Agenda Document Pack - Adult Care and Social Work Committee - 14/05/2024
North Lanarkshire Council · 14 May 2024
Back to Adult Care and Social Work Committee — 14 May 2024 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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2 May 2024 Members of the Adult Care and Social Work Committee Chief Executive’s Office Archie Aitken Chief Officer (Legal & Democratic) Civic Centre, Windmillhill Street, Motherwell ML1 1AB www.northlanarkshire.gov.uk Notice is given that a Meeting of the Adult Care and Social Work Committee is to be held in the Council Chamber, Civic Centre, Windmillhill Street, Motherwell, ML1 1AB on Tuesday, 14 May 2024 at 14:00 PM which you are requested to attend. The agenda of business is attached. Archie Aitken Chief Officer (Legal & Democratic) Members : Clerk Name: Clare Louise McDonald Clerk Telephone: 01698 302190 Clerk Email: mcdonaldcl@northlan.gov.uk M McCulloch, M Boyd, D Ashraf, C Barclay, B Baudo, G Brennan, B Burgess, A Bustard, J Cairns, T Carragher, W Goldie, J Jones, M McBride, A McCrory, B McCulloch, R McKendrick, C McManus, A McVey, G Robinson, N Shevlin, R Sullivan, J Toner, C Williams, N Wilson, G Woods. Page 1 of 270
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Agenda 1 Declarations of Interest In Terms of the Ethical Standards In Public Life Etc. (Scotland) Act 2000 2 Adult Care of Social Work - Terms of Reference Submit a copy of the remit/delegated functions of the Committee following agreement of the Policy and Strategy Committee held on 7 December 2023 5 - 6 Operational 3 Delivering for Communities - Engagement and Participation Submit report by the Chief Officer (Performance, Planning and Quality Assurance) seeking approval of the North Lanarkshire Engagement and Participation Strategy 2024/27 7 - 24 4 Supporting Unpaid Carers Submit report by the Chief Officer (Planning, Performance and Quality Assurance) seeking approval of the North Lanarkshire Carers Strategy 2024/27 and the approach to supporting carers in North Lanarkshire 25 - 132 5 Community Solutions Programme Submit report by the Chief Officer (Planning, Performance Quality Assurance) providing an overview of North Lanarkshire Community Solutions Programme and it's reach and impact during 2022/23 133 - 220 6 Charges for Non-Residential Services, Community Alarms, Meal Provision, Independent Sector Care Homes and Respite Care Submit report by the Chief Officer (North Lanarkshire Health and Social Care Partnership) advising of the charging levels to be applied for non- residential services, community alarms, meals provision, independent sector care homes and respite care in 2024/25 221 - 226 Performance Page 3 of 270
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7 Adult Social Care Performance Report - Quarter 3 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 October to 31 December 2023 (Quarter 3) 227 - 240 Financial 8 Revenue & Capital Monitoring Report Adult Social Care Period 12 Submit report by the Chief Officer (Planning, Performance and Quality Assurance) providing a summary of the revenue and financial performance of the Health and Social Care Partnership (H&SCP) - North Lanarkshire (Adult Social Care and Housing) and the financial performance of the Social Work Capital Programme 241 - 252 Contracts 9 Contract Award for Community Living Support Submit report by the Chief Officer (Planning, Performance and Quality Assurance) seeking approval to award the contract for Community Living Support 253 - 262 10 Contract Award for Provision of Dynamic Scheduling Tool Submit report by the Chief Officer (North Lanarkshire Health and Social Care Partnership) advising of action taken under delegated authority to award the Contract for the Provision of Dynamic Scheduling Tool to Cimputacenter Ltd 263 - 270 Page 4 of 270
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TERMS OF REFERENCE FOR COMMITTEES, SUB-COMMITTEES AND PANELS OF THE COUNCIL ADULT CARE AND SOCIAL WORK COMMITTEE (1) To discharge the social work functions of the Council in terms of relevant legislation, Scottish Government Guidance and direction from the Integrated Joint Board (IJB), including the functions of the Council relating to needs of:- Adults affected by:- (a) Learning Disability; (b) Mental Ill Health; (c) Substance Misuse; (d) Frailty and Long Term Conditions; (e) A Need for Care at End of Life, and (f) Caring Responsibilities. (2) To discharge the responsibility of social work services for adult protection and the contribution of Adult Social Work Services to the wider public protection agenda. (3) To accept tenders for previously approved projects within the responsibility of this Committee. (4) To consider and agree action in relation to petitions received by the Council relative to the business of the Committee. (5) To grant authority to Members to attend seminars, conferences and other visits concerning matters within the area of responsibility of this Committee, until such time as responsibility for this matter passes to the Scottish Public Services Ombudsman. (6) To discharge the responsibility of the Council in joint planning with the Health Board, Health and Social Care Partnerships the Third Sector and other Partner Agencies and Organisations and the financing thereof. (7) To monitor and approve expenditure falling within the remit of this Committee consistent with approved Council objectives. (8) To consider reports on revenue and capital schemes coming within the remit of this Committee within approved Revenue Capital Programmes. (9) To approve and monitor implementation of the Council's Capital Programme for Adult Social Care projects. Item 2 Page 5 of 270
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North Lanarkshire Council Report Adult Care and Social Work Does this report require to be approved? ☒ Yes ☐ No Ref MD/MW/AMcG Date 14/05/24 Delivering for Communities - Engagement & Participation From Morag Dendy, Chief Officer (Performance, Planning & Quality Assurance) E-mail WilliamsonM@northlan.gov.uk Telephone 07939280915 Executive Summary This report seeks approval from Committee for the North Lanarkshire Engagement & Participation Strategy 2024-2027. This strategy further embeds and supports engagement and participation across our structures and communities. Previous reporting outlined our intention to create an Active Participation and Coordination remit, hosted by one lead organisation, which is now in place. This approach supports our ambition to: • Involve people in the decisions that affect their wellbeing. • Utilise feedback on the experiences of people to improve our services. • Design services and supports based on what matters to people. • Ensure a person-centred approach that follows the principles of Getting it Right for Everyone This increased focus and additional investment, following our last report to Committee has helped develop our overall approach to promoting engagement and participation and in ensuring the voices of supported people, carers and our communities are strengthened, which is highlighted in our strategy 2024-27. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Approve the North Lanarkshire Engagement & Participation Strategy 2024-2027 (2) Endorse the approach and the contents of the report. The Plan for North Lanarkshire Priority Enhance participation, capacity, and empowerment across our communities Ambition statement (19) Improve engagement with communities and develop their capacity to help themselves Programme of Work Resilient People Item 3 Page 7 of 270
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1. Background 1.1 Since our last report to Committee in May 2023, there has been continued focus on further developing our overall approach to invest and resource engagement and participation that ensures the voices of supported people; carers and our communities are strengthened. 1.2 Co-production work has been ongoing to refresh the Engagement and Participation Strategy 2024-27. There have also been several stakeholder events held to help shape content and ensure the National Standards for Community Engagement, promoted by Scottish Community Development Centre, have been applied throughout. 1.3 As part of the work to refresh the Strategy led by the Strategic Engagement and Participation Working Group (SEPWG), a visual diagram has been designed to show the three main areas of investment that supports Engagement and Participation across our communities (Community, Carers and Supported People). The diagram, on the second page of the strategy attached at Appendix 1, highlights our ambition to ensure strong voices to: • Improve communication and increase connections. • Increase awareness of what matters. • Increase capacity for early intervention and prevention. 1.4 Following on from the successful procurement exercise resulting in a contract award to North Lanarkshire Disability Forum (NLDF) as the lead partner, alongside Lanarkshire Links and Voice of Experience Forum, as reported to Committee in September 2023, work has begun again on the recommendations from an independent review of our engagement and participation structures concluded in June 2022. 2. Report 2.1 There is a long history of engagement and participation in North Lanarkshire and the strength of connection across our network continues to promote involvement and representation to amplify voice. There have been some key achievements over the past year as set out below. Engagement and Participation Strategy 2024-2027 2.2 Over recent months a focused effort has been directed towards refreshing the Engagement & Participation Strategy that will serve as the foundation across all areas of our work. In the development of the Strategy, we have actively engaged with stakeholders; representatives of community-based organisations, supported people, carers and staff teams. 2.2.1 Learning from these sessions has highlighted what is considered good engagement and participation and provided confirmation that the refreshed strategy should: • Be short and user friendly. • Be an overarching strategy that can guide communication and action planning across all areas of services and supports. • Build from the current strategy, including what we have learned and what people have told us. Page 8 of 270
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2.2.2 It is anticipated that the Strategy will support all stakeholders across our networks as it is written in plain English to ensure it is accessible to people who do not work in the sector but have an interest or are receiving services and supports. The Strategy is included as appendix 1. Strategic Engagement and Participation Working Group 2.3 The primary function of the Strategic Participation and Engagement Working Group (SEPWG) is to drive forward the principles aligned to our Engagement and Participation Strategy. This group was re-established in the last year and has led on the coordination and development of the Strategy 2024-27. 2.3.1 The group brings together representation from across the authority and includes people who have a role to support and develop engagement and participation. The primary objective is to coordinate various activities aimed at fostering robust and effective engagement and participation across North Lanarkshire. 2.3.2 Its purpose is to streamline and synchronise initiatives that prioritise community involvement, ensuring that the voices, needs, and perspectives of people in North Lanarkshire are not just heard but actively integrated into the design and delivery of our services. Embedding Participation 2.4 There has been good progress to increase the resource and capacity across community-based organisations to strengthen the voice of supported people, including those harder to reach e.g. BAME, LGBTQI+ and those in more rural communities. 2.4.1 We recognise the importance in ensuring that engagement and participation is meaningful and not tokenistic, so the principles of engagement and participation are now included in the Staff Induction programme, both as written information and as a direct input to programme for new social work and social care practitioners. 2.4.2 A wide range of stakeholders have been actively engaged in the development of the Strategy through consultation and direct involvement. Promotion to implement the Strategy will be a shared responsibility and will include awareness raising and the development of practical tools to support: • An evidence base on how people experience services and how their experience shapes and improves future development of services and supports. • The voice of supported people in our communities • Increased capacity for early intervention and prevention. • Two-way communication and a strengthened feedback loop back to decision makers • Increased feedback and the role of lived experience in improvement of services and supports. • Increased connections with supported people and communities that are harder to engage with. • Increased awareness about what is important to supported people and their communities. 2.4.3 The refresh of our Locality Planning Group arrangements and alignment with the Locality Planning Teams and Community Boards is underway. Once finalised, this will provide sector, locality, and thematic forums, which can be influenced and shaped Page 9 of 270
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through engagement and participation with our Communities, Carers and Supported People. Care Opinion 2.5 We recognise the importance of feedback, so have actively promoted the use of Care Opinion, which is an independent, non-profit, web-based feedback platform where people submit stories to share their experiences of health and social care services. These can be both positive and negative. They are moderated and quickly forwarded to the relevant area of service who can respond directly to the story. Since 2020: • 310 stories have been submitted through Care Opinion by people of North Lanarkshire. • 239 of these stories have been shared in the year April 2023-March 2024. • Most stories received a response from the service within 24 hours. 3. Measures of success 3.1 Communities, Carers and Supported People are engaged, included and represented to the extent they wish to be. 3.2 Better opportunities exist for under-represented and seldom heard people to participate and have their voices heard. 3.3 The principles of engagement and participation are fully embedded across all our structures. 4. Supporting documentation 4.1 Appendix 1 - Engagement & Participation Strategy 2024 – 2027 Morag Dendy Chief Officer (Performance, Planning & Quality Assurance) Page 10 of 270
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☒ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Page 11 of 270
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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? The Strategy will be shared with stakeholders and published on our website. 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). CRWIA is in progress and will reference the indirect impact through adults living healthier independent lives with mention of specific groups like young carers. If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 12 of 270
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(Review date Oct 2025) Page 13 of 270
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Foreword It is my pleasure to introduce our new Engagement and Participation strategy for University Health and Social Care Partnership North Lanarkshire. This strategy aims to empower our community members, practice, staff, and partners to actively participate in decision-making processes to shape the future of our services and supports. In amplifying the voices of people in North Lanarkshire, I am confident that we can create a collaborative and inclusive North Lanarkshire. Professor Ross McGuffie Chief Officer, University Health and Social Care North Lanarkshire What people said about the development of this strategy “We should not be making decisions without supported people being involved.” (UH&SC staff member) “People are more likely to be involved if they see their involvement leading to change” (Representative from partner organisation) “100 page documents? Need for breakdown and summary we like bite sized chunks!” (Representative from supported people and carers) What is University Health and Social Care North Lanarkshire (UHSCNL)? We are a caring and empowering partnership, dedicated to working with our communities to enable people across North Lanarkshire to lead independent, fulfilling, and healthier lives. We have established partnership agreements with a range of organisations. By enhancing and extending our work through these agreements we aim to develop sustainable, innovative, and practical solutions to health and social care challenges that directly benefit our communities and our workforce. Page 14 of 270
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Our Vision A culture of engagement and participation, with the people of North Lanarkshire, is embedded in all aspects of health and social care. By • Improving communication and increasing connections • Increasing awareness of what matters • Building the capacity for early intervention and prevention There will be strong voices influencing and shaping decisions that affect people- from individual care planning to strategic decision making. Page 15 of 270
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Everyone with an interest or part to play in improving wellbeing in North Lanarkshire. This includes supported people, people with lived experience, staff, volunteers, carers and the wider communities Engagement and participation is part of everything we do as part of community planning in North Lanarkshire. It ties in to all strategies, cuts across all areas of work and a people first approach. It is one of the programmes of work within the UHSCNL Commissioning Plan 2023-26. It will facilitate engagement, meaningful participation and support strong voices. Our Strategy will be implemented across North Lanarkshire, encompassing all health and social care services, partnerships, communities and people. Our Strategy will cover a three year period, 2024-27, with regular reviews and updates to ensure it continues to be relevant. Our Strategy will be implemented through a range of activities • learning and education for staff • the Communications Action Plan • involvement in service planning • commissioning and delivery • development of accessible information Action Plans for relevant areas of services and supports will incorporate the principles of this Strategy. Page 16 of 270
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Meaningful engagement and participation will help bring about improved wellbeing for people and more valued and effective ways of working, services and supports across University Health and Social Care NL. People • Direct the care and support people receive • Apply and develop skills, knowledge and experience • Are motivated to make a difference Builds trust, improves outcomes and leads to higher satisfaction. Practice Is better informed and there are improvements in • Person -centred practice and decision making • Assessment and planning • Outcomes • Relationships Services and supports are • Better targeted, more relevant, and appropriate • Influenced by fresh perspectives, new ideas and relevant experiences • More accountable The evidence base is informed by actual need UHSCNL A shared vision supports • Clear planning • Structured, co-ordinated and consistent approach • Efficient allocation of resources • Cultural change and active citizenship. The requirements of legislation, policy and strategic drivers are met. Page 17 of 270
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(Develop into a graphic) This Group (1) building from (2) affected by (3) engaged with (4) asking (5) to come up with (6) 6. University Health and Social Care NL Engagement and Participation Strategy 5.We asked… How do we ensure meaningful engagement and participation? 5. We asked… What are the barriers and enablers to engagement & participation in UHSCNL? 5. We asked… What more can we do to enable people to engage & participate meaningfully? 5. We asked… What does positive change look like for UHSCNL in relation to engagement and participation? 1.Strategic Engagement and Participation Working Group North Lanarkshire Council NHS Lanarkshire University Health & Social Care North Lanarkshire North Lanarkshire Carers Together Scottish Care North Lanarkshire Disability Forum Voluntary Action NL Community Solutions 4.Partners Supported People Carers Communities People of NL Staff and Volunteers 3.Key Drivers National Outcomes The Plan for NL UHSCNL Strategic Commissioning Plan National Standards for Community Engagement Planning with People Equality Framework 2.Building from Engagement and Participation Strategy 2021-24 Self evaluation Improvement planning Feedback and reflection Page 18 of 270
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National Standards for Community Engagement These standards were developed and promoted nationally and are important to us in NL because we want to: o create an approach where well-being and dignity are prioritised o ensure that the services and supports are person-centred, strength based and adapt to the unique circumstances of individuals and groups o facilitate a shared responsibility, encouraging everyone to work together towards common goals The framework for our strategy is based on the National Standards for Community Engagement. The views and opinions about engagement and participation were grouped around each of the National Standards. This has informed the key statements about how we will apply each standard Page 19 of 270
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Inclusion Making it easier for individuals, groups, and communities to express what matters and what is important. • Understand and address the barriers to active participation • Reach out and connect to diverse and underrepresented groups • Apply a range of methods and approaches that support inclusion • Offer support and alternatives, considering digital inclusion • People are recognised and respected as experts in their own lives Support Enabling individuals to live as independently as possible and empowering them to direct their own care planning and collective decision-making. • Seek, recognise, and develop opportunities to support engagement and participation • Support learning opportunities to further knowledge, understanding and application • Recognise and invest in resources to realise goals and ambitions o Time to connect, build relationships, share ideas, prepare methods, deliver, digest, and follow up o Staff to support connections, have conversations and overcome barriers for individuals o Space for people to come together in accessible places on their own terms o Funds to enable activities and programmes of work o Connections with skills, knowledge, organisations, and networks Planning Planning for engagement and participation is vital. It should ensure there is a clear purpose and shared ambitions. • Engagement and participation activities are planned the right way, as opposed to the quick way • People’s involvement, their ongoing journey and personal goals are supported • There is a shared understanding of what is being asked, why we are asking and what the endpoint is • Plan for closing the feedback loop • Communicate plans operationally and strategically to ensure oversight and co- ordination Page 20 of 270
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• Engagement and participation activity is shared within planning and reporting Working Together Collaborating with colleagues, professionals, supported people and carers to develop innovative solutions and a more integrated approach to wellbeing. • Make it clear what is expected and what can be achieved • People’s definition of needs, problems and solutions differ from those of professionals • Everyone’s contributions, experience and knowledge are valued and respected • Through involvement, people are empowered to learn, develop, and influence change • Barriers are identified and challenged; solutions are identified together • Integrate knowledge and expertise of appropriate individuals, groups, and organisations Methods Utilising a variety of approaches and engagement methods to ensure that everyone has an opportunity to participate in a way that suits them. • Seek, recognise, and develop opportunities to support engagement and participation at every point of contact • Target and link to those who are, or will be, affected by planned change • Utilise a range of approaches, tools, and methods to o work in ways that are accessible o find out what matters to people o achieve shared goals Communication Having clear and open communication reflecting the Standards and ensuring a shared understanding. • Ensure communication is timely, uses plain language, is culturally sensitive and available in accessible formats • Review communications to maximise opportunities to better engage and support participation • Strengthen our communication pathways to Page 21 of 270
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o Widen the reach o Communicate clear expectations o Share progress and feedback with those involved o What people have to say is heard by those who make decisions • Recognise and share achievements Impact Continuing to learn from actions taken and evidence of what works • What happened? • What was learned? • What changed as a result? • What was the impact on those involved? • What was the impact on our practice, services and supports? • What do we do now? To assess the impact • The variety and frequency of actions to embed engagement and participation into practice are assessed • Evaluation and reflective practice enable learning to be identified • Through evaluation we are aware of the impact for people involved • Through self-evaluation we are aware of how voices have influenced change • Quality Assurance processes include assessment of engagement and participation activity • Engagement and participation activity is apparent in reporting across UHSCNL structures • Increase in application of a co-production approach • Analysis of 6 monthly reporting on Comments, Compliments and Complaints • Quarterly reporting on Care Opinion • The Quality Framework (reference this) that includes self-evaluation of engagement and participation is applied Page 22 of 270
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What we mean when we say... Inclusion of definitions of terms used in the strategy (To be completed) Inclusion of electronic weblinks to stakeholder groups, strategies and plans (To be completed) Engagement and participation activities that target children and young people should be informed by our strategies, plans and guidance specifically for children and young people. North Lanarkshire Children’s Services Plan and the GIRFEC Website. Page 23 of 270
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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/AMcG Date 14/05/24 Supporting Unpaid Carers From Morag Dendy, Chief Officer (Planning, Performance and Quality Assurance), Adult Health and Social Care E-mail dendym@northlan.gov.uk Telephone 01698 332075 Executive Summary The report provides a progress update on actions taken to support unpaid carers, over the past year, following extensive carer engagement and participation activity themed around “what might help?” The report seeks committee approval for the North Lanarkshire Carers Strategy 2024 - 2027 and endorsement on the approach to supporting Carers. Previous reporting in November 22 outlined the planned approach to strengthen supports to unpaid carers, and a number of carer led and carer informed initiatives have been introduced over the past year. These initiatives have been part of the wider approach to engagement with the participation of carers and carer organisation and in developing market facilitation to help broaden choice, control and support options for both carers and supported people. The approach to both carer support and the Carer Strategy 2024-2027 continue to be based on the principles of the Carers (Scotland) Act 2016 and Self-Directed Support (Scotland) Act 2013. Self-Directed Support (SDS) continues to be Scotland’s national Social Care policy, promoting a whole system approach that enables people to have more choice and control in their lives. SDS is based on enhancing the principles of participation, dignity, involvement, informed choice, and collaboration. The aspiration is to offer a sustainable and innovative means to achieve the outcomes that carers, as well as supported people, identify as being important to them. Through these initiatives, carers can lead full and meaningful lives, and ensures that people can engage in, participate in, and contribute to the local economy and wider society, should that be their choice. The wider approach also encompasses the principles of Getting it Right for Everyone (GIRFE) and Community Wealth building. Carers, carer focused organisations and University Health and Social Care North Lanarkshire (UHSCNL) have, over time, developed a very robust carer support infrastructure, and our Carers Strategy 2024-2027 seeks to utilise this to best effect. Item 4 Page 25 of 270
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1. Background 1.1 Scotland’s national and local public bodies are committed to improving the ways individual people, and communities are engaged in decision-making that affects them. This is particularly relevant to the development of the health and social care services upon which we all rely. (Source: Planning with People; Community engagement and participation guidance. (Published by COSLA and The Scottish Government 2021) 1.2 North Lanarkshire has a strong history of engagement and participation and long- standing relationships with supported people, carers, and community organisations. This approach has ensured that the citizens of our area can influence, inform, and shape local policy, strategy, and services. We are committed to ensuring ongoing meaningful engagement with the communities we serve. 1.3 The approach to engagement and participation has helped carers, supported people and carer focused organisations influence and shape the range of carer services described within this report as well as our local Carer Strategy 2024 -2027 (appendix 1). 1.4 Whilst we are far from immune to many of the themes and negative carer experiences outlined in the State of Caring Report (Carers Scotland, published 2023), local carer experience has been significantly more positive than that reported nationally. The Care Inspectorate inquiry into people's experience of support within North Lanarkshire, including carer experience, as well as carer feedback through engagement and participation activity related to the Carer Strategy 2024 -2027, have both demonstrated that we are performing consistently higher than the national average regarding most, if not all, aspects of carer support. Lanarkshire Carers Centre report that a number of the initiatives outlined in this report have generated significant interest from other areas, due to both their innovative nature and the efficacy of the approaches being taken. Similarly, NLCT highlight that Carer Breather has attracted similar levels of interest. All of these approaches have resulted in a demonstrably more positive local picture. 2. Report 2.1 Relationships with a wide range of carer focused organisations in supporting and facilitating engagement and participation has been a significant factor in our collective approach to date. Input from carer focused organisations has proven invaluable Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Approve the North Lanarkshire Carer Strategy 2024-2027 (2) Endorse the approach to supporting Carers in North Lanarkshire The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (20) Improve the involvement of communities in the decisions, and development of services and supports, that affect them Programme of Work Resilient People Page 26 of 270
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generally, but particularly so regarding parent carers, carers from minority ethnic backgrounds and LGBTQI+ carers. 2.2 To date, initiatives to support carers have included: 2.2.1 An innovative Hospital Discharge Payment Scheme for Carers offering a one-off payment of £1,000 to families to support their loved one for the first 6 weeks out of hospital. This was introduced to ensure people did not remain in hospital for any longer than needed to reduce the risk of delayed discharge arising from prolonged wait times for people who required support upon hospital discharge, but where social care provision could not be guaranteed due to difficulties arising from the pressures around social care recruitment, retention, and staffing. Initially introduced as a pilot \ demonstration scheme, ninety carers and ninety cared for people have benefited from this scheme to date, at a cost of £90,000. This expenditure compares very favourably when set against both the financial and human costs of delayed discharge. Although the scheme ended on 31st March 2024, further evaluation will help inform future options. 2.2.2 Expansion of Carer Breather. Designed in partnership with carers in North Lanarkshire, Carer Breather is a pioneering initiative that not only supports carers to have time out, but also ensures carers have better access to their communities and works to reduce loneliness, isolation and foster friendships and relationships. The second round of funding for Carer Breather services was allocated to 11 organisations across North Lanarkshire. Funding is being used to provide breaks to carers from their caring roles in their local communities. These breaks allow carers to access time-out a few hours per week to focus on themselves in ways that support overall wellbeing. Some services provide support for carers at the same time as providing support for the person they care for. This reflects requests from carers that they can access support that allows them to enjoy some joint time-out to relax in a community setting. Carers can self-refer to the Carer Breather services by contacting organisations directly. The range of Carer Breather services sits within a much wider range of carer break options, with the Lanarkshire Carers Short Breaks Bureau, Time to Live Funding and individual Carer Budgets ensuring that carers can exercise choice and control in accessing the type of break most in keeping with their individual needs. 2.2.3 Increased funding to PAMIS (Profound and Multiple Impairment Service) to build capacity in the PAMIS Family Support Service, offering support to families caring for a family member with complex multiple disabilities. Around 160 families in North Lanarkshire are currently supported through this service. The nature of carer support goes beyond that offered by the three commissioned carer services (Lanarkshire Carers Centre, North Lanarkshire Carers Together and Action for Children, Young Carers) as experience has shown that support around issues like postural drainage, daily stretching, physiotherapy, and specialist toileting techniques all require carers to have specialist knowledge. 2.2.4 Introduced support for carers supporting a family member with Dementia, through an Alzheimer’s Scotland. The service provides holistic support to carers of people who have been diagnosed with dementia with a focus on meeting the needs and improve the quality of life, physical and mental wellbeing of carers of people with dementia to reduce stress and distress, maintain a healthy live/work balance and a reduction in the people with dementia being admitted to long term care. 2.2.5 An extended 3-year contract for HOPE for Autism, removing the uncertainties arising from the year-to-year annual funding that was in place previously. HOPE provides an all-age information and advice service for people with Autism, family members, carers, Page 27 of 270
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and professionals. Our approach was further augmented by an investment in practitioners from Autism Network to ensure that families have access to specialist knowledge locally around neurodivergence and the challenges that can arise around neurological conditions. 2.2.6 Further investment in Lanarkshire Carers to enhance existing programmes of carer support. An update from Lanarkshire Carers is included as appendix 4. 2.2.7 Continued support for Action for Children Young Carers Project who directly work with young carers to complete Young Carer Statements, assessments, reviews, and referrals for the young carer service. An update from Action for Children young Carers is included as appendix 5. 2.2.8 Improved development opportunities for Social Work staff around commissioned organisations, Adult Carer Support Plans, carer budget processes and Young Carer Statements. 2.2.9 Organising carer awareness events in tandem with the Assistive Technology team, to promote the uptake of assistive technology as a means of supporting both carers and those being cared for as a means of maximising independence, minimising risk, and encouraging a pro-active preventative approach. 2.2.10 Hosting the first Commitment to Carers Event, celebrating the positive developments around carer support, as well as hearing the challenges being faced by carers. The second Commitment to Carers Event will take place on 21st May 2024. 2.2.11 Supporting a range of engagement and participation activity aimed at all carers, but with a focus on underrepresented individuals, groups, or communities, including carers from minority ethnic communities and LGBTQI+ communities. 2.2.12 The continued promotion of Carer Budgets (where applicable) and support around innovative use of these. Most carers who are known to services are supported through the wider carer support infrastructure described in this report. In every situation where a cared for person is in receipt of an individual budget, the unpaid caring situation is also considered, and individual budgets are adjusted accordingly to take account of that. In addition there are around eighty carers who are in receipt of an individual carer budget. 2.2.13 Preparatory work is being undertaken in anticipation of revised legislation around the right to carer breaks, including an updated Short Breaks Statement. The approach continues to be in line with a wider ethos of supporting and enabling self-help, enablement, and empowerment, so that wherever possible, carers use their own family and friends’ networks to facilitate breaks from caring, rather than rely on statutory services. As such, our approach to carer breaks will continue to be based on self-help first, and only when those possibilities either do not exist, or have been fully explored, should funded support around carer breaks be required. 2.2.14 Developments in carer support around Dementia and Autism described above at 2.2.4 and 2.2.5 were informed by findings from the most recent national Carer Census, where these two conditions, along with age related frailty, were identified as being the three largest areas of caring responsibility. In relation to frailty, North Lanarkshire has been a pathfinder area in the national Getting it Right for Everybody (GIRFE) approach where it is anticipated that learning from engagement with people with lived experience will lead to further innovation in our approach and within any services provided. Page 28 of 270
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2.2.15 Additional investment with North Lanarkshire Carers Together (NLCT) to fund an Equalities post, ensuring that underrepresented communities have access to carer related information, signposting, campaigning and carer advocacy. An update from NLCT is provided as appendix 5. 2.2.16 In addition to the detail noted above, a wide range of community and voluntary sector organisations, including those with an age related, or condition specific focus, have been in receipt of North Lanarkshire Council funding and have had a role in direct, or indirect, support to carers as well as supported people. Work around monitoring and quality evaluation regarding carer support across these organisations took place throughout the year to ensure that our approaches are not solely carer and supported people informed, but carer and supported people led. 2.2.17 Facilitating participation, particularly with harder to reach groups and those who experience exclusion, is achieved through reaching out, finding out, making connections, and presenting opportunities. Investment was made to develop networks, connect people with shared experiences, help with sharing information, identifying issues that are important to carers, supported people and communities in North Lanarkshire and delivering approaches to improve carer wellbeing. There has been direct representation in governance structures and strategic forums, involvement in improvement areas, consultation, and co-production, with identified actions that further engagement and participation in our day-to-day practice. Locally we want to ensure that we have the best possible approach to engagement with, and participation of, supported people and unpaid carers. 2.2.18 These fits with key drivers that supports a preventative and anticipatory approach and helps ensure that people can live independently and are supported within their own networks and communities. We also seek to ensure “lived experience” can influence and shape strategic direction, policy, and support services.2.2.18 The Carers Scotland: State of Caring Report (appendix 2) presents a bleak picture nationally regarding carer experiences, using the term “health and social care crisis”. The report states that “Despite their huge contribution to the Scottish economy, to our communities and to the lives of the people they care for, carers are facing deteriorating physical and mental health, loneliness and isolation with too many driven to despair and denied access to the very supports they need to maintain a healthy life.” Whilst we cannot be complacent, the local picture is much more positive, largely due to the range of support options described above, alongside the range of carer support services offered by the three commissioned carer organisations and the wider community and voluntary sector. Carers face a wide range of challenges, so a wide range of responses is needed. Based on engagement with carers, we are confident that the supports and services that are in place are the right ones, but equally, that yet more can be done, both in terms of ensuring that carers experience a consistent approach and in developing further innovative solutions to meet caring related outcome and need. 2.2.19 The Analysis of Carers (Scotland) Act 2016 funding 2022-2023: responses to Freedom of Information request (released March 2024) (appendix 5) notes that the unallocated spend in North Lanarkshire related to Implementation of the Carers (Scotland) Act 2016 stood at £1,032,017. This figure is based caring related spend reported to Committee in 2022. Since then, there has been further investment in the carer support options described above, with most of the remaining balance aligned to approaches and developments outlined in our Carer Strategy 2024-2027. A small amount was also retained to mitigate any impact that may have arisen from waiving of charges. 2.2.20 The range of support described above, and the overall approach, demonstrates that we are already meeting the main recommendations of the report: Page 29 of 270
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• Providing significantly more funding directly to third sector organisations (including Carer Centres) to expand and develop services to support unpaid carers, including a wider range of short breaks opportunities. • Ring-fencing Carers Act funding and developing consistent budget headings for use by all local areas. • Developing financial reporting processes to ensure robust tracking, monitoring and forecasting of spend under each budget heading. • Ensuring that our Annual Performance Reports provide details of support for carers / Carers Act implementation and Annual Accounts provide figures for Carers Act funding, to improve transparent reporting of impact and spend. 2.2.21 The current commissioned Carer contracts are due to end in February 2025. In line with statutory procurement rules, we will be required to begin the process of retendering for carer services later this year. This will be an opportunity to further enhance and align carer support, as set out in the Carer Strategy 2024-2027, and any remaining balance of funding, as described in 2.2.19 can be utilised to further augment carer led innovative approaches and solutions to meet caring related needs and outcomes. North Lanarkshire Carer Strategy 2024-2027 2.3 The Carers (Scotland) Act 2016 stipulates that each local authority and relevant health board must jointly publish a local carer strategy and that this should be reviewed three years after the integration start date; or the date a replacement strategic plan takes effect after a strategic plan has been reviewed; or the date the integration authority has decided not to prepare a replacement strategic plan following such a review. 2.4 The Carers (Scotland) Act 2016 further stipulates that before preparing a local carer strategy, the local authority and the relevant health board must carry out extensive consultation. As is evidenced throughout this report, the range of engagement and participation activity informing our new Carer Strategy 2024- 2027 has been extensive, and we will continue with that approach over the lifespan of the new strategy. 2.5 The previous Carer Strategy was issued as a partnership update in 2019, due to the impacts of COVID and due to the circumstances at that time, did not involve as extensive a consultation or engagement process as we would otherwise have undertaken. As such, the 2019 Strategy was a refreshed updated version of the 2015 Carers Strategy. During the intervening period between 2015 and now, the Carers (Scotland) Act 2016, enacted 2018, was introduced, and the COVID 19 pandemic occurred. 2.6 The requirement to draft the 2024 -2027 Carers Strategy gave us the opportunity to undertake extensive engagement and participation activity with carers and supported people. This has resulted in a carer led and carer informed strategy, co-produced with carers and carer organisations locally. The sense of “joint ownership” that has emerged is something that carers, carer organisations and UHSCNL can be proud of. 3. Measures of success 3.1 Carers are engaged, included, and represented to the extent they wish to be. 3.2 Creation of better opportunities for under-represented and seldom heard carers to participate and have their voices heard. Page 30 of 270
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3.3 Improved opportunities for carers to influence, shape, co-produce and \ or co-design policy, strategy, and services. This goes beyond caring related policy or strategy, as through good design and engagement, the needs of carers and cared for people can be incorporated into wider policy and strategy. 3.4 Provision of approaches which can be influenced and shaped by the engagement and participation activity set out above. 3.5 Clear focus on the nine priority areas for action that carers have identified as a priority for them, as set out in the Carer Strategy 2024-2027. • Improving preventative approaches, anticipatory and future planning (and preventing crisis). • Improving communication with carers and their access to information and advice. • Ensuring carers know their rights. • Supporting carers health and wellbeing • Ensuring carers get a break from caring. • Ensuring carers, and people being cared for, have their income maximised. • Improving carer experience around hospital discharge. • Improving awareness of and access to Assistive Technology. • Influencing and shaping policy and strategy. 3.6 Reduction in the number of carers and \ or supported people first presenting whilst already in crisis. 4. Supporting documentation 4.1 Appendix 1 North Lanarkshire Carers Strategy 2024-2027 4.2 Appendix 2 State of Caring Report (Carers Scotland) published 2023) 4.3 Appendix 3 Analysis of Carers (Scotland) Act 2016 funding 2022-2023: responses to Freedom of Information request March 2024 4.4 Appendix 4 Lanarkshire Carers Centre update for Committee. 4.5 Appendix 5 North Lanarkshire Carers Together update for Committee. 4.6 Appendix 6 Action for children Young Carers update for Committee. Morag Dendy Chief Officer/Head of Service (Performance, Planning & Quality Assurance) Page 31 of 270
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☒ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? Directed funding allocated for Carers support will be used to procure and deliver services that continue to support Carers across our communities. 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 ☒ Page 32 of 270
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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? The Carers Strategy 2024-27 will be published on the website and shared with stakeholders. 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. Our approach covers all carers, including any carers linked to the Armed Forces Community. 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 270
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1 Appendix 1 Page 34 of 270
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2 NORTH LANARKSHIRE CARER STRATEGY 2024-2027 Welcome to our Carer Strategy for North Lanarkshire, 2024 to 2027, developed with carer-focused organisa�ons and carers locally. The role of carers in suppor�ng loved ones is immense and without it, the wider impact on Health and Social Care Services would be immeasurable. Key to our progress is the strong working rela�onship between carers, carer organisa�ons, and University Health and Social Care North Lanarkshire. It is crucial that we con�nue to build on this firm founda�on. Our strategy sets out: 1. Our shared aims - shared across carers, carer organisa�ons, Community and Voluntary Sector and University Health and Social Care North Lanarkshire. 2. Our shared approach - aimed at ensuring that adult carers and young carers across North Lanarkshire can con�nue to care, so long as they are willing and able, and with the best possible health and wellbeing. 3. Our shared ambi�on – that policy and strategy not only takes account of caring related need, but that carers shape, influence and inform these, as well as the supports and services that assist, enable, and empower carers. What is University Health and Social Care North Lanarkshire (UHSCNL)? We are a caring and empowering partnership, dedicated to working with our communi�es to enable people across North Lanarkshire to lead independent, fulfilling, and healthier lives. We have established partnership agreements with a range of organisa�ons. By enhancing and extending our work through these agreements we aim to develop sustainable, innova�ve, and prac�cal solu�ons to health and social care challenges that directly benefit our communi�es and our workforce. Page 35 of 270
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3 CONTENTS 1. What is the Carer Strategy? 2. Vision and strategic priori�es 3. The context for our strategy 4. Who is a carer? 5. What carers told us is important 6. Carers rights 7. Support for carers in North Lanarkshire 8. Our approach 9. Strategic inten�on overview 10. Specific ac�ons 2024-2027 11. Investment, disinvestment, and reinvestment 12. Reviewing the strategy Appendix 1: Carer organisa�ons in North Lanarkshire Appendix 2: Achievements and Progress 2019-2024 Page 36 of 270
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4 1. WHAT IS THE CARER STRATEGY? The University Health and Social Care North Lanarkshire (UHSCNL) Carer Strategy 2024 -2027 explains our strategic inten�ons and the ac�ons we intend to take over the next three years to: • Improve the lives of carers and young carers. • Deliver posi�ve outcomes for carers and cared for people. • Ensure carers are involved in individual plans. • Ensure carers are involved in influencing and shaping policy and strategy. Why do we need a new Carer Strategy? • To con�nue to respond to the changing needs of carers and young carers. • To ensure that strong partnership con�nues to underpin how we support carers across North Lanarkshire. • To fulfil our statutory requirement to update or develop a new Carer strategy every three years. (Our previous Carer Strategy ended in March 2024.) Who is the Carer Strategy For? • Carers living in North Lanarkshire. • Carers living in North Lanarkshire caring for people elsewhere. • Carers who live elsewhere but who care for a person or people living in North Lanarkshire. How did we create the Carer Strategy? • Through engagement sessions with carers – facilitated by North Lanarkshire Carers Together, Lanarkshire Carers Centre & Ac�on for Children Young Carers Project – we sought informa�on on areas for improvement. • Using informa�on from everyday engagement ac�vity that is embedded within our support of carers across North Lanarkshire. Page 37 of 270
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5 2. VISION & STRATEGIC PRIORITIES Our shared vision is that: • Across North Lanarkshire, Carers and Young Carers, as well as the people being cared for, feel valued, respected, listened to, and well supported. • Carers and Young Carers feel as well as possible and have scope to access their interests and a life beyond any caring responsibili�es. Our strategic priori�es 2024-2027 in support of this vision are: 1. Improve preventa�ve approaches, an�cipatory and future planning. 2. Improve communica�on with carers. 3. Ensure carers know their rights. 4. Promote Income maximisa�on and social inclusion. 5. Ensure carers can get a break from caring. 6. Con�nue to ensure carers are at the heart of policy, strategy, and service design. 7. Improve carer experience around hospital discharge. These priori�es aim to ensure that all carers are valued, recognised, and supported effec�vely. Cu�ng across our priori�es are guiding principles of: • ‘Ge�ng it right first �me’ from the outset, in a �mely and efficient manner, to ensure that carers can con�nue caring for their loved ones without undue burden. • Engagement and Par�cipa�on – Crea�ng meaningful opportuni�es for carers to shape and influence local plans, policies, strategies, support, and services. • Our approach is intended to promote carer inclusion, offer support to get involved in planning and working together, assessing what methods work, effec�ve communica�on, and evalua�ng impact. This is to inform and influence decisions on services and support. Page 38 of 270
