Agenda Document Pack - Social Work Resources Committee - 28/06/2023
South Lanarkshire Council · 28 June 2023
Back to Social Work Resources Committee — 28 June 2023 and its agenda
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Council Offices, Almada Street Hamilton, ML3 0AA Tuesday, 20 June 2023 Dear Councillor Social Work Resources Committee The Members listed below are requested to attend a meeting of the above Committee to be held as follows:- Date: Wednesday, 28 June 2023 Time: 10:00 Venue: Hybrid - Committee Room 1, Council Offices, Almada Street, Hamilton, ML3 0AA The business to be considered at the meeting is listed overleaf. Yours sincerely Cleland Sneddon Chief Executive Members Margaret B Walker (Chair), Catherine McClymont (Depute Chair), Joe Fagan (ex officio), Alex Allison, John Bradley, Walter Brogan, Robert Brown, Archie Buchanan, Mathew Buchanan, Janine Calikes, Maureen Devlin, Mary Donnelly, Allan Falconer, Elise Frame, Celine Handibode, Graeme Horne, Mark Horsham, Martin Hose, Cal Johnston-Dempsey, Eileen Logan, Hugh Macdonald, Richard Nelson, Carol Nugent, John Ross, Graham Scott, David Watson Substitutes John Anderson, Maureen Chalmers, Margaret Cooper, Poppy Corbett, Margaret Cowie, Geri Gray, Susan Kerr, Ross Lambie, Richard Lockhart, Elaine McDougall, Mark McGeever, Davie McLachlan, Bert Thomson 1
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BUSINESS 1 Declaration of Interests 2 Minutes of Previous Meeting Minutes of the meeting of the Social Work Resources Committee held on 3 May 2023 submitted for approval as a correct record. (Copy attached) 5 - 10 Monitoring Item(s) 3 Social Work Resources - Revenue Budget Monitoring 2022/2023 Joint report dated 12 June 2023 by the Executive Director (Finance and Corporate Resources) and Director, Health and Social Care. (Copy attached) 11 - 20 4 Social Work Resources - Revenue Budget Monitoring 2023/2024 Joint report dated 12 June 2023 by the Executive Director (Finance and Corporate Resources) and Director, Health and Social Care. (Copy attached) 21 - 28 5 Social Work Resources - Capital Budget Monitoring 2022/2023 Joint report dated 7 June 2023 by the Executive Director (Finance and Corporate Resources) and Director, Health and Social Care. (Copy attached) 29 - 32 6 Social Work Resources - Capital Budget Monitoring 2023/2024 Joint report dated 7 June 2023 by the Executive Director (Finance and Corporate Resources) and Director, Health and Social Care. (Copy attached) 33 - 36 7 Social Work Resources – Workforce Monitoring – March and April 2023 Joint report dated 25 May 2023 by the Executive Director (Finance and Corporate Resources) and Director, Health and Social Care. (Copy attached) 37 - 44 8 Update on the 2022/2023 Risk Register and Risk Control Plan Report dated 5 June 2023 by the Director, Health and Social Care. (Copy attached) 45 - 56 Item(s) for Decision 9 Locality Based Social Work Services Modernisation Programme Joint report dated 30 March 2023 by the Director, Health and Social Care and Executive Director (Finance and Corporate Resources). (Copy attached) 57 - 84 10 Reducing Drug Deaths: The South Lanarkshire Alcohol and Drug Problem Solving Court Joint report dated 17 April 2023 by the Director, Health and Social Care and Executive Director (Finance and Corporate Resources). (Copy attached) 85 - 114 Item(s) for Noting 11 Implementing Medication Assisted Treatment (MAT) Standards in South Lanarkshire - Update Report dated 31 May 2023 by the Director, Health and Social Care. (Copy attached) 115 - 120 2
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12 Notification of Contracts Awarded October 2022 to March 2023 Report dated 17 May 2023 by the Director, Health and Social Care. (Copy attached) 121 - 124 Urgent Business 13 Urgent Business Any other items of business which the Chair decides are urgent. For further information, please contact:- Clerk Name: Tracy Slater Clerk Telephone: 07385370089 Clerk Email: tracy.slater@southlanarkshire.gov.uk 3
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SOCIAL WORK RESOURCES COMMITTEE Minutes of meeting held via Confero and in Committee Room 1, Council Offices, Almada Street, Hamilton on 3 May 2023 Chair: Councillor Margaret B Walker Councillors Present: Councillor Alex Allison, Councillor John Anderson (substitute for Councillor Elise Frame), Councillor Walter Brogan, Councillor Robert Brown, Councillor Archie Buchanan, Councillor Mathew Buchanan, Councillor Janine Calikes, Councillor Margaret Cowie (substitute for Councillor Celine Handibode), Councillor Maureen Devlin, Councillor Mary Donnelly, Councillor Allan Falconer, Councillor Graeme Horne, Councillor Mark Horsham, Councillor Martin Hose, Councillor Cal Johnston-Dempsey, Councillor Richard Lockhart (substitute for Councillor Richard Nelson), Councillor Eileen Logan, Councillor Hugh Macdonald, Councillor Catherine McClymont (Depute), Councillor Carol Nugent, Councillor John Ross, Councillor Graham Scott, Councillor David Watson Councillors' Apologies: Councillor John Bradley, Councillor Joe Fagan, Councillor Elise Frame, Councillor Celine Handibode, Councillor Richard Nelson Attending: Finance and Corporate Resources G Booth, Finance Manager (Resources); E McPake, HR Business Manager; A Norris, Administration Assistant; L O’Hagan, Finance Manager (Strategy); T Slater, Administration Adviser; M M Wilson, Legal Services Manager Health and Social Care/Social Work Resources S Sengupta, Director; I Beattie, Head of Health and Social Care (Hamilton and Clydesdale); C Cunningham, Head of Commissioning and Performance; L Purdie, Head of Children and Justice Services Chair’s Opening Remarks The Chair congratulated the Director, Health and Social Care, Soumen Sengupta, who had been appointed Honorary Professor of Strategy and Public Health at Glasgow Caledonian University. 1 Declaration of Interests No interests were declared. 2 Minutes of Previous Meeting The minutes of the meeting of the Social Work Resources Committee held on 15 February 2023 were submitted for approval as a correct record. The Committee decided: that the minutes be approved as a correct record. 2 5
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3 Social Work Resources – Revenue Budget Monitoring 2022/2023 A joint report dated 28 March 2023 by the Executive Director (Finance and Corporate Resources) and Director, Health and Social Care was submitted comparing actual expenditure for the period 1 April 2022 to 24 February 2023 against budgeted expenditure for 2022/2023 for Social Work Resources. As at 24 February 2023, there was a breakeven position after proposed transfers to reserves. Following the Council’s probable outturn exercise, the financial forecast for the revenue budget to 31 March 2023 was a breakeven position, after transfers to reserves of £5.635 million. The transfers to reserves had arisen from an unplanned underspend within Adult and Older People Services. There were also underspends within Performance and Support Services and Justice Services which had been offset by an overspend in Children and Family Services, giving an overall breakeven position. The Resource position was outlined in Appendix A to the report, with detailed variance explanations provided in appendices B to E to the report. Virements were proposed to realign budgets, which were also detailed in the appendices to the report. Officers responded to members’ questions in relation to recruitment issues, pressures on the current workforce and timescales for the Care Academy. The Committee decided: (1) that the breakeven position as at 24 February 2023 and the forecast to 31 March 2023 of a breakeven position, after proposed transfers to reserves, as detailed in Appendix A to the report, be noted; and (2) that the proposed budget virements be approved. [Reference: Minutes of 15 February 2023 (Paragraph 3) and Minutes of the Executive Committee of 1 February 2023 (Paragraph 3)] 4 Social Work Resources – Capital Budget Monitoring 2022/2023 A joint report dated 12 April 2023 by the Executive Director (Finance and Corporate Resources) and Director, Health and Social Care was submitted advising of progress on the Social Work Resources’ capital programme for 2022/2023 and summarising the expenditure position at 24 February 2023. The capital programme for Social Work Resources for 2022/2023 was £3.903 million. Anticipated spend to date was £3.788 million and spend to 24 February 2023 amounted to £4.084 million. This represented a position of £0.296 million ahead of profile and mainly reflected the timing of payments on the Community Alarm and SWiSplus Replacement projects. Work had been ongoing to monitor the predicted spend position for this financial year, with current estimates suggesting an outturn of £4.3 million and an overspend of £0.400 million. This mainly related to the timing of spend on the Community Alarm and SWiSplus replacement projects, with funding for the overall spend already identified into the next financial year. The Committee decided: (1) that the Social Work Resources’ capital programme of £3.903 million, and expenditure to date of £4.084 million, be noted; and (2) that the projected outturn of £4.3 million be noted. [Reference: Minutes of 15 February 2023 (Paragraph 4)] 6
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5 Social Work Resources – Workforce Monitoring – December 2022 to February 2023 A joint report dated 30 March 2023 by the Executive Director (Finance and Corporate Resources) and Director, Health and Social Care was submitted on the following employee information for Social Work Resources for the period December 2022 to February 2023:- attendance statistics occupational health statistics accident/incident statistics disciplinary hearings, grievances and Dignity at Work cases analysis of leavers and exit interviews Staffing Watch as at 10 December 2022 The Committee decided: that the report be noted. [Reference: Minutes of 15 February 2023 (Paragraph 5)] 6 Update on the 2022/2023 Risk Register and Risk Control Plan A report dated 17 April 2023 by the Director, Health and Social Care was submitted on risk management arrangements and the Risk Register for Social Work Resources. The Resource had followed Council guidance in developing, monitoring and updating its Risk Register on an ongoing basis. The Register had been developed to ensure that the Resource was fully aware of the main risks that it had, was able to prioritise those risks and had controls in place to eliminate or minimise the impact of risk. The scoring matrix and definitions for likelihood and impact were outlined in Appendix 1 to the report. This had resulted in risks being scored between 1 to 25 (low to very high). Risks were scored on their inherent risk (risk if nothing was done) and their residual risk (risk after applying controls). At its meeting on 15 February 2023, the Social Work Resources Committee agreed the current top 5 risks impacting on the delivery of Social Care Services, each of which remained unchanged following review:- workforce availability and capacity (lack of capacity and skills to meet increased service demands) meeting public protection and legislative duties (combined legislation/statutory duties public protection, Care Inspectorate/Self-directed Support (SDS)) market and provider capacity (procurement/supply chain) funding and budgetary pressures (reduction in funding/increased costs) winter demand pressures (emergency response) Appendix 2 to the report provided further detail on each of the top risks, together with the inherent and residual risk scores and sample controls. The Committee decided: that the contents of the report be noted. [Reference: Minutes of 15 February 2023 (Paragraph 7)] 7
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7 Social Work Resource Plan 2023/2024 A report dated 17 April 2023 by the Director, Health and Social Care was submitted on the Social Work Resource Plan for 2023/2024. Details were provided on the Resource Plan for 2023/2024, attached as Appendix 1 to the report, which outlined the:- key areas of focus for the year ahead Resource outcomes measures and actions resourcing of the Plan The Resource had established a number of outcomes to support the delivery of the Council Plan, Connect, in 2023/2024. To support those outcomes, the Resource had developed performance measures in an action plan detailed in Section 4 of the Resource Plan. Key or strategic measures would be included in the Council Plan progress reports 2023/2024, with the remaining measures being monitored and reported at Resource level. Following approval at each individual Resource Committee, the Resource Plans for 2023/2024 would be submitted, as a pack, to the meeting of the Executive Committee to be held on 21 June 2023 for noting. In line with the Council’s performance management arrangements, a mid-year progress report on actions identified in the 2023/2024 Social Work Resource Plan and an end of year report respectively would be submitted to future meetings of the Committee. Once approved, the Resource Plan would be made available on the Council’s website. Officers responded to members’ questions on measures in relation to statutory supervising targets and the Home First approach. The Committee decided: (1) that the Resource Plan 2023/2024, attached as Appendix 1 to the report, be approved; (2) that the Resource Plan 2023/2024 be uploaded onto the Council’s website; (3) that it be noted that, following Committee approval, all Resource Plans would be submitted to the Executive Committee on 21 June 2023 for noting; and (4) that it be noted that Progress Reports on the Resource Plan 2023/2024 would be submitted, at Quarter 2 and Quarter 4, to future meetings of this Committee. 8 Scheme for Curator ad Litem and Reporting Officers Panel - Jurisdiction of Glasgow Sheriff Court A report dated 18 April 2023 by the Director, Health and Social Care was submitted requesting approval for the Scheme for Curator ad Litem and Reporting Officers Panel, attached as Appendix 1 to the report, to be confirmed for application in the jurisdiction of Glasgow Sheriff Court. Under the Curator ad Litem and Reporting Officers (Panels) (Scotland) Regulations 2001, as amended, the local authority had a requirement to maintain a Panel of Curators ad Litem and Reporting Officers. The role of Curators ad Litem and Reporting Officers involved investigating the circumstances and providing a report to the court in respect of adoption or Permanence Order applications for children who could not remain with their birth families and who became accommodated by the local authority. 8
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The Scheme had been approved for Hamilton and Lanark Sheriff Courts by this Committee at its meeting on 16 November 2022 and there was now a requirement to establish a panel for Glasgow Sheriff Court’s jurisdiction within South Lanarkshire. The Committee decided: (1) that the contents of the report be noted; and (2) that the Scheme for Curator ad Litem and Reporting Officers Panel for Glasgow Sheriff Court’s jurisdiction within South Lanarkshire be approved. [Reference: Minutes of 16 November 2022 (Paragraph 12)] 9 Winter Plan Debrief – 2022/2023 A report dated 20 April 2023 by the Director, Health and Social Care was submitted on the key learning from the Lanarkshire Winter Plan 2022/2023 debrief. A report on Planning for Winter 2022/2023 was submitted to Committee at its meeting on 16 November 2023 and information was provided on the key areas of learning in relation to:- the multi-agency approach undertaken operation FLOW maximising the use of staff joint working with the Scottish Ambulance Service support from GPs over public holidays and weekends in January the vaccination programme the use of data Performance information was provided demonstrating an improvement in site occupancy levels. The Committee decided: that the key learning from the Lanarkshire Winter Plan 2022/2023 debrief be noted. [Reference: Minutes of 16 November 2022 (Paragraph 7)] 10 Urgent Business There were no items of urgent business. 9
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Executive Director (Finance and Corporate Resources) Director, Health and Social Care 1Subject: Social Work Resources - Revenue Budget Monitoring 2022/2023 1. Purpose of Report 1.1. The purpose of the report is to:- [purpose] provide information on the actual expenditure measured against the revenue budget for the period 1 April 2022 to 31 March 2023 for Social Work Resources [1purpose] 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s):- [re (1) that the Social Work Resources final outturn position as at 31 March 2023 of a breakeven, after transfer to reserves, as detailed in Appendix A of the report, be noted, and (2) that the proposed budget virements be approved. [1recs] 3. Background 3.1. This is the fifth revenue budget monitoring report presented to the Social Work Resources Committee for the financial year 2022/2023. 3.2. The report details the financial position for Social Work Resources in Appendix A, and then details the individual services, along with variance explanations, in Appendices B to E. 4. Employee Implications 4.1. There are no employee implications as a result of this report. 5. Financial Implications 5.1. As at 31 March 2023, the figures in this report show there was an unplanned underspend position against the budget, being £5.635m. This was the position before transfers to reserves. The position reported in the paper includes proposed transfers to reserves (as detailed in Appendices B to E) presented to the Executive Committee on 21 June 2023. The Resource position as at 31 March 2023, after the proposed transfers to reserves, is breakeven. Note this is before taking into account the impact of job evaluation which is covered at sections 5.5-5.11. 3 11
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5.2. The transfer to reserves arose from an unplanned underspend within Adult and Older People Services. There are also unplanned underspends within Performance and Support Services (£0.785m) and Justice Services (£0.510m), offset with an overspend in Children and Families Services (£1.295m), giving an overall breakeven. This overspend is after funding of £6m has been added in 2022/2023. 5.3. The Adult and Older People position at Appendix C shows an unplanned underspend of £5.635m before transfers to reserves. Included within this position is a commitment in relation to the Integration Joint Board (IJB). The budget delegated to the IJB has underspent by £7.510m and the Council agreed to the IJB retaining £1.423m of this non-recurring unplanned underspend within their reserves at probable outturn. This has increased slightly to £1.875m as at 31 March 2023 and is earmarked for future care costs in line with the approach to integrating health and social care budgets. Of the unplanned underspend remaining, it was agreed at probable outturn that £5.635m would be transferred to a Council reserve to be used in 2023/24 to support Children and Families pressures. 5.4. Virements are proposed to realign budgets. These movements have been detailed in the appendices to this report, as appropriate. Home Carers Job Evaluation: 5.5. There are no implications within this paper from the outcome of the Home Carers’ Job Evaluation in terms of recurring costs. The outcome of the Job Evaluation exercise for Home Carers will result in significant recurring costs for the Care at Home service that is delegated to the IJB in 2023/2024 and beyond. The costs of grade changes will be approximately £7m. The IJB have set a budget for 2023/2024, however, these costs are not included in that budget. The IJB’s Financial Regulations and Integration Scheme set out the process for such an eventuality. 5.6. The Financial Regulations state that if the Integration Joint Board’s Chief Financial Officer is advised that a significant change is likely to the Integration Joint Board's overall financial position and the deviation involves a change of policy of the Integration Joint Board or results in revenue implications for future years, a report will be provided for the Integration Joint Board in good time detailing the financial consequences to enable appropriate action to be taken timeously. 5.7. The regulations state that, if an overspend is forecast on either Parties’ in scope budget, the Chief Officer and the Integration Joint Board’s Chief Financial Officer will aim to agree a recovery plan with the relevant Party to balance the overspending budget and to determine the actions required to be taken by the IJB to deliver the recovery plan. 5.8. Ordinarily, any such event would require to be met within the envelope of funding provided to the IJB. The intense budget and service pressures on local government, the Health Board and our Health and Social Care partners has been noted previously and is ongoing, both nationally and locally. It should be noted that the financial position for both the IJB and the Council partner both indicate significant budget gaps moving forwards, and therefore it is likely that any recovery plan identified will require changes to be made to the services currently commissioned by the IJB. 12
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Back Dated Pay: 5.9. Back Dated Pay: In addition to the recurring costs, at a meeting of South Lanarkshire Council on 24 May 2023 it was asked that a review take place in relation to the implementation date of the outcome. Whilst the outcome of the Job Evaluation stated that grades were to change from 1 April 2023, there was the possibility that this review would change that outcome and back dated pay would require to be paid out. These costs would be in relation to Home Carers and, therefore, the costs are part of the services delegated to the IJB. 5.10. As of the 12 June 2022 the outcome of the review is now known. A basis has been established for back-dating to October 2020. The value of the back pay will take some time to calculate, however, these costs will require to be included in the financial position for 2022/2023. The Executive Committee (1 February 2023) had agreed that it would clawback a non-recurring underspend from the IJB of £5.6 million (as detailed at section 5.3) and use this to help with Children and Families pressures into 2023/2024. As Home Carer back pay now requires to be paid, the IJB will now not underspend and, therefore, that funding will not be available. The Council will, therefore, need to identify other funding to help with Children and Families costs into 2023/2024 and a proposal has been made to the Executive Committee on this. 5.11. As the outcome of the review was only known as this report was being finalised it has not been possible to update the figures in this report to reflect the outcome highlighted above. We will now require to quantify the full costs and the funding package and report back in August to Executive Committee. 6. Climate Change, Sustainability and Environmental Implications 6.1. There are no implications for climate change, sustainability or the environment in terms of the information contained in this report. 7. Other Implications 7.1. The main risk associated with the Council’s Revenue Budget is that there is an overspend. There are inflationary and budget pressures including utilities (as well as general inflation pressures) this year which increase the risk of overspend, however, these have mitigated through the IJB financial plan for 2022/2023. The risk is managed through four weekly Budget Monitoring Meetings at which any variance is analysed. In addition, the probable outturn exercise ensures early warning for corrective action to be taken where appropriate. 8. Equality Impact Assessment and Consultation Arrangements 8.1. This report does not introduce a new policy, function or strategy or recommend a change to an existing policy, function or strategy and, therefore, no impact assessment is required. 8.2. There was also no requirement to undertake any consultation in terms of the information contained in this report. Paul Manning Executive Director (Finance and Corporate Resources) Professor Soumen Sengupta Director, Health and Social Care 13
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12 June 2023 Link(s) to Council Values/Priorities/Outcomes Accountable, Effective, Efficient and Transparent Previous References Social Work Resources Committee – 3/5/23 Executive Committee – 21/6/23 List of Background Papers Financial Ledger and budget monitoring results to 31 March 2023 Contact for Further Information If you would like to inspect the background papers or want further information, please contact:- Graham Booth, Finance Manager Ext: 2699 (Tel: 01698 452699) Email: Graham.Booth@southlanarkshire.gov.uk 14
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Appendix A SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 31 March 2023 (No.14) Social Work Resources Summary Annual Budget Forecast for Year BEFORE Transfers Annual Forecast Variance BEFORE Transfers Annual Forecast Variance AFTER Transfers Budget Proportion 31/03/23 Actual 31/03/23 Variance 31/03/23 % Variance 31/03/23 Note £000 £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 111,620 106,534 5,086 1,141 111,620 106,745 4,875 Under 4.4% Property Costs 3,572 3,606 (34) (34) 3,572 3,599 (27) Over -0.8% Supplies & Services 7,551 7,013 538 538 7,551 7,414 137 Under 1.8% Transport & Plant 4,837 4,871 (34) (34) 4,837 4,896 (59) Over -1.2% Administration Costs 1,669 1,595 74 74 1,669 1,718 (49) Over -2.9% Payments to Other Bodies 26,874 24,813 2,061 1,031 26,874 25,198 1,676 Under 6.2% Payments to Contractors 132,532 134,469 (1,937) (2,597) 132,532 133,899 (1,367) Over -1.0% Transfer Payments 3,831 3,932 (101) (101) 3,831 4,034 (203) Over -5.3% Financing Charges 389 422 (33) (33) 389 454 (65) Over -16.7% Total Controllable Exp. 292,875 287,255 5,620 (15) 292,875 287,957 4,918 Under 1.7% Total Controllable Inc. (76,782) (76,797) 15 15 (76,782) (77,499) 717 Over recovered -0.9% Net Controllable Exp. 216,093 210,458 5,635 0 216,093 210,458 5,635 Under 2.6% Transfer to reserves as at (31/03/23) 0 0 0 0 0 5,635 (5,635) - n/a Position after Transfer to Reserves (31/03/23) 216,093 210,458 5,635 0 216,093 216,093 0 - Variance Explanations Variance explanations are shown in Appendices B -E. Budget Virements Budget virements are shown in Appendices B-E. 15
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Appendix B SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 31 March 2023 (No.14) Children and Families Services Annual Budget Forecast for Year BEFORE Transfers Annual Forecast Variance BEFORE Transfers Annual Forecast Variance AFTER Transfers Budget Proportion 31/03/23 Actual 31/03/23 Variance 31/03/23 % Variance 31/03/23 Note £000 £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 18,590 18,185 405 405 18,590 18,155 435 Under 2.3% 1 Property Costs 473 478 (5) (5) 473 492 (19) Over -4.0% Supplies & Services 769 629 140 140 769 754 15 Under 2.0% Transport & Plant 634 643 (9) (9) 634 789 (155) Over -24.4% 2 Administration Costs 336 350 (14) (14) 336 347 (11) Over -3.3% Payments to Other Bodies 11,064 10,079 985 985 11,064 10,092 972 Under 8.8% 3,a Payments to Contractors 9,117 11,580 (2,463) (2,463) 9,117 11,731 (2,614) Over -28.7% 4 Transfer Payments 3,818 3,901 (83) (83) 3,818 3,990 (172) Over -4.5% 5 Financing Charges 20 33 (13) (13) 20 38 (18) Over -90.0% Total Controllable Exp. 44,821 45,878 (1,057) (1,057) 44,821 46,388 (1,567) Over -3.5% Total Controllable Inc. (2,367) (2,268) (99) (99) (2,367) (2,639) 272 Over recovered -11.5% 6 Net Controllable Exp. 42,454 43,610 (1,156) (1,156) 42,454 43,749 (1,295) Over -3.1% Transfer to reserves as at (31/03/23) 0 0 0 - n/a Position after Transfer to Reserves (31/03/23) 42,454 43,610 (1,156) (1,156) 42,454 43,749 (1,295) Over -3.1% Variance Explanations 1. Employee costs The underspend in employee costs is mainly attributable to a slippage in the Whole Family Wellbeing funding due to recruitment and Social Worker vacancies which are actively being recruited. 2. Transport & Plant The overspend has arisen from the requirement for transport for both children in the community and looked after children. 3. Payment to Other bodies The underspend is in respect of non-recurring underspends in relation to Whole Family Wellbeing, and Mental Health monies and funding to develop both supported accommodation and young carers services. This is offset in part by an overspend as a result of the increased requirement for support with adoption allowances and fostering placements. 4. Payment to Contractors This overspend is a result of the continuing increased requirement for children’s residential school and external placements. 5. Transfer Payments This overspend relates to an increase in numbers for kinship care. 6. Income The over recovery of income mainly relates to an increase in funding due to an increase in the number of unaccompanied asylum seeking young people being supported. Budget Virements a. Part reversal transfer of Covid funding from Finance and Corporate, Payment to Other Bodies (£0.643m) 16
