Agenda Document Pack - Adult Care and Social Work Committee - 12/11/2024
North Lanarkshire Council · 12 November 2024
Back to Adult Care and Social Work Committee — 12 November 2024 and its agenda
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1 November 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, 12 November 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, A McCrory, D Ashraf, C Barclay, B Baudo, M Boyd, G Brennan, B Burgess, A Bustard, J Cairns, W Goldie, H Gray, J Jones, K Larson, B McCulloch, R McKendrick, C McManus, C Quigley, N Shevlin, L Stubbs, R Sullivan, J Toner, C Williams, N Wilson, G Woods. Page 1 of 214
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Agenda 1 Declarations of Interest In Terms of the Ethical Standards In Public Life Etc. (Scotland) Act 2000 Operational 2 Getting it Right for Everyone (GIRFE) Submit report by Chief Officer (Adult Social Work Services) endorsing the GIRFE Pathfinders journey and seeking agreement to develop the prototypes for practice solutions and principle responses identified through GIRFE engagement process. 7 - 22 3 Care Academy Submit report by Chief Officer (Performance, Planning and Quality Assurance) providing an update on the Care Academy. 23 - 28 4 Review of Commissioned Registered Social Landlord Provision Submit report by Chief Officer (Performance, Planning and Quality Assurance) providing an update on the Review of Commissioned Register Social Landlord Provision. 29 - 36 5 Cost of Living Helpline Submit report by the Chief Social Work Officer (Education, Families, Justice and Integrated Practice) informing of the income maximisation work carried out by the Cost of Living Helpline (Tackling Poverty Team) and Council Services during the period 2023/24. 37 - 58 6 Quality Assurance Annual Report 2023/24 Submit report by the Chief Officer (Performance, Planning and Quality Assurance) providing the annual report on Quality Assurance Activity for the period from 1 April 2023 to 31 March 2024. 59 - 114 7 Annual Report of the Chief Social Work Officer 2023/24 Submit report by the Chief Social Work Officer (Children, Families, Justice and Integrated Practice) seeking approval of the Annual Report of the Chief Social Work Officer 2023/24 115 - 170 Page 3 of 214
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Performance 8 Adult Social Care Performance Report - Quarter 1 2024/25 Submit report by 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 from 1 April 2024 to 30 June 2024 (Quarter 1 2024/25). 171 - 182 Financial 9 Revenue & Capital Budget Monitoring Report: Adult Social Care Period 6: 01/04/2024 to 13/09/2024 Submit report by Chief Officer (Planning, Performance and Quality Assurance) providing a summary of the revenue financial performance of the Health and Social Care Partnership (H&SCP) - North Lanarkshire (Adult Social Care and Housing) and the financial performance of the Social Work Capital Programme for the period from 1 April 2024 to 13 September 2024. 183 - 194 Contracts 10 Contract Award for Independent Advocacy (Adults) Submit report by Chief Officer (Performance, Planning and Quality Assurance) seeking approval to award the contract for the Independent Advocacy Services (Adults). 195 - 204 11 Contract Award for Mental Health Peer Support and Short - Term Mental Health Support Service Submit report by Chief Officer (Adult Social Work Services) seeking approval to award the contract for the Mental Health Peer Support and Short-Term Mental Health Support Service. 205 - 214 12 Contract Award for Support for Unpaid Carers and Young Carers Submit report by Chief Officer (Performance, Planning and Quality Assurance) seeking approval to award the contract for the Support for Unpaid Carers and Young Carers (copy to follow). Page 4 of 214
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref DF/MF/AMCG Date 12/11/24 Getting It Right for Everyone (GIRFE) From Diane Fraser, Chief Officer / Head of Service (Adult Social Work Services) E-mail FraserDi@northlan.gov.uk Telephone Executive Summary Getting it Right for Everyone is a proposed national multi-agency approach to support and services from young adulthood to end of life care which the Scottish Government is co-designing with place-based pathfinders. Health and Social Care North Lanarkshire is a place-based pathfinder for older people and frailty. This report provides an update on the national work as well as detail on the approach locally including how the work aligns with and enhances local practices. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Endorse the Getting It Right for Everyone Pathfinder journey and approve the next steps. (2) Endorse the testing of prototypes in multidisciplinary operational practice, through: • The provision and deployment of existing resources to ensure capacity, providing support and challenge via the Back-to-Basics governance structure to measure the learning. • Embedding the Getting it Right for Everyone principles and subsequent practice and ways of working underpins the Back-to-Basics/enabling approach. (3) Receive future reports with the national pathfinder learning. The Plan for North Lanarkshire Priority Enhance participation, capacity, and empowerment across our communities Ambition statement (13) Improve preventative approaches including self-management and giving people information and choice over supports and services Programme of Work Resilient People Item 2 Page 7 of 214
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1. Background 1.1 Getting it Right for Everyone is a proposed multi-agency approach to support and services from young adulthood to end of life care which the Scottish Government is co- designing with place-based pathfinders. Health and Social Care North Lanarkshire North Lanarkshire is a place-based pathfinder for older people and frailty. 1.2 The Getting it Right for Everyone approach is often referred to using the acronym GIRFE but our preference to ensure accessibility and commitment to the concept is to use the words in full. 1.2 From the inception of getting it right for everyone in 2022/23 and recruitment of pathfinders, the aim was to publish the ‘team around the person’ toolkit by Autumn 2024. 1.3 The Scottish Government also sought to work with pathfinders and partners to develop the digital requirements to support the work and the culture and leadership requirements to support implementation. 1.4 North Lanarkshire’s commitment to getting it right first time, supporting a well-equipped and confident workforce and promoting engagement and participation made the opportunity to contribute nationally to shaping the model to deliver very welcome. 1.5 Given the range of financial and demographic challenges faced locally as well as nationally, involvement in the work as a pathfinder was also welcome in shaping improved population health and wellbeing, reducing health inequalities, and creating sustainable health and care services. 1.6 The following section of the report details specifically the work of the North Lanarkshire pathfinder that has been ongoing since January 2023, a set of proposed options to operationalise getting it right for everyone within the Back-to-Basics programme and subsequent next steps and recommendations for approval by CORE and IJB. 2. Report Current position 2.1 The Pathfinder programme began in January 2023 and is underpinned by a co-design approach including: • Design School - a support model which can help teams to come together, get ready for co-design work, and engage people with lived experience on a specific policy area, problem exploration or redesign challenge. • Learning Networks to support a national practice model. 2.2 There are eleven place-based pathfinders across Scotland aligned to five thematic areas: 1. People in prisons 2. People in addiction services 3. People registered at deep end GP Practices 4. Families with multiple and/or complex needs and young people in transition from GIRFEC to GIRFE Page 8 of 214
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5. Older people and frailty 2.3 The North Lanarkshire pathfinder was geared towards a focus on frailty given the population projections of North Lanarkshire and need to reduce demand for and pressure on health and social care services. The vision set out in the Strategy for Preventing and Managing Frailty 2023-2028 describes a clear commitment to working together across health, public health, social care, housing, community, and voluntary organisations, and with older people and those who are important to them, to help them age well and live longer in good health. The strategy embraces the Getting it Right For Everyone principles and the vision and commitment to new ways of working underpinned the work of the pathfinder from the outset. 2.4 The North Lanarkshire pathfinder work sought to achieve three main things. 1. To understand people’s experiences of accessing health and social care services in a range of different settings, across thematic areas and focused geographically on Wishaw (although wider engagement took place). 2. To embed their expertise and knowledge into the final version of the principles and elements of a national toolkit that would support the approach at a local level. 3. To ensure, through the governance structure adopted, continued alignment with the Strategic Commissioning Plan programme of work and delivery plan for Back to Basics, that adopts the Human Learning Systems approach. 2.5 The pathfinder team worked to a national timeline of activity as shown in Appendix 1, concurrently the partnership has been developing the ‘Back to Basics’ transformation programme within the Strategic Commissioning Plan Programme of Work. The governance structure put in place to support the pathfinder is shown in Appendix 2. 2.6 The co-design process with people from North Lanarkshire communities, including those with lived experience and expertise in delivering services, has allowed deep and rich collaboration to consider the principles and how they should be both expressed and the thematic areas, and how they should be implemented. 2.7 Appendix 3 provides a high-level view of the reach of engagement and co-design, and Appendix 4 illustrates the high-level themes captured during the early co-design work. Image 1.0 below outlines the initial themes the pathfinder was asked to focus on to the specific prototypes that were tested. All feedback on prototypes was captured and submitted to the national policy team and design school on 3rd June 2024. Appendix 5A and 5B illustrate the prototypes on a page. Image 1.0 Initial themes to prototypes for testing. Page 9 of 214
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2.8 Members of the North Lanarkshire pathfinder team presented to the steering group on 23 May 2024 and attended a series of collaborative sense making workshops, with all pathfinders, to refine the prototypes further with final feedback submitted on 19th June to the National policy team and design school. 2.9 Consequently, the pathfinder facilitation team recognise the need to take forward the learning from the pathfinder work and agree the next steps in line with back-to-basics programme and operationalising of the enabling approach. 2.10 Specifically, the enabling approach incorporates elements of prototype 2 relative to ageing well, assessment and planning mechanisms, how the multi-disciplined team across health, public health, social care, housing, community and voluntary organisations work together and the role of the ‘sticky person’ and the community connectors (my plan, my team, personal network discussion, care co-ordinator). Furthermore, community hubs and their underpinning principles as prototype 1 provide a delivery vehicle to strengthen the delivery of more integrated supports and services within our communities augmenting our locality model. Community Hubs are a key priority for the North Lanarkshire Partnership Strategic Leadership Board. The options for taking this forward are detailed in the next section of the report. Current situation including options and implications. 2.11 The Pathfinder in the partnership is now at the stage to work with identified staff in localities to take forward the learning from the co-design process and agree the next operational steps. That is, progress the prototypes and making them real through working with designated staff and families in our communities. Explanation of prototypes: 2.12 The North Lanarkshire Pathfinder has been asked to undertake further testing of these prototypes. In this instance, ‘prototype’ refers to practice solutions and principles in response to the difficulties people with lived experience have identified through the engagement process. Testing at this stage will involve continuing to develop these prototypes through an ongoing process of co-design and co-production with people who have lived experience, including seldom heard voices, with staff across the Health and Social Care Partnership and with colleagues in the community and voluntary sector. Next steps will include developing a plan to further test the prototypes in practice. A toolkit to support operational testing developed by the Scottish Government is to be released in Autumn 2024. 2.13 The North Lanarkshire Pathfinder will focus on the following prototypes during the next phase of testing: 2.13.1 My plan – a document for anyone who wants to record details of their plan with the aim of removing the perceived need for people to ‘retell their stories’ multiple times. This includes living well, ageing well, and dying well. Areas for further development of this prototype include determining governance arrangements and ensuring General Data Protection Regulation compliance. A demonstrator will be undertaken in Airdrie and Wishaw to embed the getting it right for everyone principles across a variety of services and supports that deliver preventative and early intervention (Access Social Work, Home Assessment Team, Home Support Reablement, Community Nursing, Integrated Rehab Teams). It is envisaged this will improve access and change/adjust first point of contact including robust screening and Page 10 of 214
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allocation through multidisciplinary team conversations/activity through the enabling approach. It is hoped by this way of working that this will reduce waiting times for people, embed the team approach around the person and their plan and eradicate unnecessary referrals. 2.13.2 My team – people having a network of friends, family, and professionals as an integral component to ensuring health and well-being, with people getting the right support at the right time. The further development of this prototype includes consideration of how this will be recorded and shared, including the format this may take. This will be further tested as outlined above in the Airdrie and Wishaw demonstrator. 2.13.3 Co-ordinator – the importance of having a consistent, named person who acts as a clear point of contact is an approach being developed locally which fits well with the Pathfinder work. A named professional, who “pulls in” additional expertise where needed rather than “passes on,” ensures that a multi-disciplinary approach works effectively around a person to support achieving their outcomes and maximising independence rather than creates a confusing range of disjointed responses. 2.13.4 Community Hub Principles – clarity of vision for a community hub that underpins delivery of a facility and what it hopes to achieve for a community. The primary focus here involves principles which will support the development of Hubs which reflect local needs and where people can connect with public services and with local people involved in both service delivery and decision making. It should be noted that the Council has an approved set of hub guiding principles so the intention here would be to build upon active work being undertaken in Newmains and St Brigid’s Community Hub, Riverbank and Chryston. Further development of this prototype includes identifying what community supports and services can be delivered through the hub, in reach and outreach, as well as the development of performance indicators to determine the impact of support on the health and well-being of the communities they serve. 2.13.5 Dementia practice - Additionally, we have agreed to consider staff competencies in supporting people with dementia post diagnosis. We understand that families can sometimes have extended wait on supports and this can be a challenging time so can we consider ‘waiting well.’ We will work with staff across Home Support and Integrated Day Services in gathering data re training/development and competencies and whether this meets expectations as required in the Dementia Strategy. 2.13.6 GIRFEC to GIRFE (Moving On) - Working with our Education and Families colleagues to consider this important transition stage in a young person’s life. In what way can this transition be seamless with the right support at the right time. 2.14 Getting it right for everyone, rightly has a focus on a person-centred, integrated, and multi-agency approach to support individuals. Within the overarching commitment to self-direction this will improve access and embed practice in shared decision-making and promoting self-determination, encouraging those with lived experience, including unpaid carers and families to be equal partners in their care and support. 2.15 The approach within North Lanarkshire also has a focus on preventative and anticipatory approaches, seeking to ensure that people can remain independent and living at home, without a need for the involvement of statutory services, for as long as possible. Page 11 of 214
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2.16 In line with core principles of independence, empowerment, enablement and self-help, our approach considers as a start point: • What the person can do for themselves. • What might family, neighbours and friends be able to support. • What role local community resources could play including A Local Information System for Scotland (ALISS). • What might technology be able to help with, whether personal technology, equipment through Assistive Tec team, Making Life Easier, Community Alarm Service. • What role might there be for targeted support, such as carer organisations, condition specific, or age-related support groups or Community Voluntary Sector (CVS) organisations. This also encompasses our wide-ranging Community Solutions programme. • What role might CVS funding available through things like Time to Live, Carer Short Breaks Bureau, Carer Outcome Grants and so on play. 2.17 The wider reach of our getting it right for everyone approach requires to have an intention to ensure that there is an opportunity to get it right for people not currently known to services. This could have a balanced focus on not “clientising” anyone or moving people towards ‘service land,’ by drawing them into services unnecessarily, by promoting preventative and anticipatory planning and approaches with a view to reducing the likelihood of crisis arising in the first place. The working relationship with Community Connectors will assist in this area. We believe that such an approach encompasses: increased awareness about what is important to people – gleaned and gathered through day-to-day work, as well as focused engagement and participation activity; increased opportunity for preventative approaches, anticipatory planning and only where necessary, early intervention; increased connections and communication with people and communities that we need to work harder to engage with. 2.18 Our Pathfinder recognises the need for a renewed focus on the outcomes that people identify as being important to them. Many people are reluctant to ask for information, advice, or support, meaning that very often, their first presentation to services is at a point when they are already in crisis. Crisis is costly in terms of time, energy, and resources, but more importantly, costly in terms of the human impact. 2.19 A getting it right for everyone informed approach seeking to move from “eligibility to conversation around “what might help?” would assist with all the above and should start before the point where people need services. As such a getting it right for everyone informed approach becomes a much wider responsibility than solely that of Health and Social Care. If this approach was implemented, it would also help inform community planning, local outcome improvement plans, community agreements and become embedded in the much wider community and voluntary sector. 2.20 As outlined earlier we require to consider what the prototypes mean in real time. There has been extensive engagement and communication across the Health and Social Care regarding the need for the workforce to get back to basics, have meaningful conversations with people about what is important to them. This requires the principles to be fully understood and embedded in everyday operational practice therefore being aligned to Back to Basics and enabling approach across localities with a direct impact on day-to-day practice. Page 12 of 214
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2.21 The challenge is how we implement the getting it right for everyone principles and practice in a multidisciplinary way and ensure links to locality planning structures and operational practice. We require an emphasis on people with lived experience having a strong voice and influence therefore all decision-making being central to the person including working with our third sector community connectors on the preventative/early interventions. Community Hubs are ideally placed to progress this development. Governance 2.22 Presently the Governance structure has been a Steering Group, Operations Group being supported by the Pathfinder and Facilitation group reporting to the Strategic Commissioning Plan Programme Board. With the Back-to-Basics development this has afforded an opportunity to reconsider existing Governance structures, and this was presented to Core on Monday 1st July 2024 and the steering, operations and pathfinder facilitation governance was agreed through the partnership refreshed governance structure. Next Steps 2.23 Getting it right for everyone Principles understood and embedded in practice across the Health and Social Care partnership. 2.24 Getting it right for everyone principles aligned with the Back-to-Basics programme i.e. they become the golden thread to connect all the strands of work and connect people with the overall vision regardless of organisation or role. 2.25 The testing of prototypes in a multidisciplinary way in localities through the demonstrator sites. 2.26 Leadership commitment to support getting it right for everyone development and embed principles in everyday practice. 2.27 Agree a measurement method/outcome for evaluation. 2.28 Shared and continuous learning to enable any refinement or recourse as required through the regular back to basics/enabling approach learning sessions. 3. Measures of success 3.1 In moving from prototypes to practice, it is essential to determine and agree performance measures. How do we know we are making a difference and how might we measure this through performance outcomes. Given prototype development has reached the stage to be tested operationally, it requires further discussion with people in their communities and operational staff to further agree the detail. 3.2 This operational testing will determine how we will know that the getting it right for everyone overarching principles, and the practice solutions identified through prototyping will make a difference. Performance measures require to identify whether the issues people have raised through the co-design process are resolved and that people experience improved outcomes. Page 13 of 214
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4. Supporting documentation 4.1 Appendix 1 – The National activity timeline for the NL pathfinder 4.2 Appendix 2 – GIRFE pathfinder governance structure 4.3 Appendix 3 – Engagement and co-design on GIRFE with communities 4.4 Appendix 4 – High level themes identified through initial engagement and co-design. 4.5 Appendix 5A – Example prototype template(s) 4.6 Appendix 5B - Example prototype template Diane Fraser Chief Officer / Head of Service (Adult Social Work Services) Page 14 of 214
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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 15 of 214
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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 16 of 214
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Appendix 1 – The National activity timeline for the NL pathfinder Page 17 of 214
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Appendix 2 – GIRFE pathfinder governance structure Page 18 of 214
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Appendix 3 – Engagement and co-design on GIRFE with communities Page 19 of 214
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Appendix 4 – High level themes identified through initial engagement and co-design (includes engagement on Early and Inclusive family support). Page 20 of 214
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Appendix 5A – Example prototype template(s) Page 21 of 214
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Appendix 5B – Example prototype template Page 22 of 214
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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/AMCG Date 12/11/24 Care Academy From Morag Dendy, Chief Officer (Performance, Planning, and Quality Assurance) E-mail DendyM@northlan.gov.uk Telephone 1. Background 1.1 The Lanarkshire population is ageing with many older people and a growing number of younger people living with two or more long terms conditions such as diabetes and respiratory disease. The burden of illness will continue to increase over the next ten years as the population ages. Health and social care services are already experiencing the impact of meeting the needs of an ageing population, for example, in Home Support and District Nursing services. The vulnerability of the ageing group has been Executive Summary The Care Academy has a dual focus on supporting the ambitions of existing staff and fostering a new generation of health and care professionals. Building on the work that was already underway in North Lanarkshire, we have formally consolidated links with South Lanarkshire Council and NHS Lanarkshire to create a Lanarkshire-wide Care Academy. This report is to give Committee and update on progress to date. Recommendations It is recommended that the Adult Care and Social Work Committee. (1) Acknowledge the progress with implementation of the Care Academy Pan Lanarkshire. (2) Seek further update on progress with the workstreams in 6 months’ time. The Plan for North Lanarkshire Priority Improve economic opportunities and outcomes Ambition statement (21) Continue to identify and access opportunities to leverage additional resources to support our ambitions Programme of Work Brighter Futures Item 3 Page 23 of 214
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demonstrated in the pandemic, which has in turn created specific pressures for the care professions. 1.2 In an employment context, in 2023, Human Health and Social Work was the largest employing industry in Lanarkshire, accounting for 45,700 people. This industry is forecast to remain in the top employing sectors in the Lanarkshire between 2026 and 2033. 1.3 Future job openings are expected to be concentrated in a small number of industries. Within the period 2023 – 2026, figure 1 highlights the forecast total requirement by industry. As is clear, Human Health and Social Work has a requirement of 4,400 people (1,200 based on predicted expansion demand and 3,200 based on replacement demand). 1.4 Employment growth in this sector is driven by Scotland’s ageing population along with the aim to protect the provision of frontline services. It is therefore crucial that the attractiveness and retention of jobs within this sector is a key focus for future activity. 1.5 Opportunities to respond to workforce challenges exist with recently formed partnership arrangements which have been agreed between Universities and the Health and Social Care Partnerships across Lanarkshire. The key objectives for the partnerships are to formalise the working relationship between the council’s and the universities such that over an agreed period, there is a process in place for identifying, defining, and progressing potential opportunities for engagement through collaboration. To achieve this, the scope of the partnership agreements covers interactions such as research collaborations, honorary appointments, Graduate Apprenticeships, student placements, jointly funded posts, secondments of staff, student recruitment, student projects, education, continuing professional development and policy and practice. 2. Report 2.1 The overall vision for the Care Academy is to: 2.1.1 Develop a robust, sustained, vibrant Care Academy attracting and developing a diverse workforce for health and care services in Lanarkshire and promoting the sector as a rewarding choice for careers. 2.2 The pan-Lan membership has been reviewed with a refreshed Terms of Reference outlining the responsibilities of the Board, and areas of activity which are (and are not) within its remit. Members of the Steering Group have been selected based on their subject matter experience and expertise. 2.3 Four workstreams have been established with the remit of each clear covered in the Terms of Reference. Related task and finish groups will be enabled by workstreams as appropriate. Each workstream has authority (under the strategic direction of the Steering Group) to determine how workstream items will be resourced, progressed, monitored, and delivered. The workstreams are: 2.4 W1 – Attraction, recruitment, retention and wellbeing Developing recruitment strategies to attract prospective candidates to the sector. Engaging and focusing on employee safety, well-being motivation to enhance employee retention. 2.5 W2 – Pathways to care for young people Page 24 of 214
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Strengthening the reach and impact into the health and social care sector through a vocational education model, aiming to grow a future talent pipeline. 2.6 W3 – Adult pathways to care Improving prospects for working-age adults entering the health and social care sector, addressing poverty, and inequality, attracting passive candidates, and facilitating career change opportunities. 2.7 W4 – Funding and procurement Continually review and assess current and upcoming funding streams and identify potential gaps and opportunities. Explore the potential of community benefits opportunities. It was agreed at the most recent Board meeting to put this workstream on hold until the others are all well established. 2.8 The Care Academy is a collaborative initiative between NHS Lanarkshire, North Lanarkshire Council and South Lanarkshire Council. It reports through both North and South Lanarkshire Council’s committee structure. The Academy is authorised to work with partners such as local councils, education departments, colleges, universities, the independent sector and third-sector organisations to attract and recruit staff to the health and social care workforce. 3. Measures of success 3.1 Each of the workstreams are now established, with specific actions within each being developed by the workstreams themselves. As work progresses the Workstream Lead will be responsible for ensuring the deliverables are met with any exceptions and delays reported to the Steering Group. 3.2 A further update on progress on each of the workstreams will be brought back to IJB in 6 months. Progress and updates are also provided through: • Brighter Futures Programme Board - North Lanarkshire • Social Work Resource and Finance and Corporate Resources (Personnel Services) – South Lanarkshire • Core management team of both HSCP’s - NHSL 4. Supporting documentation N/A Morag Dendy Chief Officer (Performance, Planning and Quality Assurance) Page 25 of 214
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5.amand 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? All current and future recruitment meets the terms of Public Sector Equality Duty and Fairer Scotland Duty. 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? All current and future recruitment activity will be within the policy parameters. 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 26 of 214
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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? Campaign to promote the sector and the work of the Care Academy will be developed through Workstream 1. 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? Page 27 of 214
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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/AMCG Date 12/11/24 Review of Commissioned Registered Social Landlord Provision From Morag Dendy, Chief Officer (Performance, Planning and Quality Control) E-mail DendyM@northlan.gov.uk Telephone Executive Summary Following approval in March 2020 to remodel the current RSL services to become Retirement Housing in line with the in-house North Lanarkshire Council model, a review of Registered Social Landlord Services (RSL) commenced. Unfortunately, this review was then delayed due to the impact of the pandemic. The review recommenced in June 2023, and since then we have continued to work in partnership with the providers to reach an outcome that best serves the population of older people across North Lanarkshire. This report is to give Committee an update on the review. Recommendations It is recommended that the Adult Care and Social Work Committee. (1) Recognises the progress of this review, which when completed will further embed the principles of Self-Directed Support – Social Care (Self Directed Support) (Scotland) Act 2013. (2) Acknowledge the change in provision delivered by both Link Housing Association and Blackwood and note a review of this provision is no longer required. (3) Acknowledge concerns raised by Trust and their representatives and note agreement has been reached following a positive meeting between North Lanarkshire Council and Trust Housing Representatives. (4) Acknowledge the approval by Aspire management committee to progress to a Retirement Housing model at, Law View Housing development. (5) Note the delay in progressing the review with Hanover Scotland due to fire safety concerns and following an independent fire audit, endorse the recommencement of that review. (6) Agree a notice period to 31 March 2025 to enable transition planning with providers and individual tenants. Item 4 Page 29 of 214
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1. Background 1.1 The contracts with Registered Social Landlords (RSLs) expired in 2016/17, prompting a review of the services being provided. The review has been significantly delayed due to the impact of the Covid-19 pandemic. 1.2 The purpose of review was to ensure that people had the freedom to choose who provides the care and support they receive. We recognise it is vital that any support tenants receive are focused on their needs and are unique to them. 1.3 The decision to remodel Registered Social Landlord Provision (RSLs) was approved within the March 2020 IJB financial plan, which received cross party support. The plan detailed that the current RSL services would transition to become Retirement Housing in line with the council’s in-house model. It was noted that this change would result in future support costs being absorbed by housing benefit. 1.4 This current review commenced in June 2023. Following discussions with providers and the collation of data and impact assessments outlining the needs of tenants, North Lanarkshire Council informed all providers within the scope of the review of the initial proposal to withdraw all housing support funding. 1.5 As the review has progressed, we have provided updates via Elected Member briefings, FAQ documents and engagement sessions with Providers, residents and stakeholders.  2. Report 2.1 Registered Social Landlords provide a range of different support arrangements across North Lanarkshire. Prior to 1st April 2024 these RSLs, who ran 12 complexes, were: - • Trust Housing Association • Hanover Housing Association • Link Housing Association • Aspire • Blackwood 2.2 The services the RSLs provide primarily take the form of sheltered, very sheltered, and supported housing. North Lanarkshire Council currently provide funding that is used for on-site staff to provide a housing support service to tenants in each of the complexes. 2.3 RSL providers have been aware of the outstanding review of these services since approximately 2016/17. They have engaged with some other Local Authorities who carried out the review of this legacy funding stream, some as far back as 2016/17. Other Local Authorities have either discontinued funding or redesigned to models which include retirement housing, housing with care, amenity housing or a continuation of sheltered/very sheltered housing. The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities Programme of Work Resilient People Page 30 of 214
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2.4 Local Authorities who have not yet carried out reviews of RSL provision have indicated plans to do so. Some authorities have noted that providers have decided to redesign of their own initiative to make them suitable to the current housing and care needs of a changing population whilst remaining financially sustainable. 2.5 Equals Advocacy were commissioned to ensure an independent voice for tenants. They attended all engagement sessions and met separately with individuals and groups at later dates where this support was requested. 2.6 Tenant care and support needs are addressed by social work through individual packages of tailored care. A mix of our Homecare service and independent providers are delivering these bespoke packages in line with the ethos of Self-Directed Support (SDS). 2.7 RSLs have been using North Lanarkshire Council funding to pay for various levels of on-site staffing. However, over time the roles and responsibilities of staff within developments appears to have become unclear with possible unmet tenant needs and duplication of provision, suggesting streamlining of care and support would achieve better individual choice and outcomes for tenants. 2.8 North Lanarkshire Council funds a wealth of community resources, however tenant feedback through the engagement sessions suggested these were not being accessed by tenants within sheltered housing/very sheltered housing, with reliance for social stimulation being directed to the in-house warden service. This limits choice and participation in a wide range of unique and diverse activities to enhance overall sense of purpose, identity and holistic well-being. 2.9 On the 1 April 2024, Link Housing Association decided to implement their new Retirement Housing model across their three North Lanarkshire Sheltered Housing services. This decision was despite not having concluded the review, rather it was based on Link’s experience of the outcomes in similar reviews that have been carried out by a number of Scottish Local Authorities. This model meant the de-registering of the services with the Care Inspectorate as housing support was no longer a feature of the services. Furthermore, it meant a reduction from 35 hours weekly staffing to 25 hours weekly staffing in each service. 2.10 As of 16 July 2024, Blackwood implemented its new Retirement Housing with meals model within Buchanan House, which was previously a Very Sheltered Housing service. Buchanan House is no longer registered with the Care Inspectorate as housing support is no longer delivered. 53 hours on-site staffing weekly is now included within the service model as opposed to 70 hours weekly previously. To enable this creative and dynamic model Blackwood carried out a consultation and restructure with their employees to reflect the more practical nature of the new model. 2.11 Both Link and Blackwood now no longer receive legacy housing support funding from North Lanarkshire Council. It is important to note that commissioned Advocacy services have reported positive outcomes since the changes have been made, which mirrors feedback received from North Lanarkshire Council Housing colleagues as a result of the redesign of the Council’s Sheltered Housing to Retirement Housing. Hanover Scotland 2.12 Throughout the review period Hanover Scotland has always advised that without staff on-site, including night cover at McAlpine Court, they would not be safe to operate due to the structure of the building and the associated fire risks. Funding which is the subject Page 31 of 214
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of this review currently pays for the costs of one on-site housing support worker seven days per week, twenty-four hours per day. 2.13 Sleepover funding was agreed on a temporary basis approximately two years ago, pending this review. Hanover Scotland approached North Lanarkshire Council at this time to request funding for night cover due to the change for a standard night payment to an hourly rate for sleepover workers. Prior to this change, tenants had funded the sleepover as they benefited from the sense of security this brought them. 2.14 As part of the review of McAlpine Court, an independent assessment was commissioned by North Lanarkshire Council to review the fire evacuation measures deployed by Hanover Scotland and several recommendations have been made to safeguard tenants residing there. The aims of the recommendations would be to either: o Upgrade fire protection measures to allow a stay put policy o Deploy sufficient staffing to enable a simultaneous evacuation. o Assess the needs of tenants living within McAlpine Court to determine whether the accommodation is suitable due to dependency levels. 2.15 Hanover Scotland have always communicated that without on-site staffing a number of residents would need to move to a care home environment. As there is currently one member of staff on shift it is felt that reviews of tenants open to social work must take place to ensure that their needs are being fully met at this time. 2.16 The review was paused on 18 July 2024 due to safety concerns relating to the management of fire within McAlpine Court. We continue to discuss with Hanover the findings of our independent fire consultant in relation to their current evacuation strategy and risks posed by this. A range of options have been suggested for Hanover to consider in their role as landlord and responsible persons for having suitable and sufficient fire measures in place. It is our intention to recommence the review in the coming weeks. Aspire 2.17 Aspire currently delivers a housing support service funded by North Lanarkshire Council to tenants residing in Law View Housing Development. The landlords are Garrion and Forgewood Housing Associations. A new model of Retirement Housing which provides housing management services has been approved by the respective management committees and we have been advised that engagement with tenants will commence imminently. 2.18 The Housing Associations continue to liaise with North Lanarkshire Council about maximisation of housing benefit/service charges. North Lanarkshire Council will continue to provide support ensure a seamless transition to the new service model. It is anticipated that the housing support service will end as of 31 March 2025. Trust Housing Association 2.19 Following the proposal to withdraw all housing support funding, Trust advised it would redesign their six services to a range of retirement and amenity housing. Trust identified the models for each service. Arrangements included very sheltered complexes moving to amenity housing. 2.20 Trust advised concerns raised related specifically to 3 very sheltered complexes, proposing these complexes changed to a Housing with Care model on a revised block Page 32 of 214
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grant funding arrangement. Trust confirmed the 3 remaining sheltered complexes could easily change to a Retirement Housing model. Trust advised that they deliver a Housing with Care model in several other local authority areas and were keen to explore this as an option in North Lanarkshire. 2.21 To fully meet the principles of self-directed support legislation, our approach is to ensure that housing and care/support needs are separate and unique to everyone. 2.22 This is instead of a block of support being available as part of the overall accommodation and accessible to the group of tenants. This may not be the right support for all tenants and prevents them being involved in choosing the care provider that’s right for each person’s individual needs and situation. 2.23 At the centre of all considerations regarding the housing with care model was the vision to embrace the principles of choice and control for all current or potential future tenants living at these services. 2.24 Ongoing engagement with Trust has been maintained and during a meeting on 19 August, Trust and the council reached agreement. Trust will transition its six complexes to a combination of Retirement Housing and Retirement Housing with meals. Trust will also tender to be included as a care and support provider on the North Lanarkshire Self Directed Support Framework, which will open for entry point 5 later this year. This approach means that tenants will have the choice to choose Trust to provide their care and support. 2.25 We will work with Trust to transition from the current arrangements to the new. This move will align the end of existing arrangements with the implementation of Retirement Housing/Retirement Housing with meals. New providers will be operational and able to deliver packages of care from 1 April 2025, which will mean the current arrangements will end on 31 March 2025. 3. Measures of success 3.1 The review of Registered Social Landlord provision will be completed, with all new arrangements in place by 01 April 2025. 3.2 We will continue to engage with Trust as we transfer to the new arrangements. 3.3 We will continue to engage with Hanover Scotland re implementing the recommendations made following the independent review of the fire evacuation strategy. 3.4 We will recommence the review of Hanover Scotland. 3.5 Completion of this review will achieve the intentions as set out in the March 2020 IJB financial plan. 4. Supporting documentation 4.1 Appendix 1 JB Financial Plan 2020/2021Document.ashx (cmis.uk.com) Morag Dendy Chief Officer (Performance, Planning, and Quality Assurance) Page 33 of 214
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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? An EQIA has been completed and from the data collated and direct engagement with a range of stakeholder, it was evident that where individual tenants were assessed as requiring care and support, they received this from a provider out with the Registered Social Landlord with individual budgets arranged by social work. Tenants have access to emergency support by utilising a combination of the RSL Provider’s internal alarm service and NLC community alarm service where this has been assessed as being required. 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? Link - 24/25 Budget £46,651. Ceased 31/3/24. Blackwood - 24/25 Budget £27,208. Ceased 16/7/24. Aspire - 24/25 Budget £22,607. Hanover - 24/25 Budget £133,618. This includes a sleepover which has been funded for approximately two years and was agreed on an interim basis pending the review of Registered Social landlords. Trust operates six services across North Lanarkshire - 24/25 Budget £327,442. 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? Page 34 of 214
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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? 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? Engagement sessions took place, written information was provided, and advocacy were commissioned to ensure representation as a group and individually. Advocacy and carers were involved. 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? Service risk register – Medium. Owner – Chief Officer (Adult Social Work Services) 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 Page 35 of 214
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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 36 of 214