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6 3. THE CONTEXT FOR OUR STRATEGY Na�onal Carers Strategy The Na�onal Carer Strategy, (Sco�sh Government, December 2022) looks to progress long-term changes to improve the lives of unpaid carers across Scotland. It was created a�er extensive engagement with carer organisa�ons, carer centres, local government, and unpaid carers themselves. It sets out the ac�on the Government will take across a range of policy areas to ensure its resources for carers are directed to where they will be most effec�ve. Across Scotland, the inten�on is that all local authori�es and carer-focused organisa�ons will ensure their local strategies fit with this wider strategy. As well as mee�ng the aspira�ons of carers locally, our Carer Strategy also needs to align with the aims of the Na�onal Carers Strategy and its five pillars, which are: • Living with COVID-19 • Valuing, Recognising and Suppor�ng Carers • Health and Social Care Support • Social and Financial Inclusion • Young Carers North Lanarkshire priori�es Our Carer Strategy must also align with the ambi�ons of The Plan for North Lanarkshire that outlines the long-term vision for our area. Several Ambi�on Statements within The Plan have a direct connec�on with our Carer Strategy. These are: Statement 13. Improve preventa�ve approaches including self-management and giving people informa�on and choice over supports and services. Statement 15. Encourage the health and wellbeing of people through a range of social, cultural, and leisure ac�vi�es. Statement 18. Ensure our digital transforma�on is responsive to all people’s needs and enables access to the services they need. Statement 19. Improve engagement with communi�es and develop their capacity to help themselves. Statement 20. Improve the involvement of communi�es in the decisions, and development of services and supports that affect them. Statement 24. Review and design services around people, communi�es, and shared resources. Statement 25. Ensure intelligent use of data and informa�on to support fully evidence-based decision making and future planning. Connec�ng our work to wider ini�a�ves Local Carer strategies must also meet a range of statutory requirements as set out in the Carers (Scotland) Act 2016, and link with other na�onal or local strategies and policies, such as: Condi�on specific or age-related policies or strategies; Childrens Plan; Self-Directed Support (SDS); Ge�ng It Right for Everyone (GIRFE); and Trauma Informed Prac�ce (TIP). Page 39 of 270
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7 Our priori�es to make our vision a reality Focus of strategic ac�on during plan period Na�onal Strategy pillars links Link to Plan for NL 1. Improve preventa�ve approaches, an�cipatory planning, and future planning. 2. Improve communica�on with carers. 3. Ensure carers know their rights. 4. Income maximisa�on. 5. Ensure carers can get a break from caring. 6. Con�nue to ensure carers are at the heart of policy, strategy, and service design. 7. Improve carer experience around hospital discharge. These priori�es aim to ensure that all carers are valued, recognised, and supported effec�vely. 1. Improving preventa�ve approaches, an�cipatory and future planning (and preven�ng crisis). 2. Improving communica�on with carers and their access to informa�on and advice. 3. Ensuring carers know their rights (and that Adult Carer Support Plans and Young Carer Statements are offered and progressed consistently). 4. Suppor�ng carers health and wellbeing (including Living with COVID-19). 5. Ensuring carers get a break from caring. 6. Ensuring carers, and people being cared for, have their income maximised. 7. Improving carer experience around hospital discharge. 8. Improving awareness of and access to Assis�ve Technology. Addi�onal ac�ons for specific groups of carers 9. Young Carers 10. Parent Carers 11. BAME Carers 12. LGBTQI+ Carers Pillar 2 Pillar 2 / 3 /4 Pillar 2 Pillar 1 / 3 Pillar 3 Pillar 2 / 4 Pillar 1 / 2 Pillar 2 / 3 / 4 Statement 13 / 25 Statement 13 / 19 Statement 13 / 19 Statement 15 / 24 Statement 13 / 15 Statement 15 / 19 Statement 13 / 19 / 20 / 24 Statement 13 / 18 / 24 Cu�ng across our priori�es are guiding principles of: • ‘Ge�ng it right first �me.’ • Engagement and par�cipa�on Pillar 2 / 3 / 4 Statement 19 / 20 / 24 Page 40 of 270
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8 4. WHO IS A CARER? The Carers (Scotland) Act 2016 defines a carer as an individual who provides or intends to provide care for another individual (the cared-for person). • A young carer is a carer who is under 18 years old or is 18 years and s�ll a pupil at a school. • An adult carer is a carer who is at least 18 years old but is not a young carer. A carer can be a spouse, partner, parent, sibling, or other family member, or in the case of young carers, be a son, daughter, friend, or any other rela�on. To be recognised as an adult carer or young carer: • You can be any age, gender, culture, race, or religion, can become a carer at any �me and might care for more than one person. • You might be providing care to a parent, child, sibling, other rela�ve, partner, friend, or neighbour. • The person you care for might have a long-term physical condi�on, learning disability, mental illness, frailty, sensory impairment, or issues with substance misuse. • You do not need to live at the same address as the person you care for. • You do not need to be claiming Carers Allowance. • There is no threshold amount of �me if you provide care & you are a carer. • You can be in employment or studying and s�ll be a carer. • The person you care for does not need to be receiving social care support. We know that many carers, par�cularly in the early part of their caring journey, may not self-iden�fy as carers. O�en, this is because they see themselves primarily as a spouse or family member, for example. Who is not a Carer? The Carers (Scotland) Act 2016 also explains that: • Parents of dependent children are not usually considered carers. However, parents of dependent children with addi�onal care and support needs can s�ll be considered carers. • Paid care workers and foster carers do not fall within the defini�on of ‘Carers’ under the Act. Why it is important to iden�fy carers? The early iden�fica�on of unpaid carers is a key part of our approach. This allows us to: 1. Introduce preventa�ve approaches at the right �me. 2. Develop an�cipatory approaches and early planning. 3. Support future planning. 4. Minimise the chances of crisis occurring. 5. Target responses and resources appropriately. Local carer strategies must set out plans for iden�fying carers, such as outreach and awareness raising ac�vity, communica�on and informa�on dissemina�on, and events for and about carers. Carers in North Lanarkshire Not every carer iden�fies as a carer or is captured within the na�onal Carer Census. This makes it difficult to state with any certainty how many carers we have within our area or the demography Page 41 of 270
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9 around who is caring for who. North Lanarkshire’s popula�on is currently around 341,000 people, and around 13,000 carers in our area are known to carer organisa�ons and/or to University Health and Social Care North Lanarkshire. However, we believe that there may be as many as 50,000 to 60,000 people delivering some form of unpaid care locally at present. This figure would be in keeping with wider research on unpaid caring, which suggests that two out of three people will be a carer at some point in their lives. Page 42 of 270
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10 5. WHAT CARERS TOLD US IS IMPORTANT THE IMPACT OF CARING Being a carer can o�en be rewarding and have posi�ve impacts, but it can also result in a range of challenges. During engagement with carers to inform this strategy, the following issues and concerns were highlighted: Impact on health and wellbeing. Carers reported: • Poor physical and/or mental health. • How the challenges facing NHS services (such as the unavailability of GPs and delays ge�ng to see consultants and specialists) severely impacts their health and cared-for people’s health. • Feeling exhausted and experiencing feelings of guilt. • Struggling with the expecta�ons of the person they care for who does not want to accept other support; reliance on carers and feeling intense pressure to keep going. Impact on finance. Carers reported: • Loss of income. • Addi�onal costs associated with caring. • Struggling financially affects their health. • The need for more financial support to look a�er their health and wellbeing and greater recogni�on of the financial impacts of caring. • Access to informa�on and advice, par�cularly around income maximisa�on, is crucial. Impact on rela�onships. Carers reported: • Social isola�on. • No scope to “switch off” from caring responsibili�es. • Valuing opportuni�es to meet with other carers and accessing peer support. Impact on life balance. Carers reported: • Balancing work, rela�onships, and other caring responsibili�es with main caring responsibili�es, is challenging. • Litle scope to have a life outside of caring. • Not having any “down �me” away from caring. RECOGNITION AND SERVICE RESPONSIVENESS Through engagement, carers shared how they would wish to be recognised and how services and support could be more responsive. Recogni�on • To be recognised as carers • To be supported �meously. • To have regular breaks from caring. • To be treated with dignity and respect. Page 43 of 270
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11 • To be listened to, first �me, every �me. • To be recognised as a parent carer. • To be properly involved in hospital discharge planning. Employment and Training • The importance of training and support, notably around caring for someone with Demen�a, Au�sm, or other neurological condi�ons. Future planning • Wan�ng to be involved in shaping policy, strategy and services and recogni�on that to be able to par�cipate in this may require replacement care. • Needing to be properly involved in hospital discharge planning. • Worrying about the future. Informa�on, advice, and support. • Needing beter understanding of what is available to carers from community support op�ons. • To have responsive, flexible support when needed. • Ge�ng support when it is needed. • Consistency when engaging with Social Work; beter con�nuity, and to not feel they must fight for the support they require. Parent carers reported: • Feeling that Parent Carers are not listened to in the decisions being made for their children. • Concerns surrounding their child not being listened to. • Needing to bring in third par�es before they are taken seriously. • Needing their role as carers recognised within Educa�on. Engagement Sessions with carers from Minority Ethnic communi�es and LGBTQI+ Carers highlighted commonality with all of the areas noted above but included some specific concerns. For Minority Ethnic carers: • Services and support are not always culturally sensi�ve and can lack understanding of the needs of Minority Ethnic communities. • “Minority Ethic” is not one homogenous group and approaches need to be tailored to individual circumstances. • Lack of culturally appropriate support for older adults in the community adds to caring responsibili�es. • Many Ethnic Minority carers, par�cularly women, do not feel recognised, understood, and valued within communi�es and families; the caring role is taken for granted and considered a family duty. • Anxiety around COVID con�nues, with many older adults struggling to par�cipate in ac�vi�es and gatherings because of this. For LGBTQI+ carers: Page 44 of 270
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12 • Recogni�on that carer needs and those of the person they care for may require a specific approach, or specific support. • LGBTQI+ is not a single homogenous group. Greater understanding that approaches are appropriate and unique to individual circumstances. Working Carers • Hopes that the new Carers Leave Act, with regula�ons published and implementa�on scheduled in April 2024, will have a posi�ve impact on some of the challenges they face. Page 45 of 270
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13 6. CARERS RIGHTS The Carers (Scotland) Act 2016 outlines the rights of carers in Scotland. It explains the specific du�es and powers that each local authority must follow in order to help improve the health and wellbeing of carers, so that they can con�nue to care, if they so wish, are able and willing to provide care and have a life alongside caring. The key aspects of the Act for Local Authori�es, NHS and Health and Social Care Partnerships are: • To prepare an Adult Carer Support Plan (ACSP) or Young Carer Statement (YCS) for any carer/young carer who requests one, and to offer one to anyone who appears to be a carer. • To provide support to carers based on need which meets our eligibility criteria. • To help carers put arrangements in place for the provision of care to the cared-for person in emergencies. • To establish and maintain an informa�on and advice service for carers. • To consider whether any support should include or take the form of a break from caring. • To produce a Short Break Services Statement. • To involve carers in the planning of discharge from hospital of the cared-for person • To adhere to �mescales for the prepara�on of ACSPs/YCSs for carers of people who are terminally ill. • To prepare a local carers strategy. Our strategy sets out how we are responding to these requirements and how we will con�nue to support carers through a range of services and supports. Adult Carers Support Plan (ACSP) We will offer an Adult Carer Support Plan (ACSP) to any adult we iden�fy as a carer or any adult who requests one, in line with the statutory duty to do so. The ACSP provides a framework for iden�fica�on of adult carers’ individual needs and any supports required to help achieve personal outcomes. In North Lanarkshire, the responsibility to offer an ACSP sits with Lanarkshire Carers Centre and Social Work. Health staff also have a responsibility to offer an ACSP to all carers they encounter. Young Carers Statement (YCS) Young carers iden�fied by support agencies or who self-iden�fy as Young Carers are offered a Young Carer Statement through North Lanarkshire Young Carers which is the delegated support provider responsible for comple�on and review of YCSs. Each YCS iden�fies the caring role carried out and whether this role is manageable, safe, appropriate, and what addi�onal support is required. Eligibility Criteria We have prepared our eligibility criteria for carers using guidance issued by the Sco�sh Government. This is based on the impact that caring has on the following aspects of the carer’s life: • Health and wellbeing • Rela�onships • Living environment • Employment and training • Finances Page 46 of 270
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14 • Life balance In North Lanarkshire eligibility is based on Adult Carer Support Plans and Young Carer Statements and the iden�fied level of need. We are increasingly moving towards a “what would help” approach as opposed to “eligibility.” Waiving of charges Support and/or services to meet caring related needs iden�fied within an Adult Carer Support Plan cannot be charged for. Any charges must be waived. Hospital Discharge NHS Lanarkshire has made a commitment to involve carers in the discharge planning of the person they care for, in line with this requirement as s�pulated in the Carers (Scotland) ACT 2016. Work is ongoing in partnership with local carer organisa�ons to provide an informa�on service and direct support for carers throughout the hospital discharge process. Breaks from caring The Scottish Government has intimated an intention to pass legislation ensuring that carers will have a legal right to a break from caring. The UK Government has progressed a Bill enabling carers in paid employment to have five days unpaid annual leave from caring. Our approach to breaks from caring is set out within our Short Breaks Services Statement, which complements this strategy. Situation Suggested Response Cared for person can cope independently enough that the Carer can take a break without the need for support from services or that a family break without the need for any additional support is possible Self-help (no service responses are required around Carer breaks) Also consider whether preventative or anticipatory planning is required? Is a Future Plan in place? Cared for person requires support so that the Carer can have a break. Wider family and friends can assist with this or a family break without the need for any further support is possible Self -help (no service responses are required around Carer breaks) Also consider whether preventative or anticipatory planning is required? Is a Future Plan in place? For the scenarios above, it is suggested that the Carer identifies that they can self -manage breaks without support or service input, in line with the principles of independence, self-reliance and self-help. This approach should also mean that resources can be targeted towards those Carers with greater levels of need as suggested in the scenarios below. Page 47 of 270
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15 At present, this is an outline approach only. Each situation will be unique. There may be different options or ways of approaching this area. The Carer Strategy cannot be prescriptive and simply reflects that bespoke solutions, according to the individual circumstance of the Carer and cared for person should be the default position. Engagement and Participation with Carers and local Carer Organisations will continue to help inform this. Cared for person may need to summon assistance if the Carer is not present and there is no family or friends support available. Person’s own technology (mobile phone, Portal, Facetime and so on) or services responses such as Community Alarm Service or other Assistive technology options (for example remote support) Cared for person requires in person support and Carer requires breaks, and there is no wider support from family or friends available Carer Breather (North Lanarkshire Carers Together) A test of change Carer Sitter demonstration project is also being planned for later in 2024 – 2025 and this may offer further options, should the demonstration project prove successful. Cared for person requires in person support and Carer requires breaks and there is no support from family or friends available Flexible short break fund (Lanarkshire Carers) Carer Breaks (Lanarkshire Carers) Young Carer Breaks (Young Carers Support Project) Cared for person requires in person support and Carer requires breaks. Support Services in place – Integrated Day Service, Locality Support Service, agreed respite and so on Cared for person requires in person support and Carer requires breaks. Carer Budget following an Adult Carer Support Plan being progressed and identifying unmet need. Carer Budgets can be across Low, Moderate, Significant or Critical Carer need, dependent on individual circumstance. Cared for person may be in receipt of an Individual Budget Page 48 of 270
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16 7: SUPPORT FOR CARERS IN NORTH LANARKSHIRE University Health and Social Care North Lanarkshire As highlighted on Page 1, we are a caring and empowering partnership, dedicated to working with our communi�es to enable people across North Lanarkshire to lead independent, fulfilling, and healthier lives. The Sco�sh Government has set out nine na�onal health and wellbeing outcomes that we, along with every other health and social care partnership in Scotland, is working towards. Commissioned Carer Organisa�ons University Health and Social Care North Lanarkshire currently commissions three carer organisa�ons to ensure that carers and young carers are supported, that there is the provision of an informa�on, advice and signpos�ng service and that carer interests are represented. These organisa�ons are: • Lanarkshire Carers Centre • North Lanarkshire Carers Together • Ac�on For Children Young Carers Project All three of these organisa�ons have carer representa�on on their management board or commitee and feed into the Carer Support Network and North Lanarkshire’s Integrated Joint Board. This helps ensure that carer voices are heard, and can influence and shape policy, strategy, and service development. Lanarkshire Carers Centre www.lanarkshirecarers.org.uk Lanarkshire Carers provides informa�on, advice and a range of direct support and services which can help carers maintain or improve their quality of life and con�nue to care. Its services are open to all carers aged 18 years and older living in Lanarkshire. Its Short Breaks Bureau helps carers to take breaks from caring, while its Carer Training Programme can help carers to manage the caring role, understand specific condi�ons, and look a�er their own health and wellbeing. North Lanarkshire Carers Together www.carerstogether.org North Lanarkshire Carers Together provides a range of informa�on, advice, and signpos�ng services. Its Carer Breather helps carers to access regular short breaks from caring. A dedicated Equali�es post focuses on ensuring that under-represented groups or communi�es have a voice. Its carer advocacy work helps carers to access advocacy support (dis�nct from any advocacy provision for supported people). Ac�on For Children North Lanarkshire Young Carers www.ac�onforchildren.org Ac�on For Children North Lanarkshire Young Carers raises awareness, iden�fies, and provides direct support to children and young people who look a�er or help to look a�er someone in their family who is unwell or disabled, including children caring for parents who have mental health or substance misuse problems. Page 49 of 270
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17 OTHER GROUPS OR ORGANISATIONS PROVIDING SUPPORT TO CARERS There is a range of Community and Voluntary Sector organisa�ons which provide a range of support, including condi�on-specific and age-related support to carers, whether directly or indirectly. These organisa�ons form part of the Carer Support Network. The list of organisa�ons includes, but is not limited to: PAMIS Family Support PAMIS | Promo�ng a more inclusive society Provides support to families caring for someone with profound and mul�ple disabili�es. HOPE for Au�sm Hope for Au�sm – Providing support across Lanarkshire Provides support to people with Au�sm as well as to family members and carers. Dea�lind Scotland www.dbscotland.org.uk Provides sign guide interpreters for people with dual sensory impairment, as well as support to family members and carers. Alzheimer’s Scotland We are Scotland's demen�a charity (alzscot.org) Provides a post diagnos�c support service and support to family members and carers. North Lanarkshire Disability Forum (NLDF) www.nldforum.org.uk The lead agency locally facilita�ng the Engagement and Par�cipa�on of supported people (including carers). Voluntary Ac�on North Lanarkshire (VANL) www.voluntaryac�onnorthlanarkshire.org The lead agency for the Community Solu�ons programme, whereby people, including carers and cared for people can be supported by a diverse range of community or voluntary sector organisa�ons. Ge�ng Beter Together (GBT) www.shotshealthyliving.com Offers a post hospital discharge support service, and wider carer support op�ons to support family members and carers. Playpeace www.playpeace.org.uk Offers parental peer support and ac�vi�es for children with addi�onal support needs. Page 50 of 270
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18 OTHER SUPPORTS FOR CARERS Making Life Easier (MLE) This is an online service for people experiencing difficul�es with everyday ac�vi�es, including carers. It offers informa�on, advice and direct access to services and support, and can assist people with equipment solu�ons, many of which can be ordered online direct from its equipment service. Assis�ve Technology A range of specialist equipment technology can support carers by helping the person they care for live at home independently or alert the carer if help is needed. The range of technology available from Health and Social Care includes falls sensors, bed monitors, fire safety sensors and GPS locators. Care Opinion Offers supported people and carers an online pla�orm with which to provide anonymised feedback on their experiences of care and support. Page 51 of 270
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19 8. OUR APPROACH Our approach is based on the principles of promoting independence, self-help, enablement, and empowerment for carers in the community. We aim to support carers to maintain their autonomy and decision-making capabilities, enabling them to care for their loved ones while also prioritising their own well-being. By providing resources, information, and guidance, we seek to empower carers to access the support they need and navigate the caring journey with confidence. We recognise the strength and resilience of carers and encourage self-care practices that enhance physical, emotional, and mental well-being. Through this and peer support networks, carers can learn from each other, share experiences, and build a sense of camaraderie. We are committed to enabling carers to fulfil their caring responsibilities effectively and efficiently. By offering training, skill development opportunities, and practical assistance, to augment carers’ existing experience and expertise, carers are equipped with the tools and knowledge they need to navigate complex care situations and engage with health and social care services with confidence. At the core of our approach is the empowerment of carers to advocate for themselves and their loved ones, and to actively participate in decision-making processes that affect their lives. We strive to create a supportive environment where carers are respected, valued, and empowered to voice their needs, concerns, and aspirations, leading to positive outcomes for both them and the individuals they care for. Engagement and Participation of carers Engagement and participation underpin our approach and all of our strategic priorities and actions. We aspire to improve the ways we consult with, and involve, carers on maters which affect them. We have iden�fied five levels where outcomes need to be considered across the engagement and participation activity that takes place. These are: 1. Individual Level - Where carers and people being cared for can use lived experience, self- appraisal, and engagement through options such as feedback, surveys, and focus groups, to self-identify where support for them as an individual carer and/or to the cared for person is needed, how it is provided and in what way provision is making a positive difference. 2. Carer Support Service and/or Project Level - Where carer organisations can use engagement processes such as carer feedback, case studies, performance management and performance reporting information to discern and measure the impact and efficacy of carer support approaches. 3. Organisational Level - The organisational aim of University Health and Social Care North Lanarkshire is that people remain as independent as possible, for as long as possible, are more socially included/connected and appropriately supported where necessary. Page 52 of 270
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20 The One Plan for North Lanarkshire through several of its Ambition Statements, Local Outcome Improvement Plans, and Carer strategies, as well as the Self-Directed Support (Scotland) Act and Carers (Scotland) Act, all set out desired organisational outcomes that we work to. 4. Partnership Level - This is a shared outcome working towards people being able to maintain independent living for longer. Carers play a key role in this, in terms of supporting people at home, in their local community and in ensuring that those they care for remain as independent as possible. Carers can also lead on or inform preventative approaches and anticipatory planning. 5. National Level - Each Integration Authority, including University Health and Social Care North Lanarkshire is required to publish an annual performance report which sets out how the national health and wellbeing outcomes are being improved. Page 53 of 270
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21 9: STRATEGIC INTENTION OVERVIEW The focus of our strategic ac�ons across the three years of the Carers Strategy 2024 -2027 are as follows and detail of how we will progress these are provided in the next sec�on ‘Specific Ac�ons’. These priority area ac�ons will help to ensure that all carers are valued, recognised, and supported effec�vely. 1. Improving preventa�ve approaches, an�cipatory and future planning (and preven�ng crisis). 2. Improving communica�on with carers and their access to informa�on and advice. 3. Ensuring carers know their rights. 4. Suppor�ng carers health and wellbeing 5. Ensuring carers get a break from caring. 6. Ensuring carers, and people being cared for, have their income maximised. 7. Improving carer experience around hospital discharge. 8. Improving awareness of and access to Assis�ve Technology. 9. Influencing and shaping policy and strategy. Addi�onal ac�ons for specific groups of carers: 10. Young carers 11. Parent carers 12. BAME carers 13. LGBTQI+ carers All these ac�ons will be tackled through a shared approach across University Health and Social Care North Lanarkshire and carer organisa�ons. Page 54 of 270
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22 10: SPECIFIC ACTIONS 1. IMPROVING PREVENTATIVE, ANTICIPATORY AND EMERGENCY PLANNING Why this is a priority: Preventa�ve, An�cipatory and Emergency Planning is about taking a person-centred, thinking ahead approach. It gives carers opportuni�es to consider their op�ons and ‘plan for the future.’ Improving this area is about ensuring that the right conversa�ons take place with health and social care professionals and that carer preferences are explored and responded to. It is also about trying to prevent carers from having to repeat conversations with different organisations about their circumstances. To be effective in this area we also need to identify carers before they present at a point of crisis. We estimate that only around one in four carers is currently known to services in North Lanarkshire. Specific actions: 1. Support the development of a comprehensive system to proac�vely iden�fy and assess carers, including regular screenings, assessments, and follow-ups to ensure all carers’ needs are captured effec�vely. 2. Build in a bespoke offer for training sessions, workshops, and resources to empower carers in developing and implementing their Preventative, Anticipatory, and Emergency Plans. This can include practical information and tools tailored to the specific needs of carers and ensuring that carers are aware of the local arrangements regarding Adult Carer Support Plans and Young Carer Statements. 3. Continue with our collaborative approach to provide guidance and support in creating these plans, ensuring they align with the care needs of the cared-for individual and are regularly reviewed and updated, as necessary. 4. Utilise technology and digital platforms, and explore innovative ways to utilise technology, such as mobile apps or online platforms, to facilitate the development and sharing of Preventative, Anticipatory, and Emergency Plans among carers and care professionals. This can improve accessibility and communication, making the planning process more efficient and effective. What success will look like. • More carers will have Preventative, Anticipatory and Emergency Plans in place through reviews, adequate information on supports and services, identification, and assessment, which can help in better preparation for any unexpected situations and improve overall well- being and quality of care provided. • There will be a reduction in the numbers of carers coming into crisis. • An increasing number of carers, and cared for people, will be aware of, and using, assistive technology (digital solutions) as an integral part of caring and support arrangements. Page 55 of 270
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23 2. IMPROVING COMMUNICATION WITH CARERS AND THEIR ACCESS TO INFORMATION AND SUPPORT Why this is a priority: Effec�ve communica�on is essen�al in ensuring carers receive high-quality support that is tailored to their unique needs. Access to the right information, at the right time and in the right place, is crucial. Specific actions: 1. University Health and Social Care North Lanarkshire will continue to commission carer organisations to provide information and support: 2. In addition to commissioned services, University Health and Social Care North Lanarkshire has invested in PAMIS, HOPE for Autism, Alzheimer’s Scotland, and North Lanarkshire Disability Forum to provide condi�on specific informa�on and support to carers. What success will look like. • Carers will be able to access the right information and advice for their particular situation at the right time and place. Page 56 of 270
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24 3. ENSURING CARERS KNOW THEIR RIGHTS Why this is a priority: Carer rights and en�tlements mater to carers, not just because this helps them to feel valued and recognised for what they do, but because it is a key factor in ensuring carers receive the support they need. Understanding rights also raises awareness of choices around caring. Specific actions: 1. Con�nuing to inform carers of their right to an Adult Carer Support Plan or Young Carer Statement. 2. Expand the range of resources, such as informa�onal leaflets, online resources for staff and people, share workshops and training, that specifically outline carers' rights, en�tlements, and available support services. 3. Con�nue to support dedicated carer advocacy to assist carers in naviga�ng their rights and en�tlements, advoca�ng on their behalf when needed, and suppor�ng carers in accessing relevant support services. This can include providing individualised guidance on how to assert rights effec�vely. 4. Con�nue to support celebratory pla�orms for carers to connect with each other, share experiences, and support one another in understanding and exercising their rights. 5. Build on exis�ng partnerships with community organisa�ons, and advocacy groups to enhance carers' knowledge and awareness of their rights. What success will look like. • Carers understand what they are en�tled to. • Carers are enabled to manage their caring role and are able and willing to con�nue with their caring role. • Carers feel valued and respected by services, and are listened to, understood, and involved in individual planning, support, and services with the person that they care for as well as for themselves. Page 57 of 270
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25 4. SUPPORTING CARERS HEALTH AND WELLBEING (including Living with COVID) Why this is a priority: Supporting carers’ health and wellbeing is a key focus for statutory services, commissioned services, and others, as it is essential to the ability to continue to provide care. It is important to both carers and to the people they care for. The strain of caring can impact each carer differently; recognising that every carer has unique and specific needs with regard to maintaining their health and wellbeing is important. Many carers continue to live with the impact of COVID and require support to rebuild confidence and to feel safe to re-engage with wider communi�es and services. Specific actions: 1. Increase awareness and encourage engagement of carers who are not currently affiliated with carer organisations in North Lanarkshire. 2. Greater visibility of resources, accurate signposting, information, and advice, regardless of the carer’s entry point to carer support. 3. Continuing to support the provision of carer health checks and counselling/wellbeing services, on demand wellbeing library and health focused carer training. 4. Con�nuing to meet carers, and carer organisa�ons, regularly to hear current concerns regarding COVID and provide up-to-date informa�on. 5. Suppor�ng carers to rebuild confidence and feel safe to re-engage with wider communi�es and services. 6. Ensuring that any carers who require PPE, con�nue to have access to it. What success will look like. • Carers feel healthy and well enough to manage their caring role, have support as needed and can access opportuni�es alongside or out with caring. • Carers are able and willing to con�nue with their caring role. • Carers feel confident and supported to protect themselves from COVID, to re-engage with their communi�es, and to are supported to recover from the nega�ve impacts of COVID. Page 58 of 270
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26 5. ENSURING CARERS GET A BREAK FROM CARING Why this is a priority: Many carers may struggle to maintain their health and wellbeing without access to regular and substan�al breaks from their caring responsibili�es. Breaks from caring are important for sustaining caring rela�onships and ensuring that carers have �me for themselves and their interests. Specific actions: Our approach to breaks from caring is set out within our Short Breaks Services Statement, which complements this strategy. 1. Continue to support and develop individual choice and control regarding breaks, for both carer and cared for person. 2. Build responsiveness to ‘here and now’ situations which can arise at extremely short notice. 3. Carers will have someone to talk to through being connected to services and support. What success will look like. • Carers will be able to have breaks from caring, whether through natural supports, short break options or through individual budgets, where appropriate. • Individual carers conversations lead to personalised break from caring. • Widening the understanding of what a carer break can look like: ‘regular time for me,’ ‘small pockets of respite.’ Page 59 of 270
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27 6. ENSURING CARERS, AND PEOPLE BEING CARED FOR, HAVE THEIR INCOME MAXIMISED Why this is a priority: For most carers there is a monetary impact to caring. Income maximisa�on enables and empowers carers to self-fund costs, such as travel and ac�vi�es, and to meet addi�onal or ‘hidden’ costs associated with caring, such as increased u�lity bills or food costs. Specific actions: 1. Embedding income maximisation as part of every new Community Care Assessment and making it a consistent approach. 2. Every Adult Carer Support Plan, or Young Carer Statement to consider what financial help and support may be available. 3. Delivering awareness raising and training to UHSCNL staff and wider staff teams to ensure that carers and people being cared for have their income maximised. 4. Carer organisa�ons con�nue to offer a wide range of other financial and non-financial supports to help alleviate hardship, as well as informa�on, money advice and signpos�ng. What success will look like. • Carers will be aware of the range of the financial support or assistance available to them. • All carers locally will be aware that support put in place to meet caring related needs as identified in an Adult Carer Support Pan, cannot be charged for. • Carers will experience better financial inclusion and less hardship. • Through income maximisation, carers can enjoy greater social inclusion. Page 60 of 270
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28 7. IMPROVING CARER EXPERIENCE AROUND HOSPITAL DISCHARGE Why this is a priority: O�en a hospital admission can mark the beginning of a changing, increased, or new caring role. The right informa�on, advice, and support can help to reduce the pressure and anxiety o�en faced by carers when this occurs, and lead to more successful and posi�ve discharges from hospital. Specific actions: 1. Better and earlier discharge planning that includes carers. 2. Increased partnership working from all organisations involved in discharge. 3. Increased capacity for organisations that actively support carers at discharge and in the community. 4. A reduction in instances of carers being informed of discharge at short notice. 5. Evaluation of carer hospital discharge payment scheme 6. Implementation of discharge passport. 7. Increased feedback and engagement from carers to inform discharge improvements. 8. Continued support of hospital linked carer support workstream and its carer support staff linked to the three acute hospital sites in Lanarkshire. What success will look like. • Carers and cared for receive the right support at the right time. • Reduction in complaints. Page 61 of 270
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29 8. IMPROVING AWARENESS OF AND ACCESS TO ASSISTIVE TECHNOLOGY Why this is a priority: Technology solu�ons enable and empower people to be as independent as possible, for as long as possible, as well as reducing risk. For example, assis�ve technology could support a carer to safely leave the cared for person for periods of �me, secure in the knowledge that support could be summonsed, if required. Crea�ng greater independence can help to reduce levels of stress and strain on carers and assis�ve technology can play a key role in improving carers’ health and wellbeing. Specific ac�ons: 1. Con�nue to help carers and cared for people to use their own technology in ways that can support their independence and individual needs. 2. Con�nue to promote the support and services provided by University Health and Social Care North Lanarkshire’s Assis�ve Technology Team, for example through atendance at carer events and providing promo�onal material or merchandise. 3. Con�nue to promote the ‘think technology first’ message with partner agencies and stakeholders. 4. Reduce barriers to accessing assis�ve technology support. What success will look like. • Carers and cared for people will be aware of the range of technology options aimed at supporting independence and/or minimising risk. • A significant increase in the number of people using technology as part of their support arrangements. • Carers will be able to access Assis�ve Technology, following an ACSP or assessment when required. Carer services, carers and cared for people will be able to request this directly. • Wait �mes for equipment will be reduced, so reducing the number of delayed discharges. Page 62 of 270
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30 9. YOUNG CARERS Why additional specific actions are required for this group: For young carers, the experience of providing care can be stressful and isola�ng. For many it can nega�vely impact their experience in educa�on. It is par�cularly important to support young carers so they can s�ll enjoy being young, have a beter chance of succeeding in all parts of their lives, and be able to pursue their dreams outside of caring. Specific actions: 1. Continue to work within schools to improve the identification of young carers and ensure that they are aware of their entitlement to a Young Carer Statement. 2. Con�nue to review the support for young carers regarding the different routes to further and higher educa�on and employment. 3. Con�nue to develop transi�onal support, building on the exis�ng links with New College Lanarkshire, Skills Development Scotland, and Community Jobs Scotland. 4. Improve support of young carers with hospital discharge. (Young carers tend to be unseen regarding the discharge of cared for individuals.) 5. Through increased partnership working, innovative thinking and development, implement ways to better reach young carers from ethnic minorities. 6. Continue to deliver awareness training to UHSCNL staff, to improve recognition and support of young carers. 7. Continue to provide a range of supports, including group work programmes, one to one supports, short breaks, and in-school support, and respond in a flexible way to the issues that young carers identify. 8. Continue to ensure that the views of young carers are built into the planning and shaping of support and services and ensure links with the North Lanarkshire Engagement and Participation Strategy. What success will look like. • As far as possible, young carers will enjoy a childhood like other young people and children. • Young carers will be well supported, able to understand and cope with their caring responsibili�es and have access to the right support, at the right �me and place, should circumstances change. • Posi�ve des�na�ons become more achievable through educa�onal support. Page 63 of 270
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31 10. PARENT CARERS Why additional specific actions are required for this group: Parent carers have to balance the role of a parent with mee�ng their child’s needs as a carer. They are less likely to see themselves as a carer because looking a�er their child is something they would naturally do, regardless of the circumstances. Making the dis�nc�on between being a parent or a parent carer is important, so that there is recogni�on of any need for addi�onal support. Specific actions: 1. Implement a dedicated support framework that recognises and addresses the unique challenges and needs of parent carers. This framework should provide targeted information, resources, and services that cater to the dual role of being a parent and a carer. 2. Coordinate with carer organisations awareness campaigns and training sessions to educate UHSCNL staff, as well as parent carers themselves, about the distinction between being a parent and a parent carer. The emphasis should be on the importance of identifying parent carers and ensuring that parent carers are aware of additional support options. 3. Support the parent carer working group comprised of parent carers to provide insights, feedback, and recommendations on how best to support this specific group. Collaborate with parent carers in decision-making processes and support involvement in the development and evaluation of support initiatives. 4. Regularly review and assess the impact of support initiatives for parent carers, including the outcomes of the established working group. Ensure that any changes in circumstance, learning and recommendations can feed into the Carer Strategy to keep it “current,” as well as to continuously improve and tailor support for parent carers. What success will look like. • Parent carers feel valued and respected by services. • Parent carers are iden�fied as carers, should that be their choice, have a voice, are listened to, understood, and involved in individual planning, support, and services with the person that they care for as well as for themselves. Page 64 of 270
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32 11. MINORITY ETHNIC CARERS Why additional specific actions are required for this group: Carers from ethnic minori�es can experience addi�onal barriers and challenges. Many carers from minority ethnic backgrounds do not recognise themselves as carers due to cultural expecta�ons; the term “carer” does not exist in some cultures. People in these circumstances are also more likely to report negative experiences of trying to access help and support. Minority ethnic does not describe a single homogenous group, and person or situation specific support should be tailored to individual needs. Specific actions: 1. Working with partners to identify, engage, and support carers from Minority Ethnic communities. 2. Awareness raising and training for UHSCNL staff, wider staff teams and consideration of awareness raising through corporate communications. 3. Seek input from carers from Minority Ethnic communities regarding the barriers faced and the support required to overcome these. 4. Greater recognition of cultural differences and their implications. 5. Support tailored to individual needs. What success will look like. • Carers from Minority Ethnic communities will be able to access the range of carer support options available to other carers, with reasonable adjustment to reflect any specific needs. This could include, and is not limited to, translation services, interpreters, recognition of English as a second language, culturally sensitive support, and other considerations identified as barriers by carers from Minority Ethnic communities. Page 65 of 270
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33 12. LGBTQI+ CARERS Why additional specific actions are required for this group: LGBTQI+ carers face unique challenges, both prac�cal and emo�onal, in their caring role. They may experience addi�onal stress and strain because of worries about others’ reac�ons, or even discrimina�on, when seeking support and accessing services. LGBTQI+ carers can experience increased isola�on, as well as losing aspects of their LGBTQI+ iden�ty as a result of the demands of their caring role. Specific actions: 1. Training programmes for healthcare professionals, social workers, and service providers to increase awareness of equality issues in relation to caring and enhance their cultural competence in addressing the needs of LGBTQI+ carers. 2. Increasing visibility of LGBTQI+ carers in awareness campaigns and information materials regarding caring. 3. Expanding support services to reach diverse LGBTQI+ communities, considering factors such as age, ethnicity, and gender identity. 4. Implementing strategies to address and reduce stigma and discrimination faced by LGBTQI+ carers. 5. Promoting collaboration between LGBTQI+ organisations, carer support groups, and health and social care to create a comprehensive and integrated support network. What success will look like. • Increased awareness and understanding of the unique challenges faced by LGBTQI+ carers among healthcare professionals, service providers, and the broader community. • Better availability of accessible and inclusive support services tailored to the specific needs of LGBTQI+ carers. • Improved mental health outcomes for LGBTQI+ carers, including reduced stress and increased well-being. • An empowered and engaged LGBTQI+ carer community that actively participates in decision- making processes. • Positive changes in policies and legal frameworks that protect the rights and well-being of LGBTQI+ carers. Page 66 of 270
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34 10. INVESTMENT, DISINVESTMENT AND REINVESTMENT Given the widespread cost of living crisis and the financial pressures across Health and Social Care, the approaches described above may also require elements of disinvestment, to free up resources for reinvestment. In the lead up to the Carer Strategy 2024 -2027 there has been further investment in: • PAMIS: Family Support Service (expanded service commencing April 2024) • North Lanarkshire Carers Together: Equali�es post • North Lanarkshire Carers Together: Carer Breather • Lanarkshire Carers Centre: Carer Outcomes Grant and Flexible Support Fund • Lanarkshire Carers Centre: CarerSpace • Hospital Discharge Carer Support Scheme • Alzheimer’s Scotland: Post Diagnos�c Support Service (Demen�a) • Au�sm related support through the Au�sm Network • HOPE for Au�sm: extended contract. Investment in carer support around both Demen�a and Au�sm is a direct consequence of these being iden�fied in both the 2021 and 2023 Carer Census as being amongst the highest caring related condi�ons. A third priority caring area is around Frailty. North Lanarkshire is a pathfinder area in a na�onal programme; Ge�ng it Right for Everybody (GIRFE), with findings from this work, directly influenced by people with lived experience, expected to help influence and shape our future approaches. Page 67 of 270
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35 11. REVIEWING THE CARER STRATEGY Our Carers Strategy has an outcome focused approach. We need to ensure that in se�ng out a 3-year approach to supporting carers and cared for people, that our strategy can still be flexible enough to respond to changing circumstances without going off-course due to such changes. We need flexibility that is informed by two interconnected strands: 1. Professional expertise and knowledge, analysis, data, and research. 2. Carer experience, community knowledge, and the involvement of both carers and people being cared for. Both strands must be used to achieve impact, then assess that impact - the difference that we make; and also help us understand where that impact came from. Both approaches must also reflect the diversity of voices, backgrounds, and perspectives. Progress will be reviewed through: • The governance structure and processes of the Integrated Joint Board. • The Carers Oversight Group, which has a key role in monitoring impact. • Introducing a carer led group to support the work of the Carers Oversight Group The Strategy should also be formally reviewed at the midway point. • All stakeholders, including individual carers, and cared for people, carer organisa�ons, and wider organisa�ons with a direct, or indirect role in suppor�ng carers, can have a say in determining how things are working for them. Page 68 of 270
