Agenda pack
North Lanarkshire Council · 6 September 2022
Back to Adult Social Work, Care and Wellbeing Committee — 6 September 2022 and its agenda
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Our Ref: Your Ref: Contact: Tel: Fax: E-Mail: Date: Clare Louise McDonald 01698 302190 mcdonaldcl@northlan.gov.uk 26 Aug 2022 Members of the Adult Social Work, Care and Wellbeing Committee Chief Executive’s Office Archie Aitken Head of Legal & Democratic Solutions Civic Centre, Windmillhill Street Motherwell ML1 1AB DX 571701, Motherwell 2 www.northlanarkshire.gov.uk Notice is given that a Hybrid Meeting of the ADULT SOCIAL WORK, CARE AND WELLBEING COMMITTEE is to be held within the Council Chamber, Civic Centre, Motherwell on Tuesday, 6 September 2022 at 2:00 pm which you are requested to attend. The agenda of business is attached. Head of Legal and Democratic Solutions Members : Councillors: A Ballinger, C Barclay, B Baudo, M Boyd, G Brennan, B Burgess, A Bustard, J Cairns, C Costello, W Goldie, M Hughes, L Jarvie, J Jones, P Kelly, J Keltie, B McCluskey, B McCulloch, M McCulloch, J McPhilemy, A McVey, Stubbs, J Toner, C Williams, N Wilson, G Woods. Page 1 of 74
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AGENDA (1) Declarations of Interest in terms of the Ethical Standards in Public Life Etc. (Scotland) Act 2000 PRESENTATION (2) Presentation - Roles and Operation Hear presentation by the Chief Accountable Officer outlining the role and operation of the Committee, the Integration Joint Board and the National Care Service OPERATIONAL (3) Strategic Commissioning Plan 2023-26 (page 5 - 12) Submit report by the Head of Performance, Planning and Quality Assurance seeking approval of the approach to encourage wide participation in the development of the 2023-2026 Strategic Commissioning Plan (copy herewith) (4) Winter Planning and Enhanced Supports - Business Case for North Lanarkshire (page 13 - 32) Submit report by the Head of Planning, Performance and Quality Assurance providing an update on the progress with implementing a series of proposals to increase capacity across the Health and Social Care Service (copy herewith) (5) Charges for Non-Residential Services, Community Alarms, Meals Provision, Independent Sector Care Homes, In House Residential Care and Respite Care (page 33 - 38) Submit report by the Chief Officer, Health and Social Care advising of the charging levels to be applied for non-residential services, community alarms, meals provision, independent sector care homes, in house residential care and respite care in 2022/23 (copy herewith) PERFORMANCE (6) Adult Social Care Performance Report - Quarter 4 2021/22 (page 39 - 46) Submit report by the Chief Officer, Health and Social Care providing an update on the performance of key areas of activity within Adult Health and Social Care for the period 1 January to 31 March 2022 (Quarter 4) (copy herewith) FINANCIAL (7) Revenue and Capital Budget Monitoring Report: Adult Social Care Period 3 01/04/22 to 24/06/22 (page 47 - 60) Submit report by the Head of Planning, Performance and Quality Assurance providing a summary of the revenue financial performance of the Health and Social Care Partnership (H&SCP) North Lanarkshire for the period 1 April 2022 to 24 June 2022 (Period 3) and the financial performance of the Social Work Capital Programme (copy herewith) Page 3 of 74
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2 (8) Sundry Debt Write Off 2022 (page 61 - 66) Submit report by the Head of Adult Social Work, Health and Social Care summarising outstanding debtor accounts deemed uncollectable following all attempts at recovery or are considered uneconomicallly viable to continue pursuing (copy herewith) (9) Contracts Awarded Below Committee Approval Threshold (page 67 - 74) Submit report by the Head of Asset and Procurement Solutions advising of the contracts awarded between 1 January and 30 June 2022 with a value below the financial threshold requiring Committee approval (copy herewith) Page 4 of 74
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Strategic Commissioning Plan 2023 - 26 North Lanarkshire Council Report Does this report require to be approved? ☒ Yes ☐ No Ref MD/AH Date 06/09/22 From Morag Dendy, Head of Performance, Planning and Quality Assurance E-mail dendym@northlan.gov.uk Telephone 01698 332075 Executive Summary The Strategic Commissioning Plan (SCP) is crucial to achieving the strategic ambitions for people in North Lanarkshire. Wide engagement which brings together Strategic Needs Assessments, Locality Outcome Improvement Plans, national and local strategies, and plans, as well as learning and lessons from the transformational change agendas is being planned and developed for late August 2022. The engagement sessions, and others to be agreed with stakeholders will be designed to genuinely share, listen, and act in the complex whole system approach. A draft SCP will be presented to the IJB in late 2022. The current Programme of Work activity is framed around the ambitions of the 2020-23 Strategic Commissioning Plan and will be refreshed through the development of the revised plan. The report therefore relates to the 6 Programmes of Work noted below: PO49 Prevention and early intervention PO50.1 Do the right thing, first time PO50 Focus on what matters to people (Outcomes) PO52 Supporting people to live well connected lives PO54 Technology and sustainable solutions PO82 Work, volunteer, and care Recommendations It is recommended that the Adult Social Work, Care and Wellbeing Committee: 1. Endorse and support the approach to encourage wide participation in the development of the 2023-2026 Strategic Commissioning Plan 2. Note the contents of the report. The Plan for North Lanarkshire Priority Improve the health and wellbeing of our communities Ambition statement (20) Improve the involvement of communities in the decisions, and development of services and supports, that affect them Adult Social Work, Care and Wellbeing Committee AGENDA ITEM 3 Page 5 of 74
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1. Background 1.1 Health and Social Care North Lanarkshire published its ten-year strategy Safer, Healthier, Independent Lives, in 2016. Strategic Commissioning Plans (SCP) which are a statutory requirement, have been produced to outline the key intentions to be delivered, initially annually (2016-17, 2017-18, 2018-19, 2019-20) then a three-year plan for 2020–23. The 2023–2026 SCP will be the final plan within the ten-year strategy. 1.2 Along with Safer, Healthier, Independent Lives 2016–2026, the SCP is informed and shaped by The Plan for North Lanarkshire and Achieving Excellence. Achieving Excellence, a plan for person-centred, innovative healthcare for people in Lanarkshire, is currently being refreshed. 1.3 The SCP is further underpinned by key strategies and plans including but not limited to: a) Community Solutions Strategy and investment Plan b) Mental Health and Wellbeing Strategy for Lanarkshire c) North Lanarkshire Children’s Services Plan d) Alcohol and Drug Partnership Strategic Plan e) Tackling Poverty Strategy f) Engagement and Participation Strategy g) Market Facilitation Plan h) North Lanarkshire Strategy for Adult Carers and Young Carers i) Lanarkshire Advocacy Plan j) Lanarkshire Healthy Weight Strategy k) Digital and IT Strategy 1.4 The 9 Local Outcome Improvement Plans developed through each of the Community Boards capture local priorities and actions (noted below) which both inform and are informed by the work of the Health and Social Care Partnership and shape the Strategic Planning process. Mental Health and Wellbeing Public and community transport Tackling poverty and inequalities Community Safety Health inequalities Community Engagement Food inequality Digital Inclusion Covid 19 recovery Youth engagement and consultation Town centre and hub development Social interaction and inclusion Greenspace maintenance and environmental quality 1.5 A Strategic Needs Assessment (SNA) has been prepared to assess the current and future health, care and wellbeing needs of the community and inform decision making. The aim of the SNA is to develop evidence-based priorities for commissioning which improve the public’s health and reduce inequalities. An abbreviated version of the SNA will be shared with committee members. 2. Report Summary of Key Issues 2.1 The development of the Strategic Commissioning Plan 2023–26 is underway with discussions already commenced across a range of important forum, including Strategic Leadership Team, Strategic Planning Group, Chairs and Co-chairs of Locality Planning Groups and Partnership Boards, as well as discussion with key partner organisations and engagement forums. These discussions have helped on shaping the next steps of engagement and participation in the Strategic Commissioning Planning process as well as draw a range of related activities together to refresh how they are undertaken and aligned to use resources smartly. Page 6 of 74
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Further embedding a Whole System Approach 2.2 The Health and Social Care Partnership has long been committed to a whole system approach, recognising the co-dependencies. Ensuring engagement and participation in the development of the SCP across the whole system then clearly building performance frameworks which reflect the whole system will change meeting structures, governance arrangements and strengthen partner involvement. A whole system approach needs understand activity across: Community supports and activities Proactive and preventative activity First or initial responses Change services such as rehabilitation, recovery, treatment and reablement Ongoing interventions Complex and statutory interventions Acute or in-patient responses Strengthening engagement and participation 2.3 The Engagement and Participation Strategy, Framework and Principles 2021-24 clearly outlines the importance of, and the approach to, ensuring strong voices inform and shape the work undertaken through the Health and Social Care Partnership. 2.4 Whilst significant progress has been made in engagement and participation, in aspiring a more co-productive approach, there is more to be done. The voice of communities is embedded through Community Solutions supporting local consortia who have a broad and wide reach. The voice of carers is well represented through North Lanarkshire Carers Together. Good progress has been made in representing the voice of people with lived experience, discussions are being undertaken to invest in future approaches which robustly enhance this to increase the focus on underrepresented groups. 2.5 Frontline staff and wider stakeholders are also important in wider engagement and participation. Quarterly staff roadshows are an important vehicle to augment local arrangements and facilitate easier information sharing and participation. Delivering on major change as well as business as usual 2.6 The 6 key ambitions of the SCP 2020-23 is achieved through 41 programmes of work, previously noted through the IJB relating to the DELIVERY of services and supports, ENABLING, SUPPORTING and GOVERNING factors. It is also worthy of note however that there are several transformational change programmes being supported simultaneously, in particular: a) Child and Adolescent Mental Health Service change b) Community Nursing Review c) Development of Mental Health in Primary Care Services d) Development of Home First approach incorporating Home Assessment Teams, Integrated Rehabilitation Teams and modernisation of Home Support Services e) Development of Alcohol, Drugs and Mental Health Services The learning and development achieved through these programmes of change need to feed into the SCP 2023-26. Page 7 of 74
