Perth and Kinross Health and Social Care Partnership (HSCP) Clinical and Care Governance Assurance Report
Perth and Kinross Council · 7 October 2026
Back to Scrutiny and Performance Committee — 7 October 2026 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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PERTH AND KINROSS COUNCIL Committee: Scrutiny and Performance Committee Date of Meeting: 23 September 2026 Title of Report: Perth and Kinross Health & Social Care Partnership (HSCP) Clinical and Care Governance Assurance Report Report Number: 26/260 Report Author: Arun Singh, Chief Social Work Officer (CSWO) Purpose Of Report The purpose of this report is to provide assurance on the care and professional governance of the Perth and Kinross HSCP in respect of social work and social care services. 1. Situation 1.1 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. 1.2 The Scrutiny and Performance Committee is asked to scrutinise this report for the six-month period from 1 February 2026 to 31 July 2026. 1.3 It is recommended that the report provides assurance due to the following factors: • 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. 2 Background 2.1 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 to seek assurance from all relevant services.
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2.2 In April 2025, NHS Tayside launched the new Clinical Governance Strategy, which replaced the GIRFE Framework and provides the underpinning principles that support effective clinical governance. It also emphasises how all staff contribute to the quality of care for people who access services in Tayside. GIRFE remains Scotland’s approach to supporting adults by promoting coordinated, person-centred care and support that focuses on individual wellbeing, strengths and outcomes. 3. Assessment 3.1 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. 3.2 New red risks and changes to existing risks are discussed at each meeting. Deeper dives into 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 where 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 may remain on the register for a short time; for example, vacancies and recruitment challenges can escalate risk for a short period. 3.3 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 risk and assess the effectiveness of mitigations. Where a risk affects, or is affected by, other parts of the health or social care system, or another 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 Demand for Occupational Therapy support has increased, particularly in relation to Single Handed Care, Moving and Handling risk assessments, complex hospital discharges, out-of-area discharges, environmental assessments and specialist equipment. This has created sustained pressure on the service; however, demand is being actively prioritised through risk- based screening, professional oversight and regular monitoring of waiting lists. There is also continued demand for assessments for children, adolescents, adults and older people with complex and debilitating conditions, including major adaptations and specialist equipment such as postural care, hoisting,
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home environmental and access solutions. Referrals to the OT Duty Service remain high, and the service continues to apply professional judgement to prioritise those with the greatest level of risk and need. In response to these pressures, the Transformation Board has approved recruitment to 1 FTE OT Peripatetic Moving and Handling post and 1.5 FTE Locality OT posts. These additional posts are intended to improve capacity, support risk management and reduce waiting times over the coming period. 3.5 Clinical & Care Governance arrangements: 3.6 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. 3.7 The following services, in relation to Council oversight, provided annual reports during the reporting period, and all were deemed to have provided assurance. The Forum no longer assigns assurance levels to annual reports, recognising that such reports are intended to provide evidence of performance, governance and improvement activity rather than support a graded assessment of assurance. 3.8 Commissioned Services (Feb 2026) • Perth & Kinross HSCP commissions 128 regulated and non regulated services, spanning care homes, care at home, supported living, and third sector SLAs. • Care Inspectorate Quality Framework: Incident themes continue to inform targeted improvement activity in safe care, leadership, staffing and risk management. The HSCP uses routine monitoring, escalation routes, contractual levers and safeguarding processes to respond proportionately where concerns are identified, including suspension where criteria are met. • Adult Support and Protection is being applied appropriately where risk of harm is present. • My Health, My Care, My Home: The Care Home Support Group promotes whole system improvement through better intelligence, Multi-Disciplinary Team collaboration, and proactive assurance. • Care at Home National Expectations: Market pressures continue to heighten reliance on care at home to prevent hospital admission. Eight additional providers were commissioned this year to address capacity gaps. • During 2025 there was an improvement in the standards and quality of strategic planning, commissioning and contracting. Efforts were focused on the planning and engagement of teams, to improve analysis and planning phases of the commissioning cycle.
