Agenda Document Pack - Adult Care and Social Work Committee - 25/08/2026
North Lanarkshire Council · 25 August 2026
Back to Adult Care and Social Work Committee — 25 August 2026 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
Page 1
14 August 2026 Members of the Adult Care and Social Work Committee Chief Executive’s Office Rachel Blair Chief Officer (Legal, Democratic and Strategy) 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, 25 August 2026 at 14:00 PM which you are requested to attend. The agenda of business is attached. Rachel Blair Chief Officer (Legal, Democratic and Strategy) Members : Clerk Name: Karen Swan Clerk Telephone: 07919 730272 Clerk Email: committee@northlan.gov.uk M McCulloch, B Baudo, C Barclay, M Boyd, B Burgess, W Goldie, J Jones, P Kelly, J Keltie, K Larson, J Leckie, A McCrory, B McCulloch, R McKendrick, C Quigley, N Shevlin, L Stubbs, R Sullivan, J Toner, N Wilson, G Woods. Page 1 of 86
Page 2
Page 2 of 86
Page 3
Agenda 1 Declarations of Interest In Terms of the Ethical Standards In Public Life Etc. (Scotland) Act 2000 Operational 2 Supporting Resilience across our Communities - Petition raised by Cumbernauld Action for Care of the Elderly (CACE) Submit report by the Chief Officer (Adult Social Work) advising of the submission of a petition received from Cumbernauld Action for Care of the Elderly (CACE) Day Service. 5 - 14 3 Voluntary Action North Lanarkshire (VANL) - Community Solutions Submit report by the Interim Chief Officer (Getting it Right for Everyone) setting out the current position regarding the Community Solutions Programme. 15 - 24 4 Discharge Without Delay Programme Update Submit report by the Chief Officer (Adult Social Work Services) providing an update on the Discharge Without Delay programme. 25 - 38 5 Coming Home Implementation Submit report by the Chief Officer (Adult Social Work Services) providing an update on progress in implementing the Coming Home programme within North Lanarkshire. 39 - 48 Performance 6 Adult Social Care Performance Report - Quarter 4 2025/26 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 2026 to 31 March 2026, Quarter 4 2025/26. 49 - 60 Financial Page 3 of 86
Page 4
7 Revenue & Capital Budget Monitoring Report: Adult Social Care Period 3: 01/04/2026 to 19/06/2026 Submit report by Chief Officer (Planning, Performance and Quality Assurance) providing a summary of the revenue financial performance of the Health and 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 2026 to 19 June 2026. 61 - 74 8 Sundry Debt Write Off 2026 Submit report by the Chief Officer (Adult Care and Social Work) providing a summary of outstanding debtor accounts which are deemed uncollectable following all attempts at recovery or are considered uneconomically viable to continue pursuing. 75 - 80 Contracts 9 Contract Awards Below Committee Approval Threshold Submit report by the Chief Officer (Assets and Procurement) notifying of the Contracts Awarded since the last meeting of the Committee with a value below the financial threshold requiring approval. 81 - 86 Page 4 of 86
Page 5
North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref DF/MB/MH Date 25/08/26 Supporting Resilience across our Communities – Petition raised by Cumbernauld Action for Care of the Elderly (CACE) From E-mail Diane Fraser, Chief Officer (Adult Social Work Services) fraserdi@northlan.gov.uk Executive Summary An undertaking was previously given to update Members on progress regarding ensuring equity of service provision across the authority area and any rebalancing required to facilitate this. This report provides an update on actions arising from the previous decision to cease funding for the Day Services for citizens aged 65+ operated by Cumbernauld Action for Care of the Elderly (CACE) Day Service and Orbiston Neighbourhood Centre (ONC) Bellshill, respectively. Cessation of funding applied only to the respective Day Services operated by each organisation and not to any other services provided by them. It is acknowledged that the initial report relating to equity and rebalancing did not specifically mention any services but related more to the wider need to take such action. Funding for the respective day services mentioned above ceased at the end of April 2026, following Committee approval in late 2025, to support the wider general approach to: • Ensuring equity of provision across the authority area • Supporting the personalisation agenda • Minimising any risk to NLC of legal challenge arising from repeated year on year funding awards to incumbent organisations who were out of contract, with no competitive element. CACE subsequently launched a petition on “change.org” - to seek wider support in challenging the cessation of funding for their Day Support Service. The Adult Social Work Service is required to highlight this petition to Elected Members for consideration. A range of mitigations regarding this is also highlighted in the report. Since the decision to cease funding for day service provision was communicated to both organisations, work has been ongoing to support a transition to more individualised arrangements for people who accessed either service or to any unpaid carers involved. Item 2 Page 5 of 86
Page 6
1. Background 1.1 There are effective and impactful engagement, participation, and support (if support is 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. 1.2 The overarching Adult Social Work Service aim continues to be in ensuring equitable provision within the context set out above. This is applicable across the authority area, redressing any service provision imbalance in an appropriate and sustainable way, maintaining 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. There is a need to ensure that there is no postcode inequality in service provision. Action to rebalance support and services to reflect this aim continues to be progressed. 1.3 As part of the approach to rebalancing, cessation of funding for specific strands of service delivered by two organisations; Cumbernauld Action for Care of the Elderly (CACE) Day Service) and Orbiston Neighbourhood Centre (ONC) Bellshill, was agreed. These service strands were for congregated day service provision for citizens age 65+. Funding ceased at the end of April 2026. NLC funding to the respective organisations for other strands of service delivery was unaffected. 2. Report 2.1 This report appraises Members of the petition submitted by CACE and provides an update on the current position including setting out anticipated next steps. Current Position. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Note the submission of the petition. (2) Endorse the ongoing work to ensure equitable provision, rebalancing, and support resilient communities. (3) Note the content of the Report The Plan for North Lanarkshire Priority Enhance participation, capacity, and empowerment across our communities Ambition statement (24) Review and design services around people, communities, and shared resources Programme of Work Resilient People Page 6 of 86
Page 7
2.2 Since confirmation of the decision to cease funding for day service provision, CACE had been campaigning for a re-consideration, based on the view held by CACE, that the service provided an essential element of support to those who access it. This view was not borne out by findings within the Equality Impact Assessment (EQIA) undertaken, nor by the overall findings of the Service Review, which identified that, although people clearly valued the day service provision, there were significant mitigations and wider equity considerations that informed and supported the decision to cease funding. These mitigations are detailed in bullet points at 2.4 below. 2.3 Disinvestment in services is unlikely to be an easy or popular decision, and CACE actively sought to have the decision reviewed. As part of the CACE approach to challenging the funding decision, CACE launched a petition on “change.org” - to seek wider support in challenging the cessation of funding for the CACE Day Support Service. This petition was received by North Lanarkshire Council on 24th April 2026. The breakdown of the CACE petition highlighted that: • The Petition received a total of 2,454 signatures: • Online:1,567 signatures • From the online signatures, 557 signatures were received from individuals in the wider North Lanarkshire area: • 482 signatures were from individuals in the G67/G68/G69 postcode areas: (31% of the total online signatories) G67, G68 and G69 were the main catchment areas for CACE Day Service Provision. • 75 signatures by individuals in the wider North Lanarkshire postcode area: (5% of the total online signatories) • 1,010 signatures were from out with North Lanarkshire: (64%) of the total number of online signatories. • Paper:887 signatures • From the paper petition, 798 signatures were received from individuals in the wider North Lanarkshire area: • 798 signatures by individuals in the G67/G68/G69 postcode areas (90% of the total paper signatories) • 89 signatures by individuals out with North Lanarkshire (10% of the total paper signatories) As such, the total number of petition signatories, whether online or on paper, of 1280 signatories from CACE catchment areas of G67, G68, G69, represents approximately 1.7% of the adult population from the CACE catchment area. 2.4 The view of every citizen is important. However, the petition signatory total was low, the range of alternative support options, whether already in place, or as planned developments, may have been an important consideration that helped set minds at ease, or shaped views as whether to become a petitioner. By the time the petition was launched, anyone impacted upon by the funding decision would have been offered an assessment, review, or adult carer support plan (ACSP), and, if required, alternative support provision. The petition was supported by approximately 1.7% of the local adult population within the CACE catchment area, which, it is suggested, demonstrates a small degree of local support for any reconsideration, but does not strongly demonstrate a sufficient groundswell of opinion to merit consideration of any alternative course of action to that which was previously recommended, namely that: as: Page 7 of 86
Page 8
• There was sufficient local mitigation through the provision of alternate services to ensure that there is no detrimental impact on the twenty-six people who accessed the CACE day service or to any unpaid carer involved. Mitigations include a diverse range of other support options, including, but not limited to: self-help, family support including unpaid carers, condition specific information and advice, income maximisation, other neighborhood services such as community connectors, GP link workers, carer support workers, dementia carer link workers, post hospital discharge support, aids and adaptations, assistive technology, home support,, independent sector providers, community alarms, individual budgets and individual carer budgets. In many instances a range of supports listed were already in place for a number of individuals who had been accessing the respective Day Services. • There remained the need to ensure equity of provision across the authority area, with four of the other localities across North Lanarkshire successfully supporting citizens aged 65+ without an equivalent to the CACE Day Service. 2.5 Every individual who had been accessing the day services operated by CACE or ONC prior to the cessation of funding was offered an assessment or review, and any unpaid carers involved were offered an Adult Carer Support plan (ACSP), by Social Work. These offers were made, but not accepted, in some instances. Next Steps 2.6 Council Officers continued to engage with representatives from both CACE and ONC and indications have been very favourable that a positive transition to new, more personalised support arrangements is being achieved. Both organisations have accepted an offer of £50,000 one-off funding as a means of supporting transition to a more individualised approach to supporting people, which is being achieved through an expansion to the current befriending services offered by both organisations. CACE have also been supporting NLC to progress engagement with citizens living with dementia, and their unpaid carers, over the past few months, as part of an NLC partnership approach with Strathclyde University to living well with dementia, whilst ONC recently requested a reference from NLC for an external funding bid to further enhance their personalisation approaches. 2.7 It is anticipated that both organisations will have the opportunity to submit bids for the Community Solutions funding offered by Voluntary Action North Lanarkshire (VANL) to further support befriending locally, but not for funding for Day Service provision. The resourcing that was previously in place to fund the Day Service provision will contribute towards the wider savings agenda. 2.8 The service will report to Committee in due course on further progress in relation to supporting resilience across our communities. 3. Measures of success 3.1 The measures of success have not fundamentally changed since previous reporting. 3.2 People who previously accessed the respective day service provision offered by CACE and ONC, and their unpaid carers will be supported on an individual basis, to the extent they wish to be. 4. Supporting documentation Page 8 of 86
Page 9
Appendix 1. Letter from Diane Fraser to CACE regarding petition. Diane Fraser Chief Officer (Adult Social Work) Page 9 of 86
Page 10
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 10 of 86
Page 11
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 11 of 86
Page 12
APPENDIX 1 Our Ref: Your Ref: Contact: Tel: E-mail: Date: DF/ Diane Fraser fraserdi@northlan.gov.uk 29 April 2026 Health & Social Care Diane Fraser Chief Officer (Adult Social Work Services) Civic Centre, Windmillhill Street Motherwell ML1 1AB www.northlanarkshire.gov.uk Dear Sir / Madam Petition – Cessation of Funding for CACE Day Support Services I write to acknowledge receipt of your open letter and petition, submitted on behalf of Cumbernauld Action on Care for the Elderly (CACE), its service users, carers and families, regarding the cessation of funding for day support services. Firstly, I would like to recognise the strength of feeling expressed within the petition and the significant level of support demonstrated through the number of signatures received, as well as the wider community and stakeholder engagement outlined in your correspondence. The petition has now been reviewed in line with the Council's established petitions process Petitions process | North Lanarkshire Council. Having considered the nature of the request, namely, that the Council reconsiders a previous decision regarding funding, it has been determined that this matter cannot be addressed at officer level. In accordance with the Council’s petitions process, petitions of this nature are referred to the relevant Committee for consideration, provided they meet the competency requirements set out within that process. Having now clarified the timeline of the original decision, I can confirm that the petition falls outwith the six-month restriction period that applies to requests seeking reconsideration of Council decisions. As such, the petition will be referred to the Adult Care and Social Work Committee for consideration. The next steps are as follows: • Officers from Adult Social Work Services will prepare a detailed report for submission to a forthcoming meeting of the Adult Care and Social Work Committee. • This report will set out the background to the original decision, the issues raised within the petition, and any relevant considerations for Members. • The Committee will then consider the petition and determine what action, if any, should be taken. Page 12 of 86
