Agenda Document Pack - Audit, Performance and Risk Committee - 24/09/2026
Moray Council · 24 September 2026
Back to Audit, Performance and Risk Committee — 24 September 2026 and its agenda
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Audit, Performance and Risk Committee Thursday, 24 September 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, 24 September 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 25 June 2026 5 - 12 4. Action Log of 25 June 2026 13 - 14 5. Quarter 1 (April 2026 – June 2026) Performance Report – Adult Services 15 - 30 6. Quarter 1 (April to June 2026) Performance Report for Children and Families and Justice Social Work 31 - 56 Page 1
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7. Internal Audit Section - Update Report 57 - 106 8. Internal Audit Section Completed Projects Report 107 - 122 9. Moray Integration Joint Board Draft Strategic Risk Register 123 - 152 10 External Auditors Report to Those Charged with Governance 153 - 216 11. 2025-26 Audited Annual Accounts 217 - 290 12. Corporate Assurance and Governance Group Update 291 - 296 13. Community Support Service Implementation Plan - Progress Report 297 - 308 Item(s) which the Committee may wish to consider with the Press and Public excluded 14. CONFIDENTIAL - Internal Audit Section - NHS Grampian Internal Audit Review [Para 6.2.5] • 7. Information relating to the financial or business affairs of any particular person (other than the authority). 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, 25 June 2026 Council Chambers, Council Office, High Street, Elgin, IV30 1BX PRESENT Councillor John Divers, Ms Sonya Duncan, Councillor Scott Lawrence, Mr Derick Murray, Ms Deborah O'Shea, Ms Judith Proctor, Mr Sandy Riddell, Mr Michael Ritchie IN ATTENDANCE Chief Internal Auditor; Interim Strategic Lead; Jillian Geddes, Team Manager Children’s Services; Social Work Service Manager; Team Manager for Care at Home and START; Angela Pieri, Grant Thornton and Caroline O'Connor, Committee Services Officer ALSO IN ATTENDANCE Mr Dennis Robertson 1. Chair The meeting was chaired by Councillor Scott Lawrence. 2. Declaration of Member's Interests Mr Murray stated for transparency, in relation to Item 9 "Unaudited Annual Accounts", that he was Chair of the NHS Grampian Audit and Risk Committee. The Board noted there were no other declarations of member's interests. 3. Minute of meeting of 26 February 2026 The minute of the meeting of 26 February 2026 was submitted for approval. Mr Riddell highlighted a typographical error in the first sentence of the second paragraph of Paragraph 8 of the Minute "Internal Audit Section Completed Projects Report" where the last word should be amended to read "managed" rather than "manager". Item 3. Page 5
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Subject to the amendment above, the Committee unanimously agreed the minute of the meeting. 4. Action Log of 26 February 2026 The Action Log of the meeting of 26 February 2026 was discussed and updated accordingly. 5. Quarter 3 and 4 (October 2025 – March 2026) Performance Report – Adult Services The meeting had before it a report by the Interim Corporate Programme Manager updating Committee on performance as at Quarter 4 2026 (January – March) including information relevant to Quarter 3 (October- December 2025). Mr Riddell referred to the Actions for Improvement relating to the declining absence figures in Staff Management detailed in para 4.15, many of which were voluntary and self-management orientated, however noted the findings of the audit demonstrated a significant lack of compliance with policies. He suggested management required to exercise grip and control to ensure staff were complying with policies in order to improve staff absence. In response, the Chief Officer agreed and advised concentrated work was being undertaken which would be reported through the operational performance management group and the absence management group to ensure accountability of progress and understanding of the pressures. As a follow up question and noting the importance of having key data, the Chair queries whether gaps in data that were responsible for a more preventative approach to long term absence being unable to be undertaken, especially with regard to stress and anxiety. In response, the Chief Officer agreed managers required to be empowered with accurate data to manage absence and understand areas where wellbeing and preventative measures could be applied and that the work through the operational performance group will provide data to be analysed at a strategic level, while also informing managers. In response to a question from the Chair asking if the rising readmission rates were related to the focus on delayed discharge, the Interim Strategic Lead advised investigation was ongoing however early indications were that community hospital discharges were not the cause. She further advised the figures had dropped slightly at the end of April but the details of the findings would be provided to a future meeting. Following consideration the Committee unanimously agreed to 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. 6. Quarter 3 and Quarter 4 (October 2025 to March 2026) Performance Report for Children and Families and Justice Social Work Page 6
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The meeting had before it a report by the Interim Chief Social Work Officer/Head of Service informing Committee on Children and Families and Justice Social Work performance for Quarter 3 and Quarter 4 (October 2025 to March 2026). In introducing the report and following discussion at the previous meeting regarding the length and level of detail contained within the report, the Team Manager, Children Services confirmed work was being undertaken to reduce the length and refresh the key performance indicators and the new template would used for future reports. In response to a question from Councillor Divers relating to whether Moray Health and Social Partnership has sufficient residential care setting places or if a lack of places is contributing to the numbers of out of area placements, the Team Manager, Children's Services advised capacity within Moray is being reviewed and, while recognising children have different and complex needs which may not be able to be supported within the community, the service were committed to keeping as many children within Moray as possible. The Chief Officer further advised the service required to ensure the majority of investment is through community models supporting children in their homes and communities wherever possible. Following consideration the Committee unanimously agreed to note:- (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. 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. Following consideration the Committee unanimously agreed to note the audit update. 9. Unaudited Annual Accounts The meeting had before it a report by the Chief Financial Officer informing Committee of the Unaudited Annual Accounts of the Moray Integration Joint Board (MIJB) for the year ended 31 March 2026. Mr Riddell referenced the substantial overspend referenced in Note 1 - Community Nursing of the Management Commentary in Appendix 1 in terms of the over reliance on bank staff due to vacancies and the impact of staff regrading and asked if the budget was constructed properly in terms of staff regrading or if that would result in an overspend on the budget going forward. In response, the Chief Financial Officer Page 7
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acknowledged the regrading had not been expected however work was underway to review the budget in detail and the budget would be realigned which would come to the next Committee. In terms of vacancies, the Chief Financial Officer confirmed recruitment was challenging however measures were in place to improvement recruitment which would reduce the requirement for bank staff. To provide further assurance the Chief Officer confirmed in addition to the community nursing budget being reviewed operationally in terms of grip and control, there was also a strategic approach being undertaken in terms of identifying savings related to interlinked aspects such as equipment and prescribing budgets to ensure efficiencies. In relation to Note 3 - Mental Health, Mr Riddell referenced a continued over reliance on agency locums in psychiatry however noted a report to today's Moray Integration Joint Board advised of appointments recently made and asked if there was confidence that overspend would significantly reduce in the short to medium term. In response, the Chief Financial Officer advised mental health was being reviewed Grampian wide through KPMG to ascertain if budgets can be realigned within Grampian. Following consideration the Committee unanimously agreed to note:- (i) 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) the updated Local Code of Corporate Governance which supports the Annual Governance Statement, in Appendix 2; (iii) the accounting policies applied in the production of the unaudited Annual Accounts, pages 48 to 49 of the accounts; (iv) the Annual Governance Statement contained within the unaudited Annual Accounts and in Appendix 3; and (v) the Best Value Statements as detailed in Appendix 4. Mr Ritchie joined the meeting during discussion of this item. 10. External Audit Plan for the Year Ending 2025-26 and Update on Recommendations from 2024-25 The meeting had before it a report by the Chief Financial Officer inform the Committee of the Auditor’s Annual Plan for 2025/26 and update on the recommendations following last years audit. Following consideration the Committee unanimously agreed to note the contents of the External Auditor's Annual Plan for 2025/26 and update on audit recommendations from 2024/25. 11. Internal Audit Annual Report - 2025-26 The meeting had before it a report by the Chief Internal Auditor providing 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 Page 8
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on which to base the internal audit opinion on the adequacy of the MIJB’s systems of internal control. Following consideration the Committee unanimously agreed to note the contents of the annual report as given as Appendix 1 to this report. 12. Moray Annual Performance Report 2025-26 The meeting had before it a report by the Chief Officer presenting Committee with the draft Annual Performance Report 2025/26. Following consideration the Committee unanimously agreed to:- (i) 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 approve the draft Annual Performance Report 2025/26 for publication by 31 July 2026, subject to the inclusion of the outstanding indicators. 13. Internal Audit Follow Up Review – Adult Social Care Commissioning The meeting had before it a report by the Chief Internal Auditor advising Committee on an internal audit follow-up review to evidence implementation of recommendations from an audit undertaken of Adult Social Care Commissioning. Mr Riddell expressed concern at the revised implementation date for Recommendation 16 and the procedures currently under review, despite being due for review in Recommendation 20, noting continued extension of deadlines was unsatisfactory. In response to the concern relating to Recommendation 16, the Social Work Services Manager advised the review was completed in February 2026 and the action for weekly discussion had now been added as a standing agenda item on the weekly agendas. The Chief Internal Auditor advised that the follow-up review had been undertaken to provide assurance over the implementation of recommendations arising from an audit completed by an external internal audit provider. As a result, the Internal Audit Service has no working papers available to support the original audit findings. However, following consultation with the Chief Officer, it has been agreed that this area will be considered for review again as part of a future Annual Audit Plan. Following consideration the Committee unanimously agreed to note the contents of the report. 14. Woodview Housing Support Service Inspection Report The meeting had before it a report by the Service Manager, Provider Services updating Committee on the outcome of the Care Inspectorate inspection of Woodview Housing Support Service and providing assurance on service quality, leadership, staffing, care planning, partnership working and improvement activity. Page 9
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Following consideration the Committee unanimously agreed to:- (i) 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) 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) 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. 15. Care Inspectorate Inspection Report - 16 Barlink Road Elgin The meeting had before it a report by the Service Manager, Provider Services updating 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 providing assurance on service quality, safety, governance, staffing and improvement activity. Following consideration the Committee unanimously agreed to 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. 16. Care at Home Inspection Report The meeting had before it a report by the Service Manager, Provider Services updating Committee on the outcome of the unannounced Care Inspectorate inspection of Moray Council’s Care at Home Service and providing assurance on service quality, governance, workforce stability and improvement activity. Following consideration the Committee unanimously agreed to 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; Page 10
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(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. 17. Community Support Service Inspection Report The meeting had before it a report by the Service Manager, Provider Services updating Committee on the outcome of the unannounced Care Inspectorate inspection of Community Support Service and providing assurance on the service’s strengths, progress against previous requirements and areas where improvement activity is continuing. Following consideration the Committee unanimously agreed to:- (i) 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) note the positive findings in relation to compassionate, respectful and person- centred support, improved medication practice, safeguarding arrangements and increased leadership visibility; (iii) 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) 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 (v) instruct the Service Manager for Provider Services to provide monitoring reports to Committee on progress against the performance improvement plan. 18. Short Term Assessment Reablement Team (START) Inspection Report The meeting had before it a report by the Service Manager, Provider Services updating Committee on the outcome of the unannounced Care Inspectorate inspection of the Moray Council Short Term Assessment and Reablement Team (START), and providing assurance on the quality, safety and effectiveness of the service. Following consideration the Committee unanimously agreed to 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. 19. Internal Audit Section – Completed Internal Audit Project - NHS Grampian [Para 6.2.5] Page 11
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The meeting had before it a report by the Chief Internal Auditor providing an update to Committee on the internal audit work completed on NHS Grampian systems ad practices. Following consideration the Committee unanimously agreed to note the audit update. Page 12
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MEETING OF MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE THURSDAY 25 JUNE 2026 ACTION LOG Item No. Title of Report Action Required Due Date Action By Update for 24 September 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 Now embedded in regular reporting. Action closed. 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 have been recalculated for Q1 2026/27 and are incorporated in the Performance Report. 3. Internal Audit Section Completed Projects Report 26/02/26 Update report on absence management to be prepared once work is completed to understand how to manage for all health and social care partnership staff. Chief Officer 4. MIJB Draft Strategic Risk Register 26/02/26 Schedule session to review the MIJB’s Risk Appetite Statement in light of funding partners funding challenges TBC Chief Officer / Sonya Duncan Delivered 20 August 2026. Action Closed. Item 4. Page 13
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Item No. Title of Report Action Required Due Date Action By Update for 24 September 2026 5. Q3 & Q4 Performance Report – Adult Services 25/06/26 Details of investigation findings into rising readmission rates to be provided to future meeting. TBC Jeanette Netherwood Addressed in the Q1 206/27 report. Action Closed. 6. Q3 & Q4 Performance Report – Children and Families and Justice Social Work 25/06/26 Graph 2 – JIIs & SCIM – share information with Committee on any actions undertaken by the service that have resulted in the improved figures. CSWO In progress. 7. Unaudited Annual Accounts Amendments to be made to Management Commentary:- i) Figure 2 graph on page 7 – 2020/2021 figures to be added to graph and 2021/2022 Q4 figures to be added ii) Performance section, fourth paragraph on page 9 – amend to reflect where report to MIJB/Committees once operational actions have taken place CFO Included in updated accounts. Action closed. 8. Moray Annual Performance Report 2025-26 Amendments to be made to Appendix A: Moray area profile:- i) Moray age profile table - amend to show correct figures for 0-14 year olds in Moray and Scotland. ii) Economic status – add emphasis to Moray being in first to third lowest wage economy in Scotland Jeanette Netherwood Completed. Report now published. Action Closed. Page 14
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 24 SEPTEMBER 2026 SUBJECT: QUARTER 1 (APRIL 2026 – JUNE 2026) PERFORMANCE REPORT – ADULT SERVICES BY: INTERIM STRATEGIC LEAD 1. REASON FOR REPORT 1.1 To update the Committee on performance as at Quarter 1 2026/27 (April – June). 2. RECOMMENDATION 2.1 It is recommended that the Committee scrutinises and notes: i) performance of the agreed local indicators during Quarter 1 (April - June 2026) and the revised performance targets and thresholds outlined in Appendix 1; ii) the analysis of indicators and the actions undertaken to address performance outside acceptable target ranges; iii) performance in national indicators published in July 2026, as detailed in section 4.35 to 4.39 and Appendix 2; iv) progress with the Strategic Delivery Plan, as detailed in section 4.40 onwards; and v) the Annual Performance report for 2025/26 was published by 31 July 2026 as required. 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. 4. KEY MATTERS RELEVANT TO RECOMMENDATION Item 5. Page 15
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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 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 thresholds. RED If Moray is performing worse than target and outwith agreed thresholds. Targets and Thresholds 4.2 The Scottish Government set targets for Delayed Discharges, Mental Health and Sickness absence which remain unchanged. For the remaining indicators, the target is set as an average of the previous calendar year. In order to match other national and local data sources indicator show the last month in the reporting quarter. Thresholds are green if equal or better than target, amber if above target but within 5% or red if above target by more than 5% unless otherwise stated. Summary of Previously Agreed Indicators 4.3 Performance within Moray Health and Social Care Partnership (MHSCP), as demonstrated by the trends in agreed indicators to the end of quarter 1 of the financial year 2026/27, 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 attendance 4.4 The rate has increased since Qtr 4 and is at the highest level since Qtr 1 2023. MHSCP have determined that the change is not being impacted by significant changes in population. Therefore, to understand why this increase is occurring the Partnership have commissioned Public Health Scotland to support with a deep dive into where people are originating from, for example self-referring, through GP or NHS 111, and if it is a specific cohort (male, female, age profile), reason for attendance and locality. This information will enhance understanding and identify any specific areas to focus on. Delayed Discharges A&E attendance rate per 1,000 population (all ages) Current Target Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Q1 2026/27 Status Short Term Trend Arrow Long Term Trend Arrow 20.8 22 22.1 21 19.6 21.9 23.7 Number of delayed discharges (including code 9) at census point. Current Target Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Q1 2026/27 Status Short Term Trend Arrow Long Term Trend Arrow 26 40 32 37 38 34 37 Page 16
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4.5 Delayed Discharges increased during the period levelling at 37 which is into the red threshold resulting in additional support and resource being directed to try to address any blockages. A significant issue is the lack of available care and care home placement available. 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 are being monitored by the Home Assessment Pathway (HAP) programme (see 4.8). 4.7 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, reducing admissions, length of stay and delayed discharges. Officially launched on 5 May 2026 with additional staff posts recruited to pathways 1- 3 have met or exceeded targets. Pathway 4 which is the community crisis pathway requires further development but is progressing. Service level agreements in place with GP practices and virtual wards created. Multi- disciplinary teams supporting reablement for those discharged from hospital for a period of up to 6 weeks. • Care at home sustainability –Recruitment remains a challenge for both internal and external partners, but efforts continue to address the gaps and improve sustainability. Use of flexible commissioning through Scotland Excel’s framework for external partners continues 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. • Further development of a collaborative commissioning approach for care at home with the intention of increasing the capacity of providers available in the area. Unscheduled Care and Home Assessment Pathway 4.8 The Scottish Government have a priority to reduce unscheduled care or “medical care you need urgently that cannot be planned or foreseen in advance, or that happens when normal GP surgeries are closed.” The redesign unscheduled care (USC) is focussed on three main themes of :- a. reducing admissions, b. reducing delays and c. reducing length of stay. The measures collated and reported to NSHG for onward reporting nationally are:- • 4-hour targets for Emergency Department Number of delayed discharges (including code 9) at census point. Current Target Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Q1 2026/27 Status Short Term Trend Arrow Long Term Trend Arrow Number of bed days occupied by delayed discharges (including code 9) at census point 850 1,149 1,015 1,217 1,141 1,004 1,311 Page 17
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• Ambulance stacking • Acute delayed discharges • Overall delayed discharges • Length of stay 4.9 Moray has been working on the Home Assessment Pathways (HAP) with focussed efforts on reducing length of stay through HAP 7 day working and domestic support and reducing delays through Discharge without delay (DWD) and discharge to assess (D2A) projects, with similar activity across the 3 partnerships, and performance reporting to the NHSG Unscheduled Care Board. 4.10 Community hospitals remain occupied at 100% capacity, with a clear path and prioritisation of people requiring beds from acute hospitals. The length of stay in community hospitals has shown a reduction overall during quarter 1. Length of stay (days) Figure 1 4.11 Pharmacy, occupational therapy and social work teams are working very successfully at present to facilitate discharges. Through the medication reviews, Pharmacy have identified savings of £3,313.44 for quarter one overall recurring. The supported discharges also ensure that any necessary equipment is identified when people are in their own homes and consideration for technology enabled care is made to ensure people are as safe and supported as possible. Hospital Readmission 4.12 Further investigation of Quarter 4 performance found and that the pattern was consistent with previous years and was expected to improve, as subsequent LOS Apr May June July Averages overall 54.77 52.93 53.00 48.42 Seafield 68.29 58.85 59.27 42.38 Stephen 51.89 59.44 64.00 65.27 Turner 34.38 36.00 38.88 36.56 % Emergency Readmissions within 7 days of discharge Current Target Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Q1 2026/27 Status Short Term Trend Arrow Long Term Trend Arrow 4.0% 3.9% 4.1% 4.1% 3.8% 5.2% 3.7% % Emergency Readmissions within 28 days of discharge 8.2% 7.4% 9.4% 9.2% 8.3% 10.4% 8.3% Page 18
