Agenda Document Pack - Audit, Performance and Risk Committee - 25/06/2026
Moray Council · 25 June 2026
Back to Audit, Performance and Risk Committee — 25 June 2026 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Audit, Performance and Risk Committee Thursday, 25 June 2026 Council Chambers NOTICE IS HEREBY GIVEN that a Meeting of the Audit, Performance and Risk Committee, Council Chambers, Council Office, High Street, Elgin, IV30 1BX on Thursday, 25 June 2026 at 09:30 to consider the business noted below. AGENDA 1. Welcome and Apologies 2. Declaration of Member's Interests 3. Minute of meeting of 26 February 2026 5 - 10 4. Action Log of 26 February 2026 11 - 14 5. Quarter 3 and 4 (October 2025 – March 2026) Performance Report – Adult Services 15 - 26 6. Quarter 3 and Quarter 4 (October 2025 to March 2026) Performance Report for Children and Families and Justice Social Work 27 - 52 7. Internal Audit Section - Update Report 53 - 78 8. Internal Audit Section Completed Projects Report 79 - 110 9. Unaudited Annual Accounts 111 - 194 Page 1
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10. External Audit Plan for the Year Ending 2025-26 and Update on Recommendations from 2024-25 195 - 260 11. Internal Audit Annual Report - 2025-26 261 - 272 12. Moray Annual Performance Report 2025-26 273 - 350 13. Internal Audit Follow Up Review – Adult Social Care Commissioning 351 - 374 14. Woodview Housing Support Service Inspection Report 375 - 378 15. Care Inspectorate Inspection Report - 16 Barlink Road Elgin 379 - 382 16. Care at Home Inspection Report 383 - 386 17. Community Support Service Inspection Report 387 - 392 18. Short Term Assessment Reablement Team (START) Inspection Report 393 - 396 Item(s) which the Committee may wish to consider with the Press and Public excluded 19. CONFIDENTIAL - Internal Audit Section – Completed Internal Audit Project - NHS Grampian [Para 6.2.5] • 7. Information relating to the financial or business affairs of any particular person (other than the authority). Watching the Meeting You can watch the webcast live by going to: http://www.moray.gov.uk/moray_standard/page_43661.html Webcasts are available to view for 1 year following the meeting. You can also attend the meeting in person. If you wish to attend in person, please come to the High Street entrance door and a member of staff will let you into the Chamber. Page 2
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MORAY INTEGRATION JOINT BOARD SEDERUNT Councillor Scott Lawrence (Chair) Councillor John Divers (Voting Member) Mr Derick Murray (Voting Member) Mr Sandy Riddell (Voting Member) Mr Sean Coady (Member) Ms Sonya Duncan (Member) Ms Aimee McIntosh (Member) Ms Deborah O'Shea (Member) Ms Judith Proctor (Member) Mr Michael Ritchie (Non-Voting Member) Clerk Name: Caroline O'Connor Clerk Telephone: 07779 999296 Clerk Email: committee.services@moray.gov.uk Page 3
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MINUTE OF MEETING OF THE AUDIT, PERFORMANCE AND RISK COMMITTEE Thursday, 26 February 2026 Council Chambers, Council Office, High Street, Elgin, IV30 1BX PRESENT Mr Sean Coady, Ms Sonya Duncan, Councillor Scott Lawrence, Mr Derick Murray, Ms Deborah O'Shea, Ms Judith Proctor, Mr Sandy Riddell, Councillor Ben Williams APOLOGIES Ms Aimee McIntosh, Mr Michael Ritchie IN ATTENDANCE Deputy Head of Service; Interim Head of Service and Chief Social Work Officer; Chief Internal Auditor, Self-Directed Support and Unpaid Carers Team Manager; Service Manager Provider Services; Service Manager Primary Care Contracts; Andrew Wallace, Grant Thornton and Caroline O'Connor, Committee Services Officer 1. Chair The meeting was chaired by Councillor Ben Williams. 2. Declaration of Member's Interests The Committee noted there were no declarations of member's interests. 3. Minute of meeting of 29 October 2025 The minute of the meeting of 29 October 2025 was submitted and approved. 4. Action Log of 29 October 2025 The Action Log of the meeting of 29 October 2025 was discussed and updated accordingly. Item 3. Page 5
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5. Quarter 2 (July-September 2025) Performance Report - Adult Services The meeting had before it a report by the Corporate Programme Manager updating Committee on performance as at Quarter 2 2025 (July - September). Councillor Lawrence asked for more detailed information regarding the high numbers of cases awaiting assessments for Attention Deficit Hyper Disorder (ADHD) referenced in para 4.13 including the numbers of people being diagnosed and numbers receiving clinical interventions in order to provide a wider understanding of the increasing numbers of people seeking ADHD diagnosis. In response, the Depute Chief Officer advised information would be contained in the report on the development of mental health services due to be presented to the Board in March 2026, however noted the report would now be reported to the Board in May 2026. In the meantime a development session would be held with the Board to provide more in depth details of the improvement work being undertaken and how that sits from a national perspective. Mr Riddell queried why the long awaited report on the development of mental health services was now not to be considered at the March Board meeting. In response, the Chief Officer advised the March meeting was the budget setting meeting and, while there may be an option to hold a Special meeting of the Board in late April, a development session would provide an update and deeper dive before the paper comes to the Board in May. Noting the Board's significant concerns regarding mental health and, while an informal briefing to confirm what is being delivered and the changes being made would be helpful in advance of the formal report, Mr Riddell noted the importance of timescales in relation to mental health as there were likely to be some formal processes involved. Following consideration the Committee unanimously agreed to note the performance of local indicators for Quarter 2 (July to September 2025), against for 2025/26, as presented in the report. 6. Quarter 2 (July to September 2025) Performance Report for Children and Families and Justice Social Work The meeting had before it a report by the Interim Chief Social Work Officer/Head of Service informing the Committee on Children and Families and Justice Social Work performance as at Quarter 2 (July to September 2025). In introducing the report the Interim Chief Social Work Officer acknowledged the report was lengthy, containing very detailed information and sought guidance from the meeting as to whether they would wish future reports to be reduced in terms of the detail provided. During discussion members of the Committee agreed shorter, more focussed reports be prepared for future meetings. Following consideration the Committee unanimously agree to note:- i) the performance of local indicators for Quarter 2 as presented in the Performance Report at Appendix 1; and ii) the analysis of the local indicators as detailed in Appendix 1. Page 6
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7. Internal Audit Section - Update Report The meeting had before it a report by the Chief Internal Auditor providing Committee with an update on the work of the Internal Audit Section. Following consideration the Committee unanimously agreed to note the audit update. 8. Internal Audit Section Completed Projects Report The meeting had before it a report by the Chief Internal Auditor providing an update on audit work completed since the last meeting of the Committee. Mr Riddell expressed concern at the findings of the Absence Management audit in Appendix 1, specifically the numbers of managers who had undertaken training relating to the Health and Work Policy, the high numbers of those audited who were not complying with policies and the long hours worked by some staff and risk and legal responsibilities/liabilities regarding how absence is manager. He suggested that the agreed actions which stated staff were to be "reminded" were insufficient and training should be mandatory rather than voluntary. In response the Chief Internal Auditor confirmed the indicators of serious concerns had been contained in the report had been presented to the Council's Corporate Leadership Team who had recognised the issues to be addressed were adopting a transformational project to address the issues. The Chief Officer noted the audit undertaken was a Council audit and whilst half of the IJB employees were Council staff, further work was required to understand how to manage it for all staff with the health and social care partnership and would be reported back to this Committee to provide assurance. Councillor Lawrence, as Chair of the Council's Audit and Scrutiny Committee, confirmed the report had been discussed in detail with similar concerns expressed at that Committee and initiatives had been introduced to address the issues and lessons learned from the Council would be shared with the partnership. Following consideration the Committee unanimously agreed to note the audit update. 9. Update on the Delivery of the Unpaid Carers Strategy The meeting had before it a report by the Service Manager, Provider Services providing Committee with an update on the progress in delivering the Moray Unpaid Carers Strategy highlighting key activities, developments, and outcome achieved during the reporting period. Mr Murray suggested it would have been useful to have heard the unpaid carers representatives views on the report however noted they were not members of this Committee. In response, the Corporate Manager confirmed consideration was being given to including the unpaid carer representatives on the Committee whilst also ensuring the Board were not placing undue pressure on stakeholder members and a report would come back to a future meeting of the Board. Following consideration the Committee unanimously agreed to note:- Page 7
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i) the progress made to date in delivering the objectives of the Unpaid Carers Strategy; and ii) the findings of the evaluation of the Maryhill Practice Unpaid Carer Project (Appendix A). 10. Moray Integration Joint Board Draft Strategic Risk Register The meeting had before it a report by the Chief Officer presenting the Committee with the updated draft Moray Integration Joint Board Strategic Risk Register, providing a clear overview of current strategic risks, their assessments and mitigating actions which supports information decision-making, strengthens planning and reinforces effective risk governance aligned with the Strategic Plan. Mr Murray asked firstly whether changes to the Risk Register could be highlighted in future to easily identify changes made and secondly, queried whether the Committee were willing to accept Risk 2 as being a moderate risk for Risk Appetite given the financial pressures both NHS Grampian and Moray Council were facing. In response to the first point, the Corporate Manager advised consideration would be given on how best to highlight changes in the Risk Register and in relation to the second query, confirmed the Risk Appetite had been agreed by the Board in October 2025 however it may now be appropriate to review the Board's risk statement given the challenging financial circumstances of both partners. The Chief Officer agreed it was important to review in terms of how that would impact the Risk Appetite for change and transformation and would therefore arrange to schedule a session to discuss the Board's Risk Appetite statement. Following consideration the Committee unanimously agreed: i) to note the Board Strategic Risk Register; and ii) the mitigating controls and assurance arrangements are adequate. 11. Internal Audit Plan Year Ending 31 March 2027 The meeting had before it a report by the Chief Internal Auditor providing the Committee with information on the proposed internal audit coverage for the 2026/27 financial year. Following consideration the Committee unanimously agreed to note:- i) the proposed internal audit coverage for the 2026/27 financial year; and ii) the proposed Internal Audit Plan for 2026//27 attached as Appendix 1. 12. Payment Verification The meeting had before it a report by the Head of Service / Deputy Chief Officer providing an update on the review of the Payment Verification Assurance Service provided by National Services Scotland Practitioner Services Divisions, on behalf of NHS Grampian. Following consideration the Committee unanimously agreed to:- Page 8
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i) note the arrangements in place in Grampian for the management of the payment verification process; and ii) note the actions already taken to address outstanding issues, with plans for future action to include an update on progress to this Committee annually. 13. Unscheduled Care - Home Assessment Pathway The meeting had before it a report by the Head of Service informing Committee of the successful bid to implement a Moray Home Assessment Pathway, highlighting how the development supports the delivery of the Moray Integration Joint Board's strategic priorities as outlined in the Strategic Plan, as well as contributing to the nine national Health and Wellbeing Outcomes. Councillor Lawrence asked whether key performance indicators would allow evaluation of the effectiveness of the pathway as opposed to the work already being done that was described in the performance report to evidence the successfulness of the funding received. In response, the Chief Officer confirmed the key performance indicators were included in the application for funding and would be used to evidence the quantitative impact and outcomes. Following consideration the Committee unanimously agreed:- i) to note the content of the report; and ii) that the pathway aligns with and supports the aspirations of the Moray Integration Joint Board's Strategic Plan in relation to Home First. 14. Items for Escalation to MIJB The Committee noted that there were no items for escalation to the Moray Integration Joint Board. 15. Thanks The Committee, in noting that Councillor Ben Williams was standing down from the Moray Integration Joint Board following the March meeting of the Board, joined the Chief Officer in pay tribute to Councillor Williams for his contribution as Chair of this Committee and wished him well for the future. Page 9
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MEETING OF MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE THURSDAY 26 FEBRUARY 2026 ACTION LOG Item No. Title of Report Action Required Due Date Action By Update for 25 June 2026 1. Q1 Performance Report 31/08/23 Information to be provided about the support that is on offer to staff to help improve their wellbeing. 27 June 2024 Sean Coady/ Natalie Jeffrey Wellbeing now incorporated in performance reports. Workforce delivery plan expected late 2026 as per Scottish Government discussions. 2. Q2 Performance Report 30/01/25 Chief Officer to issue email update with information relating to the rise in targets detailed in Emergency Admissions graphs in Appendix 1. TBC Chief Officer Targets for all indicators are an average of the previous year activity, unless there is a nationally set target, such as sickness absence. Targets will be recalculated for Q1 Item 4. Page 11
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Item No. Title of Report Action Required Due Date Action By Update for 25 June 2026 2026/27 and will be presented for approval at the next meeting of this Committee. 3. Q1 (April to June 2025) Performance Report – Adult Services 29/10/25 Depute Chief Officer to prepare a detailed report on unmet need for future meeting. TBC Sean Coady Under development as part of the ongoing performance reporting. Now incorporated in quarterly performance reports. Action closed. 4. Q1 (April to June 2025) Performance Report – Children, Families & Justice SW 29/10/25 Schedule to be provided to Committee including timescales and outputs relating to the test of change to be taken forward by the Policy, Commissioning and Development Team in para 4.17 TBC Carl Campbell Briefing issued by CSWO to members 27 May 2026 – Personal Outcomes. Action now closed. 5. Q2 (July – September 2025) Performance Report – Adult Services 26/02/26 Briefing session to be scheduled in advance of report coming to Board in May providing details of mental health improvement work to include further information on ADHD diagnosis figures. April 2026 Sean Coady Development session held in April 2026 Action now closed 6. Internal Audit Section Completed Update report on absence management to be prepared once work is completed to understand Chief Officer Page 12
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Item No. Title of Report Action Required Due Date Action By Update for 25 June 2026 Projects Report 26/02/26 how to manage for all health and social care partnership staff. 7. Update on the Delivery of the Unpaid Carers Strategy 26/02/26 Report to IJB on unpaid carer representatives being added to membership of APR Committee. Sonya Duncan Stakeholder members confirmed as members of Committees. Action now closed. 8. MIJB Draft Strategic Risk Register 26/02/26 1. Consider how best to highlight changes in the Risk Register 2. Schedule session to review the MIJB’s Risk Appetite Statement in light of funding partners funding challenges TBC TBC Sonya Duncan Chief Officer / Sonya Duncan Changes now incorporated into report. Action now closed. Scheduled for November Development Session. 9. Q2 Performance Report for Children and Families and Justice Social Work 26/02/26 Circulate to members an update with findings of Short Life Working Group following benchmarking exercise undertaken in relation to people support with formal Committee report to follow. ASAP Jim Lyon Briefing issued by CSWO to members 27 May 2026 – Personal Outcomes. Action now closed. Page 13
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: QUARTER 3 & 4 (OCTOBER 2025 – MARCH 2026) PERFORMANCE REPORT – ADULT SERVICES BY: INTERIM CORPORATE PROGRAMME MANAGER 1. REASON FOR REPORT 1.1 To update the Committee on performance as at Quarter 4 2026 (January – March) including information relevant to Quarter 3 (October- December 2025). 2. RECOMMENDATION 2.1 It is recommended that the Committee scrutinises and note: i) performance against the agreed local indicators during Quarters 3 & 4 (October to March 2026); ii) the analysis of indicators and the actions undertaken to address performance outside acceptable target ranges; and iii) progress with the Strategic Delivery Plan, as detailed in section 4.27 onwards 3. BACKGROUND 3.1 The purpose of this report is to ensure the Moray Integration Joint Board (MIJB) fulfils its ongoing responsibility to ensure effective monitoring and reporting on the delivery of services and on the programme of work as set out in its Strategic Plan. 3.2 Appendix 1 identifies local indicators for the MIJB and the functions delegated by NHS Grampian (NHSG) and Moray Council, enabling broader scrutiny and assurance by the Board. 3.3 The report includes two reporting quarters due to the timing of the Committee meetings. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 Local Indicators are assessed on their performance via a common performance monitoring Red, Amber, and Green (RAG) traffic light rating system. Some of these Item 5. Page 15
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local indicators sit with acute, although require inclusion as performance can and does impact our whole system. RAG scoring based on the following criteria: GREEN If Moray is performing better than target. AMBER If Moray is performing worse than target but within agreed tolerance. RED If Moray is performing worse than target by more than agreed tolerance. Summary of Previously Agreed Indicators 4.2 Performance within Moray Health and Social Care Partnership (MHSCP), as demonstrated by the trends in agreed indicators to the end of quarter 4 of the financial year 2025/26, are showing as variable in terms of trends with several showing improvement and some showing a decline in performance. The report sets out the mitigating action being taken to address areas of declining performance. Accident and Emergency – within thresholds 4.3 Whilst it was reported the rate was improving at Qtr 2 and indeed improved further to 19.6 at Qtr 3, it has slipped to 21.9 at Qtr 4 which is a slight improvement on this period in previous years. Delayed Discharges - improving 4.4 Delayed Discharges continue to fluctuate within the period from a high of 42 to 26 (on target). Overall, there are indications of an improving trend in both short-term and long-term performance. 4.5 Analysis of the delayed discharges in NHS Scotland shows that Moray is around the Scottish average for delays at monthly census point per 100,000 population for 18+ population. The 75+ age group show that there has been a reduction in the number of bed days occupied by people in delay from 746 in March 2025 to 718 in March 2026. A&E attendance rate per 1,000 population (all ages) Current Target Q3 2024/25 Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Status Short Term Trend Arrow Long Term Trend Arrow 21.4 19.7 22 22.1 21 19.6 21.9 Number of delayed discharges (including code 9) at census point. Current Target Q3 2024/25 Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Status Short Term Trend Arrow Long Term Trend Arrow 26 33 40 32 37 38 34 Number of bed days occupied by delayed discharges (including code 9) at census point 850 981 1,149 1,015 1,217 1,141 1,004 Page 16
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4.6 The Scottish Government has a clear focus on reduction of delays, providing additional funding to address Unscheduled Care. Key and local indicators have been identified for the initiatives under the Unscheduled Care (USC) framework and information is being collated for future reporting. 4.7 Planned Date of Discharge (PDD) compliance remains high in our community hospitals and the accompanying daily report is monitoring Delayed Transfers Of Care and delays across the whole system. 4.8 Actions for improvement • Discharge Without Delay programme phase 1 now completed, progressing with phase 2. • Home Assessment Pathway – is an enhancement to discharge to assess. Officially launched on 5 May 2026 with additional staff posts recruited to. Service level agreements in place with GP practices and virtual wards created. Multi-disciplinary teams supporting those released from hospital. • Care at home sustainability – A review of internal recruitment and identification of gaps was undertaken to improve sustainability, and this continues to be reviewed and developed. Use of flexible commissioning through Scotland Excel’s framework for external partners continues to progress and selection of appropriate providers is overseen and managed via commissioning. All referrals are scrutinised through the Resource Allocation Meetings to ensure control and equity of provision. • Proportional care and telecare options - continue project and share learning with prescribing teams. Hospital Readmission - variable 4.9 The 7-day emergency readmission percentage fluctuated with Qtr 3 showing an improvement to 3.8%, almost at target, however Qtr 4 has shown levels increase to 5.2%. This pattern was also reflected for readmission within 28 days of discharge with improvement in Qtr 3 and an increase to 10.4% at Qtr 4. Whilst it should be noted that readmission is not always for the same clinical reason the variation from Qtr 3 to Qtr 4 is significant and requires further investigation as it is out with the normal fluctuations. 4.10 Actions for Improvement • Home Assessment Pathway fully commenced in May 2026, and it is expected that this will directly impact and reduce readmissions to hospital. % Emergency Readmissions within 7 days of discharge Current Target Q3 2024/25 Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Status Short Term Trend Arrow Long Term Trend Arrow 3.7% 3.1% 3.9% 4.1% 4.1% 3.8% 5.2% % Emergency Readmissions within 28 days of discharge 7.4% 6.9% 7.4% 9.4% 9.2% 8.3% 10.4% Page 17
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• Further investigation into the reasons for the readmissions at 28 days to understand if there are any identifiable causes or emerging trends. Access to Psychological Therapies – declining 4.11 Percentage of patients commencing Psychological Therapy Treatment within 18 weeks of referral Target 90% - Q3 50%, Qtr 4 41%. This is a nationally set target and is impacted by both funding available and workforce availability. 4.12 The demand for mental health and primary care Psychological Therapies continues to increase. The figures collated cover both Primary and Secondary Care. Secondary care are meeting the 18-week referral to treatment target. However Primary Care Psychological Therapies continue to perform well below the current target figure. This is due to a variety of factors. and plans are in place to improve performance and access. There is now joint management of both parts of the service with worktaking place in primary care to review triage processes, with support from secondary care, the Partnership have reached out to those who have been waiting longer than 12 weeks and have signposted to alternative available supports in the meantime. 4.13 Actions for Improvement • Review triage process for primary care • Continue to signpost to alternative supports • Group development and job planning aim to increase throughput and maximise capacity. Staff Management – NHS & Council - declining 4.14 Both NHS staff and Council staff sickness absence is above the target of 4%. Short term absences relate to colds/flu and gastro/intestinal issues, with long term absence causes for both Council and NHS staff being anxiety, stress and other mental health illnesses or for operations/post operation care. 4.15 Actions for improvement • Vaccination campaigns are actively encouraged across all staff groups to reduce severity and duration of illness. Percentage of patients commencing Psychological Therapy Treatment within 18 weeks of referral Current Target Q3 2024/25 Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Status Short Term Trend Arrow Long Term Trend Arrow 90% 44% 65% 60% 45% 50% 41% NHS Sickness Absence - % of hours lost Current Target Q3 2024/25 Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Status Short Term Trend Arrow Long Term Trend Arrow 4% 7% 4.9% 5.9% 5.2% 6.8% 6.6% Council Sickness Absence - % of calendar days lost 4% 7.3% 8.2% 8.1% 8.1% 7.9% 8.5% Page 18
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• Wellbeing Initiatives, such as the NHS Grampian “We Care” website are promoted throughout the organisation and its partners. • A cross-service health and wellbeing SWAY has been developed and will be maintained by the Health Improvement Team, to provide a single point of access to relevant information and support for all staff. • Following a successful pilot in Speyside, a Staff Wellbeing Network is now being established to build team-based wellbeing champion support across Moray HSCP. In addition, a Managers Pledge, endorsed by SMT, is being introduced during National Wellbeing Week at the end of June 2026, to promote compassionate leadership and strengthen support for staff wellbeing, resilience and access to practical resources. • An “Emoodie” app, that provides anonymous mental health support for people and analytics for the organisation, is currently being trialled by Council staff. • Safe Staffing Tools are used daily to monitor and manage workload in clinical areas. • Managers are encouraged and supported to utilise guidance and support from NHSG and Moray Council in relation to managing staff absence. Self-Directed Support (SDS) – data only 4.16 The processes for collation of data are well embedded and will provide a sound basis for future decision making. Short Name Current Target Q3 2024/25 Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Value Value Value Value Value Value SDS Services - Option 1 283 293 309 341 SDS Services - Option 2 302 323 332 308 SDS Services - Option 3 1,410 1,435 1,376 1347 4.17 Pathways are now in place, and updates to assessments have been implemented to capture each individual’s preferred SDS option more accurately. The expanded commissioning framework is expected to strengthen choice and control, ensuring decisions are driven not by commissioning models or service availability, but by the level of responsibility individuals wish to take for their own care and support. 4.18 Over the last year, uptake has shifted towards SDS Option 1, while Option 3 has declined and Option 2 has remained broadly stable. The aim is to ensure people have access to the full range of SDS options, so the increase in Option 1 is encouraging. However, there is a risk that some people may be choosing this option because of difficulties accessing support through other routes. Further work is therefore underway to capture people’s preferred option more definitively and through analysis the Partnership will explore whether the rise in Option 1 reflects genuine informed choice and control, or constraints in commissioned service availability. This analysis will include feedback from supported people and unpaid carers, analysis of unmet need and delayed support, and consideration of the sustainability of the Personal Assistant workforce, particularly in rural areas. 4.19 People choosing SDS Option 1 primarily use their budget to employ Personal Assistants. Work is underway with SDS, My Job Scotland and PA Network Scotland to strengthen the Personal Assistant workforce, with a particular focus on recruitment and retention. My Job Scotland is being promoted as the main Page 19
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platform for advertising Personal Assistant vacancies in Moray, in line with the national vision. This is helping to increase the visibility of these roles, improve workforce awareness, and support safer, more consistent recruitment practices. In parallel, local Personal Assistant networks are being developed to provide peer support, information sharing and professional connection. Work is also progressing to establish an emergency bank of Personal Assistants to support individuals when their usual arrangements break down unexpectedly. 4.20 Collectively, these measures are intended to strengthen workforce capacity and resilience, thereby enhancing the sustainability and continuity of support for individuals who employ Personal Assistants. Unmet Need Overview and Analysis – improving 4.21 The number of people assessed and waiting for a package of care decreased in this quarter, as did the number of hours of care yet to be provided. These figures are also reduced from Qtr 4 in 2024/25 as shown in figure 1 below. Figure 1 4.22 A review of rotas following budget reallocation contributed to improved performance during February and March, with unmet need on the brokerage list reducing to 171 people, with 38 new packages commencing and an additional 263 care hours delivered. Figure 2 shows the number of hours of care not provided and demonstrates that whilst there was an impact in December that efforts have been made and are showing a reduction in the overall picture compared to Qtr 4 last year. Figure 2 Page 20
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4.23 For some people, the length of time waiting for care can be significant. At the end of Qtr 4 36.97% of people (61 of 165) had been waiting over 6 months. All assessments for individuals on the list are reviewed regularly and prioritisation for care is overseen by senior managers daily basis. Unpaid Carers – in development 4.24 Progress is being made with the identification of reporting requirements around unpaid carers, and going forward will build on the information contained in the separate report regarding the Unpaid Carer Strategy being presented to this committee. Strategic Delivery Plan Updates 4.25 There are 69 actions identified in the Strategic Delivery plan with progress updates confirming an overall 54% complete or on target at the end of March 2026. As shown in figure 3 below, 13 actions were complete and 24 on target for completion as planned. Another 32 actions are progressing but have been delayed for a variety of reasons. Some of the delays relate to collaborative working with partners across Grampian. Learning from this year would advise provision of more time allocation for discussion, and recognition of governance routes is required in future planning. Strategic Delivery Plan Progress Strategic Theme Complete On target Progressing Total Building Resilience 2 5 16 23 Home First 4 9 3 16 Partners in Care 2 4 8 14 Strategic Leadership, Planning & Performance 5 6 5 16 13 (19%) 24 (35%) 32 (46%) 69 Figure 3 4.26 A number of actions within the Strategic Delivery Plan have already delivered clear and measurable outcomes. Annual health checks for adults with a learning disability improved access to preventative healthcare, with 292 checks offered and 226 completed. Mental health early intervention services also demonstrated impact, with 492 people supported through the Distress Brief Intervention Service and 357 through the Intensive Recovery and Community Support Service. In children’s services, financial inclusion pathways supported families to access help earlier, with 199 families supported and over £201,000 secured in financial gains. 4.27 Other examples include the enhanced Home First pathway, which contributed to an estimated 1,017 acute bed days saved, and the learning disability accommodation programme, which enabled more people to return to Moray and live closer to family and community supports. Community capacity has also strengthened through volunteer and community wellbeing programmes, with more than 250 volunteers active across services and wide participation in local prevention and wellbeing activity. Together, these examples demonstrate that the plan is not only progressing actions, but is beginning to deliver tangible benefits for people, communities and the wider system. An extract of completed actions Page 21
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and outcomes is included in Appendix 1 and further details are included in the Draft Annual Performance Plan 2025/26 in a separate paper to this committee. 4.28 Progress is being made across all actions albeit some are slower than others and not aligned to the original target. There is a need to review the actions and targets to ensure that they remain a strategic priority. 4.29 The refresh of the strategic plan is due and will be progressed during the next 6 months. Whilst is it likely the strategic themes of Building Resilience, Home First and Partners in Care remain the key focuses, the programmes of work to drive the required changes will be reviewed, to streamline and focus efforts where the most significant benefits can be realised. In addition, the governance framework and performance reporting framework will be refreshed and will support the clear line of sight from SMART strategic objectives to actionable delivery with ownership and oversight evidenced. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” Performance management reporting is a legislative requirement under section 42 of the Public Bodies (Joint Working) (Scotland) Act 2014. In addition to publishing an Annual Performance Report, the Moray Integration Scheme requires that the MIJB will “monitor the performance of the delivery of integrated services using the Strategic Plan on an ongoing basis” (para 5.2.2 of the Moray Integration Scheme refers). (b) Policy and Legal There are no new policy or legal implications arising directly from this report. The report is consistent with existing statutory duties and governance arrangements. (c) Financial implications There are no direct financial implications associated with this report. However, performance insights may inform future resource planning and prioritisation aligned with strategic objectives. (d) Risk Implications and Mitigation The report itself does not create new risks; however, the performance information highlights ongoing operational and strategic risks relating to delivery of the Strategic Plan, including demand, workforce capacity, delayed discharge, unmet need and access to services. These risks continue to be monitored through existing governance and performance arrangements and will be escalated where required. There is also a risk that the MIJB may not deliver on the outcomes set out in the Strategic Plan. Where such risks are identified, they will be escalated and presented to the Board for appropriate oversight and action. Page 22
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(e) Staffing Implications While there are no direct staffing implications arising from this report, it is important to acknowledge the ongoing challenges with recruitment, retention and staff absence across health and social care services. These workforce pressures continue to impact the MIJB’s ability to deliver services in line with strategic objectives. Recruitment difficulties, particularly in rural and specialist roles, combined with high levels of sickness absence in some areas, pose a significant operational risk. These issues are being monitored closely, are considered within workforce planning, and service redesign efforts. (f) Property There are no property implications directly associated with this report. (g) Equalities/Socio Economic Impact An Equality Impact Assessment (EIA) is not required for this report, as it does not introduce or amend any policy or service that would directly affect individuals with protected characteristics. However, performance data may be used to inform future service improvements that promote equity and inclusion. (h) Climate Change and Biodiversity Impacts There are no direct climate or biodiversity implications arising from this report. However, it is recognised that extreme weather events and rising energy costs may increasingly impact service delivery, particularly in rural areas. These factors will be considered in future strategic planning. (i) Directions No new directions are required as a result of this report. (j) Consultations Senior Management Team, Service Managers, Caroline O’Connor, Committee Services Officer, Moray Council and their comments are incorporated in the report. 6. CONCLUSION 6.1 This report provides the Committee with an overview of the performance of specified Local indicators and outlines actions being undertaken to improve performance. This performance report supports the MIJB’s ongoing commitment to transparency, continuous improvement, and delivery of the strategic outcomes set out in the Strategic Plan. Author of Report: Jeanette Netherwood, Interim Strategic Lead Background Papers: Available on request Ref: Page 23
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APPENDIX 1 Strategic Delivery Plan - specific outcomes 2025/26 No. Title Action Delivered Outcome 1 Learning Disability Annual Health Checks LD Health Checks – Annual Health Checks for people 16+ with a learning disability Improved access to annual health screening, earlier identification of unmet need, and referral to appropriate services. The update reports 292 health checks offered and 226 completed, with flexible delivery including home visits. 2 Unpaid carers delivery plan Implement actions outlined in the Unpaid Carers delivery plan Broader identification and support for unpaid carers through surveys, pathway development with GP practices, awareness activity, support for schools, and development of the Young Carer Statement. 3 Mental health early intervention and prevention Mental Health – Early intervention, prevention and self- management Operational commissioned services with measurable reach, including 492 individuals supported through the Distress Brief Intervention Service and 357 through the Intensive Recovery and Community Support Service, alongside wider wellbeing and signposting support in GP practices. 4 Community wellbeing and resilience Increase resilience, sustainability and growth of third/community- led groups across Moray Sustained and expanded community provision, including support to 18 BALL groups, 4 SET groups, more than 100 participants through partnership sessions with Wild Things, and 350 enquiries triaged for support and signposting. 5 Tackling child poverty Delivery of the improvement priority on tackling child poverty Better financial inclusion support, with 94% of families asked about finances through embedded pathways, 199 families supported by the money advice team, £201,104 in financial gains secured, and 610 Scottish Welfare Fund awards. 6 Keeping children safe Delivery of the improvement priority on keeping children safe Improved multi-agency practice, including completed learning reviews, rollout of a child protection voice toolkit, online safety training, increased advocacy uptake, and stronger inclusion of harm outside the home in IRDs. 7 Improving emotional and mental wellbeing for children and young people Delivery of the improvement priority on emotional and mental wellbeing Expanded support offer, including 76 new parents engaged through the Moray Parent Project, 259 one- to-one sessions, 28 group sessions, and launch of the new commissioned SAMH children and young people service with 40 referrals in its first quarter. 8 Strengthening Delivery of the Expanded universal and early help support, Page 24
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APPENDIX 1 family support improvement priority on strengthening family support including 962 parents registered with PEEP and over 1,000 attendances at sessions across Moray. 9 Discharge to Assess / Home First Discharge to Assess (D2A) / Home First The enhanced home assessment pathway launched, with additionality already exceeding Scottish Government targets in April, and the wider slippage projects reported to have saved around 1,017 acute bed days (approximately £509,000). 10 Drug and alcohol harm reduction Deliver the Moray Alcohol & Drug Partnership Strategic Delivery Plan Timely treatment access remained above the national target, stronger naloxone and harm reduction outreach, and a reduction in unplanned discharges across the year. 11 Protecting children and young people Deliver the Moray Children’s Services Plan priority on keeping children and young people safe Significant reach through prevention and awareness activity, including at least 430 children and young people engaged at school events, 98 community members engaged at RAF Lossiefest, and strong uptake of training for parents, carers and practitioners. 12 Protecting adults at risk of harm Deliver the Moray Adult Support and Protection Self-Evaluation Improvement Action Plan Increased protection activity, with 971 adult support and protection referrals, 148 multi-agency referral discussions, and 32 adults assessed as no longer at risk of harm because of their protection plan. 13 Community justice / reducing reoffending Deliver the Moray Community Justice Outcome Improvement Plan Strong Community Payback Order completion rates (81%), increased referrals from custody centres, and strengthened prison-to-community pathways and support. 14 Learning disability accommodation Learning Disability long- term sustainable accommodation Increased local housing capacity, people returning from out-of-area placements, more local tenancies, and reduced Dynamic Support Register pressure. 15 GIRFE Embed the GIRFE toolkit and principles into the planning and delivery of services GIRFE now incorporated into commissioned service specifications, refreshed policies, the Moray Community Connections digital platform, and national reporting activity. 16 Volunteers Grow the contribution of Over 250 volunteers working across social care and NHS services, expanded roles in clinical settings, Page 25
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APPENDIX 1 volunteers and major reach through community groups including 84,000 hours of physical activity and cognitive stimulation through BALL groups. 17 Quality assurance framework Embed Quality Assurance Framework Refreshed audit framework, rolling peer audit programme, quarterly reporting to the Moray Practice Governance Board, and routine scoring of files against the Care Inspectorate quality grading system. 18 Financial recovery plan Develop and monitor the Financial Recovery Plan Budget approved in March 2026, budget savings projects identified for delivery, and the medium- term financial plan approved by the MIJB. Page 26
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: QUARTER 3 AND QUARTER 4 (OCTOBER 2025 TO MARCH 2026) PERFORMANCE REPORT FOR CHILDREN & FAMILIES AND JUSTICE SOCIAL WORK BY: INTERIM CHIEF SOCIAL WORK OFFICER/HEAD OF SERVICE 1. REASON FOR REPORT 1.1 To inform the Committee on Children and Families and Justice Social Work performance for Quarter 3 and Quarter 4 (October 2025 to March 2026). 2. RECOMMENDATIONS 2.1 It is recommended Committee scrutinises and notes: i) the performance of local indicators for Quarters 3 and 4 as presented in the Performance Report at Appendix 1; and ii) the analysis of the local indicators as detailed in Appendix 1. 3. BACKGROUND 3.1 The purpose of this report is to inform Committee of the quarterly performance data which provides the analysis of the delivery of Children, Families and Justice Social Work services. 3.2 Appendix 1 identifies local indicators for the Moray Integration Joint Board (MIJB) and the functions delegated by NHS Grampian and Moray Council for Children, Families and Justice Social Work services to allow wider scrutiny by the Board. 4. SUMMARY 4.1 Work is underway to develop and agree the refresh of Moray’s key performance indicators to enable recording of local data and measures set against the national performance indicators. 4.2 Appendix 1 provides a summary and the historical trends: • Child Protection activity Item 6. Page 27
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• Looked after Children • Justice and Youth Justice 4.3 Statistics for Child Protection activity are provided against the academic calendar which runs from August to July annually. This is because this data is gathered and analysed by the Children’s Services Partnership and reported to the Child Protection Committee (CPC) through the Child Protection Minimum Data Set. Appendix 1 begins with Child Protection Q1 and Q2 from page 1 to 3, Financial Q3 and Q4 data is from page 4 to 22. Any trends or anomalies in this data are considered through the CPC Data Sub-group and reported accordingly. 4.4 Statistics for Looked After Children, Justice and Youth Justice are reported over the financial year which runs from April to March which is the reporting calendar for this data. A summary of performance for each of the reporting categories is provided below. Child Protection activity 4.5 At the end of Child Protection (CP) Quarter 2, 61 children were registered on the North East Child Protection Register (NECPR). There is no reliable way of comparing data with other areas before this information is officially published nationally. The National data for the reporting year 1 August 2023 to 31 July 2024 was published by Scottish Government on 25 March 2025. Looked After Children 4.6 At the end of Financial (Fin) Quarter 4, the number of looked after children is 164. 4.7 86% (45/52) of children in foster care are cared for by Moray Council foster carers. The Carer Recruitment Campaign has seen new foster carers and supported lodgings caregivers approved to support young people remaining in Moray in family-based care settings. There remains the commitment to support young people in family-based care settings. 4.8 21.9% (36/164) of Looked After Children are cared for in residential care. The target for this indicator (this is a ‘less than’ target, based on the assumption foster care and kinship care will be the preferred option when it is safe and appropriate, where possible) is adjusted annually to the average of comparator authorities. This figure includes four young people who are cared for on a part- time (short breaks) basis. 4.9 95.5% of brothers and sisters in Foster Care and Kinship Care remain together with at least one sibling. The Maintaining Relationships Project is developing an approach and policy to ensure brothers and sisters can remain together as far as possible and where this is their assessed needs. Due to resource limitations, this is much more difficult to achieve when there is need to accommodate large family groups (3 or more children). Justice and Youth Justice 4.10 At the end of Financial (Fin) Quarter 4, there were 492 people supported by Justice and Youth Justice Services of whom 7.9% are “care experienced” young people (CEYP). Page 28
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4.11 Overall, the number of CEYP in Justice and Youth Justice Social Work has consistently remained below 12% since 2023. 4.12 Most individuals supported by Youth Justice and Justice Social Work are male (83.3% Justice Social Work, 78.4% Youth Justice). Gender responsive support is offered to females taking account of research and data indicating women in the justice system are more likely to have experienced trauma and more likely to be a sole carer of a child or family member. 4.13 The Justice Social Work Service submitted 100% of reports to Court by their due date. This includes requests from Moray’s local Court and nationally. Policy, Development, Trauma-Informed and Commissioning 4.16 Upon the conclusion of the Personal Outcomes pilot, it is possible to report on the participating children’s personal outcomes in Q4 and next steps. Q4 feedback from nine children and young people indicates that their personal outcomes were largely stable or improving across the wellbeing indicators. 4.17 Reported progress was primarily associated with stronger relationships, better engagement in education and activities, and improved feelings of safety, inclusion and respect. Where outcomes were unchanged, this generally reflected continuing support needs rather than decline. Negative movement was limited and related mainly to emotional wellbeing, health routines, attendance, and activity levels. 4.18 Given the success of the pilot and its usefulness in answering the Promise’s ‘What Matters’ questions, full-scale implementation has been agreed to take place from mid-June 2026. 5. KEY MATTERS RELEVANT TO RECOMMENDATION 5.1 Detailed charts and performance indicator data is attached in Appendix 1. 6. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” This report notes that a review of key performance indicators is currently being developed in respect of the wider service functions that will align with key priority areas across the Children’s Services partnership. (b) Policy and Legal None arising as a direct result of this report. (c) Financial implications None arising as a direct result of this report. (d) Risk Implications and Mitigation None arising as a direct result of this report. (e) Staffing Implications Page 29
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There are no proposed changes to the staffing or reporting relationships. (f) Property None arising as a direct result of this report. (g) Equalities/Socio Economic Impact None arising as a direct result of this report. (h) Climate Change and Biodiversity Impacts None arising as a direct result of this report. (i) Directions None arising as a direct result of this report. (j) Consultations Children, Families and Justice Social Work Senior Management Team. 7. CONCLUSION 7.1 This report provides the Board with an overview of the performance of specified local and National indicators. Author of Report: Jim Lyon, Interim Chief Social Work Officer/Head of Service Background Papers: Appendix 1 Page 30
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APPENDIX 1 1 | P a g e CHILDREN, FAMILIES AND JUSTICE SOCIAL WORK - QUARTERS 3 AND 4 (OCT 2025 TO MAR 2026) PERFORMANCE REPORT PLEASE NOTE THIS REPORT IS SPLIT INTO TWO SECTIONS. THE FOLLOWING SECTION USES THE ACADEMIC CALENDAR (1 AUG – 31 JULY). THE INFORMATION PRESENTED REPRESENTS CHILD PROTECTION (CP) QUARTER 1 AND QUARTER 2 WHICH IS LATEST AVAILABLE DATA (AUG 2025-JAN 2026). Child Protection Throughout CPQs 1 and 2 there were 764 contacts, enquiries and referrals to the Access Team for 688 children as per graph 1 below: Graph 1: Referrals received by Access Team This means considerable time is spent determining the most critical matters requiring action to keep children safe. Child protection referrals are prioritised and Interagency Referral Discussions (IRDs) are held where there is potential for or significant harm to a child. In CPQs 1 and 2, 138 children were involved in 92 IRDs (IRDs consider all children in the family). This is resource intensive to ensure a proper balance of private family life and necessary state intervention to help keep children safe and provide family support. Throughout CPQs 1 and 2, physical assault (28%) was the main reason for IRDs as below: Pie Chart 1: Main reasons for IRD Child protection planning involves joint interviews with children, health assessments, and consideration of an Initial Child Protection Planning Meeting (ICPPMs). Twelve ICPPMs were held, and 24 Joint Investigative Interviews (SW & Police) were requested. Graph 2 below shows the trend across 2025/26 for Joint Investigative Interviews (JIIs) and Scottish Child Interview Model (SCIM) investigative interviews: 0 50 100 150 200 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 124 140 143 121 76 160 115 126 137 106 75 129 REFERRALS RECEIVED BY ACCESS TEAM AUG 2025 TO JAN 2026 Referrals: No. in last month Referrals: No of children Physical Assault, 28, 28% Sexual Assault, 10, 10% Domestic Abuse, 12, 12% Other reason, 3, 3% Child Criminal Exploit, 3, 3% Drugs, 9, 9% Mental Health, 13, 13% Neglect , 8, 8% Emotional abuse, 14, 14% Qs 1 & 2 - Main Reasons for IRD Page 31
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APPENDIX 1 2 | P a g e Graph 2 – JII & SCIM Graph 3 below shows the trend since Q1 2024/25 to Q2 2025/26 of Initial and Pre-birth Child Protection Planning Meetings for children (including family groups): Graph 3: Initial Child Protection Planning Meetings (ICPPM) During this period, 62 Initial and Pre-birth CPPMs were held for 112 children, 75% of whom were placed on the Child Protection Register, while 11 children were removed from the register due to a significant reduction in risk as per the registered risk categories. Reasons for new registrations can differ from the reasons for having IRDs because the information-sharing process and child in need assessment, provide a more comprehensive understanding of the family's needs and a clearer perspective on risk and safety emerges. While the most prevalent reasons can change, for example, neglect, followed by emotional abuse and parental drug use, there are also issues of child criminal exploitation. Children, Families and Justice Social Work is working closely with the police due to rising concerns of drug selling and county lines activity (cross boundaries drug dealing or people trafficking) with some linkage to organised crime. This is having an impact on safety for some children within their families. The core objective of Social Work here is to ensure the safety and wellbeing of children through timely, proportionate, and effective support, of which Child Protection activity is one aspect. Seeking to provide help and assistance for families at the earliest possible time can prevent escalation to more intrusive forms of state intervention such as the need to remove children from parental care. Children and young people experiencing the greatest levels of risk are those who require the greatest level of support to keep them 12 13 2 4 7 3 6 4 12 8 7 6 5 12 8 2 3 4 3 6 4 12 8 7 6 5 3 5 0 1 1 1 0 0 0 0 0 0 0 9 8 2 3 6 2 6 4 12 8 7 6 5 0 2 4 6 8 10 12 14 Jan-25 Feb-25 Mar-25 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 JIIS Using SCIM JII: No. of children subject to a JII as decision of IRD JII: No. of JII by SCIM as decision of IRD JII: No. of children who declined/or did not complete JII JIIs: No. of SCIM JIIs undertaken 22 10 11 26 23 20 12 6 7 11 12 14 0 5 10 15 20 25 30 Q1 Q2 Q3 Q4 Q1 Q2 Aug-Oct Nov-Jan Feb-Apr May-Jul Aug-Oct Nov-Jan 2024/25 2025/26 NO OF CHILDREN & UNBORN - ICPPMS Number of children subject to Initial and Pre-Birth CPPMs Number of Initial and Pre-Birth CPPMs Page 32
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APPENDIX 1 3 | P a g e safe by multiagency planning, coordinated support, regular review, and evidence-based means of risk reduction. Where this is provided effectively it improves personal outcomes by keeping families together, reducing harm, and supporting children to enjoy their childhoods free of state intervention in the longer term (the following section covers looked after children). Meantime, for example, quarters 1 and 2, child protection registration reasons show the range of concerns from neglect to child experiencing mental health problems (combined with other factors) as per pie chart 2 below: Pie Chart 2: CP Registration Concerns Child Affected by Parent/Carer Mental Ill-Health, 28 Child experiencing mental health problems, 1 Child Criminal Exploitation, 1 Domestic Abuse, 33 Emotional Abuse, 59 Neglect, 70 Other Concern(s), 30 Parental Alcohol Misuse, 21 Parental Drug Misuse, 36 Physical Abuse, 33 Services Finding It Hard to Engage, 23 Sexual abuse, 18 Q1 & Q2 - Child Protection Concerns Page 33
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APPENDIX 1 4 | P a g e The following section reports against the financial quarter (Oct 2025 - Mar 2026) Looked After Children & Young People Across Scotland there is an acute shortage of suitable homes and carers for children looked after away from home. The lack of options increases the risk of harm, in the short and long term, as well as placing undue and unsustainable pressure on the people entrusted with keeping Scotland’s children and adults safe. In response, a statement by all 32 CSWOs in Scotland has been drafted to ensure the public and political leaders are aware of the situation, and the need for urgent action. While this is an unusual step, the absence of care options across Scotland means, newborn babies are remaining in the care of hospital nurses, children as young as five are being placed in residential homes (institutional care) with young adults, and frequently changing staff, with growing numbers who are inexperienced. Older children are sleeping on the sofas of foster carers and residential homes. In such scarcity, where any safe care provision will do, expensive specialist options are being used for children who do not have high levels of need, making them unavailable for those children who do. Moray continues to prioritise family-based care, when safe and appropriate, with kinship care, in-house fostering, and local provision remaining central to care planning. There are continuing challenges in meeting all needs locally, particularly for a smaller number of children and young people with complex care profiles, and large families (3 or more children based on the ability to match demand with resource) who require residential or out-of-area provision, highlighting operational and financial pressures noted above. The overall number of looked after children in Moray reduced slightly (Q4) compared with the end of Q3, while the wider trend in 2024/25 into 2025/26 remains one of sustained pressure, with an increase in newly accommodated children continuing to place demand on resources and support services. This is being addressed by the Children’s Services Strategy approved by the IJB on 27 November 2025 which considers immediate and longer-term strategic need. Graph 3 below shows the number of children looked after at home and away from home at the end of Q4: Graph 3: Number of children looked after away from home and at home Overall, 45% of children were in care at home or kinship care, while 55% were in foster care, residential care, supported lodgings, or supported accommodation. Most foster households are provided by Moray carers rather than independently. Compared with Q3, the care setting profile is broadly stable, with no significant shift away from family- based care enabling most looked after children to maintain connections in their local communities, with family, friends, education and healthcare. 167 167 167 172 164 164 160 165 170 175 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 LAC - AWAY FROM HOME & AT HOME Page 34
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APPENDIX 1 5 | P a g e A significant majority of young people are cared for in family-based care (127, 69%) rather than residential care, including short breaks (37, 31%). The Carer Recruitment Campaign resulted in the approval of new foster and supported lodgings carers, strengthening capacity for children and young people to remain in local family-based care, while more needs to be done to address the growing flow-into care. At the end of Q4, 95.5% of brothers and sisters in foster and kinship care were placed together with at least one sibling, compared with a national average of 79%. Where brothers and sisters are not placed together, this reflects a range of factors, including the availability of suitable care, assessed needs for separate care, or differing individual needs. Maintaining relationships between family members remains a priority. At the end of Q4, Moray had 39 foster households, with 95% actively caring for a child with very limited unused capacity. The presence of six households providing short breaks demonstrates the continued importance of flexible, specialist support within the overall fostering resource. Grap 4 below shows fostering households and active care: Graph 4: Moray foster care households Kinship care is divided into two categories: pre-approved and approved. Moray is seeking to increase the number of kinship households to support more children and young people to remain within their own communities and networks of family and friends wherever possible. It is anticipated kinship capacity will grow through approaches such as Family Group Decision Making, and early identification of wider family strength by eco maps and genogram work helping to strengthen family-based care options. The graph below shows the number of Kinship care families and the children in their care from April 2025 to March 2026: Graph 5: Kinship Care 36 36 40 41 39 30 29 36 37 37 0 5 10 15 20 25 30 35 40 45 Q4 Q1 Q2 Q3 Q4 2025/26 MORAY - FOSTER CARE HOUSEHOLDS No. of Moray Council Fostering Households No. of Moray Council Foster Carers with 'Active' placements 2 per. Mov. Avg. (No. of Moray Council Fostering Households) Page 35
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APPENDIX 1 6 | P a g e Residential care is divided into provision within Moray and provision out with Moray. Moray’s children’s house Cala, and our commissioned houses Rowan Lea and Land Street continue to operate at full capacity, providing care for 14 children. A small number of young people are over 18 years old and are being supported through Continuing Care. Children and young people that are Out-of-area (OOA) are cared for in specialist residential houses or residential schools. There remains a consistent focus on providing care within Moray wherever possible so they can remain close to their families, communities and support networks. The number of children and young people in OOA residential care is 23. The graph below does not include young people supported through continuing care. The transition support project provides targeted support for young people moving on from residential care in Moray, and children returning to Moray from OOA residential care. The project is currently at an early stage of implementation, with a transition worker joining the team to strengthen planning, coordination and support during this period of transition. The graph below shows the pattern of internal and OOA care from April 2025 to March 2026 by care setting: Graph 6: Residential Care settings On 31 March 2026, 56 young people were receiving support from the Through Care and After Care team (TCAC), including 17 young people in Continuing Care which is likely to increase due to the increased flow- into care. The service provides support in three distinct areas: 30 27 28 35 35 35 36 36 36 32 31 30 34 31 31 23 23 24 23 23 23 26 26 25 5 6 7 6 8 10 12 12 12 14 13 13 0 20 40 60 80 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 KINSHIP CARE Kinship: No. of Children in Pre-Approved Placements Kinship: No. of Children in Approved Placements Kinship: No. of households providing Kinship Placements 11 11 11 10 10 11 13 11 10 10 8 12 18 18 21 19 18 21 29 27 33 28 23 23 0 5 10 15 20 25 30 35 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 RESIDENTIAL CARE SETTINGS Residential Care in Moray Residential Schools or Out of Area Placements Page 36
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APPENDIX 1 7 | P a g e • Through Care: Young people who receive support to plan for and prepare towards greater independence. • After Care: Young people who have left care and continue to receive support living independently or in continuing care. • Continuing Care: Young people in care up to 21 years old, no longer formally looked after; continuing to receive the same care and support, providing a more natural and seamless transition to adulthood by means of Continuing Care provision. The graph below provides the number of young people receiving these services from April 2025 to March 2026: Graph 7: Through Care, After Care and Continuing Care Youth Justice Nationally, care experienced young people (CEYP) are overrepresented in the Scottish Justice System. At the end of FQ4, 7.9% were CEYP (up to age 26) in the Justice System as depicted in the graph below: Graph 8: Care experienced young people supported by Justice Services This figure has consistently remained below 12% since 2023 with the percentage fluctuating over the last year but with an overall downward trend. The aim is to address identified needs and risks to reduce offending and maximise support, including building on existing relationships across our partnership agencies. Research informs that early entry or prolonged exposure to the criminal justice system can draw children into the system rather than rehabilitate and divert from the system, therefore, the use of short- 29 35 37 29 30 31 30 37 33 32 31 27 14 19 24 13 15 16 14 17 17 13 10 12 9 11 13 10 12 12 14 16 16 17 17 17 0 10 20 30 40 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 THROUGH CARE AFTER CARE & CONTINUING CARE TCAC: Open as Through Care TCAC: Open as Aftercare TCAC: Open as Continuing Care 507 514 527 492 489 492 50 50 46 37 38 39 9.4 9.7 8.7 7.5 7.7 7.9 0 100 200 300 400 500 600 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 Care Experienced Young People Supported by Justice Services Open to Justice Team Open to Youth Justice % CEYP open to both MYJ and JS Expon. (Open to Justice Team) Page 37
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APPENDIX 1 8 | P a g e term interventions is prioritised where possible. Children who are remanded or sentenced to custodial sentences in secure care are included in the numbers above. The average age of a child receiving Youth Justice services has been 15 years old and at the end of FQ4 there are no children under 11 years receiving support, indicating their needs are being addressed by other services. Most of the work continues to be with children aged 11 to 15 years and is undertaken in a multi- agency way, working closely with key partners such as Police Scotland, education services and our local children's houses. Whilst the team works with all schools throughout Moray, it has strong links with Moray Social, Emotion and Behavioural Needs Service (SEBN) where support is offered for social, emotional and behavioural needs. Over FQs 3 and 4 there continued to be a small number of young people aged over 18 years in the Youth Justice Service, where support has been delivered jointly with the Justice Social Work team. Planned transitions and joint working between these teams minimises the impact on the young person. At the end of FQ4, most individuals supported by Youth Justice were males accounting for 78.4% of children and young people supported by the service. There has been a small increase of females supported by the service over this quarter and feedback on the support provided has been positive. The service is committed to keeping women in their local communities where it is safe to do so and provide robust alternatives to custodial sentences. The graph below provides the ages of young people involved with Youth Justice services from October 2025 to March 2026: Graph 9: Age of children in Youth Justice Justice Social Work Services Justice Social Work reports (JSWR) remain a priority to reduce any delays in sentencing and for FQ4 the target of 100% on time has been met. There has been a slight increase in report requests over FQ3. Whilst reports are prepared at the request of any Court for an individual living in Moray, most reports are submitted to Elgin Sheriff Court. Completion of Court reports on time results in appropriate sentencing for individuals which addresses their current assessed risks and needs, and reduces time spent on remand where a community sentence is imposed. Importantly it supports a timely outcome for victims. The graph below shows the number of reports submitted on time and the number of people to whom they applied during FQs 3 and 4: 0 0 0 0 0 0 28 28 25 26 26 30 20 19 19 10 11 19 2 3 2 1 1 2 50 50 46 37 38 51 0 10 20 30 40 50 60 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 Ages of Young People in Youth Justice YJ: Age Band: 5-10 YJ: Age Band: 11-15 YJ: Age Band: 16-17 YJ: Age Band: 18+ YJ: No. open to Youth Justice Page 38
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APPENDIX 1 9 | P a g e Graph 10: Justice social work reports In addition to a standard JSWR report the Court may request additional assessments such as a Drug Treatment and Testing Order (DTTO) assessment and a Restriction of Liberty Order (ROLO). ROLOs or DTTOs can be a direct alternative to custody so effective assessments for these Orders can offer a robust community-based disposal. At the end of FQ4 there were three DTTO assessments and eight DTTO’s in process which involves at least two appointments per week for testing and supporting identified needs. A Structured Deferred Sentence (SDS) is a flexible provision with social work support for an individual after conviction but prior to sentencing. Successful completion of an SDS reduces the need for a statutory Court Order, in turn reducing the overall length of time an individual is supported by the service. The number of in SDS disposals in FQ4 has increased and remains higher than in the previous year in FQ4. Priority for SDS are women, individuals with substance/alcohol use issues and care experienced young people. Bail supervision is an alternative to remand and the priority in Moray is women, young people, those with caring or parental responsibilities and those with issues relating to mental health or addictions. Assessments are undertaken for all people and are provided on the same day where bail is being opposed by the Procurator Fiscal. There was an increase in the number of assessments requested in FQ4 and a decrease in bail supervision orders with a slight decrease compared to FQ4 in 2025. The prison population in Scotland remains very high with short term remand numbers being of concern. Bail supervision is one priority area of work which is hoped will assist in reducing these numbers whilst offering more positive outcomes for individuals within their local communities. Additional support through a third sector organisation is now in place to improve outcomes for individuals subject to bail supervision. The graph below shows Court requests, the number of people, and the numbers of bail supervision which commenced from FQ4 2025 to Q4 2026: 103 120 95 103 100 100 0 20 40 60 80 100 120 140 Q3 Q4 JUSTICE SOCIAL WORK REPORTS (JSWR) - SUBMITTED ON TIME No. Social Enquiry Reports submitted on Time No. of People % of Reports on time Page 39
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APPENDIX 1 10 | P a g e Graph 11: Bail supervision FQ4 has seen an increase in Community Payback Orders (CPO) since the previous quarter comparable to the previous year. Most individuals with a CPO are seen on the day of sentencing, or within seven days of an Order being imposed. There has been an improvement over the last year in the number of individuals seen within these timescales and additional support offered to staff when completing data to improve accuracy. Where an individual is subject to an Unpaid Work Requirement there is a focus on providing opportunities to develop skills as well as contribute to our local communities. The graph below provides the number of new CPOs with supervision requirements and people seen in seven days of the Order imposed from FQ4 2025 to FQ4 2026: Graph 12: Community Payback Orders with supervision requirement 47 44 38 36 42 12 8 14 9 10 2 8 14 9 9 0 5 10 15 20 25 30 35 40 45 50 Q4 Q1 Q2 Q3 Q4 2025-26 Bail Supervision No. of requests from Court for Bail Supervision No. of Bail Supervision cases commenced No. of individuals commenced with Bail Supervision 59 69 48 56 60 41 58 43 51 55 0 20 40 60 80 Q4 Q1 Q2 Q3 Q4 2025-26 CPOS WITH SUPERVISION No. of new CPOs with Sup Req No. seen by Supervisor within 7 days 2 per. Mov. Avg. (No. of new CPOs with Sup Req) Page 40
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APPENDIX 1 11 | P a g e Feedback from people subject to a Community Payback Order includes: Diversion from Prosecution Diversion from Prosecution (DfP) allows people accused of offences to be dealt with outside the formal justice system. Successful completion of a DfP means they will not have a conviction which may impact their current or future employment or education alongside other significant areas of their life. The Justice Social Work team undertakes all assessments of suitability; and the Youth Justice team supports young people aged 16 and 17. The referral rate varies due to the process of cases being marked by the Procurator Fiscal. There can occasionally be delays in the commencement of these cases where additional agreement is required from the Procurator Fiscal, e.g. an extended period for completion. Information contained in exit questionnaires include: Work is continuing to improve the recording and examination of data and feedback. Updated guidance for DfP has been finalised by the Scottish Government and there are plans for Community Justice Scotland to provide training to all staff which it is anticipated will improve local and national practice. Page 41
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APPENDIX 1 12 | P a g e Contracts and Commissioning Children, Families and Justice Social Work Commissioning There are seven key contracted service areas to support children, young people, families, and carers across Moray overseen by the Children, Families and Justice Social Work Commissioning Team in conjunction with the operational teams. The largest spend of all contracted areas (63%) is OOA care due to the increased flow-into care, the lack of internal resources, and the rising costs of residential care as outlined in the section on Looked After Children & Young People above. This is followed by local residential childcare costs at 10% and residential care for children with disabilities at 9%. The pie chart below provides the percentage quantities of the service areas across the financial year: Pie Chart 3: Percentage quantities of the service areas The spend trends of expenditure for the key contracted service areas in the 2025/2026 financial year show the progression of spend during the financial quarters indicating a relatively stable and even distribution throughout the year. This year saw a 10% increase in the share of OOA residential services for the reasons outlined above, while the share of all other service areas in the total spend has decreased. The distribution of expenditure for FQs 1 to 4 2026 is illustrated in the percentage spend graph below: Graph 13: 2026 Percentage spend across Service Areas Page 42
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APPENDIX 1 13 | P a g e Family support services Family support services, accounting for 11% in FQ1 to 8% of the spend in FQ4, comprise of: 1. The independent advocacy service 2. Three support services for prevention and early intervention (support & assistance): 2.1. Families Together 2.2. Functional Family Therapy 2.3. Aberlour Youth Point Moray. 1. Independent advocacy Moray’s Children’s Rights Service, delivered by Quarriers, provides independent advocacy and support to children and young people, as well as parents, carers, and siblings. In FQ4 2026 there was a total of 33 new referrals (combined young people, carers, parents and siblings) to the service while the referral rate for young people has continued to decrease, from October 2023, as illustrated in the graph below: Graph 14: Referral rates for Independent Advocacy 2023 - 2026 11% 9% 9% 8% 4% 3% 3% 3% 53% 60% 60% 63% 2% 4% 4% 3% 14% 11% 11% 10% 11% 9% 9% 9% 5% 4% 4% 4% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Q1 Q2 Q3 Q4 % of total spend across service areas Family support (advocacy; prevention) Unpaid carers Out of area residential Scotland Excel Foster Local Residential Disability Residential Children with a Disability Support Page 43
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APPENDIX 1 14 | P a g e The advocacy services active caseloads remain high despite the reducing referral numbers because exit rates from the service remain low due to sustained engagement for longer periods. For example, in FQ4, 189 young people and 147 parents, carers and siblings were receiving support. This means that the cumulative workload of the service is growing, as illustrated in the graph below: Graph 15: Young People being actively supported The advocacy team continues to attend a wide range of professional meetings to ensure children, young people, and families have their voices heard. The graph illustrates the volume and types of meetings attended in FQ3 (on the left) and 4 (on the right): Graph 16: Meetings supported in Professional Service Areas 2. Prevention and early intervention services The three prevention Page 44
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APPENDIX 1 15 | P a g e and early intervention services, Aberlour Youth Point, Families Together, and Functional Family Therapy, provided support to a total of 131 and 126 children, young people, and their families during FQ3 and Q4, respectively. The combined reach this quarter demonstrates strong service utilisation. 2.1. Aberlour Youth Point Moray Aberlour Youth Point Moray provides targeted support to children and young people who face challenges in maintaining positive engagement at home, school or within their community. The service also extends support to parents and carers of the children and young people involved. Young people assess their progress using SHANARRI indicators at the start of their engagement and at regular review points, using a six-point scale (1 = area for improvement; 6 = achievement). The scoring in this quarter FQ4 below • Suggest that benefits are sustained for most participants with most of the indicators being maintained or improved. • Improvement is evident overall, though progress is not uniform across all outcome areas: gains are most consistently evident in relational and safety-related domains; health, active and achievement indicators remain comparatively variable across individuals. • Completion numbers remain modest relative to the number currently engaged. This is demonstrated in the combined graph and table below: Graph 17/Table 1: 2026 SHANARRI indicator Scores Page 45
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APPENDIX 1 16 | P a g e Overall, the data continues to highlight the importance of tailored, person-centred planning. Completion outcomes show clear improvement, supporting the effectiveness of the support model. Positive qualitative feedback corresponds with the impact identified above: “Thank you for all you do for me and R*, I really appreciate you coming over on Xmas eve to check he is ok, you never stop. I’m glad we have a plan for the New Year” - Parent – December 2025 “You helped us all understand what has been going on” – Parent 6 January 2026 “Thanks for helping me with all of this – It’s nice to have someone to ask for help if I don’t feel confident” – Young Person 18 March 2026 2.2. Families Together This restorative family service, delivered by Children First, provides a range of supports, including one to one and group sessions, family focussed money advice service, practical assistance (e.g., food parcels and school bank referrals) and the Family Group Decision Making approach for a maximum of 6 months. A total of 21 families completed their time under the family support work with Children First during FQ3 and 4. The table on the right (Table 2: outcomes by change scores) illustrates the average impact of the service across the 21 families, comparing each family’s initial score with the final score. Both scores are selected on a 5-point scale, where a Page 46