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref AG/JC/AMCG Date 12/11/24 Cost of Living Helpline From Alison Gordon Chief Social Work Officer (Education, Families, Justice & Integrated Practice) E-mail GordonAl@northlan.gov.uk Telephone 07583111137 Executive Summary This report provides details of the income maximisation work carried out by the Cost-of- Living Helpline (Tackling Poverty Team) and Council Services during 2023/24 which generated £47,935,822 in additional benefit income for the residents of North Lanarkshire an increase of 35.1% from the previous year. Over this reporting period the continuing legacy of the pandemic and most significantly the Cost-of-Living Crisis have continued to impact disproportionately on our most disadvantaged residents and communities, bringing the importance of income maximisation and wider work to tackle poverty into sharp focus, with the impact of low paid and insecure work a particular challenge. Since establishing the ‘Cost of Living Helpline’ in early 2023, supported by additional funding provided through the Joint Integration Board, there had been an increase of 41.2% in the number of benefit checks completed for residents; rising from 18.521 benefit checks completed in 2022/23 to 26,158 benefit checks completed in 2023/24. More broadly local approaches to tackling poverty and reducing inequality in North Lanarkshire, continue to be driven by the ‘Towards a Fairer ‘North Lanarkshire Tackling Poverty Strategy with activity focused on the key drivers of poverty. Recommendations It is recommended that the Adult Care and Social Work Committee. (1) Note the contents of this report. (2) Endorse the report and note the impact of the funding of the Cost-of-Living helpline for residents. (3) Note that this report has been presented to IJB to approve the request to extend the use of the already earmarked funds (£600,000, from April 2023 to March 2025) to support the enhanced service to June 2025. Item 5 Page 37 of 214
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1. Background 1.1 Despite recent positive news on wage growth, the legacy of the global pandemic, ongoing cost-of-living crisis and high levels of deprivation, continue to acutely affect inequality and poverty in North Lanarkshire, impacting the most vulnerable in North Lanarkshire’s communities. Against this landscape the refreshed ‘Towards a Fairer North Lanarkshire’ Tackling - Poverty Strategy for 2023-2026, sets out our ambition to continue to tackle poverty and child poverty, building on our previous actions and some of the positive foundations achieved through the previous strategy for 2020-2023. The new and refreshed Tackling Poverty Strategy encompasses an integrated multi service approach within the Council, alongside an increased focus on working externally with all community planning partners, communities, and people with lived experience of poverty. 1.2 In addition, the Strategy encompasses the statutory requirement to prepare and publish a Local Child Poverty Action Report for North Lanarkshire for 2022/23, reflects the ambition of the national Tackling Child Poverty Delivery Plan 2022-26 Best Start Bright Futures published by the Scottish Government in April 2022 as the second of 3 delivery plans required by the Child Poverty (Scotland) Act 2017. 1.3 The Tackling Poverty Team, Health and Social Work Services and Housing Solutions provides service users and members of the public with advice and assistance on a wide variety of benefit-related issues. A full benefits check is offered to all new service users. Income maximisation also plays a vital role in longer term Social Work services such as Community Care, Children and Families, Kinship Care, Justice Services, Mental Health, and Addictions. 1.4 A key role of the Tackling Poverty Team is to support the income maximisation service through the First Point of Contact Team to residents, Support Services for fieldwork staff, supporting specialist Social Work Services, Education Services and Housing Services and the Resolution Team representing clients at tribunals and hearings. Successful welfare rights intervention, where individuals are awarded extra benefit, frequently means that, as a result of increased income, they are better able to manage their own affairs and may not require further health and social work services. 1.5 The cost-of-living crisis continues to exacerbate existing health inequalities through its wider impacts on physical and mental health and well-being and in line with its strong commitment to prevention, the Health and Social Care Partnership have been keen to explore options to enhance the early help and advice available to individuals and families impacted by the current crisis. 1.6 On 30th November 2022, the Integration Joint Board approved funding of £300,000 per year 2023/24 and 2024/2025 to allow the Tackling Poverty Team to recruit additional staff and for the Council to establish a ‘Cost of Living Helpline’. The Plan for North Lanarkshire Priority Improve economic opportunities and outcomes Ambition statement (11) Increase economic opportunities for adults by understanding, identifying, and addressing the causes of poverty and deprivation and barriers to financial inclusion Programme of Work Resilient People Page 38 of 214
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2. Report 2.1 Although inflation has dropped from over 11% down to just above 2% in the last year, the cost-of-living crisis continues, to have unprecedented pressures on people already in poverty in North Lanarkshire. With thousands of people being forced into poverty, having to make tough decisions about when and what they eat, keep their homes, what they can do in life, and when they can afford to heat their home. 1.2 The recovery from the pandemic, the cost-of-living crisis and a number of issues causing or exacerbating the effects of poverty on people in North Lanarkshire. Whilst Inflation has reduced in 2024, issues such as mortgage interest rates increases, price increases on energy, fuel and food increases, real term cuts in wages and welfare reforms continue to acutely affect inequality and poverty, together with other economic factors, impacts the most vulnerable in North Lanarkshire’s communities. 1.3 The supports coming from both the Scottish and UK governments, have been reduced significantly 2024/2025 and the next few years will be extremely challenging for a significant number of households. 1.4 The Tackling Poverty Team submitted its Activity Report for 2023/24 to the Wellbeing and Tackling Poverty Committee on 16th August 2024, which is remitted to the IJB Board for information. 1.5 This report outlines the activity of the Cost-of-Living Helpline and the impact of the wider use of referral pathways with Council Services, IJB Services and NHS Lanarkshire. 1.6 Since establishing the ‘Cost of Living Helpline’ in 2023, with funding provided by the Joint Integration Board, there had been an increase of 41.2% in the number of benefit checks completed for residents; rising from 18.521 benefit checks completed in 2022/23 to 26,158 benefit checks completed in 2023/24. 1.7 The additional benefit income generated by the Tackling Poverty Team and other council services increased by 35.1%, with a total of £47,935,822 of additional benefit income generated via claims, mandatory reconsiderations and appeals for benefits. 1.8 There has been a considerable increase in demand for the Tackling Poverty Team welfare rights service, with the average number of referrals per month received by the team rising from 945 in 2022/23 to 1180 referrals per month in 2023/24. A 25% increase. Maximising Income of Health and Social Work Service Users – 1.9 Social Workers can refer people and families to the Tackling Poverty Team to ensure that income is fully maximised, and that people have access to budgeting/debt advice as well as financial education. 1.10 The Tackling Poverty Team have a dedicated “support services team” for referrals from social work and other council services which may be complex and require more than initial advice offered by First Point of Contact. Referrals for Kinship Carers and those people entering residential care are sent directly to Support Services. 1.11 Considerable work has been done by the Tackling Poverty Team to promote this within social work localities and referrals have almost doubled in numbers to the team, with Page 39 of 214
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4888 benefit checks being carried out via referrals received from social workers the previous year to 9639 benefit checks completed in 2023/24. 1.12 In total £5,062,066 of additional benefit income was generated for people receiving social work services, £743,199 of this is attributed to kinship care families, £895,191 generated for people accessing Justice and children and families’ services, with the remaining £3,423,676 for those accessing adult social work and social care services. MacMillan Advice Service 1.13 The Tackling Poverty Team host the MacMillan Advice Service which offers income maximisation to those people and their families who are affected by a cancer diagnosis. 1.14 The Tackling Poverty Team received 700 referrals from MacMillan in 2023/24, the same number of referrals as the previous year. 52% of those people referred to the service had a terminal illness diagnosis. 1.15 The work carried out by the Tackling Poverty Team generated £3,542,782 in additional benefit income for patients and their families. Food Poverty 1.16 The food poverty referral gateway aim is to mitigate the need for foodbanks or reduce the use of foodbanks by ensuring access to advice services, claims for the Scottish Welfare Fund crisis grants and provide a cash first approach. 1.17 North Lanarkshire Council has led the way since 2014 in promoting a Cash First approach to tackling food poverty, by ensuring that people do not only have access to crisis grants for the immediate need, but also access to information and advice services to ensure sustainable solutions to food crisis. 1.18 Referrals to the Tackling Poverty Team for people who are presenting in food crisis have generated £1,211,758 in additional benefit income, with people receiving assistance to claim benefits such as adult disability payment, council tax reduction, Scottish child payment, pension credits and others. 1.19 Additional temporary funding was received via a Scottish Government funding bid, which was lodged by the Tackling Poverty Team in conjunction with the Food Poverty Action Group. The Tackling Poverty Team are able to provide an interim payment for service users who have been assisted with a crisis grant, the interim payment is provided for the first 24/48 hours until the crisis grant decision has been made. 1.20 The Scottish Government funding will also allow for work to be done with emergency food providers, to allow for more uniform reporting, therefore allowing us to better measure the impact this approach is having on demand for emergency food. Health Services 1.21 Detail is provided below of income maximisation and impacts of partnership working in with Health Services with respect to Tackling Poverty. Page 40 of 214
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1.22 General health staff referrals to the team have increased by 50% from 2022/23 with 591 referrals received in 2023/24. The additional benefit income generated via these referrals has been £872,366. 1.23 Referrals from Health Visitors and District Nurses are relatively low in comparison to other areas of health. The total income generated from the 119 2023/24 referrals is £144,251. 1.24 Discussions have already taken place between Health Improvement Leads and the Tackling Poverty Team to plan sessions to improve the work in this area. 1.25 NHS Lanarkshire employ Community Link Workers who will take referrals from GPs in respect of social prescribing. Temporary funding has been provided to both the Tackling Poverty Team and external partners to provide income maximisation and money advice services. 1.26 Referrals from the GP Link Workers have also fallen with 482 welfare rights referrals received in 2022/23 and 333 in 23/24. The 333 welfare rights referrals to the tackling poverty team generated £252,504 in additional benefit income. (debt advice referrals 146 2022/23 and 133 in 2023/24) Improvement Service Project (Wealth & Health Project) 1.27 Temporary funding has been provided by the Improvement Service to install a welfare rights officer within 4 GP practices in North Lanarkshire (Bellshill, Coatbridge x2, Wishaw). 1.28 This project has proven to be very successful, with a 70% increase in referrals from the previous year to 608 this year. The total additional income generated for patients from these four practices is £1,738,154. Overview NHS Lanarkshire Services – Tackling Poverty Team 1.29 The Partnership between NHS Lanarkshire Services and the Tackling Poverty Team has resulted in over 2350 patients receiving a benefit check in 2023/24, with £6,550,056 in additional benefit income being generated, with14% of the income generated within North Lanarkshire was generated from Health Referrals 1.30 Appendix 1 provides a more detailed presentation of the income generated for 2023/24 for Health and Social Care Services Conclusion and Analysis 1.31 Extending the capacity of the Tackling Poverty Team has allowed the team, to support the wider capacity issues for the Third Sector, Health and Social Care Services, Education and Families Services, Housing Solutions, and other Community Planning Partners, by providing advice, support and referral pathways for these services, and the community drop-in centres, North Lanarkshire Council’s -Work Local Hubs (available to all Council, IJB and NHS Lanarkshire staff) whilst ensuring direct access for communities through the helpline. 1.32 As recognised above it is inevitable that the pressures and reality of the Cost-of-Living Crisis means many people will also experience negative impacts on their health and wellbeing, the Tackling Poverty Team have received additional training in key areas, e.g. mental health and wellbeing to support capacity to recognise and respond to wider Page 41 of 214
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needs through the appropriate signposting and referrals. The Tackling Poverty Team and NHS Lanarkshire already have a well-developed approach for financial wellbeing, signposting to other services and referrals pathways, this builds on the learning from the NL Covid (Community Hubs) Helpline. 1.33 The Tackling Poverty Team monitors and records activity of the helpline, in number of people assisted, reason for referral, income generated, advice given, outcomes, number of people/referrals signposted to other services/agencies. The Tackling Poverty Team reports on the wider use of the referral pathways with, Council Services, IJB Services and NHS Lanarkshire. 1.34 There has been a fall in activity and referrals from the Community Link Workers and low numbers from Health Visitors and District Nurses in 2023/2024. The Tackling Poverty Team and NHS Lanarkshire staff are reviewing these referral pathways to look at what steps are required to encourage and increase the referrals from these health services during 2024/25. 1.35 To date, it is predicted that the total spends by March 2025 against the funds committed by the IJB to enhance team capacity and support the helpline will be £455,000. The underspend is due to recruitment challenges, only recruiting 2 Clerical Assistants, rather than the 4 included in the original staffing levels proposed and also due to staff moving on to permanent posts. 1.36 A request that this agreement is carry over the remaining funding committed by the IJB to allow the contracts of staff employed to be extended to support the Cost-of-Living Helpline and maintain enhanced capacity until 30th June 2025, has been submitted to the IJB Performance and Finance Board. This will allow the service to review any adjustments which require to be made to the service to align with decisions made on future core and supplementary funding streams. 1.37 It would be the intention to report back to the IJB Performance and Finance Sub Committee under the same cycle of reporting back to the Council’s Wellbeing and Tackling Poverty Committee, in 2025. 3. Measures of success 3.1 Ensuring and improving the standardised service to all residents and providing a sustainable, responsive, and effective means of quality advice and support to our communities across North Lanarkshire. 4. Supporting documentation 4.1 Appendix 1 Tackling Poverty Team – Cost of Living Helpline June 2024 4.2 Appendix 2 TOWARDS A FAIRER NORTH LANARKSHIRE 4.3 Appendix 3 North Lanarkshire Local Child Poverty Action Report 2022-2023 Alison Gordon Chief Social Work Officer (Education, Families, Justice and Integrated Practice) Page 42 of 214
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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? Tackling Poverty is fully aligned with the requirements of the Fairer Scotland Duty, its purpose being to reduce the inequalities caused by socio economic disadvantage. 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 ☐ Page 43 of 214
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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? The Tackling Poverty Officers Action Group Sub Group developed a Communications Plan. 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? Tackling Poverty has been identified as a Corporate Risk, with the Chief Social Work Officer as the risk lead. Towards a Fairer North Lanarkshire - Tackling Poverty Strategy sets out a planned approach which seeks to eliminate poverty or make very significant reductions in the level of poverty resulting in benefit to the residents and including improvement in the overall level of health and wellbeing of communities. 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? Page 44 of 214
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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). In North Lanarkshire we recognise that tackling poverty and inequality does not fall to one Service, or one Sector, we must therefore work together to use our resources effectively and efficiently to ensure that all our communities have access to opportunities that will lead to better outcomes for people in terms of employment, wellbeing and inclusive growth. If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☒ Page 45 of 214
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Tackling Poverty Team – (Cost of Living Helpline) June 2024 Page 46 of 214
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Increase Income Via Social Security – Council Services Maximise Income For Residents Brief Description All residents are offered income maximisation and we continue to promote the “no wrong door” approach Baseline From Action Plan 2022/23 - 18,521 benefit checks completed generating £35,480,020 in additional income Update There has been a 41.2% increase in the number of benefit checks completed, from the previous year, with a total of 26,158 benefit checks carried out for the residents of North Lanarkshire. The total income generated for residents via income form social security benefits is £47,935,822 an increase of 35.1% Issues/ Points to Note The Tackling Poverty Team resources have been increased via external temporary funding from NHS Lanarkshire, Improvement Service and the UK Shared Prosperity (employability), and as such have been able to meet the demand (albeit with waiting times increasing). Task is now working as per the Strategy Page 47 of 214
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Increase Income Via Social Security – Council Services Maximise Income For Residents Brief Description All residents are offered income maximisation and we continue to promote the “no wrong door” approach Issues/ Points to Note There has been a notable increase in the demand for welfare rights services, with the average number of referrals per month received by the team rising from 945 to 1180 (a 25%increase). Due to the level of demand on the Service, the normal 3-5 working day wait for services has at times had to increase to 5-7 and at peak times 7-10 working days, this is done in conjunction with the Business Manager. The managed migration for people to move from legacy benefits to Universal Credit is extremely complex and it is vitally important that our staff are on a development path around this. 29% of our staff are on temporary contracts which are due to expire in March 25, as demand increases this remains a risk for the team Task is now working as per the Strategy 792 933 885 773 1066 926 977 972 717 1031 1051 1227 1005 1153 1151 1092 1242 1165 1305 1294 902 1377 1295 1174 APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH First Point of Contact Referrals referrals 2022/23 referrals 2023/24 Page 48 of 214
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Increase Income Via Social Security Benefits – Work With Social Work Service Brief Description Social work staff refer people to the Tackling Poverty Team who will carry out all income maximisation work Baseline From Action Plan 2022/23 4888 benefit checks Update Considerable work has been done by the Support Services Team within Tackling Poverty to promote referrals for income maximisation. 9639 benefit checks have been carried out via social work referrals, generating £5,062,066 additional income. Issues / Points to Note £743,199 was generated via Kinship Care Benefit Checks – this is an area of good practice that we will highlight in the Local Child Poverty Action Report £ 709,988 was generated via referrals from Justice Services There has been considerable inroads in the work with Social Work staff, we need to build on this ensuring that Poverty Awareness Sessions are carried out for all social work staff. Task is now working as per the Strategy Page 49 of 214
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Increase Income Via Social Security Benefits – Work With Social Work Service £0.00 £100,000.00 £200,000.00 £300,000.00 £400,000.00 £500,000.00 £600,000.00 £700,000.00 £800,000.00 £900,000.00 £1,000,000.00 £1,100,000.00 £1,200,000.00 £1,300,000.00 £1,400,000.00 £1,500,000.00 £1,600,000.00 £1,700,000.00 £1,800,000.00 £1,900,000.00 £2,000,000.00 social work income generated by referring team Page 50 of 214
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Income Via Social Security Benefits – MacMillan Advice Service Task continues to have ongoing work Brief Description Maximise the income of cancer patients, their families and carers Baseline From Action Plan 700 referrals received in 2022/23 Update In 2023/24 the Tackling Poverty Team received 700 referrals. Of those referrals, 52% were for people who were terminally ill. The total income generated via MacMillan referrals for patients and their families was £3,542,782. Issues / Points to Note The MacMillan Service is embedded in the work of the Tackling Poverty Team, there is temporary funding for 2 posts, however, the referrals are dealt with by the full team Task is now working as per the Strategy Page 51 of 214
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Increase Income Via Social Security – Food Poverty (Actions 4&5) Brief Description Mitigate the need for foodbank use by ensuring access to advice services and claims to crisis Grants. Group to consider uniform recording to access all emergency food providers Baseline From Action Plan Due to the lack of uniform recording there is no baseline Update Scottish Government funded project to provide both interim payments and a Co-ordinator to work with foodbanks looking at uniformity. The funding is also to consider all emergency payments across the council and how these are used. Using the Cash First approach which is about providing sustainable solutions for people, the Team have generated income via social security benefits for people who have presented in food crisis etc, the total income generated is £1,211,758 The co-ordinator in conjunction with Scottish Welfare Fund have produced a uniform referral fund, work will be done with the emergency food providers to implement this. Issues / Points to Note A number of foodbanks have now resorted to no referral forms, operating drop in sessions, the Co-ordinator will be exploring this with these organisations. Task is now working as per the Strategy Page 52 of 214
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Increase Income Via Social Security – Food Poverty (Actions 4&5) Page 53 of 214
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Income via Social Security – Health Staff Brief Description Health staff will ensure money issues are addressed and referrals are made to the tackling poverty team Baseline From Action Plan 394 referrals received in 2022/23 Update There has been a 50% increase in the number of general health referrals to the team, with 591 referrals being received in 23/24 generating 236 claims for benefits resulting in additional benefit increases of £872,366 Issues / Points to Note The Tackling Poverty Team created a “Health Advice Co-Ordinator” post, the introduction of this post has provided improved recording with procedures put in place to ensure referrals are not only recorded accurately but outcomes are pursued. Task is now working as per the Strategy Page 54 of 214
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Income via Social Security – Improvement Service Project (GP Services) Brief Description Health staff will ensure money issues are addressed and referrals are made to the tackling poverty team Baseline From Action Plan 357 referrals 22/23 Update The Wealth and Health Project began with three GP practices, one in Airdrie, Bellshill and Coatbridge, a fourth practice in Wishaw came on board at the end of 2023. The project has seen a 70% increase in referrals from last year, with the welfare rights officer receiving 608 GP referrals in 23/24. The total additional income generated for patients from these four practices is £1,738,154 Issues / Points to Note The funding for the Wealth and Health Project is temporary with the council receiving reduced funding for 2024/25. The Improvement Service were able to provide 50% funding for the project due to its success, however, the council have been asked to cover the costs of the additional half post. Task is now working as per the Strategy Page 55 of 214
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Income via Social Security –Relaunch Health Visitor & District Nurse Referral Pathway Brief Description Poverty Awareness Training and pathway training to take place Baseline From Action Plan No baseline available Update 119 referrals were received via health visitors and district nurses in 2023/24, generating 55 claims totalling an additional benefit income of £144,251. Issues / Points to Note Discussions have taken place between the tackling poverty team and health improvement leads to plan Poverty Awareness Sessions across both disciplines. It is recognised that the sessions will be tailored to the different disciplines and patient group of health visitors and district nurses. Below is a table showing the localities referrals are generated from. Task continues to have ongoing work Locality Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw No of Referrals 31 6 38 22 21 1Page 56 of 214
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Income via Social Security –GP Community Link Worker Programme Brief Description Community Link Worker embedded within GP practices across North Lanarkshire making referrals to information and advice services Baseline From Action Plan 482 welfare rights referrals (22/23) 146 debt advice referrals (22/23) Update There has been a decrease in the number of referrals from the Financial Link Workers to advice services, this is against the trend from all other referrers. In 23/24 welfare rights referrals were 333 and debt advice 133. The income generated from the welfare rights referrals totalled £252,504 Issues / Points to Note There has been some staffing changes within the Financial Link Workers and this may be the cause of a decline in referrals, this will be addressed with all parties involved in delivering this work. The funding for this agreement for both the Tackling Poverty Team and the External Providers is due to expire in March 2025. Task continues to have ongoing work Page 57 of 214
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Income Via Social Security Benefits – Overview of Health Referrals Team total income MacMillan £3,542,782 Health General £872,366 Health Visitor Pilot £144,251 Health and Wealth Project £1,738,154 Financial Link Workers £252,504 Integrated Addiction Services £0.00 total £6,550,056.12 Page 58 of 214
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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/AMCG Date 12/11/24 Quality Assurance Annual Report 2023/24 From Morag Dendy, Chief Officer (Performance, Planning & Quality Assurance) E-mail DendyM@northlan.gov.uk Telephone Executive Summary The remit of Quality Assurance is wide and varied. It includes ensuring governance through monitoring and evaluating key aspects of social work practice and performance. A central activity is the on-going contract management of external commissioned social care providers. We continue to operate in an environment that is complex, so the sharing of best practice and solution focused ideas are integral to ensure the people of North Lanarkshire receive good quality support to help meet their outcomes. We remain committed to providing an annual report on activity carried out in the preceding year, so this report is to update Committee on our Quality Assurance activity over the annual period of 1 April 23 to 31 March 24. Recommendations It is recommended that the Adult Care and Social Work Committee. (1) Note and endorse the contents of the report. (2) Remit the report to Education, Children and Families Committee. The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities Programme of Work Resilient People Item 6 Page 59 of 214
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1. Background 1.1 This report highlights Quality Assurance activity over the period 1 April 23 to 31 March 24. It covers Contracts & Contract Management, Regulatory Activity, Procurement, Complaints, Duty of Candour, Information Governance, Market Facilitation, In House Monitoring, Safer Staffing & Communications. Full detail of these activities is included in Appendix A. 2. Report Contracts 2.1 Over the past year Quality Assurance have continued to strive to ensure that purchased services have contractual arrangements in place with clearly defined terms and conditions. These arrangements range from national frameworks to Individual Placement Agreements which balance quality against cost to achieve overall best value for services purchased to support people. As of 31 March 24, 98% of all social work spend had the provision of a formal contracting arrangement. This is an increase from 95%, reported in year 2022/23. Contract Management Framework 2.2 Adherence with the contract management framework is an integral component of the processes in place to demonstrate commissioned services are adhering to terms and conditions, outcomes are being achieved and that best value services are purchased. Contract monitoring is also a framework to inform unmet need and future strategic planning and commissioning. 2.3 Last year we reported on changes to be made to our contract management framework from 1st April 2023. From the point of implementation and throughout the duration of this reporting period, the Quality Assurance team have been evaluating the impact of the modifications. This approach reflects one of a learning organisation and focuses on our overarching aims which include monitoring our commissioned services to enable effective partnership working, early intervention and the targeting of resources to improve the experience of people. From the suite of documents which form the contract management framework and were embedded in practice throughout 2023/24, we have made further refinements. 2.4 The development of an Engagement and Participation Toolkit to support the inclusion of direct stakeholder feedback and engagement by Senior Officers was a key addition to the Contract Management Framework. Throughout this reporting period Senior Officers have embedded a variety of methods to engage with a host of stakeholders during monitoring activity. The feedback received has been invaluable in understanding what good care looks like to people using services and their carers. Regulatory Activity 2.5 As of 31 March 2024, there were 27 care homes within North Lanarkshire. From these 27 care homes all 27 had been assessed by the Care Inspectorate under the key question ‘How well do we support people’s wellbeing’. There were no services achieving grade Excellent, however, 3 (11.1%) of care homes achieved Very Good under this key question. Care homes assessed as Good and above totalled 18 which is an overall percentage of 66.7%. Page 60 of 214
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2.6 49 commissioned Self-Directed Support (SDS)/Care at Home services were inspected under the key question ‘How well do we support people’s wellbeing’. One service received a grade of Excellent (6) for this key question. Very good grades were received by 55.1% of services and 87.8% of services received grades of Good or above. In House Monitoring Framework 2.7 Following on from the development of the In-House Monitoring Framework reported on last year, this was approved by the Senior Leadership Team. Thereafter Homecare services commenced with a test of change across all six localities. Quality Assurance plan to carry out an evaluation of the In-House Monitoring Framework which will inform any refinements or modifications that may be required prior to roll out across the organisation. Market Facilitation 2.8 The past financial year has been challenging across the sector and through market facilitation, the team aim to support the social care sector through the right investment, in the right support, so that the wider aims of citizenship, social inclusion and community capacity can be achieved. 2.9 Recruitment and retention of staff remains a challenge across the social care workforce. Following on from the awards of Building Capacity Funding Phase 1 & 2 reported in last year’s annual report, North Lanarkshire Council facilitated a large-scale recruitment and career event on 27th April 2023 in Motherwell Concert Hall. The event was arranged to support our commissioned contractors to recruit suitable staff and in turn to maximise their capacity to provide care and support to the people of North Lanarkshire. Support to Unpaid Carers 2.10 The Commitment to Carers Conference was held on 5 September 2023 at the Bellshill Cultural Centre. The event was for carers, those who work with carers, and carer providers in North Lanarkshire, with the aim of discussing what’s working well and how we can further improve our services. 2.11 We aimed to reflect and build on achievements across North Lanarkshire, finding out what matters to carers and carer providers right now and sharing examples of how NLC is listening and improving on how we work with our carers. 2.12 Carer services were there to showcase the different kinds of support available to carers and hearing what we can do to provide the support people across North Lanarkshire need and want. Engagement & Participation Strategy 2024 - 2027 2.13 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. Page 61 of 214
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Procurement 2.14 Quality Assurance support individual’s rights to determine the manner in which they receive support, and this includes their right to select a contractor who is not on any of our contract frameworks. On these occasions and following due diligence checks of the preferred contractor, Individual Placement Agreements (IPA’s) are created to ensure there is a legal basis between North Lanarkshire Council and the Contractor for the delivery and manner of support. In the past year, 63 citizens of North Lanarkshire chose this route for support. This approach in aligned to the principles of Self-Directed Support. Safer Staffing 2.15 Quality Assurance have been liaising with the Care Inspectorate, other local authorities, commissioned services and internal colleagues to prepare for the implementation of the Health and Care (Staffing) (Scotland) Act 2019 which will be enacted on 1st April 2024. 2.16 Between November 2023 and February 2024, Quality Assurance staff took part in a test which was arranged by the Care Inspectorate on behalf of the Scottish Government. North Lanarkshire were one of ten authorities involved in this. The purpose was to gather information around how prepared commissioned services were for the implementation of the act and any risks that could be identified due to the implementation of the act. Complaints 2.17 Quality Assurance retains an overview role in terms of complaints made about Social Work service provision. Regular quarterly reports on complaints activity are reported through our governance structures. 205 complaints were received in the reporting period, a decrease of 16 [7.5%] from 2022-2023, 109 of these related to Adult Services. Duty of Candour 2.18 Duty of Candour is a statutory duty on Scottish organisations providing health and social care. The responsibility is to remain open and honest when something goes wrong, that is not related to the course of the condition for which the person is receiving care. 2.19 Work has been completed over the course to ensure our staff teams are fully aware of the reporting requirements associated with Duty of Candour. Over this reporting period, there were no Duty of Candour related incidents reported by North Lanarkshire Council care and support services. 3. Measures of success 3.1 The Quality Assurance Annual Report captures activity undertaken during the period 1 April 2023 to 31 March 2024 and highlights progress made in key activities noted in the last reporting period. Several developments are in progress or are planned for the period 2024/25. Page 62 of 214
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4. Supporting documentation 4.1 Appendix 1 – Quality Assurance Annual Report 2023/24 4.2 Appendix 2 – Annual Complaints Report 2023/24 4.3 Appendix 3 – Duty of Candour Report 2023/24 Morag Dendy Chief Officer (Performance, Planning & Quality Assurance) Page 63 of 214
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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 64 of 214
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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? Publish the annual report on the website, to highlight assurance measures and activity across social work services. 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 65 of 214
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Quality Assurance Annual Report 2023/2024 Appendix 1 Page 66 of 214
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1. Introduction Quality Assurance have a role within most integral components of Adult Health & Social Care social work. Activity focuses on procurement & commissioning, contract monitoring, engagement & participation, support to carers and internal governance & development arrangements. Evaluation of services provided to people to ensure they receive the right support at the right time underpins the philosophy within the team. This year has brought the launch of our new Strategic Commissioning Plan 2023 – 2026 and alongside the Plan for North Lan and the ambitions of the Quality Assurance team are aligned to these programmes of work. Last year we reported on new and extended work plans for which the team has expanded both in terms of numbers and skill mix. We have had additional Senior Officers and Resource Workers join the team who bring with them varied and extensive knowledge of operational management within the field of social care, within and out with North Lanarkshire Council. To recognise the breadth of changes to the team dynamics and work activities and promote cohesiveness the team participated in the Insights programme. The Operational Development Team facilitated this, and the outcomes originally identified were achieved. Throughout the past year we have created a structured succession planning pathway from Resource Worker to Senior Officer and this has been particularly effective, enabling two-way opportunities, development and growth. The team collated the information to inform the Chief Social Work Officer Report 2022/23 and with this being the first year this new approach has been taken a learning review highlighted key changes to take forward to the report for 2023/24. We also collaborated with the Senior Leadership Team to discuss social work self-evaluation. Feedback has influenced and will continue to shape the benchmark standards. The preparation for the transition from SWIS to Mosaic has been extensive and on-going. Quality Assurance have had representation in every workstream. As part of the redesign of Home Support the team have been involved in various workstreams supporting activity from supervision & observational monitoring approaches to the review of the service criteria to the streamlining of personal support plans (PSP’s) Quality Assurance are also involved in risk management activity around home support as well as having membership on the Programme Board. Throughout the reporting period we have endeavoured to offer new supports to our In-House services and locality teams with the test of change across homecare, our work on safer staffing and the oversight we have of care inspectorate activity and actions plans. We also produced some guidance for in house registered services completing annual returns to the Care Inspectorate. Senior Officers are linked to localities, and they have been attending Community Care Operational Meetings, sharing key information. We aim to continue to support operational colleagues to provide the best services they can whilst embedding the Back2basics approach which even at this early stage has the potential to enable the delivery of more appropriate interventions by the correct people. The Quality Assurance Team work collaboratively with a range of partners to embed the principles of Self-Directed Support. The activities reported in this 2023/24 annual report reflects our commitment to learn from what’s working well and what could be better to ensure people are central to all decisions in their lives. Page 67 of 214
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2. Contracts Quality Assurance work alongside the Corporate Procurement Team to establish and work in accordance with legal processes to support the procurement journey for all purchased services and goods across social work. This journey begins with identifying the contract route which is proportionate to the risk level and value of the contract, to developing and designing tender documentation right through to contract award and implementation. The role of Quality Assurance is to co-ordinate and facilitate all procurement activity whilst providing advice and guidance to operational colleagues to enable them to devise service specifications which clearly describes the service required and the outcomes to be achieved. Over the past year we have continued to liaise with operational colleagues in a planned and ad hoc way, to ensure contracts are clearly interpreted and applied in practice to ensure a consistency aligned to the strategic direction of UNLHSC. We have agreed modifications to be made to current frameworks which will be progressed in 2024/2025. We have strong links with our partners at Scotland Excel who are widely recognised for their expertise in public procurement. The National Care Home Contract has existed since 2006 and it provides a contractual platform offering transparency and consistency for both purchasers and providers of older people residential and nursing care home placements. Scotland Excel are the owners of this contract and North Lanarkshire have bought into this meaning that all commissioned care homes for elderly people in North Lanarkshire are subject to the terms and conditions of this contract. The National Care Home Contract contains shared terms and conditions in relation to the arrangements around placements in Scotland including the weekly charges. Weekly charges are reviewed annually by Scotland Excel, in consultation with the Scottish Government, COSLA and Scottish Care (on behalf of providers) Scotland Excel are currently redesigning the National Care Home Contract as since it’s development in 2006 there have been significant changes to the social care environment. Providers have on an annual basis signed up to a new minute of variation to reflect annual uplifts however there is a commitment to an overhaul of the contract to reflect the current social care landscape including workforce & retention challenges, cost of living impacts, changing demographics/more complex needs of the care home population and the ambition to reflect a model which champions ‘outcomes focused and responsive care’ rather than ‘adequate care’. The Quality Assurance Team are involved in discussions around this redesign, and we hope to shape and influence meaningful change which will be to the benefit of people living in a care home, their carers/families and local authorities when placing people and monitoring the achievement of outcomes and overall quality of service thereafter. Over the past year Quality Assurance have continued to strive to ensure that purchased services have contractual arrangements in place with clearly defined terms and conditions. These arrangements range from national frameworks to Individual Placement Agreements which balance quality against cost to achieve overall best value for services purchased to support people. Page 68 of 214
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Tables 2a and 2b below illustrate that as of 31 March 24, 98% of all social work spend had the provision of a formal contracting arrangement. This is an increase from 95%, reported in year 2022/23. Quality Assurance continue to progress with the necessary arrangements to ensure all spend has robust contractual and legal agreements in place; however, it should be noted that due to the fluidity of contracting and commissioning, achievement of 100% compliance may not always be possible. Table 2a 98% 2% No of Contracts 2023/2024 Contracts in Place In Development 95% 5% No of Contracts 2022 /2023 Contracts in Place In Development Page 69 of 214
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Table 2b There are currently 303 provider organisations that we contract with, and this is a decrease of two from the figure reported last year and as highlighted above. The number of out of authority care homes being utilised has reduced which is a positive as it can be assumed that more people are being placed closer to home. There has also been a decrease in residential schools. It can be seen from the graphs above that non framework self-directed support and non-traditional respite packages have increased since last year as have 3rd sector and voluntary providers. Skyview Care Home closed in June 2023, and this accounts for the reduced number of North Lanarkshire Council commissioned care homes. 10 4 27 12 141 3 10 2 7 4 9 9 4 61 0 20 40 60 80 100 120 140 160 3rd Sector / Voluntary Advocacy Care Home (NLC) Care Home Cross Border Care Home Out of Authority Carers Network Fostering & Continuing Care Mental Health Misc Non Framework Self Directed Support Non Traditional Respite Residential Schools Secure Services Self Directed Support Spread of Providers 2023/2024 7 4 28 9 148 3 11 2 3 5 1 6 13 4 61 0 20 40 60 80 100 120 140 160 3rd Sector / Voluntary Advocacy Care Home (NLC) Care Home Cross Border Care Home Out of Authority Carers Network Fostering & Continuing Care Justice Mental Health Misc Non Framework Self Directed Support Non Traditional Respite Residential Schools Secure Services Self Directed Support Spread of Providers 2022/2023 Page 70 of 214
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It is envisaged that over the coming year new providers will be added to the Self-Directed Support Framework when it opens to new tender applications. This will further build capacity across North Lanarkshire. 3. Contract Management Framework (CMF) Last year we reported on changes to be made to our contract management framework from 1st April 2023. From the point of implementation and throughout the duration of this reporting period, the Quality Assurance team have been evaluating the impact of the modifications. This approach reflects one of a learning organisation and focuses on our overarching aims which include monitoring our commissioned services to enable effective partnership working, early intervention and the targeting of resources to improve the experience of people. Adherence with the contract management framework is an integral component of the processes in place to demonstrate commissioned services are adhering to terms and conditions, outcomes are being achieved and that best value services are purchased. Contract monitoring is also a framework to inform unmet need and future strategic planning and commissioning. The development of an Engagement and Participation Toolkit to support the inclusion of direct stakeholder feedback and engagement by Senior Officers was a key addition to the Contract Management Framework. Throughout this reporting period Senior Officers have embedded a variety of methods to engage with a host of stakeholders during monitoring activity. The feedback received has been invaluable in understanding what good care looks like to people using services and their carers. It has also enabled solutions to be found when potential improvements have been raised with Senior Officers. The Quality Assurance team will continue to analyse the information collated and quarterly performance reports during 2024/25 will include statistical and impact information resulting from the direct engagement. From the suite of documents which form the contract management framework and were embedded in practice throughout 2023/24, we have made further refinements as outlined below: - • Quarterly returns are now specific to the type of service being provided e.g. Care Home, Support Provider or Funded Organisation. • Monitoring Visit Report now has mandatory and optional components included within its format which enables Senior Officers to focus their monitoring activity based on other intelligence received. • Monitoring Prioritisation Assessment form care service risks more clearly highlighted meaning that tier ratings allocated to commissioned services are more aligned to live circumstances. • Contract Monitoring Compliance Tool and sampling system designed to ensure fairness, consistency and an evidence base within our application of the contract monitoring framework. • Information available or received through other means no longer requested from commissioned services. • To support our Adult Protection Committee a range of information is being gathered around the delivery of training to our commissioned services. • Additional systems for the analysis of data received have been developed to ensure that patterns and themes are established and understood. The refinements outlined above have been made because of using the documents and tools and from gathering feedback from our commissioned services and audit and risk colleagues. With this same ethos our aim for 2024/25 is to have an on-going philosophy of co-design of our contract management Page 71 of 214
