improvement, areas of strength and good practice and highlights any patterns or themes emerging. Care Inspectorate Grading System The table below outlines the grading system used by the Care Inspectorate to determine grades for each of the key questions and quality statements. Grades range from unsatisfactory (1) through to excellent (6). The In-House Services being reported on fall under three different quality frameworks which are as follows: - Locality Support Services & Integrated Day Services – A quality framework for support services (not care at home) - Home Support Service & Community Alarms – A quality framework for support services (care at home including supported living models) Key Question 4 as stated below is not assessed for this service type. EXCELENT 06 VERY GOOD 05 GOOD 04 ADEQUATE 03 WEAK 02 UNSATISFACTORY 01 OUTSTANDING OR SECTOR LEADING MAJOR STRENGTHS IMPORTANT STRENGTHS, WITH SOME AREAS FOR IMPROVEMENT STRENGTHS JUST OUTWEIGH WEAKNESSES IMPORTANT WEAKNESSES – PRIORITY ACTION REQUIRED MAJOR WEAKNESSES – URGENT REMEDIAL ACTION REQUIRED An evaluation of excellent describes performance which is sector leading and supports experiences and outcomes for people which are outstandingly high quality. This is a demonstrable track record of innovation, effective practice and/or very high- quality performance across a wide range of its activities and from which others could learn. We can be confident that excellent performance is sustainable and that it will be maintained. An evaluation of very good will apply to performance that demonstrates major strengths in supporting positive outcomes for people. There are very few areas for improvement. Those that do exist will have minimal impact on people’s experiences and outcomes. While opportunities are taken to strive for excellence within a culture of continuous improvement, performance evaluated as very good does not require significant adjustment. An evaluation of good applies to performance where there is a number of important strengths which, taken together, clearly outweigh areas for improvement. The strengths will have a significant positive impact on people’s experience and outcomes. However improvement are requirement to maximise wellbeing and ensure that people consistently have experiences and outcomes which are as positive as possible. An evaluation of adequate applicates where there are some strengths, but these just outweigh weaknesses. Strengths may still have a positive impact by the likelihood of achieving positive experiences and outcomes for people is reduced significantly because key areas of performance need to improve. Performance which is evaluated as adequate may be tolerable in particular circumstances, such as where a service or partnership is not yet fully established, or in the midst of major transition. However, continues performance at adequate level is not acceptable. Improvements must be made by building on strengths while addressing those elements that are not contributing to positive experiences and outcomes for people. An evaluation of weak will apply to performance in which strengths can be identified but these are outweighed or compromised by significant weaknesses. The weaknesses, either individually or when added together, substantially affect peoples’ experiences or outcomes. Without improvement as a matter of priority, the welfare or safety of people may be compromised, or their critical needs not met. Weak performance requires action in the form of structured and planned improvement by the provider or partnership with a mechanism to demonstrate clearly that sustainable improvements have been made. An evaluation of unsatisfactory will apply when there are major weaknesses in critical aspects of performance which require immediate remedial action to improve experiences and outcomes for people. It is likely that people’s welfare or safety will be compromised by risks which cannot be tolerated. Those accountable for carrying out the necessary actions for improvement must do so as a matter of urgency, to ensure that people are protected, and their wellbeing improves without delay. Page 115 of 174
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69 - Residential Children’s Houses – A quality framework for care homes for children and young people and school care accommodation (special residential schools) Care Inspectorate Activity Locality Support Services Locality Support Service is a service for adults aged 16-65 with a learning disability, physical disability or long-term condition who require support to achieve their identified goals or outcomes, build confidence or maximise independence to lead healthier, safer, happier lives. This service is well connected and can support and signpost people to access services within their community including employment/voluntary opportunities, health improvement groups and further education courses. There were no care inspections within Locality Support Services during the reporting period. For details of grades and last inspection dates please refer to Table Appendix A. Integrated Day Services Integrated Day Services provide support for adults over 65, who often have complex and overlapping needs that require support from both health staff and social care staff. Support is offered either through the outreach, respite at home service, or support within the Integrated Day Service. The service is provided by both Social Work and Health staff, who work in partnership to ensure good quality support is provided. There were no care inspections within Integrated Day Services during the reporting period. Dates of the last inspections can be seen in the table Appendix B. Page 116 of 174
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70 Community Alarm Service The community alarm service provides urgent assistance to people living within their own homes who experience emergencies like taking ill or falling. People who choose to have the service are provided with an alarm unit connected to their phone system. When activated, a call is automatically made to the response centre where the staff will clarify the nature of the emergency. Staff will then alert family members or send trained community alarm staff or contact emergency services. This service operates 24-hours a day, 365 days a year, for people who are resident within North Lanarkshire area. There is currently a small charge for this service. Within the reporting period there were no inspections for this service. The table in Appendix C, highlights the core information in relation to the Community Alarm Service. Home Support Services Home Support is a service for individuals with complex health and care needs who require support to be as independent as they can be within their own homes. There are six In-House Home Support services across North Lanarkshire - Wishaw, Motherwell, Bellshill, Coatbridge, Airdrie and Cumbernauld. Airdrie Home Support were inspected three times during the reporting period. August 2024, 13 November 2024 and again on the 8 January 2025. On the 9 August 2024 the inspection focussed on 4 key questions: “How well do we support people’s wellbeing?” “How good is our leadership?” “How good is our staff team?” “How well is care and support planned?” All four key questions were awarded grades of weak (2) From this inspection requirements and areas of improvement included: Improvement and management of missed visits, reviews to be held no later than six monthly and support plans to be updated following reviews, to ensure that visits take place at the times specified, support plans reflect good practice, are person centred and outcome focussed. (see table on Appendix D) A further inspection took place on 13 November 2024 which focussed on two of the four requirements which were made on 28 September 2023. These were missed visits and reviews. It was evident that there were improvements in the number of reviews being carried out and systems had been implemented to ensure visits took place as scheduled. These requirements were then recorded as being met. The remaining two requirements from 28 September 2023 were then extended further to 6 January 2025. On the 8 January 2025 a further inspection focussed on the two outstanding requirements wand the following key questions: “How well do we support people's wellbeing” “How good is our leadership” “How well is our care and support planned” Page 117 of 174
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71 The requirements were met at this inspection and the 3 key questions above were graded adequate (3). This highlighted improvement particularly around care planning and consistent, organised visits. Bellshill Home Support were inspected on 18 April 2024 with four key questions being assessed. “How well do we support people’s wellbeing?” “How good is our leadership?” “How good is our staff team?” “How well is care and support planned?” All questions were graded Good (4) which highlighted an overall improvement in the grades from the previous inspection where grades of Adequate (3) were awarded for all key questions. Feedback reflected improvements to supervision frequency, observational monitoring and staff training. Coatbridge Home Support were inspected on 27 September 2024 with four key questions being assessed. “How well do we support people’s wellbeing?” “How good is our leadership?” “How good is our staff team?” “How well is care and support planned?” All questions were graded Adequate (3). This was an improvement on the grades awarded at the last inspection where three key questions (KQ 1, 2 and 5) were graded weak (2). Some progress was recognised from the last inspection. However there remained two of the three requirements which had not been met. These were: care plans to be person centred and outcome focussed and reviews to be carried out 6 monthly. During this inspection four of the eleven previous areas for improvement were noted as having been met. Some other areas were consolidated into new areas of improvement. These were to ensure that all staff, including management, access the relevant training appropriate to their role and apply this training in practice. A robust system was to be developed for managing complaints and to ensure that people are involved in contributing to their reviews. (See Appendix D) Feedback reflected that the staff induction process was thorough and had been developed, direct observations were taking place and staff received feedback. Supervision was taking place, recorded with follow up action and the training matrix was up to date and noted when refresher training was due. Cumbernauld Home Support was inspected on 11 September 2024 with four key questions being assessed. “How well do we support people’s wellbeing?” “How good is our leadership?” “How good is our staff team?” “How well is care and support planned?” Page 118 of 174
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72 Although two of the three requirements had been met since the last inspection no regrading took place. Therefore, grades of Adequate (3) remained for all four key questions. Feedback reflected improvements in training, supervision and audits of support reviews. A follow up inspection on 27 January 2025 focused on outstanding requirements and areas for improvement. The requirement for personal support plans being up to date, accurate, and reflective of good practice remained unmet. Additionally, there remained an area for improvement around action plans and supervision records as these had not been fully addressed. More time was required for the improvements that had been made to be embedded in practice. Feedback reflected that the care and support provided was good and positive changes continued to be implemented by the management team. Motherwell Home Support was inspected on 15 August 2024 with four key questions being assessed. “How well do we support people’s wellbeing?” “How good is our leadership?” “How good is our staff team?” “How well is care and support planned?” Three key questions were awarded grades of weak (2) however the key question “How well do we support people’s wellbeing?” was graded adequate (3). These grades were lower than those awarded previously. Requirements and areas for improvement were made. (See table Appendix D) A follow up inspection took place on 26 March 2025 and improvements had been noted. Three key questions were assessed. “How good is our leadership”, “How good is our staff team” and “How well is care and support planned” All three key questions were regraded to adequate (3). All requirements and areas for improvement had been met highlighting progress in these areas. Wishaw Home Support was inspected on 15 October 2024 with four key questions being assessed. “How well do we support people’s wellbeing?” “How good is our leadership?” “How good is our staff team?” “How well is care and support planned?” Grades of good (4) were awarded for all four key questions. The three areas noted for improvement at the last inspection were assessed during the October 2024 inspection and all three had been met. These included: improving the quality of care plans: the management of falls: ensuring prompt referrals to the appropriate professionals, when required. Areas of improvement from the October 2024 inspection included ensuring that action plans were fit for purpose and SMART (specific, measurable, achievable, realistic and time-bound) Page 119 of 174