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36 APPENDIX 1: Suppor�ng carers in North Lanarkshire Commissioned Carer Organisa�ons University Health and Social Care North Lanarkshire currently commissions three carer organisa�ons • Lanarkshire Carers Centre • North Lanarkshire Carers Together • Ac�on For Children Young Carers Project to ensure that carers and young carers are supported, that there is the provision of an informa�on, advice and signpos�ng service and that carer interests are represented. Lanarkshire Carers Centre www.lanarkshirecarers.org.uk Lanarkshire Carers Centre provide informa�on, advice and a range of direct support op�ons and services which can help carers maintain or improve their quality of life and to con�nue to care. Services are open to all carers aged 18 years and older living in Lanarkshire. • Delivers prac�cal and emo�onal support to individuals and groups, building trusted rela�onships with carers that help them to iden�fy and address their support needs and make sure they know their rights. • Offers outreach and locality support and works in partnership with a range of organisa�ons and services that also help carers. • Carer Support Workers are co-located in social work locali�es and health se�ngs and the staff team works from Lanarkshire Carers Centre in Airdrie and also Hamilton. • Support is also provided to carers from Minority Ethnic communi�es, Young Adult Carers aged 18–25 years old and other groups of carers who are under-represented. • Its Short Breaks Bureau provides a range of informa�on and support for carers to take a short break from caring, including iden�fying short break opportuni�es that meet their needs and circumstances, direct carer grant funding which may assist carers to take a short break from caring or access other things that can help reduce isola�on and exclusion, informa�on and guidance with arranging a short break and other useful resources for carers. • Accesses funding and other ini�a�ves to support carers in financial hardship due to having a reduced or limited income, par�cularly with rising cost-of-living pressures. [Lanarkshire Carers Centre is the local delivery partner through Shared Care Scotland for funding provided by the Sco�sh Government.] • Works with an independent partner to provide carers access to counselling sessions and wellbeing support. • An extensive Carer Training Programme provides in-person, online and some hybrid op�ons to suit carers circumstances, which enables carers to meet together, share experiences, develop connec�ons/friendships and access self-managed peer support, o�en out with the par�cular carer training ac�vity. Page 69 of 270
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37 North Lanarkshire Carers Together www.carerstogether.org North Lanarkshire Carers Together provide a range of carer informa�on, advice, signpos�ng services as well as a campaigning remit. • Carer Breather is an innova�ve approach to ensure that carers can access regular short breaks from caring. • A dedicated Equali�es post aims at ensuring that under-represented groups or communi�es have “a voice.” • A Carer Advocacy worker ensures that carers can access advocacy support that is dis�nct from any advocacy provision for supported people. • A Recogni�on to Rights Development Programme for carers equips par�cipants with knowledge, skills, and tools to help shape and influence policy and strategy related to caring. Ac�on For Children North Lanarkshire Young Carers Project www.ac�onforchildren.org Ac�on For Children North Lanarkshire Young Carers Project offer a support service, including short breaks for young carers across North Lanarkshire. Carers Oversight Group University Health and Social Care North Lanarkshire facilitates a group mee�ng with the three commissioned carer organisa�ons to discuss and agree approaches to suppor�ng carers, whether through direct carer support carer informa�on, advice and signpos�ng services, and carer advocacy. Carer Support Network Comprises a broader range of carer organisa�ons and other organisa�ons involved in the provision of direct carer support or indirect carer support, ensuring that the carer ‘voice’ is represented and that any planning/ac�ons taken are in line with iden�fied carer outcomes. Integrated Joint Board (IJB) Carer representa�on is a key facet of the Integrated Joint Board. Carer Support Groups All three commissioned carer organisa�ons host a range of carer groups and act as a conduit to ensure that caring related issues can be fed into the Carer Oversight Group, Carer Support Network or to University Health and Social Care North Lanarkshire. Page 70 of 270
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38 A wide range of other groups or organisa�ons also support or work on behalf of carers providing a range of condi�on specific or age-related support to Carers, whether directly, or indirectly. These organisa�ons form part of the Carer Support Network. The list of organisa�ons includes, but is not limited to: PAMIS Family Support www.pamis.org.uk Provides support to families caring for someone with profound and mul�ple disabili�es. HOPE for Au�sm www.hopeforau�sm.org.uk Provides support to people with Au�sm as well as to family members and carers. Parkinson’s self-help Group provides support to people with Parkinson’s Disease and associated Neurological condi�ons, as well as an informa�on/outreach service to family members and carers. This is augmented by The Au�sm Network, which provides bespoke addi�onal Au�sm-specific input. Dea�lind Scotland www.dbscotland.org.uk Serves the Dea�lind community, sustaining dea�lind people’s personal and professional support networks and influencing statutory services and policy. Raises awareness of deaf blindness, and highlights the everyday challenges faced by dea�lind people. Also provides sign guide interpreters for people with dual sensory impairment, as well as support to family members and carers. Alzheimer’s Scotland www.alzscot.org Alzheimer’s Scotland provide a post diagnos�c support service and also support family members and Carers. North Lanarkshire Disability Forum (NLDF) www.nldforum.org.uk North Lanarkshire Disability Forum is the lead agency for the Engagement and Par�cipa�on of supported people (including carers). It holds a fund that curated organisa�ons (those organisa�ons with par�cular skill, knowledge, experience, or exper�se) can access to facilitate engagement and par�cipa�on from specific sectors of the community. Voluntary Ac�on North Lanarkshire (VANL) www.voluntaryac�onnnorthlanarkshire.org Interfaces with third sector organisa�ons locally and acts as the lead agency for the Community Solu�ons programme, whereby people, including carers and cared for people can be supported by a diverse range of community or voluntary sector organisa�ons. VANL also support the Carer Breather programme, facilitated by North Lanarkshire Carers Together, where carers can access regular breaks from caring. Ge�ng Beter Together (GBT) www.shotshealthyliving.com GBT offer a post hospital discharge support service, and wider carer support op�ons to support family members and Carers. Page 71 of 270
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39 Playpeace www.playpeace.org.uk Offers parental peer support and ac�vi�es for children with addi�onal support needs. All of these organisa�ons have carer representa�on on their management board or commitee and act as a conduit to feed into the Carer Support Network and Integrated Joint Board. This helps ensure that carers voices are not only heard, but influence and shape policy, strategy, and service development. ApAppendipendix 1 Page 72 of 270
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40 APPENDIX 2: Achievements and Progress 2019 - 2024 Introducing a new strategy is an opportunity to look forward, but we were also keen to capture the range of successes and progress over the past five years and reflect on this too. Since 2019, our partnership of UHSCNL, Lanarkshire Carers, NLCT and Ac�on for Children - Young Carers, as well as a wide range of Community and Voluntary Sector organisa�ons, and most importantly, carers, has made considerable progress. The 2024 -2027 strategy builds on this progress. Collec�vely, we have made significant progress regarding carer informa�on, advice, and communica�on. Carers have reported that they feel recognised, supported individually, and are more involved in wider policy and strategy development. We intend to build on this progress over the next 3 years. A considerable number of ACSPs and YCPs have been progressed resul�ng in a range of good outcomes for carers. We do, however, recognise that this has not been a consistent experience for every carer. This is why this is remains a key focus within our new strategy. Support for young carers has been embedded in all secondary schools across NL for the past 20 years - ensuring that young carers are aware of how to access support. This will con�nue to be a focus in the new strategy. Our partnership has ensured that carers are aware of all four Self-Directed Support op�ons. We are also aware that this has not been everyone’s consistent experience. We want to tackle this inconsistency, hence our enhanced focus in the new strategy and links to the SDS Transforma�on agenda. We have had success in promo�ng and suppor�ng carer iden�fica�on. However, as can be seen from the strategy, more work is needed to improve in this area. Iden�fica�on of carers at the earliest possible stage helps us all. Support can be introduced at an early stage, assis�ve technology can be considered, and it is always easier to plan interven�ons when things are setled than it would be in �me of crisis. The uptake of assis�ve technology has increased significantly. We are keen to build on this to help minimise risk and maximise independence for carers. We have an expanded Assis�ve Technology team to support this, and the team has already provided very helpful and informa�ve input at locality events, carer organisa�on AGM’s as but two examples. Disability Informa�on Officers have been in post for some �me. They provide support, advice and signpos�ng to local support groups, charitable organisa�ons and University Health and Social Care services. They also assist with MLE assessments and recommenda�ons including equipment. Lanarkshire Carers, North Lanarkshire Carers Together, and Ac�on for Children Young Carers Project have provided an invaluable range of informa�on, advice, signpos�ng, and support to carers. Carers have reported that the range of support on offer has proven invaluable to them in their caring role. These supports are too numerous to men�on but further details are available on each of the organisa�on’s websites found in this strategy. University Health and Social Care North Lanarkshire would like to express our thanks to all three organisa�ons, individual carers and staff across both the statutory and voluntary sectors who have all made such a posi�ve contribu�on to carer support in North Lanarkshire over the last 4 years. Page 73 of 270
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41 We trust that our combined efforts over the next 3 years will further develop and enhance carer support and posi�ve outcomes across North Lanarkshire. Alterna�ve language op�ons This document can be made available in a range of languages. If you require a copy in an alterna�ve language please contact us at: To make a request, please contact Corporate Communica�ons on 01698 302527 or email: corporatecommunica�ons@northlan.gov.uk Page 74 of 270
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State of Caring 2023 A health and social care crisis for unpaid carers in Scotland ‘I just do not have time to look after myself’ November 2023 Appendix 2 Page 75 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 2 About this research This report, produced by Carers Scotland, explores the key findings from the State of Caring Scotland survey 2023 on the health of carers and the support they receive from local authorities, health and social care partnerships and the NHS. Carers Scotland’s annual State of Caring survey has been undertaken for over a decade and is Scotland’s most comprehensive research into the lives and experiences of unpaid carers. This year’s survey was carried out between June and August 2023 and completed by 1,771 unpaid carers in Scotland. We have interspersed this report with the voices of carers. These are highlighted in red, and we thank those quoted for sharing their experiences. Note: Not all respondents completed every question in the survey, and some questions offered the ability to select more than one option. About unpaid carers An unpaid carer is a family member, partner, friend or neighbour who helps a person with daily activities that they would not be able to manage if they did not have help. This could be a partner, family member or friend who has a long term or terminal illness, someone who is disabled, has a mental health condition, is affected by addiction or who needs extra help as they grow older. There are approximately 800,000 people in Scotland providing such unpaid care1. It would cost an estimated £13.1 billion2 every year to replace the care they provide. Carers in State of Caring 2023 The demographic breakdown of carers responding to State of Caring 2023 is as follows: • 81% of respondents are female, 18% male with the remaining 1% preferring to self- identify as either non-binary or transgender. • 3% are aged 18-34, 13% are aged 35-44, 25% are aged 45-54, 36% are aged 55-64, and 23% are aged 65+. • 29% have a disability3 • 98% of respondents are white Scottish, Irish or other white; 2% of respondents are black, Asian or minority ethnic. 1 Scotland’s Carers update release, Scottish Government 2022 2 National Care Service Financial Memorandum, Scottish Parliament 2022 3 As described under the Equality Act 2019: this defines a disabled person as someone who has a physical or mental impairment which has a substantial and long-term adverse effect on their ability to carry out normal day to day activities Page 76 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 3 • 92% of respondents are heterosexual, 4% are gay, lesbian or bisexual, the remainder preferred not to say or skipped this question. • 45% are in some form of employment and 24% are retired. • 20% also have parental responsibility for a non-disabled child under 18. • 3% have been caring for less than 1 year, 25% for 1-4 years, 25% for 5-9 years, 27% for 10-20 years and 20% for more than 20 years. • 19% provide 1-19 hours of care per week, 10% provide 20-34 hours of care pre week, 15% for 35-49 hours and 14% for 50-89 hours, 42% provide 90 or more hours of care per week. • 71% care for one person, 21% care for two people, 6% care for three people and 2% care for four or more people. The people carers care for Carers responding to State of Caring 2023 provided information about who they care for and the conditions the person(s) live with: • 35% are caring for a parent/parent-in-law, 34% were caring for a spouse or partner, 38% for a son/daughter/in-law), 11% for another relative and 3% for someone else eg. a friend or neighbour. • 18% care for someone aged under 18, 22% for someone aged 18-34 years, 30% for someone aged 35-64 and 58% for someone 65 or over • Respondents were caring for people with a range of health conditions and/or disabilities: o 90% said that the person(s) they care for has a long-term health condition or illness such as arthritis, diabetes, kidney disease o 34% a mental health condition o 29% autism, ADHD or another neurodiversity o 26% a physical disability o 25% needs that arise from being older o 24% a neurological condition such as multiple sclerosis o 24% dementia o 22% a learning disability o 18% a sensory impairment o 4% alcohol or substance misuse. Thanks Carers Scotland would like to thank each and every carer who contributed to this survey, from those who helped us develop and test the survey to every single person who took the trouble and time to tell us about their experiences. Your experiences will be used to help build a society that recognises and supports carers more. Page 77 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 4 Contents Introduction 05 Key facts 06 Carers health 07 Mental health 09 Breaks from caring 13 Social connections and loneliness 15 Support and social care 18 Planning for emergencies 20 Information and technology 22 Carers as healthcare providers 23 Carers and suppport from the NHS 27 Hospital Discharge 29 Conclusions and recommendations 31 Page 78 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 5 Introduction Last year, in State of Caring 2022, Carers Scotland provided a snapshot of the lives of unpaid carers in Scotland, setting out the toll that providing care was having upon their lives, finances, employment, health and wellbeing. Battered by the cost-of-living crisis and living with the ongoing effects of the pandemic, carers were breaking. Last month Carers Scotland published “State of Caring 2023: the financial impact of caring in Scotland”4 which brought no better news for carers, particularly those who were already struggling to make ends meet. Poverty and financial insecurity had grown yet again, as the cost-of-living crisis extended and continued its damage to carer households. In this report, “State of Caring 2023: A health and social care crisis for unpaid carers in Scotland” we show the ongoing struggle that carers face to access the services and support they need to provide care and to care for themselves including to take regular breaks from caring. We do not shy away from using the term “health and social care crisis” in this report. Despite their huge contribution to the Scottish economy, to our communities and to the lives of the people they care for, carers are facing deteriorating physical and mental health, loneliness and isolation with too many driven to despair and denied access to the very supports they need to maintain a healthy life. This cannot continue. In this report we set out a range of recommendations, not just for Government but for local councils, health and social care partnerships and NHS Boards across Scotland. Action is needed, urgently. Carers simply cannot wait. 4 Find this report at: www.carersuk.org/reports/state-of-caring-in-scotland-the-financial-impact-of-caring-in-2023/ Page 79 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 6 Key Findings Page 80 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 7 Carers health Providing care for someone has is a highly challenging responsibility, frequently affecting the physical and mental health of those who are providing care. Throughout Scotland, unpaid carers provide high levels of care, seldom having the chance to take a break from caring. They grapple with constant anxiety, stress, and the consistent prioritisation of the person they are caring for, often resulting in numerous sleepless nights and feelings of isolation. These factors collectively contribute to physical fatigue and emotional exhaustion. It is clear from the results of State of Caring 2023 that a significant number of those who provide care are not receiving the necessary support to attend to their own health and wellbeing alongside their caring responsibilities. We asked carers if caring had an impact on their health and wellbeing. In this context, it is no surprise that more than half (54%) said that their physical health had suffered because of their caring role, with one in 5 (20%) suffering a physical injury from caring Page 81 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 8 and two thirds (69%) saying that they struggled to get a good night’s sleep. Nearly four fifths (79%) of carers said that the main challenge they would face over the coming year would be the impact of caring on their physical and/or mental health. “I constantly have lack of sleep; I assist with care during the night but unable to catch up during the day due to other chores. I am constantly tired and depression kicks in which I try to hide from my family display all's fine approach” Of particular concern in the findings of State of Caring 2023 is the number of carers who have put off healthcare treatment because of their caring role. Four in 10 (41%) carers have put off healthcare treatment, with more than two fifths of carers (46%) who care for 35 hours or more a week said that they had put off such care. This increases to 50% of carers with a disability. These findings are reinforced by comments from carers themselves, further illustrating the impact caring is having on their ability to care for their own health. “I have cancelled a hospital appointment twice as I had no one to assist me after an anaesthetic” “I have been told I may have a tumour and need operation, got no offer of any assistance from social work - have no idea what will happen if I am not able to manage.” As well as having to put off treatment because of the demands of caring, nearly a third of carers (30%) have been waiting over a year for NHS specialist treatment and 18% have waited for more than six months. This can be compounded by the person they are caring for also having to wait for specialist treatment - 28% of carers reported that the person they were caring for had Page 82 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 9 been waiting over a year for specialist treatment and 16% for more than 6 months. This can add to the physical and mental demands of caring and thus the impact on carers own health. Mental Health A large proportion of carers also reported that their caring responsibilities impacted negatively on their mental health. More than a quarter of carers (28%) said their mental health was bad or very bad. This impact on mental health was particularly prevalent amongst carers in receipt of Carers Allowance. Over one third (37%) of carers on Carer’s Allowance described their mental health as either bad or very bad. This may be because those in receipt of Carers Allowance were particularly at risk of struggling to making ends meet financially and were more likely to be cutting back on essential items such as food and heating, which could explain the significant impact their the mental health. “My mental health has rapidly deteriorated in the last year. I am in a very poor place.” “I am permanently stressed depressed And just feel completely hopeless and feel like I'm serving a prison sentence for committing no crime.” Carers went on to share in detail the impact of caring on their mental health. The majority (88%) had difficulty sleeping or increased tiredness, continuous low mood (85%) and feelings of hopelessness (82%). Three quarters (79%) experienced an inability to switch off from worrying about caring and similar proportions experienced irritability and mood swings (77%), low self-esteem (76%) and regularly feeling tearful (71%). Page 83 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 10 “Tearful & very emotional, trying hard to accept how my life has changed since my caring role began in July 2021” Of significant concern is that over a third (36%) said that they had thoughts related to self-harm or suicide. We share below just a few quotes from carers – there are many more, equally distressing that set out the devastation that caring can cause to mental health. “Would like to walk into sea, to float away, but know I can’t because there’d be no-one to step in to support dad.” “It will only end when I die, but knowing my luck there will be reincarnation and it will be worse next time” “My anti-depressants were increased recently and though my mood has been less suicidal my weight has gone up- a known side effect of the tablets-Venlafaxine-this in turn makes me feel physically and mentally worse. I have no confidence in myself and look and feel a right mess. I exist I don't really live and the only thing that keeps me alive is my cat. She will be 14 next month and if anything happens to her, I cannot see any reason to go on.” Although a third (31%) of carers responding to this survey are receiving some form of NHS support for their mental health, and 17% are getting emotional support from their local carers centre, over a third (35%) indicated that they are not receiving any mental health support at all. Page 84 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 11 A quarter of carers (25%) said that accessing counselling, therapy or a listening support service which would improve their health and wellbeing. However, too many carers are struggling on unsupported. We asked carers why they might not be seeking help with their mental health and the results revealed some stark findings. Half (50%) of carers said that they were simply too busy with the demands and responsibilities of their caring role. “No time to go” “I just feel stuck and not able to make decisions about my happiness as it always comes back to my caring responsibilities.” However, delays in NHS appointments have a critical role, with a quarter (25%) of carers saying that this was the reason they had not accessed mental health support. “I am on four different waiting lists and have been for a year” Worryingly, the stigma around mental health seems to still play a role in carers who are not accessing mental health support as more than one quarter (26%) said they do not feel comfortable talking about their mental health. In addition to this, one in five (20%) said they were too embarrassed to speak about their mental health. Overall, it is clear, too many carers are missing out on the support they need to look after their own health and wellbeing while providing care. This is directly influencing many carers capacity to care. Page 85 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 12 More than a quarter of carers (24%) said they had to stop or reduce the amount of care they provided because of their poor mental health, with family or social care having to take over in 12% of these cases. Shockingly, almost three quarters (72%) said they had to continue providing care even though they felt they were at breaking point. In addition to having an influence on their capacity to care, it is also having an impact on carers’ ability to earn; vital in these times of financial strain. Around one fifth (18%) said that they had to leave a job or reduce working hours because of poor mental health caused by their caring role. Page 86 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 13 The important role of breaks from caring More than half (58%) of carers said taking a break from caring was critical to maintaining both their physical and mental health and there is a clear link between access to breaks from caring and better health outcomes amongst unpaid carers. However, just over a third of carers (35%) in State of Caring 2023 told us that they had not had any break from caring in the past year, often saying that it is just too difficult to get the breaks they desperately need. For those who have had a break only one in 10 (11%) were able to receive this break with support from social care services, with the greatest majority relying on friends and family to have any sort of break from their caring responsibilities. Some groups of carers are struggling most to take a break. Duration of care and hours spent caring have a clear impact and our evidence also suggests that the cost-of-living crisis and financial insecurity plays a significant part in the ability (or not) to take a break from caring. Page 87 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 14 More than half (51%) of carers who told us that they are struggling to make ends meet and 42% of carers on any carer benefit have not had a break. And 40% of those caring 35 hours a week or for 10 years or more have not had a break in the last year. Worryingly, almost half (49%) of carers with a disability also told us they have not had a break. “I don't feel I am able to take the time to prioritise anything for myself. I would love to be able to take a paid break without feeling guilty and for this to be on a regular basis as any other person doing a job would expect.” “Cannot get respite from my role despite being entitled to it.” “If you were guaranteed paid respite breaks throughout the year to look forward to and plan things around it would relieve so much pressure” “I'd like to go away with my husband occasionally but we're unable to leave our son alone overnight” “It feels rare that I get to commit time to doing things just for me, without worrying about fulfilling my caring role or being interrupted.” My husband has Vascular Dementia so I would dearly love to have regular breaks from caring. His personality has changed completely towards me, but only me, so its very draining to live with 24/7. Page 88 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 15 Social connections and loneliness Carers continue to tell us that their caring responsibilities bring loneliness and isolation. Over a quarter (29%) said that they always or often feel lonely, with a further 59% saying that they sometimes feel this way. However, the level of loneliness is far higher for some groups, with a further 59% saying that they sometimes feel this way. However, the level of loneliness is far higher for some groups. Carers who told us that they are struggling to make ends meet financially were almost twice as likely to be always or often lonely (50%) and 39% of carers who are on Carer’s Allowance say they are always or often lonely. This suggests that there is a link between a carer’s financial wellbeing and loneliness and isolation, for example, many carers have reported that they have cut back on social activities because of increased costs. And, 40% of carers with a disability also reported always or often feeling lonely, suggesting that carers with aal disability face greater barriers in supporting their mental health and wellbeing. Page 89 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 16 Loneliness directly affects carers’ health and wellbeing with 49% of all carers, 54% of carers with a disability, and 57% of carers on Carer’s Allowance or struggling to make ends meet saying loneliness was affecting their health. Nearly a third of carers (21%) said that they needed support to prevent or reduce their social isolation and loneliness with one in 4 (23%) saying they need more help with maintaining and building relationships with others; relationships that have been limited or lost because of their caring responsibilities. Having a life outside caring and being able to have opportunities to build and sustain connections with others is critical for carers’ health and wellbeing. Carers stated clearly in response to the survey that having time, and money, to spend time with friends and family helps sustain and improve their health and wellbeing. More than two thirds (68%) of carers that responded emphasised this was important. This was particularly prevalent in responses from older carers (65 and over) where three quarters (75%) said that spending time with friends improved their health and wellbeing. However, as the “State of Caring 2023: the financial impact of caring in Scotland” report sets out carer poverty and the cost-of-living crisis reduces this option significantly for too many with nearly half (46%) of all carers having cut back on seeing friends and family simply to make ends meet. This leaves carers isolated without valuable support. “I haven't been able to spend time with friends for 3 years now, since I became a carer. At the moment I don't have enough money to live on so can't afford breaks, to pursue hobbies or follow interests. I also can't leave my partner overnight when he is vulnerable which is a lot of the time.” “I would like to meet up with friends I have known for 70 years but can’t leave my husband for any length of time. Someone to step in & allow me to go away for a day would be wonderful.” Page 90 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 17 Many carers also told us about the importance of hobbies and interests. 57% said that engaging in hobbies and interests would improve their health and wellbeing. “I don't have time to paint, which is a lifelong hobby.” Others talked about how the chance to have education or training opportunities would help their health and wellbeing (17%) as well as the ability to be in paid employment (32%) giving opportunities for the future and much needed financial security. Healthy activities were also important to carers. 58% said that being more physically active would help their health and wellbeing and being able to eat a balanced diet (42%) both limited by time and money. “I would like to be able to go out walking or swimming more but can’t leave my husband for very long.” “Would like more exercise, to join a class” Finally, and perhaps most importantly, carers said that having good quality care services for the person they care for (45%), getting a break from caring (58%) and being valued as a carer (54%) were critical to improving their health and wellbeing. “I don't prioritise my health and wellbeing as there is nothing in place to allow me to have a break. I would like to have a hobby again and to have friends.” Page 91 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 18 Support and Social Care Unpaid carers save Scotland £12.8 billion5 per year in social care costs yet, just a third (38%) of carers are receiving support in their caring role from formal social care services. Indeed, most (44%) support received by unpaid carers responding to this survey is informal from friends, family or neighbours. Around a third of carers (37%) reported receiving some help from a local carers’ organisation, a local charity or community organisation (10%) or from a faith organisation or place or worship (3%). Of those who were receiving social care services, 57% were satisfied with the quality of care provided. Nearly half (48%) said that they felt that they would be listened to if they raised concerns about the quality of care provided. “Alanmart Day Centre are truly outstanding. My mum attends for two afternoons per week. They treat her with dignity, kindness and love. They offer her mental stimulation and a place to socialise. They help foster her sense of place in the world as a person with dementia. She also receives four daily visits from Nightingale Care, funded by the council. The carers are all very competent and a few have formed a close bond with my mum.” 5 Scottish Government, National Care Service Financial Memorandum Para 7.2 Page 92 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 19 However, only just over a third (36%) said that they felt they could rely on social care services and a similar proportion (37%) said that care support did not meet their needs or those of the person they care for. Around a third (30%) said that social care was not consistent (ie. provided by the same staff at regular times). “Care workers as individuals try very hard but are overstretched. Changes in personnel are unsatisfactory for an individual with dementia who relies on familiarity and routine. Also requires me to be more active in care giving as staff are unfamiliar with home and routine.” “Service, especially day centre, is not as good as pre Covid. There are fewer services available now as well and everything comes down to cost, not the needs/what’s best for the cared for person.” “Lack of services. No care staff. Lack of community amenities. Poor accessibility. Left to fend for yourself. Have self-directed support budget and had no support with implementing it.” “Can’t find a PA for my caree as no applicants on rural area.” “I've become disabled and struggling to cope with both of our separate needs. No staff in the Highlands to help and no support.” We asked carers what assistance from local councils and health and social care partnerships could better support them in managing their caring responsibilities. Nearly half (47%) said that councils needed to better recognise their needs as a carer and deliver increased choice (41%), better quality (37%) and more affordable (25%) services for the person they care for. Caring responsibilities can have a significant impact on carers’ ability to maintain employment. Carers are less likely to work full-time work6 (34% v 47%) and more likely to be in part-time work (16% v 12%) than non-carers7. And, given the stresses and strains that can 7 Family Resources Survey 2021/22 Page 93 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 20 result from balancing work and caring, it is unsurprising that 1 in 6 carers give up work or reduce their hours to care8. Therefore, it is of significant concern that one in five (19%) carers in State of Caring 2023 said that they needed better support from social care to return to or maintain paid employment. In State of Caring 2022, carers set out at range of services that had been reduced and had not returned to pre-pandemic levels (27% were facing reduced care at home services, 44% reduced day services and 24% reduced after school services for disabled children). In 2023, there has been little improvement, with four in ten (42%) carers say that support services were still not operating at full capacity or had not reopened and that this is one of the biggest challenges they face. Planning for Emergencies The Carers (Scotland) Act 2016 sets out that carers should be supported to develop an emergency plan as part of their Adult Carer Support Plans (ACSP) and Young Carers Statements (YCS). An emergency plan is a written record of the arrangements that are in place for the cared for person if the carer has an emergency eg. if they go into hospital or are unwell and unable to care. However, it is clear that despite the Act, there is insufficient awareness of emergency plans amongst carers. A quarter (22%) of carers had never considered planning for an emergency and a similar proportion (29%) were not sure how to plan for an emergency – and would like more support with this. Even amongst those carers who have planned for an emergency, only one in five (21%) have a formal emergency plan in place, although a larger proportion (41%) have more informal plans in place; identifying people who might be able to provide care in their absence. For those who have planned, only one in twelve (8%) have let social work services and just 3% their GP (or the GP of the person they care for) know what should happen if they are unable to provide care and support in an emergency. 8 Employers for Carers, Carers UK Page 94 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 21 There is a worrying gap between the intention of the Carers (Scotland) Act and its implementation. Carers should be enabled to plan for emergencies and processes to ensure that relevant professionals involved in care are both aware of a carer’s emergency plan and be ready to step in should a carer require support. “We were in a crisis emergency. A car accident put me in hospital. Despite this we were give zero assistance to help care for my child. He missed school due to me being unable to drive as I was physically housebound. Social Work, school and Connecting Carers charity all let us down. My son was left unable to care for himself. It was a dreadful time which has left me traumatised over the lack of care. “ “I have power of attorneys in place for my parents and myself, more needs done to support all over the age of 18 getting POAs in place as a routine.” “I did try to plan for my total knee op. Social work agreed to increase the budget for time to recover. Support provider knew I needed support. They knew it was coming. But in the end, I got NOTHING from them. I was told that they didn't have anyone to help, because most workers had been transferred to supported living during the pandemic. I was asked on the Friday if I could go in the following Wednesday. OK, I get that was a bit short notice, but since the team leader did the rota, she knew I was going in, she could have juggled things. As it was, my husband had to take time off work, my daughter, who was on maternity leave had to help out and my youngest son was coming in from his work (support worker), to help out. My daughter texted the team leader that I was out of surgery and how it went. A year later, were still waiting for her to reply.” “I have tried to plan but I don't have relatives or friends who can help. Social services can't help until an actual crisis arises.” Page 95 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 22 Information and technology to support carers Every day, nearly 1000 people start caring9. This is often a time of uncertainty, managing sudden or progressive disability, illness or frailty of a partner, family member or friend and getting the right information at the right time is critical. This criticality of information was recognised in the Carers (Scotland) Act 2016, with local authorities required to provide information and advice services for carers. We asked carers where they would go for information about caring and support. The largest proportion would rely on the voluntary sector – a local carer organisation (50%), a national carers charity like Carers Scotland (14%) or a charity specialising in a particular illness, condition or age group such as Age Scotland, MS Society Scotland (15%). Friends, family and other carers (19%) and the internet (42%) are also vital sources of information. The public sector remains critical with one in five (21%) saying they would ask their GP or other health professional, 16% social work services, 5% their local pharmacy and 6% their local council. However, one in 10 (11%) carers said they did not know where to go for information, so it is clear that more remains to be done to ensure that the ever-changing population of carers can access the information they need in a way that suits their needs. Carers continually tell us of their frustrations at having to tell their story again and again to health and social care services in order to access even minimum levels of support. As part of the consultation on the National Care Service, the majority of carers (86%) surveyed at Carers Parliament in 2021 were in favour of a new electronic health and social care record which has been proposed, believing it could help to share information and be identified as an unpaid carer. This support was reinforced by carers in this year’s State of Caring with two thirds (63%) saying that they would like systems in which information about they or the person they care for is shared across services, so they do not have to repeat themselves. Systems are in place to record caring on GP records; however, this is not necessarily consistent. Therefore, carers also identified the need for any system to be able to identify 9 Analysis from University of Sheffield, Centre for Care from the UK Household Longitudinal Survey (UKHLS), also known as Understanding Society, using data from 2010-2020. The sample includes all people who participated in the survey in any of those years. Carer churn from 2011 onwards, requiring the use of the data from 2010. Page 96 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 23 them as carers on the record of the person they care for (71%) and on their own patient record (69%). More than half (52%) of carers said they would like digital access to their own health and social care records and a similar proportion (54%) suggested that there should be an extra feature on such a record where they could identify themselves as an unpaid carer. Six in 10 (60%) carers said that they would like digital access to the patient and care records of the person they care for. Whilst this approach would need safeguards and consent, there are opportunities for this approach to support simplicity and flow of information from carers to professionals in improving the care and support of the person being cared for. Technology also offers other opportunities to make carers lives easier and to support improved health and wellbeing of both carers and those they care for. A third (35%) of carers said that they would like access to technology to support care such as remote monitoring (such as motion sensors, fall detectors), a quarter (25%) to technology to support vital signs monitoring (such as blood pressure, blood glucose, heart rate) and 23% to apps that help pain or mood management. A third (33%) said they would like to be able to access online support groups and activities for carers. Carers as healthcare providers More than three quarters (77%) of carers told us of the significant and varied health care tasks they provide to support the health of the person they care for. Recent calculations from the Scottish Government10 estimate that providing these types of tasks save the health services £320 million each year. These responsibilities can range from monitoring the mental health and wellbeing of the person they care for (68%), monitoring blood pressure or blood sugar (18%), dressing wounds (16%) and hoisting (9%) through to complex health support such as supporting home dialysis or devices that provides oxygen or continuous positive airway pressure (CPAP)11 (6%), tube feeding (2%), giving injections (12%) and making decisions about whether or not to give emergency or specialist medication (24%). 10 National Care Service Financial Memorandum 11 A CPAP (continuous positive airway pressure) machine is used in the treatment of sleep apnoea. This device delivers continuous pressurized air through tubing into a mask that you wear while you sleep. Page 97 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 24 “Luckily, I am a trained nurse. Although the older I get, the harder it is, but my husband would refuse help anyway.” “I assist my wife in setting up her Parkinson’s medication pump and her colostomy bag.” “Have had to adjust diabetic support/care due to symptoms of dementia.” Many carers talked about how they had little choice but to provide such support due to lack of local primary and community health options for the person they care for, with four in 10 (41%) saying they needed more support from the NHS or healthcare professionals. “Due to the lack of NHS support (eg. GPs being a primary problem), I just get on with dressing wounds for the person I care for. This includes buying wound dressings (Quite expensive at times) and cleaning/applying dressings. At times I have contacted the person I care for GP practice to seek advice/help, I get a response of "go to hospital". I don't mind doing these tasks for the person I care for. The point is, even when help/support is needed from the NHS it’s not there. A message of "go to hospital" is not needed and not wanted - it doesn't warrant going to hospital, also, most crucially the person I care for would absolutely not be able to manage sitting in a hospital waiting for hours on end. So, I get by doing what I need to do to ensure the person I care for has a clean wound.” “I didn't have a choice taking on monitoring my Mum’s mental health and wellbeing - she lives alone and has attempted to take her own life previously. I am mental health first aid trained through my career path however, it is very different when it is your own family there is a lot more emotion attached to decision making.” “No choice as two insulin dependent sons one with progressive neurological disorder and one registers as partially sighted.” Appendix Page 98 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 25 Although some carers spoke of the support and training they had received to carry out such tasks, others felt that this type of training was too limited and, for some, non-existent. “We had extensive support and training from health re: the current medication, delivered subcutaneously via a pump, and still have support from specialist nurses.” “I received some training for taking blood pressure though not that confident. It's a huge responsibility to monitor emergency medication. As a carer, you just have to do what you can.” “I have had training to use both the ceiling tack hoist and sling that we have and the mobile hoist. I am having to pack and dress a pressure sore for my cared for and I have had no official guidance or training on doing so. We visit the nurse twice weekly and show a photo of how the wound is looking and get supplies. My cared for is not able to get on the bed at the nurse so in the whole time that the pressure sore has been there (approx. 6 months) no health professional has seen the wound in person only in photos.” “I feel out of my depth with supporting mental health and how to help, with no training.” “Given rescue medication (syringe) to use for epilepsy. Given a brief talk but no real training or any understanding of stress this causes me to make decision on when to use this for partner.” Medication As well as a range of health support, many carers also support the medication of the person they care for carrying out a range of tasks from collecting (69%) and/or ordering (68%) medication (68%), sorting into correct doses (39%) and checking and prompting someone to take medication (67%). However, nearly half (48%) administer medication and nearly a third (30%) check for contraindications or allergies with other medications. Page 99 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 26 Whilst over a third (34%) of respondents had asked for and received help with ordering and collecting repeat prescriptions from their pharmacy, less have been able to access advice on how to take a medicine safely (20%), administering medications (19%) or dealing with devices such as inhalers (11%). Just under a third (31%) said that they had received help with treating minor health concerns but almost one in 10 (9%) would like more help with this. Keeping safe from COVID19 In 2022, 16% of respondents told us that they had concerns about returning to support services as they were worried that the person, they care for would catch COVID19, with over a third (34%) saying that keeping the person they care for safe (when there are less public health measures to reduce COVID19) would be a significant challenge over the next year. This year, these concerns remain for too many, with a quarter (26%) of carers telling us that keeping the person they care for safe from COVID19 would be a significant challenge in the coming year. “I have a reduced immune system, which not only affects my choice of wise social events, it also restricts the things to which I can take my husband” Page 100 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 27 Carers and support from the NHS Carers are an important support in helping the people they care for to have the best experience from the health services they receive. State of Caring 2023 asked carers about their experience of the NHS as a carer and what might improve this. This covers a wide range of areas from hospital admission and discharge, attending appointments and future developments such as virtual wards. Hospital Appointments The support that carers provide in helping the person they care for in their appointments with health professionals cannot be underestimated. Significant proportions of carers in State of Caring support the people they care for to attend hospital appointments. This can range from booking appointments, arranging transport and attending with the person. Nearly all the carers responding to the survey (92%) reported that they have supported someone to attend at least one appointment in the last 12 months, with 25% helping someone attend five or more appointments. Indeed, over a quarter (29%) have supported someone to attend 10 or more appointments in the last 12 months. Page 101 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 28 Hospital Admission We asked carers whether the person they care for had attended accident and emergency (A&E) in the last 12 months and their experience of this admission. A third of carers (34%) reported that they had attended A&E. Of these, a third (34%) had waited 30 minutes or less for an ambulance, 25% for between one to two hours and 29% for between two to six hours. One in eight (12%) waited eight hours or more for an ambulance to arrive. Half of carers (50%) who had attended A&E said that handover between ambulance and A&E staff had taken 30 minutes or less, but a quarter (26%) had waited between one to two hours, 19% between two to six hours and 5% eight hours or more. Waits for initial examination by a doctor or nurse took less than 30 minutes for almost a quarter (23%) of carers, between one to two hours for a third (33%) and similar percentage for between two to six hours. For 9% waits for this initial assessment took eight hours or more. Page 102 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 29 Hospital Discharge State of Caring 2022 showed a significant lack of involvement in hospital discharge. Disappointingly, this year’s report shows no improvement. Of those who had someone discharged from hospital, 60% were not informed and involved in decisions about this discharge . Worryingly, only 20% were asked about their willingness or ability to provide care and just 18% said that they received sufficient support to protect the health and wellbeing of the person they cared for as well as their own health. Only 20% received an Adult Carer Support Plan. The Carers (Scotland) Act 2016 places a duty on NHS boards to involve and inform carers in discharge of the person they care for. As such, it gives carers a right to be involved and promotes the importance of ensuring that carers have access to support. Thus this lack of progress by health services in effectively involving and supporting carers as part of discharge processes is deeply concerning, and in need of urgent action. “Admitted with same complaint – delirium and infection. Very little information. Drs not available. Information given on discharge summary on occasion incorrect – missed medications resulting in missed doses of cardiac medicine at home as informed on letter discontinued. Phone calls to GP practice who are very supportive resulting in phone calls to hospital. Human error medication missed on admission although list of medication and blister pack given to nurse. GP recommenced medication immediately and chemist delivered.” “He was discharged in the same state he went in with. No formal assessment was carried out nor the family asked how things were at home.” Page 103 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 30 “Mum was discharged and I voiced my concerns on her getting home after having a serious infection. I had to keep emphasising that it was an infection on her tooth and was still in a lot of pain even although on antibiotics which the hospital were guessing the infection was until a junior dr listened to me and got a community dentist out as mum’s tooth was badly infected and needed urgent removal that day and they still discharged her back home to missing her carer so she had missed her medication so I had to come up to attend to my mum. It was an absolute shambles.” There is also a worrying variance for some groups of carers. For carers with a disability, just a third (33%) reported being involved in decisions about discharge and only 14% were asked about their ability and willingness to provide care. Only 12% said that they received sufficient support to protect the health and wellbeing of the person they care for as well as their own health. Given these carers already have disabilities or health conditions that affect their day to day lives, it is striking that healthcare professionals, instead of providing additional consideration for their need to manage care alongside these, instead appear to offer even less support. “Being able to continue as I have a disability and my condition will get worse” Older carers are more likely to be asked about their ability and willingness to provide care (30%) and to be provided with sufficient support to protect their health and wellbeing and those of the person they care for (31%). However, given that the prevalence and incidence of most health conditions rises with increasing age12, it is concerning that large numbers of older carers in State of Caring 2023 are being neither asked about their ability to care nor provided with sufficient support to protect their health and wellbeing. Carers in the early stages of their caring journey also face additional barriers to support. Just one in 10 (9%) said that they were asked about their willingness or ability to provide care and a similar proportion – just 9% were offered an Adult Carer Support Plan. The lack of involvement of carers in hospital discharge planning and failure to listen to carers and provide them with sufficient support can have significant consequences for both carers 12 Scottish Public Health Observatory Page 104 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 31 and those they care for, with carers telling us about hospital readmissions and further deterioration of the person they care for. “We have had more than 20 admissions since January” “She was discharged but a stomach bug came 8 hours later and she fall going to the toilet in the middle of the night, and fractured her neck” “Went to hospital on Monday, discharged that day and readmitted by the Saturday.” Virtual Wards/Hospital at Home A virtual ward is services a “time-limited service enabling people who have an acute condition or exacerbation of a chronic condition requiring hospital-level care to receive this care in the place they call home, either as an alternative to hospital admission or by facilitating an earlier discharge from hospital.”