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APPENDIX 1 17 | P a g e score of 1 means the family have been struggling in this area and support is needed, and 5 means an area where help is not needed. The average change between initial and final scores indicates measurable improvement across key domains. Positive qualitative feedback corresponds with the impact identified above; as indicated by the quotes below; “I would like to take this opportunity to thank you for all your support and input with YP and his family over the past 9 months. I hope you don’t mind me saying, your approach with XX family has been thoughtful and compassionate, you create trust so naturally. It’s clear how much heart you put into your work! It has been an absolute pleasure working alongside you and I look forward to working with you again in future” – Social Worker, 27 February 2026 2.3 Functional Family Therapy Functional Family Therapy (FFT) is a short term, strengths-based programme designed to help families improve communication and relationships, with a goal of keeping them together. Currently, 18 families are receiving support through this service. Three and six families completed their involvement in FQ3 and 4, respectively. The bar chart below presents outcome measures assessed at the conclusion of their engagement. These scores, rated by young people, parents, and therapists, cover six key areas and are measured on a five-point scale, where a score of 3 or above represents a significant clinical outcome. End-of-intervention scores indicate clinically meaningful change for those completing the programme as per the bar chart below (FQ3 on the top and FQ4 on the bottom): Bar Chart 1: Clinical Outcome Measures Positive qualitative feedback corresponds with the impact identified above; as indicated by the quotes below: Page 47
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APPENDIX 1 18 | P a g e “I maybe do have something to offer. This is the best family life has been for years and years” Parent 06/10/2025 “Thank you so much for helping our family, it has really helped us” Parent, 29 January 2026 “Thank you for coming along to the meeting today, the support you are offering the family is so valuable and your input so far has demonstrated that they are capable of making steady progressive changes” – Social Worker, 2 February 2026 Support for Unpaid Carers Delivered by Quarriers, this service accounts for 3% of the total FQ4 expenditure under the Children, Families & Justice Service Commissioning Team, and fulfils statutory obligations under The Carers (Scotland) Act 2016. 1,232 adults and 168 young carers are registered as actively engaging in FQ4. These figures are lower than FQ3 – 1,264 adult carers and 217 young carers were reported. The reduction in registered carers is likely attributable to improved data quality rather than reduced need: during FQ4, Quarriers carried out a data cleanse to allow Moray Health & Social Care Partnership to distribute surveys. The data cleanse strengthens confidence in the baseline for future comparison. Positive qualitative feedback corresponds with the impact identified above; as indicated by the quotes below: - From Adult Carers: “You have been excellent helping us with organising our break, I have really appreciated having the reassurance that Quarriers is there is I need to talk. A big thank you to Quarriers” – 6 January 2026 “Everything you’ve done for me has been absolutely amazing, I’m very grateful” - 2 February 2026 “Your support was invaluable” – 24 March 2026 - In relation to or from Young Carers: “We’d like to thank you all for help and advice given” 16/02/2026 “Young carer is super excited about attending Wild Things! Activity and thank you for thinking about him” 1 April 2026 Time to Live is designed to support unpaid carers by providing micro grants to take short breaks from their caring responsibilities. These grants are part of the Short Breaks Fund managed by Shared Care Scotland on behalf of Scottish Government. Through the Time to Live grants, 41 carers were awarded at a value totalling £22,592 this quarter; the year-to-date value is £71,551. Quarriers are the delivery partner for these awards as our commissioned service provider. Grant uptake demonstrates ongoing reliance on short breaks to sustain caring roles. Out of area care via Scotland Excel and Moray frameworks Spend remains predominantly driven by out-of-area care which accounts for 63% of the total spend of the contracts held by the Children & Families and Justice Commissioning Team. Out of area residential care provision numbers increased by 3% compared with FQ3, indicating continued demand for higher-cost provision. Out of area care is provided to: Page 48
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APPENDIX 1 19 | P a g e 21 young people in residential care commissioned through the Scotland Excel Residential framework; this is an increase of 2 from FQ3 8 young people in residential care with 2 providers commissioned via Moray frameworks 8 young people in foster care commissioned through the Scotland Excel Fostering and Continuing Care Framework. Local Residential Care Local provision remains fully utilised, with transitions managed while maintaining full occupancy. This accounts for 10% of the spend, residential care is provided to 8 young people by Action for Children across two homes in Moray. This is a static number, as 8 beds are commissioned through this contract. This quarter saw one young person transition out of this service and one transition into the service. Monitoring arrangements confirm these children are fully supported, maintaining relationships with family and friends (where appropriate and according to care plans), and enjoy a wide range of inclusive community activities. Children with a Disability – Residential Services The Scotia residential service, accounting for 9% of the spend, is delivered by Aberlour Childcare Trust in Alba Place, Elgin. Currently, three young people benefit from this service. Monitoring arrangements confirm these children are fully supported, maintaining relationships with family and friends, and enjoy a wide range of inclusive community activities. Feedback from parents and the Care Inspectorate, this quarter, reflect appreciation for consistent communication and the positive impact on their children’s wellbeing. The quote from the Care Inspector below exemplifies this. “Relationships are a key strength in Scotia, with a very nurturing and loving environment” – Care Inspector – 22 January 2026 Children with a disability- support services Commissioned services supporting children and young people with disabilities account for 4% of the total expenditure and consist of two services, a short breaks provision and group activities service. Short Breaks Services This contract provides day care and overnight short breaks for 11 young people. They deliver, on average, 15-day care sessions and 21 overnight sessions per month. This allows a break for the family, the benefits of which is deemed positive, as demonstrated by the quote below. “**Young Person** is always happy to come to Alba and is always happy to tell me about his 'Alba adventures' ❤� Everyone is always incredibly accommodating and welcoming, and I'm so thankful for the rest” – Parent, January 2026 Group Activities A total of 33 sessions were delivered during this period, comprising 1 weekday holiday, 7 weekend and 20 after school sessions. In total, 68 hours of service delivery provided across 2 locations in Moray, with plans to expand as referrals from other localities increase. Page 49
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APPENDIX 1 20 | P a g e Parents report high levels of satisfaction, with young people benefiting from social opportunities and structured activities, as evidenced in the quotes below; “We’re very grateful for all of your support and everything that you do for YP” – Parent, January 2026 Trauma-Informed Practice As noted in previous reports, a range of courses, some of them consisting of multiple modules, have been made available to staff across the partnership in FQ1. Since the inclusion of the trauma informed practice modules onto CLIVE, over 691 people across the local authority have successfully completed the ‘Understanding the impact of trauma and responding in a trauma-informed way’ module. Reflective training sessions have been developed and delivered to allow staff to explore how they can take their online learning and apply it within their roles. Walk Through Lens activity is a trauma informed deep dive into a team or service, that allows managers to assess what is already working well and what may need some improvement. The initial activity is conducted with the Trauma Lead Officer, following which, future reviews can be conducted at the discretion of the manager and when appropriate. As of this report, 21 teams have conducted the activity. Following this, 5 teams have gone on to develop plans for key areas of improvement, especially where engagement with other teams, services or support may be required. These activities ceased with the departure of the Trauma Lead Officer. New Procedures Three new procedures have been ratified in relation to transition (provisionally) between Children’s and Adult’s Social Work; referrals into children connected to members of staff; and processes for the children’s Disability Team. It is nationally recognised that a well-managed and supported transition can contribute to positive outcomes and inclusion. For this reason, a procedure outlining the arrangements in Moray to support the transition between Children’s Social Work to Adult Care has been developed. The procedure outlines practice expectations around the transitions of children and young people with complex needs or disability, including continuing care arrangements for those who are eligible. It is inclusive of a range of resources for staff and people. The Referrals Involving Staff procedure outlines arrangements in Moray to progress referrals about children, young people, adults and families who are personally connected to a member of the Social Work and Social Care workforce. The purpose is to ensure children, young people and adults receive the support and help they need, whilst ensuring safeguards around confidentiality and appropriate support for personnel are in place. This is being considered for wider roll out to include other services subject of consultation and agreement. The procedure for the Disability Team outlines arrangements in place to support children with complex need and disability. It notes practice expectations, assessment process, arrangements around Self-Directed Support, scope and thresholds of funding provided to meet agreed needs as well as reviews and moving between local authorities. Training and Development Training Page 50
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APPENDIX 1 21 | P a g e The Social Work training calendar is in place, and all staff can book onto upcoming training. The current training offer includes Action Plans, Chronologies, Continuing Care Procedures, Assessment, Personality Disorder, Contextual Safeguarding, Mental Health, Substance Use and Child Protection Processes. The training suite is under regular review with more areas to be developed in line with identified needs across the service. Monthly forums continue to run to offer support to all newly qualified social workers and social workers in training across Children’s Social Work and Adult’s Services. These sessions are well attended with positive feedback being received. Throughout the second quarter, approximately a third of Children’s Social Work staff accessed training provided by the partnership. These trainings included: Gangs and County Lines Risk, Harm and Vulnerability Child Sexual Exploitation. Staff will have opportunities to benefit from training in relation to professional communication skills, corporate parenting, contextual safeguarding and leadership skills for managers soon. Development: changes to Self-Directed Support process across Children’s Social Work and Adult Social Care A review inclusive of feedback from practitioners has highlighted that generating an indicative budget: • Has become administratively cumbersome, • Can create unhelpful constraints early in the assessment process, • Often shifts the focus from the person’s outcomes to the mechanics of funding, • Can detract from relationship-based and strengths-based practice, which is central to good social work practice. In line with this, it was agreed to remove indicative budgeting from the assessment and planning process both in Children’s Social Work and Adult’s Social Care. This means that from 1 January 2026: Individuals newly referred to Children’s Social Work will not require an indicative budget as part of their assessment There will be no need to update or discuss an indicative budget during the review of existing support plans. Financial oversight, assurance of equity and consistency, and decision-making will be achieved by quality assurance through the line management or escalation to the High-Cost Package Group at a yet-to-be determined threshold. The change hopes to benefit families by the reduction of bureaucracy and management of expectations. A resource has been prepared to use when discussing the change with families we are already working with. The change will be reflected in the SDS Policy spanning Adult’s Services and Children’s Social Work and its accompanying procedure focusing on supporting children with complex needs and disability. Self-evaluation: complaints received and responded to January to June 2025 The 6-monthly analysis of complaints that were received a responded to by the Children and Families and Justice Social Work Service is an established part of the Service’s self-evaluation approach. Between January and June 2025, 30 complaints were received and responded to: 18 at Stage 1 and 12 at Stage 2. This is in line with the upward trend in the number complaints indicated by longitudinal data (since January 2022), matching trends within the local authority and elsewhere in Scotland. This suggests Page 51
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APPENDIX 1 22 | P a g e that responding to complaints is likely to place further pressure on the Service, particularly in the light of the demands of Child Friendly Complaints. Whilst the number of complaints is steadily increasing, the number of upheld complaints has been on the decline, with this reporting period closing with zero fully upheld complaints and 5 upheld complaint points. The majority of these related to a lack of communication between the Service and people receiving it; this is in line with previous findings of thematic analyses. The importance of good and timely communication will be reiterated during relevant meetings and there is training in development in respect of professional communication skills. Personal Outcomes Reporting Following reflective exchanges in the IJB and the CSWO’s Briefing paper on Personal Outcomes on 27 May 2026, work has been developing to consider how people outcomes might be included in performance reporting. Following initial exploration of options and comprehensive consultation with service managers in Children’s Social Work in September 2025, a pilot was agreed between November 2025 and January 2026, extended to February 2026, to allow further participation and feedback from practitioners. The pilot has concluded as a success with: The tool was straightforward and easy to use, with some need for guidance and prompts to explain indicators Children, young people or their families were able to engage The tool may be helpful in focusing discussion and planning. Information gathered as part of the pilot is considered a success and its usefulness in answering the Promise’s ‘What Matters’ questions, full-scale implementation has been agreed to take place from mid- June 2026 which shall be reported on in future performance reports. Page 52
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: INTERNAL AUDIT SECTION - UPDATE REPORT BY: CHIEF INTERNAL AUDITOR 1. REASON FOR REPORT 1.1 Committee is asked to consider the contents of this report; seek clarification on any points noted and otherwise note the report. 2. RECOMMENDATION 2.1 It is recommended that Committee consider and note this audit update. 3. BACKGROUND 3.1 Global Internal Audit Standards (GIAS) require the Chief Internal Auditor to prepare and present reports to committee on internal audit’s activity relative to the audit plan and on any other relevant matters. 4. KEY MATTERS RELEVANT TO RECOMMENDATION National Fraud Initiative 4.1 The National Fraud Initiative (NFI) is a biennial data-matching exercise led by the Cabinet Office on behalf of Audit Scotland, with mandatory participation from public bodies. Each organisation is required to submit data on individuals and businesses that receive public funds, whether as employees or as suppliers of goods, works, or services. The matching process identifies data “matches” for each participant that are considered worthy of investigation. There is no presumption of fraud; a match consists of two or more records in which an anomaly is identified and merits further review. Categories of information provided include procurement, payroll, housing tenancies, as well as payments made to individuals in receipt of a personal budget or residing in residential care homes. The data also includes recipients of Blue Badges, with records matched against those held by other local authorities and the Department for Work and Pensions. Following consultation with Audit Scotland, a proportionate approach Item 7. Page 53
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to testing was adopted. This involved a high-level review of all matched data, supplemented by more detailed testing of a sample of items to confirm that outcomes were as expected. 4.2 The review identified no evidence of fraud. The majority of matches arose as a result of timing differences, data quality issues, or other legitimate circumstances. However, review of the Blue Badge data highlighted a small number of cases where badges required cancellation due to changes in eligibility that had not been reported, most commonly where the Tell Us Once service had not been used. Follow Up Reviews 4.3 Internal audit reports are presented regularly to members and detail both the findings arising from audit work and management’s responses to the recommendations made, including agreed implementation dates. Internal Audit also undertakes follow-up reviews to evidence the effective implementation of these recommendations. Detailed below are the completed follow-up reviews: Self-Directed Support (SDS) – Option 2 and 3 4.4 A follow-up review has been undertaken to assess progress in implementing recommendations arising from a previous audit of Self-Directed Support Options 2 and 3. The Social Care (Self-directed Support) (Scotland) Act 2013 came into force in April 2014 and introduced the term Self-directed Support (SDS) to describe the ways in which individuals can exercise choice and control over the support or services that enable them to live independently and achieve agreed outcomes. The Follow-Up Report, presented in Appendix 1, notes that the majority of recommendations have been implemented. For the outstanding recommendations, revised implementation dates have been agreed with the Service. The Service has advised that all remaining actions are expected to be fully implemented during 2026/27. As this audit area has been subject to ongoing review over a number of years, it is proposed that no further follow-up review is undertaken. However, an audit of SDS Options 2 and 3 will be considered for inclusion in a future Internal Audit Plan. Moray Integrated Community Stores 4.5 An audit was previously undertaken of the Occupational Therapy Store, now known as the Moray Integrated Community Equipment Store. Occupational therapy stock comprises aids and equipment issued to support individuals with daily living activities, including cooking, dressing and bathing. Items vary significantly in value, ranging from low-cost aids to items costing in excess of £1,000, such as certain types of hoists and specialised seating. A key feature of the service is the management of equipment returns once items are no longer required. Where feasible, returned equipment is decontaminated and made available for reuse. The original audit identified significant areas for improvement in operational arrangements. A follow-up report, provided in Appendix 2, evidences the implementation of the agreed recommendations. Children's Services Social Care Commissioning 4.6 A follow-up review was undertaken to assess progress in implementing recommendations from a previous audit of commissioning arrangements for children’s social care services. The original audit examined key controls relating Page 54
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to external commissioning, including preventative support, restorative services, residential care and out-of-area placements. Testing covered commissioning strategies and procedures, financial monitoring and contract management arrangements. The follow-up review found that the majority of recommendations had been implemented; however, the development of a Commissioning Strategy remains outstanding, and a revised completion date has been agreed. The Follow-Up Report is included in Appendix 3. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022-2032” Internal audit work supports good governance and assists in securing appropriate systems of internal control. (b) Policy and Legal The internal audit service is provided in terms of paragraph 7:1 of the Local Authority Accounts (Scotland) Regulations 2014, and there is a requirement to provide a service in accordance with the Global Internal Audit Standards. (c) Financial Implications No implications directly arising from this report. (d) Risk Implications Audit reports highlight risk implications and contain recommendations for management to address as a means of mitigating. (e) Staffing Implications No implications directly arising from this report (f) Property No implications. (g) Equalities/ Socio Economic Impacts No implications. (h) Climate Change and Biodiversity Impacts None directly arising from this report. (i) Directions None arising directly from this report. (j) Consultations There have been no direct consultations during the preparation of this report. 6. CONCLUSION Page 55
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6.1 This report provides committee with an update on internal audit work progressed in the latest review period. Author of Report: Dafydd Lewis, Chief Internal Auditor Background Papers: Internal Audit Files Ref: mijb/ap&rc/ Page 56
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Appendix 1 Moray Council Internal Audit Section 1 BODY: Health & Social Care Moray SUBJECT: Self Directed Support (Options 2 & 3) REPORT REF: 23'025 Follow Up Audit Review Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Key Control: Effective controls operate in the management and recording arrangements for the delivery of SDS Options 2 and 3 care packages 5.1 In accordance with SDS Regulations, evidence should be maintained to document the discussions held by social workers regarding the various care delivery options discussed with High Yes 30/09/2023 Implemented. The audit follow-up review reported to MIJB’s Audit, Performance & Risk Committee on 19/06/2025 (para 7 of minute refers) and to the Council’s Audit & Scrutiny Committee on 24/06/2025 (para 7 Page 57
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Appendix 1 Moray Council Internal Audit Section 2 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation the individual using care services. of minute refers), noted that new documentation and guidance had been developed on required standards to be met and the first quality assurance review had been undertaken. The Service has introduced a quality assurance review process, in which findings are reported to the Practice Governance Board on a quarterly basis. This internal monitoring process is facilitating improvement and informing ongoing training and development activities, to ensure the required quality of care option discussions are recorded. Page 58
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Appendix 1 Moray Council Internal Audit Section 3 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 5.2 Documented procedures should be developed to support social workers and individuals using care services in the selecting of SDS care delivery options. High Yes 31/03/2024 (Revised Implementation Date 30/09/2025) Implemented. Social Work Assessment Guidance to support officers have been developed by the Service and formally agreed and put into practice from October 2024. This has been supported by further work on information to individuals, through revised guides and improved internet content, aligning available information to SDS standards and the development of a Resource Allocation process. The recommendation is now assessed as fully implemented. 5.3 An annual reference document detailing a breakdown of the rates paid to care providers should be High Yes 30/06/2023 (Revised Implementation Implemented. The annual reference document used for budgetary planning and costing of support packages has been Page 59
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Appendix 1 Moray Council Internal Audit Section 4 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation provided to all relevant officers to assist in budgetary planning and the accurate preparation of an individual's support package. Date 01/04/2025) updated to include breakdown rates for block funded services. Going forward, the extended use of framework agreements will allow the provision of the requisite detail on provider rates for costing purposes. 5.4 All officers should be reminded to update the CareFirst System to ensure the database is up-to-date and accurate for each individual using care services. High Yes 30/09/2023 Implemented. The Guidance referenced in 5.1 & 5.2 defines CareFirst requirements, with training, quality assurance, and ongoing monitoring overseen through service reviews and monthly Practice Governance Board meetings. This was reported in the follow- up report presented to MIJB’s Audit, Page 60
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Appendix 1 Moray Council Internal Audit Section 5 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Performance & Risk Committee on 19/06/2025 (paragraph 7 of the minutes refers) and to the Council’s Audit & Scrutiny Committee on 24/06/2025 (paragraph 7 of the minutes refers). 5.5 A tripartite agreement between the individual using the care service, Council and care provider should be agreed for all SDS Option 2 care packages. Medium Yes 30/09/2024 (Revised Implementation Date 31/07/2025) Implemented. Whilst the first audit follow- up exercise evidenced significant progress in implementing tripartite agreements for Option 2 packages, extension to historical packages was to be undertaken to ensure all Option 2 individuals receiving a social care service had a tripartite agreement in place. The audit review has found that this exercise to identify all Option 2 Page 61
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Appendix 1 Moray Council Internal Audit Section 6 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation arrangements and agree tripartite agreements has been completed. 5.6 A contractual agreement detailing service delivery and costs should be agreed with the 3 providers of day care services noted within the findings. High Yes 31/03/2024 (Revised Implementation Date 31/08/2025) Outstanding. The Service has advised that a significant review of future delivery needs is required for these day services, and this is intended to be completed in 2026/27. It is not intended that a third audit follow up is conducted and instead another review will be included in a future Audit Plan to evidence implementation. 5.7 Annual support plan reviews of individuals in receipt of SDS Option 2 and 3 care packages should be undertaken in accordance with agreed High Yes 30/09/2024 (Revised Implementation Date 31/12/2025) Outstanding. The follow-up review found that significant progress has been made in reviewing and if required, updating the Support Plans of individuals receiving SDS Option 2 and 3 care packages in Page 62
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Appendix 1 Moray Council Internal Audit Section 7 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation procedures. accordance with agreed procedures. However, audit testing identified continuing variances across Teams in the timeliness of Support Plan reviews. Regular reviews are essential to ensure Support Plans remain current, effective and compliant with statutory requirements. Following consultation with the Service, it is intended that progress will be made during 2026/27 to review and where required, update outstanding Support Plans. Progress will be closely monitored by Senior Management 5.8 Consideration should be given for management to undertake regular reviews of the accuracy and recording of the checks completed Medium Yes 30/09/2023 Implemented. A Standard Operating Procedure has been introduced for invoice checks, with monthly management Page 63
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Appendix 1 Moray Council Internal Audit Section 8 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation to ensure the accuracy of payments made to care providers. reviews of samples to ensure compliance. These reviews are evidenced through an invoice monitoring spreadsheet maintained by Community Care Finance. This was reported in the follow-up report presented to MIJB’s Audit, Performance & Risk Committee on 19/06/2025 (para 7 of minute refers) and to the Council’s Audit & Scrutiny Committee on 24/06/2025 (para 7 of minute refers). 5.9 The Council's charging policy should be reviewed in regard to day care and a decision made as to whether a charge should be levied for the service in the future. High Yes 30/09/2023 (Revised Implementation Date 30/09/2025) Outstanding. The review of the Social Care Charging Policy was planned but was delayed due to staffing availability and the need to align with emerging COSLA non- Page 64
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Appendix 1 Moray Council Internal Audit Section 9 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation residential care charging guidance. A change of approach has now been determined for the review of day care services charging, with its removal from the remit of the broad charging review to be undertaken for Social Care. A review of day service charging will instead be included in the overall Day Services review being undertaken as part of the 2026/27 Savings Plan. It is not intended that a third audit follow up is conducted and instead, another review will be included in a future Audit Plan to evidence implementation. Page 65
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Appendix 1 Moray Council Internal Audit Section 10 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 5.10 A review of arrangements regarding the authorisation of individual care packages should be undertaken. Thereafter, authorisation requirements should be documented and communicated to all appropriate officers. Medium Yes 31/08/2023 (Revised Implementation Date 30/06/2025) Part-Implemented. The follow-up audit noted that operating arrangements have been developed for the authorisation of individual care packages at differing monetary thresholds. In addition, a High Cost Package Panel has been established to review and authorise complex care packages. However, the authorisation requirements have not yet been formally documented, resulting in a risk of inconsistent application and a lack of clarity regarding the agreed operating arrangements. This matter has been discussed and agreed by the Operational Management Team (OMT), with formal Page 66
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Appendix 1 Moray Council Internal Audit Section 11 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation procedures expected to be issued to officers by 31 July 2026. Page 67
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Appendix 2 Moray Council Internal Audit Section 1 DEPARTMENT: Health & Social Care Moray SUBJECT: Moray Integrated Community Equipment Stores REPORT REF: 24'013 Follow Up Audit Review Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Key Control: Effective systems and procedures operating to ensure accurate records are maintained to account for all Occupational Therapy equipment held within Stores and issued to Service Users 5.1 A full stock check should be undertaken to ensure records correspond to the actual number of items held within Stores. High Yes 31/03/2024 Implemented – The review confirmed that Stores officers completed a full stock check after implementing new stock management arrangements. The stock take was verified by an officer from the Internal Audit Section with only minor variances noted between system recorded figures and the actual stock held. Page 68
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Appendix 2 Moray Council Internal Audit Section 2 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Items of equipment should be kept wherever possible in Asset Number order within the Stores Building. Asset Numbers should be clearly recorded where possible on shelving. Medium Yes 31/03/2024 Variances were investigated and explanations obtained. Implemented - Asset numbers are now clearly recorded on shelving used for storing equipment. Shelf locations across the store have also been added to the Stores Software Application (ELMS). 5.2 The software application used for purchasing equipment should be regularly updated with the stock issued to ensure an accurate unit price is maintained. Further exploration should be undertaken of ELMS with the purpose of enabling the direct purchase of equipment. Medium Medium Yes Yes 31/03/2024 (Revised Implementation Date 30/06/2025) 31/10/2024 (Revised Implementation Implemented – The follow-up review found that the separate stores management software application is no longer used to provide stock valuation for occupational therapy equipment. This function is now performed through ELMS. Implemented – The follow-up review found that while the purchasing of occupational therapy equipment is still undertaken through a separate stores management software Page 69
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Appendix 2 Moray Council Internal Audit Section 3 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Date 30/11/2025) application, the ELMS software package has been updated to include a stock valuation function. 5.3 A review should be undertaken of the current policy of revaluing re-used items of equipment at 50% of the original unit price. Medium Yes 31/01/2024 (Revised Implementation Date 30/06/2025) Implemented – It has been agreed by senior management within the service to revalue re- used equipment at 50% of the original purchase price has been reviewed and it has been decided to continue with the policy of 50% revaluation. 5.4 Users of the Service should be advised that any equipment received should be included within their personal property content insurance. Medium No 31/01/2024 (Revised Implementation Date 30/06/2025) Not Implemented – The Service has decided that individuals will not be required to include occupational therapy equipment under their personal property contents insurance. However, individuals will be advised to inform their insurer if the equipment has a structural impact on their property. Page 70
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Appendix 2 Moray Council Internal Audit Section 4 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 5.5 Maximum and minimum stock levels should be implemented in ELMS to assist officers in ensuring the effective management of stock levels. Medium Yes 31/03/2024 Implemented - The review has confirmed that maximum and minimum stock level functions are now used within ELMS. The Service also intends to review these stock level parameters regularly. 5.6 A record should be maintained of the stock checks undertaken, and any adjustments to stock figures for equipment recorded within ELMS should require the authorisation of the supervisor. Medium Yes 31/01/2024 Implemented – Records of weekly stock checks are now maintained. It was also confirmed that adjustments to stock levels within ELMS can now only be authorised by Supervisory Officers. 5.7 In regard to the stock of returned specialised chairs noted during the audit review, a decision should be undertaken regarding their future use. Medium Yes 31/03/2024 Implemented - The Service has decided to retain the chairs. A meeting between officers from the Equipment Stores of Aberdeen City, Aberdeenshire and Moray agreed to explore options regarding the use of these chairs and other equipment within the Grampian area. In Page 71
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Appendix 2 Moray Council Internal Audit Section 5 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation addition, the Service has advised that the chairs could be adapted to meet the specific needs of individuals, potentially providing an alternative to procuring new items. 5.8 Further development should be undertaken of ELMS to enable greater use of the software application in the management of stock items. Medium Yes 31/03/2024 Implemented – It was found that the Service is making greater use of the reporting functions within ELMS. In addition, data from ELMS is exported to another software application to allow for greater analysis of information. 5.9 Officers should be instructed to utilise the facility within ELMS to mark stock as out for delivery. Low Yes 30/06/2024 Implemented - Procedures are now in place requiring drivers delivering equipment from Stores to mark equipment as out for delivery within ELMS. 5.10 A review of off contract expenditure should be carried out and where necessary contracts developed. Low Yes 31/03/2024 (Revised Implementation Date 30/06/2025 Implemented – Formal contracts are now in place for the procurement of the majority of equipment, including the provision of Page 72
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Appendix 2 Moray Council Internal Audit Section 6 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Revised Implementation Date 31/10/2025) specialised chairs, as noted in the audit report findings. 5.12 Current operating practices should be recorded within a Service Operating Manual. Medium Yes 31/03/2024 Implemented - Operating Procedures are now in place to provide officers with a point of reference guidance in the administration of the Moray Integrated Community Equipment Store. 5.13 A review of service procedures should be undertaken to ensure the store is informed of a change in circumstance in a service user’s condition where an item of equipment may no longer be required. Arrangements should then be undertaken for collection at the earliest opportunity. Medium Yes 29/02/2024 Implemented - The Moray Integrated Community Equipment Service is informed of equipment issued to an individual but is no longer required. Testing has confirmed that when informed, arrangements are made for the collection of this equipment. Page 73
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Appendix 2 Moray Council Internal Audit Section 7 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation If no agreement can be made for an item of equipment to be returned to the store, consideration should be given to invoicing the service user. Medium Yes 31/01/2024 (Revised Implementation Date 30/06/2025 Revised Implementation Date 30/11/2025) Implemented – The Service has formalised procedures for issuing invoices to users when an agreement cannot be reached regarding the return of previously allocated equipment. 5.14 Improvements identified to the Service during the audit review regarding the physical security of the Occupational Therapy Stores building should be implemented as a matter of urgency. High Yes 31/03/2024 Implemented - A new alarm system has been fitted at the Moray Integrated Community Equipment Store and is now in operation. Page 74
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Appendix 3 Moray Council Internal Audit Section 1 DEPARTMENT: Health and Social Care Moray SUBJECT: Children's Services Social Care Commissioning REPORT REF: 24'012 Follow Up Audit Review Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Key Control: A clear Strategy and Procedures have been developed for Children's Services Commissioning and are regularly reviewed. 5.1 The development and agreement of a Commissioning Strategy should be progressed and agreed in accordance with the timescale detailed within the Health & Social Medium Yes 31/12/2025 (Revised Implementation Date 30/06/2026) Outstanding. The Strategic Delivery Plan for 2025-2028, approved in May 2025, commits to the development of a Strategic Commissioning Strategy under the responsibility of the Senior Management Team. The Head of Service has advised Page 75
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Appendix 3 Moray Council Internal Audit Section 2 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Care Moray Strategic Delivery Plan. resources have been allocated to complete a Commissioning Strategy by the end of June 2026. Key Control: Commissioned services are identifiable, subject to appropriate contractual arrangements and managed and monitored to ensure service delivery meets the intended outcomes. 5.2 All contractual arrangements should be aligned with the new Commissioning Procedures at the earliest opportunity to ensure consistency in the management and monitoring of performance information. Medium Yes 31/10/2024 Implemented. All contractual arrangements now reflect the current commissioning procedures and require service providers to submit tailored, but consistent, performance information on a regular basis. The follow-up audit has seen appropriate contract management and monitoring arrangements to be in place giving assurance that the required information is being tracked, pursued, received and utilised. Page 76
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Appendix 3 Moray Council Internal Audit Section 3 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 5.3 In accordance with established contractual arrangements, payments should not be made in advance of service delivery. Medium Yes 31/12/2023 Implemented. Sample testing as part of this follow-up audit has identified no instances of advance payment for the service area. Processes have improved in terms of communication with service providers and internal checks in line with best practice being undertaken prior to invoices being processed. Reminders on financial regulations requirements are also being issued annually to budget holders and staff who process invoices. Page 77
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: INTERNAL AUDIT SECTION COMPLETED PROJECTS REPORT BY: CHIEF INTERNAL AUDITOR 1. REASON FOR REPORT 1.1 To provide an update on audit work completed since the last meeting of the Committee. 2. RECOMMENDATION 2.1 It is recommended that Committee consider and note this audit update. 3. BACKGROUND 3.1 Global Internal Audit Standards (GIAS) require the Chief Internal Auditor to prepare and present reports to the committee on internal audit’s activity relative to the audit plan and any other relevant matters. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 In accordance with the approved Internal Audit Plan, the following reviews were completed: Counter Fraud Review 4.2 An audit was undertaken to review the Council’s counter-fraud framework. While the prevention and detection of fraud and error rests with management, the Internal Audit Section plays a significant role in reviewing systems and procedures to support an effective control environment. The audit programme for this review was developed from the Chartered Institute of Public Finance and Accountancy (CIPFA) Code of Practice on Managing the Risk of Fraud and Corruption. This CIPFA Code is a recognised best-practice framework for public sector bodies. It sets out principles for strong governance, accountability and effective counter-fraud strategies. This review also includes a check of systems and procedures identified as having a higher risk of fraud, with the scope of testing informed by fraud cases reported by other public sector bodies and Item 8. Page 79
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highlighted by regulatory authorities such as Audit Scotland in their Technical Bulletins. 4.3 Within the scope of this review, it is considered that the Council has an appropriate and proportionate approach to managing fraud risk and that key controls are in place. These include established policies and procedures such as the Policy to Combat Fraud, Theft, Bribery and Corruption and the Whistleblowing (Confidential Reporting) Policy. However, the review identified areas for further development and administrative improvement within the Council’s counter-fraud governance arrangements. The detailed findings and recommendations arising from this review are set out in the audit report in Appendix 1. Payroll 4.4 A review of the payroll system has been undertaken. The payroll system is one of the Council's core financial systems, administering approximately £162 million in annual expenditure. The audit involved testing a random selection of salary payments and deductions to ensure the correct calculation of remuneration and statutory/ voluntary deductions are processed timeously and accurately. The Chartered Institute of Public Finance and Accountancy Control Matrices were used to develop the audit programme. 4.5 The findings noted that within the scope of this review, effective arrangements are in place in the management of the Council’s payroll system. However, some administrative improvements were identified. Detailed findings and recommendations arising from this review are provided in the audit report in Appendix 2. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022-2032” Internal audit work supports good governance and assists in securing appropriate systems of internal control. (b) Policy and Legal The internal audit service is provided in terms of paragraph 7:1 of the Local Authority Accounts (Scotland) Regulations 2014, and there is a requirement to provide a service in accordance with published Public Sector Internal Audit Standards. (c) Financial Implications No implications directly arising from this report. (d) Risk Implications and Mitigation Audit reports highlight risk implications and contain recommendations for management to address as a means of mitigating. (e) Staffing Implications No implications directly arising from this report. Page 80
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(f) Property No implications. (g) Equalities/ Socio Economic Impacts No implications. (h) Climate Change and Biodiversity Impacts None directly arising from this report. (i) Directions None arising directly from this report. (j) Consultations There have been no direct consultations during the preparation of this report. 6. CONCLUSION 6.1 This report provides Committee with a summary of findings arising from audit project completed during the review period. Author of Report: Dafydd Lewis, Chief Internal Auditor Background Papers: Internal Audit Files Ref: Page 81
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Appendix 1 1 Final Internal Audit Report Counter Fraud Review January 2026 Distribution: Chief Financial Officer Chief Governance Officer Service Manager Organisational Development & Change Service Manager Strategic Planning & Development Service Manager Finance Operations Service Manager Internal Audit & Risk The Internal Audit Section provides Management with an opinion on the internal control environment and also categories risk ratings for recommendations as high, medium or low (detailed explanation provided in Appendix1). The audit recommendations for this review have been classified as follows Assurance Level Risk Ratings for Recommendations Substantial Priority 1 0 Priority 2 3 Priority 3 4 Confidentiality and Disclosure Clause This report (“Report”) was prepared by the Internal Audit Section of Moray Council. The matters raised in this Report are only those which came to our attention during our internal audit work. Whilst every care has been taken to ensure that the information provided in this Report is as accurate as possible, the Moray Council Internal Audit Section has only been able to base findings on the information and documentation provided and consequently, no complete guarantee can be given that this Report is necessarily a comprehensive statement of all the weaknesses that exist, or of all the improvements that may be required. This Report was prepared solely for the use and benefit of the Moray Council, Moray Integration Joint Board or the Grampian Valuation Joint Board. Moray Council's Internal Audit Section accepts no responsibility and disclaims all liability to any third party who purports to use or rely for any reason whatsoever on the Report, its contents, conclusions, any extract, reinterpretation, amendment and/or modification. Accordingly, any reliance placed on the Report, its contents, conclusions, any extract, reinterpretation, amendment and/or modification by any third party is entirely at their own risk. Please refer to the Statement of Responsibility in Appendix 2 of this report for further information about responsibilities, limitations and confidentiality. Page 82
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Appendix 1 2 Contents Page Counter Fraud Review 1. Introduction & Scope 3 2. Key Issues 4-5 Detailed Report 3. Findings/Recommendations 6-17 4. Management Response 7-17 Appendices 1. Audit Terms of Reference and Definitions 2. Statement of Responsibility Page 83
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Appendix 1 3 1. Introduction and Audit Scope The annual audit plan for 2025/26 includes a review of the Council’s counter-fraud framework, with the objective of minimising the risk and impact of fraud from internal and external threats. While the prevention of fraud and error rests with management through the design and operation of suitable systems of control, this review aims to support the Council’s counter-fraud framework by identifying any further improvements to reduce the occurrence of fraud and related risks. The Chartered Institute of Public Finance and Accountancy (CIPFA) defines fraud as “the intentional distortion of financial statements or other records by persons internal or external to the organisation, carried out to conceal the misappropriation of assets or otherwise for gain.” The Council has a responsibility to embed a robust framework for countering fraud, demonstrating strong public financial management and sound governance. Minimising losses from fraud and corruption is essential to ensuring that public funds are used for their intended purpose: providing essential services. The Council has a Policy to Combat Fraud, Theft, Bribery and Corruption, alongside other associated policies and guidance, including a Whistleblowing (Confidential Reporting) Policy and a Code of Conduct. These policies are built around a counter-fraud culture supported by practices designed to deter and detect fraudulent and corrupt activities. They also take account of the Council’s statutory obligations, particularly the provisions of the Bribery Act 2010. The scope of the audit covered governance arrangements, fraud risk assessments, staff awareness and internal controls designed to reduce fraud risks. It also assessed reporting and investigation procedures, as well as collaboration with external bodies. The audit testing programme was developed in accordance with the CIPFA Code of Practice on Managing the Risk of Fraud and Corruption, which sets out five key principles for ensuring a comprehensive and effective counter-fraud approach: • Acknowledge responsibility for countering fraud and corruption • Identify fraud and corruption risks • Develop an appropriate counter fraud strategy • Provide resources to implement the strategy • Take action in response to fraud and corruption . The audit was carried out in accordance with the Global Internal Audit Standards (GIAS). Page 84
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Appendix 1 4 2. Key Issues The audit review considers that the Council has generally an appropriate and proportionate approach to managing fraud risk, with key controls in place, including anti-fraud and corruption policies, segregation of duties in financial processes, and robust internal controls supported by prompt investigation and reporting procedures for suspected fraud. This review includes a check of systems and procedures identified as having a higher risk of fraud, with the scope of testing informed by fraud cases reported by other public sector bodies and highlighted by regulatory authorities such as Audit Scotland in their Technical Bulletins. However, areas for further development and administrative improvements within the Council’s counter-fraud strategy include: : • Training- It is pleasing to note the requirement for officers to complete the online training module designed to protect the Council from cyber- attack threats, such as ransomware, phishing and data breaches. While cyber-security remains a critical area of concern, reviews of reported frauds within the public sector indicate that significant risks often originate from financial processes. These risks include unauthorised transactions, manipulation of financial records and exploitation of weaknesses in procurement and payment systems. Consideration should be given to providing additional training to support officers who are responsible for procurement and financial processing, to help them identify potential financial risks such as false invoicing, supplier fraud and attempted manipulation of routine payment processes. • National Fraud Initiative (NFI)- The Council participates in the National Fraud Initiative (NFI), a UK-wide data-matching exercise coordinated by the Cabinet Office and administered in Scotland by Audit Scotland, to help detect and prevent fraud in the public sector. The NFI uses data- matching techniques to identify anomalies and potential fraud in areas such as housing benefits, payroll, council tax, and procurement. The Council has adopted a structured, risk-based approach for the review of matches. This process has now been further enhanced through the introduction of quality checks on the outcomes of match investigations undertaken by services by the Internal Audit Section. • Fraud/ Irregularities- Investigations into suspected fraud or irregularities involving Council officers are undertaken by Internal Audit, but may also be carried out by other services, including Human Resources and Information Governance. Financial Regulations require that any suspected irregularity involving finances, property, services, policy, or Council functions must be reported promptly to Internal Audit. While Human Resources and Information Governance inform the Page 85
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Appendix 1 5 Internal Audit Section's investigations, this is not a formalised arrangement. A structured process should be established to ensure timely notification, enabling Internal Audit to review the irregularity and determine whether a systems audit is required to improve the control environment. Page 86
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6 Findings/Recommendations - Counter Fraud Review 2025/26 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 1 Medium The Council’s fraud strategy is outlined in its Policy to Combat Fraud, Theft, Bribery and Corruption. Management is responsible for preventing and detecting fraud through effective controls, with Internal Audit providing support. Internal Audit’s approach includes an annual counter-fraud review of systems and procedures to reduce fraud risks, as well as participation in external initiatives such as the National Fraud Initiative for data matching. The scope of this annual counter-fraud review is determined from various sources, including summaries of fraud cases and other irregularities reported in Audit Scotland’s Technical Bulletins, as well as information gathered through participation in the Scottish Local Authority Investigators’ Group. A review of the guidance to organisations on the offence of failure to prevent fraud under the Economic Crime and Corporate Transparency Act 2023 noted that the Council has, in accordance with good practice, adopted a Internal Audit’s approach to supporting management in implementing effective counter-fraud arrangements should also be separately identified as part of the Internal Audit Strategy within the Annual Audit Plan. Page 87
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7 strategic approach to fraud prevention and detection. However, it is also considered that this fraud strategy should be documented as part of the Council’s annual audit planning approach. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager Internal Audit and Risk Yes 25/03/2026 The Annual Audit Plan will be amended to include a reference to Internal Audit’s Strategy for supporting the Council’s counter-fraud arrangements. Page 88
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8 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 2 Low The Elgin Neighbourhood Board was awarded £20 million as part of the UK Government’s Long-Term Plan for towns in October 2023 to support a range of community-led regeneration projects. Moray Council is the Accountable Body for the neighbourhood board funding, with responsibility for ensuring that public funds are distributed fairly and managed in accordance with public-sector financial regulations. Additionally, the UK Government requires a fraud risk assessment of the governance arrangements for the funding awarded. The Strategic Planning Development Manager contacted the Internal Audit Section to assist in developing a template for conducting the fraud risk assessment. This template has been completed; however, the assessment will be an ongoing annual requirement. The Elgin Neighbourhood Board is currently in the planning and engagement phase, focused on finalising and refining its regeneration strategy before moving into implementation. A review was undertaken of the Board’s governance documentation in relation to the An annual fraud risk assessment of Elgin Neighbourhood Board activities and governance should be undertaken. If required, the Internal Audit Section should be contacted for assistance with the process Consideration should be given to including additional reference within the Elgin Neighbourhood Board Terms of Reference of the need to inform the Service Manager Internal Audit and Risk Page 89
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9 prevention and detection of fraud. It is pleasing to note that Board Members are required to uphold the Nolan Principles of Public Life. However, to enhance clarity of responsibility and strengthen the assurance framework, consideration should be given to including a requirement for the Service Manager Internal Audit and Risk, to be informed of any matters involving, or suspected to involve, irregularities or fraud. of any matter involving or is thought to involve fraud or any suspected irregularity. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Senior Project Officer (Elgin Neighbourhood Board) Yes 31/03/2026 Include duty within updated Terms of Reference to inform the Elgin Neighbourhood Board Project Manager of any matter involving or is thought to involve fraud or any suspected irregularity, who will inform the Service Manager Internal Audit and Risk. This duty will also be included within grant awards signed with all project leads. Page 90
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10 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 3 Medium Investigations of suspected irregularities by Council officers can be undertaken by the Internal Audit Section as well as by other services, including Human Resources and Information Governance Services. Financial Regulations state, “Any matter which involves, or is thought to involve, irregularities concerning finances, property, services, or policy of the Council, or any suspected irregularity in the exercise of the functions of the Council, must be reported as soon as possible by any Officer having knowledge thereof to Internal Audit.” It is pleasing to note that both Human Resources and Information Governance Services do inform the Internal Audit Section of investigations; however, this is not a formalised arrangement. A structured approach should be agreed to ensure timely notification of investigations, allowing Internal Audit to undertake an overview of the irregularity and determine whether a review of systems or Human Resources and Information Governance Services should include within their operating procedures a requirement to notify the Internal Audit Section of any investigations undertaken into suspected irregularities by Council officers. Page 91
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11 procedures is required to strengthen current governance and control arrangements. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Information Governance Manager and Data Protection Officer Acting Senior HR Advisor Yes Yes 30/06/2026 Implemented The Guidance on Data Security Breach Management will be updated to require informing the Internal Audit Section of any suspected irregularities by Council officers. Human Resource procedures have been amended to ensure that advisors dealing with relevant cases notify Internal Audit of suspected irregularities and case tracking records updated to include this action. Page 92
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12 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 4 Low It is pleasing to note that the Payments Section maintains a Register of Interests within the Service. A Register of Interests is a formal record of officers’ personal, financial, or family connections that could, or appear to, influence their impartiality in processing payments or dealing with suppliers or contractors. This allows management to implement appropriate controls to protect the officer and reduce the risk of fraud. Maintaining such a register is considered good practice as it promotes transparency and integrity in payment processes. However, a review of the Register of Interests found that recent changes in officer appointments and responsibilities had not been updated. The requirement for a Register of Interests within the Payments Section is considered good practice; however, it should be kept up to date to reflect any changes in officers’ responsibilities or appointments. Page 93
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13 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager Finance Operations Yes Implemented The register of interests has been updated for all staffing changes and as well as updated with any existing staff interests. Page 94
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14 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 5 Medium A review of fraud cases reported by Audit Scotland, the Chartered Institute of Public Finance and Accountancy (CIPFA) and other regulatory bodies has noted that significant fraud occurs within services responsible for procurement, processing and administration of payment systems. Good practice in fraud prevention for procurement and payment activities highlights the need for regular training to ensure officers are reminded of regulations and policies and remain alert to emerging threats such as false invoicing, supplier fraud and manipulation of payment procedures. While fraud-awareness training is undertaken within the Payments Section, it is not formalised or integrated into the Council’s structured annual training framework. Discussions have been held with Service Managers from the Payments Section and Organisational Development & Change to explore opportunities to strengthen the current training programme. Consideration should be given to introducing annual fraud-awareness training for officers responsible for procurement and invoice processing. This should include officers in the Payments Section and within services. Enhancing staff awareness and understanding will strengthen internal controls, reduce exposure to fraud, and support compliance with best-practice standards. Page 95
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15 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager Organisational Development and Change/ Service Manager Finance Operations Yes 31/10/2026 The Service Managers will work collaboratively to identify a list of job roles that require training and agree the most appropriate training intervention to be incorporated into the corporate training offering on an annual basis going forward. Page 96
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16 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 6 Low As part of its counter-fraud strategy, Moray Council participates in the biennial National Fraud Initiative (NFI). The NFI is a UK-wide counter-fraud exercise, coordinated by the Cabinet Office and administered in Scotland by Audit Scotland. It uses computerised data- matching techniques to compare information about individuals held by different public bodies and across different financial systems, identifying matches that may indicate potential fraud or error. The 2024/25 NFI exercise is currently in progress. The agreed approach is for services to review and document the reasons for data matches, while the Internal Audit Section investigates potential fraud, monitors progress and reports on the outcomes. Previous exercises have not identified instances of fraud; however, participation in the NFI exercise has provided two main benefits: it confirms that fraud-prevention controls are operating effectively and offers an opportunity to cleanse and improve the accuracy of data held in Council systems. It is considered that further The Internal Audit Section should undertake sample testing of NFI investigations carried out by services to verify the accuracy and completeness of the work undertaken. Page 97
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17 improvements to the current approach should be made, with the Internal Audit Section undertaking testing of a sample of investigations carried out by services to verify the accuracy and completeness of the work undertaken. This will strengthen assurance that NFI investigations are accurate, complete, and conducted in accordance with required processes. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager Internal Audit and Risk Yes Implemented An Internal Auditor has been assigned responsibility for undertaking sample testing of NFI data-matching investigations completed by services as part of additional quality assurance procedures. Page 98
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18 Appendix 1 AUDIT TERMS OF REFERENCE AND DEFINITIONS 1. Audit Objectives 1.1 The overall audit objective is to provide an objective independent opinion on the adequacy and effectiveness of controls / processes. 1.2 The audit will for each controls / process being considered: • Walkthrough the processes to consider the key controls; • Conduct sample testing of the identified key controls, and • Report on these accordingly 1.3 All audit reviews are carried out in accordance with Global Internal Audit Standards (GIAS). 2. Definitions for Auditing Opinions and Findings 2.1 In order to assist management in using our reports: The Internal Auditor will categorise audit assurance opinion according to their overall assessment of the risk management system, effectiveness of the controls in place and the level of compliance with these controls and the action being taken to remedy significant findings or weaknesses. Assurance Level System and Testing Conclusion Full The controls tested are being consistently applied Substantial There is evidence that the level of non compliance with some of the controls may put some of the system objectives at risk. Limited The level of non compliance puts the system objectives at risk. None Significant non-compliance with basic controls leaves the system open to error or abuse. 2.2 Risk ratings for each recommendation is based on the following criteria: High Fundamental control weaknesses that require immediate attention by management to action and mitigate significant exposure to risk Medium Less critically important controls absent, not being operated as designed or could be improved Low Lower level controls absent, not being operated as designed or could be improved. Page 99
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19 Appendix 2 STATEMENT OF RESPONSIBILITY The responsibility for designing and maintaining a sound system of internal control to prevent and detect fraud and other irregularities rests with management, with internal audit providing a service to management to support them to achieve this objective. The Internal Audit Section will assess the adequacy and effectiveness of the system of internal control arrangements implemented by management and perform sample testing on those controls in the period under review with a view to providing an opinion on the extent to which risks in this area are managed. The Internal Audit Section will undertake testing with the objective of detecting significant control weaknesses. However, the audit approach alone should not be relied upon to identify all strengths and weaknesses in internal controls nor to find any fraud or irregularity. Even sound systems of internal control can only provide reasonable and not absolute assurance and may not be proof against collusive fraud. The matters raised in this report are only those that came to our attention during the course of the audit review and are not necessarily a comprehensive statement of all the weaknesses that exist or all improvements that might be made. Recommendations for improvements should be assessed by management for their full impact before they are implemented. The performance of the audit review undertaken should not be taken as a substitute for management’s responsibilities for the application of sound management practices. This report must not be disclosed to any third party or reproduced in whole or in part without the written consent of the Moray Council’s Service Manager Internal Audit and Risk. Page 100
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Appendix 2 1 Final Internal Audit Report Payroll May 2026 Distribution: Head of People, Change & Community Strategy Service Manager People Management Senior HR and Payroll Administration Adviser The Internal Audit Section provides Management with an opinion on the internal control environment and also categories risk ratings for recommendations as high, medium or low (detailed explanation provided in Appendix1). The audit recommendations for this review have been classified as follows Assurance Level Risk Ratings for Recommendations Substantial Priority 1 0 Priority 2 1 Priority 3 1 Confidentiality and Disclosure Clause This report (“Report”) was prepared by the Internal Audit Section of Moray Council. The matters raised in this Report are only those which came to our attention during our internal audit work. Whilst every care has been taken to ensure that the information provided in this Report is as accurate as possible, the Moray Council Internal Audit Section has only been able to base findings on the information and documentation provided and consequently, no complete guarantee can be given that this Report is necessarily a comprehensive statement of all the weaknesses that exist, or of all the improvements that may be required. This Report was prepared solely for the use and benefit of the Moray Council, Moray Integration Joint Board or the Grampian Valuation Joint Board. Moray Council's Internal Audit Section accepts no responsibility and disclaims all liability to any third party who purports to use or rely for any reason whatsoever on the Report, its contents, conclusions, any extract, reinterpretation, amendment and/or modification. Accordingly, any reliance placed on the Report, its contents, conclusions, any extract, reinterpretation, amendment and/or modification by any third party is entirely at their own risk. Please refer to the Statement of Responsibility in Appendix 2 of this report for further information about responsibilities, limitations and confidentiality. Page 101
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Appendix 2 2 Contents Page Payroll 1. Introduction & Scope 3 2. Key Issues 3-4 Detailed Report 3. Findings/Recommendations 5-7 4. Management Response 6-8 Appendices 1. Audit Terms of Reference and Definitions 2. Statement of Responsibility Page 102
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Appendix 2 3 1. Introduction and Audit Scope The Internal Audit Plan for 2025/26 included a review of the Council’s payroll system, focusing on assessing the adequacy and effectiveness of the controls in place to ensure the accurate payment of salaries. The audit was undertaken by testing a randomly selected sample of starters, leavers and current employees to assess the accuracy of pay calculations and to confirm that appropriate supporting documentation was retained and approved. The sample period for the audit testing was 1 April 2025 – 31 January 2026. The scope of the audit also included a review to confirm that any deductions from salary payments were made in accordance with statutory requirements or were appropriately authorised by the employee. This review included verification of amounts deducted and remitted to third parties, including HM Revenue & Customs and the North East Scotland Pension Fund. The payroll system is a core financial system of the Council and is critical to the accurate processing of staffing costs, which in 2025/26 amounted to approximately £162 million. Since 2017, the Council has operated its payroll function using the iTrent software application. It was noted that approximately 5140 officer payslips are processed each month. The iTrent system performs a dual function in supporting both payroll and human resources activities. This design facilitates the operation of key segregation-of-duties controls by ensuring an appropriate separation between processes relating to officer appointments, terminations, and grading, and the processing and payment of salaries. The audit was carried out in accordance with the Global Internal Audit Standards (GIAS). 2. Key Issues It is pleasing to report that, based on the testing undertaken and within the scope of this review, effective arrangements were found to be in place for the management of the Council’s payroll system. However, the following areas were identified as requiring further development: • It was noted that the Payroll Section has documented Payroll Guidelines that provide administrative guidance to support the accurate processing of employee pay, ensure appropriate authorisation and promote compliance with statutory requirements, while also facilitating effective workforce management and safeguarding public funds. A review of the Payroll Guidelines found that they are appropriate and relevant to current operating practices; however, it was identified that certain reference information and supporting documentation should be updated Page 103
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Appendix 2 4 to reflect the current organisational structure and standing information. Audit testing did not identify any discrepancies in the accuracy of salary payments made to employees. However, given that payroll is a core financial system, the Payroll Guidelines should be subject to an annual review to confirm whether any further updates or changes are required. • Payroll Guidelines require services to inform the Payroll Section as soon as they become aware that an employee is terminating their contract of employment. Audit testing of a random sample of former employees found that, in the majority of cases, services notified the Payroll Section promptly. However, audit testing noted examples of delays that resulted in salary overpayments, requiring recovery through the Council’s invoicing system. It is appreciated that instances of overpayments are low; however, all services should be reminded of the requirement to notify the Payroll Section of employee contract terminations promptly, as delays may result in salary overpayments that require additional administration and the recovery of payments made in error. Page 104
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5 Findings/Recommendations - Payroll 2025/26 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 1 Low The audit noted that established Payroll Guidelines are in place to provide operational and administrative guidance to officers within the Payroll Section and to services across the Council and its partner organisations. A review of the Payroll Guidelines confirmed that the core content remains relevant and reflects current payroll processes. However, it was identified that certain reference material and supporting documentation need to be updated within the Guidelines to reflect the Council’s current organisational structure and standing information. Audit testing of a sample of salary payments confirmed that no discrepancies were found in the accuracy of payments to employees. However, as payroll is a key financial system, it is recommended that the Payroll Guidelines be reviewed annually to ensure they remain current and reflect all procedural, structural, and legislative changes. Payroll Guidelines should be updated to ensure that all reference information and supporting documentation reflect current operating arrangements and the organisational structure. The Guidelines should then be subject to an annual review to maintain continued accuracy and compliance with statutory and organisational requirements. Page 105
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6 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Senior Payroll and HR Administration Adviser Yes 30/06/2026 Full review of guidelines to be carried out and updated version uploaded to interchange. Page 106
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7 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 2 Medium The Payroll Guidelines require services to notify the Payroll Section promptly when an employee’s contract of employment terminates, in order to prevent salary overpayments. Audit testing of a randomly selected sample of former employees identified one instance of an overpayment, resulting from the employing service not notifying the Payroll Section of the termination on a timely basis. This overpayment has since been recovered through the Council’s invoicing system. The audit sample size was increased and additional testing was undertaken. No significant delays were identified in the majority of cases reviewed between the employee termination notification date and the Payroll Section being informed by services. However, a further instance of delayed notification was identified. Recovery of this overpayment from the former employee is being progressed through the Council’s invoicing system. All services should be reminded of the requirement for the timely notification of employee contract terminations to the Payroll Section. Page 107
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8 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Senior Payroll and HR Administration Adviser Yes 30/06/2026 An email to be sent directly to all Budget Managers reminding them of the deadlines for receipt of forms. This will then be backed up by article in the June HR Bulletin. Late forms to be monitored and reminders to be sent to appropriate managers at the time. Annual reminder to be sent to all budget managers at the start of the calendar year with the list of deadlines. Page 108
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9 Appendix 1 AUDIT TERMS OF REFERENCE AND DEFINITIONS 1. Audit Objectives 1.1 The overall audit objective is to provide an objective independent opinion on the adequacy and effectiveness of controls / processes. 1.2 The audit will for each controls / process being considered: • Walkthrough the processes to consider the key controls; • Conduct sample testing of the identified key controls, and • Report on these accordingly 1.3 All audit reviews are carried out in accordance with Global Internal Audit Standards (GIAS). 2. Definitions for Auditing Opinions and Findings 2.1 In order to assist management in using our reports: The Internal Auditor will categorise audit assurance opinion according to their overall assessment of the risk management system, effectiveness of the controls in place and the level of compliance with these controls and the action being taken to remedy significant findings or weaknesses. Assurance Level System and Testing Conclusion Full The controls tested are being consistently applied Substantial There is evidence that the level of non compliance with some of the controls may put some of the system objectives at risk. Limited The level of non compliance puts the system objectives at risk. None Significant non-compliance with basic controls leaves the system open to error or abuse. 2.2 Risk ratings for each recommendation is based on the following criteria: High Fundamental control weaknesses that require immediate attention by management to action and mitigate significant exposure to risk Medium Less critically important controls absent, not being operated as designed or could be improved Low Lower level controls absent, not being operated as designed or could be improved. Page 109
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10 Appendix 2 STATEMENT OF RESPONSIBILITY The responsibility for designing and maintaining a sound system of internal control to prevent and detect fraud and other irregularities rests with management, with internal audit providing a service to management to support them to achieve this objective. The Internal Audit Section will assess the adequacy and effectiveness of the system of internal control arrangements implemented by management and perform sample testing on those controls in the period under review with a view to providing an opinion on the extent to which risks in this area are managed. The Internal Audit Section will undertake testing with the objective of detecting significant control weaknesses. However, the audit approach alone should not be relied upon to identify all strengths and weaknesses in internal controls nor to find any fraud or irregularity. Even sound systems of internal control can only provide reasonable and not absolute assurance and may not be proof against collusive fraud. The matters raised in this report are only those that came to our attention during the course of the audit review and are not necessarily a comprehensive statement of all the weaknesses that exist or all improvements that might be made. Recommendations for improvements should be assessed by management for their full impact before they are implemented. The performance of the audit review undertaken should not be taken as a substitute for management’s responsibilities for the application of sound management practices. This report must not be disclosed to any third party or reproduced in whole or in part without the written consent of the Moray Council’s Service Manager Internal Audit and Risk. Page 110