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Registered Services (Feb 2026) • Perth & Kinross HSCP has 9 services registered with the Care Inspectorate, which is both a registration and scrutiny body that supports improvement. • Two registered services were inspected during the last year, with one service receiving an even split of “Adequate” and “Good” grades, and the other receiving “Good” and “Very Good” grades. • One care home was involved in an LSI during the year. Improvement activity is being monitored through established oversight arrangements, with evidence of active engagement and commitment to addressing the areas identified. Perth City Locality (April 2026) • The Perth City health and social care teams deliver community services across the locality and host a number of Perth and Kinross wide services. Perth City has 8 GP practices which form 2 cluster groups. • There has been one LSI in Perth City over the past year, which began in April 2025 and concluded in September 2025. A comprehensive action plan was developed and implemented to address issues and a new management team recruited. • Complex Risk Panel is relatively new and provides structured risk management for people with Emotionally Unstable Personality Disorder. Perth City has been at the forefront of the implementation of this new approach and will continue during the coming year. • Perth City Locality continued to develop integrated working across the year utilising the Perth City Subgroup to engage with staff and stakeholders, understand what was working well and what could be improved. • The Perth City Integrated Hub that was established in November 2024 and is based in Pullar House, brings together a range of health and social care professionals to provide coordinated, seamless support for people living in Perth City. • Service planning and delivery has been influenced by feedback from staff, patients/clients, the hospital and Primary Care. South Locality (April 2026) • The South Perthshire and Kinross Locality delivers health, social work and social care services to residents across the locality, including two inpatient units: Crieff Community Hospital (CCH) and St Margaret’s Community Hospital (SMCH). The locality has 12 care homes, 2 GP cluster areas: Strathearn/Strathallan and Kinross-shire/Carse, and a total of 8 GP practices. • The Locality Social Work Team, through exception reporting and escalation to the Commissioning Team, has highlighted risks associated with the availability of non-personal care social support within the locality. These risks are being considered through commissioning and locality planning arrangements to support proportionate mitigation.
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• Two LSIs were completed during 2025/26, and both care homes continue to participate in regular multi-disciplinary meetings to support continued progress and the embedding of improvements made. Through learning from these interventions, the South Social Work Team is committed to developing a link-worker approach with all care homes for older people. This presents some capacity challenges due to having 12 care homes on the Crieff side. Access Team (June 2026) • The Access Team is the first point of contact into Adult Social Work and Social Care for all adults aged 16+ throughout Perth and Kinross, acting as an Early Intervention and Prevention team. • Access Team aims towards answering/addressing all queries within two working days and completing assessments (General Outcome Focused Assessment) within five days of allocation. • Vulnerable person reports received from the Police have risen sharply in 2026. The total number in 2025 was 1453. So far in 2026, there has been a rise of 31% in the number of reports screened by the Access Team. • During the reporting period, the approach to gathering feedback was adapted to support continued engagement during a period of operational pressure. A SurveyMonkey questionnaire has been implemented to provide a more sustainable feedback route, and responses will continue to be monitored to inform service improvement. Community Alarm (June 2026) • The Community Alarm & Telecare Service is designed to enable people to live safely, securely and independently in their own homes. All users of the Telecare Service are provided with a pendant to be worn. The base unit is connected to the digital telecare monitoring centre, where staff are available 24 hours a day, 365 days a year, to respond to any alerts. • The service currently has 3,966 clients as at 1 April 2026. This is a decrease from 4,039 clients, a reduction of 73 in the last year. • From April 2025 to March 2026, there were 1,304 new referrals. This is down from 1,395 new referrals in the previous year. The number of referrals received each month across the year remains consistent. • The Community Alarm and Telecare Service physically responded to 4,862 call-outs during 2025/26. • Risks identified within the service which are being monitored are: o Data and reporting limitations are being managed during the transition from historic Jontek data to current Sky Response reporting. Manual review and exception reporting remain in place while reporting capability is strengthened. o Telecare infrastructure and service-continuity risk is being actively monitored where analogue phone lines remain in use in sheltered housing. Interim oversight arrangements are in place while services progress transition activity linked to digital telecare, reducing the risk associated with ageing analogue infrastructure.
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o Registration and governance arrangements continue to be monitored. Community Alarms remain aligned to HART Care at Home registration while Care Inspectorate system and provider access issues are resolved, with governance oversight maintained through existing HSCP arrangements. • The service demonstrates that care is safe through a combination of external assurance, real-time monitoring, and robust governance arrangements. Independent audit confirms compliance across all core Quality Standards modules, with certification recommended. Safety is actively monitored through daily exception reporting, key performance tracking, call quality monitoring, and structured incident analysis, enabling prompt identification and response to performance issues. • The service demonstrates a person centred approach by ensuring that people are assessed properly and supported to use equipment safely at home, with clear information provided at installation and ongoing checks to make sure it continues to meet their needs. • Feedback received throughout the year was strongly positive, indicating a consistently positive user experience, with few concerns raised. JELS (June 2026) • The Joint Equipment Loan Service (JELS) is a priority-driven service responsible for the distribution, installation and collection of community nursing and occupational therapy equipment within Perth and Kinross, as well as asset managing community alarm equipment. The priority-driven service supports referrals