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Appendix C SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 31 March 2023 (No.14) Adults and Older People Services Annual Budget Forecast for Year BEFORE Transfers Annual Forecast Variance BEFORE Transfers Annual Forecast Variance AFTER Transfers Budget Proportion 31/03/23 Actual 31/03/23 Variance 31/03/23 % Variance 31/03/23 Note £000 £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 80,363 76,862 3,501 (444) 80,363 77,037 3,326 under 4.1% 1,a Property Costs 2,551 2,547 4 4 2,551 2,510 41 under 1.6% a Supplies & Services 6,194 5,787 407 407 6,194 6,074 120 under 1.9% 2,a Transport & Plant 3,853 3,904 (51) (51) 3,853 3,808 45 under 1.2% a Administration Costs 466 411 55 55 466 535 (69) over -14.8% a Payments to Other Bodies 15,235 14,224 1,011 (18) 15,235 14,559 676 under 4.4% 3,a Payments to Contractors 123,362 122,836 526 (135) 123,362 122,114 1,248 under 1.0% 4,a Transfer Payments 7 25 (18) (18) 7 36 (29) over -414.3% Financing Charges 50 56 (6) (6) 50 75 (25) over -50.0% Total Controllable Exp. 232,081 226,652 5,429 (206) 232,081 226,748 5,333 under 2.3% Total Controllable Inc. (66,747) (66,953) 206 206 (66,747) (67,049) 302 over recovered -0.5% a Net Controllable Exp. 165,334 159,699 5,635 0 165,334 159,699 5,635 under 3.4% Transfer to reserves as at (31/03/23) 0 0 0 0 0 5,635 (5,635) - n/a Position after Transfer to Reserves (31/03/23) 165,334 159,699 5,635 0 165,334 165,334 0 - - Variance Explanations 1. Employee costs The underspend is a mainly a result of an underspend in Home First funding due to recruitment challenges and vacancies across Social Workers, Day Care services and Residential homes. 2. Supplies and Services The underspend is a result of reductions in day services impacted by Covid 19. 3. Payments to Other Bodies Only part year funding is required from the Carers Act funding, resulting in a non-recurring underspend. 4. Income The over recovery of income relates to non-recurring income received from service users in respect of prior year care costs being higher than budgeted. Budget Virements a. Incorporation of Covid funding from IJB reserve Net Effect: £0, Employee costs (£0.144m), Property costs (£0.029m), Supplies and Service (£0.318m), Transport (£0.049m), Payment to Other Bodies (£0.047m), Payment to Contractors (£1.510m), Income (£2.097m) 17
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Appendix D SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 31 March 2023 (No.14) Performance and Support Services Annual Budget Forecast for Year BEFORE Transfers Annual Forecast Variance BEFORE Transfers Annual Forecast Variance AFTER Transfers Budget Proportion 31/03/23 Actual 31/03/23 Variance 31/03/23 % Variance 31/03/23 Note £000 £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 5,803 5,096 707 707 5,803 5,057 746 under 12.9% 1 Property Costs 481 489 (8) (8) 481 485 (4) over -0.8% Supplies & Services 500 523 (23) (23) 500 530 (30) over -6.0% Transport & Plant 257 231 26 26 257 192 65 under 25.3% 2 Administration Costs 330 326 4 4 330 321 9 under 2.7% Payments to Other Bodies 35 18 17 17 35 18 17 under 48.6% Payments to Contractors 10 10 0 0 10 10 0 - 0.0% Transfer Payments 0 0 0 0 0 0 0 - n/a Financing Charges 310 323 (13) (13) 310 322 (12) over -3.9% Total Controllable Exp. 7,726 7,016 710 710 7,726 6,935 791 under 10.2% Total Controllable Inc. (573) (542) (31) (31) (573) (567) (6) under recovered 1.0% Net Controllable Exp. 7,153 6,474 679 679 7,153 6,368 785 under 11.0% Transfer to reserves as at (31/03/23) 0 0 0 - n/a Position after Transfer to Reserves (31/03/23) 7,153 6,474 679 679 7,153 6,368 785 under 11.0% Variance Explanations 1. Employee costs This is an underspend due to vacancies which are being actively recruited, mainly within Admin and Clerical staff. 2. Transport & Plant The underspend is attributable to transport of community groups not being fully operational during the financial year. Budget Virements 18
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Appendix E SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 31 March 2023 (No 14) Justice Services Annual Budget Forecast for Year BEFORE Transfers Annual Forecast Variance BEFORE Transfers Annual Forecast Variance AFTER Transfers Budget Proportion 31/03/23 Actual 31/03/23 Variance 31/03/23 % Variance 31/03/23 Note £000 £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 6,684 6,391 473 473 6,864 6,496 368 under 5.4% 1 Property Costs 67 92 (25) (25) 67 112 (45) over -67.2% Supplies & Services 88 74 14 14 88 56 32 under 36.4% Transport & Plant 93 93 0 0 93 107 (14) over -15.1% Administration Costs 537 508 29 29 537 515 22 under 4.1% Payments to Other Bodies 540 492 48 48 540 529 11 under 2.0% Payments to Contractors 43 43 0 0 43 44 (1) over -2.3% Transfer Payments 6 6 0 0 6 8 (2) over -33.3% Financing Charges 9 10 (1) (1) 9 19 (10) over -111.1% Total Controllable Exp. 8,247 7,709 538 538 8,247 7,886 361 under 4.4% Total Controllable Inc. (7,095) (7,034) (61) (61) (7,095) (7,244) 149 over recovered -2.1% 2 Net Controllable Exp. 1,152 675 477 477 1,152 642 510 Under 44.3% Transfer to reserves as at (31/03/23) 0 0 0 - n/a Position after Transfer to Reserves (31/03/23) 1,152 675 477 477 1,152 642 510 Under Variance Explanations 1. Employee costs This underspend is due to vacancies which are being actively recruited. 2. Income The over recovery of income is non-recurring resulting from additional services being provided on a pan Lanarkshire basis. Budget Virements 19
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Executive Director (Finance and Corporate Resources) Director, Health and Social Care Subject: Social Work Resources - Revenue Budget Monitoring 2023/2024 1. Purpose of Report 1.1. The purpose of the report is to:- [purpose] provide information on the actual expenditure measured against the revenue budget for the period 1 April 2023 to 19 May 2023 for Social Work Resources provide a forecast for the year to 31 March 2024. [1purpose] 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s):- [re (1) the breakeven position on the Social Work Resources revenue budget, as detailed in Appendix A of the report, and the forecast to 31 March 2024 of breakeven, be noted; and (2) that the proposed budget virements be approved. [1recs] 3. Background 3.1. This is the first revenue budget monitoring report presented to the Social Work Resources Committee for the financial year 2023/2024. 3.2. The report details the financial position for Social Work Resources in Appendix A, and then details the individual services, along with variance explanations, in Appendices B to E. 4. Employee Implications 4.1. There are no employee implications as a result of this report. 5. Financial Implications 5.1. As at 19 May 2023, there is a breakeven position against the phased budget. 5.2. Within Children and Families, budget pressures are ongoing into 2023/2024 in relation to residential placements, fostering and kinship care, some of which is a legacy from the pandemic. 5.3. £5.635 million was planned to be available this financial year following the approval at probable outturn of the Adults and Older People unplanned underspend from 2022/2023 to be transferred to reserves and used to support Children and Families’ pressures in 2023/2024. As detailed in the period 14 report to this committee, the outcome of the review of Home Carers Job Evaluation changes this funding source. 4 21
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5.4. In addition, a further £3.600m is available from a balance of central funding to contribute towards the residual pressures in 2023/2024. The period 2 overspend position on Children and Families (£0.084m) assumes this funding being available (to be drawn down later in the financial year) and is currently being managed by an underspend on Performance and Support. 5.5. Virements are proposed to realign budgets. These movements have been detailed in the appendices to this report, as appropriate. Home Carers Job Evaluation: 5.6. As detailed in the Period 14 report presented to this committee the outcome of the Job Evaluation exercise for Home Carers will result in significant recurring costs for the Care at Home service that is delegated to the IJB in 2023/2024 and beyond. The costs of grade changes will be approximately £7m. The IJB have set a budget for 2023/2024 however these costs are not included in that budget. The IJB’s Financial Regulations and Integration Scheme set out the process for such an eventuality. 5.7. The Financial Regulations state that if the Integration Joint Boards Chief Financial Officer is advised that a significant change is likely to the Integration Joint Board's overall financial position and the deviation involves a change of policy of the Integration Joint Board or results in revenue implications for future years, a report will be provided for the Integration Joint Board in good time detailing the financial consequences to enable appropriate action to be taken timeously. 5.8. The regulations state that if an overspend is forecast on either Parties in scope budget, the Chief Officer and the Integration Joint Board’s Chief Financial Officer will aim to agree a recovery plan with the relevant Party to balance the overspending budget and to determine the actions required to be taken by the IJB to deliver the recovery plan. 5.9. Ordinarily, any such event would require to be met within the envelope of funding provided to the IJB. The intense budget and service pressures on local government, the Health Board and our Health and Social Care partners has been noted previously and is ongoing, both nationally and locally. It should be noted that the financial position for both the IJB and the Council partner both indicate significant budget gaps moving forwards, and therefore it is likely that any recovery plan identified will require changes to be made to the services currently commissioned by the IJB. Back Dated Pay: 5.10. Back Dated Pay: In addition to the recurring costs, at a meeting of South Lanarkshire Council on 24 May 2023 it was asked that a review took place in relation to the implementation date of the outcome. Whilst the outcome of the Job Evaluation stated that grades were to change from 1 April 2023, there was the possibility that this review would change that outcome and back dated pay would require to be paid out. These costs would be in relation to Home Carers and therefore the costs are part of the services delegated to the IJB. 5.11. As of the 12 June the outcome of the review is now known. A basis has been established for back-dating to October 2020. The value of the back pay will take some time to calculate, however these costs will require to be included in the financial position for 2022/2023. The Executive Committee (1 February 2023) had agreed that it would clawback a non-recurring underspend from the IJB of £5.6 million and use this to help with Children and Families pressures into 2023/2024. As Home Carer back pay now requires to be paid, the IJB will now not underspend and therefore that funding will not be available. 22
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The Council will therefore need to identify other funding to help with Children and Families costs into 2023/2024 and a proposal has been made to the Executive Committee on this. 5.12. As the outcome of the review was only known as this report was being finalised it has not been possible to update the figures in this report to reflect the outcome highlighted above. We will now require to quantify the full costs and the funding package and report back in August to Executive Committee 6. Climate Change, Sustainability and Environmental Implications 6.1. There are no implications for climate change, sustainability or the environment in terms of the information contained in this report. 7. Other Implications 7.1. The main risk associated with the Council’s Revenue Budget is that there is an overspend. There are inflationary and budget pressures including utilities (as well as general inflation pressures) this year which increase the risk of overspend however these have mitigated through the IJB financial plan for 2023/24. The risk is managed through four weekly Budget Monitoring Meetings at which any variance is analysed. In addition, the probable outturn exercise ensures early warning for corrective action to be taken where appropriate. 8. Equality Impact Assessment and Consultation Arrangements 8.1. This report does not introduce a new policy, function or strategy or recommend a change to an existing policy, function or strategy and therefore no impact assessment is required. 8.2. There was also no requirement to undertake any consultation in terms of the information contained in this report. Paul Manning Executive Director (Finance and Corporate Resources) Professor Soumen Sengupta Director, Health and Social Care 12 June 2023 Link(s) to Council Values/Priorities/Outcomes Accountable, Effective, Efficient and Transparent Previous References None List of Background Papers Financial Ledger and budget monitoring results to 19 May 2023 Contact for Further Information If you would like to inspect the background papers or want further information, please contact:- Graham Booth, Finance Manager Ext: 2699 (Tel: 01698 452699) Email: Graham.Booth@southlanarkshire.gov.uk 23
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Appendix A SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 19 May 2023 (No.2) Social Work Resources Summary Annual Budget Forecast for Year Annual Forecast Variance Budget Proportion 19/05/23 Actual 19/05/23 Variance 190/5/23 % Variance 19/05/23 Note £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 108,170 108,170 0 11,402 11,259 143 Under 1.3% Property Costs 4,219 4,219 0 474 470 4 Under 0.8% Supplies & Services 6,034 6,034 0 328 340 (12) Over -3.7% Transport & Plant 4,666 4,666 0 340 372 (32) Over -9.4% Administration Costs 2,062 2,062 0 65 68 (3) Over -4.6% Payments to Other Bodies 24,961 24,961 0 3,422 3,324 98 Under 2.9% Payments to Contractors 135,990 135,990 0 10,626 10,780 (154) Over -1.4% Transfer Payments 3,060 3,060 0 601 603 (2) Over -0.3% Financing Charges 403 403 0 8 12 (4) Over -50.0% Total Controllable Exp. 289,565 289,565 0 27,266 27,228 38 Under 0.1% Total Controllable Inc. (74,867) (74,867) 0 (2,546) (2,508) (38) Over recovered 1.5% Net Controllable Exp. 214,698 214,698 0 24,720 24,720 0 - 0.0% Variance Explanations Variance explanations are shown in Appendices B-E. Budget Virements Budget virements are shown in Appendices B-E. 24
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Appendix B SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 19 May 2023 (No.2) Children and Families Services Annual Budget Forecast for Year Annual Forecast Variance Budget Proportion 19/05/23 Actual 19/05/23 Variance 19/05/23 % Variance 19/05/23 Note £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 18,815 18,815 0 2,059 1,998 61 Under 3.0% 1, b Property Costs 460 460 0 63 47 16 Under 25.4% Supplies & Services 599 599 0 73 98 (25) Over -34.2% Transport & Plant 625 625 0 33 23 10 Under 30.3% Administration Costs 332 332 0 6 6 0 - 0.0% Payments to Other Bodies 10,287 10,287 0 1,177 1,178 (1) Over -0.1% a, b Payments to Contractors 5,067 5,067 0 561 705 (144) Over -25.7% 2 Transfer Payments 3,047 3,047 0 600 601 (1) Over -0.2% Financing Charges 20 20 0 1 2 (1) Over -100.0% Total Controllable Exp. 39,252 39,252 0 4,573 4,658 (85) Over -1.9% Total Controllable Inc. (2,038) (2,038) 0 (527) (528) 1 Over recovered -0.2% Net Controllable Exp. 37,214 37,214 0 4,046 4,130 (84) Over -2.1% Variance Explanations 1. Employee costs This is an underspend due to vacancies which are being actively recruited. 2. Payment to Contractors This overspend is a result of the continuing increased requirement for children’s residential school and external placements. Budget Virements a. Transfer of Whole Family Wellbeing Funding to Education Resources, Payment to Other Bodies (£0.413m). b. Transfer of Parenting Support Workers Net Effect: £0, Employee costs £0.340m, Payment to Other Bodies (£0.340m). 25
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Appendix C SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 19 May 2023 (No.2) Adults and Older People Services Annual Budget Forecast for Year Annual Forecast Variance Budget Proportion 19/05/23 Actual 19/05/23 Variance 19/05/23 % Variance 19/05/23 Note £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 77,546 77,746 0 8,028 8,028 0 - 0.0% b, c Property Costs 3,148 3,148 0 283 312 (29) Over -10.2% b Supplies & Services 4,872 4,872 0 249 227 22 Under 8.8% b Transport & Plant 3,706 3,706 0 267 304 (37) Over -13.9% Administration Costs 776 776 0 27 33 (6) Over -22.2% Payments to Other Bodies 14,077 14,077 0 2,140 2,043 97 Under 4.5% 1 Payments to Contractors 130,854 130,854 0 10,026 10,036 (10) Over -0.1% a, b, c Transfer Payments 7 7 0 1 1 0 - 0.0% Financing Charges 55 55 0 2 4 (2) Over -100.0% Total Controllable Exp. 235,041 235,041 0 21,023 20,988 35 Under 0.2% Total Controllable Inc. (65,001) (65,001) 0 (1,405) (1,370) (35) Under recovered 2.5% b Net Controllable Exp. 170,040 170,040 0 19,618 19,618 0 - 0.0% Variance Explanations 1. Payments to Other Bodies The underspend is due to unallocated funding to date. Budget Virements a. Transfer of 2023/24 Living Wage funding to Housing and Technical Resources, Payment to Contractors (£0.091m). b. Incorporation of IJB financial plan 2023/24 Net Effect: £0, Employee costs (£0.182m), Property costs £0.868m, Supplies & Services £0.324m, Payment to Contractors £6.443m, Income (£7.453m). c. Transfer of internal Home Care hours to external Net Effect: £0, Employee costs (£0.910m), Payment to Contractors £0.910m. 26
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Appendix D SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 19 May 2023 (No.2) Performance and Support Services Annual Budget Forecast for Year Annual Forecast Variance Budget Proportion 19/05/23 Actual 19/05/23 Variance 19/05/23 % Variance 19/05/23 Note £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 5,051 5,051 0 584 515 69 Under 11.8% 1 Property Costs 544 544 0 106 90 16 Under 15.1% Supplies & Services 454 454 0 1 8 (7) Over -700.0% Transport & Plant 250 250 0 2 1 1 Under 50.0% Administration Costs 324 324 0 21 18 3 Under 14.3% Payments to Other Bodies 26 26 0 2 0 2 Under 100.0% Payments to Contractors 0 0 0 0 0 0 - n/a Transfer Payments 0 0 0 0 0 0 - n/a Financing Charges 319 319 0 5 5 0 - 0.0% Total Controllable Exp. 6,968 6,968 0 721 637 84 Under 11.7% Total Controllable Inc. (611) (611) 0 (3) 1 (4) Under recovered 133.3% Net Controllable Exp. 6,357 6,357 0 718 638 80 Under 11.1% Variance Explanations 1. Employee costs This is an underspend due to vacancies which are being actively recruited, mainly within Admin and Clerical staff. 27
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Appendix E SOUTH LANARKSHIRE COUNCIL Revenue Budget Monitoring Report Social Work Resources Committee: Period Ended 19 May 2023 (No2) Justice Services Annual Budget Forecast for Year Annual Forecast Variance Budget Proportion 19/05/23 Actual 19/05/23 Variance 19/05/23 % Variance 19/05/23 Note £000 £000 £000 £000 £000 £000 Budget Category Employee Costs 6,758 6,758 0 731 718 13 Under 1.8% Property Costs 67 67 0 22 21 1 Under 4.5% Supplies & Services 109 109 0 5 7 (2) Over -40.0% Transport & Plant 85 85 0 38 44 (6) Over -15.8% Administration Costs 630 630 0 11 11 0 - 0.0% a Payments to Other Bodies 571 571 0 103 103 0 - 0.0% a Payments to Contractors 69 69 0 39 39 0 - 0.0% a Transfer Payments 6 6 0 0 1 (1) Over n/a Financing Charges 9 9 0 0 1 (1) Over n/a Total Controllable Exp. 8,304 8,304 0 949 945 4 Under 0.4% Total Controllable Inc. (7,217) (7,217) 0 (611) (611) 0 - 0.0% a Net Controllable Exp. 1,087 1,087 0 338 334 4 Under 1.2% Variance Explanations Budget Virements a. Big Lottery funding Net effect £0, Administration £0.065m, Payment to other Bodies £0.092m, Payment to contractors £0.039m, Income (£0.196m). 28
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Executive Director (Finance and Corporate Resources) Director, Health and Social Care Subject: Social Work Resources - Capital Budget Monitoring 2022/2023 1. Purpose of Report 1.1. The purpose of the report is to: [purpose] provide information on the progress of the capital programme for Social Work Resources for the period 1 April 2022 to 31 March 2023 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s): (1) that the Social Work Resources’ capital programme of £3.903 million, and expenditure for the year of £4.210 million, be noted. 3. Background 3.1. This is the final capital monitoring report presented to the Social Work Resources Committee for the financial year 2022/2023. 3.2. As noted in the last report to this Committee (3 May 2023), the budget for Social Work Resources for financial year 2022/2023 was £3.903 million. There has been no change to this budget allocation, since this last report to this Committee. 3.3. The report details the financial position for Social Work Resources in Appendix A. 4. Employee Implications 4.1. There are no employee implications as a result of this report. 5. Financial Implications 5.1. 2022/2023 Capital Programme – Final Position As detailed in Section 3.2, the total capital programme for Social Work Resources for 2022/2023 was £3.903 million. Total expenditure to the 31 March 2023 was £4.210 million, being additional spend of £0.307 million in comparison to the programme of £3.903 million. 5 29
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5.2. The additional spend of £0.307 million is mainly due to the timing of project spend on the Community Alarms and SWiSplus Replacement projects, with funding for the overall spend on these projects already identified into next financial year. 5.3. The overspends on these projects will carry forward and be offset by the funding available. An update on the 2023/2024 programme is detailed in a separate report to this Committee. 6. Climate Change, Sustainability and Environmental Implications 6.1. There are no implications for climate change, sustainability or the environment in terms of the information contained in this report. 7. Other Implications 7.1. The main risk associated with the Council’s Capital Programme is an overspend. There are detailed project management plans prepared and the risk of overspend on each project is monitored through four weekly investment management meetings. 7.2. The Council continues to experience material shortages, longer lead times and extraordinary inflationary price increases and it is anticipated that this will continue to impact the supply chain for the foreseeable future. The impact of this will continue to be monitored through the four weekly investment management meetings. Further updates will be reported in the coming months with any significant increases in contract values being brought to members’ attention. 8. Equality Impact Assessment and Consultation Arrangements 8.1. This report does not introduce a new policy, function or strategy or recommend a change to an existing policy, function or strategy and therefore no impact assessment is required. 8.2. There was also no requirement to undertake any consultation in terms of the information contained in this report. Paul Manning Executive Director (Finance and Corporate Resources) Professor Soumen Sengupta Director, Health and Social Care 7 June 2023 Link(s) to Council Values/Priorities/Outcomes Accountable, effective, efficient and transparent Previous References ▪ Social Work Resources Committee, 3 May 2023 List of Background Papers ▪ Financial ledger to 31 March 2023 30
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Contact for Further Information If you would like to inspect the background papers or want further information, please contact: Lorraine O’Hagan, Finance Manager (Strategy) Ext: 2601 (Tel: 01698 452601) E-mail: lorraine.o’hagan@southlanarkshire.gov.uk 31
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Appendix A South Lanarkshire Council Capital Expenditure 2022-2023 Social Work Resources Programme For Period 1 April 2022 – 31 March 2023 Social Work Resources Base Budget £000 Budget Adjustments £000 Slippage £000 Total Budget £000 Anticipated Spend £000 Actual Expenditure £000 Care Facilities 2,702 40 - 2,742 2,742 2,742 Other 4,691 40 (3,570) 1,161 1,161 1,468 TOTAL 7,393 80 (3,570) 3,903 3,903 4,210 32
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Executive Director (Finance and Corporate Resources) Director, Health and Social Care Subject: Social Work Resources - Capital Budget Monitoring 2023/2024 1. Purpose of Report 1.1. The purpose of the report is to: [purpose] provide information on the progress of the capital programme for Social Work Resources for the period 1 April 2023 to 19 May 2023 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s): (1) that the Social Work Resources’ capital programme of £2.030 million, and expenditure to date of £0.323 million, be noted. 3. Background 3.1. This is the first capital monitoring report presented to the Social Work Resources Committee for the financial year 2023/2024. Further reports will follow throughout the year. 3.2. The budget of £2.030 million for Social Work Resources is based on the overall Capital Programme for 2023/2024, which has been submitted for approval to the Executive Committee on 21 June 2023. 3.3. The report details the financial position for Social Work Resources in Appendix A. 4. Employee Implications 4.1. There are no employee implications as a result of this report. 5. Financial Implications 5.1. 2023/2024 Capital Programme Update The total capital programme for Social Work Resources is £2.030 million, as detailed in Section 3.2. This budget is based on the original programme of projects approved by the Council in February 2023, updated to include budget carried forward from financial year 2022/2023. The budget of £2.030 million also reflects the estimated level of spend which can be achieved in 2023/2024, based on current information. 5.2. Period 2 Position Anticipated spend to date was £0.323 million and spend to 19 May 2023 amounts to £0.323 million. 6 33
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6. Climate Change, Sustainability and Environmental Implications 6.1. There are no implications for climate change, sustainability or the environment in terms of the information contained in this report. 7. Other Implications 7.1. The main risk associated with the Council’s Capital Programme is that there is an overspend. The risk has been assessed as low given the detailed project management plans prepared and monitored for each project. The risk of overspend is managed through four weekly Investment Management Meetings. 8. Equality Impact Assessment and Consultation Arrangements 8.1. This report does not introduce a new policy, function or strategy or recommend a change to an existing policy, function or strategy and, therefore, no impact assessment is required. 8.2. There was also no requirement to undertake any consultation in terms of the information contained in this report. Paul Manning Executive Director (Finance and Corporate Resources) Professor Soumen Sengupta Director, Health and Social Care 7 June 2023 Link(s) to Council Values/Priorities/Outcomes Accountable, effective, efficient and transparent Previous References South Lanarkshire Council, 22 February 2023 Executive Committee, 21 June 2023 List of Background Papers ▪ Financial ledger to 19 May 2023 Contact for Further Information If you would like to inspect the background papers or want further information, please contact: Lorraine O’Hagan, Finance Manager (Strategy) Ext: 2601 (Tel: 01698 452601) E-mail: lorraine.o’hagan@southlanarkshire.gov.uk 34
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Appendix A South Lanarkshire Council Capital Expenditure 2023-2024 Social Work Resources Programme For Period 1 April 2023 – 19 May 2023 Social Work Resources Base Budget £000 Budget Adjustments £000 Slippage £000 Total Budget £000 Budget to Date £000 Actual Expenditure £000 Community Alarms - Analogue to Digital 1,232 - - 1,232 168 168 Swis Plus Replacement 798 - - 798 155 155 TOTAL 2,030 - - 2,030 323 323 35