. This enables multidisciplinary healthcare teams and remote monitoring to support someone to stay at home rather than being admitted to hospital. The Scottish Government has been keen to expand these virtual wards which are better known as Hospital at Home. However, such home based hospital level care is not yet widely available in all NHS areas in Scotland. Indeed, only 4% of respondents to State of Caring 2023 said that the person they care for had received care through a virtual ward/Hospital at Home. However, we asked all respondents - with or without experience of receiving care from a virtual ward - what they saw as potential benefits and drawbacks of such an approach. Nearly half (46%) of respondents said that it could prevent the person they care for being admitted to hospital unnecessarily, a third (33%) that it could allow them as a carer to provide more personalised care and 55% that the environment would be more comfortable. However, it is important to note that carers have concerns that this will increase the demands of their caring role. More than half (54%) felt that virtual wards/hospital at home would involve them providing more care. Page 105 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 32 Conclusion The findings in this report paint a stark picture of carers buckling under the strain of propping up a health and social care system that is under severe pressure. This pressure in the delivery of public sector services has meant that carers have been left to carry a growing burden of significant care – where social care cannot provide a service, it is unpaid carers who are expected to step in, where the NHS needs a “bed” it is carers who are left to support discharge. At the same time, carers physical and mental health continues to deteriorate, often significantly whilst they have little time, money or energy to be able to maintain their own health and wellbeing. Rightly, the Government has recognised the need to bring down NHS waiting lists and improve access to health services, including crucial mental health services. However, dedicated funding and planning is urgently needed to ensure that carers can access the health services they need and support for caring from social care services to prevent the shocking levels of poor health they are experiencing. Quite simply, action is needed, and it is needed now. Recommendations To ensure all carers get the support they need to look after their own health: 1. The Scottish Government should develop and introduce a Carers Health Plan, recognising that unpaid care is a social determinant of health, and setting out how they will in the short, medium and long term not only maintain and improve the health of unpaid carers and young carers but prevent long term health inequalities. 2. Support for mental health is of significant concern and the Scottish Government should fund dedicated, tailored mental health support for unpaid carers, including providing funding to local carers centres, disability and condition specific organisations and palliative care organisations to enable them to commission mental health support for those they support. This should include support for anticipatory grief, bereavement counselling and specific mental health support for young carers. Page 106 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 33 3. The Scottish Government should fast track unpaid carers to support to maintain their health whilst caring. This could include: introducing direct payments or vouchers for carers to spot purchase non-NHS assessments, physiotherapy, counselling and other such services. Carers should have access to occupational support in the same way as health and care employees. 4. To ensure that carers are able to look after their own health, the Scottish Government should progress at pace actions within the National Carers Strategy to deliver flexible health appointments for carers, including providing replacement care for appointments. 5. Local health and social care partnerships and NHS Boards should develop their own local plans to deliver regular health checks for unpaid carers to identify health concerns or pre-conditions, such as high blood pressure and diabetes. 6. Local councils should seek to develop concessionary or free access to leisure services within their areas not just to carers in receipt of Carer’s Allowance but expanding to include all carers and young carers. This could include working with local carers centres and GP practices to develop social prescribing of leisure access. 7. The Scottish Government should work with NHS Boards to ensure their plans for reducing waiting lists set out how they will consider the unique and individual needs of unpaid carers, including prioritising carers for healthcare support that will support their ability to care. 8. Prior to the introduction of a right to a break from caring in the National Care Service, the Scottish Government should commit to: • increase funding year-on-year for short breaks delivered by the voluntary sector, including through the: o Time to Live fund administered by Shared Care Scotland and local carers services. o Take a Break Scotland fund for families with disabled children and young people administered by Family Fund. • increase funding year-on-year to health and social care partnerships and local councils for a range of breaks from caring and ensure that this funding is protected within their budgets. • work to expand availability of short breaks services across Scotland to ensure that when the right to a break is introduced, there are sufficient and varied services for carers to choose from Page 107 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 34 9. The Scottish Government should work with local councils, health and social care partnerships and NHS Boards to improve knowledge of carers rights amongst staff who come into contact with them and ensuring that carers can access support when it is needed by: • improving access to Adult Carer Support Plans, in particular ensuring that they are offered as standard to all carers during the hospital discharge process. • improving referral routes between services for Adult Carer Support Plans and Young Carer Statements to ensure that carers and young carers are able to have access an assessment and services promptly. • encouraging greater and more consistent use of flexibility within self-directed support to empower and better support unpaid carers and those they care for. This should include simplifying administration, promoting the ability to employ close relatives and considering enabling unspent budgets, (which cannot be spent due to lack of services) on other costs that support wellbeing. • improving uptake of emergency planning (and anticipatory planning) within both Adult Carer Support Plans/Young Carer Statements and in care planning. 10. To improve both the visibility and value of care, the Scottish Government should introduce add a new dedicated national outcome on care to fully values and invests in those experiencing care and those providing it. 11. The Scottish Government should work with partners to develop a more coordinated approach across health, social care and local council services to refer carers to third sector and community support including, in particular food support and fuel vouchers, vital to protecting health and wellbeing. Page 108 of 270
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State of Caring 2023: A health and social care crisis for unpaid carers in Scotland 35 Carers Scotland is Scotland’s membership charity for unpaid carers. We work to represent and support the approximately 800,000 people in Scotland who provide unpaid care for ill, older or disabled family members or friends – fighting for increased recognition and support for all carers and to ensure they have a voice in the issues that affect them. www.carerscotland.org info@carerscotland.org @CarersScotland /CarersScotland © Carers Scotland, November 2023 Carers Scotland is the Scottish nation office of Carers UK. Carers UK is a charity registered in England and Wales (246329) and in Scotland (SC039307) and a company limited by guarantee registered in England and Wales (864097). Registered office 20 Great Dover Street, London SE1 4LX Page 109 of 270
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1 | Pa g e Analysis of Carers (Scotland) Act 2016 funding 2022-2023: responses to Freedom of Information request March 2024 1. Background In November 2023, the Coalition of Carers in Scotland (COCIS) submitted a Freedom of Information (FOI) request to all local authority areas in Scotland asking for details of what the funding to support implementation of the Carers (Scotland) Act 2016 had been spent on during 2022/23. This report presents the findings from analysis of the data provided in FOI responses and concludes with a series of recommendations to improve transparency of reporting and monitoring for Carers Act funding. 1.1 Unpaid carers: rights and support needs There are estimated to be at least 700,000 to 800,000 unpaid carers in Scotland, including 28,000 young carers1. The Carers (Scotland) Act 20162, aimed to enable unpaid carers to be better supported so that they could continue to care, if they wished to do so, whilst also having a life alongside caring. Breaks from caring are vital to carers’ health and well-being, yet survey data in Scotland has consistently shown that only 3-4% of carers report having breaks. For full-time carers, providing 35 or more hours of care a week, only 9-10% have access to breaks from caring.3 Since the pandemic, increasing numbers of short break services and day services have closed, or reduced their level of service, due to financial insecurity and unsustainability. This has a profound impact on carers’ health and wellbeing, with recent research from Carers UK reporting that 61% of carers have said they needed more support to be able to look after their health and wellbeing.4 Moreover, Carers Centres across Scotland report a significant increase in referrals and number of carers registered with their service over the last two years5. This is combined with an increase in the complexity of carers’ support needs. Many Carers Centres report that demand outstrips their resources and capacity to deliver much needed support. 1 https://www.gov.scot/publications/scotlands-carers-update-release-december-2022/ 2 https://www.legislation.gov.uk/asp/2016/9/contents 3 Annual Scottish Health Survey 4 https://www.carersuk.org/media/xgwlj0gn/soc23-health-report_web.pdf 5 https://www.carersnet.org/wp-content/uploads/2023/09/Carers-Centre-Funding-Report-Aug23FINAL.pdf Appendix 3 Page 110 of 270
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2 | Pa g e 1.2 Funding to support carers and implementation of Carers (Scotland) Act 2016 When the Carers Act came into e\ect on 1st April 2018, local authorities were provided with additional funding to support implementation. The funding is awarded to local authorities in the first instance, who then allocate this to Health & Social Care Partnerships (HSCPs). Funding awarded to support Carers Act implementation has increased year on year as follows: Carers Act funding awarded to local authorities since 2018 2018/19 2019/20 2020/21 2021/22 2022/23 £19.4m £27.9m £39.5m £68m £88.4m* *This £88.4m is now the baseline level of funding which is awarded annually. In a letter to councils and local integration authorities on 9 February 20226, Humza Yousaf, then Cabinet Secretary for Health and Sport, stated: “Effective support for carers is not a new issue but the consistent feedback from carer representatives is of sustained pressures on carers; huge demand for carer support; and local carer support organisations running beyond capacity. This makes it even more important that the substantial Carers Act funding uplift for 2022-23 goes to delivering the intended expansion in local carer support services. I therefore ask for your support in ensuring these additional resources are allocated in full to expanding support for unpaid carers.” This report provides details of the data received from 31* local authorities relating to Carers Act Funding awarded and allocated in 2022/23** to Health & Social Care Partnerships (HSCPs); spend of Carers Act funding allocated to HSCPs; and the reliability of figures provided in FOI responses. *One local area did not provide an FOI response. **COCIS also submitted a FOI request for Carer Act funding allocated to HSCPs and associated spend in 2023/24. Some areas were unable to respond as it was too early to report on spend this year. However, brief analysis of figures which some areas did provide, showed that the proportion of awards which were allocated to HSCP was broadly equivalent to 2022/23. Similar spending trends to those contained in this report are therefore predicted in 2023/24. 6 https://www.gov.scot/publications/carers-act-funding-letter-to-councils-and-integration-authorities/ Page 111 of 270
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3 | Pa g e 2. Headline findings and recommendations Carers Scotland Act funding awarded and allocated FOI responses were received from 31 local authorities. Data provided indicates: • Of the £88.4m awarded to local authorities only £74.9m was allocated to HSCPs. • Twelve local authority areas allocated less than 80% of the award received to the HSCP. In ten of these areas the award/allocation ratio was even more pronounced (<70%). This suggests between £12.4m to £13.5m of Carers Act funding awarded was not passed onto HSCPs (allowing for two areas that did not report their allocations). While a proportion of this funding may have been used by local authorities to deliver young carer services, where this function is not delegated to HSCPs, there is still likely to be a significant shortfall. Spend on support for carers / implementation of Carers Act Of the £74.9m reported as allocated to HSCPs, analysis of the reported spend suggests: • 92% of funding (approx. £69m) was spent on direct or indirect support for carers / implementation. • 8% of spend (approx. £6m) did not relate to support for carers / implementation or was categorised as not yet allocated / other. This indicates that the ‘real’ spend on support for carers / implementation of Carers Act by Health and Social Care Partnerships in 2022/23 was up to £19m less than the £88.4m of funding awarded. Reliability of data There were concerns related to the reliability of data provided in FOI returns, including: • Di\erences between figures provided for the funds allocated to the HSCP and actual reported spend suggests there were under/overspends in ten areas. • Discrepancies were noted by some Carers Centres in relation to the some of the data reported. • A response to a separate FOI request on Carers Act funding in 22/23 (submitted by an unpaid carer) presented a di\erent set of figures than those which were provided in the FOI response (for the same area) for this report. • Comparing data provided in FOI responses to forecasting within the Financial Memorandum produced for the National Care Service (Scotland) Bill suggests the estimated figures for existing spend on Short Breaks may be unreliable, overestimating the amount spent. As Carers Act funding is not ringfenced, many HSCPs do not appear to routinely record, track and monitor spend, which a\ects the reliability and transparency of data. Recommendations To improve transparency in the reporting and monitoring of Carers Act funding the following recommendations are made for Scottish Government and local authorities: 1. Provide significantly more funding directly to third sector organisations (including Carer Centres) to expand and develop services to support unpaid carers, including a wider range of short breaks opportunities 2. Ring-fence Carers Act funding and develop consistent budget headings for use by all local areas. 3. Develop financial reporting processes to ensure robust tracking, monitoring and forecasting of spend under each budget heading. 4. Ensure HSCP Annual Performance Reports provide details of support for carers / Carers Act implementation and Annual Accounts provide figures for Carers Act funding, to improve transparent reporting of impact and spend. Page 112 of 270
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4 | Pa g e 3. Carers (Scotland) Act funding awarded and allocated 2022/23 FOI response data indicates that, of the £88.4m Carers Act funding awarded to local authorities in 2022/23, £74.9m was then allocated to HSCPs. This suggests that between £12.4m to £13.5 m of Carers Act funding awarded to local authorities was not passed on to HSCPs (see 5.1 below for more detail). Figure 1: Carers Act funding awarded / allocated in Scotland Figure 2 below shows the breakdown of Carers Act funding awarded compared to funds allocated to the HSCP in each local authority area. Figure 2: Carers Act funding awarded and allocated by area (in £m’s) 85% 15% Carers Act funding awarded Scotland Allocated to HSCP Not allocated to HSCP 0 2 4 6 8 10 12 Aberdeen Aberdeenshire Angus Argyll & Bute City of Edinburgh Clackmannanshire Dumfries & Galloway Dundee East Ayrshire East Dunbartonshire East Lothian East Renfrewshire Falkirk Fife Glasgow Highland Inverclyde Midlothian Moray North Ayrshire North Lanarkshire Orkney Perth & Kinross Renfrewshire Scottish Borders Shetland South Ayrshire South Lanarkshire Stirling West Dunbartonshire Western Isles West Lothian Awarded Allocated Page 113 of 270
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5 | Pa g e FOI responses show that 16 areas reported award and allocation totals that were broadly similar (where between 110% and 80% of awards were allocated to HSCP). Two areas reported moderately higher allocations (>110%) to the HSCP than funding awarded (Fife 117%; Glasgow 115%). However, in the remaining 12 areas the funding allocated to HSCP was less than 80% of the grant awarded. Of these, more significant disparity between awards and allocations (<70% allocated to HSCP) was reported by ten areas (Argyll & Bute 23%; East Ayrshire 23%; East Dunbartonshire 23%; East Renfrewshire 30%; Highland 43%; North Lanarkshire 67%; Orkney 54%; Perth & Kinross 20%; Scottish Borders 57%; Western Isles 50%). Shetland did not provide a figure for their allocation to HSCP and explained that this was because funding was "not separately listed as ring-fenced therefore diGicult to identify". Clackmannanshire did not submit a FOI response. 4. Spend of Carers Act funding To support the collection and analysis of data in the FOI request COCIS collaborated with HSCP Carers Leads to identify key spend categories which were aligned with the Carers Act (see Appendix 1). These categories were then grouped under four main headings: • Direct support for carers / implementation of Carers Act • Indirect support for carers / implementation of Carers Act* • Not related to carer support / implementation of Carers Act • Not yet allocated / other *For the purposes of this report, spend reported as ‘Strategic Posts within the HSCP’ and ‘Health Board’ was categorised as indirect support for carers / implementation as no further information was available to fully analyse/breakdown these figures. 4.1 Spend of Carers Act funding awarded to local authorities Of the total funding awarded to local authority areas (£88.4m) across Scotland the percentage spend under each of these headings can be seen in Figure 3 below: Figure 3: Scottish average % spend of Carers Act funding awarded to local authorities *The ‘missing’ 15% in this figure relates to the funding which was not allocated to HSCPs. 68% 11% 2% 5% % spend of total funding awarded* Direct support for carers / implementation Indirect support for carers / implementation Not related to support for carers / implementation Other / not yet allocated Page 114 of 270
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6 | Pa g e 4.2 Spend of Carers Act funding allocated to HSCPs When reported spend was analysed against the £74.9m of funding that was reported as actually allocated to HSCPs, there was a 12% variance in the ‘direct support for carers/implementation’ heading. FOI responses suggest that of the £74.9m allocated to HSCPs: • £59m was spent on direct support for carers / implementation • £9m was spent on indirect support for carers / implementation • £2m of spend was not related to support for carers / implementation • £4m was either not yet allocated or related to ‘other’ spend Figure 4: Scottish average % spend of Carers Act funding allocated to HSCPs 4.3 Spend by local authority area Figure 5 below shows reported spend by local authority area. Figure 5: local authority spend of funding allocated to HSCPs (in £m’s) 80% 12% 2% 6% % spend of awards allocated to HSCPs Direct support for carers / implementation Indirect support for carers / implementation Not related to support for carers / implementation Other / not yet allocated 0 2 4 6 8 10 12 Aberdeen Aberdeenshire Angus Argyll & Bute City of Edinburgh Clackmannanshire Dumfries & Galloway Dundee East Ayrshire East Dunbartonshire East Lothian East Renfrewshire Falkirk Fife Glasgow Highland Inverclyde Midlothian Moray North Ayrshire North Lanarkshire Orkney Perth & Kinross Renfrewshire Scottish Borders Shetland South Ayrshire South Lanarkshire Stirling West Dunbartonshire Western Isles West Lothian Direct support for carers / implementation Indirect support for carers / implementation Not related to support for carers / implementation Other / not yet allocated Page 115 of 270
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7 | Pa g e Two areas (Clackmannanshire and Shetland) did not report on any spend. As noted above, Clackmannanshire did not submit a FOI response and Shetland explained they could not provide information on funds allocated to the HSCP / spend due to Carers Act funding not being ringfenced therefore di\icult to identify. 4.4 Not related to support for carers / implementation Figures provided suggest that a total of £1.9m of reported spend was not related to support for carers / implementation. This comprised of ten areas which reported funds being used to o\set ‘Loss of income / Waiving Charges’ (Argyll & Bute £103k; Dundee £250k; Fife £332k; Glasgow £331k; Inverclyde £317k; Midlothian £60k; North Ayrshire £157k; South Ayrshire £170k; South Lanarkshire £150k; West Lothian £29k). 4.5 Not yet allocated / other Within FOI responses ten areas reported spending that was categorised as either ‘not yet allocated’ or ‘other’. This amounted to £4.1m. As the 2022/23 financial year ended in March 2023, it is assumed that spend identified as ‘not yet allocated’ was not spent within 2022/23. Area Not yet allocated / other Aberdeen £132,604 Dundee £98,461 East Dunbartonshire £88,538 East Lothian £186,413 Falkirk £23,000 Inverclyde £284,120 North Ayrshire £1,743,307 North Lanarkshire £1,032,017 Perth & Kinross £26,000 South Ayrshire £40,000 West Dunbartonshire £505,505 4.6 ‘Real’ spend of Carers Act funding on support for carers / implementation Removing both the ‘not related to support / implementation’ (£1.9m) and ‘unallocated / other’ (£4.1m) figures from the total reported as allocated to HSCPs (£74.9m) suggests the ‘real’ spend which can be accounted for was approximately £69m. This means that potentially, up to £19m of Carers Act funding awarded to local authorities in 2022/23 was not spent for on supporting carers (allowing for the two areas which did not report on spend). 5. Reliability of figures provided in FOI responses A number of discrepancies were noted through analysis of the data provided in FOI responses. These are summarised below, alongside any additional comments provided. 5.1 Carers Act funding awarded and allocated As noted above, of the £88.4m Carers Act funding awarded in 2022/23, only £74.9m was reported as allocated to HSCPs. This indicates that up to £13.5m was not passed on. Allowing for variances in reporting (i.e. grants awarded to Clackmannanshire and Shetland which were not reported on and ‘di\erences in reported allocations and spend’ (see point 5.2 below)) this figure could be slightly lower at £12.4m. While a proportion of this funding may have been used by local authorities to deliver young carer services, where this function is not delegated to HSCPs, there is still likely to be a significant shortfall. Page 116 of 270
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8 | Pa g e 5.2 DiRerences in funds allocated and reported spend In eleven areas there were di\erences between the funds reported as allocated to the HSCP, compared to the actual spend figures provided (resulting in a total reported overspend of £470k). In seven of these areas the discrepancies were minimal (< £25k over/underspend), however in the remaining four areas these were more notable: • Overspends: two areas provided figures which indicated spending was higher than the funds allocated to the HSCP (Highland £977k; Scottish Borders £28k). Highland provided an explanation that "NHS Highland have a budget for Carers Services that is comprised of both Carers Act Implementation funds and additional funding NHS provides from its general grant funding". • Underspends: two areas provided figures which indicated that Carers Act funding allocated HSCP was not fully spent during 2022/23 (Midlothian £477k; West Lothian £43k). Midlothian provided an additional comment that the ‘Shortfall in financial year 2022/23 has been committed to other years. Note that expenditure in 2023/24 exceeds budget. It would not give an accurate year on year comparison if the shortfall was marked as ‘used for a diGerent purpose/not allocated’ without a corresponding adjustment in financial year 23/24.’ Whilst noting this, it has been included here as an underspend as this report was only able to assess figures provided for 2022/23 financial year. 5.3 Voluntary sector funding and Carer Centre feedback Voluntary sector organisations (including Carer Centres) provide a range of services and support to meet the needs of carers and are key stakeholders in supporting the implementation of the Carers Act. As such, HSCPs provide a level of funding to Carer Centres and other voluntary sector organisations to undertake these services. FOI responses suggest funding in 2022/23 for Carer Centres, Young Carer Services and other voluntary sector organisations across Scotland amounted to £17.2m. Interestingly, within FOI responses 12 areas reported no spend at all against ‘Carer Centres’. One of these areas (West Lothian) provided additional information that their funding to Carers Centres comes from ‘core funding and not from the funding allocated to support the implementation of the duties in the Carers (Scotland) Act 2016’. It is unclear from FOI responses whether this may be the case in other 11 areas and/or if funding was allocated / categorised within one of the other budget headings. FOI responses were also shared with Carers Centres, some of whom noted a number of additional discrepancies: • Inconsistences in categorisation of spend: the way spend was categorised made it unclear how funds had actually been allocated and spent. For example, one area reported spend against ‘Carer Support Plans’ (generally undertaken by Carers Centres) but this funding was not allocated to the Carers Centre; and as highlighted above, 11 areas reported no funding at all being allocated to Carers Centres. • Variances in funding allocated and received: some FOI responses reported a higher level of funding allocated to Carers Centres than that which was actually received. • Un/reliability of FOI figures provided: in one local area an unpaid carer submitted a separate FOI request on spend of Carers Act funding in 2022/23. The figures provided in response to this separate request7 were di\erent to those received in the FOI response for this report (for the same area). It is therefore unclear which set of figures is correct. 7 7 https://www.whatdotheyknow.com/request/request_for_detailed_information_6?nocache=incoming- 2532145#incoming-2532145 Page 117 of 270
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9 | Pa g e 5.4 Reviewing and forecasting Short Break funding As well as highlighting challenges with the accurate recording and reporting of Carers Act funding, the information provided in the FOI returns also raised questions around the reliability of financial forecasting. The National Care Service (Scotland) Bill includes costings for the implementation of a right to breaks from caring within the Financial Memorandum (FM). In the FM the total cost to implement a right to breaks from caring have been calculated, and the current estimated spend by local authorities on short breaks has then been deducted from this total. Within these calculations £57.7m of Carers Act funding has been included as part of the estimated current spend on short breaks (adults and young carers) 8. However, FOI responses submitted for this report suggest the actual spend on short breaks totalled £26.8m in 2022/23. This would leave a shortfall of £30.9m in the calculations for the Financial Memorandum. 6. Conclusions and recommendations The FOI responses have raised a number of concerns around both the allocation of Carers Act funding and the actual spend on supporting carers / implementation. This included funding awards which were not fully allocated to the HSCP, as well as reported spend on areas which were not related to support for carers / implementation or funds which were reported as ‘not yet allocated/other’. In addition, as Carers Act funding is not ring-fenced, the availability, reliability and transparency of data showing how money was (and is being) spent is challenging. Indeed, Equal, Expert and Valued reports produced by COCIS in 2022 and 20239 show that details of Carers Act funding and spend very rarely appear within HSCP Annual Performance Reports or Annual Accounts. These key areas of concern combine to make it extremely challenging to fully track, understand and assess the impact of funding on the lives of unpaid carers, and the implementation of the Carers Act. This report therefore makes the following recommendations for Scottish Government, councils and local integration authorities to improve transparency in the reporting and monitoring of Carers Act funding: 1. Provide significantly more funding directly to third sector organisations (including Carer Centres) to expand and develop services to support unpaid carers, including a wider range of short breaks opportunities 2. Ring-fence Carers Act funding and develop consistent budget headings for use by all local areas. 3. Develop financial reporting processes to ensure robust tracking, monitoring and forecasting of spend under each budget heading. 4. Ensure HSCP Annual Performance Reports provide details of support for carers / Carers Act implementation and Annual Accounts provide figures for Carers Act funding, to improve transparent reporting of impact and spend. 8 Social Work Scotland (2024): Costing Carers’ Rights to a Break Comments on the Revised Financial Memorandum of December 2023 to the National Care Service (Scotland) Bill 2022, pages 21-22: [1] 9 https://www.carersnet.org/carers-collaborative/ Page 118 of 270
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10 | Pa g e Appendix 1 Categorisation of reported figures within the headings used in this report to analyse spend of Carers Act funding: Direct support for carers / implementation • Carer Centres • Young Carers Services • Other voluntary sector • Short breaks (adult carers) • Short breaks (young carers) • Other (adult carers) • Other (young carers) • Awareness raising • Engagement / consultation • Carer support posts in HSCPs Indirect support for carers / implementation • Strategic posts in HSCPs • Health board Not related to support for carers / implementation • Loss of income (Waiving Charges) • Implement Living Wage Other / not yet allocated • Other / not yet allocated Page 119 of 270
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1 Update from Lanarkshire Carers for North Lanarkshire Committee 2023 Background and General Information At the Annual General Meeting that took place on 27 September 2023, Lanarkshire Carers presented their Annual Report for the reporting year 1 April 2022 to 31 March 2023: Carers at the Centre. This committee update paper should be read in conjunction with the full annual report that can be accessed using the link below, along with the accompanying documents that provide further information. Lanarkshire Carers Annual Report 2022- 2023: Carers at the Centre 132 reasons to come and have a conversation with Lanarkshire Carers Lanarkshire Carers Service we offer booklet Caring roles are unique because individual circumstances are different for each person. The contribution carers make across every locality in Lanarkshire is enormous, with people of all ages and in various situations providing care for some else. Lanarkshire Carers works with and for carers to make a positive difference to their lives. We are commissioned by Health and Social Care North Lanarkshire (HSCNL) to provide information, advice and direct support services to unpaid carers and by South Lanarkshire Health and Social Care Partnership (SLHSCP) to provide engagement, empowerment, representation, information, advice and direct support services to unpaid carers. Services are open to all carers aged 18 years and older living in Lanarkshire. Both contracts are currently in place until 2025. Both also include delegated responsibility to lead on the provision of Adult Carer Support Plans in specific circumstances. Every carer has a right to be offered an Adult Carer Support Plan and we have a partnership statement in place that sets out local arrangements and responsibilities to meet this duty. Accessing early support is key to making sure carers can manage their caring role. We provide personalised help throughout the caring journey, working with individuals and groups, building relationships with carers, helping them to identify and address their support needs and making sure carers know their rights. We offer support and services across Lanarkshire through community outreach work, as well as in our own premises in both Hamilton and Airdrie. Lanarkshire Carers staff are co-located in social work localities, the three hospital sites and community health venues. To further enhance our generic services, there is also tailored support for carers from Black, Asian and Minority Ethnic (BAME) communities, Young Adult Carers aged 18–25 years old and other groups of carers who are under-represented. We work in partnership with a range of organisations and services that also help carers. Carers most frequently self-refer to the organisation. Facilities are also in place for professionals from any organisation to make direct referrals. The organisation continues to experience, and report increased levels of new referrals, along with increased complexity of the caring roles involved. Lanarkshire Carers delivers personalised, and case managed, emotional and practical help through meaningful, outcome focussed conversations with trusted, skilled and experienced professionals. A personal outcomes approach to carers support is integral to our work, providing the right support at the right time. It starts with a conversation, helping carers to understand the impact their caring role is having on their lives, what’s important to them and who can best offer the support they need. We take a strength-based approach encouraging carers to consider what they can do for themselves; what support is available through wider community resources and through the services we provide. We use the national wellbeing indicators as a guide to help carers to think about what matters to them, developing personal outcomes that form an Adult Carer Support Plan. This is underpinned by anticipatory and preventative measures and has a focus on providing tailored support to empower the carer. Thinking ahead and planning for the future are key aspects of the conversations we have with carers. Plans are agreed in partnership with carers and rather than focus on paperwork being completed, the emphasis is on the professional relationship and the conversation. This is recorded in a purpose build client relationship management system and the process is further supported through CarerSpace; an online portal for carers to start or continue their conversation with us. Carers do not have to repeat their story as they are already using the Appendix 4Appendi Page 120 of 270
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2 outcomes of their conversations to co-produce an Adult Carer Support Plan. The information is all in one place, and all the toolkits and conversations are linked together. Lanarkshire Carers Key Figures for North Lanarkshire (from April 2022 to March 2023) • 1,127 New carers in contact with Lanarkshire Carers. • 5,976 Carers are known to Lanarkshire Carers. • 3,363 Carers accessed Lanarkshire Carers services in reporting period. • 26,062 Services access by carers from Lanarkshire Carers. • 182 Young Adult Carers known to Lanarkshire Carers. • 363 Carers from Black, Asian minority ethnic (BAME) communities known to Lanarkshire Carers. • 817 Carers attended one or more training sessions. • 99 Carers took part in one or more carers week events. • 73 Carers referred to counselling and wellbeing service. • 27 Carers benefitted from the supermarket voucher initiative. • 928 Carers benefited from grant funding. • 1,173 Carer card holders. • 1,395 Carers were signposted, referred, or informed about the role of partner organisations (2022- 2023). • 912 Adult Carer Support Plans progressed by Lanarkshire Carers. We have been able to sustain increased service delivery levels through our system change and practice development. This is particularly relevant in relation to ACSP figures reported when an artificial peak was created last year through an additional resource allocation. This involved re prioritising activities for a short period of time in response to the national winter funding package for unpaid carers. Our recorded conversations with carers have been consistently higher each quarter this year compared to the previous 3 years, with one exception – the peak due to the winter funding package. Our conversation first approach continues to support all grant funding allocation. Achieving Quality Standards - Excellence for Carers Award Lanarkshire Carers has recently successfully achieved the Carers Trust Excellence for Carers Award. The award follows a rigorous assessment of Lanarkshire Carers services to unpaid carers across both local authority areas, as well as the quality of our leadership, staff, internal processes and engagement with key local partners and stakeholders. By achieving the Excellence for Carers Award by Carers Trust, Lanarkshire Carers demonstrates: • A clear and complete approach to involving carers in the work, activity and life of the organisation at every level in meaningful ways that value carers and makes a real difference to them. • A positive approach to the use of technology and digital to support carers and ensure services to carers are inclusive, accessible, and seamless. • Everyone at the organisation is focused on making a difference for and with carers. They are clear about what their purpose is, and they take a solution focused approach that helps carers articulate the challenges that they are facing and the outcomes they are seeking to achieve. • The leadership of the organisation is an example of best practice, nurturing sustainability, lateral leadership, and succession planning, which allows for a clear focus on strategic development that has unpaid carers at its heart. • There is an abundance of team passion, commitment, and enthusiasm, at all levels, to provide excellent services for carers. • Good practice in identifying unpaid carers and supporting and being inclusive to carers from a range of backgrounds and identities, particularly carers from BAME and LGBTQ+ communities. • Lanarkshire Carers approach to supporting staff wellbeing was impressive – its carers for carers and carers for its staff and volunteers. In making the award, Carers Trust has stated in the report that: “Lanarkshire Carers demonstrates excellence across all the Excellence for Carers standard areas. The service is well run, delivers a broad range of person-centred services for carers, and has built positive partnerships with external organisations for the benefit of carers in the local area." "The team are focused on delivering excellent services but are clear on where their expertise is and recognises the value of partnership working with others to support carers in their communities." Appendix 5 Page 121 of 270
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3 "The organisation demonstrated a clarity of purpose and Carers Trust are impressed with the whole organisation- the Trustees on the Board of Directors, Management and Staff team should be immensely proud of the work that they do to make a difference to the lives of unpaid carers.” It was also noted that Lanarkshire Carers have a strong commitment to carry on making developments and improvements: “There was clear evidence of nurturing sustainability, lateral leadership and succession planning, which allows for a clear focus on strategic development, is embedded in their collective thinking and approach… a clear, cohesive and holistic narrative on their strategic focus on sustainability, outcomes and taking a carer-led approach to their delivery, culture and systems and processes… a genuine sense of inclusion with all staff, they are meaningfully involved in service development and there is a sense of shared ownership when it comes to the successes that they achieve." As an organisation run by, with and for carers we are absolutely thrilled to receive this external verification of our positive approach and clarity of purpose. It was great to be able to share this news with our Full Members who attended our AGM, especially when the theme of this event was Carers at the Centre. The team work incredibly hard to ensure quality standards are embedded in all areas of our work and to make a positive difference to the lives of carers across Lanarkshire. Governance, Involvement, Participation and Feedback As a carer-led organisation, carers can choose between Full or Affiliate Membership and can easily change between the two. The Board of Directors is elected from and by the full membership and meets regularly throughout the year. Directors volunteer their time to carry out this governance role and have overall responsibility for the organisation, our mission, vision and strategy. Some Directors currently care for someone whilst others have cared for someone in the past or have particular skills and knowledge the board needs. They all share a genuine and strong commitment to influencing and shaping services that identify, engage, inform, involve, empower and support carers. Board members make a significant contribution to the organisation both individually and collectively. The Board adopted The Scottish Good Governance Code for the Third Sector which ensures good practice. Connecting with members of the organisation is a priority and activities with Full Members have taken place throughout the year. This includes information sessions for carers who want to find out more about the organisation and how they can get involved. This work has been supported through participation and involvement training for Full Members. We recognise the contribution carers make, the rewards and challenges of caring and the impact a caring role can have on many aspects of life. Carers make time during their busy and demanding days to contact us about our services and the feedback highlights why the information, advice and support we provide matters. Comments are always read and shared, and it is very reassuring to hear about the positive difference made. We have published a collection of our #feedbackfriday posts in the booklet linked above. Through quarterly contract monitoring reporting arrangements, we provide numerous case studies and evidence of carers feedback and evaluation. We also prepare other reports and responses as required. An example of this recently was the Creative Break Time to Live snapshot report. We contacted every carer who had received micro grant funding between January and June 2023. Over 100 carers took the time to respond, telling us how we are getting this right for them. We always ask about the person they care for and when issues are identified we offer advice and can also negotiate, represent and advocate on behalf of carers in relation to this. 100% of carers responding felt listened to and supported by the member of staff who completed the grant plan with them. 100% of carers responding said a grant payment is their preferred way of accessing a short break from caring. Carer engagement and involvement is an important part of our work. We support carers to have their voices heard through local and national focus groups, surveys, consultation and other activities. The organisation also represents carers locally and nationally. Lanarkshire Carers Short Breaks Bureau (SBB) The SBB has local and national prominence and is an integral part of our commissioned service. In September 2023 we represented Lanarkshire at the International Short Break Association (ISBA) Conference in Poland. We are Shared Care Scotland’s local delivery partner for Creative Breaks Time to Live funding. We have levered in and managed extensive additional resources and funds that help support carers to access short breaks and deal with the financial impact that caring often has. The amount of individual carer grant funding Lanarkshire Carers has awarded to carers has increased significantly with a focus on supporting those in need of a personalised short break from caring as well as those needing financial assistance to cover essential and emergency costs. Page 122 of 270
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4 The ScotSpirit Holiday Voucher Scheme ensured additional breaks and holidays for carers across Lanarkshire through our local delivery of this national scheme. Developing short break initiatives such as Respitality has further expanded options for carers and we continue to distribute the Lanarkshire Carer Card initiative with access to many perks and discounts. The move to a digital card has maximized efficiency in managing this scheme, which we know is valued by many carers in Lanarkshire who apply/renew each year. We have responded to the cost-of-living crisis through partnership and development to meet the needs of carers quickly and efficiently. Lanarkshire Carers Flexible Support Fund supports this crucial part of our work, ensuring funding is available as part of a support plan for carers when this need is identified. These grants can help meet the costs of a range of things to help improve carers situations and are linked to a recorded outcome in an Adult Carer Support Plan. Many carers are facing immediate financial hardship and our response included establishing a Carer Supermarket Food Voucher Initiative. This proved to be extremely well received, offering immediate help to carers who are struggling financially. Due to the outcomes achieved, we are continuing this initiative, funded through Carers Flexible Support Fund and have developed the processes required for its successful delivery. Lanarkshire Carers distributed/approved a total of £659,181 grant payments during this reporting year equating to £12,676 of direct carer grants per week. This is a remarkable achievement for a small team who are making a very big impact. Recognition of the carers representatives involved is highlighted as they volunteer their time to bring lived experience to the grant funding panel process. Lanarkshire Carers Black, Asian and Minority Ethnic (BAME) Carer Support and Equalities Service Development activity has taken place through the delivery of our Making Carers Count project with a focus on LGBTQ+ carers. Innovation and best practice are central to our work and this year our staff learning and development programme has included the delivery of bespoke and specialised, diversity, equality and inclusion opportunities. This work also helped us achieve the Scottish Rainbow Partnership award and we were delighted to be Proud Scotland Small Employers Award winners in June 2023. Carers Census Data Lanarkshire Carers contributes to the requirement of Carer Census Data returns for North Lanarkshire, shared annually with Scottish Government to measure the impact of the implementation of the Carers (Scotland) Act 2016. We have developed systems to capture and report data on carers who access support through our service. For 2022-2023 reporting period, Lanarkshire Carers included 6,633 carer records in our return to Scottish Government (3,353 North Lanarkshire, 3,280 South Lanarkshire), detailing the types of support carers required and the how carers are supported to meet their needs. We carry out regular data cleansing activity to ensure the data we record and report on is as accurate as possible. The total number of carers supported figure reported at any time reflects only those that are currently known to the organisation and not the many carers who have moved on from the organisation due to a change in circumstance and/or support needs. Care Inspectorate ‘Understanding carer’s experiences of social work and social care service delivery’ Inquiry Following our contribution to the enhanced inquiry in North Lanarkshire, we received a detailed report from the Care Inspectorate outlining the key messages and areas of learning and improvement. Lanarkshire Carers noted a number of highlights in the local report and our practice leading to more positive experiences for carers in Lanarkshire including that: • 69% of carers in North Lanarkshire said their Adult Carer Support Plan helped them do things that are important to them compared with 42% in Scotland. • 74% of carers in North Lanarkshire said their Adult Carer Support Plan helps make sure that they get the right support to keep caring compared with 54% in Scotland. One carer from Lanarkshire, quoted in the report, refers to support available for carers and draws attention to the impact of our approach: “All the above support is provided to me by Lanarkshire Carers. They have always been transparent, honest, and timely, I would have been lost without the help and support Lanarkshire Carers have provided to me.[..] Funding to buy a cooker and folding bed from [Lanarkshire Carers Short Break Bureau] supported me through a hard time and helped [..] to cook for my family”. It was also good to see areas of our practice identified as possible positive practice examples with the care inspectorate highlighting our CarerSpace Portal, Hospital Linked Support Programme and BAME and Equalities service in their final presentation. Exemplary Status for Carer Positive This award is presented to employers in Scotland recognised for exemplary support for working carers and we were delighted to achieve this in March 2023. The health, wellbeing and development of all our staff remains a Page 123 of 270
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5 key priority supporting a diverse and highly skilled workforce able to meet the needs of carers. We have an Employee Assistance Programme and an extensive Staff Learning and Development programme. Our staff team go above and beyond to achieve the outcomes reported by the organisation with outstanding achievements over the last year. Lanarkshire Carers is a local employer of 38 people who mainly all live and work within Lanarkshire, many of whom are carers themselves. Partnership Lanarkshire Carers is an active participant in each of North Lanarkshire Local Consortiums, Strategic Commissioning Group, Carers Oversight group and other local networks and partnerships. Links are also being re-established with the Locality Planning Groups. We are supporting the consultation process in relation to the new Carers Strategy and other key documents in North Lanarkshire, providing a voice and input from and on behalf of unpaid carers. We deliver a range of information activities and presentations about the role of our organisation. www.lanarkshirecarers.org.uk 01698 428090 / 01236 755550 Author: Barbara McAuley, CEO, Lanarkshire Carers 3 October 2023 Page 124 of 270