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framework and we have had almost 25 commissioned services commit their time to a planned working group. This approach is in line with ethical commissioning which we will speak more about later in this report. The Monitoring Prioritisation Assessment (MPA) provides a tool to enable Senior Officers to assess the level of risk associated with each commissioned service. MPA’s are carried out following submission of quarterly returns by commissioned services and analysis of the data provided by Senior Officers. MPA’s will also be reviewed following monitoring visits as a matter of routine performance measurement. Other significant events highlighting deficiencies in the quality of care may also trigger a new MPA to be completed. The outcome of the MPA determines the level of monitoring activity to be applied as a way of supporting improvements and applying a level of scrutiny which is aligned to the risk. MPA’s and monitoring visit reports form the record of discussions and recommendations agreed between Senior Officers and commissioned services. Each Tier suggests a minimum monitoring frequency as set out in Table 3a below Table 3a STATUS INDICATED MONITORING LEVEL Purple Large Scale Investigation (LSI) or Service Closure Processes that are imminent within 6 months Red Significant concerns in relation to service performance, contract compliance. TIER 4 Contract monitoring visit frequency – 1 to 4 weekly. Amber Moderate concerns in relation to service performance, contract compliance TIER 3 Contract monitoring visit frequency – variable, at least quarterly but no more than monthly. Yellow Minor concerns identified in relation to service performance and contract compliance TIER 2 Contract monitoring visit frequency – variable, at least bi-annually but no more than quarterly. Green Service performance, contract compliance and engagement are satisfactory. TIER 1 Contract monitoring visit frequency – annually in most cases. Page 72 of 214
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We reported last year about the significant improvements the Quality Assurance team had made to the suite of documents which form the Contract Monitoring Framework. We have seen a more consistent approach to the monitoring of contracts across the team. Table 3b highlights Tier Levels as reported at the end of 2022/23 and for the same time in 2023/24. An improved picture can be seen in terms of Tier 4 services which have decreased to 0%. When comparing the lower Tier ratings (1 & 2) across both reporting periods there was no overall change and the same is the case with Tiers (3 & 4) Overall, the majority of providers are Tiered within the lower tier rating categories. This is positive as the intensity and frequency of Care Inspections and our monitoring activity has been enhanced. Table 3b Tier 1 Tier 2 Tier3 Tier 4 Q4 2023 to 2024 68% 25% 7% 0% Q4 2022 to 2023 85% 8% 4% 3% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Commissioned Providers Q4 Tier Ratings 2022/2023 & 2023/2024 Page 73 of 214
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4. Regulatory Activity Table 4a below details an analysis of the key question “How well do we support people’s wellbeing”. The data has been extracted from Tables 4b and 4c below. North Lanarkshire Care Homes performance measures lower than Scotland wide care homes in that 66.7% of grades of 4 and above were awarded. Scotland wider care homes achieved 74.8% of grades of 4 and above. From the figures below it would appear that North Lanarkshire care homes seem to have an overall average of grades ranging between adequate and good. An improvement area would be to start to focus on why very few care homes are achieving good or above grades. 127 Scotland wide care inspections are reported below. Please note some care homes have not been inspected or have not been inspected under this key question. Table 4a - Please note North Lanarkshire care homes are not included in the overall Scotland wide figures. How well do we support people’s wellbeing Number of Care Homes Assessed Grades Awarded Percentage North Lanarkshire Care Homes (Table 4b) 27 0 x Excellent 3 x Very Good 15 x Good 5 x Adequate 4 x Weak 0 x Unsatisfactory 0% 11.1% 55.6% 18.5% 14.8% 0% Scotland Wide Care Homes (Table 4c) 127 0 - Excellent 39 x Very Good 56 x Good 30 x Adequate 2 x Weak 0 x Unsatisfactory 0% 30.7% 44.1% 23.6% 1.6% 0% Page 74 of 214
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Table 4b The tables above differ slightly in that the key question ‘How good is our care and support during the COVID 19 pandemic’ continues to feature in 2022/23 however in 2023/24 this key question had been merged into key question 1 and no longer featured as a stand-alone key question. As of 31 March 2024, there were 27 care homes within North Lanarkshire. From these 27 care homes all 27 had been assessed by the Care Inspectorate under the key question ‘How well do we support people’s wellbeing’. There were no services achieving grade Excellent, however, 3 (11.1%) of care homes achieved Very Good under this key question. Care homes assessed as Good and above totalled 18 which is an overall percentage of 66.7%. The care homes who were assessed as Very Good under the key question ‘How do we support people’s wellbeing’ were Blair House, Kirknowe, and Summerlee. How well do we support people's wellbeing? How good is our leadership ? How good is our staff team? How good is our setting? How well is care and support planned? How good is our care and support during the COVID-19 pandemic? Adequate 2022/2023 10 5 5 3 4 1 Good 2022/2023 11 15 10 6 8 4 Very Good 2022/2023 4 1 1 3 0 0 Weak 2022/2023 2 1 0 0 2 0 0246810121416 Care Inspection Grades - North Lanarkshire Based Care Homes As At 31/03/2023 How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Adequate 2023/2024 5 7 3 5 2 Good 2023/2024 15 13 9 6 9 Very Good 2023/2024 3 2 1 2 0 Weak 2023/2024 4 3 0 3 2 Unsatisfactory 2023/2024 0 1 1 0 0 0246810121416 Care Inspectorate Grades -North Lanarkshire based Care Home as at 31/03/2024 Page 75 of 214
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From 27 care homes, 13 had been assessed under the key question ‘How well is care and support planned’. From the 13 that had been assessed 9 care homes received grades of Good and above. This is an overall 69.2%. During the reporting period Centenary House continued to be subject to Large Scale Investigation (LSI) until 11 October 2023. An improvement notice was also served by the Care Inspectorate to Centenary House on 12 July 2023 following grades of unsatisfactory being awarded in two key questions. The table above highlights the grades under key questions ‘How good is our leadership’ and ‘How good is our staff team’. The improvement notice at Centenary House was subsequently removed in December 2023 following significant improvements being identified by the Care Inspectorate. Six care homes during the reporting period were closed to admissions due to agreeing to a voluntary moratorium. One care home had an enforced moratorium placed upon them. The reasons for application of moratoriums were due to concerns around the quality of care being provided and to allow care home providers the opportunity to make the necessary improvements. Table 4c How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Adequate 2023/2024 30 27 19 12 25 Excellent 2023/2024 0 1 0 1 0 Good 2023/2024 56 44 34 37 38 Very Good 2023/2024 39 40 15 9 13 Weak 2023/2024 2 2 1 2 1 0 10 20 30 40 50 60 Care Inspectorate Grades - Care Home as at 31/03/2024 (excluding NLC) Page 76 of 214
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Care Homes in Scotland (excluding North Lanarkshire): North Lanarkshire Council currently has people placed within 141 care homes that are located elsewhere in Scotland. The total number of people placed within these care homes from North Lanarkshire is 169. Contract Monitoring activity is carried out by the host authority where the care home is geographically located although care management responsibilities remain with North Lanarkshire Council for individuals placed. Individual Placement Agreements are implemented for individuals and these agreements detail the basis for care and support. North Lanarkshire Council are notified of any Large-Scale Investigation activity or potential scenarios which may lead to the closure of the home e.g. Care Inspection Enforcement Action, Liquidation etc. Quality Assurance are currently leading on a subgroup from the Contracts and Commissioning Practice Network in relation to Care Homes. It has been evident from this activity that commissioned services and local authorities would benefit from a level of consistency in the application of contract monitoring. We hope to take this forward in 2024/25 to further shape, develop and share best practice as a sector. How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? How good is our care and support during the COVID-19 pandemic? Adequate 2022/2023 32 24 22 9 17 10 Excellent 2022/2023 0 1 0 0 0 0 Good 2022/2023 60 47 28 36 37 2 Unsatisfactory 2022/2023 1 1 1 0 1 0 Very Good 2022/2023 29 30 12 6 8 2 Weak 2022/2023 3 3 1 3 1 0 0 10 20 30 40 50 60 70 Care Inspection Grades for Care Homes in Scotland (Excluding North Lanarkshire) as at 31/03/2023 Page 77 of 214
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Table 4d How well do we support people's wellbeing? How good is our leadership? How good is our staff team? How good is our setting? How well is care and support planned? Adequate 2023/2024 3 8 1 0 3 Excellent 2023/2024 1 0 0 0 0 Good 2023/2024 16 20 9 2 9 Very Good 2023/2024 27 16 7 1 7 Weak 2023/2024 2 2 2 0 2 0 5 10 15 20 25 30 Care Inspectorate Grades - Self Directed Support including Care at Home as at 31/03/2024 How well do we support people's wellbeing? How good is our leadership ? How good is our staff team? How good is our setting? How well is care and support planned? How good is our care and support during the COVID-19 pandemic? Care & Support Environme nt Staffing Managem ent & Leadership Adequate 2022/2023 7 7 2 0 3 0 0 0 0 0 Excellent 2022/2023 1 0 0 0 0 0 3 0 0 1 Good 2022/2023 8 9 5 1 4 0 3 0 3 8 Very Good 2022/2023 11 6 3 1 3 0 19 1 9 10 Weak 2022/2023 0 0 1 0 0 0 0 0 0 0 0 5 10 15 20 Care Inspection Grades-Self Directed Support including Care at Home as at 31/03/2023 Page 78 of 214
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Self-Directed Support (SDS) including Care at Home: The tables above highlighting the Care Inspectorate grades for Self-Directed Support (SDS)/Care at Home Providers 2022/23 and 2023/24 vary as in 2022/23 a high volume of providers had not been inspected under the current Care Inspectorate methodology and therefore the previous methodology areas were included within the graph. 2023/24 focuses solely on care inspections which have taken place under the new methodology. Some services continue not to have been inspected under the new framework which highlights that no inspection activity has been undertaken for several years. We understand this is due to recovery from the pandemic and that inspection activity is prioritised based on risk and other intelligence being received. This includes information submitted in annual returns, notifications of accidents/incidents and complaints. There are 50 commissioned SDS/Care at Home services that have been inspected by the Care Inspectorate under the new methodology framework and these are highlighted above in table 4d. 49 commissioned services were inspected under the key question ‘How well do we support people’s wellbeing’. One service received a grade of Excellent (6) for this key question. This was Support for Ordinary Living (SOL). Very good grades were received by 55.1% of services and 87.8% of services received grades of Good or above. Lifeways Community Care were not inspected under this key question. Under the key question ‘How well do we support people’s wellbeing’, 4% of services received grades of Weak. This consisted of 2 services who were Cera Care and Care 1 Professional. Both services continue subject to moratorium at the end of this reporting period. The reasons for the moratoriums were due to the quality of care assessed by the Care Inspectorate. Application of the moratorium is to support the provider to make the necessary improvements required. One provider agreed to this arrangement on a voluntary basis and an enforced moratorium was applied for the other. From the 50 commissioned services, 21 were inspected by the Care Inspectorate under the key question ‘How well is care and support planned’. Of these 33.3% received grades of Very Good and 76.2% received grades of Good or above. 5. In House Monitoring Following on from the development of the In-House Monitoring Framework reported on last year, this was approved by the Senior Leadership Team. Thereafter Homecare services commenced with a test of change across all six localities. Quality Assurance plan to carry out an evaluation of the In-House Monitoring Framework which will inform any refinements or modifications that may be required prior to roll out across the organisation The aim of the In-House Monitoring Framework is to support implementation of best practice and a culture of continuous improvement. It includes a cycle of on-going self-evaluation and monitoring, with triangulation of evidence across management tiers and sections. Services will be enabled to reflect on what they are doing well, what they could do better and to plan for change and improvement. Quality Assurance plan to facilitate learning opportunities for In House Services particularly around the use of quality improvement tools and methodologies. The team are currently developing workshops and materials whilst liaising with key staff around ways of enhancing the support that they Page 79 of 214
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can provide to in house services to share knowledge of developments, opportunities and change within the social care landscape. 6. Market Facilitation The Quality Assurance team continues to promote, stimulate and support market facilitation across the social care provider framework and the community and voluntary sector (CVS) whilst remaining outside of the market. Our approach is based on strategic intervention, relationship building, light touch intervention and supporting beneficial new relationships and activities that lead to resilient and sustainable approaches, which in turn lead to continuous improvement, improved ways of working and an active learning cycle whereby planning impacts on delivery, review and learning. The past financial year has been challenging across the sector and through market facilitation, the team aim to support the social care sector through the right investment, in the right support, so that the wider aims of citizenship, social inclusion and community capacity can be achieved. Page 80 of 214
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Provider Recruitment Event - Recruitment and retention of staff remains a challenge across the social care workforce. Following on from the awards of Building Capacity Funding Phase 1 & 2 reported in last year’s annual report, North Lanarkshire Council funded and facilitated a large-scale recruitment and career event on 27th April 2023 in Motherwell Concert Hall. The event was arranged to support our commissioned contractors to recruit suitable staff and in turn maximise their capacity to provide care and support to the people of North Lanarkshire. Over 20 social care providers took part in the event and have since reported having recruited various numbers of staff, arising from attendees on the day. A survey was carried out on the day which highlighted 65% of people completing this had applied for jobs during the event. 95% intended making applications following the event. Feedback from those who attended the event included: Page 81 of 214
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Building Capacity Funding Phase 3 – Additional financial support was offered to Care at Home Providers during the reporting period. The award was made to help create capacity and in recognition of the complexity and frailty of people Care at Home Providers support and to finalise the transition from a ‘Time & Task’ model to ‘Individual Budgets’, fully supporting the principles of Self-directed Support. This approach ensures people accessing services have better choice and control over who supports them and how the support to meet their outcomes is met. Provider Capacity Portal – Quality Assurance and the Adults Team have been working with our Self- Directed Support (SDS)/Care at Home Commissioned services to establish a system to report available capacity to provide a new service. We have long recognised the demands for both social work staff and services in knowing who to make contact and with when either a service needs to be secured or capacity needs to be built upon. Throughout this year we have developed a portal whereby all commissioned services initially report their available capacity and then continue to update this as and when it occurs. The portal will be monitored by Adults/QA teams and our social work teams will have access to the data. A test of change took place with 5 providers and some feedback was provided which resulted in some refinements. We are pleased to advise that early into 2024/25 reporting period the portal will become live. 7. Support to unpaid carers Since the introduction of the Joint Partnership Statement detailed in last year’s annual report, a range of further developments to support carers have taken place. These have been part of Quality Assurance’s wider approach to Market Facilitation, to help broaden choice, control and support options for carers. Initiatives have included: • An innovative Hospital Discharge Payment Scheme for Carers – to reduce the risk of delayed discharge arising from wait times for social care provision. • Expansion of Carer Breather- an innovative Community Solutions approach to ensuring that carers, whether known to services or not, can access regular breaks from caring. • Increased funding to PAMIS to build capacity in the PAMIS Family Support Service, offering support to families caring for someone with profound, complex multiple disabilities. • Support for Dementia Carers through Alzheimer’s Scotland Dementia Carer Link Workers. • Extended contract for HOPE for Autism, removing the uncertainties arising from year-to-year annual funding. • Investment in practitioners from Autism Network to ensure that we have access to specialist knowledge around neurodivergence. • Further investment in Lanarkshire Carers to enhance existing programmes of carer support. • Continued support for Action for Children Young Carers Project. • Improved education opportunities for Social Work staff around commissioned organisations, Adult Carer Support Plans, carer budget processes and Young Carer Statements • 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. • 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 LGBTQ+ communities. Page 82 of 214
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• Where applicable, continued promotion of Carer Budgets and support around innovative use of these. • Preparation in anticipation of forthcoming legislation around the right to carer breaks, including an updated Short Breaks Statement. • Preparatory work around the next Carers Strategy for North Lanarkshire. Developments in carer support around Dementia and Autism were informed by findings from the most recent national Carer Census, where these conditions, along with age related frailty, were identified as being the three largest areas of caring responsibility. With regard to frailty, North Lanarkshire has been a pathfinder area in the national Getting it Right for Everybody (GIRFE) approach, and whilst colleagues from other parts of University Health and Social Care are leading on this, Quality Assurance have also been directly involved. In addition to the detail noted above, a wide range of age related, or condition specific community and voluntary sector organisations were in receipt of North Lanarkshire Council funding and had a role within direct, or indirect, support to carers. Work around monitoring and quality evaluation regarding carer support across these organisations took place throughout the year. The Commitment to Carers Conference was held on 5 September 2023 at the Bellshill Cultural Centre. The event was for carers, those who work with carers, and carer providers in North Lanarkshire, with the aim of discussing what’s working well and how we can further improve our services. We aimed to reflect and build on achievements across North Lanarkshire, finding out what matters to carers and carer providers right now and sharing examples of how NLC is listening and improving on how we work with our carers. Carer services were there to showcase the different kinds of support available to carers and hearing what we can do to provide the support people across North Lanarkshire need and want. Page 83 of 214
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8. Participation and Engagement 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. 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. 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, 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. 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. 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 - 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. Learning from these sessions has highlighted what is considered good engagement and participation and provided confirmation that the refreshed strategy should: Page 84 of 214
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• 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. 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. Strategic Engagement and Participation Working Group - 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. 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. 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 - 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. 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. 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. 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 through engagement and participation with our Communities, Carers and Supported People. Page 85 of 214
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Care Opinion - 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. 2024/2025 will see the introduction of a Care Opinion Newsletter which the Quality Assurance team will produce. This will enable feedback to be shared across networks as well as being another way of promoting the use of Care Opinion. The Care Opinion Newsletter will celebrate positive feedback and will highlight the lessons learned from less than positive comments received. 9. Communications Quality Assurance have a key function within the area of communication. This includes the following responsibilities: - • Overseeing and updating North Lanarkshire Council (Social Work) and UHSCNL websites • Facilitating, compiling and distributing the Public Protection Newsletter • Governing social work resources, policies and procedures held on our SharePoint site • Are owners and administrators of Viva Engage – which includes responding to queries and sharing updates in relation to Subject Access Requests and Resources, Policies & Procedures Social Work Policies & Procedures – Quality Assurance have established a policy review group with representation from all sections of social work including headquarters and localities. The aim of this group is to keep policies and procedures up to date with the appropriate owner and review date detailed. Policy control documents will ensure that the correct versions are being utilised at all times. Quality Assurance are the owners of this site and any edits made by social work colleagues must be uploaded by Quality Assurance. Representatives of this group will be responsible for liaising with their sections to be the link person for communicating changes required due to legislative requirements or other relevant factors. Over the next few months, a key aim is to have a register of all policies and procedures required across social work and a plan for reviewing implemented. Social Work Induction & Development – Talent and Organisational Development have recently developed a robust Social Work Induction programme and have also linked some materials into the Corporate Induction which is used for all North Lanarkshire Council employees. There is a vast amount of resources and materials available within the Social Work Induction programme which allows new employees to understand their new role. Page 86 of 214
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Quality Assurance have taken ownership of the Induction Programme with the aim of further developing the material and localising the content to the “approach of North Lanarkshire”. At this time a selection of representatives has been agreed across social work departments and they will be responsible for attending meetings and communicating changes and additions required to the induction and development programme to ensure it remains current and up to date and is the standardised approach to induction and development planning across social work. This work is in the early stages with all ideas for inclusion currently being considered. Quality Assurance Newsletter – Over the reporting period the newsletter was reestablished. This reports on key activity across the department. Moving forward we are keen to have engagement from commissioned services including the sharing of good news stories such as achieving high quality. A focus for the year ahead is to refresh the newsletter utilising other available platforms to engage a wider audience. 10. Information Governance We have legal and ethical duties in relation to handling and managing information to a high standard, and to improve in a transparent, fair, consistent, and secure way, with people always at the forefront of our minds. Our Information Governance Framework allows us to deploy our responsibilities and for social work this key function sits within the portfolio of the Quality Assurance Team. Our core group of Resource Workers with oversight from a Senior Officer are responsible for coordinating requests which include: o Subject access requests (SARs) including Information Commissioner’s Office (ICO) reviews and complaints. o FOISA (Freedom of information requests) including Scottish Information Commissioner reviews and complaints. o GDPR breach notifications o Data protection impact assessments (DPIAs) o DPA or schedule 2 requests o Annual ICO Stats o Quarterly Corporate KPI’s o Quarterly SAR stats Resource Workers liaise with the Freedom of Information Team and Data Protection Team who share their expert knowledge to guide internal processes in accordance with legislation. Over the reporting period there has been a focus on coaching/mentoring/training locality admin staff in relation to SARs and SARs recording. This follows on from the review and update of SAR’s recording systems. All reporting and monitoring systems within Quality Assurance for capturing information governance data have been developed and enhanced. This work has assisted with having the most up to date and accurate records available. Page 87 of 214
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11. Procurement Quality Assurance continues to lead on procurement activity for all social work services and collaborate with colleagues within Corporate Procurement, Service Leads and Locality Social Work Teams to ensure joined up planning, clear procurement processes and subsequent contract monitoring arrangements. This ensures that all commissioned contract work delivers best value, in accordance with Procurement Reform Scotland Act 2014 and the Procurement (Scotland) Regulations 2016. Quality Assurance support individual’s rights to determine the manner in which they receive support, and this includes their right to select a contractor who is not on any of our contract frameworks. On these occasions and following due diligence checks of the preferred contractor, Individual Placement Agreements (IPA’s) are created to ensure there is a legal basis between North Lanarkshire Council and the Contractor for the delivery and manner of support. In the past year, 63 citizens of North Lanarkshire chose this route for support. In the last year, Quality Assurance have supported colleagues within our adult & finance teams to review the Councils’ Self-directed Support Option 1 Direct Payments, processes and documents. This work is extensive and includes support from Legal colleagues and has included: • review of internal processes with supporting documentation • creating systems that will enable recipients of Direct Payments to send required documentation and annual financial information directly to Localities It is anticipated this work will be concluded by the end of the next financial year. 11a describes the procurement activity for Contracts over £50,000 undertaken in 2023/24. Contract Title Contract Overview Service Area / Procurement Category Total Value of Contract (Excl VAT) Contract Start Date Contract End Date Admin of Engagement & Participation (Supported People) Provision of this Contract reinforces the Council’s commitment to ensure ongoing meaningful involvement with the communities that we serve. Adult Services / Social Care Services £900,000.00 02/10/2023 01/10/2026 Page 88 of 214
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Aids for daily living The service covers the North Lanarkshire area for equipment and adaptations requests from North Lanarkshire and the whole of Lanarkshire for NHS Lanarkshire requests. Adult Services / Aids & Equipment £2,500,000.00 01/12/2023 31/05/2026 Coming Home Strategy - Advocacy The current brief of the service for adults needs to be extended due to the “Coming Home” report and the need for additional advocacy provision that this duty places upon the Health and Social Care Partnership. Adult Services / Social Care Services £90,895.00 01/07/2023 30/06/2025 Counselling Services for Care Experienced Young People Based within Intensive Services Hub, Cecil Street, Coatbridge and work with 16–25- year-olds who have experienced trauma and adversity. Education, Families & Justices/ Social Care Services £200,000.00 10/04/2023 09/04/2024 plus 3, 1 Year Extensions available Dementia – post- diagnostic support for carers Specialist support to carers who frequently report great difficulty and high levels of stress whilst caring for relatives affected by Alzheimer’s. Adult Services / Social Care Services £498,000.00 01/06/2023 31/03/2025 Digital Counselling Service and Online Platform of Support Funding had been allocated from within Scottish Government’s Mental Health Services allocation to the Council to pay for the solution in year 1. Education, Families & Justices/ Social Care Services £400,000.00 29/01/2023 30/01/2024, plus 3, 1 Year Extensions available Making Life Easier North Lanarkshire Online resource offering information, professional advice and direct access to services and support for individuals in North Lanarkshire. This service allows individuals to obtain information and/or complete self-assessments, promoting early prevention and self-management. Adult Services / Social Care Services £291,268.92 01/08/2023 31/07/2026, plus 1 Year Extension Available Supply, Installation and Servicing of Stairlifts and Hoists ADL provides specialist equipment and housing adaptations that support people to live independently in their own homes. Service covers the North Lanarkshire area for equipment and adaptations both Adult Services / Aids & Equipment £12,000,000.00 01/10/2023 30/09/2028 Page 89 of 214
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North Lanarkshire and the whole of Lanarkshire for NHS Lanarkshire requests. Signs of Safety Signs of Safety is a strengths-based safety- organised approach to child safeguarding work which expands the investigation of risk to encompass strengths and signs of safety to make an overall judgement of safety using a scale. It aims to work collaboratively and in partnership with families and children to conduct risk assessments and produce action plans for increasing safety and reducing risk and danger by focusing on strengths, resources and networks that the family have. Education, Families & Justices/ Social Care Services £95,000.00 02/10/2023 01/04/2025 Table 11b describes of the procurement activity for Contracts under £50,000 undertaken in 2023/24. Contractor Contract Overview Service Area / Procurement Category Total Value of Contract (Excl VAT) Contract Start Date Contract End Date Commercial Strategy Sourcing Route Durham University Project set-up and design: working alongside professionals to design two approaches to be tested in the schools, including reflective workshops to explore Contextual safeguarding theory and approaches within education settings. Education, Families & Justices/ Social Care Services £34,808 01/08/2023 31/12/2024 New Requirement Proposal for Funding Care Solutions The provision of Care at Home services to support the flow of hospital discharges and service user reablement. Adult Services / Social Care Services £15,700 06/03/2023 25/06/2023 New Requirement Proposal for Funding Page 90 of 214
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Invercare Services Ltd The provision of Care at Home services to support the flow of hospital discharges and service user reablement. Adult Services / Social Care Services £17,628 06/03/2023 25/06/2023 New Requirement Proposal for Funding JKL The provision of Care at Home services to support the flow of hospital discharges and service user reablement. Adult Services / Social Care Services £14,000 06/03/2023 25/06/2023 New Requirement Proposal for Funding Keane Premier The provision of Care at Home services to support the flow of hospital discharges and service user reablement. Adult Services / Social Care Services £15,784 06/03/2023 25/06/2023 New Requirement Proposal for Funding ADL Smart Platform MILE Online resource offering information, professional advice and direct access to services and support for individuals in North Lanarkshire. This service allows individuals to obtain information and/or complete self- assessments, promoting early prevention and self-management. Adult Services / Social Care Services £24,664 01/03/2023 31/07/2023 New Requirement Proposal for Funding Wise Group Community Payback Order Relational Mentoring service. Education, Families & Justices/ Social Care Services £42,000 01/06/2023 31/03/2024 New Requirement Proposal for Funding Ten for Zen To help build capacity and with the assistance from other third sector partner agencies will provide a collective effort to support Social Work to deliver vital services. Education, Families & Justices/ Social Care Services £29,250 01/04/2023 31/03/2025 New Requirement Proposal for Funding Creative Change To provide a unique in person and online experience that combines anonymity and creativity in interactive 2-hour sessions delivered twice weekly in 12 session blocks. This will include accreditation certificate from New College Lanarkshire on completion of programme for each participant. Education, Families & Justices/ Social Care Services £49,000 01/04/2023 31/03/2025 New Requirement Proposal for Funding SACRO Provision of an individual service using a mentoring approach, which is a way of helping and supporting individuals with issues they might be facing both practically and emotionally. Education, Families & Justices/ Social Care Services £38,000 01/06/2023 31/05/2024 New Requirement Proposal for Funding Page 91 of 214
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Reeltime Music Provision of the creative arts and sessions in a studio/workshop to develop skills, create and produce music. Education, Families & Justices/ Social Care Services £6,500 01/06/2023 31/05/2024 New Requirement Proposal for Funding Women’s Aid - MARAC Provision of effective management, co- ordination and administration of Multi Agency Risk Assessment Conferences (MARAC), on behalf of North Lanarkshire Council and North Lanarkshire Health and Social Care Partnership. Adult Services / Education, Families & Justices/ Social Care Services £48,624 01/07/2023 30/06/2024 New Requirement Proposal for Funding Autism Network Provision of specific knowledge, skill, experience and expertise from a curated organisation around: preventative and \ or anticipatory approaches, capacity building, developing skills and knowledge with staff involved in assessment and planning. influencing and shaping policy and strategy supporting people and families where Autism (Autistic people), neurodivergence and \ or complex need is a feature- of support requirements. Influencing and shaping approaches related to supporting people with complex care needs will predominantly, although not exclusively be people identified through the “Coming Home” *agenda. Adult Services / Social Care Services £10,000 01/11/2023 31/10/2024 New Requirement Proposal for Funding Mind of my Own Ltd Mind of my own Subscriptions – All in One. Education, Families & Justices/ Social Care Services £44,088 01/11/2023 31/10/2025 New Requirement Proposal for Funding Deaf Services Lanarkshire Provision of supports to the Deaf community to reduce inequalities for people with a sensory impairment accessing supports. Adult Services / Social Care Services £10,000 01/04/2023 31/03/2024 New Requirement Proposal for Funding Page 92 of 214
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12. Ethical Commissioning Our team responded to a request from the Scottish Government for Local Authorities to participate in a self-assessment of ethical commissioning to outline how the principles are currently embedded in commissioning and procurement practice at a local level. The assessment considered what currently works well, where there might be opportunities for improvement, what standards may be applicable, and any opportunities or barriers linked to the principles. The findings from self-assessments have been summarised and will inform a national implementation plan for ethical commissioning. The Quality Assurance team are part of an on-going working group being led and facilitated by IRISS to consider and shape training for procurement and commissioning teams. This working group aims to take forward the first four objectives within the national implementation plan referenced above. Commissioning and procurement teams are being asked by the Scottish Government to start the transition towards a National Care Service. This means working in a way that is grounded by ethical commissioning principles. The Quality Assurance team over the reporting period have participated in the Ethical Commissioning on line course available at Ethical commissioning in social care | Iriss This course is for: • Commissioning and procurement staff in public bodies • Providers of social care and support: managers and business development teams • Service managers in social work and social care • Members of Integrated Joint Boards There are 8 ethical commissioning principles in total which include Fair Working Practices and Full Involvement for People with Lived Experience. The self-assessment referenced above highlighted strengths around our procurement and commissioning approach being focused on Fair Work Practices. The Vision - By 2025, people in Scotland will have a world leading working life where fair work drives success, wellbeing and prosperity for individuals, businesses, organisations and for society. The Fair Work Dimensions Fair work is work that offers all individuals an effective voice, opportunity, security, fulfilment and respect. • It balances the rights and responsibilities of employers and workers. • It generates benefits for individuals, organisations and society. Community Benefits During 2023/24 Quality Assurance continued to increase focus on the delivery of community benefits, following new contract awards and implementation. Our approach means link Senior Officers meet with contractors to review, promote and encourage new initiatives that offer employment to people in the local community, youth training and training for people from disadvantaged groups, traineeships, apprenticeships, and volunteering opportunities. Page 93 of 214
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Scottish Living Wage Last year we reported that most contractors had indicated they were either already accredited as or were willing to become Scottish Living Wage employers. This trend continues with 98% of contractors who deliver advise, direct care & support are paying the Scottish Living Wage. The remaining 4% of contractors provide non- care related services or are within the cross- border category whereby the Scottish Living Wage does not apply. Full Involvement of People with Lived Experience Over the reporting period we will work to strengthen our involvement of people with lived experience in procurement and commissioning processes. The self-assessment we completed highlighted this as an area we must embed in all aspects of procurement and commissioning rather than pockets of activity. We will report on how this area develops next year. 13.Adult Support & Protection The Quality Assurance team have a vital role across social work in supporting commissioned services to respond in accordance with Adult Support & Protection legislation and North Lanarkshire Council policies and procedures. Quality Assurance team members also have a role in the identifying of patterns and themes arising from referral activity and for the analysis of other information sources which may suggest referrals are required. As the direct links to commissioned services Quality Assurance promote best practice in relation to Adult Support & Protection. Over the course of the reporting period the Quality Assurance team has expanded and due to this and the need for refresher training for existing team members, reflective of the revised Adult Support & Protection (Scotland) Act 2007 Code of Practice, the Adult Support & Protection Committee facilitated a training day for the team. The training content was tailored to the role of the Quality Assurance team and included a section on Large Scale investigations due to this area featuring highly within the Quality Assurance remit. The day provided an opportunity for the team to discuss Adult Support & Protection in the context of the Quality Assurance department policies and procedures to ensure linkage to localities and oversight of Adult Support & Protection activity within commissioned services. Discussions were able to centre around the role in Adult Support & Protection for Quality Assurance in terms of provider failures and establishing root causes for services which may indicate systemic failings. As a result of the training day and the discussions facilitated, there were various actions agreed to ensure consistency in approach, on-going learning and to build upon data collated and analysed. Quality Assurance continue to contribute to on-going monitoring, learning and development forums such as the Pan Lan ASP task force working group. This group was established with the aim of empowering care home managers to have confidence in their decision making around adult support 2% 98% Providers Paying Scottish Living Wage % N/a % Yes Page 94 of 214
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and protection. There have been wide ranging discussions about assessing the impact of ASP training and Quality Assurance took the lead in developing a Competency Framework which will be completed following participation in training delivered by the Adult Protection Committee. This framework is for internal and external colleagues and partner organisations. A test of change will take place over the coming months and an evaluation of whether this approach meets the intended outcomes will ensue. 14. Adult Health & Social Care Risk Management Quality Assurance have responsibility for the coordinating of the Adult Health & Social Care Risk Forum, for the facilitating of Adult Health & Social Care quarterly risk forums and for the reporting of risk to Core. Risk Forums have taken place 3 monthly during the reporting period. All activity takes place as designed within the Risk Management Corporate Risk Strategy. The risk champion within Quality Assurance attends Corporate Risk Management Meetings to ensure appropriate escalation and information sharing. Over the reporting period there has been focus on maximising attendance at risk forums, having appropriate membership, building participation and in achieving timely review of risks. Since the review of risk arrangements has taken place including discussion about roles and responsibilities and the revisiting of terms of reference attendance has increased significantly as has the enthusiasm of members. A Quality Assurance Risk Management mailbox has been set up for all communications risk related and there has been an improvement in the timescales for risk assessments being carried out. Quarterly and annual reports capture this information. Quality Assurance assist with devising any new risks and for carrying out an induction for any new members to the group. Education & Families and Justice representatives sit in the Adult Health & Social Care Risk Forum with risk information being directed to SMT Meetings. Quality Assurance link with Education & Families Risk Facilitators to establish priorities and effective reporting of risks within the field. Work in 2024/25 will focus on reframing some risks, supported by the Corporate Risk Team. The Risk Compliance Audit will also be implemented with a timescale of 6 monthly attached to this. Key findings will feature in reports to Core/SMT. It is expected that more advanced risk training will also be organised for risk champions and facilitators over the next reporting period. 15. Service and Contract Review Quality Assurance have been reviewing Registered Social Landlord Provision across North Lanarkshire over the past year. This review had commenced prior to the pandemic however was paused as a result. The review includes five providers of Sheltered/Very Sheltered/Supported Housing across a total of 12 developments. The purpose of the review is due to legacy funding arrangements and contracts having expired. Other local authorities have either carried out the review or have plans to do so imminently. The initial part of the review has included meeting with providers and gathering a range of data to assist in understanding the outcomes being achieved for people, how the different elements of service provision are being accessed and consideration of where there appears to be duplication of services. From the data it appeared that where people were assessed as requiring care and support individual packages of care were being provided by external providers including North Lanarkshire Council homecare services. The housing support services funded by North Lanarkshire Council and paid to Registered Social Landlords appeared to be utilised for social support and for in the event of an emergency situations. With access to emergency support available through the providers in house Page 95 of 214