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: UNAUDITED ANNUAL ACCOUNTS BY: CHIEF FINANCIAL OFFICER 1. REASON FOR REPORT 1.1 To inform the Committee of the Unaudited Annual Accounts of the Moray Integration Joint Board (MIJB) for the year ended 31 March 2026. 2. RECOMMENDATION 2.1 It is recommended that the Committee: i) consider and scrutinise the unaudited Annual Accounts and recommend approval to the MIJB to be submitted to the external auditor, noting that all figures remain subject to audit, in Appendix 1; ii) note the updated Local Code of Corporate Governance which supports the Annual Governance Statement, in Appendix 2; iii) note the accounting policies applied in the production of the unaudited Annual Accounts, pages 48 to 49 of the accounts; iv) note the Annual Governance Statement contained within the unaudited Annual Accounts and in Appendix 3; and v) note the Best Value Statements as detailed in Appendix 4 3. BACKGROUND 3.1 The Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Order 2014 requires that an integration joint board is subject to the audit and accounts regulations and legislation of a body under Section 106 of the Local Government (Scotland) Act 1973. 3.2 The Local Authority Accounts (Scotland) Regulations 2014 (2014 Regulations), places a statutory obligation on the MIJB to submit draft Annual Accounts for the Item 9. Page 111
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year ended 31 March 2026 to its external auditors by 30 June 2026 and the audited annual accounts are required to be approved by the MIJB and published by 30 October each year. 3.3 A copy of the unaudited accounts is attached at Appendix 1. 3.4 The MIJB has a statutory duty to conduct a review at least once in each financial year of the effectiveness of its system and to include a statement reporting the review within its Statement of Accounts. The MIJB does this through its Annual Governance Statement which is published as part of its Annual Accounts. 3.5 The MIJB has established arrangements and continues to develop its governance framework which includes the system of internal control. This system is intended to manage risk and support the achievement of the MIJB’s policies, aims and objectives. Reliance is placed on NHS Grampian and Moray Council systems of internal control that support compliance with both organisations’ policies and promotes achievement of each organisation’s aims and objectives; to the extent that these are complementary to those of the MIJB. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The Annual Accounts have been prepared in accordance with the Code of Practice on Local Authority Accounting in the United Kingdom 2025/26 (the Code) which is underpinned by the International Financial Reporting Standards (IFRS). 4.2 Grant Thornton, under the Local Authority Accounts (Scotland) Regulations 2014 is required to complete their audit by 30 September 2026, Grant Thornton is working to this deadline and audited accounts are due to be submitted to IJB in September 2026. The audited accounts and the External Auditor’s report statutory deadline for publication is 30 October 2026. 4.3 The Comprehensive Income and Expenditure Statement shows a surplus of £1.56m on the provision of services for the year. As at 31 March 2026, the Balance Sheet showed total Reserves of £3.1m. This increase is primarily due to funding relating to the Unscheduled care improvement plan and GP walk-in centre funding. Note 7 within the unaudited accounts breaks down the Reserves between what is General Reserve and available for utilisation and supporting the budget and what is earmarked for specific purposes. 4.4 The unaudited accounts are given at Appendix 1 and consist of the following: Management Commentary – provides the context through narrative that supports the financial statements. It describes the strategic intent of the MIJB, together with its performance through the year, highlighting areas of risk. It also provides some forward thinking on the forthcoming year and planned developments. Remuneration Report – details the pay and pension benefits accrued by the MIJB senior officers during 2025/26. Page 112
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Annual Governance Statement – is a means of reporting publicly on the MIJB’s governance arrangements, and seeks to provide assurance that its business is conducted in accordance with law, regulations and proper practices and that public money is safeguarded and properly accounted for. Financial Statements – provides detail of the main financial transactions through the Comprehensive Income and Expenditure Statement, Movement in Reserves Statement, and Balance Sheet. Notes to the Accounts – explains the use of accounting policies and provides supporting information to the main financial statements. 4.5 As at 31 March 2026 there were significant variances between budget and actual on several services. These are evident in the summary on the major variances included within the Management Commentary on pages 18 to 20. More details are included in the separate report, Revenue Budget Outturn for 2025/26, on this Boards agenda. 4.6 In April 2016 an updated Chartered Institute of Public Finance and Accountancy (CIPFA) / Society of Local Authority Chief Executives (SOLACE) ‘Delivering Good Governance in Local Government: Framework’ was published. The framework, whilst written in a local authority context, is applicable to integration authorities particularly as legislation recognises an IJB as a local government body under part VII of the Local Government (Scotland) Act 1973. 4.7 The Framework defines the principles that should underpin the governance arrangements and provides a structured approach. On 24 June 2021, the MIJB approved an updated Local Code of Corporate Governance based on the Framework and adopting the principles by which to evaluate performance (para 8 of the minute refers). The principles as set out in the CIPFA/SOLACE Framework are: a. Behaving with integrity, demonstrating strong commitment to ethical values and respecting the rule of law, b. Ensuring openness and comprehensive stakeholder engagement, c. Defining outcomes in terms of sustainable economic, social and environmental benefits, d. Determining the interventions necessary to optimise the achievement of intended outcomes, e. Developing the entity’s capacity, including the capability of its leadership and the individuals within it, f. Managing risk and performance through robust internal control and strong public financial management; and g. Implementing good practices in transparency, reporting and audit to deliver effective accountability 4.8 The term ‘Local Code’ refers to the governance structure in place and is a statement of the policies and procedures by which functions are directed and controlled and how engagement with service users, the local community and other stakeholders is carried out. The collective policies and procedures of the MIJB constitute a Local Code of Corporate Governance. Page 113
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4.9 The MIJB can achieve good governance by demonstrating that its governance structures comply with the principles as set out in the Framework. Regular review is carried out to assess the MIJB’s performance against the principles, identify areas for development and inform the Annual Governance Statement. Appendix 2 displays the sources utilised in assessing MIJB’s compliance against each governance principle. With regard to the partnership model of operation, reliance is also placed on the systems and procedures of Moray Council and NHS Grampian and so for completeness, assurance sources are listed for these organisations. 4.10 Whilst the MIJB has received limited assurance from the Internal Auditor, again for 2025/26 significant progress is being made to rectify this. Procedures are in place to ensure all audit recommendations and dates are not only achievable but are on the agendas for internal meetings, with oversight by the Senior Management Team. The replacement of the social care information system is in progress, however, is not expected to be fully implemented until April 2027. The governance statement from NHS Grampian attached at Appendix 3 gives assurance there are no significant control weaknesses. 4.11 One of the recommendations from the External Auditors report for 2024/25 was that the MIJB should undertake a formal review of the Best Value assurance framework and complete an assessment of the arrangements to secure best value. The outcome of the assessment was to be reported to the Audit, Performance and Risk Committee. The assessment is attached at Appendix 4. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Moray Partners in Care 2022-2032” The unaudited Annual Accounts have been completed and are available for audit inspection within the specified timescale. (b) Policy and Legal The Public Bodies (Joint Working) (Scotland) Act 2014 requires that the MIJB is subject to the audit and accounts provisions of a body under Section 106 of the Local Government (Scotland) Act 1973. The MIJB’s accounts are prepared in accordance with the Code of Practice on Local Authority Accounting in the United Kingdom 2024/25 which is underpinned by IFRS. (c) Financial implications The unaudited Annual Accounts provide all required information about the MIJB in relation to its financial position at 31 March 2026. The overriding principle in relation to annual accounts preparation is to provide a true and fair view. (d) Risk Implications and Mitigation There are no risk issues arising directly from this report. The unaudited Annual Accounts will be subjected to audit by external auditors, Grant Page 114
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Thornton, which will provide assurance that the Accounts for 2025/26 give a true and fair view of the financial position and expenditure and income of the MIJB for the year ended 31 March 2026. Effective governance is essential in providing the framework for the MIJB to conduct its business. The annual review of governance arrangements aims to ensure that internal controls, risk management and associated governance arrangements are being constantly developed with the aim of providing reasonable assurance on the framework as a whole. Regular review and application of a Local Code of Corporate Governance supports this process (e) Staffing Implications None arising directly from this report. (f) Property None arising directly from this report. (g) Equalities/Socio Economic Impact None arising directly from this report as there has been no change to policy as a result of this report. (h) Climate Change and Biodiversity Impacts There are no direct climate change and biodiversity implications. (i) Directions None arising directly from this report. (j) Consultations In preparation of the unaudited Annual Accounts, consultations have taken place between finance staff of both Moray Council and NHS Grampian. The Chief Officer and other key senior officers have been consulted for comment where appropriate 6. CONCLUSION 6.1 The Annual Accounts, subject to audit, show a surplus on the provision of services of £1.56m for MIJB for the year ending 31 March 2026. At the beginning of the year the MIJB, held in its reserves £1.45m. The closing balance on the reserves as at 31 March 2026 is £3.01m, consisting wholly of reserves earmarked for specific purposes as detailed in the unaudited annual accounts 2025/26. Author of Report: Deborah O’Shea, Chief Financial Officer Background Papers: with author Ref: Page 115
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 UNAUDITED ANNUAL ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2026 Moray Integration Joint Board Page 116
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 If you need information from the Moray Council in a different language or format, such as Braille, audio tape or large print, please contact: ياروم سلجم لبق نم تامولعم لىإ ةجاح ي ف متنك اذإ نوكتو ةغلب وأ ويدوأ ةناوطسأ ،يا ربلا لثم فلتخم لكش لىعوأ ةفلتخم نوكت نأ مط ب لاصّتلإا ءاجّرلاف ةظيلغ فورح لامعتساب ةعوب Jei pageidaujate tarnybos Moray tarybos teikiamą informaciją gauti kitokiu formatu, pvz., Brailio raštu, garso įrašu ar stambiu šriftu, kreipkitės: Jeśli potrzebują Państwo informacji od Rady Okręgu Moray w innym formacie, takim jak alfabet Braille'a, kasety audio lub druk dużą czcionką, prosimy o kontakt: Se necessitar de receber informações por parte do Concelho de Moray num formato diferente, como Braille, cassete áudio ou letras grandes, contacte: Ja Jums vajadzīga informācija no Marejas domes (Moray Council) citā valodā vai formātā, piemēram, Braila rakstā, audio lentā vai lielā drukā, sazinieties ar: ای نابز رگید یسک ےس لسنوک ےروم وک پآرگاتروص راکرد تامولعم ںیم لاثم ںوہ ˝ ،فورح ےڑب ای پیٹ ویڈآ ،ےلیربںیئامرف ہطبار رک امرف ینابرہم وت: Chief Finance Officer to the Moray Integration Joint Board, High Street, Elgin, IV30 1BX accountancy.support@moray.gov.uk Page 117
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 Table of Contents MORAY INTEGRATION JOINT BOARD MEMBERS 2025/26 .............................................. 1 MANAGEMENT COMMENTARY .......................................................................................... 2 STATEMENT OF RESPONSIBILITIES ............................................................................... 28 REMUNERATION REPORT ............................................................................................... 30 ANNUAL GOVERNANCE STATEMENT ............................................................................. 34 COMPREHENSIVE INCOME AND EXPENDITURE STATEMENT ..................................... 45 MOVEMENT IN RESERVES STATEMENT ........................................................................ 46 BALANCE SHEET .............................................................................................................. 47 NOTES TO THE FINANCIAL STATEMENTS ..................................................................... 48 Note 1 Significant Accounting Policies ............................................................................. 48 Note 2 Critical Judgements and Estimation Uncertainty .................................................. 49 Note 3 Events after the Reporting Period ........................................................................ 50 Note 4 Expenditure and Income Analysis by Nature ........................................................ 50 Note 5 Taxation and Non-Specific Grant Income ............................................................. 51 Note 6 Debtors ................................................................................................................ 51 Note 7 Usable Reserve: General Fund ............................................................................ 52 Note 8 Agency Income and Expenditure .......................................................................... 53 Note 9 Related Party Transactions .................................................................................. 54 Note 10 VAT .................................................................................................................... 56 Note 11 Accounting Standards That Have Been Issued but Have Yet To Be Adopted .... 56 Page 118
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 1 MORAY INTEGRATION JOINT BOARD MEMBERS 2025/26 Voting Members Dennis Robertson (Chair) Grampian Health Board (Vice Chair 01/04/2025 to 30/09/2025. Chair from 01/10/2025) Cllr. Elaine Kirby (Chair) Moray Council (21/11/2024 to 31/07/2025) Cllr. Bridget Mustard (Vice-Chair) Moray Council (Chair 1/08/2025 to 30/09/2025. Vice Chair from 01/10/2025) Sandy Riddell Grampian Health Board Derick Murray Grampian Health Board Alex Stephen Grampian Health Board Cllr. Peter Bloomfield Moray Council Cllr. Scott Lawrence Moray Council Cllr Ben Williams Moray Council (Left 27/03/2026) Cllr John Divers Moray Council (Joined 27/03/2026) Non-Voting Members Judith Proctor Chief Officer Jim Lyon Interim Chief Social Work Officer Jane Ewen Lead Nurse Professor Duff Bruce Non-Primary Medical Service Lead Dr Robert Lockhart GP Lead Sheila Brumby People Receiving Services Representative. Ivan Augustus Carer Representative (left 27/11/2025) Kevin Todd Moray Council Staff Representative (left 19/05/2025) Elizabeth Robinson Public Health Representative Deirdre McIntyre Grampian Health Board Staff Partnership (left 19/06/2025) Michael Ritchie Grampian Health Board Staff Partnership (Joined 16/07/2025) Page 119
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 2 MORAY INTEGRATION JOINT BOARD MEMBERS 2025/26 Continued Miriam Connor Unpaid Carer Representative (Joined 28/11/2025) Christine Stevens Unpaid Carer Representative (Joined 28/11/2025) Aimee McIntosh Third Sector Representative (joined 01/10/2025) Co-opted Members Sean Coady Head of Service and Deputy Chief Officer Deborah O’Shea Chief Finance Officer Adam Coldwells Interim Chief Executive Grampian Health Board (Left 01/10/2025) Laura Skaife-Knight Chief Executive Grampian Health Board (Joined 01/10/2025) Karen Greaves Chief Executive, Moray Council Sonya Duncan Interim Corporate Manager MANAGEMENT COMMENTARY The Role and Remit of the Moray Integration Joint Board The Public Bodies (Joint Working) (Scotland) Act 2014 required that Moray Council and Grampian Health Board prepared an Integration Scheme for the area of the local authority detailing the governance arrangements for the integration of health and social care services. This legislation resulted in the establishment of the Moray Integration Joint Board (MIJB) that became operational from 1 April 2016. Moray Council and Grampian Health Board, as the parties to the Integration Scheme, each nominate voting members to the MIJB, currently, four elected members from Moray Council and four Grampian Health Board members. Under the Public Bodies (Joint Working) (Scotland) Act 2014, a range of health and social care functions have been delegated from Moray Council and Grampian Health Board to the MIJB who has assumed responsibility for the planning and operational oversight of delivery of integrated services. MIJB also has a role to play in the strategic planning of unscheduled acute hospital-based services provided by Grampian Health Board as part of the ‘set aside’ arrangements. . Page 120
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 3 MANAGEMENT COMMENTARY (continued) Hosted services also form part of the MIJB budget. There are a number of services which are hosted by one of the three IJB’s within Grampian Health Board area on behalf of all the IJBs. Responsibilities include the planning and operational oversight of delivery of services managed by one IJB on a day-to-day basis. MIJB has responsibility for hosting services relating to Primary Care Contracts and the Grampian Medical Emergency Department (GMED) Primary Care Out of Hours service. Key Purpose and Strategy Following review and consultation, the refreshed Strategic Plan (2022-2032) is a continuation of the 2019 Strategic Plan. The current plan emphasises the strength of integration and in addition to our two main Partners – Moray Council and Grampian Health Board - the MIJB recognises the importance of the Third and Independent Sectors and Unpaid Carers, in facilitating the successful operation of the partnership of Moray Health & Social Care Partnership (Moray HSCP). As with all health and social care systems Moray is facing increasing demand for services at the same time as resources – both funding and workforce availability - are under pressure. These challenges will intensify in the coming years as our population ages and more people with increasing complex needs require support to meet their health and care needs. The MIJB sets the direction and strategic intent through the development and implementation of the Strategic Plan and seeks assurance on the management and delivery of services through Board level performance reporting which ensures an appropriate level of scrutiny and challenge. The Strategic Plan identifies priority areas to support strategic direction and vision. WE ARE PARTNERS IN CARE OUR VISION: “We come together as equal and valued partners in care to achieve the best health and wellbeing possible for everyone in Moray throughout their lives.” OUR VALUES: Dignity and respect; person-led; care and compassion; safe, effective and responsive OUTCOMES: Lives are healthier – People live more independently – Experiences of services are positive – Quality of life is maintained/improved – Health inequalities are reduced – Carers are supported – People are safe – The workforce continually improves – Resources are used effectively and efficiently Page 121
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 4 MANAGEMENT COMMENTARY (continued) STRATEGIC PLAN KEY THEMES MANAGEMENT COMMENTARY (continued) The Plan purposefully places an emphasis on prevention and early intervention activities and seeks to prioritise these activities as a long-term goal, actively pursuing good health and wellbeing for the population, with increased investment in this area of work. It highlights the Home First approach and the rationale for this is to assist people in understanding that “hospital is not always the best place for people”, a statement frequently used and in particular if you are frail and elderly can be counter intuitive to a successful recovery. Initiatives to transform services in response to high levels of demand continue. The Moray Strategic Plan was refreshed in 2022 and along with the associated delivery plan, which was updated in May 2025, highlights key priorities for transformation. Population Moray is a largely rural area covering a land mass of 2,238 sq. km. It has a long coastline on the Moray Firth with harbours, fishing villages and world-class beaches. From the 2022 census, the area’s population is 93,4001, which is an increase of 0.1% since 2011. The population growth in Moray is slowing, and it is projected that the population in Moray will start to decline by 2030. This trend is forecast to continue. The main centre of population is Elgin, which is home to more than one quarter of the people living in Moray. Other towns of population between 4,000 and 10,000 are Forres, Buckie, Lossiemouth and Keith. The table below sets out projected population growth based on the 2022 baseline, which has not changed from the 2018 publication. Across Scotland there is a projected reduction in those in the 0-15 age group, limited change in the working age population, but significant growth in adults of pensionable age. By comparison it is projected that Moray will have a greater decrease in children, a marked decrease in those of a working age, but a significantly higher change in those of a pensionable age2. 1 Scotland's Census 2022 - Rounded population estimates - data | Scotland's Census 2 Population Projections for Scottish Areas 2018-based - National Records of Scotland (NRS) BUILDING RESILIENCE – Taking greater responsibility for our health and wellbeing HOME FIRST – Being supported at home or in a homely setting as far as possible PARTNERS IN CARE – Supporting citizens to make choices and take control of their care and support Page 122
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 5 MANAGEMENT COMMENTARY (continued) Performance Reporting Performance is reported quarterly to the Audit, Performance and Risk Committee of the MIJB. In addition to the quarterly reporting, there is a requirement under the Public Sector (Joint Working) (Scotland) Act 2014 for the MIJB to produce and publish an Annual Performance Report setting out an assessment of performance in planning and carrying out the delegated functions for which they are responsible. The Annual Performance Report is due to be published by 31 July this year and will be published on the Moray HSCP website, once approved by the MIJB. There is continued focus on one of the major aims of integration and a key measurable target for MIJB, to reduce the number of Moray residents that are ready to be sent home from hospital but have been delayed in this process. This is referred to as a ‘delayed discharge’. Delayed discharge can occur due to many reasons but quite often involves the onward provision of social care which can be complex in nature and/or finite in its availability. . .MSG indicator 4 – Number of Delayed Discharge Bed Days3 Year Q1 Q2 Q3 Q4 2021/22 592 784 1,142 1,294 2022/23 1,207 1,197 1,063 751 2023/24 732 845 1,162 1,501 2024/25 922 1,115 981 1,149 2025/26 1,015 1,217 1,141 1,004 3 https://publichealthscotland.scot/publications/delayed-discharges-in-nhsscotland-annual/delayed- discharges-in-nhsscotland-annual-annual-summary-of-occupied-bed-days-and-census-figures-data- to-march-2025/ About this release - Delayed discharges in NHS Scotland monthly - Figures for April 2026 - Delayed d… -22.2% -9.0% 30.8% -10.5% -0.2% 23.2% -30.0% -20.0% -10.0% 0.0% 10.0% 20.0% 30.0% 40.0% Children (0-15) Working Age Pensionable age and overProjected change (%) Age Group Projected percentage change in population (2018- 2043) by age Moray Scotland Page 123
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 6 Table 1 MANAGEMENT COMMENTARY (continued) Figure 1 With an ageing population the number of people delayed at any one time could increase again unless viable, sustainable alternative community provision is developed. Presentations to hospital from an older population have more acuity and complexity, exacerbating the issue of delays. The Scottish Government have set targets for delayed discharges per 100,000 and for Moray the target is 26. This is a continuing challenge, but focussed efforts to review and streamline processes and improve flow across the system are being undertaken through the “Home Assessment Pathway” project, utilising Scottish Government additional funding to reduce unscheduled care. . Delayed Discharges National Indicator 19 - Number of days people spend in hospital when they are ready to be discharged (per 1,000 population). Figure 2 below shows Moray’s performance over a five-year period showing the number of delayed discharge bed days, which fluctuates through the year, however during the last two quarters of 2025/26 there has been a sustained reduction, resulting in the lowest number of days at Q4 in the five-year period. The ongoing scrutiny of delays to find solutions, progress of projects to improve efficient use of care and support resources and embedding of the Self Direct Support (SDS) framework will be contributing to this reduction. 0 500 1,000 1,500 2,000 Jun Sep Dec Mar Jun Sep Dec Mar Jun Sep Dec Mar Jun Sep Dec Mar Jun Sep Dec Mar 2021/22 2022/23 2023/24 2024/25 2025/26 MSG Indicator 4 - Number of delayed discharge bed days Page 124
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 7 MANAGEMENT COMMENTARY (continued) Figure 2 Within Children and Families and Justice Social Work, there is a continued focus on the provision of early family support, aiming to keep children in their families, when that is safe to do so. Amongst the supports and actions working towards this outcome is the provision of commissioned services deigned to deliver early and preventative support. The three commissioned prevention and early intervention services—Aberlour Youth Point, Families Together, and Functional Family Therapy—provided support to numerous families in the 2025/2026 financial year, as noted in the graph below. The supports provided included one to one and group sessions, family centred money advice service, practical assistance, family group decision making and functional family therapy focusing on improving communication and relationships. The impact of these supports is evidenced via regular contract monitoring mechanisms. Page 125
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 8 MANAGEMENT COMMENTARY (continued) . Another area of focus is to reduce the number of children in care and specifically in out-of-area care. This financial year showed a continuation of the longer-term direction of travel towards safely reducing reliance on care with the number of children looked after away from or at home reducing from 167 in October 2025 to 164 at the end of March 2026. However, this improvement is somewhat offset by a significant pressure point: a higher proportion of newly accommodated children required out-of-area care, increasing both operational complexity and financial pressure. Whilst the overall number of children entering out-of-area care can be considered low against the total number of looked after children, by the end of the financial year, this kind of care accounted for 63% of commissioned services spend, up from 53% at the start of the financial year. The Service continues to work towards the reduction of the overall number of children entering care, inclusive of the following actions planned for the next financial year: - Exploration of intensive family support service, - Services commissioned to provide early and preventative support, - The development of the Early Pathway and the refresh of GIRFEC in Moray. 112 115 131 126 100 105 110 115 120 125 130 135 Q1 Q2 Q3 Q4 Number of children 2025/2026 financial year Number of children and families supported by the 3 preventative commissioned services 3 2 8 4 0 1 2 3 4 5 6 7 8 9 Q1 Q2 Q3 Q4 Number of children 2025/2026 financial year Total new entries to out-of-area care Page 126
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 9 MANAGEMENT COMMENTARY (continued) Moray Integration Joint Board (MIJB) The MIJB has scrutinised and directed the delivery of services in line with the Integration Scheme and Strategic Plan while recognising that the cost base must change as the level of available budget in real terms is reducing. Both funding partners (Moray Council and NHS Grampian) have significant savings to achieve, and against this backdrop the MIJB directed a series of workshops during the year to support officers in their work. The focus has continued to be on achieving the highest quality and safety possible within a diminished budget, while being most efficient, and achieving the best possible outcomes for our residents. The Strategic Plan aspires to increasing spend on preventative work, “upstream” to tackle issues earlier, preventing crises where possible and reducing demand. However, a key challenge going forward will be to continue that focus at a time when budgets are under so much pressure and people are presenting with increasingly complex needs. Performance The MIJB, its committees and the Health and Social Care Partnership Senior Management Team receive regular assurance reports and updates on how the Strategic Plan commitments are being progressed through work streams and individual service plans, as well as detailed financial and performance updates. The strategic risk register was reviewed by the MIJB and Senior Management Team (SMT). It was approved in March 2026 and will form part of a robust risk monitoring framework in order to identify, assess and prioritise risks related to the delivery of services, particularly any which are likely to affect the delivery of the Strategic Plan. The inherent risks being faced by the MIJB, together with a current assessment on the level of the risks and mitigating actions being taken to reduce the impact of the risks, is reported biannually to the Audit Performance and Risk Committee for oversight and assurance. Management teams and the Care and Clinical Governance Group review and respond to any reports produced by Audit Scotland, Healthcare Improvement Scotland, the Care Inspectorate, and the Mental Welfare Commission for Scotland. Quarterly performance reports are produced for Moray HSCP management to review performance and to determine actions required to address areas for concern or to highlight areas showing improvement. This information is further scrutinised by the Senior Management team and then reported to the MIJB’s Audit, Performance and Risk Committee. There are many initiatives and ongoing projects being undertaken by Moray HSCP that are seeking to reduce the delays in hospitals and to meet unmet needs. For example, ensuring the provision of care at home is maximised within available budget is a key aspect of the Strategic Care at Home workstream. Funding has also been Page 127
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 10 MANAGEMENT COMMENTARY (continued) provided to NHS Grampian to support improvement in Unscheduled care across Grampian. Moray HSCP secured £1.38m to develop a Home Assessment Pathway (HAP) which focusses on prevention of admission to acute hospital and supported, timely discharge to assess. The programme was fully launched in May 2026 and as well as reporting through the HSCP and IJB structures, reports into the pan Grampian Unscheduled Care Delivery Board. Research into the type of equipment, benefits and impacts is being undertaken by the Digital Health Institute as part of the Growth Deal which will inform our Technology Enabled Care and Digital strategy which will provide other options for supporting people to live independently in their own homes. In addition to the Home Assessment Pathway work, the HSCP is also engaged with the collaborative initiative Discharge Without Delays which is also a Grampian wide initiative. This programme aims to reduce delays experienced by people who are medically fit to return home and is being facilitated by Health Intelligence Scotland. Whole system outcomes have been determined which will be incorporated into the revised performance report to this committee for 2025/26. This will also inform and contribute to the development of the Home Assessment Pathway work. The integration of Children & Families and Justice services into Moray HSCP under the direction of the MIJB is not yet reflected in the Board’s Strategic Plan. Work is ongoing to ensure appropriate governance of performance reporting so that it can be included in future MIJB Annual Performance Reports and the refresh of the Strategic Plan which will take place across 2026/27 will include these delegated services. Strategy and Plans The MIJB is required to review its Strategic Plan every three years as per the legislation and this is now planned to take place over 2026/27. The Strategic Plan 2022-2032 places an emphasis on prevention and early intervention with the aim of building resilience for individuals and communities. The Plan identified key aims of the MIJB and directed Moray HSCP to work closely with communities and key partners to reform the system of health and social care in Moray. It was also recognised that progress has been made against the three strategic themes and the review of the Plan focused on what already has been achieved the long-term strategic objectives make room for adapting to challenges and developments in health and social care over the coming years. The current Strategic Plan sets out the 3 key themes and the objectives; • Building Resilience – supporting people to take greater responsibility for their health and wellbeing. • Home First – supporting people at home or in a homely setting as far as possible. • Partners in Care – supporting citizens to make choices and take control of their care and support. Page 128
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 11 MANAGEMENT COMMENTARY (continued) Staff Wellbeing Moray HSCP, in partnership with Third Sector organisation Moray Wellbeing Hub, launched a new initiative designed to reduce barriers to accessing mental health support for the health and social care workforce. Funded through NHS Grampian Charity, the digital tools project offered one-to-one personal support sessions to help individuals manage and improve their wellbeing, as well as team awareness talks to build skills in peer support and colleague signposting. Through improving digital skills and fostering peer-led approaches, the initiative aimed to promote inclusion and resilience, challenge the stigma associated with accessing help, and create a more connected and supportive working environment. Promoting Health and Wellbeing Moray HSCP's commitment to promoting healthy and independent ageing was recognised on an international stage in July 2025, when Alice Illingworth, Realistic Medicine Wellbeing Co-ordinator with the Health Improvement Team, was invited to present at the End Pyjama (PJ) Paralysis global online summit. The two-day conference brought together health and care professionals from across the world who are working to reduce immobility, muscle deconditioning, and dependency in care settings, whilst protecting cognitive function, social interaction, and dignity. Alice presented on the Ageing Well work being undertaken in Moray as part of the partnership’s wider focus on preventing deconditioning – the decline in physical function experienced during periods of inactivity, which is of particular concern for less mobile older people and those experiencing extended hospital stays. Central to the presentation was the Moray Ageing Well Tool, an innovative digital self- check resource developed as part of the Making Every Opportunity Count (MeOC) programme. The tool supports older people to take control of their own health and wellbeing by encouraging individual reflection on personal needs and priorities, completing a health assessment, and connecting with relevant local services and support networks. The tool is currently in use across a range of settings, including GP practices, hospitals, social care, and the wider community. Building on the success of the initial Community Appointment Day (CAD) model piloted for musculoskeletal (MSK) Physiotherapy and Podiatry patients in Moray, the partnership and NHS Grampian continued to develop this innovative approach to service delivery during 2025/26. In October, we partnered with the Digital Health & Care Innovation Centre's (DHI) Rural Centre for Excellence to deliver an Occupational Therapy (OT) Community Appointment Day in Elgin. The event provided attendees, including those awaiting an OT assessment, with the opportunity to explore AskSARA, an online self-management tool offering personalised advice on equipment and home adaptations. Participants Page 129
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 12 MANAGEMENT COMMENTARY (continued) received hands-on support from Moray HSCP's Occupational Therapy Team to navigate the tool and review practical recommendations for remaining safe and independent at home. In July 2025, the Moray Be Active Life Long (BALL) wellbeing groups which are supported by Moray HSCP, marked a significant milestone. A celebration of their 20th anniversary brought together nearly 300 community members at a special event in Hopeman. The event recognised two decades of friendship, physical activity, and support for healthy ageing across Moray. BALL groups were developed following extensive community engagement with older people, who identified a need for greater opportunities to stay physically active and socially connected later in life. From an initial group of ten participants in 2005, the programme – which is unique to Moray – has grown into a network of 18 user-led groups welcoming more than 1,000 attendees each week. Our collaborative approach to prescribing improvement was showcased at the annual Scottish Practice Pharmacy and Prescribing Advisers (SP3A) conference in Glasgow, where Fiona Duncan, Primary Care Advanced Pharmacist, and Mandy Nascimento, Specialist Pharmacy Technician, presented on a significant joint initiative. Working in partnership, Pharmacy, Dietetics, and Health Visiting teams undertook a review of baby milk prescribing, with the aim of improving practice and reducing spend through consistent adherence to established clinical guidelines. Through targeted training, improved data sharing, and a refreshed rollout of guidance, the initiative has improved education for parents and carers on the appropriate use of baby milks and the milk ladder, supporting better clinical outcomes and more consistent practice across primary care, as well as achieving financial benefits. In June 2025, Moray HSCP launched a pilot project in partnership with Elgin Health Centre, aimed at proactively identifying unpaid carers and connecting them with appropriate support. It is estimated that approximately 16,200 adults and children in Moray provide some form of unpaid care; however, only around 13% are currently in contact with the Quarriers Carer Support Service, which is commissioned by the partnership to support adult and young carers across the area. A significant barrier to accessing support is identification – both by professionals and by carers themselves, many of whom do not recognise the care they provide as placing them in the role of a carer. Page 130
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 13 MANAGEMENT COMMENTARY (continued) The Unpaid Carers Team, working alongside Elgin Health Centre, is addressing this through staff training in carer identification and signposting to services, including Quarriers and Moray HSCP teams. The project establishes a clear carer pathway within GP practice settings, promotes annual health checks, and supports contingency planning to ensure carers receive timely information and support. The model is now being extended to other GP practices and education settings across Moray. In partnership with a range of statutory, community, and Third Sector organisations, Moray HSCP has continued to develop a Whole Systems Approach to improving healthy weight across Moray. Recognised as a key priority within Scotland’s Population Health Framework and the Board’s Strategic Plan, this collaborative model looks beyond individual choice to address the wider environmental, social, and economic factors that shape health outcomes. During the year, three interactive workshops brought together partners from across health, local authority, environmental health, children’s services, transport, education, community, and Third Sector organisations. These workshops produced a shared understanding of the causes and drivers of unhealthy weight in Moray, mapped existing provision, identified gaps and priorities for action, and generated a draft vision statement and systems map. A local action plan will be launched in 2026/27. Service Delivery/Business as Usual Moray HSCP has continued to invest in improving digital services and infrastructure for the benefit of citizens and staff. The partnership website has been migrated to a new platform, delivering improvements in accessibility, security, and user experience. The new multi-agency website, Getting It Right for Every Child (GIRFEC) in Moray (www.girfecinmoray.co.uk), was also launched as a central information resource for families, young people, and practitioners. Developed in partnership with NHS Grampian, Moray Council, and Third Sector organisations, the site includes dedicated sections on GIRFEC, the Child’s Plan, children’s rights, and a range of support services, as well as a local events calendar. Content was co-produced with local families and young people, with engaging graphics designed by a former pupil of Speyside High School during a digital media placement with Children's Services. Moray HSCP has achieved significant milestones in the national programme to transition community alarm and telecare services from analogue to digital technology, ahead of the UK-wide switchover deadline in January 2027. Page 131
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 14 MANAGEMENT COMMENTARY (continued) With approximately 1,500 community alarm and telecare devices in use by Moray residents, the Analogue to Digital Telecare (A2DT) programme represents one of our most significant transformation workstreams. Moray HSCP has been awarded both the Gold Level One and Gold Level Two Digital Telecare Implementation Awards from Digital Telecare for Scottish Local Government. The Gold Level Two award, which recognises partnerships that have delivered a live digital service to at least half of their users with a minimum of six weeks of safe, reliable operation, reflects the substantial progress achieved. At the time of the award, 56% of Moray's telecare devices were digital-ready Moray Community Justice Partnership hosted the local launch of Upside, a Scotland- wide service funded by the Scottish Government to support individuals as they leave prison and return to community life. Delivered in Moray by Turning Point Scotland, as part of a national partnership of eight leading charities, Upside provides support with housing, health, finances, substance use, and the rebuilding of family connections, with a focus on developing trusting relationships and connecting individuals with local services. The launch event also highlighted the work of Moray HSCP’s Voluntary Throughcare Service, which provides up to twelve months of support for individuals released from prison who are not subject to licence conditions. The service assists with accommodation, benefits, mental health support, addiction recovery, employment, and rebuilding family relationships, with the aim of empowering individuals to make positive and lasting change. In November 2025, Moray Council and MIJB hosted a civic reception to honour local foster carers, recognising their dedication, compassion, and the life-changing impact of their commitment to children and young people in Moray. Page 132
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 15 MANAGEMENT COMMENTARY (continued) The event brought together foster carers, elected members, board members, and officers to celebrate the remarkable contribution foster carers make to the lives of children and to communities across the area. The occasion also served to raise awareness of fostering and encourage those in Moray who may be able to offer a safe, stable, and nurturing home to a child or young person to come forward. Over the past year, Moray HSCP has made progress in strengthening and stabilising mental health services, although recognising the need for greater urgency in delivering meaningful improvements for people who have experienced long-standing gaps in support. Gaps have placed sustained pressure on GP practices, where clinicians have been supporting adults and children with complex mental health needs without consistent access to specialist services. It is acknowledged that individuals and families have waited too long for services that fully meet their needs. A number of key developments have helped improve service resilience. These include the appointment of a new Clinical Director for Moray Mental Health Services (Adult and Older Adult), the stabilisation of Consultant Psychiatry cover across Moray, the introduction of a dedicated email advice service enabling GPs to access psychiatric expertise, enhanced out-of-hours on-call arrangements through support from Royal Cornhill Hospital in Aberdeen, and an increased Community Mental Health Team presence within primary care settings. In addition, three Scottish Action for Mental Health (SAMH)-delivered services – the Distress Brief Intervention Service, Intensive Recovery and Community Support Service, and Suicide Prevention Service – are now fully staffed and operational across Moray. Mental Health and Wellbeing Practitioners based in GP practices also continue to strengthen early intervention, providing 255 appointments during August 2025 and supporting improved triage and faster responses for patients. Performance has improved in some areas of the Psychological Service, with 100% of Secondary Care referrals meeting national waiting time targets in September 2025. However, significant challenges remain within the Primary Care Psychological Service, where only 15% of referrals met the national standard and this will be prioritised for improvement. Page 133
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 16 MANAGEMENT COMMENTARY (continued) Longer Term Changes to Strategies and Plans A new initiative to strengthen and protect the ongoing relationships at the heart of care for young people leaving the care system has been launched in Moray. Care-experienced young people and practitioners co-designed the Maintaining Relationships Project to ensure that vital connections – with social workers, teachers, residential staff, and others – can be maintained safely and respectfully even after formal care arrangements have ended. The project responds directly to the experiences of young people who have described feeling “forgotten” or “abandoned” following transitions out of care. Members of the Moray Champions Board called on Moray HSCP to develop guidance enabling staff to maintain these important relationships in a way that places young people’s wishes at the centre. Launched ahead of Care Leavers Month, the project reflects Moray’s commitment to the national Promise – ensuring all of Scotland’s children and young people grow up loved, safe, and respected. The project is already attracting national interest and has the potential to provide a model for other areas across Scotland. Positive progress continues to be made in the delivery of the Children’s Services Plan 2023–2026. The annual report highlighted the difference being made by community planning partners – including Moray HSCP, Moray Council, NHS Grampian, and Third Sector organisations – working together and with local communities to safeguard, support, and promote child and family wellbeing. The next Children’s Services Plan is under development. Good progress has also been achieved in delivering the Moray Unpaid Carers Strategy, with a range of developments helping to strengthen support and improve the experiences of unpaid carers across Moray. The Strategy, which runs until 2028, is built around three strategic priorities – recognising, valuing, and supporting carers – and is underpinned by a delivery plan supported by annual Carer Act funding. Moray Alcohol and Drug Partnership (ADP) has continued to make significant progress in reducing drug and alcohol-related harms and improving outcomes for individuals and communities across Moray. Notable progress has been achieved during the year in implementing the national Medication Assisted Treatment (MAT) standards, which form a key part of Scotland's response to the ongoing drug-related deaths crisis. The standards provide a framework for ensuring that treatment is safe, person-centred, and effective. Page 134
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 17 MANAGEMENT COMMENTARY (continued) Improved referral pathways, delivered through a third sector direct access service, have reduced waiting times and enabled faster access to support, whilst frontline staff have continued to benefit from training in rights awareness, trauma-informed practice, and crisis response. In August 2025, a Recovery Together community event was held in Lossiemouth, marking International Overdose Awareness Day. The event provided an opportunity to remember those lost to substance use, support those still affected, and celebrate the strength and resilience found in recovery. The Rose Remembrance Walk and programme of activities reinforced the community's commitment to tackling stigma and promoting open conversation around recovery. Financial Review and Performance Financial performance forms part of the regular reporting cycle to the MIJB. Throughout the year the Board, through the reports it receives, is asked to consider the financial position at a given point and any management action deemed as necessary to ensure delivery of services within the designated financial framework. From the first quarter in the financial year, the Board was presented with financial information that included a forecast position to the end of the year. In November 2025 the Board received a financial report which forecast an expected overspend to the end of the financial year of £8.78m. This forecast remained fairly consistent throughout the remainder of the year and in January 2026, MIJB were forecasting an overspend to the end of the year of £8.23m, the MIJB actually out turned at £7.20m overspent. Both partners in line with the Integration Scheme, put in additional funding to cover this overspend. There was the use of ear marked reserves totalling £0.14m during the year, with new ear marked reserves totalling £1.70m leaving a balance of £3.01m in ear marked reserves to be carried forward into 2026/27. In March 2025, the MIJB agreed a savings plan of £9.47m, with a mixture of recurring savings and recurring reductions in spend. At the end of the financial year, this had been achieved in part, with recurring savings of £3.66m, £0.68m non-recurring savings and £1.03m reduction in overspend. Given the uncertainties associated with funding and the emerging overspend position at the early stage of the financial year, it was necessary to update the Board regularly on the emerging financial position. This was done formally through MIJB meetings and informally through development sessions. Page 135
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 18 MANAGEMENT COMMENTARY (continued) Service Area Budget £000’s Actual £000’s Variance (Over)/ under spend £000’s Note Community Hospitals & Services 8,033 7,932 101 Community Nursing104,360 6,244 6,670 (426) 1 Learning Disabilities 20,913 21,230 (317) 2 Mental Health 12,227 12,881 (654) 3 Addictions 1,871 1,817 54 Adult Protection & Health Improvement 278 279 (1) Care Services Provided In-House 25,190 25,495 (305) Older People Services & Physical & Sensory Disability 28,090 30,023 (1,933) 4 Intermediate Care & OT 1,845 2,039 (194) Care Services Provided by External Contractors 2,084 2,072 12 Other Community Services 10,117 10,310 (193) Administration & Management 2,056 3,086 (1,030) 5 Other Operational Services 1,413 1,351 62 Primary Care Prescribing 21,441 21,312 129 Primary Care Services 22,830 22,954 (124) Hosted Services 6,131 5,987 144 Out of Area Placements 1,780 1,834 (54) Improvement Grants 1,060 889 171 Children’s & Justice Services 21,256 22,050 (794) 6 Total Core Services 194,859 200,211 (5,352) Strategic Funds & Other Resources 14,367 6,005 8,362 7 TOTALS (before set aside) 209,226 206,216 3,010 Set Aside 20,092 20,092 - TOTAL 229,318 226,308 3,010 The table above summarises the financial performance of the MIJB by comparing budget against actual performance for the year. Page 136
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 19 MANAGEMENT COMMENTARY (continued) Significant variances against the budget were notably: Note 1 Community Nursing - This budget is overspent by £425,978 at the year end. This is predominantly due to staffing, with overspends in District nurses £431,715 (including Acute nursing at Varis, Forres and Buckie), £102,136 overspend in Health visitors, which is being reduced by an underspend in Maryhill of £107,873. The overspend is largely due to staffing as detailed above. District nurses had a budget realignment in 2025/26 of £313,982 and savings of £121,095, this was not achieved due to recruitment being successful for vacant posts that have been vacant for a significant time during which time bank staff have had to be used as well as the regrading of nurses from a band 6 to a band 7. Health visitors were expected to come in on budget after realignment and savings however the school nurses were regraded in the last quarter of the year resulting in an overspend in the budget. Note 2 Learning Disabilities (LD) – The Learning Disability (LD) service is overspent by £316,736 at the year-end. The overspend is essentially due to the purchase of care for people with complex needs which resulted in an overspend of £428,087, client and staff transport of £25,640 and property cost overspend of £23,588. This is offset by underspend of £100,173 for clinical, nursing and other services relating to consultant and management psychiatry staffing vacancies, more income received than expected of £34,358 and other small underspends of £1,239. This budget has been under pressure for a number of years due to demographic pressures, transitions from Children’s services and people living longer and getting frailer whilst staying at home. The biggest overspends was for services provided to individuals in their own homes to support their daily living needs which enables people to stay living at home or in a homely setting for as long as possible and day care which provides activities during the day in the community. Work continues to progress savings plans across the LD service; however, this is being offset by ongoing demand pressures. In particular, more individuals with complex needs moving through transitions from children to adult services and also people moving into the area who require high-cost packages of care, which is impacting on the overall financial position. Note 3 Mental Health – This budget is overspent by £654,343 at the year end. This is due to overspends in clinical, nursing and other services as a result of ongoing use of agency locums of £302,457; purchase of care £195,385 relating to purchase of care in care homes and care at home; £144,810 relating to unachieved savings and £11,691 other minor overspends. This budget is currently under pressure due to the recruitment issue for consultants and an increase in demand for services, including out of area packages as there is a lack of resource locally especially around autism and neurodiversity. Work is currently ongoing reviewing out of area packages to repatriate them to Moray. Note 4 Older People Services and Physical & Sensory Disability - This budget is overspent by £1,933,488 at the end of the year. This primarily relates to overspends for home care in the area teams £575,752, permanent care £1,328,598 due to the increase in the number of clients receiving nursing care rather than residential care, short breaks £242,362 and self-directed support of £260,758. Bad debt provision for unpaid fees was £117,582 overspent, which is particularly high this year and other Page 137
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 20 MANAGEMENT COMMENTARY (continued) minor overspends of £18,000. This is being reduced by income received during the year above budget by £609,564. The variances within this overall budget heading reflect the shift in the balance of care to enable people to remain in their homes for longer, when people are living longer with more complex care needs. Due to the increase in need and complexity along with increasing levels of growth and demand are having an impact on this budget. There are increases in permanent care which is seeing the move to nursing placements rather than residential placements. The demographics are showing we have an increasing elderly population who are living longer and requiring more complex care. Note 5 Admin and Management - This budget is overspent by £1,029,617 at the year end. This is due to interim staffing arrangements and the vacancy target for the Council side not being met by £933,334. There was a non-recurring increase in target for 2025/26 of £750,000 that was not achievable. Note 6 Children, Families and Justice Services – This budget is overspent by £793,663 at the year end. This is due to overspends in residential continuing care placements £418,127, external fostering placements £495,610, out of area residential placements £297,272, home to school taxis £28,201, no recourse to public funds costs £15,600 and self-directed support payments of £68,245. This overspend is being reduced by an underspend on mental health & wellbeing £156,041, trauma informed training £30,517, refund on Intensive Family Support contract £31,492, Criminal Justice £64,759, an overachievement of £246,097 against the vacancy target and minor underspends of £486. These overspends are related to the number of children requiring to be accommodated through the Children’s Hearing system, family breakdown, and the need to keep children safe from familial harm while living at home. The costs of care have been rising significantly, availability of the correct care provision is a national challenge, and the market is under scrutiny with consultation for possible legislation on excessive profiteering. A long and immediate term strategy has been approved by the IJB to address: the need to reduce the flow-into care, develop small group family living models in Moray with support from Housing Services, strengthen early support, prevention and diversion, and have a more local provision in the Northeast across the three Grampian local authority areas, which can more effectively contribute to the flow-out of care. Note 7 Strategic Funds and Other Resources – This budget is underspent by £8.362m as it relates to savings achieved during the year, any unallocated funding and reserves balances. MIJB’s financial performance is presented in the comprehensive income and expenditure statement (CIES), which can be seen on page 45. At 31 March 2026 there were ear marked reserves of £3.01m available to the MIJB, compared to £1.45m at 31 March 2025. These remaining reserves of £3.01m are for various purposes as described below: Page 138
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 21 MANAGEMENT COMMENTARY (continued) Earmarked Reserves Amount £000’s GP Premises 21 National Drugs MAT 250 OOH Winter Pressure funding 172 Moray Cervical screening 36 Moray hospital at home 4 Moray Psychological 275 MHO Funding 138 Adult protection funding for CA 72 National Trauma Training services 53 Moray School Nurse 32 Moray Winter Fund HCSW & MDT 182 LD Annual Health Checks 69 Community Planning partnership 2 Moray District Nurses 111 Moray Alcohol & Drug Partnership 48 GP Walk-in Service 165 Moray Unscheduled Care Improvement Plan 1,380 Total Earmarked 3,010 General Reserves 0 TOTAL Earmarked & General 3,010 Page 139
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 22 MANAGEMENT COMMENTARY (continued) GP Premises – balance of funding for improvement grants including the making of premises improvement grants to GP contractors. The continued digitalisation of paper GP records. Modifications for the purposes of improving ventilation and increase to the space available in NHS owned or leased premises for primary care multi- disciplinary teams. National Drugs Medication Assisted Treatment (MAT) for embedding and implementation of the standards will he be overseen by the MAT implementation support team (MIST). Out of Hours Winter Pressure funding – balance of funding to sustain GO out of hours and to support resilience to explore operational solutions. Moray Cervical Screening – balance of funding for smear test catch up campaign. Moray Hospital at home – development of Hospital at Home provides Acute hospital level care delivered by healthcare professionals, in a home context for a condition that would otherwise require acute hospital inpatient care. Moray Psychological – funding streams for mental health, psychological wellbeing, facilities, post diagnostic support and psychological therapies. Mental Health Officer (MHO) funding – funding to support additional mental health officer capacity. Adult protection funding for care at home– balance of funding to build capacity in care at home community-based services. National Trauma Training services – training for dealing with people affected by trauma and adversity. Moray School nurse – funding to support NHS Grampian to retain school nurse posts. Moray Winter Fund Health Care Social Workers (HCSW) – additional funding for further HCSW in both the IJB and Emergency department. Moray Winter fund Multi-Disciplinary Team – additional funding for service pressures includes Discharge to Assess, Home First Frailty team and volunteer development. Learning Disability Annual Health Checks – to implement the annual health checks. Community Planning Partnership – funding towards community planning partnership. Moray District Nurses – allocation to support recruitment and training of District Nurses. Moray Alcohol & Drug Partnership -funding to support local alcohol and drug issues. Page 140
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 23 MANAGEMENT COMMENTARY (continued) GP Walk-in Service – Scottish Government funding to expand walk-in GP services. Moray Unscheduled Care Improvement Plan – funding to enhance the delivery of unscheduled care services. All reserves are expected to be utilised for their intended purpose during 2026/27. Set Aside – Excluded from the financial performance table above on page 18 but included within the Comprehensive Income & Expenditure Account is £20.092m for Set Aside services. Set Aside is an amount representing resource consumption for large hospital services that are managed on a day-to-day basis by the NHS Grampian. MIJB has a responsibility for the strategic planning of these services in partnership with the Acute Sector and Mental Health Service. Set Aside services include: • Accident and emergency services at Aberdeen Royal Infirmary and Dr Gray’s inpatient and outpatient departments; • Inpatient hospital services relating to general medicine, geriatric medicine, rehabilitation medicine, respiratory medicine, learning disabilities, old age psychiatry and general psychiatry; and • Palliative care services provided at Roxburgh House Aberdeen and The Oaks Elgin. The budget allocated to Moray is designed to represent the consumption of these services by the Moray population. The MIJB integration scheme outlines that the method of establishing the set aside budget will take account of hospital activity data and cost information. Hospital activity data will reflect actual occupied bed day and admissions information, together with any planned changes in activity and case mix. This information was originally provided by Information Services Division, although this information hasn’t been updated since 2019/20. In the absence of updated information from Information Services Division, uplifts based on the baseline uplift was applied to the set aside budget calculation on an annual basis throughout the period up to 2024/25. During 2025/26 it was accepted that this did not provide an accurate reflection of the consumption by Moray residents within the Unplanned Care pathways and work was undertaken to update the set aside calculation. The updated set aside budget has been calculated using hospital activity data and cost information. The hospital activity data is taken from the SMR01 dataset for general/acute inpatient and day case and reflects inpatient stays and day case and outpatient activity. Costs are taken from the 2023/24 NHS Grampian cost book and uplifted by the baseline uplift amounts for 2024/25 and 2025/26 to reflect pay award Page 141
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 24 MANAGEMENT COMMENTARY (continued) and inflationary uplifts since 23/24. The set aside budget is the total of IJB activity multiplied by unit cost. The figures for 2021/22 to 2024/25 have been derived by uplifting 2019/20 figures by baseline funding uplift in 2021/22 (3.36%) ,2022/23 (6.70%), 2023/24 (5.35%) and 2024/25 (6.64%): 2025/26 2024/25 2023/24 2022/23 2021/22 Budget 20.092m 15.639m 14.665m 13.92m 13.04m Risks, Uncertainties and Future Developments The MIJB Chief Officer has a responsibility to maintain a risk strategy and risk reporting framework. Risks inherent within the MIJB are monitored, managed and reported at Audit, Performance and Risk Committee. In addition, a risk action log is monitored and managed by the Senior Management Team. The key strategic risks of the MIJB classed as ‘High’ and ‘Very High’ are presented below, the risk number relates to the MIJB internal risk numbering: Page 142
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 25 MANAGEMENT COMMENTARY (continued) VERY HIGH Risk 2 - The MIJB must operate within the resources allocated to it by the partner bodies and it is good financial practice to set a balanced budget at the start of each financial year. There is a risk that financial pressures being experienced by the funding partners will directly impact the MIJB’s strategic planning of services and its decision-making. Managing the risk – current controls in place – 1. Medium Term Financial Framework (MTFF) approved by MIJB on 26 March 2026. 2. Additional resource to support the Budget Savings Delivery has been extended until March 2026. 3. Tri-partite partnership performance meetings with partner CEOs, Finance Directors and Chair/Vice Chair of MIJB. 4. Operational financial monitoring undertaken by Chief Finance Officer (CFO), Heads of Service (HOS) and Budget Managers. 5. Budget Savings Oversight Group chaired by Chief Officer, attended by HOS, CFO and Service Managers as appropriate. 6. Monitoring of MIJB Strategic Delivery Plan ensuring all projects are aligned with savings plans. 7. Extended Resource Management Group – including financial recovery action plan. 8. SMT are actively monitoring and responding to the grip and control measures as they arise, ensuring robust oversight and challenge, ensuring that no critical issues are overlooked. 9. Financial pressures have been escalated to the Chief Executives of Moray Council and NHS Grampian, discussions continue as per the tri-partite arrangements. Assurances: • Quarterly Budget monitoring reporting to APR and MIJB. • Financial Reporting through MIJB, NHS Grampian and Moray Council. • The Project Management Office will support the Financial Recovery Savings presented as part of the budget setting for 2026/27 onwards. • Ongoing Financial Development Sessions with MIJB members. • Internal Audit quarterly reporting to APR. • External Audits presented to MIJB/ Committees as appropriate. Page 143
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 26 MANAGEMENT COMMENTARY (continued) • Six weekly Tri-partite partnership performance meetings with partner CEOs, Finance Directors and regular meetings with the Chair/Vice Chair of MIJB. • Strategic Delivery Plan (approved June 2025) incorporates the work being driven across all areas of the MIJB’s Strategic Plan priorities and will be reported regularly to AP&R Committee. • Finance workshops took place with Board members in December 2025 and February 2026. • Risk 2 presented to MIJB in January 2026 with Q3 report. Development Aims for 2026/27 Unscheduled Care Improvement Building on the work done on the National Collaborative to support Discharge without Delay and the wider Grampian performance challenges around Unscheduled Care, the IJB will maintain its focus on ensuring the services delegated to it deliver agreed targets. This will be done under the current actions in the delivery plan, and these will be refreshed as part of the development of the new Strategic Plan. Included in this work is the Home Assessment Pathway programme which will be reviewed across the year in relation to its contribution to achieving and sustaining agreed outcomes. Implementation of Organisational Structures Since its inception the MIJB has sought to ensure the most effective and efficient structures are in place to support the delivery of its strategic aims and overall strategic plan. Over the course of 2025/26 a review of the HSCM organisational structure was undertaken. This was a collaborative piece work and engaged and involved staff. A consultation took place and, following this, the focus will be on implementing the new structure and realising the opportunities and benefits set out in the initial proposals. Developing further our Children, Families and Justice priorities and strategy Children, Families and Justice Services were delegated formally to the MIJB in 2023/24 under the integration scheme and there is now reporting of these services within the Clinical and Care Governance structures in place. Moray Council and Councillors retain statutory responsibilities for outcomes for Children and also remain Corporate Parents in respect of those Children and Young People who are cared for or accommodated out with their families. MIJB is committed to ensuring it plans and commissions services that are appropriate to meet the growing demand and which focus as far as practicable on early intervention and prevention and which reduce the need for a crisis response and costly out of area placements. The IJB agreed a strategic direction in November 2025 and this, under the direction of the new, permanent Head of Service and Chief Social Work Officer (starting August 2026) will be a focus for delivery over the course of the year. Page 144
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 27 MANAGEMENT COMMENTARY (continued) Strategic Plan Review The MIJB approved its Strategic Delivery Plan at its meeting in May 2025, and this now provided a refresh of delivery under the current 10-year Strategy. However, recognising the need to ensure all services delegated to it are reflected in the Strategic Plan, and that it needs to reflect the financial reality set out in the Medium-Term Financial Framework, we plan to undertake a review of the Strategic Plan by the end of the financial year. In addition, we will seek to: • Continue to develop how we care for our staff well-being, with staff our most valuable asset, through the development of our Workforce Plan; • Set out clear ambitions under a Digital and TECH programme; • Provide leadership and participation as key partners in the pan Grampian North East Strategic Transformation Group (NESTG); • Focus our budget setting efforts in the context of the Medium-Term Financial Strategy and longer-term sustainability. ………………………… ……………………… ……………………… Dennis Robertson Judith Proctor Deborah O’Shea Chair of Moray IJB Chief Officer Chief Financial Officer Page 145
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 28 STATEMENT OF RESPONSIBILITIES Responsibilities of the MIJB • To make arrangements for the proper administration of its financial affairs and to secure that one of its officers has the responsibility for the administration of those affairs. In Moray Integration Joint Board, that officer is the Chief Financial Officer; • To manage its affairs to achieve best value in the use of its resources and safeguard its assets; • Ensure the Annual Accounts are prepared in accordance with legislation (The Local Authority Accounts (Scotland) Regulations 2014) and so far as is compatible with that legislation, in accordance with proper accounting practices (section 12 of the Local Government in Scotland Act 2003); and • To approve the Annual Accounts. Signed on behalf of the Moray Integration Joint Board Dennis Robertson Chair of Moray IJB Page 146
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 29 STATEMENT OF RESPONSIBILITIES (continued) Responsibilities of the Chief Financial Officer The Chief Financial Officer is responsible for the preparation of the Moray Integration Joint Board’s statement of accounts in accordance with proper practices as set out in the CIPFA/LASAAC Code of Practice on Local Authority Accounting in the United Kingdom (the Code) 2025/26. In preparing the Annual Accounts the Chief Financial Officer has: • Selected suitable accounting policies and applied them consistently; • Made judgements and estimates that were reasonable and prudent; • Complied with legislation; and • Complied with the local authority code (in so far as it is compatible with legislation). The Chief Financial Officer has also: • Kept proper accounting records that were up to date; and • Taken reasonable steps for the prevention and detection of fraud and other irregularities. I certify that the financial statements give a true and fair view of the financial position of the Moray Integration Joint Board as at 31 March 2026 and the transactions for the year then ended. Deborah O’Shea FCCA Chief Financial Officer Page 147
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 30 REMUNERATION REPORT Introduction This Remuneration Report is provided in accordance with the Local Authority Accounts (Scotland) Regulations 2014 (SSI2014/200) as part of the MIJB annual accounts. This report discloses information relating to the remuneration and pension benefits of specified MIJB members. All information disclosed in the tables is subject to external audit. Other sections within the Remuneration Report will be reviewed for consistency with the financial statements. Moray Integration Joint Board The voting members of MIJB are appointed through nomination by Moray Council and Grampian Health Board. There is provision within the Order to identify a suitably experienced proxy or deputy member for both the voting and non-voting membership to ensure that business is not disrupted by lack of attendance by any individual. MIJB Chair and Vice-Chair Nomination of the MIJB Chair and Vice-Chair post holders alternates every 18 months between a Councillor and a Health Board non-executive member. The MIJB does not provide any additional remuneration to the Chair, Vice-Chair or any other board members relating to their role on the MIJB. The MIJB does not reimburse the relevant partner organisations for any voting member costs borne by the partner. The MIJB does not have responsibilities in either the current or in future years for funding any pension entitlements of voting MIJB members. Therefore, no pension rights disclosures are provided for the Chair or Vice-Chair. Taxable Expenses 2024/25 Name Position Held Nomination By Taxable Expenses 2025/26 £ £ - Dennis Robertson Vice-Chair 01/04/25 – 30/09/25; Chair 01/10/25 to date Grampian Health Board - - Cllr Tracy Colyer Chair 01/04/24 – 26/09/24 Moray Council - - Cllr Elaine Kirby Chair 1/04/25 – 31/07/25 Moray Council - - Cllr Bridget Mustard Chair 1/08/25 – 30/09/25 Vice Chair 1/10/25 to date Moray Council - Page 148
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 31 REMUNERATION REPORT (continued) Officers of the MIJB The MIJB does not directly employ any staff in its own right; however specific post- holding officers are non-voting members of the Board. Chief Officer Under section 10 of the Public Bodies (Joint Working) (Scotland) Act 2014 a Chief Officer for the integration joint board has to be appointed and the employing partner has to formally second the officer to the Board. The employment contract for the Chief Officer will adhere to the legislative and regulatory framework of the employing partner organisation. The remuneration terms of the Chief Officer‘s employment are approved by the Board. Other Officers No other staff are appointed by the MIJB under a similar legal regime. Other non- voting board members who meet the criteria for disclosure are included in the disclosures below. Total 2024/25 Senior Employees Salary, Fees & Allowances Total 2025/26 £ £ £ 20,268 Simon Bokor-Ingram Chief Officer (1/04/24- 31/05/24) - - 95,673 Judith Proctor (from 25/07/24) 140,031 140,031 90,729 Deborah O’Shea Chief Financial Officer 95,135 95,135 In respect of officers’ pension benefits, the statutory liability for any future contributions to be made rests with the relevant employing partner organisation. On this basis there is no pensions liability reflected on the MIJB balance sheet for the Chief Officer or any other officers. The MIJB however has a responsibility for funding the employer contributions for the current year in respect of the officer time spent on fulfilling the responsibilities of their role on the MIJB. The following table shows the MIJB’s funding during the year to support the officers’ pension benefits. The table also shows the total value of accrued pension benefits which may include benefits earned in other employment positions and from each officer’s own contributions. Page 149
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 32 REMUNERATION REPORT (continued) NOTE: no bonuses, expenses allowances, compensation for loss of office or any taxable benefits were made in 2025/26. In Year Pension Contributions Accrued Pension Benefits Year to 31/03/25 Year to 31/03/26 As at 31/03/2026 Difference from 31/03/2025 £ £ £ 000’s £ 000’s Simon Bokor- Ingram, Chief Officer (*) 4,378 0 Pension - - Lump Sum - - Judith Proctor, Chief Officer 21,526 31,507 Pension 43 5 Lump Sum 111 8 Deborah O’Shea Chief Financial Officer 20,339 21,309 Pension 4 2 Lump Sum 31 - (*) Simon Bokor-Ingram figures included in the table above, relate to the full year 2024/25 including employment after Chief Officer, as figures are unable to be apportioned. Page 150
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 33 REMUNERATION REPORT (continued) Disclosure by Pay bands As required by the regulations, the following table shows the number of persons whose remuneration for the year was £50,000 or above, in bands of £5,000. Number of Employees in Band 2024/25 Remuneration Band Number of Employees in Band 2025/25 1 £85,000 - £89,999 - - £90,000 - £94,999 1 1 £130,000 - £134,999 - - £135,000 - £139,999 1 Exit Packages There were no exit packages agreed by the MIJB during 2025/26 financial year, or in the preceding year. ……………………….. ……………………… Dennis Robertson Judith Proctor Chair of Moray IJB Chief Officer Page 151