Page 13
You will be advised of the date of the Committee meeting at which the petition will be considered, and arrangements will be confirmed in line with the Council’s petitions process. I will continue to keep you informed as the matter progresses. Yours sincerely Diane Fraser Chief Officer (Adult Social Work Services) Page 13 of 86
Page 14
Page 14 of 86
Page 15
North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref MB/DW/AM Date 25/08/26 Voluntary Action North Lanarkshire (VANL) - Community Solutions From Maria Barry, Interim Chief Officer (Getting it Right for Everyone) E-mail BarryM@northlan.gov.uk 1. Background 1.1 Since 2012, Community Solutions has been the community led health and social care investment programme, aimed at improving health, wellbeing and social connections. The programme focuses on prevention and early intervention through investment in community led initiatives that builds community strength, uses community resources Executive Summary This report appraises Members of the current position regarding the Community Solutions programme and sets out next steps and actions. In addition, the report appraises members of the wider role of VANL as the Third Sector Interface (TSI) and the community support VANL provides utilising funding received both from North Lanarkshire Council and the Scottish Government. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) It is recommended that Committee note the contents of the report and endorses the ongoing work through the Community Solutions programme to support resilient communities. (2) It is recommended that Committee note the contents of the report and endorses the ongoing wider role that VANL undertakes as the Third Sector Interface for North Lanarkshire. The Plan for North Lanarkshire Priority Enhance participation, capacity, and empowerment across 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 3 Page 15 of 86
Page 16
and increases resilience. The programme is a collaboration between University Health and Social Care North Lanarkshire (UHSCNL) and Voluntary Action North Lanarkshire (VANL), with VANL being the local third sector interface (TSI) for the Community and Voluntary Sector (CVS). 1.2 UHSCNL has the responsibility for planning, commissioning and overseeing the delivery of community health and social care across North Lanarkshire and provides core and project funding for the Community Solutions Programme, as well as governance and delivery support for the programme. 1.3 VANL oversees the allocation of Community Solutions funding to local, community- based organisations, to deliver projects that support local residents. The diverse, large and vibrant CVS operating in North Lanarkshire, receives funding through the programme as well as from other sources, to provide information, support and care to individuals, families and groups and to work with local people to strengthen community capacity, resources and resilience. 1.3.1 The objectives of the Community Solutions Programmes are to ensure that: • The CVS has greater capacity to strengthen communities, improve lives and to advance equality and human rights. • Priority groups are helped to “live their best life”, with access to person centred, timely, effective, community-based preventative and early intervention support, provided by the CVS, complemented by timely access to public sector support, where required. • Communities are stronger, with increased resilience and inclusivity, with improved health, wellbeing and quality of life, with reduced inequality and protection of human rights. 1.4 The Community Solutions Programme helps promote and support resilience for people and communities. The current UHSCNL investment in Community Solutions of approximately £1.2million annually demonstrates a strong return on investment, whether viewed as spending to save, supporting deferred spend, or spend avoidance. 1.4.1 VANL is multi layered in its approach and also works closely with North Lanarkshire Council to deliver actions to support and engage the CVS in assisting with the delivery of the Plan for North Lanarkshire and the Framework for Working with Communities. VANL achieves this through collaborative working with CVS organisations, NLC and other NLP partners to support delivery of key local community and partnership priorities. 1.5 This funding received by VANL from NLC will specifically be used to support and build capacity in the CVS around local community planning and as follows: 1.5.1 Locality Community Planning Support – supporting CVS and public engagement in community planning at local level and delivery of Local Outcome Improvement Plans through: 1.5.2 Community Boards • Working with NLP partners to develop the role and capacity of Community Boards and their membership through delivery of relevant training, awareness raising and development and implementation of accountability processes and frameworks. Page 16 of 86
Page 17
• Playing a key role in the operation of community board meetings including minute taking, helping to set the agenda, providing updates at meetings relating to LOIP priorities and other matters of importance to local people. • Positively promoting and supporting participation from CVS in Community Boards and subgroups. 1.5.3 Local Partnership Teams and delivery of LOIP priorities • Ensuring appropriate representation at LPT meetings. • Playing a key role in the development of the LPT’s as a key mechanism for driving delivery of local priorities. • Playing a lead or support role in the development and delivery of appropriate and agreed local priorities (specifically around engagement and participation opportunities digital inclusion, climate and environment). • Updating the LOIP Management and Monitoring Framework and taking responsibility for reporting as required on priorities VANL leads on as appropriate at Community Board meetings and on progress within agreed reporting templates and timescales to Community Boards, NLP SLB and Council Committees. • Making connections and links between wider CVS activities at a strategic level and LOIP priorities to minimise duplication and facilitate a more coordinated partnership approach. 1.5.4 Wider Community engagement and consultation activity • Work with NLC to support and organise and where appropriate facilitate engagement with local communities around key local or NL wide priorities and opportunities. • Work with NLC to ensure mechanisms that enable the CVS to participate effectively in other council priorities and initiatives, such as grant opportunities, community resilience and community wealth building. 1.5.6 Volunteering Support – facilitating delivery of the North Lanarkshire Volunteering Strategy which contributes to the resource ambition of the Plan for North Lanarkshire by working with NLC, other NLP partners, CVS and other volunteer involving organisations. 1.5.7 This will include the following: • Working with NLC, other NLC partners and CVS to promote volunteering in North Lanarkshire and support individuals to access volunteer roles. • Working with NLC to develop the contribution of volunteers around delivery of the Plan for North Lanarkshire. • Working with the council to ensure volunteering opportunities support the ambition to prepare young people and the wider community for the future through a series of interconnected programmes. • Support CVS organisations to involve volunteers effectively. Wider role of VANL 1.6 It is also expected that an element of the NLC funding, alongside other funding sources and in particular from the Scottish Government will contribute to the wider role of VANL including: • Assessing CVS needs, priorities and challenges. • Helping the CVS to assess their contribution and impact more effectively Page 17 of 86
Page 18
• Facilitating CVS voice and influence through other linked partnerships, in addition to NLP. • Supporting wider understanding and appreciation of the role and contribution of the CVS. • Supporting implementation of the CommUnity Agreement in liaison with NLP partner organisations and the CVS. • Supporting wider CVS contributions to delivery of the Plan for NL ambitions by facilitating CVS capacity building – including income generation and community wealth building support. • Facilitating stronger links and synergy between community planning and the Community Solutions Programme hosted by VANL. • Being active members of the SLB Board and supporting wider CVS representation through the CVS Partnership Group. 1.7 In response to increasing financial pressures and the need to maximise investment in the Community and Voluntary Sector (CVS), VANL has undertaken a review of the programme’s operating model. The new approach seeks to streamline administration and redirect a greater proportion of funding towards frontline delivery. 1.7.1 Key considerations included: • Recognising the vital role of locality hosts and anchor organisations. • Strengthening collaboration and partnership working by developing a more strategic approach. • Supporting the long-term sustainability of the CVS. • Ensuring UHSCNL priorities were advanced and supported through the CVS. 2. Report 2.1 From April 2026, VANL has implemented a revised structure that brings locality coordination in-house, overseen by two new Consortium Leads (covering East and West, North Lanarkshire) and a part-time administrator. 2.2 This model will release an additional £101,000 for reinvestment into the sector, while delivering a more consistent and cohesive approach across all localities. In addition, a further £60,000 (£10,000 per locality) will be made available to support local anchor organisations, ensuring that local expertise, knowledge, and community relationships are at the forefront of the model. Drop-in sessions 5 will take place each month in all localities ensuring local community engagement and involvement is at the heart of the model. 2.3 The new model also enables projects that are deemed priorities to be separated from the Thematic Funds hosted by VANL. This not only increases the focus on agreed priorities but when aggregating the allocation of priority projects with the thematic funds, the new model shows an increase of total funds available from £512,000 to £553,000. In addition, the Locality Activity Funds (LAF) made available have been increased from £180,000 to £240,00 ensuring more funding is available for grass roots organisations. 2.4 The new approach undertaken by VANL increases the total funds available for distribution through Community Solutions from 58% to 66%, whilst correspondingly reducing the percentage of costs incurred in administering the Community Solutions Programme from 42% to £34%. In a time of financial restraint this is a welcome development. Page 18 of 86
Page 19
2.5 Furthermore, the new model enables and encourages a more joined up approach across the CVS enabling UHSCNL priorities to be advanced in a more efficient and collaborative manner. 2.6 VANL will continue to engage closely with the CVS and operate in a positive, responsive and collaborative manner to strengthen community capacity, enhance community wealth building and improve community cohesion. VANL will seek to ensure that community priorities are advanced and that key stakeholders are kept informed of the challenges and opportunities that exist at community level. 3. Measures of success 3.1 The Community Solutions Impact and Learning Flash Report for 2024-25 is attached to provide Members with an overview of the scale and the outcomes that are achieved through the Community Solutions Programme. 4. Supporting documentation 4.1 Appendix 1 - Community Solutions Impact and Learning Flash Report for 2024-25. Maria Barry Interim Head of Service (Getting it Right for Everyone) Page 19 of 86
Page 20
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 20 of 86
Page 21
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 21 of 86
Page 22
Appendix 1 Page 22 of 86
Page 23
Page 23 of 86
Page 24
Page 24 of 86
Page 25
North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref DF Date 25/08/26 Discharge Without Delay Programme Update From Diane Fraser, Chief Officer (Adult Social Work Services) E-mail FraserDi@northlan.gov.uk Executive Summary Discharge without delay is a national initiative aimed at ensuring people are discharged to their homes or community settings as they are medically fit. It is underpinned by a home first approach to enable people to maximise their independence. Working with the national collaborative work there has been a focus on four key areas, Frailty at the front door, Planned Date of Discharge, Step- down/ community hospitals and Discharge to Assess/ Home First which has been overseen by the Frailty and Ageing Programme Board. This report highlights the present position and progress against the Standards and requirements of the Discharge without Delay (DwD) process. Narrative updates and, where applicable, data is shown on the main domains of the DwD Guidelines. The report contains Lanarkshire’s performance against the trajectories that were set for this reporting year, and there is a link to a full data set on all aspects of how the Board performs against the total list of metrics. The report also includes commentary on ongoing work in the fields of Complex Mental Health Delays, as well as AWI/Guardianship issues. The report shows the performance of Lanarkshire against the Scotland Average and against other Board areas, as well as highlighting areas of success that are noteworthy. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Criteria to Reside improvement work to continue. (2) Collaborative work with NLHSCP colleagues to continue to strengthen relationship and improve partnership working. (3) AWI work to continue to improve delays, education and training plan to be devised. (4) Support a PDD refresh. (5) Work to commence around achieving integrated teams across the three acute sites. (6) Consideration to be given to ongoing funding for Extended Hat as well as the additional social work assistants posts. (7) Set trajectories for 26/27. Item 4 Page 25 of 86