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alarm service and also North Lanarkshire Council community alarms, as well as a range of sophisticated technology a recommendation has been made to withdraw housing support funding. North Lanarkshire Council fund a wealth of community supports which are accessible to people living in specialised housing and the Quality Assurance team have been promoting this, to ensure supports are unique to people’s wants and needs. Engagement sessions have commenced across the developments to consider the views of people and their families. Advocacy representatives have also attended to ensure that those who need support for their voice to be heard are empowered to do so. The outcome of the review will be communicated over the course of 2024.25. 16. Safer Staffing Quality Assurance have been liaising with the Care Inspectorate, other local authorities, commissioned services and internal colleagues to prepare for the implementation of the Health and Care (Staffing) (Scotland) Act 2019 which will be enacted on 1st April 2024. Preparations have included attendance at Care Inspectorate webinars, keeping abreast of all safer staffing developments and arranging for the Care Inspectorate to carry out an awareness raising session for the Quality Assurance team due to the responsibilities within the act when commissioning services. A further online session was arranged and open to all within North Lanarkshire Council. Between November 2023 and February 2024, Quality Assurance staff took part in a test which was arranged by the Care Inspectorate on behalf of the Scottish Government. North Lanarkshire were one of ten authorities involved in this. The purpose was to gather information around how prepared commissioned services were for the implementation of the act and any risks that could be identified due to the implementation of the act. Several methods were implemented to enable feedback to be captured and this included the establishing of a safer staffing working group, the devising of a questionnaire and analysis of this thereafter and having as an agenda item for monitoring visits, team meetings and provider forum meetings. The working group above has enabled the sharing of best practice and discussion around fears and apprehensions. Feedback has been that the group benefited from this approach and as learning will be on-going after enactment the group will run for the first year of implementation. This will provide a forum to measure impact of the legislation. There is a requirement for local authorities to produce an annual report for safer staffing and this will be the role of Quality Assurance. To enable the on-going compliance of the requirements of local authorities when commissioning services, work has been carried out to modify our contract management framework and associated terms and conditions. 17. Care Home Governance & Assurance A review of the enhanced clinical and care oversight arrangements for care homes took place during this reporting period. The purpose of this was to ensure continued support for care homes supporting adults and older people by building upon the learning from the arrangements implemented during the COVID pandemic. It has been widely recognised that although we are post pandemic significant achievements have been made in maximising opportunities for partnership working and the outcome of the review captures the ethos of collaboration, sector expertise, access to healthcare and supporting workforce development. Page 96 of 214
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The functions of the Care Home Assurance and Support Board are: - • Ensure assurance and support to CH sector continues in context of Excellence in Care, including IPC direct Support and embedding of the National Infection Prevention and Control manual • Oversee whole system support to care homes to improve health and wellbeing of adults living in care homes through implementation of My Health, My Care, My Home – healthcare framework for adults living in care homes and Health and Social Care Standards in Scotland • Ensure collaborative improvement model is utilised in all developments with care homes • Ensure systems and processes are in place to share intelligence between agencies to identify and allow support to be provided to care homes at risk. • Ensure systems and processes are in place to provide immediate response to serious concerns to mitigate risks • Monitor overall capacity of sector – identify risks and mitigate where possible • Ensure contingency plans are in place for the sector and regularly updated. The Care Home Assurance and Support Board also has two subgroups established. These are the Care Home Governance Group and Care Home Healthcare Framework Implementation Group. It is envisaged that following an initial gap analysis of the Healthcare Framework these two subgroups will merge with implementation of the Healthcare Framework continuing to be monitored and evaluated. Collaborative Group - The Care Home Governance Group and the Healthcare Framework implementation Group have been aiming for attendance and participation from care home managers/family members however to date representation has been low. To ensure two-way feedback Quality Assurance implemented a Collaborative Group with the aims being to ensure the voice of care home representatives are heard, to discuss the recommendations- and actions identified in the gap analysis and to feed information to and from the wider groups. The group also offers peer support and a shared learning experience and there is representation from health colleagues and Scottish Care. Care Home Provider Forum – Quality Assurance have reestablished Care Home Provider Forums which were stood down due to the pandemic. An initial meeting took place with care home managers to consider what format would work for them. It was agreed that an informal setting which could be in person or via teams, with key speakers attending and the availability of peer support would progress. Forums take place quarterly. 18. Complaints Quality Assurance retains an overview role in terms of complaints made about Social Work service provision. Regular quarterly reports on complaints activity are reported through our governance structures. The annual summary and analysis of complaints received over the period 2023/24 is attached as appendix 1. 19. Duty of Candour Duty of Candour is a statutory duty on Scottish organisations providing health and social care. The responsibility is to remain open and honest when something goes wrong, that is not related to the course of the condition for which the person is receiving care. An annual report capturing Duty of Candour activity is a requirement of the Council and the report for 2023/24 is attached as appendix 2. Page 97 of 214
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20. Quality Assurance Planned Developments This report has covered Quality Assurance activity undertaken during the period 1 April 2023 to 31 March 2024 and highlights progress made in key activities noted in the last reporting period. Several developments outlined below are in progress or planned for the period 2024/25 and we will provide updates in future reports. • Social Work Self Evaluation • Establishment of ASW Governance Subgroup • Safer Staffing Annual Report • On-going development of collaborative working groups – Safer Staffing, Care Home Governance & Contract Monitoring • Developments aligning with the principles of ethical commissioning • On-going social work induction & development planning/Social Work Policies & Procedures Review Group • Duty of Candour Reporting Processes • Awareness raising sessions delivered to Localities • Conclusion of RSL Review • Reframing of risks & 6 monthly compliance audits of risk register • Care Opinion Newsletter • Evaluation of In-House Monitoring Framework/Roll out In House Monitoring Framework • Continued evaluation of ASP practices across QA and commissioned services • Launch of the Engagement and Participation Strategy • Introduce modified contract monitoring processes • Compile and report on quarterly performance reports • Involvement in B2B Enabling Approach • Implement learning in relation to CSWO Report Page 98 of 214
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Socia Work Complaints Annual Report 2023-2024 Annual Complaints Report 2023-2024 Social Work [Adults and Education, Families & Justice] Appendix 2 Page 99 of 214
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Introduction This report provides an overview of Social Work’s performance in terms of handling complaints received between 1 April 2023 and 31 March 2024 and covers Adults and Education, Families & Justice. This report describes how complaints have been managed by social work services, details the number and nature of complaints received during the year and demonstrates our commitment to learning and improvement. Complaint Process We always aim to provide the highest possible quality of service across our communities and are committed to ensuring accountability and transparency. We recognise there are times when we get things wrong and fail to meet the expectations of those who use our services. We welcome feedback as it provides information that helps us to learn from complaints and shape and improve the way services are delivered. Complaints are viewed as a positive communication tool and are actively encouraged. As per the Scottish Public Services Ombudsman [SPSO] definition, we regard a complaint as any expression of dissatisfaction, by one or more members of the public, about our action or lack of action, or about the standard of service provided by us or on our behalf. Anyone can make a complaint, either verbally or in writing, face to-face, by phone, letter or email. People are directed and encouraged to use the North Lanarkshire Council online portal to make a complaint but retain the right to use any of the aforesaid options. A two-stage statutory social work complaints process was introduced on 1 April 2017, which harmonised complaint handling processes across all council services. The process is as follows: • Stage one – ‘frontline resolution’: we will always try to resolve complaints quickly, within five working days, and in exceptional circumstances extend for a further five days. • Stage two – ‘investigation’: if people remain dissatisfied with our stage one response, they can escalate their complaint to stage two. Complaints that are complex or need detailed investigation from the outset can be looked at immediately at stage two. These complaints will be acknowledged within three working days and a written response provided within twenty working days; this can be extended in exceptional circumstances. Following completion of the complaints process, if the person remains dissatisfied, they can ask the SPSO to consider their complaint further. We always advise of this entitlement and provide contact details. Complaint activity There remained a residual effect of the Covid 19 pandemic in terms of the numbers of complaints received in 2023-2024. However, complaint activity has been slowly returning to pre-covid levels. Overall, 205 complaints were received in the reporting period, a decrease of 16 [7.5%] from 2022- 2023. A breakdown of locality complaints are noted below: Page 100 of 214
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Education & Families 96 complaints were received in relation to Education & Families services in the reporting period, 96 received last year, so no change. The chart below is a summary of locality complaint activity for Education, Families and Justice services. Adult Social Work Services 109 complaints were received for adult services for the period, 140 received last year, a decrease of 31 [25%]. The chart below is a summary of locality complaint activity for Adult Social Work Services. Performance Indicators The Complaints Standard Authority developed a suite of four mandatory performance indicators in association with the Local Authority Complaint Handlers Network on which we are represented. These indicators [undernoted] are a valuable source of information as they help to identify recurring 13 14 10 12 15 17 15 Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw HQ Education & Families 20 6 19 16 11 23 14 Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw HQ Adult Services Page 101 of 214
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or underlying issues, derive/drive learning from complaints and highlight potential areas for improvement. • Indicator One: the total number of complaints received. • Indicator Two: the number and percentage of complaints at each stage that were closed in full within the set timescales of five and 20 working days. • Indicator Three: the average time in working days for a full response to complaints at each stage. • Indicator Four: the outcome of complaints at each stage. Education and Families – Performance Information Compliance with target statutory timeframes to complete complaint. Undernoted graphic depicts the aderhance to statutory timeframes. At Stage 1, 19% failed to meet response times, 51% did meet response times, 30% required an extention and were completed within 10 working days. Stage 2, 27% failed to meet statutory timeframes, 56% Cause of Complaints The cause of complaint is not always recorded, for those complaints that have a recorded cause, the detail is noted below: Page 102 of 214
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Cause of Complaints [Stage 1] Cause of Complaints [Stage 2] Complaint Outcome Page 103 of 214
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Adult Social Work Services – Performance Information Compliance with target statutory timeframes to complete complaint Undernoted graphic depicts the aderhance to statutory timeframes. At Stage 1, 15% failed to meet response times, 51% did meet response times, 34% required an extention. Stage 2, 16% failed to meet statutory timeframes, 79% met timeframes, 5% required an extenstion. Cause of Complaints As noted with the Education & Families data, the cause of complaint is not always recorded. For those complaints that have a recorded cause, the detail is noted below: Cause of Complaints Stage 1 Page 104 of 214
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Stage 2 Complaint Outcome Comments and compliments. Across social work, ten compliments were made 2023-2024 – seven were positive, three were neutral. 5 other comments were logged – all of which were neutral in sentiment. Learning from Complaints The learning from all social work complaints this year have highlighted: • The importance of good communication. • The need to ensuring that those who use our services and their carers have appropriate information. • The need for robust forward planning. Page 105 of 214
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• The need to ensure that equipment is clean and fully maintained prior to supply. • The need to improving information and advice for those who need to contact and seek support from social work services. • That people have the right to use their Self-directed Support (SDS) individual budgets as creatively as necessary to reach their agreed outcomes. • The need to park vehicles with courtesy. • Necessity to dispose of PPE and other personal waste responsibly. Outcomes are often specific to the complaint, but when there are organisational learning points that influence policy or procedure, we need to ensure these are acted upon. Individual learning is dealt with directly with the complainant and through supervision, and more general issues are managed through supervision with team members and reminders at team meetings. 32% of all social work complaints recorded did not record any learning outcomes, whilst 41% were attributed to communication/staff attitude as the principal cause of complaints. 27% related to other issues such as courteous parking, failure to provide services, quality of service, provision of OT equipment. We recognise the importance of learning from complaints and acknowledge that having a learning outcome recorded is an area that requires attention. We understand that complaints help organisations learn more about the experiences of people who use their services, and that complaints can be helpful to enable us to work in a better way. At present, learning from complaints is a non-mandatory performance indicator. However, the Scottish Public Services Ombudsman are interested in the systemic changes that are made following complaints. Going forward, we will work directly with our central and locality teams to ensure better recording and learning from complaints is embedded in practice to ensure quality services are delivered. Scottish Public Services Ombudsman The SPSO considered eight complaints throughout 2023-2024 six of which they decided not to follow up, one was withdrawn by the complainant. In another complaint, the SPSO recommended that we compensate a complainant for loss of kinship care allowance. A payment was suggested and accepted by the complainant. 83 66 24 16 16 Learning outcomes Communicaton No learning outcome Service improvement Improve process Miscellaneous Page 106 of 214
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Child Friendly Complaints Procedure The SPSO are introducing a new Child Friendly Complaints Procedure, which we expect will be launched in July 2024. This procedure will ensure that children’s rights under the United Nations on the Rights of the Child [UNCRC] are met through a child-centred complaint process. Their aim is to co-design and implement a public sector complaints service that meets children’s rights and needs. They are working in co-operation with children, young people, public bodies and wider stakeholders. Initially, it was envisaged that the new procedure would be fully implemented by 1 April 2024. However, following feedback from engagement and testing work, a more targeted pilot was undertaken by Aberdeen Health and Social Care Partnership. The aim of the test site was to test the new approach in practical settings, both to ensure it results in the right outcomes for children, and that it is efficient, practical, and workable for the public sector bodies managing the process. Their experiences have influenced the shape and scope of the updated procedures. Full guidance on the new process should be made available by summer 2024. Care Opinion Care Opinion is a non-profit organisation, web-based feedback platform funded mainly through subscriptions from health and care organisations. At present, 500 health and social care organisations use Care Opinion across the UK. People submit stories to share their experiences of health and social care services. These can be both positive and negative, and are moderated by Care Opinion staff, and quickly forwarded to the relevant area of service who can respond directly to the story. We recognise the importance of feedback; it is considered integral to quality improvement. For staff, it gives an opportunity to see the system and the service provided through the person’s eyes. • 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. To further support the use of Care Opinion as a vehicle to promote feedback on services, our revised Contract Management Framework requires all contracted providers, through their quarterly monitoring return, to report on their use and promotion of Care Opinion as a method of seeking feedback. We are also expanding the service tree to incorporate commissioned organisations if they wish to be included within the subscription. Training Training on the Dynamics system, where complaints are recorded, is offered as required. The licence allocation system has recently been reviewed, and licence permissions granted only to management support team members and to system administrators. Rationalisation of licence holders has increased opportunities to have closer collaboration and training across all services. Colleagues in Chief Executive’s office lead on training on system issues, and Quality Assurance Senior Officers lead on complaint handling training. Quality Assurance Quality Assurance senior officers provide training and support to social work managers and teams in relation to the complaint handling process. A suite of letter templates are available, which provide guidance on model answers and best practice when engaging with complainants. Complaints are often Page 107 of 214
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routed directly through the Quality Assurance officer who acknowledges receipt and assigns complaints to the relevant team manager. Guidance on response times and content is provided. A review of how a complaint was handled was undertaken by a Quality Assurance officer whose findings were reported to the Care and Clinical Governance Group. Complaints that relate to both health and social work/social care services are routed through the relevant lead organisations complaints process, but there is an integrated approach to resolution and any joint learning outcomes are shared. Conclusion The principal cause of complaints continues to identify poor staff communication, staff attitudes and quality of service. This is further reflected within the learning outcomes, which indicate the need to improve communication, practice and approach to those using social work services. As a service we are committed to improving learning from complaints, which is also one of the key performance indicators that are reportable to the SPSO. We will, over the course of 2024-2025 place further emphasis on identifying and applying learning from complaints, recording learning outcomes and evidencing subsequent improvements. We will also emphasise the need to ensure that all complaints are dealt with in the identified timeframes, with clear communication of outcomes. Although 100% of complaints that were sent directly to social work were acknowledged by the due dates, only 58% overall were completed within statutory timeframes. Complexity of issues, new processes, staffing, IT systems and very tight time frames for resolution were the contributory factors in failure to complete all complaints within time. Improvement in these areas is expected in 2024-2025. Further actions – 2024-2025 Several key actions have been identified to strength our approach when dealing with complaints including using the learning to improve the quality of experience for those who use our services. Many are continuing or legacy commitments made in former years and remain valid objectives. The actions are: 1. We will audit all complaints over the course of 2024 -2025 to ensure that the procedures are understood and followed. Legacy action that is on-going. 2. We aspire to ensure that logging actions and learning from complaints is done consistently to support the improvement of services that support people across our communities. 3. We will develop a programme of reflective learning sessions across teams - Complaint activity and learning remain an agenda item in team meetings and links across services and localities are maintained with Quality Assurance Senior Officer who will review complaint activity as required. Learning sessions were delivered to home support staff across all localities. 4. We will continue to promote Care Opinion as one of the key mechanisms for engaging with members of the public and to generate meaningful feedback. Further resources have been deployed to assist with this activity – a one-page newsletter/precis of Care Opinion will be drafted and circulated to all social work staff to support further usage and promotion of Care Opinion. 5. We will provide system training to all members of the management support teams who now have responsibility for logging and tracking complaints. This action has been hampered Page 108 of 214
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6. We will offer complaint handling training sessions on at least a quarterly basis as a refresher session, or for training for new staff. Training sessions are offered on an ad hoc basis, and as required by individual teams. 7. A further legacy action from 2022-2023 is the roll out and implementation of Child Friendly Complaints Handling Procedures. The SPSO have now indicated that Child Friendly Complaint Handling will not be a separate procedure per se, but practice guidance to ensure that the rights of children and young people, conferred by the UNCRC, are protected Page 109 of 214
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Duty of Candour Report: 2023-2024 Appendix 3 Page 110 of 214
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Introduction North Lanarkshire Council (NLC) recognises that when adverse events occur during the provision of treatment or care, openness and transparency is fundamental. The Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016 was implemented on 1st April 2018 placing an organisational duty (Duty of Candour) on health, care, and social work services to be open and honest with people in their care. The Duty of Candour arrangements which we have implemented reflect the Scottish Government’s commitment to place people at the heart of health and social care services in Scotland. When harm occurs the focus must be on personal contact with those affected; support, and a process of review and action that is meaningful and informed by the principles of learning and continuous improvement. The overall purpose of this duty is to ensure organisations are open, honest, and supportive when there is an unexpected or unintended incident resulting in death or harm as defined in the Act. All health and social care services in Scotland have a Duty of Candour, a legal requirement which means that when things go wrong and mistakes happen, the people affected understand what has happened, receive an apology, and that organisations learn how to improve for the future. A part of this duty is that Health and Social Care services publish an annual report about the Duty of Candour in our services. This report describes how our services have met Duty of Candour requirements between 1 April 2023 and 31 March 2024. When must the Duty of Candour procedure be activated? Organisations must activate the Duty of Candour procedure as soon as reasonably practicable after becoming aware that: • an unintended or unexpected incident occurred in the provision of the health, care or social work service provided by the organisation as the responsible person. • in the reasonable opinion of a registered health professional not involved in the incident: (a) that incident appears to have resulted in or could result in any of the outcomes mentioned below. (b) that outcome relates directly to the incident rather than to the natural course of the person’s illness or underlying condition. It is important to note that where the Duty of Candour procedure start date is later than one month after the date on which the incident occurred, an explanation of the reason for this has to be provided to the relevant person. The relevant outcomes are as follows: (a) The death of the person. (b) Permanent lessening of bodily, sensory, motor, physiologic or intellectual functions (including removal of the wrong limb or organ or brain damage) (“severe harm”). (c) Harm, which is not severe harm, but which results in one or more of the following criteria: • an increase in the person’s treatment. • changes to the structure of the person’s body. • the shortening of the life expectancy of the person. • an impairment of the sensory, motor or intellectual functions of the person which has lasted, or is likely to last, for a continuous period of at least 28 days. • the person experiencing pain or psychological harm which has been, or is likely to be, experienced by the person for a continuous period of at least 28 days. Page 111 of 214
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Or where: The person requires treatment by a registered health professional in order to prevent: • the death of the person. • any injury to the person which, if left untreated, would lead to one or more of the outcomes mentioned above Information about policies and procedures All staff who are employed in the sector should be aware that all instances that necessitate implementation of Duty of Candour must immediately be reported. In such instances, organisations must then take the appropriate action, ensuring relevant bodies [depending on the sector] such as Social Work and \ or Care Inspectorate are notified of the event. Where an incident occurs that triggers the Duty of Candour, organisations have responsibility for ensuring that the Duty of Candour procedure is followed. Training sessions on Duty of Candour were delivered to 60 home support managers and staff throughout 2023-2034. We will continue to provide support and training when necessary to minimise the impact on the organisation and the vulnerable people that we strive to support. Information on Duty of Candour and reportable incidents is described in detail within Appendix 1. All North Lanarkshire Council Social Work In-house services are required to adhere to Duty of Candour reporting requirements. Initial notifications are made when reporting accidents and incidents in accordance with North Lanarkshire Council internal CIRUS system. How many incidents happened to which the Duty of Candour applies? Over this reporting period, there were no Duty of Candour related incidents reported by North Lanarkshire Council care and support services. Conclusions The requirements for Duty of Candour are such that the number of relatable incidents are generally low nationally. Duty of Candour related knowledge and reporting requirements will continue to be a statutory reporting requirement if or when, they do occur. The actions described below are intended to ensure that there is an ongoing focus on Duty of Candour. Actions If in the future, should any incidents occur that invoke Duty of Candour proceedings, there will be a review process to identify any lessons learned and the result of any such review will be shared with the relevant person/persons. Awareness raising sessions regarding Duty of Candour will be undertaken with commissioned services over the year. Page 112 of 214
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Appendix 1 – Definition of Harm and appropriate level of response Grading of Harm Definition of Harm Level of Response No harm, incident prevented Any service user safety incident that had the potential to cause harm but was prevented. These incidents are outside of the scope of the Duty of Candour. Social work professionals may however feel it is appropriate to inform the person involved if it is in their best interest. No harm, incident not prevented Any service user safety incident that occurred but no harm was caused to the person involved. These incidents are outside of the scope of the Duty of Candour policy. Being open in a discussion between staff involved and the service user and their family is usually undertaken locally. Low Harm Any service user safety incident that led to the extra observation or minor treatment such as first aid or additional medication for the person involved. These incidents are outside of the scope of the Duty of Candour policy. Being open in a discussion between staff involved and the service user and their family is usually undertaken locally. Moderate Harm A level of harm that is not permanent but has led to a moderate increase in treatment or prolonged psychological harm of more than 28 days. For example, a return to theatre, an unplanned readmission to hospital, unexpected admission to critical care, a prolonge hospital stay or additional out service user visits. Duty of Candour is a statutory requirement. Notification should be given to the person affected or their representative in person including an explanation of the incident, the process for investigation and an apology. This will be followed up in writing and on conclusion of the investigation the findings and outcome will be available to the service user of their representative. Serious Harm Any service user safety incident that has resulted in permanent harm that is directly related to the incident and not the natural course of an illness or the underlying condition of the person affected. Examples of severe harm are permanent lessening of bodily functions, sensory, motor, physiological or intellectual function, removal of the wrong organ or limb or brain damage. Duty of Candour is a statutory requirement – see above. Death Any service user safety incident that directly resulted in the death of a person and is not related to their illness or underlying condition. Duty of Candour is a statutory requirement – see above. Page 113 of 214
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref AG/QA Date 19/11/24 Annual Report of the Chief Social Work Officer 2023/24 From Alison Gordon, Chief Officer (Chief Social Work Officer - Children, Families, Justice and Integrated Services - Education & Families) E-mail GordonAl@northlan.gov.uk Telephone 01698 332001 1. Background 1.1 The requirement that each local authority appoint a professionally qualified Chief Social Executive Summary In line with Scottish Government guidance the Chief Social Work Officer (CSWO) is required to provide an annual report. This report provides an overview of social work service delivery in North Lanarkshire for the period April 2023 to March 2024 and cover the following areas: • Governance and accountability arrangements, including partnership working. • Service Quality and Performance, including service developments. • Resources • Workforce • Future Priorities The North Lanarkshire CSWO Report 2023/24 is attached as an appendix to this report. The report also reflects social work’s contribution to the Programme of Work underpinning the Plan for North Lanarkshire. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Approve the report. (2) Note that approval of the report will also be sought through the Education, Children, and Families Committee. The Plan for North Lanarkshire Priority All priorities Ambition statement All ambition statements Programme of Work All Programmes of Work Item 7 Page 115 of 214
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Work Officer is contained in Section 45 of the Local government (Scotland) Act 1994. Statutory Guidance on the role of the Chief Social Work Officer was updated in 2016, to reflect the impact of Health and Social Care integration, extending the responsibilities of the role to provide advice to the Integration Joint Board (IJB). In addition to providing advice both to the Local Authority and IJB in relation to the discharge of statutory social work functions the role continues to carry key responsibilities for professional leadership, values, and standards both for directly provided and commissioned services. 1.2 Social Work Services in North Lanarkshire continue to play a lead role in supporting and safeguarding our communities. Adult Social Work and Social Care Services are delivered through Health and Social Care North Lanarkshire (HSCNL) whilst Children, Family and Justice Services are delivered through the Council’s Education and Families Service. 1.3 The CSWO role requires to be undertaken by one designated individual, delegation of responsibilities is permitted where required by the scale of business. In North Lanarkshire this means that the Chief Officer Adult Social Work Services, routinely exercises delegated responsibilities for decision-making and professional standards within adult services as well as providing support and cover with respect to the wider functions of the CSWO role. 1.4 The Annual Chief Social Work Report is intended to provide a key overview of social work service delivery and performance. The Office of the Chief Social Work Advisor (OCSWA) also produces a national report each year which draws on key themes and messages from CSWO reports across Scotland. 2. Report 2.1 Social Work in North Lanarkshire employs around 2,800 staff and in collaboration with commissioned services and third sector partners provides to around 30,000 individuals and families at any one time. Social work also makes a key contribution to wider partnership and community activity. 2.2 As illustrated within the report partnership working is fundamental to social work at every level and a key aspect of the CSWO role involves developing and sustaining partnership working and relationships across a range of organisations and structures. In addition to the specific responsibilities of the CSWO to the Council and HSCNL, the CSWO holds a key leadership role within several local partnerships as well as contributing to the wider national social work community. Social Work also plays a key role within the Council’s Programme of Work in particular, but not limited to, work being progressed under the Resilient People programme. Equally many of the aspirations of the wider programme including the core commitment to inclusive growth are critical to those in our communities most likely to require social work support. 2.3 Whilst the delivery of core statutory responsibilities including for public protection remain a significant part of social work service delivery, social work also plays a key role in early support and both primary and secondary prevention as highlighted within the report. Income maximisation and tackling poverty also continue to be key strands in the delivery of social work and social care in North Lanarkshire. These have become increasingly integrated into day-to-day practice and service delivery and have a strong fit with the core values of social work. Equally important and threaded through the activity reflected within this year’s report is a commitment to relationship based and trauma-informed practice. Page 116 of 214
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2.4 Demand for social work services has continued to increase across all social work care groups continuing a trend which has seen this increase beyond pre-pandemic levels however as reflected within the report the service has continued to maintain a strong ‘balance of care’ meaning that a high proportion of those receiving support receive this within the context of their own homes and communities. There has also over recent years been an increased focus on the area of ‘transitions’ to ensure those receiving support do not face a ‘cliff edge’ as they move between child and adult life or between services or statutory and voluntary supports. Whilst further work is still required in these areas progress in this is evidenced in the steadily growing number of young people supported in continuing care and in those in receipt of voluntary throughcare from justice services. 2.5 External scrutiny of social work services is undertaken primarily through the Care Inspectorate and its partner agencies. In addition to ongoing inspections of regulated services a Joint Inspection of Services for Children and Young People at Risk of harm in North Lanarkshire took place between April and October 2023 evaluating the impact of services on children and young people as Very Good and identifying a number of key strengths including in respective of collaborative leadership and the strong relational and trauma informed approaches which supported staff form trusting relationships with children, young people and their families. 2.6 Staff commitment and resilience has continued to be strong although as reflected in Section 5 of the report there remain staffing pressures in key areas including with respect to home support services, the mental health officer workforce, administrative support and other social care roles. A range of initiatives to support staff recruitment and retention against a challenging backdrop is outlined within the report and a number of these including the updating and re-evaluation of main grade social worker and occupational therapy roles have contributed to a reduction in vacancies in this critical area of the workforce. 2.7 Both despite and in response to pressures the service has continued to innovate including in the use of digital technology and has also continued to strengthen the involvement of those with lived experience in planning. 2.8 Looking forward the report reflects on future challenges including the likely increase in financial pressures, in part arising from the ending of temporary funding streams. but also identifies opportunities to build on successful areas of practice, and strong partnerships to continue to work holistically and in particular to improve early support to strengthen and empower individuals, families and communities. 3. Measures of success 3.1 N/A – Annual Report to meet reporting requirement. A range of outcome measures, KPIs and specific service standards are applied across social work services. 4. Supporting documentation 4.1 Appendix 1: Annual Report of the Chief Social Work Officer 2023/24 Alison Gordon Chief Social Work Officer Page 117 of 214
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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? No direct impact though the report provides key evidence that the effective delivery of social work services supports the Council in their delivery of Fairer Scotland Duty. As this is a retrospective report no EQIA is required 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? All recruitment is in line with our workforce plans and governed through the appropriate routes. 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? All statutory requirements are met through the role and function of the CSWO. 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 118 of 214
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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? Whilst digital developments are a feature of service improvement and delivery within social work all relevant changes reflected within the report have already been considered through relevant governance processes. 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? Key risks highlighted within the report are incorporated in relevant risk registers. The report itself is part of a wider framework of reporting which supports the scrutiny of social work services and therefore aids the Council in its duties with respect to the delivery of key statutory functions. 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. Where relevant issues are considered in planning for individual’s support, Page 119 of 214
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the service will also continue to consider the benefits of enhanced arrangement for groups of service users. An example of this is within our Restorative Justice Service which has both a veteran’s group and has also previously contributed through unpaid work to linked community projects. 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 ☒ No direct impact though the report provides key evidence that the effective delivery of social work services supports the Council duty. As this is a retrospective report no CRWIA is required 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 120 of 214
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1 Chief Social Work Officer Annual Report 2023 - 2024 Page 121 of 214
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2 ANNUAL REPORT BY CHIEF SOCIAL WORK OFFICER: NORTH LANARKSHIRE 2023-2024 ............................................... 4 THE CHIEF SOCIAL WORK OFFICER FUNCTION .................................................................................. 4 ANNUAL REPORT ................................................................................................................................ 4 1. GOVERNANCE AND ACCOUNTABILITY ARRANGEMENTS ............................................................................................ 6 1.1 NORTH LANARKSHIRE COUNCIL AND NORTH LANARKSHIRE PARTNERSHIP ............................. 6 1.2 HEALTH AND SOCIAL CARE NORTH LANARKSHIRE ...................................................................... 8 1.3 SUPPORT, CARE, PRACTICE AND STAFF GOVERNANCE ARRANGEMENTS .................................. 8 1.4 CARE HOME ASSURANCE ............................................................................................................. 9 1.5 ENGAGEMENT WITH THE PEOPLE WHO USE SUPPORT SERVICES AND THE COMMUNITY AND VOLUNTARY SECTOR .............................................................................................................................................. 10 2. SERVICE DEVELOPMENT, QUALITY AND PERFORMANCE .......................................................................................... 11 2.1 PERFORMANCE AND IMPACT MEASUREMENT ......................................................................... 11 2.2 SUPPORT TO UNPAID CARERS .................................................................................................... 12 2.3 JUSTICE SOCIAL WORK SERVICES ............................................................................................... 12 2.3.1 COMMUNITY PAYBACK ORDER - INCLUDING UNPAID WORK ...................................................................... 13 2.3.2 OTHER ACTIVITY ............................................................................................................................................ 13 2.3.3 DIVERSION FROM PROSECUTION ................................................................................................................. 14 2.3.4 OFFENCE FOCUSED WORK ............................................................................................................................ 14 2.3.5 MOVING FORWARD TO CHANGE (MF2C) ..................................................................................................... 15 2.3.6 WOMEN’S COMMUNITY JUSTICE SERVICE (WCJS) AND BAIL SUPERVISION ............................................... 15 2.3.7 NEW DEVELOPMENTS: ENHANCEMENT OF VOLUNTARY THROUGHCARE AND DRUG AND ALCOHOL SOLUTIONS COURT ................................................................................................................................................. 15 2.3.8 THROUGHCARE: ARREST REFERRAL .............................................................................................................. 16 2.4 CHILDREN AND FAMILIES SOCIAL WORK SERVICES ................................................................... 16 2.4.1 THE BALANCE OF CARE .................................................................................................................................. 17 2.4.2 MOVING ON: SUPPORTING CARE EXPERIENCED YOUNG PEOPLE ............................................................... 18 2.4.3 A LOVING HOME: ADOPTION, FOSTERING & KINSHIP CARE ....................................................................... 19 2.4.4 INTENSIVE FAMILY SUPPORT ......................................................................................................................... 21 2.4.5 YOUNG PEOPLE IN CONFLICT WITH THE LAW .............................................................................................. 23 2.4.6 CHILDREN WITH ADDITIONAL SUPPORT NEEDS........................................................................................... 24 2.5 ADULT SOCIAL WORK SERVICES ................................................................................................. 24 2.6 EARLY AND PREVENTATIVE INTERVENTIONS – RIGHT SUPPORT, RIGHT TIME .......................... 25 2.6.1 GETTING IT RIGHT FOR EVERYONE (GIRFE) .................................................................................................. 25 2.6.2 MAKING LIFE EASIER ..................................................................................................................................... 25 2.6.3 ASSISTIVE TECHNOLOGY TEAM ..................................................................................................................... 26 2.6.4 COMMUNITY ALARMS .................................................................................................................................. 26 2.6.5 EQUIPMENT & ADAPTATION SERVICE (EAS) ................................................................................................. 27 Page 122 of 214