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73 and focused to ensure a culture of continuous improvement. Review reports were to be shared with the appropriate people. Feedback reflected that there is good communication across the staff team, good management oversight and staff are supported within the workplace. Residential Children’s Houses North Lanarkshire Council Residential Children’s houses offer accommodation, care and protection to children and young people generally aged 12 to 18, who cannot, for a variety of reasons, live in the community with their parents, extended family or substitute families. There are currently 5 North Lanarkshire Residential Houses in 5 areas within North Lanarkshire: Buchanan Street, Fort Street, Cambusnethan, Forrest Street, Fort Street and Main Street. All 5 residential houses were inspected within the reporting period. More detail can be found in Appendix E. Buchanan Street Residential House was inspected during the reporting period on 5th December 2024. One key question was inspected: “How well do we support children and young people's rights and wellbeing?” This key question was graded adequate (3). An area for improvement included development of staff practice, particularly around trauma informed practice. A further area for development noted the need for collective discussions and decision-making forums to be developed with young people. The management of medication and associated procedures were an area for improvement and management meetings were to be held, to continue to develop the service. The two requirements made from the previous inspection were both met within the timescales highlighting improvements in the quality assurance processes, incident reports were recorded accurately and risk assessments and safe plans for young people were detailed. More detail can be found in Appendix E. Feedback reflected that young people felt well cared for, there was good oversight of risk for young people and personal plans were outcome focused. Cambusnethan Residential House was inspected during the reporting period on 12th June 2024. One key question was inspected: “How well do we support children and young people's rights and wellbeing?” This key question was graded adequate (3) The previous requirement made at the last inspection was met within the timescales. This highlighted improvement with the admissions and matching procedures. Three previous areas for improvements from the last inspection were also met. Three new areas for improvement were made in the inspection of 12th June 2024. These included the need for improvement in staff training in relation to children’s specific needs, to develop child friendly and SMART personal plans and to continue to review staffing levels. Feedback reflected that the home worked well with partner agencies to support young people, there were some positive outcomes for young people and support for families was very good. Page 120 of 174
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74 Forrest Street Residential House was inspected during the reporting period on 18 August 2024. One key question was inspected: “How well do we support children and young people's rights and wellbeing?” This key question was graded good (4). The areas of improvement made from the previous inspection were met at this inspection and three new areas for improvement were made at the inspection of 18 August 2024. More detail can be found in Appendix E. Feedback reflected that risk was reduced for most young people, the staff group were skilled and experienced, and all young people had personal plans which detailed their needs and wishes. Fort Street Residential House was inspected during the reporting period on 25 February 2025. One key question was inspected: “How well do we support children and young people's rights and wellbeing?” This was graded 4 (good). There was one area of improvement made at this inspection suggesting personal plans should be SMART (specific, measurable, achievable, realistic and timebound). Feedback reflected that young people had meaningful relationships with staff and managers. Additionally, it was noted that staff worked proactively to support young people, relationships with family and friends were actively promoted and young people were supported and enabled to make informed choices and decisions for themselves. A previous area of improvement made was met at this inspection as there was evidence that action was taken to improve incident records ensuring that they held accurate information and good evidence of debriefs. The de-briefs were proactively undertaken by the manager, who sought to explore and understand learning for all involved. Main Street Residential House was inspected during the reporting period on 31 January 2025 with one key question inspected “How well do we support children and young people's rights and wellbeing?” This key question was graded good (4). There was one area of improvement made suggesting that personal plans should be SMART (specific, measurable, achievable, realistic and timebound). The previous four requirements made were all met at this inspection. Conclusion From carrying out an analysis of recent inspection activity across Registered In-House services, 15 inspections are noted to have been carried out between 1 April 2024 to 31 March 2025. From the 24 services reported on, 6 home support and 5 residential children’s houses services have been inspected. Page 121 of 174
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75 From the inspections carried out during the reporting period a common theme identified for all home support services, was the need for care plans to be developed, ensuring that they were person centred, and outcome focussed. Another common theme identified was to ensure that reviews were taking place 6 monthly. Themes emerging from the 5 children’s residential houses were staff training, specifically focusing on children’s needs and ensuring that personal plans were SMART. Further information can be found in the appendices below. Page 122 of 174
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Appendix A Locality Support Services CI Status 76 Locality Support Service Date Inspection Took Place How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Overall Grade Awarded Requirements Areas for Improvement Areas of Strength Airdrie 16/05/2023 VERY GOOD - 5 VERY GOOD - 5 NOT ASSESSED NOT ASSESSED NOT ASSESSED VERY GOOD - 5 None None Support is consistent by high quality staff ensuring positive experiences and outcomes Bellshill 23/06/2023 VERY GOOD - 5 VERY GOOD - 5 NOT ASSESSED NOT ASSESSED NOT ASSESSED VERY GOOD - 5 None None Good planning with people to ensure support is person centred. Good joint working with partnership agencies and skilled staff. Coatbridge 26/05/2023 VERY GOOD - 5 VERY GOOD - 5 VERY GOOD - 5 NOT ASSESSED VERY GOOD - 5 VERY GOOD - 5 None None People are supported well to build friendships and community links with good high-quality support provided. Cumbernauld 25/09/2023 VERY GOOD - 5 VERY GOOD - 5 NOT ASSESSED NOT ASSESSED NOT ASSESSED VERY GOOD - 5 None None Support is consistent by high quality staff ensuring positive experiences and outcomes. Motherwell 07/07/2023 VERY GOOD - 5 VERY GOOD - 5 NOT ASSESSED NOT ASSESSED NOT ASSESSED VERY GOOD - 5 None None People are well supported with experienced staff and Good supportive management team. Wishaw 12/06/2023 VERY GOOD - 5 VERY GOOD - 5 NOT ASSESSED NOT ASSESSED NOT ASSESSED VERY GOOD - 5 None None Good communication between people, families and the service. People are supported to have high quality positive experiences and outcomes. Page 123 of 174
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Appendix B Integrated Day Services CI Status 77 Integrated Day Service Date Inspection Took Place How well do we support people's wellbeing? How good is our leadership ? How good is our staff team? How good is our setting? How well is care and support planned? Overall Grade Awarded Key Questions Inspected outwith New Framework Requirements Areas for Improvement Areas of Strength Harry Walker - Airdrie 27/07/2023 VERY GOOD - 5 ADEQUATE - 3 VERY GOOD - 5 VERY GOOD - 5 VERY GOOD - 5 N/A By the closing date, which will be notified by the Care Inspectorate in 2024, the provider must comply with their legislative responsibility to submit an annual return. To ensure continuous improvements the provider should develop an improvement plan. Sir John Mann - Bellshill 12/01/2024 VERY GOOD - 5 VERY GOOD - 5 VERY GOOD - 5 NOT ASSESSED GOOD - 4 GOOD - 4 N/A None People should be supported to gain and maintain their independence to ensure people feel empowered and in control. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'I am empowered and enabled to be as independent and as in control of my life as I want and can be.' (HSCS 2.2).This area for improvement was made on 30 January 2024. • People were supported by long term staff who knew them well • People enjoyed attending the service and talking to staff and peers • Various activities were on offer everyday to stimulate people both physically and mentally • Both hot and cold nutritious meals on offer everyday. Coatbridge 14/04/2024 VERY GOOD - 5 GOOD - 4 VERY GOOD - 5 GOOD - 4 GOOD - 4 N/A There were no requirements 1. To develop an improvement plan 2. Carry out regular audits to ensure robust and transparent quality assurance processes 3. To provide detailed guidance for staff, care plans need to be developed * Good communication and participation from service users * Good relationships and friendships maintained which supported positive outcomes and reduced social isolation * Well trained and knowledgable staff who were supportive of each other encouraging good teamwork Cumbernauld & Kilsyth 14/06/2019 VERY GOOD - 5 VERY GOOD - 5 VERY GOOD - 5 VERY GOOD - 5 VERY GOOD - 5 VERY GOOD - 5 N/A None None The setting is very good at promoting and enabling independence. Care and support is planned and recorded very well. Staff were organised and well trained and reviews and care plans were carried out within the timescales. Motherwell 16/11/2015 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED VERY GOOD - 5 1. Quality of Care and Support (5) 2. Quality of Staff (5) 3. Quality of Environment (5) 4 Quality of Management & Leadership (5) Areas for improvement were not part of this inspection methodology as it was prior to the introduction of the new quality frameworks when recommendations were still in force. None * The performance of the service was excellent * Good engagement with service users, relatives and staff * The manager was supportive and approachable * Service Users were supported in a respectful way esuring privacy, dignity and respect Wishaw 24/03/2017 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED GOOD - 4 1. Quality of Care and Support (4) 4 Quality of Management & Leadership (4) Areas for improvement were not part of this inspection methodology as it was prior to the introduction of the new quality frameworks when None Support Plans were person centred and individual to each person Staff provided good care and support resulting in good outcomes for people Page 124 of 174
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Appendix C – Community Alarm CI Status 78 community Alarm Service Date Inspection Took Place How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Overall Grade Awarded Requirements Areas for Improvement Areas of Strength Covers All 6 Localities 26/03/2023 VERY GOOD - 5 GOOD - 4 VERY GOOD - 5 VERY GOOD - 5 None The service should introduce an improvement plan which includes its aims and objectives. The plan should detail challenges and goals in improving outcomes for people. The improvement plan should follow SMART principles and include timescales, progress towards goals and names staff responsible in each area. * Staff were well trained *Good hygiene levels and infection prevention and control * Staff were supported well with regular supervision and meetings Page 125 of 174