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Active governance and refresh of performance 2.7 Developing the Whole System Approach described at 2.2 above, includes revision to performance reviews to promote active governance. Increasingly data will be used to assure, anticipate, and prioritise, within the Health and Social Care Partnership, with key partners and through the role governance committees play in scrutinising data in detail. 2.8 The construction of performance reviews will develop the revised structures within the Health and Social Care Partnership, using the two Sector and 3 main Area Wide constructs to promote integrated approaches, cross cutting learning and shared ambition. The review groupings in the first instance will become: North West Sector (including Airdrie, Coatbridge and North Localities); North East Sector (including Bellshill, Motherwell and Wishaw localities); Children’s health services including CAMHs Addiction, Learning Disability and Mental Health Services across health and social care Area wide health and social work services which will include home support services 2.9 Proposals to also introduce a whole system performance review are being developed to more actively include the voice of communities, the voice of carers, the voice of people with lived experience, representation of the independent sector, colleagues from acute services. Representing South H&SCP hosted services and the North Core Team. 2.10 Bringing the key considerations together, dates are being identified to facilitate 5 key engagement sessions to analyse and discuss the Strategic Needs Assessments and Local Outcome Improvement Plans for each locality and area wide services. These sessions will be held in August and will inform both the development of the SCP 2023- 26 and establish the revised performance review groups. Invitation will be made to IJB members to participate in events. 3. Measures of success 3.1 The range of associated performance measures within both the national outcome indicators and our own local performance framework will be refreshed alongside the development of the SCP 2023-26 and continued development of the Programme of Work. 4. Supporting documentation Appendix 1 – Programme of Engagement Activity Morag Dendy Head of Performance, Planning and Quality Assurance Page 8 of 74
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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? The approach outlined in the report will seek to address inequalities and promote fair work practices by creating opportunities to engage and participate in the development HSCNL key priorities and strategic direction. 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 Page 9 of 74
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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 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? Page 10 of 74
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Appendix 1 Programme of Engagement Activity August 2022 31 August 9-12pm NE Sector In person TBC (likely to be September) Area Wide Health & SW In person TBC (likely to be September) Children’s Services In person TBC (likely to be September) Mental Health Event In person September 2022 1 September Addictions, LD & MH Partnership Board In person, Dalziel 6 September Adult Social Work, Care & Wellbeing Committee In person, Council Chambers 7 September, 2pm – 4.30pm Court Area, Bron Way, Cumbernauld In person, Court Area, Bron Way, Cumbernauld 7 September IJB Liaison In person 15 September, 6.30pm – 8.00pm Community Board Strategic Engagement Session 1 Online via Cisco WeBex 29 September, 6.30pm – 8.00pm Community Board Strategic Engagement Session 2 Online via Cisco WeBex November 2022 22 November, 6.30pm – 8.30pm Shotts Community Board 23 November, 6.30pm – 8.30pm Northern Corridor Community Board 24 November, 6.30pm – 8.30pm Cumbernauld Community Board 29 November, 6.30pm – 8.30pm Coatbridge Community Board 20 November, 6.30pm – 8.30pm Wishaw Community Board 1 December, 6.30pm – 8.30pm Kilsyth Community Board 6 December, 6.30pm – 8.30pm Motherwell Community Board 7 December, 6.30pm – 8.30pm Airdrie Community Board 8 December, 6.30pm – 8.30pm Bellshill Community Board Page 11 of 74
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North Lanarkshire Council Report Does this report require to be approved? ☒ Yes ☐ No Ref MD/AH Date 06/09/22 From Morag Dendy, Head of Planning, Performance and Quality Assurance E-mail dendym@northlan.gov.uk Telephone 01698 332075 Executive Summary The current and projected demand for health and social care services is significant. To meet this demand, the Scottish Government allocated additional funding in 2021/2022 and has committed to further recurring investment from 2022/2023 to increase capacity across health and social care services with immediate effect. In February 2022, the Integration Joint Board approved a business case for the commitment of the additional funding, while also taking the opportunity to target non- recurring reserves to implement a series of proposals, including the development of a Home First model in North Lanarkshire, additional community nursing capacity, enhanced care at home capacity, and additional infrastructure supports. This report provides an update on the progress made with implementing these proposals, relating to: PO49 Prevention and early intervention PO50.1 Do the right thing, first time PO50 Focus on what matters to people (Outcomes) PO52 Supporting people to live well connected lives PO54 Technology and sustainable solutions PO82 Work, volunteer, and care Recommendations It is recommended that the Adult Social Work, Care and Wellbeing Committee: 1. Endorse and support the approach to reporting on the delivery of change through the business case. 2. Note the contents of the report Adult Social Work, Care and Wellbeing Committee Winter Planning and Enhanced Supports – Business Case for North Lanarkshire AGENDA ITEM 4 Page 13 of 74
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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 There is a long history in North Lanarkshire of focusing on people being at home for as long as possible, or as quickly as possible following a hospital admission, including but not limited to the development of Integrated Rehab Teams, Discharge to Assess and Planned Date of Discharge to support the mainstream of effective locality, area wide and hospital-based services. Prevention, early intervention and anticipatory care planning, which promotes wellbeing and reduce inequalities, has also had priority focus, in particular through the Community Solutions Programme, building communities where people can have full, independent and connected lives. Overarching the whole system is the work to ensure that when people make contact with health or social work services that the response is quick and effective, with a focus on helping people to help themselves first. The importance of getting things right first time and focusing on what matters most to people has never been more important. The development of First Point of Contact incorporating good conversations across the Health and Social Care Partnership (HSCP) and embedding the approach with a whole system focus will support getting it right first time. 1.2 In the above context, the North Lanarkshire HSCP must continue to meet people’s current care needs and plan future services while managing the current extraordinary pressures on existing services because of demographic growth, the impact of the Covid-19 pandemic and underlying financial challenges. Recognising that more of the same will not sustain robust services and supports into the future, a Strategic Commissioning Plan Programme Board (SCP PB) has been established to ensure a whole system approach is adopted to support transformational change which capitalises on the availability and use of short-term, recovery orientated resourcing and reshapes the use of core funding. 1.3 The SCP PB is maintaining oversight of these developments. The early focus is on creating additional capacity, but the SCP PB will ensure the alignment and joining of developments to create clearer pathways and avoid confusion and cross-over in teams and roles avoiding unnecessarily duplication. 1.4 Action taken now must have a lasting and sustainable impact and build resilience in the whole system supporting health and social care in North Lanarkshire. Recurring and non-recurring investment must strengthen services and supports through this winter and other periods of pressure, build on the approach to recovery and renewal set out in the NHS Recovery Plan, and support continued efforts to improve social care support. 1.5 In September 2021 the IJB approved the establishment of a Change Fund (Ring-fenced Reserve No 28: Integrated Authority Support - £6.076m) to support the remobilisation and redesign of services post Covid, to enable the delivery of the Programme of Work for the North Lanarkshire HSCP, and to achieve the ambitions set out in the Partnership’s Strategic Commissioning Plan: 1. Do the right thing first time 2. Provide a range of community services and supports to people to live well in connected communities 3. Focus on what matters to people 4. Be at the forefront of technical and sustainable solutions Page 14 of 74
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5. Promote prevention and early intervention 6. Ensure North Lanarkshire is the best place to work, volunteer and care 1.6 Priorities for the use of the Change Fund were identified as: • Prevention and early intervention, targeting spending on helping people to live healthier and safer lives and maintaining their independence at home or in the community. This will mean less spending is required on hospital or specialist care later on. • Empower individuals and communities, involving them in service design and delivery. This should result in services that match what people need and want. • Improve efficiency by adopting a whole system approach to improve and deliver services 1.7 In October 2021, the Scottish Government announced funding to help protect health and social care services over the winter period and to support longer term improvement in service capacity. This announcement was supported by new investment funding of more than £300 million nationally. The Scottish Government also announced the 2022/2023 Budget in December 2021. 1.8 The Scottish Government winter planning preparations are predicated on the following four key principles: 1. Maximising capacity through investment in new staffing, resources, facilities and services. 2. Ensuring staff wellbeing and supporting them to continue to work safely and effectively with appropriate guidance and line-management and access to timely physical, practical and emotional wellbeing support. 3. Ensuring system flow through taking specific interventions now to improve planned discharge from hospital, social work assessment, provide intermediary care and increase access to care in a range of community settings to ensure that people are cared for as close to home as possible. 4. Improving outcomes through our collective investment in people, capacity and systems to deliver the right care in the right setting. 1.9 Subject to confirmation of the 2022/2023 Scottish Government Budget, the full year effect of the 2021/2022 funding allocations in 2022/2023 is estimated as follows: Fund Funding 2021/2022 2022/2023 Care at Home Recurring £3.597m £7.194m Multi-Disciplinary Teams Recurring £1.160m £2.320m Health Care Support Workers (Band 3) Recurring £0.638m £1.276m Sub-Total Recurring £5.395m £10.790m Interim Care Non-recurring £2.320m £1.160m Total £7.715m £11.950m 1.10 In addition to the proposed funding allocation detailed in the table above, £200m nationally was announced to fund the increase in the cost of the externally commissioned pay uplift from £10.02 per hour to £10.50 per hour effective from 1 April 2022. The Scottish Government indicated that if part of the funding was not required Page 15 of 74