Page 26
1. Background 1.1 Since 2023, The DwD process has aimed to improve Hospital Discharges without Delay from acute and community hospital settings through a range of initiatives and developments. Good discharge planning requires a collaborative, whole system approach, producing a person-centred solution for every individual, achieving positive outcomes for people in hospital who require support to transition from hospital to their homely setting. The programme aligns with the Ageing & Frailty Standards and with the National DwD Best Practice Guidance. 1.2 Throughout 2025/26, the original 4 identified Key Elements and associated workstreams have continued to form the basis of the programme, these are overseen nationally and have local structures to support each area. The Key Elements noted are; 1. Acute Frailty Units, 2. PDD and IDTs, 3. Community Hospital Stepdown/ Rehabilitation, 4. D2A- Home First. 1.3 Self-Assessment processes continue to be conducted in each Board area (See appendix 2) and the Key Principles of DwD are built into the Board’s Governance Structure. This aligns with the implementation of Getting it Right for Everyone. Ongoing investment in HAT will be a vital component as we continue to strive to embed the DwD Key Elements. 1.4 The DwD programme also aligns with the North Lanarkshire Getting it Right for Everyone principles, as well as the NHS Lanarkshire “Operation Flow” Target Operating Model for Optimal Discharge. 1.5 Towards the end of 2025 the number of delays did increase and as a result escalation processes were put in place. An assessment of the performance highlighted the need for a deeper analysis of current processes and practice. Four areas were identified that had seen persistent delays which included complex care, housing, people awaiting intervention due to lacking capacity and mental health. There has been a significant amount of work undertaken to improve flow from hospital through home assessment and onwards to ongoing support. This has been aligned to the new operating model being implemented Getting it Right for Everyone. 2. Report Trajectories and Targets for 2025/26 2.1 Throughout the 2025/26 reporting period, North Lanarkshire has operated against the following Outcome measures. • A combined total Delayed Discharge figure of 94 for Lanarkshire (75 within Lanarkshire facilities and 19 within GG&C facilities). • Reduce acute Medicine for the Older Adult length of stay (LOS) by >20% by end March 2026. 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 All Programmes of Work Page 26 of 86
Page 27
• 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 Trajectories and Targets are currently being set for the reporting year 2026/27. Expected Benefits 2025/26 2.3 It was anticipated that achieving delivery on these positions by December 2025 would have been helpful in managing Whole System Winter pressures. 2.4 It was also anticipated that overall acute, health, and social care spending would have been more effectively controlled if frail, older adults avoid hospitalisation or are discharged timeously and safely. 2.5 It was anticipated that if Delayed Discharge could be positively impacted upon, the Whole system pressures, including Hospital Occupancy would return to safe levels. Present Position in Lanarkshire 2.6 DwD Needs Self-Assessment was updated in April 2026 highlighting that of the 35 key principles across the 4 key elements, North Lanarkshire UHSCP reported 2 not yet started, 30 in progress/ partially implemented and a further 3 fully implemented. A copy of the self-assessment has been attached. There is a subsequent improvement plan in place, built around the requirements of the CFSD guidance/template and this is reported at appropriate Governance forums within Lanarkshire. 2.7 Following bids, Lanarkshire received non-recurring financial Resource to assist in achieving the principles of DwD which are designated to create temporary Integrated Discharge Facilitator positions. 2.8 As highlighted in Section 6, an improvement plan has been developed which included ensuring that a range of actions were initiated which included additional Social Work Assistants (SWA) resource has been recruited to augment HAT teams. Three Senior Social Workers were appointed which led to a full complement of four as well as the appointment of a Service Manager in Home Assessment. The additional resources have been introduced over the past 6 months and are clearly having an impact and improving performance and flow. 2.9 In addition, Social Work Assistants have also been agreed to cover the Acute Frailty Units in UHW and UHM. These staff will be deployed across the frailty units as well as having a prominent presence in Front Door areas including ED departments. 2.10 A significant investment was also made to support additional Home Assessment activity as a Winter initiative. To date, this additional, temporary resource has enabled 154 additional patients to be assessed and supported at home at the cost of £513,332.82. 2.11 The number of people delayed in hospital has been rising and whilst we have seen continued progress there remains a number of people being admitted to hospital and unable to return to their home. Work with housing colleagues is ongoing and the recruitment of a housing officer is being progressed. This is to work directly with hospital staff; to provide education and raise awareness to improve the position. Page 27 of 86
Page 28
2.12 This recent investment whilst fragile due to the temporary nature of the funding will be essential in developing the foundations and taking forward the work to develop integrated discharge hubs. 2.13 The Performance since September 2025 is illustrated in Chart 1 below, and notes the point at which a return to Centralised Hospital Discharge Planning processes occurred which appears to have made the biggest singular notable impact upon Delayed Discharge performance. Senior Social Workers were appointed on both acute sites since towards the last quarter in 2025, Enhanced HAT initiative as well as additional Social Work Assistants were introduced early in 2026 which has also undoubtedly contributed to improved Delayed Discharge performance and initial signs of sustainability. However, we have seen a rise above median for the last 5 weekly data points. 2.14 Lanarkshire’s performance remains healthy in relation to other board areas and particularly in relation to the Scottish average. As seen in the Chart 1 below. Await IPQR data for May/ June to populate Chart 1 Patients in Delay related to all other Board areas and Scottish Average Other areas of progress against DwD Workstreams Acute Frailty Units 2.14 Acute Frailty Units (AFU) now exist on all 3 Hospital sites in Lanarkshire, with in-patient bed capacity as follows; • University Hospital Hairmyres 24 Bedded Area • University Hospital Monklands 24 Bedded Area • University Hospital Wishaw 24 Bedded Area 2.15 Processes and access pathways to AFU’s are in situ, although under continuous review and development. Home First/Discharge to Assess/Home Assessment Services 2.16 The Home Assessment Team (HAT) service continues to develop and has been additionally supported by extra funding to increase its reach across the winter period. Page 28 of 86
Page 29
2.17 Since January 2026, This Extended HAT resource has assessed and supported 154 patients at home. 2.18 In general, since 1st April 2025 until 31st March 2026, the mainstream HAT Service has assessed and supported 1618 service users. Planned Date of Discharge and Integrated Discharge Teams 2.19 Funded as a Winter Initiative, regular “Criteria to Reside” audits were conducted as a Test of Change. This took place over a 6-week period and was concluded on 7th April 2026, and an evaluation is in progress. The test of change highlighted several process issues that require to be addressed as well as identifying training needs, particularly around the use of AWI legislation. The test also highlighted the need for an organisation-wide PDD refresh. Dates for debrief sessions have been arranged which will determine learning and next steps. 2.20 A formal Improvement Programme initiated at University Hospital Hairmyres (UHH) is including a Refresh of PDD and the learning from this will be shared across the other Lanarkshire acute sites with a view to extending this to all NHSL sites by end of Dec 26. To that end, current focus is upon understanding existing systems and processes with Process Mapping sessions commenced in UHH and dates confirmed to commence these on the remaining two acute sites. Initial steps have been taken to establish as Integrated Discharge Hub Oversight Board to provide strategic oversight and assurance. Invitations to secure senior representation from across acute/ HSCPs/ Other partners for the Oversight Board have been made. Community Hospital and Step-Down In-Patient Rehabilitation Facilities 2.21 Ongoing work exists on the functionality of Community Facilities, and it is expected that a finalised model will be delivered with associated performance metrics against which to illustrate improvement. 2.22 Until this work is delivered, Average Length of Stay for patients in these facilities remains above target as shown in Chart 2 below. Chart 2 NHSL Community Hospital ALOS 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 Apr-26 May-26 Jun-26 Average Length of Stay (LoS) NHSL Community Hospitals (Days) Average LoS Target LoS Page 29 of 86
Page 30
Mental Health & AWI/Guardianship Delayed Discharge Issues 2.23 A deep dive into AWI cases was undertaken with sampling being done in UHM, UHW, Kilsyth Cottage Hospital with Airbles Road concluding the review on 1 May 2026. A separate report was prepared which included the breakdown of the findings. There was a common theme across all areas which highlighted a clear lack of understanding around the use of Adults with Incapacity legislation specifically in relation to Guardianship Orders. 2.24 There was evidence of capacity being called too early and when patients were experiencing delirium. The deep dive highlighted that there is a requirement for training/education around Guardianship Orders and the processes around them. 2.25 Two additional MHOs have been recruited and are based on the acute sites, they provide support to the teams and offer advice/guidance on guardianship processes as well as attending MDTs to provide input into assessments, they also support AWI delays. 2.26 Advocacy services have agreed to prioritise consideration of patients for suitability for 13za legislation. A joint piece of work has also been agreed to help the various disciplines understand the importance of each other’s roles. Work is also being undertaken around the use of 13za nationally in line with the updated guidance. 2.27 Further work has commenced around complex Mental Health delays and how these patients are managed. 3. Measures of success 3.1 Since the establishment of Locality Enabling hubs, individualised care has been enhanced, although the partnership has shown towards the end of the reporting year, that an Area Wide Discharge Planning approach for Hospital discharges appears to be more effective in providing oversight and guidance, encouraging ownership and accountability to drive discharge without delay. These Area Wide Enabling Hubs will continue for the foreseeable future and monitoring of performance will be applied to ensure we are adopting the optimum approach. It is vital to note that the appointment of additional Social Work Assistants is temporary until September 2026, and close monitoring of Delayed Discharge performance will be required to identify any result and slippage in performance thereafter. 3.2 North UHSCP has re-established its position against the Scottish Average having had a period of slightly poorer performance for several months. Lanarkshire compares very favourably with other Board areas across the country. 3.3 Criteria to Reside work has improved performance and patient centred care, as well as consolidating the relationships between Acute Hospital staff and North UHSCP staff, leading to increased mutual trust and confidence. 3.4 The DwD process has aimed to deliver Hospital Discharges without Delay from acute and community hospital settings. It requires a collaborative, whole system approach, producing a person-centred solution for every individual, achieving positive outcomes for hospital patients who require support to transition from hospital to their homely setting. Page 30 of 86
Page 31
3.5 NLHSCP are working closely with colleagues from NHSL to improve flow and ensure that those requiring a supported discharge are assessed at home timeously and avoid an unnecessary stay in hospital. Our improvement plan highlights key activity to further improve this situation. It is recognised that a significant number of people who are delayed require intensive support out with their home and/ or are awaiting legal processes to conclude. The report outlines the actions required to be taken to improve this situation. The report outlines good progress as well as highlighting the additional work required. 4. Supporting documentation 4.1 Appendix 1 - Discharge without Delay - There's No Place Like Home 4.2 Appendix 2 - DwD Monthly Measures, Information Services NHS Lanarkshire 4.3 Appendix 3 - Discharge without Delay- Self Assessment Diane Fraser Chief Officer (Adult Social Work Services) Page 31 of 86
Page 32
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 32 of 86
Page 33
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 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 33 of 86
Page 34