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Appendix D – Home Support CI Status 79 Home Support Service Date Inspection Took Place Date Draft Inspection Became Available Via Eforms Date Final Report became available via eforms How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Overall Grade Awarded Requirements Areas for Improvement Areas of Strength Airdrie 09/08/2024 17/09/2024 01/10/2024 WEAK - 2 WEAK - 2 ADEQUATE - 3 WEAK - 2 WEAK - 2 (1) By 8 April 2024, the provider must ensure the support provided to people promotes and their health and wellbeing. To achieve this the provider must: Take action reduce the number of missed visits. This should include: a) Introduce systems that further develop existing ones to reduce the likelihood of missed visits. b) Further develop existing contingencies to respond quickly to actual missed visits to ensure people receive the care and support they require (2) By 8 April 2024, the provider must ensure the support provided to people promotes and their health and wellbeing. To achieve this the provider must: a) Ensure support visits are organised to provide sufficient time and staffing to provide the assessed support at each visit.b) Ensure support visits take place, as far as possible, at the times notified to people.c) Ensure sufficient time is allowed for all support needs to be met at each visit.d) Ensure schedules are accurate and received in advance of the start of the planned supports with details of times and named staff. To support positive outcomes for people experiencing care and support, the provider should inform people of significant changes. This should include, but is not limited to, changes made to their staff team and visiting times, including when changes occur at short notice if possible. (2) To support people's health and wellbeing, the provider should ensure that requests for specified times to meet medical appointments are kept. This should include, but is not limited to, agreeing how they will support people when reasonable notice has been given. Airdrie 13/11/2024 10/12/2024 06/01/2025 WEAK - 2 (1) By 8 April 2024, the provider must ensure the support provided to people promotes and their health and wellbeing. To achieve this the provider must: Take action reduce the number of missed visits. This should include: a) Introduce systems that further develop existing ones to reduce the likelihood of missed visits. b) Further develop existing contingencies to respond quickly to actual missed visits to ensure people receive the care and support they require. MET (2) To ensure people receive appropriate supports to maintain and enhance their well-being and achieve their outcomes, the provider must: a) Have system in place to ensure reviews of people's care and support take place not less than six-monthly. b) Ensure that care plans are reviewed more regularly when a person's needs change. c) Audit the quality of reviews to ensure consistency and quality. MET (3)The provider must ensure the support provided to people promotes and their health and wellbeing. To achieve this the provider must a) Ensure support visits are organised to provide sufficient time and staffing to provide the assessed support at each visit. b) Ensure support visits take place, as far as possible, at the times notified to people. c) Ensure sufficient time is allowed for all support needs to be met at each visit. (d) Ensure schedules are accurate and received in advance of the start of the planned supports with details of times and named staff NOT ASSSESSED AT THIS INSPECTION (4) The provider must ensure service users experience care and support which is consistent, safe, and meets their needs. To do this the provider must, at a minimum, ensure that service users' personal plans: a) are current, accurate, reflect good practice in being person-centred and outcome focussed. b) have sufficient detail in them to ensure people's individualised support needs and outcomes are met. c) are subject to regular evaluation and audit to monitor quality and effectiveness. In addition, the provider must, a) ensure each person supported is provided with a copy of their care plan b) ensure all care plans are available on request for the Care Inspectorate NOT ASSESSED AT THIS INSPECTION To support positive outcomes for people experiencing care and support, the provider should inform people of significant changes. This should include, but is not limited to, changes made to their staff team and visiting times, including when changes occur at short notice if possible. MET (2) To support people's health and wellbeing, the provider should ensure that requests for specified times to meet medical appointments are kept. This should include, but is not limited to, agreeing how they will support people when reasonable notice has been given. MET During this period service management have worked hard to reduce the number of missed visits. Daily checks were introduced to provide alerts. Positive work carried out to ensure no care reviews were overdue and that management had overview of the quality of the reviews. Airdrie 08/01/2025 28/01/2025 12/02/2025 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3 Previous two (3) and (4) requirements were assessed at this visit and MET - OUTWITH THE TIMESCALES NONE The service continue to ensure staff are properly supported and trained. The quality of support plans had improved. Bellshill 18/04/2024 30/04/2024 14/05/2024 GOOD - 4 GOOD - 4 GOOD - 4 GOOD - 4 GOOD - 4 None To improve staff support the provider should ensure their policy regarding patch meetings is followed. Supervision and observation targets had improved, good quality assurance tools for observations, staff well trained Coatbridge 27/09/2024 04/11/2024 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3 By 30 November 2023, the provider must ensure that care plans are reviewed on a six-monthly basis as a minimum, in line with current legislation. To do this, the provider must, at a minimum, ensure: a) people are supported to understand and be included within their care review b) they collaborate with people and others involved with their care to gather their views on what is working well with their care and support. This includes but is not limited to reviewing health and safety risk assessments and needs assessments c) ensure that any agreed actions are completed and reviewed regularly to ensure they remain effective. Completed actions to be carried forward to the next agreed review date d) people and their representatives (where appropriate) have read over and are happy with the record of their review e) managers are involved in the monitoring and the audit of people's reviews. By 30 November 2023, the provider must ensure service users experience care and support which is consistent, safe, and meets their needs. To do this the provider must, at a minimum, ensure that service users' personal plans: a) are current, accurate, reflect good practice in being person-centred and outcome focussed b) have sufficient detail in them to ensure people's individualised support needs and outcomes are met c) are subject to regular evaluation and audit to monitor quality and effectiveness. Page 126 of 174
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Appendix D – Home Support CI Status 80 Cumbernauld 27/01/2025 04/02/2025 27/02/2025 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3ADEQUATE - 3 By 30 June 2023, the provider must ensure service users experience care and support which is consistent, safe, and meets their needs. To do this the provider must, at a minimum, ensure that service users' personal support plans are: a) Up-to-date, accurate, reflect good practice in being person-centred and outcome focussed b) Detailed enough to provide guidance to staff on how to support people, including risk assessments. c) Regularly audited to ensure consistency and quality. This has been extended to 30 April 2025 To ensure people are being supported by a competent workforce, the provider should ensure action plans generated from supervisions are completed and supervision records are regularly audited.This area for improvement has not been assessed and remains in place Cumbernauld 11/09/2024 02/10/2024 08/10/2024 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3ADEQUATE - 3 By 30 June 2023, the provider must ensure service users experience care and support which is consistent, safe, and meets their needs. Support plans require to be: a) Up-to-date, accurate, reflect good practice in being person-centred and outcome focussed b) Detailed enough to provide guidance to staff on how to support people, including risk assessments. c) Regularly audited to ensure consistency and quality. . To ensure people are being supported by a competent workforce, the provider should ensure action plans generated from supervisions are completed and supervision records are regularly audited. 2 of the 3 requirements have been met. Improvements made with training, supervision and audits of reviews. Motherwell 15/08/2024 09/09/2024 02/10/2024 ADEQUATE - 3 WEAK - 2 WEAK - 2 WEAK - 2 WEAK - 2 By 31 December 2024, the provider must provide the service in a manner which promotes quality and safety and respects the independence of service users and affords them the choice in the way in which the service is provided to them. To do this the provider must, at a minimum: -implement a SMART short focused improvement plan which is updated regularly by service -record and monitor visits completed by family members as part of their contingency planning -ensure people receive their assessed time at each visit. 1. By 31 December 2024, to ensure that people’s care and support needs are met effectively, the provider must ensure staffing arrangements are safe. To do this, the provider must, at a minimum: regularly assess and review people’s care and support needs clear systems that identify the current support needs for people experiencing care relevant training is provided to all staff to ensure their competency in all aspects of their role which must include direct observations provide regular support for staff which includes supervision and appraisal develop a long term strategy for recruitment, retention and wellbeing of staff Adult Support and Protection incidents were generally well recorded and reported to the Care Inspectorate. We could see appropriate actions had been taken. However there were delays between the incidents and when they were notified to the Care Inspectorate, some by more than a couple of weeks. Notifications should be made in the timescales identified in the Care Inspectorate guidance for notification reporting. To ensure notifiable events are reported to the Care Inspectorate in a timely manner the service should comply with the Care Inspectorate guidance for notification reporting. Motherwell 26/03/2025 01/04/2025 16/04/2025 ADEQUATE - 3 ADEQUATE - 3 ADEQUATE - 3ADEQUATE - 3 All requirements were met All previous areas of improvement were met - 2 new areas for improvement was made: To ensure a confident well trained staff team the service should ensure schedulers have the training, mentoring and support they need. 2. To ensure there is clear evidence staff support is taking place the service should develop a robust monitoring system. Wishaw 15/10/2024 22/10/2024 28/10/2024 GOOD - 4 GOOD - 4 GOOD - 4 GOOD - 4 GOOD - 4 No requirements All 3 previous areas for improvement met. Further areas of improvements as below: To support a culture of continuous improvement, the provider should ensure that all action plans are fit for purpose and SMART (specific, measurable, achievable, realistic and time-bound) focused. To ensure that people are fully involved in developing and reviewing their care plan, the provider should ensure that review records are shared with them. The care and support that people experienced was right for them. Good communication across the staff team. Page 127 of 174
