Adult Social Care Performance Report - Quarter 4 2021-22
North Lanarkshire Council · 6 September 2022
Back to Adult Social Work, Care and Wellbeing Committee — 6 September 2022 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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1 North Lanarkshire Council Report Does this report require to be approved? ☐ Yes ☒ No Ref RMcG/AH Date 06/09/22 From Ross McGuiffe, Chief Officer, Health & Social Care E-mail Ross.McGuiffe@lanarkshire.scot.nhs.uk Telephone 01698 858 143 Executive Summary The purpose of the report is to provide an update to the Committee on the performance of key areas of activity within Adult Health & Social Care for the period 1 January to 31 March 2022 (Quarter 4). Recommendations It is recommended that the Adult Social Work, Care and Wellbeing Committee: 1. Endorse the improvement actions included within Appendix 2 of the report; and 2. Note the performance of key areas of activity within Appendix 1 of the report. The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities 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. While formal review meetings were stood down during the COVID-19 pandemic, internal performance management processes have remained in place and formal review meeting have recently been reinstated. Adult Social Work, Care and Wellbeing Committee Adult Social Care Performance Report – Quarter 4 2021/22
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2 1.2 Based on a traffic-light system there are areas for improvement identified within the performance framework each quarter for those that are flagged as Red or Amber. The performance review meetings are used as a means for jointly agreeing corrective actions. 1.3 Information from these performance reviews has been supplemented with additional performance information below to offer the committee a wider overview of performance across some key areas of adult social care delivery. 2. Report 2.1 The purpose of the report is to provide an update to the Committee on wider performance of key areas of adult social care delivery, in addition to the performance areas for improvement which have been identified as part of the Chief Executive Quarterly Performance Review for the period 1 January to 31 March 2022 (Quarter 4). 2.2 The performance data for Quarter 4 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 Appendix 1: Adult Social Care Dashboard Appendix 2: Areas for Improvement (Quarter 4, January – March 2022) Ross McGuffie Chief Officer Health & Social Care North Lanarkshire
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3 5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality-and-fairer- scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts have been discussed and agreed with Financial Solutions? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.3 HR policy impact Does the report contain any HR policy or procedure impacts? Yes ☐ No ☒ If Yes, have all relevant HR impacts have been discussed and agreed with People and Organisational Development? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.4 Legal impact Does the report contain any legal impacts (such as general legal matters, statutory considerations (including employment law considerations), or new legislation)? Yes ☐ No ☒ If Yes, have all relevant legal impacts have been discussed and agreed with Legal and Democratic Solutions? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? 5.5 Data protection impact Does the report / project / practice contain or involve the processing of personal data? Yes ☐ No ☐ If Yes, is the processing of this personal data likely to result in a high risk to the data subject? Yes ☐ No ☐ If Yes, has a Data Protection Impact Assessment (DPIA) been carried out and e- mailed to dataprotection@northlan.gov.uk Yes ☐ No ☐ 5.6 Technology / Digital impact Does the report contain information that has an impact on either technology, digital transformation, service redesign / business change processes, data management, or connectivity / broadband / Wi-Fi? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact?
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4 Where the impact identifies a requirement for technology, has an assessment been carried out (or scheduled) 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?
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5 Appendix 1 – Adult Social Care Dashboard PLEASE NOTE FOR ALL INDICATORS UPWARDS ARROWS DENOTE POSITIVE PERFORMANCE Outcome (National Health & Wellbeing) Ref. KPI Target / Indicator 2021/22 2021/22 Q1 2021/22 Q2 2021/22 Q3 2021/22 Q4 Performance Compared to Previous Quarter Performance Compared to Same Quarter Previous Year Current Performance 2. People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonable practicable, independently and at home or in a homely setting in their community 2.1 Assistive Technology - Number Of People With Technology (0-17 yrs) 1452 42 39 38 36 GREEN Assistive Technology - Number Of People With Technology (18-64yrs) 633 645 634 631 Assistive Technology - Number Of People With Technology (65+) 889 880 873 866 2.2 Reablement - Number Of People Completing Reablement Process (cumulative) 2000 (500 per quarter) 373 706 916 1170 RED 2.3 Reablement - % Of New or Increased Home Support Packages Which Are Reablement 70% 68.2% 59.9% 67.7% 63.1% RED 2.4 Reablement - % Of People With No or Reduced Level of Home Support Service At End Of Process 70% 61.4% 65.5% 53.2% 52.2% RED 2.6 Balance Of Care - % Of People (Age 65+) 45% 47.6% 45.7% 44.3% 45.3% GREEN 2.7 IEAS - % Deliveries Achieved Within 7 Working Days Quarterly 80% 74.8% 70.0% 66.3% *DATA INCOMPLETE 4. Health and social care services are centred on helping to maintain or improve the quality of life of 4.2 Care Home Placements At End Of Quarter - Per 1000 Popn 65+ 24 21.4 21.4 21.0 21.3 GREEN 4.3 Care Home Placements At End Of Quarter - Per 1000 Popn 75+ 50 43.7 43.7 43.0 44.0 GREEN 4.4 Care Home - Average Length of Stay 865 851 852 831 819 GREEN
