Democracy Spraffa

Item 6 - Maintaining a Positive Balance of Care

North Lanarkshire Council · 14 February 2023
Back to IJB Performance, Finance and Audit Committee — 14 February 2023 and its agenda

Text extracted from the council's PDF. Layout and reading order may differ from the original.

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REPORT
Item No: 6 
SUBJECT:  Maintaining a Positive Balance of Care  
TO:  Integration Joint Board Performance, Finance & Audit Committee
Lead Officer
for Report: 
Morag Dendy, Head of Planning, Performance and Quality
Assurance 
Author of
Report: 
Graeme Cowan, Senior Manager, Strategy & Performance    
DATE:  14th February 2023 
1. PURPOSE OF REPORT 
1.1 This paper is coming to the Committee: 
For approval  For endorsement  To note 
1.2 The Health and Social Care Partnership is fully committed to ensuring that people are
supported to live full and active lives in their own homes and localities, minimising the use
of hospital and other care settings. This report is to advise Committee of a range of key
metric which compare the performance in North Lanarkshire across other Scottish councils
which demonstrate the sustained efforts to maintain a positive balance of care. 
2. ROUTE TO THE BOARD 
2.1 This paper has been: 
Prepared By:      
Senior Manager,
Strategy &
Performance   
Reviewed By: 
Head of Planning,
Performance & Quality
Assurance 
Endorsed By: 
3. RECOMMENDATIONS 
3.1 The Committee is asked to: 
i) Endorse and support the balance of care within North Lanarkshire; and
ii) Note the contents of the report           
4. BACKGROUND/SUMMARY OF KEY ISSUES 
4.1 The Health and Social Care Partnership is fully committed to ensuring that people are
supported to live full and active lives in their own homes and localities, minimising the use
of hospital settings. This purpose of this report is to update Committee on the positive
balance of care within North Lanarkshire, in comparison with other partnerships across
Scotland, and to provide committee with an overview of the supports and services in place
to help people live as independently as possible in their own homes for as long as possible.

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5. BALANCE OF CARE   
5.1 The provision of social care and support in North Lanarkshire is spread across a range of
organisations and settings and much of it is co-designed to meet a diverse and complex
range of individuals’ needs across North Lanarkshire’s communities. 
5.2 The balance of care is a term commonly used to refer to the balance of support and care
available within community-based settings (e.g. home care, self directed support, day
services, voluntary sector supports, support for carers), when compared with the support
and care available within residential settings (e.g. care homes, NHS continuing care
provision, etc.).   
5.3 North Lanarkshire has, for many years, had a positive balance of care, which means that
the considerable investment in community-based supports over time has resulted in a high
proportion of individuals with long-term and complex needs being able to continue to live as
independently as possible within their own homes. 
5.4 In order to allow comparison across different partnership areas, there is a standard
performance metric which looks at the proportion of individuals aged 18 and over who have
long term needs and who receive personal care at home. This metric has been used for
benchmarking purposes through Health & Social Care Partnerships’ Annual Performance
Reports (APRs) and is key metric within the National Indicator Set designed to measure the
overall impact of health and social care integration. This particular metric reflects very
positively the long-term efforts in North Lanarkshire to create and sustain the range of
supports outlined above. As the chart below illustrates, North Lanarkshire has the second
highest proportion of individuals aged 18 and over with long terms needs who receive
personal care at home in Scotland. This has remained consistent over recent years with
approximately 75% of people aged 18 and over with long term care needs receiving personal
care at home. 
Chart 1: Percentage of people aged 18+ with long term needs receiving personal care at home
(2021)

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Source: Insights in social care: statistics for Scotland 2020/21 
5.5 It is also helpful to consider an additional metric for benchmarking with other partnership
areas, namely the percentage of individuals over the age of 65 who have long term care
needs and receive 10 or more hours of home care per week. This again reflects positively
on the balance of care within North Lanarkshire, with over 50% of individuals over the age
of 65 with long term needs receiving 10 or more hours of home care per week. This is the
second highest percentage in Scotland. 
Chart 2: Percentage of people aged 65 and over with long term care needs receiving 10+ hours
of home care

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Source: Insights in social care: statistics for Scotland 2020/21  
6. CARE HOME STAYS 
6.1 As outlined in the previous section, the balance of care in North Lanarkshire tips
favourably towards community-based supports compared with most other Health & Social
Care Partnerships. Perhaps it is therefore unsurprising to note that the overall number of
registered places in care homes within North Lanarkshire is lower than the Scottish
average and lower than the majority of other partnership areas relative to its overall size of
population. The chart below illustrates the number of registered places in care homes for
older people (aged 65 and over). 
Chart 3: Rate of registered places in care homes for older people per 1,000 population aged 65
and over (2022) 
Source: Care home census for adults in Scotland, Statistics on Care Homes and Residents for
Years 2011 to 2022

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7.  SOCIAL WORK EXPENDITURE 
7.1  The overall balance of care within North Lanarkshire should also be seen within a financial
context, and in terms of the overall resources available to the service and its partners. The
importance we have placed in ensuring individuals, particularly those with complex and
long term needs, are supported to live independently within their own home and within
their own communities is reflected in the profile of the service’s expenditure. Also, when
comparing overall gross social work spend on those aged 18 and over, North
Lanarkshire’s overall spend per capita is lower than the Scottish average and lower than
the vast majority of other partnership areas which is perhaps even more noteworthy given
the pattern of social and economic deprivation across North Lanarkshire. 
Chart 4: Gross social work spend per head of population (aged 18+) 
Source: Local Government Benchmarking Framework 2020/21    
8. IMPLICATIONS 
8.1 NATIONAL OUTCOMES 
Maintaining a positive balance of care impacts on all National Health & Wellbeing
Outcomes, and specifically relates to: 
 National Outcome 2: People, including those with disabilities or long term
conditions, or who are frail, are able to live, as far as reasonably practicable,
independently and at home or in a homely setting in their community. 
8.2 ASSOCIATED MEASURE(S) 
The partnership continues to monitor progress across all service areas through its
performance framework and quarterly Chief Executive Performance Reviews and balance
of care metrics are included within the National Indicator set, reported via Annual
Performance Reports. 
8.3 FINANCIAL 
None 
8.4 PEOPLE 
None 
8.5 INEQUALITIES

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EQIA Completed: 
Yes  No  N/A 
9. BACKGROUND PAPERS 
None 
10. APPENDICES
None 
.............................................................................
HEAD OF PLANNING, PERFORMANCE AND QUALITY ASSURANCE 
Members seeking further information about any aspect of this report, please contact Graeme
Cowan on telephone number 07946702861.