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to meet the cost of the pay uplift the remainder be retained by the HSCP and was not ring-fenced. Incorporated into the business case funding is capacity to recognise the range of additional cost pressures experienced by independent sector providers. 1.11 Whilst the increase in the hourly rate for direct care staff was welcomed, it covered a proportion of the hourly rate and only for staff providing direct care. Independent sector providers are understandably impacted by the range of cost pressures, challenges in recruitment and retention and whilst all staff are experiencing the cost-of-living challenges, there are particular issues now emerging for staff within some of our key frontline service areas. Many staff of independent sector providers for example are required to use their own vehicles to deliver services, and although they are re- imbursed for this, the rapidly rising cost of fuel and other related service costs mean that our mileage rates may not always be sufficient to cover their actual costs. The Council recognised the impact of this for NLC staff in a committee paper to full Council in June 2022. 1.12 A 3% uplift in individual budgets is being implemented to ensure that the people can maintain choice and control in how they achieve outcomes across all 4 of the Self-Directed Support options: receiving support through a direct payment (1), through individual service agreement (2), organised by the council (3) or a combination of these options (4). 1.13 In summary, in respect of the financial year 2022/2023, the anticipated funding can be aligned to the indicative costs in 2022/2023 as follows: 1.14 The indicative recurring costs in 2022/2023 of £14.019m exceed the indicative recurring funding available of £11.278m by £2.741m. Whilst this funding gap will be addressed by non-recurring funding in 2022/2023, a recurring funding solution will require to be identified effective from 1 April 2023. This is being progressed as part of the development of the IJB Medium To Long Term Financial Plan. 1.15 As highlighted at paragraph 1.10, the totality of the recurring financial envelope is still to be confirmed. Part of the £200m national funding may be available to contribute to the above costs, subject to consultation with the NHSL Director of Finance and the NLC Head of Financial Solutions. 1.16 It is also anticipated that the impact of our efforts in enhancing upstream service models to support individuals to live as independently as possible in their own homes will allow us to realign our current care home funding model. It is our intention that these Page 16 of 74
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enhancements will prevent and reduce the number of people who, under current arrangements, may be assessed as requiring long-term residential care. The financial impact of these efforts will be monitored during 2022/2023. 2. Report 2.1 BUSINESS CASE PROPOSALS 2.2 Proposals to secure additional capacity, supports and activity across a range of disciplines and sectors, including our partners in the third and independent sectors, were developed and progressed in consultation with NLC and NHSL partners. These proposals, which were approved by the IJB in February 2022, are set out in Sections 7, 8 and 9. They support the wider programme of creating additional capacity across our health and care system as well as targeting our efforts to transform and redesign our services and supports to ensure people can access the right support from the right person at the right time. The business case is structured to ensure the partnership optimises the additional new Scottish Government funding, the IJB Change Fund and the use of ear-marked reserves. 2.3 The proposed developments within the business case are targeted at the following areas: 1. Assessment and planning capacity (including Home First) Proposals 1 and 2 2. Direct provision of services and supports Proposals 3, 4, 5, 6 and 7 3. Infrastructure capacity Proposals 8, 9 and 10 2.4 A 4-minute animation was created to describe the detail of the business case, making information accessible to staff and partners. The animation (available through the link below) was widely circulated for use within teams meeting and was used in staff roadshows with positive feedback. https://www.youtube.com/watch?v=kKIG51Pd67s 2.5 The original implementation assumptions were as follows: • Phase 1: 1 December 2021 to 31 December 2021 • Phase 2: 1 January 2022 to 31 March 2022 • Phase 3: 1 April 2022 to 31 March 2023 • Phase 4: 1 April 2023 to 31 March 2024 While much of the recruitment activity planned for Phases 1 and 2 has taken place, it was necessary to reschedule some planned recruitment due to the ongoing response to the Covid-19 pandemic. 2.6 This is a complex change agenda that needs a whole system approach to achieving the right things, but it also needs a fluid approach in how they are achieved. Building a confident, resilient workforce is unquestionably a priority. Permanent arrangements are clearly preferred but will not be possible across the scale of the change agenda. Robust analysis of performance and business intelligence will inform decision-making within workstreams and at the SCP PB. 2.7 Given the significant amount of recruitment activity required to support these proposals, it is important to ensure the business case aligns with the priorities and opportunities Page 17 of 74
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presented through the North Lanarkshire Care Academy and also links with local employability programmes, where appropriate. Attracting staff to benefit from the opportunities of working in North Lanarkshire will also link with any national or local recruitment campaigns. 2.8 Within each phase of the implementation process, the business plan proposals continue to be re-evaluated both within workstreams and at the SCP PB. The forward plans will be changed to reflect the reality of recruitment, the impact of development, the impact of Covid-19, the ongoing confirmation of funding available and the outcomes achieved through the preceding phases. 2.9 ASSESSMENT AND PLANNING 2.10 What We Are Aiming to Achieve • Increased assessment capacity to support the level of demand and complexity • Increased capacity to support recovery, rehabilitation and reablement • Improved the engagement with people with lived experiences and family members • Direct support to inform assessment and planning roles and facilitate quick and effective transfers of care • Assessment and planning over 7 days 2.11 Home First & Integrated Rehabilitation Capacity Description Establishment of Home Assessment Teams, incorporating time limited support at home and wider services, working alongside Allied Health Professional (AHP) colleagues, will allow us to increase the number of people assessed in their own home and to facilitate a timely discharge from hospital or prevent unnecessary admission. Whilst it is proposed these teams will work closely with integrated rehabilitation teams to manage transitions, ensuring these team are separate, ring-fenced teams will allow protection of this capacity to focus solely on facilitating discharged and flexibility of workforce across the sector. The capacity of the integrated rehabilitation teams (IRTs) will also be enhanced. These ring-fenced teams will enable: • A designated workforce whose focus is enabling discharge and maximising function in the home environment by increasing the number of timely post- discharge assessments and providing a rapid community response to prevent hospital admission • A robust discharge pathway for those who require home assessment following discharge from both front door and downstream wards • Flexibility to deploy the workforce across the sectors • Home first conversation to become the norm at every stage of the person’s journey (Why not home? Why not now?) • Clear leadership within discharge services • The approach to avoiding admission will be developed with the IRT and locality teams • Wide-ranging strong links with discharge facilitators within the hospital discharge hub • Close links with hospital Planned Date of Discharge (PDD) teams to identify appropriate patients for the pathway. Page 18 of 74
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• Close working relationship with IRTs, District Nurses, Acute AHP staff, Hospital at Home and Hospital Discharge Support Programme (3rd sector) with access to equipment stores. • Current IRTs to reduce waits for planned AHP input. The teams provide: • Up to a 3-day assessment period followed by a maximum of 2 weeks of input from the appropriate team members. People will be referred / signposted to the appropriate teams and services at the earliest opportunity if a clear ongoing need is identified. However, there are ambitions that a proportion of people would not require ongoing input. • Home support from ring-fenced staff whilst under the care of the team. Decisions regarding ongoing home support will be made as soon as possible. A minimum of 72 hours’ notice will be provided prior to transfer to long-term home care services (during which time the team will continue support). • Referral and signposting to appropriate ongoing support and interventions e.g. Reablement; IRT; promotion of self-management through use of North Lanarkshire leisure; use of assistive technology • Work towards providing a 7-day service as recruitment allows. • Investment Phase 1 2021/22 £m Phase 2 2021/22 £m Phase 3 2022/23 £m Total £m Recurring Cost 3.283 2.032 1.840 7.155 Non-recurring costs 0 0 0.820 0.820 Total 3.283 2.032 2.660 7.975 Progress Home First Recruitment Social Work posts: • In post: 2 Senior social workers, 1 Social Worker & 1 Social Work Assistant Home Support posts: • Service Delivery Manager in place • Bulk of Service Delivery Coordinators in place; some out-of-hours posts being re- advertised externally • 2 Support Officers in place with remaining posts being re0-advertised • Home Support Workers in place to support soft launch in Wishaw and roll-out to Cumbernauld; short-leeting for remaining posts taking place w/c 18th July AHPs: • Discharge Without Delay Manager and Discharge to Assess Co-ordinators in post • One Community OT in post. Recruitment underway for remaining 5 posts. • Remaining Home First AHP recruitment to be phased as Home Assessment rolled out • Home Assessment Teams Roll-Out • ‘Soft launch’ of HAT team on 25 April 2022. Since then, we have worked closely with 29 patients (as at 5th July). • 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. • 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. Page 19 of 74
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• Roll-out underway in Cumbernauld and currently reviewing timeline for roll-out to other localities • Training ongoing • Evaluation of service to continue on a 3-monthly basis • Satellite stores for small stock of aids/adaptations to be set up for equipment • Comms required to ensure the public and staff awareness of the team and their role • Challenges: o Lack of admin support o Pharmacy input – currently under discussion. o Joined up working with H&SC/SLC o Access to pool cars o Accommodation within UHW & UHW o Newly appointed workers to HAT continuing to carry cases from previous post o Delay in recruitment of AHP staff o Communication channels between professions/teams need to be clarified. Integrated Rehab Team Expansion Recruitment • NLC Team Leads in post; advert closed for NHSL Team Lead posts • OT Professional Leads: NHSL Professional Lead in place; NLC Professional Lead – advert closed • Permanent OT posts advertised • Advanced Practitioner OT posts largely filled; 2 part-time posts going back out to advert • Advanced Practitioner Physio posts filled; closing date extended for Band 5 post • Admin posts largely fille Page 20 of 74
