Maintaining a Positive Balance of Care
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 MD/GC Date 21/02/23 Maintaining a Positive Balance of Care From Morag Dendy, Head of Planning, Performance & Quality Assurance E-mail DendyM@northlan.gov.uk Telephone 01698 332068 1. Background 1.1 The Health and Social Care Partnership is fully committed to ensuring that people are supported to live full and active lives in their own homes and localities, minimising the use of hospital settings. This purpose of this report is to update Committee on the positive balance of care within North Lanarkshire, in comparison with other partnerships across Scotland, and to provide committee with an overview of the supports and services in place to help people live as independently as possible in their own homes for as long as possible. Executive Summary The Health and Social Care Partnership is fully committed to ensuring that people are supported to live full and active lives in their own homes and localities, minimising the use of hospital and other care settings. This report is to advise Committee of a range of key metric which compare the performance in North Lanarkshire across other Scottish councils which demonstrate the sustained efforts to maintain a positive balance of care. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Endorse and support the balance of care within North Lanarkshire; and (2) Note the contents 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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2. Report 2.1 Balance of care 2.1.1 The provision of social care and support in North Lanarkshire is spread across a range of organisations and settings and much of it is co-designed to meet a diverse and complex range of individuals’ needs across North Lanarkshire’s communities. 2.1.2 The balance of care is a term commonly used to refer to the balance of support and care available within community-based settings (e.g., home care, self-directed support, day services, voluntary sector supports, support for carers), when compared with the support and care available within residential settings (e.g. care homes, NHS continuing care provision, etc.). 2.1.3 North Lanarkshire has, for many years, had a positive balance of care, which means that the considerable investment in community-based supports over time has resulted in a high proportion of individuals with long-term and complex needs being able to continue to live as independently as possible within their own homes. 2.1.4 In order to allow comparison across different partnership areas, there is a standard performance metric which looks at the proportion of individuals aged 18 and over who have long term needs and who receive personal care at home. This metric has been used for benchmarking purposes through Health & Social Care Partnerships’ Annual Performance Reports (APRs) and is key metric within the National Indicator Set designed to measure the overall impact of health and social care integration. This particular metric reflects very positively the long-term efforts in North Lanarkshire to create and sustain the range of supports outlined above. As the chart below illustrates, North Lanarkshire has the second highest proportion of individuals aged 18 and over with long terms needs who receive personal care at home in Scotland. This has remained consistent over recent years with approximately 75% of people aged 18 and over with long term care needs receiving personal care at home. Chart 1: Percentage of people aged 18+ with long term needs receiving personal care at home (2021) Source: Insights in social care: statistics for Scotland 2020/21
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2.1.5 It is also helpful to consider an additional metric for benchmarking with other partnership areas, namely the percentage of individuals over the age of 65 who have long term care needs and receive 10 or more hours of home care per week. This again reflects positively on the balance of care within North Lanarkshire, with over 50% of individuals over the age of 65 with long term needs receiving 10 or more hours of home care per week. This is the second highest percentage in Scotland. Chart 2: Percentage of people aged 65 and over with long term care needs receiving 10+ hours of home care Source: Insights in social care: statistics for Scotland 2020/21
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2.2 Care Home Stays 2.2.1 As outlined in the previous section, the balance of care in North Lanarkshire tips favourably towards community-based supports compared with most other Health & Social Care Partnerships. Perhaps it is therefore unsurprising to note that the overall number of registered places in care homes within North Lanarkshire is lower than the Scottish average and lower than the majority of other partnership areas relative to its overall size of population. The chart below illustrates the number of registered places in care homes for older people (aged 65 and over). Chart 3: Rate of registered places in care homes for older people per 1,000 population aged 65 and over (2022) Source: Care home census for adults in Scotland, Statistics on Care Homes and Residents for Years 2011 to 2022
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2.3 Social Work Expenditure 2.3.1 The overall balance of care within North Lanarkshire should also be seen within a financial context, and in terms of the overall resources available to the service and its partners. The importance we have placed in ensuring individuals, particularly those with complex and long term needs, are supported to live independently within their own home and within their own communities is reflected in the profile of the service’s expenditure. Also, when comparing overall gross social work spend on those aged 18 and over, North Lanarkshire’s overall spend per capita is lower than the Scottish average and lower than the vast majority of other partnership areas which is perhaps even more noteworthy given the pattern of social and economic deprivation across North Lanarkshire. Chart 4: Gross social work spend per head of population (aged 18+) Source: Local Government Benchmarking Framework 2020/21 3. Measures of success 3.1 The partnership continues to monitor progress across all service areas through its performance framework and quarterly Chief Executive Performance Reviews and balance of care metrics are included within the National Indicator set, reported via Annual Performance Reports.
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4. Supporting documentation 4.1 None Morag Dendy Head of Performance, Planning & Quality Assurance 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? 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.