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Executive Director (Finance and Corporate Resources) and Director, Health and Social Care Subject: Social Work Resources – Workforce Monitoring – March and April 2023 1. Purpose of Report 1.1. The purpose of the report is to: - [purpose] provide employment information for March and April 2023 relating to Social Work Resources [1purpose] 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s): - [recs] (1) that the following employment information for March and April 2023 relating to Social Work Resources be noted: - attendance statistics. occupational health. accident/incident statistics. discipline, grievance and Dignity at Work cases. analysis of leavers and exit interviews. Staffing Watch as of 11 March 2023 [1recs] 3. Background 3.1. As part of the Council’s performance management arrangements, regular workforce monitoring reports are submitted to Committee. This report for Social Work Resources provides information on the position for March and April 2023. 4. Monitoring Statistics 4.1. Attendance Statistics (Appendix 1) Information on absence statistics is analysed for the month of April 2023 for Social Work Resources. The Resource absence figure for April 2023 was 7.4%, this figure has decreased by 0.8% when compared to last month and is 2.3% higher than the Council-wide figure. Compared to April 2022, the Resource absence figure has decreased by 0.9%. Based on the absence figures at April 2023 and annual trends, the projected annual average absence for the Resource for 2023/2024 is 7.4%, compared to a Council- wide average figure of 5.1%. 7 37
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Managers follow the procedures outlined in the Maximising Attendance Policy to support employees to remain at work, or to return to work after a sickness absence. There are comprehensive employee supports in place and additionally, Personnel Services work in close partnership with line managers and Resource Management Teams on a case management basis to ensure that appropriate actions are taken. 4.2. Occupational Health (Appendix 2) In terms of referrals to occupational health, which include medical examinations and physiotherapy, overall, 246 referrals were made this period. This represents an increase of 3 when compared with the same period last year. 4.3. Accident/Incident Statistics There were 34 accidents/incidents recorded within the Resource this period, an increase of 12 when compared to the same period last year. 4.4. Discipline, Grievance and Dignity at Work (Appendix 2) During the period, 2 disciplinary hearings were held within the Resource, a decrease of 4 when compared to the same period last year. No appeals were heard by the Appeals Panel, a decreased of 1 when compared to the same period last year. No grievance hearings were raised within the Resource, a decrease of 1 when compared to the same period last year. No Dignity at Work complaints were raised within the Resource, this figure remains unchanged when compared to the same period last year. 4.5. Analysis of Leavers (Appendix 2) There were a total of 21 leavers in the Resource this period eligible for an exit interview. This figure has decreased by 19 when compared with the same period last year. Seven exit interviews were conducted in this period, a decrease of 10 when compared to the same period last year. 4.6. When processing an employee termination, managers were asked to identify whether they intended to replace the employee who had left the Council. If they indicated that they did not intend to replace the employee, they were asked to select from the following options: plan to hold for savings fill on a fixed term basis pending savings transfer budget to another post end of fixed term post 4.7. Appendix 2a provides a breakdown of vacant posts and whether these are being replaced or held for savings. In the period March to April 2023, 49 employees (38.03 FTE) in total left employment, managers indicated that 43 posts (34.43 FTE) were being replaced, 2 posts (0.81 FTE) were being filled on a fixed term basis, 1 post (0.29 FTE) was due to the end of a fixed term contract and 3 posts (2.50 FTE) are being held pending a savings or service review. 5. Staffing Watch 5.1. There has been an increase of 1 in the number of employees in post from 10 December 2022 to 11 March 2023. 6. Employee Implications 6.1. There are no implications for employees arising from the information presented in this report. 38
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7. Financial Implications 7.1. All financial implications are accommodated within existing budgets. 8. Climate Change, Sustainability and Environmental Implications 8.1. There are no Climate Change, Sustainability and Environmental Implications in terms of the information contained within this report. 9. Other Implications 9.1. There are no implications for sustainability or risk in terms of the information contained within this report. 10. Equality Impact Assessment and Consultation Arrangements 10.1. This report does not introduce a new policy, function or strategy or recommend a change to an existing policy, function or strategy and therefore no impact assessment is required. 10.2. There was no requirement to undertake any consultation in terms of the information contained in this report. Paul Manning Executive Director (Finance and Corporate Resources) Professor Soumen Sengupta Director, Health and Social Care 25 May 2023 Link(s) to Council Values/Priorities/Outcomes Accountable, effective, efficient and transparent Fair, open and sustainable Ambitious, self aware and improving Excellent employer Focused on people and their needs Working with and respecting others Previous References Social Work Resources – 3 May 2023 List of Background Papers Monitoring information provided by Finance and Corporate Resources Contact for Further Information If you would like to inspect the background papers or want further information, please contact: - Eileen McPake, HR Business Manager Ext: (Tel: 01698 454647) E-mail: Eileen.McPake@southlanarkshire.gov.uk 39
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2021 / 2022 2022 / 2023 2023 / 2024 2021 / 2022 2022 / 2023 2023 / 2024 2021 / 2022 2022 / 2023 2023 / 2024 2021 / 2022 2022 / 2023 2023 / 2024 % % % % % % % % % % % % April 4.5 6.2 6.5 April 9.6 12.6 9.4 April 6.2 8.3 7.4 April 4.3 5.6 5.1 May 5.0 5.7 May 9.3 10.1 May 6.5 7.1 May 4.9 5.4 June 3.9 5.9 June 7.6 11.3 June 5.2 7.6 June 4.7 5.3 July 6.1 6.0 July 10.3 11.8 July 7.5 7.9 July 4.0 4.6 August 7.3 6.0 August 10.2 10.8 August 8.2 7.5 August 4.7 4.4 September 7.6 5.9 September 10.3 9.6 September 8.5 7.1 September 6.4 5.4 October 6.9 5.8 October 11.3 10.4 October 8.4 7.3 October 6.3 5.8 November 6.2 6.0 November 10.8 10.4 November 7.7 7.4 November 6.9 6.5 December 5.5 6.4 December 11.1 10.6 December 7.3 7.7 December 6.9 7.0 January 7.4 5.2 January 13.0 12.0 January 9.2 7.4 January 7.0 5.8 February 7.5 5.8 February 10.1 11.0 February 8.3 7.5 February 6.6 5.9 March 8.0 7.0 March 12.8 10.9 March 9.5 8.2 March 7.9 6.4 Annual Average 6.3 6.0 6.5 Annual Average 10.5 11.0 9.4 Annual Average 7.7 7.6 7.4 Annual Average 5.9 5.7 5.1 Average Apr-Mar 6.3 6.0 6.5 Average Apr-Mar 10.5 11.0 9.4 Average Apr-Mar 7.7 7.6 7.4 Average Apr-Mar 5.9 5.7 5.1 1855 1028 2883 16205 Resource TotalManual Workers No of Employees at 30 April 2023 No of Employees at 30 April 2023 No of Employees at 30 April 2023 No of Employees at 30 April 2023 Appendix 1 Absence Trends - 2021/2022, 2022/2023 & 2023/2024 Social Work Resources APT&C Council Wide 40
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Mar - Apr Mar - Apr 2022 2023 MEDICAL EXAMINATIONS Number of Employees Attending EMPLOYEE COUNSELLING SERVICE Total Number of Referrals PHYSIOTHERAPY SERVICE Total Number of Referrals REFERRALS TO EMPLOYEE SUPPORT OFFICER 56 70 REFERRALS TO COGNITIVE BEHAVIOUR THERAPY 0 2 TOTAL 243 246 Mar - Apr Mar - Apr 2022 2023 Specified Injuries* 1 1 Over 7 day absences 1 2 Over 3 day absences** 2 0 Minor 8 10 Near Miss 1 0 Violent Incident: Physical**** 5 15 Violent Incident: Verbal***** 4 6 Total Accidents/Incidents 22 34 Mar - Apr Mar - Apr 2022 2023 Total Number of Hearings 6 2 Total Number of Appeals 1 0 Time Taken to Convene Hearing March - April 2023 0-3 Weeks 4-6 Weeks Over 6 Weeks 1 1 0 Mar - Apr Mar - Apr 2022 2023 Number of Grievances 1 0 Number Resolved at Stage 2 1 0 Mar - Apr Mar - Apr 2022 2023 Number of Incidents 0 0 Mar - Apr Mar - Apr 2022 2023 Career Advancement 8 3 Child Caring / Caring Responsibilities 0 1 Disatisfaction with terms and conditions 0 1 Further Education 0 1 Moving outwith area 2 0 Personal Reasons 1 0 Poor relationship with managers / colleagues 1 0 Other 5 1 Number of Exit Interviews conducted 17 7 Total Number of Leavers Eligible for Exit Interview 40 21 Percentage of interviews conducted 43% 33% Appendix 2 83 75 21 20 SOCIAL WORK RESOURCES 83 79 CAUSE OF ACCIDENTS/INCIDENTS *A Specified Injury is any fracture (other than to the fingers, thumbs or toes), amputation, loss of sight, serious burns, crushing injury, scalping, loss of consciousness caused by asphyxiation/ head injury, a chemical or hot metal burn to the eye or penetrating injury as defined by the HSE. **Over 3 day / over 7day absence is an injury sustained outwith specified injury category that results in a period of absence of absence as defined by the HSE. ***Near Miss - Any unexpected, unplanned occurrence (except Dangerous Occurrences) that does not lead to injury of persons, damage to property, plant or equipment but may have done so in different circumstance. ANALYSIS OF REASONS FOR LEAVING ****Physical violent incidents are included in the "Specified" figures, where applicable, to provide the "Total Specified" figures. ****Physical violent incidents and ***** Verbal Violent Incidents are included in the "Over 3-day or Over 7-day" figures, where applicable, to provide the "Total Over 3-day or Over 7-day" figures. ****Physical Violent Incidents and ***** Verbal Violent Incidents are included in the "Minor" figures, where applicable, to provide the "Total Minor" figures. RECORD OF DISCIPLINARY HEARINGS RECORD OF GRIEVANCE HEARINGS RECORD OF DIGNITY AT WORK 41
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FTE* H/C** FTE H/C FTE H/C Terminations/Leavers 14.41 18 250.40 323 264.81 341 Being replaced 11.91 15 242.69 314 254.60 329 Filled on fixed term basis 0.00 0 0.00 0 0.00 0 Plan to transfer this budget to another post 0.00 0 0.45 1 0.45 1 End of fixed term contract 0.00 0 2.65 3 2.65 3 Held pending service Review 2.50 3 2.80 3 5.30 6 Plan to remove for savings 0.00 0 1.81 2 1.81 2 * Full time equivalent ** Head count/number of employees FTE* H/C** FTE H/C Terminations/Leavers 23.62 31 23.62 31 Being replaced 22.52 28 22.52 28 Filled on fixed term basis 0.81 2 0.81 2 Plan to transfer this budget to another post 0.00 0 0.00 0 End of fixed term contract 0.29 1 0.29 1 Held pending service Review 0.00 0 0.00 0 Plan to remove for savings 0.00 0 0.00 0 * Full time equivalent ** Head count/number of employees Apr-23 Cumulative total Appendix 2a Mar-23 Reconciliation figure Cumulative totalApr 2022 - Feb 2023 42
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As at 11 March 2023 Total Number of Employees F/T P/T F/T P/T 204 186 948 1328 Director Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Fixed SCP Teacher TOTAL 1.00 1105.28 633.47 523.69 36.80 29.76 2.00 0.00 0.00 2332 As at 10 December 2022 Total Number of Employees F/T P/T F/T P/T 198 183 963 1321 Director Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Fixed SCP Teacher TOTAL 1.00 111.64 617.78 536.93 35.80 30.76 2.00 0.00 0.00 1335.91 Salary Bands MALE FEMALE TOTAL 2665 *Full - Time Equivalent No of Employees Appendix 3 JOINT STAFFING WATCH RETURN SOCIAL WORK RESOURCES *Full - Time Equivalent No of Employees Salary Bands 2666 MALE FEMALE TOTAL 43
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Director, Health, and Social Care Subject: Update on the 2022/2023 Risk Register and Risk Control Plan 1. Purpose of Report 1.1. The purpose of the report is to:-[p provide an update on risk management arrangements and the risk register for Social Work Resources [1purpose] 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s):- [ (1) that the contents of the report be noted; and (2) that the set of top risks for Social Work Resources be approved. 3. Background 3.1. The Council’s Risk Management Strategy promotes consideration of risk in service delivery, planning and decision-making processes. The strategy requires Resources to record and review risks and control actions regularly. Social Work Resources follows the guidance in developing, monitoring and updating the risk register on an ongoing basis. 3.2. The purpose of the risk register is to ensure that Social Work Resources is fully aware of its top risks; that these risks are prioritised; and that controls are in place to eliminate or minimise the impact of the risks. 3.3. The Resource scores these risks in accordance with the Council’s Corporately agreed scoring mechanism, based on likelihood and impact. This results in risks being scored between one and twenty-five (low – very high). Risks are scored on their inherent score (risk if we do nothing) and their residual risk (risk after applying controls). Further detail on the Council’s scoring matrix and approach to risk appetite is outlined in appendix one. 3.4. Each Resource has a Resource Risk Management Group which has responsibility for the promotion and management of risk. The Social Work Resources Risk Management Group continues to meet on a regular basis to provide operational oversight of all risks impacting on the delivery of social care services. 8 45
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3.5. This particular report provides an update to Social Work Resources Committee on a number of interrelated pieces of work that have been undertaken with regard to risk in the context and how these impact on the delivery of social care services. Notably, this report will cover the following areas: • a reviewed list of top risks impacting on social care as per agreement at Social Work Resources Committee on 3 May 2023 • reviewing the Council’s top risks for 2023/2024 4. Review of the Top Risks Impacting on Social Care Services 4.1. At its meeting of 3 May 2023, Social Work Resources Committee agreed the current top 5 risks impacting on the delivery of social care services as detailed below. Whilst the top risks as remain unchanged the level of impact has increased significantly. • Workforce availability and capacity (lack of capacity and skills to meet increased service demands) • Meeting public protection and legislative duties (combined legislation/statutory duties public protection, Care Inspectorate/self-directed support (SDS)) • Market and provider capacity (procurement/supply chain) • Funding and budgetary pressures (Reduction in funding/increased costs) • Winter demand pressures (Emergency Response) 4.2. Whilst the top risks as remain unchanged a number of recent factors have materialised which impact directly on the top risks relating to funding and budgetary pressures and market/provider capacity. Although these do not alter the risk scoring at this stage, they do emphasise further challenges which require to be accounted for in a risk context. Of note and for information, these additional challenges are related to: • the outcome of the Care at Home job evaluation which will require a recurring funding solution to be agreed • ongoing pressures within the Children’s Social Work element of the Children and Justice budget • care home providers market stability, both general (e.g. related to ongoing negotiations on the National Care Home Contract) and specific to individual homes (e.g. those subject to external review or where owner has placed them in administration) 4.3. Appendix 2 provides further detail on each of these top risks, alongside the inherent and residual risk scores and sample controls. 4.4. Whilst these top risks are the primary focus of the Resource in terms of oversight, monitoring and management, there are other risks (whilst deemed to be of lesser impact at this point in time) that the Resource are required to monitor and contribute to by way of mitigation. Some of these risks are wider organisational risks which require all departments of the Council to respond to by working together corporately. The list below provides some additional detail in this regard: • Deliver Strategic Commissioning Plan Outcomes IJB • IT development and functionality • Pandemic response and recovery • National Care Service/independent Review Adult Social Care • Failure to meet sustainable development and climate change objectives 46
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• Fraud, theft organised crime and cyber attacks • Historic Child Abuse • Increased levels of adverse weather • Cost of Living Crisis • Refugee resettlement and asylum seeker dispersal programme • Disruption to Council Services due to industrial action 4.4. From a risk appetite and tolerance perspective, the Council aims to be risk embracing, in that it will accept a tolerable level of risk in seeking service efficiencies and in agreeing control measures. The level of risk facing the Council is measured both before (inherent risk) and after (residual risk) consideration of controls. The Council should never carry a very high residual risk exposure as this would indicate instability, but a low residual risk exposure should also be avoided as this indicates lack of innovation. 4.5. The Council’s universal risk tolerance levels were updated as part of the review of the Risk Management Strategy last year, with the ideal risk profile defined as: No more than 10 per cent of residual risks at a very high level No more than 15 per cent of risks at a high level Around 50 to 60 per cent of residual risks at a medium level No more than 30 per cent of residual risks at a low level 4.6. Social Work Resources currently has a risk profile of 31%, in respect of the 16 risks referred to in sections 4.1 and 4.3. This is mainly due to the 5 top risks having a residual score of very high. This, however, is reflective of the environment and risks which the service currently operates within. 4.7. Risk will remain a standing item on the Social Work Resources Committee agenda and the risk register and reporting of risk will be a dynamic process, with Committee receiving updates on any changes to levels of risk or new risks which may evolve overtime. 5. Reviewing the Council’s Top Risks for 2023/2024 5.1. An annual review of the Council’s top risks is underway with views sought from Heads of Service, Senior Managers, Elected Members and Trade Unions. 5.2. The review will support the systematic identification and assessment of top risks and cross cutting themes across the Council which will be monitored through individual Resource risk registers. 5.3. Details of the finalised top risks in ranking order will be presented to the Risk and Audit Scrutiny Committee on 31 October 2023, with presentation following at Social Work Resources Committee on 6 December 2023. 6. Major Projects, Partnerships, or Change 6.1. Within Social Work Resources, 13 partnerships have been identified. None are considered to be high risk. Major projects/transformational change programmes are reported to Committee. 47
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7. Next steps 7.1. The Resource Risk Management Group will continue to meet on a regular basis. The Risk Register will be reviewed on an ongoing basis by the group to ensure that risks remain valid for the appropriate Service areas and to identify new areas of risk that affect the Resource. An update report will be provided regularly to Committee. 7.2. Moreover, future reports and proposals brought before Social Work Resources Committee will show the correlation and read across with the top risks to assure Committee that such proposals are geared towards providing further levels of mitigation. 8. Employee Implications 8.1. Time will be required for the Resource Risk Management Group to manage the Resource risk register and risk control plan. 9. Financial Implications 9.1. There are no direct financial implications associated with the Resource’s top risks. There are a number of proposed risks which are classified under the heading of financial. Where this is the case, the appropriate controls and actions have been included in the risk control cards and progress will be monitored. 10. Climate Change, Sustainability and Environmental Implications 10.1. Sustainable development issues are included within the Council’s top risk register through being linked directly to the Council Plan objective ‘make communities safer, stronger and sustainable’. 11. Other Implications 11.1. Failure to demonstrate that risk is actively considered and managed cannot only lead to avoidable financial loss but could also affect delivery of services and the reputation of the Resource. 12. Equality Impact Assessment and Consultation Arrangements 12.1. This report does not introduce a new policy, function or strategy or recommend a change to existing policy, function or strategy and therefore, no impact assessment is required. 12.2. Consultation on the content of this report has been undertaken with the Resource Management Team. Soumen Sengupta Director, Health and Social Care 5 June 2023 Link(s) to Council Values/Priorities/Outcome Accountable, effective and efficient 48
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Previous References Social Work Resources Committee – 3 May 2023 List of Background Papers None Contact for Further Information If you would like to inspect the background papers or want further information, please contact:- Ciana Stewart, Planning and Performance Manager Ciana.stewart@southlanarkshire.gov.uk 49
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Appendix One – Risk scoring matrix, likelihood and impact definitions Likelihood Score 1 2 3 4 5 Description Rare Unlikely Possible Likely Almost certain Likelihood of occurrence 1 in 10 years 1 in 3 years 1 in 2 years Annually Monthly Probability of occurrence The event may occur in certain circumstances The event could occur The event may occur The event will probably occur The event is expected to occur or occurs regularly Impact Reputation Financial Service delivery/ Time to recover Compliance Safety 1 Negligible Public concern restricted to local complaints <£50,000 per annum No impact to service quality; limited disruption to operations. No external interest Minor injury – no lost time 2 Minor Minor adverse local/public/me dia attention and complaints £50,000- £250,000 per annum Minor impact to service quality; minor service standards are not met; short term Very minor attention from legislative /regulatory body Minor injury – resulting in lost time 3 Moderate Adverse national media Public attention £250,000 to £500,000 per annum Significant fall in service quality; major partnership relationships strained; serious disruption in service standards Short-term attention from legislative/ regulatory body Major injury or ill health resulting in lost time 4 Major Serious negative national or regional criticism £500,000 to £1million per annum Major impact to service delivery; multiple service standards are not met; long term disruption to operations; multiple partnerships affected Medium-term attention from legislative/ regulatory body Fatality; Or injuries to several people 5 Catastrophic Prolonged international, regional and national condemnation >£1million per annum Catastrophic fail in service quality and key service standards are not met; long term catastrophic interruption to operations; several major partnerships are affected National impact with rapid intervention of legislative/ regulatory body Multiple fatalities; Or injuries to large number of people The assessments for impact and likelihood combine to provide an overall inherent risk score on the scale of between 1 and 25, using the Council’s recognised risk matrix. 50
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Risk matrix Likelihood 5 Almost Certain 5 10 15 20 25 4 Likely 4 8 12 16 20 3 Possible 3 6 9 12 15 2 Unlikely 2 4 6 8 10 1 Rare 1 2 3 4 5 1 Negligible 2 Minor 3 Moderate 4 Major 5 Catastrophic Impact The risk score is calculated as follows: Likelihood score x Impact score = Risk Score Risks scored 15 to 25 are considered to be very high risks and risks scored 8 to 12 are considered to be high risks. Very high and high risks are monitored closely. 51
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Appendix Two Social Work Resources Risk Register (February 2023) Extract of risks with residual score category of Very High Sample of Controls Risk Category Key Risk Inherent risk score 1st line of defence: Operational management 2nd line of defence: Corporate functions (not internal audit) that oversee or who specialise in compliance or the management of risk (CMT) 3rd line of defence independent assurance (internal/external audit and any other scrutiny or regulatory body) Residual Risk Score 1 1 Very High (15-25) Workforce Availability and Capacity Description • Lack of capacity and skills to meet increased service demands. • National shortage of skilled workforce across all sectors • Recruitment, selection, and retention of Social Care Staff challenging • Growing demographic and post pandemic service demands • Workforce profile shows an ageing workforce within social care • Competition with other industry sectors and Local Authorities 25 Prioritising workloads, raising concern within management team Social Care and Social Work Critical Functions Framework Care at Home social media recruitment campaign (Everyday heroes) Workforce Monitoring reports to SWC Personnel targeted recruitment campaigns Increase use of social media to recruit Care Academy Workforce Strategy for Health and Social Care Scotland SSSC (Scottish Social Services Council) registration requirements 20 52
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Sample of Controls Risk Category Key Risk Inherent risk score 1st line of defence: Operational management 2nd line of defence: Corporate functions (not internal audit) that oversee or who specialise in compliance or the management of risk (CMT) 3rd line of defence independent assurance (internal/external audit and any other scrutiny or regulatory body) Residual Risk Score 2 1 Very High (15-25) Meeting Public Protection and Legislative Duties Description • Ability to meet increased demands and risks with regards Public Protection (Child Protection, Adult Support and Protection, MAPPA and Gender Based Violence) • Meeting all legislative duties pertaining to assessment, support planning and reviews 25 SwisPlus system records legislative rationale for intervention. Improve reports on legislative timescales targets being met ASP decision making support tool for staff. Wellbeing portal for all staff to access. Risk Assessment for Service Users PPE support to all who require A risk assessment is part of care management function. Mandatory training and LOL courses for all staff, specific legislation LOL’s available. Workforce updates to all SW Committee Meetings. Serious Incident recording and action Previous inspections reports by CI: SDS, Children’s Services and ASP inspection. All registered care services have oversight by Care Inspectorate Other inspection: Mental Welfare Commission reviews 20 53
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Sample of Controls Risk Category Key Risk Inherent risk score 1st line of defence: Operational management 2nd line of defence: Corporate functions (not internal audit) that oversee or who specialise in compliance or the management of risk (CMT) 3rd line of defence independent assurance (internal/external audit and any other scrutiny or regulatory body) Residual Risk Score 3 1 Very High (15-25) Market and Provider Capacity Description • The market has insufficient capacity and choice to meet demand • Risks of Providers not being able to sustain their business models/supply chain issues • Providers are able to maintain compliance with national standards and quality of service delivery • Future arrangements with regards to the National care Home Contract and rates agreed 25 Quality Assurance & Commissioning Team in place Procurement Network Oversight meetings in place Mapping tool developed in support of care at home service Oversight of all SL based registered care services maintained Social Work Scotland Care Market intelligence shared. Market facilitation plan Care Inspectorate regulation of all care services Scottish Care support of independent, private, voluntary care providers. 20 54