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 34 ANNUAL GOVERNANCE STATEMENT The Annual Governance Statement describes the Moray Integration Joint Board’s (MIJB) governance arrangements and reports on the effectiveness of the MIJB’s system of internal control. Scope of Responsibility The MIJB is responsible for ensuring that its business is conducted in accordance with the law and appropriate standards, and that public money is safeguarded and used efficiently and effectively in pursuit of best value. In discharging its responsibilities, the MIJB has established arrangements for its governance which includes the system of internal control. This system is intended to manage risk and support the achievement of the MIJB’s policies, aims and objectives. The system provides reasonable but not absolute assurance of effectiveness. The MIJB places reliance of the systems of internal control of NHS Grampian systems and Moray Council, which supports organisational compliance of policies and procedures in addition to those of the MIJB. Assurances are required on the effectiveness of the governance arrangements of all three organisations, meaning a significant failure in one of the three Partners may require to be disclosed in the annual accounts of all three Partners. The Governance Framework The CIPFA/SOLACE framework for ‘Delivering Good Governance in Local Government’ last updated in 2016 remains current and provides a structured approach in defining seven principles that underpin effective governance arrangements. Whilst the framework is written specifically for Local Government, the principles apply equally to integration authorities, and while the MIJB continues to evolve as an entity in its own right. It continues to draw on the governance assurances of NHS Grampian and Moray Council as its principal funding partners. Given the scope of responsibility within the MIJB and the complexities surrounding the assurance arrangements, a Local Code of Corporate Governance was developed and the MIJB assesses the effectiveness of its governance arrangements against the principles set out in the document. The Code outlines the seven governance principles from the CIPFA/SOLACE guidance (as referenced below) and provides the sources of assurance for assessing compliance relative to the MIJB, Moray Council and NHS Grampian. These assurances include referencing the governance arrangements of NHS Grampian and Moray Council which are summarised annually and published in their respective Annual Governance Statements which form part of the annual accounts of each organisation. The respective governance statements can be found on the individual organisations’ websites: Moray Council: Annual Accounts - Moray Council and NHS Grampian: https://www.nhsgrampian.org/about-us/annual- accounts/. Page 152
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 35 ANNUAL GOVERNANCE STATEMENT (continued) Key Governance Arrangements All scheduled meetings of the Audit Performance and Risk Committee and the Clinical Care Governance Committee were held as timetabled during 2025/26. Moray HSCP established an emergency response group in March 2020, which has since transitioned into a Daily Response meeting. Representation from partner organisations continues through Moray HSCP staff, maintaining effective links and information flow to support a co-ordinated response across Grampian and within Moray. Governance standards and collaborative working continue to operate across the wider system, including NHS Grampian Directorates and pan Grampian partnership arrangements. The Grampian Operation Performance Escalation System (GOPES) supports senior leaders to have oversight of system pressures and coordinate responses. This has strengthened the use of defined performance thresholds escalation levels and decision making. Evaluation of the Effectiveness of Governance Governance Principle 1 – Behaving with integrity, demonstrating strong commitment to ethical values and respecting the rule of law Assessment of Effectiveness • The activities of the MIJB are governed by a Board comprising both voting and non-voting members, drawn from a diverse range of backgrounds to support inclusive and informed decision making. The Board meets bi-monthly and is supported by regular development sessions, providing dedicated time for in depth exploration of key strategic and operational issues. • Governance is further strengthened through the work of two committees: the Audit, Performance and Risk Committee, and the Clinical and Care Governance Committee, each operating with clearly defined remits to provide assurance and support effective scrutiny. • The MIJB operates in accordance with Standing Orders, which set out the rules governing the proceedings of the Board and its Committees. These are supported by the Scheme of Administration, which defines the structure and remit of the Board’s committees, ensuring clarity, consistency and transparency in governance arrangements. • To uphold high standards of ethical conduct, the MIJB has appointed a Standards Officer. This role supports compliance with the Ethical Standards in Public Life etc. (Scotland) Act 2000, which requires members of devolved public bodies to adhere to Codes of Conduct approved by Scottish Ministers. • The Standards Officer also ensures alignment with guidance issued by the Standards Commission for Scotland, reinforcing the Board’s commitment to integrity, accountability, ethical governance and supporting members to maintain high standards of conduct in decision making. Page 153
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 36 ANNUAL GOVERNANCE STATEMENT (continued) Governance Principle 2 – Ensuring openness and comprehensive stakeholder engagement Assessment of Effectiveness • The MIJB’s Standing Orders provide for public and press access to meetings and reports, supporting transparency and accountability. Hybrid meeting arrangements continued throughout 2025/26 in response to positive feedback and to enhance accessibility for members and the public. • A dedicated Moray HSCP website supports access to Board information, including key strategies and supporting documentation and is subject to ongoing review and improvement. Agendas, reports and minutes for all committees are publicly available via the Moray Council website. • The voting and non-voting membership arrangements of the MIJB are in line with the Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Order 2014. The Board comprises eight voting members, with equal representation from Moray Council and NHS Grampian Board, alongside a range of non-voting members including professional advisors and stakeholder representatives. These arrangements ensure input from key stakeholder groups, including staff, third sector partners, people who use services and unpaid carers, supporting inclusive engagement and a broad range of perspectives in decision making. • The Community Empowerment (Scotland) Act 2015 places a statutory duty on MIJB and its Community Planning Partners to engage with communities on the planning and delivery of services and securing local outcomes. The MIJB’s approved Communications and Engagement Strategy supports active and meaningful engagement with all stakeholders and communities, ensuring that their views inform planning, delivery and continuous improvement of services. Governance Principle 3 – Defining outcomes in terms of sustainable economic, social and environmental benefits Assessment of Effectiveness • The MIJB Strategic Plan 2022-2032 building on the foundations of the 2019 plan, sets out long-term strategic objectives designed to be flexible and responsive to emerging challenges across health and social care. • To support delivery of a 3-year Delivery Plan was approved by MIJB in May 2025, underpinned by a medium-term financial framework. Together these provide a structured approach to translating strategic priorities into deliverable actions, aligned to available resources and focused on sustainable service delivery. • The strategic plan is supported by a comprehensive suite of documents, including a performance framework, workforce plan, and a communications, engagement and participation plan. The strategic plan and supporting documents will be prioritised for a refresh during 2026/27. • Collectively, these arrangements provide a clear and structured approach to defining, monitoring and delivering outcomes, with a clear focus on medium term priorities and measurable improvement. The outcomes are aligned to the Page 154
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 37 ANNUAL GOVERNANCE STATEMENT (continued) delivery of integrated health and social care services and are intended to improve population health, wellbeing and service sustainability within Moray. • In support of environmental sustainability, a Climate Change Duties report is prepared and submitted annually on behalf of the MIJB, demonstrating compliance with statutory environmental responsibilities and supporting continued progress against natural climate change objectives. Governance Principle 4 – Determining the interventions necessary to optimise the achievement of intended outcomes Assessment of Effectiveness • The MIJB’s decision making processes are designed to ensure that Board members receive clear, objective and comprehensive analysis of available options. Proposals set out how intended outcomes will be delivered, supported by proportionate assessment of risks, opportunities and implications. This supports informed and transparent decision making and enables the Board to determine appropriate interventions aligned to strategic priorities. • Board papers reflect the broad range of strategic and operational pressures under consideration. These include regular updates on current developments, alongside agenda items addressing opportunities and challenges, particularly those associated with transformation. • The MIJB recognises the importance of strong financial governance and has adopted the CIPFA Financial Management Code as a guiding framework for effective financial management. A Medium-Term Financial Strategy, approved in March 2026, supports this approach and is subject to regular review to ensure alignment with the Strategic Plan, Delivery Plan and the integration of delegated children’s services. These arrangements have operated effectively during the year, supporting the Board to determine and implement appropriate interventions and respond to emerging challenges. Governance Principle 5 – Developing the entity’s capacity, including the capability of its leadership and the individuals within it Assessment of Effectiveness • The Senior Management Team (SMT) and Officers and have established a programme of development sessions with Board members, with a focus on the challenging financial position and opportunities for service transformation. These sessions provide a structured forum to explore strategic challenges, consider options and support collective understanding of priorities. • Officers present a range of proposals through this process aimed at delivering the MIJB’s strategic objectives whilst contributing to the achievement of required financial efficiencies. • The MIJB continues to prioritise leadership development and collaborative working through regular development sessions involving Board members and h Officers. These sessions enable shared learning, strategic dialogue, and constructive challenge, supporting continuous development of leadership capability across the organisation. Page 155
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 38 ANNUAL GOVERNANCE STATEMENT (continued) Governance Principle 6 – Managing risk and performance through robust internal control and strong public financial management Assessment of Effectiveness • As part of a robust risk monitoring framework the Strategic Risk Register was co-developed with Board members during a dedicated development session in October 2024 and formally approved by the Board in May 2025. This updated register is reviewed monthly by the Senior Management Team and updated and presented at least biannually to Audit, Performance and Risk Committee, and annually to MIJB. The Committee agreed that emerging or escalating risks would be reported in line with business need. A further Board development session to review and refresh the register is planned for November 2026. • The operational Performance Management Framework has been reviewed and is nearing completion. A key improvement has been the focus to shift towards more integrated reporting across all delegated services, rather than individual service level reports, to provide a more cohesive view of system performance. Reporting is presented three times per year to the Audit, Performance and Risk Committee. • The system of internal control system remains aligned with those of MIJB’s Partner organisations, reflecting their operational responsibility for service delivery under direction of the MIJB. The Audit, Performance and Risk Committee continues to receive assurance through regular reporting on the effectiveness of internal control arrangements. • During 2025/26, targeted improvement work has been undertaken in partnership with Internal Audit and the Operational Management team to strengthen arrangements for audit planning, coordination and delivery. This has included improving oversight of the full audit plan, clarifying ownership of actions, and strengthening processes to support the timely and consistent implementation of audit recommendations. This work has provided greater visibility of progress, supported more effective management control, and is beginning to address a number of legacy actions, some of which require review to ensure continued relevance within the current operating context. • The MIJB Chief Internal Auditor undertakes an annual review of the adequacy and effectiveness of internal controls, with the opinion incorporated within this statement. • The MIJB benefits from the oversight of an independent S95 Officer, who is a member of the Board. This Officer provides expert advice on all financial matters and ensure timely preparation and reporting of budget estimates, monitoring reports and annual accounts. • Governance arrangements continue to reflect recognised good practice frameworks, including the Code of Practice on Managing the Risk of Fraud and Corruption, Public Sector Internal Audit Standards (incorporating the principles of the Role of the Head of Internal Audit) and Audit Committees: Practical Guidance for Local Authorities and Police. These frameworks support the MIJB’s commitment to strong financial stewardship and effective internal control. Page 156
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 39 ANNUAL GOVERNANCE STATEMENT (continued) Governance Principle 7 – Implementing good practices in transparency, reporting and audit to deliver effective accountability Assessment of Effectiveness • MIJB business is conducted through an approved cycle of Board and Committee meetings. To promote openness and accessibility, recordings of Board meetings are made available to the public. In addition, agendas, reports and minutes are published and accessible for the public to scrutinise. There is a standardised reporting format in place to ensure consistency, clarity and transparency how information is presented and decision-making processes. • The MIJB demonstrates its commitment to accountability through publication of its Annual Accounts and Annual Performance Report, both of which are subject to formal Board approval. These reports provide a clear account of financial stewardship, performance and progress against strategic priorities. • The Chief Internal Auditor reports independently to the Audit, Performance and Risk committee and has direct access to the Chief Officer, Chief Financial Officer and Chair of the Audit, Performance and Risk committee on any matter of concern. Throughout 2025/26, regular reporting has supported effective scrutiny of internal control arrangements, risk management and the delivery of the internal audit plan, strengthening overall assurance to the Board. Review of Adequacy and Effectiveness The MIJB has a responsibility for conducting, at least annually, a review of the effectiveness of the governance arrangements, including the system of internal control. The review is informed by the work of the Senior Management Team (which has responsibility for the development and maintenance of the internal control framework environment), the work of the Internal Auditors and the Chief Internal Auditor’s annual report and the reports from the External Auditor and other review agencies and inspectorates. Internal Audit Opinion Moray Council’s Internal Audit Section delivers the internal audit service for the Moray Integration Joint Board (MIJB). The Council’s Service Manager Internal Audit and Risk (Chief Audit Executive (CAE)) has recently been re-appointed as the Chief Internal Auditor to the MIJB until 31 March 2028. The Internal Audit Section has adopted the Global Internal Audit Standards (GIAS), which requires the Chief Internal Auditor to deliver an annual internal audit opinion and report. This report has been used to inform this governance statement. The Chief Internal Auditor’s evaluation of the adequacy and effectiveness of governance, risk management and the internal control framework is informed by the findings of audits undertaken on services operating under the direction of the MIJB. Additional assurance is obtained from the Internal Audit Service Provider for NHS Grampian regarding governance processes within that organisation. This includes the provision of relevant internal audit reports to the Chief Internal Auditor. In addition, reports issued by other external review agencies are considered as part of the overall assurance assessment. Page 157
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 40 ANNUAL GOVERNANCE STATEMENT (continued) Internal Audit operates independently within the organisation, with no management- imposed limitations on the scope of work undertaken. In accordance with GIAS, the Chief Internal Auditor prepares a risk-based Audit Plan for the MIJB. The Annual Audit Plan for 2025/26 included the following reviews: • Complex and Challenging Behaviour Services– A review of systems and procedures within Complex and Challenging Behaviour Services. • Social Care (Short Breaks)– A review of the governance, administrative and financial arrangements supporting the delivery of Social Care (Short Breaks), with particular regard to eligibility determination, record‑keeping and financial control processes. • Non-Payroll Expenditure–A review of non-payroll expenditure to test compliance with Financial Regulations, procurement requirements and payment-processing procedures. The audit of the Complex and Challenging Behaviour Service highlighted sustained levels of overtime worked by some officers, which, while demonstrating strong commitment, raises concerns about long-term service sustainability. Management has established a short-life working group to address these staffing pressures. The audit review of Social Care (Short Breaks) identified a need to consider the development of a charging policy for accommodated respite short breaks. This reflects findings from another audit review, which also suggested exploring charging arrangements for non-residential care services. The review of payments made through the Council’s Financial Management System identified instances where financial controls were not operating effectively, resulting in transaction processing errors and the need to recover expenditure from a service provider. While the majority of transactions tested were compliant and appropriately authorised, these findings, together with those from the Complex and Challenging Behaviour Service, highlight the need for improved compliance with Financial Regulations to ensure effective financial management, safeguard resources, and maintain robust governance. Follow-up reviews undertaken by the Internal Audit Section identified that several previously agreed recommendations remain outstanding, with revised implementation timescales required. Timely implementation of audit recommendations is critical to strengthening internal controls; delays increase the risk that control weaknesses persist. However, the MIJB has made notable progress in strengthening governance arrangements. Improvements include regular reporting on the implementation of audit recommendations to Senior Management and the Practice Governance Board, as well as more structured engagement with the Internal Audit Section. This includes attendance by the Chief Internal Auditor at Senior Management Team meetings to support the decision-making framework and the timely resolution of audit findings. Page 158
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 41 ANNUAL GOVERNANCE STATEMENT (continued) It was also noted that a replacement for the existing social work and social care case management system has been approved, with implementation planned by March 2027. As this system is the core database for highly sensitive social work information and supports the administrative and financial management of social care packages, its replacement represents a significant step towards strengthening information governance, improving operational resilience and enhancing overall service assurance. While progress has been made in strengthening governance and internal control arrangements within the MIJB, the outcomes of the audit work undertaken identified significant findings. In addition, several recommendations from previous reviews remain outstanding. After careful consideration of these factors, the Chief Internal Auditor has provided limited assurance that the MIJB had adequate systems of governance and internal control in place for the year ended 31 March 2026. Prior Year Governance Issues The Annual Governance Statement for 2024/25 highlighted a number of areas for development in looking to secure continuous improvement. An assessment of progress is provided below: Area for Improvement Identified in 2024/2 Action Undertaken / Progress Made in 2025/26 Developing further our approaches to frailty and Discharge without Delay. Realigning our organisational structure to ensure effective delivery of strategy and transformation. Progress has been made across the year in relation to improving the Partnership’s Delayed Discharge (DD) performance. Central to this has been the development of the Home Assessment Pathway (HAP) and its Discharge to Assess and Discharge without Delay Principles. The IJB retains a target of 26 DDs and, through the Grampian wide Unscheduled Care Programme, a target of no more than 5 delays in Dr Gray’s. Whilst overall DDs have reduced over the course of the year and we have, at times achieved the target, this has not yet been sustained. Work is ongoing to deliver that sustained improvement. Significant progress has been made in developing the organisational restructure. This has been a highly collaborative process with our teams. The structure will be implemented over 2026/27. Page 159
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 42 Area for Improvement Identified in 2024/2 Action Undertaken / Progress Made in 2025/26 Integration of Children’s Social Work and Justice Services governance and oversight within the IJB. Further strengthen performance oversight of the Board’s key strategies and priorities. Continue to improve on the progress for compliance with audit recommendations. Governance arrangements in these services have been set out and reporting is in place. In addition, a review of governance of the joint (IJB and Moray Council) Whole Family Wellbeing Fund (WFWF) took place and was agreed by partners, giving greater clarity on the oversight, decision making and reporting of this fund. An agreed performance structure is in place for the MIJB and has operated over the year. In addition, Moray HSCP has set out a revised structure for governance of the delivery plan and key strategic change, as well as in relation to Budget Savings Delivery. Progress has been made in strengthening arrangements. A dashboard of all audits and actions has been developed that enables a new Corporate IA Group to track progress and report / escalate issues. IA reports to the Moray HSCP every month and this enables positive dialogue with the Chief Internal Auditor. Page 160
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 43 Further Developments Following consideration of the review of adequacy and effectiveness, the following action plan has been established to ensure continual improvement of the MIJB’s governance arrangements and progress against the implementation of these issues will be assessed as part of the next annual review. Areas of focus for 2026/27 1. Review of the IJB’s Strategic Plan. 2. Implement new arrangements for lived experience members’ voting rights and support them in this transition. 3. Continue to implement strengthened arrangements for implementing Internal Audit actions. 4. Continued focus on budget savings delivery and medium-term financial challenge. Key Governance challenges going forward will involve: • Providing capacity to meet statutory obligations and ambitions to transform services, whilst managing expectations, increasing complexity and rising demand for services and the wider societal economic challenges now presented that also potentially drive demand. • As a Board, difficult decisions will be required in balancing how we meet the needs of our community whilst operating within the available resource envelope, this will be supported by our approach to risk as set out in our risk appetite statement. • Continuing to address our work force challenges in respect of recruitment and retention and where persistent vacancies will necessitate the need for redesign of roles and/or services. • Continuing to work closely with NHS Grampian, Moray Council and Moray Community Planning Partnership to build on existing relationships and establishing collaborative leadership, and to maximise the opportunities from an expanded health and social care remit within a pan Grampian approach and contribute to the emerging work of the North East Strategic Transformation Group (NESTG). • Continuing to implement the recommendations of internal and external audit, including learning from national reviews. • There have been no significant events up to the authorised for issue date. ANNUAL GOVERNANCE STATEMENT (continued) Page 161
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 44 ANNUAL GOVERNANCE STATEMENT (continued) Statement In our respective roles as Chair and Chief Officer of the MIJB, we are committed to ensuring good governance and recognise the contribution it makes to securing delivery of service outcomes in an effective and efficient manner. This annual governance statement summarises the MIJB’s current governance arrangements and affirms our commitment to ensuring they are regularly reviewed, developed and fit for purpose. Whilst recognising that improvements are required, as detailed earlier in the statement, it is our opinion that a reasonable level of assurance can be placed upon the adequacy and effectiveness of the MIJB’s governance arrangements. The ongoing challenge will be to meet all operational demands and pressures as we continue to operate within the legacy of the Covid 19 pandemic and global financial pressures, both of which have impacted at a socioeconomic level on our region and the community. Pressure on financial settlements is increasing for all partners, and we will continue to engage with them, the Scottish Government and the wider community to agree plans and outcomes that are both sustainable and achievable within this context. Taking that forward will be challenging as we aim to fulfil the nine Health and Wellbeing national health and well-being outcomes, and the strategic priorities identified and detailed in our Strategic Plan. Good governance remains an essential focus in delivering services in a way that both meets the needs of communities and discharges statutory best value responsibilities. These were arrangements in place for 2025/26 and up to the date of authorised for issue. ………………………… ……………………… Dennis Robertson Judith Proctor Chair of Moray IJB Chief Officer Page 162
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 45 COMPREHENSIVE INCOME AND EXPENDITURE STATEMENT This statement shows the cost of providing services for the year ended 31 March 2026 according to generally accepted accounting practices. 2024/25 2025/26 Net Expenditure Net Expenditure £ 000 £ 000 8,329 Community Hospitals 7,932 6,166 Community Nursing 6,670 19,975 Learning Disabilities 21,230 12,055 Mental Health 12,881 1,763 Addictions 1,817 273 Adult Protection & Health Improvement 279 22,754 Care Services Provided In-House 25,495 27,034 Older People & Physical & Sensory Disability Services 30,023 1,972 Intermediate Care and Occupational Therapy 2,039 1,817 Care Services Provided by External Providers 2,072 10,280 Other Community Services 10,310 3,152 Administration & Management 3,086 1,535 Other Operational services 1,351 21,937 Primary Care Prescribing 21,312 21,331 Primary Care Services 22,954 5,665 Hosted Services 5,987 1,971 Out of Area Placements 1,834 1,021 Improvement Grants 889 19,626 Children & Justice Services 22,050 6,020 Strategic Funds & Other Resources 6,005 15,639 Set Aside 20,092 210,315 Cost of Services 226,308 (209,779) Taxation and Non-Specific Grant Income (note 5) (227,868) 536 Deficit/(Surplus) on provision of Services (1,560) 536 Total Comprehensive Income and Expenditure (1,560) There are no statutory or presentational adjustments which reflect the MIJB’s application of the funding received from partners. The movement in the General Fund balance is therefore solely due to the transactions shown in the Comprehensive Income and Expenditure Statement. Consequently, an Expenditure and Funding Analysis is not provided in these annual accounts. Page 163
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 46 MOVEMENT IN RESERVES STATEMENT This statement shows the movement in the year on the MIJB’s reserves. The movements which arise due to statutory adjustments which affect the General Fund balance are separately identified from the movements due to accounting practices. Additional detail included within note 7 on page 52. Movement of Reserves During 2025/26 General Fund Balance £000 Opening Balance at 1 April 2025 (1,450) Total Comprehensive Income and Expenditure (1,560) (Increase) in 2025/26 (1,560) Closing Balance at 31 March 2026 (3,010) Movement of Reserves During 2024/25 General Fund Balance £000 Opening Balance at 1 April 2024 (1,986) Total Comprehensive Income and Expenditure 536 Decrease in 2024/25 536 Closing Balance at 31 March 2025 (1,450) Page 164
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 47 BALANCE SHEET The Balance Sheet shows the value of the MIJB’s assets and liabilities as at the balance sheet date. The net assets of the MIJB (assets less liabilities) are matched by the reserves held by the MIJB. 31 March 2025 £000 Notes 31 March 2026 £000 1,450 Short Term Debtors 6 3,010 Current Assets - Short Term Creditors - Current Liabilities - Provisions - Long Term Liabilities 1,450 Net Assets 3,010 1,450 Usable Reserve General Fund 7 3,010 1,450 Total Reserves 3,010 The unaudited annual accounts were issued on 25 June 2026. The Annual Accounts present a true and fair view of the financial position of the MIJB as at 31 March 2026 and its income and expenditure for the year then ended. Deborah O’Shea FCCA Chief Financial Officer Page 165
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 48 NOTES TO THE FINANCIAL STATEMENTS Note 1 Significant Accounting Policies General Principles The Financial Statements summarise the MIJB’s transactions for the 2025/26 financial year and its position at the year-end of 31 March 2026. The MIJB was established under the requirements of the Public Bodies (Joint Working) (Integration Joint Boards) (Scotland) Act 2014 and is a Section 106 body as defined in the Local Government (Scotland) Act 1973. The Financial Statements are therefore prepared in compliance with the Code of Practice on Local Authority Accounting in the United Kingdom 2025/26, supported by International Financial Reporting Standards (IFRS), unless legislation or statutory guidance requires different treatment. The accounts are prepared on a going concern basis, which assumes that the MIJB will continue in operational existence for the foreseeable future. The historical cost convention has been adopted. Accruals of Income and Expenditure Activity is accounted for in the year that it takes place, not simply when settlement in cash occurs. In particular: • Expenditure is recognised when goods or services are received, and their benefits are used by the MIJB. • Income is recognised when the MIJB has a right to the income, for instance by meeting any terms and conditions required to earn the income, and receipt of the income is probable. • Where income and expenditure have been recognised but settlement in cash has not taken place, a debtor or creditor is recorded in the Balance Sheet. • Where debts may not be received, the balance of debtors is written down. Funding The MIJB is primarily funded through funding contributions from the statutory funding partners, Moray Council and Grampian Health Board. Expenditure is incurred as the MIJB commissions’ specified health and social care services from the funding partners for the benefit of service recipients in Moray area. Cash and Cash Equivalents The MIJB does not operate a bank account or hold cash. Transactions are settled on behalf of the MIJB by the funding partners. Consequently, the MIJB does not present a ‘Cash and Cash Equivalent’ figure on the balance sheet. The funding balance due to or from each funding partner as at 31 March is represented as a debtor or creditor on the MIJB’s Balance Sheet. Page 166
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 49 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 1 Significant Accounting Policies (continued) Employee Benefits The MIJB does not directly employ staff. Staff are formally employed by the funding partners who retain the liability for pension benefits payable in the future. The MIJB therefore does not present a Pensions Liability on its Balance Sheet. The MIJB has a legal responsibility to appoint a Chief Officer. More details on the arrangements are provided in the Remuneration Report. The charges from the employing partner are treated as employee costs. Where material the Chief Officer’s absence entitlement as at 31 March is accrued, for example in relation to annual leave earned but not yet taken. Charges from funding partners for other staff are treated as administration costs. Reserves The MIJB’s reserves are classified as either Usable or Unusable Reserves. The MIJB’s only Usable Reserve is the General Fund. The balance of the General Fund as at 31 March shows the extent of resources which the MIJB can use in later years to support service provision. Indemnity Insurance The MIJB has indemnity insurance for costs relating primarily to potential claim liabilities regarding Board members. Grampian Health Board and Moray Council have responsibility for claims in respect of the services that they are statutorily responsible for and that they provide. Unlike NHS Boards, the MIJB does not have any ‘shared risk’ exposure from participation in the Clinical Negligence and Other Risks Indemnity Scheme (CNORIS). The MIJB participation in the CNORIS scheme is therefore analogous to normal insurance arrangements. Note 2 Critical Judgements and Estimation Uncertainty In applying the accounting policies, the MIJB has had to make certain judgements about complex transactions or those involving uncertainty about future events. There are no material critical judgements or estimation uncertainty. Page 167
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 50 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 3 Events after the Reporting Period The unaudited accounts were issued by Deborah O’Shea, Chief Financial Officer on 25 June 2026. Events taking place after this date are not reflected in the financial statements or notes. Note 4 Expenditure and Income Analysis by Nature 2024/25 2025/26 £000 £000 98,217 Services commissioned from Moray Council 106,355 112,061 Services commissioned from Grampian Health Board 119,918 37 Auditor Fee: External Audit Work 35 210,315 Total Expenditure 226,308 (209,779) Partners Funding Contributions and Non- Specific Grant Income (227,868) 536 Deficit on the Provision of Services (1,560) Page 168
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 51 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 5 Taxation and Non-Specific Grant Income 2024/25 2025/26 £000 £000 88,441 Funding Contribution from Moray Council 94,522 121,338 Funding Contribution from Grampian Health Board 133,346 209,779 Taxation and Non-specific Grant Income 227,868 The funding contribution from Grampian Health Board shown above includes £20.092m in respect of ‘set aside’ resources relating to acute hospital and other resources. These are provided by Grampian Health Board who retains responsibility for managing the costs of providing the services. The MIJB however has responsibility for the consumption of, and level of demand placed on, these resources. Note 6 Debtors 31 March 2025 31 March 2026 £000 £000 1,187 Grampian Health Board 2,747 263 Moray Council 263 1,450 Debtors 3,010 Amounts owed by the funding partners are stated on a net basis. Creditor balances relating to expenditure obligations incurred by the funding partners but not yet settled in cash terms are offset against the funds they are holding on behalf of the MIJB. Page 169
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 52 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 7 Usable Reserve: General Fund The MIJB holds a balance on the General Fund for two main purposes: • To earmark, or build up, funds which are to be used for specific purposes in the future, such as known or predicted future expenditure needs. This supports strategic financial management. • To provide a contingency fund to cushion the impact of unexpected events or emergencies. This is regarded as a key part of the MIJB’s risk management framework. The table below shows the movements on the General Fund balance: Earmarked Reserves General Reserves PCIP & Action 15 Other Earmarked Total £000 £000 £000 £000 Balance at 1 April 2024 - 33 1,953 1,986 Transfers (out) 2024/25 - (33) (503) (536) Balance at 31 March 2025 - - 1,450 1,450 Transfer in/(out) 2025/26 - - 1,560 1,560 Balance at 31 March 2026 - - 3,010 3,010 Primary Care Improvement Fund (PCIP) - The purpose of this fund is to ring fence funding received from the Scottish Government as part of its Primary Care Transformation Plan; this includes Action 15 funding as part of this plan. This reserve is now depleted. Other earmarked reserves are noted in detail on pages 21 to 23. Page 170
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 53 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 8 Agency Income and Expenditure On behalf of all IJB’s within Grampian Health Board, the MIJB acts as the lead manager for Grampian Medical Emergency Department (GMED) and Primary Care Contracts. It commissions services on behalf of the other IJBs and reclaims the costs involved. The payments that are made on behalf of the other IJBs, and the consequential reimbursement, are not included in the Comprehensive Income and Expenditure Statement (CIES) since the MIJB is not acting as principal in these transactions. The amount of expenditure and income relating to the agency arrangement is shown below: 2024/25 2025/26 £000 £000 10,680 Expenditure on Agency Services 11,266 (10,680) Reimbursement for Agency Services (11,266) - Net Agency Expenditure excluded from the CIES - Page 171
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 54 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 9 Related Party Transactions The MIJB has related party relationships with Grampian Health Board and Moray Council. In particular the nature of the partnership means that the MIJB may influence, and be influenced by, its partners. The following transactions and balances included in the MIJB’s accounts are presented to provide additional information on the relationships. Transactions with Grampian Health Board 2024/25 2025/26 £000 £000 (121,338) Funding Contributions received from the NHS Board (133,346) 111,864 Expenditure on Services Provided by the NHS Board 119,691 197 Key Management Personnel: Non-Voting Board Members 227 (9,227) Net Transactions with Grampian Health Board (13,428) Key Management Personnel: The Chief Officer and Chief Financial Officer are non- voting Board members and are both employed by Grampian Health Board and recharged to the MIJB. Details of the remuneration of both officers are provided in the Remuneration Report. The Chief Officer is a joint appointment made by Moray Council and Grampian Health Board and is jointly accountable to the Chief Executives of both organisations, as such this post is jointly funded. The Chief Financial Officer, whilst a Board appointment, does not share this arrangement of funding. Balances with Grampian Health Board 31 March 2025 31 March 2026 £000 £000 1,187 Debtor balances: Amounts due from Grampian Health Board 2,747 1,187 Net Balance due from Grampian Health Board 2,747 Page 172
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 55 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 9 Related Party Transactions (continued) Transactions with Moray Council 2024/25 2025/26 £000 £000 (88,441) Funding Contributions received from the Council (94,522) 98,179 Expenditure on Services Provided by the Council 106,294 75 Key Management Personnel: Non-Voting Board Members 96 9,813 Net Transactions with Moray Council 11,868 Balances with Moray Council 31 March 2025 31 March 2026 £000 £000 263 Debtor balances: Amounts due from Moray Council 263 263 Net Balance due from Moray Council 263 Page 173
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 56 NOTES TO THE FINANCIAL STATEMENTS (continued) Note 10 VAT The MIJB is not registered for VAT and as such VAT is settled or recovered by the partners. The VAT treatment of expenditure in the MIJB accounts depends on which of the partners is providing the services as each of these partners are treated differently for VAT purposes. VAT payable is included as an expense only to the extent that it is not recoverable from His Majesty’s Revenue and Customs. VAT receivable is excluded from income. Note 11 Accounting Standards That Have Been Issued but Have Yet To Be Adopted The Code requires the MIJB to identify any accounting standards that have been issued but have yet to be adopted and could have material impact on the accounts. This applies to the adoption of the following new or amended standards within the 2026/27 Code: • Amendments to FRS 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (Amendments to Heritage assets) issued in March 2024; • Amendments to the Classification and Measurement of Financial Instruments (Amendments to IFRS 9 and IFRS 7) issued in May 2024; • Annual improvements to IFRS accounting standards – Volume 11 issued in July 2024; and • Contracts Referencing Nature-dependent Electricity (Amendments to IFRS 9 and IFRS 7) issued in December 2024. The Code requires implementation from 1 April 2026 and there is, therefore, no impact on the 2025/26 financial statements. The above amendments are not anticipated to have a material impact on the information provided in the financial statements. Page 174
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APPENDIX 1 Moray Integration Joint Board Annual Accounts 2025/26 57 Page 175
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LOCAL CODE OF CORPORATE GOVERNANCE APPENDIX 2 GOVERNANCE PRINCIPLES Principle A Behaving with integrity, demonstrating strong commitment to ethical values and respecting the rule of law SOURCES OF ASSURANCE MIJB MORAY COUNCIL NHS GRAMPIAN Code of Conduct (Jan 2025 – standards for member and ethical conduct) Codes of Conduct Codes of Conduct Financial Regulations (May 2025) Financial Regulations & Authorisation policy Standing Financial Instructions Standards Officer Appointment (2026 – oversight of ethical standards and complaints) Scheme of Administration Schedule of Reserved Decisions Standing Orders (May 2022) Standing Orders Operational Scheme of Delegation Register of Interests (annually) Human Resources Policies Standing Orders Scheme of Administration (June 2018) Scheme of Delegation Human Resources Policies ( and Once for Scotland policies around Employee Conduct) Integration Scheme (Mar 2023) Register of Interests Staff Governance Committee Updated IJB Report Format (Sept 2022 – includes governance, risk and implications sections) Integrity Group Register of Interests Information Commissioners Officer Registration Employee Induction Process Feedback Service Duty of Candour Arrangements Computer Use Policy Staff Surveys Whistleblowing Standards Duty of Candour Arrangements Employee Induction Process Members handbook (2020 under review, expected 2026) Monitoring Officer Annual Report SLT Compliance Sub Group Care for People Plan (May 2026) Staff Engagement Programme Duty of Candour Arrangements Page 176
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LOCAL CODE OF CORPORATE GOVERNANCE E-Learning module on GDPR Policy for the Prevention, Detection and Investigation of Suspected Fraud, Theft or Corruption Whistleblowing policy Whistleblowing Policy GOVERNANCE PRINCIPLES Principle B Ensuring openness and comprehensive stakeholder engagement SOURCES OF ASSURANCE MIJB MORAY COUNCIL NHS GRAMPIAN Strategic Plan (2022-2032) Community Consultation & Engagement Annual Delivery Plan (includes Financial Plan) Performance Management Framework (under review) Complaints Procedures & Responses Performance Management Framework Annual Performance Report (produced annual for public accountability) Use of Social Media Freedom of Information Compliance Communications & Engagement Strategy (updated framework in development, expected 2026) Freedom of Information Compliance Feedback Service Community Consultation Locality Planning Population Health Committee Third Sector Involvement in planning and service design Community Asset Transfers Grampian Clinical Strategy IJB Membership – Broad Range of Stakeholders Participatory Budgeting Plans NHS Grampian Area Partnership Forum Use of Social Media (public communication and engagement channel Equality, Diversity and Human Rights Policy Freedom of Information Compliance and reporting Stakeholder Engagement Framework Workforce Forum Complaints Handling Policy (including Learning – SPSO aligned) Page 177
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LOCAL CODE OF CORPORATE GOVERNANCE Staff Surveys (feedback and organisational learning) Governance Framework (transparency, reporting and accountability arrangements) Community Risk Register (2021) IJB & Committee meetings held in public Unpaid Carers Strategy Moray Mental Health and Wellbeing Strategy 2016- 2026 Locality Planning GOVERNANCE PRINCIPLES Principle C Defining outcomes in terms of sustainable economic, social and environmental benefits SOURCES OF ASSURANCE MIJB MORAY COUNCIL NHS GRAMPIAN Strategic Plan (2022-2032 – defines outcomes and priorities) Moray 2027 – a Plan for the Future Annual Delivery Plan (includes Financial Plan) Annual Performance Report (measures delivery against outcomes) Corporate Plan – currently being updated Governance Framework Performance Management Framework (under review) Community Planning Board Performance Management Framework Annual Climate Change Duties and Responsibilities (statutory reporting and compliance) Local Outcome Improvement Plans – Updated with Partner Agencies Population Health Committee Page 178
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LOCAL CODE OF CORPORATE GOVERNANCE Equalities Outcomes (April 2025 – supports equiable service delivery) Governance Framework Grampian Clinical Strategy Best Value Report & Action Plan (continuous improvement and value for money) Performance Management Framework Equality & Diversity: Outcomes Best Value Report & Action Plan Improvement and Transformation Plans GOVERNANCE PRINCIPLES Principle D Determining the interventions necessary to optimise the achievement of intended outcomes SOURCES OF ASSURANCE MIJB MORAY COUNCIL NHS GRAMPIAN Risk Management Processes (identification, escalation and mitigation of risks) Risk Management Processes Risk Management Processes Audit Planning (Internal & External) Audit Planning (Internal & External) Audit Planning (Internal & External) Performance Management Framework Performance Management Framework Performance Management Framework Budget Monitoring Processes Budget Monitoring Processes Budget Monitoring Processes Page 179
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LOCAL CODE OF CORPORATE GOVERNANCE Financial Planning (aligned to strategic and financial sustainability) Financial Planning – in line with Cipfa’s FM Code Principles Financial Planning MIJB Committee Structure (decision making and oversight arrangements) Moray Council Committee Structure Health & Safety Committee Governance Framework Asset Management Group Annual Accountability Review Health and Safety Arrangements Guide to Scrutiny at Moray Council Asset Management Group Business Continuity Planning Workforce and ICT Strategies Ministerial Strategic Group – Self Assessment May 2019 Ministerial Strategic Group – Self Assessment – May 2021 Grampian Clinical Strategy Clinical Governance Committee Page 180
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LOCAL CODE OF CORPORATE GOVERNANCE GOVERNANCE PRINCIPLES Principle E Developing the entity’s capacity, including the capability of its leadership and the individuals within it. SOURCES OF ASSURANCE MIJB MORAY COUNCIL NHS GRAMPIAN Workforce Planning and Organisational Development Workforce Planning Employee Induction Processes Workforce Forum Elected Member Induction / Development Board Member Induction MIJB Voting Member Briefings (support for informed decision making) Employee Development Team Staff Partnership Representation MIJB Development Sessions (ongoing governance and leadership development) Moray Management Methods Leadership Schemes Board Member Induction (roles, responsibilitie and governance requirements) Employee Induction Processes Staff Governance Committee System Leadership Programme Employee Review and Development Programme ‘’ We Care’’ programme Strategic Transformation Plan 2023-25 Staff Leadership Forum NHSG 3 Year Delivery Plan 2023-26 Best Value Action Plan developed Page 181
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LOCAL CODE OF CORPORATE GOVERNANCE GOVERNANCE PRINCIPLES Principle F Managing risk and performance through robust internal control and strong public financial management. SOURCES OF ASSURANCE MIJB MORAY COUNCIL NHS GRAMPIAN Financial Regulations (May 2025) Financial Regulations (update 29.6.23) Standing Financial Instructions Risk Management Strategy and Reporting (including escalation and oversight) Risk Management Policy & Strategy Budget Monitoring & Financial Planning Governance Framework (roles, responsibilities and assurance routes) Following the Public Pound – ALEO Funding Risk Management Framework & Reporting Budget Monitoring & Financial Planning (including in year reporting to MIJB) Performance Management Framework Audit Planning (Internal & External) Production of Annual Accounts Scheme of Delegation Policy for the Prevention, Detection and Investigation of Suspected Fraud, Theft or Corruption Audit Planning (Internal & External) Section 95 Officer Appointment Schedule of Reserved Decisions Business Continuity & Incident Response Plans Fraud, Theft, Bribery & Corruption Policy Operational Scheme of Delegation Performance Management Framework Participation in National Fraud Initiative Annual Report and Accounts (including annual governance statement) Clinical & Care Governance Committee (oversight of quality and safety risks) Information Assurance Group Performance, Assurance, Infrastructure and Finance Committee Moray Performance Review (Chief Executive) Budget Monitoring & Financial Planning Clinical Risk Management Group Internal and External Audit Plans Audit Planning (Internal & External) Business Continuity & Incident Response Planning Integration Scheme (Mar 2023 defines delegated functions and partner responsibilities) Procurement Regulations & Training Page 182
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LOCAL CODE OF CORPORATE GOVERNANCE Audit, Performance and Risk Committee Business Continuity Plans – to be revisited post pandemic Risk Policy (Sept 2020 – under review, update scheduled 2026) Clinical Risk Management Group (operational risk identification and escalation) Financial Recovery Plan Reserves Policy 2024 Internal Auditor Reappointment (2026) Operational Management Team (oversight of audit actions, risk and internal controls) GOVERNANCE PRINCIPLES Principle G Implementing good practices in transparency, reporting and audit to deliver effective accountability. SOURCES OF ASSURANCE MIJB MORAY COUNCIL NHS GRAMPIAN Committee Reporting Framework (including escalation to MIJB and committees) Committee Reporting Framework Board sub-Committee Reporting Framework Financial Reporting – Budget Monitoring (regular reporting to MIJB) Financial Reporting – Budget Monitoring Financial Reporting – Budget Monitoring Production & Approval of Annual Budget Production & Approval of Annual Budget Production of Annual Report and Accounts Production of Annual Accounts (including Annual Governance Statement) Production of Annual Accounts Audit Planning (Internal & External) Page 183
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LOCAL CODE OF CORPORATE GOVERNANCE Audit Planning and reporting (Internal & External) Audit Planning (Internal & External) Assurance Framework Consultation and Stakeholder feedback mechanisms Statutory Returns Public Sector Reform Act disclosure Governance Framework (including assurance and reporting arrangements) Consultation Annual Complaints Report Externally commissioned review of Commissioned services Chief Social Work Officer Annual Report Annual Duty of Candour Report Locality Plans Scottish Public Services Ombudsman – Complaints Reporting and Responses Annual Climate Change Reporting Annual Complaints Report (including learning and service improvement actions) Annual Duty of Candour Report (statutory reporting and learning) Audit, Performance and Risk Committee (oversight of audit, risk and governance reporting) Page 184
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APPENDIX 3 1 NHS Grampian Board Secretariat Summerfield House 2 Eday Road Aberdeen AB15 6RE Deborah O’Shea Chief Finance Officer Moray Health and Social Care Partnership Date 4 June 2026 Our Ref GB/JA Enquiries to Julie Anderson Email jule.anderson24@nhs.scot Dear Debs, Governance Statement 2025/26 The Chief Executive is required to prepare a Governance Statement which forms part of the Accountability Report in the Integrated Joint Board’s annual report and accounts as part of the Health and Social Care partnerships. The Governance Statement requires each Chief Executive, in their capacity as Accountable Officer, to report that they have maintained sound and effective systems of internal control, performance and risk management across all of the Board’s activities. In preparing the Governance statement, the Chief Executive is required to seek assurance from a range of sources to evidence the organisation’s performance, risk management and internal control framework, including responses to actual and emerging risks. NHS Grampian is due to report its annual accounts by 26th June 2026 and a draft governance statement has been appended to aid in the preparation of the Integrated Joint Board’s draft accounts for the year ended 31st March 2026. Should you require any clarification on the above or need guidance on matters that need to be considered or reported in the formal statement please do not hesitate to contact myself at julie.anderson24@nhs.scot. Yours sincerely Julie Anderson Assistant Director of Finance Page 185
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2 Draft NHS Grampian Governance Statement 2025/2026 NHS Grampian is required to operate within the aspects of the Scottish Public Finance Manual (SPFM) which are set out within the guidance issued to Chief Executives and more generally to all Board members by the Scottish Government Health and Social Care Directorates as being applicable to NHS Boards. The SPFM is issued by Scottish Ministers to provide guidance to the Scottish Government and other relevant bodies on the proper handling and `reporting of public funds. The SPFM sets out the relevant statutory, parliamentary and administrative requirements, emphasises the need for efficiency, effectiveness and economy, and promotes good practice and high standards of propriety. As Accountable Officer, the Chief Executive is responsible for maintaining an adequate and effective system of internal control that identifies, prioritises and manages the principal risks facing the organisation, promotes achievement of the organisation’s aims and objectives and supports compliance with the organisation’s policies and safeguarding public funds. The Board continually monitors and reviews the effectiveness of the system of internal control with a specific focus on the delivery of safe and effective patient care, achievement of national and local targets and demonstrating best value and the efficient use of resources. Key elements of the system of internal control include: • A Board which meets regularly to discharge its governance responsibilities, set the strategic direction for the organisation and approve decisions in line with the Scheme of Delegation. The Board comprises the Executive Directors and Non- Executive members. The Board activity is open to public scrutiny with papers and minutes of meetings publicly available on the Board website; • Scheme of Delegation, Standing Orders and Standing Financial Instructions approved by the Board are subject to regular review to assess whether they are relevant and fully reflective of both best practice and mandatory requirements; • Mature and organisation wide risk management arrangements built on localised risk registers and processes which ensure, as appropriate, escalation of significant instances of non-compliance with applicable laws and regulations that exceed our risk appetite; • Dedicated full-time members of staff for key statutory compliance functions including Information Governance, Health and Safety, fire and asbestos, tasked with ensuring they are up to date with all relevant legislation and are responsible for co-ordinating management action in these areas; • A focus on best value and commitment to ensuring that resources are used efficiently, effectively and economically taking into consideration equal opportunities and sustainable development requirements; • Each key governance committee is supported by a designated lead Executive Director who has the delegated management accountability for statutory and regulatory matters; Page 186
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3 • Regular review of financial performance, risk management arrangements and non-financial performance against key service measures and standards by the Performance, Assurance, Finance and Infrastructure Committee & the Board; • Enhanced arrangement for financial management and control associated with financial recovery, including a Financial Recovery Board chaired by a non executive Board member and finance reports to every PAFIC and public Board meeting • Regular review of service quality against recognised professional clinical standards by the Clinical Governance Committee; • Regular review of workforce arrangements and implementation of the NHS Scotland Staff Governance standard by the Staff Governance Committee; • An active joint management and staff partnership forum (Grampian Area Partnership Forum) with staff side representation embedded in all key management teams and a dedicated full-time Employee Director who is a member of the Board; • Regular review of priorities for infrastructure investment and progress against the agreed Asset Management Plan by an Asset Management Group chaired by a Director and including management representatives from all operational sectors and representation from the clinical advisory structure; • Clear allocation of responsibilities to ensure we review and develop our organisational arrangements and services in line with national standards and guidance including consultation with all stakeholders on service change proposals to inform decision making; • Promotion of effective cross-sector governance arrangements through participation by the IJB Board members and the Chief Executives of each of the partner organisations in the regular meetings between the Chief Executives of all Public Sector organisations in Grampian and performance review meetings with each IJB Chief Officer to further develop and drive improvement through integrated service delivery; • A patient feedback service to record and investigate complaints and policies to protect employees who raise concerns in relation to suspected wrongdoing such as clinical malpractice, fraud and health and safety breaches; and • Separate governance arrangements for the NHS Grampian Charity including a Chair of the Trustees elected from within the body of the Trustees, an annual general meeting of all Trustees to agree all policy matters and an NHS Grampian Charity sub-committee with delegated authority to manage the day to day operational matters of the charity. Based on the evidence considered during the review of the effectiveness of the internal control environment NHS Grampian has confirmed that there are no known outstanding significant control weaknesses or other failures to achieve the standards set out in the guidance on governance, risk management and control. Page 187
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APPENDIX 4 Moray Health & Social Care Partnership Best Value Statement March 2026 Page 189
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APPENDIX 4 Best Value – Accountability and Governance Overview Purpose and framework This Best Value assurance narrative is aligned to the Scottish Government’s revised statutory Best Value guidance (2020). It is intended to support internal and external audit by setting out how Moray Health and Social Care Partnership (Moray HSCP)) and the Moray Integration Joint Board (MIJB) secure and evidence Best Value through existing governance, performance and assurance arrangements, rather than through bespoke measures or parallel reporting systems. Accountability and governance overview Accountability for securing Best Value within Moray Health and Social Care Partnership rests with the Moray Integration Joint Board (MIJB) as the accountable body. The MIJB is supported by the Chief Officer and Chief Finance Officer, with governance arrangements set out within the Integration Scheme, Standing Orders and Scheme of Administration. Scrutiny and assurance are provided through the MIJB committee structure, in particular the Audit, Performance and Risk Committee and the Clinical and Care Governance Committee. Assurance is achieved from established systems including quarterly performance and financial reporting, monitoring of Directions issued to Moray Council and NHS Grampian, internal and external audit activity, and publication of the Annual Performance Report. Risk management and assurance The MIJB manages risk as an integral part of its governance and Best Value arrangements. Strategic risks are identified, assessed and recorded within the MIJB Strategic Risk Register, which is aligned to the Strategic Plan and Risk Appetite approved by the Board. Ultimate accountability for strategic risk rests with the MIJB, with scrutiny and assurance provided through the Audit, Performance and Risk Committee. The Strategic Risk Register is reviewed by the Board on a regular basis, supported by interim reporting where material changes or emerging risks require escalation. Page 190
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APPENDIX 4 Assurance on the effectiveness of risk management is provided through a combination of Board and committee reporting, internal and external audit activity, and disclosure within the Annual Governance Statement. Development sessions and early financial risk consideration In addition to formal Board and committee reporting, Moray HSCP works closely with the MIJB through structured development sessions, particularly in relation to financial planning and emerging financial challenges. These sessions provide an opportunity for early discussion of significant budget pressures, savings proposals, and financial risks before formal papers are presented for decision. This approach supports informed and transparent decision-making by enabling Members to explore the strategic context, implications and risk profile of proposals in advance, including financial, reputational, operational and political considerations. It also allows the Board to determine its appetite for accepting or mitigating risk at an early stage, helping to ensure that subsequent formal reports are well-focused, proportionate and aligned with the Board’s expectations. By using development sessions in this way, the MIJB strengthens its governance and Best Value arrangements, supporting robust scrutiny while maintaining pace and clarity in decision-making during periods of financial constraint. Best Value assurance – key questions How do you receive assurance that the services supporting delivery of the strategic plan are securing Best Value? Assurance is provided through established governance and assurance arrangements, including quarterly performance and financial reporting to the MIJB and its committees, internal and external audit activity, and publication of the Annual Performance Report. In line with statutory guidance, IJB Directions issued to Moray Council and NHS Grampian are legally binding and provide a key mechanism for ensuring delivery of the Strategic Plan. A governance procedure is in place to monitor implementation and performance of Directions, with updates provided through Moray HSCP Senior Leadership Team and reported to the MIJB committee structure. Page 191
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APPENDIX 4 Do you consider there to be sufficient buy-in to the IJB’s longer-term vision from partner officers and members? The Strategic Plan was developed collaboratively with NHS Grampian, Moray Council and stakeholders. Partner boards have formally approved the Plan, and officers participate in joint planning and delivery groups to ensure alignment with wider system objectives. The IJB benefits from established joint working arrangements and strong links with Community Planning Partners. How is value for money demonstrated in decisions made by the IJB? All papers presented to the MIJB include consideration of financial implications. Business cases and proposals are supported by proportionate impact assessments covering resource implications, risks, timelines and anticipated outcomes. The governance procedure for Directions requires delegated leads to bring forward delivery proposals, enabling the MIJB to assess value for money as part of its decision-making. Do you consider there to be a culture of continuous improvement? The MIJB is committed to a culture of continuous improvement and redesign. Learning from performance reporting, audit activity and service review informs priorities within the Annual Strategic Delivery Plan, supporting sustainability and value for money in the current operating climate. Internal audit are key partners of Moray HSCP and are regular attenders at the Senior team meetings. Have service reviews been undertaken and is there evidence of improvement or reduced pressures through joint working? The Strategic Plan and Strategic Delivery Plan set out a programme of service review and redesign in response to increasing demand, financial and workforce pressures. Where redesign is undertaken, impact measures are identified to monitor sustainability, performance and outcomes. Have improvement actions been prioritised in terms of greatest impact? Improvement actions are prioritised through the Strategic Delivery Plan and agreed priorities, supported by proactive horizon scanning and programme planning. Page 192
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APPENDIX 4 What steps are taken to ensure quality of care is not compromised by cost-saving measures? All service change proposals are subject to appropriate assessment prior to approval, including equality and financial impact assessments, alongside stakeholder engagement where required. Proposals progress through established governance routes to ensure quality and safety are maintained. Is performance information reported at sufficient detail to assess value for money? Performance reporting to the MIJB is aligned to the Strategic Delivery Plan. The performance framework for Directions continues to be refined to strengthen assessment of impact and value for money. How does the IJB ensure management of resources is effective and sustainable? The MIJB receives regular reports on financial performance, strategic risks, workforce capacity and delivery of Directions. This provides ongoing assurance that resources are managed effectively Links to Evidential documents: Strategic Plan Integration Scheme Standing Orders Financial Regulations Quarterly Budget monitoring Reports Directions Policy Annual Performance Report; Equalities Report 2025-2029 Equality Impact Assessments MIJB Strategic Risk Register Page 193
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: EXTERNAL AUDIT PLAN FOR THE YEAR ENDING 2025/26 AND UPDATE ON RECOMMENDATIONS FROM 2024/25 BY: CHIEF FINANCIAL OFFICER 1. REASON FOR REPORT 1.1 To inform the Committee of the Auditor’s Annual Plan for 2025/26 and update on the recommendations following last years audit. 2. RECOMMENDATION 2.1 It is recommended that the Committee considers and notes the contents of the External Auditor’s Annual Plan for 2025/26 and update on audit recommendations from 2024/25. 3. BACKGROUND 3.1 In September 2022, Grant Thornton was confirmed as the external auditor of the Moray Integration Joint Board (MIJB). The appointment was for financial years 2022/23 to 2026/27 inclusive. 3.2 Grant Thornton were appointed by the Accounts Commission to deliver the public audit for Moray, they will provide independent assurance to the people of Scotland that public money is spent appropriately and provides value. Audit work is carried out in accordance with International Standards on Auditing, the Code of Audit Practice https://www.audit-scotland.gov.uk/publications/code-of-audit- practice-2021 and any other relevant guidance. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 An Annual Audit Plan for 2025/26 has been received from Grant Thornton and is attached at Appendix 1 to this report. The Plan sets out the scope of the audit work and the auditors approach to the audit. The Plan details the initial risks identified by Grant Thornton and planned work to be undertaken for the audit of Item 10. Page 195
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the financial statements for the year ending 2025/26. Grant Thornton also aim to add value to the MIJB through its work. 4.2 The Audit Plan identifies the main risks for the MIJB which will be the focus of audit testing and are outlined in page 7 of the Plan. In order to assist with the assessment of risk, an Informing the Audit Risk Assessment was completed by senior managers and is attached at Appendix 2. 4.3 On page 27 of the Audit Plan, Grant Thornton has shown the External Audit fee for 2025/26 as being £35,480 (£36,500 for 2024/25, which also included an additional fee of £2,500). 4.4 The annual accounts timetable, including key deadlines are shown on page 23 of the audit plan and requires the MIJB to submit the Unaudited Annual Accounts along with supporting working papers to Grant Thornton by 30 June 2026 following consideration by those charged with governance at the meeting of the MIJB on 25 June 2026. The MIJB will be asked to approve the audited annual accounts and to consider the Annual Audit Report at its meeting on 24 September 2026. 4.5 As part of the audit on 2024/25 accounts, Grant Thornton produced the Annual Audit Report to the meeting of the MIJB on 30 October 2025 (para 3 of the minute refers), within which there were a number of recommendations following the work on the Wider Scope audit. Attached at Appendix 3 is the latest update on the recommendations, all of which have been actioned. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and MIJB Strategic Commissioning Plan ‘Partners in Care’ 2022 – 2032 The work undertaken by External Audit seeks to provide assurance to the MIJB on the financial governance and resource management. It will express a view on the key risks to be managed in order to secure operational efficiency in line with the Strategic Plan 2022 - 32. (b) Policy and Legal The external audit is conducted in terms of statutory powers afforded to the appointed External Auditor and in accordance with Grant Thorntons Code of Practice. (c) Financial implications The annual audit fee set for 2025/26 by Grant Thornton and paid by the MIJB is £35,480. (d) Risk Implications and Mitigation The risks associated with the Audit Plan have been identified and categorised within the Plan on page 10. (e) Staffing Implications Page 196
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Preparation of the MIJB’s financial statements will require input and coordination from the MIJB Chief Financial Officer and the finance teams of both Moray Council and NHS Grampian which forms part of the scheduled work. (f) Property None arising directly from this report. (g) Equalities/Socio Economic Impact None arising directly from this report as there has been no change to policy. (h) Climate Change and Biodiversity Impacts None arising directly from this report. (i) Directions None arising directly from this report. (j) Consultations The content of the Plan has been discussed with the Chief Officer, Chief Internal Auditor and Senior Managers prior to production and their comments have been incorporated where appropriate. 6. CONCLUSION 6.1 The Annual Audit Plan informs the MIJB, its Committees and officers of the work to be undertaken by External Audit (Grant Thornton) in the year ahead. 6.2 The Audit recommendations from 2024/25 audit have been considered and progress has been made on them all. Author of Report: Deborah O’Shea Background Papers: with author Ref: Page 197
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Moray Integration Joint Board External Audit Plan - Draft Financial year ending 31 March 2026 Prepared for those Charged with Governance, the Controller of Audit and the Accounts Commission 24 March 2026 APPENDIX 1 Page 198
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Contents Section Page 1. Introduction and Headlines 03 2. Identified risks 06 3. Other matters 10 4. Materiality 13 5. IT audit strategy 16 6. Wider scope and Best Value arrangements 18 7. Logistics 22 8. Audit Fees 25 9. Independence matters 28 10. Communication of audit matters with those charged with governance 30 11. Appendices 33 Moray Integration Joint Board External Audit Plan 2025/26 2 Page 199
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Introduction and Headlines01 Moray Integration Joint Board External Audit Plan 2025/26 3 Page 200
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Introduction and headlines (1) Purpose This document provides an overview of the planned scope and timing of the external audit of Moray Integration Joint Board (the IJB) for those charged with governance. We are appointed by The Accounts Commission as the external auditors of the IJB for the five-year period 2022/23 to 2026/27. Respective responsibilities The Code of Audit Practice (the Code) summarises where the responsibilities of auditors begin and end and what is expected from the audited body. Our respective responsibilities, and that of the IJB are summarised in the Appendix of this Audit Plan. We draw your attention to this and the Code. Scope of our Audit The scope of our audit is set in accordance with the Code and International Standards on Auditing (ISAs) (UK). We are responsible for forming and expressing an opinion on the IJB’s financial statements, which have been prepared by management with the oversight of those charged with governance (the Audit, Performance and Risk Committee). Our audit of the financial statements does not relieve management, the IJB Audit, Performance and Risk Committee or the Board of your responsibilities. It is your responsibility to ensure that proper arrangements are in place for the conduct of your business, and that public money is safeguarded and properly accounted for. As part of our wider scope work, we will consider how you are fulfilling these responsibilities. Our audit approach is based on a thorough understanding of the IJB and is risk based. Significant risks Those risks requiring special audit consideration and procedures to address the likelihood of a material financial statement error have been identified as: • Management override of controls (ISA (UK) 240); We will communicate significant findings on these areas as well as any other significant matters arising from the audit to you in our Annual Audit (ISA 260) Report. Materiality We have calculated our planning materiality to be £5.258 million (PY: £5.070 million) for the IJB, which equates to 2.5% (PY: 2.5%) of your prior year gross expenditure as per the audited 2024/25 financial statements. Performance materiality has been determined as £3.943 million (PY: £3.802 million) and is based on 75% (PY: 75%) of planning materiality. We are obliged to report uncorrected omissions or misstatements other than those which are ‘clearly trivial’ to those charged with governance. Clearly trivial has been calculated at 5% of materiality being £0.263 million (PY: £0.254 million). A lower materiality threshold will of £25,000 will be used on salary and pension (CETV) tables for senior management and board members. We will revisit our materiality throughout our audit including updating to reflect the draft unaudited financial statements for 2025/26. Moray Integration Joint Board External Audit Plan 2025/26 4 Page 201
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Introduction and headlines (2) Audit Fees Audit fees were shared by Audit Scotland with the IJB in January 2026. The baseline audit fee set is £35,480. Audit fees are paid to Audit Scotland who in turn pay Grant Thornton UK LLP. The baseline audit fee has been agreed with the audited body. We reserve the right to review our fee during the audit should significant delays be encountered and/or new technical matters arise. Adding Value Through the Audit Our overall approach to adding value through the audit is clear and upfront communication, founded on our public sector credentials. We use our LEAP audit methodology and data analytics to ensure delivery of a quality audit. We have also invited members of your financial reporting team to our annual Local Government Chief Accountants workshop, which is led by our internal financial reporting technical team. Other Matters We summarise other audit matters for the Audit, Performance and Risk Committee’s awareness. This includes: • Consideration of going concern in accordance with Practice Note 10. • In accordance with the Code and planning guidance we also required to complete and submit a number of information returns and other deliverables to Audit Scotland during the year. Moray Integration Joint Board External Audit Plan 2025/26 5 Wider Scope and Best Value Audit In accordance with the Code, our planning considers the Wider Scope and Best Value areas of audit. We have identified the following wider scope significant risk and will conclude on this during the audit: • Financial sustainability – The IJB faces significant financial challenges over the medium and longer-term. The latest revenue monitoring report confirms the IJB are projecting a significant deficit of £8.233 million for 2025/26 which will require the partner authorities to provide additional funding contributions at year end. These additional funding contributions are factored into both partners in-year budgets. The IJB prepare a Medium-Term Financial Strategy which estimates a £38 million funding deficit to 2030/31 and there is a risk that the transformation and savings plans are not sufficient to address the identified funding gap over the medium term. As part of our integrated wider-scope work, we also use a risk-based approach to assess and report on whether the IJB has made proper arrangements for securing Best Value. Page 202
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Identified risks02 Moray Integration Joint Board External Audit Plan 2025/26 6 Page 203
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Significant risks identified (1) Significant risks are defined by ISAs (UK) as risks that, in the judgement of the auditor, require special audit consideration. In identifying risks, audit teams consider the nature of the risk, the potential magnitude of misstatement, and its likelihood. Significant risks are those risks that have a higher risk of material misstatement. Moray Integration Joint Board External Audit Plan 2025/26 7 “In determining significant risks, the auditor may first identify those assessed risks of material misstatement that have been assessed higher on the spectrum of inherent risk to form the basis for considering which risks may be close to the upper end. Being close to the upper end of the spectrum of inherent risk will differ from entity to entity and will not necessarily be the same for an entity period on period. It may depend on the nature and circumstances of the entity for which the risk is being assessed. The determination of which of the assessed risks of material misstatement are close to the upper end of the spectrum of inherent risk, and are therefore significant risks, is a matter of professional judgment, unless the risk is of a type specified to be treated as a significant risk in accordance with the requirements of another ISA (UK).” (ISA (UK) 315). In making the review of unusual significant transactions “the auditor shall treat identified significant related party transactions outside the entity’s normal course of business as giving rise to significant risks.” (ISA (UK) 550). Management should expect engagement teams to challenge management in areas that are complex, significant, or highly judgmental, which may be the case for accounting estimates, related parties and similar areas. Management should also expect to provide engagement teams with sufficient evidence to support their judgments and the approach they have adopted for key accounting policies referenced to accounting standards or changes thereto. Where estimates are used in the preparation of the financial statements, management should expect teams to challenge management’s assumptions and request evidence to support those assumptions. Page 204