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North Lanarkshire Carers Together (NLCT) provide a Campaigning and Representation service and are the dedicated Information and Advice service for carers and professionals who come into contact with carers. Information Over the past reporting period we have worked with 475 carers, 298 of those were new to the service and had not been in contact before, with the remaining 177 coming back to us as trusted providers of Information, Advice, and an active referral service. It is pleasing that so many carers trust our staff, and we have seen the number of contacts we make with carers increase significantly to an average of 4.6 times. This is more time spent emotionally supporting carers, providing information on their rights, and actively linking them into available supports in the community. The average length of each of these contacts is just under 1 hour, so this is reflective of the ongoing and increased challenges being faced by carers during the current climate of cost-of-living pressures and social care crises. The services our staff provide however, mean that more than 86% of carers who contact us can have their support needs met by us and our partners, rather than statutory services. This is testament to the vibrant third sector and the relationship we enjoy with so many of our brilliant partners. During the carer contacts, 1024 signposts and referrals were made on behalf to carers. These included carers directed to Bereavement/Counselling, Care Opinion, Carer Support across a range of organisations, Community Groups, Funds & Trusts, Tackling Poverty Team, and Health & Social Care services. In May 2023 we sent out over four thousand newsletters providing a range of information on ours and partners services. We have also increased our presence online via our website and social media channels. We use Facebook and Twitter and have seen our Twitter presence increase by over 27% in the last 2 years, and Facebook increase by 49% in the last 2 years. On Facebook alone, we reached 43,825 people in the last year. Our Mail Chimp platform is our way of keeping carers and our partners up to date with newsflashes and alerts direct to their email inboxes. Our experienced staff team have noted that our response and reaction rate to these emails are better than average comparative to other third sector organisations we have worked within. These platforms are a modern, convenient way to take part in snap polls, surveys and to keep up to date with information relevant to carers and the people they care for. While we still engage with carers face to face and in-person, the use of these platforms mean we can optimally meet our contractual obligations regarding engagement and participation. A novel way of ensuring information is available; our listening audience continues to grow as we share the stories of carers and partners through our Carer Podcast. Following the launch last year with the actor Jane McCarry, we have other interviews available to listen, including a local GP discussing the importance of carers being supported and listened to; a carer discussing the challenges and sharing her story in accessing respite for her husband; and a Senior Officer from Health & Social Care discussing the upcoming refresh of the North Lanarkshire Strategy for Carers. We were delighted to have recently been entrusted with additional investment to recruit a Carer Information & Engagement Worker (Equalities) with a focus on providing a service to marginalised communities, such as the BAME, LGBTQI+, and rural communities of carers. Carer Engagement & Representation Aligning closely with the North Lanarkshire Engagement and Participation Strategy and the Coalition of Carers in Scotland 3 Best Practice Standards for Carer Engagement, we recognise carer engagement Appendix 5 Page 125 of 270
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and representation is essential to the development of local services and policies and to feed into national and local consultations. This must be meaningful, supported, funded and crucially the loop needs to close in that there has to be feedback to carers who give their time to contribute. NLCT frame all consultation with our guiding principle ‘We Asked, You Said, We Did’ and is our promise to those carers who form part of our Carer Forum. The Forum meets in-person, digitally and also has a closed private social media group. It has eighty-eight members. The Care Inspectorate is a scrutiny body which supports improvement in the quality of care in Scotland to ensure it meets high standards. Where they find that improvement is needed, they will support services to make positive changes, including recommendations to underpin that support. On hearing the Inspectorate’s intention to undertake a National Inquiry into carers’ experiences of adult social work and social care, which included a more detailed scrutiny into 5 Health & Social Care Partnership areas, North Lanarkshire Carers Together campaigned in late February last year to have North Lanarkshire as one of those areas, and following this intimation, North Lanarkshire Health & Social Care volunteered to take part and we were delighted to lead on this locally from April through to June, in partnership with Lanarkshire Carers. It was a detailed and intensive piece of work including scrutiny of Health & Social Care as well as surveys and facilitated discussions with both Carer Centre’s staff and managers, a specific survey by a nominated staff member in both Carer Centre’s and detailed group and one-to-one discussions with carers themselves into their experiences. It was not a good picture for carers across Scotland, but carer’s experiences were heard to be better in North Lanarkshire compared to other areas in Scotland. We also led on other consultations to shape services including Scottish Government changes to Carers Allowance, and the digitisation of the Community Alarm system in North Lanarkshire. Campaigning In partnership with the Carer Positive Team at Carers Scotland, our service host two events each year identifying and encouraging local partners to become carer positive employers and recently campaigned in support of the private members bill to Westminster for statutory time off for those working alongside a caring role. As costs of living continued to increase, carers told us how difficult things were becoming for them. Their feedback combined with timely reports from national organisations led to our Cost-of-Living campaign focussing on the impacts on carers in North Lanarkshire. We published our findings, making recommendations to Health and Social Care North Lanarkshire early last year. These recommendations were met in full besides one for a cash-first payment to support families due to potential triggers of a benefits check that was advised by Social Security Scotland. Our most recent campaign was on carer breaks in North Lanarkshire. The topic was high on the local agenda, but one carers story brought to the attention of Health & Social Care prompted a wide- reaching consultation to ascertain carers experiences of sourcing information on and accessing a short break. The report concluded with recommendations on improving the landscape, with one key recommendation being that carers are involved in every future step looking to improve short breaks. A key piece of work we provide is our Carer Aware Programme - where we deliver information sessions to carers and partners, informing them of the Carers (Scotland) Act 2016, of carer rights, and where and how to access support and services for carers locally. Over the past year we have delivered twelve sessions to 175 participants, which includes six sessions to ninety front-line Health & Social Care staff. Page 126 of 270
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Partners and carers who take part continue to tell us the rich value the information brings and helps to improve outcomes for carers. Carer Breather One of the more significant carer-led developments over the last 2 years was the Carer Breather programme. Designed by carers from the offset through robust consultation on what types of short break would help most to allow them a local and regular breather from caring; the first round of services ending in March last year was a huge success. Evaluations proved successful with a published report now available. In our role as Carer Network Lead, we were delighted to have been entrusted for a further 2 years covering the period April 2023 – March 2025 to lead on new Carer Breather services. A fresh investment of £600,000 by Health & Social Care to our partnership with Community Solutions (VANL) meant that through a multi-agency panel which included carers, we were able to allocate this investment into organisations and community groups geographically spread across North Lanarkshire to provide local carer breaks. A key addition this time around includes better provision for parent carers of children with additional support needs. Services offering these supports include One Parent Families Scotland, Play Peace and Pamis. The organisations funded in this round are: • Bazooka Arts • Getting Better Together Shotts • Glenboig Development Trust • North Lanarkshire Disability Forum • One Parent Families Scotland • Pamis • Parkinson’s Self-Help Group Airdrie • Play Peace • The Haven • The Health and Wellness Hub • Watch Us Grow Carer Breather is pioneering and has attracted national attention as a model of good practice in supporting carers and has been nominated for a national award. Advocacy North Lanarkshire Carers Together have one staff member providing an Independent Advocacy service for adult carers living in North Lanarkshire. Over the course of the last year, we have provided 1-to-1 advocacy to forty carers for a range of support needs. The carers ranged from aged eighteen up to carers in their seventy’s, carers who lived across the six localities in North Lanarkshire and who cared for people with mental health challenges, autism, learning and physical disabilities, and addiction. The Page 127 of 270
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type of help and support we have provided includes support with Self Directed Support packages, hospital discharge, housing, accessing respite or short break provision, and Power of Attorney. This service ensures that carers have full access to their rights as outlined within the Carers (Scotland) Act 2016. We know that health and social care systems can often be difficult to navigate, coupled with the fact that many people struggle to understand their rights as unpaid carers, and our service seeks to address those issues. Family Support Service Commissioned by North Lanarkshire Council Education & Families, our Family Support Service has grown this year with two full time staff now providing a whole-family support service since January. Support to families is community based, responsive, timely, and flexible whilst providing the opportunity for families to be listened to. The support can be emotional or practical, help to understand the child/young person’s diagnosis and needs, signposting to further services, and support that may benefit the family within the local community. The support is tailored to meet the needs of each individual family, and this is aligned with the Ten Principles of Intensive Family Support within The Promise as well as the child/young person’s Wellbeing Plan and is underpinned by Children’s Rights. Families able to access the service are those where there is a child/young person with: • A neurodevelopmental profile • Social communication difficulty • Challenges with emotions • Behavioural issues • Other similar challenges • There is no need for a diagnosis to access the service. It is a niche service with referrals only accepted via the young person’s school or for those children on the waiting list for a neurodevelopmental assessment, via the Neurodevelopmental Team. Over the course of this year, we have worked intensively with 227 families, ensuring parents/guardians are better informed and more able to cope with challenges they may have been facing and young people meet their own outcomes. Page 128 of 270
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كككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككككك NLYC has continued to complete Young Carer Statements, assessments, reviews, and referrals for the young carer service. This includes online referrals via www.northlanarkshireyoungcarers.org We have been very busy providing varied and extensive short breaks for our service users in line with the requirements of the Carers Act Scotland. In the last quarter we completed over 50 (1:1s) and 36 young carer Groups. (Within the service and the community) We continued to apply for short breaks funding from the Lanarkshire Carers Centre (Short Break bureau). In March alone the team at NLYC successfully applied for £3990. Through Action for Children, we continued to provide added value which allowed us to enhance the service environment and quality of outings. We have been involved in aspects of development of the Childrens Plan in NL as well as the Carers Strategy group in NL. We participated in young carers day 2024 and had a large article in the Daily Record online platform. We continued to develop new awareness materials for the public as well as updating our website and Facebook resources. We continue to work with several partners including: ASH, NLCT, Reel time studios, Landed, CAMHS, New College Lanarkshire, Lanarkshire Carers Centre, FAMS, H&W HUB. Partnership remains critical to the success of the service. We supported NLC on design of the new Carers Strategy document via several meetings and provision of statistics. Staff continued to provide Mental Health supports to young carers including access to professional counselling for the most effected young carers. The service continues to work in most High schools in NL. In quarter four we presented to over 1500 first year pupils, 50 staff and 105 children attended school drop ins. We had some issues with our vehicle pool, with one vehicle being out of use for three months. We continued to have issues changing the electricity supplier for our new location in enterprise House. We had two staff leaving service, but this was covered by management. We have continued to work with Lanarkshire Carers Centre and the short breaks bureau to provide short breaks finance to service users and their families. In addition, we secured over £1k in respitality support from the Bureau for our families. We continue to work with Lanarkshire Carers Together, VANL, Education via high schools in North Lanarkshire and advocacy services. Our awareness presentations and drop-in sessions continue within the high schools in North Lanarkshire. (This is a major part of our work). This quarter we worked with ASH, NLCT, Reel time studios, Landed, CAMHS, New College Lanarkshire, FAMS. We worked with Outward bound) on a residential in April), Carers Trust, Coalition of Carers, we also worked with Cumbernauld ‘Lantern house’ Theatre, Flip-out, Innoflate (Cumbernauld), The Health and Wellness Hub (Motherwell), Motherwell and Airdrie Consortium, CYPF Network, CSN Network, NHS Lanarkshire, Carers Rights and Support Steering Group and VANL. Adults form North Lanarkshire Carers Together have used our podcast suite twice this quarter. We continue to work closely with Motherwell FC and the Charity Foundation and Ravenscraig sport venue. Many short breaks for carers have been provided. We have settled into our new premises � Ě9كﻼÄx”9�ك• ¾╔→╗╤كĚ→╗ك9→σ σ ň╤╤¾¾ Appendix 6 Page 129 of 270
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which we continue to develop, and this has been viewed very positively by carers and families and other partners. Financially, we successfully applied for £25k of additional funding for 2024-25 to support mental health and Cumbernauld \ Kilsyth area. We now have 10 season tickets to Motherwell FC which are used by YC and families. Some recent stats: 16 cases closed this 4th quarter. 142 actual young carers with direct support Over 130 families \ siblings involved in some form with NLYC. Over 1500 school children received awareness training Together, VANL, Education via high schools in North Lanarkshire and advocacy services. Our awareness presentations and drop-in sessions continue within the high schools in North Lanarkshire. (This is a major part of our work). Recently we worked with ASH, NLCT, Reel time studios, Landed, CAMHS, New College Lanarkshire, FAMS. We worked with Outward bound) on a residential in April), Carers Trust, Coalition of Carers, we also worked with Cumbernauld ‘Lantern house’ Theatre, Flip-out, Innoflate (Cumbernauld), The Health and Wellness Hub (Motherwell), Motherwell and Airdrie Consortium, CYPF Network, CSN Network, NHS Lanarkshire, Carers Rights and Support Steering Group and VANL. Adults form North Lanarkshire Carers Together have used our podcast suite twice this quarter. We continue to work closely with Motherwell FC and the Charity Foundation and Ravenscraig sport venue. Many short breaks for carers have been provided. We have settled into our new premises which we continue to develop, and this has been viewed very positively by carers and families and other partners. Financially, we successfully applied for £25k of additional funding for 2024-25 to support mental health and Cumbernauld \ Kilsyth area. We now have 10 season tickets to Motherwell FC which are used by YC and families. This has been a very busy period for NLYC. We have continued to provide short breaks, complete Young Carer Statements, and provide advice and support to families. Added value remains a very important part of the service with budgets so tight. Partnership also remains critical, and we worked with a variety of carer partners, local businesses, national carer organisations and local sports facilities. We continued to work with the Motherwell FC community Trust providing sports sessions for our young carers. In March we had a large article in the Daily Record around carers day and one of our service users. This highlighted what the service means to him and his family. Young carers enjoyed trips to Wicked, The woman in Black, Flip-out, Innoflate, Café Ceramo, Golf, Bowling, Cinema, and local restaurants. We had 203 young carers attend a cinema event in Cumbernauld theatre recently. We have continued to develop our service to make it more short break friendly. Recently we fitted a pool, table, air hockey table and two retro gaming machines. We also have a darts board and invested in more PS5 games for young carers. We work directly with our service users and their families. We consult via meetings, on-line support, school support and through our secure Facebook page and website. We regularly phone our service users as well as using texting services. We use questionnaires and group \ individual feedback sessions as well as provide comments and suggestions platform Page 130 of 270
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within the service and on-line. In quarter four our YC were consulted on the new Carers Strategy document for BL, as well as by ASH Scotland (Vaping) and landed. We have had very positive feedback from service user families. As part of our review, we ask for feedback from families and parents as to the service provision. We also invite comments via Facebook. We have recently been involved in several electronic surveys around service user feedback via Action for Children and the carers Trust. This quarter we had a questionnaire on the new Carers Strategy document for NLC. In quarter four we introduced new Friday feedback sessions held in localities in NL and attended by young carers. (we used menti-meter) We are aware of the North Lanarkshire Health and Social Care partnership page on care opinion. We see it as a platform for the public to comment on service provision. We encourage parents to utilise the site, however as we are a children’s service our service users tend to communicate directly with us, and not via the site, we have had no young carer related comments placed on the site for North Lanarkshire. We will look to promote better use of the site for our families wishing to feedback on services moving forward. Action for Children is committed to ensuring our employees and workers are enabled to work in a safe way and protected from harm and safeguarding is integral to everything we do. Funds have been used in line with service level agreement. Action for Children have also supported the service with substantial Added value via: Herbalife, Covid Fund, William Grant Foundation. The service has also successfully applied for £20k of mental health funding recently and 3% to support young carers in the Cumbernauld locality. In quarter 4 we met with over 1500 school pupils in NL to give awareness training. We have been using facilities in Cumbernauld, Motherwell, and Wishaw. In quarter four we secured £5k of funding to support carers in Kilsyth and Cumbernauld locality, working with local companies to improve quality of life within the carer’s community. Page 131 of 270
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North Lanarkshire Council Report Adult Social Care Committee Does this report require to be approved? ☐ Yes ☒ No Ref MD/AMcG Date 14/05/24 Community Solutions Programme From Morag Dendy, Chief Officer Performance, Planning & Quality Assurance E-mail Thomas.moan@vanl.co.uk Telephone 07923 444638 Executive Summary This report provides an overview of our North Lanarkshire Community Solutions Programme and its reach and impact during 2022-23. Community Solutions is a successful, cross-sector health and social care investment and improvement initiative, established in 2012. The programme’s aim is to improve people’s health, wellbeing, quality of life and equality by investing in community-led initiatives which build community, family and individual strengths and resources - with a focus on prevention and early intervention. The programme is an innovative, effective, and respected partnership between the University Health and Social Care North Lanarkshire (UHSCNL) North Lanarkshire Children’s Services Partnership (NLCSP) Voluntary Action North Lanarkshire and the wider community and voluntary sector. The programme also involves and supports people, unpaid carers and the wider public in the development, design, delivery and evaluation of the programme. During 2022-23, the Community Solutions Programme: • awarded £3.1 million in funding to 233 projects/services delivered through 98 community and voluntary sector (CVS) organisations. • through these funded projects provided support to 43,100 people in North Lanarkshire, with the majority reporting benefit. Above data for the period 2023-24 will be available in September 2024. Recommendations It is recommended that the Adult Care and Social Work Committee note this report, specifically: (1) The Community Solutions programme’s achievements between 2022-23. (2) The programme priorities for 2023-25 and that the Annual Report for this period will be available in Sept. 2024 and will provide details of achievements for this period. Item 5 Page 133 of 270
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1. Background 1.1 Community Solutions is a successful, cross-sector health and social care investment and improvement programme for North Lanarkshire, established in 2012. The programme is improving people’s health, wellbeing, quality of life and equality by investing in community-led initiatives which build community, family and individual strengths and resources - with a focus on prevention and early intervention. 1.2 The programme invests strategically in the Community and Voluntary Sector (CVS) through several, complementary strands of work. 1.2.1 Local partnership-working between the CVS and public sector through six Community Solutions Locality Consortia, to identify and respond to local needs supported by six Improving Lives Locality Development Plans (LDPs), which are developed collaboratively by partners with people, carers and residents. These LDPs identify priorities for local CVS capacity-building support and for funding awards to the CVS through the Improving Lives Local Activity Fund, which makes small funding awards to CVS organisations to help them deliver additional support to residents. The six Community Solutions LDPs link to and support delivery of the Community Solutions Strategy and Investment Plan; the UHSCNL Commissioning Plan and the Locality Outcome Improvement Plans. 1.2.2 Development and delivery of direct support and services by CVS organisations on a range of thematic issues including anticipatory care; befriending; carers’ support; community transport; hospital discharge support, mental health and wellbeing and more. A phased review of these themes by a cross-sector panel is currently underway and will report from autumn-winter 2024. 1.2.3 Capacity building on the following: • carers, with delivery supported by Carers Together North Lanarkshire. • the CVS generally and CVS organisations specifically supporting children, young people and families, with work supported by VANL and the six Community Solutions Locality Hosts. • volunteering supported by VANL, working with the wider CVS and public sector partners and the six Community Solutions hosts. (3) The contribution of the Programme to the Plan for North Lanarkshire’s health and wellbeing priority. (4) The role of the CVS in delivering the highly cost-effective services funded through the programme. (5) the collaborative, cross-sector approach to designing, governing, and delivering the programme, which includes staff from the council, NHS Lanarkshire, VANL and the CVS. The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (13) Improve preventative approaches including self-management and giving people information and choice over supports and services Programme of Work All Programmes of Work Page 134 of 270
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1.3 Community Solutions is a partnership programme involving a mix of partners and funders as follows: 1.3.1 University Health and Social Care North Lanarkshire (UHSCNL) which is responsible for planning, commissioning, and overseeing the delivery of community health and social care services across North Lanarkshire. HSCNL provides core and project funding for the Community Solutions Programme, as well as governance and delivery support for the programme. 1.3.2 The North Lanarkshire Children’s Services Partnership which is responsible for planning, commissioning, and overseeing children and young people’s services across North Lanarkshire. The partnership provides funding for the CVS to support children and young people’s mental health and wellbeing, which is managed through the Community Solutions Programme 1.3.4 NHS Lanarkshire, which provides funding for Improving Cancer Journey and Social Prescribing, supported by funding from MacMillan Cancer Care and the NHS Charities Together. 1.3.5 The Scottish Government, which provides funding for the Communities Mental Health and Wellbeing Fund directly to VANL and also for the Children and Young People’s Mental Health and Wellbeing Fund through the council. 1.3.6 Voluntary Action North Lanarkshire (VANL), the local Third Sector Interface (TSI), which hosts and manages the programme on behalf of UHSCNL, the North Lanarkshire Children’s Services Partnership and NHS Lanarkshire. VANL has Service Level and/or funding agreements with North Lanarkshire Council on behalf of the UHSCNL, NHS Lanarkshire and the Scottish Government. 1.3.7 The six CVS organisations that act as locality hosts for the programme and which receive annual funding to support their role. Locality Host Organisation Airdrie Diamonds in the Community Bellshill Orbiston Neighbourhood Centre Coatbridge Glenboig Development Trust Motherwell The Health and Wellness Hub The North Cornerstone House Wishaw & Shotts Getting Better Together 1.4 The Community Solutions programme is also supported by: 1.4.1 Wider engagement of our diverse, large, and vibrant CVS, with nearly 100 CVS organisations receiving funding through the programme and participating in the six Community Solutions Locality Consortia – along with public sector colleagues. 1.4.2 Participation of carers, people and residents in a range of different ways. Programme Governance and Accountability 1.5 The Community Solutions governance arrangements are supported as follows. • Six Locality Consortia, convened and supported by the six Locality Hosts. Page 135 of 270
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• A partnership Governance Group, convened and supported by VANL, with members including: o Council and NHS staff. o Representatives of the locality hosts and consortia. o Representatives for carers and people. o VANL’s CEO and a trustee representative. • Participation in UHSCNL Strategy Leadership Team meetings and Integrated Joint Board (IJB). 1.6 Programme accountability is supported through the above governance arrangements and: • Publication of Annual Programme Impact and Learning Reports. • Impact and Learning Reports for specific funds. • Regular updates and formal annual reports to IJB in autumn each year • Formal reports to other funders. • And, with this first report, to NLC’s Adult Social Care Committee. 2. Report Community Solutions Programme Achievements 2022-23 2.1 Highlights of the programmes achievements during 2022-23 are provided below, with full details provided in the Community Solutions Annual Report 2022-23. 2.1.1 During 2022-23, over £3.1m of funding was managed through the Community Solutions Programme by VANL on behalf of several funders including: • University Health and Social Care North Lanarkshire • North Lanarkshire Council • Scottish Government 2.1.2 Funding awards were made to a total of 233 projects, delivered by 98 CVS organisations. This included: • £2.2m distributed to CVS organisations to deliver direct support to local people. • £180k distributed to 6 Locality Activity Funds (£30k each) which funded 66 CVS projects providing support to local people. • £40K funding to Carers Together North Lanarkshire to support capacity building with carers with the North Lanarkshire Carers’ Network. • £30k for VANL to support capacity building work with CVS organisations supporting children, young People and families. • £60k for VANL to support general CVS capacity building, including governance, funding, finance, evaluation and other issues. • £38k for VANL to support volunteering development. • £240k distributed to 6 CVS Locality Host Anchor Organisations (£40k each) to convene the six Locality Consortia; support development and delivery of the LDPs and LAF; support CVS capacity building and volunteering. • £300k to support overall programme management, delivery and evaluation costs through VANL. 2.1.3 The CVS organisations receiving funding through the programme provided a wide range of supports and services to the public during 2022-23, including: Page 136 of 270
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• arts, play and drama. • bereavement and grief support • befriending • carers support, including sitter services, wellbeing therapies and breaks from caring. • community cafes and lunch clubs • community engagement projects • healthy eating and cooking classes • mental health and wellbeing support and holistic therapies • outdoor activities • physical activity and exercise 2.1.4 As a result of the above funding to CVS organisations providing direct services to the public, 43,100 unique individuals were supported A summary of the number of individuals receiving a service through Community Solutions’ funded projects reporting a positive outcome is provided below. Group Achieved Outcome Reported Outcome Children, Young People and Families 4,215 Children and young people’s health and wellbeing was improved. 941 Family relationships were strengthened. 1,141 Children, young people and families have become more resilient. Adults 14,007 Adults felt more connected, included, and safe. 16,050 Adults have improved health and wellbeing. 8.422 Adults felt more informed and aware. Carers 3,364 Carers felt more informed and aware. 3,770 Carers health and wellbeing was improved. 2,027 Carers were more able to have a life outside of caring. Page 137 of 270
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Programme Achievements 2023-24 2.2 Between April 2023-and March 2024, VANL managed the following Community Solutions Programme funds on behalf of funders, with just over £4 million in funding invested by 31st March through the following funds, capacity building and programme support. • Anticipatory Care. • Befriending. • Cancer Screening Inequalities Fund. • Carer Breather Fund - Phase Two. • Children, Young People and Families Mental Health and Wellbeing Fund - Phase Four. • Community Mental Health and Wellbeing Fund - Phase Two. • Community Transport. • Hospital Discharge. • Improving Cancer Journeys. • Improving Lives Initiative. • Locality Activity Fund • Positive Smoke Free Role Models • Social Prescribing • Support in the Right Direction 2.3 The Community Solutions Impact and Learning Report for 2023-24 is currently being collated and will be available in September 2024. This will be published on the Community Solutions website and formally shared with partners and Committee. 3. Measures of success Programme Evaluation 3.1 The Community Solutions programme supports evaluation of the reach and impact of every funded project and the programme as a whole through a sophisticated approach that also supports ongoing performance management, learning and improvement. This is supported by the Programme’s Performance Management, Evaluation, Learning and Improvement Framework (PMELI) and resources and guidance and support from VANL staff. 3.2 The programme’s PMELI Framework supports funded projects to provide information on the services they deliver, the number of people assisted, and people reported views on the benefits of the support provided - based on the following, standard outcome measures. Group No. Outcome Adults 1 People feel more connected, included and safe 2 Improved health and wellbeing 3 People feel more informed and aware Page 138 of 270
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Carers 4 Carers feel more informed and aware 5 Carers health and wellbeing are improved 6 Carers are more able to have a life outside of caring Children, Young People & Families 7 Health and wellbeing improved 8 Family relationships are strengthened 9 Children, young people and families become more resilient 3.3 From 2023-24, evaluation of peoples’ outcomes will also be complemented by performance measures such as funded projects satisfaction with the support provided by VANL. 3.4 The Community Solutions programme partners have commissioned an external charity, “The Lens”, to provide intensive support during May 2024 to explore key areas of work that will improve health and wellbeing and inclusion, whilst reducing demand on public services. 3.4.1 Our new Community Connectors’ scheme which is currently being piloted across North Lanarkshire. 3.4.2 Continuation of our effective support for people discharged from hospital provided by the CVS. 3.4.3 Support for unpaid carers – especially short breaks from caring – which is already demonstrating benefits. 3.4.4 Strengthening CVS support for physical activity given the significant benefits to health that can be achieve through physical activity and the potential for the CVS to provide further support. 3.4.5 Strengthening volunteer driver support for people attending health and social care appointments, to support access and inclusion more cost-effectively. 4. Supporting documentation 4.1 Appendix 1 - The Community Solutions Strategy and Investment Plan 2022-25. 4.2 Appendix 2 - The Community Solutions Impact and Learning Report 2022-23. Morag Dendy Chief Officer / Head of Service (Performance, Planning & Quality Assurance) Page 139 of 270
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? All funding has been allocated with robust financial governance in place. 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 Page 140 of 270
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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? There is a robust communication plan promoting the work of Community Solutions. 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? Any risk would relate to allocated funding to a third sector organisation and the programme outcomes identified not being met. The risk is held on the service risk register. 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. 5.11 Children’s rights and wellbeing impact 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). Page 141 of 270
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If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 142 of 270
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Community Solutions Strategy and Investment Plan 2022-251 Community Solutions Strategy and Investment Plan 2022-25 Appendix 1 Page 143 of 270
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Community Solutions Strategy and Investment Plan 2022-252 1. About Community Solutions 2. Strategy and Investment Plan Purpose and Development 3. Vision and Mission 4. Approach and Values 5. Priorities for Investment 6. Investment Approach 7. Evaluating Impact 8. Supporting Learning and Continuous Improvement Appendix One: Background and Context Appendix Two: Summary of Stakeholder Feedback 2021 3 6 7 8 11 13 15 16 17 20 CONTENTS Contents Community Solutions Strategy and Investment Plan 2022-25 This report can be provided in printed and other formats on request at communitysolutions@vanl.co.uk Page 144 of 270
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Community Solutions Strategy and Investment Plan 2022-253 Health and Social Care Partnership North Lanarkshire (HSCNL) which is responsible for planning, commissioning and overseeing the delivery of community health and social care services across North Lanarkshire. HSCNL provides core and project funding for the Community Solutions Programme, as well as governance and delivery support for the programme. The North Lanarkshire Children’s Services Partnership, which is responsible for planning, commissioning and overseeing children and young people services across North Lanarkshire. The Children’s Services Partnership provides funding for the Community and Voluntary sector to support children and young people’s mental health and wellbeing, which is managed through the Community Solutions Programme. Voluntary Action North Lanarkshire (VANL), the local Third Sector Interface (TSI), which hosts and manages the programme on behalf of HSCNL and the Children’s Services Partnership. The diverse, large and vibrant Community and Voluntary Sector (CVS) operating in North Lanarkshire, which receives funding through the programme and other sources to provide information, support and care to individuals, families and groups and work with local people to strengthen community capacity, resources and resilience. Local people who support programme planning, delivery and evaluation as service users, carers, volunteers and residents. 1. About Community Solutions Community Solutions is a successful, cross-sector health and social care investment and improvement programme for North Lanarkshire, established in 2012, which is improving people’s health, wellbeing, quality of life and equality by investing in community-led initiatives which build community, family and individual strengths and resources - with a focus on prevention and early intervention. The programme is an innovative, effective and respected partnership and collaborative initiative between a statutory and community and voluntary organisations and the public. 1. About Community Solutions The programme invests in CVS organisations operating in North Lanarkshire. Page 145 of 270
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Community Solutions Strategy and Investment Plan 2022-254 1. About Community Solutions 1.1 Funding The Community Solutions programme manages a number of funding streams from a variety of funders to provide grant funding to the Community and Voluntary Sector. The programme’s current funders are: Health and Social Care North Lanarkshire Scottish Government North Lanarkshire Council NHS Lanarkshire The amount of funding managed through the programme varies year on year and can reduce or increase. Also, CVS organisations which receive project funding through the Community Solutions programme usually have other funding for their core costs and some also raise matching project funding. During 2022-23 the Programme managed £3.6 million in funding and this will increase to over £4 million from April 2023 for at least two years. The programme’s key funds and priorities for 2022-25 are as follows. Improving Lives Initiative, which includes funding for: Six local community and voluntary sector (CVS) “anchor” organistions to act as locality hosts for the Community Solutions programme Six Local Activity Funds to provide “micro-grants” to local CVS organisations Ten “Community Connectors” who will capture and share up to date information about sources of community support by CVS organisations and assist local people with health challenges including cancer and other long term conditions by connecting them to local CVS services and facilitating access to statutory services if required. All the above will also assist improvements to “social prescribing” approaches to supporting people, with improved collaboration between NHS staff and CVS organisations. Thematic Funds on a variety on key issues and for key groups, such as: community Mental Health and Wellbeing children, young people and families older and frail people living at home people discharged from hospital discharge support unpaid carers 1.2 Achievements Evaluation of services and projects funded through the Community Solutions Programme, up to March 2022, demonstrate it is highly cost- effective, providing support to thousands of people with good personal outcomes. More information about the Programme’s reach and impact can be found online, including the 2020-21 Annual Report (and summary) and previous Annual Reports. In 2019, an independent review of the Community Solutions programme by the national Improvement Service for local government, highlighted the programme’s strengths as: having a strong focus on personal outcomes approach demonstrating positive engagement and participation providing an effective use of resources Page 146 of 270
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Community Solutions Strategy and Investment Plan 2022-255 1. About Community Solutions 1.3 Programme Governance, Management and Support VANL is funded by HSCNL on a recurrent annual basis, to host, manage and support the programme, including: planning and development communications management of funding awards performance management, evaluation, learning and improvement In addition, VANL is commissioned by HSCNL to provide capacity building support on key issues, including: Children, Young People and Families First Point of Contact and Three Conversations Improving Cancer Journey Volunteering Community Solutions is governed through a “triple-lock” approach and supported and managed at both locality and North Lanarkshire wide levels. Six local CVS organisations receive funding to act as “locality hosts” for the Community Solutions Programme in their area and convene locality Community Solutions consortia meetings involving CVS funded organisations; HSCNL locality and VANL staff. These consortia review local needs and priorities ; agree a Locality Development Plan and manage a Local Activity Fund for their area. The six locality host organisations also meet regularly with key VANL staff to share information and discuss key issues to inform locality and NL-wide developments. VANL convenes and supports a Community Solutions Governance Subgroup, which meets at least quarterly with representatives from HSCNL, VANL and the CVS to support strategic planning, review, improvements and reporting. HSCNL senior management and its Integrated Joint Board agree the programme’s strategy and funding and review progress reports. Community Solutions Strategy & Investment Plan 2022-25 VANL staff also provide wider capacity building support for the CVS and support links between the Community Solutions Programme, health and social care, children’s services and community planning. Much of this work resourced by VANL’s complementary, core funding from the Scottish Government (SG) and North Lanarkshire Council (NLC). VANL’s support for the Community Solutions programme is monitored through the programme’s “triple-lock” governance arrangements. 5 Page 147 of 270
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Community Solutions Strategy and Investment Plan 2022-256 2. Strategy and Investment Plan Purpose and Development 2. Strategy and Investment Plan Purpose and Development 2.1 Purpose This Strategy and Investment Plan sets out how the Community Solutions Programme will invest the funding it receives from its funders as set out above, to contribute to improved health, wellbeing, quality of life and equality of the people of North Lanarkshire by strengthening community capacity and resilience and delivering person-centred, community-based support and services to priority groups. This plan replaces the Community Solutions previous Strategy for 2018-2023. This is earlier than planned given major developments within the programme and the challenges of the COVID pandemic. 2.2 Development This new Strategy and Investment Plan has been developed collaboratively with keya stakeholders and is informed by: evidence of local needs experience of delivering Community Solutions and evaluation of Community Solutions funded projects to date priorities and commitments as set out in the Plan for North Lanarkshire, Health and Social Care NL Commissioning Plan and related strategies and plans on issues such as the Tackling Poverty Strategy, with reference to relevant national commitments (see Appendix One) This Plan was developed consultatively with key stakeholders (see Appendix Two) supported by: discussions at the North Lanarkshire Partnership Strategic Investment in the CVS Working Group (2020-21) an online survey and focus groups for key Community Solutions stakeholders including funded projects (Aug-Sept 2021) discussion at the Community Solutions Governance Sub- Group (2021-Feb 2022) discussion with HSCNL Core Management Team and Strategic Leadership Team (Feb-March 2022) approval by the Integrated Joint Board (IJB) (March 2022) Page 148 of 270
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Community Solutions Strategy and Investment Plan 2022-257 3. Vision and Mission The Community Solutions vision is for a North Lanarkshire where: 3. Vision and Mission Community Solutions Strategy & Investment Plan 2022-257 the community and voluntary sector have greater capacity to strengthen communities, improve lives and advance equality and human rights communities are stronger, more resilient and inclusive, with improved health, wellbeing and quality of life, with reduced inequality and protection of 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 community and voluntary organisations, complemented by timely access to public sector services The Community Solutions Mission: to provide strategic investment and support to the CVS, so the sector is able to work with local people and public sector colleagues to achieve its vision. Page 149 of 270
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Community Solutions Strategy and Investment Plan 2022-258 4. Approach and Values Community Solutions values and approach underpin our mission and provide the foundation upon which the Programme is built. Mental and physical health and wellbeing and their connection The social, economic, and environmental influences on health, wellbeing, and equality and the actions needed to tackle these 4.1 Hollistic and Integrated Approach The Community Solutions Programme takes a holistic and integrated approach to health, wellbeing, quality of life and equality encompassing: 4. Approach and Values Equality Health Wellbeing Quality of life Community Solutions Strategy & Investment Plan 2022-258 Page 150 of 270
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Community Solutions Strategy and Investment Plan 2022-259 Community Solutions takes a strategic investment approach which prioritises the following in line with HSCNL’s ambitions. Investment in health improvement, prevention, and early intervention activities, which reduce inequalities and protect human rights Investment in crisis and ongoing support, with a focus on recovery and re-enablement, self-directed support, and self-management Cost-effective, community-based support and services provided by CVS organisations Capacity building within the CVS and wider community by supporting key CVS ‘anchor’ organisations and volunteering to build the community infrastructure and capacity to support provision of good community-based support over time 4.2 Strategic Investment Approach 4. Approach and Values Health improvement, prevention & early intervention Crisis, recovery & ongoing support CVS Community- based support & services CVS & Volunteering Capacity building Page 151 of 270
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Community Solutions Strategy and Investment Plan 2022-2510 4. Approach and Values 4.3 Values Community Solutions also takes a value-based approach. 4.3.1 Person-centred and empowering 4.3.2 Collaborative working and co-production To achieve goals and improvements where we develop equal relationships between people who use services and people who provide services – with support provided ‘with people’ rather than ‘to them’. This means involving local people - including those receiving support - and service providers in the CVS and statutory sectors to facilitate a positive and participatory cycle of planning, delivery, evaluation, learning and continuous improvement. This approach is informed by the Ladder of Participation and National Community Engagement Standards. Placing the person at the centre of the service, helping them to live their best life and supporting their human rights by: Actively listening and understanding their needs. Supporting people to develop their personal resources and capabilities. Helping them to develop and sustain supportive relationships and social connections. Planning Delivery EvaluationLearning = Service users Service providers Page 152 of 270
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Community Solutions Strategy and Investment Plan 2022-2511 5. Priorities for Investment 5. Priorities for Investment 5.1 Priority Groups Community Solutions is committed to helping reduce health and related social and economic inequalities in North Lanarkshire - which are unfortunately extensive and deeply-rooted – and advance human rights. We will do this by focusing our investment on improving lives for priority groups who are experiencing one or more types of inequality. These groups are: Black and minority ethnic groups Carers Children, Young People and Families LGBTIQA+ (Lesbian; Gay; Bi-sexual; Transgender; Intersex; Queer; Asexual) Older adults People affected by addiction People affected by cancer People who are frail People on low incomes People with physical disabilities People with learning difficulties and/ or neurodiversity People with long term conditions People with mental health challenges, including trauma A B C Community Solutions Strategy and Investment Plan 2022-25 Page 153 of 270
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Community Solutions Strategy and Investment Plan 2022-2512 5. Priorities for Investment Community Solutions Strategy & Investment Plan 2002-25 5.2 Support for Priority Groups Community Solutions will invest in the following community capacity and supports for our priority groups to help improve people’s lives, reduce inequality, and support their human rights. 5.3 Building CVS and Wider Health and Social Care System Capacity As well as facilitating allocation of funding to enable CVS organisations to deliver support to priority groups, the Community Solutions programme is supported by VANL staff to assist the CVS to increase capacity and impact by: Providing information and guidance to help organisations secure additional and future funding Providing guidance on key issues such as governance; planning; finance and evaluation Facilitating access to free or low-cost learning opportunities for staff and volunteers Providing volunteering guidance, including support for Volunteer-Friendly accreditation Facilitating information sharing and peer support; collaborative working; learning and improvement The Community Solutions programme also supports improvements within the wider health and social care system including: Development and facilitation of the “first point of contact,” “three conversations” and “social prescribing” approaches to help people express their needs; feel empowered; and access community supports and services as quickly as possible Supporting digital inclusion to enhance public access to health and social care information and services Enabling healthy living, wellbeing, and recovery by supporting: creative activities complementary therapies good sleep green wellbeing through access to green space and connection to nature healthy eating physical activity smoke-free living and avoiding harm from other substance misuse Enabling positive relationships and social connections through befriending; family support; volunteering; and digital inclusion Increasing mobility and access to services through active travel, community transport and digital inclusion Providing home and community-based support to enable timely and effective discharge from hospital Enabling empowerment, recovery, and resilience through: assisted self-management peer-support and collective advocacy (with individual advocacy funded directly by HSCNL) self-directed support Community Solutions Strategy and Investment Plan 2022-25 Page 154 of 270
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Community Solutions Strategy and Investment Plan 2022-2513 6. Investment Approach 6. Investment Approach The Community Solutions Programme takes the following mixed investment approach to maximise impact and outcomes for local people. 6.1 Open commissioning With any eligible CVS organisation able to apply Funding streams are allocated a budget to provide funding awards for 1-3 years, with annual review. Examples include: Carers’ Breather Fund – North Lanarkshire Council funding via VANL Community Mental Health and Wellbeing Fund - Scottish Government funding via VANL Children and Young People Mental Health and Wellbeing – North Lanarkshire Council funding, linked to North Lanarkshire Children’s Services Partnership via VANL Prevention and Early Intervention Fund - HSCNL funding via VANL Community Solutions Strategy and Investment Plan 2022-25 Page 155 of 270
