Adult Social Care Performance Report - Quarter 2 2022-23
North Lanarkshire Council · 21 February 2023
Back to Adult Care and Social Work Committee — 21 February 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref RMcG/MD/GC Date 21/02/23 Adult Social Care Performance Report – Quarter 2 2022/23 From Ross McGuffie, Chief Officer, Health & Social Care E-mail Ross.McGuffie@lanarkshire.scot.nhs.uk Telephone 01698 858 143 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 1 July to 30 September 2022 (Quarter 2). 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. Note 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 (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities
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1. Background 1.1 The Chief Officer has joint quarterly performance review meetings with the Chief Executive of NHS Lanarkshire and the Chief Executive of North Lanarkshire Council. These meetings are supported by a Chief Executive Performance Framework comprising a range of performance measures from across both health and social work systems, including relevant targets and trajectories. 1.2 Based on a traffic-light system there are areas for improvement identified within the performance framework each quarter for those that are flagged as Red or Amber. The performance review meetings are used as a means for jointly agreeing corrective actions. 1.3 Information from these performance reviews has been supplemented with additional performance information below to offer the committee a wider overview of performance across some key areas of adult social care delivery. 2. Report 2.1 The purpose of the report is to provide an update to the Committee on wider performance of key areas of adult social care delivery, in addition to the performance areas for improvement which have been identified as part of the Chief Executive Quarterly Performance Review for the period 1 July to 30 September 2022 (Quarter 2). 2.2 The performance data for Quarter 2 and associated trend information is included as Appendix 1. 2.3 Areas for improvement and planned actions are agreed and developed on an exception basis (i.e., for those indicators which are amber or red, based on tolerance thresholds). These are detailed as Appendix 2 of this report. 3. Measures of success 3.1 Measures of success are contained within Appendix 1 of this report. 4. Supporting documentation 4.1 Appendix 1: Adult Social Care Dashboard 4.2 Appendix 2: Areas for Improvement (Quarter 2, July – September 2022) Ross McGuffie Chief Officer Health & Social Care North Lanarkshire
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5. Impacts ( http://connect/report-template-guidance ) 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 have 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 have 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 have 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?
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Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☒ No ☐ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? The associated risks for Home Support are identified and managed in accordance with the agreed corporate project risk management and methodology and monitored through the Home Support programme board and wider corporate groups where appropriate. 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.
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Appendix 1 – Adult Social Care Dashboard PLEASE NOTE FOR ALL INDICATORS UPWARDS ARROWS DENOTE POSITIVE PERFORMANCE Outcome (National Health & Wellbeing) Ref. KPI Target / Indicator 2021/22 2021/22 Q3 2021/22 Q4 2022/23 Q1 2022/23 Q2 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year Current Performance 2. People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community 2.1 Assistive Technology - Number Of People With Technology (0-17 yrs) 38 36 34 34 GREEN Assistive Technology - Number Of People With Technology (18-64yrs) 1452 634 631 635 629 Assistive Technology - Number Of People With Technology (65+) 873 866 852 853 2.2 Reablement - Number Of People Completing Reablement Process (cumulative) 2000 (500 per quarter) 916 1170 354 678 RED 2.3 Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 67.7% 63.1% 67.1% 60.6% AMBER 2.4 Reablement - % Of People With No or Reduced Level of Home Support Service At End Of Process 70% 53.2% 52.2% 56.2% 50.2% RED 2.6 Balance Of Care - % Of People (Age 65+) 45% 44.3% 45.3% 45.5% 45.4% GREEN 2.7 IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 66.3% 61.7% 66.6% 75.1% AMBER 4. Health and social care services are centred on helping to maintain or 4.2 Care Home Placements At End Of Quarter - Per 1000 Popn 65+ 24 21.0 21.3 22.0 22.2 GREEN 4.3 Care Home Placements At End Of Quarter - Per 1000 Popn 75+ 50 43.0 44.0 45.5 46.3 GREEN 4.4 Care Home - Average Length of Stay 865 831 819 828 939 AMBER
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improve the quality of life of people who use those services 4.5 Number Of People With Self Directed Support 1000 1200 1256 1280 1322 GREEN 4.6 Number Of People With A Direct Payment 240 308 321 298 328 GREEN 7. People who use health and social care services are safe from harm 7.1 % Of Adult Protection Referrals Passed To Care Team For Investigation 20% 20.3% 18.9% 15.0% 17.5% 7.2 % Of Adult Protection Investigations Going To Initial Case Conference 20% 41.0% 23.9% 19.6% 16.3% 7.3 Adult Protection - % Of Referrals With Decision Within 5 Days 60% 74.1% 79.3% 72.8% 76.3% GREEN 7.4 % of Adult Protection Referrals Which Did Not Go On To Investigation Or Other Service 50% 62.7% 66.3% 72.1% 67.4%
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Appendix 2 – Areas for Improvement (Quarter 2, July – September 2022) 1. Reablement & Home Support NLC in-house Home Support provision has increased over the last 28 months with pressures in the system caused by a number of factors including reduced availability of alternatives to in-house home support, pressures from hospital referrals/ discharges, staff absence, skills, training, increased acuity and complexity. Recruitment and retention to posts at all grades has been challenging and there has been a higher than usual turnover. In particular Home Support Worker, Support Officer and Service Delivery Coordinators are difficult to recruit and retain. These new roles were introduced just prior to the pandemic, and it was not possible to establish them fully due to changes in working arrangements and the difficulties of delivering training. The feedback from staff is that the roles are challenging and therefore it has not been possible to sustain staff in post. The tasks and skill set needs to be reviewed for a number of posts, including administration and management roles which are critical to supporting our staff. The current Home Support operational model needs to be reviewed to embed Home Support provision, assessment and planning and longer-term care and support provision for North Lanarkshire. To facilitate this, it will be necessary to ensure that the model reflects the pathway which will ensure that: • All individuals will have an opportunity to be assessed at home when they are being discharged from hospital, or when their health is deteriorating to the point that they may need hospital • Community supports will be considered, and individuals will be signposted • Reablement and rehabilitation will be integral to supporting people and will be offered to everyone unless there is no reablement potential due to complex health and/or palliative care needs. The Home Support element of the Reablement provision will have dedicated management team. • During the period of assessment, a lead worker will be allocated to identify personal outcomes and develop a support plan to meet those outcomes. Capacity within the reablement service has reduced significantly since the onset of the C-19 pandemic, as a result of the pressures and demands outlined above. Efforts continue to ensure reablement capacity within the service is protected with reablement and rehabilitation key priorities for the future of the operating model. 324 people completed the reablement process in quarter 2, which was 31 fewer than the previous quarter and significantly below the target of 500 people per quarter. It is crucial that the Reablement Service is supported to fully recover to ensure consistent practice across all 6 localities in supporting people’s rehabilitation or reablement needs. 258 people have completed the reablement process in October and November 2022, suggesting an increase in flow through the service
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2. Integrated Equipment & Adaptation Service Overall performance for equipment deliveries within seven working days was 75.1% for Quarter 2, an improvement from 66.6% for Quarter 1. The service continues to prioritise work for supporting hospital discharges and admission prevention, which can often affect its ability to deliver other equipment requests within agreed timescales.