Perth and Kinross Health and Social Care Partnership (HSCP) Draft Clinical and Care Governance Assurance Report
Perth and Kinross Council · 25 March 2026
Back to Scrutiny and Performance Committee — 25 March 2026 and its agenda
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Perth and Kinross Council Scrutiny and Performance Committee 25 March 2026 Perth and Kinross Health & Social Care Partnership (HSCP) Draft Clinical and Care Governance Assurance Report Arun Singh, Chief Social Work Officer (CSWO) (Report No.26/78) 1. Purpose Of Report This purpose of this report is to provide assurance on the Care and Professional Governance of the Perth and Kinross HSCP in respect to Social Work and Social Care services. 2. Situation 2.1 This report provides assurance on the Social Work and Social Care governance arrangements for services delegated within the Perth and Kinross Integration Scheme (approved June 2022) by the Council and delivered by the HSCP. Clinical Governance is a statutory reporting requirement at NHS Board level and our integrated approach enables Perth & Kinross Council to be assured about the standards and quality of social work and social care services. 2.2 The Scrutiny and Performance Committee is asked to scrutinise this report and agree the level of assurance. The timescale for the data within this report are the four months between 1st October 2025 to 31 January 2026 2.3 The recommended level of assurance is: Reasonable Assurance; due to the following factors: • Recent annual reports received in line with the agreed reporting framework demonstrated reasonable levels of assurance to the Care and Professional Governance Forum. • Reporting and escalation of operational risks which have a bearing on clinical and care governance and associated mitigating actions and an established process for ensuring that the strategic risks to the Perth & Kinross Integration Joint Board take account of this where appropriate.
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3. Background 3.1 Perth & Kinross HSCP has an established Care and Professional Governance Forum (CPGF). The role of the CPGF is to ensure there are effective and embedded systems for Clinical, Care and Professional Governance and seek assurance from all services within. 3.2 In April 2025, NHS Tayside launched the new Clinical Governance Strategy, which replaces the GIRFE Framework and provides the underpinning principles that support effective clinical governance and to emphasise how all staff contribute to the quality of care for people who access services in Tayside. GIRFE remains Scotland’s approach to supporting adults to promoting coordinated, person-centred are and support that focuses on individual wellbeing, strengths and outcomes. 4. Assessment 4.1 Clinical & Care Risk Management The operational / team level risk registers for Adult Social Work and Social Care services are discussed monthly at the HSCP CPGF. 4.2 New red risks and changes to existing risks are discussed at each meeting. Deeper dives of red and amber risks are undertaken on a monthly and quarterly basis respectively outwith the CPGF for more detailed discussion with Service leads. Amber risks can be managed at service level as they are understood, have effective controls and clear mitigating actions in place. In addition, they can be monitored and addressed within existing management capacity without requiring escalation. Amber risks can be fluid and be on the register for a short time, for example, vacancies and recruitment challenges can escalate risk for a short period. 4.3 The reviewing of risks supports a proportionate approach to assurances, with relevant risks being regularly monitored. Scrutiny of risks ensures measures are put in place to minimise the risk(s) and assess the effectiveness of mitigations in place to minimise the risk. Where the risk affects, or is impacted by, other parts of the health or social care system, or indeed other agency, we are assured that they are fully informed and engaged in the process. 3.4 There is one red risk currently on the Risk Register for Social Work and Social Care: Risk 1 – Lack of OT capacity Because of increased demand for Single Handed Care and Moving & Handling (M&H) Risk Assessments, there is increased demand to support complex hospital discharges (including out of area hospitals) – environmental
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assessments and M&H equipment. In addition, there is increased demand for general assessments for long term conditions. There is consistently high intake of daily referrals by the OT Duty Service; an average of 40 referrals daily. During the reporting period vacancies impacted on the flow of assessments and provision of equipment, albeit mitigations are in place which include recruitment to vacant posts, and each referral is prioritised according to presenting need and allocated on that basis. There is management oversight of the current challenges and collaborative working with Health colleagues. The Allied Health Professional Transformation Review has approved a number of improvement actions to support capacity as well as giving consideration to a peripatetic M&H service to address the backlog and deploy resources to those areas with the greatest backlog. 4.5 Clinical & Care Governance arrangements: 4.6 All services/localities report exceptions on a two monthly basis, and all services and localities reported to the CPGF during this time period. There were no issues highlighted in respect of social work or social care other than the risk above for escalation to Scrutiny and Performance Committee. 4.7 The following services in relation to Council oversight, provided annual reports during the reporting period, and were given assurance levels as follows: 4.8 Internal and External Care at Home & Reablement (Nov 2025): • Staff rotas are being reviewed to ensure staff capacity and service user demand are met. • There is ongoing engagement with the contracts and commissioning team in respect to the quality of services of externally commissioned care at home services. • Recruitment challenges remain in frontline posts. • We have reduced unmet need hours, average days for either hospital referrals or community referrals and waiting times due to the work of the coordinators and the management team. Assurance level – Reasonable Learning Disabilities Service (Nov 2025) • Challenges around the implementation of our KPIs for the Social Work team with significant work undertaken. With the introduction of Mosaic, it has been difficult to pull data from this new system, which has also had an impact on completion of our care support plan reviews.