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2.12 Enhanced Community Nursing Capacity Description Scottish Government funding allocated 123 Health Care Support Workers (HCSWs) to NHS Lanarkshire. The North Lanarkshire share of this is 40 WTE. These HCSWs will be used to support a refresh of our existing care management approach. Care Management is where we use early warning indicator tools such as SPARRA (Scottish Patients at Risk of Readmission and Admission) to identify those people in our communities who are at highest risk of admission to hospital. These individuals are allocated a district nurse to undertake focused work with them to care plan and minimise the risk but their social care needs are provided separately. The testing of a new approach involves the additional HCSW being placed in existing community nursing teams supporting them to meet all care needs whilst they are being care managed. This will support a very person-centred approach focusing on what matters most to these people and their families but also on stabilising their conditions and reducing their risk of admission. Some of this funding has also been skill-mixed to ensure that we have enough of a registrant workforce to supervise the HCSW. The home first approach will ensure that people can return to their own home whilst assessment of future needs is undertaken. Any nursing needs during this time would have previously been provided within Acute services. This new resource will enable these needs to be met in the community. Additional registered nurses will enable new developments such as administration of IV antibiotics whilst we undertake a full community nursing review. Investment Phase 1 2021/22 £m Phase 2 2021/22 £m Phase 3 2022/23 £m Total £m Recurring Cost 1.492 0.079 0.316 1.887 Non-recurring costs 0 0.235 0.185 0.420 Total 1.492 0.314 0.501 2.308 Progress • 27.4 WTE of 40 WTE Band 3 Healthcare Support Worker posts filled • 5 Band 5 nurse posts filled plus 2 Band 6 nurse on a temporary basis due to difficulties in filling Band 5 posts. • Senior nurse and practice assessor posts currently being recruited to. 2.13 DIRECT PROVISION OF SERVICES AND SUPPORTS 2.14 What we are aiming to achieve • Robust management of direct support – forward placing • Increased quality of support • Support to frontline staff • Quality assurance / outcomes focus with people who use services and families • Increased capacity within Community Alarm, Equipment and Adaptations and Assisted Technology • Increased capacity out of hours Page 21 of 74
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2.15 Increased Capacity Across Home Support Service, Equipment and Adaptations Service, Community Alarms Service & Assistive Technology Description The expansion of current direct provision of support will include: • Home support expansion, making permanent some temporary measures which are required longer term to facilitate improved capacity and quality of service. Both frontline practitioners as well as logistics and operational management posts are included in the immediate requirements. • Increased capacity within the Equipment and Adaptation Service • Development of a dedicated Technology Team to support the use of technology within the HSCP to support individuals within their homes and communities. This team will focus on embedding technology into assessment and planning processes; providing training to all staff groups on technology and its use in care and support; supporting with risk assessments; ensuring technology support advice is embedded in SDS; and providing high level data on the technology being used within our communities. Investment Phase 1 2021/22 £m Phase 2 2021/22 £m Phase 3 2022/23 £m Total £m Recurring costs 3.932 0.144 0 4.076 Non-recurring costs 0 2.644 0 2.644 Total 3.932 2.789 0 6.720 Progress Home Support Expansion • 71.89 WTE permanent posts funded by the Business case allocated across localities; process commencing to match existing temporary staff into these posts within each team. • Continuing to identify key training that all staff must undertake (e.g. for Home Support Workers: adult support and protection, medication, moving and assisting, dementia awareness, long term conditions, and specific roles including reablement, intensive and longer term). • As well as agreeing key training, methods, frequencies including refresher training, venues and facilitators must also be identified. • Challenges: o A high number of staff require moving and assisting refresher training following the pandemic, creating risk for the service and individuals receiving care and support. o Number of staff applying for Home Assessment Team posts o Insufficient dedicated training resource Community Alarms, Equipment Store and Assistive Tech • Recruitment to new posts on track. • Test Assistive Tech training for Adult Health & Social Care staff completed in Cumbernauld. • Rolling out training to Adult Health & Social Care staff over the course of 2022/23. Page 22 of 74
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2.16 Hospital at Home Description Extension of Working Hours • Introduction of (Band 7) to allow service hours and to continue until 10pm. • Increased Band 7 Advanced Nurse Practitioners (ANP) capacity to enable patient admission to service 7 days a week, 8am-10pm. • HIS have allocated £212k non-recurring one-year funding towards this. • There is a current national shortfall in the availability of qualified Advanced Practitioners, therefore a training programme would need to be offered and supported, this requires up to 2 years to complete (although some potential internal H@H candidates have already been supported through the advanced clinical care and Non-Medical Prescribing programmes, so may require less support before becoming fully qualified). Permanent funding of Step down Pathway • During the Covid pandemic a “step down” hub was created to ring fence staff to assist with anticipated hospital flow and create a designated pathway for Acute inpatients to be discharged into the Hospital @ Home (H@H) service. • This service improvement contributed to increased referral activity and admitted an average of 38 patients per month in 2021. Due to the clinical presentation of the patients at admission to H@H the model has been slightly adapted to allow the patients to be managed by a junior doctor (with Consultant in-reach when necessary) and Band 5 nurses • Junior doctors have been difficult to recruit on a continuing basis; however, an ANP band 7 nurse can provide clinical management to these patients. Investment Phase 1 2021/22 £m Phase 2 2021/22 £m Phase 3 2022/23 £m Total £m Recurring Cost 0.437 0 0 0.437 Non-recurring costs 0 0 0 0 Total 0.437 0 0 0.437 Progress • Step Down posts already recruited using Covid monies - staff have been made substantive • One vacancy out to advert. • Next steps: o Identify training requirement of Acute staff as part of establishment of Home Assessment/Discharge without Delay o Build Assistive Tech training into Reablement & Intensive Services workstream plan o Ongoing awareness raising across all localities Page 23 of 74
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2.17 Bed Modelling Description Building on a well-established direction of travel, continued development of a model of community response that focuses on reablement and rehabilitation with a view to shortening hospital stays and supporting people home earlier, reducing the risk of deterioration and maximising the chance of independent living. This approach affects the demands placed on, and the offer available through off-site facilities. We will seek to continue to provide greater consistency between sites and continuity of care between inpatient facilities and the community. Progress Since January 2022, 18 individuals have been supported via interim placements. These individuals have had a wide range of needs with many moving on to their preferred choice of care home, and a small number returning home with a package of support. 2.18 Support to the Independent Sector self-directed support providers including support at home Description The scale of investment in direct provision of supports is both welcome and a challenge. The additional resourcing of hourly rates of pay for frontline staff to £10.02 is also welcome but again presents challenge. The ability of the independent sector to attract and retain direct support staff will be increasingly challenging. The ability if the independent sector to recruit and retain first line managers will also be challenged by a competitive market as will lower differentials between organisational levels. It was agreed that a local provider sustainability fund is established to facilitate an individualised approach to: • Supporting recruitment and retention • Supporting staff wellbeing • Supporting cross sector support to SVQ2 • Increase to Scottish Care support to the sector It was also agreed that a Programme of Work is established to strengthen the support across the sector and to facilitate allocation of local supports to evidence direct benefit and a longer-term exit plan, led by quality assurance. Investment Non-recurring funding of £0.5m each year for 2 years totalling £1m (2021/2022 - £0.5m; 2022/2023 - £0.5m). Progress Following an internal planning session to agree parameter, information was then shared with relevant providers re the focus/purpose of the ‘Building Capacity’ funding. We adapted our Proposal for Funding process to enable applications to be submitted and tracked. The closing date for applications was Friday 12th August. 21 applications have been received, at a total request of £153,261. Evaluations are Page 24 of 74
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taking place, with intention to notify successful applicants by Friday 2nd Sept. Successful awards will be granted from 5th Sept. We have indicated the requirement for a 6-month interim update on how awards have impacted capacity, with a final report to confirm how objectives have been met. This will inform phase 2. 2.19 Investment in Communities Description To make prevention and early intervention a reality, additional investment is required to add to the community capacity building work already well embedded through the Community Solutions Programme through VANL. Further investment will see development across a number of key priorities for the Partnership, in particular: • First Point of Contact and 3 conversations • Develop the response to frailty • Promoting active health • Further developing social prescribing • Increasing the response to wellbeing • Address digital exclusion The range of achievements through Community Solutions Programme Approach has seen significant development through anchor organisations of Support in the Right Direction Community Connectors, Improving Cancer Journey and Social Prescribing. Early findings from the innovation test site introducing 3 conversations to improve First Point of Contact has indicated that there is a need to invest more significantly in a robust response through the sector which would facilitate a further focus on prevention and wellbeing through connectedness and valued activity with a combination of paid roles and community investment funding. The funding proposals were based on the appointment of 9 Community Connectors across key anchor organisations to support 3 Conversations with Older Adults, Younger Adults and Carers. An umbrella approach through Community Solutions will ensure a co-ordinated approach throughout North Lanarkshire and link clearly to the Community Consortia in promoting local opportunities for and with people, avoiding the need for more formal services for longer. The Community Connectors will also play an important role in the transitional arrangements for people at the point they may need more formal responses from the HSCP. A core investment of £1.1m supports the current programme activity but an additional £1.2 over a two-year period will enable the considerable expansion of the offer. A Programme of Work led jointly by Quality Assurance and Health Improvement, has been established to strengthen the support cross sector and facilitate allocation to support local volunteering, evidence direct benefit. Investment Phase 1 2021/22 £m Phase 2 2021/22 £m Phase 3 2022/23 £m Total £m Recurring Cost 0 0 0 0 Non-recurring costs 0.618 0.618 0 1.236 Total 0.618 0.618 0 1.236 Page 25 of 74