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Significant risks identified (4) Significant risk Description Key aspects of our proposed response to the risk Management override of controls Under ISA (UK) 240 there is a non-rebuttable presumed risk that the risk of management override of controls is present in all entities. Our risk focuses on the areas of the financial statements where there is potential for management to use their judgement to influence the financial statements alongside the potential to override the entity’s internal controls, related to individual transactions. We have therefore identified management override of controls, in particular journals, management estimates and of transactions outside the course of business as a significant risk of material misstatement. We will: • Confirm our understanding over the agreement of balances and transactions to the year end submissions from Moray Council and NHS Grampian. • Document our understanding of and evaluate the design effectiveness of management’s key controls over journals at the partner authorities; • Gain an understanding of the critical judgements applied by management in the preparation of the financial statements and consider their reasonableness; • Evaluate the rationale for any changes in accounting policies, estimates or significant unusual transactions. Moray Integration Joint Board External Audit Plan 2025/26 8 Page 205
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Significant risks identified (2) Moray Integration Joint Board External Audit Plan 2025/26 9 Significant risk Description Key aspects of our proposed response to the risk Fraud in revenue recognition Under ISA (UK) 240 there is a rebuttable presumed risk that revenue may be misstated due to the improper recognition of revenue. This presumption can be rebutted if the auditor concludes that there is no risk of material misstatement due to fraud relating to revenue recognition. (rebutted) Having considered the risk factors set out in ISA 240 and the nature of the revenue streams at the IJB, we have determined that the risk of fraud arising from revenue recognition can be rebutted, because: • there is little incentive to manipulate revenue recognition; and • opportunities to manipulate revenue recognition are very limited. Therefore, we do not consider this to be a significant risk for the IJB. Fraud in expenditure recognition As set out in practice note 10 (Revised 2020) ‘The Audit of Public sector Financial Statements’, issued by the Public Audit Forum, which applies to all public sector entities, we consider there to be an inherent risk of fraud in expenditure recognition. The IJB delegates services to Moray Council and NHS Grampian. A budget is agreed by all parties in advance of the financial year. It is up to the Council and the NHS Board to spend the delegated budget, as agreed with the IJB. (rebutted) Having considered the risk factors set out in PN 10 and the nature of the expenditure streams at the IJB, we have determined that the risk of fraud arising from revenue recognition can be rebutted, because: • opportunities to manipulate expenditure recognition are very limited. Therefore, we do not consider this to be a significant risk for IJB Page 206
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Other matters03 Moray Integration Joint Board External Audit Plan 2025/26 10 Page 207
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Other matters (1) Other work In addition to our expected responsibilities under the Code of Practice, we have a number of other audit responsibilities, as follows: • We audit parts of your Remuneration Report, as required under the Code, and check whether these sections have been properly prepared (opinion). These procedures are performed to a lower materiality. • We read the sections of your Statement of Accounts which are not subject to audit and check that they are consistent with the financial statements on which we give an opinion (opinion). • We carry out work to satisfy ourselves that disclosures made in your Annual Governance Statement are in line with requirements set out in Delivering Good Governance in Local Government: Framework (Revised 2025) (opinion). • We consider our other duties under the Code and planning guidance (2025/26), as and when required, including: • Supporting Audit Scotland’s reporting to the Accounts Commission. • Contributing to Audit Scotland Performance Reports and providing regular updates to Audit Scotland to share awareness of current issues. • Contributing to the National Fraud Initiative (NFI) report. • Notifying the Controller of the Audit when circumstances indicate a statutory report may be required. • Completing mandated information requests and returns and notifying Audit Scotland of any cases of money laundering or fraud. • Review of Technical guidance prior to issue by Audit Scotland. Moray Integration Joint Board External Audit Plan 2025/26 11 Other material balances and transactions Under International Standards on Auditing, "irrespective of the assessed risks of material misstatement, the auditor shall design and perform substantive procedures for each material class of transactions, account balance and disclosure". All other material balances and transaction streams will therefore be audited. However, the procedures will not be as extensive as the procedures adopted for the risks identified in this report. Internal control environment During our initial audit planning we will develop our understanding of your control environment (design and implementation) as it relates to the preparation of your financial statements. In particular we will: • Consider key business processes and related controls. • Assess the design of key controls over all significant risks we have identified. This will include key controls over: • Journal entries and other key entity level controls. Our focus is on design and implementation of controls only. We do not intend to assess or place any reliance on the operating effectiveness of your controls during our audit. Page 208
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Other matters (2) Going concern assessment As auditors, we are required to obtain sufficient appropriate audit evidence regarding, and conclude on: • whether a material uncertainty related to going concern exists; and • the appropriateness of management’s use of the going concern basis of accounting in the preparation of the financial statements. The Public Audit Forum has been designated by the Financial Reporting Council as a “SORP-making body” for the purposes of maintaining and updating Practice Note 10: Audit of financial statements and regularity of public sector bodies in the United Kingdom (PN 10). It is intended that auditors of public sector bodies read PN 10 in conjunction with (ISAs) (UK). PN 10 was updated in 2020 to take account of revisions to ISAs (UK), including ISA (UK) 570 (Revised September 2019) on going concern. PN 10 allows auditors to apply a ‘continued provision of service approach’ when auditing going concern in the public sector, where appropriate. Audit Scotland’s also issued further guidance in a Going Concern publication in December 2020). Within our wider scope work we will conclude on the IJB arrangements to ensure financial sustainability. Internal Audit We read and understand the work of Internal Audit during the year, and how this work feeds into management’s governance processes and inclusion within the Annual Governance Statement. We do not rely directly upon the work of Internal Audit, and our approach is fully substantive. Moray Integration Joint Board External Audit Plan 2025/26 12 Financial reporting developments During our audit we will actively discuss emerging financial reporting developments with you. Progress against prior year audit recommendation As part of our final account's procedures, we will follow up on the implementation of prior year audit recommendations and report on progress against the recommendations in full within our Annual Audit Report. Page 209
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Materiality04 13Moray Integration Joint Board External Audit Plan 2025/26 Page 210
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Our approach to materiality (1) The concept of materiality is fundamental to the preparation of the financial statements and the audit process and not only applies to the monetary misstatements but also to disclosure requirements and adherence to acceptable accounting practice and applicable law. Moray Integration Joint Board External Audit Plan 2025/26 14 Matter Description Planned audit procedures 1 Determination We have determined planning materiality (financial statement materiality) at the planning stage of the audit based on professional judgement in the context of our knowledge of the IJB, including consideration of factors such as shareholder expectations, industry developments, financial stability and reporting requirements for the financial statements. We have determined financial statement materiality based on a proportion of the gross expenditure of the IJB for the financial year. We determine planning materiality to: – establish what level of misstatement could reasonably be expected to influence the economic decisions of users taken on the basis of the financial statements; – assist in establishing the scope of our audit engagement and audit tests; – determine sample sizes; and – assist in evaluating the effect of known and likely misstatements in the financial statements. 2 Other factors An item does not necessarily have to be large to be considered to have a material effect on the financial statements. An item may be considered to be material by nature when it relates to: – instances where greater precision is required (e.g. senior management remuneration, pension CETV tables and audit fees). 3 Reassessment of materiality Our assessment of materiality is kept under review throughout the audit process. We reconsider planning materiality on receipt of the draft statement of accounts and if, during the course of our audit engagement, we become aware of facts and circumstances that would have caused us to make a different determination of planning materiality. Misstatements, including omissions, are considered to be material if they, individually or in the aggregate, could reasonably be expected to influence the economic decisions of users taken on the basis of the financial statements; Judgments about materiality are made in light of surrounding circumstances, and are affected by the size or nature of a misstatement, or a combination of both; and Judgments about matters that are material to users of the financial statements are based on a consideration of the common financial information needs of users as a group. The possible effect of misstatements on specific individual users, whose needs may vary widely, is not considered. (ISA (UK) 320) Page 211
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Our approach to materiality (2) Moray Integration Joint Board External Audit Plan 2025/26 15 Materiality area 2025/26 planning materiality Qualitative factors considered Headline materiality for the financial statements £5.258 million Our materiality has been set at 2.5% of prior year gross expenditure of the IJB as per the 2024/25 financial statements (2024/25: 2.5%). In setting this threshold, the following factors have been considered: • There were no significant findings in the 2024/25 audit report. • No significant deficiencies have been identified with the IJB’s control environment. • The level of public interest in the IJB for Scotland by the public and the Scottish Government. Performance materiality for the financial statements £3.943 million Performance materiality has been set at 75% of financial statements materiality (2024/25: 75%). Performance materiality is used for the purposes of assessing the risks of material misstatement and determining the nature, timing, and extent of further audit procedures. This is the amount we set at less than materiality for the financial statements as a whole, to reduce to an appropriately low level the probability that the aggregate of uncorrected and undetected misstatements exceeds materiality for the financial statements as a whole. Reporting threshold £0.263 million This balance is set at 5% of materiality (2024/25: 5%). All misstatements above this threshold will be reported. Materiality for the senior management remuneration disclosure £25,000 PM: £18,750 Due to the public interest in senior officer remuneration disclosures, we apply specific audit procedures to this work and set a lower materiality level for this area. We design our procedures to detect errors in specific accounts at a lower level of precision which we have determined to be applicable for senior officer remuneration disclosures. We evaluate errors in this disclosure for both quantitative and qualitative factors against this lower level of materiality. We will apply heightened auditor focus in the completeness and clarity of disclosures in this area and will request amendments to be made if any errors exceed the threshold we have set or would alter the bandings reported for any individual. As a lower materiality is determined, we are required to determine a performance materiality (PM) for the Remuneration Report. Lower performance materiality has been set at 75% of Remuneration Report materiality. Page 212
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|© 2026 Grant Thornton UK LLP Commercial in Confidence IT audit strategy05 Moray Integration Joint Board External Audit Plan 2025/26 16 Page 213
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|© 2026 Grant Thornton UK LLP Commercial in Confidence IT audit strategy In accordance with ISA (UK) 315, we are required to obtain an understanding of the IT environment related to all key business processes, identify all risks from the use of IT related to those business process controls judged relevant to our audit and assess the relevant IT general controls (ITGCs) in place to mitigate them. Our audit will include completing an assessment of the design and implementation of ITGCs related to security management; technology acquisition, development and maintenance; and technology infrastructure. IT application Audit area Planned level IT audit assessment Oracle EBS Financial reporting – Moray Council • ITGC assessment (design and implementation effectiveness only) eFinancials Financial Reporting – NHS Grampian • ITGC assessment (design and implementation effectiveness only) The following IT applications are in scope for IT controls assessment based on the planned financial statement audit approach, we will perform the indicated level of assessment: Moray Integration Joint Board External Audit Plan 2025/26 17 Page 214
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Wider Scope and Best Value arrangements 06 Moray Integration Joint Board External Audit Plan 2025/26 18 Page 215
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Wider scope and best value arrangements (1) Our responsibilities under the Code of Audit Practice extend beyond the audit of the financial statements. The Code of Audit Practice sets out four areas that constitute the wider scope of public audit in Scotland. These are summarised below: We consider each of these areas through our audit planning process and have set out below the identified areas of risk for our wider scope work. From our initial planning work, we have identified one significant risk in relation to Financial Sustainability. We will continue to review your arrangements before we issue our Annual Audit Report. A conclusion on the effectiveness and appropriateness of arrangements the IJB has in place for each of the wider scope areas will be reported in the Annual Audit Report. 19Moray Integration Joint Board External Audit Plan 2025/26 Financial management Has the body got sound budgetary process, financial capacity and the control environment and internal controls are operating effectively. Financial Sustainability How the body looks forward to the medium and longer term to consider whether the body is planning effectively to deliver its services or the way in which they should be delivered. Vision, Leadership and Governance How effective are the body’s scrutiny and governance arrangements, leadership and decision making, and transparent reporting of financial and performance information. Use of Resources to Improve Outcomes How the body makes best use of their resources to meet stated outcomes and improvement objectives, through effective planning and working with strategic partners and communities. Page 216
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Wider scope and best value arrangements (2) 20Moray Integration Joint Board External Audit Plan 2025/26 Risk assessment of the IJB’s wider scope arrangements The risk assessment process has identified one significant risk. The risk is reflected below, and we have confirmed the planned audit procedures to be carried out in response to the risk. Area 2025/26 risk assessment 2025/26 risk -based procedures planned Financial Management Financial Sustainability Significant Risk - Financial sustainability The IJB faces significant financial challenges over the medium and longer-term due to the uncertainty over future Scottish Government funding allocations, workforce pressures and the rising cost of inflation. The 2025/26 budget was approved by the Board in March 2025 and projected an overall deficit for the financial year of £1.000 million, the deficit funded using earmarked reserves. The latest revenue monitoring report provides an update on the projected outturn at 31 December 2025 and highlights a deteriorating financial position for 2025/26, with the IJB projecting a significant deficit of £8.233 million for the full year. This is a result of increasing costs to the IJB due to rising demand for services, alongside the non-delivery of approximately £3.133 million of identified savings plans. This deficit will require the partner authorities to provide significant additional funding contributions at year end for the IJB to break-even. These additional funding contributions are factored into both partners in-year budgets. The IJB prepare a Medium-Term Financial Strategy (2026/27 – 2030/31) (MTFS) which will be presented to the Board in March 2026. The MTFS shows the IJB is facing significant and increasing overspends against future forecast budgets and the funding deficit over the period is projected to be £38 million. As a result of this significant funding deficit, the IJB will need to identify new approaches to manage the funding gap over the longer term. However, there is a risk that the transformation and savings plans agreed by the Board to address future financial pressures are not sufficient to address the identified funding gap over the medium term. We will: • Review progress against the 2025/26 savings plans and budget • Review how the IJB identifies significant financial pressures and builds them into its plans. • Review how the IJB plans to bridge its funding gap and identify achievable savings and future transformation. • Follow up the recommendations raised in the 2024/25 Annual Audit Report Page 217
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Wider scope and best value arrangements (3) 21Moray Integration Joint Board External Audit Plan 2025/26 Best Value Under the Code of Audit Practice, the duty on auditors to consider the arrangements an audited body has in place to secure Best Value applies to audited bodies that fall within section 106 of the Local Government (Scotland) Act 1973. Consideration of the arrangements the IJB has in place to secure Best Value will be carried out alongside the wider scope audit, and a conclusion on the arrangements the IJB has in place will be reported in the Annual Audit Report. Page 218
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Logistics07 Moray Integration Joint Board External Audit Plan 2025/26 22 Page 219
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Logistics Moray Integration Joint Board External Audit Plan 2025/26 23 The audit timeline Planning: March 2026 Key Dates Finals / Wider Scope: August - September 2026 Completion: September 2026 Key elements • Planning meeting with management to set audit scope • Agree timetable and deliverables with management and the Audit, Performance and Risk Committee • Issue the Audit Plan to management and the Audit, Performance and Risk Committee • Document design effectiveness of systems and processes Key elements • Audit team to complete fieldwork and detailed testing • Review of key judgements and estimates • Feedback on draft financial statements Key elements • Draft Audit Findings issued to management • Audit Findings meeting with management • Draft Auditor’s Annual Report issued to Audit, Performance and Risk Committee • Audit Findings presentation to Audit, Performance and Risk Committee • Annual Audit Report • Finalise and sign financial statements and audit report Year End: 31 March 2026 Audit, Performance and Risk Committee 24 September 2026 Audit phases: Audit, Performance and Risk Committee 25 June 2026 Audit Plan submitted to Audit Scotland: By 31 March 2026 Page 220
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Our team and communications Moray Integration Joint Board External Audit Plan 2025/26 24 Grant Thornton core team Service delivery Audit reporting Audit progress Technical support Formal communications Annual client service review The Audit Plan The Auditor’s Annual Report Audit planning meetings Audit clearance meetings Communication of issues log Technical updates Informal communications Open channel for discussion Communication of audit issues as they arise Notification of up-coming issues As part of our overall service delivery, we may utilise colleagues who are based overseas, primarily in India and the Philippines. Those colleagues work on a fully integrated basis with our team members based in the UK and receive the same training and professional development programmes as our UK based team. They work as part of the engagement team, reporting directly to the Audit Senior and Manager and will interact with you in the same was as our UK based team albeit on a remote basis. Our overseas team members use a remote working platform which is based in the UK. The remote working platform (or Virtual Desktop Interface) does not allow the user to move files from the remote platform to their local desktop meaning all audit related data is retained within the UK. Angela Pieri Engagement Leader Andrew Wallace Senior Audit Manager Christie Hastings (Planning) Alexander Chapman (Fieldwork) Audit Senior • Key contact for senior management and the Audit, Performance and Risk Committee • Overall quality assurance • Audit planning • Resource management • Performance management reporting • On-site audit team management • Day-to-day point of contact • Audit fieldwork Page 221
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Audit Fees08 Moray Integration Joint Board External Audit Plan 2025/26 25 Page 222
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Audit Fees (1) Relevant Professional Standards Across all sectors and firms, the Financial Reporting Council (FRC) has set out its expectation of improved financial reporting from organisations and the need for auditors to demonstrate increased scepticism and challenge and to undertake additional and more robust testing. As a firm, we are absolutely committed to meeting the expectations of the FRC on audit quality and public sector financial reporting. This includes, for Audit Scotland contracts, meeting the expectations of the Audit Scotland Quality Team and the Scottish quality framework. We are required to consider all relevant professional standards, including paragraphs 4.1 and 4.2 of the FRC’s Ethical Standard (revised 2024) which stipulate that the Engagement Lead (Key Audit Parter) must set a fee sufficient to enable the resourcing of the audit with partners and staff with appropriate time and skill to deliver an audit to the required professional and Ethical standards. Audit fees were shared by Audit Scotland with the IJB in January 2026. Audit fees are paid to Audit Scotland who in turn pay us. We reserve the right to review our fee during the audit should significant delays be encountered and/or new technical matters arise. Audit Scotland set the baseline audit fee. We can increase the fee, from the baseline, for the inclusion of additional risks, new technical matters or where specific client matters are identified, such as prior year misstatements and disclosure amendments re-occurring during the audit. Moray Integration Joint Board External Audit Plan 2025/26 26 The baseline fee of £35,480 has been set by Audit Scotland. In accordance with Audit Scotland guidance, we are able to discuss a variation to the audit fee where additional work is required. Further detail on the audit fee is available on the following page. Page 223
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Audit Fees (2) Audit fees for 2025/26 Additional Fees (Non-Audit Services) Fee Assumption In setting the fee for 2025/26 we have assumed that you will: • prepare a good quality set of accounts, supported by comprehensive and well-presented working papers which are ready at the start of the audit • provide appropriate analysis, support and evidence for all critical and significant judgements and estimates made in preparing the financial statements • provide early notice of proposed complex or unusual transactions which could have a material impact on the financial statements • Provide ongoing access to officers and management experts throughout the audit and timely responses to audit queries. Moray Integration Joint Board External Audit Plan 2025/26 27 Service Fees (£) External Auditor Remuneration £37,830 Pooled Costs £1,300 Contribution to Performance Audit and Best Value £7,050 Sectoral cap adjustment -£10,700 2025/26 Fee £35,480 Service Fees (£) At planning stage we confirm there are no planned non-audit services Nil Page 224
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Independence matters09 Moray Integration Joint Board External Audit Plan 2025/26 28 Page 225
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Independence considerations Ethical Standards and ISA (UK) 260 require us to give you timely disclosure of all significant matters that may bear upon the integrity, objectivity and independence of the firm or covered persons (including its partners, senior managers, managers). In this context, there are no matters that we are required to report. As part of our assessment of our independence at planning we note the following matters: We confirm that there are no significant facts or matters that impact on our independence at planning as auditors that we are required or wish to draw to your attention and consider that an objective reasonable and informed third party would take the same view. The firm and each covered person have complied with the Financial Reporting Council’s Ethical Standard and confirm that we are independent and are able to express an objective opinion on the financial statements. No non-audit services provided by Grant Thornton UK LLP have been identified. Any changes and full details of all fees charged for audit related and non-audit related services by Grant Thornton UK LLP and by Grant Thornton International Limited network member Firms will be included in our Annual Audit Report at the conclusion of the audit. Matter Conclusions Relationships with Grant Thornton We are not aware of any relationships between Grant Thornton and the IJB that may reasonably be thought to bear on our integrity, independence and objectivity. Relationships and Investments held by individuals We have not identified any potential issues in respect of personal relationships with the IJB or investments in the IJB held by individuals. Employment of Grant Thornton staff We are not aware of any former Grant Thornton partners or staff being employed, or holding discussions in respect of employment, by the IJB as a director or in a senior management role covering financial, accounting or control related areas. Business relationships We have not identified any business relationships between Grant Thornton and the IJB . Contingent fees in relation to non-audit services No contingent fee arrangements are in place for non-audit services provided. Gifts and hospitality We have not identified any gifts or hospitality provided to, or received from, a member of the IJB’s board, senior management or staff (that would exceed the threshold set in the Ethical Standard). Moray Integration Joint Board External Audit Plan 2025/26 29 Page 226
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Communication of audit matters with those charged with governance 10 Moray Integration Joint Board External Audit Plan 2025/26 30 Page 227
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Communication of audit matters with those charged with governance (1) Moray Integration Joint Board External Audit Plan 2025/26 31 Our communication plan Audit Plan Annual Audit Report Respective responsibilities of auditor and management/those charged with governance Overview of the planned scope and timing of the audit, form, timing and expected general content of communications including significant risks and Key Audit Matters Planned use of internal audit Confirmation of independence and objectivity A statement that we have complied with relevant ethical requirements regarding independence. Relationships and other matters which might be thought to bear on independence. Details of non-audit work performed by Grant Thornton UK LLP and network firms, together with fees charged. Details of safeguards applied to threats to independence Significant matters in relation to going concern Views about the qualitative aspects of the IJB’s accounting and financial reporting practices including accounting policies, accounting estimates and financial statement disclosures ISA (UK) 260, as well as other ISAs (UK), prescribe matters which we are required to communicate with those charged with governance, and which we set out in the table here. This document, the Audit Plan, outlines our audit strategy and plan to deliver the audit, while the Annual Audit Report will be issued prior to approval of the financial statements and will present key issues, findings and other matters arising from the audit, together with an explanation as to how these have been resolved. We will communicate any adverse or unexpected findings affecting the audit on a timely basis, either informally or via an audit progress memorandum. Page 228
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Communication of audit matters with those charged with governance (2) Our communication plan Audit Plan Annual Audit Report Significant findings from the audit Significant matters and issue arising during the audit and written representations that have been sought Significant difficulties encountered during the audit Significant deficiencies in internal control identified during the audit Significant matters arising in connection with related parties Identification or suspicion of fraud involving management and/or which results in material misstatement of the financial statements Non-compliance with laws and regulations Unadjusted misstatements and material disclosure omissions Moray Integration Joint Board External Audit Plan 2025/26 32 Respective responsibilities As auditor we are responsible for performing the audit in accordance with ISAs (UK), which is directed towards forming and expressing an opinion on the financial statements that have been prepared by management with the oversight of those charged with governance. The audit of the financial statements does not relieve management or those charged with governance of their responsibilities. Page 229
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Appendices12 Moray Integration Joint Board External Audit Plan 2025/26 33 Page 230
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|© 2026 Grant Thornton UK LLP Commercial in Confidence New or revised IFRS New or revised accounting standards that are in effect for reporting periods beginning on or after 1 January 2026. Amendment to IFRS 9 and IFRS 7 - Contracts Referencing Nature-dependent Electricity The International Accounting Standards Board (IASB) issued amendments to IFRS 9 and IFRS 7 to improve the reporting of nature-dependent electricity contracts, such as power purchase agreements (PPAs). These contracts, which secure electricity from sources like wind and solar power, can vary due to uncontrollable factors like weather. The amendments clarify the 'own-use' requirements, permit hedge accounting for these contracts, and introduce new disclosure requirements to help investors understand their impact on a company's financial performance and cash flows. The amendments are effective from 1 January 2026. Amendments to IFRS 9 and IFRS 7 – Classification and measurement of financial instruments These amendments clarify the requirements for the timing of recognition and derecognition of some financial assets and liabilities, adds guidance on the solely payment of principal and interest (SPPI) criteria, and includes updated disclosures for certain instruments (e.g. instruments with features linked to environmental social and governance (ESG) targets). The amendments are effective from 1 January 2026. IFRS 18 Presentation and Disclosure in the Financial Statements IFRS 18 will replace IAS 1 Presentation of Financial Statements. All entities reporting under IFRS Accounting Standards will be impacted. The new standard will impact the structure and presentation of the statement of profit or loss as well as introduce specific disclosure requirements. Some of the key changes are: • Introducing new defined categories for the presentation of income and expenses in the income statement • Introducing specified totals and subtotals, for example the mandatory inclusion of ‘Operating profit or loss’ subtotal. • Disclosure of management defined performance measures • Enhanced principles on aggregation and disaggregation which apply to the primary financial statements and notes. IFRS 18 will be effective in the UK from 1 January 2027. IFRS 19 Subsidiaries without Public Accountability: Disclosures IFRS 19 provides reduced disclosure requirements for eligible subsidiaries. A subsidiary is eligible if it does not have public accountability and has an ultimate or intermediate parent that produces consolidated financial statements available for public use that comply with IFRS Accounting Standards. IFRS 19 is a voluntary standard for eligible subsidiaries and is effective in the UK from 1 January 2027. 34Moray Integration Joint Board External Audit Plan 2025/26 Page 231
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|© 2026 Grant Thornton UK LLP Commercial in Confidence 35Moray Integration Joint Board External Audit Plan 2025/26 35 Responsibilities Moray Integration Joint Board Your responsibilities include: • Maintaining adequate accounting records and working papers • Preparing accounts for audit, comprising financial statements, which give a true and fair view, and related reports • Establishing and maintaining a sound system of internal control • Establishing sound arrangements for proper conduct of affairs, including the regularity of transactions • Maintaining standards of conduct for the prevention and detection of fraud and other irregularities • Maintaining strong corporate governance arrangements and a financial position that is soundly based • Establishing and maintaining an effective internal audit function. External Audit Our responsibilities include: • Compliance with the FRC Ethical Standard • Compliance with the Code and UK Auditing Standards (ISA’s UK) in the conduct and reporting of our financial statements audit • Compliance with the Code and guidance issued by Audit Scotland in the conduct and reporting of our wider scope work • Providing assurance on specified returns and other outputs (where required), as specified in guidance issued by Audit Scotland • Liaison with and notifying Audit Scotland when circumstances indicate a statutory report may be required. • Contributing to relevant performance studies (as set out in Audit Scotland’s Planning Guidance for 2025/26). The Code sets out auditor responsibilities and responsibilities of the audited body. Key responsibilities are summarised below. Please refer to the Code for further detail. Page 232
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© 2026 Grant Thornton UK LLP. All rights reserved. ‘Grant Thornton’ refers to the brand under which the Grant Thornton member firms provide assurance, tax and advisory services to their clients and/or refers to one or more member firms, as the context requires. Grant Thornton UK LLP is a member firm of Grant Thornton International Ltd (GTIL). GTIL and the member firms are not a worldwide partnership. GTIL and each member firm is a separate legal entity. Services are delivered by the member firms. GTIL does not provide services to clients. GTIL and its member firms are not agents of, and do not obligate, one another and are not liable for one another’s acts or omissions." Moray Integration Joint Board External Audit Plan 2025/26 36 Page 233
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MANAGEMENT RESPONSE TO INQUIRIES Moray Integration Joint Board 2025/26 APPENDIX 2 Page 234
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Table of Contents Section Page Purpose 3 General Enquiries of Management 4 Fraud 7 Fraud Risk Assessment 8 Laws and Regulations 13 Impact of Laws and Regulations 14 Related Parties 16 Going Concern 18 Accounting Estimates 20 Accounting Estimates - General Enquiries of Management 21 Appendix A – Accounting Estimates 24 2 Page 235
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Purpose This report includes a series of questions on each of these areas and the response we have received from Moray Integration Joint Board’s management. The Audit Committee should consider whether these responses are consistent with its understanding and whether there are any further comments it wishes to make. 3 Page 236
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General Enquiries of Management Question Management response 1. What do you regard as the key events or issues that will have a significant impact on the financial statements for 2025/26? Underlying deficit/ unachieved savings. Increasing costs through inflation impacting this and full costs of increases not being met through allocation from Scottish Government. Increasing demand (volume) and increasing complexity of care 2. Have you considered the appropriateness of the accounting policies adopted by Moray Integration Joint Board’s? Have there been any events or transactions that may cause you to change or adopt new accounting policies? If so, what are they? Accounting Policies are reviewed each year as the Accounts are prepared and changes incorporated where deemed necessary. No changes to accounting policies are anticipated for the 2025/26 accounts 3. Is there any use of financial instruments, including derivatives? If so, please explain No 4. Are you aware of any significant transaction outside the normal course of business? If so, what are they? Not aware 4 Page 237
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General Enquiries of Management Question Management response 5. Are you aware of any changes in circumstances that would lead to impairment of non-current assets? If so, what are they? N/a 6. Are you aware of any guarantee contracts? If so, please provide further details N/a 7. Are you aware of the existence of loss contingencies and/or un-asserted claims that may affect the financial statements? If so, please provide further details N/a 8. Other than in house solicitors, can you provide details of those solicitors utilised by Moray Integration Joint Board’s during the year. Please indicate where they are working on open litigation or contingencies from prior years? In house solicitors have been using external providers Brodies for some areas of work. 5 Page 238
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General Enquiries of Management Question Management response 9. Have any of the Moray Integration Joint Board’s service providers reported any items of fraud, non- compliance with laws and regulations or uncorrected misstatements which would affect the financial statements? If so, please provide further details Not aware of any 10. Can you provide details of other advisors consulted during the year and the issue on which they were consulted? N/A 11. Have you considered and identified assets for which expected credit loss provisions may be required under IFRS 9, such as debtors (including loans) and investments? If so, please provide further details N/A 6 Page 239
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Fraud Matters in relation to fraud ISA (UK) 240 covers auditors responsibilities relating to fraud in an audit of financial statements. The primary responsibility to prevent and detect fraud rests with both the Audit Committee and management. Management, with the oversight of the Audit Committee, needs to ensure a strong emphasis on fraud prevention and deterrence and encourage a culture of honest and ethical behaviour. As part of its oversight, the Audit Committee should consider the potential for override of controls and inappropriate influence over the financial reporting process. As Moray Integration Joint Board’s external auditor, we are responsible for obtaining reasonable assurance that the financial statements are free from material misstatement due to fraud or error. We are required to maintain professional scepticism throughout the audit, considering the potential for management override of controls. As part of our audit risk assessment procedures we are required to consider risks of fraud. This includes considering the arrangements management has put in place with regard to fraud risks including: • assessment that the financial statements could be materially misstated due to fraud, • process for identifying and responding to risks of fraud, including any identified specific risks, • communication with the Audit Committee regarding its processes for identifying and responding to risks of fraud, and • communication to employees regarding business practices and ethical behaviour. We need to understand how the Audit Committee oversees the above processes. We are also required to make inquiries of both management and the Audit Committee as to their knowledge of any actual, suspected or alleged fraud. These areas have been set out in the fraud risk assessment questions below together with responses from Moray Integration Joint Board’s management. 7 Page 240
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Fraud risk assessment Question Management response 1. Has Moray Integration Joint Board’s assessed the risk of material misstatement in the financial statements due to fraud? How has the process of identifying and responding to the risk of fraud been undertaken and what are the results of this process? How do the Moray Integration Joint Board’s risk management processes link to financial reporting? The MIJB has established risk management, governance and operating procedures to mitigate the risk of material misstatement in the financial statements. Agreed arrangements within the NHS for the investigation of fraud. In regard to the MIJB, Financial Regulations detail that all staff irregularities should be reported to the Chief Internal Auditor. This is supported by the Council’s Policy to Combat Fraud, Theft, Bribery and Corruption and the Whistleblowing Policy. In addition, an annual review of its counter-fraud framework is undertaken to help minimise the risk and impact of fraud. Although management is responsible for designing and operating effective controls, the review provides additional assurance by identifying improvements to strengthen fraud prevention and detection. It covers governance, fraud risk assessments, staff awareness etc. The review follows the CIPFA Code of Practice and includes targeted testing in higher-risk areas informed by public-sector fraud cases and regulatory guidance All irregularities and system reviews will be reported to the Audit, Performance and Risk Committee. The strategic risk register detailing the MIJB’s principal risks are regularly reviewed by SMT, with an annual report provided to MIJB Board. Services are also required to maintain risk registers detailing identifiable risks and mitigating actions/controls. In addition, the Chief Internal Auditor (MIJB) also prepares a risk-based audit plan that considers the IJB’s strategic objectives, associated risks and senior management's view. 2. What have you determined to be the classes of accounts, transactions and disclosures most at risk to fraud? Risk registers are also maintained by the parent organisations. Internal Audit will also review and test transactions to ensure compliance with Council Regulations and Procedures. IDEA, a computer-assisted software system, is used to analyse data and select samples for transaction testing under the direction of MIJB. 3. Are you aware of any instances of actual, suspected or alleged fraud, errors or other irregularities either within Moray Integration Joint Board as a whole, or within specific departments since 1 April 2025? If so, please provide details No irregularity known below the £5000 reporting threshold 8 Page 241
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Fraud risk assessment Question Management response 4. As a management team, how do you communicate risk issues (including fraud) to those charged with governance? Both the NHS and the Council have their own regulations regarding fraud. The NHS Counter Fraud Authority (NHSCFA) is a health authority charged with identifying, investigating and preventing fraud and other economic crimes within the NHS and the wider health group. The Council’s Financial Regulations require that all irregularities be reported to the Service Manager Internal Audit and Risk (CAE). The Service Manager Internal Audit and Risk (CAE) is also responsible for supporting the Council’s risk management arrangements which includes regularly reviewing the principal risks facing the Council. Principal risks facing the MIJB are reviewed regularly by SMT and the strategic risk register is then accordingly updated. The Chief Internal Auditor has an agreement to report NHS Grampian internal audit reviews to the MIJB Audit, Performance and Risk Committee. An agreed protocol is also being developed to govern fraud investigations, recognising that officers employed by both NHS Grampian and the Council have access to each organisation’s systems. This protocol is intended to ensure consistent, controlled and secure handling of any investigation where cross-organisational access or activity is involved 5. Have you identified any specific fraud risks? If so, please provide details Do you have any concerns there are areas that are at risk of fraud? Are there particular locations within Moray Integration Joint Board where fraud is more likely to occur? As part of the risk-based approach to developing the Annual Audit Plan, the Chief Internal Auditor considers fraud risks when determining which reviews should be undertaken. Where a specific fraud-related risk requires further scrutiny, it will either be included as a stand-alone project within the Audit Plan or incorporated into the annual counter-fraud review. However, the scope of this work applies only to services funded by the Council. 6. What processes do Moray Integration Joint Board have in place to identify and respond to risks of fraud? The NHS Counter Fraud Authority (NHSCFA) is responsible for identifying, investigating and preventing fraud within the NHS. The Council Financial Regulations detail that irregularities should be reported to the Audit and Risk Manager. This is supported by the Policy to Combat Fraud, Theft, Bribery and Corruption and the Whistleblowing Policy. In addition, the Council participates in the National Fraud Initiative data matching exercise and also publicises a point of contact to report fraud or irregularities involving the misuse of council resource 9 Page 242
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Fraud risk assessment Question Management response 7. How do you assess the overall control environment for Moray Integration Joint Board, including: • the existence of internal controls, including segregation of duties; and • the process for reviewing the effectiveness the system of internal control? If internal controls are not in place or not effective where are the risk areas and what mitigating actions have been taken? What other controls are in place to help prevent, deter or detect fraud? Are there any areas where there is a potential for override of controls or inappropriate influence over the financial reporting process (for example because of undue pressure to achieve financial targets)? If so, please provide details The responsibility for developing and maintaining sound control environment rests with management. However, internal audit prepares a risk based audit plan which considers the MIJB’s strategic objectives and associated risks. While the prevention of fraud and error rests with management through the design and operation of suitable systems of control, reviews undertaken by Internal Audit will make recommendations to improve the control environment. In addition, an annual review of the Council’s counter-fraud framework is undertaken, and this extends to services that fall under the direction of the MIJB. 8. Are there any areas where there is potential for misreporting? If so, please provide details None noted 10 Page 243
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Fraud risk assessment Question Management response 9. How does Moray Integration Joint Board communicate and encourage ethical behaviours and business processes of it’s staff and contractors? How do you encourage staff to report their concerns about fraud? What concerns are staff expected to report about fraud? Have any significant issues been reported? If so, please provide details Established arrangements exist to communicate and encourage ethical behaviours and business processes of its staff and contractors. Managers have an ongoing responsibility for implementing effective systems of control which secure the legitimacy of expenditure, the safeguarding of assets and income, the reliability of management information, the accuracy of record keeping and compliance with statutory guidance. They are also responsible for communicating this policy to their staff and ensuring established systems are followed. As detailed, the NHS Counter Fraud Authority (NHSCFA) is responsible for identifying, investigating and preventing fraud and other economic crimes within the NHS and the wider health group. The Council has a Policy to Combat Fraud, Theft, Bribery and Corruption. This policy is built around a counter fraud culture supported by practices to deter and detect fraudulent and corrupt activities. It takes account of the Council’s statutory obligations, including, and in particular, the provisions of the Bribery Act 2010. Council Financial Regulations detail that all irregularities should be reported to the Audit and Risk Manager. In addition, a Confidential ‘whistle blowing’ policy and procedure is in place, enabling employees to raise any concerns about any aspect of the Council’s work without fear of victimisation, subsequent discrimination or disadvantage, and in the knowledge that such concerns will be properly investigated 10. From a fraud and corruption perspective, what are considered to be high-risk posts? How are the risks relating to these posts identified, assessed and managed? There is an expectation that all staff and elected board members will act within the law and with honesty and integrity at all times. In particular, all staff and elected board members are expected to refrain from engaging in fraudulent or corrupt activity of any kind and shall refrain from offering, making or accepting bribes, whether financial or otherwise. Governance standards promote values and behaviours for the MIJB that demonstrate how it will uphold good practice and high standards of conduct. These include codes of conduct for both elected board members and employees and reflect the principles of public life identified by the Nolan Committee, including selflessness, honesty and integrity. This also takes in the Duty (Public Service) and Respect principles added by the Scottish Government 11. Are you aware of any related party relationships or transactions that could give rise to instances of fraud? If so, please provide details How do you mitigate the risks associated with fraud related to related party relationships and transactions? None noted 11 Page 244
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Fraud risk assessment Question Management response 12. What arrangements are in place to report fraud issues and risks to the Audit Committee? How does the Audit Committee exercise oversight over management's processes for identifying and responding to risks of fraud and breaches of internal control? What has been the outcome of these arrangements so far this year? The Global Internal Audit Standards (GIAS) applicable to Local Government in Scotland requires Internal Audit to report functionally to the Audit, Performance and Risk Committee on various issues relative to the work of the Internal Audit Service, including special investigations. The Audit, Performance and Risk Committee has a remit which includes ensuring that the highest standards of probity and public accountability are demonstrated. This involves oversight of internal control processes as a contribution to good governance and generally supporting an anti-fraud, theft, corruption, and bribery culture. This Committee considers reports produced by Internal and External Audit on the IJB’s systems; reports which include recommendations to strengthen internal controls and in turn reduce the risk of fraud and related behaviours going undetected. Further to the agreement reached with NHS Grampian, any internal audit reviews that are relevant to the MIJB are reported by the Chief Internal Auditor to the Audit, Performance and Risk Committee. This ensures that the Committee is kept informed of audit matters that may impact services directed by the MIJB and supports effective oversight across both partner organisations. 13. Are you aware of any whistle blowing potential or complaints by potential whistle blowers? If so, what has been your response? None noted 14. Have any reports been made under the Bribery Act? If so, please provide details None noted 12 Page 245
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Law and regulations Matters in relation to laws and regulations ISA (UK) 250 requires us to consider the impact of laws and regulations in an audit of the financial statements. Management, with the oversight of the Audit Committee, is responsible for ensuring that Moray Integration Joint Board’s operations are conducted in accordance with laws and regulations, including those that determine amounts in the financial statements. As auditor, we are responsible for obtaining reasonable assurance that the financial statements are free from material misstatement due to fraud or error, taking into account the appropriate legal and regulatory framework. As part of our risk assessment procedures we are required to make inquiries of management and the Audit Committee as to whether the body is in compliance with laws and regulations. Where we become aware of non-compliance or suspected non-compliance we need to gain an understanding of the non-compliance and the possible effect on the financial statements. Risk assessment questions have been set out below together with responses from management. 13 Page 246
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Impact of laws and regulations Question Management response 1. How does management gain assurance that all relevant laws and regulations have been complied with? What arrangements does Moray Integration Joint Board have in place to prevent and detect non-compliance with laws and regulations? Are you aware of any changes to the Moray Integration Joint Board’s regulatory environment that may have a significant impact on the Moray Integration Joint Board’s financial statements? Generally speaking each service area are familiar with the statutory regime in which they operate and will keep up to speed with developments through their professional associations such as CIPFA or SOLAR. Changes to legislation, consultations and guidance are notified to the IJB by the Scottish Government and are distributed to the relevant departmental area. The legal section has teams which specialise in different areas of Council activity and will be involved (at the request of client departments) in the implementation of more complex changes (such as formation of the IJB) and in any areas where legislation is unclear. Legal compliance will often be subject to external regulation (for example data protection). The IJB’s Integration Scheme (detailing the powers given to officers to implement services under specified legislation) is reviewed annually in line with revised legislative powers, in consultation with client departments 2. How is the Audit Committee provided with assurance that all relevant laws and regulations have been complied with? Overview of committee reports undertaken by Legal Services 3. Have there been any instances of non-compliance or suspected non-compliance with laws and regulation since 1 April 2025 with an on-going impact on the 2025/26 financial statements? If so, please provide details Not aware of any 4. Are there any actual or potential litigation or claims that would affect the financial statements? If so, please provide details None known 14 Page 247
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Impact of laws and regulations Question Management response 5. What arrangements does Moray Integration Joint Board have in place to identify, evaluate and account for litigation or claims? The legal section within Moray Council has teams which specialise in different areas of activity and will be involved (at the request of client departments) in the implementation of more complex changes (such as formation of the MIJB) and in any areas where legislation is unclear. Where necessary external advice will be sought 6. Have there been any reports from other regulatory bodies, such as HM Revenues and Customs, which indicate non-compliance? If so, please provide details None known 15 Page 248
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Related Parties Matters in relation to Related Parties Moray Integration Joint Board are required to disclose transactions with bodies/individuals that would be classed as related parties. These may include: ■ bodies that directly, or indirectly through one or more intermediaries, control, or are controlled by Moray Integration Joint Board ■ associates; ■ joint ventures; ■ a body that has an interest in the authority that gives it significant influence over the Moray Integration Joint Board; ■ key management personnel, and close members of the family of key management personnel, and ■ post-employment benefit plans (pension fund) for the benefit of employees of the Moray Integration Joint Board, or of any body that is a related party of the Moray Integration Joint Board. A disclosure is required if a transaction (or series of transactions) is material on either side, i.e. if a transaction is immaterial from the [type of body]’s perspective but material from a related party viewpoint then the Moray Integration Joint Board must disclose it. ISA (UK) 550 requires us to review your procedures for identifying related party transactions and obtain an understanding of the controls that you have established to identify such transactions. We will also carry out testing to ensure the related party transaction disclosures you make in the financial statements are complete and accurate. 16 Page 249
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Related Parties Question Management response 1. Have there been any changes in the related parties including those disclosed in Moray Integration Joint Board’s 2025/26 financial statements? If so please summarise: • the nature of the relationship between these related parties and Moray Integration Joint Board whether Moray Integration Joint Board has entered into or plans to enter into any transactions with these related parties • the type and purpose of these transactions No changes 2. What controls does Moray Integration Joint Board have in place to identify, account for and disclose related party transactions and relationships? Senior Officers and Elected Board Members make annual returns and members interests are regularly updated on the website, any significant factors that arise as part of this process would be factored into the Related Parties Note in the Annual Accounts 3. What controls are in place to authorise and approve significant transactions and arrangements with related parties? Normal procedures following the parties authorisation policies would apply – transactions over agreed limits are checked by Chief Financial Officer or Director of finance 4. What controls are in place to authorise and approve significant transactions outside of the normal course of business? For significant transactions that are new and outside the normal course of business IJB Board approval is required 17 Page 250
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Going Concern Matters in relation to Going Concern The audit approach for going concern is based on the requirements of ISA (UK) 570, as interpreted by Practice Note 10: Audit of financial statements and regularity of public sector bodies in the United Kingdom (Revised 2020). It also takes into account the National Audit Office's Supplementary Guidance Note (SGN) 01: Going Concern – Auditors’ responsibilities for local public bodies. Practice Note 10 confirms that in many (but not all) public sector bodies, the use of the going concern basis of accounting is not a matter of significant focus of the auditor’s time and resources because the applicable financial reporting frameworks envisage that the going concern basis for accounting will apply where the body’s services will continue to be delivered by the public sector. In such cases, a material uncertainty related to going concern is unlikely to exist. For this reason, a straightforward and standardised approach to compliance with ISA (UK) 570 will often be appropriate for public sector bodies. This will be a proportionate approach to going concern based on the body’s circumstances and the applicable financial reporting framework. In line with Practice Note 10, the auditor’s assessment of going concern should take account of the statutory nature of the body and the fact that the financial reporting framework for local government bodies presume going concern in the event of anticipated continuation of provision of the services provided by the body. Therefore, the public sector auditor applies a ‘continued provision of service approach’, unless there is clear evidence to the contrary. This would also apply even where those services are planned to transfer to another body, as in such circumstances, the underlying services will continue. For many public sector bodies, the financial sustainability of the body and the services it provides are more likely to be of significant public interest than the application of the going concern basis of accounting. Financial sustainability is a key component of value for money work and it is through such work that it will be considered. Page 251
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Going Concern Question Management response 1. What processes and controls does management have in place to identify events and / or conditions which may indicate that the statutory services being provided by Moray Integration Joint Board will no longer continue? Regular reporting on the IJB’s Finances would highlight any conditions which may mean the MIJB is no longer able to deliver statutory duties. Regular performance reports would also highlight this 2. Are management aware of any factors which may mean for Moray Integration Joint Board that either statutory services will no longer be provided or that funding for statutory services will be discontinued? If so, what are they? Not aware of any 3. With regard to the statutory services currently provided by Moray Integration Joint Board does Moray Integration Joint Board expect to continue to deliver them for the foreseeable future, or will they be delivered by related public authorities if there are any plans for Moray Integration Joint Board to cease to exist? The MIJB would expect to continue to deliver statutory services 4. Are management satisfied that the financial reporting framework permits Moray Integration Joint Board to prepare its financial statements on a going concern basis? Are management satisfied that preparing financial statements on a going concern basis will provide a faithful representation of the items in the financial statements? The annual accounts are prepared on a going concern basis and this will provide a faithful representation of the items included in the financial statements Page 252
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Accounting estimates Matters in relation to accounting estimates ISA (UK) 540 (Revised December 2018) requires auditors to understand and assess a body’s internal controls over accounting estimates, including: • The nature and extent of oversight and governance over management’s financial reporting process relevant to accounting estimates; • How management identifies the need for and applies specialised skills or knowledge related to accounting estimates; • How the body’s risk management process identifies and addresses risks relating to accounting estimates; • The body’s information system as it relates to accounting estimates; • The body’s control activities in relation to accounting estimates; and • How management reviews the outcomes of previous accounting estimates. As part of this process auditors also need to obtain an understanding of the role of those charged with governance, which is particularly important where the estimates have high estimation uncertainty, or require significant judgement. Specifically do Audit Committee members: • Understand the characteristics of the methods and models used to make the accounting estimates and the risks related to them; • Oversee management’s process for making accounting estimates, including the use of models, and the monitoring activities undertaken by management; and • Evaluate how management made the accounting estimates? We would ask the Audit Committee to satisfy itself that the arrangements for accounting estimates are adequate. 20 Page 253
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Accounting Estimates - General Enquiries of Management Question Management response 1. What are the classes of transactions, events and conditions, that are significant to the financial statements that give rise to the need for, or changes in, accounting estimate and related disclosures? None directly but the value of the pension liability from partner organisations would have implications 2. How does the Moray Integration Joint Board’s risk management process identify and address risks relating to accounting estimates? Managed by the partner organisations 3. How does management identify the methods, assumptions or source data, and the need for changes in them, in relation to key accounting estimates? The results of prior year audits are looked at to see whether there was any material concerns raised or amendments made 4. How do management review the outcomes of previous accounting estimates? The results of prior year audits are looked at to see whether there was any material concerns raised or amendments made 5. Were any changes made to the estimation processes in 2025/26 and, if so, what was the reason for these? No changes Page 254
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Accounting Estimates - General Enquiries of Management Question Management response 6. How does management identify the need for and apply specialised skills or knowledge related to accounting estimates? Each area is looked at in isolation and the relevant skills/knowledge/capacity considered 7. How does the Moray Integration Joint Board determine what control activities are needed for significant accounting estimates, including the controls at any service providers or management experts? Ensuring that relevant information is provided on time and accurately to ensure that the information received can be relied upon 8. How does management monitor the operation of control activities related to accounting estimates, including the key controls at any service providers or management experts? Regular updates provided by preparers of the Accounts on any issues that arise 9. What is the nature and extent of oversight and governance over management’s financial reporting process relevant to accounting estimates, including: - Management’s process for making significant accounting estimates - The methods and models used - The resultant accounting estimates included in the financial statements. The unaudited accounts are reported to Committee and then again upon completion of the audit. External Audit reporting also helps to inform on estimates Page 255
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Accounting Estimates - General Enquiries of Management Question Management response 10. Are management aware of any transactions, events, conditions (or changes in these) that may give rise to recognition or disclosure of significant accounting estimates that require significant judgement (other than those in Appendix A)? If so, what are they? Not aware of any 11. Why are management satisfied that their arrangements for the accounting estimates, as detailed in Appendix A, are reasonable? No major changes required to annual accounts in previous years 12. How is the Audit Committee provided with assurance that the arrangements for accounting estimates are adequate ? Annual accounts are reported 23 Page 256
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Appendix A Accounting Estimates Estimate Method / model used to make the estimate Controls used to identify estimates Whether management have used an expert Underlying assumptions: - Assessment of degree of uncertainty - Consideration of alternative estimates Has there been a change in accounting method in year? Valuation of defined benefit net pension fund liabilities Based on information from actuaries Information provided to actuaries based on year end position reducing the need for use of estimates. Yes Disclosure in accounts regarding the changes that could happen and the impact it would have on the figures included in the accounts No Accruals Based on actual entries in the ledger, or on information received from departments No In most cases based on actual ledger entries so no estimation . Where estimates are provided we know it will be based on professional judgement and we would query if it was materially different from estimates provided No Accrued income Based on actual entries in the ledger, or on information received from departments No In most cases based on actual ledger entries so no estimation . Where estimates are provided we know it will be based on professional judgement and we would query if it was materially different from estimates provided No 24 Page 257
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Best Value Consolidated List of Improvement Actions APPENDIX 3 1 2024/25 Recommendations • Recommendations identified on the wider scope risks and planned audit work. Background Recommendations Action Owner Progress Update March 2025 Completion Date (black – due date Green completed date) 1.Financial Management – Reporting of savings The budget and financial reports presented to the Board and Audit, Risk and Performance Committee do not detail whether savings are expected to be recurring in nature. Adding this context into both documents would provide a clear indication as to whether savings are expected to be one off savings or whether the benefit will continue in future years. The IJB prepare a year-end outturn which includes the final high-level savings position. However, this report does not include the appendix presented as part of the in-year monitoring reports detailing the final delivery position. It would be good practice to provide this same level of detail as part of the year-end outturn report which allows a comparison across the full financial year. The IJB should indicate whether savings are expected to be recurring or non-recurring in nature. The IJB should prepare a report showing a breakdown of savings delivered on a project basis as part of the year-end outturn report CFO Recurring and non recurring savings have been reported throughout 2025/26. The outturn report includes savings details 30 June 2026 25 June 2026 2.Assessment over the arrangements to secure Best Value We have noted that the IJB have no mechanism for formally reviewing and reporting on the arrangements to secure best value. The IJB should undertake a formal review of the Best Value assurance framework and complete an assessment of the arrangements to secure best value. The outcome of the assessment should be reported to the Audit, Performance and Risk Committee CFO Self assessment reported to Audit, Performance & Risk 25 June 2026. 31 March 2026 25 June 2026 Page 258
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Best Value Consolidated List of Improvement Actions APPENDIX 3 2 Prior Year Recommendations • Recommendations made as part of the wider scope work for the 2023/24 audit. Background Recommendations Progress update 2024/25 Progress Update at March 2026 Completion Date (black – due date Green completed date) 1. Financial Sustainability – Reserves The IJB intend to utilise £1.346 million of earmarked reserves to bridge the budget deficit in 2024/25. There is a risk that continued reliance on reserves to bridge funding gaps will create financial sustainability issues for the IJB. The IJB will need to continue to monitor the percentage level of adequate reserves as funding gaps continue to grow and the IJB looks to transformation in future years to ensure reserves do not dip to an unsustainable level. The 2025/26 budget has been agreed, with the IJB intending to use £1.000 million of earmarked reserves balances. The IJB have a limited amount of reserves balances (£1.450 million as at end of 2024/25) and continued use of reserves balances to manage the funding gap is not sustainable. The IJB should aim to bridge funding gaps through transformation and identifying alternative ways to deliver services 2026/27 budget has been agreed without the use of any reserves to balance the budget. There is no general reserve but there is ear marked reserves totalling £3m 31 March 2026 implemented 2. Senior Management Team Following the retirement of the previous Chief Officer, the current Chief Officer has been appointed on an interim basis. Furthermore, the Chief Social Worker at the Council is also appointed on an interim basis. The IJB and Council need to secure permanent positions for the both posts to provide certainty over the future direction of the IJB. The IJB have recruited a permanent Chief Officer who has been in role since November 2024 and had previously been appointed on an interim basis. To date, no permanent appointment has been made to the CSWO role meaning this recommendation is in progress. Recruitment has been successful for the appointment of a permanent Chief Social Work Officer, the candidate will be commencing with Moray HSCP in August 2026; 31 March 2026 implemented 3. Internal Audit Limited Assurance Opinion This is the third year in succession that Internal Audit have provided a limited assurance opinion. Fundamentally, this indicates there are weaknesses in the framework of governance, risk management and control. The IJB should have definitive plans in place to avoid further limited assurance opinions This is the fourth year in succession that Internal Audit have provided a limited assurance opinion. Fundamentally, this indicates there are weaknesses in the framework of governance, risk management and control. The IJB still require to put definitive plans in place to avoid further limited assurance opinions. Significant progress has been made, however there are still concerns with the recommendations being implemented following audits and progress on CareFirst (system is currently being replaced with a go live date of 31 March 2027), that the Internal Audit Manager is still considering giving a limited assurance. Will be in place for 2026/27 4. Performance Report - Management should review the format of the Performance Report and content to ensure it is succinct, focuses on the IJB;s performance and outcomes, and supports the user of the financial statements to understand the IJB’s purpose and achievements in year There has been no updates to the format of the Performance Report in 2024/25. The performance was reviewed during 2025/26 following the approval of the Strategic delivery plan approved by the IJB Committee on 27 March 2025. Format was updated from the Q3 report implemented Page 259
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Best Value Consolidated List of Improvement Actions APPENDIX 3 3 Background Recommendations Progress update 2024/25 Progress Update at March 2026 Completion Date (black – due date Green completed date) 5. Financial Sustainability – Transformation A depth of pace will need to be undertaken on the transformation programme to ensure the IJB can bridge the significant funding gap in a short space of time, to ensure that not only efficiencies can be delivered but that financial sustainability can be achieved. To ensure financial sustainability for the medium to longer term, the IJB will need to ensure that it is able to deliver increased productivity and efficiency initiatives to reduce costs and deliver financial benefits. The IJB will need to upscale the pace and delivery of transformation to achieve and mitigate the risk of becoming financially unsustainable A significant transformation/ savings plan is in place for 2024/25 onwards Savings plan in place for 2025/26 covered 2 financial years and the savings plan in place for 2026/2 will again be over more than 1 financial year. Transformation plans are also part of the savings plan for future years In conjunction with the medium term financial framework 6. Vision, Leadership and Governance – Internal Audit Moray IJB should ensure audit recommendation dates are realistic when set and are monitored for implementation. Where dates are moved or not met, a thorough understanding and follow up of these should be sought and explanations provided. A mechanism should be implemented to follow up on officers should missing recommendation deadlines become regular. Internal audit consult senior managers as part of the audit process. All dates set by internal audit are in agreement with the service with realistic achievable dates See details at point 3 above, same requirement Page 260
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: INTERNAL AUDIT ANNUAL REPORT – 2025/26 BY: CHIEF INTERNAL AUDITOR 1. REASON FOR REPORT 1.1 This report provides Committee with details of internal audit work undertaken relative to the Moray Integration Joint Board (MIJB) for the financial year ended 31 March 2026, and the assurances available on which to base the internal audit opinion on the adequacy of the MIJB’s systems of internal control. 2. RECOMMENDATION 2.1 It is recommended the Committee consider and note the contents of the annual report given as Appendix 1 to this report and seeks clarification on any matters relating thereto. 3. BACKGROUND 3.1 The purpose of this report is to present the Audit, Performance and Risk Committee with the Internal Audit Annual Report for the year to 31 March 2026 which includes the Chief Internal Auditor’s independent assurance opinion on the adequacy of the MIJB’s systems of internal control. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The Global Internal Audit Standards (GIAS) require that the Chief Audit Executive (CAE), the MIJB’s Chief Internal Auditor, to provide an annual internal audit opinion and report on the adequacy and effectiveness of the MIJB’s systems of governance, risk management and internal controls. This opinion supports the preparation of the Annual Governance Statement and contributes to the MIJB's overall assurance framework and governance arrangements. 4.2 The report covers the year to 31 March 2026 and is provided in Appendix 1. Item 11. Page 261
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5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022-2032” Internal audit work supports good governance and assists in securing appropriate systems of internal control. (b) Policy and Legal The internal audit service is provided in terms of paragraph 7:1 of the Local Authority Accounts (Scotland) Regulations 2014, and there is a requirement to provide a service in accordance with the Global Internal Audit Standards. (c) Financial Implications No implications directly arising from this report. (d) Risk Implications Audit reports highlight risk implications and contain recommendations for management to address as a means of mitigating. (e) Staffing Implications No implications directly arising from this report (f) Property No implications. (g) Equalities/ Socio Economic Impacts No implications. (h) Climate Change and Biodiversity Impacts None directly arising from this report. (i) Directions None arising directly from this report. (j) Consultations There have been no direct consultations during the preparation of this report. 6. CONCLUSION 6.1 This report provides a summary overview of the nature and extent of audit work carried out during the year and informs the annual internal audit opinion on the internal control environment operating within the MIJB. Author of Report: Dafydd Lewis, Chief Internal Auditor Background Papers: Internal Audit Files Ref: mijb/ap&rc Page 262