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3 2.6.6 INTEGRATED DAY SERVICES (IDS) .................................................................................................................. 27 2.6.7 HOME ASSESSMENT TEAM (HAT) ................................................................................................................. 27 2.6.8 HOME SUPPORT SERVICE .............................................................................................................................. 28 2.6.9 TRANSFORMATIONAL SELF-DIRECTED SUPPORT (SDS) AGENDA & INDIVIDUAL BUDGETS ....................... 29 2.6.10 COMMUNITY LIVING CHANGE FUND/COMING HOME ....................................................... 29 2.7 DIGITAL SYSTEMS TRANSFORMATION ............................................................................................................. 30 3. STATUTORY INTERVENTIONS ...................................................................................................................................... 31 3.1 MENTAL HEALTH OFFICERS SERVICE AND ADULTS WITH INCAPACITY ACT (SCOTLAND) 2000 . 31 3.2 MENTAL HEALTH (CARE AND TREATMENT) ACT 2003 AND MENTAL HEALTH (SCOTLAND ACT 2015) 32 3.3 DEVELOPMENT OF MHO SERVICE TO MEET NEEDS .................................................................. 33 3.4 APPROPRIATE ADULT SERVICES ................................................................................................. 33 3.5 PUBLIC PROTECTION .................................................................................................................. 34 3.5.1 ADULT SUPPORT AND PROTECTION VESTIGATIONS/CASE CONFERENCES AND STATUTORY ORDERS/ FUNCTIONS ............................................................................................................................................................. 34 3.5.2 MAPPA (MULTI-AGENCY PUBLIC PROTECTION ARRANGEMENTS) ............................................................... 35 3.5.3 CHILD PROTECTION INCLUDING CONTEXTUAL SAFEGUARDING ................................................................. 36 3.5.4 GENDER BASED VIOLENCE ............................................................................................................................ 39 4. RESOURCES ................................................................................................................................................................. 40 4.1 FINANCIAL MODELLING FOR SERVICE DELIVERY ....................................................................... 41 5. WORKFORCE ............................................................................................................................................................... 41 5.1 WORKFORCE PLANNING ............................................................................................................ 41 5.2 SOCIAL WORK RECRUITMENT AND RETENTION........................................................................ 42 5.3 SOCIAL CARE ............................................................................................................................... 43 5.4 OTHER RECRUITMENT AND RETENTION CHALLENGES ............................................................. 44 5.5 CARE ACADEMY .......................................................................................................................... 44 5.6 WORKFORCE DEVELOPMENT AND STAFF SUPPORT ................................................................. 44 5.7 ASSESSMENT CENTRE AND REGISTRATION ................................................................................ 45 5.8 POST GRADUATE OPPORTUNITIES ............................................................................................. 45 5.9 SOCIAL WORK DEGREE PATHWAY WITH THE OPEN UNIVERSITY .............................................. 45 5.10 STUDENT SOCIAL WORK HUB .................................................................................................. 45 5.11 NEWLY QUALIFIED SOCIAL WORK PROGRAMME .................................................................... 46 5.12 OTHER KEY TRAINING AND DEVELOPMENT ACTIVITIES ......................................................... 46 5.13 TRAUMA INFORMED PRACTICE ............................................................................................... 47 5.14 REVISION OF SUPERVISION POLICY ......................................................................................... 47 5.15 SUPPORT FOR STAFF WELLBEING ............................................................................................. 48 6. LOOKING FORWARD – PRIORITIES FOR 2024-2025 AND BEYOND ............................................................................ 48 Page 123 of 214
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4 ANNUAL REPORT BY CHIEF SOCIAL WORK OFFICER: NORTH LANARKSHIRE 2023-2024 THE CHIEF SOCIAL WORK OFFICER FUNCTION Every local authority must appoint a professionally qualified Chief Social Work Officer (CSWO) as reflected in Section 46 of the Local Government (Scotland) Act 1994. The CSWO provides professional leadership, accountability, and governance, for the delivery of social work and social care services, including commissioned services. The CWSO also provides advice on social work service delivery and on related issues to the local authority Chief Executive, Elected Members, and the Integrated Joint Board (IJB) promoting understanding of the range of social work and social care services, and the complexities involved in delivering statutory responsibilities which require both consideration of need and the management of risk and liberties. The then Scottish Office specifically recognized that the need for the CSWO role was driven by “the particular responsibilities which fall on social services in that they affect personal lives, individual rights and liberties to an extent that other local authority services do not.” (Circular: SWSG2/1995 May 1995). Operationally the CSWO also has a direct remit for decisions on specific statutory matters including in relation to secure accommodation, adoption and welfare guardianship as illustrated below. A further aspect of the CSWO role is to inform the delivery of wider services which support or impact on social welfare. The CSWO role within North Lanarkshire is held by the Chief Officer, Children, Families, Justice, and Integrated Services however the CSWO is supported by the Chief Officer, Adult Social Work Services who holds delegated responsibilities with respect to adult social work and social care, deputises in other areas as required and works alongside the CSWO in relation to the other functions of the role. ANNUAL REPORT In line with Scottish Government guidance, the CSWO is required to provide an annual report. This report provides an overview of social work service delivery in North Lanarkshire for the period April 2023 to March 2024 and covers the following areas: • Governance and accountability arrangements, including partnership working and statutory functions • Service Quality and Performance, including key service improvement activity and challenges impacting on service delivery • Resources • Workforce Issues, including workforce planning, training, and development • Future Priorities – Social work landscape and priorities looking forward to 2024/25 Social Work Services continue to play a critical role in supporting communities in North Lanarkshire and in meeting both national and local priorities to improve outcomes and empower those individuals and families who may face exclusion or a range of adversities. Demand challenges driven by societal factors including the legacy of the pandemic and the cost-of-living crisis, demographic change and health inequalities have continued to impact on social work services over the past year alongside the challenging financial context for the public sector and whilst recruitment challenges have eased in some areas of the service they continue to present substantial challenges in others. This is reflected within the report along with our achievements as staff across the service continue to work with resilience and commitment to achieve the best possible outcomes for those we support. Page 124 of 214
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5 I would like to record my thanks and pay tribute to all staff involved in the delivery of social work services in North Lanarkshire for their work over the past year I would also like to thank all internal and external partners, carers, families, and communities who have supported us in our work. Alison Gordon Chief Social Work Officer Page 125 of 214
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6 1. GOVERNANCE AND ACCOUNTABILITY ARRANGEMENTS Adult Social Work and Social Care Services are delivered through University Health and Social Care North Lanarkshire (UHSCNL) whilst Children, Family and Justice Services are delivered through the Council’s Education and Families Service. Primary reporting and governance arrangements for Adult Social Work are through the Integrated Joint Board (IJB) and its Performance, Finance and Audit Sub-Committee but with local authority oversight and scrutiny also maintained through them Council’s Adult Care and Social Work Committee. Reporting and governance of Children and Justice Social Work Services is in turn primarily exercised through the Council’s Education, Children and Families Committee with reporting also to other council committee’s including Audit and Scrutiny Panel where relevant on specific issues. Social Work Chief Officers are part of the Council’s Corporate Management Team whilst a number a number of joint arrangements support governance, service delivery and practice alignment across all social work care groups, including regular Social Work Solutions (Business) Meetings, the Social Work Leadership Team, and a Social Work Workforce Group. Social Work in North Lanarkshire directly employs around 2,800 staff and in collaboration with commissioned services and third Sector partners, we are involved in providing support to around 30,000 individuals and families at any one time, in addition playing a key role in wider partnership and community planning activity. Partnership working at local level remains fundamental to social work and a key aspect of the CSWO role involves developing and sustaining partnership working and relationships across a range of organisations and structures. In addition to the responsibilities of the CSWO to the Council and UHSCNL, the CSWO holds a key leadership role within several local partnerships, as well as contributing to the wider national social work community, as illustrated below: 1.1 NORTH LANARKSHIRE COUNCIL AND NORTH LANARKSHIRE PARTNERSHIP The Plan for North Lanarkshire | North Lanarkshire Council sets out the shared priorities of NLC and partners and has a focus on inclusive growth and tackling inequalities. The plan focuses on: • improving economic opportunities and outcomes • supporting all children and young people to realise their full potential • improving the health and wellbeing of communities • enhancing participation, capacity and empowerment across our communities and improving North Lanarkshire’s resource base Social Work continues to play a fundamental role in working towards these aims, notably around supporting children and young people to achieve their potential, improving community health and well-being and in supporting and facilitating engagement and participation. The plan is supported by a five-year Programme of Work, approved in March 2023. The Programme of Work has seven priorities for delivery: • Transforming Places – to deliver transformational change across town centres and local communities. • Invest in North Lanarkshire – Faster delivery of outcomes and investment. • Sustainable Futures - Focus commitments towards Net Zero Carbon and climate resilience and the associated energy solutions and investments required to make it a reality. • Resilient People - Deliver whole family support locally, when families need it, in a way that addresses the impacts of poverty and reduces inequality. • Brighter Futures - Support and improve educational attainment, employment opportunities, entrepreneurship, and volunteering. Page 126 of 214
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7 • Digital North Lanarkshire - Develop a skilled digital workforce, promote an innovative, sustainable culture and be the Digital Leader for a transformed North Lanarkshire. • One Service - Ensure services are delivered, in a streamlined, efficient, and supportive model, with the overall vision of inclusive growth and prosperity for all. Whilst all services contribute and are supported by change activity across these seven priorities, social work’s role is particularly significant within the Resilient People and Brighter Future strands of the programme which have key interdependencies in terms of delivery models with elements of the Digital and One Service programmes. This is reflected in the participation of senior social work managers in the programme boards and the CSWO’s role as SRO for Resilient People. Connections made across the wider range of corporate work programmes, continue to make a meaningful difference to people who use social work services. Examples include employability services, homelessness prevention and community wealth and capacity building with key examples of progress detailed within the relevant sections of this report. Across the service a key focus remains to promote resilience, encourage and support preventative planning and anticipatory approaches and minimise the risk of crisis and the involvement of the Community and Voluntary Sector continues to be an essential strand of our wider approach, in promoting self-help, independence and resilience. The North Lanarkshire Council Equality Strategy 2019 – 2024, sets out key objectives for success with all council services committed to knowing, understanding, and involving our communities and demonstrating leadership in equalities and human rights. There is recognition that the poverty, disadvantage, and inequalities that exist for some people in North Lanarkshire can be further exacerbated due to specific characteristics. Clearly this is a key area for social work and during this period this has also aligned closely with our work to embed trauma informed practice and systems and the strengthening focus around the United Nations Convention on the Rights of the Child (UNCRC) Adult Services have developed a Service Equality Action Plan which details how the service will meet the objectives identified in the Equality Strategy within Adult Health and Social Care. The plan includes equality actions in relation to the implementation of a new social work information system and the refresh of the Engagement and Participation Strategy. A programme of training in relation to good practice in Equality Impact Assessments has been initiated with around 40 senior staff having participated to date whilst the CSWO has taken on the role of Executive Race Champion for the Council. North Lanarkshire Children’s Services Partnership (CSP) is the structure through which partners provide governance, strategic planning, direction, and delivery of shared priorities for children’s services in North Lanarkshire. The Children’s Service Partnership Board membership includes Elected Members, UHSCNL/NHS Board representation and representation from young people through links with North Lanarkshire Youth Council, and Champion’s Board links. There are developed links and cross over with other strategic partnerships such as NL Child Protection Committee and the Tackling Poverty Strategy. The North Lanarkshire Children’s Services Plan is refreshed every three years and supported through annual reporting: Annual Report 2023-24 Social Work has a key role in all the CSP priorities. The CSWO is lead officer for the CSP and chairs the Improving Children’s Services Group which has oversight of the work of task groups delivering on the priorities in the Children’s Services Plan that are organised under the foundation of The Promise, Voice, Family, Care Scaffolding and People. The Community Justice Partnership, currently also chaired by the CSWO has responsibility for the multi-agency oversight of Community Justice in North Lanarkshire. Page 127 of 214
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8 The partnership has continued to benefit from strong collaboration with a wide range of partners including employability services and the NL Alcohol and Drug Partnership. This has supported continued developments in a range of areas including diversion, throughcare, bail supervision and our local Arrest Referral Pilot initiated in April 2023. Commitment from partners has also ensured a holistic response to the needs, examples being ‘keep well’ clinics for justice service users and a dedicated employability worker Routes to Work. A partnership steering group has also been stood up to support Early Release. NL Community Justice Annual Report 2022-23 and our new CJOIP: Community Justice Outcome Improvement Plan 2023 to 2028 was informed by significant engagement including with those with lived experience and a Strategic Needs Assessment and sets the framework for our ongoing activity in this area. North Lanarkshire Partnership (NLP) brings together the major public sector agencies in the area along with Voluntary Action North Lanarkshire (VANL) the third sector interface in the area. NLP operates as the overarching framework for partnership working and the priorities for delivery across the partnership are included in The Plan for North Lanarkshire. The nine Community Boards continue to support community leadership, involvement, and capacity building, with local outcome and improvement plans (LOIP) guiding this work. Social work services support these local partnership structures. The CSWO continues to have the role of Community Co-ordinator for one of the local boards and the Chief Officer Adult Social Work and Senior Managers for Quality Assurance and Strategy & Performance provide links to the UHSCPNL and its strategic commissioning activity across all Community Boards. Senior Social Work Managers also participate in area-based teams and the sub-groups which support the delivery of the LOIPs (Local Outcome Improvement Plans). 1.2 HEALTH AND SOCIAL CARE NORTH LANARKSHIRE UHSCNL adopted its new Strategic Commissioning Plan 2023-26 from April 2023, setting out key priorities for the next three years with the aim of ensuring that people are robustly supported to live in their own homes and lead independent lives in their communities. The plan was developed through a collaborative process with people who use Health and Social Care services, partners, the public, and partnership staff. Key priorities include: • Do the right thing first time • Increased focus on prevention, early intervention and tackling inequalities by working with communities and people • Develop and support a workforce for the future • Improve mental health and wellbeing • Support people through a whole family approach Under each priority area, an agreed set of short- and medium-term goals has been developed underpinned by the Programme of Work which sets out in detail the programmes to be progressed. These are updated on an annual basis to ensure we are able to respond to any new or emerging issues. The plan will be implemented over the next three years, with ongoing monitoring to ensure that services continue to meet the needs and goals of local people. The Annual Performance Report for 2023-24 which will be published later in the year, and this will give further details and achievements of the partnership. 1.3 SUPPORT, CARE, PRACTICE AND STAFF GOVERNANCE ARRANGEMENTS Page 128 of 214
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9 Coherence in practice and staff governance within social work are maintained through a variety of processes and key forums. In addition, the HSCP’s Support Care and Clinical Governance Committee (SCCGC) has met quarterly over the reporting period, currently chaired by the HSCP Medical Director but with the rotational chairing arrangement also involving the CSWO/Chief Officer Adult Social Work. Adult Social Work Governance meetings included a robust programme of assurance and improvement for Adult Social Work Services and feed into the SCCGC framework. Over the 24/25 a review of the current framework will be undertaken by the professional and operational managers supported by our Quality Assurance team. A programme of work to support assurance, performance and improvement in the service delivery is planned. There is a commitment to ensure that practitioners and managers are supported with linked assurance activity which will include. • Introduction of self-evaluation for each of the teams • Audit of key processes including supervision • Feedback from individuals and carers experience • Feedback from staff • Monitoring of regulated services and regulated workforce • Staff/ individuals and carers safety • Review of complaints and compliments • 6 monthly reports on learning and development • Planned programme of review current policies and procedures Our In-House Monitoring Framework was approved, and a test of change has been in progress over the reporting period. A full evaluation is pending and, following refinements, will be rolled out across our adults and children’s services. The Quality Assurance team have also prioritised the review of our contract monitoring processes to take account of multiple reporting requirements for commissioned services whilst information governance, complaints and Duty of Candour activity also continues to be overseen by our Quality Assurance team with key learning and reflections taken forward. This work is reflected in the Quality Assurance Annual Report ADD LINK whilst work over the coming months will further expand on the streamlining and connection of activity to date. 1.4 CARE HOME ASSURANCE A review of the enhanced clinical and care oversight arrangements for care homes took place during this reporting period. The purpose of this was to ensure continued support for care homes supporting adults and older people and improvements in care and outcomes by building upon the learning from the arrangements implemented during the COVID pandemic. It has been widely recognised that although we are post pandemic, significant achievements have been made in maximising opportunities for partnership working and the outcome of the review captures the ethos of collaboration, sector expertise, access to healthcare and support for workforce development. The functions of the refreshed Care Home Assurance and Support Board are to: - • Ensure assurance and support to care home sector continues in the context of Excellence in Care, including Infection Prevention and Control (IPC), direct support and the embedding of the national IPC manual. • Oversee whole system support to care homes to improve the health and wellbeing of adults living in these environments, through implementation of My Health, My Care, My Home – the healthcare framework for adults living in care homes, and Health and Social Care Standards in Scotland Page 129 of 214
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10 • Ensure that a collaborative improvement model is utilised in all developments with care homes • Ensure systems and processes are in place to share intelligence between agencies to identify and allow support to be provided to care homes at risk. • Ensure systems and processes are in place to provide immediate response to serious concerns to mitigate risks • Monitor overall capacity of the sector – identify risks and mitigate where possible • Ensure contingency plans are in place for the sector and regularly updated. Two subgroups, the Care Home Governance Group and Care Home Healthcare Framework Implementation Group have also been established. It is envisaged that following an initial gap analysis of the Healthcare Framework these two subgroups will merge with implementation of the Healthcare Framework continuing to be monitored and evaluated. 1.5 ENGAGEMENT WITH THE PEOPLE WHO USE SUPPORT SERVICES AND THE COMMUNITY AND VOLUNTARY SECTOR Engagement and Participation There has been considerable progress in enhancing participation, capacity, and empowerment across our communities, in line with Ambition Statement 19, in the Plan for North Lanarkshire - Improve engagement with communities and develop their capacity to help themselves. This also a priority the UHSCNL Strategic Commissioning Plan and is critical to ensuring: • We involve people in the decisions that affect their wellbeing. • Improvement comes from feedback on the experiences of services and supports. • Our services and supports continue to be based on what matters to people. • We have a continued focus on person centred approaches to embed the wider approach to Getting it Right for Everyone (GIRFE). During 2023-24 there was an increased focus on these areas has sought to ensure that the voices of supported people, carers and communities were strengthened. The diagram above depicts the three principal areas of investment that sought to: • Improve communication and increase connections. • Increase awareness of what matters to people • Increase capacity for early intervention and prevention. Page 130 of 214
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11 UHSCNL Engagement and Participation Strategy Refresh 2024-2027 The Engagement and Participation Strategy has been refreshed to cover 2024-27. The approach to the refresh has engaged stakeholders, representatives of community-based organisations, supported people, carers and communities and representatives from UHSCNL staff. Strengthening the voice of supported people and unpaid carers. There have been significant developments to strengthen the voice of supported people through the awarding of a contract, following a tender process, to a consortium bid, headed by North Lanarkshire Disability Forum, alongside Voice of Experience and Lanarkshire Links increasing capacity to include those we need to work harder to reach, for example, people from minority ethnic communities, people from the LGBTQI+ communities and those in more rural communities, including through the recruitment of an Equalities Information Worker in North Lanarkshire Carers Together. This Equalities post augments a similar post that was already in place with Lanarkshire Carers. Extensive engagement and participation activity was also undertaken to inform the North Lanarkshire Carers’ Strategy 2024-2027 with carer feedback has influenced and shaped developments described elsewhere in this work. Within Children’s Services the Voice Task Group supporting the work of the partnership has been strengthened with young people also increasingly involved in planning and commissioning, including having a direct role in the tender for a specific counselling service for care experienced young people and more broadly in decision-making around allocation of funds for community mental health and wellbeing supports. Over two thousand families also participated in a survey which has informed the shaping of whole family supports. In Justice Services two development workers with lived experience have been employed and have supported consultation activity with those involved with the service including the development of a digital questionnaire which has supported more routine gathering of feedback. 2. SERVICE DEVELOPMENT, QUALITY AND PERFORMANCE 2.1 PERFORMANCE AND IMPACT MEASUREMENT Our formal reporting is presented for a variety of audiences, reflecting the scheme of integration and delegation of services to the North Lanarkshire Integrated Joint Board (IJB) and the governance of services within several partnership arrangements. As reflected above there are mature governance frameworks for the Local Authority, the Health & Social Care Partnership, and the other established partnerships, including the North Lanarkshire Alcohol and Drug Partnership and the North Lanarkshire Community Justice Partnership (NLCJP). Performance reporting is presented to the various boards, committees, and groups of these organisations on a cyclical basis, covering the key performance indicators for the relevant services and areas of work. Indicators are in place for core aspects of service, such as access, operational performance, workforce, quality, and outcomes, ensuring that we both monitor and demonstrate how we have met the needs of the community, produced positive outcomes for the supported people and that the work represents best value for the Local Authority. Critically in addition to quantitative data a variety of methods are used to measure impact, outcomes and how people experience our service as reflected throughout this report. In addition to these internal arrangements, performance and quality is both monitored and regulated by several external bodies, including the Scottish Government, the Scottish Social Services Council, and the Care Inspectorate. All Social Work services provide validated performance and demographic data to the Scottish Government and the various agencies who support Social Work development in Scotland. This data supports the creation of national Page 131 of 214
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12 indicator sets, such as the Local Government Benchmarking Framework and the Integration Indicators. North Lanarkshire provides annual returns for several national datasets, which can then be used for benchmarking purposes. 2.2 SUPPORT TO UNPAID CARERS Unpaid carers continue to provide the vast majority of support to people who need it, across North Lanarkshire. Estimates vary as to the number of unpaid carers in our area, but we believe there could be as many as 50,000 or so unpaid carers, with about 13,000 of these being known to services and the Community and Voluntary Sector (CVS). We have a robust carer support infrastructure in place, with three commissioned carer focused organisations: • North Lanarkshire Carers Together (NLCT) • Lanarkshire Carers • Action for Children Young Carers Project All of whom provide a wide range of carer focused support or information. There is also a broader range of other CVS organisations with a direct, or indirect, role in supporting carers. These, and many other carer focused organisations are part of a wider Carer Support Network (CSN), where caring related topics and issues of common interest can be raised, discussed and actions taken to improve carer experiences. Alongside ongoing carer support, our focus during 2023-24 was engagement with carers (to augment ongoing day to day carer engagement) to help inform and develop the North Lanarkshire Carer Strategy for 2024-27. Engagement activity, facilitated by the commissioned carer organisations and the wider CSN, meant that a wide range of carers helped to inform and shape the new strategy; offering feedback relating to a range of topics of interest to carers around what was working well, not so well, and suggestions for improvement. There was recognition through this work, that many carers experienced disappointment or frustration – citing not being listened to, or having to tell their story multiple times, experiencing an inconsistent approach, or poor outcomes. Our intention is to use such instances to inform and drive improvement, through what is, a carer led and carer informed Carer Strategy, to be launched in May 2024. Conversely, there was also a wide range of examples that demonstrated that when carer support is done well, outcomes can be very positive. Such was the wealth of information provided, that alongside the strategy itself, consideration has been given to publication of some of the positive stories that we heard- to help promote awareness of preventative and anticipatory approaches leading to good outcomes, imaginative and creative use of carer budgets, or the enabling role that assistive technology can play. 2.3 JUSTICE SOCIAL WORK SERVICES Justice Social Work Services have seen demand relating to core statutory responsibilities increase as the justice system continues to address the backlog of COVID impacts with, for example, a 69% increase in hours of unpaid work requirements imposed over the past two years. Alongside this service delivery has been shaped by key priorities set out in both our new Community Justice Outcome and Improvement Plan (2023-2028) and the Scottish Government’s Vision for Justice published in February 2022, and its supporting strategy published in June 2022, with an increased focus on areas such as diversion from prosecution and bail supervision. The service continues to promote a holistic approach to working with people with convictions to ensure that in addition to robust risk management, support is offered to address the range of issues, such as health and employment barriers, which can inhibit rehabilitation and inclusion and in turn better lives and safer communities. Page 132 of 214
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13 2.3.1 COMMUNITY PAYBACK ORDER - INCLUDING UNPAID WORK The communities of North Lanarkshire have benefited from 92,624 hours of unpaid work delivered by the Restorative Justice Team. This constitutes an increase in activity of just over 20% since the last reporting year. Of note, service activity in this area has risen by 54% over the last 2 years. Demand continues to grow and during the period of this report 133,941 hours were imposed by Courts in relation to Unpaid Work and Other Activity, a 69% increase in the hours imposed in this regard over the last 2 years. The following paragraphs provide an overview of some unpaid work activities. More detail on specific activity is referenced in the Community Payback Annual Report. The bike recycling workshop refurbished bikes which are donated by individuals or have been discarded in local recycling centres. The bikes are repaired to a gold standard and are distributed to local community groups, schools and individuals. This helps to maximise opportunities for better health and wellbeing and provides greater transportation access. Service users within the workshop also undertake bike repair for individuals who are unable to afford the cost of this. Due to the success of this workshop, a mobile bike recycling trailer has been purchased and this enables the provision of bike maintenance and repair within the local communities. In total 8,746 hours of unpaid work were completed through this initiative in 2023/24. This represents a significant increase in activity over the last 2 years when 1,075 hours were completed in 2021/2022, and 6,213 hours were completed in 2022/2023. The woodwork workshop teaches joinery skills which enables bespoke items to be made from reclaimed wood pallets which were destined for landfill. Partnership working with family learning centres, nurseries, schools and communities have allowed for unpaid work service users to be involved in the construction of outdoor classrooms, and play equipment in the form of trucks, trains, cares. This approach has helped to promote outdoor play for children throughout our community. Squad placements have benefitted the local communities through activities such as landscaping. In total 54 squad have been completed within North Lanarkshire. These range from one to two-day pieces of work to larger projects with a duration of four to six months. The home improvement workshop provides opportunities for services users to gain experience in decorating, painting, and plastering. Once the individuals are proficient in these disciplines, they utilise the skills on projects within the local community. In partnership with local housing colleagues and school staff the Restorative Justice unpaid work team has also facilitated learning events at our community allotments in Townhead, Clydeside, and in Wishaw. These events enable children and people in the local community to sow seeds and learn about different growing techniques. Participants can take away some of the produce and can be invited back later in the year to experience the harvest taking place. This project has allowed for a creative teaching space which helps individuals to develop new skills which they can contribute to the benefit of the local community. 2.3.2 OTHER ACTIVITY The availability of Scottish Government Covid-19 recovery funding has enabled the continued commissioning of Third Sector colleagues to assist in the delivery of ‘other activity’ programmes. Co-production of this aspect of Community Payback Orders includes collaboration between Justice Services and a variety of organisations including the Wise Group, Creative Change Collective, SACRO, Reeltime Music and Ten for Zen. Page 133 of 214
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14 In addition to the above commissioned third sector organisations, Justice Services provides a range of opportunities for service users to engage in Other Activity. The e-learning workbook resource pack provides blended digital learning which can be completed in partnership with staff. The Centre for Clinical Interventions as well as NHS Mental Health Foundation Trust resources are also utilised to complete workbooks in the following: • Anxiety, Self-Care, Social Anxiety, Bereavement, PTSD, Self-harm, Sleeping Problems, Depression and Low Mood, Obsessions/ Compulsions and Panic. • Alcohol and You, Cannabis and You, Cocaine, Gambling, Anger Management and Procrastination. • Goal Setting, Self-Development, Writing applications and Interview techniques. 2.3.3 DIVERSION FROM PROSECUTION In partnership with Police Scotland, a bespoke Diversion from Prosecution awareness training session was delivered by Justice Services in December 2023. This session was delivered at Jackton Police College to Inspectors in Lanarkshire. Following this event, it was identified that Police Sergeants would also benefit from this training. Consequently, a further five training sessions were delivered in March 2024. It is envisaged that this awareness raising will result in a further increase in people being diverted from the justice system through Diversion from Prosecution. Within the reporting period of 2023–2024, 242 individuals were diverted from formal justice systems by being involved in the Diversion from Prosecution Scheme. This is a 38.29% increase from the previous year’s figures of 175. 2.3.4 OFFENCE FOCUSED WORK Offence focused intervention continues to be central to the delivery of Justice Social Work services, regardless of whether that engagement is mandated through Community Payback Order, Statutory Licence, Structured Deferment or Diversion from Prosecution. This is delivered through a trauma informed approach, considering wellbeing and individual responsivity and supporting others to recognise the links between wellbeing and risk whilst person-centred case management plans are informed by LSCMI, other relevant accredited risk assessment tools, the service user’s views, and professional judgement. Offence focussed interventions remain a priority area of work and a crucial element of supervision, particularly for those convicted of sexual offending, physical violence, and intimate partner violence. Such interventions are delivered by social work case managers as well as pathways into a dedicated programmes which offer trauma informed therapeutic interventions to individuals convicted of domestic abuse and sexual harm. Increasing accessibility to offence focussed interventions is also a priority area in our Prison Based Social Work (PBSW) team based in HMP Shotts. During this period PBSW staff successfully cleared the Programme Case Management Board waiting list of 102 individuals in the establishment who did not have a risk assessment and were awaiting access to an intervention programme. This also enabled the Risk Management Team to make informed decisions about individuals who could be considered for progression. Through collaboration with Scottish Prison Service (SPS) staff, a streamlined system has been implemented to ensure that all individuals are risk assessed within the first five months of entry into HMP Shotts and ahead of their first Integrated Case Management Meeting (ICM). In addition to offence related work Justice Social Work support individuals in areas such as education, employment, health, leisure, housing and financial needs. The Justice Outcome Star is employed to identify the service user's priority areas of need, and to support measure progress and outcomes. Page 134 of 214
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15 2.3.5 MOVING FORWARD TO CHANGE (MF2C) NLC Justice Services have been one of the pilot areas for the new Scottish Government MF2C programme which has been designed to supersede the MFMC (Moving Forward Making Changes) programme. This programme is an intensive cognitive behavioural therapy intervention for men over the age of 18 who have committed sexual offences. The programme seeks to assist participants in addressing their offending and reduce their risk of reoffending as part of a Court Order or release Licence. The new programme has been adapted to incorporate up to date literature, can be delivered in Prison based establishments as well as the community. The Justice Programme Service is currently maintaining delivery of the MF:MC programme to relevant service users, whilst also delivering the pilot MF2C programme. In time the service will transition to increasing MF2C delivery while reducing and phasing out MF:MC delivery. The pilot has been delivered on a 2:1 basis with a small group of service users and with relative success in relation to low reoffending rates. The pilot has been considered as part of the wider evaluation by Scottish Government and a decision reached that full implementation of the new programme will begin throughout 2024-25. 2.3.6 WOMEN’S COMMUNITY JUSTICE SERVICE (WCJS) AND BAIL SUPERVISION The Women’s Community Justice Service (WCJS) was established in 2014 in response to the Commission on Women Offenders by Dame Elish Angiolini. The service works with women who are involved in the justice system. The majority of the service users are subject to Community Payback Orders with requirements of supervision and/or unpaid work. Additionally, the service work with women subject to parole board licences, those subject to bail supervision and also alternatives to prosecution. A key development in the WCJS, has been the recruitment of a Justice Support Worker to support women who are made subject to Bail Supervision. Proactive engagement has taken place with the Pan-Lanarkshire Court Social Work Team to agree a pathway for early identification of these cases and to ensure timeous communication with the WCJS. This supports the national vision for Justice to reduce the number of women who experience custody. A partnership approach is adopted to plan, intervene/support and review service users' needs and risks. This assists to build on strengths and work towards achieving their goals and aspirations. With regards to unpaid work the female specific service allows for female only unpaid work activities. Most of the women using the service have experienced trauma and much of the work involves supporting them with their emotional and mental health needs. Multi agency partnership working with Children and Families, Shine Women’s Mentoring Service, Domestic Abuse and Addiction Services is crucial to support this service user group. Additionally, the Women’s Community Justice Service have commissioned a new intervention resource entitled ‘Managing Emotions and Relationships’. This approach enables staff to utilise Cognitive Behaviour Therapy to facilitate structured conversations that help Women to develop better coping strategies. 2.3.7 NEW DEVELOPMENTS: ENHANCEMENT OF VOLUNTARY THROUGHCARE AND DRUG AND ALCOHOL SOLUTIONS COURT Voluntary Throughcare Through the local Community Justice Partnership employability subgroup, additional funding was secured to extend the offer of our current voluntary throughcare service beyond HMP Addiewell. As a result, a Justice Support Worker was recruited and the Bridges and Beyond initiative now offers person centred outreach support to individuals serving a short-term sentence in various prisons across central Scotland. Page 135 of 214
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16 The Bridges and Beyond service has supported 53 service users in 2023-24. The service aims to remove barriers to employment and resettlement for those serving short term prison sentences is crucial in helping to reintegrate individuals into the community and reduce the prison population. Drug and Alcohol Solutions Court In September 2023, NLC Justice Services recruited two Justice Support Workers funded by the North Lanarkshire Drug & Alcohol Partnership (NLADP) to support the introduction of a Lanarkshire wide Drug & Alcohol Solutions Court. This has been instigated as a 12-month test for change. The initiative is based at Hamilton Sherrif Court and adopts a public health approach to working with people who are impacted by drug and, or alcohol, and who are in conflict with the law. The age range for eligibility is 35-55, and consideration is being given to extending this to people aged between 21-55. Despite the early stages of the test for change, outcome star data indicates that all service users currently engaged in Structured Deferred Sentence through the new test for change have reported progress across multiple life domains. Service user feedback indicates that those individuals who have previously breached more stringent orders such as Drug Treatment and Testing Order, find the flexibility and assertive outreach dimension to the support as well as the trauma informed approach within court more effective. 2.3.8 THROUGHCARE: ARREST REFERRAL An Arrest Referral test for change has continued to operate in North Lanarkshire’s Police Custody Suites. Importantly this service is delivered by people with lived experience of the justice system offering an opportunity for partnership working with individual being held in custody with a focus on early intervention, direct and practical support, and a pathway for referral to appropriate agencies. This test for change is being funded by the NLADP and will be independently reviewed. 2.4 CHILDREN AND FAMILIES SOCIAL WORK SERVICES Children and families social work, working closely with our partners, has continued over this period to focus on embedding a culture that enables practice that is rights-based, trauma informed and built on relationships. To promote this, we developed further training in Safe and Together where domestic abuse is a concern and continued to implement the Contextual Safeguarding approach where young people are at risk in the community. Agreement was also secured to begin the implementation of Signs of Safety. Taken together, these complimentary approaches support staff practise in ways that build relationships with children, young people, and their families in need of support and protection by building on strengths. Crucially these approaches also form a key part of our commitment to keep The Promise by finding creative ways of supporting children remain cared for and loved in their families, reducing the need for crisis support or alternative care. We were therefore pleased that the Joint Inspection of Services for Children at risk of harm found our impact on children was Very Good as a result of children’s experience of nurturing relationships to keep them safe (see section 2.4.3 for more detail). Page 136 of 214
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17 2.4.1 THE BALANCE OF CARE Our balance of care data outlined in the table shows that overall, the number of children in care has remained stable from 2020-2024. However, this needs to be seen in the context of a 20% increase in children referred to the service over the same period and within this a significant 44% increase in child protection referrals and the higher number of Unaccompanied Asylum Seeking Children now supported (55 and increasing) having arrived through the now mandatory National Transfer Scheme (NTS) or presenting directly from the community. In this context the maintenance of a stable position reflects the use of strengths-based approaches outlined above, finding solutions for children through family group decision making and a strategic approach to investment in family support through funds such as the Community Mental Health and Wellbeing Framework and Whole Family Wellbeing Fund. Positively, we have also continued to reduce our use of out of authority foster placements which means more children have remained in North Lanarkshire close to their families and communities. Placement type Number as of 31 March 2020 Number as of 31 March 2021 Number as of 31 March 2022 Number as of 31 March 2023 Number as of 31 March 2024 Foster NLC 100 112 94 112 109 Foster Care (Independent) 67 61 53 51 47 Home Supervision 298 227 188 205 196 Formal Kinship Care 355 321 307 325 358 Informal Kinship Care 153 170 183 191 180 Residential (NLC) 28 27 27 31 32 Residential (Independent) 13 11 11 9 7 Secure* 0 2 6 7 5 Continuing Care 45 53 73 74 77 *number of young people spending time in any secure accommodation during full year. Nothwithstanding this, there are some significant pressures. The numbers of young people in need of our residential care or secure care has increased. In large part this is due to an increase in young people being at risk of violence in the community and/or criminal and sexual expliotation. These risks to young people compounded pressures and difficutlies facing families. Similar trends are seen elswhere in the UK (Jay, 2024). Our children’s houses therefore continued to look after young people with a high level of complex needs. Following a 59% reduction in missing episodes Page 137 of 214