Discharge Without Delay Monthly Return Board: NHS Lanarkshire Month: Apr-25 - Apr-26 (Data Subject To Change) Measure Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 Apr-26 Target/Trajectory DwD Key Performance Indicators DWD Total Reportable Delayed Discharges - snapshot position at census 131 131 155 176 140 183 177 163 148 177 159 146 141 Acute Delayed Discharges - snapshot position at census 73 71 88 108 86 111 103 90 84 108 96 87 73 Average LOS for Acute Geriatric Patients (Days) 13.8 14.2 14.3 14.1 13.1 13.9 13.6 13.2 15.2 17.2 15.3 14.8 14.4 Average Length of Stay in Community Hospitals (Days) 40.4 38.2 39.7 35.3 39.3 32.0 39.0 35.8 35.5 35.2 36.9 39.3 35.3 Acute Geriatric Patients Acute Geriatric Admissions (No.) 788 912 822 881 894 873 850 841 766 711 710 850 826 Average Daily Acute Geriatric Admissions (No.) 26 29 27 28 29 29 27 28 25 23 25 27 28 Acute Geriatric Discharge Rate within 72 Hours (%) 25.4% 29.5% 29.9% 29.2% 29.8% 27.6% 25.5% 27.1% 22.5% 22.5% 20.4% 28.7% 24.8% Average LOS for Acute Geriatric Patients (Days) - listed in KPI above 13.8 14.2 14.3 14.1 13.1 13.9 13.6 13.2 15.2 17.2 15.3 14.8 14.4 Acute Geriatric Discharge without Delay Rate (%) 85.2% 86.6% 88.2% 84.7% 84.7% 81.9% 79.9% 80.7% 79.9% 81.9% 83.9% 84.1% 84.6% Acute Geriatric Weekend Discharge Rate (%) 12.3% 10.3% 12.0% 10.2% 13.5% 9.6% 10.5% 13.4% 10.8% 12.2% 12.3% 12.7% 9.6% General Medicine, Acute Medicine, Geriatric Medicine ALOS 75 year olds and over only 10.9 11.2 10.5 11.3 10.8 10.5 11.1 11 11.3 12.7 12.2 11.7 11.3 Acute Frailty Unit Admissions to Frailty Unit (No.) -- 656 602 612 634 628 559 576 560 509 530 702 640 Average Daily Admissions to Frailty Unit (No.) -- 21 20 20 20 21 18 19 18 16 19 23 21 Discharge Rate direct from Frailty Unit (%) -- 45.7% 47.5% 44.4% 40.9% 42.4% 44.9% 39.2% 44.5% 42.6% 43.2% 45.9% 41.4% Discharge without Delay Rate from Frailty Unit (%) -- 95.5% 98.1% 92.8% 95.7% 89.3% 90.1% 91.5% 88.4% 95.3% 94.6% 89.7% 92.2% Weekend Discharge Rate from Frailty Unit (%) -- 13.7% 17.8% 14.9% 17.7% 14.7% 15.2% 17.4% 15.7% 17.3% 15.7% 16.1% 13.3% Average Length of Stay in Frailty Unit (Days) -- 3.2 3.3 3.0 2.9 3.1 3.7 3.3 3.7 4.3 3.4 3.0 3.0 Delayed Discharges in Frailty Unit - snapshot position at census (No.) -- -- -- -- 2 3 5 2 0 0 2 0 2 Average daily waits for community hospital bed in Frailty Unit (No.) TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD % of beds occupied by Reportable and Health Delays in Frailty Unit (%) TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD % of beds occupied by non-Frailty patients (non-Geriatric Medicine patients) TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD Average Time to admission to Frailty Unit (hh:mm) TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD Community Hospitals and Step-down facilities Community hospital admissions (No.) 114 101 102 115 122 105 116 111 131 95 114 120 101 Average Daily Community hospital admissions (No.) 4 3 3 4 4 4 4 4 4 3 4 4 3 Average Length of Stay in Community Hospitals (Days) - listed in KPI above 40.4 38.2 39.7 35.3 39.3 32.0 39.0 35.4 35.7 32.3 37.1 39.0 35.3 Community hospital Discharge without Delay Rate (%) 53.5% 64.4% 50.0% 51.3% 46.7% 45.7% 50.0% 34.2% 41.2% 47.4% 50.9% 53.3% 49.5% Weekend Discharge Rate from Community hospitals (%) 6.1% 13.9% 9.8% 7.0% 12.3% 7.6% 5.2% 4.5% 9.9% 3.2% 7.9% 10.8% 3.0% Community hospital delayed discharges - snapshot position at census (No.) 58 60 67 68 54 72 74 73 64 69 63 59 68 % Ave daily beds lost due to delayed discharges in Community Hospitals (%) TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD Appendix 2 Page 34 of 86
Page 35
DwD Operational Definitions Measure Operational Definition DwD Key Performance Indicators Total Reportable Delayed Discharges - snapshot position at census Total reportable delayed discharges as per PHS definition at census snapshot position https://publichealthscotland.scot/search?q=Delayed+Discharge+&search= Acute Delayed Discharges - snapshot position at census Total reportable delayed discharges as per PHS definition at census snapshot position https://publichealthscotland.scot/search?q=Delayed+Discharge+&search= Average LOS for Acute Geriatric Patients (Days) Average number of days from admission to discharge for specialty AB urgent and unscheduled discharges within acute setting Average Length of Stay in Community Hospitals (Days) Average LOS from admission/transfer to community hospital or step down facility for admission cohort to discharge in days. Acute Geriatrics Acute Geriatric Admissions (No.) Urgent and Unscheduled (non-elective or planned transfer) admissions to specialty AB in the month Average Daily Acute Geriatric Admissions (No.) Urgent and Unscheduled (non-elective or planned transfer) admissions to specialty AB in the month divided by days in month Acute Geriatric Discharge Rate within 72 Hours (%) Percentage of above patient cohort discharged in 72 hours Average LOS for Acute Geriatric Patients (Days) - listed in KPI above Average number of days from admission to discharge for specialty AB urgent and unscheduled discharges within acute setting Acute Geriatric Discharge without Delay Rate (%) Percentage of above patient cohort discharged who were not a delayed discharge as per PHS definition https://publichealthscotland.scot/search?q=Delayed+Discharge+&search= Acute Geriatric Weekend Discharge Rate (%) Percentage of above patient cohort discharged at the weekend General Medicine, Acute Medicine, Geriatric Medicine ALOS 75 year olds and over only in an Acute Setting (Days) Average number of days from admission to discharge for specialty A1 General Medicine, A11 Acute Medicine, and AB Geriatric Medicine, urgent and unscheduled discharges within acute setting, age 75 and over Acute Frailty Unit Admissions to Frailty Unit (No.) The number of admissions to the Unit from areas such as ED or transfers from Assessment Areas in the month Average Daily Admissions to Frailty Unit (No.) The number of admissions to the Unit from areas such as ED or transfers from Assessment Areas in the month divided by days in month Discharge Rate direct from Frailty Unit (%) The % of cohort above discharged home or homely setting directly from the Frailty Unit Discharge without Delay Rate from Frailty Unit (%) Percentage of above patient cohort discharged who were not a delayed discharge as per PHS definition https://publichealthscotland.scot/search?q=Delayed+Discharge+&search= Weekend Discharge Rate from Frailty Unit (%) Percentage of above patient cohort discharged at the weekend Average Length of Stay in Frailty Unit (Days) Average stay in days from admission/transfer to Frailty Unit to discharge from Frailty Unit Delayed Discharges in Frailty Unit - snapshot position at census (No.) The number of those reported as Delayed Discharges as per PHS Definition at census snapshot position https://publichealthscotland.scot/search?q=Delayed+Discharge+&search= Average daily waits for community hospital bed in Frailty Unit (No.) Average daily patients waiting in the Frailty Unit for a bed in Community Hospital or Step Down or Rehabilitation Area. % of beds occupied by Reportable and Health Delays in Frailty Unit (%) Numerator = number of beds occupied by delayed discharges in the month including reportable and health delays. %. Denominator = all staffed available beds in Frailty Unit. % of beds occupied by non-Frailty patients (non-Geriatric Medicine patients) Number = number of beds occupied in Frailty Units that are classed as non-Frailty patients, ie. non-Geriatric Medicine AB specialty patients. Denominator = Frailty Unit total occupied beds Average Time to admission to Frailty Unit (hh:mm) Average time in hours / minutes from presentation at ED to admission to Frailty Unit, or time from admission to Front Door Short Stay Area to transfer/admission to Frailty Unit Community Hospitals (includes step down facilities in an acute setting) Community hospital admissions (No.) Urgent and Unscheduled (non-elective or planned transfer) admissions to a Community Hospital or Step down facility in the month Average Daily Community hospital admissions (No.) Urgent and Unscheduled (non-elective or planned transfer) admissions to a Community Hospital or Step down facility in the month divided by days in month Averge Length of Stay in Community Hospitals (Days) Average LOS from admission/transfer to community hospital or step down facility for admission cohort to discharge in days. Community hospital Discharge without Delay Rate (%) Percentage of above patient cohort discharged who were not a delayed discharge as per PHS definition https://publichealthscotland.scot/search?q=Delayed+Discharge+&search= Weekend Discharge Rate from Community hospitals (%) Percentage of above patient cohort discharged at the weekend Community hospital delayed discharges - snapshot position (No.) Total reportable delayed discharges in community hospital or step down facility as per PHS definition at census snapshot position https://publichealthscotland.scot/search?q=Delayed+Discharge+&search= % Ave daily beds lost due to delayed discharges in Community Hospitals (%) % of Ave daily beds lost in the month due to delayed discharge patients in community hospital or step down facility Page 35 of 86
Page 36
NHS Scotland Health Board 1.9 Principles University Hospital Hairmyres University Hospital Monklands University Hospital Wishaw North Lanarkshire UHSCP South Lanarkshire UHSCP N/A 0 0 0 6 6 Not Started 0 0 0 0 0 0 Partially Implemented/In Progress 11 9 6 6 6 6 Fully Implemented 3 5 8 2 2 2 1.4 Principles University Hospital Hairmyres University Hospital Monklands University Hospital Wishaw North Lanarkshire UHSCP South Lanarkshire UHSCP N/A 0 0 0 2 2 Not Started 0 0 0 0 0 Partially Implemented/In Progress 12 11 10 10 7 Fully Implemented 0 1 2 0 3 1.2 Principles University Hospital Hairmyres University Hospital Monklands University Hospital Wishaw North Lanarkshire UHSCP South Lanarkshire UHSCP N/A 0 0 0 0 0 Not Started 1 1 1 1 1 Partially Implemented/In Progress 8 9 8 9 9 Fully Implemented 1 0 1 0 0 1.5 Principles University Hospital Hairmyres University Hospital Monklands University Hospital Wishaw North Lanarkshire UHSCP South Lanarkshire UHSCP N/A 0 0 0 0 0 Not Started 1 0 0 1 0 Partially Implemented/In Progress 4 5 5 5 4 Fully Implemented 0 0 0 1 3 1.9 2.2 1.3 2.3 1.3 1.3 2.8 3.0 1.6 1.2 1.2 3.0 1.8 1.6 2.3 1.4 14. Patients managed in an Acute Frailty Unit should be reviewed by a Pharmacist, who ideally works with the frailty team and patient to undertake a Standardised Medication Review (via 7 step process) which is captured electronically to support seamless information sharing with Primary Care, but also to aid evaluation and service improvement. DwD Key Element: 3. Community Hospital / Step-Down Rehabilitation DwD Key Element Board RAG DwD Key Element: 4. Discharge to Assess (D2A) / Home First DwD Key Element Board RAG DwD Key Element: 1. Acute Frailty Units - Site Score Discharge Without Delay Self-Assessment NHS Board Results Matrix (Consolodated across submitted locations) NHS Lanarkshire DwD Key Element Board RAGDwD Key Element: 1. Acute Frailty Units DwD Key Element: 2. Planned Date of Discharge (PDD) & Integrated Discharge Teams DwD Key Element Board RAG DwD Key Element: 2. Planned Date of Discharge (PDD) & Integrated Discharge Teams - Site Score 1. The majority of patients in Acute Frailty Units are discharged home or transferred to the most appropriate non-acute care setting for their individual needs, supporting the right patient journey and reducing the risk of harm from multiple moves. 2. Each acute hospital has a dedicated Acute Frailty Unit that facilitates admission within 4 hours of identified need to minimise hospital induced dependency. 3. Acute Frailty Unit is specifically staffed by nurses with experience in frailty and appropriate band 3 or 4 staffing compliment to minimise hospital induced dependency. Work force tools should be used to quantify nursing and health care assistant requirement. 4. Staff in the Acute Frailty Unit have received training in the principles of Realistic Medicine to ensure equitable, personcentred, and value-based delivery of health and social care. 5. Acute Frailty Unit should have sufficient capacity and turnover to meet patient demand based on pre-agreed admission criteria. Services should know daily demand and then model optimal (but achievable) length of stay and capacity need to meet this demand. This ensures patients identified as benefiting from frailty unit admission will be accommodated without delay. 6. Optimal length of stay (LOS) up to 4 days. 7. Acute Frailty Unit admissions are pre-assessed by the frailty team or using locally pre-agreed criteria. 8. Acute Frailty Units admit and discharge 7 days per week and are supported by acute frailty multi-disciplinary team (MDT). The definition of 7 day MDT is 3 or more members of MDT working together over the weekend. The MDT representatives are Pharmacy, Medical, Occupational Therapy, Physiotherapy, Discharge Team and Advanced Practice / Frailty nursing. 9. Acute Frailty Unit has access to Home First / Community Reablement / Discharge to Assess (D2A) within 24 hours of an identified need. 10. Patients in Acute Frailty Units access locality acute rehabilitation wards / step-down or community hospital in-patient facility (for patients with potential PDD >7-9 days) within 24 hours of identified need. 11. Care home patients are able to return to care home without needing reassessment and existing packages of care are restarted within 24 hours of request from Acute Frailty Unit. 12. Acute Frailty Units have a staff member with dedicated time to focus on discharge, ideally in bigger teams this is a hospital discharge coordinator aligned to respective Integrated Discharge Hub, supporting discharges 7 days per week 13. Acute Frailty Unit has daily huddles 7 days per week attended by senior decision maker and multi-disciplinary team (MDT). DwD Principle DwD Principle $SSHQGL[ Page 36 of 86
Page 37