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• Integration of services – significant challenges mitigated by the introduction of a Senior Practitioner/Band 7 Manager within the team who will support the Integrated Manager and give us a better management structure. • Annual Health Checks have been a big success and we have seen an increase of around 67.6% on last year. • Scope Team OT in post for 16 months and have seen a real benefit from her input both through transition work and pilot work. Assurance level – Reasonable 4.9 Complaint summary: April May June July Aug Sept Oct Nov Dec Jan Feb March 12 10 8 6 4 2 0 Complaints Closed 2025-2026 Stage 1 Stage 2 *Reference to 4 or fewer, is to avoid potential identification due to the small numbers involved. (≤4) • Total number of complaints received between October 2025 and January 2026 = 34 • Stage 1 = 34 • 9 Stage 1 complaints progressed to Stage 2. • Total number of complaints closed between October 2025 and January 2026 = 31 • % Stage 2 responded to within timescales = 50% • Stage 2 not responded to within timescales =50% Services the complaints relate to as below • Perth City Locality Social Work South – 5 • Perth Locality Social Work South ≤4 • Mental Health Team - ≤4 • HART Team ≤4 • North Locality Social Work Strathmore – ≤4 • North Locality Social Work Highland - ≤4
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• Care Homes PKC – 5 • Access Team – ≤4 • Community Alarm/Telecare – ≤4 • Contracts and Commissioning Team – ≤4 • Care at Home – ≤4 • SCOPE – ≤4 • Hospital discharge Team – ≤4 • Occupational Therapy – ≤4 • JELS - ≤4 • Top themes Overall (more than one theme can be applicable per complaint) • Service Provision - 24 • Employees – 7 • Communication - ≤4 Upheld or Partially Upheld complaints (more than one theme can be applicable per complaint) ≤4 Stage 1 complaints were upheld. Actions taken from upheld/partially upheld stage 1 complaints following fact finding: • Further training conducted to ensure staff are fully aware of expected protocols to be applied when carrying out service user community contact. • Reiteration of the importance of reviewing assessments with clients to ensure their views are upheld correctly. • Decisions to be monitored to ensure correct policy is adhered to. • Knowledge of service provision to be reviewed to ensure policies are being followed when providing a duty service and response. 4.10 Scottish Public Services Ombudsman Reports There have been no complaints referred to the SPSO during the time period. 4.11 External Reports & Inspections There were no external inspections during the time period. 4.12 Adult Support & Protection (ASP) During the reporting time period, there were two active Large Scale Investigations. One of these is in relation to a Care Home, and one a Care at Home provider in P&K HSCP (one involving medication administration and provision of palliative care, and one involving various concerns). There are no current active protection orders in place. A training resource is being developed to support practitioners gather the necessary evidence where concerns exist around coercive control and undue pressure.
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There are two learning reviews ongoing; one regarding the death of an individual who was open to multiple services but brought a history of non-engagement, and one regarding the decreasing trend over the past 5 years of P&K Care Homes receiving inspection grades of “good” or above. 4.13 Local actions to mitigate risks of Drug related deaths in Perth and Kinross include: Implementation and embedding of the Medication Assisted Treatment (MAT) Standards. Current RAG scores as at Dec 2025 are green apart from MAT Standard 7, which is being progressed in line with national recommendations. • Perth and Kinross Community Pharmacy Buvidal prescribing test of change in development. • SLA developed and ADP funding awarded for 12 months. 4.14 Workforce There is one red risk in relation to workforce capacity which is detailed above and the mitigations in place 4.15 Financial The composition of the Senior Management Team allows for a discussion of any financial issues from the perspective of Care & Professional Governance. 4.16 Risk Assessment/Management Key risks and assurance processes are detailed in earlier sections of this report. 4.17 Equality and Diversity, including health inequalities Details regarding any Equality, diversity and health inequalities are included, if required within each service exception report. There are no exceptions requiring to be escalated to CGC. 3.18 Communication, involvement, engagement and consultation All HSCP Staff have been invited to complete the latest iMatter survey, and teams will meet to discuss the results of these and create actions to take forward 5. Recommendation
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This report is being presented for: • Reasonable Assurance As Chief Social Work Officer for Perth & Kinross Council, I would suggest that the level of assurance provided is: Reasonable Assurance Level of Assurance System Adequacy Controls Substantial Assurance A sound system of governance, risk management and control exists, with internal controls operating effectively and being consistently applied to support the achievement of objectives in the area audited Controls are applied continuously or with only minor lapses. Reasonable Assurance There is a generally sound system of governance, risk management and control in place. Some issues, non-compliance or scope for improvement were identified which may put at risk the achievement of objectives in the area audited. Controls are applied frequently but with evidence of non-compliance. Limited Assurance Significant gaps, weaknesses or non- compliance were identified. Improvement is required to the system of governance, risk management and control to effectively manage risks to the achievement of objectives in the area audited. Controls are applied but with some significant lapses. No Assurance Immediate action is required to address fundamental gaps, weaknesses or non- compliance identified. The system of governance, risk management and control is inadequate to effectively manage risks to the achievement of objectives in the area audited. Significant breakdown in the application of controls.