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Progress • Outline proposal developed for Community Connector posts hosted within host organisations in each of the 6 localities. • This comes with challenges due to each organisation having different terms and conditions, e.g., Voluntary Action North Lanarkshire (VANL) cannot recruit to posts. The posts need to be nested within ‘anchor’ organisations. Further work to be done to develop the proposal to achieve the intended outcomes. • Scottish Government has confirmed another 12 months of Community Mental Health and Wellbeing monies. 2.20 INFRASTRUCTURE SUPPORT COSTS 2.21 What we are aiming to achieve All of the transformational change required and described above cannot be achieved, sustained and evidenced without additional infrastructure growth, required on a recurring and non-recurring basis. The infrastructure developments to support all of the above include: • Programme management resource and capacity • Additional social work management capacity • Increased focus on Technology Enabled Care including: community alarms, Making Life Easier, assistive technology • HSCP approach to technology in business, including: SWIS, Midas, Morse, trakcare, dynamic scheduling, GP system upgrade • Business functions including HR, Finance, and IT • Quality Assurance, commissioning, and procurement capacity • Performance and data intelligence capacity • Staff health and wellbeing, in particular the infrastructure to support the use and monitoring the impact of the additional funding to support staff health and wellbeing across the partnership. Page 26 of 74
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2.22 Social Work Management posts Description Additional resource is required to enable the Service to implement the necessary service design and improvements in Adult Social Work Services. There is a need for additional support to deliver on the key priorities and ensure that there is professional leadership and advice throughout the redesign of services. Mental Health and Addiction Services The national and local focus on addiction services is both welcomed and necessary to address the unacceptable impact of drug and alcohol harm. The strategic and operational capacity to support this work is placing considerable strain on existing resources. Whilst the preferred position may be the appointment of temporary Service Manager capacity, a more pragmatic approach may need to be taken to release capacity in staff who hold the expertise required. Access to services and assessment and planning The work on improving access to services, including Three Conversations, Assessment and planning as well as providing professional oversight to the recovery of direct services including IDS, LSS and Integrated Equipment and Adaptation Service. The work of Health and Wellbeing, Trauma Informed Practice and Rapid Transition Housing has developed over the past few months but now needs to be fully implemented. Therefore, there is a need for temporary support to provide the necessary capacity. Whilst the preferred position may be the appointment of temporary Service Manager capacity a more pragmatic approach may need to be taken to release capacity in staff who hold the expertise required. Complex care in older adults Additional capacity for 23 months to advance key strategic areas such as unscheduled care, discharge without delay, support and care for people who live with dementia or have palliative care needs, housing, review of ASG and oversight of Care Homes. Whilst the preferred position is the appointment of temporary Service Manager capacity a more pragmatic approach may need to be taken to release capacity in staff who hold the expertise required. Resource Worker capacity In addition to the above, there is a need for additional Resource Worker capacity to support the professional leadership required and support the delivery of mental, addictions and complex care strategies. Investment Phase 1 2021/22 £m Phase 2 2021/22 £m Phase 3 2022/23 £m Total £m Recurring Cost 0 0 0 0 Non-recurring costs 0 0 0.303 0.303 Total 0 0 0.303 0.303 Progress • Two Service Managers have been appointed to support the ‘Access to services and assessment and planning’ and ‘Complex care in older adults’ workstreams with start dates to be agreed. • Plans are in place to reconfigure the resource worker posts to one senior officer post. Page 27 of 74
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2.23 Quality Assurance / Performance & Analytics / Financial Management Description With significant investment in direct service, comes the requirement for increased robustness in quality assurance, performance monitoring, HR support and financial advice. Historically the quality assurance role has focused on independent sector provision, in particular nursing homes. The positive balance of care and the focus on care and support at home requires that emphasis to spread across all areas of service provision. Contract arrangements have progressed with vigour over the last 18 months with clear specification and contract around social care services. With the increased rigour of contractual arrangements, the monitoring requirements also become clear, again requiring increased capacity to respond. The quality assurance team also leads on the communities, carer and advocacy provision. Additional capacity is required to effectively support monitoring and performance analysis across the sector. There will be additional implementation, reporting and analytical requirements. Additional resource is therefore required to support HR, finance, system developments and reporting infrastructures. Analytical information will be required timeously to inform future decision-making. It is anticipated that a reporting framework will be developed around the following Key Performance Indicators. 1. No of delays at census point 2. No of DD occupied bed days 3. No of people discharged into an interim care home 4. No of people who have moved on from interim placement by the agreed date for the placement to end 5. Average length of interim care placements 6. No of NHS staff recruited to band 3 and 4 posts 7. Increase in assessments carried out at home rather than hospital 8. Reduction in no of people waiting for an assessment 9. Reduction in length of time waiting for an assessment 10. Reduction in no of people waiting for a care at home service 11. Reduction in unmet hours of care 12. Evidence of the types of service and activity funded and the no of people supported 13. % increase in use of community equipment and tech 14. Evidence of resource to support the use of technology and digital resources 15. Investment Phase 1 2021/22 £m Phase 2 2021/22 £m Phase 3 2022/23 £m Total £m Recurring Cost 0 0 0.464 0.464 Non-recurring costs 0 0 0.157 0.157 Total 0 0 0.620 0.620 Progress • Two Senior Officers have been appointed in the Quality Assurance team and one Senior Officer, with start dates to be agreed. An additional Resource Worker has been appointed to the Quality Assurance team. • Recruitment continues for the remaining outstanding posts. Page 28 of 74
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2.24 Staff Health & Wellbeing Description On 5 October 2021, the Cabinet Secretary for Health and Social Care announced an additional package of support of £4 million for staff wellbeing focusing on people’s physical and emotional needs. An allocation of £245,302 (£126,859 North & £118,442 South) was notified to Chief Officers, with a stipulation that this funding was provided for the 2021/22 financial year. A small team of existing and additional staff, led by Health Promoting Health Services is working alongside colleagues in acute services to: • Support comms and provide continued focus on sharing good information, including how to identify what would help and how that can be actioned • Ensure wide uptake • Ensure underrepresented staff groups are encouraged to consider what works for them • Impact is monitored qualitatively as well as quantitively • Learning from the pandemic and responses required through recovery are taken forward to inform future design. • Investment Phase 1 2021/22 £m Phase 2 2021/22 £m Phase 3 2022/23 £m Total £m Recurring Cost 0 0 0 0 Non-recurring costs 0.087 0 0 0.087 Total 0.087 0 0 0.087 Progress Two posts will be recruited to with one hosted by each of the partner organisations (NHSL and NLC). 3. Measures of success 3.1 Progress continues to be made at pace to implement the business case and undertake the recruitment as approved in order to progress the necessary change activity in line with the Scottish Government funding allocations. 3.2 A governance structure has been established to oversee the implementation of the business case, with the SCP PB meeting 4-weekly to ensure the development of new operating models remains on track, is aligned with planned recruitment activities and is delivering the planned benefits. 4. Supporting documentation Appendix 1 – Summary of Costings Morag Dendy Head of Planning, Performance and Quality Assurance Page 29 of 74
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☐ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality-and-fairer- scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts have been discussed and agreed with Financial Solutions? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? There are significant financial implications, both recurring and non-recurring detailed throughout the report and summarised in Appendix 1. The financial risks associated with each proposal outlined in this business case have been assessed. Action is being taken to mitigate the risks identified. The risks will continue to be closely monitored within each workstream and by the SCP PB. Progress updates will be reported to the North Lanarkshire IJB (Performance, Finance and Audit) Committee. 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? The implications on the staffing establishments for the NLC and NHSL partners are outlined in each of the ten proposals as appropriate which are detailed in Sections 7, 8 and 9. 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 ☐ Page 30 of 74
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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? 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? Initial risks relate to the availability of the workforce, management capacity recruitment and being unable to demonstrate improvement in relation to the key outcomes. A risk and issues log is being created. Page 31 of 74
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Appendix 1 Summary of Costings FULL YEAR COSTS Assessment and Planning Direct Provision of Services and Supports Infrastructure Support Costs Total Home First & Integrated Rehab Teams Community Nursing Capacity Total HS expansion (incl Tech posts) Hospital @ Home Bed Modelling Indep Sector Investment in Communities Total SW Management Quality Assurance / Performance / Finance Staff Health & Wellbeing HR/ ESC/OD Total Total of 3 phases 7,974,576 2,307,816 10,282,392 6,720,245 436,885 - 1,000,000 618,406 8,775,536 302,930 550,061 86,525 - 939,517 19,997,445 Phase 1 3,282,545 1,492,112 4,774,657 3,931,613 436,885 - 500,000 - 4,868,498 550,061 86,525 - 636,587 10,279,742 Phase 2 2,032,220 314,232 2,346,452 2,788,632 - - 500,000 618,406 3,907,038 302,930 - - - 302,930 6,556,419 Phase 3 2,659,812 501,472 3,161,284 - - - - - - - - - - 3,161,284 check sum - - - - - - - - - - - - - RECURRING FULL YEAR COSTS Assessment and Planning Direct Provision of Services and Supports Infrastructure Support Costs Total Home First & Integrated Rehab Teams Community Nursing Capacity Total HS expansion (incl Tech posts) Hospital @ Home Bed Modelling Indep Sector Investment in Communities Total SW Management Quality Assurance / Performance / Finance Staff Health & Wellbeing HR/ ESC/OD Total Total of 3 phases 7,154,605 1,887,352 9,041,957 4,075,996 436,885 - - 4,512,881 463,536 - - 463,536 14,018,374 Phase 1 3,282,545 1,492,112 4,774,657 3,931,613 436,885 - - 4,368,498 463,536 - - 463,536 9,606,691 Phase 2 2,032,220 79,048 2,111,268 144,383 - - 144,383 - - - - 2,255,651 Phase 3 1,839,841 316,192 2,156,033 - - - - - - - - 2,156,033 check sum - - - - - - - - - - - - - NON RECURRING FULL YEAR COSTS Assessment and Planning Direct Provision of Services and Supports Infrastructure Support Costs Total Home First & Integrated Rehab Teams Community Nursing Capacity Total HS expansion (incl Tech posts) Hospital @ Home Bed Modelling Indep Sector Investment in Communities Total SW Management Quality Assurance / Performance / Finance Staff Health & Wellbeing HR/ ESC/OD Total Total of 3 phases 819,971 420,464 1,240,435 2,644,248 1,000,000 618,406 4,262,654 302,930 86,525 86,525 - 475,981 5,979,070 Phase 1 - - 86,525 86,525 - 173,051 173,051 Phase 2 235,184 235,184 2,644,248 500,000 618,406 3,762,654 302,930 - - - 302,930 4,300,768 Phase 3 819,971 185,280 1,005,251 - 500,000 500,000 - - - - 1,505,251 Page 32 of 74