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Sample of Controls Risk Category Key Risk Inherent risk score 1st line of defence: Operational management 2nd line of defence: Corporate functions (not internal audit) that oversee or who specialise in compliance or the management of risk (CMT) 3rd line of defence independent assurance (internal/external audit and any other scrutiny or regulatory body) Residual Risk Score 4 1 Very High (15-25) Funding and Budgetary Pressures Description • Risk that services have to re-prioritised as a result of reductions in budgets • Reduction in early intervention and prevention activity as a result of having to respond to statutory duties such a public protection 25 Budget holder responsibility and monitoring. Care Packages linked to finance module Voluntary Sector commissioned services can lever additional funding to the area Revenue and Capital budget monitoring reports to SW Committee Four weekly monitoring and reporting of financial performance to CMT COSLA role in support of LA’s and links to Scottish Government Audit Scotland reports and briefings 20 55
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5 1 Very High (15-25) Winter Demand Pressures Description • Increased service demand beyond normal levels as a result of the impact of seasonal Flu, other respiratory conditions and increased unwellness in the population • Impact on workforce availability due to potential increases in sickness/absence • Impact of adverse weather on service delivery 25 Planning for Winter 2022/2023 commenced in July 2022 All health and social care staff offered flu and COVID 19 vaccines. Covid and Flu Vaccine Programme for public GP and Pharmacy Opening Maximising Planned Date of Discharge, Discharge Without Delay and Home First Multi-agency approach across NHS Lanarkshire, the two H&SCPs/IJBs, North and South Lanarkshire Councils together with the respective supports. NHS 24 etc. NHS Scotland, Public Health Scotland, Healthier Scotland driving forward Winter 2022 Vaccines programme. Overall Resilience Planning 20 56
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Director, Health and Social Care Executive Director (Finance and Corporate Resources) Subject: Locality Based Social Work Services Modernisation Programme 1. Purpose of Report 1.1. The purpose of the report is to:- [purpose] • advise of proposals to update the model of delivery of services with a reconfiguration of front line posts, increased Senior Pracitioner posts and development of additional Operations Manager posts and Fieldwork Managers across localities • update the committee in relation to recruitment and retention challenges across localities primarily with Qualified Social Worker posts 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s):- [recs] (1) note the contents of the report; (2) approve the resource’s proposals to progress changes to the operational structure across social work services; (3) approve the amendments to the establishment in the posts identified in section 7 of the report. 3. Background 3.1. The Social Work teams operating within the four localities are the essential core of the Social Work Service. They undertake the Council’s statutory duties relating to Assessment and Care Management, Mental Health and Public Protection. The primary workforce comprises Social Workers and Mental Health Officers who are regulated by the Scottish Social Services council (SSSC). This workforce is managed by Team Leaders who are also registered Social Workers who provide the professional support and leadership that is vital to delivering services and protecting the most vulnerable of South Lanarkshire’s citizens. The workforce is deployed in: • Children • Justice • Adult and Older People • Hospitals Social Work Team • CARes • Mental Health 9 57
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3.2. In Adult and Older people teams, this workforce is supplemented by a cohort Occupational Therapists (OT) who are registered with the Health and Care Professions Council (HCPC). Similar to the Social Workers, registered OT Team Leaders manage them. These OT’s are therefore also in scope in this report. There is currently a gap in the service delivery model within Adult and Older People, where there is no Grade 4 Operations Manager in the structure. 3.3. In Children and Justice Services there is currently a Grade 4 Operations Manager role in part of the structure, but not within Fieldwork Services. 3.4. Team Leaders, manage Social Workers and also assign work to Senior Practitioners, who are also managed by the Fieldwork Managers in a professional development capacity (this is a matrix management arrangement). The Team Leaders also oversee a group of para professional Social Work Assistant/Family Support Worker and similar roles. This para professional workforce is similarly responsible for care managing and safeguarding vulnerable people. 3.5. Recruitment and staff retention has been challenging across social work services over a number of years. This is not solely a South Lanarkshire issue but a national concern. 3.6. Within the Social Work Risk Register, Service Demand Pressures and Workforce Availability have been reported as Very High Risk since the pandemic started and the recruitment and retention pressures for Qualified Social Workers (QSW) has not abated. • At May 2023, there was a 25% vacancy rate in QSW’s, this is primarily within locality offices. • In some offices, the vacancy rate in QSW is at 50%. 3.7. Within Localities, some of the key front line services that are provided are to undertake the public protection duties such as child protection adult protection and managing high risk offenders. In addition, there has been an increase in referrals in relation to public protection. There is a significant risk that public protection duties will be compromised due to recruitment and retention issues. In addition, the knock on effect is that other statutory duties such as assessment and care management for all other duties are being reprioritised in order to ensure statutory public protection responsibilities are being met. 3.8. Social Work has developed a Sustainability and Value Option Appraisal Screening Scale (Appendix 1), to provide oversight and ensure that public protection duties are a priority. Currently within Services and localities work is routinely being redistributed and reprioritised in order to meet the staffing challenges, however this is not sustainable. It is also important to note that across the service in terms of retention that there needs to be a balance of experienced and newly qualified social workers to ensure the correct skill set is in place and staff are trained and capable of undertaking the public protection duties. The current recruitment and retention issues are impacting on this balance. 58
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3.9. In terms of the current service model, the Social Work Committee of 7 September 2022 approved the report entitled “Enhancing Social Work Fieldwork Capacity” which begun to address emergent issues in respect of Social Worker capacity in Adult services. That paper approved funding to support the extension of Senior Practitioner roles and an intent supported by approved funding for a “review of the current delivery model and structure to support workforce development, recruitment and retention and staff/management ratios.” 3.10. There have been identified service model improvements that are required in relation to: • Staff and management ratios • The gap in a Grade 4 management post in some areas of the structure • The matrix management of the Social Worker Senior Practitioner role • The impact of the current structure on service demand and delivery • Staff and caseload ratios 3.11. Previously reported to Committee in September 2022, was funding to improve Adult Fieldwork Capacity and Adult Services. Following on from this there are proposed changes in relation to Commissioning, Quality and Assurance and Planning and Performance. 4. Current Challenges 4.1. The Setting the Bar report (Social Work Scotland, 2022), “found that the size of the social work workforce in Scotland has remained relatively unchanged in recent years, and now faces retention and recruitment challenges”. It notes factors such as poor management of caseloads, shortcomings in support for front line workers, loss of administrative support and consequent task acquisition as being material factors in workforce attraction and retention in a profession where, “within six years, 75% remain registered, meaning 1 in 4 staff will leave the profession. This report proposes measures which will improve South Lanarkshire’s position as an employer of this workforce by strengthening the management and support capacity. 4.2. It is evident that the Council faces ongoing challenges in recruiting and retaining Social Workers and their Team Leaders in a very competitive labour force market. Their qualifications and skills are highly sought after and there are extensive opportunities for those working at this level to secure employment in neighbouring authorities in similar or more specific roles. In addition, a few neighbouring authorities offer a higher salary level and may secure applications from the most experienced workforce in their adjacent authorities. 4.3. A previous report to the Social Work Committee detailed an implementation of the Social Worker Senior Practitioner grade that had been previously primarily progressed with the Mental Health Officers (MHO’S) in recognition of the more advanced skill set. The definition of Senior Practitioner role has been extended in consultation with the trade unions and enabled Social Workers and potentially OTs with additional training, and established skills in undertaking more complex work, to advance through the Senior Practitioner Grade. This provides a stronger career pathway for Registered practitioners and creates the facility to offer more specialist roles akin to the MHO such as coaching, mentoring and complex work as an additional accountability. This in turn will support retention, succession planning and service demand. 59
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4.4. However, the clarification for the criteria for the Senior Practitioner role requires appropriate management arrangements to be put in place. The delivery model will work better with the Senior Practitioner reporting to an Operations Manager for both work being assigned and for professional practice and development. This management arrangement will support opportunities for progression and career pathways. 4.5. Due to the challenges known locally and described in this section, the service requires to modernise its approach to service delivery and create a service model to mitigate the risks that have been ongoing in recruitment and with retention particularly in local offices. 5. Employee Engagement and Consultation 5.1. Consultation and engagement events took place in March 2023 across Children and Justice Services. Attached at Appendix 2 is a report that highlights the feedback from the events and this demonstrated that there is a clear need to modernise redesign and demonstrate a commitment to recruitment and with retention for our workforce. It also recognised that the biggest area of risk for the service was in locality settings and settings primarily responsible for delivering public protection arrangements i.e. child protection and adult support and protection. It is in the delivery of public protection responsibilities primarily within localities that the service see the biggest turnover of staff that creates a risk in the service. These issues and challenges are also reflected across adult and older people’s services. 6. Three Horizons Redesign Proposal 6.1. As a result of Service demands and the Service Model improvement requirements that have emerged, it is proposed that: ▪ The current role of Operations Manager within Social Work is expanded into locality structures ▪ The Operations Manager already exists across Social Work. The tasks in this job profile of both managing an operational service and contributing to more strategic and governance activity would provide the role the service requires within its structure. ▪ This Operations Manager would report into the Fieldwork Manager and hence provide a clear career pathway. ▪ This report proposes a remodelling of the line management arrangements for the posts in scope that would involve the deletion of a number of Team Leader posts and the creation of Operations Manager posts. The proposal takes account of the need to ensure appropriate spans of responsibility for the post holder. 6.2. The establishment of Operations Manager posts will increase capacity with the new Operations Managers assuming wider public protection responsibilities in chairing Adult Protection Child Protection and high risk Multi Agency Public Protection Arrangements (MAPPA). It is envisaged that the implementation will be phased in over a period of around 12 months. See Appendix 3 for an illustration of current structure and proposed structure. 60
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6.3. The service recommends that a further element of Horizon one is the establishment of Planning and Performance roles in each of the Localities to support these new management arrangements. These new roles would assume responsibility for the management of data which is used to monitor, prioritise, report on and plan locality social work services and allocation of resources. In addition the Quality and Commissioning Service Manager is currently established on a fixed term basis and it is proposed this is a permanent arrangement. These additions would apply only for HSCP posts. 6.4. Horizons two and three will build upon this platform and can run in parallel. There is recognition within the service that there is an opportunity to modernise and integrate practice at the locality level. Children’s services have already commenced this transition through the creation of Early Help Hubs (EEH) which are successfully developing a network of community partnership resources which can wrap around the household in need of support. The HSCP have also undertaken tests of change in using the Community Led Support model (Community Led Support - NDTi), which like the child and family hubs, promotes “good conversations” and early intervention to provide help and promote engagement with universal, local third sector or statutory services, There is an opportunity to progress this approach across all of the locality Social Work services once there is a stable base to support the work required. This redesign of existing resources and operational models would comprise Horizon two of this change programme. 6.5. Horizon three is also relevant for all of Social Work but has a particular resonance for the HSCP as it considers the integration of practice models in the localities. Whilst there are examples of integrated teams e.g. CARes they tend to sit alongside rather than being embedded in locality team structures. Horizon three would involve further testing the opportunity to better integrate and embed these elements within the locality teams. By its nature, this work will take a little longer to mature than the more pressing matters which horizon one addresses. 7. Senior Practitioners 7.1. As advised at section 4.3 the extension of the Senior Practitioner role has previously been agreed. The redesign of the locality model of delivery will support the recruitment of Senior Practitioners who will report to the new Operations Managers. It is proposed that up to a third of the current front line Social Worker and Occupational Therapist posts can and should be advertised and recruited to as Senior Practitioner roles. This will not only support recruitment of experienced staff but also demonstrate and support a career pathway for existing staff to remain within South Lanarkshire. 7.2. It should be noted that progression to a Senior Practitioner post is not based on a recognition or reward for length of service but dependent on service needs and demands; post qualifying and training awards; a commitment to undertaking complex intensive work; coaching and mentoring and leadership qualities as part of a team. They will be practitioners who can work professionally and autonomously across partnerhsip and wider stakeholder groups and should be the Operations Managers and Services Managers of the future within South Lanarkshire. 61
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8. Employee Implications 8.1. The proposed changes on a permanent basis to the staffing establishment are set out in the tables below: Table 1 HSCP Social Work Post Current No of posts Proposed No of posts Grade SCP range Hourly rate Annual salary Gross cost Total cost Operations Manager 0 32 G4 L2- L5 82 - 88 £25.37 - £27.76 £46,298 - £50,659 £60,330 - £66,013 £1,930,560 - £2,112,416 Team Leader 36 0 G3 L8 79 - 80 £24.28 - £24.64 £44,309 - £44,966 £57,738 - £58,590 (£2,078,568) - (£2,109,240) Planning and Performance Officer 0 4 G3 L4 72 - 74 £22.07 - £22.53 £40,276 - £41,115 £52,480 - £53,573 £209,920 - £214,292 8.2. The changes proposed in the above as part of the redesign will be delivered within the existing budget provision. This includes a sum of £365,689 of the HSCP’s funds previously set aside for this purpose at the Social Work Committee of 7 September 2022 from new ring fenced funding for improving capacity for Adult Social Workers. Table 2 Commissioning and Quality Assurance Team Post Current No of posts Proposed No of posts Grade SCP range Hourly rate Annual salary Gross cost Total cost Service Manager 0 1 G5 L1- L5 96 - 103 £31.25 - £34.65 £57,028 - £63,233 £74,312 - £82,398 £74,312 - £82,398 8.3. The funding for the above post will come from continued reduced expenditure on commissioned areas. The Leadership role for this team has been central to its success. It is proposed that this leadership role is made substantive to support this essential activity on an ongoing basis. Budget will be realigned from identified budget lines in order to fund the post above. Table3 Children and Families Post Current No of posts Proposed No of posts Grade SCP range Hourly rate Annual salary Gross cost Total cost Operations Manager 0 20 G4 L2- L5 82 - 88 £25.37 - £27.76 £46,298 - £50,659 £60,330 - £66,013 £1,206,600 - £1,320,260 Team Leaders 22.5 0 G3 L8 79 - 80 £24.28 - £24.64 £44,309 - £44,966 £57,738 - £58,590 (£1,299,105 - £1,303,628) 62
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8.4. The changes to the delivery model identified above come out as cost neutral in relation to the changes from Team Leaders to Operation Manager posts. In order to create additional Senior Practitioner posts for locality based staff that undertake public protection/child protection duties, this will result in a reduction of 3.5 FTE substantive posts from the current Children and Families establishment. This should however support a higher skilled and experienced workforce and address retention issues to support full recruitment and retention. Table 4 Justice Services Post Current No of posts Proposed No of posts Grade SCP range Hourly rate Annual salary Gross cost Total cost Fieldwork Manager 0 2 G5 L1 96 - 97 £31.25 - £31.73 £57,028 - £57,904 £74,312 - £75,449 £148,624 - £150,898 Operations Manager 4 7 G4 L2- L5 82 - 88 £25.37 - £27.76 £46,298 - £50,659 £60,330 - £66,013 £180,990 - £198,039 Team Leader 4 0 G3 L8 79 - 80 £24.28 - £24.64 £44,309 - £44,966 £57,738 - £58,590 (£230,952) - (£234,360) 8.5. The changes in the above model of delivery will be delivered within the current Section 27 allocation to justice services to deliver statutory Justice services. these proposals are within the current budget allocation for staffing to deliver services. 8.6. Normal recruitment processes will be followed to provide access to these opportunities for all staff in a fair and reasonable way. 9. Financial Implications 9.1. The changes proposed in this report for HSCP staff will be delivered within the existing budget provision. This includes a sum of £365,689 of the HSCP’s funds previously set aside for this purpose at the Social Work Committee of 7 September 2022 from new ring fenced funding for improving capacity for Adult Social Workers. The Service Manager post for Commissioning and Quality Assurance is self-funding from continued reduced expenditure on commissioned areas with budget being realigned as required. 9.2. The redesign within Children and Families will be within existing staff budget allocation. Whilst this will result in an overall reduction in front line staff (3.5 FTE QSW posts removed from establishment) with increased Senior Practitioner posts, it will promote better retention and recruitment of more experienced staff and build resilience in the system. There is no additional budget required to make the changes to establishment and roles. 9.3. The changes to the Justice Services are within existing budget allocation for Justice services and can be met within existing Section 27 Grant from Scottish Government for Justice services. 63
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10. Climate Change, Sustainability and Environmental Implications 10.1. There are no implications in relation to climate change, sustainability and environmental implications contained within this report. 11. Other Implications 11.1. These proposals mitigate the existing risk that there is insufficient capacity in the registered workforce to meet statutory duties. By not addressing the current recruitment and retention challenges there is a risk that the council will not meet its statutory requirements for delivering public protection arrangements and wider social work services. 12. Equality Impact Assessment and Consultation Arrangements 12.1. Engagement and consultation has taken place across the service as identified in appendix 1. Also across management teams within Adult and Older People Services. This is not a change in policy so no Equality Impact Assessment is required. 12.2. The proposals set out in this report have been the subject of discussion with the trade unions. Professor Soumen Sengupta Director, Health, and Social Care Paul Manning Executive Director (Finance and Corporate Resources) 30 March 2023 Link(s) to Council Values/Priorities/Outcomes caring, connected, sustainable communities our children and young people thrive people live the healthiest lives possible Previous References Enhancing Social Work Fieldwork Capacity, Social Work Resources Committee, September 2022 Social Work Resources Workforce Plan, Social Work Committee, September 2022 List of Background Papers Appendix 1 Sustainability and Value Option Appraisal Screening Scale Appendix 2 Children and Justice Engagement Events Appendix 3 Structure Chart Illustration. Current and Proposed Structure Contact for Further Information If you would like to inspect the background papers or want further information, please contact: - Ian Beattie, Head of Health and Social Care Ext: 453701 Email: ian.beattie@southlanarkshire.gov.uk Liam Purdie Head of Children and Justice Services & CSWO Ext: 454887 Email: liam.purdie@southlanarkshire.gov.uk 64
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Appendix 1 Proposed Value & Sustainability Option Appraisal Screening Scale 65
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Appendix 2 Children and Justice Services Staff Consultation Events May 2023 Elizabeth Pollock May 2023 Final Version 9 67
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CONTENTS 1. Background 2. Attendance 3. Consultation and Engagement 4. Summary 5. Appendix 1 – Opinion meter Results 6. Appendix 2 – Consultation comments 68
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1. BACKGROUND Over the past few years there have been changes in legislation, policy and guidance on a national level that has impacted on how we deliver services and prioritise work within Children and Families and Justice Social Work Services. These include The Children and Young People (Scotland) Act 2014, the Staying Put agenda and Continuing Care, Self- Directed Support, delivery of The Promise and the challenges around children and young people’s mental health. In Justice Services there have been changes to MAPPA guidance and increased focus on risk assessments, Adult Support and Protection, Community Justice developments, presumption against short term sentencing, inclusion as prevention and a review of diversion from prosecution. In addition, there is the new national strategy and associated documents such as the performance framework and delivery plan. The above have brought increased challenges to how we deliver services within the same financial envelope and staffing resource. The SMT agreed that it is timely to look at how we currently deliver services as this has not changed in a number of years and is on a very traditional basis. Staff views were sought on current structures and operating models and whether they support the Resource and staff to deliver services to as high a standard as possible. To take this work forward engagement sessions were organised with staff to seek their views about what is working well and whether there are areas that require to change or develop to meet the changing demands on the service and the profession. Four Children and Justice Services Staff Consultation Events were arranged and took place on 1, 6, 9 and 10 March 2023. Each event was opened and chaired by Liam Purdie, Chief Social Work Officer and Head of Children and Justice Services with tables facilitated by staff independent of Children and Justice Services. The purpose of these events was to allow staff the opportunity to provide their opinions and views on the current service provision and on what a future service reorganisation could look like. 2. ATTENDANCE Over the four dates, 332 staff were invited. The attendance rate was 65%. Staff invited to these events included locality staff, Family Connections, Intensive Family Support Service (IFSS), Throughcare and Aftercare Team, Early Help Hubs, Unpaid Work, Court team and representatives from Administration Services. Job roles included Social Work Assistants, Family Support Workers, Social Workers, Team Leaders, Fieldwork Managers, Service Managers, etc. 69
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3. CONSULTATION AND ENGAGEMENT At the beginning of each event a live opinion meter survey was completed with 7 questions asked. A summary of the results is: ➢ 66% of respondents did not think current services were fit for purpose. ➢ 65% of respondents did not think current structures supported relationship-based interventions. ➢ 53% of respondents did not agree that current structures supported reflective practice and opportunities for reflective supervision. ➢ 48% of respondents did not believe there was a clear pathway for them within the current structure. ➢ 38% of respondents stated relationship-based practice is most important in being able to deliver high quality services. ➢ 93% of respondents agreed to commit to change or redesign of how service are delivered The full results of these surveys are detailed in Appendix 1. Group discussions were held where 4 questions were asked: – 1. In terms of the current operating model in the service what currently works well? We are looking for feedback in relation to team structures, roles and remits, responding to demand etc. 2. What are the barriers to delivering services? Are there things in our gift to change? Can we still meet our statutory requirements? 3. Try and identify 3 areas of work or 3 areas of changes that would improve services and how would the support staff and service users. 4. What are the priorities you think the service should look at over the next year? All attendees were asked to provide opinions on each of these questions resulting in 566 recorded comments. The comments were organised into categories relevant to their meaning with main topics of discussion being identified. The graphic below shows that workforce emerged in the discussion across all four questions as an area which works well, albeit with barriers, but which can be changed and should be made a priority. Other areas to emerge included: workload; operational (in relation to matters which pertain to the day-to- day operation of the service); specialist teams; processes and procedures; administration; and accommodation. Although these were the most discussed points it should be noted that this list is not exhaustive. A more comprehensive list of comments made are included in appendix 2. 70