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results have confirmed. It should be noted that a readmission may relate to a different clinical reason from the original admission. Readmission Rates Figure 2 4.13 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. Access to Psychological Therapies 4.14 The Scottish Government standard is for 90% of patients to begin psychological therapy within 18 weeks of referral. Performance improved from March to 56% in April and 48% in May, before falling to 26% in June. 4.15 The demand for mental health and primary care Psychological Therapies continues to increase and performance in this area is impacted both by funding and workforce availability. The figures collated cover both Primary and Secondary Care. Secondary care are meeting the 18-week referral to treatment target. Percentage of patients commencing Psychological Therapy Treatment within 18 weeks of referral Current Target Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Q1 2026/27 Status Short Term Trend Arrow Long Term Trend Arrow 90% 65% 60% 45% 50% 41% 26% Page 19
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Figure 3 4.16 However, Primary Care Psychological Therapies continue to perform well below the current target figure. There is now joint management of both parts of the service with work taking 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. There will be an 18-week lag in actions being undertaken and a resultant improvement, and MHSCP would therefore hope to demonstrate an improved performance in quarter 2. 4.17 Actions for Improvement • Review triage process for primary care • Continue to signpost to alternative supports • Group programmes and job planning aim to increase throughput and maximise capacity. Staff Management – NHS & Council 4.18 Both NHS staff and Council staff sickness absence remain above the target of 4%. Whilst the NHS staff sickness is reducing slowly the Council staff sickness has increased and further detailed investigations are underway. NHS Sickness Absence - % of hours lost Current Target Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Q1 2026/27 Status Short Term Trend Arrow Long Term Trend Arrow 4% 4.9% 5.9% 5.2% 6.8% 6.6% 6.1% Council Sickness Absence - % of calendar days lost 4% 8.2% 8.1% 8.1% 7.9% 8.5% 10% Page 20
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4.19 Short term absences (under 4 weeks) largely relate to colds/flu and gastro/intestinal issues across the workforce with long term absence causes being anxiety, stress, and other mental health illnesses or for operations/post operation care. 4.20 Council employed staff absences showed from Q1 2025/26 to Q1 2026/27 that days lost from sickness increased from 2934 to 3703 (769 days), most of these (666 days) were increases in “long term days”. Of the 3703 days absence, 69% (2554) related to long term days lost in Q1 2026/27. The absence due to depression, stress and anxiety increased by 375 days which is a 66% increase from Qtr 4 2025/26 to Qtr 1 2026/27. This is an area of concern for the Senior Management Team who are seeking to understand the root cause of the issue and take action to reduce. 4.21 The Moray HSCP trialled the “Emoodie” app for Council employed staff, which is intended to provide anonymous mental health support for staff and organisational analytics. However, uptake was low and the evidence of impact was inconclusive. 4.22 Actions for improvement • Heads of Service are working with Service Managers to proactively seek any areas they can support further to reduce the levels of sickness. • Vaccination campaigns are actively encouraged across all staff groups to reduce severity and duration of illness. • A single point of access for relevant information and support for Staff Wellbeing, maintained by Health Improvement Team, continues to be promoted throughout the organisation and its partners. • A Staff Wellbeing Network is now established and a Managers Pledge, endorsed by SMT, has been introduced to promote compassionate leadership and strengthen support for staff wellbeing, resilience, and access to practical resources. • 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 4.23 The processes for collation of data are well embedded and will provide a sound basis for future decision making. Pathways are in place, and updates to assessments have been implemented to capture individual’s SDS option accurately. Self-Directed Support – Option 1 Q4 2024/25 Q1 2025/26 Q2 2025/26 Q3 2025/26 Q4 2025/26 Q1 2026/27 Status Short Term Trend Arrow Long Term Trend Arrow Data only 283 293 309 341 330 Self-Directed Support – Option 2 Data only 302 323 332 308 314 Self-Directed Support – Option 3 Page 21
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Self-Directed Support – Option 1 4.24 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. 4.25 There is a continued shift from SDS Option 3 to Options 1 and 2 and this is in line with the Partnerships’ strategic aim to ensure people have access to the full range of SDS options. However, there is a risk that some people may be choosing this option because of difficulties accessing support through other routes. The Partnership are continuing work to establish recording of preferred options in a manner that enables more definitively and through analysis, so the Partnership can confirm 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. 4.26 At the end of Quarter 1, approximately 400 Personal Assistants were employed through SDS Option 1 arrangements in Moray, delivering a range of tailored supports including personal care, community participation, and replacement care to enable unpaid carers to access breaks from caring responsibilities. Personal Assistants continue to play a significant role in supporting people to achieve personal outcomes and maintain independence within their local communities. 4.27 Moray SDS Team continues to participate in the national My Job Scotland Personal Assistant recruitment initiative and is one of fifteen organisations using the platform as the primary route for advertising vacancies. This approach supports a more visible and consistent recruitment process and contributes to wider efforts to strengthen the Personal Assistant workforce. 4.28 During the reporting period, recruitment activity facilitated by the SDS Team resulted in 372.5 hours of Personal Assistant support being secured, alongside the recruitment of additional relief staff. This reflects ongoing efforts to build workforce resilience and increase the availability of flexible support options for individuals choosing SDS Option 1. Unmet Need Overview and Analysis 4.29 The number of people assessed and waiting for a package of care increased in this quarter (figure 4 below), as did the number of hours of care yet to be provided. This reflects a combination of increasing demand for care at home services, workforce and provider capacity challenges, and the growing complexity of care needs, resulting in demand exceeding the capacity available to deliver support. Self-Directed Support – Option 2 Data only 1,410 1,435 1,376 1,347 1,283 Page 22
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Figure 4 4.30 Regular information gathered from all Care at Home providers is used to monitor levels of provision, workforce capacity, and service pressures across Moray. This supports ongoing management of unmet need, enables emerging issues to be identified early and informs actions to maximise available capacity and prioritise care delivery. 4.31 Figure 5 shows the number of hours of care assessed but not provided and shows there was a peak in December that has been reduced and is sitting slightly below the position at Qtr 4 last year. Figure 5 4.32 For some people, the length of time waiting for care can be significant. At the end of Qtr 1 29.7% of people (58 of 195) had been waiting for more than six months. All individuals on the waiting list are reviewed regularly to ensure risks are identified and managed appropriately. Prioritisation of available capacity is based on assessed need and risk, with daily oversight by senior managers. 4.33 Care at Home teams continue to improve efficiency by consolidating rotas and reducing unfilled runs, which occur when no carer is allocated and overtime is needed to maintain service delivery. Due to contractual requirements for Social Page 23
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Care Assistants, these changes require a 28-day implementation period. Alongside these efficiency measures, recruitment activity is ongoing within approved budgetary limits to increase workforce capacity where possible. As rota changes are embedded and newly recruited staff become established in post, the service is expected to be in a stronger position to take on additional care packages and reduce unmet need. Unpaid Carers 4.34 The Carer census information is being collated for submission, and a quarterly report has been developed for review by the Carers steering group, which will be presented to this Committee in the next quarter. There is now a clear pathway for unpaid carers to which performance information is aligned that will aid future reporting to this Committee in quarter 3 to allow for sufficient information to be collated. National Indicators 4.35 The national performance indicators were published in July and were included in the MHSCP Annual Performance Report as shown in Appendix 2. The performance of MHSCP was above the Scottish average for 14 of the 19 reported indicators for this reporting period. This was an improvement from the previous reporting period where 8 indicators were above the Scottish average. 4.36 National indicators 1-9 based on Health and Care Experience (HACE) survey results conducted October to December 2025 regarding previous 12 months so responses will reflect part 2024/25 and 2025/26. The survey response rate for Moray was particularly good at 29% whilst the Scottish average was 19%. 4.37 Moray is placed top for indicator 1 “Percentage of adults able to look after their health very well or quite well”, and above Scottish average and maintaining our position in relation to other partnerships for other indicators with the exception of indicator 6 “Percentage of people with positive experience of care at their GP practice”, which is just slightly below. Indicator 8 “Percentage of carers who feel supported to continue in their caring role” is below Scottish average but is following the trend line, and the Partnership are anticipating an improvement following the allocation of dedicated Social Work resource during 2025. Indicator 9 “Percentage of adults supported at home who agree they felt safe” has shown a significant improvement in both our performance and position, moving from below Scottish average to above. 4.38 There are caveats around the completeness of data for indicators 11-19 as detailed in the annual performance report page 69, so these figures are not the final financial year results, however Moray is performing very well for indicators 12-16 in relation to other Partnerships and the Scottish average. 4.39 Indicator 17 “Proportion of care services graded “good (4) or better in Care Inspectorate inspections” has shown a significant improvement from 73.8% to 86.2% and now in the top third of partnerships as opposed to the bottom third in previous years. Page 24
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Strategic Delivery Plan Updates 4.40 There are 69 actions identified in the Strategic Delivery plan 2025-28. At the end of June 2026, progress updates indicated that 56% of actions were either complete or on track for delivery. As shown in Table 1 below, 16 actions had been completed and a further 22 were progressing in line with planned timescales. The remaining 31 actions were underway but experiencing delays for a variety of reasons, including dependencies on collaborative work with partners across Grampian. Strategic Delivery Plan Progress Strategic Theme Complete On target Progressing Total Building Resilience 4 3 16 23 Home First 4 9 3 16 Partners in Care 3 4 7 14 Strategic Leadership, Planning & Performance 5 6 5 16 16 (23%) 22 (32%) 31 (45%) 69 Table 1 4.41 A number of actions are fully completed, particularly in relation to prevention, building community capacity and integrated working. Annual health checks for people aged 16+ with a learning disability have been embedded as business as usual, while engagement with the third sector and people with lived experience is now fully embedded within commissioning processes. Community resilience has also been strengthened through ongoing support for local wellbeing groups, including Be Active Life Long (BALL) and Sing, Exercise and Team (SET) groups, helping people to remain active, connected and independent within their communities. In addition, multidisciplinary team mapping and implementation has been completed across Moray, supporting more coordinated and integrated service delivery. 4.42 Significant progress has also been achieved in strategic development and infrastructure. Learning disability accommodation programmes have successfully increased local housing capacity and enabled people to return from out-of-area placements, while older people's supported accommodation requirements have been incorporated into the Local Housing Strategy. Technology Enabled Care Analogue to Digital programme has reached the final phase with a target completion of November 2026. Volunteer development has exceeded expectations, with over 250 volunteers now contributing across health and social care services. The Quality Assurance Framework is now embedded through regular audit activity, and the Financial Recovery Plan has been approved alongside a medium-term financial plan, providing a stronger foundation for sustainable service delivery. 4.43 The Strategic Delivery Plan is currently being reviewed and refreshed to ensure that actions, timescales, and delivery arrangements remain realistic and achievable. Learning from progress during 2025/26 has highlighted the need to allow additional time for partnership discussions and decision-making processes, as well as ensuring governance requirements are fully reflected in future planning and delivery schedules. Page 25
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4.44 As work progresses on the refresh of the strategic plan, (report to the Board 24/9/26), the Strategic Delivery Plan for 2025-2028 will need to be reviewed and refreshed to ensure the actions and targets align appropriately. Learning from 2025/26 actions and timescales has highlighted the need to allow additional time for partnership discussions and decision-making processes, as well as ensuring governance requirements are fully reflected in future planning and delivery schedules. 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. (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. Page 26
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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 27
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APPENDIX 1 Page 28
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APPENDIX 2 National performance Indicators 1-9 based on Health and Care Experience Survey (HACE) during October to December 2025 for year 2025/26 Page 29
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National performance Indicators 11-20 * 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 30
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 24 SEPTEMBER 2026 SUBJECT: QUARTER 1 (APRIL TO JUNE 2026) PERFORMANCE REPORT FOR CHILDREN AND FAMILIES AND JUSTICE SOCIAL WORK BY: 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 1 (April to June 2026). 2. RECOMMENDATIONS 2.1 It is recommended Committee scrutinises and notes: i) the performance of local indicators for Quarter 1 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: Item 6. Page 31
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• Child Protection activity • 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 Child protection activity remained at a high level during the quarter, requiring a coordinated multi-agency response; 17 children were removed from the Child Protection Register following a significant reduction in assessed risk. Looked After Children 4.6 Scotland’s shortage of suitable care placements continues to present significant operational, financial and safeguarding pressures, particularly for children with complex needs and larger sibling groups. 4.7 Moray continues to prioritise family-based and local care, with 75% of looked after children and young people supported in family settings and 73% of brothers and sisters living together. 4.8 Local residential provision remains fully utilised, caring for 14 children, while 21 children and young people require out-of-area residential placements. 4.9 Demand for transition support has increased, with 65 young people receiving Through Care and After Care services, including 19 supported through Continuing Care. 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). 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. Page 32
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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 4.14 Commissioned prevention and early intervention services supported 136 children, young people and families, with positive outcomes in wellbeing and family relationships. 4.15 Out-of-area care accounted for 64% of commissioned expenditure, highlighting continued demand and significant financial pressure 4.16 The successful personal outcomes pilot will be implemented across Children’s Social Work from July 2026, strengthening outcome-focused planning and reporting. 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 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. Page 33
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(j) Consultations Children, Families and Justice Social Work Senior Management Team. 7. CONCLUSION 7.1 This report provides the MIJB with an overview of the performance of specified local and National indicators. Author of Report: Stephen Morgan, Chief Social Work Officer/Head of Service Background Papers: Appendix 1 Page 34
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APPENDIX 1 1 | P a g e CHILDREN, FAMILIES AND JUSTICE SOCIAL WORK – QUARTER 1 (APR TO JUN 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 3 WHICH IS LATEST AVAILABLE DATA (FEB TO APR 2026). Child Protection Throughout CPQ 3 there were 332 contacts, enquiries and referrals to the Access Team for 304 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 CPQ 3, 56 children were involved in 37 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 CPQ 3, physical assault (32%) 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). Ten ICPPMs were held, and 23 Joint Investigative Interviews (SW & Police) were requested as decision of IRD. Graph 2 below shows the trend across 0 50 100 150 Feb-26 Mar-26 Apr-26 98 122 11288 117 99 REFERRALS RECEIVED BY ACCESS TEAM - 2026 Referrals: No. in last month Referrals: No of children Physical Assault, 18 Sexual Assault, 10 Domestic Abuse, 12 Other reason, 1 Child Criminal Exploit, 2 Drugs, 4 Mental Health, 1 Neglect , 6 Emotional abuse, 2 Q3 - Main Reasons for IRD Page 35
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APPENDIX 1 2 | P a g e 2025/26 for Joint Investigative Interviews (JIIs) and Scottish Child Interview Model (SCIM) investigative interviews: Graph 2 – JII & SCIM Graph 3 below shows the trend since Q1 2025/26 to Q3 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 Q3, 10 Initial and Pre-birth CPPMs were held for 14 children, 93% of whom were placed on the Child Protection Register, while 17 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 safe by multiagency planning, coordinated support, regular review, and evidence-based means of risk 7 6 5 11 7 5 7 6 5 11 7 5 0 0 0 0 0 0 7 6 5 11 7 5 0 5 10 15 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 Apr-26 JII & 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 23 20 1412 14 10 0 5 10 15 20 25 Q1 Q2 Q3 Aug-Oct Nov-Jan Feb-Apr 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 36
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APPENDIX 1 3 | P a g e 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, quarter 3, 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, 14 Child experiencing mental health problems, 1 Domestic Abuse, 13 Emotional Abuse, 38 Neglect, 29Other Concern(s), 9 Parental Alcohol Misuse, 8 Parental Drug Misuse, 15 Physical Abuse, 23 Services Finding It Hard to Engage, 12 Sexual abuse, 9 Q3 - Child Protection Registration Concerns Page 37
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APPENDIX 1 4 | P a g e The following section reports against the financial quarter (Apr - Jun 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 started to decline by end of Q4 into the beginning of Q1 but has started to slowly increase towards the end of Q1. Graph 3 below shows the number of children looked after at home and away from home at the end of Q1: Graph 3: Number of children looked after away from home and at home Overall, 44% of children were in care at home or kinship care, while 56% were in foster care, residential care, supported lodgings, or supported accommodation. Most foster households are provided by Moray carers rather than independently. Compared with Q4, 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. A significant majority of young people are cared for in family-based care (121, 75%) rather than residential care, including short breaks (41, 25%). At the end of quarter 1, 73% of brothers and sisters are living together. This a slight reduction from the previous quarter and equates to one family group. 172 164 164 161 166 168 155 160 165 170 175 Jan-26 Feb-26 Mar-26 Apr-26 May-26 Jun-26 LAC - AWAY FROM HOME & AT HOME Page 38
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APPENDIX 1 5 | P a g e The Maintaining Relationships Guidance continues to be embedded into practice across services. A new Pathways Assessment has been agreed, which includes a dedicated section to identify, record, and support young people's networks and relationships. This strengthens the focus on maintaining connections with important adults and support networks as young people transition through key stages of their journey. At the end of Q1, Moray had 37 foster households, with 78% actively caring for a child. The presence of five households providing short breaks demonstrates the continued importance of flexible, specialist support within the overall fostering resource. Graph 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 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 36 40 41 39 37 29 36 37 37 29 0 10 20 30 40 50 Q1 Q2 Q3 Q4 Q1 2025/26 2026/27 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) 28 35 35 35 36 36 36 32 31 30 28 29 29 31 23 23 24 23 23 23 26 26 25 23 22 21 7 6 8 10 12 12 12 14 13 13 13 16 17 0 20 40 60 80 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 Apr-26 May-26 Jun-26 KINSHIP CARE SETTINGS Kinship: No. of households providing Kinship Placements Kinship: No. of Children in Approved Placements Kinship: No. of Children in Pre-Approved Placements Page 39