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APPENDIX 1 INTERNAL AUDIT ANNUAL REPORT and OPINION 1 APRIL 2025 to 31 MARCH 2026 Page 263
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CONTENTS PAGE SECTION-1 INTRODUCTION 3 SECTION 2 BASIS OF OPINION 4 SECTION 3 SUMMARY AND LIMITATIONS OF WORK THAT SUPPORTS OPINION 4 - 9 SECTION 4 OPINION 9 Page 264
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SECTION 1 – INTRODUCTION Purpose of this report 1.1 The Global Internal Audit Standards (GIAS) require the Chief Internal Auditor to provide a written statement to support the Annual Governance Statement. This report constitutes that statement. In compliance with the GIAS, it presents an independent opinion on the overall adequacy and effectiveness of the Moray Integration Joint Board’s (MIJB) risk management, control and governance arrangements, based on the work undertaken by the Internal Audit Section during the year. 1.2 The evaluation also takes into account the findings and conclusions of reports issued by other external and internal review bodies, where relevant. Further detail on the scope of internal audit work, the responsibilities of Internal Audit, and the level of assurance provided on the adequacy and effectiveness of the MIJB’s internal control environment is set out in Section 4 of this report. Responsibilities of Management and Internal Audit 1.3 It is management’s responsibility to maintain systems of risk management, internal control and governance. Internal audit is an element of the internal control framework established by management to examine, evaluate, report on accounting and other operational controls. It assists management in effectively discharging its responsibilities and functions by examining and evaluating those controls. However, internal audit cannot be held responsible for internal control failures. 1.4 The role of the Internal Audit Section includes assessing the adequacy of risk management, internal controls and governance arrangements put in place by management, as well as performing testing on a sample of transactions to ensure those controls were operating effectively during the period under review. The Service Manager Internal Audit and Risk (Chief Audit Executive (CAE)) at Moray Council is the appointed Chief Internal Auditor of the MIJB. Moray Council’s Internal Audit Section allocates a portion of its available audit days to reviewing the systems and practices of the MIJB. 1.5 The Global Internal Audit Standards (GIAS) require officers of the Internal Audit Section to communicate promptly any facts or matters that may affect their independence. This report confirms that all staff members involved in the 2025/26 internal audit reviews were independent of operational processes and that their objectivity was not compromised. Page 265
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SECTION 2 –BASIS OF ANNUAL INTERNAL AUDIT OPINION 2.1 The evaluation by the Chief Internal Auditor of the adequacy and effectiveness of the MIJB’s framework of governance, risk management and internal control is based on the following: • The audit work undertaken by the Internal Audit Section during the year to 31 March 2026. • The audit work undertaken by the Internal Audit Provider of NHS Grampian for the year ended 31 March 2026. • Any issues highlighted in the governance statement by the Chief Officer of the MIJB for the year ended 31 March 2026. • Reports issued by the MIJB’s External Auditor and other external review agencies. • Knowledge of the MIJB’s governance, risk management and performance monitoring arrangements. SECTION 3- SUMMARY AND LIMITATIONS OF WORK THAT SUPPORTS THE ANNUAL INTERNAL AUDIT OPINION Progress on the 2025/26 Internal Audit Plan 3.1 The Internal Audit Section operates independently within the organisation and as the Chief Internal Auditor, I can confirm that management has imposed no limitations on the scope of the audit work undertaken. The Internal Audit Annual Audit Plan, presented to the Audit, Performance and Risk Committee, outlines the framework for developing audit work. In addition, the selection of audit topics was based on corporate planning documents, budget data and information from the strategic risk register. Input from senior management regarding potential audit areas was also taken into account. 3.2 Internal audit work has been undertaken in accordance with an established methodology that promotes quality and conformance with the Global Internal Audit Standards and the agreed Internal Audit Annual Audit Plan. 3.3 A summary of the audit projects completed from the MIJB Audit Plan is summarised as follows: • A review was undertaken of the Complex and Challenging Needs Service, which supports individuals with complex care needs at purpose-built facilities in Elgin and Lhanbryde, as well as in their own homes across Moray. The audit examined administrative systems and procedures for delivering and managing the service, with a focus on budget management and arrangements for assisting individuals with personal funds. Findings from the review indicated that some officers are working significant overtime each week. While the audit acknowledges the dedication of officers in meeting care needs, this raises concerns about the sustainability of these working arrangements. The Service is addressing this issue by establishing a short- life working group to identify solutions and support ongoing staffing challenges. It was also noted that, since the audit, vacancies have decreased. Page 266
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• A review was undertaken of payments made to suppliers of goods and services processed through the Council’s Financial Management System (FMS) under the direction of the MIJB. The testing approach was developed using the Chartered Institute of Public Finance and Accountancy (CIPFA) Control Matrices, alongside consultation with the External Auditor. Data analysis software (IDEA) was used to randomly select payments, stratified by financial value, for testing. In addition, the audit examined payments to identify potential duplicates for further investigation. Findings highlighted a significant payment to a care provider caused by an administrative error, as well as VAT that was not reclaimed from HMRC due to incorrect coding. The audit sample also identified another significant payment made without consultation with senior management or the Chief Financial Officer, which refunded a care provider a substantial sum relating to personal care contributions for an individual. While the audit review was based on sample testing and most transactions were processed and authorised correctly, compliance with Financial Regulations remains essential to support effective financial management, prevent fraud and misuse of resources, ensure adherence to statutory requirements and sound governance principles. • An internal audit of Social Care (Short Breaks) was undertaken. The audit focused on eligibility, authorisation and recording practices to confirm that processes are appropriately managed and adequately documented. The findings identified the requirement for some administrative improvements; however, the review also highlighted the need to develop a charging policy for accommodated respite short breaks. This reflects findings from another audit review, which also suggested exploring charging arrangements for non- residential care services. The current financial environment is recognised, alongside the need to consider income-generation opportunities where appropriate. • The Council’s Audit Plan for 2025/26 included a review of the Council’s sickness absence management arrangements, including those relating to officers under the direction of the MIJB. Effective absence management is essential for maintaining service delivery, controlling costs and supporting employee well-being, as it directly impacts productivity, financial resources and organisational health. The audit found that the Council has a range of employee policies and procedures that support effective strategies for managing staff absence, including a Health & Work Policy. However, audit testing on a sample of employees on sick leave found that management interventions and/or their timing were, in most cases, not in accordance with the Health & Work Policy or associated guidance. • An internal audit was undertaken to verify the implementation of recommendations arising from a previous review of the Adult Social Care Commissioning Service. The need for the audit was agreed by this Committee on 30 March 2023, following concerns raised by Health & Social Care Moray senior management regarding administrative arrangements within the Adult Social Care Commissioning Service. A private firm of auditors was engaged to undertake the initial review; however, responsibility for the follow-up audit to report on the implementation of the recommendations was assigned to the Internal Audit Section. Findings from the follow-up review noted that, while the majority of recommendations have been completed, some remain outstanding and require revised implementation dates. Page 267
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• Global Internal Audit Standards (GIAS) require an internal audit service to consider whether resources are being used efficiently, effectively and ethically as part of its evaluation of governance, risk management and controls. As a result, further monitoring has been introduced to record instances where the audit process has identified quantifiable examples of recoverable income, savings and incorrect expenditure during the audit reviews. As this is the first time such information has been required, some of the savings detailed were identified during 2024/25, with follow-up work undertaken in 2025/26 to confirm the implementation of the recommendations. SERVICE AREA FINDINGS SAVINGS VALUATION Disabled Parking Scheme Reconciliation of disabled parking badge applications to the Financial Management System identified additional cases where users of the Service require invoicing. £24,000 Health and Social Care Moray- Children Services A duplicate payment was identified through the analysis of creditor payments. £23,355 Health and Social Care Moray- Adult Services (Out of Area Placements) Creditor testing identified a requirement to recover an out of area personal care contribution. £20,517 Health and Social Care Moray- Children Services Testing identified a VAT accounting error requiring correction. £9,276 TOTAL £77,148 • The Internal Audit Section reports follow-up reviews to the Audit, Performance and Risk Committee to evidence the implementation of recommendations. The follow-up reviews of Self-Directed Support Option 1 and Self-Directed Support Options 2 and 3 found that, despite significant progress in implementing audit recommendations, some remain partially complete. No further follow-up reviews are planned. However, an audit of Self-Directed Support Option 1 has been included in the 2026/27 Internal Audit Plan, and consideration will be given to including a review of Self-Directed Support Options 2 and 3 in a future Internal Audit Plan. The requirement to revisit audit reviews to evidence the implementation of recommendations has resulted in an additional workload for the Internal Audit Section. Implementation of recommendations is a key determinant in assessing the adequacy and effectiveness of the internal control system. If recommendations are not implemented in a timely manner, weaknesses in control and governance frameworks will remain. While the demands on officers’ time are acknowledged, delays in responding to audit queries and recommendations can be challenging and do impact the timely reporting of audit reviews to this Committee. Page 268
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• As the Chief Internal Auditor of the Moray Integration Joint Board (MIJB), my role includes providing assurance on the internal controls of systems and practices required by the MIJB to deliver services, irrespective of whether Council or NHS systems are used. An agreement was reached in 2024 with the senior management of NHS Grampian and its Internal Audit provider to allow me to receive copies of NHS Grampian’s internal audit reports of relevance to the MIJB and to update this Committee on the findings of these reviews. Various topics have been reported, enabling members to form a more overarching view of MIJB governance and internal control arrangements, irrespective of whether Council or NHS Grampian systems are used in the delivery of services. 3.4 Governance - from a review of the Annual Governance Statement prepared for inclusion within the MIJB accounts, it was found to be prepared in line with good practice guidance issued by CIPFA / SOLACE. The statement included an assessment of the effectiveness of governance arrangements within the MIJB regarding the seven principles of good governance identified within the guidance. It also referenced the governance processes of the principal partner bodies (NHS Grampian and Moray Council) as sources of additional assurance. 3.5 The review of the Chief Social Work Officer’s report showed that a range of governance arrangements are in place to ensure services are delivered effectively. It was noted that the HSCM Clinical and Care Governance Group (CCGG) oversees the effectiveness of clinical and care governance arrangements across HSCM services, ensuring that risks, quality and compliance are appropriately managed to assure both the Senior Management Team and the MIJB Clinical and Care Governance Committee. The Chief Social Work Officer’s report notes that a comprehensive review of strategic Board-level risks has been completed, resulting in clearer risk ownership, strengthened mitigations and enhanced monitoring arrangements. Oversight of these risks is provided by the Audit, Performance and Risk Committee, which escalates any exceptions to the Board as required. Work is ongoing to further develop the operational and corporate risk frameworks within HSCM to ensure alignment with the Strategic Risk Register, supporting more consistent and effective risk management across the organisation. Nevertheless, a number of challenges are expected to continue into the forthcoming reporting year, with the external operating environment placing ongoing strain on available resources and demand pressures remaining significant. 3.6 It is encouraging that agreement has been reached to replace the current social work and social care case management system, with implementation planned by March 2027. Given the system’s role as the primary database for highly sensitive social work information and its importance in supporting the administrative and financial management of social care packages, this development represents a significant step towards enhancing information governance, operational resilience and overall service assurance. 3.7 The Global Internal Audit Standards recommend maintaining an active and structured working relationship between the internal audit function and senior management. A positive working relationship already exists; however, in 2025/26, senior management further strengthened this engagement by inviting the Chief Internal Auditor to attend Senior Management Team meetings. This development enhances the governance framework by enabling quicker resolution of key audit findings and ensuring that internal audit activities remain aligned with organisational priorities. Page 269
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3.8 Risk management- procedures are well developed, with a risk management policy and strategy in place, a risk appetite statement prepared and the risk register reviewed and updated regularly. The risk register summarises the principal risks facing the organisation under nine themes, focusing on critical areas including finance, environment and operational continuity, as well as transformation risks associated with change and infrastructure, given the MIJB’s reliance on support from both the Council and NHS Grampian. I note that the risk category relating to the MIJB’s ability to deliver services within available resources and achieve agreed savings targets has increased from high to very high. This change reflects increased financial pressures, including delays in achieving planned savings, unfunded high‑cost care packages, rising demand and complexity of care, and overspends following successful recruitment within the Care at Home Service after previous periods of underspend. Statement on Conformance with the Global Internal Audit Standards 3.9 The Local Authority Accounts (Scotland) Regulations 2014 require that “a local authority must operate a professional and objective internal auditing service in accordance with recognised standards and practices in relation to internal auditing.” The recognised standards adopted by all Scottish councils are the Global Internal Audit Standards (GIAS), developed by the Chartered Institute of Public Finance and Accountancy (CIPFA) and the Chartered Institute of Internal Auditors (CIIA). 3.10 The Global Internal Audit Standards (GIAS) came into effect on 1 April 2025, replacing the Public Sector Internal Audit Standards (PSIAS). All Scottish local authorities are required to undergo an External Quality Assessment (EQA) every five years. As part of the Council’s membership of the Scottish Local Authorities Chief Internal Auditors’ Group, it was agreed that this requirement would be met through a reciprocal arrangement, whereby each internal audit service reviews another council and, in turn, receives a review. An EQA of the Council’s Internal Audit Section was completed by the Chief Internal Auditor of Perth and Kinross Council, and the findings were reported to the Audit, Risk and Performance Committee on 29 September 2024. The overall conclusion of the external assessment was that the Council’s Internal Audit Section fully conforms with the PSIAS. 3.11 In addition to an External Quality Assessment (EQA), an annual internal assessment is now required to review compliance with the Global Internal Audit Standards (GIAS). A review was undertaken during 2025/26, resulting in updates to the internal audit reporting format, project scoping document and internal operating procedures. The Internal Audit Charter has also been updated and was presented to the Council’s Audit and Scrutiny Committee for approval on 19 November 2025 (Item 11). Included within the Council’s Audit Plan for 2026/27 is a formal assessment that will involve reviewing the Internal Audit Section’s procedures and processes against the GIAS to identify areas for improvement and to inform the development of a Quality Assurance and Improvement Plan (QAIP). The findings from this assessment will also be reported to this Committee. 3.12 The Global Internal Audit Standards require an assessment of whether internal audit staffing resources are sufficient to meet the MIJB’s audit needs. Where it is believed that resource levels may adversely impact the delivery of the annual internal audit opinion, this must be reported to this Committee. While the current financial climate is recognised, demands on the Internal Audit Service have increased in recent years and staffing levels have previously been highlighted as a concern to members and senior management. However, with the appointment of Page 270
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a temporary part‑time Auditor, it is considered that current resources are sufficient to meet the MIJB’s audit requirements. SECTION 4 – ANNUAL INTERNAL AUDIT OPINION 4.1 Any system of control can only ever provide reasonable and not absolute assurances that control weaknesses or irregularities do not exist or that there is no risk of error, fraud or breaches of laws or regulations. Furthermore, it is management's responsibility to establish an appropriate internal control system and monitor its effectiveness. The Chief Internal Auditor is responsible for providing an annual assessment of the robustness of the internal control system. (Assurance was obtained in the interim form at the time of drafting this report from the Internal Audit Provider of NHS Grampian). 4.2 As the appointed Chief Internal Auditor, I am required to provide an opinion on the governance and internal control systems of the Moray Integration Joint Board. This assessment has again been particularly challenging. It is acknowledged that the Service has made significant progress by introducing improved governance arrangements, notably through regular reporting on the implementation of audit recommendations at Senior Management and Practice Governance Board meetings. A more structured framework has also been established with regular meetings between senior management and the Internal Audit Section to discuss control issues and the implementation of recommendations. In addition, as the Chief Internal Auditor, I attend Senior Management Team Meetings, which in my opinion also strengthen governance arrangements and support informed decision-making and facilitate more timely resolution of audit findings aligned with organisational priorities. 4.3 As detailed above, significant progress has been made in strengthening governance and internal controls within the MIJB and it is anticipated that this will support the delivery of required improvements going forward. However, the audits undertaken have identified notable findings with future implementation timescales and follow-up reviews have highlighted recommendations that remain outstanding and require either revised implementation dates or a further internal audit review. In addition, progressing the development of a single case recording system within the Service remains a matter of significant importance. After careful consideration, it is my opinion that I can provide limited assurance that the Moray Integration Joint Board has adequate systems of governance and internal control. . Dafydd Lewis Chief Internal Auditor 13 May 2026 Page 271
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: ANNUAL PERFORMANCE REPORT 2025/26 BY: CHIEF OFFICER 1. REASON FOR REPORT 1.1 To present the Committee with the draft Annual Performance Report 2025/26. 2. RECOMMENDATION 2.1 It is recommended that the Committee: i) consider and note the draft Annual Performance Report 2025/26 at Appendix 1; ii) note that the information for national indicators will be added once published in early July, and that these additions will be approved by the Chair and Vice Chair of the Board prior to publication; and iii) recommend that the Moray Integration Joint Board approves the draft Annual Performance Report 2025/26 for publication by 31 July 2026, subject to the inclusion of the outstanding indicators. 3. BACKGROUND 3.1 The Public Bodies (Joint Working) (Scotland) Act 2014 specifies that a performance report must be produced by an Integration Authority (IA) to ensure that performance is open and accountable and sets out an assessment of performance in planning and carrying out the integration functions for which they are responsible. This is to be produced for the benefit of Partnerships and their communities. 3.2 The required content of the Annual Performance Report (APR) is set out in the Public Bodies (Joint Working) (Content of Performance Report) (Scotland) Regulations 2014. 3.3 APRs should demonstrate how the partnership has performed against the National Health and Wellbeing Outcomes, within the context of the Strategic Plan Item 12. Page 273
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and Financial Statement. To support this, a set of Core Integration Indicators have been developed by the Scottish Government and the Board is expected to report upon performance using these and other locally specified indicators. 3.4 The Act obliges the IA to prepare a Performance Report for the previous reporting year and for this to be published by the end of July each year. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The APR provides an opportunity to present the story of the partnership’s overall performance over the 12 month period, including progress against the nine National Health and Wellbeing Outcomes and the commitments contained within the 2022-32 Strategic Plan. 4.2 The report sets out the challenges services face as they seek to meet increasing needs whilst reducing spend to keep within the approved budget. This highlights the pressures on services, the exceptional work of staff and the ways in which services worked collaboratively with partners to continue to provide care and support to the people of Moray. 4.3 The report has a slightly amended structure to previous years, focussing on the 3 Strategic Themes, the objectives of the Strategic Plan and Strategic Delivery plan with clear links to the National outcomes. This change is part of the continued efforts to demonstrate and strengthen the links between the Strategic Plan, service delivery plans, and related performance monitoring reports. 4.4 The draft APR, attached at Appendix 1, will be updated to include national indicators and Ministerial Strategic Group indicators when they are published in early July. It is proposed that this Committee consider this report and recommend that the Moray Integration Joint Board (MIJB), approve the draft Annual Performance Report for publication by 31 July 2026, subject to the inclusion of these outstanding indicators. It is further proposed that the Chair and Vice Chair of MIJB approve these additions prior to publication. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022-2032” As defined within the Moray Integration Scheme values and meeting the strategic aims contained within the MIJB Strategic Plan; Moray Partners in Care 2022-32. Annual performance reports will be of interest to Grampian Health Board and Moray Council in monitoring the success of the integrated arrangements that they have put in place and in considering whether or not there is a need to review the Integration Scheme. (b) Policy and Legal IJBs have a legal obligation to produce an annual performance report in line with The Public Bodies (Joint Working) (Content of Performance Reports) (Scotland) Regulations 2014 and the Scottish Government Guidance: Page 274
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Health and Social Care Integration Partnerships: reporting guidance. This includes reporting on the national Core Suite of Integration Indicators provided by Public Health Scotland, using these to support reporting on how well the Partnership are progressing the nine National Health and Wellbeing Outcomes which apply to integrated health and social care. The Moray APR complies with all the requirements with the exception of a breakdown of spend per locality. Systems to facilitate a robust report on this have not yet been implemented. (c) Financial implications None directly associated with this report. (d) Risk Implications and Mitigation IJBs have a legal obligation to produce an annual performance report which meets the requirements set by Scottish Government. Should an APR not be provided there would be a failure to meet legislation and it would be difficult for the Moray IJB to confirm it undertakes its duties related to accountability and good governance. (e) Staffing Implications None directly associated with this report. (f) Property None directly associated with this report. (g) Equalities/Socio Economic Impact An Equality Impact Assessment is not required as there are no changes to policy arising from this report and therefore there will be no differential impact on people with protected characteristics. However, individual strategies will comply with the need for an Equalities Impact Assessment and is considered as part of service planning process. (h) Climate Change and Biodiversity Impacts None directly associated with this report. (i) Directions None directly associated with this report. (j) Consultations Chief Officer; Heads of Services; Chief Financial Officer, Service Managers and Caroline O’Connor, Committee Services Officer, Moray Council, have been consulted for their areas of responsibility and comments have been incorporated into this report and appendix. 6. CONCLUSION 6.1 Health and Social Care Moray’s Annual Performance Report is an opportunity to reflect on the varied activities and improvements that have been achieved over the year and consider how well the Partnership is delivering the Strategic Plan. Page 275
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Author of Report: Jeanette Netherwood, Corporate Programme Manager, MHSCP Background Papers: Ref: Page 276
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Annual Performance Report 2025/26 1 Moray Integration Joint Board APPENDIX 1 Page 277
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Annual Performance Report 2025/26 2 Moray Integration Joint Board Contents 1. Foreword from MIJB Chair and Vice-Chair ................................................. 2 2. Chief Officer’s Introduction ...................................................................... 5 3. Background .............................................................................................. 7 4. Board and Partnership Overview ............................................................... 8 5. Our Strategic Plan – Vision and Priorities ................................................ 10 6. Understanding Need in Moray ................................................................. 12 7. The Year in Context ................................................................................. 14 8. Performance Management and Reporting ............................................... 15 9. Strategic Theme 1 - Building Resilience ................................................... 17 10. Strategic Theme 2 : Home First ............................................................... 29 11. Strategic Theme 3: Partners in Care ........................................................ 38 12. Strategic Theme 4: Strategic Leadership, Planning and Performance ...... 44 13. Financial review and performance .......................................................... 52 APPENDICES ..................................................................................................... 61 14. Appendix A: Moray area profile ............................................................... 62 15. Appendix B: National Health & Wellbeing Outcomes .............................. 63 16. Appendix C: Core suite of national indicators ......................................... 64 17. Appendix D: Ministerial Group Indicators ................................................ 68 18. Appendix E: Inspections of services ........................................................ 69 19. Appendix F: Moray Integration Joint Board - Changes to Membership of Moray Integration Joint Board, decisions and directions .................................... 71 1. Foreword from MIJB Chair and Vice-Chair Page 278
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Annual Performance Report 2025/26 3 Moray Integration Joint Board On behalf of Moray Integration Joint Board (IJB), we are pleased to present our Annual Performance Report for 2025/26. This report reflects a year of significant challenge, continued change and meaningful progress for both the Board and Moray Health & Social Care Partnership (HSCP) – formerly Health & Social Care Moray. Across Scotland, health and social care services continue to face deepening challenges, with rising demand, increasing complexity of need, mounting service delivery costs, workforce pressures and significant financial constraints. It is welcome that more people are living longer; however, many are living with multiple long-term conditions and increasingly complex needs, requiring greater support to remain independent, connected and well within their own communities. At the same time, public services continue to operate within an extremely challenging financial environment, with difficult decisions required to reduce overspends and balance budgets. Despite these continued pressures, colleagues across Moray HSCP have continued to show remarkable commitment, compassion and resilience. Every day, staff across services go above and beyond to support people, families and communities across Moray. Their professionalism, adaptability and determination to provide high-quality care and support in challenging circumstances deserves sincere recognition and thanks. We also extend our heartfelt thanks to unpaid carers and volunteers across Moray. Their vital contributions underpin the resilience of our communities, and we recognise the invaluable role they play in supporting the health, wellbeing and independence of so many people. We would also like to recognise the valuable contribution of Moray IJB members, whose leadership, scrutiny and commitment have helped guide and support the strategic direction of health and social care services throughout the year. Against this backdrop, our focus has remained clear: improving health and wellbeing outcomes for people in Moray, supporting independence, positive experiences and quality of life, and working with communities and partners to deliver sustainable, high- quality services for the future. This report highlights the progress made during 2025/26 as Moray continues to shift the balance of care towards prevention, early intervention and community-based support to help people live well and independently at home for longer. During the year, we continued to see positive impact from collaborative and community-focused approaches, including: [to be added from submissions]. Page 279
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Annual Performance Report 2025/26 4 Moray Integration Joint Board While there is much to be proud of, we also recognise there are areas where improvement is still needed. Demand for services continues to grow, recruitment and workforce challenges remain significant, and difficult decisions continue to be required about how services are planned and delivered within available resources. Being open and transparent about these challenges is important. Delivering sustainable health and social care services for the future will require continued transformation, strong partnership working and meaningful engagement with staff, people with lived experience, unpaid carers, communities and partner organisations. This collective effort will be essential to improving experiences and outcomes for people, while helping to manage increasing demand and the rising cost and complexity of care. Although challenges remain, this report demonstrates the strength of partnership working across Moray and the dedication of the people who deliver, support and shape our services every day. Together, we continue to build on progress and work towards better outcomes for the people and communities of Moray. Dennis Robertson Chair Moray Integration Joint Board Councillor Bridget Mustard Vice-Chair Moray Integration Joint Board Page 280
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Annual Performance Report 2025/26 5 Moray Integration Joint Board 2. Chief Officer’s Introduction As I present this year’s Annual Performance Report for Moray’s Integration Joint Board, I do so with a strong sense of pride and gratitude. Throughout the year, our focus remained on improving health and wellbeing outcomes for the people of Moray, supporting independence, reducing inequalities, strengthening communities and redesigning services to ensure they remain sustainable for the future. As demand for services continues to grow and people's needs become increasingly complex, we are continuing to shift the balance of care towards prevention, early intervention and community-based support. This means helping people stay well for longer, supporting independence wherever possible and ensuring care is provided in the most appropriate setting, close to home and connected to local communities. This report highlights not only the challenges faced during the year, but also the progress made through partnership working, service redesign and the continued commitment of our workforce, communities and partners. Importantly, this year’s report is structured around the priorities set out within our Strategic Delivery Plan. This allows us to better demonstrate both the activity delivered during the year and also the difference this work is making for people and communities across Moray. Many of the examples throughout this report show how services are continuing to evolve — building on people’s strengths, improving personalised care, strengthening community support and working more collaboratively across organisational and professional boundaries. Throughout the year, our focus remained on improving health and wellbeing outcomes for people, supporting independence, reducing inequalities, strengthening communities and redesigning services to ensure they remain sustainable for the future. A key priority has been the continued shift towards strengths-based approaches, earlier intervention and prevention wherever possible. Across Moray, services have worked together to empower people with greater knowledge, choice and control over decisions about their own health and support, helping to reduce avoidable crisis, improve wellbeing and support people to live safely and independently within their own homes and communities for longer. At the same time, it’s important this report reflects the scale of challenge facing health and social care services both locally and nationally. The continuing financial climate has created significant pressure across the public sector, with rising demand for services, increasing complexity of care and escalating operating costs continuing to impact service delivery. Throughout this period, our Page 281
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Annual Performance Report 2025/26 6 Moray Integration Joint Board priority has remained protecting frontline services as far as possible, while ensuring resources are used effectively and sustainably. Good progress has been made during the year to strengthen financial oversight, control spending, secure best value and deliver identified medium and longer-term savings. Alongside this, we have continued to develop new approaches to service delivery, partnership working and community-based support. While progress has been made, we recognise there is still much more to do. Some people continue to experience delays, barriers and pressures within services, and we remain committed to listening to feedback, learning from experience and continuing to improve the quality and accessibility of support across Moray. I would like to thank all staff, partners, unpaid carers, volunteers, communities and people with lived experience who continue to contribute to improving health and social care services across Moray. Their dedication, expertise and commitment remain central to the progress outlined throughout this report. Judith Proctor Chief Officer Moray Integration Joint Board Page 282
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Annual Performance Report 2025/26 7 Moray Integration Joint Board 3. Background It is now 10 years since Moray IJB was established as a statutory public body by the Scottish Government under the Public Bodies (Joint Working) (Scotland) Act 2014. Under this legislation, all Integration Joint Boards (IJBs) are required to prepare and publish an annual performance report. The purpose of the report is to provide a clear and transparent account of how well the Integration Authority has carried out its responsibilities in planning and delivering integrated health and social care services. It is designed to support accountability to local communities, people who access services, unpaid carers and partners, and to support ongoing reflection on performance, learning and continuous improvement. Annual performance reports also play an important role in demonstrating progress towards the National Health and Wellbeing Outcomes, and in showing how effectively resources are being used to deliver care and support. They provide assurance at both local and national level, helping the public, partner organisations and the Scottish Government understand the impact of integration and the extent to which services are meeting people’s needs. Moray IJB is responsible for planning and commissioning a wide range of health and social care services for the people of Moray. These services are delegated to the Board by NHS Grampian and Moray Council. Day-to-day provision of services is carried out through Moray Health & Social Care Partnership (HSCP), which brings together staff employed by the local authority and NHS to manage and deliver joined-up services across communities for children and adults. This report sets out how well the Moray IJB has carried out its responsibilities over the past year. It highlights progress made in delivering the vision and commitments set out in the Strategic Plan, Partners in Care 2022–32, approved in November 2022, along with the supporting Delivery Plan approved in October 2023. It includes a profile of Moray (Appendix A), an assessment of performance against the Moray Strategic Plan and a range of national and local indicators, including the core suite of integration indicators (Appendix C), and Ministerial Strategic Group measures linked to the National Health and Wellbeing Outcomes (Appendix B. In doing so, the report reflects on what is working well, where challenges remain, and the actions being taken to improve outcomes for people and communities. Finally, the report includes an overview of the Board’s financial performance during the reporting period, providing transparency on how resources have been used to support the delivery of integrated services and whether best value has been achieved Page 283
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Annual Performance Report 2025/26 8 Moray Integration Joint Board 4. Board and Partnership Overview Health and social care services in Scotland are delivered through Integration Joint Boards (IJBs), established under the Public Bodies (Joint Working) (Scotland) Act 2014. The purpose of integration is simple: to make care and support more joined-up and easier for people to access. It is designed to help people get the right support, at the right time, in the right place – with a strong emphasis on prevention, early support, and care delivered as close to home as possible. Moray Integration Joint Board Moray Integration Joint Board (IJB) was established in April 2016. It is responsible for planning and overseeing a wide range of health and social care services for people living in Moray. These responsibilities are formally delegated to the Board by Moray Council and NHS Grampian through a legal agreement known as the Scheme of Integration. Moray IJB brings together elected members, NHS representatives, professional officers, and representatives from the third sector, along with people with lived experience of services and unpaid carers. In total, there are eight voting members – four appointed by Moray Council and four by NHS Grampian – supported by a wider group of non-voting members who contribute to decision-making and assurance. The Board’s role is to set the strategic direction for community health and social care in Moray and to agree priorities through its Strategic Plan. It does not deliver services directly. Instead, it directs how resources should be used to achieve agreed outcomes and holds the local system to account for delivery. Moray IJB receives funding contributions from Moray Council and NHS Grampian. These resources are used to plan and commission services that respond to local needs. The Board employs two direct staff members: the Chief Officer and the Chief Finance Officer. All other staff within the partnership remain legally employed by the partner NHS Board or Local Authority. Moray Health & Social Care Partnership Operationally services are delivered through Moray Health & Social Care Partnership (HSCP) – formerly Health & Social Care Moray – a partnership between NHS Grampian and Moray Council that brings together staff from Moray Council and NHS Grampian. Moray HSCP is operationally led by the Chief Officer, supported by senior and operational management teams. The Chief Officer is accountable to both partner organisations (as well as strategically to the IJB) and works closely with them to ensure services are delivered in line with the Board’s strategic priorities and the partner organisations’ financial settlements. Page 284
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Annual Performance Report 2025/26 9 Moray Integration Joint Board Services are delivered not only by Moray HSCP staff, but also through a network of commissioned partner organisations across the third and independent sectors. In primary care, this includes independent contractors such as GPs, dentists, optometrists, and pharmacists who provide services under national arrangements. Services The services planned and overseen through Moray IJB include: • Social work and social care services for adults, including older people, mental health services, learning disability services, and support for people with physical and sensory disabilities • Social work and social care services for children and families • Children and families health services including health visiting, school nursing, and allied health professions. • Justice services • Primary care services, including general practice and community nursing • Allied health professions such as physiotherapy and occupational therapy • Community hospitals • Health improvement services • Community dental, ophthalmic, and pharmaceutical services • Certain unscheduled care services linked to acute hospitals • Support for unpaid carers Moray also hosts some services on behalf of the wider Grampian area, including primary care contractor services and the GMED out-of-hours service. Page 285
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Annual Performance Report 2025/26 10 Moray Integration Joint Board 5. Our Strategic Plan – Vision and Priorities Moray Integration Joint Board (IJB) is legally required to develop and implement a Strategic Plan. This must align with the Scottish Government’s National Health and Wellbeing Outcomes (Appendix B) and detail how integrated health and social care services will be funded and delivered for the Moray partnership area. The Strategic Plan sets out the shared vision and local priorities that guide how services are planned and delivered to improve the health and wellbeing of people in Moray. It describes how local services contribute to the national outcomes and support the core aims of integration. The IJB must formally review and, if necessary, revise its Strategic Plan at least every three years. The current Strategic Plan is overdue for review, and work is underway to strengthen planning capacity and support the development of a refreshed plan for 2026-2029 to reflect recent developments and future priorities. Our Moray vision “We come together as equal and valued partners in care to achieve the best health and wellbeing possible for everyone in Moray throughout their lives.” Our three strategic priorities The Strategic Plan is built around three priorities: Building Resilience Supporting people to take greater control of their health and wellbeing by: • focusing on prevention and reducing inequalities. • strengthening and supporting communities that care for one another. Home First Supporting people to remain at home or in a homely setting wherever possible by: • ensuring people receive the right care, in the right place, at the right time. • helping build safe and supportive communities. Partners in Care Supporting people to be active partners in their care and support by: • working in partnership with individuals, families, and communities. • listening to what people tell us and being open and transparent in how decisions are made. • aiming to make a positive difference beyond the services we directly deliver. Page 286
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Annual Performance Report 2025/26 11 Moray Integration Joint Board The strategic intentions continue to align with the triple aim set out in Scotland’s national Health and Social Care Delivery Plan: • Better Care: improving the quality of care by targeting investment where it can have the greatest impact and delivering effective, person-centred services. • Better Health: improving health and wellbeing by supporting healthier lives from the earliest years, reducing health inequalities and placing greater emphasis on prevention, early intervention, and self-management. • Better Value: improving the sustainability and value of services by making the best use of available resources, delivering care as efficiently and consistently as possible, investing in approaches that are proven to work, and focusing on prevention and early support. The Strategic Delivery Plan, updated in May 2025, sets out the key actions and areas of work that will support delivery of Moray’s strategic priorities. The integration of Children & Families and Justice Services into Moray Health & Social Care Partnership under the direction of Moray IJB will be incorporated into the next Strategic Plan. Page 287
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Annual Performance Report 2025/26 12 Moray Integration Joint Board 6. Understanding Need in Moray Moray faces increasing and changing demand driven by an ageing population, rising long-term conditions and persistent inequalities, requiring a continued shift towards prevention, community-based care and partnership approaches to improve outcomes and ensure sustainable services. Understanding the needs of local people and communities is essential to planning sustainable health and social care services. The Moray Joint Strategic Needs Assessment 2024 (JSNA) brings together evidence about the health, wellbeing and wider circumstances of people living in Moray. It helps inform priorities, service planning and future commissioning decisions across health and social care. The JSNA highlights a number of significant challenges and emerging pressures that continue to shape demand for services across Moray. Health inequalities and poverty While Moray is often seen as a relatively affluent area, poverty and inequality exist across many communities. Health outcomes continue to be strongly linked to deprivation, housing, employment, income and access to transport. People living in more disadvantaged circumstances are more likely to experience poorer health outcomes, lower life expectancy, and higher levels of alcohol and drug- related harm, mental ill health, and preventable illness. This highlights the importance of targeting support towards those most at risk and continuing to focus on prevention, early intervention and reducing inequalities. An ageing population and increasing complexity of need Moray’s population is ageing, with significant projected growth in the number of people aged over 80 in the coming years. As people live longer, more are living with multiple long-term conditions, frailty, dementia and increasing care and support needs. This is increasing demand for community-based services, care at home, reablement, housing adaptations and anticipatory care. Supporting people to remain independent and well at home for as long as possible continues to be a key strategic priority. Long-term conditions and mental wellbeing Page 288
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Annual Performance Report 2025/26 13 Moray Integration Joint Board Demand for health and social care services continues to grow as increasing numbers of people live with long-term conditions and multi-morbidity. Common causes of ill health and premature death in Moray include cardiovascular disease, cancer, neurological conditions and musculoskeletal conditions. At the same time, demand for mental health support continues to increase, including rising levels of anxiety, depression and dementia. These trends reinforce the need for more joined-up, person-centred approaches that support prevention, self-management and earlier intervention. Rurality, housing and wider pressures Moray’s geography and rural communities can create additional challenges in accessing services and support. Transport, fuel poverty, housing suitability and the wider cost of living continue to affect people’s health and wellbeing. Many households include someone living with a long-term illness or disability, increasing the need for accessible housing, adaptations and community support. Addressing these wider factors requires close partnership working across health, social care, housing, communities and the wider public sector. Service demand and sustainability Health and social care services continue to face growing demand alongside workforce and financial pressures. Increasing levels of need, combined with challenges in recruitment and retention, rising complexity of care, and pressure across urgent and unscheduled care services, mean that current models of care are becoming increasingly difficult to sustain. The JSNA highlights the importance of continuing to redesign services around prevention, community-based care, early support and partnership working to improve outcomes and ensure long-term sustainability. Looking ahead Taken together, these challenges point towards a continued strategic shift in Moray towards: • prevention and early intervention. • more care delivered at home or in local communities. • integrated and person-centred support. • reducing inequalities and tackling the wider causes of poor health. • transforming services to ensure they remain sustainable for the future. The Moray Area Profile can be found at Appendix A. Page 289
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Annual Performance Report 2025/26 14 Moray Integration Joint Board 7. The Year in Context A changing landscape for health and social care Health and social care services across Scotland continue to face significant challenge. People are living longer and increasingly require support for multiple long-term conditions, frailty and complex care needs. Demand for services continues to rise, while workforce pressures, inflation and financial constraints continue to impact the delivery of care and support. Nationally, Integration Joint Boards (IJBs) continue to face growing financial sustainability challenges. Audit Scotland highlighted that increasing demand and cost pressures are continuing to outstrip funding growth across the sector. At the same time, expectations of services continue to grow, and partnerships are required to redesign services to ensure they remain sustainable, person-centred and focused on prevention. For Moray, these pressures are further shaped by: • our rural geography and dispersed population • increasing demand for care and support • workforce recruitment and retention challenges • increasing complexity of care needs • health inequalities experienced by some communities • pressures across primary care, community services and hospital flow. Our response Throughout 2025/26, Moray HSCP continued to focus on: • prevention and early intervention • supporting independence and community-based care • redesigning services to improve sustainability • strengthening partnership and locality working • improving access to support • reducing delayed discharge and avoidable hospital admission • tackling inequalities and improving wellbeing. Page 290
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Annual Performance Report 2025/26 15 Moray Integration Joint Board 8. Performance Management and Reporting This report brings together a wide range of information and evidence to show how health and social care services in Moray performed between 1 April 2025 and 31 March 2026. It highlights the progress made towards delivering the Moray Integration Joint Board’s Strategic Plan and provides an overview of performance against national and local measures during 2025/26. Local context Monitoring performance helps us understand what is working well, where improvement is needed, and whether we are delivering on the priorities set out in Moray Integration Joint Board’s (IJB) Strategic Plan. Moray Health & Social Care Partnership has arrangements in place to regularly review performance across services using a range of local and national measures. This helps ensure services remain focused on improving outcomes for children and adults. Performance information is reviewed throughout the year by operational managers and senior leaders to identify progress, emerging pressures and any need for further action. Quarterly performance reports are considered by the Senior Management Team and formally scrutinised by Moray IJB’s Audit, Performance and Risk Committee. National context All health and social care partnerships in Scotland are measured against a national framework designed by the Scottish Government to assess progress in improving health and social care services. The National Health and Wellbeing Outcomes provide the overall framework for planning and delivering integrated health and social care services. These outcomes focus on improving people’s experiences of care and support, helping people to live healthier and more independent lives, and ensuring services are safe, effective and sustainable. Performance is also measured using a set of Core National Indicators (Appendix ?), which allow comparisons to be made across Integration Joint Boards and against the Scottish average. The indicators cover a range of areas including people’s experiences of care, health outcomes, hospital activity, community support, and support for unpaid carers. Each indicator helps measure progress towards one or more of the National Health and Wellbeing Outcomes. Throughout 2025/26, Moray HSCP continued to respond to growing demand, increasing complexity of need and ongoing workforce and financial pressures. While these Page 291
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Annual Performance Report 2025/26 16 Moray Integration Joint Board challenges are being felt across Scotland, our focus remains on supporting people to live well, independently and safely within their own communities for as long as possible. This report highlights how we are continuing to shift our approach from responding to crisis towards prevention, early intervention and community-based support. By investing in services that help people stay well, strengthening support for unpaid carers, expanding opportunities for self-management and redesigning services around people's needs, we are working to improve outcomes while ensuring services remain sustainable for the future. Across all of our strategic priorities, a common theme emerges helping people receive the right support, in the right place, at the right time. Whether through supporting children and families, enabling people to return home sooner from hospital, improving access to community support, or embracing innovation and partnership working, we are building a health and social care system that promotes independence, reduces inequalities and delivers care closer to home. Page 292
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Annual Performance Report 2025/26 17 Moray Integration Joint Board 9. Strategic Theme 1 - Building Resilience Strategic Objective 1: We focus on prevention and tackling inequality National Wellbeing Outcome Description Outcome 1: Health and Wellbeing People are able to look after and improve their own health and wellbeing and live in good health for longer. Outcome 2: Living in the community People, including those with disabilities, long- term conditions, or who are frail, are able to live as far as reasonably practicable, independently at home, or in a homely setting, in their community. Outcome 5: Health inequalities Health and social care services contribute to reducing health inequalities. Why this matters Improving health is about far more than treating illness. Many of the factors that influence health and wellbeing – such as poverty, housing, education, employment, and social connection – develop long before someone requires health or social care services. Preventing ill health, identifying problems earlier and reducing inequalities are therefore central to Moray Integration Joint Board’s strategic vision. Investing in prevention not only improves people’s quality of life but also helps ensure health and social care services remain sustainable for the future. During 2025/26, work under this strategic objective focused on improving access to preventative healthcare, strengthening community support, tackling the wider causes of poor health, and encouraging healthier lifestyles across all ages. Early Intervention and Prevention Learning Disabilities Annual Health Check Programme People with learning disabilities often experience poorer health outcomes and face barriers to accessing routine healthcare. Annual health checks help identify health issues earlier, enabling timely intervention and reducing inequalities in access to care. The programme continues to make a measurable difference across Moray. Since implementation began, 292 people have been offered an annual health check, with 226 completed. Flexible delivery arrangements, including home visits, have helped reach individuals who may otherwise struggle to engage with traditional healthcare settings. Page 293
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Annual Performance Report 2025/26 18 Moray Integration Joint Board The programme has identified a wide range of previously unmet health needs, allowing earlier referral and coordinated support from appropriate services. Importantly, the programme has now moved from implementation into business as usual, embedding preventative care into routine practice. Impact • 292 people offered an Annual Health Check • 226 health checks completed • Earlier identification of unmet health needs and improved access to preventative care • Flexible delivery helping improve access for harder-to-reach individuals • Programme now established as an ongoing service Strengthening community support through social prescribing Social prescribing helps connect people with community groups, activities and practical support that can improve wellbeing and reduce social isolation while reducing reliance on formal services. During 2025/26, progress was made in establishing the infrastructure required to support a sustainable social prescribing model across Moray. While direct delivery is still at an early stage, important foundations have been put in place to support future implementation and evaluation. The Grampian Social Prescribing Toolkit, developed collaboratively with partners, provides a consistent approach to implementation across the region. Work during the year has laid the foundations for a pilot at Maryhill GP Practice in Elgin, which will help refine the model before wider rollout. Impact • Foundations established for a sustainable social prescribing model • Digital systems developed to support future delivery and evaluation • Regional toolkit completed to support consistent implementation • Pilot model developed for testing during 2026/27 Tackling poverty and reducing inequalities Poverty remains one of the strongest predictors of poor health outcomes. Addressing health inequalities therefore requires coordinated action across health, social care and wider community partners. Page 294
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Annual Performance Report 2025/26 19 Moray Integration Joint Board Moray HSCP continued to contribute to the development of a Moray-wide Poverty Strategy and Action Plan during 2025/26. This work will be strengthened further through the establishment of a new Anti-Poverty Strategic Group from 2026/27. Alongside strategic development, work has also focused on helping frontline staff recognise and respond to the impact of poverty through the Making Every Opportunity Count (MEOC) approach. Refreshed awareness sessions incorporating Realistic Medicine principles have equipped staff with practical skills and confidence to have supportive conversations with people about the wider factors affecting their health and wellbeing. While the longer-term impact of this work will take time to emerge, it has strengthened awareness of the relationship between poverty and health and increased confidence among staff to have supportive conversations about the wider circumstances affecting people's wellbeing. Impact • Continued development of a Moray-wide Poverty Strategy • New Anti-Poverty Strategic Group established for 2026/27 • 19 awareness sessions delivered • 155 staff from Moray HSCP, Dr Gray’s Hospital and the third sector participated Supporting healthier lifestyles: Whole Systems Approach to Improving Healthy Weight Obesity and poor diet are influenced by a complex combination of social, environmental and economic factors. Addressing these challenges requires coordinated action across organisations rather than focusing solely on individual behaviour change. During the year, Moray HSCP led on the development of a Whole Systems Approach to Healthy Weight, bringing together partners from health, education, local government, the third sector and wider community planning partnership. The stakeholder network expanded from approximately 35 organisations to more than 75, creating stronger shared ownership of healthy weight outcomes across Moray. Workshops and engagement activity increased understanding of how local policies and environments influence health and encouraged collaborative action across multiple sectors. Rather than relying on individual projects, this work is helping partners consider healthy weight as part of wider prevention, community planning and population health improvement activity. Impact Page 295
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Annual Performance Report 2025/26 20 Moray Integration Joint Board • Partnership network expanded from approximately 35 to over 75 organisations • Shared understanding of healthy weight strengthened across sectors • Foundations established for long-term system-wide action Nutrition and Hydration Week Good nutrition and hydration are fundamental to maintaining health, independence and quality of life, particularly for older adults and vulnerable groups. Local activity in support of National Nutrition and Hydration Week in March 2026, brought together 16 organisations across health, care and community settings to promote simple, practical interventions that support healthier everyday choices. Activities for patients, residents, supported people and practitioners included hydration stations, healthy snack initiatives, interactive challenges and accessible information. Feedback demonstrated increased awareness, healthier choices and improved confidence among staff and participants. Many organisations introduced changes designed to continue beyond the campaign itself, creating longer-term benefits. Impact • 16 organisations participated across Moray • Increased awareness of healthy nutrition and hydration • Practical improvements embedded within participating settings • Campaign messages extended through social media and community engagement Supporting healthier choices for children and families The Snacktember project encouraged healthier snacking among children while helping families overcome barriers to accessing fruit and vegetables. Working with three early years settings, one primary school and a youth club, the month-long initiative reached 130 families across Moray. Incentivised through fruit and vegetable-specific vouchers redeemable at a local supplier, alongside child-focused rewards, Snack-tember combined positive reinforcement, peer influence and school-based support Voucher uptake increased significantly during the programme, rising from 61% in the first week to almost 90% in the second week as awareness and engagement grew. Evaluation showed that 82% of parents reported the vouchers influenced their purchasing decisions, around 68% observed increased interest in healthier snacks from their children, and 82% intended to continue providing healthier snacks after the campaign. Page 296
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Annual Performance Report 2025/26 21 Moray Integration Joint Board The project also highlighted that affordability and availability continue to be barriers for some families, reinforcing the importance of longer-term system-wide approaches alongside targeted interventions. Impact • 130 families engaged • Voucher uptake increased to almost 90% • 82% of parents reported healthier purchasing choices • Evidence generated to inform future healthy weight initiatives Looking ahead The work undertaken during 2025/26 demonstrates a continued shift towards prevention, early intervention and reducing inequalities. While many of these initiatives are laying the foundations for longer-term change, they are already improving access to support, strengthening partnerships and helping people make healthier choices. The next phase of delivery will focus on embedding these approaches into routine practice, expanding successful models and ensuring that prevention remains at the heart of health and social care. Objective 2: We nurture and are part of communities that care for each other National Wellbeing Outcome Description Outcome 1: Health and Wellbeing People are able to look after and improve their own health and wellbeing and live in good health for longer. Outcome 4: Quality of life Health and social care services are centred on helping to maintain or improve the quality of life of people. Outcome 6: Carers are supported People who provide unpaid care are supported to look after their own health and wellbeing, including reducing any negative impact of their caring role on their own health and well-being. Why this matters Strong communities play a vital role in improving health and wellbeing. Families, unpaid carers, neighbours, volunteers and community organisations provide invaluable support that helps people stay independent, connected and resilient. Page 297
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Annual Performance Report 2025/26 22 Moray Integration Joint Board Building these community assets not only improves quality of life but also helps prevent crises and reduces demand on statutory services. During 2025/26, Moray HSCP continued to strengthen community partnerships, improve support for unpaid carers and develop more integrated services that help people access the right support at the right time. Supporting unpaid carers Unpaid carers make a significant contribution to the health and wellbeing of people across Moray. Recognising, identifying and supporting carers is essential to ensuring they can continue in their caring role, if they choose to do so, while maintaining their own health and wellbeing. During the year, implementation of the Moray Unpaid Carers Strategy 2023–2028 continued, with a strong emphasis on ensuring that services reflect the experiences of carers themselves. Surveys involving adult carers, young carers and partner organisations provided valuable insight into priorities and challenges. The findings have been used to strengthen the implementation plan and inform the specification for the future commissioned carers support service for adult and young carers. The feedback also reinforced the continuing pressures experienced by unpaid carers, highlighting the importance of maintaining accessible support and information services. Awareness of carers' needs has also increased across health, education and social care through regular communications, targeted training and the continued development of the partnership’s Carer Aware initiative. Schools have worked with the Young Carers Strategy Officer to identify Young Carer Champions, improving recognition of young carers and helping them access appropriate support. Impact • Lived experience directly informed future service design • New commissioned carers support service strengthened through consultation • 10 schools identified Young Carer Champions • Greater awareness of young carers across education and social work • Carer Aware initiative progressed towards implementation Strengthening community support and reducing isolation Communities themselves are often the best source of prevention and wellbeing. Local groups provide opportunities for people to remain active, build friendships and maintain independence. Page 298
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Annual Performance Report 2025/26 23 Moray Integration Joint Board The Be Active Life Long (BALL) programme, initiated and supported by Moray, continues to demonstrate the value of community-led prevention. It celebrated its 20th anniversary during 2025/26, reflecting two decades of community-led prevention. Eighteen groups across Moray now support around 1,000 members, delivering opportunities for physical activity, cognitive stimulation and social connection. During the year, participants collectively accessed more than 84,000 hours of activity, helping reduce loneliness and improve wellbeing. It also contributed more than £37,800 to the local economy through the use of local activity providers and the hire of community settings for sessions. Partnership working has continued to expand opportunities for residents through initiatives such as chair-based exercise programmes delivered with Dance North and accessible outdoor activities developed alongside Wild Things, supporting both physical and mental wellbeing. The Community and Volunteering Team also responded to 350 enquiries, connecting people to information, support and local activities. Impact • 18 BALL groups supporting approximately 1,000 members • Over 84,000 hours of activity delivered annually • 168 chair-based exercise Seated Exercise and Tea (SET) classes resulting in more than 3,300 attendances • More than 100 people participated in accessible outdoor wellbeing activities Improving access to primary care and mental health support Sustainable communities require accessible health services that provide early support and reduce the need for more intensive intervention. Implementation of the Moray Primary Care Improvement Plan continued during 2025/26, expanding multidisciplinary support available through GP practices. Services including Community Treatment and Care, First Contact Physiotherapy, Occupational Therapy and Mental Health and Wellbeing Practitioners are now available across every Moray GP practice, providing patients with faster access to the most appropriate professional. Mental health services have also expanded through new commissioned services delivered by Scottish Association for Mental Health (SAMH). Demand has continued to grow, with the Intensive Recovery and Community Support Service supporting 128 people during Quarter 3, compared with 85 people during Quarter 1, demonstrating increasing utilisation. Page 299
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Annual Performance Report 2025/26 24 Moray Integration Joint Board While demand for support continues to increase, these developments are helping ensure more people can access appropriate support earlier and closer to home. Mental Health and Wellbeing Practitioners embedded within GP practices offered 2,344 appointments during the previous financial year, helping people receive timely support and reducing pressure on general practice. Work has also continued to improve access to psychological therapies by strengthening pathways between primary and secondary care, ensuring people receive support from the most appropriate service without unnecessary delays or repeat referrals. Alongside service delivery, the Third Sector partner Moray Wellbeing Hub supports opportunities to ensure that people with lived experience help shape future mental health services and priorities. Impact • Multidisciplinary primary care services available across all Moray GP practices • New SAMH services fully operational and supporting increasing numbers of people • 2,344 Mental Health and Wellbeing Practitioner appointments delivered • Improved pathways reducing unnecessary delays between services • Lived experience informing future mental health planning Supporting children, young people and families Building resilient communities begins with giving children and families the best possible start in life. Community events such as the Summer Pop Up in the Park and Holiday Hub Hangout created welcoming spaces where families could access support, connect with local organisations and influence future services. Around 200 people attended the events, supported by more than 20 partner organisations and delivered through a partnership between the Moray Health Improvement Team, Moray Council Youth Work Team, Community Wardens and Lossiemouth Community Hub. Young people reported increased confidence and awareness of local opportunities, while feedback identified priorities for future community development. Work under the Children's Services Plan 2023-2026 continued to improve outcomes across several priority areas. Financial inclusion initiatives supported families experiencing poverty, with audits showing 94% of families were asked about their financial circumstances through health visiting and midwifery services. The Money Advice Team supported 199 families, securing over £201,000 in financial gains while helping reduce debt by more than £95,000. Page 300
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Annual Performance Report 2025/26 25 Moray Integration Joint Board Support for children with additional support needs also expanded, with Scottish Government investment improving communication support for 150 non-verbal children and increasing opportunities for participation in sport and leadership activities. Mental wellbeing remained a key priority. The newly commissioned SAMH service for children and young people received 40 referrals shortly after launch, while the Moray Parent Project provided extensive one-to-one and group support, helping parents build confidence to support both their own wellbeing and that of their children. Despite these positive developments, the impact of poverty and inequalities continues to affect outcomes for some children and families, reinforcing the need for sustained partnership working. Impact • Around 200 people engaged through community family events • Over 20 organisations working together to support local families • 199 families received money advice, securing more than £201,000 in financial gains • 150 non-verbal children benefited from enhanced communication support • New children and young people's mental wellbeing service successfully launched • Continued expansion of early intervention and family support services Supporting children and families with disability and neurodiversity Children and young people with additional support needs and neurodiverse conditions often require coordinated support across education, health and community services to help them achieve their full potential. During 2025/26, investment and partnership working have increased both the range of support available and opportunities for children and families to participate fully in their communities. A Scottish Government investment of £485,000 has strengthened communication support services, with 150 non-verbal children benefiting from enhanced provision. Support for parents has also expanded, helping families build confidence in supporting their children, with 83% of participants reporting increased confidence after accessing services. The focus on inclusion has extended beyond education into community life. Participation in sport among children and young people with additional support needs increased from 39% to 47%, while 66 young people became Young Sports Leaders, creating new opportunities for leadership, confidence and social connection. Demand for neurodevelopmental assessments continues to rise and currently exceeds available capacity. Work continues at a regional level to develop a Grampian-wide Page 301
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Annual Performance Report 2025/26 26 Moray Integration Joint Board pathway that will provide a more consistent and sustainable approach for children and families. Impact • £485,000 invested to strengthen support and communication provision • 150 non-verbal children benefited from enhanced communication support • 83% of parents accessing support reported increased confidence • Participation in sport increased from 39% to 47% • 66 young people with additional support needs became Young Sports Leaders Keeping children safe Protecting children is a shared responsibility that depends on strong partnership working, continual learning and listening to the voices of children and families. During the year, two multi-agency learning reviews were completed, providing opportunities to strengthen practice and improve local procedures. Additional staff have been trained to lead future reviews, helping to embed a culture of continuous learning across services. A new Child Protection Voice Toolkit has been developed to ensure children's experiences and perspectives are better reflected in protection processes, with training now underway. Online safety work also expanded through collaboration with Police Scotland, including education around harmful online ideologies and emerging risks for young people. Quality assurance activity continues to demonstrate positive practice, with solution- focused approaches increasingly evident within child protection planning meetings. Advocacy services for children and parents involved in child protection processes have also seen increased uptake, helping families understand their rights and participate in decisions affecting them. Impact • Two multi-agency learning reviews completed • Additional staff trained to lead future reviews • New Child Protection Voice Toolkit introduced • Increased access to advocacy for children and parents • Strengthened partnership approaches to safeguarding and online safety Improving emotional and mental wellbeing Good mental health in childhood lays the foundation for lifelong wellbeing. During 2025/26, Moray continued to strengthen early intervention and improve access to support for children, young people and their families. Page 302
