Perth and Kinross Health and Social Care Partnership (HSCP) Clinical and Care Governance Assurance Report
Perth and Kinross Council · 17 September 2025
Back to Scrutiny and Performance Committee — 17 September 2025 and its agenda
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PERTH AND KINROSS COUNCIL Scrutiny and Performance Committee 17 September 2025 Perth and Kinross Health & Social Care Partnership (HSCP) Care and Professional Governance Assurance Report Arun Singh – Chief Social Work Officer, Perth and Kinross Council (Report No.25/234) 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. 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 and agree the level of assurance. The timescale for the data within this report are the four months between 1 March 2025 and 30 June 2025. 1.3 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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2 Background The Getting It Right For Everyone (GIRFE) framework is a nationally endorsed, multi-agency approach to health and social care in Scotland, designed to ensure that services are person-centred, coordinated, and responsive across the lifespan. It promotes collaborative working between professionals and organisations to deliver consistent, high-quality support tailored to individual needs. GIRFE has underpinned governance arrangements across Perth and Kinross HSCP and aligns with the Health and Social Care Standards and the Quality of Care Approach, supporting assurance across six evolving domains: Information Governance Professional Regulation and Workforce Development Patient/Service user/Carer and Staff Safety Patient/Service user/Carer and Staff Experience Quality and effectiveness of care Promotion of Equality and Social Justice . In April 2025, NHS Tayside launched its new Clinical Governance Framework which replaces the above noted GIRFE framework. The aim of the new Clinical Governance Framework is to deliver an assurance framework which supports integrated systems of clinical governance for NHS Tayside and HSCPs. Key within the new framework is the use of a Quality Management System (QMS) approach. This is a consistent and coordinated approach to planning, improving, controlling and assuring high quality care. It is applied across all levels of an organisation – from team to board with the ultimate aim of delivering better population health and wellbeing, better care experience, better value and better staff experience. 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. The co-chairs of the CPGF are transitioning reporting and assurance from GIRFE to ensure it aligns to this new NHS Tayside Clinical Governance Framework. The CPGF Forward Planner is attached in Appendix 1, this provides an overview of Social Work reporting to the forum. There are occasions where scheduled reports are moved to other reporting periods due to circumstances. 3 Assessment 3.1 Care and Professional Risk Management
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The operational / team level risk registers for Adult Social Work and Social Care services are discussed monthly at the HSCP CPGF. 3.2 New risks and changes to existing risks are discussed at each meeting. Deeper dives of red and amber risks are undertaken on a quarterly and six monthly basis respectively outwith the CPGF for more detailed discussion with Service leads. 3.3 Our 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 Ref Risk Exposure – No controls Current Risk Exposure Rating (RER) Risk Trend (↑/→/↓) Please include data from previous four reporting periods Oct 2024 Feb 2025 Apr 2025 Jun 2025 L C RE R L C RE R L C RE R L C RE R L C RE R 1 - - - - - - - - - - - - 4 4 16 → 2 - - - - - - - - - - - - 5 4 20 → 3 - - - - - - - - - - - - 5 4 20 → 3.5 Three new red risks were added to the Risk Register for Social Work and Social Care during the reporting period: Risk 1 – Increase in registrants and impact on Learning and Development (L&D) team to support SVQ’s. Risk of increased registrants on the SSSC register which could result in more staff requiring SVQ qualifications. This has a risk on the ability of the current L&D Team to support the need for increased SVQ’s. To support control of the risk, the L&D are: • Planning and preparing with current SVQ waiting lists • Exploring opportunities for supporting qualifications for registrant, E.G. Practice Development Awards • Working with the Serivces to consider qualification needs • Maintaining connection with SSSC in relation to decisions re registration and connect this with our strategic planning Risk 2 – Variation in supervision practices across services. Due to there being no agreement across the service of standard supervision practice, there is a risk of different practices for supervision across services. To support control of the risk, the L&D:
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• Works collaboratively with Teams to support the update of the supervision policy and supervision documents • Provide Supervision PDA and other learning opportunities to enable Line Managers with skills for effective supervision • Are supporting the Prioritisation of Supervision and learning to support wellbeing and enabling environments conducive to implementing improvement Risk 3 – Sustaining a learning culture amongst staff and services Due to capacity issues operationally and staff requiring to prioritise operational work, there is a risk staff may need to cancel or not attend learning sessions. To support control of the risk, the L&D are: • Working with TL's and teams to ensure that if staff cannot attend learning sessions that they cancel • Work with SM's TL's to support learning & development planning for staff booking on sessions, to explore time and space are created within the team for learning and development • Work with strategic planning and business support to consider how the learning culture is supported to enable the workforce with skills, confidence, wellbeing at work Following inclusion of these risks on the Risk Register by service leads, discussions between the Chief Social Work Officer (Co-Chair of the CPGF) and Heads of Integrated Health and Care have led to agreement of withdrawal of these risks from the Risk Register. It was acknowledged that whilst these areas require service improvement and oversight, there are no issues associated with service continuity or safety that would merit a red risk rating. It has been agreed to remit the issues to the Social Work Governance and Assurance Group and consider as part of workforce planning. It was also agreed that future risks added to the Risk Register would be signed off by the Head(s) of Integrated Health and Care. 3.6 Clinical & Care Governance arrangements: As per the Integration Scheme (June 2022) each HSCP in Tayside is a Lead Partner for a number of services that are better planned for and managed by one HSCP but provided for all communities across Tayside. These services report through to the CPGF for that HSCP. At the CPGF the Lead Partner Service reports receive the relevant level of scrutiny as other reports. 3.7 Systems and processes have been established to ensure that all three HSCPs receive copies of reports from other Lead Partner Services to support integration, and effective whole system working. 3.8 All services/localities report exceptions on a two monthly basis, and all service localities reported to the CPGF during this time period. There were no issues highlighted in respect of social work or social care for escalation to Scrutiny and Performance Committee.