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APPENDIX 1 6 | P a g e 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 21. The graph below does not include young people supported through continuing care. The graph below shows the pattern of internal and OOA care from June 2025 to June 2026 by care setting: Graph 6: Residential Care settings On 30 June 2026, 65 young people were receiving support from the Through Care and After Care team (TCAC), including 19 young people in Continuing Care which is likely to increase due to the increased flow- into care. The increase is in After Care and this is due to natural progression due to age. The service provides support in three distinct areas: • 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 June 2025 to June 2026: Graph 7: Through Care, After Care and Continuing Care 11 11 11 10 10 11 13 11 10 10 8 12 11 10 12 18 18 21 19 18 21 29 27 33 28 23 20 21 21 21 0 10 20 30 40 50 Apr-25 May-25 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 Apr-26 May-26 Jun-26 RESIDENTIAL CARE SETTINGS Residential Care in Moray Residential Schools or Out of Area Placements Source: LAC List - Monthly 37 29 30 31 30 37 33 32 31 27 24 26 27 24 13 15 16 14 17 17 13 10 12 15 17 19 13 10 12 12 14 16 16 17 17 17 20 19 19 0 5 10 15 20 25 30 35 40 Jun-25 Jul-25 Aug-25 Sep-25 Oct-25 Nov-25 Dec-25 Jan-26 Feb-26 Mar-26 Apr-26 May-26 Jun-26 THROUGH CARE AFTER CARE & CONTINUING CARE TCAC: Open as Through Care TCAC: Open as Aftercare TCAC: Open as Continuing Care Page 40
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APPENDIX 1 7 | P a g e Youth Justice Nationally, care experienced young people (CEYP) are overrepresented in the Scottish Justice System. At the end of FQ1, 9.75% 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 there have been no significant sustained increases. 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 continues to be 15 years old and at the end of FQ1 with most of the work being with children aged 11 to 15 year. This is undertaken in a multi-agency way, working closely with key partners such as Police Scotland, education services and our local children's houses. At the end of FQ1, most individuals supported by Youth Justice were males accounting for over 80% of children and young people supported by the service which is consistent with numbers from the previous Quarter. The graph below provides the ages of young people involved with Youth Justice services from January to June 2026: Graph 9: Age of children in Youth Justice 492 489 492 456 488 492 37 38 39 35 55 487.5 7.7 7.9 7.6 11.2 9.75 0 200 400 600 Jan-26 Feb-26 Mar-26 Apr-26 May-26 Jun-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) 0 0 0 0 1 1 26 26 30 24 27 32 10 11 19 9 14 13 1 1 2 7 4 2 37 38 51 40 46 48 0 10 20 30 40 50 60 Jan-26 Feb-26 Mar-26 Apr-26 May-26 Jun-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 41
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APPENDIX 1 8 | P a g e Justice Social Work Services The graph below shows the number of reports submitted on time and the number of people to whom they applied during FQ1. There has been a very slight increase in the number of reports completed then the previous quarter and a consistency in the target of 100% being met: 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 FQ1 there were nine DTTOs in process which involves at least two appointments per week for testing and supporting identified needs. 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. There is no significant variation between the number of requests for assessment or imposition of bail supervisions orders between FQ4. The graph below shows Court requests, the number of people, and the numbers of bail supervision which commenced from Q4 to Q1 2026: Graph 11: Bail supervision FQ1 has seen a slight decrease in Community Payback Orders (CPO) since the previous quarter. There is a target for individuals made subject to a CPO to be seen within seven days of an Order being imposed. FQ1 shows the number meeting this target has dropped significantly and there is scrutiny of these cases being undertaken to provide a rationale for this. Initial findings suggest there is an element of inaccurate recording which will be addressed through staff supervision. 120 129 103 112100 100 0 50 100 150 Q4 Q1 JUSTICE SOCIAL WORK REPORTS (JSWR) - SUBMITTED ON TIME No. Social Enquiry Reports submitted on Time No. of People % of Reports on time 42 40 10 129 11 0 10 20 30 40 50 Q4 Q1 2026/27 Bail Supervision No. of requests from Court for Bail Supervision No. of Bail Supervision cases commenced No. of individuals commenced with Bail Supervision Page 42
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APPENDIX 1 9 | P a g e The graph below provides the number of new CPOs with supervision requirements and people seen in seven days of the Order imposed from FQ1 2025 to FQ1 2026: Graph 12: Community Payback Orders with supervision requirement 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. 69 48 56 60 5558 43 51 55 39 Q1 Q2 Q3 Q4 Q1 2025-26 2026/27 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) I found it quite therapeutic having a safe place to talk and work on issues I feel I've been a great help in the community It has made me realise I have a lot to lose and that it is not worth losing my life & family Page 43
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APPENDIX 1 10 | P a g e 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. Information contained in exit questionnaires include: Learning what is and isn’t okay and how to deal with these situations helped me get into my community more and be positive Better able to manage emotions. Not as easily led. Don’t want to get into any more trouble Page 44
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APPENDIX 1 11 | P a g e Contracts and Commissioning Personal outcomes project update In July 2025, the CSWO requested that performance reporting in Children’s Social Work move towards people outcomes. People outcomes are things that matter to children and young people, aligning with SHANARRI indicators. Following initial exploration of options and comprehensive consultation with senior managers within Children’s Social Work in September, a pilot was agreed to take place between Nov 2025 and January 2026. 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. Given the success of the pilot, full-scale implementation has been agreed to take place from July 2026. Children and Families and Justice Social Work Commissioning The Children, Families and Justice Social Work Commissioning Team oversees seven commissioned service areas supporting children, young people, families and carers across Moray. During FQ1, expenditure continued to be dominated by out-of-area (OOA) care placements, which accounted for 64% of total commissioned spend. This reflects ongoing pressures associated with increasing numbers of children entering care and the complexity of need. Across commissioned services, performance data and stakeholder feedback demonstrate positive outcomes for children, young people and families, particularly in relation to advocacy, family relationships, emotional wellbeing and maintaining children within family settings where safe and appropriate. 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 Page 45
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APPENDIX 1 12 | P a g e 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: Percentage spend across Service Areas Family support services Family support services, accounting for 11% in FQ1 2025/26 to 7% of the spend in FQ1 2026/27, comprise: 1. The independent advocacy service (1%) 2. Three support services for prevention and early intervention (support & assistance) (6%): 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 FQ1 2026/27 there was a total of 88 new referrals (combined young people, carers, parents and siblings) to the service, this is a significant increase which is demonstrated from October 2023, as illustrated in the graph below: Page 46
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APPENDIX 1 13 | P a g e Graph 14: Referral rates for Independent Advocacy 2023 - 2026 The increasing caseload highlights both the demand for advocacy support and the importance of ensuring children and families have their views represented in decision-making processes, as illustrated in the graph below: Graph 15: Young People being actively supported The advocacy team attended a wide range of professional meetings, ensuring that children, young people and families were able to contribute to decisions affecting their lives and have their views represented effectively. The graph illustrates the volume and types of meetings attended in FQ1: Page 47
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APPENDIX 1 14 | P a g e Graph 16: Meetings supported in Professional Service Areas 2. Prevention and early intervention services The three prevention and early intervention services supported 136 children, young people and families during FQ1, demonstrating sustained demand for preventative support. These services contribute to reducing escalation of need and helping families remain safely together wherever possible. 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 for this quarter indicates that: • 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: FQ1 SHANARRI indicator Scores Page 48
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APPENDIX 1 15 | P a g e In this quarter Aberlour Youth Point finished their support with 7 young people and their families. As illustrated on the chart below, the average outcomes for these young people included improvements in the self-assessed areas of SHANARRI. 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 reinforces the positive outcomes demonstrated through performance data: “I’ve never had a positive role model in my life. Having support from you has given me that for the first time” – Young Person, 22/04/2026 “Thank you for your support in the child planning meeting. I feel you are the only person who talked about us as a family” – Parent, 02/05/2026 “Thank you so much for all the work you have done with T*. Parents have expressed how amazing your support has been for her and how well she has been doing” – Social Worker 11/06/2026 Overall, outcomes data and stakeholder feedback demonstrate that the service continues to improve wellbeing, resilience and engagement for young people facing complex challenges. Page 49
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APPENDIX 1 16 | P a g e 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. Positive qualitative feedback corresponds with the impact identified above; as indicated by the quotes below; “1-1 sessions are beneficial; it is helping me build my confidence back” – Parent, April 2026 “I was worried about you visiting, I wasn’t sure how to act around you, but you have made me at ease and I can be myself with you” – Parent, 22/05/2026 “Thank you for being the biggest support to our family. If it wasn’t for you I don’t think we would of managed as much as we did” – Parent 21/05/2026 “Thank you so much for organising funding to fund for sensory items for family, it has made such a difference to them” – Social Worker, 12/06/2026 Nine families completed their time with Children First during this quarter, all 9 families demonstrated positive progress with total scores increasing by 87 points overall, this is demonstrated below through comparison of each family’s initial score with their final score. Their average improvement was 9.7 points per family, with 2 families achieving the largest increases of 12 points improvement each. The individual family scores can be seen in the table and chart below: The average pre and post scores are demonstrated in the chart below: Family Total Start Score Total End Score Total Increase 1 3 13 10 2 5 12 7 3 3 11 8 4 3 13 10 5 3 14 11 6 3 9 6 7 4 15 11 8 4 16 12 9 4 16 12 TOTAL 32 119 87 6 7 8 10 10 11 11 12 12 0 2 4 6 8 10 12 Family 6 Family 2 Family 3 Family 4 Family 1 Family 7 Family 5 Family 9 Family 8 Total Impact per Family Total Incease per Family Page 50
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APPENDIX 1 17 | P a g e The service continues to deliver both practical and emotional support, helping families strengthen relationships, improve financial resilience and prevent escalation of need. 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, 8 families are receiving support through this service. Seven families completed their involvement in FQ1. 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 exceeded the clinical threshold across all measured outcome domains, indicating meaningful improvements in family functioning, emotional wellbeing and communication for families completing the programme. Bar Chart 1: Clinical Outcome Measures Positive qualitative feedback corresponds with the impact identified above; as indicated by the quotes below: “You’re so clever! Why did I not see this before? I’m so glad you came around because you just explain everything to me and it makes so much sense!” – Parent 10/04/2026 “I am definitely feeling better and able to do so much more – I was stuck” – Mum, 13/04/2026 “My mum smiles” – Younger sibling, 20/04/2026 “I am going to miss working with you and the FFT team you all provide a wonderful service and make a huge difference to the lives of families we support… I will 100% be singing FFT’s praises from the rooftop, with my new team” – Social Worker, 05/06/2026 “Finally, I have somebody who just gets me. I don’t think I’m going mad anymore!” Young person, 07/05/2026 “I really like talking to you because I feel like you really understand me” – Young person, 26/05/2026 Overall, outcome measures and feedback indicate that FFT continues to deliver meaningful improvements in family relationships, communication and emotional wellbeing, supporting children and young people to remain safely within their family networks. Page 51
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APPENDIX 1 18 | P a g e Support for Unpaid Carers Delivered by Quarriers, this service accounts for 3% of the total expenditure under the Children, Families & Justice Service Commissioning Team, and fulfils statutory obligations under The Carers (Scotland) Act 2016. 1,085 adults and 165 young carers are registered as actively engaging. Positive qualitative feedback corresponds with the impact identified above; as indicated by the quotes below: - From Adult Carers: “Without Quarriers here to pick us up when we are going through difficult times. I have no idea, certainly from my point of view, how I’d cope. Plus, all the various meetings, counselling, mediation etc. you offer to assist our caring roles” – Adult Carer, 09/04/2026 “Thank you so much, I can’t tell you how much I appreciate your call” – Adult Carer, 21/05/2026 “Without Quarriers I don’t know how my mental health would be” – Adult Carer, 11/06/2026 - From Young Carers: “I just wanted you to know I got accepted for the young carers grant, I have received the payment and put it towards my car” – Young Carer, 14/04/2026 “I enjoy talking to you, you let me know it’s ok to have feelings” – Young Carer, 21/05/2026 “I am really enjoying the resilience work, it is showing me that I am a positive person” Young Carer 26/06/2026 “Thank you for checking in on me. I am doing okay just now; I appreciate you reaching out” – Young Carer 31/05/2026 Out of area care via Scotland Excel and Moray frameworks Spend remains predominantly driven by out-of-area care which accounts for 64% 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 1% compared with FQ4, indicating continued demand for higher-cost provision. Out of area care is provided to: ✓ 20 young people in residential care commissioned through the Scotland Excel Residential framework; this is an increase of 2 from FQ3 ✓ 10 young people in residential care with 3 providers commissioned via Moray frameworks ✓ 9 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 9% 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. Regular contract monitoring confirms the service continues to provide stable, high-quality care, supporting young people to maintain family relationships, participate in their local communities and achieve positive individual outcomes. Children with a Disability – Residential Services The Scotia residential service, accounting for 8% of the spend, is delivered by Aberlour Childcare Trust in Alba Place, Elgin. Currently, three young people benefit from this service. Page 52
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APPENDIX 1 19 | P a g e 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 3% 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. Speaking about their daughter “she really loves her time in Alba, and it’s one night I can relax knowing she is safe” – Parent, 28/05/2026 Group Activities A total of 33 sessions were delivered during this period, comprising 66 hours of service delivery through term time sessions, holiday and weekend sessions provided across 2 locations in Moray, with plans to expand as referrals from other localities increase. Parents report high levels of satisfaction, with young people benefiting from social opportunities and structured activities, as evidenced in the quotes below; • “Excellent service and we are very grateful” – Parent, April 2026 • “I made a friend” – Young Person, April 2026 • “Thank you for my picnic and taking me to the park” – Young person, June 2026 Overall, commissioned children's services continue to demonstrate positive outcomes for children, young people, families and carers across Moray. Performance information and stakeholder feedback indicate that services are effectively supporting wellbeing, strengthening family relationships and helping to prevent escalation of need. However, the continuing demand for out-of-area residential placements remains a significant financial pressure, reinforcing the importance of investment in preventative and local service provision. New procedures In quarter 1, a new and a revised procedure have been completed and disseminated. The Significant Occurrence Procedure was introduced to assist Moray Social Work Services staff in reporting and recording significant occurrences in their service. The Procedure does not outline how to respond to or manage significant occurrences; rather, it aims to provide reassurance to senior Page 53
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APPENDIX 1 20 | P a g e management. Self-evaluation activity undertaken by the Policy, Development and Commissioning Team pointed to some weaknesses that were mitigated via the revision. The Life Story Procedure sets out Moray’s approach to life story work with looked after and accommodated children and young people. Life story work is an ongoing, child centred process involving everyday conversations as well as life story books, memory boxes and, where applicable, later life letters. The procedure details responsibilities and practice expectations intended to support consistent gathering, recording and safe storage of important life story information, and to help children and young people understand their history, identity and current circumstances. Both of these procedures are available on interchange. Training and development Children’s Social Work Development Plan 2026-2027 Children’s Social Work workforce came together within the Learning from Practice event in March 2026 to reflect on the developments over the last few years: celebrate achievements and plan for next steps. Progress includes stronger assessment practice, greater focus on children, young people and families’ voices, clearer procedures, quality assurance activity, support for newly qualified staff and improved structures for reflection and learning. Key risks are inconsistent implementation, variable communication, limited capacity and uneven visibility of children’s, young people’s and families’ voices in assessment, planning and decision-making. In line with the above the 2026–2027 priorities, summarised in the Learning from Practice report and plan, focus on outcome-focused evaluation, governance and reporting, practitioner engagement, joint training, quality assurance, workforce development and embedding new systems, tools and practice developments across the service. Regular updates in relation to the plan will be provided. Training Supporting social work staff through the provision of ongoing training and development is essential to delivering safe, effective and high-quality services. Training helps staff develop the skills and confidence needed to respond to the diverse and often complex needs of children, adults and families, while also supporting consistent and informed decision-making. It also promotes professional growth, improves job satisfaction and wellbeing, and strengthens the organisation's ability to retain a skilled and resilient workforce. The key areas staff must be trained on include adult protection, child protection and trauma-informed practice. Completion of training focusing on these topics is part of the SSSC registration requirement. The current training rates in these areas are outlined in the table below. Training area Number of participants* Q4 2024-25 Q1 2025-26 Adult protection 292 163 Child protection 362 177 Trauma-informed practice 371 178 Page 54
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APPENDIX 1 21 | P a g e In quarter 1, the following training sessions were offered: - Trauma-informed training on CLIVE; accessible at any time - Child protection training on CLIVE and in practice development workshops - Adult protection training on CLIVE and in practice development workshops These training areas will remain key to the provision offered to social workers by the training team as they are essential Continuing Professional Development requirements for social workers maintaining SSSC registration. Other training is available via the booking service on CLIVE and is developed and delivered in consultation with team and service managers. Page 55
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 24 SEPTEMBER 2026 SUBJECT: INTERNAL AUDIT SECTION - UPDATE REPORT BY: CHIEF INTERNAL AUDITOR 1. REASON FOR REPORT 1.1 This report provides Committee with an update on the work of the Internal Audit Section. 2. RECOMMENDATION 2.1 Committee is asked to consider the contents of the report, seek clarification on any points noted and otherwise note this audit update. 3. BACKGROUND 3.1 The Global Internal Audit Standards (GIAS) require the Chief Internal Auditor to prepare and present reports to the Committee on Internal Audit’s activities against the Internal Audit Plan and on any other relevant matters. 4. KEY MATTERS RELEVANT TO RECOMMENDATION Internal Audit Plan 2027/28 4.1 Preparation for the Audit Plan for 2027/28 has started. Internal Audit’s approach to annual audit planning is risk-based, with all services provided by the Council under the direction of the Moray Integration Joint Board included within an ‘audit universe’ and subject to audit review. The audit universe is reviewed and updated on an ongoing basis. However, consultation on projects for review will also be undertaken with senior officers and the Chair of this Committee. The Internal Audit provider for NHS Grampian is responsible for the preparation of its Annual Internal Audit Plan. Follow Up Reviews 4.2 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 obtain assurance that recommendations Item 7. Page 57