1.2 1.6 2.3 1.2 1.4 1.8 1.2 1.2 1.4 1.2 1.2 1.0 1.2 1.2 1.2 1.2 0.2 2.0 1.2 1.2 1.2 1.2 1.2 1.5 DwD Principle 1.0 1.2 1.8 1.2 1.6 1.5 2.0 DwD Key Element: 4. Discharge to Assess (D2A) / Home First - Site Score DwD Key Element: 3. Community Hospital / Step-Down Rehabilitation - Site Score 11. Multi-disciplinary team (MDT) meetings take place on acute wards a minimum of five days per week and are attended by a senior decision-maker alongside the wider MDT. The use of the MDT Observational Tool supports teams in delivering exemplar MDT practice, ensuring effective communication, shared decision-making, and high-quality discharge planning. 12. Each acute ward has a defined mean length of stay (LOS) and daily discharge target, co-produced as part of the Discharge Without Delay programme. These targets help ensure patient demand is effectively managed while supporting the delivery of value-based health and social care—focusing on outcomes that matter to patients, reducing unnecessary delays, and optimising resource use. DwD Principle 6. The Integrated Discharge Team is aligned to specific high-volume discharge wards-such as the Acute Frailty Unit, General Medicine and Orthopaedics—to support timely, coordinated discharge planning and delivery. 7. If a potential new care at home need is assessed in an acute hospital, to support timely discharge and accurate assessment, this is delivered via Home First / Discharge to Assess (D2A) services within 48-72 hours of need identification. 8. Discharge teams and local D2A / Home First services have a process for resource matching so that services are available on the agreed PDDs. 9. Patients with a potential Planned Date of Discharge (PDD) exceeding 7–9 days should be transferred to step-down/ community hospital within 48–72 hours of their need being recognised. Transferring patients from acute hospital who could be discharged home within the same week is NOT considered optimal practice, as it may lead to unnecessary transitions and delays to discharge. 10. Access to new care home placement from an acute hospital is not optimal practice and patient assessment should be continued in the community / step-down rehabilitation/community hospital facility, if discharge home to assess is felt not possible. 1. Boards should adhere to the principles of Planned Date of Discharge (PDD), with forward-planned discharge dates set by the multidisciplinary team (MDT) as part of a co-produced discharge plan. It is essential that the PDD is recorded electronically to support timely, coordinated, and person-centred discharge planning 2. Not every patient requires a Planned Date of Discharge (PDD). If the patient assessment is incomplete and there is no clearly agreed multidisciplinary team (MDT) plan, 'PDD under review' is documented. 3. At any point in time, 50% of patients on a ward may be "PDD under review". 4. Acute hospitals have an Integrated Discharge Team representing all localities and Health and Social Care Partnerships (HSCPs), ensuring equitable access to discharge pathways via a single point of contact—regardless of where the patient is from. 5. Discharge Coordinators are aligned to acute wards, while Social Workers and Community Care Assistants are linked to step-down and community hospital areas. This alignment supports the co- production and effective delivery of Planned Date of Discharge (PDD), ensuring continuity, coordination and avoidance of unwarranted variation. 1. These facilities should work towards delivering a mean length of stay (LOS) position of 28 days or 20% improvement versus 2024 baseline, to ensure sufficient flow to accommodate total local population need, without delay. 2. Facilities should accommodate appropriate referrals within 48-72 hours of request. Patients who could have been discharged home from acute within the week should not routinely be transferred, unless significant capacity available in step-down facility 3. Community hospital / step-down in-patient rehabilitation services should be scoped to deliver an appropriate bed base to meet population need. Therefore, when flow is optimal (as per above), this capacity meets population demand and all frail patients with need get access to in-patient rehabilitation, without delay to transfer from acute. 4. These facilities have a "no waiting list culture" as delays cause harm and dependency to this population while waiting in an acute bed. 5. These facilities have support from local Geriatric team often in form of Advanced Nurse Practitioner, Frailty nurse or consultant. 6. These facilities should be supported by dedicated discharge staff possibly more aligned to social work, supporting discharge process back to communities. 7. These facilities should be able to access a package of care (POC) or new care home placement within 7-10 days of request or Discharge to Assess (D2A) within 48-72 hours, with a process for matching home care resource allocation to facilitate discharge on the agreed Planned Dates of Discharge (PDD). 8. HSCPs should scope out demand for POC and relationship with D2A, to ensure that population need can be met, without delay, so that ongoing access for step-down rehabilitation is available for those who need. 9. These facilities should be staffed appropriately by nurses and healthcare assistants (supported by workforce tools) and trained Pharmacists/Occupational Therapists/Physiotherapists and support staff to meet in-patient rehabilitation need and prevent hospital induced dependency. These staff should ideally transition between hospital and local community to provide care continuity at time of discharge. The role of generic workers to support 7 day mobility should be considered. 10. These facilities have MDT meetings, held at least 3 times per week attended by senior decision maker and wider MDT following planned date of discharge process to forward plan discharges. 6. D2A service is aligned to transitional MDT services with staff working across hospital and community interface to enhance discharge process and care continuity. 7. D2A is also aligned to wider locality Integrated Enhanced Community Support Teams, to ensure home care is not seen in isolation. 1. Discharge to Assess (D2A) / Home First service is aligned around key discharging wards, for example Acute Frailty Units, Medicine for the Elderly, Respiratory, General Medicine, and Orthopaedic wards. 2. D2A services are available within 24 hours of assessed need from Acute Frailty Unit and 48-72 hours of standard ward referral, with a process for matching home care resource allocation to facilitate discharge on the agreed Planned Date of Discharge (PDD). 3. These community D2A services have a rehabilitation and enablement focus to accurately assess persons care needs in homely environment. 4. D2A services should be scoped to meet population need, so that patients are discharged on their PDD, without delay and the subsequent hospital induced dependency to the patient and escalating home care need to the service is avoided. Whole-system funding and trust may need to be agreed to support resource need. 5. Patients on D2A pathway should undergo regular assessment of home care need to ensure flow through the service in a timely manner so population need can be met, and service capacity is always available. Page 37 of 86
Page 38
Page 38 of 86
Page 39
North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref DF/AB/CL Date 23/03/26 Coming Home Implementation From Diane Fraser, Chief Office (Adult Social Work Services) E-mail fraserdi@northlan.gov.uk Executive Summary This report provides the Social Work Committee with an update on progress in implementing the Scottish Government's Coming Home programme within North Lanarkshire. The programme aims to ensure that people with learning disabilities and complex care needs are supported to live safely and successfully within their local communities, with the right support at the right time. Demand for support through the Dynamic Support Register (DSR) has continued to increase, with the number of individuals recorded rising from 45 to 59 during the reporting period. This reflects sustained pressure across the health and social care system. Despite this, positive progress has been achieved, including the elimination of inappropriate out-of- area placements and an increase in the number of individuals successfully moving on from the register following improvements in their circumstances and support arrangements. Significant challenges remain. The number of individuals in hospital has remained consistently high, highlighting ongoing barriers to timely discharge and limitations in community-based support capacity. Individuals within the highest risk categories continue to require intensive and coordinated multi-agency intervention. The Scottish Government's Coming Home Action Plan and associated £20 million national investment, including funding administered through ILF Scotland, present an important opportunity to strengthen local provision and accelerate progress. However, maximising the benefits of this investment will require continued development of provider capacity, workforce capability, housing options and confidence in the delivery of Self-Directed Support. The Dynamic Support Register has become an important tool for strategic oversight, risk management and service planning for individuals with complex needs. Building on its success, its application is being extended to support other high-risk groups, including Item 5 Page 39 of 86
Page 40
1. Background 1.1 This report provides a further update to the Social Work Commitee on progress in delivering the Coming Home programme, a key component of national policy aimed at reducing reliance on institutional care and supporting individuals to live within their own communities. 1.2 The programme sits within a broader context of increasing demand, system complexity, and the need to rebalance provision away from hospital and out-of-area placements towards sustainable, community-based models of care and support. 1.3 The Dynamic Support Register (DSR) remains a central component of local delivery, providing oversight of individuals with the highest levels of complexity and risk, and enabling prioritised, coordinated intervention. people within forensic and mental health settings, and young people transitioning to adult services. Work is also underway to strengthen the involvement of people with lived experience and their families in shaping service design and strategic planning, ensuring their voices influence the future development of services. Overall, while meaningful progress has been made, sustained partnership working, investment in community capacity and continued focus on preventative and person-centred approaches will be essential to reduce system pressures, improve outcomes and deliver long-term sustainability in line with national policy ambitions. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Note the current position and increasing demand within the Dynamic Support Register. (2) Acknowledge the progress achieved, including reduced inappropriate out-of-area placements and increased throughput. (3) Recognise the ongoing pressure relating to delayed discharge and community capacity. (4) Support continued multi-agency action to develop sustainable, community-based solutions in line with the Coming Home programme. 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 86
Page 41
2. Report System Demand and Risk Profile 2.1 The table below summarises recent position statements: Category 31-Mar- 25 30-Jun- 25 30-Sep- 25 31-Dec- 25 31-Mar- 26 Red: Inappropriate Out of Area (IOOA) 1 1 0 0 0 Red: In Hospital 14 15 15 15 15 Red: At Risk of Support Breakdown (ARSB) 2 0 2 2 2 Amber: Enhanced Monitoring (EM) 8 11 4 6 4 Green: Out of Area (Appropriate) (OOA) 14 14 14 14 15 2.2 The table above reflects the number of people on the register at this time total of 36. 2.3 Encouragingly, there has been a notable increase in the number of individuals removed from the register, a total of 23 indicating improved throughput and positive outcomes for a number of individuals. 2.4 The table below summarises the category of individuals on prior to being removed from the register: Category prior to being removed from Register 31-Mar- 25 30-Jun- 25 30-Sep- 25 31-Dec- 25 31-Mar- 26 Red: In Hospital 6 6 12 14 14 Red: At Risk of Support Breakdown (ARSB) 0 0 1 1 1 Amber: Enhanced Monitoring (EM) 0 0 3 6 8 Green: Removed from Register 6 6 16 21 23 2.5 Red risk relating to inappropriate out-of-area placements has been eliminated, and there has been some reduction in enhanced monitoring cases. However, the number of individuals in hospital has remained consistently high at approximately 15 throughout the period. This highlights an ongoing and persistent challenge in progressing discharge and securing appropriate community-based supports. 2.6 The data demonstrates that while the DSR approach is supporting movement and improved outcomes for some individuals, there continues to be sustained pressure within the most complex and high-risk cohorts. In response, further approaches are Page 41 of 86
Page 42
being tested and refined, including strengthened escalation processes and enhanced communication across partner agencies. Coming Home and National Investment (ILF Scotland) 2.7 The Scottish Government and COSLA’s Coming Home Action Plan (2026) represents a significant national commitment to supporting people with learning disabilities and complex support needs to live within their own communities. The plan will provide £20 million to support almost 400 individuals through the development of tailored support and housing solutions located close to home, family, and established support networks. A significant proportion of this funding will be delivered through ILF Scotland, reflecting its role in enabling flexible, person-centred support arrangements which extend beyond traditional funding models. 2.8 For North Lanarkshire, this investment aligns closely with local strategic priorities to reduce delayed discharge and support individuals with complex needs to live in community settings. It presents an opportunity to further strengthen partnership working, maximise access to ILF funding, and accelerate delivery of sustainable, person-centred solutions. 2.9 However, successful delivery is dependent on: • continued development of provider capacity, • workforce flexibility, and • confidence in the implementation of Self-Directed Support. 2.10 These factors will be critical in ensuring that national investment translates into improved outcomes for individuals and a reduction in system pressures locally. 2.11 ILF Scotland has scheduled a series of consultation events to inform the deployment of this funding. Members of the North Lanarkshire Coming Home Implementation Group have been invited to participate and will seek to articulate local priorities, including the need for a broader range of housing options and a skilled, sustainable workforce to support delivery of this agenda. Embedding a framework to support the use of the Support Register 2.12 A framework has been developed in North Lanarkshire to support the purpose of the register. The ensures that the complex support needs pathway is established and will be supported by national guidance to use the DSR effectively and the Learning Disability Complex Care Oversight Group has been established to provide oversight using the DSR as a critical tool for system oversight and risk management. 2.13 The Learning Disability Complex Care Oversight Group has demonstrated clear benefits in strengthening oversight, coordination, and planning for individuals with the most complex needs. As a result, there is ongoing work to extend this approach to other population groups within North Lanarkshire. 2.14 A similar process will also be established for individuals within forensic inpatient settings to support proportionate and timely discharge planning and return to community living using the DSR tool. 2.15 Similarly, this approach is being applied within mental health services for individuals with complex presentations, with a focus on enabling safe and efficient discharge. Page 42 of 86
Page 43