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3.9 The following services in relation to Council oversight, provided annual reports during the reporting period, and were given assurance levels as follows: South Locality Report (7 March 2025) • Update on the Social Work and Social Care Forum which meets 4 weekly and works to a workplan of improvement including the examination of data/trends • Improved recruitment picture over the reporting picture • Social Work teams involved in ‘growing our own’ social workers, with Practice Educators and Link Workers trained in the locality to support the initiative • Continued challenges with some teams with long term sickness • Demand for Services remain high presenting challenges to wating time targets • Care at Home tendering process has led to several new providers entering the market leading to reduction in waiting times and better choice of SDS options • No waiting list for the Home Assessment and Recovery Team (HART) • Complexity of need continues to increase • Increase in Large Scale Investigations – potentially due to extremely challenging staff retention and recruitment for some care homes in the area Level of Assurance: Reasonable 3.10 Joint Equipment Loan Store (06 June 2025) • It was noted that some data regarding the service is not available due to the changes/upgrade with ELMS2 reporting. • There has been an increase in clients in year-on-year trend • Reduction of items in stock due to better stock management with review of discontinued TEC and slings etc • No significant variances in trend data from previous reporting period • PKC internal audit was undertaken of full service from referrals, delivery to instillation. Audit conclusion ‘ The internal audit review is able to place reasonable assurance on the overall control environment for JELS. The agreed actions, once implemented, should enable internal audit to place substantial assurance on these • Team working on the 6 improvement areas identified as part of internal audit and making good progress. • The service uses Care Opinion but has received no feedback thus far. The benefit of gaining service user feedback was discussed, and it was mentioned that the Handheld scanners will have short codes installed to do a smaller satisfaction survey in the future Assurance level – Limited (due to lack of data being available for the service, Lead Officer requested to provide update once data available) 3.11 Access Team/Social Prescribers/Wellbeing Support Team (06 June 2025) • Access Team has been operational for two years, changes to IT system impacting on flow and time for staff to input into the new system
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• Significant waiting lists for the Social Prescribers Team – review of work and processes underway. • The Wellbeing Support Team have a small waiting list due to staffing changes, and controls are in place for this. • With regards to improvement going forward – The Access Team remains subject to review with plans to develop integrated single point of contact. Social Prescribers have a development day planned for July and are implementing new processes to monitor and review practice. Wellbeing Support Team also subject to review and will be involved in the review of the mental health pathways throughout Perth and Kinross. • Recognised the need for service user feedback to support service improvement. Limited Care Opinion responses provide very positive feedback of staff approach and intervention impacting on change. Assurance level - Reasonable 3.12 Community Alarm & Telecare (06 June 2025) • Good use of data to provide assurance of performance • Analogue to digital transfer has been completed • Whilst calls handled by the service appears to have reduced, there were a significant number of test calls in previous reporting period associated with transfer from analogue to digital devices • When changing over from the Jontek platform to Sky Response (Chubb), issues of migration were noted which risked the loss of data that required to be retained for 12 months. An IT solution allows for time limited access which is compliant with retention schedule. • Service user feedback very positive. Assurance level - Reasonable 3.13 Complaint summary: 0 2 4 6 8 10 12 April May June July Aug Sept Oct Nov Dec Jan Feb March Complaints Closed 2024-2025 Stage 1 Stage 2
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• Total number of complaints received during March - June 2025 = 29 • Stage 1 = 29 • 6 Stage 1 complaints progressed to Stage 2. o Total number of complaints closed during March - June 2025 = 22 • % Stage 2 responded to within timescales = 100% open complaints still within timescale of response. • % Stage 2 not responded to within timescales = 0% o Services the complaints relate to as below • Mental Health Team – 2 • North Locality Social Work Highland - 1 • North Locality Social Work Strathmore – 1 • North Locality Social Work Blairgowrie – 6 • Perth City Locality Social Work North – 1 • Perth City Locality Social Work South - 3 • Occupational Therapy - 3 • Access Team – 3 • Day Opportunities LD (Gleneagles) – 1 • Day Opportunities LD (Blairgowrie) – 2 • South Locality Social Work Crieff -1 • HART – 2 • Contracts and Commissioning – 2 o Top themes ▪ Overall (more than one theme can be applicable per complaint) • Service Provision - 14 • Employees – 14 • Communication - 2 0 1 2 3 4 5 6 7 8 9 April May June July Aug Sept Oct Nov Dec Jan Feb March Complaints Closed 2025-2026 Stage 1 Stage 2