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have been effectively implemented. Details of the completed follow-up reviews are provided below: Children's Services Social Care Commissioning 4.3 A further follow-up review has been undertaken to assess the implementation of a recommendation arising from a previous audit of the arrangements for commissioning children’s social care services. The original audit, reported to this Committee on 29 February 2024 (para 9 of the minute refers), evaluated the key controls in place within Children’s Services relating to the external commissioning of social care provision. This included contracts for preventive support, restorative services, residential care and out of area residential placements, necessitated by the limited availability of specialised provision within the Moray locality. The audit testing undertaken included a review of commissioning strategies and procedures, an evaluation of financial monitoring arrangements and an assessment of the effectiveness of contract management and monitoring processes. This follow-up review found that the outstanding recommendation relating to the implementation of a Commissioning Strategy for social care has been substantially implemented, with the Strategy having been developed and agreed by senior management; however, at the time of this review, it was still awaiting formal approval by the Board. The development of the Commissioning Strategy represents a significant improvement to the control framework, providing a structured approach to the planning, commissioning and monitoring of social care services. This will help ensure that future service provision is aligned with the needs of communities, supports strategic objectives and facilitates the effective use of resources Governance arrangements to prevent Fraud and Corruption 4.4 An audit of the Council and MIJB’s governance arrangements for preventing fraud and corruption was carried out using CIPFA’s Code of Practice on Managing the Risk of Fraud and Corruption. The audit was undertaken in partnership with the internal audit services of NHS Grampian and Aberdeenshire/ Aberdeen City Councils which enabled a more comprehensive, collaborative approach, benefiting from shared expertise and reflecting the integrated delivery of services across Council and NHS systems. Findings detailed a need to strengthen coordination and clarity around fraud investigation responsibilities across partner organisations, alongside improving the Council’s counter-fraud arrangements through enhanced use of data analysis and proactive audit work. Enclosed in Appendix 1 is the follow up report confirming the implementation of the agreed recommendations. Complex and Challenging Behaviour 4.5 An audit was previously undertaken of the Complex and Challenging Needs Service. The Service provides support to individuals with complex care needs through purpose-built facilities located in Elgin and Lhanbryde, as well as within individuals’ own homes across Moray. The scope of the audit included a review of the systems and procedures used in the administration of the Service, together with an examination of the operational and accounting arrangements in place to support individuals in managing their personal funds. A follow-up review has now been undertaken and it is pleasing to note the progress made in implementing the recommendations. However, a further review will be required, as some Page 58
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recommendations have not been fully implemented. The follow-up report is enclosed 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 “Moray 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. (f) 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 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 Page 59
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Ref: mijb/ap&rc/ Page 60
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Appendix 1 1 Final Internal Audit Report (Follow Up Review) Governance arrangements to prevent Fraud and Corruption June 2026 Distribution: Head of Service & Depute Chief Officer (MIJB) Chief Governance Officer Chief Financial Officer Head of People, Change & Community Strategy 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 2 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 61
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Appendix 1 2 Contents Page Governance arrangements to prevent Fraud and Corruption 1. Introduction & Scope 3 2. Key Issues 3-4 Detailed Report 3. Findings/Recommendations 5-13 4. Management Response 5-14 5. Follow Up Reviews 6-14 Appendices 1. Audit Terms of Reference and Definitions 2. Statement of Responsibility Page 62
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Appendix 1 3 1. Introduction and Audit Scope The Annual Audit Plan for 2024/25 provides for a review of the Council and the Moray Integration Joint Board (MIJB) governance arrangements to prevent fraud and corruption. The primary responsibility for preventing and detecting fraud and corruption rests with management who should ensure adequate systems of internal control, segregation of duties and proper authorisation procedures. However, the Internal Audit Section does have a role in supporting these arrangements by assessing the adequacy of these controls, and in accordance with the Council’s Financial Regulations for the Service Manager Internal Audit and Risk to investigate in consultation with the Depute Chief Executive Education, Communities & Organisational Development irregularities concerning finances, property, services or policies of the Council. The audit also reviewed the arrangements for the investigation, preventing and detecting fraud and corruption within the MIJB. The Council’s Service Manager Internal Audit and Risk is also the Chief Internal Auditor of the MIJB. The CIPFA Code of Practice on Managing the Risk of Fraud and Corruption was used as the template for developing an audit programme for this review. The audit was also undertaken as part of a joint working arrangement with the internal audit service providers of NHS Grampian, Aberdeen City and Aberdeenshire Councils. This has allowed the sharing of knowledge and agreement in the audit testing to ensure consistency and a more overarching review of the Integration Joint Boards (IJBs) counter fraud and corruption arrangements within the Grampian area. The IJBs deliver services through officers and systems of the Council and NHS Grampian. Officers from the Council and NHS Grampian will have access to the systems of both organisations. It is hoped these joint working arrangements with the internal audit service providers within Grampian will continue as it provides the opportunity for a more cross-organisational review of the IJB’s risk management, control and governance processes irrespective of NHS Grampian or Council systems are used in the delivery of services. The audit was carried out in accordance with the Global Internal Audit Standards (GIAS). 2. Key Issues • The Global Internal Audit Standards require the Chief Internal Auditor to provide an opinion on the overall adequacy and effectiveness of the MIJB risk management, control and governance processes. MIJB delegated services are delivered by Council and NHS Grampian employed officers with access to systems of both organisations. Responsibility for investigating fraud within the Council lies with the Page 63
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Appendix 1 4 Service Manager Internal Audit and Risk, but for NHS Grampian, it is the responsibility of the NHS Counter Fraud Authority. It is appreciated that the occurrence of fraud is rare, but consideration should be given to developing a protocol between the Service Manager Internal Audit and Risk in consultation with the Chief Internal Auditor of Aberdeenshire/ Aberdeen City Councils and the NHS Counter Fraud Authority. This should assist in providing greater clarity and co-ordination of responsibility in the notification, investigation and reporting of alleged frauds within the MIJB, irrespective of whether the Council or NHS Grampian employs the officer delivering the delegated service. • The CIPFA Code of Practice on Managing the Risk of Fraud and Corruption requires that an “organisation should make arrangements for appropriate resources to support the counter fraud strategy”. This includes the need to detect fraud through data and intelligence analysis. The staff resources of the Internal Audit Section are limited, but consideration should be given to including a project within the Annual Internal Audit Plan to review Council systems and practices where fraud or irregularities have occurred in other organisations. The testing undertaken should make use of data evaluation software in the analysis of information, and a review of fraud cases and other irregularities reported within the media, Audit Scotland Technical Bulletins and participation in the Scottish Local Authority Investigator's Group. Page 64
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5 Governance arrangements to prevent Fraud and Corruption - 2024/25 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 1 Medium A review of the Council’s policy framework which supports a counter fraud strategy, noted a range of policies to inform officers in their conduct and responsibilities as employees. These policies also protect officers from false allegations of fraud or corruption. However, the audit review noted that the Code of Conduct for Employees and the Policy on Outside Employment had not been reviewed for a number of years. It is appreciated that both the Code of Conduct for Employees and the Policy on Outside Employment detail best practices and are still relevant; however, both documents should be reviewed and if required updated. The Code of Conduct for Employees and the Policy on Outside Employment should be reviewed and if required updated. In addition, future dates of review should thereafter be agreed. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager Organisational Development & Change Yes 31/03/2026 The employment policy framework is reviewed annually, resulting in agreement on the priorities for policy review according to a range of factors, such as changed legislation. The Code of Conduct for Employees and the Policy on Outside Employment remain appropriate and have not been identified as a priority for updating; however, they will be included in the annual plan for policies review for 2025/26. Page 65
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6 Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A The Code of Conduct for Employees has now been reviewed, updated, and approved by the Corporate Committee on 26 May 2026. The updated Code of Conduct incorporates the Policy on Outside Employment. Page 66
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7 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 2 Low It was noted that the Council’s website included details on reporting allegations of potential fraud to the Internal Audit Section. However, reference is made specifically to the reporting of Housing and Social Security Benefits fraud, as this used to be the most significant area of allegations received for investigation. A review of the wording used within the Council’s internet site should be undertaken, as a need to report a potential fraud may relate to any service area of the Council. In addition, research noted online fraud reporting function within other Local Authorities as an additional method for an individual to report an allegation of fraud. Current wording used within the Council’s internet site for reporting an allegation of fraud should be reviewed and updated. In addition, consideration should be given to the development of an online reporting function as an additional method for an individual to raise a concern of fraud to the Council. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager Internal Audit & Risk Yes 31/03/2025 The information on the Council’s website for reporting fraud will be reviewed and updated. The timescale for implementation of this recommendation has been set at 31 March 2025 due to the need to update web pages and develop an online fraud reporting function, which requires support from the ICT Section. Page 67
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8 Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A Information relating to fraud reporting on the Council’s website has been reviewed and updated. The revised webpage now includes an online reporting facility for suspected fraud. Page 68
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9 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 3 Low As part of the audit planning of projects to be included within the Annual Audit Plan for 2023/24, a joint working arrangement was agreed with the internal audit service providers of NHS Grampian, Aberdeen City and Aberdeenshire Councils to review the Integration Joint Boards governance arrangements to prevent fraud and corruption. This has allowed for a more overarching review to be undertaken. As part of the joint audit working arrangement, this has also enabled the sharing of knowledge and information. The Financial Regulations of the MIJB were updated last year to include revised wording for reporting and investigating a suspected irregularity. However, it was noted that our neighbouring Councils had developed a “Counter Fraud Process” detailing best practices to follow in assessing a referral and investigating fraud. The occurrence of fraud is rare and the nature of each investigation can vary in nature, but consideration should be given to reviewing and if required, adapting this procedural document within Moray. Consideration should be given for the Internal Audit Section to develop a “Counter Fraud Process” procedure. Page 69
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10 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager Internal Audit & Risk Yes 30/11/2024 The “Counter Fraud Process” already developed by a neighbouring Council will be used to prepare a similar procedural guidance document for the Moray Council. Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A A ‘Counter Fraud Process’ procedural document has been developed and agreed for use within the Internal Audit Section to support investigations into irregularities. Page 70
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11 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 4 Medium The Council’s Service Manager Internal Audit and Risk is the appointed Chief Internal Auditor for delivering an internal audit service to the MIJB. MIJB delegated services are undertaken by Council and NHS Grampian officers and systems. Officers of both the Council and NHS Grampian are required to use the systems of each organisation to deliver services. The Service Manager Internal Audit and Risk is responsible for investigating suspected irregularities within the Council, and the NHS Counter Fraud Authority investigates NHS Grampian's allegations of fraud. However, an issue may occur if an officer employed by the Council commits fraud involving an NHS system and vice- versa as to whether the allegation within the MIJB should be investigated by the Council’s Service Manager Internal Audit and Risk or the NHS Counter Fraud Authority. The nature of the fraud may have a cross organisational implication regarding access to information and the individual officer's terms and conditions of employment from each organisation. Consideration should be given to the Service Manager Internal Audit and Risk, in consultation with the Chief Internal Auditor of Aberdeenshire and Aberdeen City Councils, to discuss and if possible, agree on a protocol for the notification, investigation and reporting of alleged fraud within the Grampian IJBs with the NHS Counter Fraud Authority. This may require a “letter of understanding” detailing agreed arrangements for the fraud investigation. Page 71
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12 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager Internal Audit & Risk Yes 30/11/2024 Contact will be made with the Chief Internal Auditor of Aberdeenshire and Aberdeen City Councils to discuss arranging a meeting with the NHS Counter Fraud Authority to agree a protocol for investigating fraud within the Grampian IJBs. Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A Discussions have been held with NHS Grampian and a single point of contact has been agreed to ensure a coordinated approach to investigating alleged irregularities within the Integrated Joint Boards. This will help ensure that investigations are undertaken by the appropriate organisation, irrespective of whether the officer is employed by the Council or NHS Grampian. In addition, this approach will facilitate any cross-organisational investigation requirements. Page 72
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13 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 5 Medium At a Special Meeting of the Moray Council on 28 February 2024, it was decided to reduce the Internal Audit Section staffing budget by replacing the Corporate Investigations Officer’s post with a 0.5 full-time equivalent. The remaining budget was used to appoint an Assistant Auditor, but this proved unsuccessful, with no suitable applicants. The CIPFA Code of Practice on Managing the Risk of Fraud and Corruption requires that an “organisation should make arrangements for appropriate resources to support the counter fraud strategy” of the Council. This includes the need to detect fraud through data and intelligence analysis. The limited staff resources of the Internal Audit Section are appreciated, but consideration should be given to including a project within the Annual Internal Audit Plan to review systems and practices where fraud or irregularities have been reported within other organisations. During this review, it was noted that a financial fraud was reported in the media of an officer in another Local Authority embezzling over £1 million in council tax refunds. Further to consultation with the Council’s Taxation Manager, additional controls have been introduced to current operating arrangements. The Service Manager Internal Audit and Risk should consider including a project within the Annual Internal Audit Plan to review Councill systems and practices where fraud has occurred within other organisations. Identification of the scope and testing to be undertaken will be determined from a review of fraud cases reported in the media, Audit Scotland Technical Bulletins and participation in the Scottish Local Authority Investigator's Group. The use of information data evaluation software should also be used in the analysis of information and databases. Page 73
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14 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager Internal Audit & Risk Yes 28/02/2025 A project will be included to support the Council’s and MIJB counter fraud and corruption arrangements in the Annual Internal Audit Plan. The scope of the audit and testing undertaken will be determined from frauds reported within other organisations. The use of IDEA data analysis software will be further developed in the analysis of information used for audit testing. Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A A counter fraud review was undertaken as part of the Audit Plan for 2025/26 and was reported to the Audit and Scrutiny Committee on 25 March 2026 (Item 9). The review assessed governance arrangements, fraud risk identification, staff awareness, internal controls, reporting procedures and collaboration with external bodies, in accordance with best practice as set out in CIPFA’s Code of Practice on Managing the Risk of Fraud and Corruption. A further counter fraud review has been incorporated into the 2026/27 Audit Plan, which was presented to the Audit and Scrutiny Committee on 25 March 2026 (Item 10). Page 74
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15 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 75
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16 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 76
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Appendix 2 1 Final Internal Audit Report (Follow Up Review) Complex and Challenging Needs Service August 2026 Distribution: Service Manager Provider Services Team Manager/Consultant Practitioner Complex and Challenging Needs 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 1 Priority 2 8 Priority 3 5 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 77
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Appendix 2 2 Contents Page Complex and Challenging Needs Service 1. Introduction & Scope 3 2. Key Issues 3-4 Detailed Report 3. Findings/Recommendations 5-26 4. Management Response 6-27 5. Follow Up Review 7-27 Appendices 1. Audit Terms of Reference and Definitions 2. Statement of Responsibility Page 78
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Appendix 2 3 1. Introduction and Audit Scope The annual Internal Audit plan for 2025/26 includes a review of the Complex and Challenging Needs Service. This service supports individuals with complex care needs at purpose built facilities in Elgin and Lhanbryde, as well as within their own homes across Moray. At the time of the audit, the care facility in Elgin provided support to four adults. The accommodation consists of a large bungalow with shared living rooms, a communal kitchen and a garden. The facility in Lhanbryde serves as the administrative base for the service and supports eight individuals in separate, purpose built accommodation, with access to a communal area used for social activities. The overall budget for delivering the Complex and Challenging Needs Service in 2024/25 was approximately £7.7 million. The scope of the audit was to review the systems and procedures for delivering and managing the Complex and Challenging Needs Service, specifically at the care facilities in Elgin and Lhanbryde. This was an audit of the administrative arrangements, rather than an assessment of the quality of care provided. The Care Inspectorate in Scotland, as the national regulatory body for care services, is responsible for ensuring that care services meet the required standards. The audit focused on reviewing policies, procedures, and operating practices in the administration of the Complex and Challenging Needs Service, particularly in relation to budget management and the arrangements for assisting people in managing their personal funds. However, the audit did include a check to ensure that Support Plans for individuals supported by the service were reviewed in accordance with agreed timescales. The audit was carried out in accordance with the Global Internal Audit Standards (GIAS). 2. Key Issues • The Complex and Challenging Needs Service provides 24-hour support to individuals with specific care requirements. The audit found that the Service has a number of staff vacancies and as with other care sectors, is experiencing difficulties in recruiting officers. Analysis of payroll expenditure indicated that the majority of officers are working additional overtime hours each week. Random testing of overtime claims noted that some officers who are supporting individuals are often working more than 60 hours per week. The audit notes the demands on the Service and the commitment of officers to support the care needs of individuals; however, it does question the sustainability of current working arrangements Page 79
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Appendix 2 4 • The Service also supports people at both care facilities in managing their personal funds. Officers assist individuals with payments for groceries, utilities and other living expenses. Separate records are maintained for each individual and any cash held on their behalf is stored securely. Documented guidelines outline the procedures for officers in administering these funds; however, these guidelines have not been reviewed or updated for several years. Consideration should be given to transitioning from a cash-based system to individual bank accounts, which would allow for the introduction of additional controls. • This audit focused on the financial administration of the Complex and Challenging Needs Service. However, it also included a check to confirm that the Support Plans of individuals at both care facilities had been reviewed in accordance with agreed timescales. The audit found that the majority of care packages sampled had not been reviewed for over a year. In accordance with Health & Social Care Moray Eligibility Criteria Policy, there is a requirement for a Social Worker/Community Care officer to undertake annual reviews where support is provided to meet eligible needs, or more frequently as a response to a significant change in circumstances. Page 80