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Summary of questions and responses Question 1. In terms of the current operating model in the service what currently works well. We are looking for feedback in relation to team structures, roles and remits, responding to demand etc. 71
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Within this section, 3 particular areas were noted as most discussed from a total of 149 comments received. These are: workforce (49, 33%); Specialist Teams (30, 20%); and Processes and Procedures (20, 13%). It was noted that there is a sense of teamwork with workers working well together, sharing knowledge between new and experienced staff. Supervision and management support is good although not all experiences are the same. It was acknowledged that the specialist teams such as Throughcare and After Care (TCAC), Whole System Approach (WSA), Young People’s Support Service (YPSS), Early Help Hubs and self-directed support work well to support local office teams by moving some of the less complex cases on. These teams have enabled staff to develop their skills and to provide support to the service user. Early Help Hubs are able to forge relationship-based practice, are locality based, accessible and have smaller caseloads. However, it was noted that when these specialist teams are at capacity referrals are returned to local offices to progress. Processes and procedures have been changed to ensure workload is shared more evenly across the staff group in order that the same person is not always responsible for a certain area of work. Within Justice, a new focus group is being piloted around Trauma Informed Practice to recognise trauma for both service users and staff. Good supervision has been noted as being crucial for workers and although this can be seen as positive in some areas, in others it is not consistent. Within localities there is a strong sense of commitment, motivation and desire to work with children and families to bring about change. Question 2. What are the barriers to delivering services. Are there things in our gift to change? Can we still meet our statutory requirements? 72
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There are many barriers noted with 217 comments given. The main areas identified were: operational (54, 25%); workload (47, 22%); workforce (29, 13%); and accommodation (25, 12%). Barriers to working operationally were duty systems, waiting lists to access services, processes needing reviewed and a 9 – 5 working day. While specialist teams are seen as positive, they are also seen as a barrier. Lower-level cases are removed from the local office which leaves more intense and complex pieces of work, with higher risk cases being picked up by newly qualified or inexperienced staff. Therefore, workload can be intense with large complex caseloads in local teams. High staff turnover has left staff feeling overwhelmed and undervalued with no opportunities for secondments to learn new skills. Lack of access to buildings, safe spaces and bookable rooms has created a barrier for service users to get the assistance. In some cases, where access is denied to a building, service users are being asked to call a telephone number to access assistance. Question 3. Try and identify 3 areas of work or 3 areas of changes that would improve services and how would they support staff and service users. Within ‘changes that would improve services’ 113 comments were noted. The most discussed were operational (34, 30%), workforce (24, 21%), and workload (9, 8%). 73
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It was suggested that the workforce be reviewed to ensure that a mixture of experience and different skill sets are within teams. Cases should be allocated to workers dependent on their experience and skill with caseloads reduced to match the complexity of cases allocated. It should be noted that cases can also be picked up from being on duty, these should also be factored into a workers’ caseload. Operationally, it was suggested that specialist teams be expanded to include other areas for example: permanence/kinship; Children with disabilities etc. and be replicated across localities. These teams could help with prioritising the workload which in turn could aid staff retention. Groupwork would be helpful in peer learning and sharing good practice across all localities. It was also suggested that the 9 – 5 working days be reviewed to allow flexibility when working with families. Workloads which are too high or contain too many complex cases make it difficult to prioritise caseloads or allow time to build relationships with families. Question 4. What are the priorities you think the service should look at over the next year. Within ‘priorities over the next year’ 87 comments were noted. The most areas discussed were Operational (27, 31%), Workforce (24, 28%), Specialist Teams (8, 9%) and Workload (7, 8%) 74
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Specific areas emerged in the discussion: ➢ Reduce bureaucracy by simplifying forms thereby reducing time in completing paperwork. Administrative tasks are becoming onerous and time consuming taking away time which could be spent with service users. ➢ Restructure the teams to ensure mixture of staff with different skillsets, to allow workers to specialise in areas to support the service user ie children with disability and kinship and to allow staff to build relationships with service users. Ensure staff health and wellbeing is considered and that they are valued. ➢ Expanding the programme of specialised teams to consider: Child Protection; Children with disabilities; Early Intervention etc. ➢ SUMMARY From the consultation events, the most important asset within Children and Justice Services is its workforce. Overwhelmingly there was agreement that change is needed, and participants were enthusiastic and committed to transforming services. Suggestions emerging from the discussions on how to improve service delivery and strengthen the workforce capacity are as follows: ➢ Teams are supporting each other by offering support and advice on both work and personal matters. This could be complemented with further training, for example, Managing Trauma, with all training being conducted in person and online. ➢ Supervision should continue, time should be protected for staff to speak to managers and team meetings should take place to ensure communication between managers and staff is maintained. ➢ Restructuring teams to look at skillset and experience, playing to people’s strengths while considering caseload sizes and the complexity of cases being allocated. Ensuring staff feel valued is challenging but should be a priority. Specialist Hubs are viewed as an asset but can also be perceived in a negative way. Suggestions on improvements are noted below: ➢ Early Help Hubs work well in taking away lower level/tariff areas of work but once the team reaches capacity the allocation is referred back to local office to be picked up therefore adding to the locality pressure. The referral flow requires to be reviewed. Consideration should be given to expand this model for other service and locality areas. The following are examples of areas discussed however are not a complete list: • Children with disabilities; • Child Protection; • Early Intervention; • SDS; • Specialist Women’s hubs etc. ➢ New hubs would allow staff to specialise and would offer a clear pathway for allocations. It was suggested that staff rotate in and out of these teams to expand experience and knowledge which could be shared. 75
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➢ The inclusion of administrative staff within these teams would be beneficial to both staff and teams. ➢ Potential workload and number of staff required would need to be considered when comparing the complexities of potential service users within these teams. Time to build relationships with the service users, family members and carers should also be considered. ➢ It was noted that locality staff and roles should be respected as there is the potential to exclude and alienate this staff group if the model of individual hubs was to be expanded. ➢ Consideration needs to be what hubs and where would these be located, would there be hubs in all localities? The rurality of Clydesdale could be problematic if this model was to be expanded. Operationally, consideration should be given to accommodation, how staff can meet with service users, and on the level of paperwork which is required. ➢ Safe spaces for service users and staff to meet. ➢ Paperwork should be reviewed to simplify forms etc. to reduce duplication of effort. ➢ Administration support is not always available therefore workers are spending more time doing administrative tasks. Dedicated administration staff could support the process. An opinion meter was used at the beginning of the consultation event to garner opinions and support discussions. This was a useful tool which allowed immediate responses to be viewed and noted. However future events should consider other more up-to-date interactive tools such as software like Jamboard, a collaborative digital whiteboard, would be useful in allowing staff to add comments and ideas to. This type of software would add an element of fun and anonymity while still managing to achieve the desired outcomes. All options on any available software which would aid consultations should be explored. To ensure continued feedback and staff engagement a follow up survey should be considered. 76
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Appendix 1 – Live opinion meter results 33% 17% 14% 20% 17% Locality Area Team C&F Children’s and Families … Locality Area Team… Justice Service… Other What service do you work in? 0% 50% 100% Yes No Don’t know 12% 66% 21% Do you think the current operating structures in social work services are currently fit for purpose? 0% 50% 100% Yes No Don’t know 23% 65% 11% Do the current structures support you in delivering relationship- based interventions and practice? 0% 100% Yes No Don’t know 37% 53% 10% Does the current structures support reflective practice and opportunities for reflective supervision? 0% 20% 40% 60% Yes No Don’t know 33% 48% 19% Is there a clear pathway for you in the current structure? 0% 10% 20% 30% 40% 7% 11% 38% 23% 20% 1% What is most important to you in being able to deliver high quality services? 0% 50% 100% Yes No Don’t know 93% 3% 4% If change is needed, are you up for committing to change and redesign of how we deliver social work? 77
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Appendix 2 – Consultation comments Below is an example of staff comments made during the consultation events. 1. In terms of the current operating model in the service what currently works well? We are looking for feedback in relation to team structures, roles and remits, responding to demand etc. v ‘Workers supportive of each other with a mix of experience and new’ v ‘Learning from other teams and disciplines’ v ‘Team structures within localities: colleagues at the same level share decision-making and provide support (although availability to do this is affected by staff numbers).’ v ‘Being part of a team – sense that people work well together – open to support each other and sharing practice experience – nobody is precious.’ v ‘Pre covid people looked for permission but COVID was liberating, allowed initiative’ v ‘works well and helps to reduce the workload in local office’ v ‘Specialist Teams have enabled staff to develop skills’ v ‘The impact of the hubs on Duty provisions viewed as positive’ v ‘The introduction of the specialised TCAC team has been really positive, for both LO and Residential staff, the support provided to older young people is really valuable’ v ‘More focused teams – gives more opportunities for people to be referred to, less of a sense that you have to do everything’ v ‘Sharing workload and preventing same workers always have to complete reports ie CP Referral’ v ‘Advocacy referrals are being submitted at an earlier stage before it reaches critical stage. There has been an expansion of services - Justice and a move to earlier intervention in general.’ v ‘Hamilton Justice Team have piloted a focus group around Trauma Informed Practice – this has been a positive way to recognise trauma for both service users and staff.‘ v ‘Procedures/processes keep people on track; although they can feel restrictive and onerous, they are a safety net and work well to ensure work is completed properly.’ v ‘Good Supervision is essential and needs to be constructive/consistent- workers felt however that on occasion this is not the case as supervision is cancelled/rescheduled with no clear directive as to next appointment’ v ‘Remote projects within unpaid work – this has helped people with health issues to complete the order’ W orkforce Specialist Teams / Hubs Processes and Procedures 78
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2. What are the barriers to delivering services? Are there things in our gift to change? Can we still meet our statutory requirements? v ‘Making basic appointments to meet service users’ v ‘Staff stagnate in same job for years/change better than a rest and all that!!’ v ‘No male service similar to Women’s Hubs’ v ‘Council priority to improve the lives and prospects for all in South Lanarkshire, SW deal with the most vulnerable, yet we make it more difficult for them to communicate/contact/met/visit us’ v ‘Duty systems don’t always work’ v ‘Waiting lists and availability – capacity for other services – throughcare, young persons service – not able to take cases from locality’v ‘IRD process needs overhaul’ v ‘Early intervention hub not particularly working as workers believe that they have too many cases and therefore the reflux of cases are then being returned to the local office placing them under greater pressure’ v ‘Disability not served well by social work across the life span.’ v ‘A social work service which is limited to 9 – 5 is a barrier.’ v ‘Increasing complexities of the work across all services’ v ‘Children and family local team should have an emphasis around preventative work. If the service user/family need the support from the outside hub – not everyone can access this service. This causes more pressure on workers in respect of higher tariff case work.’v ‘Due to the above, NQSW are carrying higher tariff cases – rather than being able to start with less complex cases where they can learn and develop skills then be more capable and confident to manage the more challenging and higher tariff work’ v ‘In respect of unpaid work – there is conflict in terms of long term objectives and there is too much energy spent on getting them to attend their work place. The attendance is taking priority over the quality of experience.’ v ‘No time to do development work (group work, or pilot a men’s HUB)’ v ‘Caseload excessive’ v ‘Caseload 40, with 18 statutory reports to produce (35 hour working week)’ v ‘Volume of work – can specialist teams manage the demand, also how do localities manage the workloads when cases can’t be moved/absorbed to other teams.’ v ‘Expectations on staff – workers generally feel that they are being pulled in too many different directions due to demand of workloads and unrealistic expectations’ v ‘Some work during the pandemic was great – more flexible and responding to people’s needs, more therapeutic, have gone backwards from this’ v ‘Staff turnover has been huge’ v ‘Making people feel valued can be a challenge!‘ v ‘“Revolving door syndrome” – where we are losing skilled and experienced practitioners. We need to look at ways to retain skilled staff and invest in them.’ v ‘Embed senior practitioners but agree salary that does not impact on the role of the current team leaders’ v ‘Imbalance between experienced and inexperienced staff.’ v ‘Staff are feeling overwhelmed, supervision not regular, no incentives to stay and pay rates higher elsewhere’ v ‘Working in silos – we need more joined up work across C&F, Justice and A/OP – better sense of equal accountability’ v ‘In the localities there is a mis match between the complexity of the work that comes in and the collective experience of the staff group.’v ‘No opportunity for secondment to other parts of the service to gain more experience and /or ‘recharge batteries’’ v ‘Need to be able to retain experienced staff in area teams for longevity and continuity and have peer support for new workers caseload’v ‘Rooms and safe space to meet service users (Battle of the rooms)’ v ‘Lack of access to buildings – service users can’t build relationships/worker safety – escalates crisis; v ‘Barriers for the public to access local offices. All offices are closed and those in help are sent away and told to call to request assistance. This is a barrier which is detrimental to service users in need of assistance.’ v ‘Consider shared working arrangements across other council services to allow use of building facilities to update case records rather than travelling back to local office ie. Clydesdale locality’ v ‘Booking Rooms can create barriers for the service users as they are faced with security guards which are not always the most empathic to individual need ‘ Operational W orkload W orkforce Accommodation 79
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3. Try and identify 3 areas of work or 3 areas of changes that would improve services and how would the support staff and service users. v ‘Mixture of workers - experience and new with different skill set’ v ‘Redesign of local offices with consideration of roles and responsibilities. C&F local office could benefit from clearer boundaries/roles on what is their work/role/ Roles changing over time e.g. family support what is role of family support worker – taking on different tasks in the local offices.’ v ‘Develop trauma informed services which encompass support to staff as well as service users to improve retention.’ v ‘Specialist teams from permanence/kinship. Help to break the cycle of kinship placements breaking down – teenage years/financial implications – external placements – improve outcomes for children’ v ‘Make better use of the skills of staff within specialist roles within the organisation - suggest an electronic mentoring support space where they respond to questions/offer support to colleagues in the local office when dealing with more complex, specialist situations’ v Localities – clarify role & remit. Still a ‘jack of all trades’ approach. Can some time-consuming tasks – e.g. contact – be done elsewhere. Needs to be more streamlined – e.g. localities work with more complex cases. v ‘Lack of resilience built up due to people moving around, losing staff to specialist services’ v ‘Develop a specialist team for children with disabilities – lack of knowledge about the assessment process for children and families staff and assessments are often delayed due to inexperience – this would result in a review of case load would enable staff to carry out greater relationship based practice’ v ‘Sharing good work between localities. Replicate what works in one locality across other areas ie Family Support Hubs. Improve connections between localities’ v ‘Replicate dedicated teams within localities’ v ‘Develop specialist areas of work within local offices to help prioritise work and improve staff retention’ v ‘Groupwork required across board to promote peer learning and reduce time for SW involvement (more service users undertaking intervention at the same time)’ v ‘More flexibility when we work with families - review 9 –5 working patterns’ v ‘Need to be more creative around SDS as a lower tariff intervention for women’ v ‘Identifying priorities and who would take them forward. Work to people’s strengths’ v ‘Demand from duty – increase in tariff of referrals – the rollover of duty work onto caseload/general working week’ v ‘Local office caseloads reduced to reflect the increasing complexity of cases’ v ‘Smaller caseloads. To enable relationships to be built with young person’ W orkforce Operational W orkload 80
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4. What are the priorities you think the service should look at over the next year? v ‘Review of KPIs - what are the priorities?’ v ‘Creating time and space for SW to build relationships with service users’ v ‘Focus on children with disability and kinship’ v ‘Restructure the locality based on community need’ v ‘Produce clear criteria for referral pathways, to ensure service-users are referred appropriately.’ v ‘Plan changes systematically to enable time to review the impact on other parts of the system’ v ‘Create space & time to build relationships with service users – reduce caseloads’ v ‘Localities have a sense of being ‘set adrift’ – need to work on this.’ v ‘Focused interventions need to be rolled out within services, need to prioritise around eg life story work, resulting in worse outcomes for CYP and escalation’ v ‘Re-evaluating roles – there has been changes in services over time – expansion or contraction in service areas but structures have not been looked at/changed (Justice)’ v ‘Protecting social work staff and role and ensuring that people are provided with the support they need to do their job (staff wellbeing!!!)’ v ‘Retention of staff - trying to reduce sickness, staff leaving, to support staff throughout the services. Recruit more efficiently – reduce the time it takes to have new people in post.’ v ‘Ensure all staff are trauma informed’ v ‘Develop peer mentor across all areas of service to enable relationship practice and improve outcomes for service users’ v ‘Staff wellbeing and being able to be together as a team consistently for training, group supervision and team building’ v ‘A lot of localities work is formal child protection – should we have Child Protection Teams?’ v ‘Work on hubs and all additional services – how are these services supported to operate within their remits whilst also supporting locality staff without backlog/bottleneck occurring’ v ‘Consider the role of specialist teams and areas of work that would better fit this model e.g. children with disabilities’ v ‘Early Intervention – supporting children at an earlier stage’ v ‘A lot of localities work is formal child protection – should we have Child Protection Teams?’ Operational W orkforce Specialist Teams / Hubs 81
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Current Structure Proposed Structure • Span of control for Operations Managers will be 7-10 staff. • A third of all front-line Social Work posts to be offered as Senior Practitioners for internal and external recruitment (Approximately 60 - 65) • Blue – existing posts • Green – new posts Adult and Older Peoples / Children & Justice Locality Manager / Service Manager Grade 5 L1-8 Fieldwork Manager Grade 5 L1 Operations Manager Grade 4 L2-5 Senior Practitioner Grade 3 L4-8 Qualified Social Worker/OT Grade 3 L2-4 Qualified Social Worker/OT Grade 3 L2-4 Adult and Older Peoples / Children & Justice Locality Manager / Service Manager Grade 5 L1-8 Fieldwork Manager Grade 5 L1 Team Leader Grade 3 L4-8 Senior Practitioner G3 L4-8 Appendix 3 9 83
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Director, Health and Social Care Executive Director (Finance and Corporate Resources) Subject: Reducing Drug Deaths: The South Lanarkshire Alcohol and Drug Problem Solving Court 1. Purpose of Report 1.1. The purpose of the report is to:- [purpose] update the Committee on an innovative two year test of change Problem Solving Court Service note the findings of the independent evaluation of the Justice Support Worker pilot and how it has informed that of the Problem Solving Court service presented here and seek approval for the posts as detailed in Section 7 to be added to the establishment on a temporary two-year basis [1purpose] 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s):- [recs] (1) that the contents of the report are noted; (2) note the findings of the independent evaluation of the Justice Support Worker pilot and how it has informed that of the Problem Solving Court service presented here; and (3) that the posts are added to the establishment on a two-year basis as detailed in Section 7. [1recs] 3. Background 3.1. Justice Social Work Services (JSW) in partnership with Hamilton Sheriff Court have developed a two-year test of change Alcohol and Problem-Solving Court (SLADPSC). 3.2. A funding application was made in November 2022 to the CORRA Foundation who administer funding to support the National Drugs Mission on behalf of The Scottish Government. We received confirmation in May 2023 that our application for funding for two years was successful. Section 7 details the funding and staff costings. 3.3. The premise of the project is to adopt a public health approach to support those in conflict with the law whose offending is related to their substance use, with the long- term aim of permanently exiting the justice system. 10 85
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3.4. A Structured Deferred Sentence model would operate whereby there is a period of deferment for sentencing with the premise that if the person engages with services and supports with no further offending, they will be admonished for the offence. This limits further stigmatisation and employability challenges further on in the person’s life. 3.5. The wider aims of this project are to reduce drug use levels that are harmful to those within the justice system and prevent drug related deaths. Through taking a public health approach to this dedicated court vulnerable people will be supported with housing, financial welfare, employability, and mental health. 3.6. This concept is aligned with South Lanarkshire’s Alcohol and Drug Partnership (ADP) Public Health Approach to Justice delivery plan (priority area 4), whereby the overarching principles of early intervention and prevention with a public health approach underpin this proposal. 3.7. Through this initiative the aim is to primarily reduce drug use levels that are harmful to those in conflict with the law and to divert people from the justice system where possible whilst supporting those who are in it. The Changing Lives (2022) Scottish Drug Death Task Force publication recommends increased alternatives to custody for those who use drugs and a more joined up approach from the start of a person journey through the criminal justice system improving targeted pathways for care. 3.8. The national Medication Assisted Treatment (MAT) standards have been produced in response to the emergent public health crisis by the Drug Death Task Force on behalf of Scottish Government. The MAT Standards aim to ensure everyone who needs it is offered, and supported, to access a consistent and evidence-based service that delivers safe, high-quality care and treatment. The development of our SLADPSC as described here will contribute to the delivery of MAT Standard 3 (Assertive Outreach and Anticipatory Care) namely that all people at high risk of drug-related harm are proactively identified and offered support to commence or continue MAT. 3.9. SLADPSC provides an innovative approach to early intervention which has the potential to prevent people’s trajectory Community Payback Orders (CPO’s). 3.10. Embedding Peer mentors within this initiative endorses an assertive outreach approach with lived experience providing practical and persistent support to wider recovery services. 3.11. Justice Social work Services has previously received funding for establishing peer mentors from CORRA in 2021. When this funding expired the Social Work Resource Committee approved its permanency within the Justice Social Work establishment in February 2023 committee. 3.12. The implementation of peer mentors to the Problem Solving Court is informed through the recent evaluation from Iconic Consultancy (Appendix 1). 4. Evidence of Need 4.1. SLADP drug death analysis data has informed the need for this dedicated court approach. 86