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Community Solutions Strategy and Investment Plan 2022-2514 6.2 Targeted investment Restricted selected CVS organisations and structures, including: 6.2.1 Locality Community Solutions Hosts: Recurrent, annual funding awarded to six CVS organisations in HSCNL localities through a targeted, competitive process to support: community engagement in HSC issues generally and Community Solutions programme, with links to Community Planning the six locality Community Solutions “Consortia” involving CVS and public sector staff to enable them to identify local needs and priorities; develop and agree a Locality Development Plan; agree funding for local projects and activities using their Community Solutions Local Activity Fund 6.2.2 Locality Activity Funds (LAF) This fund is allocated to each locality, with small grants awarded to local projects and activities as agreed by each consortia in line with their priorities as set out in their Locality Development Plan. 6.2.3 NL Wide Projects Funding for various NL-wide projects including: North Lanarkshire Carers’ Network: direct award to Carers’ Together from April 2022 for three years Community Support for Hospital Discharge: direct commission from the Getting Better Together Healthy Living Project based in Shotts – from October 2021 for three years 6.2.4 NL Wide Projects Direct funding award to Voluntary Action North Lanarkshire for programme management and delivery support and capacity building as set out in section 1.3. 6. Investment Approach Page 156 of 270
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Community Solutions Strategy and Investment Plan 2022-2515 7. Evaluating Impact 7. Evaluating Impact The Community Solutions programme is committed to evaluating the impact of our investment on: people receiving support - with a focus on two main outcomes of improving health and wellbeing and reducing inequalities supported by relevant measures funded CVS organisations – reach and impact the programme as a whole The programme develops appropriate performance and outcomes measures to support evaluation and reporting of reach and impact for each of the three levels above, which are reviewed and updated as required. Funded projects are provided with guidance to enable them to capture, assess and report on outcomes for individuals receiving support and overall project impact, learning and improvements. Programme staff capture and report on performance measures for the programme and wider CVS and health and social care system. The following information about Community Solutions impact and learning will be available online from autumn 2022 on a new Community Solutions website information about each funded project, including activities, reach and outcomes personal stories of people supported by funded projects an annual Programme Impact and Learning Report Community Solutions Strategy and Investment Plan 2022-25 Page 157 of 270
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Community Solutions Strategy and Investment Plan 2022-2516 8. Supporting Learning and Continuous Improvement 8. Supporting Learning and Continuous Improvement The programme supports learning and continuous improvement within funded projects, the programme and more widely by: publishing and actively sharing: an annual Impact and Learning Report for the Programme as a whole summary information about each funded project, including their activities and impact and anonymized personal stories of people receiving support selected in-depth case studies for priority groups and areas of support convening and facilitating learning and improvement events on key issues, informed by above information. using evidence and learning to facilitate improvements within funded projects; the programme as a whole; the wider CVS; HSC more widely. Community Solutions Strategy and Investment Plan 2022-2516 Page 158 of 270
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Community Solutions Strategy and Investment Plan 2022-2517 Appendix One Appendix One: Background & Context NL is the fourth largest council area in Scotland with over 340,000 people. People aged 16-64 are currently the largest age group in North Lanarkshire, however projections show that in the coming years the proportion of over 75’s will rise by as much as 20%. 1. North Lanarkshire and its people 1.1 Strengths North Lanarkshire is a key strategic location in central Scotland with affordable housing and good employment opportunities in all sectors. North Lanarkshire’s communities of place and interest are diverse, with a wide range of different groups and over 50 languages spoken. Our people have many skills and contribute a great deal to their local community and North Lanarkshire as a whole through paid work, volunteering, and caring roles. North Lanarkshire has a vibrant and growing business sector which provides local employment, services, wand goods. The public sector “anchor” organisations serving North Lanarkshire – North Lanarkshire Council, NHS Lanarkshire, Police Lanarkshire and Fire and Rescue Lanarkshire blic services, are major employers. Our Community and Voluntary Sector (CVS) is rich and diverse and provides a wide range of support and services to local people. Our statutory and community and voluntary organisations work together and with local communities to improve quality of life, wellbeing, and equality for residents, whilst managing COVID and climate emergency challenges. Many people in North Lanarkshire experience significant challenges which have increased due to the COVID pandemic, Brexit and the climate emergency. The nine North Lanarkshire Community Board profiles for 2021 show that: 15% of residents are income-deprived compared to a Scottish average of 12% unemployment rates are 5.7% compared to a Scottish average of 4.6% 19% of P4-P7 children receive school meals compared to the Scottish average of 17%. 8% of people aged over 65 receive attendance allowance helping them to manage their daily care needs, whereas the Scottish average is 14% 22% of older people receive pension credit as a top-up to their income: the Scottish average is 14% Number of people with long term conditions/disability – NL v Scotland Life expectancy for males in NL is 74.5, compared to the national average of 77. For females it is 79.2 in NL, compared to the national average of 81. 1.2 Challenges We have many excellent public and community and voluntary sector services and support, despite ongoing financial and COVID 19 pressures. These include: school, further and community education social housing health and social care money and welfare benefits assistance employability support digital inclusion support healthy living support on issues such as nutrition, physical activity, and mental health. Page 159 of 270
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Community Solutions Strategy and Investment Plan 2022-2518 The Community Solutions Strategy and Investment Plan supports delivery of the Plan for North Lanarkshire - our Community Plan - and its nine Local Outcome Improvement Plans (LOIPS) as well as the Health and Social Care Strategic Commissioning Plan. 2. Local Plans and Strategies 2.1 Plan for North Lanarkshire and LOIPs This plan supports the delivery of: the following four key themes within the Plan for NL: support all children and young people to realise their full potential. improve the health and wellbeing of our communities. enhance participation, capacity, and empowerment across our communities. improve North Lanarkshire’s resource base (by investing in CVS capacity building including growth of its paid and volunteer workforce) key LOIP priorities such as tackling poverty, improving mental health and supporting digital inclusion The HSCNL Strategic Commissioning Plan supports delivery of the ambitions of the Plan for North Lanarkshire and is the “parent” strategy for the Community Solutions programme. This plan will support progress of HSCNL’s six ambitions: do the right thing first time provide a range of services to support people to live well in connected communities focus on what matters to people be at the forefront of technical and sustainable solutions promote prevention and early intervention ensure North Lanarkshire is the best place to volunteer, work and care The Community Solutions Strategy and Investment Plan also supports progress on a range of other key North Lanarkshire Strategies and Plans, which are linked to the Plan for North Lanarkshire and HSCNL Strategic Commissioning Plan and include; Action on Climate Together North Lanarkshire - Action Plan Alcohol and Drug Strategy Children’s Services Plan Community and Voluntary Sector Strategy Lanarkshire Mental Health and Wellbeing Strategy Lanarkshire Healthy Weight Strategy Sport and Physical Activity Strategic Framework A Smoke Free Lanarkshire: For You, For Children, Forever Strategy for Adult Carers and Young Carers Volunteering Strategy (forthcoming June 2022) Tackling Poverty Strategy 2.2 Health and Social Care Strategic Commissioning Plan Appendix One Page 160 of 270
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Community Solutions Strategy and Investment Plan 2022-2519 All North Lanarkshire’s local plans and strategies listed above, and this Community Solutions Strategy and Investment Plan. support progress on key Scottish Government’s priorities. 3. Context: National Priorities 3.1 Scottish Government Health and Wellbeing Outcomes People can look after and improve their own health and wellbeing and live in good health for longer People, including those with disabilities or long-term conditions, or who are frail, can live, as far as reasonably practicable, independently and at home or in a homely setting in their community People who use health and social care services have positive experiences of those services, and have their dignity respected Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services Health and social care services contribute to reducing health inequalities People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and well-being People who use health and social care services are safe from harm People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide Resources are used effectively and efficiently in the provision of health and social care services 3.2 Public Health Priorities for Scotland All partners in the Community Solutions programme support the vision of “a Scotland where we…” live in vibrant, healthy and safe places and communities flourish in our early years have good mental wellbeing reduce the use of and harm from alcohol, tobacco and other drugs where we have a sustainable, inclusive economy with equality of outcomes for all eat well have a healthy weight and are physically active 3.3 Getting it Right for Every Child wellbeing outcomes The national “Getting it Right for Every Child” (GIRFEC) approach eight wellbeing outcomes for every child: Safe Healthy Achieving Nurtured Active Responsible Respected Included Appendix One Page 161 of 270
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Community Solutions Strategy and Investment Plan 2022-2520 Appendix Two: Summary of Stakeholder Feedback This Strategy was developed consultatively with stakeholders supported by various engagement activities during 2021-22, including: a stakeholder survey stakeholder focus groups discussion in key fora, including the Community Solutions Governance Sub-group; North Lanarkshire Community and Voluntary Sector Strategic Investment Working Group; Partnership for Change; North Lanarkshire Carers’ Network Key feedback from stakeholders is summarised below. 1. Continue to invest strategically in CVS to build the sector’s capacity and sustainability so it is able to provide effective community-based support and services to improve local people’s health, wellbeing, quality of life and equality with a focus on prevention, early intervention and recovery approaches such as: befriending and other social support digital inclusion support healthy living support money and welfare support “Three Conversations” and “social prescribing” approaches self-directed support in social care assisted self-management of conditions 2. Strengthen the CVS paid workforce and volunteering. 3. Strengthen links and synergy between the Community Solutions Programme and Community Planning both North Lanarkshire-wide and locality levels through the six Community Solutions consortia and nine Community Boards. 4. Continue to support unpaid carers; children and families; disabled people; and older adults; and also strengthen engagement with and support for other equality groups including: black and minority ethnic groups LGBTIQA+ (Lesbian, Gay, Bi-sexual, Transgender, Intersex; Queer, Asexual) people with learning difficulties/neuro-diverse young people 5. Strengthen CVS support for mental health and wellbeing and assess their contribution more effectively – including: promotion of mental wellbeing suicide prevention challenging stigma support and recovery for people affected by trauma 6. Improve access to befriending support (map current provision and access to identify and address gaps) 7. Strengthen links and complementary investment between CS and Alcohol and Drug Partnership 8. Support CS-funded CVS organistions reduce their carbon emissions 9. Strengthen evaluation and learning from the programme to support ongoing service improvements, inform future investment decisions and contribute to wider “systems” change Appendix Two Page 162 of 270
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Community Solutions Impact and Learning Report 2022-23 Appendix 2 Page 163 of 270
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Community Solutions Impact and Learning Report – 2022-23 2 Contents 1. Introduction – Page 3 2. Background to Community Solutions - Page 4 3. Community Solutions Achievements 2022-23 – Page 8 4. Community Solutions Priorities for 2022-23 – Page 35 5. Appendices – Page 41 Page 164 of 270
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Community Solutions Impact and Learning Report – 2022-23 3 1. Introduction The Community Solutions Programme is a North Lanarkshire partnership initiative involving: • Health and Social Care North Lanarkshire’s (HSCNL) public sector partner organisations – North Lanarkshire Council (NLC) and NHS Lanarkshire • Voluntary Action North Lanarkshire (VANL) - the programme’s host organisation • The Community and Voluntary Sector (CVS) funded organisations and projects This report provides an overview of the work and achievements of Health and Social Care North Lanarkshire’s Community Solutions Programme and its funded projects during 2022-23, with a focus on activity, reach and, where possible, outcomes and learning. This report is formally presented to HSCNL’s Integrated Joint Board (IJB) and is also being shared with all stakeholders to provide accountability for the programme and to support understanding, learning, and improvement within the programme and more widely across health and social care and community planning. This report is complemented by progress reports and in-depth Impact and Learning Reports for each fund at appropriate intervals. Many thanks to the funded projects which provided information and to the VANL staff who prepared this report. Page 165 of 270
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Community Solutions Impact and Learning Report – 2022-23 4 2. Background to Community Solutions Community Solutions is a successful, cross-sector health and social care investment and improvement programme for North Lanarkshire. The programme – which was established in 2012 – aims to improve people’s health, wellbeing, quality of life, and equality by investing in community-led initiatives which build community, family, and individual strengths and resources, with a focus on prevention and early intervention. The programme invests strategically in the CVS through several complementary strands of work: • Local partnership-working between the CVS and public sector through six Community Solutions Locality Consortia, to identify and respond to local needs, including development of a Local Partnership Plan and management of a Local Activity Fund which makes small funding awards to CVS organisations • Development and delivery of direct support and services by CVS organisations on prioritised thematic issues including anticipatory care; befriending; carers’ support; community transport; hospital discharge support, and more. In order to ensure best fit with current and emerging needs, a review of these themes by a cross-sector panel is currently underway and will report in early 2024 • Capacity building for carers and the CVS The programme is an innovative, effective, and respected partnership and collaborative initiative between statutory and community and voluntary organisations and the public, including: • HSCNL which is responsible for planning, commissioning, and overseeing the delivery of community health and social care services across North Lanarkshire. HSCNL provides core and project funding for the Community Solutions Programme, as well as governance and delivery support for the programme • The North Lanarkshire Children’s Services Partnership (NLCSP) which is responsible for planning, commissioning, and overseeing children and young people’s services across North Lanarkshire. The partnership provides funding for the CVS to support children and young people’s mental health and wellbeing, which is managed through the Community Solutions Programme • VANL, the local Third Sector Interface (TSI), which hosts and manages the programme on behalf of HSCNL and the Children’s Services Partnership • The diverse, large, and vibrant CVS operating in North Lanarkshire, which receives funding through the programme and other sources to provide information, support, and care to individuals, families, and groups, working with local people to strengthen community capacity, resources, and resilience • Local people who support programme planning, delivery, and evaluation as service users, carers, volunteers, and residents Page 166 of 270
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Community Solutions Impact and Learning Report – 2022-23 5 2.1 Vision and Mission 2.1.1 Vision The Community Solutions vision is for a North Lanarkshire where: • The CVS has greater capacity to strengthen communities, improve lives, and advance equality and human rights • Priority groups are helped to ‘live their best life’ with access to person-centered, timely, effective community-based preventative and early intervention support, provided by community and voluntary organisations, complemented by timely access to public sector services • Communities are stronger, more resilient and inclusive, with improved health, wellbeing and quality of life, with reduced inequality and protection of human rights 2.1.2 Mission The Community Solutions mission is to provide strategic investment and support to the CVS, so the sector can work with local people and public sector colleagues to achieve its vision. 2.2 Approach and Values Community Solution’s values and approach underpin our mission and provide the foundation upon which the Programme is built. 2.2.1 Holistic and Integrated Approach The Community Solutions Programme takes a holistic and integrated approach to health, wellbeing, quality of life, and equality encompassing: • Mental and physical health and wellbeing and their connections • The social, economic, and environmental influences on health, wellbeing, and equality and the actions needed to tackle these 2.2.2 Strategic Investment Approach Community Solutions takes a strategic investment approach which prioritises the following in line with HSCNL’s ambitions: • Investment in health improvement, prevention, and early intervention activities, which reduce inequalities and protect human rights • Investment in crisis and ongoing support, with a focus on recovery, re- enablement, self-directed support, and self-management • Cost-effective, community-based support and services provided by CVS organisations • Capacity building within the CVS and wider community by supporting key CVS ‘anchor’ organisations and volunteering to build the community infrastructure and capacity to support provision over time of good community-based support Page 167 of 270
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Community Solutions Impact and Learning Report – 2022-23 6 2.2.3 Values Community Solutions also takes a value-based approach. The Community Solutions Programme values are: • Person-centered and empowering, placing the person at the centre of the service, helping them to live their best life and supporting their human rights by: o Actively listening and understanding their needs o Supporting people to develop their personal resources and capabilities o Helping them to develop and sustain supportive relationships and social connections • Collaborative working and co-production to achieve goals and improvements where we develop equal relationships between people who use services and people who provide services, with support provided ‘with people’ rather than ‘to them’. This means involving local people – including those receiving support – and service providers in the CVS and statutory sectors to facilitate a positive and participatory cycle of planning, delivery, evaluation, learning, and continuous improvement. This approach is informed by the Ladder of Participation and National Community Engagement Standards. 2.3 Programme Governance Community Solutions is governed through a ‘triple-lock’ approach and supported and managed locally and across North Lanarkshire: • Six local CVS organisations receive funding to act as ‘locality hosts’ for the Community Solutions Programme in their area, and to convene Community Solutions Locality Consortia meetings involving CVS-funded organisations; HSCNL locality, and VANL staff. These consortia review local needs and priorities; agree a Locality Development Plan and manage a Local Activity Fund (LAF) for their area. The six locality host organisations also meet regularly with key VANL staff to share information and discuss key issues to inform locality and North Lanarkshire-wide developments • VANL convenes and supports the Community Solutions Governance Group, which meets at least quarterly with representatives from HSCNL, VANL and the CVS to support strategic planning, review, improvements, and reporting • HSCNL’s senior management and its Integrated Joint Board agree the programme’s strategy and funding and review progress reports 2.4 Programme Delivery and Evaluation Support VANL hosts and manages the Community Solutions programme on behalf of HSCNL and the NLCSP and receives funding to cover the costs of this work, which includes the following: • Programme governance support Page 168 of 270
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Community Solutions Impact and Learning Report – 2022-23 7 • Facilitating collective planning and development of the programme overall and specific funds • Programme communications and liaison with key stakeholders • Management of funding awards • Evaluation, learning and improvement support for each custodian fund and funded projects • Overall co-ordination of programme performance management, evaluation, and reporting In addition, VANL is commissioned by HSCNL and others to provide capacity- building support – currently on the following three, key issues: • CVS support for children, young people, and families • CVS and localities • Volunteering VANL staff also provide wider capacity-building support for the CVS and support links between the Community Solutions Programme, health and social care, children’s services, and community planning. Much of this work is resourced by VANL’s complementary, core funding from the Scottish Government and NLC. VANL’s support for the Community Solutions Programme is monitored through the Programme’s ‘triple-lock’ governance arrangements. Page 169 of 270
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Community Solutions Impact and Learning Report – 2022-23 8 3. Community Solutions Achievements 2022/23 3.1 Custodian Funds and Funding Management During 2022-23, over £3.1m of funding was managed through the Community Solutions Programme by VANL on behalf of several funders including: • Health and Social Care North Lanarkshire • Scottish Government • NLC (linked to NLCSP) Funding awards were made to a total of 233 projects, delivered by 98 CVS organisations. In addition, VANL received £208,000 in funding to support CVS capacity building as outlined above. The funding to support delivery and evaluation of the Community Solutions programme has been allocated as follows: Funding Item Funding Amount (£) 1. Health and Social Care North Lanarkshire (2022-23) 1.1 Locality Funding Locality Hosts funding (six localities) 240,000 Locality Activity Funding (six localities) 180,000 Subtotal: Locality Funding 420,000 1.2 Thematic Funding Anticipatory Care 40,000 Carer Breather 248,000 Community Food 40,000 Community Transport 72,000 Home Visiting and Befriending 195,000 Hospital Discharge 77,500 Positive Smoke Free Role Models (six localities) - Funding from 2019, delayed due to COVID-19 18,000 Physical Activities 40,000 Page 170 of 270
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Community Solutions Impact and Learning Report – 2022-23 9 Funding Item Funding Amount (£) Substance Misuse Fund 50,000 Subtotal: Thematic Funding 780,500 1.4 CVS Capacity Building Support Carers’ Network (HSCNL) 40,000 Carer Strategy Implementation Support (NLC) 40,000 Children, Young People, and Families (VANL) 30,000 CVS and locality support (VANL) (Locality Partnership Development Plan) 60,000 Volunteering (VANL) 38,000 Subtotal: CVS Capacity Building Support 208,000 1.5 VANL Programme Delivery and Evaluation Support Community Solutions Hosting and Management 80,000 1.6 Unallocated funding carried forward to 2023-24 14,747 Sub-total: HSCNL Funding 2022-23 1,503,247 2. Scottish Government Funding – direct to VANL or via third party 2.1 Children and Young People’s Mental Health and Wellbeing Fund (Phase Three) (via NLC to VANL) 2.1.1 Phase Three Custodian Fund managed by VANL, with NLC colleagues on behalf of Scottish Government and awarded to CVS organisations 465,000 2.1.2 VANL Delivery Costs 51,000 Funding Item Funding Amount (£) Page 171 of 270
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Community Solutions Impact and Learning Report – 2022-23 10 Subtotal: Children and Young People’s Mental Health and Wellbeing Fund 516,000 2.3 Community Mental Health and Wellbeing Fund (direct to VANL) 2.3.1 Custodian Fund managed by VANL on behalf of Scottish Government and awarded to CVS organisations. (Paid in March 2023, however, spend is for projects delivered in 2023-24. Therefore, reporting on outcomes and activities will be covered in the 2023-24 report 2.3.2 VANL Delivery Costs 955,000 71,000 Subtotal: Community Mental Health and Wellbeing Fund 1,026,000 2.4 Support in the Right Direction (Custodian fund via Inspiring Scotland managed by VANL through Community Solutions programme with funding for two CVS organisations. No delivery costs for VANL) 99,952 Subtotal: Support in the Right Direction 99,952 Sub-total: Scottish Government Funding 2022-23 1,641,952 TOTAL Programme Funding 2022-23 3,145,199 Please see the Appendices for a full break-down of the distribution of all Community Solutions funding for 2022-23. 3.2 Localities The Community Solutions programme is rooted in our local communities to support effective partnership working between the CVS and public sector as well as the engagement of service users, carers, and the wider public. This partnership working and engagement is supported by Community Solutions via: • 6 CVS locality host organisations • 6 Local Consortia Page 172 of 270
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Community Solutions Impact and Learning Report – 2022-23 11 • 6 LAFs 3.2.1 Locality Hosts The Community Solutions programme is supported at locality level by six CVS “anchor” organisations that as act as “locality hosts” for the programme. The locality hosts are responsible for: • Convening and supporting the six Community Solutions Locality Consortia • Developing and delivering Locality Partnership Development Plans (LPDP) with members of the consortia, other CVS organisations, service users and unpaid carers • Managing, in collaboration with local consortia and VANL, the LAF for their locality • Working with VANL to support wider CVS and volunteer capacity building and links with community planning The Community Solutions’ locality hosts for 2022-23 are listed below, each of which received £40,000 of funding to support them in delivering these activities. Locality Locality Hosts 1 3.2.2 Locality Consortia The Community Solutions Locality Consortia comprise representatives from the local CVS and health and social care staff from the council and NHS. They meet at least quarterly to discuss key local issues, and support development and delivery of their Local Development Plan and LAF. Revised and updated consortia Terms of Reference are being developed in partnership with Locality Hosts and will be published in Autumn 2023. 1 The Health and Wellness Hub acted as interim Locality Host for Airdrie from April-September 2022 as no organisation could be secured to act as Host, until Diamonds in the Community were instated in October 2022. Page 173 of 270
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Community Solutions Impact and Learning Report – 2022-23 12 3.2.3 Locality Activity Fund (LAF) There are six Community Solutions LAFs, providing small grants to CVS organisations in each locality to help them deliver a new or improved activity to support residents. Each consortium decides on how to allocate these Funds in line with their Locality Development Plan. LAF awards are then managed by locality hosts and VANL. During 2022-23 each locality had a £30k LAF to allocate – a total of £180k, which was distributed to a total of 66 projects. (See diagram below and Appendix B.) LAF Awards 2022-2023 – Reach and Activities In 2022-23, Locality Activity Fund awards … Funded 66 projects Supported 6980 individuals, including 540 carers Supported the delivery of 1601 activities (excluding daily/monthly activities) Including community development projects, outdoor projects, post-Covid recovery, cooking, food and nutrition, physical activity, and arts projects See Appendix B for a full list of funded projects by locality. LAF Awards 2022-2023 – Impact In 2022-23, as a result of Locality Activity Fund projects… 913 people felt more connected, included and safe 726 people have improved health and wellbeing 1056 people felt more informed and aware 136 carers felt more informed and aware Carers Children, Young People and Families Adults 507 carers health and wellbeing was improved 401 carers were more able to have a life outside of caring 328 children, young people or families’ health and wellbeing was improved 228 families relationships were strengthened 139 children, young people and families have become more resilient Page 174 of 270
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Community Solutions Impact and Learning Report – 2022-23 13 3.3 Thematic Funding Community Solutions funding is awarded to a range of CVS organisations to provide services and support to residents on selected, priority ‘thematic’ issues, which are outlined below, with details of funding, reach, and outcomes for 2022-23. 3.3.1 Anticipatory Care Background Community Solutions funds local CVS organisation Equals Advocacy to employ advocacy workers to support anticipatory care for older, frail adults in liaison with health and social care staff. This funding has been in place since 2012. Anticipatory Care in North Lanarkshire helps connect older, frail adults to services and support at an early stage, supported by a Primary Care Frailty Multidisciplinary Team (MDT) and an independent advocacy worker, employed by Equals Advocacy. GPs support this service and approach by identifying an older person with increasing frailty. The person is then referred to Equals Advocacy who help the person complete one or more assessments at home, supported by an advocacy worker. This information is shared with the MDT which then develops and agrees an Anticipatory Care Plan in liaison with the service user. During 2022-23, Equals Advocacy received a funding award of £40,000 through the Community Solutions Programme to support their role in this service. Achievements 2022-23 Equals Advocacy support evaluation of their advocacy service through feedback questionnaires at the start and end of their engagement with advocacy support, and provide VANL with an anonymised summary of information to support reporting. In 2022-23, Community Solutions funding has supported Equals Advocacy to… Support 138 individuals through the Anticipatory Care project Deliver 190 activities Support 138 total individuals to meet Community Solutions personal outcomes such as.. 138 people felt more connected, included and safe 138 people had improved health and wellbeing, and felt more informed and aware 9 carers… felt more informed and aware health and wellbeing was improved Page 175 of 270
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Community Solutions Impact and Learning Report – 2022-23 14 3.3.2 Befriending Background Befriending provides support to people who are lonely and isolated to increase their social support and connections, thus improving their quality of life and wellbeing. Since 2012, Community Solutions has provided funding to the following nine CVS organisations to recruit, and support trained, volunteer befrienders: • Befriend Motherwell • CACE (Cumbernauld Action for Care of the Elderly) • Elim Befriending • Getting Better Together • Glenboig Development Trust • Home-Start • Orbiston Neighbourhood Centre • Volunteering Matters • YMCA Bellshill and Mossend Total amount awarded: £194,688 Achievements 2022-23 Supported 1338 individuals through 6342 activities Including telephone befriending, home visits, group and 1-1 befriending, and volunteer recruitment Supported 2152 unique individuals . meet Community Solutions personal outcomes Secured an additional £167,769 of funding from other sources Been supported by 112 f volunteers, who dedicated 5978 volunteering hours For example, • 320 people’s mental health and wellbeing improved • 824 people felt more connected, included and safe • 524 people felt more informed and aware *The number of people who met Community Solutions personal outcomes is higher than the total individuals supported as it is the number of unique individuals who reported on each outcome In 2022-23, Community Solutions funded Befriending projects… For children, young people and families... • 179 had improved health and wellbeing • 128 had increased resilience 3.3.3 Carer Breather Phase One (Year Two) Background The Community Solutions Carer Breather Fund was established in 2020, informed by a cross-sector review of previous Community Solutions funding for unpaid carers. The purpose of the fund is as follows: Page 176 of 270
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Community Solutions Impact and Learning Report – 2022-23 15 • To enable CVS organisations to enhance and extend regular and locally based support for unpaid carers, including carers who do not necessarily wish to identify as a carer and/or are unknown to formal services • For carers to be supported to: o Enjoy the benefits of regular and ongoing breaks in their neighbourhood o Access support without having to formally link up with a carers’ support organisation Community Solutions provided Carer Breather funding to the following nine CVS organisations in Phase One: • Bazooka Arts • Getting Better Together • Glenboig Development Trust • Parkinson’s Self-Help Group Airdrie • Parkinson’s Self-Help Group Motherwell • The Haven • The Health and Wellness Hub • Watch US Grow Total amount awarded: £248,000 Achievements 2022-23 In 2022-23, Community Solutions funded Carer Breather projects… Delivered 7162 activities Supported 2379 cared for people and 2656 carers and their wider families Been supported by 51 volunteers, who devoted 1568 hours Supported 5361 individuals to achieve carer-specific community solutions personal outcomes For example, • 1853 carers’ felt more informed and aware • 1892 carers’ health and wellbeing was improved • 1626 carer’s were more able to have of a life outside of caring Including therapeutic arts workshops, craft activities, garden projects, drop in sessions *The number of people who met Community Solutions personal outcomes is higher than the total individuals supported as it is the number of unique individuals who reported on each outcome The Impact and Learning report for Phase One of the Carer Breather Fund is available on the new Community Solutions website. Page 177 of 270
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Community Solutions Impact and Learning Report – 2022-23 16 3.3.4 Children and Young People’s Mental Health and Wellbeing Fund Phase Three Background The purpose of this fund is to improve the mental health and wellbeing of children and young people in North Lanarkshire by increasing support provided by local CVS organisations in liaison with schools. The fund was developed in 2020 with an initial pilot (Phase One) involving schools, staff in the council’s Education and Families team, VANL staff, and CVS organisations. Decisions regarding funding awards are led by schools, and informed by local needs and learning from the previous phase. The fund is managed and supported by School Cluster Improvement and Integration Leads (CILLs) and VANL staff, who work closely together. The fund supports delivery of the Scottish Government Children and Young People’s Mental Health and Wellbeing framework and the North Lanarkshire Children’s Services Plan, and is part of a suite of mental health and wellbeing initiatives for children and young people in North Lanarkshire, managed through our Children’s Services Partnership. Funding is provided by the Scottish Government via NLC to VANL for distribution to the North Lanarkshire CVS. The Impact and Learning reports for Phases One, Two, and Three of the Children and Young People’s Mental Health and Wellbeing Fund is available on the new Community Solutions website. Funding Awards 2022-2023 Total number of CVS projects funded: 75 Total amount awarded: £465,000 Achievements 2022-23 Page 178 of 270
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Community Solutions Impact and Learning Report – 2022-23 17 3.3.4.1 Children and Young People’s – Reach and Activities In 2023-23, the Children and Young People’s Community Mental Health and Wellbeing Fund… Supported 2276 primary school children, 472 secondary school children, 445 wider family members* (*parents, siblings, carers) and 144 care experienced young people Awarded funding to 75 projects across 16 CVS organisations Delivered projects to 170 primary schools, and 34 secondary schools involving 23 clusters Delivered the following activities • Art, play and drama therapy • Additional support needs tailored supports • Counselling, trauma and bereavement • Digital activities • Equine therapy • Healthy eating and nutrition • Mindfulness and selfcare workshops • Parental supports • Physical and outdoor activities 3.3.4.2 Children and Young People’s - Impact The outcomes for children and young people supported by the above funded projects are assessed using ‘The SHANARRI Wellbeing indicators for children and young people’. Outcomes for 2022-23 for children and young people (CYP) are summarised below: Page 179 of 270
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Community Solutions Impact and Learning Report – 2022-23 18 3.3.5 Community Mental Health and Wellbeing Fund Phase One Background The Community Mental Health and Wellbeing Fund is a national fund established by the Scottish government in late 2021 to help local CVS groups provide increased mental health and wellbeing support. The Scottish Government asked the 32 Third Sector Interfaces (TSIs) in Scotland, including VANL as North Lanarkshire’s TSI, to manage this funding on their behalf. VANL was required to manage the fund in partnership with HSCNL and, given the existence of the successful Community Solutions programme, it made sense to incorporate this new fund into the programme, thus supporting synergy with other programme funding. In February of 2022, VANL was allocated an initial £995k from the Scottish government to distribute to organisations in North Lanarkshire’s CVS. VANL received 85 applications requesting a total of £2.1 million in funding. The initial funding allocation meant only the top 30 projects could be funded. VANL then secured an additional £720k of funding from the Scottish Government, bringing the total distributed in 2022/23 to £1.6 million. The Impact and Learning report for Phase One of the Community Mental Health and Wellbeing Fund is available on the new Community Solutions website. Funding Awards 2022-23 Number of Projects: 53 (See Appendix E for full list) Total amount: £1.6 million Achievements 2022-23 3.3.5.1 Community Mental Health and Wellbeing – Reach and Activities In 2022-23, the Community Mental Health and Wellbeing Fund… Been supported by 502 volunteers who devoted 25,585 hours Helped projects to secure an additional £569,045 of additional funding Supported 22,414 individuals through 14,385 activities For example, activities include: • healthy eating education • arts projects • stress management • relaxation • bereavement support wellbeing classes • men’s groups • exercise • garden projects Page 180 of 270
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Community Solutions Impact and Learning Report – 2022-23 19 3.3.5.2 Community Mental Health and Wellbeing – Impact In 2022-23, the Community Mental Health and Wellbeing Fund … Supported 31,832 individuals to meet Community Solutions personal outcomes Of the 22,414 people supported, those that reported on outcomes met showed: • 12,307 adults’ health and wellbeing improved (1218 carers) • 12,845 adults felt more connected, included and safe • 7304 adults felt more informed and aware (1218 carers) • 4334 children and young people’s health and wellbeing improved • 1339 family relationships strengthened • 1500 children & young people have increased resilience *The number of people who met Community Solutions personal outcomes is higher than the total individuals supported as it is the number of unique individuals who reported on each outcome 3.3.6 Community Transport Background The Community Solutions funding to support Community Transport has been provided to the North Lanarkshire CVS organisation Getting Better Together (GBT) since 2016. Community Transport supports vulnerable residents to travel to essential appointments and key activities, supporting their health, wellbeing, and inclusion. Community Transport services are demand-responsive and therefore determined by service users’ requirements. GBT received a Community Solutions funding award of £72,000 during 2022-23, which, combined with funding from other sources, helped GBT deliver the following community transport services: • Transport for community groups, schools, CVS, and non-profit organisations using bookable, fully wheelchair accessible minibus and multi-purpose vehicles • A volunteer driver service, where volunteers use their own car to transport people to essential NHS appointments and are reimbursed for their expenses • A Community Transport HUB pilot partnership with NHS Lanarkshire and Community Transport Glasgow providing transport support for patients, staff, samples, and supplies Page 181 of 270
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Community Solutions Impact and Learning Report – 2022-23 20 Achievements 2022-23 In 2022-23, with Community Solutions funding, Getting Better Together’s Community Transport project… Avoided estimated £57,329 total probable cost for NHS Lanarkshire, of which £34,830 was due to the Volunteer Driver Service Been supported by 5 volunteer drivers who gave 1566 hours Provided 8054 passenger journeys, covering 52,000 miles 1032 of the 8054 total journeys were provided by volunteer drivers, covering a total of 22,000 miles The Community Transport Hub pilot began on 1st April 2019. Due to the COVID-19 pandemic, GBT adapted its existing services in 2021-22 to pilot the Community Transport Hub with NHS Lanarkshire. GBT continued with this work in 2022-23, supplying the NHS five days a week with two drivers and vehicles, providing 1512 journeys covering 28,000 miles. 3.3.7 Hospital Discharge Background The Community Solutions funding for the Hospital Discharge Support Service (HDSS) has been provided to the CVS organisation Getting Better Together (GBT) since 2013. The aim of the HDSS is to help patients and carers to access additional community- based support following hospital discharge to: • Support rehabilitation and recovery, including physical activity • Support self-management • Reduce loneliness and isolation The service is available to all North Lanarkshire residents aged over 16. The HDSS has a base in the University Hospitals in Monklands and Wishaw. HDSS staff also liaise with University Hospital Hairmyres and other rehabilitation settings throughout Lanarkshire to support the discharge of North Lanarkshire-based patients. HDSS staff provide guidance and support to patients, carers, and families through the discharge process. The service uses a person-centred approach – with staff discussing personal outcomes with patients, carers, and families. Staff also signpost service users to sources of personal and community support – including support - Page 182 of 270
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Community Solutions Impact and Learning Report – 2022-23 21 provided by CVS organisations – that they can access following discharge from hospital. The funding award to GBT to provide the HDSS during 2022-23 was £77,500. Achievements 2022-23 In 2022-23, with Community Solutions funding, the Hospital Discharge Support Service… Supported 1223 individuals Supported 761 individuals to meet Community Solutions personal outcomes Delivered 890 activities including hospital discharge transport, and referrals and signposting to appropriate services Of the 761 individuals that reported on Community Solutions personal outcomes: • 228 peoples’ health and wellbeing improved • 241 people felt more informed and aware • 148 carers felt more informed and aware • 144 carers’ health and wellbeing improved 3.3.8 Improving Lives Initiative 3.3.8.1 Introduction to Initiative The proposal for the Community Solutions Improving Lives Initiative (ILI) was developed collaboratively during 2022-23 with the Community Solutions Governance Group, HSCNL Core Management team, NHS Lanarkshire Health Improvement senior staff, and Macmillan Cancer Support. This development was informed by wider learning and engagement through the Community Solutions programme in recent years. Agreement was supported through development and discussion of a SBAR (Situation, Background, Action, Recommendation) summary, which was agreed by the Community Solutions Governance Group in September 2022 and approved in December 2022 by HSCNL Core Management Team. 3.3.8.2 Improving Lives Initiative Aim The aim is to help improve people’s physical, mental, and social wellbeing through a locally co-ordinated approach to providing community-based support for vulnerable and equality groups, as set out in the Community Solutions Strategy and investment Plan 2022-25 and summarised below. • People with health challenges and/or wellbeing crisis will be supported by “three conversations” and “social prescribing” approaches to aid recovery and/or to improve their wellbeing by helping them: Page 183 of 270
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Community Solutions Impact and Learning Report – 2022-23 22 o Express their support needs and priorities (self-directed support) o Strengthen their capacity for adopting and sustaining suitable self- management approaches o Access urgent and longer-term healthy living and social support (which may include access to community-based healthy living activities and/or referral to more formal services) • Vulnerable and equality groups will be helped to access community-based healthy living support and activities including: o Active travel o Harm minimisation from alcohol, drugs, and tobacco, including promoting smoke-free homes and communities o Healthy diets for all ages, including breastfeeding o Good sleep o Nature connectedness o Physical activity o Supportive relationships and social connections, including befriending 3.3.8.3 Locality Hosts, Consortia, and LAF including new Locality Development Planning The ILI provides increased funding for 24 months for our six Community Solutions locality hosts – complementing their existing recurrent funding – to enable them to do the following work in addition to their existing locality support work: • Improve engagement with the CVS within their localities • Supporting the adoption of the ALISS (A Local Information System for Scotland) service directory • Supporting the work of the Community Connectors (see below) • Strengthening links between Community Solutions and Community Planning at locality level It will also provide increased funding for the Community Solutions LAF for 24 months (complementing existing recurrent funding) to increase small grant funding for local CVS organisations to improve support for local people. This will mean the LAF budget will increase from £180,000 a year across the six localities to £300,000 a year for 24 months. 3.3.8.4 Social Prescribing With additional funding from NHS Charities Together, the existing Community Solutions programme will be strengthened by improving processes and networks to make social prescribing more efficient in North Lanarkshire. This work will bring social prescribing partners together and form the interface between statutory and third sector provision, establishing a more holistic approach to care, consistent language and direction, and increasing knowledge of access pathways among all partners. 3.3.8.5 Improving Cancer Journey Page 184 of 270
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Community Solutions Impact and Learning Report – 2022-23 23 With additional funding from Macmillan Cancer Support and the Scottish Government for the roll-out of the Improving Cancer Journey across North Lanarkshire, the ILI will improve outcomes for people living with, and beyond, cancer through the introduction of Community Connectors posts across North Lanarkshire, offering Holistic Needs Assessments at the point of diagnosis. These new posts will ensure everyone in North Lanarkshire diagnosed with cancer can easily access nonclinical support when needed, to enable them to live as well and as independently as possible. 3.3.8.6 Community Connectors The ILI will also see the appointment of a team of 10 Community Connectors to support vulnerable people in the community by using the “three conversations” model. This will include people referred through the Improving Cancer Journey project, connecting them to non-clinical support provided by CVS organisations. Due to the complex nature of the partnership, discussion is still ongoing to finalise the funding to increase the number of Community Connectors from six to 10, using funding from the Improving Cancer Journey project. The deployment of the Community Connectors is also subject to an allocation process that is still to take place. 3.3.9 Physical Activities Background During 2022-23, Community Solutions provided the then North Lanarkshire Leisure Trust with £40,000 to support provision of physical activities for people across North Lanarkshire with a range of health conditions to enhance their physical and mental wellbeing. Referrals to the service were received from a health and social care staff. Achievements 2022-23 In 2022-23, with Community Solutions funding the Physical Activities project… Supported 3038 individuals across the service overall Supported 3038 individuals to meet the Community Solutions personal outcome: ‘Adults health and wellbeing is improved’ Including: • 2278 new referalsto the general project • 760 new referals to specialist health classes Delivered 79 classes each week Page 185 of 270
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Community Solutions Impact and Learning Report – 2022-23 24 3.3.9 Positive Smoke-Free Role Models Background In partnership with NHS Lanarkshire’s ‘Quit Your Way’ Tobacco Control Team and Community Links, VANL managed funding for the Positive Smoke-Free Role Models Project. The project provided funding for CVS organisations across the six North Lanarkshire localities to develop and deliver: • Work across the North Lanarkshire Health and Social Care Partnership area which developed and promoted the concept of positive smoke-free role models • Engagement with individuals, communities, and organisations to understand, sign up, and pledge action to become Positive Smoke-Free Role Models NHS Lanarkshire’s Positive Smoke-Free Role Models project has a particular focus on children, and works towards: • Preventing children and young people becoming the next generation of people who smoke • Protecting children, adults, and pets from the harmful effects of second-hand smoke The Project was originally launched in 2019, but work was postponed in 2020 due to the Covid-19 pandemic. The Project was re-launched in April 2023. NHSL allocated £36k of custodian funding for VANL to manage. (Split between the six localities, providing £6K to each.) Funding decisions are made by locality consortia, allocation of funding will follow the LAF model (see section 3.2.3). Page 186 of 270