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Annual Performance Report 2025/26 27 Moray Integration Joint Board The Moray Parent Project supported 76 new parents during the latter part of the year, delivering 259 individual sessions and 28 group sessions to help parents build confidence and support their own and their children's emotional wellbeing. Support for children experiencing emotional school avoidance has also expanded by embedding a successful pilot within an existing service, creating a sustainable early intervention model without additional cost. Alongside direct support, more than 160 professionals attended the "Children's Mental Health is Everyone's Business" event at Moray UHI in Elgin, increasing awareness of available services and strengthening partnership working across education, health and social care. Grampian Children and Adolescent Mental Health Service (CAMHS) continued to meet the national 18-week standard for more than 90% of referrals, although waiting times for non-urgent presentations remain around six months, highlighting continuing pressures on specialist services. Impact • 76 new parents supported through the Moray Parent Project • 259 one-to-one sessions and 28 group sessions delivered • New SAMH service launched with 40 referrals shortly after opening • Early intervention for emotional school avoidance embedded into mainstream delivery • 160 professionals strengthened their knowledge of children's mental health support Strengthening family support Helping families early can prevent difficulties from escalating and improve outcomes for children. During 2025/26, Moray HSCP continued to expand universal and targeted family support, recognising that confident and supported parents create stronger outcomes for children. The PEEP early years programme continued to grow through a partnership approach, with 962 parents registered and more than 1,000 attendances at sessions across Moray. The programme supports positive parent-child relationships and early child development while helping families build local support networks. The Moray Parent Project has evolved beyond its original focus on mental wellbeing and is now supporting wider family resilience and parenting confidence. Work also continued to strengthen children's rights through the ongoing development of the Getting it Right for Every Child (GIRFEC) website and expanded reach of the Children's Rights Service. Page 303
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Annual Performance Report 2025/26 28 Moray Integration Joint Board Support for young people affected by alcohol and drugs has been strengthened through the extension of the YP Zone (Aberlour Youth Point) service, secured through a combination of local and national funding. A new Drug and Alcohol Group has also been established to improve coordination across services. Closer collaboration between children's health services and Early Learning and Childcare settings is improving transitions into nursery, enabling providers to better plan support for children with additional needs before they start. Impact • 962 parents registered with the PEEP programme • More than 1,000 attendances at family support sessions • Parent support expanded beyond mental wellbeing to wider family resilience • YP Zone service extended through additional funding • Improved partnership working supporting smoother transitions into early learning Looking ahead Communities are strongest when people are connected, supported and able to help one another. During 2025/26, Moray HSCP continued to strengthen the networks, partnerships and community resources that enable this to happen. The next phase of work will build on these foundations by expanding support for unpaid carers, embedding integrated models of primary and mental health care, strengthening community-led prevention and ensuring that children and families can access the right support as early as possible. Page 304
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Annual Performance Report 2025/26 29 Moray Integration Joint Board 10. Strategic Theme 2 : Home First Objective 3: We work together to give you the right care in the right place at the right time National Wellbeing Outcome Description Outcomes 4: Quality of life Health and social care services are centred on helping to maintain or improve the quality of life of people. Why this matters Most people want to remain independent and receive care and support at home or within their own community wherever possible. Achieving this requires health and social care services to work seamlessly together, ensuring people receive the right support at the right time while avoiding unnecessary hospital admissions or delays. During 2025/26, Moray HSCP continued to strengthen community-based services, improve urgent care pathways and empower people to have greater choice and control over how their support is delivered. Supporting people to remain safely at home: Home Assessment Pathway Helping people return home safely after time in hospital or avoid unnecessary admission to hospital requires coordinated support from a range of professionals. Medication can often be a significant barrier to independence, particularly for older people living with multiple long-term conditions. A dedicated pharmacist joined the Home Assessment Pathway in January 2026 to undertake comprehensive medication reviews for people supported through the enhanced Discharge to Assess (D2A) service. Although the role is relatively new, it is already demonstrating significant benefits by reducing unnecessary medication, lowering the risk of falls and simplifying treatment regimes. The reviews have also identified medicines that were no longer required but continued to be prescribed, reducing waste while improving patient safety. In several cases, medications associated with confusion, falls and declining function in older adults were safely discontinued without adverse effects. Importantly, reducing medication burden has also enabled some people to require fewer daily care at home visits, supporting greater independence at home. Impact • 46 people received specialist medication reviews Page 305
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Annual Performance Report 2025/26 30 Moray Integration Joint Board • Daily tablet burden reduced by 56 doses • 25 falls-risk increasing medicines removed • Significantly lowered the combined side-effect risks from certain medications • 6 regular care visits no longer required • Ongoing prescribing savings of approximately £220 per month • Improved patient safety and reduced unnecessary medicines Supporting greater choice and control Self-Directed Support (SDS) enables people and families to have greater choice and control over how their care and support is arranged. During 2025/26, work continued to strengthen understanding of the available options while improving the flexibility and sustainability of local support arrangements. A new SDS Operational Group now brings together practitioners, independent advisers, advocacy services and Third Sector partners to promote consistent practice and shared learning across Moray. Practical improvements have also been introduced for people choosing to employ their own Personal Assistants, including dedicated recruitment support, monthly drop-in sessions and the establishment of an emergency pool of Personal Assistants to provide cover when needed. Information has been refreshed through updated webpages and guidance materials, making it easier for individuals and families to understand their options and make informed decisions. Alongside this, the Day Opportunities Team has continued to support people and unpaid carers to access meaningful activities within their communities using a strengths-based approach that builds on individual skills, interests and existing connections. Positive feedback has been received from individuals and families regarding the impact of this support. One individual described the support as being "a life raft in a raging sea", highlighting the value of timely and person-centred intervention. Impact • Multi-agency Self-Directed Support Operational Group established • Improved independent advice and advocacy across all four SDS options • Enhanced recruitment support for Personal Assistant employers • Emergency Personal Assistant pool established • Updated information resources improving access and understanding Page 306
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Annual Performance Report 2025/26 31 Moray Integration Joint Board • Positive feedback demonstrating significant benefit for individuals and families Providing urgent care closer to home: Out of Hours primary care (GMED) When GP practices are closed, timely access to urgent care is essential. GMED provides urgent assessment and treatment while helping ensure patients receive care in the most appropriate setting, reducing unnecessary attendance at Emergency Departments. Throughout 2025/26, GMED continued to provide urgent out-of-hours primary care across Grampian, helping people access the right care at the right time while reducing unnecessary demand on hospital services. Key developments have included enhancements to weekend skill mix, continued contribution to unscheduled care system improvements, and national recognition for teaching excellence. Together, these demonstrate GMED’s ongoing role in delivering high quality urgent care, supporting workforce development, and ensuring patients receive the right care, in the right place, at the right time. During the year, GMED managed 107,825 patient contacts across Grampian, including advice calls, consultations, home visits and mental health support. Within Moray alone, the service managed 16,043 contacts (14.8% of total activity), demonstrating its important role within the local urgent care system. Elgin, Forres and Buckie remain the busiest locations. Access to specialist mental health expertise during weekends has been enhanced through the introduction of a Mental Health Nurse within the Out of Hours service. This has improved multidisciplinary working and ensured people experiencing mental health difficulties are assessed by the clinician best placed to meet their needs. Earlier specialist assessment supports better decision-making and more appropriate onward referral while making better use of clinical resources. Beyond activity levels, GMED's greatest contribution is its ability to direct patients to the right service first time. Through effective clinical assessment and triage, many patients receive appropriate treatment within primary care, avoiding unnecessary hospital attendance and protecting capacity for those with the greatest need. Impact • 107,825 contacts managed across Grampian; 16,043 contacts from Moray residents • Thousands of patients supported through advice, consultations and home visits • Reduced unnecessary pressure on Emergency Departments • Improved patient access to appropriate care closer to home Page 307
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Annual Performance Report 2025/26 32 Moray Integration Joint Board • Specialist mental health nursing introduced to weekend service • Earlier access to appropriate assessment Improving the wider urgent care system GMED has also played an important role in supporting the wider redesign of unscheduled care through its involvement in the Flow Navigation Centre. Providing dedicated clinical support has strengthened coordination across services, enabling faster decision-making, reducing duplication and helping patients access the most appropriate care pathway. Positive feedback from clinicians and partner organisations has resulted in the arrangement being extended while longer-term service models are developed. Impact • Improved coordination across urgent care services • Better clinical decision-making and patient navigation • Reduced duplication between services • Enhanced resilience across the unscheduled care system Investing in the workforce of the future Providing the right care at the right time depends on developing a skilled and sustainable workforce. During 2025/26, GMED's partnership with the University of Aberdeen was recognised through a Principal's Teaching Excellence Award Certificate of Commendation, acknowledging the quality of out-of-hours placements provided for Year 4 medical students. The service has also supported pharmacists undertaking Independent Prescribing training through supervised shadowing opportunities, helping develop advanced clinical assessment and real-time prescribing skills while strengthening the future urgent care workforce. Impact • Recognition for teaching excellence • Strengthened partnership with the University of Aberdeen • Expanded learning opportunities for future independent prescribers Supporting young people's health and emotional wellbeing School nurses continue to play a vital role in supporting the health and wellbeing of children and young people, providing targeted support and ensuring referrals reach the most appropriate services. Page 308
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Annual Performance Report 2025/26 33 Moray Integration Joint Board Feedback from young people consistently highlights the value of having a trusted professional who listens and provides practical strategies to manage challenges such as anxiety and emotional wellbeing. Comments included: "It's really helped me." "Someone different to talk to and help you." "Helped me with strategies and ways to manage my anxiety." Parents also reported positive experiences, with one describing the service as having "helped greatly" by providing practical advice and reassurance. The service continues to use feedback to drive continuous improvement and ensure support remains responsive to the needs of children, young people and families. Impact • Positive feedback received from primary and secondary pupils • Young people reported improved confidence and coping strategies • Families valued practical advice and support • Continuous feedback informing service improvement Looking ahead The work undertaken during 2025/26 demonstrates continued progress towards delivering care closer to home, improving coordination between services and giving people greater choice and control over their care. As demand for services continues to grow and people’s needs become more complex, these integrated and person-centred approaches will remain essential to ensuring people receive the right care, in the right place, at the right time, while supporting the long-term sustainability of health and social care services in Moray. Objective 4: We help build communities where people are safe National Wellbeing Outcome Description Outcome 7: People are safe People who use health and social care services are safe from harm. Why it matters Creating safe communities is about more than responding when things go wrong. It means working together to prevent harm, identify risks early and ensure people can access the support they need when they need it. Throughout 2025/26, partners across Page 309
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Annual Performance Report 2025/26 34 Moray Integration Joint Board Moray continued to strengthen approaches to suicide prevention, alcohol and drug support, public protection and community justice, helping people stay safe and improving outcomes for some of the most vulnerable members of our communities. Suicide prevention and early intervention Suicide prevention remains a key public health priority. During the year, a wide range of awareness, training and capacity-building activities were delivered across schools, workplaces, community organisations and armed forces settings, helping to increase understanding of suicide risk and build confidence in supporting people who may be struggling. Learning from suicide deaths continues to inform local improvement activity. Moray partners have worked closely with regional colleagues to review emerging trends and strengthen local responses. Work is now underway to establish a multi-agency suicide review process in Moray, helping services better understand the circumstances surrounding deaths and identify opportunities for earlier intervention. Additional staff have been trained to deliver Applied Suicide Intervention Skills Training (ASIST), increasing local capacity to support people experiencing suicidal thoughts. Work also continued on the development of a local suicide cluster response protocol and the introduction of new systems to improve data collection and learning. Although suicide rates are influenced by many factors and changes may take time to emerge, these activities are helping build community capacity to recognise risk and support early intervention. Impact • Increased suicide prevention awareness across schools, workplaces and communities • Expanded local capacity to deliver suicide intervention training • New approaches being developed to strengthen learning from suicide deaths • Improved partnership arrangements to identify risks and respond earlier Reducing alcohol and drug-related harm Supporting people affected by alcohol and drug use remains a key priority. Throughout 2025/26, partners continued to focus on reducing harm, improving access to treatment and supporting long-term recovery. Timely access to treatment remained consistently above national standards, supported by strong partnership working and continued implementation of Medication Assisted Treatment (MAT) Standards. Outreach activity, welfare checks and assertive engagement helped people remain connected to services and reduced the number of unplanned discharges from treatment programmes. Page 310
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Annual Performance Report 2025/26 35 Moray Integration Joint Board Moray also strengthened its ability to identify and respond to emerging risks through the establishment of a local Early Warning Group, bringing partners together to monitor trends in drug use, overdoses and wider harm indicators. Access to residential rehabilitation continued to improve, supported by dedicated link worker arrangements that help individuals prepare for treatment and maintain recovery following discharge. Impact • Treatment access consistently exceeded national targets • Fewer people disengaged from treatment and support services • Improved access to residential rehabilitation and recovery support • New partnership arrangements established to monitor emerging risks and trends Protecting children and young people Partnership work across Moray continues to focus on preventing harm, supporting families and ensuring children and young people are safe, heard and supported. Preventative education programmes on healthy relationships, online safety and harmful online influences reached hundreds of young people, parents and professionals during the year. Training developed locally by Moray partners on harmful online ideologies attracted significant interest beyond Moray and has since been shared regionally, nationally and internationally. Progress has also been made in strengthening child protection practice through new multi-agency guidance, enhanced training, improved approaches to capturing the voice of the child and continued implementation of evidence-based family support programmes. Investment through Scotland’s Bairns’ Hoose programme has enabled further development of trauma-informed support for children who have experienced harm. Improvements to local facilities and specialist staffing are helping create more child- centred environments and experiences. There are encouraging signs that this work is making a difference. During the year, more children were able to leave the Child Protection Register because risks within their home circumstances had reduced and family situations had improved. Impact • Hundreds of children, families and professionals engaged in prevention and safety programmes • Increased support for children affected by trauma and abuse • More children able to leave child protection processes due to improved family circumstances Page 311
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Annual Performance Report 2025/26 36 Moray Integration Joint Board • Moray recognised nationally for innovative work on online safety and harmful ideologies Protecting adults at risk of harm Adult Support and Protection activity increased during the year, reflecting both growing complexity of need and continued vigilance in identifying and responding to concerns. Partnership working between social work, health services, Police Scotland and advocacy services continues to ensure adults at risk are supported and protected. Advocacy remains an important part of the process, helping individuals have their views represented in decisions affecting their lives. Adults supported through protection plans reported positive outcomes, including improved safety, better living conditions, increased confidence and reduced anxiety. Work also continued to strengthen quality assurance arrangements, with new case conference standards introduced across Grampian to improve consistency and support better outcomes. Impact • Increased identification and investigation of adults at risk of harm • Strong advocacy support ensuring people's voices are heard • More adults reporting improved safety and wellbeing • Enhanced quality assurance and partnership working arrangements Supporting rehabilitation and reducing reoffending Community justice partners continue to work together to support rehabilitation, reduce reoffending and help people successfully reintegrate into their communities. Community Payback Order completion rates remained strong, demonstrating continued engagement with community-based justice interventions. New approaches have focused on improving employability, developing practical skills and strengthening trauma-informed practice across services. Partnership working with prisons, housing providers, health services and recovery organisations has also been strengthened to improve support before and after release from custody. This includes enhanced liberation planning, better referral pathways and greater involvement of people with lived experience in shaping services. Impact • Strong completion rates for community justice interventions • Improved pathways between prison, health and community services • Increased focus on employability, recovery and rehabilitation • Greater involvement of people with lived experience in service development Page 312
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Annual Performance Report 2025/26 37 Moray Integration Joint Board Tackling violence against women and girls Preventing violence against women and girls remains a key priority for partners across Moray. Throughout the year, activity focused on raising awareness, strengthening professional skills and improving support for women, children and families affected by abuse. Public awareness campaigns, conferences and training events engaged hundreds of practitioners and community members, helping build understanding of the causes and consequences of violence against women and girls. The partnership continued to strengthen trauma-informed responses, improve referral pathways and support implementation of evidence-based approaches such as the Safe and Together model, which aims to improve outcomes for children while increasing accountability for perpetrators. Work also progressed to support implementation of the Caledonian Programme, helping address abusive behaviour and improve safety for women and children, contributing to earlier identification of abuse and more coordinated support for women, children and families affected by violence. Impact • Hundreds of people engaged through awareness raising and training activities • Continued development of trauma-informed support services • Increased local capacity to support children and families affected by domestic abuse • Strengthened partnership approaches to prevention and perpetrator accountability Page 313
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Annual Performance Report 2025/26 38 Moray Integration Joint Board 11. Strategic Theme 3: Partners in Care Strategic Objective 5: We are an ambitious and effective partnership National Wellbeing Outcome Description Outcome 8: Workforce People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide. Outcome 9: Use of resources Resources are used effectively and efficiently in the provision of health and social care. Why this matters The health and social care system is facing growing demand from an ageing population, increasing numbers of people living with long-term conditions and significant workforce pressures. Meeting these challenges requires more than additional resources—it requires partners to work differently, redesign services and embrace innovation. During 2025/26, Health and Social Care Moray continued to strengthen partnership working across organisations, communities and the wider public sector to develop more sustainable models of care that improve outcomes for local people. Redesigning services for the future Rising demand, workforce pressures and changing population needs mean health, and social care services must continue to adapt to remain sustainable. Across Scotland there is a growing focus on helping people remain independent for longer, reducing unnecessary hospital stays and ensuring care is provided closer to home wherever possible. During the year, Moray continued work to redesign a number of services to better meet future demand. This includes work linked to national Discharge Without Delay and Home Assessment Pathway programmes, helping shape future models of care for people living with frailty and informing the future role of community hospitals. A review and redesign of Adult Day Care Services also progressed, bringing Artiquins together with Cedarwood within shared accommodation. This enables better use of high-quality facilities while supporting the continued delivery of services that meet people's needs. A wider review of day services is now underway to explore future options through engagement and consultation. Impact • Service redesign supporting more sustainable models of care • Better use of existing community facilities • Learning from national programmes informing future service development • Wider review of day services progressing to support long-term sustainability Page 314
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Annual Performance Report 2025/26 39 Moray Integration Joint Board Expanding choice and independence through Care at Home Demand for care at home continues to increase as more people wish to remain living independently within their own communities. During 2025/26, a new commissioning framework was introduced to strengthen delivery of care at home under Self-directed Support (SDS) options 2 and 3 , helping ensure people have greater choice and control over how their care is arranged. Implementation has taken longer than originally anticipated, reflecting the complexity of changing commissioning arrangements. The focus is now on embedding the new approach and demonstrating improved outcomes, quality and flexibility for people who require support. Work during 2026/27 will focus on embedding the framework and demonstrating benefits for people receiving support. Impact • New commissioning frameworks introduced • Greater emphasis on personal choice and independence • Foundations established for improved quality and sustainability Housing as part of health and wellbeing Having the right home is fundamental to living independently and maintaining good health. Suitable housing can reduce reliance on hospital care, support recovery and improve quality of life. The new Moray Local Housing Strategy recognises the growing need for supported accommodation for older people and people living with learning disability or mental health conditions, embedding these priorities into long-term planning across partner organisations. Although Moray does not currently have dedicated supported living accommodation for people under 65 with mental health needs, health, housing and third sector partners continue to work together to develop individual solutions while exploring future accommodation options. For people with learning disabilities, investment in local accommodation has enabled more individuals to remain in Moray, closer to their families and communities. The completion of Western Village in Elgin has supported people to return from out-of-area placements, reducing reliance on external provision while providing more person- centred support. This has also contributed to reduced Dynamic Support Register pressures, with earlier reporting noting a 60% reduction in the red category largely through successful transitions from out-of-area placements and hospital settings Work is now progressing to develop additional accommodation for people with complex needs through the Woodview programme. Impact • Local Housing Strategy strengthens links between housing and health Page 315
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Annual Performance Report 2025/26 40 Moray Integration Joint Board • More people with learning disabilities supported to live locally • Reduced reliance on out-of-area placements • Further supported accommodation development planned through Woodview Embedding a person-centred approach Improving services means ensuring people don’t have to navigate complex systems or repeat their story to multiple professionals. Throughout the year, Moray HSCP continued to embed the Getting It Right for Everyone (GIRFE) approach across health and social care. GIRFE promotes joined-up, person- centred support by encouraging professionals to work together around what matters most to the individual. Progress included identifying local champions, strengthening staff resources and incorporating GIRFE principles into newly commissioned services, refreshed policies and the Moray Community Connections digital platform. Embedding GIRFE helps reduce duplication, improves coordination between services and ensures conversations focus on what matters most to individuals. Moray's work has also been recognised nationally, being the first Health and Social Care Partnership invited to report its progress to the National GIRFE Collaborative. Impact • GIRFE principles embedded across new service specifications and policies • Local champion network established • Enhanced toolkit developed for staff • National recognition for Moray's leadership in implementing GIRFE Supporting people with long-term conditions As more people live longer with conditions such as diabetes, preventing illness and supporting self-management are becoming increasingly important. Supporting people to manage long-term conditions earlier can improve quality of life and reduce the need for more intensive intervention later. Dietetic services continued to work alongside the Moray Leisure Centre Heart of Moray programme to support healthier lifestyles, weight management and early intervention for people at risk of or living with diabetes. Partnership working across primary care and community services is strengthening access to support, while digital solutions are being explored to reach more people and encourage long-term behaviour change. Further expansion of these services is planned during 2026/27. Impact • Greater integration between dietetic and community services • Improved focus on prevention and early intervention Page 316
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Annual Performance Report 2025/26 41 Moray Integration Joint Board • Digital approaches being developed to increase access and participation Using technology to help people live independently Technology has an increasingly important role in helping people remain safe and independent at home while supporting more responsive care. During 2025/26, Moray successfully completed the transition from analogue to digital community alarms, ensuring continued reliability as national telecommunications systems change. This achievement was recognised with a Gold One Digital Telecare Implementation Award from Digital Telecare for Scottish Local Government. The partnership also continued to explore innovative approaches through the Smart Housing, Smart Communities initiative, testing how digital monitoring and predictive technologies could enhance telecare and support independent living. While recruitment to the pilot has been slower than anticipated, the project has been extended to allow further learning that will inform future service development. Impact • Successful transition to digital community alarms • Gold national award recognising implementation • Continued investment in innovative technology to support independent living Building a digital future for health and care Through the Moray Growth Deal's Rural Centre of Excellence for Digital Health and Care, partners are developing new ways of supporting people to manage their own health and wellbeing. The programme includes a series of "Living Labs" bringing together practitioners, supported people and unpaid carers to explore areas for research and development such as supported self-management, long-term conditions, care at home and mental wellbeing. The partnership also continues to develop Moray Community Connections, an online platform that helps people identify local services, community support and referral pathways, making it easier to access help at the right time. These developing initiatives are helping shape future approaches that could enable more people to manage their own health and wellbeing and access support closer to home. Impact • Digital innovation supporting prevention and self-management • Moray Community Connections improving access to local services • Learning from national digital programmes helping shape future care Page 317
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Annual Performance Report 2025/26 42 Moray Integration Joint Board Improving care through safer prescribing Older people living in care homes often take multiple prescriptions that have accumulated over many years. While many medications remain essential, others may no longer provide benefit and can increase the risk of falls, confusion, or unnecessary side effects. During the year, a dedicated pharmacist-led programme reviewed medication for residents across care homes, working closely with GP practices, care home staff, and pharmacy teams to ensure treatment remained appropriate and person-centered. The reviews resulted in 300 medicines being stopped or reduced, including 57 medicines associated with an increased risk of falls. Overall, daily medication administrations were reduced by 187 doses, simplifying treatment for residents and reducing the burden on care staff. The work also highlighted opportunities to improve quality of care. In one instance, medication intended only for short-term use had continued unnecessarily, while another resident was routinely being woken to receive sleeping medication. Addressing issues such as these has improved both patient experience and medication safety. Care homes also reported practical benefits, with one home reducing medication rounds by up to 2.5 hours each day, allowing staff to spend more time providing direct care. Impact • 300 medicines stopped or reduced • 57 falls-risk increasing medicines removed • 187 fewer daily medication administrations • Reduced medication burden for frail older people • One care home reduced medication rounds by up to 2.5 hours • Annual prescribing savings of £11,298 • All participating care homes requested the programme continue Using resources wisely through partnership working Making best use of limited resources allows more investment to be directed towards frontline care and support. During 2025/26, Moray’s pharmacy teams worked closely with GP practices and NHS Grampian’s Medicines Unit to review prescribing and identify clinically appropriate efficiencies. Originally established as a temporary spend-to-save initiative, the Specialist Pharmacy Technician role has delivered such significant benefits that it has now been made a permanent part of the service. Working collaboratively across Moray, the programme achieved £378,931 in efficiencies during 2025/26, substantially exceeding the original target of £200,000. This was achieved through evidence-based prescribing reviews, improved adherence to Page 318
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Annual Performance Report 2025/26 43 Moray Integration Joint Board regional formularies and ensuring patients received equally effective but more sustainable treatments where clinically appropriate. The work has also reduced unnecessary appointments and administrative workload, allowing clinical time to be focused where it is most needed. Several of the approaches developed in Moray have since been adopted across NHS Grampian, demonstrating the wider value of local innovation. Impact • £378,931 prescribing efficiencies delivered during 2025/26 • 189% of the original savings target achieved • Specialist Pharmacy Technician role made permanent following successful evaluation • Strong partnership working between pharmacy teams, GP practices, and NHS Grampian • Local innovations informing prescribing improvements across the wider health system Looking ahead Meeting future demand will require continued collaboration, innovation, and a willingness to redesign traditional models of care. During 2025/26, Health and Social Care Moray strengthened the foundations for this transformation by developing more integrated services, investing in digital solutions, and working with partners to ensure people can access the right support, in the right place, at the right time. An ambitious and effective partnership is one that continuously looks for better ways of delivering care and support. During 2025/26, collaborative working has demonstrated that improving quality and improving value can go hand in hand. By reducing unnecessary medication, supporting safer prescribing, and making better use of resources, the partnership has improved outcomes for patients while helping ensure the long-term sustainability of health and social care services across Moray. Page 319
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Annual Performance Report 2025/26 44 Moray Integration Joint Board 12. Strategic Theme 4: Strategic Leadership, Planning and Performance Objective 6: We make a positive impact beyond the services we deliver National Wellbeing Outcome Description Outcome 8: Engaged workforce People who work in health and social care services are supported to continuously improve the information, support, care and treatment they provide, and feel engaged with the work they do. Outcome 9: Use of resources Resources are used effectively and efficiently in the provision of health and social care. Why this matters Strong leadership, effective partnerships and good governance create the foundations for better care, better health and better value for the people of Moray. While much of this report focuses on frontline services, delivering sustainable health and social care also depends on effective leadership, a skilled workforce, strong partnerships and responsible stewardship of public resources. As demand continues to grow and financial pressures increase, we must continually improve how services are planned, delivered and supported. During 2025/26 we continued to invest in our workforce, embrace innovation, strengthen governance, make better use of technology and engage more effectively with our communities. Together, these activities help ensure services remain resilient, accountable and sustainable for the future. Supporting and developing our workforce Our staff are our greatest asset. Their knowledge, skills and commitment underpin every service we provide, yet like many health and social care organisations across Scotland, we face significant workforce challenges. Like health and social care organisations across Scotland, Moray continues to face significant workforce challenges. Analysis shows an increasing number of experienced staff approaching retirement, creating risks around succession planning and the retention of valuable knowledge and skills. Levels of staff absence for both NHS staff and Council staff were 6.6% and 8.5% at the end of quarter 4, above the national target of 4%. Short term absences relate to colds/flu and gastro/intestinal issues, with long term absence causes for both Council and NHS staff being anxiety, stress and other mental health illnesses or for Page 320
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Annual Performance Report 2025/26 45 Moray Integration Joint Board operations/post operation care. Absences can result in pressures for remaining workforce where it is not possible to suspend or reduce service delivery. At the same time, high levels of sickness absence and recruitment difficulties in some services, particularly mental health and community hospitals, place additional pressure on existing teams and increase reliance on bank, agency and overtime staffing. There is a need to use bank and agency staffing to supplement our workforce, particularly in mental health and community hospitals. Levels of overtime in our complex and challenging services and care at home services are high and are required due to the number of vacancies that exist. Workforce planning is underway as a partnership, with both employing partners and a new national workforce subgroup. Aspects under review are potential retirements and succession planning, absence monitoring, agency and bank use, overtime reliance, difficult to fill vacancies as well as rural displacement and use of Artificial Intelligence. Designing a sustainable workforce that will meet future challenges and opportunities is key for delivery of our strategic aims. Organisation change has commenced with the aims of addressing gaps in operational management, professional supervision and optimising the integration of adult, children, families and justice services and ensuring the right mix of multi-disciplinary teams at a locality level to better meet the needs of local communities and address persistent health inequalities in communities with higher levels of need. The first phase was completed with the senior management structure being approved by MIJB in November 2025, and further phases are to be completed by end of 2026. Recognising that a healthy workforce is essential to delivering high-quality care, significant investment has been made in staff wellbeing. A central Staff Health & Wellbeing resource was developed as a single point of access for support and information, receiving more than 1,500 views during the year. Local wellbeing information areas have also been established across teams, making support more visible and accessible. A network of 18 Staff Health & Wellbeing Champions has been created to promote wellbeing initiatives, encourage peer support and help colleagues access available services. Early feedback suggests the network has increased confidence in having wellbeing conversations and strengthened local ownership of health and wellbeing initiatives. National Wellbeing Week at Dr Gray's Hospital brought together NHS services and third sector partners to provide practical advice, health checks and wellbeing activities for Page 321
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Annual Performance Report 2025/26 46 Moray Integration Joint Board staff. The event strengthened awareness of available support while reinforcing the importance of staff wellbeing across the organisation. Impact • Workforce planning continues to address future retirement risks • Succession planning is being strengthened across services • More than 1,500 wellbeing resource views • 18 Wellbeing Champions established • Increased awareness and accessibility of staff support • Continued focus on creating a healthy and resilient workforce Learning from safety incidents Creating a culture where staff feel confident to report incidents is fundamental to improving safety. During 2025/26, reporting of adverse events increased across Health and Social Care Moray. While some incidents reflected challenging working environments—particularly violence and aggression experienced by frontline staff—the increase in reporting is also considered to reflect improvements in reporting systems and a stronger culture of openness. Information gathered through incident reporting is used to identify trends, implement improvements and reduce future risks to both staff and people using services. Encouragingly, reports involving sharps injuries reduced during the year, although the number of incidents meeting Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) criteria increased from two to four, highlighting the importance of continued vigilance and preventative action. Impact • Improved reporting arrangements strengthening organisational learning • Better understanding of risks across services • Reduction in sharps-related incidents • Continued focus on preventing workplace violence and aggression Volunteers strengthening community support Volunteers make a vital contribution to health and social care across Moray, enhancing services, reducing isolation and strengthening community resilience. A new Re-engage Volunteer role has also been introduced, recognising that many people wish to volunteer around work, family or other commitments. The role provides Page 322
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Annual Performance Report 2025/26 47 Moray Integration Joint Board flexible opportunities while enabling volunteers to gain skills, confidence and social connections. Looking ahead, volunteers will play an important role in supporting older people returning home from hospital who may have little or no support, helping them settle safely back into their communities. Within NHS services, new opportunities have also been introduced, including Visitor Volunteers, Pharmacy Support Volunteers and a patient clothes bank at Dr Gray's Hospital, improving patient Within NHS services, new opportunities have also been introduced, including Visitor Volunteers, Pharmacy Support Volunteers and a patient clothes bank at Dr Gray's Hospital, improving patient experience while allowing clinical staff to focus on delivering care. Impact • More than 250 volunteers supporting services • New flexible volunteering opportunities created • Increased community capacity and social connection • Additional support for patients and frontline staff Strengthening governance and accountability Strong governance helps ensure public resources are used effectively, risks are managed appropriately and learning leads to service improvement. During 2025/26 governance arrangements for delivery of savings programmes were strengthened through the introduction of a dedicated Budget Savings Oversight Group. The group provides additional scrutiny and support to ensure planned savings are delivered while maintaining service quality and patient/supported person safety. Learning from inspections, audits, significant adverse events and service reviews continues to be embedded across the organisation. Senior managers maintain oversight of recommendations and improvement actions to ensure lessons are translated into meaningful service improvements. Creating a culture where staff feel confident to report incidents remains an important part of improving safety. Reporting of adverse events increased during the year, reflecting both the challenges faced by frontline services and improvements in reporting systems and organisational learning. Information gathered through incident reporting is used to identify trends, reduce risks and improve safety for staff and people using services. Encouragingly, reports involving sharps injuries reduced during the year. Page 323
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Annual Performance Report 2025/26 48 Moray Integration Joint Board Impact • Stronger governance arrangements established • Improved oversight of savings programmes • Learning from audits, inspections and incidents embedded across services • Improved reporting arrangements supporting organisational learning • Continued focus on accountability, quality and safety Looking ahead Building a sustainable health and social care system requires investment in people as well as services. Over the coming year, work will continue to strengthen workforce planning, improve staff wellbeing and develop innovative approaches that enable Health and Social Care Moray to meet future demand while continuing to deliver high- quality care. Objective 7: We are transparent and we listen to you National Wellbeing Outcome Description Outcome 3: Positive experiences People who use health and social care services have positive experiences of those services and have their dignity respected. Outcome 9: Use of resources Resources are used effectively and efficiently in the provision of health and social care. Why this matters Being transparent means more than publishing information. It means communicating openly, involving people in decisions that affect them and learning from feedback to improve services. By listening to our communities and acting on what they tell us, we can build trust and deliver services that better meet local needs. Making information easier to access During summer 2025, the Moray HSCP website was rebuilt and moved onto a new digital platform. While much of the content remained the same, the redevelopment significantly improved how people access information. The new website offers a modern, accessible design that works more effectively across mobile devices, alongside improved navigation and search functionality. Behind the scenes, enhanced security, managed hosting and automatic backups have created a more resilient platform that can support future digital developments. Page 324
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Annual Performance Report 2025/26 49 Moray Integration Joint Board The project reduced hosting costs by more than 75% and was delivered entirely using in-house expertise.. Impact • Modern, accessible website • Improved user experience • More secure and resilient digital infrastructure • Over 75% reduction in hosting costs Keeping communities informed Throughout the year, the partnership continued to use proactive communications to keep local people informed about services, public health campaigns, recruitment opportunities and developments across health and social care. A total of 41 proactive news releases were issued during 2025/26, compared with 29 the previous year, helping raise awareness of the work of Moray IJB and Moray HSCP, and celebrate the work of staff, volunteers and community partners. Social media also continued to play an important role in connecting with communities. Facebook remains the partnership's primary channel with almost 8,000 followers, and saw strong levels of engagement during the year: These channels provide accessible and timely information while helping promote healthier lifestyles, recruitment campaigns and opportunities for community involvement. The continued development of Moray Community Connections is also helping people find local support, community groups and services more easily, making it simpler to access information and assistance when needed. Impact • Increased proactive communications throughout the year • More than 2.18 million social media views and 18,307 social media • Engagement increased by 12% • Greater awareness of local services and initiatives Giving people a stronger voice Listening to local people is essential to designing services that meet the needs of our communities. In August 2025, Moray Council launched Moray Engage, a new online platform that provides a single place for residents to participate in consultations, community projects and discussions about local services. Page 325
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Annual Performance Report 2025/26 50 Moray Integration Joint Board As a Community Planning Partnership member, Moray HSCP has its own dedicated space on the platform to gather views on health and social care priorities. During the platform's first year the platform received more than 35,500 visits and over 8,000 responses across all projects. Five Moray HSCP projects were published during 2025/26: • Carer Aware Campaign design poll • Improving Healthy Weight in Moray • Moray Adult Unpaid Carer Survey • Moray Young Carer Survey • Moray Short Breaks (Respite) Service Review Together these projects generated over 1,400 visits and 326 responses, achieving a strong engagement rate of 39%. Impact • Greater opportunities for community participation • Five engagement projects delivered • Strong engagement across projects Learning from complaints and feedback Feedback, whether positive or negative, helps us understand people's experiences of care and support. By listening to concerns and acting on what we learn, we can improve services and strengthen public confidence. During 2025/26, Moray HSCP received 169 complaints, compared with 138 in the previous year. After excluding withdrawn, duplicate or out-of-remit cases, complaint levels remain broadly consistent with previous years when considered alongside expanded service responsibilities. The most common themes related to communication, particularly within services experiencing high demand such as GMED, adult mental health and access teams. Of the complaints investigated during the year, 12% (18 complaints) were fully upheld, with the remainder partially upheld or not upheld. Complaints provide valuable learning that is shared across teams and used to improve how services operate, ensuring complaints contribute to continuous service improvement in line with the expectations of the Scottish Public Services Ombudsman. Where complaints can be resolved quickly, we aim to respond within five working days. More complex complaints requiring investigation have a target response time of 20 working days. Average response times were: Page 326
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Annual Performance Report 2025/26 51 Moray Integration Joint Board Complaint type Average response Social work and social care – early resolution 11 working days Social work and social care – investigation 37 working days Health services – early resolution 5 working days Health services – investigation 60 working days Improving response times remains a priority and progress continues to be monitored by the Senior Management Team. Impact • Learning from 169 complaints used to improve services • Communication identified as a key improvement priority • Ongoing work to improve response times and strengthen accountability Looking ahead Strong leadership, effective partnerships and meaningful engagement will remain essential as health and social care continues to evolve. During the coming year, we will continue to invest in our workforce, embrace innovation, strengthen governance and work alongside local communities to design services that are sustainable, person- centred and responsive to the needs of the people of Moray. Page 327
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Annual Performance Report 2025/26 52 Moray Integration Joint Board 13. Financial review and performance Financial performance forms part of the regular reporting cycle to the Moray IJB. Throughout the year the Board, through the reports it receives, is asked to consider the financial position at a given point and any management action deemed as necessary to ensure delivery of services within the designated financial framework. From the first quarter in the financial year, the Board was presented with financial information that included a forecast position to the end of the year. In November 2025, the Board received a financial report which forecast an expected overspend to the end of the financial year of £8.78m. This forecast remained fairly consistent throughout the remainder of the year and in January 2026, MIJB were forecasting an overspend to the end of the year of £8.23m, the Moray IJB actually out turned at £7.20m overspent. Both partners, in line with the Integration Scheme, put in additional funding to cover this overspend. There was the use of ear marked reserves totalling £0.14m during the year, with new ear marked reserves totalling £1.70m leaving a balance of £3.01m in ear marked reserves to be carried forward into 2026/27. In March 2025, the Moray IJB agreed a savings plan of £9.47m, with a mixture of recurring savings and recurring reductions in spend. At the end of the financial year, this had been achieved in part, with recurring savings of £3.66m, £0.68m non-recurring savings and £1.03m reduction in overspend. Given the uncertainties associated with funding and the emerging overspend position at the early stage of the financial year, it was necessary to update regularly on the emerging financial position. This was done formally through Moray IJB meetings and informally through development sessions. The table below summarises financial performance by comparing budget against actual performance for the year. Page 328
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Annual Performance Report 2025/26 53 Moray Integration Joint Board Service Area Budget £000’s Actual £000’s Variance (Over)/ under spend £000’s Note Community Hospitals & Services 8,033 7,932 101 Community Nursing 6,244 6,670 (426) 1 Learning Disabilities 20,913 21,230 (317) 2 Mental Health 12,227 12,881 (654) 3 Addictions 1,871 1,817 54 Adult Protection & Health Improvement 278 279 (1) Care Services Provided In-House 25,190 25,495 (305) Older People Services & Physical & Sensory Disability 28,090 30,023 (1,933) 4 Intermediate Care & OT 1,845 2,039 (194) Care Services Provided by External Contractors 2,084 2,072 12 Other Community Services 10,117 10,310 (193) Administration & Management 2,056 3,086 (1,030) 5 Other Operational Services 1,413 1,351 62 Primary Care Prescribing 21,441 21,312 129 Primary Care Services 22,830 22,954 (124) Hosted Services 6,131 5,987 144 Out of Area Placements 1,780 1,834 (54) Improvement Grants 1,060 889 171 Children’s & Justice Services 21,256 22,050 (794) 6 Total Core Services 194,859 200,211 (5,352) Strategic Funds & Other Resources 11,619 3,257 8,362 7 TOTALS (before set aside) 206,478 203,468 3,010 Set Aside 20,092 20,092 - TOTAL 226,570 223,560 3,010 Page 329
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Annual Performance Report 2025/26 54 Moray Integration Joint Board Significant variances against the budget were notably: Note 1: Community Nursing - This budget is overspent by £425,978 at the year end. This is predominantly due to staffing, with overspends in District nurses £431,715 (including Acute nursing at Varis, Forres and Buckie), £102,136 overspend in Health visitors, which is being reduced by an underspend in Maryhill of £107,873. The overspend is largely due to staffing as detailed above. District nurses had a budget realignment in 2025/26 of £313,982 and savings of £121,095, this was not achieved due to recruitment being successful for vacant posts that have been vacant for a significant time during which time bank staff have had to be used as well as the regrading of nurses from a band 6 to a band 7. Health visitors were expected to come in on budget after realignment and savings however the school nurses were regraded in the last quarter of the year resulting in an overspend in the budget. Note 2: Learning Disabilities (LD) – The Learning Disability (LD) service is overspent by £316,736 at the year-end. The overspend is essentially due to the purchase of care for people with complex needs which resulted in an overspend of £428,087, client and staff transport of £25,640 and property cost overspend of £23,588. This is offset by underspend of £100,173 for clinical, nursing and other services relating to consultant and management psychiatry staffing vacancies, more income received than expected of £34,358 and other small underspends of £1,239. This budget has been under pressure for a number of years due to demographic pressures, transitions from Children’s services and people living longer and getting frailer whilst staying at home. The biggest overspends was for services provided to individuals in their own homes to support their daily living needs which enables people to stay living at home or in a homely setting for as long as possible and day care which provides activities during the day in the community. Work continues to progress savings plans across the LD service; however, this is being offset by ongoing demand pressures. In particular, more individuals with complex needs moving through transitions from children to adult services and also people moving into the area who require high-cost packages of care, which is impacting on the overall financial position. Note 3: Mental Health – This budget is overspent by £654,343 at the year end. This is due to overspends in clinical, nursing and other services as a result of ongoing use of agency locums of £302,457; purchase of care £195,385 relating to purchase of care in care homes and care at home; £144,810 relating to unachieved savings and £11,691 other minor overspends. This budget is currently under pressure due to the recruitment issue for consultants and an increase in demand for services, including out of area packages as there is a lack of resource locally especially around autism and neurodiversity. Work is currently ongoing reviewing out of area packages to repatriate them to Moray. Page 330
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Annual Performance Report 2025/26 55 Moray Integration Joint Board Note 4: Older People Services and Physical & Sensory Disability - This budget is overspent by £1,933,488 at the end of the year. This primarily relates to overspends for home care in the area teams £575,752, permanent care £1,328,598 due to the increase in the number of clients receiving nursing care rather than residential care, short breaks £242,362 and self-directed support of £260,758. Bad debt provision for unpaid fees was £117,582 overspent, which is particularly high this year and other minor overspends of £18,000. This is being reduced by income received during the year above budget by £609,564. The variances within this overall budget heading reflect the shift in the balance of care to enable people to remain in their homes for longer, when people are living longer with more complex care needs. Due to the increase in need and complexity along with increasing levels of growth and demand are having an impact on this budget. There are increases in permanent care which is seeing the move to nursing placements rather than residential placements. The demographics are showing we have an increasing elderly population who are living longer and requiring more complex care. Note 5: Admin and Management - This budget is overspent by £1,029,617 at the year end. This is due to interim staffing arrangements and the vacancy target for the Council side not being met by £933,334. There was a non-recurring increase in target for 2025/26 of £750,000 that was not achievable. Note 6: Children, Families and Justice Services – This budget is overspent by £793,663 at the year end. This is due to overspends in residential continuing care placements £418,127, external fostering placements £495,610, out of area residential placements £297,272, home to school taxis £28,201, no recourse to public funds costs £15,600 and self-directed support payments of £68,245. This overspend is being reduced by an underspend on mental health & wellbeing £156,041, trauma informed training £30,517, refund on Intensive Family Support contract £31,492, Criminal Justice £64,759, an overachievement of £246,097 against the vacancy target and minor underspends of £486. These overspends are related to the number of children requiring to be accommodated through the Children’s Hearing system, family breakdown, and the need to keep children safe from familial harm while living at home. The costs of care have been rising significantly, availability of the correct care provision is a national challenge, and the market is under scrutiny with consultation for possible legislation on excessive profiteering. A long and immediate term strategy has been approved by the IJB to address: the need to reduce the flow-into care, develop small group family living models in Moray with support from Housing Services, strengthen early support, prevention and diversion, and have a more local provision in the Northeast across the three Grampian local authority areas, which can more effectively contribute to the flow- out of care. Page 331
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Annual Performance Report 2025/26 56 Moray Integration Joint Board Note 7: Strategic Funds and Other Resources – This budget is underspent by £8.362m as it relates to savings achieved during the year, any unallocated funding and reserves balances. MIJB’s financial performance is presented in the comprehensive income and expenditure statement (CIES), which can be seen on page 44. At 31 March 2026 there were ear marked reserves of £3.01m available to the MIJB, compared to £1.45m at 31 March 2025. These remaining reserves of £3.01m are for various purposes as described below: Page 332
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Annual Performance Report 2025/26 57 Moray Integration Joint Board Earmarked Reserves Amount £000’s GP Premises 21 National Drugs MAT 250 OOH Winter Pressure funding 172 Moray Cervical screening 36 Moray hospital at home 4 Moray Psychological 275 MHO Funding 138 Adult protection funding for CA 72 National Trauma Training services 53 Moray School Nurse 32 Moray Winter Fund HCSW & MDT 182 LD Annual Health Checks 69 Community Planning partnership 2 Moray District Nurses 111 Moray Alcohol & Drug Partnership 48 GP Walk-in Service 165 Moray Unscheduled Care Improvement Plan 1,380 Total Earmarked 3,010 General Reserves 0 TOTAL Earmarked & General 3,010 Page 333
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Annual Performance Report 2025/26 58 Moray Integration Joint Board GP Premises – balance of funding for improvement grants including the making of premises improvement grants to GP contractors. The continued digitalisation of paper GP records. Modifications for the purposes of improving ventilation and increase to the space available in NHS owned or leased premises for primary care multi-disciplinary teams. MAT Standards - National Drugs Medication Assisted Treatment (MAT) for embedding and implementation of the standards will he be overseen by the MAT implementation support team (MIST). Out of Hours Winter Pressure funding – balance of funding to sustain GO out of hours and to support resilience to explore operational solutions. Moray Cervical Screening – balance of funding for smear test catch up campaign. Moray Hospital at Home – development of Hospital at Home provides Acute hospital level care delivered by healthcare professionals, in a home context for a condition that would otherwise require acute hospital inpatient care. Moray Psychological – funding streams for mental health, psychological wellbeing, facilities, post diagnostic support and psychological therapies. Mental Health Officer (MHO) funding – funding to support additional mental health officer capacity. Adult protection funding for care at home – balance of funding to build capacity in care at home community-based services. National Trauma Training services – training for dealing with people affected by trauma and adversity. Moray School Nursing – funding to support NHS Grampian to retain school nurse posts. Moray Winter Fund Health Care Social Workers (HCSW) – additional funding for further HCSW in both the IJB and Emergency department. Moray Winter fund Multi-Disciplinary Team – additional funding for service pressures includes Discharge to Assess, Home First Frailty team and volunteer development. Learning Disability Annual Health Checks – to implement the annual health checks. Community Planning Partnership – funding towards community planning partnership. Moray District Nursing – allocation to support recruitment and training of District Nurses Moray Alcohol & Drug Partnership - funding to support local alcohol and drug issues . Page 334
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Annual Performance Report 2025/26 59 Moray Integration Joint Board GP Walk-in Service – Scottish Government funding to expand walk-in GP services Moray Unscheduled Care Improvement Plan – funding to enhance the delivery of unscheduled care services. All reserves are expected to be utilised for their intended purpose during 2026/27. Set Aside – Excluded from the financial performance table but included within the Comprehensive Income & Expenditure Account is £20.092m for Set Aside services. Set Aside is an amount representing resource consumption for large hospital services that are managed on a day-to-day basis by the NHS Grampian. MIJB has a responsibility for the strategic planning of these services in partnership with the Acute Sector and Mental Health Service. Set Aside services include: • Accident and emergency services at Aberdeen Royal Infirmary and Dr Gray’s inpatient and outpatient departments; • Inpatient hospital services relating to general medicine, geriatric medicine, rehabilitation medicine, respiratory medicine, learning disabilities, old age psychiatry and general psychiatry; and • Palliative care services provided at Roxburgh House Aberdeen and The Oaks Elgin. The budget allocated to Moray is designed to represent the consumption of these services by the Moray population. The MIJB integration scheme outlines that the method of establishing the set aside budget will take account of hospital activity data and cost information. Hospital activity data will reflect actual occupied bed day and admissions information, together with any planned changes in activity and case mix. This information was originally provided by Information Services Division, although this information hasn’t been updated since 2019/20. In the absence of updated information from Information Services Division, uplifts based on the baseline uplift was applied to the set aside budget calculation on an annual basis throughout the period up to 2024/25. During 2025/26 it was accepted that this did not provide an accurate reflection of the consumption by Moray residents within the Unplanned Care pathways and work was undertaken to update the set aside calculation. The updated set aside budget has been calculated using hospital activity data and cost information. The hospital activity data is taken from the SMR01 dataset for general/acute inpatient and day case and reflects inpatient stays and day case and Page 335
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Annual Performance Report 2025/26 60 Moray Integration Joint Board outpatient activity. Costs are taken from the 2023/24 NHS Grampian cost book and uplifted by the baseline uplift amounts for 2024/25 and 2025/26 to reflect pay award and inflationary uplifts since 23/24. The set aside budget is the total of IJB activity multiplied by unit cost The figures for 2021/22 to 2024/25 have been derived by uplifting 2019/20 figures by baseline funding uplift in 2021/22 (3.36%) ,2022/23 (6.70%), 2023/24 (5.35%) and 2024/25 (6.64%): 2025/26 2024/25 2023/24 2022/23 2021/22 Budget 20.092m 15.639m 14.665m 13.92m 13.04m Page 336
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Annual Performance Report 2025/26 61 Moray Integration Joint Board APPENDICES A. Moray Area Profile B. National Health & Wellbeing Outcomes C. Core Suite of National Indicators D. Ministerial Group Indicators E. Inspections of Services F. Moray Integration Joint Board – changes to membership, decisions and directions Page 337
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Annual Performance Report 2025/26 62 Moray Integration Joint Board 14. Appendix A: Moray area profile • Moray spans 864 square miles in North East Scotland • Comprising mainly coastal and rural communities • Rounded Population 93,400 (Scotland’s Census 2022 – Rounded population estimates, 2023), 1.72% of Scotland’s total population. • Population predicted to fall by 2.6% in next 10 years according to publicly available data last updated in 2022. Moray age profile 0-14 year olds 15 -64 year olds People aged 65 and over Moray 14,500 57,500 21,400 Scotland 21,400 3,153,300 1,091,100 Community • In 2023 it was estimated that there were 43,891 households in Moray. • 62.2% of adults living in Moray rate their neighbourhood as a good place to live (Scotland 59.1%) • The crime rate in Moray is 41 per 1,000 population (Scotland 55) • The rate of non-accidental fires in Moray is 13 per 10,000 population (Scotland 28) • In Moray, 45 drug crimes are recorded per 10,000 population (Scotland 97) Economic status • 12.5% of Moray households are estimated to be workless (Scotland 17.8%) • 20.1% of children aged under 16 within Moray are living with low income families (UK 20.1%) • In May 2023, 11.6% of all Moray households were on Universal Credit - 5,103 households (Scotland 18.7%) • 63.6% of homes were in Council Tax Bands A-C, 7.34% were in Council Tax Bands F-H, compared to 60.0% and 14.2% respectively in Scotland. Deprivation • Moray is the second least deprived mainland local authority in Scotland • (SIMD 20) • 2.7% of Moray population live within the highest of the Scottish Index of Multiple Deprivation (SIMD) quintiles (most deprived) • 13.3% live in the least deprived quintile. Page 338
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Annual Performance Report 2025/26 63 Moray Integration Joint Board 15. Appendix B: National Health & Wellbeing Outcomes National context The Scottish Government measures the performance of all health and social care partnerships against a set of high-level statements of what we should be aiming to achieve through integration and ultimately through the pursuit of quality improvement across health and social care. The National Health and Wellbeing Outcomes provide a strategic framework for the planning and delivery of health and social care services, and they focus on the experiences and quality of services for people receiving these services, carers and their families. National Health and Wellbeing Outcomes (NH&W) 1 Health & wellbeing People are able to look after and improve their own health and wellbeing and live in good health for longer. 2 Living in the community People, including those with disabilities or long term conditions, or who are frail, are able to live, as far as reasonably practicable, independently and at home or in a homely setting in their community. 3 Positive experiences People who use health and social care services have positive experiences of those services, and have their dignity respected. 4 Quality of life Health and social care services are centred on helping to maintain or improve the quality of life of people who use those services. 5 Health inequalities Health and social care services contribute to reducing health inequalities. 6 Support for carers People who provide unpaid care are supported to look after their own health and wellbeing, including to reduce any negative impact of their caring role on their own health and well- being. 7 Safe from harm People using health and social care services are safe from harm. 8 Workforce People who work in health and social care services feel engaged with the work they do and are supported to continuously improve the information, support, care and treatment they provide. 9 Use of resources Resources are used effectively and efficiently in the provision of health and social care. Page 339
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Annual Performance Report 2025/26 64 Moray Integration Joint Board 16. Appendix C: Core suite of national indicators Source information from Public Health Scotland National Indicators (to be updated in July when figures are published) The Core Suite of National Indicators have been developed from national data sources to enable comparisons between Integration Authority areas and with Scotland. Each indicator acts as a measure of progress against at least one outcome. There are 23 indicators in total with four (10, 21,22 and 23) still to be defined. Indicators 1-9 which are based on the Health and Care Experience (HACE) survey will not be updated as part of the May release as the information is not yet available. Results from the 2026 HACE survey will be available in the 7 July publication. Moray Core Suite of National Integration Indicators (to be updated in July when stats are published) Moray HSCP was in the top 50% for eight of the 19 reported indicators for this reporting period. This was a decrease from the previous reporting period where 11 were in the top 50%. Areas of particular strength were in relation to lower premature mortality rate, emergency admissions, emergency bed days, readmissions within 28 days and falls. There has been a significant reduction in the premature mortality rate (NI-11) and emergency admission rate (NI-12) (per 100,000 population) in comparison to the Scottish rate, with reductions of 25% and 29% respectively. Overall, we performed the same or better than Scotland for 12 of the 19 national indicators, with seven performing worse than Scotland. This is the same as the previous reporting period. Page 340
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Annual Performance Report 2025/26 65 Moray Integration Joint Board Summary of our performance at a glance - National Indicators GREEN Our performance has improved compared to last year. AMBER Our performance is similar to last year. RED Our performance has declined compared to last year. The results of the 2026 HACE survey will be published by the Scottish Government on 26 May 2026 and will be included in the PHS Core suite publication on 7 July 2026. Any further questions and comments on the HACE survey should be sent to patientexperience@gov.scot. .Outcome indicators Results for 2, 3, 4, 5,7 and 9 are not comparable to previous years due to changes in survey wording National Indicator (will be updated in July) Scotland Our result (2024/25) NH&W Outcomes 1 Percentage of adults able to look after their health very well or quite well 91% 92% 1 2 Percentage of adults supported at home who agree that they are supported to live as independently as possible 72% 72% 2 3 Percentage of adults supported at home who agree that they had a say in how their help, care or support was provided. 60% 59% 2, 9 4 Percentage of adults supported at home who agree that their health and care services seemed to be well co-ordinated 61% 66% 3 5 Percentage of adults receiving any care or support who rate it as excellent or good 70% 69% 2, 3 6 Percentage of people with positive experience of the care provided by their GP practice 68% 69% 3, 4 7 Percentage of adults supported at home who agree that their services and support had an impact in improving or maintaining their quality of life. 70% 69% 4 8 Percentage of carers who feel supported to continue in their caring role 31% 28% 6 9 Percentage of adults supported at home who agree they felt safe 73% 70% 7 Page 341
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Annual Performance Report 2025/26 66 Moray Integration Joint Board National Indicator Scotland Our result NH&W Outcomes Data indicators 11 Premature mortality rate 463 403 1, 5, 7 12 Emergency admission rate 11,462* 7,379* 1, 2, 4, 5 13 Emergency bed day rate 106,455* 72,740* 1, 2, 4, 5 14 Readmission to hospital within 28 days 104* 72* 7, 9 15 Proportion of last 6 months of life spent at home or in a community setting 89%* 93%* 7, 9 16 Falls rate 22.9* 11.2* 7, 9 17 Proportion of care services graded 'good' (4) or better in Care Inspectorate inspections 73.8% 81.9% 3 18 Percentage of adults with intensive care needs receiving care at home 65% 60% 6 19 Number of days people spend in hospital when they are ready to be discharged 952 865 9 20 Percentage of health and care resource spent on hospital stays where the patient was admitted in an emergency** Not available Not available * The primary source of data for these indicators are Scottish Morbidity Records (SMRs) which are nationally collected discharge-based hospital records. In accordance with the recommendations made by Public Health Scotland (PHS) and communicated to all Health and Social Care Partnerships, the most recent reporting period available with complete and robust data is calendar year 2025. Reporting on 2025 calendar year rather than 2025/26 financial year may not fully reflect local activity, however, this is still recommended due to data quality and completeness levels at the time of reporting. **PHS has not provided information for indicator 20 beyond 2019/20 because detailed Patient Level Information Costing System (PLICS) cost information is not available. PHS previously published information to calendar year 2020 using costs from 2019/20 as a proxy but, given the impact of the COVID-19 pandemic on activity and expenditure, PHS no longer consider this appropriate. Page 342
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Annual Performance Report 2025/26 67 Moray Integration Joint Board HOLDING PAGE - Detailed analysis of each National Indicator will be presented in this section prior to publication Page 343
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Annual Performance Report 2025/26 68 Moray Integration Joint Board 17. Appendix D: Ministerial Group Indicators Page 344