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5 Findings/Recommendations - Complex and Challenging Needs Service 2025/26 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 1 High Officers of the Service support individuals with complex care needs at the care facilities in Elgin and Lhanbryde, as well as within their own homes. A review of the staffing complement at the time of the audit identified significant vacancies. As with other social care providers, the Service is experiencing difficulties in recruiting officers. An analysis of payroll costs found that the majority of officers employed within the Service are working more than their contracted hours each week. Approximately £750,000 was paid in overtime during 2024/25. Audit testing of individual overtime claims, undertaken to verify accuracy and compliance with Financial Regulations, revealed that some Support Workers are regularly working in excess of 60 hours per week. While the audit acknowledges the commitment of officers to meeting the needs of individuals supported by the Service, it also raises concerns about the sustainability of the current working arrangements. The ongoing recruitment campaign for officers within the Complex and Challenging Needs Service should be maintained. Consideration should also be given to exploring alternative approaches to reduce the significant levels of overtime currently worked by some officers. Page 81
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6 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager (Provider Services) Yes Ongoing A short-life working group will be established to seek solutions and support the ongoing staffing challenges facing the Service. Since the audit, there has been a reduction in vacancies at Woodview from 19.1 FTE to 10.6 FTE (as of 1st October), and at Barlink from 4.49 FTE to 0.45 FTE for Support Workers and 1 FTE for a Keyworker (as of 1st October). While the appointment of new staff will not have an immediate impact on reducing overtime, due to the requirement for training and shadow shifts, it is expected that, over time, this will lead to a decrease in overtime usage. In addition, a review of staffing arrangements is ongoing to identify improvements in service delivery. The combination of recent staff recruitment and a review of current service delivery methods is expected to support a significant reduction in overtime in the future. This will be closely monitored by senior management. Page 82
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7 Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Part Implemented 31/03/2027 The follow-up review found that the Service has made significant progress through the implementation of a Change Management Plan. This has included a comprehensive review of the staffing structure, including the regrading of Support Worker posts. The expected outcomes of these changes include a reduction in the Service's reliance on officer overtime to meet operational demands. However, as the changes have only recently been implemented, the follow-up review has been unable to evidence their impact on the use of overtime. A revised implementation date of 31 March 2027 has been agreed with the Service. Page 83
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8 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 2 Medium The audit reviewed a random sample of officers overtime and travel/expenses claims to verify their accuracy and ensure correct authorisation in accordance with Financial Regulations. Testing identified one case where an officer had submitted an overtime claim for 13.75 hours and a travel/expenses claim for 27 miles in advance of the date the work was to be undertaken. Further investigation found that the officer had neither worked the planned additional hours nor incurred the mileage claimed, due to sickness absence. This is not in compliance with Financial Regulations. The officer has since reimbursed the overpaid amount and the mileage claimed. The audit also found that approximately one-third of all travel claims submitted by the service were not dated at the time of signing, either by the submitting officer or the authorising officer. In accordance with Financial Regulations, officers within the Complex and Challenging Needs Service should be reminded that claims for overtime and travel/expenses must only be submitted after the hours have been worked or the mileage incurred. Additionally, all travel/expenses claims must be dated at the time they are signed by both the submitting and authorising officers. Page 84
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9 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Assistant Managers Service Manager (Provider Services) Yes Yes 30/09/2025 31/03/2026 All staff are to be informed, in accordance with the Financial Regulations, of the correct procedure for completing and submitting travel and expense claims. In addition, these requirements will be reminded during Supervision and Team Meetings Digital solutions will be explored with the Payroll Service for submitting expenses claims. Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A The follow-up review noted, from meeting minutes, that officers have been reminded of the correct procedures for submitting travel and subsistence claims. Management has also implemented additional verification controls to review the accuracy of claims. Follow-up audit testing of a sample of travel and subsistence claims submitted by officers within the Service identified no discrepancies. Page 85
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10 Part - Implemented 31/12/2027 It was noted that a new payroll software application is currently being implemented, which will facilitate the electronic submission of claims. The Service advised that the system is being rolled out on a phased basis, with implementation within the Complex and Challenging Behaviour Service scheduled for 2027/28. Page 86
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11 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 3 Medium A review was undertaken of non-staffing expenditure made by the Complex and Challenging Needs Service. This involved testing a random sample of payments to suppliers of goods and services and checking to ensure compliance with Financial Regulations and Procurement Guidelines. The review found that mostly correct procurement and authorisation processes had been undertaken. However, an example was noted where Guidelines had not been followed in the procurement for the purchase and installation of a bicycle shed to the value of £25,000. Officers involved in the purchasing of goods and services should be reminded of the need to comply with Financial Regulations and Procurement Guidelines. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Team Manager/Consultant Practitioner Residential Complex and Challenging Needs Yes Implemented A grant was secured for the bike shed, and all work was completed within the £25,000 grant allocation. Staff have been reminded of the requirement to comply with the Council’s Procurement Guidelines. Page 87
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12 Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A The follow-up review noted from the minutes of meetings within the Service that officers have been reminded of the requirement to comply with Financial Regulations and Procurement Guidance. Page 88
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13 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 4 Low Analysis of the Financial Management System indicated that the overall budget for delivering the Complex and Challenging Needs Service in 2024/25 was £7.7 million, with the majority of expenditure related to staffing costs. It was found that the staffing budget is regularly reviewed to ensure accuracy and alignment with the needs of individuals supported by the Service. However, a number of other non staffing budget headings that is not material in value e.g. non domestic rates, utilities and ad- hoc repairs had a budget allocation which did not correspond to actual expenditure incurred. A financial “housekeeping” exercise should be undertaken to review and adjust the budget allocations for non-staffing costs to better reflect current expenditure. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Team Manager/Consultant Practitioner Residential Complex and Challenging Needs / Accountant Yes 31/03/2026 The Service, in consultation with the Accountancy Section, will review the non- staffing budget to ensure it is more closely aligned with actual expenditure. Page 89
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14 Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Outstanding 31/03/2027 It is acknowledged that significant resources have been required to implement the Change Management Plan detailed within Finding 1. The Service is currently consulting with Accountancy to review non-staffing budgets and ensure they are more closely aligned with actual expenditure. However, the Service has advised that a revised implementation date of 31 March 2027 is required to fully implement this recommendation. Page 90
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15 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 5 Medium The audit visit to the care facility in Lhanbryde found that funds are held in both cash and within a bank account of monies collected through fundraising activities and donations. These funds are intended for the benefit of the people supported by the Service. The administrations of these funds are similar to the requirements of a Private Fund within a School. The audit checked the income and expenditure activity of these funds and undertook a reconciliation to confirm the accuracy of the monies held to supporting documentation. It is pleasing to report that no discrepancies were noted. However, there are no operating guidelines to support officers in the administrative requirements in the management of these funds. Guidelines should be developed detailing the administrative requirements in the management and accounting arrangements of monies held from fundraising activities and donations. Page 91
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16 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Assistant Managers (Woodview) Service Manager (Provider Services) Yes Yes 31/03/2026 28/02/2026 A financial procedure will be developed for the management and administration of funds collected from events, donations, and fundraising, as well as the expenditures used to benefit individuals using the service. This will include the opening of a new bank account (where an admin fee is not charged). A management panel will be established to oversee and agree the allocation of funds. Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented Implemented N/A N/A Guidelines have been developed and are in operation detailing the administrative requirements in the management and accounting arrangements of monies held from fundraising activities and donations, The follow-up review confirmed that a management panel has been established to oversee the allocation of funds generated through events, donations and fundraising activities. Page 92
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17 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 6 Medium The audit review noted that officers at the care facilities support individuals in the management of their personal monies. Cash sums are stored securely for individuals at the care facilities and are used for purchases such as groceries, day trips, utility bills and other living expenses. Operating arrangements for administering these funds are detailed within the Financial Guidelines developed by the Service. The audit reviewed these arrangements, including a reconciliation of supporting documents to the cash held for a sample of individuals. The following points were noted: • Resident funds are administered in cash. Records are maintained to evidence and reconcile individual balances against the monies held. However, it is considered that the amounts of cash stored at the care facilities for some individuals exceed routine weekly expenditure requirements. Consideration should be given to implementing alternative methods for managing the personal funds of individuals, such as individual banking arrangements. Page 93
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18 • The Financial Guidelines document detailing the administration arrangements for individuals’ funds has not been reviewed or updated since 2022. The Financial Guidelines document for administering individuals’ funds should be reviewed and updated as required. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager (Provider Services)/ Service Manager (Learning Disability) / Chief Financial Officer (MIJB) Assistant Managers (Woodview) Yes Yes 31/03/2026 30/09/2025 A review will be undertaken to explore alternative methods for managing the personal funds of individuals, including consultation with guardians, social work, and Finance. The Financial Guidelines document for administering individuals’ funds will be reviewed and updated. A request will also be submitted to Community Finance for weekly cash uplifts, thereby reducing the amount of funds held within the service Page 94
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19 Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented Implemented N/A N/A The Financial Guidelines for administering individuals’ funds has been reviewed and updated. The follow-up review noted progress in addressing the issues identified in the original audit. The Service has explored the use of individual banking arrangements for the management of funds held on behalf of individuals; however, administrative challenges remain where appointeeship arrangements are in place. Audit testing found a reduction in the amount of cash held since the original review. In addition, revised operating arrangements, including the increased use of purchasing cards, have reduced reliance on cash transactions and strengthened the associated control framework. Page 95
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20 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 7 Low The audit visit to the care facility at Lhanbryde noted the provision of two petty cash accounts: an Adult Services account with an imprest amount of £250 and a Children’s and Young Persons account with an imprest amount of £120. The review found that the Adult Services account was well managed and operated in accordance with Financial Guidelines. However, further to discussions with officers indicated that greater use is now being made of the purchasing card. The Children’s and Young Persons petty cash account had not been used since 2022. This account was initially established to support a young person before they turned 18 and transitioned into Adult Services. Consideration should be given to closing both the Adult Services and Children and Young Persons petty cash accounts. Page 96
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21 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Assistant Mangers (Woodview) Yes Implemented Petty cash has now been closed for both services, and evidence of this closure has been submitted to Internal Audit. Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A The follow-up review has confirmed that both petty cash accounts have been closed. Page 97
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22 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 8 Medium The audit included a review to ensure that Support Plans for individuals at both care facilities had been updated to confirm that care and support continue to meet their needs and agreed outcomes. It was found that the majority of care packages sampled had not been reviewed for over a year. This finding has also been noted in other social care reviews to highlight the requirement for regular reviews of Support Plans for individuals receiving services. It is acknowledged that management at Health and Social Care Moray are aware of this issue and are progressing the necessary actions in accordance with the Eligibility Criteria Policy, which requires a Social Worker or Community Care Officer to undertake annual reviews where support is provided to meet eligible needs. Support Plans for users of the Complex and Challenging Needs Service should be reviewed at least annually in accordance with the agreed policy. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Service Manager (Learning Disability) Yes 31/12/2025 All out-of-date support plans to be updated. Page 98
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23 Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A The follow-up review confirmed that all Support Plans for people using the service had been reviewed and where required updated. Page 99
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24 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 9 Low The care facility at Lhanbryde has one dedicated pool car that officers use to support individuals within the community. It was noted that the annual mileage used for this vehicle was approximately 7,000 miles in 2024/25. A previous audit of pool cars noted that best value is obtained when comparing the cost of purchasing and use of a pool car is achieved when mileage in excess of 12,000 a year is undertaken. Analysis of mileage claimed by officers of the Service when using their personal vehicles noted a cumulative total of approximately 17,000 in 2024/25. Increasing the use of the pool car may provide a financial saving to the Service. Consideration should be given to increasing the use of the available dedicated pool car by officers of the Service. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Assistant Managers (Woodview) Yes 31/01/2026 A review of the current pool car arrangements will be carried out, and a more proactive approach will be implemented for its use during care and support visits outside of Woodview, which currently incur a mileage charge. Page 100
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25 Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented N/A The follow-up review noted that the Service now has access to a dedicated pool car for undertaking care and support visits. Audit analysis of a sample period of mileage claims submitted by officers within the Service found a significant reduction in expenditure compared with the corresponding period in 2025. Page 101
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26 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 10 Low The care home facility at Lhanbryde operates a closed-circuit television (CCTV) system as an additional security measure for the property. The use of CCTV requires compliance with Data Protection Legislation, including the completion of a Data Protection Impact Assessment (DPIA). A DPIA is a structured process that systematically analyses the data protection risks associated with CCTV systems. It was found that no DPIA had been completed. Additionally, officers operating the CCTV at the facility had not undertaken the necessary training provided by the Council. It was also noted that the location of the CCTV monitor within the property is in an accessible area, which is not in accordance with Data Protection Legislation. A Data Protection Impact Assessment (DPIA) should be completed for the care home facility at Lhanbryde. All officers operating CCTV must complete the Council’s CCTV training module. The location of the CCTV monitor within the property in Lhanbryde should also be relocated to ensure that footage can only be viewed by trained officers who require access as part of their duties. Page 102
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27 Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Assistant Managers (Woodview) Assistant Managers (Woodview) Yes Yes Implemented Implemented DPIA for the CCTV system at Woodview has been completed and approved. Training has been completed for all staff with access to the CCTV system at Woodview. In addition, access to the CCTV monitor at Woodview is now restricted. Follow Up Review Implementation Status Revised Implementation Date Internal Audit Review Outcome Implemented Implemented N/A N/A The follow-up review confirmed that a DPIA had been completed and approved for the CCTV system at Woodview, Lhanbryde. It has been confirmed that all staff with access to the CCTV system have completed the required training and that physical access to the CCTV monitor is now restricted. Page 103
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28 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 104
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29 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 105
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 24 SEPTEMBER 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 Committee is asked to 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: Social Care (Short Breaks) 4.2 An internal audit review of accommodated Social Care (Short Breaks) was undertaken. The Scottish Government defines a Short Break as any form of service or assistance that enables carers to have periods away from their caring routines or responsibilities. The audit primarily focused on accommodated Short Breaks within the older persons’ care sector. 4.3 The audit reviewed processes for assessing care needs, ensuring accurate payments to providers at agreed contract rates and confirming that charges to supported persons align with Scottish Government guidance. Detailed findings and recommendations are provided in the audit report in Appendix 1. Item 8. Page 107
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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 “Moray 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 audit project completed during the review period. Author of Report: Dafydd Lewis, Chief Internal Auditor Background Papers: Internal Audit Files Ref: Page 108
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Appendix 1 1 Final Internal Audit Report Social Care (Short Breaks) June 2026 Distribution: Chief Finance Officer – MIJB Locality Manager – West Team Manager (East Community Care) Team Manager (West Community Care) Unpaid Carers Team Manager 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 2 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 109
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Appendix 1 2 Contents Page Social Care (Short Breaks) 1. Introduction & Scope 3 2. Key Issues 3-4 Detailed Report 3. Findings/Recommendations 5-11 4. Management Response 6-11 Appendices 1. Audit Terms of Reference and Definitions 2. Statement of Responsibility Page 110
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Appendix 1 3 1. Introduction and Audit Scope An Internal Audit of accommodated Social Care (Short Breaks) has been undertaken as part of the 2025/26 coverage of Moray Integration Joint Board (MIJB) activity. There has been a requirement to further develop the audit programme for this review, as the original scope was to assess the processes and accounting arrangements for charging care to individuals receiving a service. However, it was noted early in the audit process that a review is currently ongoing within the Service to explore charging arrangements for Social Care services. The audit has therefore been expanded to review the procedures and administrative arrangements in procuring accommodated Short Breaks for individuals requiring support in a care home environment for an intended temporary period. Short Breaks are a common feature in delivering support for Unpaid Carers under the authority's responsibilities established by "The Carers (Scotland) Act 2016". The audit has mainly focused on accommodated Short Breaks for the older persons care sector, attracting an annual budget provision of £517,000 for the 25/26 financial year. The audit examined the processes in place for assessing care needs and for ensuring accurate payments are made to third-party providers for accommodated Short Breaks at agreed contract rates. In addition, the review assessed whether the arrangements for charging supported persons contributions towards the cost of applicable Short Break provision are compliant with Scottish Government charging guidance. This audit review covers a further sector of residential care service provision and complements recent audit activity on Out of Area Placements, Older Persons Permanent Residential Care and Procurement & Creditor Payments, ensuring substantial coverage of residential care over consecutive Internal Audit Plans. The audit was carried out in accordance with the Global Internal Audit Standards (GIAS). 2. Key Issues • In accordance with the Scottish Government Charging for Residential Accommodation Guidance (CRAG), local authorities have discretion to apply charges for Short Break provision, however Scottish Government regulations waive charging where the support is provided to meet the needs of unpaid carers or for individuals with a terminal illness within specific parameters. The audit identified that no supported individuals receiving a Short Break service within a care home setting were referred Page 111