relating to hospital discharges, prevention of admission and palliative care, as well as keeping older and vulnerable people safe in their own homes within the community. • The Community equipment stock shows that (as of 01/04/2026) 14,229 clients are recorded with equipment in use (Community Nursing, OT, & TEC) • JELS has identified a small number of system-wide risks over the reporting period. These are subject to ongoing review, monitoring and escalation where required, with learning used to strengthen operational controls and safe equipment provision. • JELS demonstrates adherence to best practice and relevant national standards through active participation in the SNAEP (Scottish National Association of Equipment Providers) network. • Through SNAEP, JELS benefits from shared learning, peer review and continuous improvement initiatives, supporting robust quality assurance processes and evidence-based decision-making. • Demand has continued to increase, with a rise in both clients and equipment in use, reflecting sustained growth in service reach and complexity of need. • Performance data indicates a generally efficient and responsive service, while recognising increasing demand and complexity. Current performance includes:
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o 81% of deliveries completed within 30 days, supporting timely access to essential equipment. o An average delivery time of 7.6 days, demonstrating effective operational turnaround. • Activity data shows increased delivery volumes and reduced collections, consistent with more people requiring equipment for longer periods, further evidencing demand pressures on the system. • JELS is person-centred, actively using feedback from service users, carers and staff to shape and improve service delivery. Engagement gathered through compliments, complaints and Care Opinion informs continuous improvement. Feedback highlights strong communication, respectful and professional staff interactions, and equipment tailored to individual needs, supporting independence, wellbeing and safe care at home. 3.9 Complaint summary: 0 2 4 6 8 10 12 April May June July Aug Sept Oct Nov Dec Jan Feb March Complaints Closed 2025-2026 Stage 1 Stage 2 0 2 4 6 8 10 12 14 April May June July Aug Sept Oct Nov Dec Jan Feb March Complaints Closed 2026-2027 Stage 1 Stage 2
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• Total number of complaints received during the time period = 55 • Stage 1 = 39 • Stage 2 = 16 • Total number of complaints closed in the time period = 41 • % Stage 2 responded to within timescales = 44% • Stage 2 not responded to within timescales = 56% • Performance against Stage 2 timescales is below the expected standard. This is being monitored through complaints governance arrangements, with learning used to improve responsiveness, communication and oversight of agreed actions. The most common reason for complaints being completed outwith timescale relate to the complex nature of the complaint that requires thorough investigation. The complaints relate to the following services: • Contracts and Commissioning – 4 • Occupational Therapy – 5 • HART Team – 6 • Access Team – 10 • Care at Home – <4 • PKC Internal LD Service – <4 • SCOPE – <4 • North Locality Social Work Strathmore – 4 • North Locality Social Work Highland – 5 • City Locality Social Work South – <4 • Perth Locality Social Work North – <4 • Hospital Discharge Team – 4 • Community Inclusion LD (PKC Supported Living) – <4 • Care Homes – <4 • Mental Health Team – <4 • Social Work OOHS – <4 • Top themes ▪ Overall (more than one theme can be applicable per complaint) • Service Provision – 24 • Policy and Procedure – <4 • Communication – 5 • Employees – 19 Upheld or Partially Upheld complaints (more than one theme can be applicable per complaint) • 13 Stage 1 complaints were fully or partially upheld • Stage 2 complaints responded to in the reporting period, <4 complaints was upheld, <4 were partially upheld and 10 were not upheld.
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3.10 Scottish Public Services Ombudsman Reports There have been no complaints referred to the SPSO during the time period. 3.11 External Reports & Inspections There were no external inspections during the time period. 3.12 Adult Support & Protection (ASP) The P&K HSCP Care & Professional Governance Forum meeting in May 2026 received its quarterly ASP update report. This report summarised that there were no active LSIs or protection orders in place within P&K HSCP. Learning from previous LSIs has identified the need to strengthen earlier intervention and prevention arrangements, including clearer escalation pathways to identify emerging indicators of harm in support provision. This will be linked to LSI guidance to support a coordinated and joined-up approach to safeguarding and protection. The Independent Sector Lead for Scottish Care continued to meet providers following completion of an LSI, providing opportunities for feedback and reinforcing principles of equity, partnership working, fairness, diplomacy and communication. The commissioning team is reviewing whether earlier intervention through the Care Home Oversight Group is supporting improvement at an earlier stage and reducing the need for more intensive LSI activity. This will help strengthen assurance that quality of care and protection concerns are identified and addressed proportionately. 3.13 MAT Standards Local actions to mitigate the risk of drug-related deaths in Perth and Kinross include the implementation and embedding of the Medication Assisted Treatment (MAT) Standards. Current RAG scores are green apart from MAT Standard 7, which is being progressed in line with national recommendations. • Perth and Kinross Community Pharmacy Buvidal dispensing test of change is in development. A service level agreement has been signed off and ADP funding awarded for 12 months. Identified P&K pharmacists have been trained and patients have been identified. Now scheduled to go live in July 2026.
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3.14 Workforce There is one red risk in relation to workforce capacity, as detailed above in respect of OT capacity and the mitigations in place. 3.15 Financial The composition of the Senior Management Team allows for a discussion of any financial issues from the perspective of Care & Professional Governance. 3.16 Risk Assessment/Management Key risks and assurance processes are detailed in earlier sections of this report. 3.17 Equality and Diversity, including health inequalities Details regarding any equality, diversity and health inequalities are included, where required, within each service exception report. There are no exceptions requiring escalation 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 and create actions to take forward. 4 Recommendation This report is being presented for: • Assurance As Chief Social Work Officer for Perth & Kinross Council, I would suggest that this report provides assurance in respect to the quality of social work and social care services delegated to the HSCP