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Appendix D – Home Support CI Status 81 Childrens Residential Children's House Date Inspection Took Place How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? How well do we support children and young people's rights and wellbeing? Overall Grade Awarded Requirements Areas for Improvement Areas of Strength Buchanan Street 05/12/2024 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED ADEQUATE - 3 ADEQUATE - 3 None 1. To ensure that all young people consistently experience trauma informed responses to their care and support needs, the provider should continue to develop staff practice which is based on the principles of relational practice. The expected impact of any natural consequences should be carefully considered prior to being implemented. 2. To ensure that all young people's care and support needs are met by a staff team that works well together, the provider should maintain regular opportunities for collective discussion and decision making forums, to enable and promote agreed ways of working with young people. 3.To ensure the safety and wellbeing of all young people, the provider should provide closer monitoring of medication procedures to minimise the likelihood of errors occurring in practice. 4. To ensure that all young people receive high quality care and support, the provider should commit to regular, effective staff supervision for all members of staff, in line with their policy. 5. To ensure that all young people receive high quality care and support, the provider should undertake analysis, to determine the training and development needs of staff to promote professional growth. 6. To ensure that all young people receive high quality care and support from a service which is well led and managed, the provider should enable regular i d h i i Young people felt well cared for. There was good oversight of risk for young people. Personal plans were outcome focused. Cambusnethan 12/06/2024 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED ADEQUATE - 3 ADEQUATE - 3 None 1. To ensure that young people's needs are met, the provider should source and implement staff training relating to the specific needs of all young people 2. To ensure that young people's needs and wishes inform their care and support, the provider should develop SMART personal plans which are informed by young people and are written in a child friendly style 3.To ensure young people's needs are met, the provider should keep staffing levels under review to ensure the correct number of staff are always available to meet the needs of children and young people. Cambusnethan worked well with partner agencies to support young people. There were some positive outcomes for young people and support for families was very good. Forest Street 08/08/2024 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED GOOD - 4 GOOD - 4 None 1. To ensure that young people can assess their achievements, the provider should ensure that personal plans adequately document young people's progress toward good outcomes 2. To ensure the safety and wellbeing of all young people living at Forrest Street Residential Children's House, the provider should ensure that in each instance, admissions and matching assessments include assessment of the needs of young people already living in the house. The management team at Forrest Street Residential Children's House should inform decisions. 3. To ensure that young people help to inform improvement planning and continue to contribute to evaluations of progress toward identified outcomes, the provider should create a more streamlined approach to this process Risk was reduced for most young people and Leaders worked effectively with partners Fort Street 25/02/2025 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED GOOD - 4 GOOD - 4 None 1. To ensure that young people achieve positive outcomes which are specific to them as individuals, personal plans should be SMART (specific, measurable, achievable, realistic and timebound.) Young people had meaningful relationships with staff. Partners felt that managers and staff worked proactively with them to support young people. Relationships with family and friends were actively promoted. The quality of the environment was very good. Young people were supported and enabled to make informed choices and decisions for themselves. The house provided a safe place for young people Main Street 31/01/2025 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED GOOD - 4 GOOD - 4 None 1. To ensure effective oversight and governance of experiences and outcomes for young people, the provider should continue to improve quality assurance processes. 2. To ensure effective involvement of young people and their progress towards identified outcomes, personal plans should be SMART (specific, measurable, achievable, realistic and timebound) Most young people thrived, enjoying positive relationships with staff. The provider was responsive to risk impacting young people's safety and wellbeing. Education and employment was the norm for most young people. Some young people felt a strong sense of belonging. Interests and aspirations were fully supported. Personal plans should be SMART (specific, measurable, achievable, realistic and timebound). Leadership was positive and enabling. Page 128 of 174
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Appendix E – Children’s Houses CI Status 82 Childrens Residential Children's House Date Inspection Took Place How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? How well do we support children and young people's rights and wellbeing? Overall Grade Awarded Requirements Areas for Improvement Areas of Strength Buchanan Street 05/12/2024 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED ADEQUATE - 3 ADEQUATE - 3 None 1. To ensure that all young people consistently experience trauma informed responses to their care and support needs, the provider should continue to develop staff practice which is based on the principles of relational practice. The expected impact of any natural consequences should be carefully considered prior to being implemented. 2. To ensure that all young people's care and support needs are met by a staff team that works well together, the provider should maintain regular opportunities for collective discussion and decision making forums, to enable and promote agreed ways of working with young people. 3.To ensure the safety and wellbeing of all young people, the provider should provide closer monitoring of medication procedures to minimise the likelihood of errors occurring in practice. 4. To ensure that all young people receive high quality care and support, the provider should commit to regular, effective staff supervision for all members of staff, in line with their policy. 5. To ensure that all young people receive high quality care and support, the provider should undertake analysis, to determine the training and development needs of staff to promote professional growth. 6. To ensure that all young people receive high quality care and support from a service which is well led and managed, the provider should enable regular management meetings and other opportunities to develop the service. Young people felt well cared for. There was good oversight of risk for young people. Personal plans were outcome focused. Cambusnethan 12/06/2024 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSEDADEQUATE - ADEQUATE - 3 None 1. To ensure that young people's needs are met, the provider should source and implement staff training relating to the specific needs of all young people 2. To ensure that young people's needs and wishes inform their care and support, the provider should develop SMART personal plans which are informed by young people and are written in a child friendly style 3.To ensure young people's needs are met, the provider should keep staffing levels under review to ensure the correct number of staff are always available to meet the needs of children and young people. Cambusnethan worked well with partner agencies to support young people. There were some positive outcomes for young people and support for families was very good. Forest Street 08/08/2024 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSEDGOOD - 4 GOOD - 4 None 1. To ensure that young people can assess their achievements, the provider should ensure that personal plans adequately document young people's progress toward good outcomes 2. To ensure the safety and wellbeing of all young people living at Forrest Street Residential Children's House, the provider should ensure that in each instance, admissions and matching assessments include assessment of the needs of young people already living in the house. The management team at Forrest Street Residential Children's House should inform decisions. 3. To ensure that young people help to inform improvement planning and continue to contribute to evaluations of progress toward identified outcomes, the provider should create a more streamlined approach to this process Risk was reduced for most young people and Leaders worked effectively with partners Fort Street 25/02/2025 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSEDGOOD - 4 GOOD - 4 None 1. To ensure that young people achieve positive outcomes which are specific to them as individuals, personal plans should be SMART (specific, measurable, achievable, realistic and timebound.) Young people had meaningful relationships with staff. Partners felt that managers and staff worked proactively with them to support young people. Relationships with family and friends were actively promoted. The quality of the environment was very good. Young people were supported and enabled to make informed choices and decisions for themselves. The house provided a safe place for young people Main Street 31/01/2025 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSEDGOOD - 4 GOOD - 4 None 1. To ensure effective oversight and governance of experiences and outcomes for young people, the provider should continue to improve quality assurance processes. 2. To ensure effective involvement of young people and their progress towards identified outcomes, personal plans should be SMART (specific, measurable, achievable, realistic and timebound) Most young people thrived, enjoying positive relationships with staff. The provider was responsive to risk impacting young people's safety and wellbeing. Education and employment was the norm for most young people. Some young people felt a strong sense of belonging. Interests and aspirations were fully supported. Personal plans should be SMART (specific, measurable, achievable, realistic and timebound). Leadership was positive and enabling.Page 129 of 174
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Appendix E – Children’s Houses CI Status 83 Childrens Residential Children's House Date Inspection Took Place How well do we support people's wellbeing ? How good is our leadership ? How good is our staff team? How good is our setting? How well is care and support planned? How well do we support children and young people's rights and wellbeing? Overall Grade Awarded Requireme nts Areas for Improvement Areas of Strength Buchanan Street 05/12/2024 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED ADEQUATE - 3 ADEQUATE - 3 None 1. To ensure that all young people consistently experience trauma informed responses to their care and support needs, the provider should continue to develop staff practice which is based on the principles of relational practice. The expected impact of any natural consequences should be carefully considered prior to being implemented. 2. To ensure that all young people's care and support needs are met by a staff team that works well together, the provider should maintain regular opportunities for collective discussion and decision making forums, to enable and promote agreed ways of working with young people. 3.To ensure the safety and wellbeing of all young people, the provider should provide closer monitoring of medication procedures to minimise the likelihood of errors occurring in practice. 4. To ensure that all young people receive high quality care and support, the provider should commit to regular, effective staff supervision for all members of staff, in line with their policy. 5. To ensure that all young people receive high quality care and support, the provider should Young people felt well cared for. There was good oversight of risk for young people. Personal plans were outcome focused. Page 130 of 174
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Appendix E – Children’s Houses CI Status 84 undertake analysis, to determine the training and development needs of staff to promote professional growth. 6. To ensure that all young people receive high quality care and support from a service which is well led and managed, the provider should enable regular management meetings and other opportunities to develop the service. Cambusneth an 12/06/2024 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED ADEQUATE - 3 ADEQUATE - 3 None 1. To ensure that young people's needs are met, the provider should source and implement staff training relating to the specific needs of all young people 2. To ensure that young people's needs and wishes inform their care and support, the provider should develop SMART personal plans which are informed by young people and are written in a child friendly style 3.To ensure young people's needs are met, the provider should keep staffing levels under review to ensure the correct number of staff are always available to meet the needs of children and young people. Cambusnethan worked well with partner agencies to support young people. There were some positive outcomes for young people and support for families was very good. Page 131 of 174