2.16 A comparable model of oversight is already embedded within the Social Work Transition Team, in partnership with Education and Families and Adult Social Work, supporting young people leaving school. This includes monitoring those with the most complex needs, including young people in residential placements, ensuring early and coordinated planning. Lived Experience 2.17 The experiences of individuals who have experienced extended hospital delays are currently reflected within individual care planning processes. However, there is recognition, in line with Scottish Government expectations, that this requires to be strengthened at a strategic level. 2.18 The Coming Home Implementation Group is working in partnership with Equals Say Advocacy to develop appropriate mechanisms to capture the views of individuals and families. This work will adopt a trauma-informed approach, recognising the sensitivities associated with delayed discharge and out-of-area placements. The intention is to ensure that lived experience informs service planning and strategic development across North Lanarkshire in a systematic and meaningful way. Summary 2.19 Demand within the Dynamic Support Register has increased, with total numbers rising from 45 to 59, indicating sustained system pressure. 2.20 Positive progress is evident, including the elimination of inappropriate out-of-area placements and an increase in individuals successfully moving on from the register. 2.21 Despite this, a consistently high number of individuals remain in hospital, highlighting ongoing challenges in discharge and community capacity. 2.22 The Coming Home Action Plan and associated ILF investment present a significant opportunity to accelerate progress; however, local capacity, workforce, and market development remain critical enablers. 2.23 The DSR model is demonstrating impact and is being extended to other high-risk groups, including forensic and mental health populations, as well as supporting transition planning. 2.24 Work is underway to strengthen the role of lived experience in informing strategic decision-making and service design. Strategic Implications 2.25 Continued alignment with the Coming Home agenda and national policy direction. 2.26 Opportunity to accelerate delivery of community-based solutions and reduce reliance on hospital and out-of-area provision, Rebalance Care. 2.27 Requirement to embed DSR approaches more widely as a core model of strategic oversight and risk management for complex populations. Operational Implications 2.28 Ongoing pressure within high-risk cohorts, particularly individuals in hospital, requiring sustained multi-agency leadership and coordination. Page 43 of 86
Page 44
2.29 Need to strengthen escalation routes and coordination across health, social work, housing, and providers. 2.30 Expansion of DSR approaches will require clear governance, capacity, and consistency of practice. Financial Implications 2.31 Potential to maximise access to ILF funding and reduce high-cost placements over time. 2.32 Continued risk of cost pressure where discharge is delayed or where specialist provision is limited. 2.33 Investment in early intervention and community supports will be critical to achieving longer-term sustainability. 2.34 It is important to reiterate the significant financial commitment associated with supporting individuals with the most complex needs who remain in hospital settings for extended periods. Current projected annual costs for a small number of individuals illustrate the scale of resource required: 2.35 These figures highlight both the intensity of support required and the substantial financial pressure on the system. They reinforce the importance of transparency with the Integration Joint Board in relation to high-cost care arrangements, ensuring clear oversight of the financial implications associated with delayed discharge. 2.36 While these packages reflect the complexity of individual need and the requirement to ensure safe, high-quality care, they also underline the importance of accelerating the development of sustainable, community-based alternatives in line with the Coming Home agenda. Strategic investment in earlier intervention, workforce capacity, and £0 £200,000 £400,000 £600,000 £800,000 £1,000,000 £1,200,000 1 2 3 4 5 Current Projected Annual Costs Page 44 of 86
Page 45
flexible support approaches will be essential to improving outcomes for individuals whilst reducing long-term financial pressure. Workforce and Market Implications 2.37 Requirement to further develop a resilient and flexible provider market. 2.38 Need for a skilled workforce capable of supporting complex and neurodivergent needs. 2.39 Increased confidence and consistency in the application of Self-Directed Support will be essential. Risk Implications 2.40 Risk of continued institutionalisation and delayed discharge if community capacity is not strengthened. 2.41 Risk of placement breakdown for individuals at the most complex end of need. 2.42 Dependency on national funding translating effectively into local delivery. 3. Measures of success 3.1 The success of the Coming Home programme within North Lanarkshire will be demonstrated through: 1. Elimination and prevention of inappropriate out-of-area placements. 2. Reduction in the number of individuals experiencing delayed discharge from hospital. 3. Increased numbers of individuals supported safely within their local communities. 4. Increased numbers of individuals moving positively off the Dynamic Support Register. 5. Improved engagement of people with lived experience in strategic planning and service development. 6. Increased provider market capacity and availability of community-based support options. 7. Improved financial sustainability through a reduction in reliance on institutional and high-cost placements. 4. Supporting documentation 4.1 N/A Diane Fraser Chief Officer (Adult Social Work Services0 Page 45 of 86
Page 46
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? The report concerns people with learning disabilities and complex support needs, a protected group under the Equality Act 2010, and describes actions intended to advance equality of opportunity, reduce social exclusion, and address inequalities experienced by individuals who may also face socio-economic disadvantage. A strategic Equality Impact Assessment will be undertaken for the wider Coming Home Programme and associated complex support pathway. The programme affects people with protected characteristics and informs ongoing service development, commissioning, housing and support arrangements. An EQIA is not required for this individual update report. 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 report highlights significant financial considerations associated with supporting individuals with complex needs, particularly where delayed discharge results in prolonged hospital stays and high-cost care arrangements. The report also identifies opportunities to maximise access to Scottish Government and ILF Scotland funding and notes that investment in community-based supports, housing options and workforce capacity will be critical to improving outcomes and achieving longer-term financial sustainability. No immediate additional financial commitment is sought through this report. 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 ☐ Page 46 of 86
Page 47
If Yes, please provide a brief summary of the impact? The report relates to the Council's and HSCP's statutory responsibilities towards adults with learning disabilities and complex support needs and references the implementation of national policy and existing legislative duties. No new legal powers, legislative changes, or employment law implications arise directly from the report. 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? The report describes the continued development and wider application of the Dynamic Support Register as a service redesign and data management tool supporting multi-agency oversight, planning, and risk management. It does not, however, contain any direct impacts relating to connectivity, broadband, Wi-Fi, or major technology infrastructure changes. 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? The report includes stakeholder engagement, lived experience involvement, partnership communication, and consultation activity that may require communications support, although no major communications campaign is proposed. 5.9 Risk impact Is there a risk impact? Yes ☒ No ☐ Page 47 of 86
Page 48
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? The report identifies significant strategic, operational, financial and service delivery risks relating to delayed discharge, community capacity, workforce availability, placement stability, and the delivery of the Coming Home programme. It also outlines measures in place to manage and mitigate these risks. 5.1 0 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. 5.1 1 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). The report includes information relating to transition planning and support for young people with complex needs as they move from children's to adult services, particularly those requiring coordinated multi-agency planning and oversight. If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☒ Page 48 of 86
Page 49
North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? Ref CR/SF Date ☐ Yes ☒ No 25/08/26 Adult Social Care Performance Report – Quarter 4 2025/26 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 performance scorecard and 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 performance review meetings are used as a means for jointly agreeing corrective actions. 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 January 2026 to 31st March 2026, Quarter 4 2025/26. 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 6 Page 49 of 86
Page 50
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 that have been identified as part of the Chief Executive Quarterly Performance Review, for the period 01st January 2026 to 31st March 2026, Quarter 4 2025/26. 2.2 The new Social Work Case Management System continues to be developed and adopted by services and teams. Some aspects of reporting are still in development, pending adoption of Mosaic and confirmation of new recording processes. Once complete and the new recording processes verified, developed reports will be subject to testing and validation before the publication of information and measurement of the data extracted from the system. 2.4 Whilst every effort is being made to maintain continuity of reporting, the ability to provide data and information remains impacted in the short term and there is some disruption to the Social Care reporting contained within the Chief Executives Scorecard. Some metrics in Appendix 1 have no current value and are not available as these parts of the Mosaic system are not operational. 2.6 Areas for improvement and planned actions are agreed and developed on an exception basis (i.e., for those indicators which are 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. 4. Supporting documentation 4.1 Appendix 1: Adult Social Care Dashboard 4.2 Appendix 2: Areas for Improvement 01st January 2026 to 31st March 2026, Quarter 4 2025/26. Claire Rae Chief Officer North HSCP Page 50 of 86
Page 51
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 51 of 86
Page 52
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 52 of 86
Page 53
Appendix 1 – Adult Social Care Dashboard PLEASE NOTE FOR ALL INDICATORS UPWARDS ARROWS DENOTE POSITIVE PERFORMANCE Ref. KPI Target 2025-26 2024/25 Q4 2025/26 Q1 2025/26 Q2 2025/26 Q3 2025/26 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 33 22 22 25 28 RED 2.16 Assistive Technology - Number Of People With Technology (18-64yrs) 622 270 303 298 321 2.17 Assistive Technology - Number Of People With Technology (65+) 912 673 745 727 734 2.18 Reablement - Number Of People Completing Reablement Process 2000 (500 per quarter) 1788 317 604 940 1157 RED 2.19 Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 63.0% 62.4% 60.4% 66.9% 66.9% ➔ RED 2.2 Reablement - % Of People With No or Reduced Home Support Service Required At End Of Process 70% 62.5% 65.3% 56.8% 51.2% 47.3% RED 2.21 Balance Of Care - % Of People (Age 65+), inclusive of SDS (service users aged 65+ with a >£10K budget) 45% 48.9% … … ... 2.X IRT - Referral to Treatment within 12 weeks, excluding Major Equipment 90% 89.9% … … ... 2.X HAT – Service users where HAT service ends within 1/2 days from Assessment to service completion ... 7.0% 8.8% 10.0% 8.2% 14.0% ... 2.X HAT – Service users with no further service required on completion of HAT ... 55.2% 61.7% 71.6% 72.6% 70.8% ... 2.22 IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 73.4% 72.7% 79.2% 80.7% 81.9% GREEN 4.2 Complaints Processed Within Timescale (NLC) 85% 60.0% (Stage 1) 76.9% (Stage 2) 92.1% (Stage 1) 76.5% (Stage 2) 78.8% (Stage 1) 92.9% (Stage 2) 86.8% (Stage 1) 100.0% (Stage 2) 77.1% (Stage 1) 94.1% (Stage 2) ... ... GREEN 4.3 Care Home Placements At End Of Quarter - Per 1000 Popn 65+ 24 21.9 22.1 22.3 22.2 21.9 ➔ GREEN 4.4 Care Home Placements At End Of Quarter - Per 1000 Popn 75+ 50 45.4 46.1 46.6 46.1 45.5 GREEN Page 53 of 86
Page 54
4.5 Care Home - Average Length of Stay 865 776 735 881 978 782 GREEN 4.6 Number Of People With Self Directed Support 1,000 2214 2193 2272 2227 2268 GREEN 4.7 Number Of People With A Direct Payment 240 395 356 368 367 378 GREEN 7.X Conflict of Interest 80% 86.5% 83.1% 85.3% 84.6% 86.1% GREEN 7.X Data Protection Essentials 80% 86.4% 81.1% 84.6% 84.6% 84.6% ➔ GREEN 7.X Employee Code of Conduct 80% 84.5% 78.4% 82.5% 82.6% 83.8% GREEN 7.X Information security awareness 80% 85.7% 81.6% 83.3% 82.7% 82.5% GREEN 7.X Introduction to Risk Management 80% 82.2% 79.2% 83.5% 83.7% 84.3% GREEN 7.X Prevent 80% 82.1% 79.8% 82.8% 81.8% 82.4% GREEN 7.X Records and information management 80% 79.3% 75.8% 80.0% 79.6% 79.2% AMBER 7.X For Referrals in Period, Proportion Completing Duty to Inquire With Investigatory Powers From Referral Within Timescale 60% 86.2% 88.1% 91.7% ... GREEN 7.X For Referrals in Period, Proportion Going to Case Conference From DTI With Investigatory Powers Within Timescale 60% 28.6% 22.2% 20.0% ... RED 7.X Proportion of Adult Welfare Concerns in Period with No Further Action 50% 86.2% 91.2% 90.1% ... GREEN 9.4 Breakeven Position - Projected Outturn (NLC) >=0 £6.181m underspend -£5.939m overspend £4.406m overspend £2.645 overspend £0.445 underspend ... ... ... 9.6 Sickness Absence (NLC) - days lost per person 9.22 12.92 3.35 8.15 12.99 17.92 RED Page 54 of 86
Page 55