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4.2. The SLADPSC criteria has been informed through the drug death statistics for South Lanarkshire in 2021/2022. 4.3. This mirrored the national statistics of 66% of male deaths between 35 and 54 years old. 4.4. Key facts of drug related deaths in South Lanarkshire: 93 people died of drug use in 2021, with 76% relating to polydrug use; and with 73% of these not in treatment or receiving support 72% of those who died were male 73% were aged 35 and above 68% were unemployed at the time of death 84% of whom were on opiate substitute treatment 45% had experienced a previous near-fatal overdose 29% of those who died had a physical health issue implicated in their cause of death 4.5. In addition South Lanarkshire Social Work Information System (SWiS) identified 90% of 21 to 25 year olds subject to statutory CPO’s have been assessed with alcohol and/or drugs being a significant factor in their offending. 4.6. There were 224 CPO cases (out of a total of 573) that had Community Addiction Recovery Services (CAReS) involvement from 31st March 2021 - 1st April 2022. This indicates the ongoing need for a structured and supportive level of supervision with medically assisted intervention. We understand that 165 of these were breached and returned to court. The structure of statutory orders as dictated in the JSW National Standards and Outcomes Guidance in relation to compulsory supervision attendance, warning and breach procedures makes compliance extremely difficult for those with entrenched substance use. 5. Operation of SLADPSC 5.1. It is envisaged this court will operate fortnightly with dedicated Sheriffs who will consider those that meet all of the following criteria: between 21-55 years old have previously been subject to a CPO/custody/diversion from prosecution or at risk of custody have a drug use dependency or regular use that contributes to offending (this can include alcohol but not solely) motivated to engage with a structured deferred sentence for between 6-9 months and undertake an appropriate treatment plan (may or may not be medically assisted). 5.2 Sheriffs will be able to request a JSW Report which will identify an appropriate treatment and support plan. Once accepted into the SLADPSC, participants will receive support from their Justice Social Worker and CAReS (Community Addictions and Recovery Service statutory substance use treatment services for South Lanarkshire) nursing staff commensurate with their needs. 5.3. JSW will provide a welfare approach which will include housing, health and offending behaviour supports. CAReS nursing staff would participate in the delivery of on- going assessments, care planning, treatment and support of people with alcohol and drug issues to promote health, independence and recovery. 87
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5.4. Integration into recovery communities will be facilitated by commissioned peer mentors who will also work in collaboration with the recovery oriented services with lived experience specifically Beacons, Liber8, Turning Point (TPS), The GIVIT and My Support Day. Participants will be asked to engage with counselling, treatment, regular supervision and attend monthly review hearings before the Sheriff. 5.5. The JSW, in consultation with CAReS nurses, will prepare monthly reports for participants on the programme which ensures that the Sheriff is informed about each person’s progress, as well as any setbacks or compliance concerns. 5.6. It is intended that on successful completion of the Structured Deferred Sentence the person will be admonished and receive a graduation certificate. In the event there is future offending or significant disengagement from the Structured Deferred Sentence, JSW will assess suitability for a CPO. 5.7. A key feature is the inclusion of the family members in the programme. As well as the reports provided by the JSW and addiction worker, the Sheriff would have the option of asking family members for updates on how an individual has been progressing between review hearings. This offers motivation for participants and supports family members inclusion in the recovery journey. 5.8. Through the inclusion of service user’s and families perspective we have an opportunity to change the mind-set of broader workforce/communities and making informed changes to how we support those in conflict with the law. 6. Smart Objectives 6.1. The project outcomes align to the national Logic Model for reducing drug deaths and harms. We have identified the following objectives over the 2-year period; 85% of those who use substances to be provided pathways into wider employment, health and welfare opportunities 70% of those on Structured Deferred Sentence disposal sustaining and completing their period of support 90% provided with medically assisted treatment and/or recovery plans in conjunction with access to community oriented recovery networks 85% of families with lived experience to be provided with advice and support in the recovery journey 6.2. Our high level objectives are: to reduce drug and alcohol related deaths South Lanarkshire reduce the volume of CPO breaches and non-completion preventing those in conflict with the law proceeding further into the justice system reduce remand and short term custodial sentences provide long term Structured Deferred Sentence options for those with problematic drug and alcohol use 88
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7. Employee Implications 7.1. To support this initiative, the following temporary posts should be added to the Social Work Resources establishment for a two-year basis. These posts will be recruited to permanent contracts and the staff will redeployed in the service at the end of the pilot if a permanent funding solution is not realised. 8. Financial Implications 8.1. The total cost of the proposal is £0.302m per annum which includes the costs of the posts at 7.1 of £0.136m and services commissioned from the 3rd sector and NHS Lanarkshire costing £0.166m. 8.2 Funding bids have been submitted to CORRA Improvement fund and South Lanarkshire ADP. The ADP have confirmed funding of £0.134m over the 2 years; and CORRA have confirmed their funding of £0.2m. 8.3 The balance of funding will be made available non-recurrently from within the existing Section 27 Justice budget as outlined in the table below: Year 1 Year 2 Expenditure £0.302m £0.302m Funding ADP £0.089m £0.045m CORRA £0.100m £0.100m SLC S27 £0.113m £0.157m Total Funding £0.302m £0.302m 9. Climate Change, Sustainability and Environmental Implications 9.1. There are no Climate Change, Sustainability or environmental implications associated with this report. 10. Other Implications 10.1. The proposals outlined in this report help to mitigate key Social Work risks with regards to fulfilling statutory and core duties and workforce availability. 10.2. There are no other issues associated with this report. Post Proposed number posts Grade SCP Range Hourly Rate Annual Salary Gross cost inc. on costs 30.3% Total Cost Social Worker 2 G3 L4 72 -74 £22.07 - £22.53 £40,275 - £41,115 £52,479 - £53,572 £104,958 - £107,144 Justice Social Work Team Leader 0.5 G3 L8 79 – 80 £24.28 - £24.64 £44,309 - £44,966 £57,734 - £58,590 £28,867 - £29,295 2.5 £133,825 - £136,439 89
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11. Equality Impact Assessment and Consultation Arrangements 11.1. This report does not introduce a new policy, function, or strategy, or recommend a change to existing policy, function, or strategy and, therefore, no impact assessment is required. Professor Soumen Sengupta Director, Health and Social Care Paul Manning Executive Director (Finance and Corporate Resources) 17 April 2023 Link(s) to Council Values/Priorities/Outcomes focused on people and their needs Previous References None List of Background Papers Changing Lives Drug Death Task Force publication 2022 Final Report https://drugdeathstaskforce.scot/news-information/publications/reports/final-report/ Contact for Further Information If you would like to inspect the background papers or want further information, please contact: - Gillian Booth, Service Manager (Children and Justice Services) Ext: 3913 (Phone: 01698 453913) Email: gillian.booth@southlanarkshire.gov.uk 90
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Justice Support Worker Evaluation Final Report March 2023 South Lanarkshire Council 10 91
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16 Orchardfield Avenue, Edinburgh, EH12 7SX 0131 627 0070 www.iconic-consulting.co.uk ian@iconic-consulting.co.uk Company registration number: SC415033 VAT number: 159 8925 47 Contents 1 Introduction ................................................................................................................... 1 2 Implementation ............................................................................................................. 2 3 Impact ............................................................................................................................ 7 4 Conclusions .................................................................................................................. 18 Appendix – Evaluation Grid ................................................................................................. 20 92
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1 1 Introduction This concise report presents the findings of a formative evaluation of the Justice Support Workers pilot in South Lanarkshire during the period August 2021 to March 2023. South Lanarkshire Justice Social Work Services and South Lanarkshire Alcohol and Drug Partnership secured Scottish Government Drugs Death Task Force grant funding of £91,500 to employ two Justice Support Workers for an 18 month pilot. The Justice Support Worker application form summarised the aims of the pilot as follows: The project will test the feasibility of a peer delivered intervention for people with problematic substance use who are transitioning from the justice system. Peer navigators (Justice Support Workers) will enhance and support relationships with people nearing the end of their involvement with statutory justice social work services such as diversion from prosecution or Community Payback Orders. Navigators who have lived experience will be skilled at developing trusting relationships with those who can be difficult to engage. They will make connections, offer hope, and build self-esteem which could be protective against drug related death, reduce re-offending and other negative outcomes. Relationships formed will help to enhance support for people on their road to recovery and encourage them to stay connected to support and treatment services. Greater social integration will also contribute to a reduction in social isolation and promote desistance from offending. The vision of maintaining justice service users in treatment and enhancing their support network will be led by a dedicated management team. The team will oversee implementation of the project and ensure peer mentors receive the required support, supervision, and training. We believe this test of change will help to deepen an understanding of a recovery informed approach within justice social work services towards persons who have substance use issues. The project will also influence the culture and generate further improvements within justice and other areas of service delivery leading to lives being saved. Iconic Consulting was commissioned to evaluate the pilot in April 2022. The evaluation involved: • A document review including the funding application form, job description, Annual Report submitted in August 2022, and the Steering Group minutes and action log. • Analysis of service user and outcome data recorded by South Lanarkshire Council. • Observation of Steering Group meetings throughout 2022. • Interviews in May 2022 and January 2023 with the Justice Support Workers. • Interviews with seven staff from the Justice Social Work team in July / August 2022 and January / February 2023 involving managers, team leaders and social workers. The term ‘Social Work consultees’ is used in this report to protect confidentiality. • Consultation with seven service users (six male and one female) who had given their consent to be interviewed as part of the evaluation. All interviews were conducted remotely by telephone or video conferencing. This report is structured as follows: • Section 2 reviews implementation of the pilot. • Section 3 assesses the pilot’s impact. • Section 4 presents our overall conclusions. 93
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2 2 Implementation The Justice Support Worker pilot appears to have been well implemented at both the operational and strategic level. This section reviews implementation and focuses on staffing, engagement, service users, monitoring and evaluation, and governance. Staffing The purpose of the Justice Support Worker, as set out in the job description was: To improve outcomes for persons with substance use issues who are involved with Justice Services and build trusting relationships with service users whom they will work with through the transition from statutory to mainstream services in the community. Offer support and encouragement to individuals who are involved with Justice Services to promote their recovery and connect them with treatment and recovery services appropriate to their needs.in the community. The job description also set out the key tasks as: To work in partnership with local services and recovery communities to provide: • Peer-based recovery support, on an individual or group basis, to individuals recovering from substance use and involved with justice services. • Undertake practical support with service users to establish routines. • Provide peer-based recovery support in community and prison settings. • Connect service users to the local Beacons Recovery networks, support them to register with GPs and to access the medication required to meet their needs. The job description included a behaviour framework which outlined a range of attributes for the role. One of the requirements was for the workers to have experience of accessing drug and alcohol services and Justice services. This requirement directly addressed the aims of the pilot – the provision of peer-led support to people with substance misuse problems in the criminal justice system. Two full-time posts were created and filled in August and September 2021. Both Workers were female and had the required experience. The two Justice Support Workers were assigned to the four Social Work teams in South Lanarkshire with one dividing their time between the Social Work teams based in Hamilton and Lanark, and the other between the teams based in Cambuslang and East Kilbride. The Hamilton / Lanark based Worker left in September 2022. To fill the vacancy a one-year post was advertised in October 2022 but no suitable applications were received. Following confirmation of additional funding from South Lanarkshire Council, the vacancy was re-advertised and a new postholder is expected to start in March 2023. South Lanarkshire Council provided comprehensive support, supervision and training to the Justice Support Workers which greatly assisted the implementation of the service, in our view. As new recruits to the Council, with no previous experience of social work, adequate support was crucial. 94
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3 Each Worker was supervised by a Team Leader, and regular supervision and support sessions took place throughout the pilot. The supervision sessions covered workload, training needs and wellbeing. Additional support was provided where necessary. This was most clearly demonstrated when extra administrative support and a different working pattern was put in place for one of the Workers whose individual support needs added to the challenges posed by an already significant admin workload involved in the role. A Justice Social Work manager oversaw and took a close interest in implementation of the pilot. The Workers benefitted from internal training on the Social Work Information System (SWIS) and Outcome Stars as well external training such as Scottish Drugs Forum’s Naloxone, Alcohol Awareness, Benzodiazepine Awareness. Feedback from the Justice Support Workers and Social Work consultees on the support, supervision and training process was positive. Overall, we commend South Lanarkshire Council Justice Social Work for their awareness and actions in meeting the support, supervision and training needs of workers recruited with non- traditional social work backgrounds, skills and experiences. There was a clear understanding of the Justice Support Worker role among other members of the Social Work team and this helped implementation. Several consultees commented on the Justice Support Worker salary. The role is Grade 1 Level 4 and had, we understand, a starting salary of £21,000 when the pilot commenced. There were suggestions the salary did not reflect the role’s value and Workers were undertaking tasks outwith the remit of the job although consultees did not specify what these tasks were. There were also suggestions the salary was lower than comparable jobs in other organisations, although this was disputed by some consultees and others highlighted that a benchmarking exercise was undertaken at the outset with input from the Council’s Personnel Services and other stakeholders. We have not attempted to verify these claims by examining roles and salaries as that is outwith the evaluation remit. We have however, chosen to highlight the comments because they were made by several consultees who were concerned the salary could be a factor in staff retention and recruitment. Engagement Justice Social Work services implemented a thorough process to identify potential service users. During case review meetings, Team Leaders and Social Workers carefully considered the involvement of the Justice Support Workers. The main criteria was substance misuse however the decision making process was more nuanced taking into account factors such as the service user’s needs, motivation and goals, as well as the Justice Support Worker’s capacity. Social Work consultees reported that a proportion of people allocated to the Justice Support Workers did not engage. The Workers suggested the main reason for non-engagement was readiness i.e. service users were not at a stage where they were willing or able to seek support for their substance misuse. One of the Social Work consultees suggested there may be a gap in terms of how the service supports service users who are not ready to engage with the Justice Support Workers and this may be an issue the service considers further in the future. There was a suggestion motivational support may help. Recommendation 1: South Lanarkshire Council assesses the support options available to service users who are not ready to engage with the Justice Support Workers. 95
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4 Our review of the spreadsheet the Justice Support Workers maintained at the outset of the pilot highlighted the effort they made to engage service users in the first place and to maintain their engagement if and when it was established. This is demonstrated in the spreadsheets by the number of times the Justice Support Workers attempted to contact service users by text, telephone, and in- person. We commend the Justice Support Workers for their methodical approach to engagement as well as their perseverance and understanding of service users’ circumstances. Our review of the spreadsheet also illustrated the ongoing issues service users experienced which impacted on their engagement with the Justice Support Workers. This included problems with mobile phones (no credit, phone not working, phone been pawned, and changing numbers), substance misuse and relapse, family and relationships, housing, finances, poor health (mental and physical), breaching Orders, and being arrested. In terms of engagement, this resulted in service users not answering calls from the Justice Support Workers or meetings being missed. The Workers were diligent in trying to maintain contact with service users and would leave voicemails, send texts, phone again later, and visit services user, which added to their workload. The spreadsheets and our consultation demonstrated the deep level of engagement the Justice Support Workers had with service users. This was evident in the length of time the Workers supported service users, the regularity of contact and the range of ways they supported people. Monitoring and evaluation South Lanarkshire Council Justice Social Work developed an Evaluation Grid at the request of the Corra Foundation who managed the funding on behalf of the Scottish Government. The Grid is shown in the Appendix and has been referred to throughout this evaluation. We also developed the summary shown opposite to guide the evidence gathering and evaluation process. As a pilot project there was a justifiable need to gather comprehensive evidence on the implementation and impact of the service. This initially involved recording information on a bespoke spreadsheet, which supplemented client information recorded on the Council’s SWIS system. Maintaining the bespoke spreadsheet was found to be time-consuming which was adding to the workload and, at times, stress of the Workers. The spreadsheet was replaced by a second, shorter version that was designed to be easier to maintain; information was also still recorded in SWIS. Although the second spreadsheet was less time consuming to maintain, comprehensive records were not kept, as the workers still found it difficult to find the time to log details on the spreadsheet as well as SWIS. Record keeping was also affected by the departure of one of the Workers and sick leave. As a result, this evaluation has not had the benefit of comprehensive information on service users and has instead relied on fragmented and incomplete information from the two spreadsheets and SWIS. We fully understand the workload issues Workers faced and how this impacted on record Target group Engagement ➔ Impact ➔ Outcome Evidence Evidence Evidence Service users • Service user characteristics • Engagement with workers - frequency, issues addressed, support provided, non- engagement & reasons • Take home Naloxone training participation / kits provided & used • Engagement & completion of CPOs or DTTOs (compare if possible to previous) • Self-reported registration and engagement with GPs / health • Engagement with substance misuse services inc. Beacons, CAReS, recovery cafes, CA/NA/AA and sustaining that engagement • Self-reported alcohol and drug use • Self-reported health and wellbeing • Self-reported engagement with community, groups, activities, other services • Other self-reported outcomes • Progression to volunteering, training, learning, employment • Feedback on relationship with workers, benefits and impact • Feedback from workers on relationship with service users, benefits and impact REDUCE DRUGS DEATHS Workers / SLC / Steering Group • Staff retention • Staff training requested and completed • Supervision – regularity and follow-up actions • Steering Group meetings and attendance • Feedback from workers on benefits and challenges • Feedback from line managers and other SW staff on benefits and challenges inc. applying learning to their own role • Feedback from Steering Group members on benefits and lessons 96
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5 keeping. Now that the service has secured additional funding from South Lanarkshire Council, we recommend the Workers are no longer required to maintain the bespoke spreadsheet. Recommendation 2: The Justice Support Workers are no longer required to maintain the bespoke service user spreadsheet. Outcomes Stars were identified by South Lanarkshire Council at the outset as a means of evidencing impact. To track progress, the intention was that Workers would help service users complete the Justice Outcome Star at the beginning of their engagement and at regular intervals throughout. The Workers did use the Outcome Stars throughout the pilot period. They reported that completing the Stars provided an opportunity for service users to reflect on their situation, review progress and highlight issues - it appears to us to be a useful tool in the support provided to service users. As an evaluation tool, use of the Outcome Star has had its challenges but has nonetheless been useful. One of the Workers struggled to find the time to record the Outcome Star data online due to workload commitments although this challenge to the evaluation was overcome as admin support later uploaded the information. The main challenge from an evaluation perspective has been producing an accurate progress report. South Lanarkshire Council and ADP (who hold the Outcome Star licence and are responsible for extracting information) eventually provided information for 38 service users who had completed at least two Outcome Stars. Based on the challenge one of the Workers faced recording Outcome Star information online, and the challenge South Lanarkshire Council and ADP experienced producing a comprehensive report, we recommend Justice Social Work carefully consider the ongoing use of the Justice Outcome Star with Justice Support Worker clients. Recommendation 3: South Lanarkshire Council Justice Social Work carefully consider the ongoing use of the Justice Outcome Star taking into account the benefits as a tool to support engagement and reflection and evidence of progress and impact, against the time involved in gathering, recording and reporting on the information. Service users The Justice Support Workers were allocated 88 cases, involving 84 individuals, from August 2021 to March 2023. This exceeds the target of 50 to 60 service users during the funding period. Approximately three quarter of service users were male (73%) which broadly reflected the Justice Social Work caseload. Approximately a third of service users were recorded as homeless. Service users came from across South Lanarkshire as shown by the number of cases from the four Social Work offices: • East Kilbride – 33% • Cambuslang / Rutherglen – 18% • Hamilton – 34% • Clydesdale – 15% Information provided in August 2022, showed that 94% of service users identified as White Scottish and 77% were aged 25-49 years. 97
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6 Governance A Steering Group was established to oversee implementation, and review, the Justice Support Worker pilot. Terms of Reference were developed at the outset and the Group met regularly throughout the pilot period. In total eight online meetings took place in August, September and December 2021; March, April, June, August and October 2022. Managers and Team Leaders from the Council’s Justice Social Work justifiably made up the majority of Steering Group members. Other members of the Group were drawn from partner organisations such as South Lanarkshire Community Addiction Recovery Service (CAReS), South Lanarkshire Alcohol and Drug Partnership, and South Lanarkshire Council’s Employability Services. There tended to be around six attendees at each meeting. Minutes were not taken but an Action Log was updated after every meeting and it was used as a means of keeping track of progress. Some of the consultees for this evaluation had attended Steering Group meetings. They reported the Group was useful, particularly the meetings in the first six months when the service was being implemented. There was a view the Group had served its purpose and did not need to re-convene. We therefore recommend the Justice Support Worker Steering Group is not re-convened, unless circumstances change. Recommendation 4: The Justice Support Worker Steering Group is not re-convened, unless circumstances change. 98