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Appendix E – Children’s Houses CI Status 85 Forrest Street 08/08/2024 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED GOOD - 4 GOOD - 4 None 1. To ensure that young people can assess their achievements, the provider should ensure that personal plans adequately document young people's progress toward good outcomes2. To ensure the safety and wellbeing of all young people living at Forrest Street Residential Children's House, the provider should ensure that in each instance, admissions and matching assessments include assessment of the needs of young people already living in the house. The management team at Forrest Street Residential Children's House should inform decisions.3. To ensure that young people help to inform improvement planning and continue to contribute to evaluations of progress toward identified outcomes, the provider should create a more streamlined approach to this process Risk was reduced for most young people and Leaders worked effectively with partners Fort Street 25/02/2025 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED GOOD - 4 GOOD - 4 None 1. To ensure that young people achieve positive outcomes which are specific to them as individuals, personal plans should be SMART (specific, measurable, achievable, realistic and timebound.) Young people had meaningful relationships with staff. Partners felt that managers and staff worked proactively with them to support young people. Relationships with family and friends were actively promoted. The quality of the environment was very good. Young people were supported and enabled to make informed choices and decisions for themselves. The house provided a safe place for young people Page 132 of 174
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Appendix E – Children’s Houses CI Status 86 Main Street 31/01/2025 NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED NOT ASSESSED GOOD - 4 GOOD - 4 None 1. To ensure effective oversight and governance of experiences and outcomes for young people, the provider should continue to improve quality assurance processes. 2. To ensure effective involvement of young people and their progress towards identified outcomes, personal plans should be SMART (specific, measurable, achievable, realistic and timebound) Most young people thrived, enjoying positive relationships with staff. The provider was responsive to risk impacting young people's safety and wellbeing. Education and employment was the norm for most young people. Some young people felt a strong sense of belonging. Interests and aspirations were fully supported. Personal plans should be SMART (specific, measurable, achievable, realistic and timebound). Leadership was positive and enabling. Page 133 of 174
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref CR/SF Date 01/08/25 Adult Social Care Performance Report – Quarter 4 2024/25 From Claire Rae, Chief Officer, North Lanarkshire HSCP E-mail Claire.Rae@lanarkshire.scot.nhs.uk Telephone 01698 858143 1. Background 1.1 The Chief Officer has joint quarterly performance review meetings with the Chief Executive of NHS Lanarkshire and the Chief Executive of North Lanarkshire Council. These meetings are supported by a Chief Executive Performance Framework comprising a range of performance measures from across both health and social work systems, including relevant targets and trajectories. 1.2 Based on a traffic-light system there are areas for improvement identified within the performance framework each quarter for those that are flagged as Red or Amber. The Executive Summary The purpose of the report is to provide an update to the Committee on the performance of key areas of activity within Adult Health & Social Care for the period 01st Jan 2025 to 31st March 2025, Quarter 4 2024/25. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Endorse the improvement actions included within Appendix 2 of the report; and (2) Acknowledge the performance of key areas of activity within Appendix 1 of the report. The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (25) Ensure intelligent use of data and information to support fully evidence based decision making and future planning Programme of Work Resilient People Item 7 Page 135 of 174
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performance review meetings are used as a means for jointly agreeing corrective actions. 1.3 Information from these performance reviews has been supplemented with additional performance information below to offer the committee a wider overview of performance across some key areas of adult social care delivery. 2. Report 2.1 The purpose of the report is to provide an update to the Committee on wider performance of key areas of adult social care delivery, in addition to the performance areas for improvement which have been identified as part of the Chief Executive Quarterly Performance Review for the period 01st Jan 2025 to 31st March 2025, Quarter 4 2024/25. 2.2 The performance data for Quarter 4 and associated trend information is included as Appendix 1. The following new indicators were added to the CE reporting and appear in Appendix 1: • Balance of Care - % Of People (Age 65+), inclusive of SDS (service users aged 65+ with a >£10K budget) • IRT – Referral to Treatment within 12 weeks, excluding Major Equipment • HAT – Service users where HAT service ends within 1/2 days from Assessment to service completion • HAT – Service users with no further service required on completion of HAT 2.3 The Balance of Care indicator in North Lanarkshire has been updated to better align with the evolving Social Work approach that emphasises Self-Directed Support. Previously, the measure focused solely on adults over 65 receiving over 10 hours of traditional home support. The revised indicator now includes those with individual budgets of £10,000 or more, offering a more accurate reflection of current support arrangements. Additionally, new indicators for HAT (Home Assessment Team) and IRT (Integrated Rehabilitation Team) have been introduced to monitor system performance and support initiatives like improved Hospital Flow and Home Support Redesign. These indicators aim to track service efficiency and outcomes, although specific targets for these metrics are still being developed. 2.4 In addition, the partnerships compliance with North Lanarkshire Council mandatory training has been added to the scorecard. 2.5 Areas for improvement and planned actions are agreed and developed on an exception basis (i.e., for those indicators which are amber or red, based on tolerance thresholds). These are detailed as Appendix 2 of this report. 3. Measures of success 3.1 Measures of success are contained within Appendix 1 of this report. Page 136 of 174
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4. Supporting documentation 4.1 Appendix 1: Adult Social Care Dashboard 4.2 Appendix 2: Areas for Improvement 01st Jan 2025 to 31st March 2025, Quarter 4 2024/25. Claire Rae Chief Officer North HSCP Page 137 of 174
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Page 138 of 174
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Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☐ No ☒ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. 5.11 Children’s rights and wellbeing impact Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 139 of 174
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Appendix 1 – Adult Social Care Dashboard PLEASE NOTE FOR ALL INDICATORS UPWARDS ARROWS DENOTE POSITIVE PERFORMANCE Ref. KPI Target 2024-25 2023/24 Q4 2024/25 Q1 2024/25 Q2 2024/25 Q3 2024/25 Q4 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year Current Performance 2.15 Assistive Technology - Number Of People With Technology (0-17 yrs) 1,452 31 35 36 34 33 GREEN 2.16 Assistive Technology - Number Of People With Technology (18-64 yrs) 624 632 617 627 622 2.17 Assistive Technology - Number Of People With Technology (65+) 858 905 860 893 912 2.18 Reablement - Number Of People Completing Reablement Process 2000 (500 per quarter) 2011 527 987 1387 1788 ... RED 2.19 Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 60.8% 61.1% 57.1% 56.5% 63.0% RED 2.2 Reablement - % Of People With No or Reduced Home Support Service Required At End Of Process 70% 58.5% 62.6% 58.1% 63.6% 62.5% RED 2.21 Balance Of Care - % Of People (Age 65+), inclusive of SDS (service users aged 65+ with a >£10K budget) 45% 48.2% 46.4% 48.9% … NEW 2.X IRT - Referral to Treatment within 12 weeks, excluding Major Equipment 90% 74.3% 81.1% 81.4% 87.0% 89.9% NEW 2.X HAT – Service users where HAT service ends within 1/2 days from Assessment to service completion 5.0% 8.9% 6.7% 6.5% 7.0% … … NEW 2.X HAT – Service users with no further service required on completion of HAT 62.1% 61.9% 65.5% 62.3% 55.2% … … NEW 2.22 IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 63.4% 87.1% 65.8% 60.1% 73.4% RED 4.2 Complaints Processed Within Timescale (NLC) 85% 92.9% (Stage 1) 100% (Stage 2) 81.1% (Stage 1) 87.5% (Stage 2) 84.6% (Stage 1) 63.6% (Stage 2) 90.3% (Stage 1) 71.4% (Stage 2) 60.0% (Stage 1) 76.9% (Stage 2) RED Page 140 of 174
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Ref. KPI Target 2024-25 2023/24 Q4 2024/25 Q1 2024/25 Q2 2024/25 Q3 2024/25 Q4 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year Current Performance 4.3 Care Home Placements At End Of Quarter - Per 1000 Popn 65+ 24 22.0 22.1 22.2 22.0 21.9 GREEN 4.4 Care Home Placements At End Of Quarter - Per 1000 Popn 75+ 50 45.9 46.3 46.6 46.1 45.4 GREEN 4.5 Care Home - Average Length of Stay 865 834 708 789 966 776 GREEN 4.6 Number Of People With Self Directed Support 1,000 2089 2054 2114 2119 2214 GREEN 4.7 Number Of People With A Direct Payment 240 379 355 365 377 395 GREEN 7.X Conflict of Interest 80% 70.0% 72.0% 76.0% 83.7% 86.5% GREEN 7.X Data Protection Essentials 80% 72.0% 73.0% 77.0% 83.6% 86.4% GREEN 7.X Employee Code of Conduct 80% 89.0% 87.0% 87.0% 81.2% 84.5% GREEN 7.X Information security awareness 80% 70.0% 72.0% 75.0% 82.9% 85.7% GREEN 7.X Introduction to Risk Management 80% 65.0% 100.0% 70.0% 78.4% 82.2% GREEN 7.X Prevent 80% 63.0% 66.0% 70.0% 78.4% 82.1% GREEN 7.X Records and information management 80% 64.0% 67.0% 75.8% 79.3% … AMBER 7.21 % Of Adult Protection Referrals Passed To Care Team For Investigation 20% 20.1% 24.7% 30.6% 34.7% 35.7% GREEN 7.23 Adult Protection - % Of Referrals With Decision Within 5 Days 60% 81.7% 80.3% 83.6% 82.5% 81.5% GREEN 7.24 % of Adult Protection Referrals Which Did Not Go On To Investigation Or Other Service 50% 71.5% 66.0% 57.4% 56.4% 53.4% GREEN 9.4 Breakeven Position - Projected Outturn (NLC) >=0 £3.331m underspend £0.059m underspend £1.270m underspend £1.396m projected underspend £6.181m underspend ... ... ... 9.6 Sickness Absence (NLC) - days lost per person 9.22 13.74 3.48 6.34 9.52 12.92 RED Page 141 of 174
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Appendix 2 – Areas for Improvement 1. Reablement and Rehabilitation Target 2024/25 2024/25 Q3 2024/25 Q4 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Reablement - Number Of People Completing Reablement Process 2000 (500 per quarter) 1387 1788 ... RED Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 56.5% 63.0% RED Reablement - % Of People With No or Reduced Home Support Service Required At End Of Process 70% 63.6% 62.5% RED IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 60.1% 73.4% RED Narrative & Corrective Action The indicators for Reablement presented in the CE Scorecard have not met the targeted levels of performance. During 2023/24, the number of people completing the Reablement process increased, however in 2024/25 there has been a reversal of this trend. The percentage of new or increased Home Support packages that are Reablement is relatively stable in a range, around but below, the targeted level of 70%. However, the percentage of people with no, or reduced Home Support at the end of the Reablement process has failed to meet the targeted level of performance for some time. Additional data/information on Reablement is available from the HAT and IRT datasets. HOME ASSESSMENT TEAM The most recent HAT reporting covers a period beyond Q4 2024/25 and extends to May 2025. This reporting notes that since the beginning of the service, 3,496 referrals were accepted by HAT. Since the start of the service, referrals that were not accepted grew in volume up until May 2024, however this trend then reversed, with very few referrals not accepted (21 in March 2025 and 12 in April). Over the last year, 369 referrals were not accepted; 66% of referrals that were not accepted over the past year were from UH Wishaw. Page 142 of 174