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18 over the previous 3 years, the number increased in 2023-24 with young people often facing strong ‘pull factors’ linked to criminal exploitation and peer relationships. We continued to promote and invest in approaches such as Contextual Safeguarding (see section 3.6.3), and intensive family support (see section 2.4.4) to address these concerns. 2.4.2 MOVING ON: SUPPORTING CARE EXPERIENCED YOUNG PEOPLE As part of our relationship-based approach, we have focused on supporting young people make a positive transition from care into independence. The table above illustrates a 71% increase in the number of young people in continuing care (remaining in the care placement after reaching the age of 18) so they can leave care when ready and further to our investment in after care services we have seen a 107% increase in the number of young people receiving support – 252 18–26-year-olds as of 31 March 2024. Much of this support is coordinated by the Care Experienced Young Persons Operations Group comprising several partners and care experienced young people as illustrated below: A Housing Operations subgroup looks at the housing needs, resources to support preparation and sustainability and matching of young people to available properties. Through coordinated support there was a noted improvement in care experienced young people sustaining tenancies, with over 100 young people sustaining their tenancy long term. This was supported by partnership working with housing colleagues and the Tackling Poverty Team to quickly identify any debt and budget management issues that may have impacted on young people sustaining a tenancy and ensure their rights to financial support were in place. A dedicated and coproduced counselling service, the Exchange Counselling Project, was established and now operates from our Aftercare Hub 5 days a week as well as reaching out to young people as required. In 2023-24, the service worked intensively with 42 young people, with 78% of young people reporting improved wellbeing on finishing counselling. Referrals indicated anxiety, family relationships/ home issues, violence and abuse, and bereavement were the main reasons for presentation. Following a review of the unmet health needs of care leavers, NHS Lanarkshire agreed funding for two Throughcare and Aftercare Nursing posts to deliver front line health support to care leavers and undertake an analysis of the challenges and barriers faced by care experienced young people accessing adult services. One of the nurses started in November 2023 and was working with 28 care leavers by March 2024. From the outset, it was apparent that this support has made a significant difference in enabling care experienced young people to exercise their rights to appropriate health care. Care leavers told us that they would like information about their rights and entitlement to support and this should be accessible in the one place. Given the preference of young people to communicate and access information digitally, an Page 138 of 214
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19 aftercare website was developed in partnership with a group of care experienced young people and care leavers. Aftercare North Lanarkshire went live in March 2024 and can be accessed via the QR code below. 2.4.3 A LOVING HOME: ADOPTION, FOSTERING & KINSHIP CARE The Children’s Carers Service provides support to kinship carers, supported carers of young adults, as well as to adopters and foster carers to achieve loving homes for children and young people into adulthood. Despite a reduction of the overall number of carers, we have been able to place more children in North Lanarkshire thanks to the commitment and flexibility of our carers supported by our carers team. Recruitment therefore continues to be a high priority. As can be seen from the table below, interest in fostering or adoption has remained static post-Covid and the numbers of potential carers deciding to progress to an assessment has not increased. Positively, however, 2023-24 saw an increase in fostering approvals on the previous year. This was an indicator of the increased focus on recruitment through community-based initiatives. Adoption approvals have also increased, representing the continued interest and enquiries for adoption which has now been consistent for several years. As illustrated in the table below, this means that we are able to match children in need of adoption to adoptive parents, mostly within North Lanarkshire. The recruitment strategy group developed an action plan to widen recruitment opportunities focussing on digital promotion and increased presence within local communities. This included recruitment stands within hospitals and local community events, on-line drop-in sessions for targeted staff groups within North Lanarkshire, and mail drops in local communities. These were in addition to the bi-annual radio and media campaigns. 15 11 15 14 1 1 1 1 11 18 19 17 0 5 10 15 20 2020-2021 2021-2022 2022•2023 2023-24 Adoption 2020-2024 Direct Adoption Agreed Permanence Order With Authority to Adopt Agreed Children Linked Page 139 of 214
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20 As well as recruitment, retention of existing carers has been a priority for the service. The training and support programme for carers has therefore been enhanced to include adopters and kinship carers. Early indications are this has been successful in increasing numbers of participants and feedback has been positive about the added value to carers understanding of each other's roles and the needs of the children within their care. To support carer wellbeing, sessions in mindfulness and mindful yoga were provided along with a second therapeutic support group for adopters and permanent carers. An increase and backdating of fostering allowances (in line with the Scottish recommended allowance) and fees (10% uplift) recognised the value North Lanarkshire places on its foster care resources. Similarly, an increase and backdating of kinship allowances in line with the Scottish recommended allowance recognised the valuable and important role kinship carers have. There continues to be an increase in children being placed with kinship carers. Therefore, there is a higher demand for support for kinship carers from the kinship team. Over the last year support for kinship carers has developed and over and above the allowances paid, the service provided direct support to 190 kinship carers. Kinship support groups also took place on a fortnightly basis across Noth Lanarkshire and individual therapeutic and groupwork sessions were also introduced involving mindfulness and yoga which were well attended by kinship carers at the children’s carers centre. The number of children formally looked after in kinship care has increased over the past three years and in response, we have recruited additional support workers to help carers manage the complexity and emotional demands of their caring role. This will increase our capacity for practical and emotional support going forward. Our Virtual School has also prioritised support to kinship families including in school holiday periods. 68 120 128 131 30 63 68 57 16 21 28 28 7 8 10 9 0 50 100 150 2020-2021 2021-2022 2022-2023 2023-2024 Initial Enquiries and All Outcomes 2020-2024 Initial Enquires Initial Interviews Attended Prep Group Progressed to Full Assessment 17 10 14 11 16 10 7 7 8 10 7 3 7 3 6 0 2 4 6 8 10 12 14 16 18 2019-2020 2020-2021 2021-2022 2022-2023 2023-2024 Approved Assessments by Type of Resource2019-2024 Approved Assessments Adoption Foster Care Page 140 of 214
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21 When children need care, the priority continues to be to secure a foster family where brothers and sisters remain together. In the last year, five of the eight groups of brother and sisters that required a fostering home, were placed together. The reasons for not keeping brothers and sisters together were due to individual children’s needs and, for one family, difficulty finding carers to keep four brothers/sisters together. However, in this situation, North Lanarkshire carers have actively promoted their relationships. Updated permanence planning training for staff and guidance for independent chairs emphasised the priority in considering brother and sister relationships. In response to feedback from our inspection from January 2023 specific life story training by was also commissioned and delivered. Another area identified for improvement including through inspections of registered services was linked to risk assessments. As a result, the risk assessments for placement requests and specific incidents were reviewed and updated and is now established in practice. 2.4.4 INTENSIVE FAMILY SUPPORT Community Alternatives & Families First Our Intensive Social Work Services Team continue to successfully deliver whole family support 7 days a week where families need a high level of support to prevent a child or young person entering care or to sustain a care placement. The service uses a range of materials to support interventions, such as structured parenting programmes and thematic interventions. Over 2023-24, a review was undertaken of the core programmes and interventions used to support children, young people, and their parents to ensure continuity and alignment with the supports available across the partnership. To support the workforce, staff training and development sessions were undertaken in partnership with health, early years and children’s house staff focusing on the Solihull approach to parenting, Assessment of Care Toolkit, Infant Mental Health Indicator set in additional to training in Contextual Safeguarding and Safe and Together. This enhanced the individual and groupwork support provided through the service and with partner agencies. The service also delivered eleven thematic workshops to social work staff. Intensive Services work with around 450 children, young people, and their families at any given time. Over 2023-24 52% of the children and young people supported were living at home with their family; 20% were supported in a residential, foster or a kinship care placement; 17% of the young people supported were care leavers needing a high level of emotional and practical support and 11% were young people in the community subject to Structured Deferred Sentence or Diversion from Prosecution or were supported through Youth Bridges whilst detained in Polmont YOI for a period and through their transition back to the community. 82 102 105 111 64 93 98 94 0 20 40 60 80 100 120 2020-2021 2021-2022 2022-2023 2023-2024 Number of Kinship Assessments Approved 2020-2024 No of Kinship Assessments Total Approved Page 141 of 214
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22 Weekend support is a crucial feature of our approach to prevent crises or a child coming into care. On average the service supported 28 individuals and families each weekend on a planned basis. The service also worked closely with the Social Work Emergency Service (SWES) to respond to emerging care, protection, and support needs out of office hours. In recognition of the additional challenges experienced by families over the school holiday periods and to offer positive opportunities during the Easter and summer holidays, the service delivered individual support to families and daily structured activities in the local community for younger children, attracting up to 40 participants and family-based day trips with around 45 participants. There were a range of activities arranged for teenagers with between 6-10 participants in attendance at each and one weekend activity camp. All activities and trips received positive feedback from the participants. Family Group Decision Making (FGDM) and Lifelong Links The FGDM and Lifelong Links Service are an integral part of Intensive Services as part of our commitment to build on family assets, promote and maintain important relationships. The team practice from a rights respecting and strengths-based approach to support children remain in their family through listening and supporting families to develop a family plan to sustain family care. The Lifelong links service has now been operational for nearly two years, supporting young people make sense of their care journey and support reconnection for those who have lost connection to important people in their life. The QR code below links to an animation that explains more about Lifelong Links and a young person’s experience of the service. Referrals to FGDM and Lifelong Links have remained consistent over the past two years. Year Number of FGDM Referrals Number of Lifelong Links Referrals 2021-22 115 N/A 2022-23 171 14 (partial year) 2023-24 172 16 Page 142 of 214
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23 Of the referrals received for FGDM during 2023-24, 70 were successfully progressed to family meetings where a family plan was devised, and 28 referrals progressed to a significant piece of work being concluded with the family without a family meeting. Lifelong Links is long term work that takes a trauma informed approach going at the pace of the young person as they come to understand their life story and consider who they want to reconnect with and how. Up until end of March 2024, 4 connections and 14 lifelong connections have been established with young people. A Right to an Education Our Virtual School, which is an integrated service comprising social work and education staff, has a focus on inclusion, providing bespoke packages of support based on a child’s needs, strengths, interests, and future career aspirations. For young people who are at significant risk of leaving school without formal qualifications, individual teaching input is provided. Supported by curricular leads, this session Virtual School teachers were able to extend the range of subject areas they could support young people to achieve in beyond English and Mathematics. National qualifications have been achieved in History, Modern Studies, Media, People in Society, Hospitality and PE. In session 2023-24 a total of 87 National 3 and 4 level qualifications were achieved by 27 young people working individually with Virtual School teachers: 93% achieved a qualification in English and 93% achieved a qualification in Maths. 63% achieved three or more national qualifications, 37% achieved four or more and 19% achieved five or more. In addition, ongoing partnership work across our schools and wider services to support care experienced learners and reduce school exclusions continues to move forward positively with significant improvements recorded. For example, over the past five school sessions, exclusions of care experienced learners have reduced overall by 93% (158 to 11), learning days lost reduced by 93.5% (339.5 to 22) and the number of care experienced learners receiving an exclusion reduced by 88% (92 to 11). This is an area of work we continue to prioritize in line with our commitment to fulfilling the ambitions of The Promise. 2.4.5 YOUNG PEOPLE IN CONFLICT WITH THE LAW At 13.0 per 1000, the proportion of children referred to the Children’s Reporter (SCRA) locally on offence grounds has increased and remained higher than the national average. In parallel the number of referrals for Early and Effective Intervention have decreased by 17%. In response to this and feedback from young people during a service review, plans are already in in place to promote EEI as an effective alternative to referrals to SCRA. During the year we launched our new EEI youth work service, The Compass Project, with the aim of promoting rights and relationships over behavioural responses. The service delivers group work and bespoke individual support and a route into preventative 158 105 82 19 11 339.5 233 138.5 40 22 92 72 56 15 11 0 100 200 300 400 2019-20 2020-21 2021-22 2022-23 2023-24 Care Experienced Exclusions Summary: 2019-24 CE Exclusions Days Days Lost Young People Page 143 of 214
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24 universal offers (such as DofE) as part of a prevention model. This project launched in January 2024 and already 5 young people have gained outdoor learning awards and were linked into universal support and youth work programmes. Between January 2023 and January 2024, North Lanarkshire also participated in a pilot with SCRA and South Lanarkshire Council to improve the experiences and outcomes for children referred to hearings on offence grounds by increasing their understanding of their rights, improving relationships, and ensuring supervision orders are tailored to the plan of support. A dedicated speech and language service was offered to provide advice to social workers and families and, where appropriate, direct support to young people to address unmet need and help them express their views in hearings: ‘I like working with you. After I work with you my brain feels less fuzzy’ The pilot was evaluated by the University of West of Scotland, and initial findings have highlighted the impact of the focus on relationships. The researchers found that support workers roles went beyond offence-focused interventions to encompass a comprehensive family support approach. This included accompanying young people to the hearings, providing practical advice, facilitating access to education or employment opportunities, and most importantly building trusting relationships that help understand the young person's perspective better. This perspective was supported by young people on the project who discussed the importance of the relationship-based practice that they engaged in which helped build relationships with their own families, communities, and education. Youth Bridges has continued to provide support to young people subject to diversion from prosecutions and structured deferred sentences and to young people under 21 subject to remand/ custody in Polmont YOI and through their transition back to the community. The number of under 18s from North Lanarkshire continued to decline with only 2 young people under 18 being remanded to Polmont YOI over the year. One young person was remanded to secure care. This is in line with the Scottish Government’s to end remand to Polmont for those under 18 in 2024. 01/04/23- 30/06/23 01/07/23- 30/09/23 01/10/23- 31/12/23 01/01/24- 31/03/24 Young People Supported 37 43 43 42 New admissions Polmont YOI 8 7 11 7 Diversion/ Structured Deferred Sentence 9 7 9 13 Ongoing Support 20 27 23 2 2.4.6 CHILDREN WITH ADDITIONAL SUPPORT NEEDS There was an increase in requests for assistance to the service for children and young people with complex needs, particularly around young people experiencing neurodiversity. Across the year, 211 had access to an individual budget. As a part of a wider service evaluation, we found that budgets alleviated stress for families and improved outcomes, but that staff wanted to feel more confident in this area of work. The service has therefore strengthened its central support to staff working with this group of children and young people to improve assessment and planning. Alongside this we also used grant funding to invest in family support for children with additional support needs, working in an integrated way across Social Work, Health, and Education. Improving the experiences and outcomes for this group of children remains a key priority and further work in this area is planned over the coming year. 2.5 ADULT SOCIAL WORK SERVICES In January 2024, a whole system project of work (Back-to-Basics), which aims to support individuals differently, commenced. Back to Basics is an overarching approach, which comprises a range of discrete and inter-related Page 144 of 214
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25 programmes, projects and activities that support our wider approach across the whole system to ensure that when people contact services, the response is quick and effective, with a focus on helping people to help themselves first. The overall ambition of the project is to have a system that is streamlined, minimises the risk of repeat actions for people and makes best use of resources. This will ensure that we are offering people the right support, at the right time and so increasing their quality of life, as well as increasing the quality of experience for staff in terms of work satisfaction. Access Social Work continues to be the initial point where many people first come into contact with our service. Pressures around Access, like other teams, continues to be grow. There is a high volume of requests for support which could better be met by resources out with statutory services. As part of the Back to Basics approach this work will be a focus of our development and improvements in the coming months. 2.6 EARLY AND PREVENTATIVE INTERVENTIONS – RIGHT SUPPORT, RIGHT TIME Self-directed support, Getting It Right for Every Child (GIRFEC) and Getting It Right for Everyone (GIRFE) as well as the Carers (Scotland) Act 2016 all emphasise the importance of choice and control early interventions and preventative approaches. Our approach across 2023-24 sought to embrace these principles to ensure that people who required our support experienced responses in line with these aspirations. 2.6.1 GETTING IT RIGHT FOR EVERYONE (GIRFE) Getting it right for everyone (GIRFE) is a Scottish Government led multi-agency approach to Health and Social Care support and services. Building on existing best practice and aligning with the GIRFEC approach within children’s services it aims to provide a national framework to deliver Health and Social Care services that support person centred outcomes for everyone throughout their adult lives. GIRFE is focused on providing a more personalised way to access help and support at the time when people need it. It is aimed at placing the person at the centre of all decision making that affects them, with a joined-up consistent and multi-disciplinary approach. UHSCNL is one of 10 place-based pathfinders with the progression of this work supported by the Scottish Government’s GIRFE Design School. Our focus is on Frailty and Older People with the pathfinder linking to a range of local as well as national aspirations, policies and strategies including The Plan for North Lanarkshire, the Health & Social Care North Lanarkshire Strategic Commissioning Plan and the Strategy for Preventing and Managing Frailty. Learning from GIRFE work locally and nationally will inform future policy and practice across the authority. Nationally, GIRFE work has reached the point where 16 prototypes are currently being tested, with North Lanarkshire focusing on the following areas: ageing well, personal networks, accessible and usable information, peer support and Community Hubs. A process of co-production with both people who live and use services in North Lanarkshire and Health and Social Care staff is underway, with the consultation and co-design process having involved over 600 people to date. Active testing of the GIRFE prototypes is now underway to enable the approach to be more widely interpreted and implemented both locally and nationally. 2.6.2 MAKING LIFE EASIER Disability Information Officers have been active in the community over the past year, promoting our Making Life Easier, web-based service and supporting individuals to use the site and undertake self-assessments. The service also developed telephone assessments to help assessing staff during clinics/assessments. In addition, the service invested time in work with ADL Smart care working on a new and improved website and life curve and reviewing the content of the service system. Page 145 of 214
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26 2.6.3 ASSISTIVE TECHNOLOGY TEAM The assistive technology team have continued to work across social work and the partnership to improve quality, delivery, and safety in assessment and care planning aiming to identify and achieve outcomes with people supported by the service in the least invasive of ways. The team’s main ambition is that all individuals working for UHSCNL consider assistive technology as a necessary tool to enhance and safeguard wellbeing and making sure the most vulnerable people have the skills, connectivity, and devices to participate in a digital nation. There is also focus on reducing carer stress and empowering individuals, supporting independence and on reducing isolation whilst the team can also offer solutions which complement other services whilst mitigating some of the demand on them. Across 2023-24 1,081 people were referred to the team. 36% of people accessing the service were over 80 years of age, 38% between 61-80. There were 1,005 assessments of need and 267 assistive technology flat visits. There continues to be upward trend for all referrals, assessments undertaken, and equipment provided. The assistive technology flat has been further developed and showcases an extensive range of council provided assistive technology as well as technology which can be purchased privately. Funding for the flat derived from housing budgets 2023-24. This will not continue for 2024-25 and an alternative source of funding will be sought. 2.6.4 COMMUNITY ALARMS As of 31 March 2024, Community Alarm Service supported approximately 7,700 people with 6,150 individuals supported in individual homes and a further 1,550 people in housing with support accommodation. The community alarm service also supports around 1,000 pieces of assistive technology programmed through the alarm receiving centre, with equipment ranging from door contacts to hard-wired smoke detectors for individuals with a cognitive impairment. Response Advisors also provide support to out-of-hours Home Support and takes social work emergency service calls from 01.30am. The average call volume each month received within Community Alarm is around 48,000 with around 2,180 of these leading to a visit from a Community Alarm Home Support worker (HSW) for face-to-face support to be provided. The service’s current alarm receiving centre ‘Tunstall’ servers had been identified as becoming obsolete/end of life by colleagues from Infrastructure resulting in the procurement of a ‘Software as a Service’ (SAAS) solution as we transitioned to the new ‘Alarm Receiving Centre’ (ARC). As all UK telephone lines are being migrated to digital it is also essential that we move to a fully digital community alarm system for both the devices and the ARC and to support this Analogue to Digital Board meets every 8 weeks to have oversight of the ongoing works being undertaken to transition the Community Alarm Service to a fully Digital solution. Replacement of these analogue alarms commenced in January 2023 and to date 3,000 units have been purchased and replaced. A further 1,000 units are currently being procured for a planned installation by the end of September 2024. Page 146 of 214
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27 Staffing levels within the Community Alarm service have remained largely unchanged since the service was established and a priority over the next period is to review this in the light of both digital system developments, high call levels and the diversity of needs supported by the service. 2.6.5 EQUIPMENT & ADAPTATION SERVICE (EAS) The service has been internally reviewed and evaluated over the last year with changes informed both by scrutiny of key processes and feedback from both Health and Social Care staff and service users. Importantly the service has cleared all outstanding waiting lists and is progressing a proactive service delivery approach to facilitate delivery by priority, helping avoid hospital admission and facilitating timely discharges. The service has also procured a new equipment ordering system which has assisted staff to deal with the demand on service in a more streamlined way aiding improved communication and response times. The service can now record and report more accurate performance information whilst qualitative data on how equipment delivered by the service has impacted on people has been collated through a survey. Core staffing has been enhanced through recruitment to additional posts and training. Looking ahead, the service is seeking to procure recycling equipment to ensure appropriate standard are met, increase recycling time and rates within the service, and to reduce waste whilst there is ongoing work with Enterprise and Communities colleagues to improve adaptation processes. 2.6.6 INTEGRATED DAY SERVICES (IDS) Integrated Day Services (IDS) for older adults have continued to support people with complex support needs to safely live in their own homes, often preventing admissions to hospital. Support that the service provides covers the six North Lanarkshire localities. During Covid there were changes with IDS Nursing staff being redeployed to older adult community mental health teams and these changes have remained apart from one locality. This will be addressed through the current service review to agree a service model fit for purpose post covid, ensuring improved supports for older adults in North Lanarkshire aligned to the Dementia Strategy. The IDS outreach via community groups continues in each locality, and these are well attended however transport and community venues can be a constraint and locality link workers continue to work with local agencies to address this and overcome any barriers to accessing this support. This is an alternative low-level support for older adults whereby the fuller service is for people more advanced in their dementia journey. It is noted across North Lanarkshire that dependency levels and complexity of need of people living in the community and needing support from IDS has increased. IDS staff continue to provide high levels of support to people known to the service as well as to unpaid carers and continue to stay committed, focused, and passionate about the positive contribution IDS has to older adults living in North Lanarkshire. 2.6.7 HOME ASSESSMENT TEAM (HAT) North Lanarkshire’s Home Assessment Team (HAT) is a multi-disciplinary Social Work, Health and Social Care resource which applies a whole system approach to planning and preparation for hospital discharge and admission avoidance by facilitating both assessment and intervention within each person’s own home. During the reporting period 1,224 patients have been referred to HAT and supported to return home from hospital. Page 147 of 214
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28 As illustrated by the chart below, there has been a gradual build-up in the volume of referrals as staff have been recruited and trained. Whilst all localities are not yet fully operational, an average of 102 people are currently supported by the service every month. Those people who are referred to HAT are also being discharged quicker from hospital to be fully assessed in their home environment, with 94% of individuals referred to HAT and discharged from hospital on the same day. As the HAT developed, the team were able to accept more complex cases and fully implement the multi-disciplinary teamwork that is required to support a ‘Home First’ approach. As more complex cases have been accepted, the proportion of people recorded as completing the service with no further service required has decreased; however, we know from our monitoring of delayed discharges that the HAT approach is improving flow. The contribution of the Home Assessment Team also appears to be having an indirect impact on the Partnership’s overall performance in relation to patients’ discharge being delayed in hospital. 2.6.8 HOME SUPPORT SERVICE As of the end of February 2024, there were 2,305 people being supported by 955 Full Time Equivalent (FTE) care at home staff across North Lanarkshire. The in-house service has a workforce of Home Support Workers (HSW) in Reablement, HAT, Intensive, Longer-term Home Support provision and the Community Alarm Service. Across these services, a total of 1,403 staff are employed, with a worker profile of 6% male staff (figure inclusive of 101 sessional staff). In addition, there are 235 back-office staff in various support roles. Over the past year, increasing demand, service complexity and the recruitment and retention of a skilled and flexible workforce has remained a challenge. To mitigate this, we have implemented a range of actions to support improvement in the quality and consistency of care and support across our Home Support Service. The service model is being reviewed to ensure it is fit for purpose, in the current environment, and into future, including consideration of new roles introduced since 2019. Planned changes will ensure that the service is sustainable and can support both demand pressures and our strategic ambitions, in line with ‘enabling hubs and the Back-to-Basics approach. To support this, stakeholder consultation events were held in local communities to capture feedback on the current and future service model with surveys to seek views on the service being issued prior to events, with paper copies and QR codes also made available at these events. Initial analysis of feedback from people using the service and carers who responded reported positive experiences of care and support delivered by HSWs (Home Support Worker). A common theme from consultation however was the service not always getting the right balance of care and support for individuals receiving a service. Data from consultation events was captured and any operational issues were addressed Page 148 of 214
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29 by Service Delivery Managers with a more general improvement action being the was provision of a link to all HSWs to assist the service to prioritise reviews where the support required to be adjusted to meet individual outcomes Consultation events were also held for office-based staff during July 2023, and again held in each locality area. The events supported the workforce to understand and commit to the vision behind service transformation. The service continues to work closely with the Care Inspectorate to meet requirements and improvements that have been identified through the inspection process. All teams have now received a full inspection, with some teams receiving follow up visits to address outstanding requirements. The new inspection year will commence in April 2024, and the service has been informed each team will receive a full inspection during follow up visits. Over the last few months, the service has taken delivery of a brand-new fleet of hybrid 4x4 vehicles to replace its ageing fleet. This investment supports North Lanarkshire Council’s drive towards ensuring that a more environmentally friendly fleet of vehicles are in place supporting the citizens of North Lanarkshire. 2.6.9 TRANSFORMATIONAL SELF-DIRECTED SUPPORT (SDS) AGENDA & INDIVIDUAL BUDGETS The overarching aim of the SDS (SELF DIRECTED SUPPORT) transformation agenda in North Lanarkshire is aligned with the intention and values underpinning the SDS Act 2013 - to support and empower people to achieve the outcomes that are important to them, to lead full and meaningful lives, and to participate in, and contribute to, their communities. Our approach has a focus on ensuring that we deliver fully on the SDS principles of participation and dignity, involvement, informed choice, and collaboration. In 2023/2024 we supported 2,480 people with an individual budget, delivered across the four options as shown involving 99.7 million in resourcing and reflecting the centrality of self-directed support to social work practice: Option 1 – Direct payment - 360 Option 2 – Budget managed by support provider – 1,957 Option 3 – Budget managed by local authority - 152 Option 4 – Budget managed by a mixture of first three options - 11 Over this period North Lanarkshire have been represented on national groups reviewing the SDS Standards and facilitated by Social Work Scotland. We continue to be part of the national group who are developing an approach to the realisation of the standards reflecting our desire to support decision making as close to people as possible, decisions being made quicker, empowering frontline workers and leaders, and increase local creativity. 2.6.10 COMMUNITY LIVING CHANGE FUND/COMING HOME The Coming Home team has been in place since 2023, funded from the community change funding from Scottish Government to identify and support planning for people in hospital or out of area for prolonged and unnecessary reasons. The team have, through collaboration, identified the people who fall into this category and in line with Scottish Government guidance, have populated a Dynamic Support Register (DSR) for North Lanarkshire. Coming Home Review and implementation groups have been created to implement all the required measures to minimise people having to leave our area for support or treatment and the team continue to link with each allocated social worker for those on the DSR to track progress towards ensuring a suitable and preferred living arrangement is identified and actively pursued. Page 149 of 214
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30 Understanding who is at risk of support breakdown is a priority and prevention of hospital admission is key. Work has therefore also commenced to understand the at-risk population in more detail, with the aim being to explore what is required to keep people as well supported and safe as possible. North Lanarkshire’s allocation of the change fund was committed for a two-year period and is set to cease in March 2025. We understand no further change fund resourcing will be available after this date. We recognise the areas of focus and are using existing resources to develop our understanding further, with the aim being to minimise any impact. 2.7 DIGITAL SYSTEMS TRANSFORMATION During 2023-24, there has been significant progress and investment in digital solutions to support the management of social work and social care services. In addition to developments in Assistive Technology and those linked to the Community Alarm Service reference above these have included: Mosaic Case Management System As part of the North Lanarkshire Council’s Digital NL programme of work and Digital and IT Strategy 2019-24, the council carried out a cloud readiness assessment to determine which line of business system would be suitable for transitioning to a range of cloud-based solutions. This reinforced existing service concerns around the functionality of our SWIS case management system and led to a tender for a new system. Mosaic, the new Social Care Case management system, will be used across all social work services and the tackling poverty team presenting significant opportunities to improve worker access to relevant information, provide a single source for data on the people we support, improve data analytics and reporting to inform service improvement, and better opportunities for data sharing across the partnership. Reflecting the scale of work required to safely and effectively support this transition the development and implementation of Mosaic is supported by a project team, which has spent several months working with teams from across all care groups and the wider system to configure the system to reflect our streamlined processes and workflows with testing to take place in late summer, supported by a training programme for staff commencing in Autumn 2024. Importantly the functionality of the new system is designed to better support practice. Dynamic Scheduling System for Care at Home Services (CM 2000) As reflected above the Home Support Service is currently engaged in a service redesign exercise and within the context of the wider redesign activity, has procured a digital solution to ensure staff capacity is optimally utilised supporting the provision of over 6,000 visits per day by the approximately 750 home support workers on shift daily and importantly also supporting improvement in continuity of service and the matching of the right staff with the right skills to people at the right time, essential to the provision of quality care and services. Procurement in February 2024 of the CM2000 product is anticipated to support service delivery by aiding back-office staff to schedule support and adapt quickly to changing needs efficiently and effectively with the opportunity to explore additional benefits which would allow both supported people and family members to access care notes via an application allowing real time updates. ELMS 2 – Equipment Management System (Integrated Equipment & Adaptation Service) The Integrated Equipment & Adaptation Service has for many years used a software platform which is no longer supported. The system manages the day-to-day demands of delivering independent living equipment services across both North and South Lanarkshire. This includes stock control and asset management. The legacy system has suffered from a lack of integration across other systems and applications resulting in a reliance on paper-based systems and processes requiring significant double keying, A newly procured software solution, ELMS 2, will now be implemented to better support service requirements including: • Direct ordering and tracking of orders technology providing delivery routes and times • Linking directly to the stock control process, reducing administrative functions Page 150 of 214
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31 • Use on handheld devices reducing the reliance on printed paperwork and providing real-time delivery information to the prescribers and route management • Improved monitoring of equipment due for review and maintenance • Giving staff direct access to equipment catalogues stock levels and service users equipment history ELMS 2 also offers interoperability and integration with Mosaic, Implementing these systems presents not just a shift from legacy systems, some of which are end of life, but also a cultural shift in using digital platforms which allow the service to function differently. The ability to access and generate accurate and real time information to support practitioners, the ability for supported people to access their own data and the enhanced data quality and integration offered by these products will continue to support the service across a range of settings. 3. STATUTORY INTERVENTIONS 3.1 MENTAL HEALTH OFFICERS SERVICE AND ADULTS WITH INCAPACITY ACT (SCOTLAND) 2000 There has continued to be considerable demand placed upon the Mental Health Officer (MHO) Service in recent years in terms of orders being sought under incapacity law in part because of large scale investigations which meant that a considerable resource had to be channelled towards meeting the demands of making new applications for orders. There has also been a significant increase in private guardianship applications. As illustrated in the above graphic there is a marked increase in new orders. During the period 2022-23, there were 150 new ‘private’ Guardianship Orders, with a rise to 248 in 2023-24, an increase of 49.2% on the previous year. Guardianship Orders granted to the local authority also rose from 73 in 2022-23 to 114 in 2023-24, representing an increase of 43.9%. A similar trend is seen with Intervention Orders which rose from 5 in 2022-23 to 19 in 2023-24. This representing an increase of 116.7%. The overall number Guardianship Orders in place for individual's resident in North Lanarkshire has fallen very slightly by 23 to 1,031, involving 237 (23%) orders where the CSWO is appointed as Welfare Guardian, with the remaining 794 (77%) being ‘private’ Guardianship Orders. Reviews of all orders take place on a regular basis, with the intention of ensuring that powers are being used in accordance with the principles of the Adults with Incapacity (Scotland) Act 2000. Despite the slight fall referenced above the significant increase in new orders is matched by an ongoing increase in 9 15 38 24 9 19 38 30 42 80 24 34 0 6 4 3 3 3 0 10 20 30 40 50 60 70 80 90 AIRDRIE BELLSHILL COATBRIDGE CUMBERNAULD MOTHERWELL WISHAW Number of New Legal Orders GUARDIANSHIP ORDERS (LOCAL AUTHORITY) GUARDIANSHIP ORDERS (PRIVATE) INTERVENTION ORDER FINANCIAL/PROPERTY Page 151 of 214
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32 applications as illustrated below: Between April 2023 to March 2024, 272 new Guardianship Orders were requested an increase of 2% on the previous year– this total is inclusive of renewal requests for ‘private’ Guardianship Order. Local Authority applications and renewals totalled at 153 for the period. This continues a trend which has seen an increase of 67.3% in applications since April 2021. It is possible that the impact of Covid and extensions to the expiry date of orders during the pandemic may have had a bearing on these figures. However, what is evidenced is an upward trend in demand placed upon the service to allocate MHOs, to complete reports to support AWI applications, to the Courts, under incapacity law. This alongside recruitment challenges described below has led to delays in the ability to allocate MHOs to support applications which are less urgent, a situation which the service recognises runs counter to our desire to support anticipatory planning for individuals. 3.2 MENTAL HEALTH (CARE AND TREATMENT) ACT 2003 AND MENTAL HEALTH (SCOTLAND ACT 2015) National trends for civil detentions under the Mental Health (Care and Treatment) (Scotland) Act 2003 have continued to rise both nationally and locally. Locally there has been a significant increase in the number of recorded Emergency Detention Certificates, up by 102% on the previous year and Short-Term Detention Certificates have increased by 4.4% on the previous year, 2022-23 however, the number of Compulsory Treatment Orders has decreased slightly at 2.7% less than the previous year. There has been a modest increase of 6.7% seen in the number of new requests for Mental Health Officer (MHO) input to ‘forensic’ mental health orders under the Criminal Procedure (Scotland) Act 1995. The requirement for MHOs to be appointed to Compulsion Order with Restriction Orders (COROs) and Compulsion Orders rose significantly with an increase of 52.2% on the previous year, 2022-23. All these figures are illustrated in the table below: Total Emergency Detention consents (101) 203 [102% increase] Total Emergency Detentions where no consent was sought (76) 47 [47.2% decrease] Consent refused by MHO – Emergency Detentions (0) 0 [No change] Total Short Term Detention consents (247) 258 [4.4% increase] Consent refused by MHO – Short Term Detentions (11) 6 [58.8% decrease] Page 152 of 214
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33 Total Compulsory Treatment Orders (191) 186 [2.7% decrease] Total Forensic Report Requests (28) 30 [6.7% increase] Total Forensic orders supervised (CORO/CO) (17) 29 [52.2% increase] 2022-23 data for comparison is highlighted in red. 3.3 DEVELOPMENT OF MHO SERVICE TO MEET NEEDS Previous reports outlined a rapid development within the service during the Covid pandemic. This saw the implementation of remote working and a centralisation of the MHO Service. Over the past two years, there has been a return to face-to-face working with clients alongside a hybrid approach to meetings. The centralisation of the MHO service at that time was seen to provide a degree of flexibility in the allocation of MHOs across the council area, to help relieve resourcing pressures in specific localities, as far as was possible. On review in 2023 it was however agreed that a return to locally based teams provided better connections and working arrangements for staff and better supported effective planning for individuals. This has now been actioned following appropriate consultation processes. Internal development opportunities continue with Mental Health Officer forums held quarterly. These events allow discussion on upcoming legislation and legislative changes and provide an opportunity for guest speakers to attend. Remote external training and development opportunities also continue through organizations' such as the Scottish Forensic Network and Scottish Association of Social Workers. 3.4 APPROPRIATE ADULT SERVICES It is a statutory duty for local authorities to deliver an Appropriate Adult (AA) Service under the Criminal Justice (Scotland) Act 2016 (s99), in line with functions conferred by the 2019 regulations. This legislation also places a statutory duty on Police Scotland (and other policing authorities as listed within the National Guidance) to facilitate an Appropriate Adult (AA) whereby they believe that an adult (above the age of 16) requires support with communication and understanding, owing to a mental disorder (s42). Over the last financial year, 12 new appropriate adults have been recruited, making the total number of Appropriate Adults within North Lanarkshire Council 39. 29 of these carry out the AA role on a duty rota basis during office hours whilst the remaining 10 undertake their role as an AA out-of-hours through the Social Work Emergency Service (SWES). In comparison to the last financial year, requests to the AA Service have increased by 30.5% from 59 to 77. This continues to be monitored through quarterly reports alongside regular meetings with the AA’s and with Police Scotland. The primary reason for people who requiring an AA was Learning Disability which accounted for 37 of the 77 referrals. 32 of the referrals were for Victims whilst 22 were for those ‘Officially Accused’, 16 ‘Not Officially Accused’ and 5 Witnesses. Of these 31 requests were to support adults involved with a Police Statement with the remaining referrals varied for support in procedures such as Caution and Charge, DNA, Medical Examinations, Police Interview Rights of Suspects (PIRoS) and Interviews. Currently, a process to gather feedback from the people using the service is being developed, to support feedback, assurance, and improvement. Links have also been made with other AA services and with the Care Inspectorate to share knowledge, skills, and experience to further develop the AA service within NLC. In the next financial year, the aim is to have developed a wider self-evaluation framework. As part of this development, a staff survey has been undertaken which has provided a further insight into the AA service as well as offering invaluable feedback on how to support and further develop the AA team. Page 153 of 214