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7 3 Impact Based on the evidence available for this evaluation, the Justice Support Worker pilot has impacted positively on service users and South Lanarkshire Council’s Justice Social Work. In this section we examine this dual impact and identify the key factors that contributed, in our view, to it. Impact on service users The service impacted positively on service users in the following ways: • Recovery from substance misuse • Improved health and wellbeing • Improved finances • Improved family relationship • Improved engagement with Justice Social Work Recovery from substance misuse Significantly, the Justice Support Workers have had a positive impact on substance misuse among service users. This is significant because the role was established primarily to support the recovery of Justice Social Work clients with substance misuse issues. The Justice Support Workers worked closely with service users, supporting them to engage in substance misuse services as demonstrated by the following: • 70% of service users engaged with CAReS • 67% of service users engaged with Harm Reduction • 54% of service users engaged with The Beacons It should be noted that the proportion of service users who engaged with the three services prior to their involvement with the Justice Support Workers was not recorded. The added value of the Workers is not therefore known. However, five of the seven service users we spoke to during this evaluation engaged with The Beacons for the first time as a direct result of support from the Justice Support Workers. These service users reported they were unaware The Beacons existed and would have been very unlikely to engage with the service had it not been for the Workers. It was quite striking how limited some service users’ knowledge of substance misuse support was. Some added that their Worker either took them to The Beacons for their initial visit or met them there, demonstrating the proactive work undertaken by the Justice Support Workers. This is noteworthy because research on locality social work practice undertaken in February 2020 that led to the establishment of the Justice Support Worker role (cited in the application form), found that Justice Social Work staff were referring or signposting individuals to substance misuse treatment and support services however, uptake was very low or non-existent in some cases. The Justice Support Workers appear to have delivered on the aim set out in the application form to support people through the transition period, assist them to develop recovery capital by connecting them with the local recovery networks (The Beacons) and help them to remain in treatment provided by CAReS. The Workers’ support with recovery from substance misuse included emotional support when service users were struggling or had relapsed. It also included practical support such as taking service users to pick up methadone prescriptions. Significantly, the Workers helped a number of service users to access other services including residential rehabilitation such as Turnaround. Other services 99
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8 recorded on the spreadsheet included Thriving Survivors, Alcoholics Anonymous / Narcotics Anonymous / Cocaine Anonymous / Fellowship meetings, SISCO, 218 Project, Second Chance, Women’s Aid, and Venture Trust. Evidence from the Justice Outcome Stars completed by 38 service users, demonstrated a significant improvement in terms of substance misuse. The information showed that 74% had improved their score on the drugs and alcohol question shown opposite, 13% had maintained their score and 13% had a lower score. The average score among service users who reported an improvement increased from approximately 2.5 to 5.7 on the scale opposite – an improvement of 3.2 out of 10. In other words, the service users went from describing their substance misuse as “My drug use and/or drinking is a problem. I don’t have help or don’t engage with it” to “I’m motivated to tackle my drug or alcohol problems and am starting to make changes for myself”. Further evidence of the Justice Support Workers’ positive impact on substance misuse comes from their involvement with Naloxone training and distribution. Naloxone is a medication that can reverse the effects of opioids and has been used in Scotland for several years to provide emergency support to people who experience an opioid overdose. The Justice Support Workers benefitted from Naloxone training at the start of their employment, and during the course of the pilot they supported nine service users to complete Naloxone training and ten service users were provided with take home Naloxone kits to be used in an emergency situation. Service users also provided powerful testimony about the positive impact the Justice Support Workers had on their recovery from substance misuse. “I’m in recovery, she got me in recovery... I’m at The Beacons the now and that’s been going quite good and she helps me with my medication as well…I’m not taking drugs, I’m not taking alcohol anymore… If it wasn’t for her I would have nothing, I would be back to square one again going round in a big circle….. I see her once or twice a week and once a month I see her at a meeting with my Social Worker. She tells me how well I’m doing. I used to be dead selfish and she helped me find that in myself”. (Service user). “I seen her and the next day she drove me down to (a substance misuse service in) the Gorbals and she introduced me to people. Then she mentioned about The Beacons, so she picked me up and I went there. I prefer that one and I’ve stuck to that. It’s very relaxed place and you can speak freely. It’s a good place. She’s keeping in touch with me and trying to help me. It’s good to talk to someone who has been through what I have instead of talking to someone who hasn’t got a Scooby. Someone who has been in the same boat as me; they’ve went through it all. It’s a lot easier to open up… If you go to the doctors you just don’t get any help at all whereas [Justice Support Worker] got me in to support groups right away. I was never offered anything before over the last 20 years. There is a lot of help 100
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9 out there but nobody tells you. [Justice Support Worker] is trying to get me in to detox next”. (Service user). “She told me about The Beacons. My social anxiety was really bad. She gave me the push and encouragement I needed and she is the one who got me involved in The Beacons. And she still pushes me to go… I have been on a journey. I had been through treatment but she told me where she thought I was going wrong. I’ve not relapsed since and my recovery is going really well. It is the best it’s been and I’m in a really good place at the moment. I am totally abstinent and have been for a while”. (Service user). “I’m in rehabilitation now and it is basically through the help I got from [Justice Support Worker] and my Social Worker… Without her I’d probably be out on the streets, probably still drinking and not interacting with anybody”. (Service user). Improved health and wellbeing Justice Support Worker records show 99% of service users were registered with a GP. Access to a GP was identified at the project development stage as a foundation for good health and wellbeing and other positive outcomes. It is not known how many of the service users were registered with a GP before they were supported by the Workers so the added value is unknown. However, some of the service users we spoke to reported that their Justice Support Worker had helped them register with a GP when they had moved to a new area. “I’d moved about for quite a while and when I returned here I didn’t have a doctors, she helped me sort all that out... My mental health was crippled and she gave me the guidance to go to the doctor, I got medication and an appointment for a mental health assessment and she has walked beside me in this journey. Things with my health are so much better”. (Service user). A Social Work consultee explained how a Justice Support Worker had accompanied a service user to a GP appointment and helped them access treatment for a physical health problem. In doing so the Justice Support Worker had acted like an advocate. There was an improvement in the mental health and wellbeing scores recorded using the Justice Outcome Star. Information for 38 service users showed that 82% had improved their score on the mental health and wellbeing question shown opposite, 16% had maintained their score and 3% had a lower score. The average score among service users who reported an improvement increased from approximately 2.7 to 5.3 on the scale opposite – an improvement of 2.6 out of 10. In other words, they went from describing their mental health and wellbeing as “I have difficulties with my emotional or mental health. I don’t have help or don’t engage with it” to “I’m motivated to improve my emotional and mental health and am trying to make changes”. 101
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10 Service users reported the support of the Justice Support Workers had led to improved mental health and wellbeing. For some this was the result of the Workers helping service users to overcome problems that reduced their anxiety and stress. They cited examples of support such as access to emergency food parcels, resolving problems with utility companies and bills, resolving problems with landlords which also benefitted their mental health. In addition, some of the serviced users shared that they had faced traumatic experiences in their lives and made the following comments when asked what difference support from the Workers had made to them. “She was a great support to me over Christmas as it was a really stressful time and I had Court coming up as well. I was speaking to her and texting her and she was a great support. She helped me get through it and stay sober. She points me in all the right directions and I’m in a good place today. I am finding myself again as I was a bit broken with alcohol… I was really struggling but she was there. I had a lot of shame and guilt when I had to have a Criminal Justice Social Worker, I hit a low point with depression and stuff. My light was nearly out but when I met [Justice Support Worker] she was like I had a pilot light on a boiler and now it’s like a roaring fire. I am looking forward to the future. She has been a big figure in my life that has helped me stay on the right path with my recovery… She helped save my life”. (Service user). “I think I’d probably be dead by now without [Justice Support Worker]. The reason I say that is because of my alcohol and drugs”. (Service user). “I am feeling a wee bit better now as I’ve opened up in the groups, told them what’s on my mind. All through the years I’ve held it all in”. (Service user). Improved financial situation Some consultees reported their financial situation had improved as a result of support from the Justice Support Workers. For some this occurred from reduced expenditure on alcohol and drugs. Other service users highlighted that the Workers had helped them overcome financial crises with access to emergency food parcels, completing a benefits application form, providing a new phone (supplied free by a supermarket) or a top-up for their pre-payment energy meter. “I’ve got more money in my pocket now because of her, because I’ve not been drinking. I’ve found myself with more money and we are looking at trying to get me my own place to stay, a house, as well”. (Service user). “I had no power and gas in my house and [Justice Support Worker] sorted it straightaway. If I’d told my Social Worker it could have taken 2 or 3 days. And then she got me involved with the foodbank which was a help. I actually texted my Social Worker months ago, could have been 7 or 8 months ago, and I’m still waiting for a reply. I’ve had 3 or 4 parcel through [Justice Support Worker]. I know the Social Worker is busy”. (Service user). Improved relationships Some service users highlighted that support from the Justice Support Workers had led to improved relationships with their family. They explained that substance misuse and involvement in the criminal justice system had led to strained or broken family relationships. They added that the 102
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11 emotional and practical support of the Justice Support Workers had helped them to begin to mend some of the relationship problems they had created. “She’s given me guidance and connected thoughts and feelings, and being able to communicate to others what my feelings are has made a massive difference for me. It has really helped my relationships everywhere in my life… My world had got smaller, I isolated myself and hid away but she gave me a push and helped open it up again”. (Service user). There was an improvement in relationships and family scores recorded using the Justice Outcome Star. Information on 38 service users showed that 82% had improved their score on the relationships and family question shown opposite, 13% had maintained their score and 5% had a lower score. The average score among service users who reported an improvement increased from approximately 2.9 to 5.9 on the scale opposite – an improvement of 3 out of 10. In other words, they went from describing their relationships as “I have difficulties with my relationship with a partner or family. I don’t have any support with this” to “I’m motivated to improve things in my relationship or with other family and am trying to do this”. Improved engagement with Justice Social Work Justice Social Work staff suggested the Workers had a positive impact on service user engagement with social work. They felt service users who engaged with the Justice Support Workers were less likely to engage in risk-taking behaviour and criminal activity, and therefore less likely to breach their Community Payback Orders or licence. Some of these consultees suggested that an analysis of Social Work records would demonstrate this link. Such information was not available to this evaluation, and we therefore recommend South Lanarkshire Council analyses its records to assess whether there is a significant difference in compliance with Orders and licences for service users who engaged with the Justice Support Workers and those who did not. Recommendation 5: South Lanarkshire Council analyses its records to assess whether there is a significant difference in compliance with Orders and licences for service users who engaged with the Justice Support Workers and those who did not. The flexibility Justice Support Workers have to be able to continue to work with service users after their Order ends was also highlighted as a positive. There was a suggestion this could help reduce the likelihood of re-offending. The fact that the Justice Support Workers supported service users in the community was also important. The outreach approach, particularly attending The Beacons on a weekly basis, helped engage service users in a way that an office-based approach would not have, in our view. “I meet her at The Beacons. It was her who told me about that place and it’s been a great help. It’s an easy place to meet her. It’s a central point for us to meet there”. (Service user). 103
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12 The positive impact of the Justice Support Workers in terms of engagement with social work was very clearly evidenced during our consultation with service users and Social Work consultees. “I have changed my life completely. She’s put me on the right path to stop me re-offending, stop me getting into trouble”. (Service user). “My Social Worker was phenomenal as well but I was just more at ease if [Justice Support Worker] was there at the meetings. I was distancing myself from the Social Worker… If the Criminal Justice team had more people like [Justice Support Worker] it would be a lot more easy for people to be on licence. I know people leaving the jail saying they don’t want a Criminal Justice team Social Worker as they might get a recall but if they had someone like [Justice Support Worker] they might not feel like that”. (Service user). “People are more willing to comply with their CPO because they’ve got their Justice Social Worker who they recognise has a statutory role but they are actually engaging in a deeper level because they’ve also got [Justice Support Worker] who they don’t see as a Social Worker. They are fulfilling the conditions of their Order more so now because they’ve got that additional support that is less formal… I haven’t had any breaches, I don’t even think there have been any warnings amongst the people who are working with [Justice Support Worker] and most of the cases allocated to her are complex cases, obviously there is substance misuse but there is also a lot of trauma, complex trauma, emotional wellbeing, issues in terms of housing, benefits… She is going out and chapping on doors, getting people to where they need to be and that cuts down on warnings”. (Social Work consultee). One of the Justice Support Workers highlighted an interesting case study which demonstrates the positive impact the service has had. The service user had a significant and serious criminal record but had not re-offended since working with the Justice Support Worker. One of the other agencies involved with the service user had relayed to the Worker that the service user had “walked away from trouble” and added “this is down to you... you are the worker they have needed all their life”. There was a significant improvement in the crime-free life scores recorded using the Justice Outcome Star. Information on 38 service users showed that 87% had improved their score on the crime-free life question shown opposite, 5% had maintained their score and 8% had a lower score. The average score among service users who reported an improvement increased from approximately 3.3 to 6.3 on the scale opposite – an improvement of 3 out of 10. In other words, they went from describing their crime-free life as “I’m breaking the law or rules but I’m accepting help with my behaviour” to “I’m motivated to live a crime-free life and am starting to change my behaviour”. 104
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13 Impact on Justice Social Work service The service impacted positively on South Lanarkshire Council’s Justice Social Work service in the following ways: • Increased capacity • Reduced stress and anxiety • Improved knowledge of, and links with, third sector services • Changing the culture Increased capacity The Justice Support Workers provided additional capacity to the Justice Social Work team. Assigning tasks to Justice Support Workers allowed Social Workers more time than would otherwise have been the case to focus on their statutory duties and manage their caseload. It was reported that the Justice Social Workers acted, in some cases, like a buffer or filter between the service user and Social Workers, for example, by helping service users with problems or answering queries, which allowed the Social Workers to focus on their statutory duties. Several Social Work staff commented that they did not know how they coped before the Justice Support Workers were in post. “[Justice Support Worker] can do a lot of the very practical stuff we just don’t have time to. Visiting people, taking them along to different services, different organisations, settle in to a new flat, helping people with the welfare issues. As much as we’d like to we can’t be sitting on the phone to Scottish Power trying to sort out somebody’s debt… Ultimately it frees up more time to do your own statutory work”. (Social Work consultee). “I honestly can’t remember how we did our jobs without them [Justice Support Worker and Social Work Assistant] because it is scary how much they support us with. The level of support from [Justice Support Worker] has been immense. She undertakes tasks that I wish I was able to but physically just don’t have the capacity… It lets me do my role”. (Social Work consultee). “They have alleviated the pressure and provided a service that people just wouldn’t get otherwise”. (Social Work consultee). “It has shown, irrespective of the peer element, that there is a role for someone with really good social support skills. It has really got its place in Justice Social Work”. (Social Work consultee). Reduced stress and anxiety There was also a suggestion from some Social Work consultees that increased capacity within the team could, in some cases, help reduce stress and anxiety among staff. “Before we had [Justice Support Worker] I was burning myself out trying to do everything for people we are working with and the staff team were all similar… It helps to have someone to do that so you don’t go home worrying that you feel bad because you weren’t able to do that”. (Social Work consultee). “They took the heat off the team”. (Social Work consultee). 105
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14 Some consultees noted that Social Workers’ caseloads, and the serious and sensitive issues they worked on, meant that stress and anxiety were still concerns despite the welcome addition of the Justice Support Workers. Improved knowledge of, and links with, third sector services Social Work staff reported that their knowledge of services for people with substance misuse problems had improved as a direct result of working with the Justice Support Workers. In particular, their knowledge of third sector services in this field had improved and some consultees suggested, before the pilot, they had quite limited knowledge of such services. In addition, Social Work consultees had established links and “knew who to contact” at services. This, they reported, would help them support other service users in the future regardless of whether a Justice Support Worker was involved in a case or not. “She has done loads of networking and knows loads and loads of people in recovery services. She has got so much knowledge. It’s quite enviable… She also got some people she knew to come in and speak to the team about Naloxone, which was something some of us didn’t actually know existed”. (Social Work consultee). “We all speak about a robust care plan and it feels like it is undertaken now. Previously it was like what third sector resources are there but now we’ve got somebody who knows and can really push that engagement. I am seeing people coming to the end of an Order and they are confident now because they know what services are there and they have a face they know there, like The Beacons. It is really reassuring for people”. (Social Work consultee). Changing the culture Some Social Work consultees talked about the Justice Support Workers helping to “change the culture” of the team. They explained this was particularly evident in the first six months of the pilot when the Workers brought a different perspective, an in-depth understanding of substance misuse and support services, and a way of engaging service users. “[Justice Support Workers] has got Social Workers thinking more about the games people with addiction might play, the lies they might try to tell. In some respects she has made us less naïve”. (Social Work consultee). Key factors We suggest the following were key factors in the positive impact summarised above: • Empathy • Personal skills and attributes • Perception Empathy The Justice Support Workers’ lived experience undoubtedly helped them to engage service users and this was underlined by the services users we consulted during this evaluation. They felt the Workers’ experiences gave legitimacy to what they were saying as they had “walked the walk”. Service users explained the Justice Support Workers empathised with them i.e. they were able to share their own experience of recovery and they understood their situation and challenges. Knowing 106
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15 the Workers had overcome their own challenges helped service users at times when they were struggling and the words of encouragements from the Workers carried extra significance. The Workers’ lived experience was sometimes a valuable tool when it came to the supervision of the Community Payback Orders or licences. Several examples were cited of the Workers recognising that service users were - as they described in their own words - “at it” and withholding or fabricating information. Not only did the Workers have the lived experience to recognise this, they also had a strong enough relationship with the service users to be able to point this out and get the service user to tell the whole story. Several consultees noted that this understanding and insight was a distinguishing feature of the Justice Support Worker’s role. “I am in recovery and she has lived experience of recovery. She has been a great support, showing me the way, guiding me and just understanding. She’s non-judgemental with her lived experience she is able to relate and she is a big support figure in my life. I clicked with her straightaway, she is very easy to talk to and she makes you feel very relaxed. She is one of the people I trust the most. She is very real, there is nothing fake about her. She understands. A lot of the time when you try to talk to somebody that hasn’t been on that path they don’t really understand where you are at or what’s going on but when you talk to someone like [Justice Support Worker], somebody who is in recovery, it tends to just flow and she just understands what I am trying to say. She’s brilliant that way. She’s straight to the point but that’s what I need, I’ve really needed that. She is direct, straight to the point but she’s a great communicator. I have a great relationship with my Social Worker, who is great as well, but there are certain things I would only speak to [Justice Support Worker] about because she’s been there, she’s been through it, she understands the pain, she’s been through similar. It’s just not the right relationship to talk about that type of stuff with the Social Worker”. (Service user). “A spoon is a spoon with her. She’ll tell you it straight which I liked. She was like a mother figure to me. She is a very good listener. I could speak to her about anything like financial help, relationships. I could open up to her about my life’s story and I know she could be trusted. She basically knew when you were at it. She’s been through the same thing and she totally understands”. (Service user). “Some people have been waiting for years for this kind of support. At last, someone that gets me. It is giving people hope. Hope that there is a way out of this and showing them the way. Encouraging people. Being really practical with them and honest with them as well. That’s what people need. They need the: I get you; I get you bullshit; I get your pain. It helps that we’ve been through it. 100%. People tell us stuff that they would never, ever disclose to their Social Workers. They need that therapeutic relationship. There’s no judgement – we are here to help not judge. It’s about trust”. (Justice Support Worker). “When she is talking about addiction, because she has that lived experience, she can be a bit more blunt, a wee bit more direct and I think they take it a bit more on board given that it coming from this woman who has been there, got the t-shirt, is in recovery and is showing that you can make positive changes. It has been a real opportunity… She is very direct but because of her own experience and knowledge, service users tolerate that better than if a Social Worker said it in that way. They can see she is saying that from experience rather 107
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16 than me who they think got it from reading a Journal”. (Social Work consultee). Personal skills and attributes Although lived experience was clearly important, it was not the only factor that enabled the Justice Support Workers to engage service users. The Workers’ personal skills and attributes were also critical, in our view. Without these the Justice Support Workers would not have been able to build the trust relationship that allowed them to work with service users over an extended period. This was evident throughout our discussions with service users who talked about the Workers with genuine warmth and gratitude for the non-judgemental way they treated them and the emotional and practical support they provided. Service users reported that they could rely on the Workers who were there when they needed them and delivered what they said they would do. “She’s like a wee Mum to me. She’ll tell me if I’m doing wrong and she’d put me in the right place, right there on the spot. She’s dead straightforward”. (Service user). “It’s just something about her, she gets me, It’s like magic. She’s just kept me on the right path basically. She is a wonderful, wonderful, down to earth person. I could tell her anything, anything at all. It’s really, really, different to Social Workers, I’ve had ones in the past that I couldn’t trust but I feel like I can trust her in every way”. (Service user). “She’s one of the few people I know who will be there for me even when the chips are down. She never gives up on you and she always fights your corner. When you feel like you’ve got no fight left, she is ready to fight for you. She’s brilliant”. (Service user). It was clear that some of the service users saw the Workers as a maternal figure given their age and gender. This was the case with both the male and female service users we spoke with. As yet, the role has not been undertaken by a male worker. It is possible there may be a change in dynamic between a male worker and some service users, and we recommend South Lanarkshire Council carefully consider this issue should a male worker be appointed in the future. Recommendation 6: South Lanarkshire Council monitor and assess service user engagement should a male Justice Support Worker be appointed in the future. Perception The way the Justice Support Workers were perceived by service users was also important. The Workers were not viewed in the same way as Social Workers, there was a different dynamic and relationship as they were not involved in the formal supervision of the Order or licence and engagement with the Justice Support Workers was voluntary. In some cases, it appears that service users saw the Workers as independent and not part of Social Work services. This was, we believe, based on the breadth of support the Justice Support Workers provided, the personal way they worked with service users, and the advocacy role they sometimes took on in helping service users. Several consultees, including the Justice Support Workers and service users, noted that the Workers were sometimes quite direct when speaking to service users. The service users not only accepted this but responded positively as they reported they appreciated the honesty and the “tough love”. The ability to communicate with service users in this way, and be respected for it, is a noteworthy achievement which very clearly demonstrates the different dynamic that exists compared to Social Workers. This was point was reflected in some of the earlier quotes, as well as the following. 108