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North Lanarkshire Council Report Adult Social Work, Care and Wellbeing Committee Does this report require to be approved? ☐ Yes ☒ No Ref JC/PMcA/ES Date 06/09/22 Charges for Non-Residential Services, Community Alarms, Meals Provision, Independent Sector Care Homes, In House Residential Care and Respite Care From Ross McGuiffie, Chief Officer, Health and Social Care, North Lanarkshire E-mail Ross.mcguiffe@lanarkshire.scot.nhs.uk Telephone 01698 858143 Executive Summary The purpose of this report is to advise Committee of the charging levels to be applied for non-residential services, community alarms, meals provision, independent sector care homes, in house residential care and respite care in 2022/23. The Council’s charging policy has been updated for 2022/23 to reflect the new rates. It should be noted that the charges for 2022/23 would normally increase by the CPI% rate set in January 2022, however the rates will not be increased for 2022/23 and therefore will remain at 2021/22 rates. Recommendations It is recommended that the Adult Social Work, Care and Wellbeing Committee notes: a) the threshold figure for payment of home support charges set at £229 for single people and £349 for couples; b) the hourly rate for home support of £18.20; c) the daily rate for attending an Integrated Day Service of £10.00; d) the weekly rate for a Community Alarm of £3.40; e) the charge for meals provided in day services of £5.15; f) implementation of the increase to Independent Sector Care Home fees as negotiated via COSLA, Scottish Care and the Scottish Government; g) a charge for in house residential care of £666.00 per week; h) an uplift in charges for residential respite in line with increases in pensions and allowances; and i) free personal care and nursing care will rise from £193.50 to £212.85 and £87.10 to £95.80 AGENDA ITEM 5 Page 33 of 74
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1. Background 1.1 Local Authorities are empowered through the Social Work (Scotland) Act 1968 and the Housing Scotland Act, 2001 to apply charges for services. In setting its charging levels, North Lanarkshire Council has followed the national guidance issued by COSLA in respect of charging. 1.2 The COSLA guidance operates on the principle that people on the lowest levels of income do not pay for the service and that those who do pay contribute according to their means. This objective is achieved by setting a charge threshold which is up-rated annually and applying a taper contribution of income above the threshold level (see 2.1). 1.3 In accordance with COSLA guidance, North Lanarkshire Council maximises the income of all service users who are liable to make a contribution towards the cost of the service. In 2021/22, the Financial Inclusion Team generated benefit income in the region of £1.3m for people receiving a non-residential service. 1.4 The charges for 2022/23 would normally increase by the CPI% rate set in January 2022, however the rates will not be increased for 2022/23 and therefore will remain at 2021/22 rates. 2. Report 2.1 In line with the COSLA recommendations, the charge threshold for 2022/2023 will be £229 per week for a single person and £349 for couples (2021/22 £222 and £338). Persons with income less than those figures will not be required to pay for home support services. 2.2 When calculating maximum service users charge, the Council deducts from their assessable income any costs which the service user is liable for in respect of housing costs, i.e. rent, mortgage, council tax and water charges. A taper contribution of 50% of excess income is then applied. For example, a single person with income of £256 per week after deductions would have their charge assessed as follows: Income £256 Threshold £229 Disposable Income £27 Client charge = £27 x 50% = £13.50 2.3 The hourly rate for Home Support Services will remain at 2021/22 rate of £18.20 2.4 The charge applied for attending an Integrated Day Service will be £10.00 per day 2.5 Charges for meals provided in day services will also remain at 2021/22 rate of £5.15 2.6 The Community Alarm charge will remain at 2021/22 rate of £3.40 per week The Plan for North Lanarkshire Priority Improve economic opportunities and outcomes Ambition statement (12) Ensure our residents are able to achieve, maintain, and recover their independence through appropriate supports at home and in their communities Page 34 of 74
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Independent Sector Care Home Fees 2.7 Care home fees are negotiated annually via COSLA, Scottish Care and the Government. The weekly rates for 2022/23 are £832.10 (Nursing Care) and £719.50 (Residential Care) both effective from 11 April 2022. This settlement recognises the Scottish Government’s policy of increasing the earnings of direct care staff within adult social care with an increase to staff salaries of 4.8%. All other staff roles (excluding the manager, management support and nurses) are also subject to a 4.8% increase in the cost model. An increase to nursing salaries of 3% has been included with a commitment to vary this rate to align with the final Agenda for Change pay increase. The settlement also recognises other financial pressures within the older person’s care home sector and reflects a number of exceptional changes in the cost of calculations in the non-staffing areas of the cost model. The settlement recognises that all parties to the negotiations support the need for a redesign of the current NCHC and are seeking to engage in this important work with some urgency. In-house Residential Care 2.8 The Council is required to set a rate for residential care provided in its own homes. The current rate of £666 will remain for 2022/23. Respite 2.9 The weekly charge for residential respite (£108.30 in 2021/22) will rise in line with increases in pensions and allowances to £110.85 for 2022/23. Free Personal Care 2.10 The rates to be applied to free personal care and nursing care for people in residential homes for 2022/23 will rise in accordance with the Scottish Government directive from £193.50 to £212.85 and £87.10 to £95.80. 3. Measures of success 3.1 Through the income maximisation and charging policy, service users have their income fully maximised through the social security benefit system. 3.2 This policy ensures that disability benefits etc are claimed and the Council in turn receive revenue from charges for services. 4. Supporting documentation Ross McGuiffie Chief Officer, Health and Social Care North Lanarkshire Page 35 of 74
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality-and-fairer- scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts have been discussed and agreed with Financial Solutions? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? Rates have been maintained at 2021/22 levels, this ensures consistency with all other NLC fees and charges. 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? Page 36 of 74
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Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? 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? Page 37 of 74
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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 AGENDA ITEM 6 Page 39 of 74
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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 Page 40 of 74
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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? Page 41 of 74
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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? Page 42 of 74
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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 Page 43 of 74
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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% - - Page 44 of 74
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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 Page 45 of 74
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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. Page 46 of 74
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North Lanarkshire Council Report Adult Social Work, Care and Wellbeing Committee Does this report require to be approved? ☐ Yes ☒ No Ref RM/MD/NL/LH Date 06/09/22 Revenue & Capital Budget Monitoring Report: Adult Social Care Period 3: 01/04/2022 to 24/06/2022 From Morag Dendy, Head of 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 2022 to 24 June 2022 (Period 3) and includes projected outturn forecasts for the financial year ended 31 March 2023, 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 £243.902m and is currently projecting an underspend of £4.510m. The Social Work capital programme has a total budget of £2.504m and is currently projecting a break-even position. Recommendations It is recommended that the Adult Social Work, Care and Wellbeing 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 AGENDA ITEM 7 Page 47 of 74
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1. Background 1.1 The Council approved its General Revenue Fund Budget on 17 February 2022, and the Integration Joint Board (IJB) approved its Financial Plan on 23 March 2022. The approved Gross Expenditure Budget for the H&SCP – NL (Adult Social Care and Housing) is £243.902m. 1.2 2022/23 is the second year of the Council’s five-year capital investment programme. The programme approved funding of £2.200m for Social Work for the current year. Reprofiling of £0.304m, from 2021/22, has resulted in a revised budget of £2.504m, as demonstrated by Appendix 6. 2. Report Revenue: Analysis of Significant Variances 2.1 Within Employee Costs, the Service currently anticipates an underspend of £2.870m. This relates to slippage in relation to the recruitment of posts linked to the “Winter Planning and Enhanced Supports” business case. 2.2 Within Admin costs, the Service is currently anticipating an underspend of £0.908m, mainly as a result of less than anticipated spend within Carers budgets. 2.3 Payments to Other Bodies are detailed in Appendix 2. This expenditure accounts for £144.601m of the annual budget and is forecast to have an in-year underspend of £1.089m. This is primarily in relation to staff shortages within the care at home sector who provide services to individuals via the SDS commissioning framework. It is anticipated that this is an in-year underspend only and these budgets will be required in full in 2023/24. 2.4 The Service anticipates an under-recovery of income of £0.371m. This is a result of the committed income recovery from NHSL, in respect of the Integrated Equipment and Adaptations Service, being lower than the historic budget level; coupled with lower than budgeted receipts from charges for Community Alarms and the Integrated Day Services. Revenue: Earmarked Reserves 2.5 The Integration Joint Board have set aside reserves totalling £39.919m for specific Adult Social Care commitments. As expenditure within these areas is currently anticipated to be met from reserves, the totals shown within Appendix 3 are excluded from this outturn position. It is anticipated that £16.617m of the earmarked reserves will be utilised during 2022/23, with £15.302m being carried forward to 2023/24. Revenue: 2022/23 Savings 2.6 The Integration Joint Board approved gross savings within the Adult Social Care service of £2.025m. The Service uses a variety of information, records, and processes to monitor achievement of its approved budget savings and as at Period 3 the Service anticipates £0.653m (32%) will be delivered by the financial year-end. 2.7 Appendix 4 provides further analysis of the savings. The budget gap of £1.372m will be funded by IJB reserves. Page 48 of 74