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34 3.5 PUBLIC PROTECTION 3.5.1 ADULT SUPPORT AND PROTECTION VESTIGATIONS/CASE CONFERENCES AND STATUTORY ORDERS/ FUNCTIONS Over the period, North Lanarkshire received 3,314 ASP referrals, an increase of 9%, compared to 2022-23 (3034 to 3314). This is the fifth consecutive year that an annual increase has been measured. Referrals from NHS Lanarkshire colleagues continue to rise, showing a 11% increase compared to last year from 583 to 645 whilst ASP referrals from Police Scotland have increased 24% from 330 to 410. Social Work referrals fell slightly by 2% from 408 to 399, whilst Scottish Fire and Rescue increased 5% from 110 to 116. Care homes were the highest ASP referrer group in 2023-24 accounting for 34% (1,124) of all ASP referrals received a 21% increase on the previous year from 933 to 1,124, in part reflecting the challenges in managing increasing complexity of care needs within group living settings. Monitoring and support in this area is provided by colleagues in Quality Assurance. In addition, a pan Lanarkshire task group has been set up through North and South Lanarkshire’s Adult Support and Protection Committees with all care home stakeholders involved. This aims to provide support to care homes to achieve a balanced and consistent approach in relation to ASP referrals and decision making. Whilst Police ASP referrals have increased, Police ‘Adult Concern reports’ continue to increase also with a total of 4,280 Police ‘Adult Concern’ Reports received during the period an increase of 7% and reflecting the significant activity undertaken to keep adults in our communities safe. Physical harm remains the most common harm type for referral with 1,594 referrals received, up 11% from last year This high number of referrals with physical harm as the primary harm type is closely linked to the high number of ASP referrals received from the care home sector which often relate to witnessed/unwitnessed falls and low-level altercations between residents. As noted, work with care homes and stakeholders remains a priority in ASP. Cases featuring self-neglect can be some of the most difficult and complex for practitioners to manage as they often span ethical, legal, and practical considerations. For the period there were 309 ASP referrals relating to self-neglect, an 11% increase in comparison to the previous year. Supporting good practice in these circumstances is a priority and this area has been targeted through ASP multi agency training with a specific focus on defensible decision making and professional curiosity. 408 110 330 583 3034 399 116 410 645 3,314 0 500 1000 1500 2000 2500 3000 3500 Social Work Fire & Rescue Scotland Police Scotland NHS Total ASP referrals ASP referral sources 2022-23 2023-24 Page 154 of 214
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35 ASP Inquiry with investigatory activity It is important to note that NLC Social Work Adult Support and Protection procedures have now been updated. Key changes within the procedures centre on language and how we now view ASP ‘Inquiries and investigations.’ We now refer to initial inquires as ‘inquiries without investigatory activity’ and ASP investigations and ASP ‘Inquiry with investigatory activity.’ Importantly investigatory activity involves any direct contact with the adult or their legal proxy, as such, it is anticipated there will be a rise in investigatory activity, and this should be reflected in future reports. There was a total of 477 inquiries with investigatory activity in the reporting period reflecting the number of ASP referrals which converted to inquiry with investigatory activity is 14%. This is a slight increase from last year’s conversion rate of 13%. ASP Case Conferences A total of 66 initial case conferences held and 56 review cases conferences were held meaning 14% of all investigatory activity led to an initial case conference. This conversion rate has declined from the last reporting period (17% to 14%) and reflects a continued decline in this rate over the last three years. Statutory Orders issued over the period: Type of Protection Orders Number of Protection Orders granted Assessment Order 0 Removal Order 1 Temporary Banning Order 0 Banning Order 0 Temporary Banning Order with Power of Arrest 4 Banning Order with Power of Arrest 2 Total 7 The use of protection orders fell 50% compared to last year (15 to seven). It is recognised that where ‘adults at risk ‘are subject to protection planning measures, and as such, a range of actions have been implemented to mitigate risk of harm, this can reduce the requirement for an ASP Protection Order. 3.5.2 MAPPA (MULTI-AGENCY PUBLIC PROTECTION ARRANGEMENTS) Justice Social Work continues to work effectively within MAPPA arrangements to manage and support people convicted of sexual offences or otherwise identified as presenting a risk of serious harm (ROSH) to maximise public protection, whilst maintaining a proportionate and individualised approach to risk and need. The number of individuals managed under MAPPA has continued to grow year on year in part due to the rise in online offences contributing to increased demand pressures on the service. The increase in the number of individuals being managed under the MAPPA process with no corresponding increase in resource in funding and staff continues to put pressure on the service. This is a situation which shows no signs of diminishing in the coming years. This reporting year has witnessed an 8.4% increase in MAPPA activity from the previous year. Overall, the number of individuals managed under MAPPA have grown significantly since arrangements were established 17 years ago. Page 155 of 214
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36 More specific detail of MAPPA related activity is published annually within the pan-Lanarkshire MAPPA report. MAPPA arrangements interface often with other public protection processes including child and adult protection and with adult social work more broadly due to the increasing number of individuals managed through MAPPA who have care needs relating to frailty or disability. MAPPA awareness sessions for wider staff groups are therefore held regularly. In March 2024, a local multi-agency event was held, focused-on people being managed and supported under the Justice system with a diagnosed learning disability, or with neurodiversity challenges. This event was provided delivered by NHS colleagues. In addition, in partnership with South Lanarkshire Council and MAPPA partners two multi-agency events were hosted in September 2023. Staff from Social Work, Police Scotland, Housing, and NHS Lanarkshire attended a full day input in relation to Risk Practice which was delivered by Professor Hazel Kempshall. This offered a valuable opportunity for colleagues to reflect on shared responsibilities, joint practice and strengthened collaborative approaches to managing risk and enhancing public protection. 3.5.3 CHILD PROTECTION INCLUDING CONTEXTUAL SAFEGUARDING Following a trend identified in previous annual reports, child protection notifications have continued to increase as illustrated below representing a 125% increase from 2017/18. Year Number of Referrals Investigations Percentage Of Referrals Proceeding to Investigation Number of Investigations That Proceeded to Case Conference Number Of Registrations from Case Conferences 2023-24 2,326 768 33% 254 179 2022-23 1,895 775 41% 264 198 2021-22 1,714 754 44% 229 177 2020-21 1,482 831 56% 261 199 2019-20 1,617 800 49% 339 254 2018-19 1,150 642 56% 329 251 2017-18 1,030 692 67% 340 252 The overall increase in the number of referrals received is related to the extension of our child protection framework in line with child protection national guidance which now includes areas including care and risk management arrangements for those young people whose behaviour may present a risk of harm to others and extra familial harm within the contextual safeguarding approach. These extensions to our framework alongside Equal Protection legislation and additional pressures on families have increased demand but also consistency in practice and recognition, and response to harm, strengthened by early response to risk and harm by embedding our revised IRD (Initial Referral Discussion) guidance. Contextually it is notable that one in four children still live in poverty and progress in addressing the developmental concerns for children at 27-30 months slowed in 2023-24. Given the established links between poverty, harm, and statutory interventions we believe this is also a factor in the continued demand for support to children in potential need of protection. As noted elsewhere tackling poverty is fundamental to protecting children and supporting families in North Lanarkshire and both child protection and family support responses are integrated with our approach to tackling poverty, under the leadership of the Chief Social Work Officer. Page 156 of 214
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37 Our increased referral numbers have not resulted in an increase in children whose names are placed on the child protection register and this is due to the routes into our IRD process and the routes out of IRD. This means that alongside or as alternative to Child Protection Registration children can, where appropriate be supported by care and risk management processes, a referral to the Young People’s Safeguarding Panel and through family support provided to the family through the Getting it Right for Every Child (GIRFEC) pathway. There has been an increase in older children’s (12+) names being registered on the child protection register. This change indicates that practitioners and managers are increasingly focussing on and recognising the protection of older children and their rights in line with our commitments to Keeping the Promise, the United Nations Convention on the Rights of Children (UNCRC (United Nations Convention on the Rights of the Child)) and our investment in contextual safeguarding, The service has continued to work with the partners in the Child Protection Committee, the Chief Officers, and Lead Officers groups to monitor and understand the relationship between child protection referrals and rates of registration to ensure the right children get the right support when they need it. Our data suggests that children and families are receiving early help and support through our cluster wellbeing approach. This is telling us that our strategic focus and commitment to early help and support, through staged intervention and planning for wellbeing, through the clusters is the right direction of travel to improve outcomes for children and families. Joint Inspection Between April 2023 and October 2023, the partnership was also subject to external scrutiny through Joint Inspection of services for children and young people at risk of harm. The main findings from the inspection were: • The partnership has a strong multi-agency approach to early intervention, collaborative working, and information sharing. • Staff are confident in their knowledge, skills, and ability to recognise, report and respond to signs of child abuse, neglect, and exploitation. We work together to ensure timely identification and responses to safety concerns for children and young people at risk of harm • Staff demonstrate trauma informed and relational practices, which help children and young people experience supportive and trusting relationships with them. • Children and young people have early access to services to support their mental health and emotional wellbeing, before concerns escalated. Partnership approaches were helping to identify need and secure support earlier. 131 125 116 111 54 96 96 0 20 40 60 80 100 120 140 2018 2019 2020 2021 2022 2023 2024 No. on Register as at 31 March 2024 56 63 54 58 24 33 29 38 44 33 32 19 34 31 27 12 22 16 5 25 29 0 0 2 0 1 2 510 6 5 5 5 2 2 0 20 40 60 80 2018 2019 2020 2021 2022 2023 2024 Age Range On The Child Protection Register As At 31 March 0 to 4 years 5 to 10 years 11 to 15 years 16 years and over Unborn Page 157 of 214
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38 • The majority of children and young people are meaningfully and appropriately involved in decisions about their lives. Staff listen to children and young people and understand them. • Senior leaders have a clear vision, which was understood by staff. It was threaded through strategic documents, plans, and outcomes. The partnership was highly aspirational and has a strategic focus to improve outcomes for children and young people. • Collaborative leadership is strong across the partnership. Leaders are aware of strategic risk and jointly deployed resources to the areas of greatest need. Areas identified for Improvement: • Chronologies, assessments, and plans are in place and staff are confident in assessing risks and preparing plans, the quality of these chronologies, assessment and plans is inconsistent. This will be the focus of our improvement work moving forward. Improvement activity cannot be achieved by the Social Work service alone and we are progressing the areas of improvement highlighted by our own self-evaluation activity and the findings from inspection as part of the wider partnership. Partnership actions are driven through our child protection business plan with the three main areas of focus being: • Voice: Strengthen Voice of children, young people, and families within the delivery of CPC functions • Operational practice: Strengthen joint operational practice with a focus on the quality of assessment and planning for individual children and young people. • Data: Strengthen the use of data to drive improvements in practice and process and strategic planning These areas for improvement are being addressed by the Continuous Improvement Group which reports to both the CPC and Children’s Services Planning Partnership. Contextual Safeguarding As reflected above we have continued our commitment to embedding contextual safeguarding as a key vehicle to address the increase in extra-familial harms impacting on our young people. Over the course of 2023 and into 2024, we targeted Domains 2-3 above - improving staff awareness and understanding across the workforce while embedding the recognition of, and response to, extra familial harm within child protection processes. This was reflected in the finding of the Joint Inspection of a culture of rights-based, relational practice and collaboration between young people and staff. Going forward we will have a focus on the conditions of abuse, improving safety, and providing support in a Page 158 of 214
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39 trauma informed way (Domain 1) in addition to taking a more strategic approach to the collation of impact data and monitoring of outcomes (Domain 4). Key areas of development to promote social work practice in this area included the creation of an online training module, the development of a Directory of resources and the availability of consultations for practitioners dealing with complexities in this area. A key area of our systems supporting young people who may be experiencing extra-familial harm is our Young Peoples Safeguarding Panel. Over this period panel actions were strengthened to focus on welfare and safety not surveillance with a fourteen individual young people and two groups of young people referred. Key themes identified included that many young people discussed experienced some neurodevelopmental difficulty, requiring specific support and follow up. The panel continues to play a key role locally in ensuring that the exploitation that underpins the offences that some young people commit is addressed through disruption and the reframing of information provided to SCRA (Scottish Children’s Reporter Administration) and COPFS (Crown Office and Procurator Fiscal Service) to highlight the exploitation and support to young people and peer groups in addition to the increased use of the National Referral Mechanism where appropriate. Our senior officer for contextual safeguarding, played a leading role in a UK-wide research study of the experiences of social workers using the contextual safeguarding approach. The findings of this continue to inform our approach to staff support and training. - Sustaining Social Work: Practitioner experiences of Contextual Safeguarding | Contextual Safeguarding 3.5.4 GENDER BASED VIOLENCE Social Work staff across care groups continue to have a key role with respect to both the prevention and response to Gender Based Violence (GBV). The last year has seen work progress through the VAWG to carry out Customer Journey Mapping, a process of gathering information from women on their experience of services. Women interviewed were survivors of domestic abuse. Key improvement actions have been developed from the information given including domestic abuse inputs to trainee GPs (scheduled for the new year) an audit of out of hours homeless services to determine domestic abuse practice and a domestic abuse development session for frontline police officers in Lanarkshire Division. A multi-year funding solution is now in place for North Lanarkshire MARAC. MARAC in North Lanarkshire in 2023/24 discussed 424 cases, 96% of victims discussed were female and referrals included 852 children. A quality assurance sub-group is now in place and is chaired by Education and Families Manager (Social Work Justice). A process of auditing MARAC meetings and MARAC cases has been approved. The implementation of the Safe and Together Model continues with over 150 children, families and justice social workers trained in the model. Over 500 staff from multi-agency partner services have completed the Overview course. Work is progressing to support workers to take learning into practice. Monthly Safe and Together workshops where staff are supported to apply Safe and Together tools to a specific case are established. Workshops are open to workers who have and haven’t completed Safe and Together training. Strategic linkages are in place with North Lanarkshire Council Equally Safe at Work planning group. The group have representation from the VAWSG and has been working towards Bronze Award renewal. With a key milestone being the launch of North Lanarkshire Council Sexual Harassment Policy. UP2U Family Practice Model The UP2U intimate partner violence approach continues to be invested in by Justice Social Work (JSW) with new staff continuing to be trained in this programme and existing staff being given access to refresher training inputs. Page 159 of 214
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40 UP2U – Creating healthy relationships 2 is the updated version of the domestic abuse intervention programme. Staff have begun to use the updated programme with individuals convicted of intimate partner violence and who are subject to a requirement to undertake UP2U. Integral to this intervention is the offer and provision of partner support for those who have been or are still the victims of intimate partner violence. UP2U family practice is a version of the UP2U programme that can be delivered in a Children and Families context, and this adopts a more flexible approach to early intervention where domestic abuse has been identified within a family. This aims to work with perpetrators of domestic abuse to consider the impact on their children and the wider family. All children and families social work teams have identified Family Practice trainers, and this is an intervention that can be utilized as part of child’s plans. 4. RESOURCES For financial year 2023/24 North Lanarkshire Council had gross annual social work budget of almost £310m. This was allocated as £255m for Adult Social Care and £55m for Children, Families & Justice. The equivalent funding for the previous financial year was £292m. In totality Social Work activity during 2023-24 was undertaken within the overall budget resource and resulted in an underspend position. Social Work FY23-24 - Gross Expenditure Budget £309.547m ACCESS SOCIAL WORK (£1.097m) All Support Functions (£24.790m) ASC Locality Support (Inc A&P) (£23.367m) Assistive Technology (£0.130m) CARE HOMES (£44.157m) CARERS SUPPORT (£3.805m) CHILDREN AND FAMILIES (£28.834m) COMMUNITY ALARMS (£2.561m) HOME SUPPORT (£55.331m) IEAS (£6.290m) JUSTICE SERVICES (£8.495m) MENTAL HEALTH&ADULT PROTECTION (£3.307m) REGISTERD SOCIAL LANDLORDS (£0.716m) SELF DIRECTED SUPPORT (£97.047m) Children & Families A&P (£9.620m) Page 160 of 214
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41 Within Adult Social Care the underspend was almost entirely because of ongoing recruitment issues being seen across the sector, both internally and within the care at home sector reducing the payments to these bodies. The overall underspends across the service were a continuation of the 2022-23 position. These underspends however are non-recurring and the longer-term outlook for the service projects financial pressures across the following areas: • Home Support • Independent Care Homes • Self-Directed Services • Integrated Equipment and Adaptation Service • Children’s Houses • External Placements 4.1 FINANCIAL MODELLING FOR SERVICE DELIVERY Financial Planning and monitoring continue to be a key responsibility for the management team. The Council’s financial strategy includes Service input to four key processes. These are: • Preparation of detailed single year budget • In–year budget monitoring and projections • Preparation of rolling 3-year budgets • Preparation of a Medium-Term Financial Plan Alongside these the Council Finance Team work closely with the IJB Chief Finance Officer to prepare a medium-term financial plan for the Health and Social Care Partnership. In terms of financial modelling the Management Team increasingly take a whole systems approach to delivering new and more efficient operating models which often requires joint working with other Council services and key external partners. With respect to Children’s Services the council and local partnership is one of three areas who have committed to working with the Promise team nationally on ‘Human and Economic Cost Modelling’, work which is intended to support longer term change both nationally and locally by identifying how money is currently spent and the system changes required to move the balance of spend toward early intervention and family support in line with the aspirations of Christie. 5. WORKFORCE Workforce planning within social work is overseen by the Social Work Workforce Group, which both informs and is informed by the Council’s corporate ‘Workforce for the Future Strategy’ and the wider UHSCPNL workplan. 5.1 WORKFORCE PLANNING Challenges in the labour market have impacted on recruitment to certain posts and the pressures on local authorities and HSCPs to provide services in the face of savings agendas has also impacted on workforce plans. Demand pressures have also continued to impact on the ask of the social work workforce over this period. To support overcome these challenges, a close partnership approach between the service and HR colleagues has been built. Working together on recruitment, training and development and the management of employee absence, as well Page 161 of 214
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42 as developing and implementing initiatives has supported the service to manage demands whilst supporting workforce resilience. 5.2 SOCIAL WORK RECRUITMENT AND RETENTION Enhanced whole career support and development, allied to the wider ambitions of Workforce for the Future and the Scottish Government ambition to create a strategic framework from qualification though to enhanced practice, remains at the forefront of NLCs commitment to Social Workers. This work commences prior to recruitment, building strong relationships with further education establishments and supporting student placements in the development of future qualified Social Workers. Our commitment to the provision of Practice Learning has remained strong and a model which continues to include student hubs has supported ensure quality learning experiences are available to all students as referenced in section 5.10 below. To support both enhanced career pathways and recruitment our Social Work Trainee Scheme was recently re- established and funding for eight Social Work employees agreed via an earmarked reserve. In order to support access to a broader range of staff courses varying in length from 18 months to three years, dependent on the individual’s current qualification level, have been sourced and funded, with the employees fully supported in becoming qualified Social Workers. Due to popular demand 14 candidates who were not successful this time have had learning pathways identified to support them to continue their journey to become a Social Worker. A further 25 employees are also working through development plans with a view to progressing to the social work degree pathway. NLC has also sponsored five self-funded employees, as they studied for their Social Work qualification. Recruitment opportunities were made available to these students as they neared completion of their course. All five were successful and subsequently offered Social Work positions within NLC. In addition to internal pathways, we continue to recruit externally, and advertising frequency and dates have been reviewed to streamline processes and quicken the employee onboarding experience with improvements seen in recent campaigns. We continue to offer immediate access to our Senior Practitioner scheme for eligible Social Workers. These processes will continue to be reviewed, and improvements made wherever possible to support our ability to attract and retain social workers in what remains a challenging context. During 23/24 we also commissioned research into the recruitment of social workers from global ethnic minority communities, as we endeavour both to recruit a more diverse and representative workforce and improve the support and the experience of our BAME staff. It is hoped that any changes implemented for Social Work recruitment will also be of benefit to authority wide recruitment processes. Whilst too early to assess the full impact of the regrading of main grade, senior practitioner and first line management social work roles reported last year and actioned on 1 May 2023 the council is now more competitive in terms of salary, when compared to the other authorities and there are early indications of reducing vacancies and there is hope that this plus the support and development that is offered will encourage applicants and assist in the retention of current Social Workers. In line with the re-evaluation of roles the job description and employee specification for social workers has now been reviewed, and issued to all Social Workers, bringing this in line with the expectations of the role within an increasingly complex context whilst remaining grounded in relationship-based practice. Recruitment to temporary posts however remains challenging. These requirements exist for a number of reasons, including temporary promotions, maternity leave and long-term absence cover and the increasing number of roles related directly or as backfill for posts supported through temporary funding streams principally linked to Scottish Government recovery funding in justice services and change initiatives in other areas. Temporary vacancies are being Page 162 of 214
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43 closely monitored in terms of numbers, locations and the impact on teams. Whilst for a period, and in line with predicted turnover, the service was able to offer permanent contracts against temporary vacancies for social workers the capacity to do this has reduced as vacancies have decreased and many temporary funding streams remain committed only to the end of the parliamentary term. Whilst social Workers are being appointed through NLC recruitment processes and entering the workforce with new skills, creativity, and commitment there are now issues relating to the balance of experience within the service with a high number of relatively newly qualified staff. To mitigate this for both new and experienced Social Workers, managers are monitoring caseloads, assisting in the prioritisation of statutory responsibilities, and ensuring additional supports, such as Health and Wellbeing, are available when required. Support is also being provided through the hubs and the TOD Team are working closely with the service. The commitment to the requirements of the Support Year in Practice in both time and resource is substantial. A review of the Supported Year in Practice has recently been undertaken to ensure compliance with new requirements issued by SSSC, ‘Definitions of employer support 2023’. Prior commitment to NQSW support and development assisted NLC, however lack of funding from the SSSC or Scottish Government to support these requirements beyond the pilot period is disappointing and reconfiguration within the TOD team and additional input from managers will be required to retain commitment to this key area of support for staff. Targeted advertising has proven invaluable in securing the skill and experience required for specific posts in hospital and home assessment teams however recruitment, in particular external recruitment in the key area of Mental Health Officer roles has remained challenging and has not kept pace with need impacting on service provision in key areas. We continue to be committed to promoting the MHO programme to existing Social Workers within the service. The route is through the MHO Traineeship Scheme, which supports Social Workers in gaining an MHO award – a postgraduate award through the University of Strathclyde, Glasgow. It is expected that three MHO trainees will successfully complete the MHO Award in June 2024, to then take up full-time MHO vacancies within the service. To further support the MHO Service and to help expedite the discharge of hospital patients awaiting powers under AWI legislation (typically in the form of Guardianship Orders), the MHO Service now has eight sessional MHOs who can be allocated work thus easing a significant pressure on Locality-based MHOs. Funding for temporary positions within the Community Mental Health Teams continues, allowing Social Workers from across Education and Families, Adults and Justice Services who are considering applying for the MHO award, to be a part of a Mental Health Team. The establishment of the Practice Assessor role and the ongoing work of the postholder, not only for MHO students but also for those who have expressed an interest in the course, is invaluable. Opportunities for experienced Social Workers including MHOs include the Senior Practitioner Scheme. This scheme maintains our commitment to Social Workers, and Community Occupational Therapists, beyond qualification and appointment. With over 50 practitioners holding the status the scheme enables those who meet the criteria to progress to an enhanced salary scale. The service also benefits with Senior Practitioners committing to undertake additional responsibilities within the authority. 5.3 SOCIAL CARE Linked with both the national and local focus on supporting hospital discharge and providing quality support and reablement within the community a significant focus remains on the recruitment of home support workers and other social care roles. Recruitment to these positions is in line with the strategic direction of the service and whilst there has been success, staff turnover has resulted in little net increase in staffing numbers overall. Monitoring of recruitment and the placement of newly appointed HSW across the six localities therefore continues with the wider Home Support Service review referenced earlier having a key focus on a sustainable staffing model. Page 163 of 214
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44 In recognition of the key role that Home Support Schedulers play within the Home Support Service, six new Home Support Scheduler Supervisors have been introduced. To date, five positions have been filled, and the remaining one will be advertised. These roles will direct, guide, and instruct scheduling through a person-centered approach, ensuring excellent customer service. 5.4 OTHER RECRUITMENT AND RETENTION CHALLENGES Other areas in which recruitment challenges are evident include roles within Locality Support Services and Clerical and Administration posts. The recruitment and retention difficulties within Social Work administration have resulted in a planned review and redesign which will progress over the coming year. In the interim action is being taken to promote recruitment to these difficult to fill roles, for example, linking directly with local colleges as adverts are released and work continues to develop apprenticeship schemes as a route into these areas. The service has also benefited from the corporate Summer Placement Programme developed to provide paid work to NLC pupils for seven weeks of the school summer holidays. Over the summer, fifty placements were made within Social Work services in roles such as HSW, Locality Support Worker and Clerical Assistant. Placements within other services have also been facilitated, for example in Early Years, Customer Service, Health and Safety and Sports Development. 5.5 CARE ACADEMY During this year and drawing on funding from the UK Shared Prosperity Fund and earmarked HSCP reserves projects taken forward under this umbrella have included: Project one – Trainee Social Worker Scheme As noted in section 5.2 above there are eight internal Social Work trainees who have been successful in becoming part of this programme with a further 46 now on the pathway to gaining the necessary qualification which will allow them to be considered for future programmes. Project two – Upskilling for Home Care Workers In line with the qualification agenda, we continue to utilise the monies available from the UK Prosperity Fund to develop a training pathway for our Home Support staff. Our partnership with New College Lanarkshire has enabled us to procure access to ongoing spaces for the programme over the next year with another 60 workers currently undertaking qualification from our August 2023, November 2023, and March 2024 cohorts. The success of this programme has also allowed us the opportunity to extend this relationship with New College Lanarkshire with us recognising the ongoing staffing difficulties within the service and the level of new recruits also requiring access to qualifications within a shorter time frame. Project three – Home Care Support Officers We are continuing to liaise with services across the Home Support workforce to identify opportunities to support this group of staff to access suitable qualifications and opportunities for future employment pathways. However, this work will now be aligned with the redesign of the home support service and the new structure of the staffing complement. We envisage using available monies from the UK Prosperity Fund to ensure that we invest in this group of staff to both attract and retain the quality and skills of our support staff who are a vital resource for home support services. The group which will be targeted initially are the Schedulers and Senior Schedulers. A relevant career pathway has been built for this group of staff with access to a recognised qualification. 5.6 WORKFORCE DEVELOPMENT AND STAFF SUPPORT Our online platform for learning, LearnNL is a key component in providing improved access to learning and provides each employee with an individual learning record linked to the Performance Review and Development (PRD process). Page 164 of 214
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45 The reporting function within LearnNL allows us to filter and sort information in a variety of ways and ensures that training-related information can be shared quickly and easily with colleagues and with the Care Inspectorate when required. A specific social work space developed within the platform allows staff to see what training opportunities they should be accessing as part of their mandatory training requirement and optional opportunities for development and future progression. 5.7 ASSESSMENT CENTRE AND REGISTRATION Continued provision of qualifications through the Assessment Centre The Assessment Centre continues to support Scottish Vocational Qualification (SVQ), and Professional Development Award (PDA) qualifications required to meet registration, role and CPD requirements. This is achieved through both in house assessment and access to SVQs through external providers. Active Candidates – External Programmes (2023 – present) Scottish Credit and Qualifications Framework (SCQF) Level 6 (SVQ2) – 48 including Home Support and Locality Support Staff SCQF Level 7 (SVQ3) – 23 including Residential Workers, Locality Workers, and Justice Staff SCQF Level 9 (SVQ4) – six including Senior Residential Worker, & Locality Support Manager Higher National Certificate (HNC) – two Residential Worker and Children & Families Support Worker Active Candidates – Internal Programmes (2023 – present) SCQF Level 7 (SVQ3) – two: one HSW and one Technology Support Assistant 5.8 POST GRADUATE OPPORTUNITIES The team also continue to provide access to Post Graduate Certificate opportunities through the Learning and Development budget. The numbers undertaking some form of qualification are detailed below: • Advanced Practice skills – one commenced September 2023 • Postgraduate in Child Welfare and Protection at Stirling University – four candidates commenced September 2023 due finish June 2024 • Postgraduate Certificate in Children and Young People in Conflict with the Law – two candidates started in September 2023 completed June 2023 • Postgraduate in Adult Support and Protection – three • Postgraduate Certificate Securing Children’s Futures – one • Postgraduate in Mental Health – three • MSc In Leading People Centred Care – one • Part funding of final year of PHD qualification – one 5.9 SOCIAL WORK DEGREE PATHWAY WITH THE OPEN UNIVERSITY As reflected in section 5.2 there continues to be a strong appetite across all our Social Work and Social Care workforce in becoming a Social Worker. We have had interest expressed from admin staff, HSWs, education and family support workers, locality day services staff and other staff. We are currently working with 46 members of staff on individual learning plans; all of whom are undertaking Open University modules and working towards a degree in Social Work. The monies received from the UK prosperity fund enabled us to fund modules for staff from October 2023 to May 2024. We anticipate further use of the UK prosperity fund later this year to again support staff on the pathway and further modules commencing in October 2024 and February 2025. 5.10 STUDENT SOCIAL WORK HUB Page 165 of 214
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46 From August 2023 to date, 60 Social Work students were placed within North Lanarkshire; 52 being external students from four different Universities, with 14 of these students securing Social Work posts within North Lanarkshire and now progressing onto our NQSW supported year. From August 2023 onwards we have been developing two student Hubs: one Community Care Hub and one Justice Hub. Both Hubs have evaluated well, with very positive feedback received. We have seconded two full-time Practice Learning Officers and a permanent Practice Learning Officer who also oversees the NQSW supported year. Our Hub activity continues to grow and expand, and we foresee this continuing to develop in line with Service needs and demands. The Hubs are a reflective and educational forum for the students to experience peer to peer support, 1:1 teaching and support from their Practice Learning Officer. They also take part in extensive training sessions and presentations by external speakers whilst direct teaching from their Practice Learning Officer has included risk assessment theory, outcome focused practice, anti-oppressive practice, reflective practice, unconscious bias training, exploration of use of self, development of professional accountability, authority, and assertiveness. All of which are crucial in solidifying the fundamentals required of a qualified Social Worker. The students have also benefited from the relationship and links created within the Hub to gain shadowing opportunities and learning experiences with various other service areas/ 5.11 NEWLY QUALIFIED SOCIAL WORK PROGRAMME The Newly Qualified Social Worker (NQSW) Supported Year referenced in section 5.2 above will become mandatory across Scotland from October 2024. This is to ensure that support is given to NQSW in their transition to front line practice enabling us to develop an increasingly confident and competent workforce for the people who use our services and their families. 5.12 OTHER KEY TRAINING AND DEVELOPMENT ACTIVITIES Provision of a practice learning pathway for link workers We have 120 link workers, and twenty-five practice educators based onsite with students on traditional placements. We currently have five link workers applying to undertake the PDAPL, which starts in September 2024. We also have a waiting list of link workers all interested and working towards making applications for the next PDAPL intake in January 2025. To fully support the Service and ensure the learning and development needs of all staff are met, a Social Work Learning and Development sub team was established in March 2023 consisting of two Senior Learning and Development Advisors, two Learning and Development Advisors and two Clerical Assistants. This team have been responsible for the implementation of a range of initiatives including: An updated programme of Adult Support and Protection Training including the delivery of ASP Level 1 refresher training to 1,000 staff and bespoke ASP level 2 training for home support team leaders. Provision of Getting it Right in Child Protection training including a broad range of e learning modules in child protection awareness, contextual safeguarding, understanding child neglect, assessment and planning for children and young people, child sexual exploitation and Age of Criminal Responsibility with over 2, 800 course completions. Safe and Together - We are working alongside our Child Protection Committee and our partners at the Safe and Together Institute to look at the further possibilities of commissioning specialist eLearning modules and materials in relation to the Safe and Together Model. Page 166 of 214
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47 Continued provision of Moving and Handling and Medication training - 352 Home Support staff and nine Home Support team leaders have attended role specific moving and handling training during reporting period. Implementation of a robust induction programme for HSW’s 152 HSWs have attended induction training since April 2023. The online HSW induction course is currently being reviewed. Carrying out a full Training Needs Analysis (TNA) across the Service to identify key learning and development needs as part of the development of the Learn NL Social Work dashboard. Refresh and reintroduction of Assessment, Planning and Recording Practice learning, this will also align with the most recent Back to Basics approach in Adult Services and Signs of Safety and Healing in Children’s Services ensuring person centred practice is at the forefront. This work was supported by a Steering Group of managers, practitioners and TOD staff who refined the training materials to ensure alignment with North Lanarkshire’s value base and best practice in addition to making the training more accessible, sustainable, engaging, and interactive to enable staff to re-access the training materials and learning whenever they require in the future. Introduction of Autism Awareness and Neurodiversity training delivered by facilitators with lived experience has also been a huge success. As of March 2024, we have commissioned Part 1 “Making Connection” and Part 2 “Building Bridges” as well as bespoke models which has resulted in 61 members of Social Work staff completing this targeted training. Refresh of the Senior Practitioner programme - It is envisaged that the new model will enable Senior Practitioners to be involved in development opportunities across the services and to utilise their enhanced skills and qualifications for the benefit of the wider community. We also envisage the involvement of our senior practitioners in the roll out of future assessment and planning developments and offering support to their Senior Social Workers by fulfilling supervising and mentoring roles to our NQSW in their supported year as per the revised standards and framework. Justice training and staff development has included Naloxone Training delivered In partnership with NHS Lanarkshire’s Harm Reduction Team, to help staff to respond confidently and appropriately to situations of overdose and assist combating the number of drug deaths among people engaging with Justice Services in North Lanarkshire. A continued training schedule is in place to ensure that all relevant staff receive training on this intervention. 5.13 TRAUMA INFORMED PRACTICE Implementation of Trauma Informed training Towards the end of March 2024, we successfully adopted and integrated Trauma Informed Practice eLearning modules from the NHS digital platform TURAS to our own LearnNL. Since the launch of the modules in March 2024 staff have been able to access all the materials digitally. We envisage that work in this area will continue to grow with the roll out of the face-to-face ‘skilled’ and ‘enhanced‘ level training, as well developing our training for trainers programme which will enable us to develop our own team of in-house facilitators ready and able to respond to any training requirements in relation to trauma informed practice. 5.14 REVISION OF SUPERVISION POLICY Over the past year and following consultation our supervision policy has been updated and linked to a new toolkit of resources to support reflective and outcome focused practice aligned to developments in practice and also recognising that whilst one-to one supervision remains fundamental to social work practice that other supports such as group supervision and case consultations can play a key role in supporting practice. Page 167 of 214
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48 5.15 SUPPORT FOR STAFF WELLBEING Within each locality a variety of teams have held development days focussing on Health and Wellbeing (HWB), staff resilience and supports, team building, and this continues. Recruitment for an North Lanarkshire HWB officer took place, an appointment made in early 2024 to support this activity and to work with the NHSL HWB officer for a joined- up partnership approach. HWB is at the forefront of staff development. Various Social Work management teams were subsequently engaged by Organisational Development (and the health-based Staff Health and Wellbeing Officer), with particular focus on the ‘Stay Conversation’ project. These initial briefings and workshops have led to engagement across a range of teams for ongoing collaboration looking at enhancing Social Work Wellbeing. 6. LOOKING FORWARD – PRIORITIES FOR 2024-2025 AND BEYOND Continuing the pattern of the last two years demand for social work and social care services, often accompanied by increased complexity of presenting need, has continued to grow and surpass pre-pandemic levels across all areas of social work driven by a range of demographic and societal trends including continuing cost-of-living pressures impacting on the resilience of our communities. This is a pattern that is likely to continue into the immediate future. Whilst the service has been successful in maintaining a strong balance of care existing pressure points such as those on care at home services and MHO services have also been supplemented by new ones, for example growing demand for children’s house places. Neither the council or IJB have to date responded to financial pressures by reducing core social work staffing, however nor has there been capacity simply to expand resources to meet demand and pressures on wider budgets are also likely to continue to impact on social work service delivery. Moreover, innovation and investment in service improvement and redesign for longer term sustainability is increasingly reliant on temporary funding streams many of which are uncertain beyond the current Scottish parliamentary term creating additional challenges in planning, Alongside additional uncertainty associated with future proposals for a National Care Service, the proposed National Social Work Agency, review of elements of social work education and discussions on a national improvement programme, albeit focussed primarily on social care, have brought welcome attention at national level to the key role of social work. It is however disappointing in this context that commitments for investment have not matched those made to some other areas of the public sector with even relatively modest developments like the embedding of the ‘Supported Year In Practice’ from 2024 implemented with no funding support. Locally there is some indication that investment in the social work workforce may be reducing vacancy levels and the number of our own staff seeking a pathway into social work is positive and encouraging however although the potential introduction of a graduate apprenticeship in social work nationally is a welcome development it is unlikely on its own to meet need. Key areas of workforce focus for us going forward will include continuing efforts to grow our MHO workforce and to address the workforce vetting requirements associated with the introduction of MAPPS (a highly secure home office system) within justice services. Further work is also planned to consider the implications of local research relating to diversity in recruitment alongside national findings on racism experienced by BAME staff. In addition, continued attention to staff well-being and trauma informed systems will remain key both to supporting retention and best practice. In this context both to support improved outcomes and experiences for those who need our support and for demand and cost avoidance, the continuation of our focus on prevention will be critical over the coming year. Vital to delivering this will be our programmes to improve core practice such as the ‘Back to Basics’ work in Adult Services and ‘Signs of Safety and Healing’ in Children’s Services alongside continuing investment in early family support and carer support. We will also continue to maximise the opportunities created by the integrated working embedded in the Programmes of Work for the Council and that supporting the HSCP’s Strategic Commissioning Plan with a key focus also on improving outcomes and continuity of support at key transition points. Page 168 of 214