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17 “Sometimes I would be uptight about going in to speak to [Justice Social Worker] because she was my Criminal Justice Social Worker. I didn’t even know [Justice Social Worker]’s position, I didn’t know if she was a Social Worker I just didn’t feel uptight about speaking to her, I felt more at ease, if that makes sense… See when [Justice Support Worker] came on board I got the feeling it put my Social Worker at ease as well and the meetings were more constructive. When it was just the Social Worker it was much more formal, I felt I had to watch what I was saying. I wish [Justice Support Worker] had been on board from the start and I’ve been working with my Social Worker for a number of years”. (Service user). 109
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18 4 Conclusions Overall, this evaluation has shown that the South Lanarkshire Justice Support Worker pilot, which benefitted from Scottish Government Drugs Death Task Force grant funding, has been well implemented and impactful. The service has delivered significant benefits for service users and the Justice Social Work which, in our view, provides proof of concept for a peer delivered intervention, based in Social Work services, for people with problematic substance use who are transitioning from the justice system. The Justice Support Workers were allocated 88 cases, involving 84 individuals, from August 2021 to March 2023, which exceeded the target of 50 to 60 service users during the funding period. There is extensive qualitative and quantitative evidence of the positive impact the pilot had on service users. Significantly, the Justice Support Workers have had a positive impact on substance misuse among service users. This is significant because the role was established to support the recovery of Justice Social Work clients with substance misuse issues. It was also significant that the Workers helped improve service user engagement with Justice Social Work and therefore could reduce the likelihood of re-offending. There were also notable improvements in health and wellbeing (particularly mental health), personal finances, and family relationships which further contribute to service user stability. The evaluation commended South Lanarkshire Council Justice Social Work’s awareness and action in meeting the support, supervision and training needs of workers recruited with non-traditional social work backgrounds, skills and experiences. The Justice Support Workers integrated well with the team and the pilot had a positive impact on South Lanarkshire Justice Social Work which should not be overlooked. The addition of two full-time Justice Support Workers clearly benefitted the service in terms of increased capacity. By taking on tasks that Social Workers did not have the capacity to do, the Workers allowed their colleagues to concentrate on their statutory duties. There were some suggestions this helped reduce stress and anxiety among Social Workers. The Workers improved the team’s knowledge of support available to people with substance misuse problems, particularly third sector services. There was also a view that the Justice Support Workers had a positive impact on the culture of the team in terms of understanding and engaging people with substance misuse problems. We identified three key factors in the positive impact evidenced by the evaluation. The Justice Support Workers’ lived experience was clearly a crucial factor. A range of consultees felt strongly that this experience gave legitimacy to what the Workers were saying to service users. The Workers empathised with service users and understood what they were going through. Interestingly service users not only accepted but appear to have welcomed the way the Workers spoke to them - which was quite direct at times - as it was informed by the Workers’ own experiences. Although lived experience was clearly a key factor, it was also abundantly clear that the Workers’ personal skills and attributes were also important. The Workers had excellent communication and people skills which enabled them to build trusting relationships with service users and Social Work colleagues across several offices. The way the Justice Support Workers were perceived by service users was also a contributory factor in the success of the pilot. The Workers were not viewed in the same way as Social Workers, there was a different dynamic and relationship which helped them engage service users. 110
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19 There was a consensus among consultees not only for the continuation of the Justice Support Worker role but for its expansion. Social Work consultees added that they felt there was more than enough demand for additional Justice Support Workers, which, ideally, would be a permanent full- time Worker based in all four locality offices across South Lanarkshire. Based on the evidence gathered during this evaluation, we would support such a move given the positive impact on service users and the Justice Social Work team. 111
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20 Appendix – Evaluation Grid Outcomes What are your indicators? Measurement of indicators Outputs Targets Measurement of outputs A short-term outcome would be to introduce this new service across the Social Work Justice Service. We will set in place a clear and supportive framework for the Justice Support Workers which would enable them to embed their roles within statutory settings. This would enable service users to access suitable recovery tailored services, which in turn will facilitate a higher degree of retention rate in treatment and support services. Evidence service users are engaging and collaborating with the Justice Support Workers in a meaningful way and registered with GP and evidence this through self- reporting - G.P registration. • SWIS recording system. • Feedback from service users in relation to service and access to recovery services. • Ensure informed and supportive induction program is made available to the Justice Support Workers through allocation of the two Resolute Justice Team Leaders to supervise and support their professional growth in this unique role. • Dedicated team leaders to provide regular supervision to the Justice Support Workers. • Co-ordinate all the relevant training/peer support opportunities for the Justice Support Workers to safeguard their developments and make sure they feel fully equipped to deliver the required service standards. • Ensure the Outcomes Star training/guidance is offered to the Justice Support Workers. • Allocate a Justice Support Worker with lived experience to work with a service user. • Enquire about GP registration. • Support attendance and registration with the GP. During the funding period 50 to 60 service users are connected to their GPs and other relevant treatment providers in the community. They are also supported to access responsive treatment services during and beyond the life span of their Community Payback Order. • Allocations to the Justice Support Worker are recorded in each locality of SWIS. • Records of GP registrations within localities. The long-term outcomes would include service users having an improved experience of transitioning out of justice services with greater retention in treatment and support services. This will be achieved through service users developing trusting and Volume of justice service users on Community Payback Order are in attendance at the Beacons and other recovery-based resources and have access to • Data from the Beacons and referrals made to other relevant treatment, recovery, and harm • Allocate a Justice Support worker with Lived experience to offer information about the Beacons • Support attendance either virtually or in person at the Beacons recovery network and other resources which would be conducive to their treatment needs and promote their wellbeing and retention in treatment. In the first instance ensure each service user on the Justice Support Workers’ caseload have access to the Beacons and/or other suitable recovery/ • As above. • Data from the Beacons and other recovery services would support the gathering of required information. 112
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21 Outcomes What are your indicators? Measurement of indicators Outputs Targets Measurement of outputs sustainable relationships with the Justice Support Workers. suitable treatment options for their substance use. reduction services. • Feedback from service users in relation to service and access to recovery services. • For the ongoing development of the service, we will conduct service user survey. treatment resources. • Data evidencing a reduction in drug related deaths in South Lanarkshire. Service users are connected to recovery networks such as Beacons and all of them are registered with a GP. Thus, more service users can access responsive treatment options and complete their Community Payback Order successfully. Monitoring of take home naloxone could also be encouraged and monitored to achieve the overarching aim of reducing drug related deaths. Collection and analysis of relevant data from the justice IT systems and regular feedback from the service users and partner agencies would confirm the level of progress being achieved. • Application of an Outcomes Star tool would enable the justice services to evidence the achieved progress in every case. • Allocate a Justice Support Worker who will remind service user about appointments and supports their attendance at various identified resources. • Justice Support Worker will complete the Outcomes Star with each service users from an outset of their involvement and will complete another one after a three-month period and/or at the completion stage to measure and evidence achieved changes in each case. • We will also conduct a staff survey to ensure we continue to develop this service provision. • We are also exploring ways to undertake a small scale of independent evaluation of the service. Maximum number of service users complete their Community Payback Orders and have an established links with the recovery and treatment services and/or Beacons. • Cross referencing SWIS records and feedback from the service users and staff through an independent evaluation process and survey exercises would support the collection of required data. 113
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Director, Health and Social Care Subject: Implementing Medication Assisted Treatment (MAT) Standards in South Lanarkshire - Update 1. Purpose of Report 1.1. The purpose of the report is to: - [purpose] provide an update on the local approach to the national priority to implement Medication Assisted Treatment Standards for people with problematic drug use [1purpose] 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s): - [recs] (1) that progress to implementing the Medication Assisted Treatment Standards is noted. [1recs] 3. Background 3.1. In 2021, there were 1,330 drug misuse deaths registered in Scotland. This was a decrease of 1% (9 deaths) compared with 2020. It is the second highest drug misuse deaths figure on record. Deaths have increased substantially over the past few decades – there were more than five times as many deaths in 2021 compared with 1996. 2021 is the first year since 2013 that drug misuse deaths have not increased. https://www.nrscotland.gov.uk/files//statistics/drug-related-deaths/21/drug-related- deaths-21-report.pdf 11 115
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3.2. Nationally, opioids continue to be present in majority of deaths with a noted increase in the additional presence of multiple other contributory substances (e.g. benzodiazepines, pregabalin and gabapentin). This change in use and potential for increased levels of harm resulted in delivery of a set of standards known as the Medication Assisted Treatment (MAT) Standards (Appendix 1). They were produced in response to the emergent public health crisis by the Drug Death Task Force on behalf of Scottish Government. The expectation is that these Standards will be prioritised and delivered by services operating within Health and Social Care Partnerships (HSCPs). 3.3. The MAT Standards aim to ensure everyone who needs it is offered, and supported, to access a consistent and evidence-based service that delivers safe, high-quality care and treatment in line with the Rights, Respect and Recovery Strategy (2019). 3.4. As a member of the local Alcohol and Drug Partnership (ADP), South Lanarkshire HSCP is working in collaboration with other ADP partners to maximise the capacity capable of providing a whole system response to people adversely affected by substance use. Delivery of the MAT Standards will be complemented and achieved in partnership with ADP commissioned services. 3.5. It was agreed in June 2022 at a meeting of South Lanarkshire Integration Joint Board (IJB) that updates on delivery and impact of the MAT Standards be routinely reported to future meetings, an update will be presented at the IJB meeting on 20 June 2023, this paper details the progress to allow Social Work Resources Committee members to be fully informed. 4. Progress Update 4.1. Local implementation of the MAT Standards is being delivered through the extension of an urgent response delivery model that has built upon a successful test-of-change project carried out by the HSCP’s Community Addiction Recovery Service (CAReS) in the Clydesdale Locality. This test-of-change provided evidence that nursing staff with the appropriate level of skill and competence would be able to implement and deliver the standards with equity and with appropriate level of professional governance. 4.2. The local urgent response delivery model has the following components: • The option for individuals to start MAT from the same day of presentation. • Support to make an informed choice on what medication to be prescribed and the appropriate dose. • All at high risk of drug-related harm are proactively identified and offered support to commence or continue MAT. • Offer of evidence-based harm reduction at the point of MAT delivery. • Support to remain in treatment for as long as requested. 116
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4.3. Currently the focus in South Lanarkshire is on standards 1-5, however the RAG status chart below outlines our progress in respect of each standard: MAT STANDARD RAG RATING UPDATE JUNE 2023 1 AMBER Standard processes in place for Urgent Response Team which went live on 1st March 23. A robust data collection process is now in place. 2 PROVISIONAL GREEN Process evidence is in place and choice is being delivered in all settings. Process is in place for gathering experiential evidence which has begun to be collected. 3 AMBER Outreach services are available and pan-Lanarkshire documentation is currently being developed to capture all assertive outreach referrals pathways. Numerical and experiential evidence collection has commenced. 4 AMBER Harm reduction standard operational procedure and training plan are in place and harm reduction training is being rolled out to each locality. Evidence reflects that harm reduction advice is consistently offered at the point of MAT delivery in all settings. 5 AMBER There are several pathways in place to support people remaining in treatment for as long as required. Currently finalising information sharing protocol to enable data sharing across NHS Lanarkshire and commissioned services. 6 AMBER A pan-Lanarkshire multi-agency steering group is in place and a training plan is under development in conjunction with the development of appropriate training resources. 7 RED A Short Life Working Group will be set up to examine what shared care should mean in a Lanarkshire context; how we can ensure that primary care provide full support to patients on MAT, regardless of prescriber; and that communication pathways and data sharing is in place to allow seamless care for patients across primary care and addictions services 8 AMBER A review of statutory addiction services is scheduled to enable a redesign of the service model. which in conjunction with commissioned service provision will ensure full implementation and sustainment of MAT Standards across South Lanarkshire. Development of data collection processes for all services is in progress to provide numerical and experiential evidence 9 AMBER A steering group is established and joint working between mental health and addiction services (including commissioned services) is in place. A pan- Lanarkshire short life working group will be established to develop a protocol outlining the expectations for the holistic, joined up care of people with a co-occurring mental health condition and problem substance use. 10 AMBER A pan-Lanarkshire multi-agency steering group is in place and a training and delivery plan will be developed to support implementation of trauma informed care across all services. 117
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4.4. It is worth noting the MAT Standard 7 - All people have the option of MAT shared with Primary Care - will be particularly challenging as this model of shared care arrangements with GP Practices has not been the norm in Lanarkshire. A review of the Community Prescribing Service (CPS) which includes GP and Pharmacist Specialists in Addictions, is being planned in North Lanarkshire; and it is anticipated that a revised service model may contribute to achievement of this particular standard for Lanarkshire as a whole. 4.5. The clinical, care and professional governance for implementation of the MAT standards is via the appropriate existing governance structures and frameworks within South Lanarkshire HSCP and NHS Lanarkshire. 4.6. The extension of the local urgent response delivery model will facilitate a dynamic response to people who find it difficult to engage in care; and who are at increased risk due to transitions of care and/or challenged in access opportunities to treatment. Learning in regard to service user outcomes and service provision will inform future planning of service delivery and robustly evidence if these additional posts are critical (or not) to ongoing achievement of the MAT Standards. Review of service delivery will be objectively facilitated by people who have lived experience and will be reported into the local MAT Standard Implementation Steering Group by the South Lanarkshire ADP support team. 5. Employee Implications 5.1. All related posts are employed by NHS Lanarkshire. In addition to 3 whole time equivalent (wte) Trainee Advanced Nurse Practitioners currently in post, 3 wte Recovery Support Workers have been recruited and are expected to take up post by early July 2023. Their role will focus on delivering a wraparound service to each individual service user to support them through the initial stages of stabilisation and recovery and ensuring that a person-centred holistic approach to care and treatment is provided. Once individual service users have reached a position of stabilisation they will be connected to their locality addiction team and the recovery community in South Lanarkshire with the support of their Recovery Support Worker. 5.2. A further 3wte posts are/will be recruited to. These posts include a Project Lead, Experiential Lead and Administrative support. 6. Financial Implications 6.1. Funding is being provided by the Scottish Government over a four-year period to support implementation of the MAT Standards within NHS Boards and HSCPs. This funding will sit within the respective ADPs and be administered by the ADP Finance Group. 6.2. At this stage, Scottish Government have not confirmed an on-going additional revenue funding allocation in support of the MAT Standards. A further challenge for ADPs then is to establish what the local approach should be after this four-year funding period; and to plan for an eventuality where no further national resourcing is forthcoming. 7. Climate Change, Sustainability and Environmental Implications 7.1. There are no climate change, sustainability and environmental implications in terms of the information contained in this report. 118
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8. Other Implications 8.1. The developments described within this report contribute to the mitigation of a number of risks within the Social Work Resources Risk Register, noteably: • Demand pressures • Meeting Public Protection and Legislative Duties 8.2. There are no other issues associated with this report. 9. Equality Impact Assessment and Consultation Arrangements 9.1. CAReS works closely with the South Lanarkshire ADP support team to ensure all service planning is informed by lived experience representation. 9.2 The local urgent response delivery model has been shaped by multiple representations of lived experience and recovery community colleagues who are active and contributing members of Lanarkshire Drug Death Prevention Steering Group and associated work streams; and the Lanarkshire Drug Death Review Group. 9.3. An ADP-planned service user and living experience consultation has commenced with the gathering of experiential data from individuals accessing the Urgent Response service. The planned recruitment of an Experiential Lead will widen the scope and breadth of this consultation and engagement process inclusive of vulnerable and hard to reach populations, families and carers. The findings of this consultation will inform any ongoing equality impact assessment that will be reported and responded to by MAT Standard Implementation Steering Group. Professor Soumen Sengupta Director, Health and Social Care 31 May 2023 Link(s) to Council Values/Priorities/Outcomes • Accountable, Effective, Efficient and Transparent Previous References None List of Background Papers NRS, 2022, Drug Related Deaths in Scotland in 2021 https://www.nrscotland.gov.uk/files//statistics/drug-related-deaths/21/drug-related- deaths-21-report.pdf Scottish Government, 2019, Rights, Respect and Recovery: alcohol and drug treatment strategy. https://www.gov.scot/publications/rights-respect-recovery/ Medication Assisted Treatment (MAT) Standards https://www.gov.scot/publications/medication-assisted-treatment-mat-standards- scotland-access-choice-support/pages/3/ Contact for Further Information If you would like further information, please contact: - Name: Jennifer Russell, Mental Health Integration Manager and Substance Misuse Lead Email: Jennifer.Russell@lanarkshire.scot.nhs.uk 119
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Appendix 1: Summary of the Medication Assisted Treatment (MAT) Standards 1) All people accessing services have the option to start MAT from the same day of presentation. 2) All people are supported to make an informed choice on what medication to use for MAT, and the appropriate dose. 3) All people at high risk of drug-related harm are proactively identified and offered support to commence or continue MAT. 4) All people are offered evidence-based harm reduction at the point of MAT delivery. 5) All people will receive support to remain in treatment for as long as requested. 6) The system that provides MAT is psychologically informed (tier 1); routinely delivers evidence-based low intensity psychosocial interventions (tier 2); and supports individuals to grow social networks. 7) All people have the option of MAT shared with Primary Care. 8) All people have access to independent advocacy and support for housing, welfare and income needs. 9) All people with co-occurring drug use and mental health difficulties can receive mental health care at the point of MAT delivery. 10) All people receive trauma informed care. 120
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Report Agenda Item Report to: Social Work Resources Committee Date of Meeting: 28 June 2023 Report by: Director, Health and Social Care Subject: Notification of Contracts Awarded: October 2022 to March 2023 1. Purpose of Report 1.1. The purpose of the report is to: - [purpose] provide notification, in-line with Standing Orders on Contracts, to Committee of contracts awarded by Social Work Resources during the period 1 October 2022 to 31 March 2023 [1purpose] 2. Recommendation(s) 2.1. The Committee is asked to approve the following recommendation(s): - [recs] (1) that the details of the contracts awarded be noted. [1recs] 3. Background 3.1. It is a requirement of Clauses 21.8 and 22.5 of the Standing Orders on Contracts that details of the acceptance of all tenders above £50,000 be reported retrospectively to the relevant committee for noting, other than those under Clause 21.3 where the award is not the lowest in a price only tender, or costs exceed the approved financial provision. In these instances, a report is submitted to the appropriate committee and subsequent authority to award is granted by that committee. 4. Contract Awards 4.1. Contracts awarded for the period 1 October 2022 to 31 March 2023, on the basis of lowest offer and/or most economically advantageous offer submitted, are detailed in Appendix 1. 5. Employee Implications 5.1. Contract management, including performance appraisal, will be undertaken by both Social Work Resources and the Procurement Service. 6. Financial Implications 6.1. Appropriate budgetary provision is available for each of the contracts awarded. 7. Climate Change, Sustainability and Environmental Implications 7.1. Ther are no Climate Change, Sustainability or Environmental Implications associated with this report. 12 121
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8. Other Implications 8.1. There are no direct risks or implications for sustainability in terms of the information contained in this report. 9. Equality Impact Assessment and Consultation Arrangements 9.1. This report does not introduce a new policy, function or strategy nor recommend a change to an existing policy, function or strategy and therefore, no impact assessment is required. 9.2. There is also no requirement to undertake any consultation in terms of the information contained in this report. Professor Soumen Sengupta Director, Health and Social Care 17 May 2023 Link(s) to Council Values/Priorities/Outcomes Accountable, Effective, Efficient and Transparent Previous References none List of Background Papers Standing Orders on Contracts Contact for Further Information If you would like to inspect the background papers or want further information, please contact: - Emma Smith, Corporate Procurement and Transactions Manager Ext: 5329 (Tel: 01698 455329) Email: emma.smith@southlanarkshire.gov.uk 122
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Appendix 1 Contracts Awarded by Social Work Resources over £50,000 in value Contractor CRN Value of Contract Awarded Date of Award Brief Description Contract Period Care & Repair in South Lanarkshire SLC/PS/SW/21/081 £135,500 25-Nov-22 Assistive Technology Installation 01/12/2022 – 30/11/2023 Haven Products Ltd SLC/PS/SW/22/014 £180,000 14-Dec-22 Supply of Homecare Uniforms - Tunics and Trousers 31/12/2022 – 31/12/2024 Ext 31/12/2025 Precious Care Services Ltd ta My Homecare Glasgow SLC/PS/SW/22/027 £102,690 10-Oct-22 Provision of Care at Home Services - Negotiated 10/10/2022 – 30/06/2024 Rutherglen Community Carers SLC/PS/SW/22/040 £285,000 28-Mar-23 Carer Respite Service for People with Dementia 01/04/2023 – 31/03/2026 Ext 31/03/2028 123
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Contract extensions awarded over £50,000 in value Contractor CRN Value of Contract Awarded Date of Extension Brief Description Contract Extension period SACRO SLC/PS/SW/21/087 £97,500 27-Mar-23 Bail Mentoring and Support 31/03/2023 - 31/01/2024 124