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Revenue: Covid – 19 2.8 During 2022/23 the Scottish Government was in regular discussions with H&SCP’s with respect to in-year IJB Covid costs. The latest forecast included in this report is for in- year gross Covid costs of approximately £2.838m which is fully offset by income received. Appendix 5 provides further analysis of the Covid Costs and funding. Revenue: Provider Uplift 2.9 Funding has been provided by the Scottish Government (£200M across Scotland) as additional investment in Health & Social Care (including Scottish Living Wage increase up to £10.50 per hour). Work is underway to ensure the uplift to the £10.50 is being implemented and a supplementary exercise is being undertaken to assess the uplift in light of other factors, including the increasing cost of living. Capital: Analysis of Significant Variances 2.10 The Integrated Equipment and Adaptation (IEAS) capital programme budget for 2022/23, is currently forecasting a break-even position. There are, however, heightened uncertainties in respect of demand and complexity of need. 2.11 Appendices 7 and 8 outline 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 Analysis Appendix 3 Revenue - Earmarked Reserves Analysis Appendix 4 Revenue - 2022/23 Savings Monitoring Report Appendix 5 Revenue - COVID 19 Costs Appendix 6 Capital – Budget Movements 2022/23 Appendix 7 Capital – Summary Expenditure by Thematic Appendix 8 Capital – Summary Expenditure by Division Morag Dendy Head of Planning, Performance and Quality Assurance Page 49 of 74
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality-and-fairer- scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts have been discussed and agreed with Financial Solutions? 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 Financial Solutions 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 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 ☐ Page 50 of 74
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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 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? 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 Page 51 of 74
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Appendix 1 CATEGORY BUDGET ACTUAL YEAR TO DATE ANNUAL PROJECTED ANALYSIS TO DATE TO DATE VARIANCE BUDGET OUTTURN VARIANCE % (1) (2) (3) (4) (5) (6) (7) (8) (9) EMPLOYEE COSTS 16,748,540 16,086,172 662,368 FAV 87,734,569 84,864,318 2,870,251 FAV 3.3% Slippage in relation to the recruitment of posts linked to the Business Case PROPERTY COSTS 1,955,569 1,955,559 10 FAV 2,515,508 2,515,465 43 FAV 0.0% SUPPLIES & SERVICES 949,645 947,973 1,672 FAV 4,771,427 4,764,182 7,245 FAV 0.2% TRANSPORT & PLANT 324,561 323,131 1,430 FAV 1,690,897 1,684,699 6,198 FAV 0.4% Lower than anticipated vehicle contract hires ADMINISTRATION COSTS 209,756 0 209,756 FAV 2,559,307 1,650,362 908,945 FAV 35.5% Lower than anticipated spend in relation to Carers budgets PAYMENTS TO OTHER BODIES 14,659,007 14,407,516 251,491 FAV 144,601,809 143,512,013 1,089,796 FAV 0.8% Please refer to Appendix 2 for analysis OTHER EXPENDITURE 1,057 1,057 0 28,858 28,858 0 0.0% APPORTIONED EXPENSES 0 0 0 0 0 0 0.0% CFCR 0 0 0 0 0 0 0.0% CAPITAL EXPENDITURE 0 0 0 0 0 0 0.0% TOTAL EXPENDITURE 34,848,135 33,721,408 1,126,727 FAV 243,902,375 239,019,897 4,882,478 FAV 2.0% NLC CONTRIBUTION 42,854,562 42,854,562 0 185,758,836 185,758,836 0 0.0% NLC CONTRIBUTION - HOUSING 1,870,010 1,870,010 0 1,870,010 1,870,010 0 0.0% NLC CONTRIBUTION - TRANSPORT 169,458 169,458 0 550,737 550,737 0 0.0% INCOME FROM HEALTH 2,943,152 2,913,761 (29,391) ADV 54,078,807 53,951,447 (127,360) ADV -0.2% Under-recovery of budgeted funding from NHSL, with regard to the Integrated Equipment & Adaptations Service, partially offset by contributions to SDS care packages FEES AND CHARGES 248,968 175,374 (73,594) ADV 1,438,167 1,119,263 (318,904) ADV -22.2% Lower than anticipated income in relation to charges for Integrated Day Services and also Community Alarms OTHER LOCAL AUTHORITIES 6,921 6,921 0 30,000 30,000 0 0.0% USE OF IJB RESERVES 0 0 0 0 0 0 0.0% OTHER INCOME 31,603 48,857 17,254 FAV 175,818 250,584 74,766 FAV 42.5% Overrecovery in relation to returned private sector housing grants TOTAL INCOME 48,124,674 48,038,943 (85,731) ADV 243,902,375 243,530,877 (371,498) ADV -0.2% NET EXPENDITURE (13,276,539) (14,317,535) 1,040,996 FAV 0 (4,510,980) 4,510,980 FAV FAV = Favourable variation, underspend etc ADV = Adverse variation, overspend, income under-recovery etc PROJECTED OUTTURN ADULT SOCIAL CARE & HOUSING - INTEGRATED Revenue Budget Monitoring Report: Subjective Analysis 01 April 2022 - 24 June 2022 Period 3 Page 52 of 74
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Appendix 2 DESCRIPTION BUDGET ACTUAL ANNUAL PROJECTED TO DATE TO DATE BUDGET OUTTURN % (1) (2) (3) (5) (6) (8) (9) SDS Framework 1 & 2 8,779,852 8,537,215 242,637 FAV 94,304,755 93,253,329 1,051,426 FAV 1.1% Demand led activity. Independent Care Homes 5,305,102 5,305,102 0 FAV 40,983,557 40,983,557 0 0.0% Demand led activity. Payments to NHS Lanarkshire 0 0 (0) ADV 1,462,489 1,462,489 0 0.0% Position reflects anticipated in year payments Non Traditional Respite 0 0 (0) ADV 335,283 335,283 0 0.0% Position reflects anticipated Locality demand Other Local Authorities - General 0 (0) 0 FAV 125,335 125,335 0 0.0% Position reflects anticipated in-year demand Voluntary Organisations 479,201 486,459 (7,258) ADV 4,370,126 4,401,573 (31,447) ADV -0.7% Position reflects anticipated in-year demand Payments to Other Bodies - General 16,111 (0) 16,111 FAV 857,820 788,003 69,817 FAV 8.1% Position reflects anticipated in-year demand Housing Support (RSL's) 43,051 43,051 0 FAV 669,363 669,363 0 0.0% Position reflects projected contract levels Locality Flexibility 34,450 34,450 0 FAV 218,068 218,068 0 0.0% Position reflects anticipated Locality demand Private Sector Housing Grants 0 0 (0) ADV 1,152,378 1,152,378 0 0.0% Position reflects level of demand for private sector adaptations Medical Fees 1,240 1,240 0 122,635 122,635 0 0.0% Position reflects Service's approach to absence management Other 0 0 0 0 0 0 0.0% TOTAL EXPENDITURE 14,659,007 14,407,516 251,491 FAV 144,601,809 143,512,013 1,089,796 FAV 0.8% FAV = Favourable variation, underspend etc ADV = Adverse variation, overspend, income under-recovery etc ADULT SOCIAL CARE & HOUSING - INTEGRATED Revenue Budget Monitoring Report: PTOB Analysis 01 April 2022 - 24 June 2022 Period 3 (4) (7) ANALYSIS OF VARIATIONS YEAR TO DATE PROJECTED OUTTURN VARIANCES VARIANCE Page 53 of 74
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Appendix 3 Description of Earmarked Reserve 2022/23 Reserve Total 2022/23 2023/24 Balance no longer required Total Comments Carers Support 1,431,747 1,431,747 0 1,431,747 Winter Planning & Enhanced Support - Business Case 5,601,110 2,263,793 3,337,317 5,601,110 Unmet savings 3,420,209 1,732,270 1,687,939 3,420,209 Covid Support 3,000,000 3,000,000 0 3,000,000 Digital Improvements 2,960,400 1,197,000 1,763,400 2,960,400 Social Care Demand Risk 13,940,548 5,500,000 8,440,548 13,940,548 Programmes for Change 1,565,356 1,492,805 72,551 1,565,356 Totals 31,919,370 16,617,615 15,301,755 0 31,919,370 ADULT SOCIAL CARE & HOUSING - INTEGRATED Revenue Budget Monitoring Report: PROPOSED Earmarked Reserves Analysis 2022/2023 Period 3 Page 54 of 74
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Appendix 4 £000 £000 £000 £000 £000 ASC04 LA Service changes - Muirpark 1,372 0 1,372 Agreement to delay and fund from IJB reserves 1,372 0 ASC11 Inflation increase from NHSL on Resource transfer and Social Care Funding 653 653 0 0 0 Totals 2,025 653 1,372 1,372 0 ADULT SOCIAL CARE & HOUSING - INTEGRATED Value CommentaryBudget GapTarget Value Value Deliverable APPROVED SAVINGS Saving Gap Revenue Budget Monitoring Report: 2022/23 Savings Monitoring Report Description of Approved Saving 01 April 2022 - 24 June 2022 Period 3 REPLACEMENT SAVING/FUNDING Description Page 55 of 74
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Appendix 5 Assumed Budget Projected Outturn Projected Outturn Variance COMMENT £'000 £'000 £'000 Increased Costs Personal Protection Equipment 0 396 (396) Partner Payments 0 2,106 (2,106) In line with Scottish Government guidance and principles regarding Occupancy and Sustainablity payments to partners Loss of Income - Integrated Day Services 0 250 (250) Expected underachievement of Savings 0 86 (86) Delay in property integration of the Integrated Day Service and Locality Support Service Service Costs Total 0 2,838 (2,838) Income Scottish Government Covid Funding for IJB's 0 (2,838) 2,838 deferred income via NHSL partner TOTAL NET COSTS 0 0 0 DESCRIPTION OF COVID-19 COSTS ADULT SOCIAL CARE & HOUSING - INTEGRATED Revenue Budget Monitoring Report: COVID-19 Costs 01 April 2022 - 24 June 2022 Period 3 Page 56 of 74
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Appendix 6 APPROVED BUDGET 2,200,000 Movements to budget Period Division Thematic category Theme Reprofiling from 2021/22 400,000 Included in opening budget Social Work Key Ambition Integrated equipment & adaptations Acceleration in 2021/22 (95,808) Included in opening budget Social Work Key Ambition Integrated equipment & adaptations REVISED BUDGET TOTAL 2,504,192 Social Work Capital Programme Capital Budget Monitoring Report: Budget Movements 2022/23 01 April 2022 - 24 June 2022 Period 3 Page 57 of 74
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Appendix 7 Thematic Category Budget £ Actual £ Actual % Committed £ Committed % Uncommitted £ Final Outturn £ Outturn variance £ Key Ambition 2,504,192 176,313 7.0% 176,313 7.0% 2,327,879 2,504,192 0 Total 2,504,192 176,313 7.04% 176,313 7.04% 2,327,879 2,504,192 0 YTD OUTTURN Social Work Capital Programme Capital Budget Monitoring Report: Summary Expenditure by Thematic Category 01 April 2022 - 24 June 2022 Period 3 Page 58 of 74
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Appendix 8 Theme Budget £ Actual £ Committed £ Uncommitted £ Final Outturn £ Outturn variance £ SOCIAL WORK Integrated equipment & adaptations 2,504,192 176,313 176,313 2,327,879 2,504,192 0 TOTAL SOCIAL WORK 2,504,192 176,313 176,313 2,327,879 2,504,192 0 OUTTURN Social Work Capital Programme Capital Budget Monitoring Report: Summary Expenditure by Division 01 April 2022 - 24 June 2022 Period 3 YTD Page 59 of 74
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North Lanarkshire Council Report Adult Social Work, Care and Wellbeing Committee Does this report require to be approved? ☒ Yes ☐ No Ref PMcA/AB/DF Date 06/09/22 Sundry Debt Write Off 2022 From Diane Fraser, Head of Adult Social Work, Health & Social Care E-mail fraserdi@northlan.gov.uk Telephone 01698 332001 Executive Summary The purpose of this report is to present to Committee a summary of outstanding debtor accounts which are deemed uncollectable following all attempts at recovery or are considered uneconomically viable to continue pursuing. In accordance with financial guidelines a bad debt provision has previously been established for the outstanding accounts highlighted below. Recommendations It is recommended that Committee: (1) Notes the decision of the Chief Accountable Officer and the Head of Financial Solutions under delegated responsibilities to write off £13,702.54 for debts under £500. (2) Approve the write off of £35,851.67 which includes debts greater than £500. (3) Remit this report to Finance & Resources Committee. The Plan for North Lanarkshire Priority Improve North Lanarkshire's resource base Ambition Statement (21) Continue to identify and access opportunities to leverage additional resources to support our ambitions AGENDA ITEM 8 Page 61 of 74