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Appendix 1 4 for a financial assessment during 2025/26. Consequently, no charges were applied in respect of contributions towards the cost of Short Break provision. Audit testing confirmed that the sample reviewed included Short Break cases that would be eligible for charging under CRAG, including extended stays in care home settings spanning several months. These arrangements were in place for reasons including delays in the commencement of community care packages and pending decisions regarding permanent care home placement. While the current financial climate and the sensitivity associated with charging for social care services are acknowledged, management should consider exploring the implementation of charging for eligible services. • The Carers (Scotland) Act 2016 requires local authorities to ensure that carers receive the necessary support to maintain their wellbeing while providing care. As recognised good practice, Carer Support Plans provide a formal mechanism to document carers' needs and personal outcomes, separately from the supported person's care and Support Plan. While the audit identified that Short Breaks were being provided to support unpaid carers, audit testing found that, in the majority of cases reviewed, a Carer Support Plan was not in place to substantiate the carer’s assessed needs. Further promotion and development of Carer Support Plans would strengthen the identification of carers' needs and outcomes, support the sustainability of caring arrangements, and provide clear evidence of appropriate assessment, decision-making and agreed support. Page 112
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5 Findings/Recommendations - Social Care (Short Breaks) 2025/26 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 1 High The Charging for Residential Accommodation Guidance (CRAG) issued by Scottish Government provides for temporary residents, defined "such as respite", which aligns with the provision of accommodated Short Breaks. CRAG states that for temporary residents, undertaking a financial assessment of ability to pay for the first 8 weeks is at local authority discretion. If a financial assessment is made it must follow CRAG but if no assessment is undertaken a local authority can charge an amount that appears reasonable for the supported person to pay. After 8 weeks, an assessment of ability to pay, under CRAG conditions, must be carried out. However, Scottish Government regulations waive charging for breaks which support unpaid carers or those with terminal illness within specific parameters. The Authority currently has no charging policy in place for Short Break provision. The audit identified that no referrals for financial A formal charging policy for accommodated Short Break provision should be introduced, compliant with CRAG, including clear criteria for when financial assessments and charges apply and when exemptions are required. Page 113
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6 assessment were undertaken in respect of Short Break provision during the 2025/26 financial year. Consequently, no charges are levied to individuals receiving a service to recover contributions towards the cost of Short Break social care. The audit review noted that, based on research undertaken, other local authorities have charging policies in place for accommodated Short Break provision. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Locality Manager - West Yes 31/05/2027 There is a short life working group which was formulated prior to the audit due to identification of the need to consider a charging policy and guidance for short breaks. This group will progress with recommendations from the Short Breaks audit with regard to charging policy development. Page 114
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7 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 2 High Audit testing identified expenditure recorded as Short Break provision which, on further analysis, related to individuals remaining in residential accommodation for extended periods ranging from five to sixteen months. Short Breaks are typically intended to provide time-limited respite support, depending on assessed need. In the majority of cases reviewed, individuals initially presented for a Short Break, however subsequent changes in circumstances or care requirements resulted in these arrangements being extended while decisions regarding future care were pending. Despite these changes, the cases continued to be classified and funded as Short Breaks. Enquiries with the Service identified instances where Short Break provision had been approved due to the unavailability of community care packages or where it was used as an interim measure pending permanent residential care placement. It is noted that the Service is currently undertaking work to reclassify Short Break provision within CareFirst and the Financial Management System. This work aims to distinguish between planned, emergency and Short Break placements should be subject to timely review and if required reclassification. Financial assessments should be undertaken in line with the charging policy to be developed. Page 115
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8 interim Short Breaks and to improve service planning, budgeting, and the quality of management information. Under this revised approach the extended stays described above will be categorised as Short Breaks - Interim. As described in Finding 1, a recommendation has been made to consider the development of a charging policy for Short Break provision. However, audit testing found that, irrespective of the length of stay for individuals classified as receiving Short Breaks, financial assessments are only undertaken once individuals are reclassified as receiving community-based care or permanent residential care. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Locality Manager - West Yes 31/05/2027 As referred to in recommendation 1 above, the short life working group will support progression of an updated charging policy and guidance. The short break definition and classifications will be monitored via the existing Resource Allocation Meeting (RAM) structure. Page 116
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9 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 3 Medium The audit review noted that Short Breaks are used to support unpaid carers. Under "The Carers (Scotland) Act 2016", the Authority has a duty to ensure that carers receive the support necessary to maintain their wellbeing while providing care. Carers are also entitled to a Support Plan, which formally identifies and documents their needs and outcomes. An Adult Carer Support Plan is not required in order for an Unpaid Carer to receive support but is considered an important tool in improving support for unpaid Carers to access the necessary resources and formally recognise their role in line with the aims of The Carers Act. Audit testing found that in the majority of the cases sampled where Unpaid Carer support was stated as the reason for the need for Short Break, an Adult Carers Support Plan was not in place to substantiate the Carers needs. At the time of the audit, a pilot project was in operation within a Social Care team to develop separate Adult Carer Support Plans alongside Where Short Breaks are provided to support unpaid carers, Carer Support Plans should be promoted and developed to formalise carers' needs and support the delivery of personalised outcomes- focused support. Page 117
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10 the Cared For Person's Needs Assessment. Activity is also ongoing to separate costs of supporting Carers on a more refined basis for service planning and information availability. A future audit review of Support for Carers is planned and will be included within a future Internal Audit Plan. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Unpaid Carers Team Manager Yes 31/03/2027 Governance for this action will primarily be through the Unpaid Carers Strategy Oversight Group and linked to the Self-Directed Support Standards Steering Group. Work is already underway in relation to the separate recording on the CareFirst system to ensure a clear distinction between supports for the cared for person and for the unpaid carer. A temporary work around is currently in place until the move to the new Social Care recording system, Mosaic, is complete. A test of change is currently in place in relation to recording supports for the unpaid carer via an Adult Carer Support Plan. Page 118
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11 Ref Risk Ratings for Recommendations Audit Finding Audit Recommendation 4 Low During the audit review, instances of inaccurate recording of Short Breaks were identified within the CareFirst system. CareFirst is the primary information system used for the management of social care packages. Inaccuracies included end dates not being updated to reflect approved extensions or differences between planned and actual end dates, end dates not being entered, and services not being correctly categorised as Short Breaks. While the limitations of the CareFirst system are acknowledged, and it is noted that a replacement social care case management system has been procured with implementation planned by March 2027, the requirement for accurate and complete data input remains. Officers should be reminded of the importance of accurate and complete data recording within the CareFirst system of Short Breaks, as it is the primary system used to record social care activity and to support the validation of payments for care provided. Management Response Responsible Officer Accepted (Yes/ No) Timescale for Implementation (Date Required) Agreed Management Action/Management Comment Team Managers – East & West Community Care Yes 31/01/2027 Team Managers will support operational staff to undertake learning and refresher opportunities surrounding accuracy of recording and its importance within their role. Page 119
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12 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 120
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13 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 121
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 24 SEPTEMBER 2026 SUBJECT: MORAY INTEGRATION JOINT BOARD DRAFT STRATEGIC RISK REGISTER BY: CHIEF OFFICER 1. REASON FOR REPORT 1.1 To present the Draft Strategic Risk Register for scrutiny by the Audit, Performance and Risk (APR) Committee prior to submission to the Moray Integration Joint Board (MIJB) for approval. 2. RECOMMENDATION 2.1 It is recommended that the Committee: i) scrutinises the updated Strategic Risk Register attached at Appendix 1; ii) notes the current risk ratings, controls, assurances and areas of ongoing exposure; iii) considers whether any matters require amendment or escalation prior to submission to the Moray Integration Joint Board; and iv) recommends the Strategic Risk Register to the Moray Integration Joint Board for approval. 3. BACKGROUND 3.1 The Risk Management Framework review was approved by the Moray Integration Joint Board (MIJB) at their meeting on 25 June 2020 (para 9 of the minute refers). Risk Appetite Statements are included in Appendix 1. 3.2 Risk scores are determined using the MIJB Risk Policy (Section 5), based on likelihood and impact. Item 9. Page 123
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3.3 As agreed at Audit, Performance and Risk Committee on 26 October 2023 (para 8 of the minute refers), the reporting frequency was amended from quarterly to biannually unless significant changes arise. 3.4 The MIJB Chief Internal Auditor issued a ‘Limited Assurance’ rating for MIJB for 2025/26 to the meeting of Audit, Performance and Risk Committee on 25 June 2026 (para 11 of the minute refers), reflected within Strategic Risk 8. 3.5 As agreed at the MIJB meeting on 25 September 2025 (para 11 of minute refers), the Strategic Risk Register is subject to scrutiny by the Audit, Performance and Risk Committee, with submission to the Board for approval. 3.6 Since the last formal review, a number of refinements have been made to the Strategic Risk Register, including updates to risk narratives, controls, assurances and governance arrangements to reflect organisational developments, legislative change and emerging assurance activities. These changes do not alter the overall strategic risk profile of the Board. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The Strategic Risk Profile The overall strategic risk profile remains unchanged, with one risk remaining assessed as Very High and the remaining risks assessed as Medium. No changes are proposed to the overall risk ratings. 4.2 Governance and Assurance Updates A number of updates have been made to the register to reflect: • the introduction of voting rights for stakeholder members and associated governance arrangements; • the continued development of the Corporate Assurance and Governance Group (CAG); • progress in relation to workforce, engagement and strategic planning arrangements; • updates to financial governance and performance assurance mechanisms; and • revised assurance and control measures relating to internal audit, hosted services and organisational risk management. 4.3 Internal Audit and Governance Strategic Risk 8 continues to reflect the Internal Audit opinion of Limited Assurance and the actions being taken to strengthen governance, assurance and audit tracking arrangements. The register has been updated to reflect progress made through management oversight, internal audit engagement and the Corporate Assurance and Governance Group. 4.4 Workforce and Organisational Change Workforce-related assurances have been refreshed to reflect workforce engagement activity, the extension of the Moray Carers Strategy to March 2028 and ongoing organisational review activity across Moray Health and Social Care Partnership. Page 124
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4.5 Risk Appetite The Strategic Risk Register continues to reflect the Board's approved Risk Appetite Statement. Members participated in a Board Development Session on risk management in August 2026 and a separate report on the updated Risk Policy is due to be considered by the Moray Integration Joint Board at their meeting on 24 September 2026 following the Audit, Performance and Risk Committee's scrutiny of this register. No changes to the Risk Appetite Statement are proposed within this report. However, should the Board subsequently agree any amendments to its risk appetite, the implications for the Strategic Risk Register will be considered as part of the next review cycle and reflected in future reports as appropriate. 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 MIJB requires effective governance arrangements for those services and functions delegated to it and Risk Management systems are integral to this. (b) Policy and Legal As set out in the terms of reference, the Board has responsibility to provide assurance of the adequacy of the risk management framework. There are no legal implications arising from this report. (c) Financial implications There are no direct financial implications arising from this report however, the Board should note the failure to manage risks effectively could have a financial impact for the MIJB. (d) Risk Implications and Mitigation The Strategic Risk Register remains the Board's primary mechanism for monitoring strategic risks. The updated register reflects changes to controls, assurances and governance arrangements whilst maintaining the current overall risk profile. Any future amendments to the Board's approved Risk Appetite Statement will be considered through subsequent reviews of the Strategic Risk Register. (e) Staffing Implications There are no additional staffing implications arising from this report. The workforce risk narrative has been updated to reflect current workforce assurances and organisational review activity. (f) Property There are no property implications arising from this report. (g) Equalities/Socio Economic Impact An Equalities Impact Assessment is not required, as no service, policy or organisational changes are being proposed. Page 125
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(h) Climate Change and Biodiversity Impacts There are no impacts arising from this report. (i) Directions None arising from this report. (j) Consultations Consultation on this report has taken place with the Board members, and Senior Management Team. Board Members also participated in a Development Session on risk management in August 2026. 6. CONCLUSION 6.1 The Strategic Risk Register continues to provide a comprehensive overview of the Board's strategic risks, controls and assurances. Whilst a number of updates have been made to reflect organisational developments, governance changes and assurance activities, the overall strategic risk profile remains unchanged. The Committee is asked to scrutinise the updated register and recommend it to the Moray Integration Joint Board for approval. Author of Report: Sonya Duncan, Interim Corporate Manager Background Papers: held by HSCM Ref: Page 126
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MIJB RISK REGISTER SUMMARY – March 2026 APPENDIX 1 Risk Assessment Table – Multiply likelihood score by impact score to determine the risk rating (score). Risk No Risk Risk Owner Previous Risk Rating Last Reviewed Change Current Rating 1 There is a risk that the MIJB does not function as set out within the Integration Scheme, Strategic Plan and in-line with its Governance Framework and fails to deliver its objectives or expected outcomes. Chief Officer Contributor: Senior Leadership Team Error! Reference source not found. September 2026 Medium 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 indirectly impact the MIJB’s strategic planning of services and its decision-making Chief Officer Contributor: Chief Finance Officer/ Heads of Service/ Chief Nurse Very High September 2026 Very High 3 There is a risk that the MIJB’s workforce strategy is not delivered impacting the quality of paid and unpaid Health & Social Care. Chief Officer Contributor: Chief Finance Officer/ Heads of Service/ Chief Nurse Medium September 2026 Medium 4 There is a risk that the MIJB is unable to operate effectively as a Public Body. Chief Officer Contributor: Corporate Manager/ Chief Finance Officer Medium September 2026 Medium 5 There is a risk that the MIJB does not comply with the necessary legislative and regulatory requirements in which it operates. Chief Officer Contributor: Senior Leadership Team Medium September 2026 Medium 6 There is a risk that the MIJB’s strategic aspirations are not sufficiently transformative and as a result, that it is unable to deliver outcomes for people in a sustainable way. Chief Officer Contributor: Senior Leadership Team Medium September 2026 Medium 7 There is a risk that the MIJB is unable to exert influence on services delegated but hosted within another organisation. Chief Officer Contributor: Heads of Service Medium September 2026 Medium 8 There is a risk that the MIJB’s internal control and governance arrangements are not sufficiently robust, as evidenced by the 2024/25 Internal Audit opinion of ‘limited assurance’ Chief Officer Contributor: Senior Leadership Team Medium September 2026 Medium Page 127
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Risk 1: There is a risk that the MIJB does not function as set out within the Integration Scheme, Strategic Plan and in-line with its Governance Framework and fails to deliver its objectives or expected outcomes. Consequence: Legal and Regulatory Implications, Reputational Damage, Loss of Stakeholder Trust, Resource Challenges, Service Disruption, Failure to deliver Health Outcomes Risk Rating: Medium Risk Appetite: Moderate-High Risk Movement: Historical Risk Rating: Medium September 2025 Rationale for Risk Appetite as reflected by MIJB in Appendix 2: • Strategic Priorities require innovative approaches to integration that may involve governance development • Outcomes depend on our ability to make timely decisions through efficient governance structures • The board recognises that complete risk aversion would prevent necessary transformation of services • A Moderate appetite allows for controlled governance exploration while maintaining core statutory compliance Rationale for Risk Rating: The risk remains Medium because, although core governance elements (Integration Scheme, Governance Framework, Scheme of Administration, member induction and Standards training) are in place and routinely used, the breadth of delegated functions and ongoing structural change still create exposure to [inconsistent application of governance requirements across services]. [Whilst the extension of voting rights to stakeholder members introduces new governance arrangements, revised role profiles, training and updated guidance are being implemented to support effective decision making]. Risk scoring before mitigations/controls Mitigations / Current controls in place Risk scoring after mitigations/controls 4 5 20 1. Integration Scheme approved March 2023. 2. Consultation with legal representative for all reports to committees and attendance at committee for key reports. 3. Induction sessions are held for new MIJB members. 4. Conduct and Standards training held for MIJB Members in June 2022, February 2024 [and August 2026] provided by [The Standards Officer]. 2 3 6 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 128
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Assurances: • Scheme of Integration • Programme of Development Sessions held throughout the year with all MIJB members and Officers • Audit, Performance and Risk Committee (APR) provides quarterly scrutiny of governance compliance with minutes reported to the Board. • Internal Audit conducts reviews with formal recommendations and monitoring to APR • Budget Savings Oversight Group monitors financial governance monthly with escalation pathways to SMT and MIJB. • Service Reporting to Board for strategic decisions and updates. • Monthly Tri-partite partnership performance meetings with partner CEOs, Finance Directors and Chair/Vice Chair of MIJB • Care Inspectorate assessment of services, including governance impact on service delivery. • Annual governance statement for external audit. • 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 bi- annually to AP&R Committee • [SMT Operational Finance Performance meetings scrutinise areas of concern and performance issues]. • [Updated standards training delivered to stakeholder members to support their transition into voting roles]. • [Extension of voting rights to stakeholder members to be formally presented, approved and incorporated into governance arrangements, including amendments to role profiles, committee memberships, appointment documentation and Member Handbook]. Gaps in Assurance: As part of HSCM structural review, mapping of the delegated Children’s, Families and Justice services will take place to ensure the statutory governance requirements and those of MIJB are robust. [The Strategic Planning and Commissioning Group is currently being refreshed and will provide oversight of planned business across HSCM. The process is underway to recruit a Head of Strategy, Performance and Commissioning]. Current Performance: • The Scheme of Administration is updated as required. • The Governance Framework was approved by MIJB on 28 January 2021. 5. Regular Senior Management Team (SMT) and Operational Management Team (OMT) meetings to provide direction and support to managers and teams, with agreed focus and priorities aligned to the Strategic Delivery Plan 6. The Corporate Assurance and Governance Group scrutinises progress on audit actions, operational risks, and inspection findings, reporting to SMT Operational Finance Performance Group Page 129