Appendix 2 – Areas for Improvement 1. Assistive Technology Target 2025/26 2025/26 Q3 2025/26 Q4 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Assistive Technology - Number Of People With Technology (0-17 yrs) 1452 25 28 RED Assistive Technology - Number Of People With Technology (18-64yrs) 298 321 RED Assistive Technology - Number Of People With Technology (65+) 727 734 RED Narrative & Corrective Action Performance for the Assistive Technology indicators improved during Q4 across all age groups, with an increase in the number of people supported through technology- enabled care when compared with the previous quarter. Despite this improvement, performance remains below the targeted level at year-end. Interpretation of these indicators requires recognition of the improvements to reporting through ELMS2, which have significantly improved data completeness. As a result, the current figures provide a more accurate representation of operational activity and meaningful comparisons with earlier reporting periods are difficult. Demand for Assistive Technology continues to increase as the Partnership strengthens its Home First approach and supports more people to remain safely and independently at home. Assistive Technology plays an important role in supporting hospital discharge, preventing avoidable admission and providing alternatives to more intensive forms of support. The current performance indicators do not wholly reflect the significant volume of assessment, advisory and preventative activity carried out alongside the provision of equipment and technology. The service continues to operate within a challenging environment, with workforce capacity and competing operational priorities affecting both service delivery and the pace of reporting development. Activity remains focused on improving data quality and ensuring that performance reporting more accurately reflects the full range of service activity. Work continues to strengthen the integration of Assistive Technology within assessment, reablement and discharge pathways, including closer alignment with Home Assessment and wider community services. As part of the Enabling Approach, practitioners routinely consider technology-enabled care as part of their assessment and support planning, helping people to maintain independence and reducing reliance on longer-term support where appropriate. A review of the Assistive Technology indicators and associated targets remains planned as part of future performance framework development. This will consider improvements in data quality and reporting, ensuring that the performance measures reflect the increasing contribution Assistive Technology makes to supporting independence, prevention and Home First approaches. 2. Reablement and Rehabilitation Target 2025/26 2025/26 Q3 2025/26 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) 940 1157 RED Page 55 of 86
Page 56
Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 66.9% 66.9% ➔ RED Reablement - % Of People With No or Reduced Home Support Service Required At End Of Process 70% 51.2% 47.3% RED Narrative & Corrective Action Performance across the Reablement indicators remains below target at year-end, although this is within the context of significant operational change across Home Support, Home Assessment and wider hospital discharge pathways. The number of people completing the Reablement process reached 1,157 by Q4 against an annual target of 2,000. The proportion of new or increased Home Support packages delivered through Reablement remained stable at 66.9%, just below the 70% target. However, the proportion of people requiring no or reduced Home Support at the end of the process reduced further to 47.3%. This reduction reflects the increasing complexity of people supported through community pathways and the continued implementation of the Home First approach. Demand for direct support through Home Assessment has increased, with more people supported to return home following a hospital stay, although capacity within Home Assessment has not necessarily increased at the same pace; vacancies and absence continue to impact on the service’s ability to maximise activity and respond to a growing demand. Whilst performance against the outcome indicator has deteriorated, there is evidence that assessment-at-home is integral to the wider model. The proportion of Home Assessment Team completions requiring no further support following intervention has increased, demonstrating the value of timely assessment and intervention in supporting people to regain independence. The Q4/year-end Reablement position represents part of a wider system supporting increasing numbers of people with greater complexity and need. The redesigned Home Support operating model introduces a functional split between Assessment & Planning, and Living Well at Home. Assessment and Planning brings together Home Assessment, Reablement and Intensive Services, whilst Living Well at Home will focus on longer-term support for people with more complex needs. The redesign aims to reduce duplication, improve efficiency, support timely hospital discharge, preventing avoidable admission and maximising independence through time- limited assessment, reablement and recovery. The redesign aligns with the Partnership’s Home First and Getting It Right for Everyone approaches. Robust assessment in a person’s own home supports evidence-based decision making on longer-term need, enabling people to regain confidence, function and independence wherever possible before longer-term care arrangements are considered. During 2025/26, implementation progressed through phased redesign activity, including the adoption of an enabling approach across all localities, further development of Home Assessment pathways, workforce realignment and continued implementation of digital scheduling and reporting. A significant programme of improvement remains underway. This includes phased implementation of the functional split, process mapping, development of operational guidance, workforce training, digital systems refinement and refreshed performance reporting. The Home Support Operating Model Oversight Group monitors the progress of the change programme. The priority for 2026/27 is to consolidate the new operating model, strengthen assessment and planning practice, improve consistency across localities and ensure that performance reporting better reflects the full pathway from hospital discharge and Home Assessment through Reablement and, where required, longer-term support. This will include further work to understand demand, capacity, outcomes and the impact of increasing complexity on the proportion of people who require no or reduced support following intervention. 3. Adult Protection Target 2025/26 2025/26 Q3 2025/26 Q4 Performance Compared to Previous Quarter Performance Compared to Same RAG Status Page 56 of 86
Page 57
Quarter Previous Year For Referrals in Period, Proportion Going to Case Conference From DTI With Investigatory Powers Within Timescale 60% 22.2% 20.0% ... RED Narrative & Corrective Action Performance for this indicator remained below target during Q4, with 20.0% of relevant inquiries progressing to Case Conference within the required timescale. Performance remains below the 60% target and has reduced over successive quarters. Adult Support and Protection activity continues to operate within a context of sustained demand. During Q4, we received 803 Adult Support and Protection referrals, which is an 11% increase compared with the same period in the previous year. Care homes remained the largest source of referrals, while Cumbernauld recorded the highest number of referrals across the six localities. Physical harm remained the most common reason for referral, while self-neglect became the second most frequently recorded harm type. These trends highlight the increasing complexity of Adult Support and Protection activity and the need for coordinated multi-agency responses. 97 119 152 168 109 151 7 0 20 40 60 80 100 120 140 160 180 Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw HQ/Other Referrals in Quarter - Locality Page 57 of 86
Page 58
There were 335 inquiries with investigatory activity commenced during the quarter, with 42% of referrals progressing to this stage. Although referral volumes remain high, the number of Initial Case Conferences held during the quarter was comparatively low. Local Adult Support and Protection teams have identified ongoing recording and completion issues within Mosaic in relation to Case Conference information and caution is required when interpreting some elements of the information. Work is underway with operational managers to strengthen recording practices, improve oversight of Adult Support and Protection activity and reinforce expectations regarding decision-making and case progression. This includes additional scrutiny of referrals receiving no further action at the referral stage and a renewed emphasis on procedural compliance and feedback to referring agencies. Although the reported performance position for this particular indicator is below target, it reflects the substantial Adult Support and Protection activity across all localities, with the volume of investigations, protection planning and wider welfare interventions increasing whilst continuing to safeguard adults at risk of harm. 4. Sickness Absence Target 2025/26 2025/26 Q3 2025/26 Q4 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Sickness Absence (NLC) - days lost per person 9.22 12.99 17.92 RED Narrative & Corrective Action 1 2 2 3 5 9 14 15 21 35 42 86 112 119 337 NOT RECORDED Material Harm Suicidal Ideation Hoarding Domestic Abuse Institutionalised Harm None/Not Known Sexual Harm Other (please specify) Self Harm Neglect and Acts of Omission Financial Psychological/Emotional Harm Self Neglect Physical Harm Referrals in Quarter - Harm Type Page 58 of 86
Page 59
Sickness absence within North Lanarkshire Council Adult Social Work services increased during Q4, with the average number of days lost per employee rising to 17.92 days. This represents a deterioration from the previous quarter and remains well above the targeted level. The position at year-end reflects the continuing challenges associated with workforce capacity, recruitment and retention pressures, and the impact of both short and long-term absence across a number of service areas. For March 2026, the top five absence reasons were: Top 5 Absence Reasons Absence Reason FTE Days Lost in Period Abdominal & Gastric 170.35 Anxiety/Stress/Depression/Other Mental Health 1350.59 Bone/Muscle/Joint 808.99 Cancer 133.78 Post-Operative 119.14 As with previous reporting periods, a range of factors influence the level of sickness absence, including stress-related absences and those related to other long-term health conditions. Over half of absence is long-term absence. Workforce pressures and the increasing complexity of service demand continue to present challenges for frontline services. Long Term Short Term 59% 41% Page 59 of 86
Page 60
Page 60 of 86
Page 61
North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref CR/MD/NS/LH Date 25/08/26 Revenue & Capital Budget Monitoring Report: Adult Social Care Period 03: 01/04/2026 to 19/06/2026 From Morag Dendy, Chief Officer (Planning, Performance and Quality Assurance) E-mail scottn@northlan.gov.uk Executive Summary This report provides a summary of the revenue financial performance of the North Lanarkshire Council element of the North Lanarkshire University Health & Social Care Partnership (UHSCP); this includes the Council’s Adult Social Care Service and IJB-delegated Housing budget. This report also provides the financial performance of the Social Work capital programme. The report incorporates the period 1 April 2026 to 19 June 2026 (Period 03) and includes projected outturn forecasts for the financial year ended 31 March 2027, with major outturn variances highlighted and explained per the approved Financial Regulations. North Lanarkshire UHSCP (Adult Social Care & Housing) has a gross revenue expenditure budget of £308.401m and is currently projecting an overspend of £2.627m. This adverse variance is predominantly the result of overspends relating to Independent Care Homes and ‘Care at Home’ costs, both of which are partially offset by underspends in relation to vacancies. Any overspend presented for the financial year ended 31 March 2027, will be fully funded by IJB reserves. The Social Work capital programme has a total approved budget of £2.310m and is anticipated to outturn with a break-even 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 Item 7 Page 61 of 86
Page 62
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 26 February 2026, and the Integration Joint Board (IJB) approved its Financial Plan on 18 March 2026. The approved Gross Expenditure Budget for North Lanarkshire UHSCP (Adult Social Care & Housing) is £308.401m. The current 2026/27 budget incorporates £11.843m of savings for Adult Social Care. 2.2 The overall projected outturn position of the Service is an overspend of £2.627m. 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 2027, will be fully funded by IJB reserves. Revenue: Analysis of Significant Variances 2.4 Within Employee costs, the Service currently anticipates an underspend of £0.996m. This is in relation to slippage linked to the recruitment of posts across the Service. 2.5 Admin Costs are anticipated to be overspent by £0.097m. This is mainly in relation to legal fees and costs linked to ‘safeguarding’; where Sheriffs are appointing Safeguarders on a more frequent basis. 2.6 Payments to Other Bodies and Transfer Payments are detailed in Appendix 2. This expenditure accounts for £191.691m of the annual budget and is forecast to have an in-year net overspend of £4.436m (2.3%). 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. A further element of the overspend anticipated within ‘Payments to Other Bodies’ is in relation to expenditure which will further initiatives regarding ‘Winter Planning’, all of this expenditure is fully offset by income received from NHS Lanarkshire. 2.7 The Service anticipates an over recovery of income of £0.893m. This is mainly because of unbudgeted income received in relation to Winter Planning as referenced in paragraph 2.6. This over recovery is partially offset by an under recovery in relation to less than budgeted income from Charges within the Integrated Day Services. Revenue: Earmarked Reserves 2.8 The Integration Joint Board have total reserves of £24.056m, for specific Adult Social Care commitments as detailed in Appendix 3. Programme of Work Statutory / corporate / service requirement Page 62 of 86
Page 63
2.9 The Service intends to utilise £1.792m of reserves during the year for specific projects and initiatives. As previously stated, any overspend for the financial year will be fully funded from reserves, therefore a year-end drawdown of £2.627m is anticipated. Overall, a total of £4.419m of reserves are expected to be used during 2026/27. 2.10 The remaining £19.636m will be carried forward to 2027/28. Of this, £6.392m has been assessed by the Service and set aside for specific projects and initiatives as detailed in Appendix 3. This leaves a balance of £13.243m, 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 North Lanarkshire UHSCP was approved by the Integrated Joint Board in March 2026 which identified an overall budget gap for 2026/27 of £23.923m of which £11.843m 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 2026/27, 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 5-year Strategic Capital Investment Programme on 14 March 2024. Financial Year 2026/27 is the third year of the programme, with £1.994m approved for Social Work for the current year. Reprofiling from 2025/26 coupled with a ‘Trend based adjustment’ results in a revised budget of £2.310m, as demonstrated by Appendix 5. 2.16 A 10% Trend-Based Adjustment has been applied to reflect historic profiling challenges in delivering major capital projects which are often caused by procurement challenges, contractor issues, and site conditions. This adjustment provides a more realistic forecast for the Treasury Management Strategy and informs the Council’s borrowing needs. 2.17 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. 2.18 The Service currently anticipate a breakeven 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. 2.19 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 63 of 86