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6 people who use those services 4.5 Number Of People With Self Directed Support 1000 1127 1127 1200 1256 GREEN 4.6 Number Of People With A Direct Payment 240 282 298 308 321 GREEN 7. People who use health and social care services are safe from harm 7.1 % Of Adult Protection Referrals Passed To Care Team For Investigation 20% 17.7% 17.9% 20.3% 18.9% - - 7.2 % Of Adult Protection Investigations Going To Initial Case Conference 20% 18.9% 16.9% 41.0% 23.9% - - 7.3 Adult Protection - % Of Referrals With Decision Within 5 Days 60% 79.5% 76.5% 74.1% 79.3% GREEN 7.4 % of Adult Protection Referrals Which Did Not Go On To Investigation Or Other Service 50% 69.9% 65.7% 62.7% 66.3% - -
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7 Appendix 2 – Areas for Improvement (Quarter 2, July - September 2021) 1. A wide range of activity is underway, both locally and nationally, to drive further improvement in performance in how we support timely discharges. These include: • Whole system improvement work on the PDD process • Home Support recruitment – over 200 applicants in latest round, though important to note this could impact on independent sector capacity • Lanarkshire is a demonstrator site for Home First/Discharge without delay. • Rapid response, focused on supporting people at home, is having an impact • Expanding Hospital at Home service and considering expanding to under 65s • Additional CSWs are being recruited so that District Nursing Teams can enhance the care offering to those on both Home Support and District Nursing caseloads, freeing up further Home Support capacity to concentrate on other cases Home Assessment Team (HAT) / Home First The HAT team for HSCNL went live on 25 April 2022. During its soft launch phase HAT has demonstrated its potential to positively impact on the flow of the hospital team as its intervention has prevented admission into hospital as well as reducing hospital stays. A plan is underway within UHW for accommodation to include the HAT team when working from UHW. The team will be based with the hospital social work team and discharge coordinators. A full and comprehensive overview of patient user journeys show that, as a result of HAT input, a number of patients/service users have been turned around at the hospital front door preventing admission. This turn-around provides a positive outcome, whereby assessment can take place within a patient’s/service user’s own home environment, as opposed to an unfamiliar, busy, hospital environment. Next tasks to be completed: • Agree plan for scale-up of HAT and review timeline for roll-out of HAT • Resolve issues regarding management of AHPs to enable recruitment to be progressed • Ongoing training • Evaluation of service to continue on a 3-monthly basis • Technology to be explored further – twitter/yammer to be set up for whole team • Admin support to be explored • Permanent pharmacist to be discussed/explored
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8 • Satellite stores for small stock of aids/adaptations to be set up for equipment (possible piggyback on IRT stores) and require OOH store. Current recommendation is Dalziel as OOH based in building. • Access to TrakCare clinical portal • Joined up working with South Lanarkshire HSCP • Working rota as HAT develops and grows. At this time social work remain working a 5-day week Mon/Thurs 08:45 am to 16:45pm and Friday 08:45am to 16:15pm • Leaflet to be complete with first HAT patient included (with patients’ permission) • Communications to be involved to ensure the public and others are aware of the team and their role Reablement Capacity within our reablement teams has been limited for a significant period of time during the pandemic, as resources have been prioritised to focus on operational pressures across the Home Support service. This has been particularly acute during periods of significant C-19 infection / isolation amongst staff over the past two years. However, efforts continue to re-establish capacity across all our reablement teams to ensure individuals are offered support to retain and regain their skills and confidence to live independently in their own homes. A Home Support Programme Board was established in 2021 to oversee the redesign of the Home Support Service, and there is a dedicated workstream focusing on our Reablement and Intensive service. Progress to date: • Weekly meetings have been re-established across all teams. • Daily handovers are also being re-established; however, accommodation continues to present difficulties within some teams. • Teams have noted a decrease in referral activity since the introduction of the Enhanced District Nursing Service. Next tasks to be completed: • Review capacity/resources within reablement teams to ensure flow from Home Assessment Team to the reablement service. • Review practice across localities and agree criteria and working model to ensure consistency across the service. • The Reablement / Intensive Workstream will examine and review existing teams’ practice across localities to agree the criteria and working model to ensure consistent practice.