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Community Solutions Impact and Learning Report – 2022-23 25 Achievements In 2022-23, with Community Solutions funding the Positive Smoke Free Role Models (PSFRM) project has… Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw and Shotts 40 volunteers promoting PSFRM across LAF funded projects Provides information about PSFRM on their website and notice board 143 pledges across the locality Recruited 6 volunteers to promote PSFRM Promoted the Project through befriending volunteers and staff Used £3K of funding to support PSFRM pledges Used £3K of funding to support PSFRM pledges Worked with senior NHS Health Improvement staff to create resources and promote PSFRM across the locality 3 staff have completed Vaping and E cigarette awareness training Supported 167 people to make the pledge Attend the Tobacco Control Implementation Group 3.3.10 Substance Misuse Fund Background North Lanarkshire has some of the highest levels of alcohol- and drug-related deaths in Scotland. To tackle this, VANL manage the Substance Misuse Fund on behalf of the North Lanarkshire Alcohol and Drug Partnership (NLADP). The fund aims to support individuals and families to overcome some of the challenges they face in their life, while living with the impact of substance misuse in our communities. The fund’s objectives are to: • Work with people who experience challenges as a result of problematic alcohol and/or drug use with new needs which are not currently being met by existing services • Provide vital wellbeing support on issues such as: personal finances, employment; housing; food; digital inclusion; physical health; and improving home and community life • Help people to access immediate and emerging forms of support within our growing community recovery activities The NLADP allocated £50,000 of funding for VANL to manage in 2022-23. Two projects were awarded £1600 each. To date, funding decisions have been made by locality consortia, with allocation of funding following the LAF model (see section Page 187 of 270
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Community Solutions Impact and Learning Report – 2022-23 26 3.2.3). However, as result of key early learning, this approach is now being reviewed and the fund will be re-launched once that review in complete. 3.3.11 Support in the Right Direction Background The Scottish Government funds a national ‘Support in the Right Direction’ (SiRD) programme which aims to empower people and carers receiving social care support and services to be equal partners in their care where they have real choice and control over their lives, including: • Decisions about where they live and the services they receive • Participation in fulfilling activities and their community • Employment, if appropriate This is usually referred to as ‘self-directed support’. The national SIRD Fund has been managed by Inspiring Scotland on behalf of the Scottish Government and VANL since 2017. VANL has distributed this funding through the Community Solutions Programme to two CVS organisations: • Equals Advocacy • North Lanarkshire Disability Forum Their Community Solutions funding helps these two organisations provide the following services: • General and focussed in-depth self-directed support including 1-to-1 case work, online and Zoom conversations, and information sessions • Community connectors, who work directly with people to find suitable supports such as groups and activities Funding Awards 2022-23 Number of Projects: 2 Total amount: £99,952 Page 188 of 270
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Community Solutions Impact and Learning Report – 2022-23 27 Achievements 2022-23 In 2022-23, the Support in the Right Direction project has Supported 537 individuals Of the total 141 individuals supported through case work, 87 were carers This includes: • 141 people provided focused support • 195 people supported through case work • 125 people supported with general independent support activities • 66 of those were carers living with a condition • 36 were carers accessing support for their own personal outcomes 3.4 Review of Community Solutions Thematic Funding In line with the Community Solutions Strategy and Investment Plan 2022-25, the Community Solutions Governance Sub-Group on Wednesday 16th November 2022 approved the decision to undertake a review of the NL-Wide Thematic Funded Programme in 2023-24. Currently, HSCNL funds the following thematic projects through Community Solutions: • Anticipatory Care • Carer Strategy • Community Food • Community Transport • Physical Activities • Hospital Discharge • Home Visiting and Befriending The review will identify: • If investment should be continued on the basis of the current and/or any new themes • How future investment should be made and any other changes/improvements to the approach, for example the balance of the funding awarded within local HSCNL sectors and NL-Wide levels; and/or if a theme should be a separate strategic thread • Whether and how additional investment could be secured and provided for some key strategic initiatives in the future A cross-sector Thematic Review Group has been established to identify any gaps in the current NL-wide funded themes and decide if a revised focus or reframing of the current themes is appropriate. The group will report its findings in late 2023, with any changes being implemented in 2023-24. Page 189 of 270
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Community Solutions Impact and Learning Report – 2022-23 28 3.5 Capacity Building VANL receives recurrent funding through HSCNL to support capacity building in the following areas: • Carers • CVS capacity building for the sector generally and for CVS organisations to support Children, Young People and Families (CYPF) • Volunteering 3.5.1 Carers’ Capacity Building Background Community Solutions supports capacity building for carers by funding North Lanarkshire Carers Together to support the North Lanarkshire Carer Forum and a range of other carers’ support activities. Achievements 2022-23 During 2022-23, North Lanarkshire Carers Together received a grant of £40,000, allowing them to: • Support the North Lanarkshire Carer Forum, which brings carers together to share information, provide peer support, and develop collective views to inform improved policy and practice • Support development and delivery of the Carer Breather Fund (see Section 3.3.3), including supporting network organisations with general guidance around Carer Breather Fund applications for Phase Two • Influence carers’ policy and services through participation in the North Lanarkshire Carers’ Strategy Group and other forums • Hold a ‘Conversation Café’ co-production event at the February 2023 network meeting which invited carers to share their experiences of services in North Lanarkshire with the network. This led to a carer representative being invited on to the CSN 3.5.2 Community and Voluntary Sector Capacity-Building Background VANL receives funding through the Community Solutions programme to support our provision of capacity-building support to the CVS so the sector is able to effectively contribute to improved health and wellbeing of residents and local communities through: o Provision of support and services to improve physical and mental health o Community wealth-building to support social and economic inclusion o Protection and improvements to our natural environment, including climate action The capacity-building support and services provided by VANL includes the following: • Information provision through our ‘Working Together for a Better North Lanarkshire’ website, digital bulletins and social media Page 190 of 270
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Community Solutions Impact and Learning Report – 2022-23 29 • Organisational development guidance on issues such as: o Set up and governance o Strategic planning o Income generation o Finance o HR o Performance management and evaluation • Peer support and learning opportunities by: o Providing or facilitating access to structured training and informal learning o Convening and supporting the CVS Strategic Partnership Group and linked thematic networks on key issues such as befriending; mental health and wellbeing; employability o Organising regular events for the CVS, including locality meetings and an annual conference • Supporting CVS to participate in our local partnerships and contribute to delivery of associated plans including: o Our North Lanarkshire Community Planning Partnership, North Lanarkshire Partnership and its Plan for North Lanarkshire, associated North Lanarkshire- wide strategies such as the Tackling Poverty Strategy and nine linked Local Outcome Improvement Plans. (See partnership section in the diagram below) o Health and Social Care North Lanarkshire partnership and its Commissioning Plan and linked strategies on mental health and wellbeing, alcohol and drugs, and the Community Solutions Strategy and Investment Plan. (See partnership section in the diagram below) o The Children’s Services Partnership and Plan – see the Children, Young People, and Families section below VANL staff also undertake organisational reviews of CVS organisations receiving funding through Community Solutions to provide appropriate due diligence checks and identify areas where they may require support on above issues. Achievements 2022-23 VANL’s CVS capacity-building work was supported during 2022-23 with a £60,000 grant provided through Community Solutions, and supplemented by core funding from the Scottish Government and North Lanarkshire Council. (Also see the Children, Young People, and Families section below.) Page 191 of 270
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Community Solutions Impact and Learning Report – 2022-23 30 VANL staff provided the following support to CVS organisations and facilitated partnership working during 2022-23… Supported CVS to contribute to delivery of the following • 3 x Action on Climate Together North Lanarkshire (ACT Now NL) • 3 x Employability • 1 x Children, Young People and Families • 3 x Community Solutions • 8 x Mental Health and Wellbeing • 1 x Working Together for a Better NL Published 19 e-bulletins for the NL CVS and statutory partner - in liaison with HSCNL and Council colleagues – on the following topics Provided 169 CVS organisations with guidance on key issues to support their sustainability and effectiveness including income generation, governance, ICT, human resources • Plan for North Lanarkshire • Linked strategies on key issues such as mental health, tackling poverty, and climate and green wellbeing • and complementary nine Local Outcome Improvement This was achieved through the capacity building support above and also by: • Facilitating CVS representation and engagement with the North Lanarkshire Strategic Leadership Board and the nine, linked Locality Community Boards and associated sub-groups; North Lanarkshire Tackling Poverty Group; Lanarkshire Mental Health Strategy Board • Co-ordinating the Action on Climate Together North Lanarkshire initiative and facilitating community climate and green wellbeing action VANL staff provided the following support to CVS organisations and facilitated partnership working during 2022-23 cont’d… Completed 8 organisational reviews for CVS organisations Provided training to over 182 CVS staff and volunteers on a range of topics such as child protection, mental health and climate emergency training . Organised the CVS annual conference on the theme of Community Wealth Building. • Befriending • Children, Young People and Families • Community and Voluntary Sector Partnership Group (CVSPG) • Employability Network • Mental Health and Wellbeing Network Supported the CVS to network, collaborate and influence policy and practice through the following CVS networks: 3.5.3 Children, Young People, and Families VANL staff undertake capacity-building with the CVS to strengthen the support they provide to local children, young people, and families to improve their health, wellbeing, and inclusion. VANL does this by: • Convening and supporting the North Lanarkshire CVS Children, Young People and Families Network to provide information-sharing; peer support; and to support CVS partnership working with the public sector through the North Lanarkshire Children’s Services Partnership; HSCNL; North Lanarkshire Partnership (NLP) • Supporting the CVS to strengthen their contributions to: Page 192 of 270
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Community Solutions Impact and Learning Report – 2022-23 31 o Helping mothers breastfeed successfully with bespoke training from the Infant Mental Health Team and links with community midwives o Child protection, through provision of training by VANL staff o Tackling poverty, including supporting CVS organisations that support: Employment Money and welfare advice Community food support o Children and young people’s mental health, including: A key role in developing arrangements for the Children and Young People’s Community Mental Health and Wellbeing Fund (see 3.4.4) CVS support for improving infant mental health with access to Infant Mental Health Training and the Infant Mental Health toolkit • Encouraging young people to volunteer to support development of their skills and confidence, and community engagement and contribution • Supporting CVS participation in the Children’s Services Partnership (CSP) and facilitating links between the CSP, Community Solutions, HSCNL and community planning Achievements 2022-23 During 2022-2023, HSCNL provided VANL with a grant of £30,000 to support the CVS to strengthen their support for children, young people, and families as outlined above. This funding was complemented by VANL’s core funding from the Scottish Government and North Lanarkshire Council which also supports VANL ability to provide capacity-building support to the CVS for children, young people, and families. Page 193 of 270
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Community Solutions Impact and Learning Report – 2022-23 32 During 2022-23, VANL staff supported the following children, young people and families capacity- building work Supported CVS organisations to help families affected by child and family poverty Supported CVS contributions to the delivery of the NL Tackling Poverty Strategy Supported members to access training on issues such as Child Protection and mental health Supported members to liaise with schools and access other school-managed funding such as the Pupil Equity Fund Convened 4 meetings of the Children, Young People and Families Network involving 30 CVS organisations which supported work on the following issues: Supported members with their applications to Phase 3 of the Children and Young People’s Mental Health and Wellbeing Fund (21 members were successful) 3.5.4 Volunteering VANL staff support volunteering developments across North Lanarkshire, working with: • The CVS – which involves and relies on many thousands of volunteers to deliver their support and services • Public sector partners – including North Lanarkshire Council, NHS Lanarkshire, Police and Fire and Rescue – which also involve volunteers and support volunteering more widely • Employers in all sectors, including the business sector, which contributes through employer-supported volunteering VANL staff support volunteering strategically and operationally including: • Setting up and convening the North Lanarkshire Volunteering Partnership to facilitate improved cross-sector support for volunteering • Promoting volunteering opportunities to the public and supporting matching to roles • Supporting volunteer-involving organisations to improve their recruitment and support for volunteers, including accreditation through the Volunteer-Friendly award Achievements 2022-23 Page 194 of 270
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Community Solutions Impact and Learning Report – 2022-23 33 During 2022-23, VANL staff supported the following Volunteer Development activities… Facilitated development and agreement, and supported delivery of a first NL Volunteering Strategy Provided 860 Saltire Award Certificates to children and young people in NL to accredit their volunteering contribution Facilitated and chaired three NL Volunteering Partnership meetings, with 15 participants in attendance at each Registered 104 new volunteers with 94 suitable matches made to volunteering opportunitiesHandled 119 individual enquiries relating to volunteering Matched 94 volunteers with suitable volunteering opportunities Completed 65 PVG checks, for volunteers and paid members of staff *Due to changes in legislation and arrangements for PVG checks, VANL is no longer allowed to do this Page 195 of 270
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Community Solutions Impact and Learning Report – 2022-23 34 4. Community Solutions Priorities 2023-24 This section provides an overview of development priorities for the Community Solutions Programme during 2023-24. 4.1 Custodian Fund Developments 4.1.1 Cancer Screening Inequalities Fund The Cancer Screening Inequalities Fund was approved by HSCNL in early 2023 for the delivery period from summer 2023 to March 2024, to support increased take-up of cervical and breast screening in Airdrie and Bellshill localities due to their particularly low uptake rates: • Cervical screening uptake is falling in Lanarkshire and across Scotland. Evidence demonstrates that uptake is around 20% lower in those from the lowest socio- economic areas in comparison to those in living in the highest • There is also growing concern over the youngest 25-34-year-old group and their participation in screening • There is less available data on uptake in Black and Minority Ethnic (BAME) communities, those that experience physical or learning disability, and LGBT communities, but indications are that screening uptake is generally lower compared to the white UK population A total of £15k was made available (£7.5k for each locality) to CVS organisations for delivery in either or both locality areas. A cross-sector funding panel met in May 2023 and awarded funding to two projects: • Bear Necessities (Airdrie) - £7.5k • Culture Junction (Bellshill) - £7.4k These projects will be delivered over the course of summer 2023 to March 2024, and reported on in Summer 2024. 4.1.2 Carer Breather Fund Phase Two Funding for Phase Two of the Carer Breather Fund – for £543k covering the period from April 2023 to March 2025 – was approved by HSCNL in December 2022. Staff in VANL worked with North Lanarkshire Carers Together (NLCT) to promote the fund and support assessment and awards. Applications were assessed and award decisions made by a cross-sector panel including representatives from VANL, NCLT and carer representatives, with awards issued by the end of March 2023. Funding was awarded to 11 organisations: • Bazooka Arts • Getting Better Together • Glenboig Development Trust • North Lanarkshire Disability Forum • One Parent Families Scotland • PAMIS (Promoting a More Inclusive Society) • Parkinson’s Self-Help Group Airdrie • Play Peace • The Haven • The Health and Wellness Hub Page 196 of 270
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Community Solutions Impact and Learning Report – 2022-23 35 • Watch Us Grow Learning from Phase One will support delivery of Phase Two, which will be supported by the updated Carer Pathway Toolkit. Use of the toolkit will be mandatory for projects receiving funding in Phase Two. 4.1.3 Children and Young People’s Community Mental Health and Wellbeing Fund Phase Four Funding for Phase Four of this fund was agreed by NLC and the Children’s Services Partnership in spring 2023, with a launch event in June 2023. As with previous phases, funding awards for Phase Four were made to local CVS organisations to provide support to children and young people to improve their mental health and wellbeing. The approach to awarding funding decisions has been revised for Phase Four, with funding decisions now being be made throughout the school year from August 2023 until April 2024, using ongoing needs assessment by Cluster Improvement Integration Leads (CIILs) and local head teachers. From February 2023, the online platform GLOW has been introduced as a directory of available services and supports, to support CIILS to allocate funding based on pupils’ need. 4.1.4 Community Mental Health and Wellbeing Being Fund Phase Two Funding for Phase Two of the Community Mental Health and Wellbeing Fund was announced by the Scottish Government in autumn 2022, with a total of £955k available to fund CVS organisations in North Lanarkshire. Learning from Phase One informed this second phase, including ringfenced funding to support BAME and LGBTIA+ groups. Applications were sought from CVS organisations during November/December 2022. A cross-sector panel involving staff from VANL, NHS Lanarkshire, and North Lanarkshire Council assessed all applications and made funding decisions in early March 2023. Awards were issued by the end of March 2023 for activity to be delivered from April. Funding was awarded to 33 funded projects. 4.1.5 Improving Lives Initiative With the recommissioning of the Locality Hosts completed, the priority for the Improving Lives Initiative is to re-establish the joint meetings of the Locality Hosts as a platform for sharing best practice and to build a consistent approach for the locality consortiums to work across all six localities in North Lanarkshire. Some key documents are being reviewed/introduced which include: • An updated Terms of Reference • A Role Descriptor for the Locality Hosts • A Code of Conduct for Consortium Members • Guidance on Developing a Locality Development Plan • Guidance on the Use of the Locality Fund Page 197 of 270
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Community Solutions Impact and Learning Report – 2022-23 36 The other focus will be to complete the alignment of the six planned Community Connectors with the funding from Macmillan Cancer Support and the Scottish Government to recruit key workers as part of the Improving Cancer Journey. This will create an integrated holistic team of 10 Community Connectors that will support people with cancer and those affected by cancer, such as family and close friends. The Community Connectors will also provide support to people with other health conditions and people requiring other forms of health and social care support. The role of the Community Connectors is to provide non-clinical support to improve the lives of people going through difficult times, by connecting them into natural supports in their community provided by the CVS and statutory supports when appropriate. The Community Connectors will be co-located and work closely with the six Locality Hosts, who will be allocated a proportion of an additional £141,000 to enhance their role as Locality Hosts; along with a proportion of an additional £120,000 to distribute through the Locality Activity Fund. Another priority for the coming year will be to establish referral pathways for the team of 10 Community Connectors, the focus will be on three main areas: • Referrals from cancer clinics for people affected by cancer as part of the Improving Cancer Journey initiative. This is being led by the Improving Cancer Journey Programme Manager and will be routed through an Administrative Hub housed within NHS Lanarkshire • Referrals from HSCNL services in the community. Links are being established with Service Managers responsible for Adult Social Work Services, Home Assessment Teams, Integrated Rehab Teams and other HSCNL Teams based in each of the localities • Patients from the two acute hospitals in North Lanarkshire who are frequently readmitted to hospital. As part of the work undertaken through the Discharge without Delay programme, there is a cohort of people who are frequently readmitted to hospital following a discharge as no further clinical support can be provided, typically at 7 and 28 days. Work is being undertaken to develop a process where such people can be identified and referred on to get non-clinical support from the Community Connectors The final main priority is to introduce and promote two key approaches: the use of Care Opinion as an on-line independent, anonymised and moderated feedback system that gathers the experiences of people that get support from Community; and voluntary sector organisations funded through the Community Solutions Programme. The approach that will be promoted is the use of the ALISS service database. Developed and supported by the alliance with funding from the Scottish Government, the service database feeds into other service directories used by NHS Inform and other statutory services. Page 198 of 270
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Community Solutions Impact and Learning Report – 2022-23 37 4.1.6 Review of Community Solutions Thematic Funding The focus for the coming year is to complete the Thematic Funding Review, to more appropriately align it to the priorities contained in the Community Solutions Strategy and Investment Plan (2022-25) and the new HSCNL Strategic Commissioning Plan (2023-26). The aim is also to ensure that the thematic funding, which is currently £510,000 per year from the recurring funding provided by HSCNL, is invested to build the capacity of the CVS and to inform service change to provide a more sustainable model of service as appropriate. The review will identify where current thematic funding can be more sustainably funded through other routes, if there are any new themes that should be funded, and it there are any of the existing themes that should be refocused to provide a more effective service. 4.2 Capacity Building 4.2.1 Carers North Lanarkshire Carers Together have been re-commissioned to support the Carers Network; Carer Breather Fund; and other carers developments. 4.2.2 Children, Young People and Families During 2023-24, VANL staff will continue to develop and deliver capacity-building support to the CVS as set out above in section 3.5.3, so these organisations are more able to contribute to improve the wellbeing of our children, young people, and families. 4.2.3 CVS Capacity Building During 2023-24, VANL staff will continue to develop and deliver capacity-building support to the CVS, as set out above in section 3.5.2, so both Community Solutions funded organisations and the wider sector are better able to contribute to improved wellbeing of residents and communities. 4.2.4 Volunteering Volunteering Support During 2023-2024, VANL staff continued to support volunteering across North Lanarkshire, working closely with public sector partners and the CVS in the ways set out in section 3.5.4. 4.3 Programme Performance Management, Evaluation, Learning and Improvement 4.3.1 Development of Improved Approach During 2022-23 VANL staff reviewed the Community Solutions approach to performance management, evaluation, learning and improvement for funded projects, funds, and the programme as a whole. The following resources were developed during 2022-23: Page 199 of 270
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Community Solutions Impact and Learning Report – 2022-23 38 • A new Community Solutions Performance Management, Evaluation, Learning and Improvement (PMELI) Framework • A new evaluation guide for funded projects and wider CVS • New resources complimenting the PMELI Framework including a feedback survey for funded projects, guidance on preparing case studies, and personal stories The new framework was approved by the Community Solutions Governance Group in November 2022. The guide was launched in March 2023 for implementation from April 2023, supported by the Evaluation Guide which was also available from April. A briefing event was held in April 2023 with the following organisations to introduce the new framework: • Locality hosts and consortia members • CS governance group • HSCNL staff 4.3.2 Review of Software and Revised Approach Over the past two years, the Community Solutions Programme has seen a significant increase in the number of managed funds. This has led to a significant increase in the evaluation returns received from funded projects. Therefore, in line with the new framework, the reporting requirements for projects funded through the Community Solutions Programme were reviewed in April 2023. Also, to manage this increased workload, a review of available software was conducted in June/July 2023. The new reporting requirements using the JotForm platform have been designed to more appropriately demonstrate the impact that the CVS has on improving the health and wellbeing of people and communities in North Lanarkshire. This learning will feed into improvements on three levels: • For individual projects • For the Community Solutions Programme • For the sector as a whole 4.3.3 CVS Contribution to Mental Health and Wellbeing During 2022-23, VANL staff developed – in liaison with NHS and CVS colleagues – a pilot initiative to support more in-depth assessment of CVS organisations’ contributions to mental health and wellbeing outcomes for the people they support. The pilot supports a small number of CVS organisations - including Community Solution-funded organisations – to use the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) to capture more robust evidence on the difference their support has made to their service users’ mental health. The pilot commenced in May 2023 and will run until June 2024. A recruitment event was held in May 2023 to recruit participating organisations. Learning from the pilot will deepen understanding of the CVS contribution to mental health and wellbeing, with a view to influencing future investment in community- Page 200 of 270
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Community Solutions Impact and Learning Report – 2022-23 39 based mental health support in North Lanarkshire. The approach may also be rolled out more widely across the CVS if the pilot demonstrates viability and usefulness. 4.4 Programme Communications and Liaison During 2023-24 VANL staff will continue to: • Communicate and liaise with all programme stakeholders including funded projects, locality hosts and consortia, and HSCNL colleagues • Represent the Community Solutions Programme and CVS on HSCNL’s Strategic Leadership Team, IJB Board, and Performance, Finance and Audit Committee • Share key information about the programme online through Community Solutions e-bulletins Development of a new Community Solutions website was planned for 2022 but due to staffing capacity issues has been deferred to early 2024. 4.5 Programme Governance VANL staff will continue to convene and support the Community Solutions Governance Group during 2023-24 as outlined above in section 2.3. During 2022-23 membership of the group was reviewed to strengthen representation and engagement of key stakeholders including: • HSCNL staff • Council staff from the Enterprise and Communities, and Education and Families departments • Locality hosts and consortia (for implementation from spring 2023) Page 201 of 270
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Community Solutions Impact and Learning Report – 2022-23 40 Appendix A Appendix B Locality Activity Fund Distribution 2022-23 Total number of projects funded in the six Community Solutions localities: 66 Total income for 2022-23: £180,000 Plus, underspend carried forward (c/f) from 2021-22: £16,174 Total spend: £166,275 Community Solutions Locality Host Funding 2022-23: Total Awards £240k CVS Organisation Project Total Funding Amount (£) A.1 Diamonds in the Community (Airdrie) Locality Host 40,000 A.2 Orbiston Neighbourhood Centre (Bellshill) Locality Host 40,000 A.3 Glenboig Development Trust (Coatbridge) Locality Host 40,000 A.4 CACE (Cumbernauld) Locality Host 40,000 A.5 The Health and Wellness Hub (Motherwell) Locality Host 40,000 A.6 Getting Better Together (Wishaw and Shotts) Locality Host 40,000 Page 202 of 270
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Community Solutions Impact and Learning Report – 2022-23 41 Airdrie Locality Organisation Project Total Funding Amount (£) B.1 Airdrie Action Partnership (hosted by Bear Necessities) Christmas Appeal 3,350 B.2 Airdrie Helping Hands Christmas Food Parcels 1,000 B.3 Equal Futures Strengthening Social Relationships 3,000 B.4 Friends of Airdrie and Coatbridge Islamic Centre (FACIC) Cricket for Health and Family 3,867 B.5 Nurture Scotland KIN-ect! 1,945 B.6 Parkinson’s Self-Help Group Airdrie Time for Me 5,040 B.7 The Health and Wellness Hub Wraparound Wellbeing Support 5,100 B.8 Upperton Residents Committee Upperton Allotment Community Shed 420 B.9 Voice of Experience Forum Voice of Experience Forum Calendar 22/23 2,440 B.10 Whinhall Allotments Muddy Boots Sensory Project 504 No. of projects: 10 Total 26,666 Balance c/f to 2022-23 Page 203 of 270
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Community Solutions Impact and Learning Report – 2022-23 42 Bellshill Locality Organisation Project Total Funding Amount (£) B.11 A-Jabs Amateur Boxing Club Summer Project and Drop In 5,354 B.12 Lanarkshire Community Food and Health Partnership Cooking on a Budget (Slow Cooker) 2,875 Cooking Towards Addiction Recovery 2,265 Summer Family Cooking Project 2,180 B.13 Nurture Scotland KIN-etc! 2,500 B.14 Salvation Army Youth Club 1,595 B.15 Thorniewood Community Café Caring Cuppa Community Café 3,200 B.16 VIP Muddy Feet 5,150 B.17 YMCA Bellshill and Mossend Y Hang Out 2,880 YMCA Farmbots 4,200 YMCA Women’s Health Project 2,220 No. of projects: 11 Total 34,419 (Using c/f underspend from 2020/21) Page 204 of 270
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Community Solutions Impact and Learning Report – 2022-23 43 Coatbridge Locality Organisation Project Total Funding Amount (£) B.18 Glenboig Development Trust Coatbridge Health and Wellbeing PB 10,000 B.19 Men’s Shed Men’s Shed 1,853 No. of projects: 2 Total 11,853 Balance c/f to 2022-23 Page 205 of 270
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Community Solutions Impact and Learning Report – 2022-23 44 Cumbernauld and the North Locality Organisation Project Total Funding Amount (£) B.20 Cardowan Community Meadow Cardowan Health and Wellbeing Project 3,000 B.21 Gartcosh Tenants and Residents Association Gartcosh Social Inclusion Project 1,850 B.22 Landed Peer Education Positive Smoke Free Role Models 1,850 B.23 Moodie Blues 50+ Discovery Award Group Community Christmas Fun Day 550 B.24 Moodiesburn Youth Club Health Project for Young People 3,000 B.25 Never Alone Depression Peer Support Group March 2,000 Depression Peer Support Group July 1,400 B.26 New Adventures Community Group Marketing for Our Future 1,550 B.27 Spina Bifida Hydrocephalus Scotland Sowing Community Seeds 5,000 B.28 Strathcarron Hospice Bereavement Support Group 1,110 Community Loss and Bereavement Resource Boxes 2,000 B.29 TRASH Music Drumbernauld/Jambernauld – Musical Youth Club for Cumbernauld 4,713 No. of projects: 12 Total 28,023 Balance c/f to 2022-23 Page 206 of 270
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Community Solutions Impact and Learning Report – 2022-23 45 Motherwell Locality Organisation Project Total Funding Amount (£) B.30 Befriend Motherwell Intergenerational Cookery Project 1,060 B.31 Craigneuk Lifelong Learning Association Craigneuk Christmas Community Celebration Project 2,000 B.32 Dalziel St. Andrew’s Church Carpet Bowls 1,000 B.33 Economic Forum for Women Empowerment Community Meals 2,000 B.34 Elim Befriending Pantomime Outing 500 B.35 Forgewood Housing Co-operative Food for Forgewood 1,200 B.36 Fresh Start NL Widening the Welcome in North Lanarkshire 1,000 B.37 Lanarkshire Community Food and Health Partnership Big Chef Little Chef 3,018 Cooking with ESOL Learners 2,705 Men’s Cooking Club 2,705 B.38 Motherwell Citizens Advice Bureau Community Engagement Project 4,539 B.39 Motherwell Salvation Army Motherwell SCRAN Youth Club 2,725 B.40 North Lanarkshire Disability Forum (NLDF) NLDF Connect 5,190 B.41 The Miracle Foundation Wall of Hope 1,750 Page 207 of 270
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Community Solutions Impact and Learning Report – 2022-23 46 No. of projects: 14 Total 31,392 (Using c/f underspend from 2020/21) Wishaw and Shotts Locality Organisation Project Total Funding Amount (£) B.42 The Brave Jnr Esports: For the Players: SCQF Level 6 1,950 Esports Livestream Project 2,120 B.43 Elements Netball Club Netball Club 2,109 B.44 Garrion People's Housing Co-operative Winter Wonders @ Law View 1,500 B.45 Getting Better Together Walking Football 2,300 Breakfast Club and Walking Bus Project 2,730 B.46 Lanarkshire Community Food and Health Partnership Big Chef, Little Chef 2,814 Big Chef, Little Chef 2 2,082 Men’s Cooking Club 2,407 Men’s Cooking Club 2 2,226 B.47 Nurture Scotland KIN-ect! 2,245 B.48 People at Leisure Scotland (PALS) People at Leisure Scotland (PALS) 1,476 B.49 Salsburgh Mother and Toddler Group Pre-School Play for Learning 2,383 B.50 Shotts Bon Accord Football Academy Shotts Bonny! Play and Spray Project 1,650 B.51 Shotts Golf Club Sunday Sweep 400 Page 208 of 270
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Community Solutions Impact and Learning Report – 2022-23 47 Appendix C Community Solutions Thematic Funding 2022-23: Total Awards £890.5k C.1 Anticipatory Care: Total Awards £40k CVS Organisation/Project Total Funding Amount (£) Equals Advocacy 40,000 C.2 Carer Breather: Total Awards £248k Bazooka Arts 22,848 Getting Better Together 22,240 24,000 Glenboig Development Trust 21,160 22,736 Parkinson’s Self Help Group Airdrie 16,390 Parkinson’s Self Help Group Motherwell 30,000 The Haven (Carer Breather) 27,950 The Haven (Carer Sitter pilot) 7,069 The Health and Wellness Hub 23,476 Organisation Project Total Funding Amount (£) B.52 Wishaw YMCA Crafting Club 2,880 Jam Sessions 650 No. of projects: 17 Total 33,922 (Using c/f underspend from 2021/22) Page 209 of 270
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Community Solutions Impact and Learning Report – 2022-23 48 CVS Organisation/Project Total Funding Amount (£) Watch Us Grow 29,000 C.3 Carers’ Support Network: Total Awards £40k North Lanarkshire Carers Together 40,000 C.4 Community Transport: Total Awards 72k Getting Better Together 72,000 C.5 Befriending: Total Awards £195k Befriend Motherwell 8,000 CACE 20,600 Elim Christian Centre 14,228 Getting Better Together 29,000 Glenboig Development Trust 20,000 HomeStart 33,000 Orbiston Neighbourhood Centre 20,000 Volunteering Matters 29,800 YMCA Bellshill 20,000 C.6 Hospital Discharge Support Programme: Total Award £77.5k Getting Better Together 77,500 C.7 Positive Smoke-Free Role Models: Total Award £36k Airdrie 6,000 Bellshill 6,000 Coatbridge 6,000 Cumbernauld 6,000 Motherwell 3,000 Page 210 of 270
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Community Solutions Impact and Learning Report – 2022-23 49 CVS Organisation/Project Total Funding Amount (£) Wishaw and Shotts 6,000 C.8 Physical Activities: Total Award £60K North Lanarkshire Leisure Trust 60,000 C.9 Support in the Right Direction (Self Director Support) Fund 2022-23: Total Awards £100k Equals Advocacy 16,838 North Lanarkshire Disability Forum 89,133 Appendix D Community Solutions Children and Young People Fund 2022-23: Total Awards: £465k (plus £57k 21-22 underspend) for 75 projects across 16 CVS organisations (See main body of this report – and also the separate Learning and Impact Report – for this Fund) CVS Organisation Project Total Funding Amount (£) Schools’ Cluster D.1 Lanarkshire Community Food and Health Partnership (LCFHP) Come Dine with Me 2,972 Airdrie Academy D.2 Hope for Autism Support for School Transitions 2,920 Airdrie Academy Support for School Transitions – Additional Funds 1,620 Airdrie Academy D.3 Make and Create Arts Creative Families at Airdrie 3,000 Airdrie Academy Page 211 of 270
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Community Solutions Impact and Learning Report – 2022-23 50 CVS Organisation Project Total Funding Amount (£) Schools’ Cluster D.4 Reeltime Music Creative Project using Music & Media 3,600 Airdrie Academy D.5 The Health and Wellness Hub Emotional Wellbeing in Schools 1,504 Airdrie Academy D.6 The Miracle Foundation Supporting Children and Young Peoples Mental Health 3,600 Airdrie Academy D.7 Action for Children Young Carers - Primary School Awareness Programme 5,724 Bellshill D.8 Home Start Practical Steps Towards Change 11,032 Bellshill D.9 VIP Arts and Sports Academy Creative Me! Wellbeing Programme 6,105 Bellshill Creative Me! Wellbeing Programme 16,330 Bellshill/Cardin al Newman D.10 LCFHP Cooking Club 5,154 Braidhurst D.11 One Parent Families Scotland OPFS Lanarkshire Creating Connections: Braidhurst: Ailsa Family Learning Centre 2,302 Braidhurst OPFS Lanarkshire Creating Connections: Braidhurst: Logan’s Nursery 2,302 Braidhurst OPFS Lanarkshire Creating Connections: Braidhurst: Forgewood Family Learning Centre 3,198 Braidhurst OPFS Lanarkshire Creating Connections: Braidhurst: Ladywell Primary 3,198 Braidhurst Page 212 of 270
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Community Solutions Impact and Learning Report – 2022-23 51 CVS Organisation Project Total Funding Amount (£) Schools’ Cluster D.12 The Health and Wellness Hub Emotional Wellbeing in Schools 1,005 Braidhurst and Dalziel 8,935 Braidhurst and Dalziel D.13 Outlet Play Wild Passport 4,307 Brannock and Taylor Individual Support – SOARing Outdoors 3,556 Brannock and Taylor Small Group – SOARing Outdoors 2,413 Brannock and Taylor Individual Support – SOARing Outdoors (evening) 1,648 Brannock and Taylor D.14 VIP Arts and Sports Academy Creative Transitions Project 28,274 Brannock and Taylor D.15 Bazooka Arts Group Therapeutic Arts Programme 14,000 Calderhead D.16 Social Track Empowering young people through action sports 6,000 Calderhead D.17 LCFHP Come Dine with Me 4,757 Caldervale D.18 Make and Create Arts Positive Creations 5,000 Caldervale D.19 Reeltime Music Creative Project using Music & Media 1,600 Caldervale D.20 The Health and Wellness Hub Emotional Wellbeing in Schools 1,882 Caldervale D.21 The Miracle Foundation Supporting Children and Young People’s Mental Health 3,600 Caldervale D.22 Hope for Autism Autism informed support through a group drop-in opportunity 3,180 Chryston Page 213 of 270
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Community Solutions Impact and Learning Report – 2022-23 52 CVS Organisation Project Total Funding Amount (£) Schools’ Cluster D.23 LCFHP Cooking Club 6,280 Chryston D.24 The Health and Wellness Hub Emotional Wellbeing in Schools 4,515 Chryston D.25 The Miracle Foundation Supporting Children and Young People’s Mental Health 9,360 Chryston/ Kilsyth/ Cumbernauld D.26 Outlet Play SOARing Outdoors 8,645 Clyde Valley D.27 Social Track Empowering Young People through Action Sports 10,000 Clyde Valley D.28 LCFHP Big Chef Little Chef 7,307 Coatbridge D.29 The Miracle Foundation Supporting Children and Young People’s Mental Health 5,400 Coatbridge 6,600 Coltness D.30 Bazooka Arts Group Therapeutic Arts Programme 30,417 Coltness and St Aidan’s D.31 OPFS OPFS Lanarkshire Creating Connections 5,000 Cumbernauld Academy D.32 Outlet Play Individual Support 3,840 Cumbernauld Academy Group Support 5,543 Cumbernauld Academy D.33 Parent Action for Safe Play (PASP) PASP Play Champion Programme 5,280 Cumbernauld Academy D.34 Outlet Play Individual Support – SOARing Outdoors 1,778 Dalziel Group Support – SOARing Outdoors 2,353 Dalziel Small Group – SOARing Outdoors 1,832 Dalziel Page 214 of 270
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Community Solutions Impact and Learning Report – 2022-23 53 CVS Organisation Project Total Funding Amount (£) Schools’ Cluster SOARing Outdoors 5,399 Dalziel D.35 OPFS OPFS Lanarkshire Creating Connections 5,000 Greenfaulds D.36 Outlet Play SOARing Outdoors 3,719 Greenfaulds D.37 PASP PASP Play Champion Programme 7,392 Greenfaulds D.38 The Miracle Foundation Supporting Children and Young People’s Mental Health 3,000 Greenfaulds D.39 Hope for Autism Lunch Time Club 1,858 Kilsyth D.40 LCFHP Cooking Club 3,140 Kilsyth D.41 Outlet Play Individual Support – SOARing Outdoors 2,656 Kilsyth Small Group – SOARing Outdoors 1,603 Kilsyth 2,298 Kilsyth D.42 Reeltime Music Creative Project using Music & Media 4,200 Kilsyth D.43 OPFS OPFS Lanarkshire Creating Connections 5,000 Our Lady’s High School Cumbernauld D.44 Outlet Play Small Group – SOARing Outdoors 2,189 Our Lady’s High School Cumbernauld D.45 Reeltime Music Creative Project using Music & Media 6,400 Our Lady’s High School Cumbernauld D.46 Circle Whole Family Support Service 17,361 Our Lady’s High School Motherwell D.47 Reeltime Music Creative Project using Music & Media 2,400 Our Lady’s High School Motherwell Page 215 of 270
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Community Solutions Impact and Learning Report – 2022-23 54 CVS Organisation Project Total Funding Amount (£) Schools’ Cluster D.48 The Miracle Foundation Supporting Children and Young People’s Mental Health 1,800 St Aidan’s D.49 LCFHP The Nurture Project 4,000 St Ambrose Big Chef Little Chef 6,576 St Ambrose D.50 Make and Create Arts Positive Creations 7,000 St Ambrose D.51 The Health and Wellness Hub Emotional Wellbeing in Schools 280 St Ambrose D.52 Bazooka Arts Group Therapeutic Arts Programme 1,472 St Ambrose/St Andrew’s D.53 LCFHP Big Chef Little Chef 11,691 St Andrew’s D.54 Make and Create Arts Positive Creations 9,000 St Andrew’s D.55 Bazooka Arts Group Therapeutic Arts Programme 6,465 St Margaret’s D.56 LCFHP The Nurture Project 1,600 St Margaret’s D.57 The Health and Wellness Hub Emotional Wellbeing in Schools 7,785 St Margaret’s D.58 Volunteering Matters North Lanarkshire Youth Befriending Project 4,502 St Margaret’s D.59 LCFHP Big Chef Little Chef 6,576 St Maurice D.60 The Miracle Foundation Supporting Children and Young People’s Mental Health 7,200 St Maurice D.61 PASP PASP Play Champion Programme 6,228 St Maurice Page 216 of 270
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Community Solutions Impact and Learning Report – 2022-23 55 Appendix E Community Solutions Community Mental Health and Wellbeing Fund 2022-23: Total Awards £1.6 million across 42 CVS organisations and 53 projects (See main body of this report – and also the separate Learning and Impact Report – for this Fund) CVS Organisation Project Total Funding Amount (£) E.1 Airdrie Citizens Advice Bureau Action Beyond Courage 41,081 E.2 Bazooka Arts Connect Access 38,276 Connect Community 48,653 E.3 Bipolar Scotland Enabling Groups 10,106 E.4 CACE Groups 50,000 E.5 Cloudberry Communities Natural Connections 38,000 E.6 Community Action Newarthill Summer Programme 11,034 E.7 The Conservation Volunteers Natural Connections Legacy 40,975 E.8 Cruse Bereavement Bereavement Support 10,654 E.9 Cumbernauld FM Living History 35,584 E.10 Deaf Services Lanarkshire Wellbeing Activities 23,452 E.11 Deafblind Scotland Don't Worry Be Happy 10,073 E.12 Drumpellier Christian Fellowship Townhead Community Hub 37,060 E.13 Fair Play Foundation Active8 20,530 Page 217 of 270
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Community Solutions Impact and Learning Report – 2022-23 56 CVS Organisation Project Total Funding Amount (£) E.14 FAMS Charity Moving Forward 35,370 E.15 Forgewood Housing Coop Taking Steps 44,484 E.16 Getting Better Together The Parent Journey 26,649 Active Lifestyles 15,000 E.17 Glenboig Development Trust Mentoring Futures 47,675 Garden Project 49,584 Stop the World 47,117 E.18 Health & Wellness Hub Transforming Lives 47,902 E.19 Hope Community Garden Project 10,880 E.20 Kirkshaws Neighbourhood Centre Health & Wellbeing Project 21,214 E.21 Lanarkshire Association for Mental Health (LAMH) Wishaw Wellbeing 32,020 E.22 LAMH Recycle Personalised Community Supports with Peer Mentoring 50,000 E.23 MADE4U IN ML2 Wellbeing in ML2: Adults and Older People 48,834 E.24 Maggie's Lanarkshire Wellbeing Sessions 18,848 E.25 Motherwell FC The Well Hub 18,000 E.26 Motherwell Foodbank Motherwell Foodbank @ Maranatha 31,304 E.27 New Opportunities New Opportunities Project 31,239 Page 218 of 270
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Community Solutions Impact and Learning Report – 2022-23 57 CVS Organisation Project Total Funding Amount (£) E.28 North Lanarkshire Recovery Communities Peace of Mind Therapies 10,300 E.29 One Parent Families Scotland Cumbernauld 37,684 Airdrie 37,684 E.29 One Parent Families Scotland Motherwell and Bellshill 37,684 E.30 PAMIS (People with Profound and Multiple Learning Disabilities) Wellbeing Project 12,037 E.31 Parkinson’s Self- Help Group Nurture, Develop and Grow 11,045 E.32 Rivals School of Martial Arts Food for Thought 30,000 E.33 Scottish Huntington’s Association National HD Specialist 10,188 E.34 Social Track Active Travel for Mental Health 50,000 Free Your Inner Child 49,000 E.35 Street Soccer Scotland Positive Change Through Football 10,593 E.36 The Haven Cumbernauld, Coatbridge, Airdrie 39,700 Wishaw & Shotts, Motherwell, Bellshill 39,700 E.37 The Miracle Foundation Encouraging Growth & Resilience Mental Health Workshops 46,835 E.38 Venture Scotland Challenge Yourself, Discover Yourself 49,931 Page 219 of 270
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Community Solutions Impact and Learning Report – 2022-23 58 CVS Organisation Project Total Funding Amount (£) E.39 Veterans Community Lanarkshire Veterans Community 17,500 E.40 Viewpark Conservation Group Mental Health and Greenspace Project 46,100 E.41 Windmills connect@windmills 10,000 E.41 Windmills (Community Café supporting training and employment of people with Learning Disabilities) familycook-in@windmills 1 27,800 skills@windmills 1 48,400 E.42 YMCA Bellshill & Mossend Virtual Wellbeing Space 19,020 [document ends] Page 220 of 270
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North Lanarkshire Council Report Adult Care & Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref JC/PMCA/MS/AMcG Date 14/05/24 Charges for Non-Residential Services, Community Alarms, Meals Provision, Independent Sector Care Homes & Respite Care From Ross McGuffie, Chief Officer, Health and Social Care NL E-mail Ross.McGuffie@lanarkshire.scot.nhs.uk Telephone 01698 858143 Executive Summary The purpose of this report is to advise Committee of the charging levels to be applied for non-residential services, community alarms, meals provision, independent sector care homes and respite care in 2024/25. The Council’s charging policy has been updated for 2024/25 to reflect the new rates. In line with the Discretionary Fees & Charges Policy report agreed at Policy and Strategy Committee on 28/09/23 the services discretionary charges will increase by 5%. Recommendations It is recommended that the Adult Care and Social Work Committee recognises: (1) The threshold figure for payment of home support charges set at £273 for single people and £417 for couples. (2) The hourly rate for home support of £19.11. (3) The daily rate for attending an Integrated Day Service of £10.50. (4) The weekly rate for a Community Alarm of £3.57. (5) The charge for meals provided in day services of £5.41. (6) Implementation of the increase to Independent Sector Care Home fees as negotiated via COSLA, Scottish Care and the Scottish Government. (7) An uplift in charges for residential respite in line with increases in pensions and allowances; and (8) Free personal care and nursing care will rise from £233.10 to £248.70 and £104.90 to £111.90. The Plan for North Lanarkshire Priority Improve economic opportunities and outcomes Ambition statement (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities Programme of Work Statutory / corporate / service requirement Item 6 Page 221 of 270
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1. Background 1.1 Local Authorities are empowered through the Social Work (Scotland) Act 1968 and the Housing Scotland Act, 2001 to apply charges for services. In setting its charging levels, North Lanarkshire Council has followed the national guidance issued by COSLA in respect of charging. 1.2 The COSLA guidance operates on the principle that people on the lowest levels of income do not pay for the service and that those who do pay contribute according to their means. This objective is achieved by setting a charge threshold which is up-rated annually and applying a taper contribution of income above the threshold level (see 2.1). 1.3 In accordance with COSLA guidance, North Lanarkshire Council maximises the Income of all service users who are liable to make a contribution towards the cost of the service. In 2023/24, the Tackling Poverty Team generated benefit income in the region of £770k for people receiving a non-residential service. 1.4 The Council’s charging policy has been updated for 2024/25 to reflect the new rates. In line with the Discretionary Fees & Charges report agreed at Policy and Strategy Committee on 28/09/23 the services discretionary charges will increase by 5%. 2. Report 2.1 In line with the COSLA recommendations, the charge threshold for 2024/2025 will be £273 per week for a single person and £417 for couples (2023/24 £252 and £384). Persons with income less than those figures will not be required to pay for home support services. 2.2 When calculating maximum service users charge, the Council deducts from their assessable income any costs which the service user is liable for in respect of housing costs, i.e. rent, mortgage, council tax and water charges. A taper contribution of 50% of excess income is then applied. For example, a single person with income of £280 per week after deductions would have their charge assessed as follows: Income £280 Threshold £273 Disposable Income £7 Client charge = £7 x 50% = £3.50 2.3 The hourly rate for Home Support Services will increase to £19.11. 2.4 The charge applied for attending an Integrated Day Service will increase to £10.50 per day. 2.5 Charges for meals provided in an Integrated Day Service will increase to £5.41 per day. 2.6 The Community Alarm charge will increase to £3.57 per week. Independent Sector Care Home Fees - Interim 2.7 The Nursing and Residential Care Home interim rates are based on benchmarks for direct care costs and care home costs in the National Care Home Contract (“NCHC”) Care Home Cost Model. Page 222 of 270
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2.8 The rates which will apply to payment for Nursing and Residential Care for 2024/25, effective from 8th April (commencement of the tax year for pension uprating), are as undernoted: • Nursing Care Rate per person per week - £948.59 (2023/24 £888.50) • Residential Care Rate per person per week - £825.94 (2023/24 £762.62) 2.9 This settlement reflects the challenging environment faced and the desire for all stakeholders to work in partnership. This recognises the Scottish Government’s policy of increasing the earnings of direct care staff within commissioned adult social care to £12.00 per hour in line with the Adult Social Care Pay policy commitment. 2.10 The Care Home Cost Model benchmarks Domestic and Catering staff to the National Minimum Wage, which is set by the UK Government and, as of 1 April 2024, this is £11.44. 2.11 This rate currently excludes an increase in pay for nurses and associated differentials. The offer comes with a commitment to consider the appropriate uplift to nursing care rate, maintaining associated differentials, within the model once Agenda for Change (AfC) pay negotiations have been concluded. Respite 2.12 The weekly charge for residential respite (£123.55 in 2023/24) will rise in line with increases in pensions and allowances to £135.00 for 2024/25. Free Personal Care 2.13 The rates to be applied to free personal care and nursing care for people in residential homes for 2024/25 will rise in accordance with the Scottish Government directive from £233.10 to £248.70 for free personal care and £104.90 to £111.90 for nursing care. 3. Measures of success 3.1 Through the income maximisation and charging policy, service users have their income fully maximised through the social security benefit system. 3.2 This policy ensures that disability benefits etc are claimed and the Council in turn receive revenue from charges for services. 4. Supporting documentation 4.1 N/A Ross McGuffie Chief Officer, Health and Social Care NL Page 223 of 270