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Upheld or Partially Upheld complaints (more than one theme can be applicable per complaint) • There was one upheld complaint in April. 3.14 Scottish Public Services Ombudsman Reports There have been no complaints referred to the SPSO during the time period. 3.15 External Reports & Inspections There were no inspections during the time period. 3.16 Adult Support and Protection (ASP) Each adult protection committee is responsible for submitting national ASP data to the Scottish Government on a quarterly basis. The national ASP data set sets out key quantitative quality indictors from rate of referral and from whom, the numbers of inquiries undertaken and how many of these lead to ASP case conferences. Numbers of new protection orders applied for are also reported as are those granted in Court and the numbers of new large-scale investigations opened in each quarter. It also extends to reporting on how many ASP episodes were opened where the adult had caring responsibilities for either another adult or child at the time of the incident that led to the ASP referral. This is the first time that Perth & Kinross has been able to report on this data set in full. Our move to a new social work recording system (MOSAIC) has allowed us to build this data set into MOSAIC. The quarter 1 data return does come with caution, as the numbers of ASP inquiries appear to be lower than expected. Anecdotal evidence also supports that more inquiries were completed than the data provided by MOSAIC. Therefore, the ASP Lead Officer is working with the MOSAIC team to unpick this so that we can be more assured that the data shared is reliable and therefore shared with confidence. The Adult Protection Committee (APC) - Quality Assurance and Improvement subgroup will review the data on a quarterly basis to give some analysis to the data and provide an update to the APC. An early assessment of this new data shows that ASP referrals from health show an increase. The draft APC annual report for 24/25 gives more insight to this: • Referrals from NHS 24 have increased from 177 in 23/24 to 210 in 2024/25. • Referrals from NHS primary care services have increased from 81 to 164 in 23/24 to 24/25 • Referrals submitted by our Scottish Ambulance colleagues have increased from 24 in 23/24 to 46 in 24/25. These appear to demonstrate the value of the NHS Tayside adult protection team where health services are supported and encouraged to recognise when an adult might be at risk of harm and to report it. We are confident that increases in identification do not necessarily mean an increase in prevalence.
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Our use of large-scale investigations in quarter 1 remains comparable with 24/25. We are committed to reviewing our LSI processes following a differing in view with the registration requirements of one of the care homes in Perth & Kinross. 3.17 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 June 2025 are green apart from MAT Standard 7 which relates to people may choose to receive their medication or support through primary care providers which include GP and community pharmacy. We will be following a NHS Tayside initiative, working with our pharmacy colleagues to implement this standard locally. • National Mission to reduce drug deaths funding utilised to increase IDART staff compliment to reduce waiting times and enhance service provision e.g. – provision of an OT service and the creation of a new psychology assistant post to provide low level psychological interventions. • Creation of a multiagency referral pathway for all new substance use referrals. • Creation of a near fatal overdose pathway and multiagency group to review all reported near fatal overdoses. During the reporting period there were 16 incidents reviewed. • Funding provided to third sector partners to employ assertive outreach workers to actively engage with service users. • Creation of a residential rehabilitation pathway and funding panel to facilitate access to rehabilitation services for service users, with 6 requests approved and none declined during the reporting period. 3.18 Workforce There is one red risk in relation to workforce capacity which is detailed above and the mitigations in place 3.19 Financial The composition of the Senior Management Team allows for a discussion of any financial issues from the perspective of Care & Professional Governance. 3.20 Risk Assessment/Management Key risks and assurance processes are detailed in earlier sections of this report. 3.21 Equality and Diversity, including health inequalities Equality, diversity and health inequalities are core to the Getting it Right Framework and the domains within. Each service provides exception reports which include this aspect. Currently there are no exceptions requiring to be escalated to CGC. 3.22 Communication, involvement, engagement and consultation
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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 4 Recommendation 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.