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May 2025 was the thirteenth consecutive month where the volume of referrals exceeded 100. The average number of total monthly referrals over the past year was 127. The monthly referral distribution across the localities has been relatively stable over the past year: • Wishaw: 350 (21%) • Cumbernauld: 327 (20%) • Airdrie: 294 (18%) • Motherwell: 261 (16%) • Coatbridge: 226 (14%) • Bellshill: 181 (11%) Referral Sources There is very little difference in percentage terms from previous reporting regarding the HAT referrals by hospital of origin. However, it is notable this is the first reporting period where UH Monklands has overtaken UH Wishaw and it has now accepted 85 more referrals than UHW since the start of HAT. • UH Monklands: 1,731 – 50% • UH Wishaw: 1,646 – 47% • Other: 119 – 3% (includes older referrals with no source recorded) HAT Inputs The average number of input services for HAT cases has increased over time. Page 143 of 174
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The data on input services continues to reflect the expanding scope and complexity of support provided by HAT. Of the total referrals, only 1% (41 individuals) had no input services recorded, likely representing older cases, while 53% received one or two services. Notably, the proportion of individuals receiving three or more services has risen slightly and the average number of input services per referral has gradually increased; assuming that input services is a proxy of the intensity of support needs among service users, this may be an early indication that the HAT service is dealing with more complexity over time. Home Support remains the most frequently provided input service, involved in 87% of referrals, which is consistent with previous reporting. The volume of referrals where Occupational Therapy and Physiotherapy are input services has grown. HAT Outputs Around 96% of all referrals, or 3,349 individuals have completed the HAT service since its inception. Of those who completed the process, 14% (466 people) were re- admitted to hospital and 37% (1,238 individuals) were identified as needing further services; these proportions appear to be consistent over time. Page 144 of 174
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At the point of completion, 63% of individuals required no further support, while 37% were recorded as needing at least one service. Of those, the majority (73%) required only one service, with the remainder needing two or more. The most frequently provided services were IRT (Physiotherapy) and Reablement, each accounting for 14% of completions, followed by IRT (Occupational Therapy) and mainstream Home Support each accounting for 10%. IRT REABLEMENT Throughout 2024/25, the overall number of IRT/Reablement referrals has decreased, however it should be noted that this decrease follows a notable and significant increase in the volume of referrals at the start of the financial year. There is no target set for this metric, however it complements the Reablement information presented above and should be considered in the context of a wider system of Reablement, Rehabilitation and Home Support. Page 145 of 174
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The overall number of waits has decreased in-line with the decrease in referrals; the number of people waiting for IRT Reablement allocation in Q4 was the lowest level experienced in financial year 2024/25. Detailed activity information is available in the IRT dataset. The contact activity for IRT Reablement in February 2025 presented below shows that the most prevalent contact type is telephone call. 35 30 36 27 15 25 11 13 9 8 14 4 13 0 5 10 15 20 25 30 35 40 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 May-25 No. of referrals - May-24 to May-25 15 12 18 13 6 13 5 5 6 8 5 3 6 0 2 4 6 8 10 12 14 16 18 20 May-24 Jun-24 Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24 Jan-25 Feb-25 Mar-25 Apr-25 May-25 No. waiting on allocation on last day of month - May-24 to May-25 Page 146 of 174
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HOME SUPPORT REDESIGN The Home Support Redesign Programme is focussed on Home Support that achieves individual outcomes for people using the service and their families. The redesign is based on core principles that are aligned with B2B, SDS and developments in Hospital Flow. It is supported by several products that have been produced to progress the work, including service specifications, a workforce profile and an analysis of demand/capacity data. The proposal is for a “Living Well” service that provides Home Support to achieve individual outcomes for the people using the service and a distinct “Assessment & Planning” service, to include Rehabilitation and Reablement services, ensuring that people receive a holistic assessment of their need and are provided with the most appropriate services to meet the individual outcomes. 2. Complaints Target 2024/25 2024/25 Q3 2024/25 Q4 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Complaints Processed Within Timescale (NLC) 85% 90.3% (Stage 1) 71.4% (Stage 2) 60.0% (Stage 1) 76.9% (Stage 2) RED Narrative & Corrective Action All NLC complaints are collated via one centralised, customer service portal, logged centrally and monitored through the relevant NLC governance process. A detailed dashboard provides live management and performance information. As the cost of a licence for the system increased substantially from April 2023, the number of licences allocated to SW services has been reduced and consequently, only members of management support and complaint administrators have been granted a licence. The rationalisation of licence permissions ensures confidentiality for social work complaints. Within Adult SW Services, in-house monitoring by the Quality Assurance team has been introduced to support improvements in managing complaints. 0 10 20 30 40 50 60 aaNew Visit aaTelephone Assessment aClosing Summary Duty Repeat Visit Screening Telephone Calls zDiscussed with OT/PT zDiscussed with Senior/Team Leader zEmails Contact activity by contact type - Mar 2025 Airdrie Bellshill Coatbridge Cumbernauld Motherwell Page 147 of 174
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Whilst complaints processed within timescale has failed to meet the performance target, as a balancing measure, University Health and Social Care North Lanarkshire receives significant volumes of feedback from service users through Care Opinion. UHSCNL had a total of 49 stories published on Care Opinion during February 2025; 90% of those were positive of their experience. 3. Sickness Absence Target 2024/25 2024/25 Q3 2024/25 Q4 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Sickness Absence (NLC) - days lost per person 9.22 9.52 12.92 RED Narrative & Corrective Action The Partnership continues to work towards reducing sickness absence rates as part of the Adult Social Care Services Savings Delivery Plan and the Health Care Services Savings Delivery Plan. These reviews, which began in April 2024, will run through the 2024/25 and 2025/26 financial years. Despite ongoing efforts, sickness absence remains an issue, and actions are being taken to reduce the rate. Within the partnership, long and short-term sickness absence continues to be managed in accordance with the relevant organisational policies and monitored at service level. Attendance Management Reviews are taking place as required and local Managers are complying with the requirements of the policy. Managers are focussing on cases that have breached sickness absence triggers and other long-term absences, whilst there remains a wider focus on the Health and Wellbeing of staff as a key contributing factor to levels of sickness absence. Page 148 of 174
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref CR/MD/PH/LH Date 02/09/25 Revenue & Capital Budget Monitoring Report: Adult Social Care Period 03: 01/04/2025 to 20/06/2025 From Morag Dendy, Chief Officer (Planning, Performance and Quality Assurance) E-mail hendryp@northlan.gov.uk Telephone Paula Hendry, Business Finance Manager, 07471321768 Executive Summary This report provides a summary of the revenue financial performance of the Health & Social Care Partnership (H&SCP) – North Lanarkshire (Adult Social Care & Housing) and the financial performance of the Social Work capital programme. The report incorporates the period 1 April 2025 to 20 June 2025 (Period 03) and includes projected outturn forecasts for the financial year ended 31 March 2026, with major outturn variances highlighted and explained per the approved Financial Regulations. H&SCP – North Lanarkshire (Adult Social Care & Housing) has a gross revenue expenditure budget of £281.777m and is currently projecting an overspend of £5.939m. This adverse variance is predominantly the result of overspends relating to Overtime, Independent Care Homes and ‘Care at Home’ costs, all of which are partially offset by underspends in relation to vacancies across the Service. Any overspend presented for the financial year ended 31 March 2026, will be fully funded by IJB reserves. The Social Work capital programme has a total budget of £2.364m and is anticipated to outturn with a balanced position. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Acknowledge the revenue financial outturn position; and (2) Acknowledge the capital financial outturn position. The Plan for North Lanarkshire Priority Improve North Lanarkshire's resource base Ambition statement (25) Ensure intelligent use of data and information to support fully evidence based decision making and future planning Programme of Work Statutory / corporate / service requirement Item 8 Page 149 of 174
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1. Background 1.1 The Council’s approved Financial Regulations require the Chief Executive to remain within the approved budgetary provision, and to report all significant deviations - defined as the higher of £100,000 or 5% - within budget monitoring reports. Where significant deviations are identified, the Chief Executive must provide explanatory commentary, outline the action required to rectify such deviations and where relevant, must also highlight the impact this has on other budget headings. 2. Report Revenue: Summary of Financial Position 2.1 The Council approved its General Revenue Fund Budget on 20 February 2025, and the Integration Joint Board (IJB) approved its Financial Plan on 19 March 2025. The approved Gross Expenditure Budget for the H&SCP – NL (Adult Social Care and Housing) is £281.777m. The current 2025/26 budget incorporates £10.386m of savings for Adult Social Care. 2.2 The overall projected outturn position of the Service is an overspend of £5.939m. Appendices one to four provide further information in respect of this position. Further information regarding savings is included at Appendix 4. 2.3 Any overspend presented for the financial year ended 31 March 2026, will be fully funded by IJB reserves. Revenue: Analysis of Significant Variances 2.4 Within Employee costs, the Service currently anticipates an underspend of £0.777m. This is in relation to slippage linked to the recruitment of posts across the Service, which is being partially offset by higher than anticipated home support overtime costs. 2.5 Transport and Plant is anticipated to be underspent by £0.121m. This is mainly due to less than anticipated costs in relation to staff mileage and vehicle contract hire costs. 2.6 Payments to Other Bodies and Transfer Payments are detailed in Appendix 2. This expenditure accounts for £177.435m of the annual budget and is forecast to have an in-year net overspend of £6.752m (3.8%). This is primarily in relation to anticipated spend in ‘Care at Home’ and Independent Care Homes. These projections are demand led and are based on full year costs for both current clients and those anticipated, therefore projections will alter as the year progresses. Updates will be provided in future reports. 2.7 The Service anticipates a total under recovery of income of £0.099m and is predominantly in relation to less than anticipated income relating to the Integrated Day Services. Revenue: Earmarked Reserves 2.8 The Integration Joint Board have total reserves of £25.278m, for specific Adult Social Care commitments as detailed in Appendix 3. 2.9 The Service intends to utilise £2.396m of reserves during the year for specific projects and initiatives. As previously stated, any overspend for the financial year will be fully Page 150 of 174