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? Discretionary rates have increased by 5% in line with Discretionary Fees & Charges Policy agreed at Committee on 28th September 2023. 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 Page 224 of 270
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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? 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 225 of 270
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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/SF Date 23/04/24 Adult Social Care Performance Report – Quarter 3 From Ross McGuffie – Chief Officer – North Lanarkshire HSCP E-mail Ross.McGuffie@lanarkshire.scot.nhs.uk Telephone 01698 858143 1. Background 1.1 The Chief Officer has joint quarterly performance review meetings with the Chief Executive of NHS Lanarkshire and the Chief Executive of North Lanarkshire Council. These meetings are supported by a Chief Executive Performance Framework comprising a range of performance measures from across both health and social work systems, including relevant targets and trajectories. 1.2 Based on a traffic-light system there are areas for improvement identified within the performance framework each quarter for those that are flagged as Red or Amber. The 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 October 2023 to 31st December 2023 (Quarter 3). Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Endorse the improvement actions included within Appendix 2 of the report; and (2) Acknowledge the performance of key areas of activity within Appendix 1 of the report. The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (25) Ensure intelligent use of data and information to support fully evidence based decision making and future planning Programme of Work Resilient People Item 7 Page 227 of 270
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1.3 Information from these performance reviews has been supplemented with additional performance information below to offer the committee a wider overview of performance across some key areas of adult social care delivery. 2. Report 2.1 The purpose of the report is to provide an update to the Committee on wider performance of key areas of adult social care delivery, in addition to the performance areas for improvement which have been identified as part of the Chief Executive Quarterly Performance Review for the period 01st October 2023 to 31st December 2023 (Quarter 3). 2.2 The performance data for Quarter 3 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 3, October – December 2023) Ross McGuffie Chief Officer North HSCP Page 228 of 270
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Page 229 of 270
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Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☐ No ☒ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? 5.10 Armed Forces Covenant Duty Does the report require to take due regard of the Armed Forces Covenant Duty (i.e. does it relate to healthcare, housing, or education services for in-Service or ex- Service personnel, or their families, or widow(er)s)? Yes ☐ No ☒ If Yes, please provide a brief summary of the provision which has been made to ensure there has been appropriate consideration of the particular needs of the Armed Forces community to make sure that they do not face disadvantage compared to other citizens in the provision of public services. 5.11 Children’s rights and wellbeing impact Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 230 of 270
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Appendix 1 – Adult Social Care Dashboard PLEASE NOTE FOR ALL INDICATORS UPWARDS ARROWS DENOTE POSITIVE PERFORMANCE Ref. KPI Target 2023/24 2022/23 Q3 2022/23 Q4 2023/24 Q1 2023/24 Q2 2023/24 Q3 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year Current Performance 2.11 Assistive Technology - Number Of People With Technology (0-17 yrs) 1,452 33 30 28 28 31 GREEN 2.12 Assistive Technology - Number Of People With Technology (18-64yrs) 629 633 632 631 618 2.13 Assistive Technology - Number Of People With Technology (65+) 839 853 818 825 856 2.14 Reablement - Number Of People Completing Reablement Process 2000 1049 1418 376 816 1355 RED 2.15 Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 55.0% 61.2% 64.0% 70.3% 70.0% GREEN 2.16 Reablement - % Of People With No Home Support Service Required At End Of Process 50% 34.2% 28.8% 21.3% 22.6% 32.8% RED 2.18 Balance Of Care - % Of People (Age 65+) 45% 43.7% 42.6% 40.2% 36.7% 34.0% RED 2.19 IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 63.4% 51.5% 47.5% 49.9% 53.5% RED 4.3 Care Home Placements At End Of Quarter - Per 1000 Popn 65+ 24 21.5 21.2 21.7 22.0 21.9 GREEN 4.4 Care Home Placements At End Of Quarter - Per 1000 Popn 75+ 50 44.8 44.2 44.9 45.8 45.6 GREEN 4.5 Care Home - Average Length of Stay 865 743 870 832 891 835 GREEN 4.6 Number Of People With Self Directed Support 1,000 2042 1956 2070 2093 2092 GREEN 4.7 Number Of People With A Direct Payment 240 336 359 329 342 357 GREEN Page 231 of 270
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7.19 % Of Adult Protection Referrals Passed To Care Team For Investigation 20% 16.2% 11.7% 12.4% 14.8% 12.7% RED 7.2 % Of Adult Protection Investigations Going To Initial Case Conference 20% 14.1% 21.2% 20.3% 10.4% 19.2% AMBER 7.21 Adult Protection - % Of Referrals With Decision Within 5 Days 60% 78.4% 73.4% 76.6% 77.8% 76.3% GREEN 7.22 % of Adult Protection Referrals Which Did Not Go On To Investigation Or Other Service 50% 69.0% 71.2% 76.6% 74.2% 75.9% GREEN Page 232 of 270
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Appendix 2 – Areas for Improvement 1. Reablement and associated services Target 2022/23 2023/24 Q2 2023/24 Q3 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year Current Performance Reablement - Number Of People Completing Reablement Process 2000 816 1355 R Reablement - % Of People With No Home Support Service Required At End Of Process 50% 22.6% 32.8% R Balance Of Care - % Of People (Age 65+) 45% 36.7% 34.0% R IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 49.9% 53.5% R Narrative & Corrective Action During Q3, there were more service users starting the Reablement process than previous quarters in 2023/24; during Q3, the service supported in excess of 500 people, which is a level of service that had been targeted prior to the Covid 19 pandemic and the achievement of this represents the significant effort and progress in enhancing the Reablement service in North Lanarkshire. Page 233 of 270
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Consequently, there were more service users completing the Reablement process in Q3 than in previous quarters. This increase in demand is potentially driven by the Firebreak carried out during Q3 and additional focus on system flow that creates downstream demand within rehabilitation services. 11 24 29 31 16 14 37 28 22 29 36 30 34 29 31 43 29 2611 19 16 26 14 15 18 36 1912 36 32 33 34 28 52 35 50 26 18 19 36 17 15 33 35 28 25 33 22 27 24 20 39 28 26 0 50 100 150 200 250 APR-23 MAY-23 JUN-23 JUL-23 AUG-23 SEP-23 OCT-23 NOV-23 DEC-23 Service users starting reablement process by locality Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw Page 234 of 270
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There is a dynamic relationship between Reablement services and the capacity offered by the Home Assessment Teams (HAT). Since the creation of the HAT, there have been 1658 referrals accepted and the latest data available shows that in February 2024 the highest monthly volume of referrals were received to date. 25 17 28 25 19 11 15 24 18 30 31 33 36 28 37 32 39 25 12 6 10 20 8 7 10 24 9 29 42 17 42 24 34 40 35 68 28 15 26 18 19 23 30 33 3140 21 8 15 22 19 23 34 40 0 50 100 150 200 250 APR-23 MAY-23 JUN-23 JUL-23 AUG-23 SEP-23 OCT-23 NOV-23 DEC-23 Service users completing reablement process by locality Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw Page 235 of 270
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We can see in the data that as the teams have developed throughout financial years 2022/23 and 2023/24 that more people are being referred to HAT and are following that pathway. Those people who are referred to HAT are being discharged quicker from hospital to be fully assessed in their home environment. Page 236 of 270
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25% 67% 33% 55% 48% 58% 70% 78% 73% 78% 80% 64% 58% 69% 62% 63% 61% 59% 57% 55% 54% 54% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% May 2022 Jun 2022 Jul 2022 Aug 2022 Sep 2022 Oct 2022 Nov 2022 Dec 2022 Jan 2023 Feb 2023 Mar 2023 Apr 2023 May 2023 Jun 2023 Jul 2023 Aug 2023 Sep 2023 Oct 2023 Nov 2023 Dec 2023 Jan 2024 Feb 2024 People completing service with no further service noted as being required by month 0 days 82% 1 days 13% 2-4 days 4% 5-7 days 1% 8+ days 0% Number of days from HAT referral to hospital discharge 2023/24 0 days 65% 1 days 22% 2-4 days 9% 5-7 days 2% 8+ days 2% Number of days from HAT referral to hospital discharge 2022/23 Page 237 of 270
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Following the establishment of HAT, there was a natural, gradual build and expansion of the team and this is reflected in the gradual build-up in the volume of referrals. As the teams have become more established, their ability to accept more complex cases and fully support the multi-disciplinary team working that is required has increased and now presents a true “Home First” approach to rehabilitation for the patient. We can see above that over time, as more complex cases were being accepted in financial year 2023/24, that the proportion of people recorded as completing the service with no further service required decreased, however we know from our monitoring of delayed discharges that the HAT approach is improving flow. The average number of input services from HAT appears to be settled at an average of around 2.2. The largest input service remains Home Support, followed by OT, which is now a consistent trend in the data. On completion of HAT, for those requiring a further service, the largest proportion is CAS, followed by Home Support Reablement/Mainstream, and IRT OT and Physio. The learning from Operation Flow and associated Firebreaks, along with the application of the Human Learning Systems approach across North Lanarkshire as an overarching approach to service design and change is manifest in the “Back to Basics” initiative that is being developed within the HSCP. This work will inform the system design and how rehabilitation services, including Reablement, IRT and Home Assessment Teams interact, complement, and support each other. This approach is also informing the design and implementation of the new Social Work information system, Mosaic. 2. Adult Protection Target 2022/23 2023/24 Q2 2023/24 Q3 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year Current Performance Service at Completion HS - Reablement 12% HS - Mainstream 12% IRT - Physio 10% IRT - OT 11% Rehabilitation - Other 1% CAS 17% Locality SW Referral 1% IDS 0% LSS 1% District Nurse 6% NL Leisure 1% Third Sector 3% Input SW 3% OT 57% Physio 18% AHP Support Staff 16% Home Support 80% CAS 22% Technology 3% Pharmacy 3% Com. Nursing Team 10% Med. Realignment 2% Page 238 of 270
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% Of Adult Protection Referrals Passed To Care Team For Investigation 20% 14.8% 12.7% R Narrative & Corrective Action The number of ASP referrals received by localities continues to rise. Care Homes continue to be the primary source of referrals for ASP and this has been a consistent trend over the last 12 months. It is important to recognise that number of referrals does not automatically equate to the number of adults at risk of harm. Work continues to be undertaken with Care Homes and relevant stakeholders to promote high-quality ASP referrals and defensible decision- making that is based on a good understanding of risk, harm, and the impact (or lack-of) this has on the adult being referred. This encourages awareness of whether ASP is the correct referral route to take in certain situations and circumstances. Community based referrals are more likely to progress to ASP investigation when compared to referrals from Care Homes. Referrals generated by Social Work and partners often relate to multiple types of harm but our analysis has identified that self-neglect and hoarding continue to rise; these cases are often complex and require a long-term, inter-agency response. Caution should be applied when interpreting ASP Investigation and Case Conference data. The performance database shows a relatively low conversion rate for both in comparison to information gathered via locality trackers. An ongoing audit is being completed with colleagues from performance to establish why this is the case and to rectify any issues identified. Police “Adult Concern” reports continue to rise; combined with ASP referrals, these generate a significant body of protection work that is undertaken by localities to keep adults in the community safe. The total of AP1 referrals submitted by Health colleagues in North HSCP increased in Q3 by 15%; 102 were submitted compared with 89 in the previous quarter. Staff in Cumbernauld submitted the most AP1 in Q3 (25%), followed by Coatbridge and Motherwell at (18%). The most common reported type of harm was “Physical Harm/Abuse/Assault,” comprising 25% of referrals. The quarterly NHSL Public Protection newsletter was published during this quarter and is a key tool in raising awareness with Health colleagues, as are briefings sessions for managers, which have been arranged in February 2024 to disseminate ASP Learning Review Guidance. In addition, multi-agency, bespoke ASP training is available and a bespoke training programme is offered to the three Acute hospital sites. Page 239 of 270
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref RM/MD/NL/LH Date 14/05/24 Revenue & Capital Budget Monitoring Report: Adult Social Care Period 12: 01/04/2023 to 01/03/2024 From Morag Dendy, Chief Officer (Planning, Performance and Quality Assurance) E-mail LynchN@northlan.gov.uk Telephone Nicola Lynch, Business Finance Manager, 07581007187 Executive Summary This report provides a summary of the revenue financial performance of the Health & Social Care Partnership (H&SCP) – North Lanarkshire (Adult Social Care & Housing) and the financial performance of the Social Work capital programme. The report incorporates the period 1 April 2023 to 1 March 2024 (Period 12) and includes projected outturn forecasts for the financial year ended 31 March 2024, with major outturn variances highlighted and explained per the approved Financial Regulations. H&SCP – North Lanarkshire (Adult Social Care & Housing) has a gross revenue expenditure budget of £258.937m and is currently projecting an underspend of £2.726m. This is an adverse movement of £0.386m since the previous committee report and is predominantly as a result of the finalisation of 2023/24 pay award figures offset by less than anticipated spend in Carers budgets and increased contributions from NHS Lanarkshire towards an SDS package. The Social Work capital programme has a total budget of £2.188m and is currently projecting an overspend of £0.033m. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Acknowledge the revenue financial outturn position, (2) Acknowledge the capital financial outturn position, The Plan for North Lanarkshire Priority Improve North Lanarkshire's resource base Ambition statement (25) Ensure intelligent use of data and information to support fully evidence based decision making and future planning Programme of Work Statutory / corporate / service requirement Item 8 Page 241 of 270
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1. Background 1.1 The Council approved its General Revenue Fund Budget on 23 February 2023, and the Integration Joint Board (IJB) approved its Financial Plan on 22 March 2023. The approved Gross Expenditure Budget for the H&SCP – NL (Adult Social Care and Housing) is £258.937m. 1.2 2023/24 is the third year of the Council’s five-year capital investment programme. The programme approved funding of £2.200m for Social Work for the current year. Net reprofiling, as well as an adjustment following an update to the Strategic Capital Investment Programme (P&S December 2022 Committee) has resulted in a revised budget of £2.188m, as demonstrated by Appendix 4. 2. Report Revenue: Analysis of Significant Variances 2.1 Within Employee costs, the Service currently anticipates an underspend of £3.406m. This primarily relates to slippage in relation to the recruitment of posts across the Service. 2.2 Property Costs are anticipated to be overspent by £0.556m. This is predominantly due to higher than anticipated spend on Adaptation and Care of Gardens, via the HRA budget, all of which is offset by higher contributions from NLC Housing, shown as income. 2.3 Supplies and Services are anticipated to be overspent by £0.276m. This is mainly as a result of an anticipated overspend in equipment and adaptations. 2.4 Transport and Plant is anticipated to be overspend by £0.248m. This is mainly due to higher than anticipated costs in relation to staff mileage, coupled with estimated running costs associated with vehicles for use across the Service. 2.5 Admin costs are anticipated to be underspent by £0.832m and this is as a result of lower than anticipated spend in Carers budgets. 2.6 Payments to Other Bodies and Transfer Payments are detailed in Appendix 2. This expenditure accounts for £153.503m of the annual budget and is forecast to have an in-year net overspend of £1.216m (0.8%). This is primarily in relation to the Care at Home sector who provide services to individuals via the SDS commissioning framework. This projected outturn includes a drawdown of £1.6m from the social care demand reserve as per the IJB strategy to address demand pressures within the 2023/24 Financial Plan. These projections are demand led and are based on full year costs for both current clients and those anticipated, therefore projections will alter as the year progresses, updates will be provided in future reports. 2.7 The Service anticipates a total over recovery of income of £0.761m. An over-recovery of £0.495m relates to Adaptations and Care of Gardens as highlighted in section 2.2 and £0.198m relates to returned private sector housing grants, these are both partially offset by an under-recovery of £0.185m which is mainly as a result of lower than anticipated income from charges for Community Alarms and Integrated Day Services. Page 242 of 270
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Revenue: Earmarked Reserves 2.8 The Integration Joint Board have set aside reserves of £35.767m for specific Adult Social Care commitments. It is anticipated that £15.244m of the earmarked reserves will be used during 2023/24, with £20.523m being carried forward to 2024/25, as highlighted in Appendix 3. All expenditure to be met from reserves are excluded from the outturn position. Capital: Analysis of Significant Variances 2.9 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. The Service currently anticipates an overspend of £0.033m. 2.10 Following on from the pandemic, there are heightened 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. 2.11 Appendix 5 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. 4. Supporting documentation 4.1 Appendix 1 Revenue – Subjective Analysis 4.2 Appendix 2 Revenue – Payments to Other Bodies & Transfer Payments Analysis 4.3 Appendix 3 Revenue – Status of Earmarked Reserves 4.4 Appendix 4 Capital – Budget Movements 2023/24 4.5 Appendix 5 Capital – Summary Expenditure by Thematic Category Morag Dendy Chief Officer (Planning, Performance and Quality Assurance) Page 243 of 270
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? The Adult Social Care management team will continue to review and implement management action and initiatives, with the aim of remaining within approved budget resources. This action will include vacancy management, curtailment of non- essential expenditure, and maximising income. This report has been prepared by service-based Finance personnel in consultation with budget managers, in accordance with the Financial Regulations. 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts been discussed and agreed with People Resources? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts been discussed and agreed with Legal and Democratic? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☒ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ Page 244 of 270
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5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? Where the impact identifies a requirement for significant technology change, has an assessment been carried out (or is scheduled to be carried out) by the Enterprise Architecture Governance Group (EAGG)? Yes ☐ No ☐ 5.7 Environmental / Carbon impact Does the report / project / practice contain information that has an impact on any environmental or carbon matters? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.8 Communications impact Does the report contain any information that has an impact on the council’s communications activities? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 5.9 Risk impact Is there a risk impact? Yes ☒ No ☐ If Yes, please provide a brief summary of the key risks and potential impacts, highlighting where the risk(s) are assessed and recorded (e.g. Corporate or Service or Project Risk Registers), and how they are managed? All activities undertaken by the Council are subject to risk, and in acknowledging the Council’s approved Risk Management Strategy, Services manage these as part of their overall corporate and service planning processes. The demands and restrictions resulting from Covid, and the current economic climate has the potential to impact upon the Council’s ability to provide quality services within approved budget levels. The Service continues to face increasing demand pressures for provision within the home support, self-directed support 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 245 of 270
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5.11 Children’s rights and wellbeing impact Does the report contain any information regarding any council activity, service delivery, policy, or plan that has an impact on children and young people up to the age of 18, or on a specific group of these? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact and the provision that has been made to ensure there has been appropriate consideration of the relevant Articles from the United Nations Convention on the Rights of the Child (UNCRC). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 246 of 270
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APPENDIX 1 [1] [2] [3] [5] [6] [7] EMPLOYEE COSTS 93,766,538 90,360,741 3,405,797 FAV 3.6% (667,412) Slippage in relation to recruitment of posts in general across the Service PROPERTY COSTS 2,817,536 3,373,359 (555,823) ADV (19.7%) (393,715) Higher than anticipated spend on Adaptations and Care of Gardens (both Housing) SUPPLIES & SERVICES 5,807,039 6,082,636 (275,597) ADV (4.8%) (86,767) Projected overspend in equipment and adaptations and small tools, offset by underspends in ICT, and other Supplies areas TRANSPORT & PLANT 1,788,318 2,036,080 (247,762) ADV (13.9%) 259 Higher than anticipated costs in staff mileage, coupled with estimated running costs associated with vehicles for across the Service ADMINISTRATION COSTS 1,226,734 394,253 832,481 FAV 67.9% 174,710 Lower than anticipated spend in Carers budgets PAYMENTS TO OTHER BODIES 55,056,120 54,925,776 130,344 FAV 0.2% 26,918 Please refer to Appendix 2 for analysis TRANSFER PAYMENTS 98,446,795 99,793,452 (1,346,657) ADV (1.4%) (13,801) Please refer to Appendix 2 for analysis CAPITAL FINANCING COSTS 0 (0) 0 0.0% 0 REVENUE FINANCING COSTS 0 0 0 0.0% 0 OTHER EXPENDITURE 28,858 6,328 22,530 FAV 78.1% 5,137 Minor underspend in "other" expenditure TOTAL EXPENDITURE 258,937,938 256,972,624 1,965,313 FAV 0.8% (954,670) NLC CONTRIBUTION (193,414,555) (193,414,555) 0 0.0% 0 NLC CONTRIBUTION - HOUSING (1,945,010) (2,440,010) 495,000 FAV (25.5%) 345,000 In relation to higher than anticipated spend on Adaptations and Care of Gardens NLC CONTRIBUTION - TRANSPORT (550,737) (550,737) 0 0.0% 0 INCOME FROM HEALTH (55,985,194) (56,238,008) 252,814 FAV (0.5%) 172,207 Higher than anticipated contributions in relation to SDS package FEES AND CHARGES (1,428,167) (1,243,017) (185,150) ADV 13.0% 6,642 Lower than anticipated income in relation to charges for Integrated Day Services and Community Alarms OTHER LOCAL AUTHORITIES 0 0 0 0.0% 0 BUDGETED USE OF IJB RESERVES (5,027,390) (5,027,390) 0 0.0% 0 OTHER INCOME (586,885) (784,933) 198,049 FAV (33.8%) 44,591 Overrecovery in relation to returned private sectors housing grants and recharge income from other Council Services INCOME (258,937,938) (259,698,650) 760,713 FAV (0.3%) 568,440 NET EXPENDITURE 0 (2,726,026) 2,726,026 FAV 0.0% (386,231) [4] NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Subjective Analysis Period 12 (01 April 2023 - 01 March 2024) Adult Social Care & Housing - INTEGRATED CATEGORY ANNUAL BUDGET PROJECTED OUTTURN PROJECTED OUTTURN VARIANCE % MOVEMENT VARIANCE ANALYSIS Page 247 of 270
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APPENDIX 2 [1] [2] [3] [5] [6] [7] SDS Framework 1 & 2 97,732,362 99,087,996 (1,355,634) ADV (1.4%) 1 Demand led activity. Independent Care Homes 44,038,741 44,723,515 (684,774) ADV (1.6%) 23,138 Demand led activity. Payments to NHS Lanarkshire 2,311,732 2,041,768 269,964 FAV 11.7% (153) Position reflects anticipated in year payments Non Traditional Respite 335,283 64,108 271,175 FAV 80.9% (6,973) Position reflects anticipated Locality demand Other Local Authorities - General 127,909 94,879 33,030 FAV 25.8% (22,095) Position reflects anticipated in-year demand Voluntary Organisations 5,889,605 5,653,071 236,534 FAV 4.0% 15,354 Position reflects anticipated in-year demand Payments to Other Bodies - General 859,769 648,326 211,443 FAV 24.6% 25,677 Position reflects anticipated in-year demand Housing Support (RSL's) 714,433 705,456 8,977 FAV 1.3% (13,802) Position reflects projected contract levels Locality Flexibility 218,068 136,072 81,996 FAV 37.6% 20,370 Position reflects anticipated Locality demand Private Sector Housing Grants 1,152,378 1,074,771 77,607 FAV 6.7% (7,031) Position reflects anticipated in-year demand Medical Fees 122,635 106,980 15,655 FAV 12.8% (1,256) Position reflects Service's approach to absence management Agency Fees 0 382,287 (382,287) ADV 0.0% (20,113) Position reflects anticipated in year payments Other 0 0 0 0.0% 0 TOTAL EXPENDITURE 153,502,915 154,719,228 (1,216,314) ADV (0.8%) 13,117 [4] NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Payments to Other Bodies & Transfer Payments Analysis Period 12 (01 April 2023 - 01 March 2024) Adult Social Care & Housing - INTEGRATED CATEGORY ANNUAL BUDGET PROJECTED OUTTURN PROJECTED OUTTURN VARIANCE % MOVEMENT VARIANCE ANALYSIS Page 248 of 270
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APPENDIX 3 Contract Monitoring Staff 160,386 73,010 87,376 0 160,386 22/23 Saving: Muirpark 788,000 788,000 (0) 0 788,000 Carers Act 2018 - Support 2,700,995 89,000 2,611,995 0 2,700,995 Covid Reserve 750,000 0 750,000 0 750,000 Social Care Demand risk 9,348,640 3,544,492 5,804,148 0 9,348,640 Tech digitial Improvements 566,400 186,681 379,719 0 566,400 Violence Against Women (Joint Intiative with SLC) 30,000 30,000 0 0 30,000 Increase Advocacy provider 118,208 70,667 47,541 0 118,208 LSWM post 76,635 63,720 12,915 0 76,635 Discharge to assess/ PDD 304,345 214,848 89,497 0 304,345 Adapations Funding 388,315 388,315 0 0 388,315 Tech Improvements - SWIS 700,000 20,000 680,000 0 700,000 Tech Improvements - Comm Alarms 587,932 138,328 449,604 0 587,932 Tech Improvements - Home Scheduling System 3,775,744 400,035 3,375,709 0 3,775,744 Adult Protection Contribution 50,000 34,293 15,707 0 50,000 MH 2 NL10s 188,924 57,287 131,637 0 188,924 Cost of Living Helpline 574,912 215,279 359,633 0 574,912 HS resilience 3,646,000 2,888,454 757,546 0 3,646,000 Local Gov pay award (cost of 2022/23 pay award in 2023/24) 2,830,443 2,830,443 0 0 2,830,443 Staff Training Academy "grow your own" 1,200,000 283,326 916,674 0 1,200,000 Social Worker Regrading 3,169,000 345,892 2,823,108 0 3,169,000 Building Capacity Funding Across The Ip Sector (part of Business Case) 0 The Winter Planning & Enhanced supports Business Case TOTAL 35,766,563 15,243,892 20,522,671 0 35,766,563 3,811,684 2,581,821 1,229,863 3,811,684 NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Status of Earmarked Reserves Period 12 (01 April 2023 - 01 March 2024) Adult Social Care & Housing - INTEGRATED TOTALDESCRIPTION OF EARMARKED RESOURCE Approved Reserve Total 2023/24 2024/25 No Longer Required Page 249 of 270
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APPENDIX 4 Approved budget (5 year Capital Program, commencing 2021/22) 2,200,000 Reprofiling from 2021/22 200,000 Included in opening budget Social Work Key Ambition Integrated equipment & adaptations Acceleration in 2022/23 (11,847) Included in opening budget Social Work Key Ambition Integrated equipment & adaptations Updated Strategic Capital Investment Prg (P&S Dec 2022) (200,000) Included in opening budget Social Work Key Ambition Integrated equipment & adaptations REVISED CAPTIAL BUDGET 2023/24 2,188,153 0 0 0 Theme NORTH LANARKSHIRE COUNCIL Capital Budget Monitoring Report - Budget Movements 2023/24 Period 12 (01 April 2023 - 01 March 2024) Social Work Capital Programme BUDGET MOVEMENTS 2023/24 £ Period Division Thematic Category Page 250 of 270
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APPENDIX 5 Social Work: Integrated Equipment and Adaptations 2,188,153 1,591,215 1,940,201 280,665 2,220,866 (32,713) TOTAL 2,188,153 1,591,215 1,940,201 280,665 2,220,866 (32,713) UNCOMMITTED FINAL OUTTURN OUTTURN VARIANCE NORTH LANARKSHIRE COUNCIL Capital Budget Monitoring Report - Summary Expenditure by Thematic Category Period 12 (01 April 2023 - 01 March 2024) Social Work Capital Programme Theme BUDGET ACTUAL COMMITTED Page 251 of 270
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref MD/MW Date 14/05/24 Contract Award for Community Living Support From Morag Dendy, Chief Officer (Planning, Performance and Quality Assurance) E-mail DendyM@northlan.gov.uk Telephone 01698 332075 Executive Summary Committee is asked to approve the award of a contract for Community Living Support (the ‘Agreement’) to Neighbourhood Networks. The Agreement is for a period of 36 months anticipated to commence on 1 June 2024. The value of the Agreement is up to one million, two hundred and nine thousand, nine hundred- and sixty-pounds Sterling (£1,209,960) exclusive of VAT. Support to be delivered through this contract will be a key part of our ambitions to deliver accessible and high-quality independent living support with an increased focus on early and preventative supports. This is a core strand of the Resilient People Programme of Work. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Approves the award of the Agreement to Neighbourhood Networks at a value of up to one million, two hundred and nine thousand, nine hundred and sixty Pounds Sterling (£1,209,960) exclusive of VAT. 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 9 Page 253 of 270
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1. Background 1.1 We continue to develop our approach to improving choice and control for adults and young people transitioning to adulthood, who have additional support needs. The aim of Community Living Support is to provide as broad a range of support options as possible, to reflect the range of support need that people have. This is in keeping with the principles of the Self-Directed Support (Scotland) Act 2013. 1.2 This report updates Committee on the outcome of the recent Procurement Exercise to identify a suitable provider organisation to deliver community-based support, themed around locally based approaches and peer support. Access to a locally based community link worker will be available on an “as required” basis as well as offering a baseline level of contact to encourage full and active lives. This service extends reach and complements the existing provider support framework and support provided through statutory services to meet the objectives of the Resilient People Programme of Work. 1.3 The detail of requirement for the tender was based on our experience over two decades of the efficacy of the approach, with this type of support option having been available within North Lanarkshire since 2003. Since the inception of this model of support in North Lanarkshire, many people have benefited from the support provided and have moved on to greater levels of independence or have moved on from requiring any support. For this reason, there is a necessity of having this type of support option available. 1.4. Co-production and co-design of support options continues to be a key element of our approach, and engagement with stakeholders was undertaken as part of the process. 2. Report 2.1 A group of technical and procurement representatives was formed to develop and agree the procurement strategy for the Agreement to enable the council to achieve maximum benefit for the requirements. 2.2 The initial estimated value of the Agreement dictated that the procurement procedure be undertaken in accordance with the Public Contracts (Scotland) Regulations 2015. An advert for the procurement opportunity was published on the Public Contracts Scotland website. 2.3 The procurement procedure was undertaken as an “Open Procedure” following the Regulations for contracting social and other specific services. Invitation to Tender documentation published by the council received a total interest from 37 companies with the council receiving 3 tender submissions. 2.4 Based on the evaluation criteria and scoring methodology set out in the invitation to tender package within the procurement procedure, an evaluation of tender responses received was completed by the User Intelligence Group (UIG). Selection stage responses were assessed first and compliant tenderers that satisfied / declared that they met the published minimum selection stage criteria progressed to the award stage evaluation. Following identification of the recommended tenderer(s), their selection stage responses were assessed in more detail to ensure they satisfied the minimum selection stage criteria applied. Page 254 of 270
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2.5 This recommendation to award the Agreement follows the completion of a procurement procedure where Neighbourhood Networks has been evaluated as demonstrating Best Value for the council. 2.6 Appendix 1 confirms the scoring achieved by each tenderer, further details of the procurement procedure is provided in Appendix 2 and the SME status and location of all tenderers is located within Appendix 3. Financial/Budget Consideration 2.7 The value of the Agreement is up to one million, two hundred and nine thousand, nine hundred and sixty Pounds Sterling (£1,209,960) exclusive of VAT. 2.8 The costs associated with delivery of the Agreement will be contained within the Adult Social Care budget. Price Stability 2.9 Pricing is fixed for the duration of the Agreement. Community Benefits 2.10 The council is committed to maximising the delivery of community benefits. The procurement included a community benefit requirement, this approach is designed to deliver local community benefits where possible. 2.11 Within their tender, Neighbourhood Networks committed to deliver the following community benefits within the Agreement: Community Benefit Type Quantity Committed Non-financial Support for a Community Project / Organisation 10 2.12 The community benefits delivered as part of the Agreement do not include the creation of jobs or apprenticeships. Fair Work First 2.13 Within their tender submission, Neighbourhood Networks demonstrated commitment to the Scottish Governments “Fair Work First” initiative, such as being an accredited Living Wage employer, have no zero hour contracts, a wide range of employee benefits and an environment where staff voice is sought, represented, and responded to. Neighbourhood Networks are committed to comprehensive staff training as well as continuous professional development. Neighbourhood Networks commit to flexible working and family friendly working practices, are committed to fair work practices and actively promote equality and diversity. Contract Management 2.14 Officers from Quality Assurance will be responsible for managing the Agreement which will be undertaken in accordance with the contract and supplier management conditions applied within the Agreement. Page 255 of 270
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3. Measures of success 3.1 The Agreement will deliver key outcomes including: • Early and accessible help and support. • Access to community-based peer support. • Greater social inclusion and independence. • Sustainable delivery model based on co-production with supported people and unpaid carers. 3.2 Best Value has been demonstrated by fulfilment of a competitive tender process, considering both price and technical aspects. 4. Supporting documentation 4.1 Appendix 1 – Summary of Tender Evaluation Process 4.2 Appendix 2 – Summary of Procurement Process 4.3 Appendix 3 – SME Status and Location of All Tenderers Morag Dendy Chief Officer (Planning, Performance and Quality Assurance) Page 256 of 270
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? The funding required for the community support service is a budgeted for within the Adult Social Work Budget. The service being commissioned helps ensure that we meet the aims and objectives within the Resilient People Programme of Work. The spend on this service, which provides support to people with low to moderate additional support needs has been proven, over time, to reduce the risk of needs increasing, with previous independent evaluation concluding that for every £1 spent on this model of support, over £8 in future costs would be saved. 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 ☒ Page 257 of 270
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No high-risk elements are anticipated. Sharing of personal data relates solely to consensual sharing of information between the data subject, UHSCNL and the provider. 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? 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? The purpose of support being available within the person’s immediate neighbourhood \ community is to bring support services closer to home. This should result in a positive environmental/carbon impact. It is anticipated that people’s health and wellbeing outcomes will also be improved. However, the main aim of the service is not related to environmental nor carbon impact considerations. 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? Successful delivery of this project will require ongoing work by the successful provider to involve the people being supported as well as any involved unpaid carers, to ensure effective engagement and communication with local community and voluntary sector services, and other partners. It is expected that the provider will develop a communication and engagement plan with a key focus on engaging with all the involved stakeholders. Communication is expected to promote equality and diversity, particularly around Disability, as a protected characteristic, and help avoid digital exclusion. Promoting improved anticipatory planning with ageing carers is a key element of the service, and effective communication with families is an essential part of the wider approach. 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? Page 258 of 270
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The main risk identified is that the service provided may not necessarily support to reduce demand for higher levels of support on every occasion. That does not mean the service will have “failed.” Due to the nature of the needs of the people being supported, deteriorating health or a need for increased support is always a possibility. In mitigation, the service acts as an “early warning system” where such scenarios can be flagged up at the earliest opportunity, thus helping facilitate both preventative and anticipatory approaches. 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). This service is aimed at supporting adults with additional support needs who will be living in their own homes or transitioning from living with unpaid carers to living in their own homes. In some instances, this may involve older children (aged 16-18) who are transitioning to adulthood, but in those circumstances, they would legally be considered as being adults, given that they would be signing for their own Scottish Secure Tenancy Agreement. If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☒ Page 259 of 270
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Appendix 1 – Summary of Tender Evaluation Process Final Rank Tenderer Name Total Tender Score (%) Recommended for Award (Yes / No) 1 Neighbourhood Networks 78.97 Yes 2 Carluke Dignity Care Ltd 67.20 No 3 Adigo Care 47.42 No Page 260 of 270
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Appendix 2 – Summary of Procurement Process Response CPT Contract Reference Allocated: NLC-CPT-23-104 Procurement Procedure Utilised: Competitive tender in the style of an “Open Procedure” following the Regulations for contracting social and other specific services Governing Legislation / Regulations: Public Contracts (Scotland) Regulations 2015 Tender Platform Utilised: PCS-Tender (PCST) Date Contract Notice Published: 09/02/2024 Total Expressions of Interest Received: 37 Tender Return Deadline: 12/03/2024 Number of Tenders Received: 3 Tenders from SME’s: 3 Tenders from Supported Businesses: 0 Number of Non−compliant Tenders: 0 Number of Compliant Tenders: 3 Number of Recommended Tenderers: 1 Basis of Award: Quality: 80% Price: 20% Evaluation Team: Adult Social Work Services Staff Anticipated Start Date of the Agreement: 1 June 2024 Total Agreement Period (Months): 36 months Awarded Value of the Agreement: Up to £1,209,960 Page 261 of 270
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Appendix 3 – SME Status and location of all Tenderers Name of Tenderer Size of Tendering Organisation (Micro, Small, Medium, or Large) Location (Local Authority / Council Area) Does the Tenderer have a base within Lanarkshire? Adigo Care Medium Edinburgh Yes Carluke Dignity Care Ltd Small Carluke Yes Neighbourhood Networks Small Glasgow No Page 262 of 270
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North Lanarkshire Council Report Adult Care & Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref RMCG/GC/SJH Date 14/05/24 Contract Award for Provision of Dynamic Scheduling Tool NLC- CPT-23-107 From Ross McGuffie, Chief Officer, University Health & Social Care NL E-mail Ross.mcguffie@lanarkshire.scot.nhs.uk Telephone 01698 858143 Executive Summary The purpose of the report is to seek homologation of the decision taken by the Chief Executive to award the Provision of Dynamic Scheduling Tool NLC-CPT-23-107 to Computacenter Ltd as it was necessary due to the procurement timescales and committee cycle dates to award the contract under section 23.3.2 of the Council’s General Standing Orders. The contract is for an initial period of 48 months and anticipated to commence on 18 March 2024. The Council reserves the right to extend the contract for additional periods up to a maximum of a further 24 months. The overall value of the contract shall not exceed that of two million, two hundred and nine thousand pounds Sterling (£2,209,000) exclusive of VAT. Recommendations It is recommended that the Committee: (1) Homologate the decision taken by the Chief Executive to award the Contract to Computacenter Ltd. The Plan for North Lanarkshire Priority Improve North Lanarkshire's resource base Ambition statement (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities Programme of Work Statutory / corporate / service requirement Item 10 Page 263 of 270
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1. Background 1.1 The current contract for the provision of a scheduling tool is due to expire on 31st October 2024, and the Council has no further option to extend as this product is end of life. Therefore, the need to seek a replacement tool was essential. 1.2 With the existing product coming to an end in October 2024, it was essential that we build in as close to 6 months of overlap as possible to ensure the safe transition between the two systems to maintain the smooth running of essential services. 1.3 The initial aim had been to finalise the procurement exercise in time for approval at the February Committee, but due diligence took longer than initially thought, exacerbated by staff leave. 1.4 Staff from Adult Health and Social Care conducted an extensive benchmarking exercise in partnership with Computacenter Ltd. Whilst the market for “off the shelf software” is extensive, this exercise reduced the availability of suppliers to two with the one selected offering best value, both economically and qualitatively. 1.5 Supporting residents at home in North Lanarkshire has been a significantly challenging and demanding area of social care delivery. The introduction of this contract will support this service delivery by aiding back-office staff to schedule support and adapt quickly to changing needs efficiently and effectively. 1.6 The contract has the opportunity to explore additional benefits which would allow both service users and family members to access care notes via an app allowing real time updates. The Council recognise this as an added benefit and will explore this as part of developing this contract. 1.7 The contract will provide a Dynamic Scheduling Tool which will offer a wide range of benefits to staff and service users alike with the council able to produce accurate reports which will help to inform future demand upon the service. There will be a more effective and efficient service delivery model with a reduction in overtime and an increase in customer satisfaction thus improving Service Level Agreements (SLAs). 1.8 The requirements within the Agreement are currently under contract with Advanced/Korona. This arrangement is due to expire on 31st October 2024, with the Agreement detailed within this report due to supersede it. 2. Report 2.1 A group of technical and procurement representatives was formed to develop and agree the procurement strategy for the Agreement to enable the council to achieve maximum benefit for the requirements. 2.2 The initial estimated value of the Agreement dictated that the procurement procedure be undertaken in accordance with the Public Contracts (Scotland) Regulations 2015. 2.3 The procurement procedure was undertaken as a “Direct Award” from the Scottish Procurement framework agreement for Software Value Added Reseller (SVAR) SP-21- 034. Page 264 of 270
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2.4 Following the justification detailed and appraised within the associated contract strategy document, the Direct Award procedure was considered to demonstrate Best Value as the framework chosen allows for extensive benchmarking to be conducted and ensure the council receive best value. 2.5 The tender received from Computacenter Ltd underwent appropriate appraisal to ensure it was complete / compliant with the council’s requirements and demonstrated best value. Financial / Budget Consideration 2.6 The pre-tender whole life estimate budget for the Agreement was £4.3 million. Following completion of the procurement procedure, the value of the Agreement to be awarded is two million, two hundred and nine thousand pounds Sterling (£2,209,000) exclusive of VAT. 2.7 The costs associated with the contract are recurring licensing costs and on-off implementations costs, also allowing for contingencies and/or additional integrations. 2.8 The costs associated with delivery of the Agreement will be contained within the Integrated Joint Board resources budget for Adult Health and Social Care. Price Stability 2.9 Pricing is fixed for the first forty-eight months of the contract, with the option of an additional 24 months would thereafter increase in line with the CPI (Consumer Price Index). Community Benefits 2.10 The procurement did not include a community benefit requirement. Fair Work First 2.11 Within their tender submission, Computacenter Ltd advised that they commit to all areas of the Scottish Governments “Fair Work First” initiative. Contract Management 2.12 Officers from Adult Heath and Social Care will be responsible for managing the Agreement which will be undertaken in accordance with the contract and supplier management conditions applied within the Agreement. 3. Measures of success 3.1 The Agreement will deliver the following outcomes: Page 265 of 270
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3.1.1 Best Value has been considered to be demonstrated by conducting an extensive benchmarking exercise where six products were considered and evaluated in partnership with Computacenter Ltd resulting in the product offered by Access Group offering best value to North Lanarkshire Council. 3.1.2 Aligns with Digital NL work streams, corporate transformation and future policy and practice developments. 3.1.3 Will support dynamic scheduling of home support visits for service users. 3.1.4 With improve digital communication channels with the development of a customer portal for service users and carers/representatives of service users. 3.1.5 Will support a consistent assessment and care planning approach across all care groups, which integrates all assessment and planning formats to maximise efficiency of social work practice and fulfil the local authority’s legal duties relating to social work whilst meeting Statutory requirements for reporting. 3.1.6 Facilitates reporting of outcomes in line with The Plan for North Lanarkshire. 3.1.7 Addresses any GDPR requirements in relation to the secure upload and access to information, including retention, destruction, and archiving. 3.1.8 Will provide a source for all data to be held collectively in one location thus reducing the requirement for individual spreadsheets/database/word documents held by differing members of staff and home support teams. 3.1.9 Will provide dashboard analysis and reporting to better inform future investment and current service provision and legislative compliance. 3.1.10 Will facilitate direct front facing contact with individuals who use services. 3.1.11 Will streamline workflow and processes and provide a holistic view of all service user visits. 3.1.12 Will enable staff to work with a mobile offline solution with automatic upload to online system upon re-connection. 4. Supporting documentation N/A Ross McGuffie Chief Officer, University Health & Social Care NL Page 266 of 270
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5. Impacts 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality- and-fairer-scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts been discussed and agreed with Finance? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? Funding has been secured for the duration of the project and any potential extensions to the contract. 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? The new dynamic scheduling tool will allow for more efficient use of staff’s time with real-time view of worker availability and demand. 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 267 of 270
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A DPIA has been completed as part of the overall Home Support Redesign project. A specific DPIA has been commenced to cover the specific impacts of the dynamic scheduling tool. 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? Several technical implications, service redesign/business change process and digital channel requirements are detailed throughout the report. All are currently contained within the delivery plans of the workstreams associated with the Home Support and Discharge Without Delay Programme Board. 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? As detailed in the report, throughout the lifetime of the contract it is intended that information will be available to service users, carers and their representatives via digital portals reducing the need for paper documents. 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? As detailed in the report, throughout the lifetime of the contract it is intended that information will be available to service users, carers and their representatives via digital portals reducing the need for paper documents. A communication plan is in place to engage and consult with key stakeholders. 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? Associated risks are identified and managed in accordance with the Corporate Risk Register and will be monitored through the Home Support and Discharge Without Delay Programme Board. Project risks will be recorded in project risk register, including operational practice for the Home Support Service, and will be monitored by the service through the Page 268 of 270
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Home Support and Discharge Without Delay Programme Board, updated as required within the service risk register. Existing Corporate risk for Data Governance will be updated to reflect any relevant mitigation or new risk aspects. 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 269 of 270
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