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• Re-appointment of Standards Officer agreed by MIJB [29 January 2026]. • [Member Handbook updated and is scheduled for circulation to members in October 2026 following approval of formal process by the Board]. • Quarterly performance to APR including benchmarking and targets. • All committees submitted required reports on schedule in [2025/26] • 100% of new members received induction on appointment • [Engagement with existing stakeholder members to confirm their willingness to continue in role under revised responsibilities.] Further Controls Required Further Controls Owner Complete integration of Children’s, Families and Justice. Organisational Review and Change process underway. [Due to organisational policies, this is being taken forward in stages]. HoS/CO [March 2027] Target Date Page 130
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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 indirectly impact the MIJB’s strategic planning of services and its decision-making. Consequence: Inability to deliver strategic priorities, potential statutory service cuts. Reduced service capacity, financial instability, compromised care delivery Risk Rating: Very High Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: Very High January 2026 Rationale for Risk Appetite (as detailed in Appendix 2) • Willing to accept moderate financial risks in pursuit of strategic objectives • Conservative approach to core budget management • Higher tolerance for innovative projects with clear benefits • Low tolerance for financial decisions that could threaten long-term sustainability Rationale for Risk Rating: The risk remains rated at Very High due to in year pressures, savings slippage and recurrent cost growth outpacing available funding, including high-cost care packages and demand growth in adults and children’s services. While the grip/control, oversight and escalation processes are in place, residual exposure to overspend and delivery risk remains high. Managing the risk - Current controls in place 5 5 25 1. Medium Term Financial Framework (MTFF) approved by MIJB on [26 March 2026]. 2. Some additional resource to support the Budget Savings Delivery has been extended to [December] 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. Extended Resource Management Group [oversees all staffing and any financial implications. Also, all High Cost Packages are scrutinised by the group]. 7. [SMT Operational Finance Performance meetings scrutinise areas of concern and performance issues]. 8. SMT are actively monitoring and responding to the grip and control measures as they arise, ensuring robust oversight 4 5 20 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 131
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Assurances: • Quarterly Budget monitoring reporting to MIJB • Financial Reporting through MIJB, NHS Grampian and bv Moray Council • The Project Management Office continues to support the Budget Savings Delivery 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. • 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 progress continues to be reported to APR Committee on a bi-annual basis]. • Finance workshops took place with Board members in December 2025 and Feb 2026 [and another is scheduled for January 2027]. Gaps in Assurance: Slippage in savings programme for 2025/26 was presented to MIJB in January 2026. Unprecedented growth and demand across adults and childrens services, adding significant pressure to all budgets and delivery of savings previously identified. Current Performance: [The Revenue Budget Outturn for 2025/26 was presented and a balanced budget for 2026/27 was agreed by MIJB on 26 March 2026. A Financial Savings Plan for 2026/27 was agreed by MIJB on 26 March 2026. Quarter 1 budget monitoring report will be presented to MIJB on 24 September 2026. Approved Audited accounts for 2025/26 will be presented to APR for scrutiny by APR committee 24 September 2026 and to MIJB for approval on 24 September 2026. APR committee presented with biannual update on Strategic Delivery Plan 29 October 2025]. Comments: Further Controls Required Further Controls Owner Target Date Review Date Review Notes / Decisions Risk 3: There is a risk that the MIJB’s workforce strategy is not delivered, impacting the quality of paid and unpaid Health and Social Care. Consequence: Service disruption and reduced capacity, Increased Workload and staff burnout, Significant Financial impact, Deteriorating Staff and Unpaid Carers Risk Rating: Medium 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. Page 132
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Morale and Engagement, Compromised Patient Safety and Care Quality, Negative Public Perception and Reputation Damage Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: Medium November 2025 Rationale for Risk Appetite (as detailed in Appendix 2) MIJB will only accept minimal risk to people accessing services, unpaid carers or staff when the comparative risk of doing nothing is higher than the risk of intervention. Safety risks inherent in Health and Social care services demand exceptional management and clinical care standards. The Board recognises that: • Individual safety is paramount • Person-centred care involves supporting informed decision-making, which may introduce nuanced risk scenarios A balanced approach is critical, considering both individual and community safety risks Rationale for Risk Rating: The risk remains Medium because recruitment and retention challenges, geography and housing constraints continue to affect capacity and service resilience. Residual risk remains until workforce plans are refreshed and resourced. Managing the risk - Current controls in place 5 5 25 1. Ongoing review of HSCM Structure to identify areas for consideration, development, reconfiguration. 2. Moray Council conducted an assessment of needs, including people working in the Health and Care sector. 3. Staff wellbeing is a key focus and there are many initiatives across both parent organisations offering information, support and access to activities. 4. Collaborative approaches with educational institutions e.g. intakes and programmes for future workforce development. 5. Professional Development and retention programmes; Incentives have been secured to attract additional NHS dentists and dental practices to Moray. The Scottish Dental Access Initiative includes Moray, with grants of £50,000 and above available to allow dental practices to be established or extended, provided there is a seven-year commitment to providing NHS treatment. A recruitment and retention bonus is also being offered to eligible new dentists in Moray. 6. GP sustainability Group and Primary Care Vison for the Future Group now progressing across Grampian. 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 133
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Assurances: • The Operational Moray Workforce Forum meets quarterly. • The HSCM Response Group continues to focus on leadership around emerging issues, including staffing. • The Carers Strategy extension was approved by MIJB June 2025, extending to March 2028. The focus is on developing support to the large, valued workforce of unpaid carers within Moray. • The Resource Management Group (RMG) scrutinises all vacancies before being considered for external advertisement. • The HSCM organisational review takes account of recruitment challenges and consultation with staff will be key to developing any changes. • [Clinical teams use national workforce model tools in operational planning]. Gaps in Assurance: • [Further capacity is required to develop and implement workforce plans aligned to the refreshed Strategic Delivery Plan and associated financial savings requirements]. • [The Workforce plan will be developed alongside the refresh of the Strategic Plan]. Current Performance: Comments: [Staffing issues are monitored by the Service Managers] working collaboratively to seek opportunities to make jobs more attractive where it has proven difficult to recruit in the past. There is the risk that staff move from one position to another within HSCM, as in unintended consequence creating a vacancy elsewhere in the system. This needs to be considered when fixed term contracts and secondments are planned; consideration needs to be given to the whole of HSCM and not services in isolation. Many of our staff may have transferrable skills and experience. Further Controls Required Further Controls Owner Target Date [Review and update of the Workforce Plan alongside the Strategy and refresh and Scottish Government guidance] Head of Strategy TBC Review Date Review Notes / Decisions Risk 4: There is a risk that the MIJB is unable to operate effectively as a Public Body. Consequence: Suboptimal outcomes for people, Erosion of organisational trust and credibility, Increased legal and regulatory compliance risks. Risk Rating: Medium 7. iMatter reports provide an opportunity for staff [to share their views on the MIJB and wider organisation. There was a slight increase in participation and team action plans in 2026]. Page 134
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Workforce demotivation and disengagement, missed strategic opportunities and collaborative potential, reduced organisational responsiveness and adaptability Risk Appetite: Low-Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: Medium November 2025 Rationale for Risk Appetite (as detailed in Appendix 2) The Board acknowledges the critical importance of: • Robust stakeholder relationships • Effective collaboration and co-production • Adaptive partnership working • Recognising diverse stakeholder capacities and readiness for change Strategic principles guiding stakeholder engagement: • Maintaining constructive, transparent relationships • Balancing organisational objectives with collaborative dynamics • Ensuring inclusive and meaningful engagement processes • Protecting long-term partnership sustainability Continuous Improvement in communication processes Rationale for Risk Rating: The risk remains Medium because engagement and communications processes are variable across a complex landscape, and the current Communication & Engagement Strategy (2019) is being updated. Whilst SOCG locality work, and adoption of ‘Planning with People’ principles, and strengthened digital channels are in place, assurance on consistency and outcome capture needs to improve within the limited capacity. Assurances: • Oversight and scrutiny by Clinical and Care Governance Committee, Audit Performance and Risk Committee and MIJB • Strategic Planning & Commissioning Group (SPCG) • 3rd Sector and Stakeholder Representatives on MIJB and committees • Local Outcome Improvement Plan (LOIP). • Community Planning Managing the risk - Current controls in place 4 4 16 • [Refocus of Strategic Planning & Commissioning Group (SPCG) to support locality engagement]. • Continued working with Community Planning colleagues to oversee the development of locality planning. • Grampian Joint Strategic Needs Assessment Group, including participation from community groups. • Engagement with diverse groups across Moray e.g. Moray Alcohol & Drug Partnership (ADP), School Nurses. • ‘Planning with People’ principles adopted as per Healthcare Improvement Scotland (HIS) 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 135
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• ADP • Stakeholder Representative on GP Vision Board • Summary reports of MIJB submitted to Moray Council and NHSG committees. • The Programme Management Office ensures that all programmes of work incorporate appropriate engagement as standard business as usual practice. Gaps in Assurance: • Seek to improve the level of engagement across Moray. • Communication and Engagement Strategy was approved in 2019 and is currently being updated. • More systematic approach to stakeholder consultation required. • Establish a more robust process for youth representation pathways. • [Refocus of Strategic Planning & Commissioning Group (SPCG) to support locality engagement]. Current Performance: • Locality Plans reviewed with the Strategic Delivery Plan • LOIP plans linked to MIJB Strategic Plan • [Annual Performance Report for 2025/26 published in July 2026]. Comments: • Communications & Engagement will be factored into the ongoing structural review, providing a more systematic approach to engagement in localities. Further Controls Required Further Controls Owner Target Date Update MHSCP Communication and Engagement Strategy Corporate Manager December 2026 Review Date Review Notes / Decisions Page 136
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Risk 5: There is a risk that the MIJB does not comply with the necessary legislative and regulatory requirements in which it operates. Consequence: Significant reputational impact and potential resource allocation challenge and possible financial and operational strain, potential impact on communities and staff. [Potential regulatory intervention, reputational damage, financial consequences, governance failure and ability to meet statutory obligations]. Risk Rating: Medium Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: Medium November 2025 Rationale for Risk Appetite (as detailed in Appendix 2) The MIJB has minimal tolerance of harm happening to people as a result of its actions, recognising the need to balance the risk of doing nothing and the risk of action or intervention. The Moray Integration Joint Board (MIJB) recognises its statutory obligations under the Civil Contingencies Act 2004, including its Category 1 Responder responsibilities introduced through the Civil Contingencies Act 2004 (Contingency Planning) (Scotland) Regulations 2021. Rationale for Risk Rating: The risk remains Medium as regulatory requirements span multiple domains (performance, finance, resilience, decision making), and system pressures raise the likelihood of standards not being met at times. Controls exist (learning loops, statutory reporting, resilience planning), but full assurance depends on Business Continuity planning being complete and visible across both parent bodies. Managing the risk - Current controls in place 5 5 25 1. Continuous emergency preparedness awareness with partners in Grampian Local Resilience Partnership (GLRP) – including exercises and debriefs. 2. Learning from Inspection Reports, Adverse Events, Complaints, actions plans and performance measures monitored by Clinical Risk Management (CRM), Clinical and Care Governance Group (CCGG) and Operational Management Team (OMT) with oversight by SMT. 3. HSCM Civil Contingencies group review specific risks and action plans to mitigate, developing plans and testing arrangements in partnership with NHSG and Council. 4. Annual review of internal resilience and emergency processes with Senior Managers on Call. 5. Timetable of statutory reporting across the financial year. 6. Implementation of [Corporate Assurance and Governance Group, scrutinising audit, operational risks, inspection reports etc., reporting to SMT Operational Finance Performance Group]. 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 137
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Assurances: • Quarterly reporting to Clinical and Care Governance and Audit, Performance and Risk Committees • Annual Performance Report – published July [2026] • Chief Social Work Officer’s Report • Internal and External Audits • Senior Management Meetings fortnightly • Joint meeting of MIJB Chief Officer with two Partner Body Chief Executives. • Annual report on MIJB activity developed and reported to Moray Council and NHSG • All Inspection reports reported to APR Committee with action plans developed and monitored Gaps in Assurance: Business Continuity (BC) Planning work is underway to ensure HSCM has a register of all plans and timescales – to be monitored by OMT and escalations to SMT. Current Performance: There are Resilience and Business Continuity processes in place, and these are reviewed regularly. Annual Performance Report for [2025/26] was approved by the MIJB and published in July [2026]. [Audited annual accounts will be presented to MIJB in September 2026]. Category One Responder duties incorporated in the role of Corporate Manager. Comments: Structure review of HSCM to mitigate the governance risk of services not meeting standards and adequate service delivery. The Manchester Arena Inquiry and Grenfell Inquiry has resulted in a focus on Category 1 responders’ responsibilities, together with an increase of additional policies/procedures to be developed, implemented and exercised with no additional resource. Implementation plan for new Scottish Government Resilience Standards will be required once received. Further Controls Required Further Controls Owner Target Date Business Continuity Planning Senior Management Team April 2027 Review Date Review Notes / Decisions Page 138
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Risk 6: There is a risk that the MIJB’s strategic aspirations are not transformative and as a result, it is unable to deliver outcomes for people in a sustainable way. Consequence: Persistent health inequalities, erosion of public trust and organisational reputation, potential legal challenges, significant reputational damage to MIJB, potential long-term negative impacts on community health outcomes, reduced effectiveness of healthcare resource allocation Risk Rating: Medium Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: Medium November 2025 Rationale for Risk Appetite (as detailed in Appendix 2) The Moray Integration Joint Board (MIJB) faces significant challenges in maintaining service delivery across its delegated services from NHS Grampian and Moray Council. These challenges stem from three key areas: Resource Constraints Budgetary pressures are leading to reduced staffing resources, affecting service delivery capacity and quality. This situation requires careful management to maintain essential services while operating within financial constraints. System Pressures The healthcare system continues to experience significant strain from high levels of unplanned admissions and delayed discharges. While teams across the care pathway are working collaboratively to address these issues, the complexity of the situation, combined with limited community care availability, makes sustainable improvement challenging. Service Redesign The financial recovery plan necessitates fundamental service redesign to deliver outcomes more efficiently. While the aim is to enhance service quality through these changes, public expectations may need to adjust to align with what is deliverable within budget constraints. This requires careful management of both service transformation and stakeholder expectations. The Moray Integration Joint Board (MIJB) is committed to: • Maintaining exemplary standards of governance • Balancing innovative approaches with robust regulatory compliance • Proactively managing emerging risks in a dynamic healthcare landscape • Prioritisation of Moray’s unique community needs Regulatory risks will only be considered with: 1. Comprehensive consultation with relevant regulatory bodies 2. Clearly defined and documented defensible risk mitigation strategies 3. Transparent decision-making processes 4. Thorough impact assessments MIJB will only take regulatory risks knowingly, following consultation with the relevant regulatory body and where we have clear risk mitigation in place. Page 139
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Potential impacts to the wide range of services in NHS Grampian and Moray Council commissioned by the MIJB arising from reductions in available staff resources as budgetary constraints impact. Unplanned admissions and delayed discharges place additional cost and capacity burdens on the service. The level of delayed discharges has remained challenging, reflecting the sustained pressure in the system and the lack of availability of care in the community. There are sustained focussed and collective efforts by all those working in the pathway. However, this is a complex area and will require continued effort to realise reductions and maintain them. [The future savings plan will require significant service transformation to meet outcomes that are financially sustainable. It is recognised that public expectations may differ to what can be delivered within budget]. The Moray Integration Joint Board (MIJB) faces significant challenges in maintaining service delivery across its commissioned services from NHS Grampian and Moray Council. Rationale for Risk Rating: The risk remains at a Medium rating due to persistent system pressures, including high levels of unplanned admissions, delayed discharges, and constrained community capacity, all of which limit the Partnership’s ability to progress transformation at the intended pace. Significant financial constraints and limited workforce capacity continue to impact the feasibility and timing of redesign work. Public expectations also remain higher than what can be delivered within current resources. Although strong governance arrangements, performance oversight, and collaborative work across the pathway are in place, these structural challenges continue to create a sustained risk that the MIJB may be unable to deliver all strategic aspirations in a sustainable way. Managing the risk - Current controls in place 5 4 20 1. Clinical and Care Governance (CCG) oversight is provided through the CCG Committee, supported by the Clinical and Care Governance Group, Clinical Risk Management (CRM) and Practice Governance structures, ensuring professional standards are monitored and risks escalated appropriately. 2. HSCM Clinical Risk Management (CRM) Group and NHS Grampian CRM Group review High and Very High operational health service risks. 3. Annual Performance Reports provide assurance across services delivered in Moray. 4. Regular Internal and External scrutiny is provided through inspections. 5. Internal/External Inspection reports are scrutinised by appropriate operational groups with actions tracked and monitored through the appropriate governance groups. 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 140
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Assurances: Audit, Performance and Risk and Clinical and Care Governance Sub-Committees oversight and scrutiny. The Clinical and Care Governance Framework was refreshed and presented to CCG Committee in November 2023. The Strategic Delivery Plan was approved by MIJB June 2025 Gaps in Assurance: Process for highlighting recurring themes or strategic expectations from external inspections requires further development to ensure Committee has sight of significant issues. Current Performance: External inspection reports are scrutinised and actions arising are allocated to responsible officers. A summary of inspections is included in the Annual Performance report. Risk Management session delivered for managers in HSCM in September 2023, by the NHSG Risk Advisor. Comments: No major concerns identified for HSCM services in any audits or inspections during 2024/25. The current financial pressures will impact HSCM’s ability to deliver on the priorities set out in the strategic plan and requires a level of transformation to match this. Further Controls Required Further Controls Owner Target Date Review Date Review Notes / Decisions 6. Care Home Collaborative Support Group provides oversight, ensuring risks in care homes are monitored and mitigated through partnership working. 7. Children and Adult Protection Committees provide specialist scrutiny and ensure statutory safeguarding duties are met. 8. Robust governance arrangements such as SMT, OMT and daily operational huddles ensure regular oversight, co- ordinated decision making and early escalation of system pressures. 9. Organisational Review of HSCM structures is underway to strengthen strategic capacity and ensure the organisation is equipped to deliver transformation and ability to respond to increasing demands across the system. Page 141