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1. Background 1.1 During 2021/22 the Council issued invoices with an approximate value of £114m. 1.2 Within Adult Health & Social Care there are a number of chargeable services mainly in the following areas: • Home Care Charges • Nursing Home and Residential Home Accommodation Charges • Community Alarms • As well as chargeable services, invoices are raised to other local authorities, health, and universities. 1.3 The value of Adult Health & Social Care invoices raised during 2021/22 was £72m. This figure includes invoices raised to other local authorities, health, and universities (£65m). 1.4 In conjunction with the corporate debt recovery team, every effort is made to recover any unpaid debt including reminder letters, the use of collection agents and legal action. However, despite these steps there are a number of debts that are deemed uncollectible or are considered not economically viable to engage further collection activities and costs. This annual process of assessing the likelihood of debt non- recovery conforms to accepted best accounting practice and is a realistic assessment of expected income. 1.5 The Council will continue to seek collection of the outstanding balance if the circumstances of the debtor alter, and recovery is deemed practical. 2. Report 2.1 Analysis of the outstanding balances has been conducted and £49,554.21 has been identified as uncollectable. 2.2 There are a number of reasons why the outstanding balances are being written off and these are summarised below: (a) Deceased. The debtor is deceased and there have been insufficient funds within the estate to meet the sum due. (b) Small Balances/Uneconomic to Pursue. There are insufficient funds or no realisable assets that are available to meet the debt and it is uneconomic to continue to seek recovery of the sum due. (c) Gone Away. The debtor has moved address and cannot be located. (d) Recovery exhausted. Despite all efforts the service has now been informed that these accounts will not be recovered. Page 62 of 74
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2.3 The following tables categorise the value of debt recommended for write off by cause and value: Cause Analysis No of accounts £ Deceased 28 11,817.95 Small Balances/Uneconomic to Pursue 3 7.5 Gone Away 0 0.0 Recovery Exhausted 153 37,728.76 Total 184 49,554.21 Value Analysis < £500 155 13,702.54 > £500 29 35,851.67 Total 184 49,554.21 The value of accounts identified for write off represents a very small proportion of the accounts raised annually by Adult Health & Social Care. This is reflective of a number of activities aimed at improving collection rates, reducing debt arising and streamlining the recovery process. 3. Measures of success 3.1 The Service continues to engage in a number of activities aimed at improving collection rates, reducing debt arising and streaming the recovery process. These include: • Implementation of Debt Recovery Procedures • Performance Management Reports • Payment Arrangements • Payment by Direct Debit The Council will continue to seek collection of the outstanding balance if the circumstances of the debtor alter, and recovery is deemed practical. 4. Supporting documentation 4.1 No appendices Diane Fraser Head of Adult Social Work Service Page 63 of 74
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality-and-fairer- scotland-duty-impact-assessments Yes ☐ No ☐ 5.2 Financial impact Does the report contain any financial impacts? Yes ☐ No ☒ If Yes, have all relevant financial impacts have been discussed and agreed with 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? Page 64 of 74
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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? Page 65 of 74
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North Lanarkshire Council Report Adult Social Work, Care and Wellbeing Committee Does this report require to be approved? ☐ Yes ☒ No Ref CG/JMcK Date 07/09/21 Contracts awarded below Committee approval threshold From Head of Asset and Procurement Solutions E-mail mckinstryj@northlan.gov.uk Telephone James McKinstry 07939 281102 1. Background 1.1 The Councils General Contract Standing Orders (the ‘GCSOs’) outline financial approval thresholds for contracts for goods, works and services. Contract awards above £500,000 for Supplies and Services and above £2,000,000 for Works require approval by the Committee. These contract awards are considered by the Committee on a case-by-case basis. 1.2 Where the value of a contract award is between £50,000 and £500,000 for Supplies and Services and between £500,000 and £2,000,000 for Works, GCSOs require that the Head of Asset and Procurement Solutions award these contracts on behalf of the appropriate Chief Officer. Executive Summary This report notifies the Committee of the contracts awarded between 1 January 2022 and 30 June 2022. It sets out those contracts awarded with a value below the financial threshold requiring Committee approval. Recommendations The Adult Social Work, Care and Wellbeing Committee are: • advised of the Contracts awarded below Committee approval threshold between 1 January 2022 to 30 June 2022 as per the process within the Council’s General Contract Standing Orders. 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 AGENDA ITEM 9 Page 67 of 74
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1.3 The Head of Asset and Procurement Solutions is required to notify Committee on a regular basis of any such contracts awarded on behalf of Procuring Service Areas. 2. Report 2.1 The GCSOs require that contracts in excess of £500,000 for supplies and services and £2,000,000 for works are approved, on a case-by-case basis, by the Committee before award. 2.2 The GCSOs require that contracts with a value above £50,000 but less than £500,000 for Supplies and Services and above £500,000 but less than £2,000,000 for Works are awarded by the Head of Asset and Procurement Solutions on behalf of the appropriate Chief Officer. 2.3 The contracts awarded by the Head of Asset and Procurement Solutions that are under the £500,000 Committee financial approval threshold for Supplies and Services and £2,000,000 for Works in the period from 1 January 2022 to 30 June 2022 are detailed in Appendix 1. 3. Measures of success 3.1 Contracts support the delivery of Council and service priorities. 3.2 Appointment of contractors who have suitable experience and capability to deliver the required supplies, services or works. 3.3 Contracts awarded by the Council are compliant with GCSOs and procurement legislation. 3.4 The Council’s Contract Register is kept updated by services and management information is comprehensive and accurate. 3.5 Best Value is both demonstrable and achieved. 4. Supporting documentation 4.1 Appendix 1 – Summary of contracts awarded. James McKinstry Head of Asset and Procurement Solutions Page 68 of 74
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5. Impacts ( http://connect/report-template-guidance ) 5.1 Public Sector Equality Duty and Fairer Scotland Duty Does the report contain information that has an impact as a result of the Public Sector Equality Duty and/or Fairer Scotland Duty? Yes ☐ No ☒ If Yes, please provide a brief summary of the impact? If Yes, has an assessment been carried out and published on the council’s website? https://www.northlanarkshire.gov.uk/your-community/equalities/equality-and-fairer- scotland-duty-impact-assessments Yes ☐ No ☒ 5.2 Financial impact Does the report contain any financial impacts? Yes ☒ No ☐ If Yes, have all relevant financial impacts have been discussed and agreed with Financial Solutions? Yes ☒ No ☐ If Yes, please provide a brief summary of the impact? Where Financial impacts have been identified, they have been established and addressed in each specific Contract Strategy and incorporated into the project. The Council’s Procurement Strategy proposes methods of maximising the delivery of procurement benefits that could bring improved financial return to the Council and the areas wider economy. Certain benefits have a monetary value attached and these will be monitored on a project-by-project basis. 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? Where HR impacts have been identified, they have been established and addressed in each specific Contract Strategy and incorporated into the project. Contracts awarded by the Council are compliant with GCSOs and procurement legislation. 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? Where Legal impacts have been identified, they have been established and addressed in each specific Contract Strategy and incorporated into the project. Contracts awarded by the Council are compliant with GCSOs and procurement Page 69 of 74
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legislation. 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 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? Sustainable procurement is one of the key objectives of the Council’s Procurement Strategy and will have a positive impact, including, embedding sustainable procurement as business as usual and incorporating community benefits into the Councils contracts. Supporting local businesses and SMEs through closer working with colleagues in the Council’s Enterprise department and by making our processes more streamlined and accessible. Where Environmental/Carbon impacts have been identified, they have been established and addressed in each specific Contract Strategy and incorporated into the project. 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? Where Risk impacts have been identified, they have been established and addressed in each specific Contract Strategy and incorporated into the project. Page 70 of 74
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Contract award procedures may be susceptible to legal challenge if they are not discharged in accordance with GCSO and procurement legislation. Page 71 of 74
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APPENDIX 1 Contract Description Contract Award Date Contract Start Date Contract End Date Contract Extension Contract Value (inc extension) (£s) Pre- Procurement Estimate (£’s) Successful Tenderer Supplies Services Works No of Tenders Received Route* Post Diagnostic Dementia Support 01/04/2022 01/04/2022 31/03/2024 N/A £194,000.00 £194,000.00 Alzheimer Scotland Services 1 DAH&SC* Distress Brief Intervention 01/04/2022 01/04/2022 31/03/2024 N/A £470,600.00 £470,600.00 Lifelink Services 1 DAH&SC* *Legislation allows for Direct Award due to the sensitive and specialist area of work. This conforms with the Procurement Reform (Scotland) Act 2014 and the Procurement Scotland Regulations 2016 for Health and Social Related Services and Scottish Government guidance. Key – Procurement Route CO - Contract Open Procedure CR - Contract Restricted Procedure FO - Framework Open Procedure FR - Framework Restricted Procedures FMCC - Mini Comp Council Framework FMC3 - Mini Comp 3rd Party Framework DAFC - Direct Award Council Framework DAF3 - Direct Award 3rd Party Framework DAH&SC - Direct Award Health & Social Care Related Services Page 72 of 74
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N - Negotiated Contract EXT - Extension to Contract/Framewor Page 73 of 74
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