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Annual Performance Report 2025/26 APPENDIX D 18. Appendix E: Inspections of services The annual performance report requires the IJB to report on inspections by external bodies. Inspections, Assurance and Service Quality Moray Health & Social Care Partnership monitors the quality and performance of both directly delivered services and externally commissioned services. This includes reviewing Care Inspectorate gradings, inspection findings, improvement requirements, complaints, and provider quality assurance information to ensure services remain safe, effective and person-centred. Overall, inspection findings during 2025/26 provide assurance that the majority of services are delivering good quality care, with most services graded Good (4) or Very Good (5) on the six-point scale. Indicator Result Services inspected 24 Services graded Good or above 92% Services with improvement requirements 3 Services supported through improvement planning 5 Inspection findings across services highlighted a number of common strengths, including committed staff teams, positive relationships with people using services, and a strong focus on person-centred care. Where improvement areas were identified, these generally reflected recurring themes across services, including medication management, care planning and recording, workforce capacity, and the need for robust and consistent quality assurance processes. Internal services In 2025/26, the Care Inspectorate inspected six internal services: • Community Support Service • Moray Supported Lodgings • Barlink • CALA • Woodview • START Inspection feedback across internal services was consistently positive, highlighting strong staff commitment, person-centred approaches, and positive outcomes for Page 345
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Moray Integration Joint Board - Annual Performance Report 2025/26 70 people using services. Performance across services was generally stable, with limited variation in grading. Where areas for improvement were identified, these related mainly to consistency of practice, including aspects of care planning, documentation and quality assurance processes. Action plans were developed and monitored through established quality assurance and improvement arrangements. Commissioned services In 2025/26, the Care Inspectorate inspected 18 externally commissioned services. Inspection findings identified a range of strengths across commissioned services, including caring staff, positive relationships with people using services, and a continued commitment to supporting people safely within their communities. While most commissioned services performed well, inspection findings indicated a greater degree of variation in performance compared to internal services. Where improvement requirements were identified, these reflected similar system-wide themes, particularly in relation to medication management, quality assurance and workforce capacity. Providers were supported through improvement planning and ongoing contract monitoring arrangements to address identified areas. Targeted assurance and improvement activity During 2025/26, the partnership undertook a significant assurance and improvement process in response to concerns identified within one service. This involved multi- agency review and oversight arrangements, engagement with families, the provider and regulatory partners, and ongoing monitoring to support improvement and ensure the safety and wellbeing of residents. Page 346
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Moray Integration Joint Board - Annual Performance Report 2025/26 71 19. Appendix F: Moray Integration Joint Board - Changes to Membership of Moray Integration Joint Board, decisions and directions Changes to Integration Joint Board Membership and Governance During 2025/26, the Moray Integration Joint Board (IJB) experienced a number of changes to its membership and leadership arrangements. A planned transition in Board leadership took place during the year. Dennis Robertson served as Vice Chair from 1 April to 30 September 2025 before assuming the role of Chair from 1 October 2025. Councillor Bridget Mustard joined the Board on 1 August 2025 and served as Chair from 1 August to 30 September 2025, before taking up the position of Vice Chair from 1 October 2025. There was one change to the voting membership representing Moray Council, with Councillor John Divers joining the Board on 27 March 2026 following the departure of Councillor Ben Williams. Within the non-voting membership, changes reflected both organisational appointments and representative succession. Following the appointment of Judith Proctor as Interim Chief Officer in July 2024, the Board continued to benefit from her leadership throughout 2025/26. Jim Lyon remained in post as Interim Chief Social Work Officer. The Board welcomed Aimee McIntosh as Third Sector Representative from 1 October 2025. Changes also took place within the Unpaid Carer Representative membership, with Ivan Augustus standing down in November 2025 after almost ten years of service. Miriam Connor and Christine Stevens were subsequently appointed as Unpaid Carer Representatives. There were also changes to staff partnership representation during the year. Kevin Todd, Moray Council Staff Representative, stood down in May 2025. Deirdre McIntyre concluded her role as Grampian Health Board Staff Partnership Representative in June 2025 and was succeeded by Michael Ritchie in July 2025. The Board's co-opted membership was strengthened through the appointment of Karen Greaves as Moray Council representative in March 2025 and Laura Skaife-Knight as NHS Grampian representative from October 2025. Existing co-opted members continued to provide professional and operational expertise to support the Board's governance and decision-making. The Board also maintained a pool of substitute members to support continuity of governance, with Councillor Sonya Warren joining as a substitute member in February 2025. Page 347
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Moray Integration Joint Board - Annual Performance Report 2025/26 72 Decision and directions Agendas and reports for all MIJB meetings during 2024/5 are set out in the papers which are published on the Moray Council website. Board meetings are open to the public and webcast, meaning they can be watched remotely as they happen or the recording viewed at a later time. Decisions taken by the Board in2025/26 included: May 2025 • Approved the final draft of the Strategic Delivery Plan (2025-2028). • Approved the new format of the Moray Integration Joint Board Risk Register. • Endorsed the updated Moray Mental Health and Wellbeing Strategy Delivery Plan 2024-2026. • Endorsed the Moray Mental Health and Wellbeing Strategic Performance Framework. • Approved the final MIJB Equality Mainstreaming Progress Report 2021- 2024. • Approved the MIJB Equality Outcomes for the period 2025-2029. • Approved mainstreaming of the Equality Duty. • Approved changes to the Moray Integration Joint Board Financial Regulations. June 2025 • Approved the unaudited Annual Accounts to be submitted to the external auditor, noting all figures remain subject to audit. Noted the Annual Governance Statement and accounting policies applied in the production of the unaudited Annual Accounts. • Approved the updated Local Code of Corporate Governance which supports the Annual Governance Statement. • Approved the proposed reduction in the number of formal meetings from 18-15 per year. • Approved the publication of the Annual Performance Report 2024/25 by 31 July 2025. • Approved a two-year extension to the current Moray Carers Strategy 2023-26, extending its term to March 2028. September 2025 • Approved the updated Moray Integration Joint Board Strategic Risk Register, including the adequacy of the identified mitigating controls. • Approved the Children Services Plan 2024-25 Annual Report. • Approved the publication of the Health and Social Care Moray Annual Complaints report 2024/25. October 2025 • Approved the Audited Annual Accounts for the financial year2024/25 and the letter of Representation. November 2025 • Agreed to increase the non-voting stakeholder members from five to six, to enable the inclusion of the two Unpaid Carer Stakeholder representatives on the MIJB membership from 28 November 2025. • Approved the draft Public Sector Climate Change submission to Sustainable Scotland Network for the reporting year 2024/25. • Endorsed the proposed revised management structure for the Senior Management Team of Health and Social Care Moray. Page 348
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Moray Integration Joint Board - Annual Performance Report 2025/26 73 January 2026 • Agreed the reappointment of the Board’s Chief Internal Auditor for a further two year period. • Formally nominate for approval by the Standards Commission, the reappointment of the Board’s Standards Officer and Depute Standards Officer, for a further period of two years until 1 April 2028. March 2026 • Approved the Board’s Strategic Risk Register, noting the current risk ratings, controls, assurances and areas of ongoing exposure. • Approved the 2026/27 proposed savings plan. • Approved the Revenue Budget for 2026/27, following consideration on risks. • Approved the updated Medium Term Financial Framework. Page 349
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Moray Integration Joint Board - Annual Performance Report 2025/26 74 Find out more about Moray Integration Joint Board and Moray Health & Social Care Partnership on our website: https://hscmoray.co.uk/index.html Follow us on social media Facebook @ hscmoray Instagram @hscmoray For further information contact: Moray Health & Social Care Partnership Moray Council Offices High Street Elgin Moray IV30 1BX Page 350
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: INTERNAL AUDIT SECTION FOLLOW UP REVIEW – ADULT SOCIAL CARE COMMISSIONING BY: CHIEF INTERNAL AUDITOR 1. REASON FOR REPORT 1.1 The report advises the Committee on an internal audit follow-up review to evidence implementation of recommendations from an audit undertaken of Adult Social Care Commissioning. 2. RECOMMENDATION 2.1 It is recommended that Committee considers and notes the contents of this report and seeks clarification on any points. 3. BACKGROUND 3.1 This report sets out the findings of a follow-up review undertaken by the Internal Audit Section to evidence the implementation of recommendations contained within an Improvement Action Plan prepared by Health and Social Care Moray. The Improvement Action Plan was developed in response to the findings of an audit of adult social care commissioning undertaken by KPMG Governance, Risk & Compliance Services (KPMG). This follow-up review was agreed as part of the 2025/26 Internal Audit Plan. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 An audit was undertaken by KPMG in 2022/23 of adult social care commissioning. The review was requested by the Audit, Performance and Risk Committee of the Moray Integration Joint Board (MIJB) on 31 March 2022 (para 11 of minute refers). The need for the review was highlighted due to concerns raised by senior management regarding the administrative arrangements within the Adult Social Care Commissioning Service and the findings from a peer review report in January 2022. The peer review was an audit of systems and procedures Item 13. Page 351
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within the Adult Social Care Commissioning Service by the Strategic Procurement Manager Aberdeen City and Aberdeenshire Councils Shared Services (Commissioning), with the purpose of providing evidence and assurance that the Commissioning Service was robust, appropriate, equitable, efficient and provided value for money for the population of Moray. 4.2 However, upon receipt of the “peer review” report, the Adult Social Care Commissioning Service and a former Head of Service/Chief Social Work Officer (CSWO) raised concerns regarding its validity. These concerns relate to the sample of contracts selected for review and the assumptions drawn from the testing undertaken. Due to these misgivings, the MIJB’s Audit, Performance and Risk Committee agreed on 31 March 2022 to request an external audit review of the Adult Social Care Commissioning Service. KPMG was subsequently appointed to undertake this review. The Internal Audit Section was not involved in the procurement process, determination of the audit scope, or the review of working papers/draft report to evidence any findings or recommendations made by KPMG. However, the Internal Audit Section was subsequently asked by the former Chief Officer of the MIJB to undertake a follow-up review to provide assurance on the implementation of the recommendations contained within the audit report. 4.3 The scope for this external review detailed the following “broad purpose of the audit”: • To enable a reasonable level of assurance to be provided to the Integration Joint Board on the effectiveness of the Commissioning Service. • From the audit findings, the opportunity to highlight to the Commissioning Service any required improvements to ensure an adequate and efficient service can be delivered in meeting the needs of the Moray population. 4.4 The review was completed in February 2023, and the audit report, which included recommendations for service improvements, was approved by the MIJB Audit, Performance and Risk Committee on 30 March 2023 (para 11 of the minutes refers). However, at the Committee meeting on 26 October 2023 (para 12 of the minutes refers), an Improvement Action Plan was agreed. This plan was developed from the recommendations previously detailed in the KPMG audit report. It was considered necessary to provide greater clarity regarding those recommendations and to facilitate more effective monitoring of implementation progress and reporting to committee. 4.5 In accordance with the Internal Audit Plan 2025/26, a follow-up review was undertaken to provide assurance on the implementation of the recommendations detailed in the Improvement Action Plan. This has been a challenging exercise, as the Internal Audit Section was not involved in the original review and has no evidence to support the recommendations. Nevertheless, a follow-up review was completed and the report is attached in Appendix 1. The majority of recommendations have been implemented; however, some have been completed through alternative arrangements that are now more closely aligned with service delivery, or there has been a need to agree on revised implementation timescales. A further follow-up review is not Page 352
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proposed. Instead, an audit of adult social care commissioning will be considered for inclusion in a future Internal Audit Plan. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022-2032” Internal audit work supports good governance and assists in securing appropriate systems of internal control. (b) Policy and Legal The internal audit service is provided in terms of paragraph 7:1 of the Local Authority Accounts (Scotland) Regulations 2014, and there is a requirement to provide a service in accordance with published Public Sector Internal Audit Standards. (c) Financial Implications No implications directly arising from this report. (d) Risk Implications and Mitigation Audit reports highlight risk implications and contain recommendations for management to address as a means of mitigating. (e) Staffing Implications No implications directly arising from this report. (f) Property No implications. (g) Equalities/ Socio Economic Impacts No implications. (h) Climate Change and Biodiversity Impacts None directly arising from this report. (i) Directions None arising directly from this report. (j) Consultations There have been no direct consultations during the preparation of this report. 6. CONCLUSION 6.1 This report provides Committee with a summary of findings arising from a follow up review undertaken of an audit of Adult Social Care Commissioning. Author of Report: Dafydd Lewis, Chief Internal Auditor Background Papers: Internal Audit Files Page 353
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APPENDIX 1 Moray Council Internal Audit Section 1 DEPARTMENT: Moray Integration Joint Board SUBJECT: Adult Social Care Commissioning- Follow up review (Based from an audit undertaken by KPMG) REPORT REF: 26’016 Follow Up Audit Review Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Internal Audit Report Category: Governance 1 (2.1.1a- HSCM Code) Introduce a Terms of Reference for the Managers Commissioning Meeting High Yes 31/08/2023 Implemented – Terms of reference for the Managers’ Commissioning Meeting were developed and agreed as final on 27/09/2023. However, the Head of Service later decided that a Managers’ Commissioning Meeting was no longer required, as the purpose and intended outcomes of this meeting are now Page 355
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Appendix 1 Moray Council Internal Audit Section 2 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation addressed through service specific groups including the Learning Disability Transformation Board, Care at Home Steering Group, Health & Social Care Moray (H&SCM) Mental Health Steering Group, Care Home Owners and Managers meetings and the Drug and Alcohol Partnership meetings. 2 (2.1.1b) Ensure Commissioning activities are a standing item on every agenda for Practice Governance Board and that it is discussed. High Yes 31/08/2023 Not Implemented– Agendas for the Practice Governance Board meetings were reviewed for the period May 2024 to October 2025 and commissioning activities were not detailed on any of the agendas. H&SCM has decided on alternative arrangements where commissioning activities are discussed as appropriate at Operational Management Team meetings that are held fortnightly. No further follow up required Page 356
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Appendix 1 Moray Council Internal Audit Section 3 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 3 (2.1.2a) Ensure Commissioning is represented at Practice Governance Board High Yes 29/02/2024 Not Implemented - A review of a sample period (May 2024 to October 2025) of Practice Governance Board meeting agendas and minutes noted that the Commissioning Service was not represented at the majority of the meetings. Alternative arrangements implemented, where the Commissioning Service is now represented at Operational Management Team meetings. No further follow up is planned. 4 (2.1.2b) The Terms of Reference for Managers Commissioning meetings will cover attendance and expectations for Deputes and decision making High Yes 29/02/2024 Implemented – The Terms of Reference for the Managers’ Commissioning Meetings were amended to include a requirement for attendance and expectations regarding deputisation and decision-making. However, as detailed previously (Ref: No. 1), the Head of Service decided that a Managers’ Commissioning Meeting is no longer required Page 357
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Appendix 1 Moray Council Internal Audit Section 4 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation due to Commissioning activities being discussed at more service specific meetings. 5 (2.1.3) An Agenda and Action Log will be created for Managers Commissioning meetings. High Yes 31/05/2023 Implemented – The follow-up review confirmed that agendas and action logs had been maintained until 2024 for the Managers’ Commissioning Meetings. However, as detailed previously, the Head of Service has decided that there is no longer a requirement for Managers’ Commissioning Meetings. Internal Audit Report Category: Team Structure and Roles 6 (2.2.1a) Ensure every member of staff that works in the Commissioning Team has a Job Description and it is available High Yes 31/05/25023 Implemented – Job descriptions have been provided for the following roles, which make up the Commissioning Team: Senior Commissioning Officer, Commissioning Co-ordinator, and Clerical Assistant. 7 (2.2.1b) Ensure every member of staff that works in the commissioning team has had the opportunity to discuss their High Yes 31/05/2023 Implemented – Discussions with officers from the Commissioning Service confirmed that there have been opportunities to review and Page 358
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Appendix 1 Moray Council Internal Audit Section 5 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation job description at supervision to determine understanding discuss their job descriptions during supervision meetings. Supervision meetings are held regularly and are diarised. 8 (2.2.2a) Commissioning and Procurement will meet regularly to corroborate the contract timeline High Yes 31/08/2023 Implemented – Verbal confirmation has been provided by both Commissioning and Procurement Services officers that regular meetings are taking place at which contracts and timelines are being discussed. Diary entries were observed. 9 (2.2.2b) The Commissioning Manager and Chief Finance Officer will meet every month to review block funded commissioned budgets High Yes 31/08/2023 Not Implemented– Whilst there are regular meetings diarised between Commissioning and Accountancy staff, monthly meetings between the Commissioning Manager (Service Manager) and the Chief Finance Officer to discuss block contracts are not taking place. Discussions have been held with the Chief Finance Officer, and it is now the view that monthly meetings are not required, Page 359
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Appendix 1 Moray Council Internal Audit Section 6 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation as budgets for block contracts are agreed in advance. No further follow up is planned. 10 (2.2.2c) A presentation of the remit of the Commissioning Team and future direction of the commissioning function will be created and delivered for colleagues in Health and Social Care Moray. High Yes 31/08/2023 Implemented – Two Development days have been held to date on 11 September 2024 and 14 May 2025, with another scheduled for 11 March 2026. The Development days were attended by a wide-range of staff from within Health and Social Care Moray and the sessions included a presentation by the Chief Social Work Officer. Themed group discussions were held, covering commissioning activities and processes and the broader elements of social work activity. In addition, the Strategic Delivery Plan for 2025-2028, approved in May 2025, commits to the development of a Strategic Commissioning Strategy under the responsibility of the Senior Management Page 360
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Appendix 1 Moray Council Internal Audit Section 7 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Team. The Head of Service has advised resources have been allocated to complete a Commissioning Strategy by the end of June 2026. 11 (2.2.3a) A team meeting will be held every week to discuss workload, and this will be monitored with a work tracker High Yes 29/02/2024 Implemented – The workload tracker was observed and was up to date at the time of testing for this follow-up review. Sample meeting notes were also examined to confirm that workload discussions were taking place. 12 (2.2.3b) A Contract work plan that informs the Departmental Procurement Action Plan and a Monitoring annual work plan will be created. High Yes 29/02/2024 Implemented – The Commissioning team maintains a document (separate from their Contracts Database) that highlights expiring contracts and informs the work plan. It was noted that regular meetings are also held with Procurement Officers from Financial Services to discuss work planning. The Departmental Procurement Action Plan is a proactive process. Whilst there are still a small number Page 361
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Appendix 1 Moray Council Internal Audit Section 8 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation of contracts that have expired, the majority now have clear end dates, which can be built into future planning processes for Procurement and Commissioning Services. 13 (2.2.3c) All staff will engage with supervision sessions with their line manager in accordance with policy. High Yes 29/02/2024 Implemented – Supervision sessions are regularly undertaken for all staff within the Commissioning Service. These sessions provide an opportunity for oversight and support by reviewing staff wellbeing, workload, performance, development needs, and compliance with policies and standards. Internal Audit Report Category: Training 14 (2.3.1) A training matrix will be created that clearly details intended training for all Commissioning Team staff members. Staff will be trained in core and service specific training. Medium Yes 31/08/2023 Implemented – A training matrix was introduced in 2025. Confirmation of training completed has been obtained on a sample basis for Procurement, General Data Protection Regulation, Customer Excellence and Ethical Commissioning. Page 362
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Appendix 1 Moray Council Internal Audit Section 9 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Internal Audit Report Category: Process Documentation 15 (2.4.1) A detailed Commissioning Procedure will be created with underpinning process maps and guidance. High Yes 31/08/2023 Implemented – A Commissioning Procedures document is in place and was approved by the Head of Service in September 2023. The Procedures became due for review in September 2025. At the time of the follow-up, the Service Manager advised that a review of the Procedures is underway 16 (2.4.2a) The Commissioning Procedure will be discussed at the weekly Commissioning Team Meetings and supervision. High Yes 31/08/2023 Revised Implementation Date 31/03/2026 Part Implemented – Minutes of the Commissioning Team meeting note that the Procedures were last discussed in January 2024. The Service has been reminded of the importance of ensuring regular updates to the Procedures and maintaining their consistent application. A date for finalisation has been agreed, and approval will be sought by 31 March 2026. Page 363
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Appendix 1 Moray Council Internal Audit Section 10 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 17 (2.4.2b) A library of process maps and guidance documents should be maintained and made available to staff for future reference. High Yes 31/08/2023 Implemented – A sample of guidance documents and process maps has been reviewed, which form part of a wider library of supporting documents available to Commissioning staff. 18 (2.4.3) Budget Managers will be informed through a workshop of their budgetary responsibilities. High Yes 31/08/2023 Implemented - This is carried out by the Accountancy service through Budget Manager training. Internal Audit Report Category: Contract Management 19 (2.5.1) An action plan will be put in place to ensure all contracts are current, appropriate and signed. Agreement needs to be reached with Procurement colleagues and Service Managers regarding the timeline of this. High Yes 28/02/2025 Revised Implementation Date 31/07/2026 Part Implemented- A Commissioning Service Database is maintained which details information including contract end dates and the point at which a review should begin regarding future procurement arrangements. In addition, the Procurement Section within Financial Services maintains an Action Plan (DPAP) that sets out information and timelines for all contracts. Regular meetings take place Page 364
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Appendix 1 Moray Council Internal Audit Section 11 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation between Commissioning and Procurement Officers to discuss current contract management and future service delivery requirements. A review of the Commissioning Service Database and the DPAP noted that a small number of contracts (six at the time of the audit) had expired between three and five years ago. Explanations have been sought for each of these six contracts. It has been advised that, for three of the contracts, future service delivery requirements will be determined by the end of July 2026. The remaining three contracts relating to day services require a more significant review of future delivery needs, which the service intends to complete in 2026/27. No further follow up is planned. Page 365
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Appendix 1 Moray Council Internal Audit Section 12 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 20 (2.5.2) Invoices are matched against Service Agreements within the CareFirst system, ensuring approved expenditure matches provider invoice. This is detailed within the Invoice Processing Standard Operating Procedure (SOP). High Yes 28/02/2025 Implemented– Invoices are logged in a spreadsheet and checked against the contract with the care provider, which is saved within the CareFirst system. A sample of invoices from the spreadsheet was selected for testing and was confirmed against the care provider agreements. It was noted that the invoice processing system guidance is detailed in the Standard Operating Procedures; however, these Procedures are currently under review, despite being due for review in 2024. 21 (2.5.3) Invoices are recorded and approved by Managers. Moray Council Payments Team have a further check in place to ensure all invoices have appropriate approval. This is detailed within the Invoice Processing High Yes 28/02/2025 Implemented - All invoices are uploaded to the Financial Management System via the online Accounts Payable system. Invoices are then automatically allocated to budget managers, determined by the financial codes. The budget manager is required to authorise each invoice individually (there is also a facility Page 366
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Appendix 1 Moray Council Internal Audit Section 13 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation Standard Operating Procedure (SOP). to return an invoice to the administrator where a query is evident). Following authorisation, the invoice is passed to the Payments Section for processing. At this stage, Payments can also raise a query against an invoice. 22 (2.5.4a) A robust process will be put in place that provides a clear audit trail for the authorisation of contracts and associated documentation. High Yes 28/02/2025 Implemented– A Commissioning Service Database has been developed, which records information in relation to care contracts. Detailed information is recorded regarding the contract dates and stages as part of an audit trail. There is both a current tab and a separate tab to record archived information. 23 (2.5.4b) Health and Social Care Management will put in place a peer support system and management quality check system for the Commissioning Team and Community Care Finance. High Yes 28/02/2025 Implemented - A weekly team meeting was established for Senior Commissioning Officers and the Service Manager with responsibility for Commissioning. Two development days were organised and operated on 11/9/24 and Page 367
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Appendix 1 Moray Council Internal Audit Section 14 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 14/5/25. The first focused on the roles and responsibilities of the Commissioning remit and was attended by Service Managers from both Children’s and Adult Services, and the second looked at monitoring, with another planned for March 2026. Day to day management of other Commissioning staff has been allocated to one of the three Senior Commissioners. It should be noted that the Service Manager remit has changed and Community Care Finance is now managed by the Chief Finance Officer. Internal Audit Report Category: Strategy 24 (2.6.1) The Commissioning Service will attend and be active members of the Strategic Planning and Commissioning Group. Medium Yes 29/02/2024 Implemented – A follow-up review noted from the minutes of the Strategic Planning and Commissioning Group that meetings were attended by the Service Manager with responsibility for Commissioning. However, Page 368
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Appendix 1 Moray Council Internal Audit Section 15 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation since March 2025 there have been no meetings of the Strategic Planning and Commissioning Group. At the time of the audit, the Chief Officer provided an update in that recruitment was actively being pursued for a new Head of Service post which will hold responsibility for Strategic Planning. It was advised that these meetings will resume during 2026. No further follow-up is planned. Internal Audit Report Category: Invoicing 25 (2.7.1) The Community Care Finance (CCF) team will include a process for variances (when an invoice does not match the CareFirst Service Agreement) in a Standard Operating Procedure (SOP) for the invoicing process. Medium Yes 29/02/2024 Implemented – The follow-up review noted that a process is now in place for investigating variances between invoices from care providers and the service agreements detailed in the CareFirst system. It was noted that officers from CCF query any variation with the Page 369
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Appendix 1 Moray Council Internal Audit Section 16 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation are providers and/or Social Work to verify the reason for the deviation in cost. 26 (2.7.2) The Community Care Finance Team will ensure all evidence is retained throughout the invoicing process to ensure there is an adequate audit trail for all decision making. Medium Yes 29/02/2024 Implemented – Changes to the payment-processing system require that all invoices are saved electronically as part of the system requirements. Evidence is also retained relating to any further action taken by officers in the processing of an invoice for payment. Internal Audit Report Category: Contract Register 27 (2.8.1) The Departmental Contract Database will be reviewed, brought up to date and maintained. High Yes 31/08/2024 Implemented – It was found that the Commissioning Service Database is being updated following quarterly reviews of planned and current commissioning activities undertaken by Senior Commissioning Officers. From these meetings, instructions are provided to the Clerical Assistant to update and maintain the Database. Page 370
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Appendix 1 Moray Council Internal Audit Section 17 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 28 (2.8.2a) The Departmental Contract Database will be a protected document and updated by the Commissioning Team's Clerical Assistant under instruction from Senior Commissioning Officers and Commissioning Co-ordinators. High Yes 31/08/2024 Implemented – The Commissioning Service Database is updated by the Clerical Assistant on a quarterly basis under the direction of Senior Commissioning staff. Editing of the Contracts Database is password protected. . 29 (2.8.2b) Senior Commissioning Officers will carry out quarterly checks on the Departmental Contract Database regarding the information being up to date and accurate with no gaps in data. High Yes 31/08/2024 Implemented – The process has been confirmed whereby the Clerical Assistant is responsible for updating the Database, based on updates arising from the quarterly meeting and under the direction of Senior Commissioning staff. In addition, it has been confirmed that Senior Commissioning staff will also review the Database regularly to ensure it has been updated appropriately. Page 371
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Appendix 1 Moray Council Internal Audit Section 18 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation 30 (2.8.3) The Departmental Contract Database will be saved on the Moray Council Social Care Shared Drive. High Yes 31/08/2024 Implemented– The follow up review has verified that the Database is saved within the Commissioning area of Social Care Shared Drive. Internal Audit Report Category: Performance Management System 31 (2.9.1a) A Performance Management system should be put in place. High Yes 29/02/2024 Revised Implementation Date 31/07/2026 Not Implemented– Whilst improvements have been made in relation to monitoring the progress of contract work through the use of a workload tracker, there has been no progress in developing a team-wide performance management framework. There are currently no team key performance indicators in place. Internal Audit Report Category: Contract Review 32 (2.10.1a) The Contract Management Process in place will be reviewed, standardised and strengthened with process maps. This process ensures Medium Yes 31/08/2023 Implemented – The Contract Monitoring process has been reviewed and strengthened. Process maps are in place to support process for the comments, complaints and incidents aspects of contracts. In addition, evidence has Page 372
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Appendix 1 Moray Council Internal Audit Section 19 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation monitoring of providers for suitability. This will be reflected in the contract. been noted of contract monitoring through communication with care providers to verify the quality and consistency of service delivery. In addition, a Multi-Agency Monitoring and Support Group has been established. Continuous monitoring of care providers is required to verify compliance with contract conditions. 33 (2.10.1b) A Contract Record Document will be created that will support the reviewing of contracts. Medium Yes 31/08/2023 Implemented – A Contract Record Document has been developed. This is still a relatively new process for Adult Care Commissioning Services and is being completed as contracts fall due for renewal consideration by the Service. Internal Audit Report Category: Block Contracts 34 (2.11.1) All providers are subject to an annual contract meeting and a 6 monthly budget meeting to ensure best value Low Yes 31/08/2023 Implemented - A timetable of meetings has been observed and tested, covering both annual contract meetings and budget Page 373
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Appendix 1 Moray Council Internal Audit Section 20 Risk Ratings for Recommendations High Key controls absent, not being operated as designed or could be improved. Urgent attention required. Medium Less critically important controls absent, not being operated as designed or could be improved. Low Lower level controls absent, not being operated as designed or could be improved. No. Audit Recommendation Priority Accepted (Yes/ No) Date of Completion Status / Explanation is being achieved. This is reported to the Chief Finance Officer as required. This will be in every contract going forward. meetings with care providers. It was noted that where examples of services are being delivered without a formal contract in place, these providers were still receiving contract meetings. Reporting to the Chief Finance Officer has not been undertaken. Further discussion should take place between Commissioning and the Chief Finance Officer in order to establish if periodic updates would be beneficial. No further follow up is planned. Page 374
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: WOODVIEW HOUSING SUPPORT SERVICE INSPECTION REPORT BY: SERVICE MANAGER, PROVIDER SERVICES 1. REASON FOR REPORT 1.1 To update the Committee on the outcome of the Care Inspectorate inspection of Woodview Housing Support Service and to provide assurance on service quality, leadership, staffing, care planning, partnership working and improvement activity. 2. RECOMMENDATION 2.1 It is recommended that the Committee: i) consider and note the outcome of the Care Inspectorate inspection of Woodview Housing Support Service, including Grade 5 – Very Good evaluations for wellbeing and care planning, and Grade 4 – Good evaluations for leadership and the staff team; ii) consider and note the positive assurance provided by the inspection findings in relation to person-centred support, meaningful outcomes, strong relationships, effective partnership working and safe, consistent care delivery; iii) consider and note the improvement opportunities identified by the Care Inspectorate and the actions already being progressed by management to strengthen quality assurance, recording, training and service-specific procedures; and iv) instruct the Service Manager for Provider Services to provide updates to the Committee of progress against actions. 3. BACKGROUND Item 14. Page 375
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3.1 The purpose of this report is to ensure the Moray Integration Joint Board (MIJB) fulfils its responsibility of ensuring effective monitoring and reporting on the delivery of services and on the programme of work as set out in the MIJB Strategic Plan. 3.2 The Care Inspectorate carried out an inspection of Woodview Housing Support Service. The inspection findings provide positive assurance on the quality of care and support delivered to people with complex needs and on the arrangements in place to support safe, person-centred and outcome-focused practice. 3.3 The inspection evaluated four quality indicators: how well the service supports people’s wellbeing, how good the leadership is, how good the staff team is, and how well care and support is planned. The service was evaluated as Very Good for wellbeing and care planning, and Good for leadership and the staff team. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 A summary of the Care Inspectorate’s evaluations for each inspected area of Woodview Housing Support Service is noted in Table 1. The inspection outcome provides positive external assurance that the service is delivering strong outcomes for people supported and that improvement activity is being actively progressed. Table 1: Care Inspectorate evaluation outcomes Area Rating How well do we support people's wellbeing? 5 – Very Good How good is our leadership? 4 – Good How good is our staff team? 4 – Good How well is our care and support planned? 5 – Very Good Person-centred support, wellbeing and outcomes 4.2 The inspection identified significant strengths in how Woodview supports people’s wellbeing. People receive highly personalised care that reflects their needs, routines, preferences and aspirations, with staff providing responsive and proactive support that promotes safety, independence and quality of life. 4.3 Families reported high levels of satisfaction and described positive improvements in wellbeing, confidence and daily outcomes. The service’s use of core staffing teams was noted as a strength, supporting continuity, trust and a detailed understanding of each person’s individual needs. 4.4 Care and support planning was evaluated as Very Good. Personal plans were detailed, regularly reviewed and reflected people’s rights, choices and outcomes. Families, guardians and external professionals were actively involved, supporting a strong partnership-based approach to care planning and review. 4.5 The service supports meaningful activity and community inclusion, with people benefiting from daily engagement, wider community opportunities and planned experiences that contribute to confidence, independence and quality of life. Page 376
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Leadership, staffing and improvement activity 4.6 Leadership was evaluated as Good, with inspectors noting a clear understanding of service performance and improvement priorities. Management oversight, quality assurance processes and a proactive approach to improvement provide assurance that the service is reflective and responsive. 4.7 The staff team was evaluated as Good. Staff were recognised as committed and motivated, with positive feedback from families and evidence of strong teamwork, supportive working arrangements, induction, training and supervision. 4.8 The service continues to maintain safe and consistent care delivery during periods of workforce pressure. Staffing levels were noted as meeting assessed need, demonstrating resilience and effective operational management. 4.9 The Care Inspectorate identified improvement opportunities relating to the service improvement plan, service-specific policies and procedures, consistency of recording, medication outcomes, incident debriefs and completion of required training and practice sessions. These areas are already recognised by management and are being progressed through existing improvement and governance arrangements. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” The findings support the delivery of the Moray Integration Joint Board Strategic Plan, Partners in Care 2022 – 2032, by providing assurance that adult social care services are safe, person-centred, outcome-focused and subject to effective governance. The report also contributes to the Committee’s role in monitoring performance, quality and risk across integrated services. (b) Policy and Legal There are no new policy or legal implications arising directly from this report. The inspection provides assurance in relation to the service’s compliance with relevant care standards, person-centred planning expectations and statutory responsibilities for the delivery of registered housing support services. (c) Financial implications None directly associated with this report. (d) Risk Implications and Mitigation There are no new risk issues arising directly from this report. The inspection outcome provides positive assurance in relation to service quality, person- centred care, care planning, partnership working, staffing and governance. Identified improvement opportunities are being managed through existing quality assurance and improvement arrangements. Page 377
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(e) Staffing Implications There are no new staffing implications arising directly from this report. The inspection findings provide assurance that staffing arrangements are supporting safe and consistent care delivery, with positive feedback on teamwork, induction, training and supervision. Completion of outstanding training and practice sessions will continue to be monitored through existing management arrangements. (f) Property None directly associated with this report. (g) Equalities/Socio Economic Impact An Equality Impact Assessment is not required as there are no proposed changes to policy, service design or eligibility arising from this report. The inspection findings indicate that the service is delivering person-centred support that reflects individual needs, rights, choices, preferences and outcomes. (h) Climate Change and Biodiversity Impacts No climate change or biodiversity implications arise directly from this report. (i) Directions There are no directions arising from this report. (j) Consultations The following were consulted prior to the report being submitted: • Woodview Housing Support Service management • Social Work/Social Care Practice Governance Board • Head of Adult Services 6. CONCLUSION 6.1 This report provides the Committee with assurance on the outcome of the Care Inspectorate inspection of Woodview Housing Support Service. The inspection confirms strong performance across the service, with Very Good evaluations for wellbeing and care planning and Good evaluations for leadership and the staff team. The findings highlight person-centred, outcome-focused support, strong relationships, effective care planning, partnership working and a committed workforce. Improvement opportunities have been identified and are being progressed through existing governance and quality assurance arrangements. Author of Report: Rob Outram, Team Manager Background Papers: Available on request Ref: Page 378
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: CARE INSPECTORATE INSPECTION REPORT – 16 BARLINK ROAD, ELGIN BY: SERVICE MANAGER, PROVIDER SERVICES 1. REASON FOR REPORT 1.1 To update the Committee on the outcome of the unannounced Care Inspectorate Core Assurance inspection of the housing support and care at home service at 16 Barlink Road, Elgin, and to provide assurance on service quality, safety, governance, staffing and improvement activity. 2. RECOMMENDATION 2.1 It is recommended that the Committee consider and note: i) the outcome of the Care Inspectorate Core Assurance inspection of the housing support and care at home service at 16 Barlink Road, Elgin; ii) the assurance provided by the inspection findings in relation to safe, person-centred care, wellbeing, leadership, legal compliance, staffing and planned care and support; and iii) that the inspection identified a small number of proportionate improvement actions which are being addressed through existing management and quality assurance arrangements. 3. BACKGROUND 3.1 The purpose of this report is to ensure the Moray Integration Joint Board fulfils its ongoing responsibility to monitor the delivery, quality, performance and risk profile of delegated health and social care services, including registered care and support services operated by Moray Council. Item 15. Page 379
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3.2 On 28 April 2026, the Care Inspectorate carried out an unannounced Core Assurance inspection of the housing support and care at home service at 16 Barlink Road, Elgin. 3.3 The service is operated by Moray Council and provides housing support and care at home for four adults with learning disabilities and complex needs within a shared residential setting. Core Assurance inspections are used by the regulator to confirm that well-performing services continue to deliver safe, effective and person-centred care. This inspection did not re-grade the service, but considered key assurance areas including legal assurances, wellbeing, leadership, staffing and planned care and support. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The Care Inspectorate inspection provides positive assurance that people supported at 16 Barlink Road continue to receive care and support that meets their needs and protects their safety, wellbeing and rights. The findings confirm that the service is operating effectively and that improvement activity is proportionate and appropriately managed. Legal compliance, governance and assurance 4.2 The inspection found that the service was operating in line with its registration requirements, with appropriate policies, procedures and insurance arrangements in place. This provides assurance that the service is functioning within the required legal and regulatory framework. 4.3 Leadership arrangements were described as visible, approachable and responsive. There was evidence of a culture of continuous improvement, with leaders seeking feedback from families, staff and professionals, using audit activity to inform improvement and responding effectively to incidents and learning. 4.4 There have been no complaints upheld since the previous inspection. This provides further assurance regarding the quality, consistency and responsiveness of the service. 4.5 The inspection identified a small number of improvement actions relating to topical medication expiry monitoring, a minor recruitment documentation oversight, ongoing review of staffing levels and further development of incident management systems. These actions are limited in scope and are being progressed through existing management and quality assurance arrangements. Quality of care, wellbeing and person-centred support 4.6 People were found to experience care that promoted dignity, respect and individual choice. Staff demonstrated compassionate practice and supported individuals in a way that enhanced personal wellbeing and the quality of the home environment. Page 380
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4.7 The inspection noted effective health monitoring, timely access to healthcare and safe, competent medication administration. Positive feedback from families was also noted in relation to health and wellbeing support. 4.8 Care plans and risk assessments were found to be detailed, regularly reviewed, informed by professional guidance and developed with involvement from individuals and families. This supports meaningful activity, promotes choice and enhances quality of life for people supported. 4.9 Staffing arrangements were generally appropriate to meet assessed needs. The inspection noted robust induction processes, good oversight of staff competency and compassionate, timely care delivery. This provides assurance that people are supported by trained and competent staff. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” The findings support the delivery of the Moray Integration Joint Board Strategic Plan Partners in Care 2022 – 2032 by providing assurance that registered care and support services are safe, person-centred, outcome- focused and subject to effective governance. The report also contributes to the Committee’s role in monitoring performance, quality and risk across integrated services. (b) Policy and Legal There are no new policy or legal implications arising directly from this report. The inspection provides assurance that the service is operating in line with its registration requirements and within the required legal and regulatory framework for housing support and care at home services. (c) Financial implications None directly associated with this report. (d) Risk Implications and Mitigation There are no new risk issues arising directly from this report. The inspection outcome provides positive assurance in relation to service quality, safe care delivery, legal compliance, leadership, staffing and planned care and support. The small number of improvement actions identified are proportionate and are being managed through existing service oversight, audit and improvement arrangements. (e) Staffing Implications There are no new staffing implications arising directly from this report. The inspection noted that staffing arrangements were generally appropriate to meet assessed needs, with robust induction, oversight of staff competency and compassionate, timely care delivery. The service will continue to review staffing levels through existing operational arrangements. Page 381
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(f) Property None directly associated with this report. (g) Equalities/Socio Economic Impact An Equality Impact Assessment is not required as there are no proposed changes to policy, service design or eligibility arising from this report. The inspection findings indicate that the service is delivering person-centred care which promotes dignity, respect, individual choice, wellbeing and involvement of people and their families. (h) Climate Change and Biodiversity Impacts No climate change or biodiversity implications arise directly from this report. (i) Directions There are no directions arising from this report. (j) Consultations The following were consulted prior to the report being submitted: • Service management team for 16 Barlink Road • Social Work/Social Care Practice Governance Board • Head of Adult Services 6. CONCLUSION 6.1 This report provides the Committee with assurance on the outcome of the Care Inspectorate Core Assurance inspection of the housing support and care at home service at 16 Barlink Road, Elgin. The inspection confirms that people continue to receive care and support that meets their needs and protects their safety, wellbeing and rights. It also evidences effective leadership, legal compliance, appropriate staffing arrangements, person-centred care planning and a clear commitment to continuous improvement. The improvement actions identified are limited in scope and are being addressed through existing management and quality assurance arrangements. Author of Report: Service Manager, Provider Services Background Papers: Available on request Ref: Page 382
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: CARE AT HOME INSPECTION REPORT BY: SERVICE MANAGER, PROVIDER SERVICES 1. REASON FOR REPORT 1.1 To update the Committee on the outcome of the unannounced Care Inspectorate inspection of Moray Council’s Care at Home Service and to provide assurance on service quality, governance, workforce stability and improvement activity. 2. RECOMMENDATION 2.1 It is recommended that the Committee consider and note: i) the outcome of the Care Inspectorate inspection of Moray Council’s Care at Home Service, including the Grade 5 – Very Good evaluations for both inspected quality indicators; ii) the assurance provided by the inspection findings in relation to safe, person-centred care, staff competence, workforce stability, governance and quality assurance arrangements; and iii) that there were no new areas for improvement identified and that previous areas for improvement have been met. 3. BACKGROUND 3.1 The purpose of this report is to ensure the Moray Integration Joint Board (MIJB) fulfils its ongoing responsibility to ensure effective monitoring and reporting on the delivery of services and on the programme of work as set out in its Strategic Plan. 3.2 Between 26 November and 5 December 2025, the Care Inspectorate carried out an unannounced inspection of Moray Council’s Care at Home Service. Item 16. Page 383
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3.3 The inspection considered two quality indicators: how well the service supports people’s wellbeing and how good the staff team is. Both indicators were evaluated as Grade 5 – Very Good, providing strong external assurance on the quality, safety and effectiveness of the service. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 A summary of the Care Inspectorate’s evaluations for each inspected area of the service is noted in Table 1. Grade 5 – Very Good indicates major strengths in supporting positive outcomes, with only minor areas for improvement. Table 1: Care Inspectorate evaluation outcomes Area Rating How well do we support people's wellbeing? 5 – Very Good How good is our staff team? 5 – Very Good How well do we support people's wellbeing? 4.2 The Care Inspectorate found significant strengths in the care provided, with evidence that people experienced positive outcomes and received compassionate, respectful and relationship-based support. 4.3 People’s personal plans were detailed, up to date and person-centred, reflecting individual needs, preferences and outcomes. This enabled staff to deliver tailored care and support independence, dignity and wellbeing. 4.4 The service responded well to changes in people’s needs, with personal plans updated promptly and additional support put in place where circumstances changed. 4.5 Safe medication practices were noted, with very few errors recorded. This provides assurance that staff are following appropriate procedures and that systems are in place to support safe care delivery. How good is our staff team? 4.6 The inspection identified significant strengths in the staff team and how this supported positive outcomes for people. Staff were described as motivated, skilled and committed to delivering high-quality care. 4.7 Staff told inspectors they enjoyed their roles, felt valued and experienced strong team support. This contributes to morale, continuity and retention within the service. 4.8 Training completion was excellent, with staff competent in key areas including medication, moving and handling and infection prevention and control. Recruitment processes were also robust and supported safer staffing arrangements. 4.9 The inspection also noted effective governance and quality assurance arrangements, including supervision, practice observation, management Page 384
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oversight, competency checks and monitoring of continuity and performance data. These arrangements support continuous improvement and provide assurance that risk is being managed appropriately. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” The findings support the delivery of the Moray Integration Joint Board Strategic Plan, Partners in Care 2022 – 2032, by providing assurance that commissioned and directly delivered adult social care services are safe, person-centred, outcome-focused and subject to effective governance. The report also contributes to the Committee’s role in monitoring performance, quality and risk across integrated services. (b) Policy and Legal There are no new policy or legal implications arising directly from this report. The inspection provides assurance in relation to the service’s compliance with relevant care standards, safer recruitment expectations and statutory responsibilities for the delivery of registered care at home services. (c) Financial implications None directly associated with this report. (d) Risk Implications and Mitigation There are no new risk issues arising directly from this report. The inspection outcome provides positive assurance in relation to service quality, safe care delivery, medication practice, workforce stability and governance. Ongoing monitoring through existing quality assurance and performance arrangements will continue to support risk management and sustained improvement. (e) Staffing Implications There are no new staffing implications arising directly from this report. The inspection findings provide assurance that staffing levels are safe and stable, training compliance is strong and staff report feeling valued and supported. (f) Property None directly associated with this report. (g) Equalities/Socio Economic Impact An Equality Impact Assessment is not required as there are no proposed changes to policy, service design or eligibility arising from this report. The inspection findings indicate that the service is delivering person-centred care that supports individual needs, preferences, dignity and wellbeing. Page 385
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(h) Climate Change and Biodiversity Impacts No climate change or biodiversity implications arise directly from this report. The delivery of care at home across a rural geography remains sensitive to severe weather, transport disruption and wider system pressures; these matters continue to be managed through existing operational and business continuity arrangements. (i) Directions There are no directions arising from this report. (j) Consultations The following were consulted prior to the report being submitted: • Care at Home Steering Group • Social Work/Social Care Practice Governance Board • Head of Adult Services 6. CONCLUSION 6.1 This report provides the Committee with assurance on the outcome of the Care Inspectorate inspection of Moray Council’s Care at Home Service. The service was evaluated as Grade 5 – Very Good across both inspected quality indicators, reflecting significant strengths in person-centred care, safe practice, workforce capability, governance and positive outcomes for people. No new areas for improvement were identified and all previous areas for improvement have been met. Author of Report: Joan Hall, Team Manager, Care at Home Chris Milton, Performance Officer Background Papers: Available on request Ref: Page 386
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: COMMUNITY SUPPORT SERVICE INSPECTION REPORT BY: SERVICE MANAGER, PROVIDER SERVICES 1. REASON FOR REPORT 1.1 To update the Committee on the outcome of the unannounced Care Inspectorate inspection of Community Support Service and to provide assurance on the service’s strengths, progress against previous requirements and areas where improvement activity is continuing. 2. RECOMMENDATION 2.1 It is recommended that the Committee: i) consider and note the outcome of the Care Inspectorate inspection of Community Support Service, including the Good evaluation for wellbeing and Adequate evaluations for leadership, staffing and care planning; ii) consider and note the positive findings in relation to compassionate, respectful and person-centred support, improved medication practice, safeguarding arrangements and increased leadership visibility; iii) consider and note the areas for continued improvement, including quality assurance, staffing oversight, consistency of care planning and complaints learning, and the structured improvement activity now being progressed through Practice Governance arrangements; iv) consider and note the key improvement activity set out in Section 5, including strengthened complaints learning, staffing oversight, staff development, care planning, review arrangements and quality assurance; and Item 17. Page 387
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v) instruct the Service Manager for Provider Services to provide monitoring reports to Committee on progress against the performance improvement plan. 3. BACKGROUND 3.1 The purpose of this report is to ensure the Moray Integration Joint Board (MIJB) fulfils its ongoing responsibility to ensure effective monitoring and reporting on the delivery of services and on the programme of work as set out in its Strategic Plan. 3.2 The Care Inspectorate carried out an unannounced inspection of Community Support Service, with the inspection completed on 18 March 2026. 3.3 Community Support Service provides care at home and housing support to adults with learning disabilities and/or mental health conditions across Moray. At the time of inspection, the service was supporting 62 individuals within their own homes, with support focused on promoting independence, wellbeing and community engagement. 3.4 The inspection found that the service continued to deliver positive outcomes for people, particularly in relation to wellbeing, relationships and person-centred support. It also identified areas where further improvement is required to strengthen consistency, oversight and assurance. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 A summary of the Care Inspectorate’s evaluations for each inspected area of the service is noted in Table 1. The evaluation of Good for wellbeing provides positive assurance on the quality of direct support experienced by people. The Adequate evaluations identify areas where strengths are present but where further consistency and improvement are required. Table 1: Care Inspectorate evaluation outcomes Area Rating How well do we support people’s wellbeing? 4 – Good How good is our leadership? 3 – Adequate How good is our staff team? 3 – Adequate How well is our care and support planned? 3 – Adequate How well do we support people’s wellbeing? 4.2 The inspection found that people experienced kind, dignified and respectful care. Strong and trusting relationships were evident between staff and individuals, and feedback from people using the service and families was positive. 4.3 Support arrangements promoted choice, independence and inclusion, enabling individuals to participate in their communities and maintain their identity, beliefs and lifestyle preferences. Page 388
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4.4 The service demonstrated effective support for people’s health and wellbeing, including appropriate referrals to health professionals and support to attend appointments. Safeguarding processes were noted as robust, with staff confident in identifying and responding to risk. 4.5 Medication management has shown significant improvement, with strengthened procedures and more reliable delivery of medication in line with best practice. Previous requirements in this area have been met. Leadership, staff team and care planning 4.6 Leadership within the service has become more visible and accessible, with improved communication noted by staff and families. There is evidence of increased engagement with stakeholders and a more responsive management approach. 4.7 The service has taken steps to engage people and staff in improvement activity, including through surveys and feedback mechanisms. This provides a foundation for strengthening co-production and continuous improvement. 4.8 The inspection identified areas where further consistency is required. These include quality assurance and oversight, staffing deployment and monitoring, care planning accuracy and review arrangements, and complaints recording and learning. 4.9 The areas for improvement are recognised by the service and improvement work is already underway. The inspection noted a trajectory of progress, particularly in medication management, while confirming the need to embed more consistent systems and practice across the service. 5. KEY IMPROVEMENT ACTIVITY 5.1 The service has developed a focused improvement plan in response to the Care Inspectorate findings. The actions are being monitored through Practice Governance arrangements, with progress updates recorded against each area of improvement and oversight maintained by the service management team. 5.2 Improvement activity is strengthening complaints handling and organisational learning. A front-line resolution log has been introduced, with guidance and templates in place. Complaints and front-line resolution activity are now discussed through Practice Governance so that learning can be captured, shared and reflected within the Service Improvement Plan. 5.3 The service is improving staffing oversight and consistency of support through the use of reporting tools, including Looker and Birdie reports, to identify variance in staffing deployment, visit delivery and training compliance. These reports are reviewed through Practice Governance to support timely management action and provide stronger assurance that people receive planned care. 5.4 Staff development and supervision arrangements are also being strengthened. A Training Needs Analysis has been updated, staff training is being recorded electronically, and skills matching is being linked to individual care plans. A Page 389
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supervision tracker is in place, with first quarter supervision substantially progressed and outstanding sessions actively monitored. 5.5 Significant work is being undertaken to improve care planning, review arrangements and quality assurance. Individual support plans are being transferred to Birdie, audited as they are completed, and reviewed to ensure risk assessments, professional guidance, finance plans, decision-making information and support arrangements are accurate and current. As at 1 June 2026, 60 plans had been completed, with a small number remaining to be audited. 5.6 The action plan demonstrates positive progress across a number of areas, including complaints handling, care planning, staff supervision, review activity and quality assurance. Some actions remain in progress, particularly in relation to digital monitoring of visit delivery, medication competency assurance and the ongoing completion of care plan audits. These areas will continue to be monitored through governance arrangements until fully embedded. 6. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” The findings support delivery of the Moray Integration Joint Board Strategic Plan Partners in Care 2022 – 2032 by providing assurance on the quality and effectiveness of adult social care services that support independence, wellbeing and community inclusion. The report contributes to the Committee’s role in monitoring performance, quality and risk across integrated services. (b) Policy and Legal There are no new policy or legal implications arising directly from this report. The inspection provides assurance in relation to registered care at home and housing support services, while identifying areas where improvement activity is required to further strengthen compliance, consistency and governance. (c) Financial implications None directly associated with this report. (d) Risk Implications and Mitigation The inspection identifies moderate risk areas associated with inconsistent quality assurance systems, variability in staffing oversight and deployment, gaps in care planning accuracy and review processes, and the need to strengthen complaints recording and learning. These risks are recognised and are being addressed through ongoing improvement activity, leadership oversight and continued monitoring. (e) Staffing Implications There are no new staffing implications arising directly from this report. The inspection identified that while many individuals benefit from consistent staffing, variability in staffing levels has affected continuity of care in some Page 390
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instances. Recruitment activity and improved oversight of staffing deployment and digital monitoring systems are being progressed. (f) Property None directly associated with this report. (g) Equalities/Socio Economic Impact An Equality Impact Assessment is not required as there are no proposed changes to policy, service design or eligibility arising from this report. The inspection findings indicate that the service promotes person-centred support, choice, independence and inclusion for adults with learning disabilities and/or mental health conditions. (h) Climate Change and Biodiversity Impacts No climate change or biodiversity implications arise directly from this report. The delivery of community-based support across Moray remains sensitive to severe weather, transport disruption and wider system pressures; these matters continue to be managed through existing operational and business continuity arrangements. (i) Directions There are no directions arising from this report. (j) Consultations The following were consulted prior to the report being submitted: • Community Support Service management team • Social Work/Social Care Practice Governance Board • Head of Adult Services 7. CONCLUSION 7.1 This report provides the Committee with assurance on the outcome of the Care Inspectorate inspection of Community Support Service and the improvement activity now being taken forward. The service was evaluated as Good for supporting people’s wellbeing, reflecting positive outcomes, compassionate support and strong relationships with people using the service and their families. The inspection also recognised progress in medication management and improvements in leadership visibility and communication. While areas for continued improvement remain in relation to quality assurance, staffing oversight, care planning consistency and complaints learning, the service has established a structured improvement plan with governance oversight through Practice Governance arrangements. The improvement activity described in Section 5 provides assurance that the service is responding positively to the inspection findings, with progress already evident and further work continuing to embed consistent systems and practice across the service. Author of Report: Joan Hall, Team Manager Background Papers: Available on request Ref: Page 391
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 25 JUNE 2026 SUBJECT: SHORT TERM ASSESSMENT REABLEMENT TEAM (START) INSPECTION REPORT BY: SERVICE MANAGER, PROVIDER SERVICES 1. REASON FOR REPORT 1.1 To update the Committee on the outcome of the unannounced Care Inspectorate inspection of the Moray Council Short Term Assessment and Reablement Team (START), and to provide assurance on the quality, safety and effectiveness of the service. 2. RECOMMENDATION 2.1 It is recommended that the Committee consider and note the positive outcome of the Care Inspectorate inspection of the START Service, including the very good evaluations achieved across wellbeing, leadership and staffing, the good evaluation for care and support planning, and the continued progress made since the previous inspection. 3. BACKGROUND 3.1 The purpose of this report is to support the Moray Integration Joint Board’s (MIJB) ongoing responsibility to monitor the delivery, quality and performance of delegated services, in line with the Strategic Plan and associated governance arrangements. 3.2 Between 28 October and 4 November 2025, the Care Inspectorate carried out an unannounced inspection of the Moray Council START Service. The service provides short-term, reablement-focused support to adults and older people in their own homes across Moray, with a particular focus on supporting recovery, promoting independence and reducing longer-term reliance on care services. Item 18. Page 393
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4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The inspection outcome was positive and provides strong assurance regarding the quality of support delivered by the START Service. A summary of the Care Inspectorate’s evaluations is noted in Table 1. Table 1 Area Rating How well do we support people's wellbeing? 5 - Very Good How good is our leadership? 5 - Very Good How good is our staff team? 5 - Very Good How well is our care and Support Planned? 4 - Good How well do we support people's wellbeing? 4.2 The service received very positive feedback from people using the service and their families. People described care staff as ‘wonderful’, ‘marvellous’ and ‘smashing’, reflecting respectful, dignified and person-centred support. 4.3 Staff supported and encouraged people in ways that helped them regain skills, confidence and independence following illness, hospital discharge or a change in circumstances. This is consistent with the service’s reablement focus and contributes positively to outcomes for people. 4.4 Medication arrangements were found to be very good. Systems for storing, administering and monitoring medication supported safe practice while also respecting people’s abilities, choices and independence. How good is our leadership? 4.5 Leadership within the service was evaluated positively. Staff spoke highly of the support received from supervisors and the service manager, describing managers as approachable, helpful and responsive. 4.6 The service had developed a detailed and easy to follow action plan in response to the previous inspection. This provided a clear framework for improvement and demonstrated effective management oversight. 4.7 Quality assurance systems were found to be very good and supported effective monitoring of key areas of practice, including medication management, care reviews, staff support and wider service performance. How good is our staff team? 4.8 Staff had a comprehensive understanding of people’s needs and were enthusiastic about supporting people to gain more independence and control. The inspection highlighted the positive contribution of a confident, capable and stable workforce. 4.9 People benefitted from a well-trained staff team, supported by effective induction, supervision and access to learning and development. Page 394
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4.10 Staffing levels and rota arrangements were considered very good. Staff had sufficient time to provide safe, unhurried and meaningful support, which contributed to positive experiences for people using the service. How well is our care and support planned ? 4.11 Care and support planning had improved since the previous inspection. Where people required ongoing care, this was supported by individualised personal plans developed in partnership with people and, where appropriate, their families or representatives. 4.12 People were included in discussions and decisions about changes to their support, helping them to feel empowered and in control. The inspection noted that further strengthening of consistency and detail within personal plans would support continued improvement, and this will be taken forward through existing service improvement arrangements. 5. SUMMARY OF IMPLICATIONS (a) Corporate Plan and 10 Year Plan (Local Outcomes Improvement Plan (LOIP)) and Moray Integration Joint Board Strategic Plan “Partners in Care 2022 – 2032” The findings support the delivery of the Moray Integration Joint Board Strategic Plan Partners in Care 2022 – 2032 by providing assurance that registered care and support services are safe, person-centred, outcome- focused and subject to effective governance. The report also contributes to the Committee’s role in monitoring performance, quality and risk across integrated services. (b) Policy and Legal There are no direct policy or legal implications arising from this report. The report provides assurance on regulated service performance and supports the MIJB’s governance and monitoring responsibilities. (c) Financial implications None directly associated with this report. (d) Risk Implications and Mitigation There are no new risk issues arising directly from this report. The inspection outcome provides positive assurance regarding the quality and safety of the service. Areas identified for continued development will be progressed through existing quality assurance and service improvement arrangements. (e) Staffing Implications There are no staffing implications arising directly from this report. The inspection findings provide positive assurance regarding staff competence, stability, leadership support and workforce culture within the service. (f) Property None directly associated with this report. Page 395
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(g) Equalities/Socio Economic Impact An Equality Impact Assessment is not required as there are no proposed changes arising from this report. The inspection findings demonstrate that the service supports people in a person-centred way, with an emphasis on dignity, choice, independence and individual outcomes. (h) Climate Change and Biodiversity Impacts There are no direct climate change or biodiversity implications arising from this report. (i) Directions There are no directions arising from this report. (j) Consultations The inspection process included engagement with people using the service, families, staff and partner professionals. The findings in this report reflect the published Care Inspectorate inspection report. 6. CONCLUSION 6.1 The Care Inspectorate inspection of the START Service provides a positive and evidence-based assessment of service quality, leadership, staffing and outcomes for people. The service achieved very good evaluations in relation to wellbeing, leadership and staffing, and a good evaluation for care and support planning. The findings demonstrate a service with strong leadership, a skilled and committed workforce, effective quality assurance arrangements and a clear focus on supporting people to regain confidence, independence and control. The areas identified for continued development are incremental and will be progressed through established improvement arrangements. Author of Report: Joan Hall, Team Manager START Chris Milton, Performance Officer Background Papers: Available on request Ref: Page 396