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funded from reserves, therefore a year-end drawdown of £5.939m is anticipated. Overall, a total of £8.335m of reserves are expected to be used during 2025/26. 2.10 The remaining £16.943m will be carried forward to 2026/27. Of this, £7.128m has been assessed by the Service and set aside for specific projects and initiatives as detailed in Appendix 3. This leaves a balance of £9.815m, specifically for ‘social care demand risk’, which has been earmarked to offset any budget pressures, including shortfalls in savings, and any unanticipated increase in demand. 2.11 All expenditure to be met from earmarked reserves are excluded from the outturn position. Revenue: Savings 2.12 The Financial Plan of the Health & Social Care Partnership was approved by the Integrated Joint Board in March 2025 which identified an overall cost pressure for 2025/26 of £14.729m of which £10.386m relates to Adult Social Care. 2.13 To address this cost burden the Service has developed a savings delivery plan which aims to deliver this saving value in 2025/26, details of which, and progress made to date are outlined in Appendix 4. 2.14 Updates on these savings will be provided in future reports; however Members should note that the current projected overspend (referenced at 2.2 above) should reduce as progress towards the achievement of these savings is made. Capital: Summary of Financial Position and Analysis of Significant Variances 2.15 The Council approved its new 5-year Strategic Capital Investment Programme on 14 March 2024. Financial Year 2025/26 is the second year of the programme, with £2.200m approved for Social Work for the current year. Net reprofiling from 2024/25, results in a revised budget of £2.364m, as demonstrated by Appendix 5. 2.16 The Integrated Equipment and Adaptation (IEAS) capital programme funds equipment for individuals and adaptations to properties to allow those individuals to live independently at home. 2.17 At this early stage in the financial year, the Service currently anticipates a balanced position. There remain uncertainties in respect of demand and complexity of need and therefore this budget will continue to be monitored closely, and any forecast movements will be highlighted in future reports. 2.18 Appendix 6 outlines the Service’s total capital budget, outturn position and current contractual commitments. 3. Measures of success 3.1 The Service operates within approved budget resources. Page 151 of 174
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4. Supporting documentation Appendix 1 Revenue – Subjective Analysis Appendix 2 Revenue – Payments to Other Bodies & Transfer Payments Analysis Appendix 3 Revenue – Status of Earmarked Reserves Appendix 4 Revenue – Savings Monitoring Appendix 5 Capital – Budget Movements 2025/26 Appendix 6 Capital – Summary Expenditure by Thematic Category Morag Dendy Chief Officer (Planning, Performance and Quality Assurance) Page 152 of 174
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? The Adult Social Care management team will continue to review and implement management action and initiatives, with the aim of remaining within approved budget resources. This action will include vacancy management, curtailment of non- essential expenditure, and maximising income. This report has been prepared by service-based Finance personnel in consultation with budget managers, in accordance with the Financial Regulations. 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ Page 153 of 174
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5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☒ No ☐ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? All activities undertaken by the Council are subject to risk, and in acknowledging the Council’s approved Risk Management Strategy, Services manage these as part of their overall corporate and service planning processes. The demands and restrictions resulting from Covid, and the current economic climate has the potential to impact upon the Council’s ability to provide quality services within approved budget levels. The Service continues to face increasing demand pressures for provision within the home support, ‘care at home’ and independent care home arenas. To mitigate these pressures the Service reviews and considers data and trends in relation to current and anticipated demand on an ongoing basis to underpin projections of need and cost, and to agree appropriate operational and management action. 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. Page 154 of 174
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5.11 Children’s rights and wellbeing impact Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 155 of 174
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APPENDIX 1 [1] [2] [3] [5] [6] EMPLOYEE COSTS 91,392,637 90,615,094 777,543 FAV 0.9% Anticipated underspend mainly as a result slippage in relation to recruitment across the Service. This is partially offset by higher than anticipated costs in relation to home support overtime costs. PROPERTY COSTS 3,609,510 3,650,886 (41,376) ADV (1.2%) Dilapidations costs in relation to McGregor Road (Cumbernauld Locality Support Service) partially offset by the resultant in-year underspends across rents and utilities as a result of the Service moving out of McGregor Road. SUPPLIES & SERVICES 6,645,577 6,595,637 49,940 FAV 0.8% Minimal underspends across the Service in all Supplies and Services budgets TRANSPORT & PLANT 2,308,312 2,187,271 121,041 FAV 5.2% Projected underspends in relation to Staff mileage and Vehicle Contract Hires ADMINISTRATION COSTS 356,766 356,766 0 0.0% Anticipated overspend in relation to 'Adare' printing and postange costs, fully offset by underspends across all other Admin budgets PAYMENTS TO OTHER BODIES 62,434,915 66,280,069 (3,845,154) ADV (6.2%) Please refer to Appendix 2 for analysis TRANSFER PAYMENTS 115,000,887 117,908,180 (2,907,293) ADV (2.5%) Please refer to Appendix 2 for analysis CAPITAL FINANCING COSTS 0 0 0 0.0% REVENUE FINANCING COSTS 0 0 0 0.0% OTHER EXPENDITURE 28,858 22,858 6,000 FAV 20.8% TOTAL EXPENDITURE 281,777,462 287,616,762 (5,839,299) ADV (2.1%) NLC CONTRIBUTION (217,357,670) (217,357,670) 0 0.0% NLC CONTRIBUTION - HOUSING (2,573,453) (2,573,453) 0 0.0% INCOME FROM HEALTH (59,382,114) (59,399,362) 17,248 FAV (0.0%) FEES AND CHARGES (1,470,798) (1,362,347) (108,451) ADV 7.4% Lower than anticipated income in relation to charges for Integrated Day Services OTHER LOCAL AUTHORITIES 0 0 0 0.0% BUDGETED USE OF IJB RESERVES 0 0 0 0.0% OTHER INCOME (993,427) (985,050) (8,377) ADV 0.8% INCOME (281,777,462) (281,677,882) (99,580) ADV 0.0% NET EXPENDITURE 0 5,938,880 (5,938,879) ADV 0.0% anticipated Drawdown from IJB Reserves 5,938,879 Balance 0 NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Subjective Analysis Period 03 (01 April 2025 - 20 June 2025) Adult Social Care & Housing - INTEGRATED CATEGORY ANNUAL BUDGET PROJECTED OUTTURN PROJECTED OUTTURN VARIANCE % VARIANCE ANALYSIS [4] Page 156 of 174
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APPENDIX 2 [1] [2] [3] [5] [6] Care at Home (SDS Framework 1 & 2) 115,000,887 117,908,056 (2,907,170) ADV (2.5%) Demand led activity. Independent Care Homes 48,936,855 53,137,826 (4,200,971) ADV (8.6%) Demand led activity. Payments to NHS Lanarkshire 2,330,117 2,330,117 0 0.0% Position reflects anticipated in year payments Other Local Authorities - General 133,467 133,400 67 FAV 0.1% Position reflects anticipated in-year demand Voluntary Organisations & Payments to Other Bodies - Gen 8,930,761 8,600,228 330,533 FAV 3.7% Position reflects anticipated in-year demand Locality Flexibility 218,068 192,965 25,103 FAV 11.5% Position reflects anticipated Locality demand Private Sector Housing Grants 1,763,012 1,763,012 0 0.0% Position reflects anticipated in-year demand Medical Fees 122,635 122,635 0 0.0% Position reflects Service's approach to absence management Agency Fees 0 10 (10) ADV 0.0% Position reflects anticipated in-year payments Other 0 0 0 0.0% TOTAL EXPENDITURE 177,435,802 184,188,249 (6,752,447) ADV (3.8%) [4] NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Payments to Other Bodies & Transfer Payments Analysis Period 03 (01 April 2025 - 20 June 2025) Adult Social Care & Housing - INTEGRATED CATEGORY ANNUAL BUDGET PROJECTED OUTTURN PROJECTED OUTTURN VARIANCE % VARIANCE ANALYSIS Page 157 of 174
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APPENDIX 3 Carers Act 2018 - Support 2,603,618 131,632 2,471,986 0 2,603,618 Social Care Demand risk 16,469,053 6,654,373 9,814,680 0 16,469,053 Tech Improvements - SWIS 84,674 84,674 0 0 84,674 Tech Improvements - Comm Alarms 230,052 46,200 183,852 0 230,052 Tech Improvements - Home Scheduling System 3,331,742 420,979 2,910,763 0 3,331,742 MH 2 NL10s 149,374 0 149,374 0 149,374 Cost of Living Helpline 136,688 136,688 0 0 136,688 Home Support resilience 576,966 84,381 492,585 0 576,966 Staff Training Academy "grow your own" 704,161 352,915 351,246 0 704,161 MHO Building Capacity Funding 388,337 108,150 280,187 0 388,337 Statutory Appropriate Adults 160,738 0 160,738 0 160,738 Participation & Engagement Locality 6,000 5,859 141 0 6,000 Sessional - School summer placements 127,890 0 127,890 0 127,890 The Winter Planning & Enhanced supports Business Case 309,293 309,293 (0) 0 309,293 TOTAL 25,278,586 8,335,144 16,943,442 0 25,278,586 NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Status of Earmarked Reserves Period 03 (01 April 2025 - 20 June 2025) Adult Social Care & Housing - INTEGRATED TOTALDESCRIPTION OF EARMARKED RESOURCE Approved Reserve Total 2025/26 2026/27 No Longer Required Page 158 of 174
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APPENDIX 4 £ £ £ £ £ 1 Home Support: Home Support re-design which will include the introduction of the dynamic scheduling tool to support the process of streamlining shift patterns alongside service provision. The re-design will further develop the enabling approach as the operating model. 2,838,245 277,569 2,560,676 2,560,676 0 2 Independent Care Homes: Focus the strategic direction to reduce both the length of stay in care homes and the number of people being placed. 4,709,274 508,303 4,200,971 4,200,971 0 3 Care at Home: A review of the guided self-assessment process to align with a more strategic assessment and planning practice. 2,838,245 0 2,838,245 2,838,245 0 TOTAL 10,385,764 785,873 9,599,891 9,599,891 0 7.57% 92.43% 92.43% 0.00% Delivered Gap Replacement Revised-Gap DESCRIPTION OF APPROVED SAVING Target Value Value Deliverable All gaps are partially funded from in-year underspends and balance will be funded in 2025.26 from IJB reserves Commentary NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Savings monitoring Period 03 (01 April 2025 - 20 June 2025) Adult Social Care & Housing - INTEGRATED Value APPROVED SAVINGS REPLACEMENT SAVING / FUNDING Savings Gap Reasons for Savings Gap DESCRIPTION Revised Savings GapRef. Page 159 of 174
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APPENDIX 5 Approved: Year 2 budget (5 year Capital Program 2024/25 to 2028/29) 2,200,000 Reprofiling from 2024/25 164,472 Included in opening budget Social Work Key Ambition Integrated equipment & adaptations REVISED CAPTIAL BUDGET 2024/25 2,364,472 0 0 0 Theme NORTH LANARKSHIRE COUNCIL Capital Budget Monitoring Report - Budget Movements 2024/25 Period 03 (01 April 2025 - 20 June 2025) Social Work Capital Programme BUDGET MOVEMENTS 2025/26 £ Period Division Thematic Category Page 160 of 174
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APPENDIX 6 Social Work: Integrated Equipment and Adaptations 2,364,472 178,353 219,404 2,145,068 2,364,472 0 TOTAL 2,364,472 178,353 219,404 2,145,068 2,364,472 0 FINAL OUTTURN OUTTURN VARIANCETheme BUDGET ACTUAL COMMITTED NORTH LANARKSHIRE COUNCIL Capital Budget Monitoring Report - Summary Expenditure by Thematic Category Period 03 (01 April 2025 - 20 June 2025) Social Work Capital Programme UNCOMMITTED Page 161 of 174
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref DF/PMcA/ES Date 02/09/25 Sundry Debt Write Off 2025 From Diane Fraser, Head of Adult Social Work, Health & Social Care E-mail fraserdi@northlan.gov.uk Telephone 01698 332001 1. Background 1.1 During 2024/25 the Council issued invoices with the approximate value of £108m. 1.2 Within Adult Health & Social Care there are a number of chargeable services mainly in the following areas: • Home Care Charges Executive Summary The purpose of this report is to present to Committee a summary of outstanding debtor accounts which are deemed uncollectable following all attempts at recovery or are considered uneconomically viable to continue pursuing. In accordance with financial guidelines a bad debt provision has previously been established for the outstanding accounts highlighted below. Recommendations It is recommended that Adult Care and Social Work Committee: (1) Notes the decision of the Chief Accountable Officer and the Head of Financial Solutions under delegated responsibilities to write off £107,825.60 for debts under £500. (2) Approve the write off of £55,409.02 which includes debts greater than £500. (3) Remit this report to Finance & Resources Committee. The Plan for North Lanarkshire Priority Improve North Lanarkshire's resource base Ambition statement (21) Continue to identify and access opportunities to leverage additional resources to support our ambitions Programme of Work Statutory / corporate / service requirement Item 9 Page 163 of 174