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49 The redesign of social work administration to a business support model alongside work to introduce the new social work management system Mosaic and the ELMs2 and Dynamic Scheduling Systems for the Integrated Equipment Service and Home Support respectively, will all involve significant preparation and time and people resource over the coming year but are again vitally important to future operational efficiency. Finally, the requirement to respond to and embrace a plethora of national policy and legislative drivers, external scrutiny findings and continued reporting requirements to the SCAI (Scottish Child Abuse Inquiry) will also continue to place significant demands on the service over the coming year. A continued focus on strong partnership working across and beyond social work including with those who use our services will be central to ensuring that our workforce is not overwhelmed and can instead continue its central role in delivering positive outcomes for our communities. Page 169 of 214
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☐ Yes ☒ No Ref CR/SF Date 12/11/24 Adult Social Care Performance Report – Quarter 1 2024/25 From Claire Rae – Chief Officer – North Lanarkshire HSCP E-mail Claire.Rae@lanarkshire.scot.nhs.uk Telephone 01698 858143 1. Background 1.1 The Chief Officer has joint quarterly performance review meetings with the Chief Executive of NHS Lanarkshire and the Chief Executive of North Lanarkshire Council. These meetings are supported by a Chief Executive Performance Framework comprising a range of performance measures from across both health and social work systems, including relevant targets and trajectories. 1.2 Based on a traffic-light system there are areas for improvement identified within the performance framework each quarter for those that are flagged as Red or Amber. The 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 April 2024 to 30th June 2024 (Quarter 1 2024/25). Recommendations It is recommended that the 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 8 Page 171 of 214
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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 April 2024 to 30th June 2024 (Quarter 1). 2.2 The performance data for Quarter 1 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 (01st April 2024 to 30th June 2024, Quarter 1) Claire Rae Chief Officer North HSCP Page 172 of 214
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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 173 of 214
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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 174 of 214
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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 2023/24 Q1 2023/24 Q2 2023/24 Q3 2023/24 Q4 2024/25 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year Current Performance 2.15 Assistive Technology - Number Of People With Technology (0-17 yrs) 1,452 28 28 31 31 35 GREEN 2.16 Assistive Technology - Number Of People With Technology (18-64yrs) 632 631 618 624 632 2.17 Assistive Technology - Number Of People With Technology (65+) 818 825 856 858 905 2.18 Reablement - Number Of People Completing Reablement Process 2000 (500 per quarter) 376 816 1355 2011 527 GREEN 2.19 Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 64.0% 70.3% 70.0% 60.8% 61.1% RED 2.2 Reablement - % Of People With No or Reduced Home Support Service Required At End Of Process 70% 45.8% 48.0% 58.8% 58.5% 62.6% RED 2.21 Balance Of Care - % Of People (Age 65+) 45% 40.2% 36.7% 34.0% 36.4% 37.1% RED 2.22 IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 47.5% 49.9% 53.5% 63.4% 87.1% GREEN 4.2 Complaints Processed Within Timescale (NLC) 85% 84% (Stage 1) 100% (Stage 2) 76.5% (Stage 1) 57.1% (Stage 2) 81.3% (Stage 1) 100% (Stage 2) 92.9% (Stage 1) 100% (Stage 2) 81.1% (Stage 1) 87.5% (Stage 2) GREEN 4.3 Care Home Placements At End Of Quarter - Per 1000 Popn 65+ 24 21.7 22.0 21.9 22.0 22.1 GREEN 4.4 Care Home Placements At End Of Quarter - Per 1000 Popn 75+ 50 44.9 45.8 45.6 45.9 46.3 GREEN 4.5 Care Home - Average Length of Stay 865 832 891 835 834 708 GREEN 4.6 Number Of People With Self Directed Support 1,000 2070 2093 2092 2089 2054 GREEN Page 175 of 214
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4.7 Number Of People With A Direct Payment 240 329 342 357 379 355 GREEN 6.1 Community Alarm Service Users 75 Years And Over Per 1000 Population Under Review 191.8 193.9 196.5 195.8 196.7 … … … 7.2 % Of Adult Protection Referrals Passed To Care Team For Investigation 20% 12.4% 14.8% 12.7% 20.1% 24.7% GREEN 7.21 % Of Adult Protection Investigations Going To Initial Case Conference 20% 20.3% 10.4% 19.2% 11.9% 12.3% RED 7.22 Adult Protection - % Of Referrals With Decision Within 5 Days 60% 76.6% 77.8% 76.3% 81.7% 80.3% GREEN 7.23 % of Adult Protection Referrals Which Did Not Go On To Investigation Or Other Service 50% 76.6% 74.2% 75.9% 71.5% 66.0% GREEN 9.4 Breakeven Position - Projected Outturn (NLC) >=0 3.014m Underspend 4.304m Underspend 3.112m Underspend £3.331m underspend £0.059m underspend … … ... 9.6 Sickness Absence (NLC) - days lost per person 9.22 3.34 6.93 10.29 13.74 3.48 GREEN Page 176 of 214
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Appendix 2 – Areas for Improvement 1. Reablement and Rehabilitation Target 2024/25 2023/24 Q4 2024/25 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 60.8% 61.1% RED Reablement - % Of People With No or Reduced Home Support Service Required At End Of Process 70% 58.5% 62.6% RED Balance Of Care - % Of People (Age 65+) 45% 36.4% 37.1% RED Narrative & Corrective Action Reablement / Home Assessment Team Since the creation of HAT and at the end of Q1, there had been a total of 2119 referrals accepted by HAT, although the 110 referrals in June was a decrease from the 128 accepted in May. Over a rolling twelve months, Wishaw has accepted 25% of the total referrals, with Airdrie, Motherwell and Cumbernauld having between 18% and 22% of the total. The proportion for Bellshill and Coatbridge is increasing as the teams develop. It is of note that the number of referrals that have not been accepted has grown recently, with 60 referrals not being accepted in June. The referrals by locality in the last year were: Airdrie Bellshill Coatbridge Cumbernauld Motherwell Wishaw Total 254 98 103 283 238 331 1307 19% 7% 8% 22% 18% 25% 100% The hospitals where referrals originated from are shown in the table that follows. There is little difference in the proportionality from previous reporting. Those categorised as “Other” represent older cases when a prior recording system was in use. Monklands 979 46% Wishaw 1071 51% Other 69 3% As the data set develops, it is likely that a seasonal trend will emerge in the referral data, with variation during holiday periods. Page 177 of 214
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The majority of referrals received related to females (60%), with the largest number in the age range 75-84 years old (40%). Under 65s only accounted for 9% of referrals and no referral referring to anyone under 18 was recorded. Input Services Page 178 of 214
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The overwhelming majority of referrals to HAT have input services, i.e. a service is already in place at the time of the referral; 62% had 1 or 2 services and 35% had 3 or more services. This is consistent across recent reporting and the average number of input services from HAT has only shown a slight increase over time. Overall, the largest input service remains Home Support, followed by OT and this is fairly consistent. Outcomes 13% of people were re-admitted to hospital at the end of the HAT process. At the end of the HAT process, for those noted as reaching this stage, recordings show that 63% required no further service, with 37% noted as having at least 1 service. Page 179 of 214
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For those requiring further service, the service with the highest number was CAS., followed by Home Support Reablement and IRT (Physio). This figure will differ in the future as ongoing service is being reconfigured to not include referrals being made to other service, such as NL Leisure. Significant effort continues to be applied to reduce discharge delays and a more coordinated approach to the work of the Flow Boards and concise monthly planning should see sustained impacts on overall system performance. This work is in preparation for Firebreak ’24, which is taking place during 16-25 September. A newly implemented Optimal Discharge Planning Target Operating Model (TOM) is now in place, designed to improve patient discharge experiences across all hospitals in Lanarkshire and ensure that patients have a smooth and well-coordinated transition from hospital to home or other care settings, avoiding unnecessary delays and improving overall outcomes. The TOM introduces four Discharge Pathways to identify and address the specific discharge needs of each patient, ensuring that every step is tailored to their situation. The Multidisciplinary Team (MDT) approach to be employed emphasises the importance of early and continuous discharge planning involving the entire MDT, ensuring all patients receive the right care at the right time. Partners have agreed on the key principles for effective discharge planning, which involves early patient and family engagement, detailed assessments, and proactive arrangements to ensure a seamless discharge process. The overall goal is to make every discharge a positive experience for our patients, supporting their recovery and reducing their time in hospital in line with our commitment to Patient-Centred Care. Materials have been produced to support staff, including a video explaining the roles and responsibilities within the MDT and the activities that ensure timely and safe discharges, team briefing sessions about the new Optimal Discharge Target Operating Model and a new Turas module on Optimal Discharge. Page 180 of 214
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2. Adult Social Work Target 2024/25 2023/24 Q4 2024/25 Q1 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year RAG Status % Of Adult Protection Investigations Going To Initial Case Conference 20% 11.9% 12.3% RED Narrative & Corrective Action The overall number of Adult Protection referrals has decreased by 13% when compared with Q1 of 2023/24. A significant part of this overall decrease is due to a decrease in the number of referrals from the Care Home sector, which fell 34% (from 367 to 204). Despite this, Police and Health Adult Protection referrals have both increased; Police referrals have increased by 30% in comparison to Q1 of 2023/24 (94 to 121) and Health referrals have increased by 15% (155 to 178). Some additional analysis may be required, as the number of Police adult concern reports have decreased significantly; a decrease of 30% when compared with 2023/24 (1184 to 812). Adult Protection Referrals Apr 2024 May 2024 Jun 2024 Total Airdrie 46 44 40 130 Bellshill 38 43 36 117 Coatbridge 43 69 40 152 Cumbernauld 55 34 28 117 Motherwell 23 30 18 71 Wishaw 35 42 35 112 SWES 27 39 26 92 Total referrals received= 791 Police Adult Protection Concern Reports Apr 2024 May 2024 Jun 2024 Total Airdrie 59 71 40 170 Bellshill 35 35 19 89 Page 181 of 214
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Coatbridge 70 57 60 70 Cumbernauld 73 96 82 187 Motherwell 44 41 32 117 Wishaw 50 59 70 179 Total referrals received= 812 Around 20% of all Adult Protection referrals were progressed as an inquiry with investigatory activity, however only 9% of inquires with investigatory activity went on to progress to an initial case conference (13 total initial case conferences were held and 10 review case conferences). Analysis of the referrals has highlighted that Community based referrals are more likely to progress to ASP investigation when compared to referrals from Care Homes. Referrals generated by Social Work and community 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. It is important to highlight that the NLC Social Work Adult Support and Protection procedures have been updated. There are significant changes to the language used in the procedures and describe how we now view ASP “Inquiries and investigations”. The service now refers to initial inquires as ‘inquiries without investigatory activity’ and ASP investigations and ASP ‘Inquiry with investigatory activity’. Importantly, investigatory activity involves any direct contact with the adult or their legal proxy and as such, it is anticipated there will be a rise in investigatory activity, which will be reflected in future reports. Internal audits of ASP records have identified discrepancies between the Social Work Information System and the Locality trackers submitted by senior social workers on a weekly basis. Ongoing work will be completed with colleagues in localities to ensure that required information is recorded on SWIS, accurate records of Case Conferences are stored in SWIS, and performance and management information is produced. Page 182 of 214
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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 12/11/24 Revenue & Capital Budget Monitoring Report: Adult Social Care Period 06: 01/04/2024 to 13/09/2024 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 2024 to 13 September 2024 (Period 06) and includes projected outturn forecasts for the financial year ended 31 March 2025, 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 £268.341m and is currently projecting an underspend of £0.477m. This favourable variance is predominantly the result of the non-recurring underspend of £6.9m on pension costs resulting from the reduced contribution rate to the Strathclyde Pension Fund coupled with underspends due to vacancies. This is offsetting overspends within overtime to compensate for the high vacancy levels as well as within Transport Costs and Payments to Other Bodies. This underspend is positive movement of £0.206m since the previous committee report resulting from reduced spend in Care Homes and Equipment and adaptations. The Social Work capital programme has a total budget of £2.171m and is currently projecting a breakeven position. 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 9 Page 183 of 214
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1. Background 1.1 The Council approved its General Revenue Fund Budget on 15 February 2024, and the Integration Joint Board (IJB) approved its Financial Plan on 27 March 2024. The approved Gross Expenditure Budget for the H&SCP – NL (Adult Social Care and Housing) is £268.341m. 1.2 The Council approved its new 5-year Strategic Capital Investment Programme on 14 March 2024. Financial Year 2024/25 is the first year of the programme, with £2.200m approved for Social Work for the current year. Net reprofiling from 2023/24, results in a revised budget of £2.171m, as demonstrated by Appendix 4. 2. Report Revenue: Analysis of Significant Variances 2.1 Within Employee costs, the Service currently anticipates an underspend of £5.461m. This is in relation to the non-recurring reduction of employer’s superannuation costs, coupled with slippage in relation to the recruitment of posts across the Service. Both of which being partially offset by higher than anticipated costs in relation to home support staffing costs. 2.2 Transport and Plant is anticipated to be overspend by £0.573m. 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. 2.3 Payments to Other Bodies and Transfer Payments are detailed in Appendix 2. This expenditure accounts for £165.756m of the annual budget and is forecast to have an in-year net overspend of £4.517m (2.7%). This is primarily in relation to the Care at Home sector who provide services to individuals via the SDS commissioning framework. 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. 2.4 The Service anticipates a total over recovery of income of £0.081m. An over-recovery of £0.142m relates to returned private sector housing grants and recharge income from other Council Services, these are both partially offset by an under-recovery of £0.145m which is mainly as a result of lower than anticipated income from charges for Community Alarms and Integrated Day Services. Savings 2.5 The Financial Plan of the Health & Social Care Partnership was approved by the Integrated Joint Board in March 2024 which identified an overall cost pressure for 2024/25 of £22.856m of which £11.4m relates to Adult Social Care. 2.6 To address this cost burden the service have developed a savings delivery plan which aims to deliver this saving value over the two years 2024/25 and 2025/26. In order to spread these savings over 2 years the Service is using the non-recurring pension underspend and reserves to offset the shortfall in year 1. 2.7 The plan includes the following areas: Page 184 of 214
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• Reducing current overspends to align with allocated budgets. • Review of all Registered Social Landlords services in North Lanarkshire keeping with the approach taken by other local authorities • Review of all overtime and agency costs • Review of non-traditional respite, advocacy and community services. • Review of whole system approach to ensure that when people contact the services the response is quick and effective, with a focus on helping people to help themselves first. • Review of all vacant posts. 2.8 Updates on these savings will be provided in future reports however Members should note that the current projected underspend should continue to grow as progress towards the achievement of these savings is made. Revenue: Earmarked Reserves 2.9 The Integration Joint Board have reserves of £24.804m for specific Adult Social Care commitments as detailed in Appendix 3. 2.10 It is anticipated that £4.257m of the earmarked reserves will be used during 2024/2. As detailed in section 2.6, this includes provision to offset the shortfall on savings. 2.11 The remaining £20.547m will be carried forward to 2025/26. Excluding the £12.151m for Social Care Demand Risk, these reserves values have been assessed by the service and set aside for the specific projects and initiatives detailed in Appendix 3. The demand risk value has been ear marked to offset any additional budget pressures that may arise as well as any unanticipated increase in demand. 2.12 All expenditure to be met from reserves are excluded from the outturn position. Capital: Analysis of Significant Variances 2.13 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 a breakeven position. 2.14 Following on from the pandemic, there remain uncertainties in respect of demand and complexity of need and therefore this budget will continue to be monitored closely, and any forecast movements will be highlighted in future reports. 2.15 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 Appendix 1 Revenue – Subjective Analysis Appendix 2 Revenue – Payments to Other Bodies & Transfer Payments Analysis Page 185 of 214
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Appendix 3 Revenue – Status of Earmarked Reserves Appendix 4 Capital – Budget Movements 2024/25 Appendix 5 Capital – Summary Expenditure by Thematic Category Morag Dendy Chief Officer (Planning, Performance and Quality Assurance) Page 186 of 214
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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 187 of 214
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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 188 of 214
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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 189 of 214
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APPENDIX 1 [1] [2] [3] [5] [6] [7] EMPLOYEE COSTS 90,648,940 85,187,814 5,461,126 FAV 6.0% (639,099) Anticipated underspend mainly as a result of the non-recurring reduction of employer's Superannuation costs, coupled with slippage in relation to recruitment across the Service. Both of which partially offset by higher than anticipated costs in relation to home support staffing costs PROPERTY COSTS 3,163,701 3,227,977 (64,276) ADV (2.0%) (11,749) SUPPLIES & SERVICES 6,302,410 6,231,673 70,737 FAV 1.1% 279,310 Underspends in other Supplies areas, partially offset by overspends in equipment and adaptations and small tools TRANSPORT & PLANT 1,788,318 2,361,585 (573,267) ADV (32.1%) 77,995 Projected overspend in relation to Internal Transport charges and staff mileage costs ADMINISTRATION COSTS 653,063 644,077 8,986 FAV 1.4% 112,927 PAYMENTS TO OTHER BODIES 59,583,474 60,470,970 (887,496) ADV (1.5%) 407,200 Please refer to Appendix 2 for analysis TRANSFER PAYMENTS 106,173,176 109,803,216 (3,630,040) ADV (3.4%) (79,685) 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 19,161 9,697 FAV 33.6% 8,479 TOTAL EXPENDITURE 268,341,940 267,946,473 395,467 FAV 0.2% 155,378 NLC CONTRIBUTION (207,287,791) (207,287,791) 0 0.0% 0 NLC CONTRIBUTION - HOUSING (2,229,010) (2,229,010) 0 0.0% 0 INCOME FROM HEALTH (56,616,985) (56,698,186) 81,201 FAV (0.1%) (5,016) FEES AND CHARGES (1,418,167) (1,272,937) (145,230) ADV 10.2% 49,815 Lower than anticipated income in relation to charges for Integrated Day Services and Community Alarms OTHER LOCAL AUTHORITIES 0 (3,528) 3,528 FAV 0.0% 0 BUDGETED USE OF IJB RESERVES 0 0 0 0.0% 0 OTHER INCOME (789,987) (932,263) 142,275 FAV (18.0%) 5,929 Overrecovery in relation to returned private sectors housing grants and recharge income from other Council Services INCOME (268,341,940) (268,423,714) 81,774 FAV (0.0%) 50,728 NET EXPENDITURE 0 (477,241) 477,241 FAV 0.0% 206,106 [4] NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Subjective Analysis Period 06 (01 April 2024 - 13 September 2024) Adult Social Care & Housing - INTEGRATED CATEGORY ANNUAL BUDGET PROJECTED OUTTURN PROJECTED OUTTURN VARIANCE % MOVEMENT VARIANCE ANALYSIS Page 190 of 214
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APPENDIX 2 [1] [2] [3] [5] [6] [7] SDS Framework 1 & 2 105,396,093 109,312,599 (3,916,506) ADV (3.7%) (79,536) Demand led activity. Independent Care Homes 46,974,146 48,290,107 (1,315,961) ADV (2.8%) 361,233 Demand led activity. Payments to NHS Lanarkshire 2,348,638 2,322,525 26,113 FAV 1.1% 24,769 Position reflects anticipated in year payments Non Traditional Respite 335,283 101,645 233,638 FAV 69.7% 8,354 Position reflects anticipated Locality demand Other Local Authorities - General 127,909 96,891 31,018 FAV 24.3% 20,238 Position reflects anticipated in-year demand Voluntary Organisations & Payments to Other Bodies - Gen 8,304,417 8,174,373 130,044 FAV 1.6% 36,381 Position reflects anticipated in-year demand Housing Support (RSL's) 777,083 490,617 286,466 FAV 36.9% (149) Position reflects projected contract levels Locality Flexibility 218,068 214,659 3,409 FAV 1.6% (668) Position reflects anticipated Locality demand Private Sector Housing Grants 1,152,378 1,156,571 (4,193) ADV (0.4%) (51,543) Position reflects anticipated in-year demand Medical Fees 122,635 114,200 8,436 FAV 6.9% 8,435 Position reflects Service's approach to absence management Other 0 0 0 0.0% 0 TOTAL EXPENDITURE 165,756,650 170,274,186 (4,517,536) ADV (2.7%) 327,515 [4] NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Payments to Other Bodies & Transfer Payments Analysis Period 06 (01 April 2024 - 13 September 2024) Adult Social Care & Housing - INTEGRATED CATEGORY ANNUAL BUDGET PROJECTED OUTTURN PROJECTED OUTTURN % MOVEMENT VARIANCE ANALYSIS Page 191 of 214
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APPENDIX 3 Contract Monitoring Staff 87,351 74,279 13,072 0 87,351 22/23 Saving: Muirpark 27,485 19,533 7,952 0 27,485 Carers Act 2018 - Support 2,595,745 364,226 2,231,519 0 2,595,745 Social Care Demand risk 12,682,932 531,933 12,150,999 0 12,682,932 Tech digitial Improvements 389,719 122,829 266,890 0 389,719 Increase Advocacy provider 65,667 65,667 0 0 65,667 Discharge to assess/ PDD 109,196 54,257 54,939 0 109,196 Adapations Funding 308,571 308,571 0 0 308,571 Tech Improvements - SWIS 700,000 60,920 639,080 0 700,000 Tech Improvements - Comm Alarms 464,604 33,600 431,004 0 464,604 Tech Improvements - Home Scheduling System 3,698,423 302,393 3,396,030 0 3,698,423 Adult Protection Contribution 50,000 38,299 11,701 0 50,000 MH 2 NL10s 161,633 61,824 99,809 0 161,633 Cost of Living Helpline 359,993 264,904 95,089 0 359,993 HS resilience 656,188 272,853 383,335 0 656,188 Staff Training Academy "grow your own" 1,128,466 413,563 714,903 0 1,128,466 Building Capacity Funding Across The Ip Sector (part of Business Case) 0 The Winter Planning & Enhanced supports Business Case TOTAL 24,804,931 4,257,377 20,547,554 0 24,804,931 1,318,958 1,267,726 51,232 1,318,958 NORTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report - Status of Earmarked Reserves Period 06 (01 April 2024 - 13 September 2024) Adult Social Care & Housing - INTEGRATED TOTALDESCRIPTION OF EARMARKED RESOURCE Approved Reserve Total as at 1 April 2024 2024/25 2025/26 No Longer Required Page 192 of 214
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APPENDIX 4 Approved: Year 1 budget (5 year Capital Program 2024/25 to 2028/29) 2,200,000 Reprofiling from 2023/24 (28,677) Included in opening budget Social Work Key Ambition Integrated equipment & adaptations REVISED CAPTIAL BUDGET 2024/25 2,171,323 0 0 0 Theme NORTH LANARKSHIRE COUNCIL Capital Budget Monitoring Report - Budget Movements 2023/24 Period 06 (01 April 2024 - 13 September 2024) Social Work Capital Programme BUDGET MOVEMENTS 2024/25 £ Period Division Thematic Category Page 193 of 214
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APPENDIX 5 Social Work: Integrated Equipment and Adaptations 2,171,323 624,311 782,503 1,388,820 2,171,323 (0) TOTAL 2,171,323 624,311 782,503 1,388,820 2,171,323 (0) NORTH LANARKSHIRE COUNCIL Capital Budget Monitoring Report - Summary Expenditure by Thematic Category Period 06 (01 April 2024 - 13 September 2024) Social Work Capital Programme UNCOMMITTED FINAL OUTTURN OUTTURN VARIANCETheme BUDGET ACTUAL COMMITTED Page 194 of 214
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North Lanarkshire Council Report Adult Care and Social Work Committee Does this report require to be approved? ☒ Yes ☐ No Ref: NLC-CPT-24-042 Date: 12 November 2024 Contract Award for Independent Advocacy (Adults) From Morag Dendy, Chief Officer (Performance, Planning, and Quality Assurance) E-mail DendyM@northlan.gov.uk Telephone: 07939280915 Executive Summary The Adult Care and Social Work Committee is asked to approve the award of a contract for Independent Advocacy Services (Adults) (the ‘Agreement’) to Equal Say Limited. The Agreement is for an initial period of 36 months anticipated to commence on 1 March 2025. The council reserves the right to extend the Agreement for additional periods up to a maximum of a further 24 months. The value of the Agreement is Three Million, Five Hundred and Seven Thousand, Four Hundred- and Five-pounds Sterling (exclusive of VAT). Recommendations It is recommended that the Adult Care and Social Work Committee: (1) Approves the award of the Agreement to Equals Say Limited at the value of pounds Sterling (£3,507,405) exclusive of VAT. The Plan for North Lanarkshire Priority Enhance participation, capacity, and empowerment across our communities Ambition Statement (13) Improve preventative approaches including self-management and giving people information and choice over supports and services Programme of Work Resilient People 1. Background 1.1 The contract supports the Council to fulfil its statutory obligations for the provision of advocacy services. The Mental Health (Care and Treatment) Act (Scotland) 2003 imposed a Item 10 Page 195 of 214
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duty on local authorities and health boards to collaborate to ensure the availability of independent advocacy services within their area. The Act gives everyone with mental illness, learning disability, dementia and other related conditions the right to access independent advocacy support. The Mental Health (Scotland) Act 2015 builds on the rights enshrined within the 2003 Act to widen access to independent advocacy support. 1.2 Independent advocacy supports people to have their voices heard and their rights and interests protected. Independent advocacy is a positive force in influencing social change, with the work and ethos of advocacy underpinned by a person-focused and human rights framework. The importance and benefits of independent advocacy are now widely recognised and woven into the fabric of health and social care provision and legislation in Scotland. Advocacy for carers and for people affected by drug and alcohol misuse will be incorporated into the requirements of the new contract. 1.3. The Agreement is for a single contractor to deliver the following objectives: • Independent advocacy core service • Independent advocacy for carers • Independent advocacy for people affected by substance and alcohol misuse • Independent advocacy for prisoners in HMP Shotts 1.4. The Procurement process sought to identify advocacy focused organisations with an ethos and approach to support people to have their voices heard and their rights and interests protected. 1.5. This was achieved through quality procurement questions, with shortlisted bidder’s responses being assessed by experienced evaluators. Included in the process was an element of evaluation by people with lived experience. Reference to model responses were developed to assist evaluators in determining the quality of responses received from bidders. 1.6. The lived experience panel consisted of lay members who have directly interacted with the services previously. The panel were fully briefed on the procurement process and the importance of their role within that. Due diligence was followed to ensure people had the capacity and understanding to take part in the evaluation exercise. Bidders were asked to deliver a 10-minute presentation to the panel. Panel members were able to ask clarification questions at the end of the presentations. This method of evaluation added value to the exercise and ensured achievement of best value in the next generation of this contract. 1.7. The current contract was reviewed in February 2024 and concluded that independent advocacy services are required. North Lanarkshire Council wish to continue the success of current delivery and improve upon it in the new contract. 1.8. The requirements within the Agreement are currently under contract with Equal Say Ltd and Equals Advocacy Ltd [previously tendered on a two Lot basis for provision of advocacy for adults [aged 16-64] and for older adults [aged over 65] This arrangement is due to expire on 28 February 2025. The Agreement detailed within this report will 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. Page 196 of 214
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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 and the UK Find a Tender (FTS) website. 2.3 The procurement procedure was undertaken as an “Open Procedure”. Invitation to Tender documentation published by the council received a total interest from three companies with the council receiving three 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 members identified by the 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 2.5 This recommendation to award the Agreement follows the completion of a procurement procedure where Equal Say Limited 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 pre-tender whole life estimate budget for the Agreement was £3,507,405. Following completion of the procurement procedure, the value of the Agreement to be awarded is Three Million Five Hundred and Seven Thousand Four Hundred and Five pounds (£3,507,405) exclusive of VAT. 2.8 The costs associated with delivery of the Agreement will be contained within the Revenue budget for Adult Social Work. Price Stability 2.10 The cost is broken down into Direct and Indirect Costings therefore demonstrates the various elements for which the budget is being utilised to deliver the Contract. The maximum budget is £701,481 per year excluding VAT and cannot exceed this budget amount. Provider’s proposal is within the budget. Community Benefits 2.11 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. 2.12 Within their tender, Equal Say Limited committed to deliver the following community benefits within the Agreement: Page 197 of 214
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Community Benefit Type Quantity Committed New Job for an Individual not from a Priority Group (Full Time) 2 Educational Visits 9 2.13 The community benefits delivered as part of the Agreement includes/does not include the creation of jobs or apprenticeships. Fair Work First 2.14 Within their tender submission, Equal Say Limited have demonstrated commitment to the Scottish Governments “Fair Work First” initiative, such as being an accredited Living Wage employer, have no zero-hour contracts unless requested by staff, a wide range of employee benefits and an environment where staff voice is sought, represented, and responded to. Equal Say Limited are committed to comprehensive staff training as well as continuous professional development. Equal Say Limited commit to flexible working and family friendly working practices, are committed to fair work practices and actively promote equality and diversity. 2.15 Equal Say Limited have the bronze award from NLC, reflecting recognition that they are consistent in following the four pillars of the scheme. Contract Management 2.16 Officers from Quality Assurance and Adult services 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; • Persons have their wishes, views, values and preferences considered within any decision-making processes. • Persons have their human, legal and other rights safeguarded, and others, involved in the care and support of such Persons will be aware of the centrality of such rights • Persons feel able to have some ownership and involvement in shaping the service • Persons feel supported to address stigma, combat discrimination and feel that the service promotes their inclusion through the development of promotional strategies. • Persons using the service will have a wider understanding of the services and treatment that is available to them. • Persons using the service will have increased understanding of the rights that the Carers Act conveys, and how to claim them. Page 198 of 214
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3.2 Best Value has been considered to be demonstrated by Equal Say Limited. 4. Supporting documents 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 (Performance, Planning & Quality Assurance) Page 199 of 214
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? All contracted providers required to pay SLW. 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? Budget allocation/value has been agreed for the duration of 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? 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? Procurement of services related to our obligations to ensure Advocacy Provision is available. The exercise is to re-tender services where the contract is due to end. 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 200 of 214
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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? If services are not procured, we will not be able to fulfil our obligations in ensuring Advocacy Provision is available. All risks relating to provider sustainability are 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). If Yes, has a Children’s Rights and Wellbeing Impact Assessment (CRWIA) been carried out? Yes ☐ No ☐ Page 201 of 214
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Appendix 1 – Summary of Tender Evaluation Process Final Rank Tenderer Name Total Tender Score (%) Recommended for Award (Yes / No) 1 Equals Say Limited 79.00% Yes 2 The Advocacy Project 68.80% No 3 VoiceAbility Advocacy 60.80% No Page 202 of 214
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Appendix 2 – Summary of Procurement Process Response CPT Contract Reference Allocated: NLC-CPT-24-042 Procurement Procedure Utilised: Open Procedure Governing Legislation / Regulations: Public Contracts (Scotland) Regulations 2015 Date Contract Strategy Approved: 22 August 2024 Tender Platform Utilised: PCS-Tender (PCST) Date Contract Notice Published: 09 September 2024 Total Expressions of Interest Received: Three NLC Based Expressions of Interest: Tender Return Deadline: 30 September 2024 Number of Tenders Received: Three Tenders from SME’s: 3 Tenders from NLC Based Tenderers: 1 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 Health & Social Care staff Anticipated Start Date of the Agreement: 01 March 2025 Total Agreement Period (Months): 60 Awarded Value of the Agreement: £ 3,507,405.00 Page 203 of 214
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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) Equals Say Limited Micro North Lanarkshire The Advocacy Project Medium United Kingdom VoiceAbility Advocacy Medium Greater Glasgow Page 204 of 214
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North Lanarkshire Council Report Adult Care and Social Work Does this report require to be approved? ☒ Yes ☐ No Ref: NLC-CPT-24-046 Date: 12 November 2024 Contract Award for Mental Health Peer Support and Short-Term Mental Health Support Service From Diane Fraser, Chief Officer (Adult Social Work Services) E-mail breena@northlan.gov.uk Telephone: 07939281050 Executive Summary The Adult Care and Social Work Committee is asked to approve the award of a contract for Mental Health Peer Support and Short-Term Mental Health Support Service (the ‘Agreement’) to Lot 1 Scottish Association for Mental Health (SAMH) and Lot 2 Scottish Association for Mental Health (SAMH). The Agreement is for an initial period of 36 months anticipated to commence on 01 February 2025. The council reserves the right to extend the Agreement for additional periods up to a maximum of a further 12 months. The maximum value of the Agreement is Three Million Eighty-One Thousand Two Hundred and Four Pounds Sterling (£3,081,204) exclusive of VAT. Recommendations It is recommended that the Adult Care and Social Work Committee: (1) approves the award of the Agreement to Scottish Association for Mental Health (SAMH) at the value of Three Million Eighty-One Thousand Two Hundred and Four Pounds Sterling (£3,081,204) exclusive of VAT. 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 Resilient People 1. Background 1.1 To identify and procure a mental health and wellbeing service that provides support to Item 11 Page 205 of 214
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residents of North Lanarkshire experiencing mental health challenges. The service will be instrumental in ensuring that North Lanarkshire Council meets it statutory duties in accordance with the Mental Health (Care and Treatment) (Scotland)Act 2003 and the requirements of the Scottish Government as outlined in the Mental Health Strategy 2017- 2027. The service will assist with recovery via a Peer Support model and prevent/ support hospital admission and discharge via a short-term crisis service. 1.2. The demand for such services is widely acknowledged both locally and nationally. According to the ‘The Scottish Health Survey 2022- volume 1: main report – Gov.Scot ‘ one in three people in Scotland is affected by mental health problems in any one year. Further, that levels of deprivation experienced by an individual correlate with increased likelihood of developing poor mental health. 1.3. The Agreement is structured into two Lots: Lot 1 Peer Support Service with Information and Lot 2 Short-Term Support Service. 1.4. The objectives of the service for Lot 1 – Peer Support Service with Information Service & Lot 2 – Short-Term Support Service. are to: • The development of a service offering recovery and inclusive support through crisis and short support to those residing in North Lanarkshire over the age of 16 years. • Short-term support may include the prompting and support to individuals to adhere to prescribed medications. • The development of a service offering peer support, advice, information, and signposting to relevant resources. • The development of an integrated approach to information sharing and planning between the Contractor and health and social care staff. Referral is only made with the consent of the person being referred (or their Guardian/’Power of Attorney’, where relevant). • Personalised support for individuals to take control of their lives. • The provision of a responsive and flexible services and support for those experiencing mental health difficulties in North Lanarkshire. 1.5. The Procurement process sought to identify mental health and peer support focused organisations with an ethos and approach to preventative and anticipatory support. 1.6 This was achieved through quality procurement questions, with shortlisted bidder’s responses being assessed by experienced evaluators. Included in the process was an element of evaluation by people with lived experience. Reference to model responses were developed to assist evaluators in determining the quality of responses received from bidders. 1.7 The lived experience panel consisted of lay members who have directly interacted with the services previously. The panel were fully briefed on the procurement process and the importance of their role within that. Due diligence was followed to ensure people had the capacity and understanding to take part in the evaluation exercise. Bidders were asked to deliver a 10-minute presentation to the panel. Panel members were able to ask clarification questions at the end of the presentations. This method of evaluation added value to the exercise and ensured achievement of best value in the next generation of this contract. 1.8. The current contract was reviewed in June 2024 and concluded that both peer support and short-term recovery services are required. North Lanarkshire Council wish to continue the success of current delivery and improve upon it in the new contract. 1.9. The requirements within the Agreement are currently under contract with Scottish Association for Mental Health. This arrangement is due to expire on 31 January 2025 with the Agreement detailed within this report due to supersede it. Page 206 of 214
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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 Procurement (Scotland) Regulations 2016. 2.3 The procurement procedure was undertaken as an “Open Procedure”. Invitation to Tender documentation published by the council received a total interest from five companies with the council receiving three 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 members identified by the 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 2.5 This recommendation to award the Agreement follows the completion of a procurement procedure where SAMH 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 pre-tender whole life estimate budget for the Agreement was £3,081,204. Following completion of the procurement procedure, the value of the Agreement to be awarded is Three Million Eighty-One Thousand Two Hundred and Four Pounds Sterling (£3,081,204) exclusive of VAT 2.8 Some costs savings over the life of the contract will be achieved by dovetailing support options with the additional resource allocated to the Community & Voluntary Sector to support mental health and wellbeing. By reducing the intervention period and directing people to existing local community supports, we are able to reduce the allocation to this provision. 2.9 The costs associated with delivery of the Agreement will be contained within the Revenue budget for Adult Social Work. Price Stability 2.10 The cost is broken down into Direct and Indirect Costings therefore demonstrates the various elements for which the budget is being utilised to deliver the Contract. The maximum budget is £770,301 per year excluding VAT and cannot exceed this budget amount. Provider’s proposal is within the budget. Page 207 of 214
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Community Benefits 2.11 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. 2.11.1 Within their tender, SAMH committed to deliver the following community benefits within the Agreement: Community Benefit Type Quantity Committed Lot 1 Educational Visits 4 Lot 1 Work Experience Placements for an Individual 16+ years of age 4 Lot 1 Non-Financial Support for a Community Project / Organisation 4 Lot 1 Business Mentoring and Advice to Support SME / Social Enterprise / Voluntary Organisation Lot 2 Educational Visits 4 Lot 2 Work Experience Placements for an Individual 16+ years of age 4 Lot 2 Non-Financial Support for a Community Project / Organisation 4 Lot 2 Business Mentoring and Advice to Support SME / Social Enterprise / Voluntary Organisation 4 2.11.2 The community benefits delivered as part of the Agreement includes / does not include the creation of jobs or apprenticeships. Fair Work First 2.12 Within their tender submission, SAMH demonstrated commitment to the Scottish Governments “Fair Work First” initiative, such as being an accredited Living Wage employer, have no zero-hour contracts unless requested by staff, a wide range of employee benefits and an environment where staff voice is sought, represented, and responded to. SAMH are committed to comprehensive staff training as well as continuous professional development. SAMH commit to flexible working and family friendly working practices, are committed to fair work practices and actively promote equality and diversity. Contract Management 2.13 Officers from Adults and 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. 3. Measures of success The Agreement will deliver the following outcomes. • supporting individuals with severe and enduring mental health issues • prevent avoidable hospital admissions Page 208 of 214
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• advance positive mental health by collaborating with medical, Social Work and other professionals by applying recovery principles. 3.1 Best Value has been considered to be demonstrated by SAMH. 4. Supporting documents 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 Diane Fraser Chief Officer (Adult Social Work) Page 209 of 214
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? All providers required to pay SLW. 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 budget allocation/values have been agreed for the duration of 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? 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 210 of 214
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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 211 of 214
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Appendix 1 – Summary of Tender Evaluation Process Final Rank Tenderer Name Total Tender Score (%) Recommended for Award (Yes / No) 1 Lot 1 SAMH 90.20% Yes 2 Lot 1 Lanarkshire Association for Mental Health 82.20% No 3 Lot 1 Penumbra 79.20% No 1 Lot 2 SAMH 97.20% Yes 2 Lot 2 Lanarkshire Association for Mental Health 94.20% No 3 Lot 2 Penumbra 89.20% No Page 212 of 214
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Appendix 2 – Summary of Procurement Process Response CPT Contract Reference Allocated: NLC-CPT-24-046 Procurement Procedure Utilised: Open Procedure Governing Legislation / Regulations: Public Contracts (Scotland) Regulations 2015 Date Contract Strategy Approved: 20 August 2024 Tender Platform Utilised: PCS-Tender (PCST) Date Contract Notice Published: 23 August 2024 Total Expressions of Interest Received: 5 NLC Based Expressions of Interest: Tender Return Deadline: 01/10/2024 Number of Tenders Received: 3 Tenders from SME’s: 3 Tenders from NLC Based Tenderers: 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: 01 February 2025 Total Agreement Period (Months): 48 Awarded Value of the Agreement: £3,081,204 Page 213 of 214
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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) Scottish Association for Mental Health (SAMH) Micro North Lanarkshire Lanarkshire Association for Mental Health Micro North Lanarkshire Penumbra Mental Health Services Micro North Lanarkshire Page 214 of 214