Page 64
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 2026/27 Appendix 6 Capital – Summary Expenditure by Thematic Category Morag Dendy Chief Officer (Planning, Performance and Quality Assurance) Page 64 of 86
Page 65
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 65 of 86
Page 66
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 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 66 of 86
Page 67
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 67 of 86
Page 68
APPENDIX 1 [1] [2] [3] [5] [6] EMPLOYEE COSTS 104,978,037 103,982,238 995,799 FAV 1.0% Anticipated net underspend mainly as a result of slippage in relation to recruitment across the Service. PROPERTY COSTS 3,167,876 3,167,876 0 0.0% SUPPLIES & SERVICES 5,974,742 5,974,742 0 0.0% TRANSPORT & PLANT 2,238,985 2,223,415 15,570 FAV 0.7% Projected underspends in relation to Staff mileage and Vehicle Contract Hires, partially offset by increased charges from Internal Transport ADMINISTRATION COSTS 326,576 423,887 (97,311) ADV (29.8%) Anticipated overspend in relation to legal fees and costs linked to 'safeguarding' PAYMENTS TO OTHER BODIES 66,243,878 68,461,905 (2,218,027) ADV (3.4%) Please refer to Appendix 2 for analysis TRANSFER PAYMENTS 125,447,631 127,666,044 (2,218,413) ADV (1.8%) 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 23,858 21,899 1,959 FAV 8.2% Minimal underspend TOTAL EXPENDITURE 308,401,583 311,922,006 (3,520,423) ADV (1.1%) NLC CONTRIBUTION (244,010,024) (244,010,024) 0 0.0% NLC CONTRIBUTION - HOUSING (2,223,453) (2,223,453) 0 0.0% INCOME FROM HEALTH (60,197,141) (61,101,934) 904,793 FAV (1.5%) Unbudgeted income in relation to 'Winter Planning' which fully offsets expenditure to the same value. FEES AND CHARGES (1,447,852) (1,424,831) (23,021) ADV 1.6% Anticipated under-recovery of 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 (523,113) (534,645) 11,532 FAV (2.2%) Overrecovery in relation to returned private sectors housing grants INCOME (308,401,583) (309,294,888) 893,304 FAV (0.3%) NET EXPENDITURE 0 2,627,119 (2,627,119) ADV 0.0% anticipated Transfer (to) / from IJB Reserves 2,627,119 Balance 0 NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Subjective Analysis Period 03 (01 April 2026 - 19 June 2026) Adult Social Care & Housing - INTEGRATED CATEGORY ANNUAL BUDGET PROJECTED OUTTURN PROJECTED OUTTURN VARIANCE % VARIANCE ANALYSIS [4] Page 68 of 86
Page 69
APPENDIX 2 [1] [2] [3] [5] [6] Care at Home 125,447,631 127,666,044 (2,218,412) ADV (1.8%) Demand led activity. Independent Care Homes 53,423,971 54,743,820 (1,319,849) ADV (2.5%) Demand led activity. Payments to NHS Lanarkshire 2,284,725 2,341,459 (56,734) ADV (2.5%) Position reflects anticipated in year payments Other Local Authorities - General 77,533 67,186 10,347 FAV 13.4% Position reflects anticipated in-year demand Voluntary Organisations & Payments to Other Bodies - Gen 8,820,199 9,662,704 (842,505) ADV (9.6%) Position reflects anticipated 'Winter Planning' spend, full offset by income Locality Flexibility 219,803 219,968 (165) ADV (0.1%) Position reflects anticipated Locality demand Private Sector Housing Grants 1,270,012 1,270,012 0 0.0% Position reflects anticipated in-year demand Medical Fees 147,635 156,757 (9,122) ADV (6.2%) Position reflects Service's approach to absence management Agency Fees 0 0 0 0.0% Position reflects anticipated in-year payments Other 0 0 0 0.0% TOTAL EXPENDITURE 191,691,509 196,127,949 (4,436,440) ADV (2.3%) [4] NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Payments to Other Bodies & Transfer Payments Analysis Period 03 (01 April 2026 - 19 June 2026) Adult Social Care & Housing - INTEGRATED CATEGORY ANNUAL BUDGET PROJECTED OUTTURN PROJECTED OUTTURN VARIANCE % VARIANCE ANALYSIS Page 69 of 86
Page 70
APPENDIX 3 Specific Service Earmarked Reserves Tech Improvements - Comm Alarms 111,388 71,920 39,468 0 111,388 Tech Improvements - Home Scheduling System 3,044,849 302,326 2,742,523 0 3,044,849 MH 2 NL10s 149,374 0 149,374 0 149,374 Home Support resilience 250,000 95,534 154,466 0 250,000 Staff Training Academy "grow your own" 426,402 220,988 205,414 0 426,402 2026 Summer Students & Interns 181,924 181,924 0 0 181,924 FAI Legal Costs 83,393 83,393 0 0 83,393 Children & Adult Protection - resourcing 60,337 40,225 20,112 0 60,337 MARR charts / Home support 110,000 0 110,000 0 110,000 Pharmacy post 50,000 0 50,000 0 50,000 Earmarked Reserves created from "funding received with direction" Carers Act 2018 - Support 2,439,109 128,504 2,310,605 0 2,439,109 MHO Building Capacity Funding 290,705 276,619 14,086 0 290,705 Statutory Appropriate Adults 174,542 36,623 137,919 0 174,542 SDS transformational funding 458,571 0 458,571 0 458,571 The Winter Planning & Enhanced supports Business Case 21,987 21,987 0 0 21,987 Risk-based earmarked reserves Social Care Demand risk 16,203,435 2,959,650 13,243,785 0 16,203,435 TOTAL 24,056,016 4,419,693 19,636,323 0 24,056,016 NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Status of Earmarked Reserves Period 03 (01 April 2026 - 19 June 2026) Adult Social Care & Housing - INTEGRATED TOTALDESCRIPTION OF EARMARKED RESOURCE Approved Reserve Total 2026/27 2027/28 No Longer Required Page 70 of 86
Page 71
APPENDIX 4 CATEGORY £ £ £ £ £ 1 TRANSFORMATION Home Support Redesign: Finalise the Home Support operating model focussing on Home Assessment with a reablement ethos to ensure those requiring ongoing paid support have the right support. In addition, develop and embed work practices that deliver more efficient practices and utilise resource more effectively. This will remove duplication and align staff teams and budgets appropriately. 3,000,000 3,000,000 0 0 0 2 TRANSFORMATION Home First Approach - Independent Care Homes: Fully implement a Home First approach supporting people at home for as long as possible, thus reducing the length of stay per resident. Development of community services to provide a range of support to ensure inclusiveness, reduce isolation as well as being able to access specialist support for those who are frail and/ or living with a long term condition to age well. 4,900,000 3,663,507 1,236,493 1,236,493 0 3 TRANSFORMATION Individual Budgets: It is proposed that the work to review Individual Budgets will continue. The work that has been undertaken has demonstrated that by adopting a strengths-based approach and working with families and communities’ people can be supported at home through a broad range of community resources. There will be an emphasis on early intervention and promoting independence for as long as possible utilising resources to compliment individual, paid support. This proposal will Review of Individual Budget Care Packages across Social Care. The saving will be apportioned across each locality. 3,000,000 781,587 2,218,413 2,218,413 0 4 MODERNISATION & EFFICIENCY Workforce Review - Social Care: Review and redesign infrastructure across Social Care to streamline portfolios and create more efficient practice to support operations there will be less demand in some areas and opportunity to skill mix. As this develops vacant posts will be reviewed. 300,000 59,318 240,682 240,682 0 5 MODERNISATION & EFFICIENCY Area Wide Equipment & Contract Review: Review the infrastructure across area wide social work services by considering; utilising the recurring underspend within the EAS service; utilise saving from recent end to contractual arrangements for community-based day support services and explore commissioning arrangements for Carers and Advocacy contracts within already set exit points. 642,722 624,126 18,596 18,596 0 TOTAL 11,842,722 8,128,538 3,714,184 3,714,184 0 68.64% 31.36% 31.36% 0.00% Delivered Gap Replacement Revised-Gap Commentary All gaps are partially funded from in-year underspends and balance will be funded in 2026.27 from IJB reserves NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Savings monitoring Period 03 (01 April 2026 - 19 June 2026) Adult Social Care & Housing - INTEGRATED Value APPROVED SAVINGS REPLACEMENT SAVING / FUNDING Savings Gap DESCRIPTION Revised Savings GapRef. DESCRIPTION OF APPROVED SAVING Target Value Value Deliverable Page 71 of 86
Page 72
APPENDIX 5 Approved: Year 3 budget (5 year Capital Program 2024/25 to 2028/29) 1,994,077 Reprofiling from 2025/26 (SLIPPAGE) 515,886 Included in opening budget Social Work Key Ambition Integrated equipment & adaptations TOTAL ASC WORKING BUDGET 2026/27 2,509,963 0 0 0 Trend Based Adjustment (199,400) TOTAL Approved Service Budget 2,310,563 Theme NORTH LANARKSHIRE COUNCIL Capital Budget Monitoring Report - Budget Movements 2024/25 Period 03 (01 April 2026 - 19 June 2026) Social Work Capital Programme BUDGET MOVEMENTS 2026/27 £ Period Division Thematic Category Page 72 of 86
Page 73
Appendix 6 Social Work: Integrated Equipment and Adaptations 2,509,963 219,449 311,610 2,198,353 2,509,963 (0) TOTAL ASC WORKING BUDGET 2026/27 2,509,963 219,449 311,610 2,198,353 2,509,963 (0) Trend Based Adjustment (199,400) (199,400) (0) Total Approved Service Budget 2,310,563 219,449 311,610 2,198,353 2,310,563 (0) Theme BUDGET ACTUAL COMMITTED NORTH LANARKSHIRE COUNCIL Capital Budget Monitoring Report - Summary Expenditure by Thematic Category Period 03 (01 April 2026 - 19 June 2026) Social Work Capital Programme UNCOMMITTED FINAL OUTTURN OUTTURN VARIANCE Page 73 of 86
Page 74
Page 74 of 86
Page 75
North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref GT/PMcA/SS Date 25/08/26 Sundry Debt Write Off 2026 From Diane Fraser, Chief Officer (Adult Social Work Services) E-mail scottn@northlan.gov.uk 1. Background 1.1 During 2025/26 the Council issued invoices with the approximate value of £107m. Within Adult Health & Social Care there are a number of chargeable services mainly in the following areas: • Home Care Charges • Nursing Home and Residential Home Accommodation Charges • Community Alarms 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 the Adult Care and Social Work Committee: (1) Notes the decision of the Chief Officer (Finance and Technology) under delegated responsibilities to write off £132,349.57 for debts under £500. (2) Approve the write off for £39,904.48 which includes debts greater than £500. 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 8 Page 75 of 86
Page 76
• As well as chargeable services, invoices are raised to other local authorities, health, and universities. 1.2 The value of Adult Health & Social Care invoices raised during 2025/26 was £62m. This figure includes invoices raised to other local authorities, health, and universities £59m. 1.3 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. 1.4 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 £172,254.05 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 table categorise the value of debt recommended for write off by cause and value: Reason No. of Accounts Value £ Deceased 686 54,703.69 Small Balances/Uneconomic to Pursue 60 1,262.28 Gone Away 103 1,413.04 Recovery Exhausted 7699 114,875.04 Sequestration/Liquidation 0 0 Total 8458 172,254.05 Value Analysis < £500 8523 132,349.57 > £500 25 39,904.48 Total 8458 172,254.05 Page 76 of 86
Page 77
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. These include: • Implementation of Debt Recovery Procedures • Performance Management Reports • Payment Arrangements • Payment by Direct Debit 3.2 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 No support documentation. Diane Fraser Chief Officer (Adult Social Work Services) Page 77 of 86
Page 78
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 78 of 86
Page 79
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 79 of 86
Page 80
Page 80 of 86
Page 81
North Lanarkshire Council Report Adult Health and Social Care Committee Does this report require to be approved? ☐ Yes ☒ No Ref JMcK/CPT Date 25/08/26 Contracts awarded below Committee approval threshold From James McKinstry - Chief Officer (Assets and Procurement) E-mail McKinstryJ@northlan.gov.uk 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 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 Health and Social Care 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 9 Page 81 of 86
Page 82
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) Page 82 of 86
Page 83
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 83 of 86
Page 84
Appendix 1 – Summary of Contracts Awarded Contract Ref NLC-SLP-25-154 Title Technology Solution to provide Early Intervention Falls Prevention Classification Services – Standard Chief Officer, Procuring Service Area Diane Fraser, Chief Officer (Adult Social Work Services) Competition Governance by Value The Framework terms & conditions, with adherence to the council’s GCSO 13 on 3rd party frameworks Procurement Route Call-off following Direct Award using a Third Party Framework (Single Contractor Framework) No. of Framework Contractors 1 Award Criteria Best Value assessment, in accordance with the Framework Information Comments This call-off was made considering the relevant technical and commercial information from Scottish Government, Software Value Added Reseller (SVAR) Framework (SP-21-034) Award Details Value £169,293.64 Contract Duration 12 months Contractor Name Computacenter (UK) Ltd Contractor Size Large Company Contractor Location Hertfordshire 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 84 of 86
Page 85
Contract Ref NLC-CPT-25-107 Title Complex Housing Advocacy Classification Services – Health and Social Related Chief Officer, Procuring 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 seeking offers 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. Award Details Value £50,500 Contract Duration 24 months Contractor Name Shelter, The National Campaign For Homeless People Ltd Contractor Size Large Company Contractor Location Glasgow 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 85 of 86
Page 86
Contract Ref NLC-CPT-25-159 Title Autism and Neurodivergence Support Classification Services - Social & Specific Chief Officer, Procuring Service Area Diane Fraser, Chief Officer Social Work (Adults) 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 seeking offers 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. Award Details Value £85,000 Contract Duration 12 months Contractor Name Hope for Autism Contractor Size SME 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 86 of 86