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• Nursing Home and Residential Home Accommodation Charges • Community Alarms • As well as chargeable services, invoices are raised to other local authorities, health, and universities. 1.3 The value of Adult Health & Social Care invoices raised during 2024/25 was £62m. This figure includes invoices raised to other local authorities, health, and universities £59m). 1.4 In conjunction with the corporate debt recovery team, every effort is made to recover any unpaid debt including reminder letters, the use of collection agents and legal action. However, despite these steps there are a number of debts that are deemed uncollectible or are considered not economically viable to engage further collection activities and costs. This annual process of assessing the likelihood of debt non- recovery conforms to accepted best accounting practice and is a realistic assessment of expected income. 1.5 The Council will continue to seek collection of the outstanding balance if the circumstances of the debtor alter, and recovery is deemed practical. 2. Report 2.1 Analysis of the outstanding balances has been conducted and £163,234.62 has been identified as uncollectable. 2.2 There are a number of reasons why the outstanding balances are being written off and these are summarised below: • Deceased. The debtor is deceased and there have been insufficient funds within the estate to meet the sum due. • Small Balances/Uneconomic to Pursue. There are insufficient funds or no realisable assets that are available to meet the debt and it is uneconomic to continue to seek recovery of the sum due. • Gone Away. The debtor has moved address and cannot be located. • Recovery exhausted. Despite all efforts the service has now been informed that these accounts will not be recovered. • Sequestration/Liquidation. 2.3 The following tables categorise the value of debt recommended for write off by cause and value: Deceased 1059 55,244.10 Small Balances/Uneconomic to Pursue 112 1,573.48 Gone Away 333 4,413.24 Recovery Exhausted 6215 101,266.00 Sequestration/Liquidation 55 737.80 Total 7774 163,234.62 Value Analysis < £500 7764 107,825.60 > £500 10 55,409.02 Total 7774 163,234.62 Page 164 of 174
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2.4 The value of accounts identified for write off represents a very small proportion of the accounts raised annually by Adult Health & Social Care. This is reflective of a number of activities aimed at improving collection rates, reducing debt arising and streamlining the recovery process. 3. Measures of success 3.1 The Service continues to engage in a number of activities aimed at improving collection rates, reducing debt arising and streaming the recovery process. 3.2 These include: • Implementation of Debt Recovery Procedures • Performance Management Reports • Payment Arrangements • Payment by Direct Debit 3.3 The Council will continue to seek collection of the outstanding balance if the circumstances of the debtor alter, and recovery is deemed practical. 4. Supporting documentation 4.1 n/a Diane Fraser Chief Officer (Adult Social Work Services) Page 165 of 174
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Page 166 of 174
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Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☐ No ☒ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. 5.11 Children’s rights and wellbeing impact Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 167 of 174
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref JMcK/CPT Date 02/09/25 Contracts awarded below Committee approval threshold From James McKinstry - Chief Officer (Assets and Procurement) E-mail McKinstryJ@northlan.gov.uk Telephone 07939 281 102 Executive Summary In accordance with the Council’s General Contract Standing Orders (“GCSOs”), GCSO 21.10 requires a summary report be presented to members with details of contracts awarded since last committee, specifically for the spend range: • over £50,000 but below £500,000 for supplies or services; and, • over £500,000 but below £2,000,000 for works. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Acknowledge the contract awards made since last committee reporting cycle. The Plan for North Lanarkshire Priority All priorities Ambition statement All ambition statements Programme of Work Statutory / corporate / service requirement Item 10 Page 169 of 174
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1. Background 1.1 The Local Government (Scotland) Act 1973 section 81 requires local authorities to “…make standing orders with respect to the making by them or on their behalf of contracts for the supply of goods or materials or for the execution of works.”. 1.2 The Council’s General Contract Standing Orders (“GCSOs”) set out the council’s specific procurement procedures and responsibilities at all spend levels, and include the reporting requirements of procurement activity, including contracts awards, to committee for either approval or acknowledgement. 2. Report 2.1 In accordance with GCSO 21.10, this report summarises the contract awards since last committee, specifically for the spend range: • over £50,000 but below £500,000 for supplies or services; and, • over £500,000 but below £2,000,000 for works. 2.2 If you require further information regards the contract awards reported, please refer to the lead service area / Chief Officer detailed in the appendix. 3. Measures of success 3.1 All requirements contracted contribute to either the council’s programme of work and/or fulfil a statutory requirement. 3.2 All contract awards secure best value for the council in accordance with their evaluation criteria. 3.3 All necessary diligence has been undertaken in the evaluation and appointment of contractors. 3.4 All contract awards are logged in the council’s contract register. 4. Supporting documentation 4.1 Appendix 1 – Summary of contracts awarded. James McKinstry Chief Officer (Assets and Procurement) 5. Impacts 5.1 Impacts considered as part of the contract award procedures are recorded in the individual contract award reports held by the lead service area. Page 170 of 174
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Appendix 1 – Summary of Contracts Awarded Contract Ref NLC-CPT-24-064 Title Direct Payment Service Classification Services - Social & Specific Chief Officer, Service Area Morag Dendy, Chief Officer (Planning, Performance and Quality Assurance) Competition Governance by Value Higher Threshold Regulated Procurement – The Public Contracts (Scotland) Regulations 2015 Procurement Route Open Procedure No. of Expressions of interest 9 No. of Bids Received 2 Award Criteria Most Economically Advantageous Tender Evaluation Scores – Successful 84.40% Evaluation Scores – Unsuccessful 74.80% Award Details Value £415,788 Contract Duration 36 months Contractor Name Glasgow Centre for Inclusive Living Contractor Size Small Contractor Location Glasgow Status - Payment of Living Wage? Yes Status - Living Wage Accredited? No Impacts this section highlights which impacts were considered for this contract award procedure Public Sector Equality Duty and Fairer Scotland Duty ☒ HR Policy Impact ☐ Data Protection Impact ☒ Environment / Carbon Impact ☒ Risk Impact ☐ Children’s Rights and Wellbeing Impact ☐ Financial Impact ☐ Legal Impact ☐ Technology / Digital Impact ☐ Communications Impact ☐ Armed Forces Covenant Duty ☐ Further details regarding these impacts can be obtained from the Lead Service Area / Chief Officer Page 171 of 174
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Contract Ref NLC-CPT-24-077 Title Provision Of Support For People Affected By Huntington’s Disease Classification Services - Social & Specific Chief Officer, Service Area Morag Dendy, Chief Officer (Planning, Performance and Quality Assurance) Competition Governance by Value Lower Threshold Regulated Procurement, procured in accordance with The Procurement Reform (Scotland) Act 2014 AND The Procurement (Scotland) Regulations 2016 Procurement Route Direct Award for a Health or Social Related Service without advertising No. of Contractors Invited 1 Award Criteria Best Value Approach Comments As permitted by the rules for commissioning health and social related services and within this spend threshold, the Service Area can award directly with consideration of the needs for the service users and to provide continuity of service. The appointed Contractor already provides this critical service across Lanarkshire, and this contract provides further provision for 36 months. Award Details Value £398,898 Contract Duration 36 months Contractor Name Scottish Huntington’s Association Contractor Size Small Contractor Location South Lanarkshire Status - Payment of Living Wage? Yes Status - Living Wage Accredited? No Impacts this section highlights which impacts were considered for this contract award procedure Public Sector Equality Duty and Fairer Scotland Duty ☒ HR Policy Impact ☐ Data Protection Impact ☒ Environment / Carbon Impact ☐ Risk Impact ☐ Children’s Rights and Wellbeing Impact ☐ Financial Impact ☐ Legal Impact ☐ Technology / Digital Impact ☐ Communications Impact ☐ Armed Forces Covenant Duty ☐ Further details regarding these impacts can be obtained from the Lead Service Area / Chief Officer Page 172 of 174
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Contract Ref NLC-CPT-24-062 Title Multi Agency Risk Assessment Conferences (MARAC) Classification Services - Social & Specific Chief Officer, Service Area Diane Fraser, Chief Officer (Adult Social Work Services) Competition Governance by Value Lower Threshold Regulated Procurement, procured in accordance with The Procurement Reform (Scotland) Act 2014 AND The Procurement (Scotland) Regulations 2016 Procurement Route Direct Award for a Health or Social Related Service without advertising No. of Contractors Invited 1 Award Criteria Best Value Approach Comments As permitted by the rules for commissioning health and social related services and within this spend threshold, the Service Area are able to award directly with consideration of the needs for the service users and to provide continuity of service. Award Details Value £223,912 Contract Duration 24 months with option to extend for up to 24 months (24 + 12 + 12) Contractor Name Women’s Aid South Lanarkshire and East Renfrewshire (WASLER) Contractor Size Small Contractor Location South Lanarkshire Status - Payment of Living Wage? Yes Status - Living Wage Accredited? No Impacts this section highlights which impacts were considered for this contract award procedure Public Sector Equality Duty and Fairer Scotland Duty ☒ HR Policy Impact ☐ Data Protection Impact ☒ Environment / Carbon Impact ☐ Risk Impact ☒ Children’s Rights and Wellbeing Impact ☐ Financial Impact ☒ Legal Impact ☐ Technology / Digital Impact ☐ Communications Impact ☐ Armed Forces Covenant Duty ☐ Further details regarding these impacts can be obtained from the Lead Service Area / Chief Officer Page 173 of 174
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Contract Ref NLC-CPT-24-114 Title Provision Of Information And Advice Service (Autism) Classification Services - Social & Specific Chief Officer, Service Area Diane Fraser, Chief Officer (Adult Social Work Services) Competition Governance by Value Lower Threshold Regulated Procurement, procured in accordance with The Procurement Reform (Scotland) Act 2014 AND The Procurement (Scotland) Regulations 2016 Procurement Route Direct Award for a Health or Social Related Service without advertising No. of Contractors Invited 1 Award Criteria Best Value Approach Comments As permitted by the rules for commissioning health and social related services and within this spend threshold, the Service Area are able to award directly with consideration of the needs for the service users and to provide continuity of service. Award Details Value £62,500 Contract Duration 6 months Contractor Name The Hope Centre Contractor Size Small Contractor Location North Lanarkshire Status - Payment of Living Wage? Yes Status - Living Wage Accredited? Yes Impacts this section highlights which impacts were considered for this contract award procedure Public Sector Equality Duty and Fairer Scotland Duty ☒ HR Policy Impact ☐ Data Protection Impact ☒ Environment / Carbon Impact ☐ Risk Impact ☒ Children’s Rights and Wellbeing Impact ☐ Financial Impact ☒ Legal Impact ☐ Technology / Digital Impact ☐ Communications Impact ☐ Armed Forces Covenant Duty ☐ Further details regarding these impacts can be obtained from the Lead Service Area / Chief Officer Page 174 of 174