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Risk 7: There is a risk that the MIJB is unable to exert influence on services delegated but hosted within another organisation. Consequence: Legal challenge from Moray citizens and staff, potential intervention or censure from Scottish Government, systemic service failures, particularly in areas such as IT, Human Resources, Legal and compliance services Risk Rating: Medium Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: Medium November 2025 Rationale for Risk Appetite (as detailed in Appendix 2) Extremely low tolerance for: • Systemic support service failures • Potential compromise of organisational effectiveness • Risk of legal and regulatory non-compliance • Diminished service delivery capacity Low tolerance in relation to not meeting requirements. Rationale for Risk Rating: The risk remains Medium because hosted services are subject to partner governance, financial constraints and workforce pressures outside MIJB’s direct control. The tri-partite working forums improve visibility and influence but cannot fully eliminate dependency risks. Parent organisations experiencing: • Significant financial constraints • Staffing challenges • Potential resource allocation limitations The projected overspend in hosted services sits within each MIJB and HSCM is one of the partners who can influence decisions. Assurances: These largely come from the systems, process and procedures put in place by NHS Grampian, which are still being operated, along with any new processes which are put in place by the lead MIJB. [The North East System Transformation Group brings together NHS Grampian, Aberdeen City, Aberdeenshire and Moray Councils, and their respective IJBs to identify and develop whole-system transformation and efficiency opportunities Managing the risk - Current controls in place 5 4 20 1. Chief Officer regularly meets with Chief Officers of Aberdeen City Health and Social Care Partnership and Aberdeenshire Health and Social Care Partnership. 2. Significant changes to service delivery are discussed across all three HSCPs. 3. Agreement that proposals regarding significant service changes are presented to all three MIJB’s for approval. 4. Internal Audit review of MIJB Hosted Services and monitoring of agreed recommendations. 3 3 9 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 142
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that improve outcomes and make best use of collective resources across Grampian]. Gaps in Assurance: Implementation of the Internal Audit recommendations relating to Service Level Agreements remains in progress. Current Performance: Comments: Further Controls Required Further Controls Owner Target Date Review Date Review Notes / Decisions Page 143
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Risk 8: There is a risk that the MIJB’s internal control and governance arrangements are not sufficiently robust to provide full assurance, as evidenced by the [2025/26] Internal Audit Annual Opinion of ‘Limited Assurance’ Consequence: • Weaknesses in internal controls may lead to financial mismanagement, service delivery failures, reputational damage, and non-compliance with statutory duties. • Delays in implementing audit recommendations may result in prolonged exposure to known risks and inefficiencies. • A continued ‘limited assurance’ position may reduce stakeholder confidence in the MIJB’s governance and oversight arrangements. Risk Rating: Medium Risk Appetite: Moderate (as per Appendix 2) Risk Movement: Historical Risk Rating: Medium November 2025 Rationale for Risk Appetite (as detailed in Appendix 2) • The MIJB recognises the importance of strong internal controls and governance to support safe, effective, and sustainable service delivery. • While some risk is accepted in the pursuit of transformation, assurance processes must be timely, transparent, and responsive to audit findings. Rationale for Risk Rating: The risk remains Medium because the [2025/26] Internal Audit Annual Opinion was ‘Limited Assurance’ with delays in recommendations and weaknesses noted in contract management, digital and tracking arrangements. Controls have strengthened (end to end audit tracking, SMT engagement, governance statement) but residual risk persists until audit actions are closed and key enablers are delivered. Assurances: • Internal Audit Annual Report presented to APR Committee [June 2026]. • Internal Audit Quarterly reporting of audit progress and follow-up to APR Committee. Managing the risk - Current controls in place 4 5 20 1. ‘End to end’ process for agreeing, implementing and tracking audits is now established with regular OMT/SMT oversight. 2. Governance statement prepared in line with CIPFA/SOLACE guidance. 3. Internal audit attending regular SMT meetings to discuss audit plan work and any emerging risks. 4. Financial resource from HSCM to MIJB Internal Audit team to improve capacity for collaboration and oversight. 5. [The Corporate Assurance and Governance Group scrutinises progress on audit actions, operational risks, and inspection findings, reporting to SMT Operational Finance Performance Group]. 2 3 6 Untreated Likelihood Untreated Impact Untreated Score Current Likelihood Current Impact Current Score Page 144
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• Oversight by SMT. • [Additional Internal assurance arrangements implemented (CAG) to provide support and operational assurance to SMT in accordance with agreed timescales]. Gaps in Assurance: [Updated operational Risk Policy framework is out for consultation with Services]. Current Performance: • [The audit of Adult Social Care Commissioning audit (2022) has concluded. • Audit plan for 2026/27 includes follow-up reviews to verify progress. • Continued collaborative partnership working with Internal Audit and SMT]. Comments: Further Controls Required Further Controls Owner Target Date • [Continue to identify capacity to progress the Digital work stream, including digitalisation where possible. This timescale is under discussion with service and Internal Audit due to delays out with MHSCP control]. • Progress development of unified case recording system. [As above]. • HSCM Risk Framework currently being updated. CFO/HoS HoS SMT [December 2027] [September 2027] November 2026 Review Date Review Notes / Decisions Page 145
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MIJB Risk Appetite Statement The Moray MIJB recognizes that effective risk management is fundamental to achieving its strategic objectives in delivering integrated health and social care services. This statement defines the level and type of risk the MIJB is willing to accept in pursuit of achieving the outcomes defined in the strategic plan, Partners in Care 2022-2032. Moray MIJB adopts a balanced approach to risk-taking, acknowledging that transformation, innovation and service improvement often require managed risk-taking while ensuring the safety and wellbeing of its staff and the public remains paramount. Strategic Risk: MODERATE-HIGH • Higher appetite for strategic initiatives supporting integration • Willingness to innovate in service delivery • Acceptance of calculated risks in pursuit of transformation • Support for pilot projects with clear business case and evaluation criteria At this appetite level, the board is willing to accept some uncertainty in governance processes where: - Clear oversight mechanisms remain in place - Core statutory obligations continue to be met - Potential benefits to service delivery are significant - Learning opportunities from governance adjustments can be captured Financial Risk: MODERATE • Willing to accept moderate financial risks in pursuit of strategic objectives • Conservative approach to core budget management • Higher tolerance for innovative projects with clear benefits • Low tolerance for financial decisions that could threaten long-term sustainability Clinical Safety Risk: LOW • Minimal appetite for risks affecting patient/service user safety • Strong controls and monitoring required for all clinical activities • Zero tolerance for non-compliance with clinical governance standards • Comprehensive risk assessments required for any service changes • Operational Risk: MODERATE • Moderate tolerance for operational changes that improve efficiency • Willing to consider new service delivery models • Acceptance of short-term disruption for long-term benefits • Regular monitoring and review of operational changes Reputational Risk: LOW-MODERATE • Conservative approach to actions that could damage public trust • Proactive stakeholder engagement in major decisions Page 146
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• Low tolerance for activities that could undermine partnership working • Emphasis on transparent decision-making Workforce Risk: MODERATE • Moderate appetite for workforce development initiatives • Innovation in recruitment and retention strategies • Support for new ways of working • Low tolerance for risks affecting staff wellbeing Risk Governance • Regular review of risk appetite by the MIJB Board • Clear escalation procedures for risks exceeding appetite levels • Integration of risk appetite into decision-making processes • Regular reporting on risk profile against appetite Implementation • Risk appetite to be considered in all significant decisions • Regular training for staff on risk management • Clear communication of risk appetite across the organization • Annual review and update of risk appetite statement Monitoring and Review • Bi-annual review of risk register against appetite levels • Annual review of risk appetite statement • Regular reporting to Audit and Risk Committee • Adjustment of appetite levels based on changing context This statement will be reviewed annually and updated as required to reflect changes in the operating environment and strategic priorities. Page 147
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Likelihood – What is the likelihood of the risk occurring? Assess using the criteria below. Rare (1) Unlikely (2) Possible (3) Likely (4) Almost Certain (5) Do not believe this event would happen Will only happen in exceptional circumstances Not expected to happen but definite potential exists Unlikely to occur May occur occasionally Has happened before on occasions Reasonable chance of occurring Strong possibility that this could occur Likely to occur This is expected to occur frequently/ in most circumstances more likely to occur than not Impact – What could happen if the risk occurred? Assess for each category and use the highest score identified. The impact scale is from an organisational level perspective. It reflects the key areas that if impacted could prevent the organisation achieving its priorities and objectives. The scale is a guide and cannot cover every type of impact therefore judgement is required. Category Negligible (1) Minor (2) Moderate (3) Major (4) Extreme (5) Patient or Service user Experience Reduced quality patient experience/clinical outcome not directly related to delivery of clinical care Unsatisfactory patient experience/clinical outcome directly related to care provision – readily resolvable Unsatisfactory patient experience/ clinical outcome, short term effects – expect recovery less than 1wk Unsatisfactory patient experience /clinical outcome, long term effects - expect recovery over more than 1week Unsatisfactory patient experience/clinical outcome, continued ongoing long term effects Objectives/ Project Barely noticeable reduction in scope/quality/ schedule Minor reduction in scope/quality/schedule Reduction in scope/quality/project objectives or schedule Significant project overrun Inability to meet project/corporate objectives, reputation of organisation seriously damaged Page 148
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Injury /illness (physical and psychological) to patient/service user/visitor/staff/carer Adverse event leading to minor injury not requiring first aid Minor injury or illness, first aid treatment required Agency reportable, e.g. Police (violent and aggressive acts) Significant injury requiring medical treatment and/or counselling Major injuries/long term incapacity /disability (e.g. loss of limb), requiring, medical treatment and/or counselling Incident leading to death(s) or major permanent incapacity Complaints/Claims Locally resolved verbal complaint Justified written complaint peripheral to clinical care Justified complaint involving lack of appropriate care Claim above excess level. Multiple justified complaints Multiple claims or single major claim Complex Justified complaint Service/ Business Interruption Interruption in a service which does not impact on the delivery of patient care or the ability to continue to provide service Short term disruption to service with minor impact on patient care/service provision Some disruption in service with unacceptable impact on patient care Temporary loss of ability to provide Service. Sustained loss of service which has serious impact on delivery of patient care resulting in major contingency plans being invoked Permanent loss of core service/ facility Disruption to facility leading to significant “knock on” effect -- to function Staffing and Competence Short term low staffing level temporarily reduces service quality (less than 1 day) Short term low staffing level (>1 day), where there is no disruption to patient care Ongoing low staffing level reduces service quality Minor error due to lack of/ ineffective training/ implementation of training Late delivery of key objective/service /care due to lack of staff Moderate error due to lack of/ ineffective training / implementation of training Ongoing problems with staffing levels Uncertain delivery of key objective/service/care due to lack of staff Major error due to lack of/ ineffective training / implementation of training Non-delivery of key objective/ service/care due to lack of staff. Loss of key staff Critical error due to lack of/ ineffective training/ implementation of training Page 149
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Financial (including Damage/Loss/Theft/ Fraud Negligible organisational/ personal financial loss up to £1k Minor organisational/ personal financial loss of £1-10K Significant organisational/personal financial loss of £10- 100k Major organisational/personal financial loss of £100k- 1m) Severe organisational financial loss of more than £1m Inspection/ Audit Small number of recommendations which focus on minor quality improvement issues Recommendations made which can be addressed by low level of management action Challenging recommendations that can be addressed with appropriate action plan Improvement Notice Enforcement/prohibition action Low Rating Critical report Prosecution Zero rating Severely critical report Adverse Publicity/ Reputation Rumours, no media coverage Little effect on staff morale Local media coverage – short term. Some public embarrassment Minor effect on staff morale/public attitudes Local media – long term adverse publicity Significant effect on staff morale/public perception of the organisation National media adverse publicity less than 3 days Public confidence in the organisation undermined Use of services affected National/International media/ adverse publicity, more than 3 days MSP/MP/SEHD concern (Questions in Parliament) Court Enforcement/Public Enquiry/FAI Risk Scoring Consequences/Impact Likelihood Negligible Minor Moderate Major Extreme Almost Certain Medium High High V High V High Likely Medium Medium High High V High Possible Low Medium Medium High High Unlikely Low Medium Medium Medium High Rare Low Low Low Medium Medium Review Timescales – When a risk rating has been assigned the criteria below should be used to assess the review timescales. Page 150
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Very High or High Requires monthly monitoring and updates. Medium Requires quarterly monitoring and updates. Low Requires 6 monthly monitoring and updates. Page 151
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 24 SEPTEMBER 2026 SUBJECT: EXTERNAL AUDITORS’ REPORT TO THOSE CHARGED WITH GOVERNANCE BY: CHIEF FINANCIAL OFFICER 1. REASON FOR REPORT 1.1 To request the Committee consider the reports to those charged with governance from the Board’s External Auditor for the year ended 31 March 2026. 2. RECOMMENDATION 2.1 It is recommended that the Committee considers and notes the reports from the External Auditor within Appendices 1 and 2. 3. BACKGROUND 3.1 The responsibilities of Audit Scotland as the independent auditor are established by the Local Government (Scotland) Act 1973, the code of Audit Practice (2021), which can be found at Code of Audit Practice and supplementary guidance, and are supported by the auditing profession’s ethical guidance. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The work carried out by Grant Thornton during 2025/26 has produced two reports that are subject to the consideration of those charged with governance. The reports are attached as follows: • Independent Auditors Report to those charged with governance (Appendix 1) • The Annual Audit Report 2025/26 (Appendix 2) 4.2 The audit opinions expressed were all unqualified and are reported within the ‘independent auditors report’ included within Appendix 1. 4.3 The Annual Audit Report included at Appendix 2 provides an Action Plan where recommendations for improvement are made, based on the findings of the Item 10 Page 153
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review. These recommendations have been discussed with management and corresponding actions have been agreed, together with timescales for completion. 4.4 The Annual Audit Report provides a summary of the significant audit risks identified during planning. The results and conclusions of this work are noted within the report. 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 work of the external auditor and the production of these reports for those charged with governance have been completed within the specified timescales agreed. (b) Policy and Legal The Public Bodies (Joint Working ) (Scotland) Act 2014 requires that the Moray Integration Joint Board (MIJB) is subject to the audit and accounts provisions of a body under Section 106 of the Local Government (Scotland) Act 1973. (c) Financial implications There are no direct financial implications arising from this report. (d) Risk Implications and Mitigation The external auditor, Grant Thornton, through the audit process, provides assurance to the Board that the Annual Accounts for 2025/26 give a true and fair view of the financial position. The Annual Audit Report highlights risks identified during the audit process and recommendations for action that have been agreed by management. (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 resultant policy change. (h) Climate Change and Biodiversity Impacts There are no direct climate change and biodiversity implications as there has been no change to policy. (i) Directions None arising directly from this report (j) Consultations Page 154
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Consultation has taken place between Grant Thornton and the Chief Financial Officer of the MIJB in preparation of the Annual Audit Report. Any comments received have been considered in writing this report. 6. CONCLUSION 6.1 The External Auditor has issued an unqualified opinion for the 2025/26 Annual Accounts. The Annual Audit Report, Independent Auditors’ Report and the Letter of Representation present the full findings. Author of Report: Deborah O’Shea, Chief Financial Officer Background Papers: with author Ref: Page 155
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APPENDIX 1 Independent auditor’s report to the members of Moray Integration Joint Board and the Accounts Commission Reporting on the audit of the financial statements Opinion on financial statements We certify that we have audited the financial statements in the annual accounts of Moray Integration Joint Board for the year ended 31 March 2026 under Part VII of the Local Government (Scotland) Act 1973. The financial statements comprise the Comprehensive Income and Expenditure Statement, Movement in Reserves Statement, the Balance Sheet and notes to the financial statements, including material accounting policy information. The financial reporting framework that has been applied in their preparation is applicable law and UK adopted international accounting standards, as interpreted and adapted by the Code of Practice on Local Authority Accounting in the United Kingdom 2025/26 (the 2025/26 Code). In our opinion the accompanying financial statements: • give a true and fair view of the state of affairs of the Board as at 31 March 2026 and of its income and expenditure for the year then ended; • have been properly prepared in accordance with UK adopted international accounting standards, as interpreted and adapted by the 2025/26 Code; and • have been prepared in accordance with the requirements of the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003. Basis for opinion We conducted our audit in accordance with applicable law and International Standards on Auditing (UK) (ISAs (UK)), as required by the Code of Audit Practice approved by the Accounts Commission for Scotland. our responsibilities under those standards are further described in the auditor’s responsibilities for the audit of the financial statements section of our report. We were appointed by the Accounts Commission on 18 May 2022. Our period of appointment is five years, covering 2022/23 to 2026/27. We are independent of the Board in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK including the Financial Reporting Council’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. Non-audit services prohibited by the Ethical Standard were not provided to the Board. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. Conclusions relating to going concern basis of accounting We have concluded that the use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Page 156
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APPENDIX 1 Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the Board’s ability to continue to adopt the going concern basis of accounting for a period of at least twelve months from when the financial statements are authorised for issue. These conclusions are not intended to, nor do they, provide assurance on the Board’s current or future financial sustainability. However, we report on the Board’s arrangements for financial sustainability in a separate Annual Audit Report available from the Audit Scotland website. Risks of material misstatement We report in our Annual Audit Report the most significant assessed risks of material misstatement that we identified and our judgements thereon. Responsibilities of the Chief Financial Officer and Moray Integration Joint Board for the financial statements As explained more fully in the Statement of Responsibilities, the Chief Financial Officer is responsible for the preparation of financial statements that give a true and fair view in accordance with the financial reporting framework, and for such internal control as the Chief Financial Officer determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the Chief Financial Officer is responsible for assessing the Board’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless there is an intention to discontinue the Board’s operations. The Moray Integration Joint Board is responsible for overseeing the financial reporting process. Auditor’s responsibilities for the audit of the financial statements Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the decisions of users taken on the basis of these financial statements. Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities outlined above to detect material misstatements in respect of irregularities, including fraud. Procedures include: • using our understanding of the local government sector to identify that the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003 are significant in the context of the Board; Page 157
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APPENDIX 1 • inquiring of the Chief Financial Officer as to other laws or regulations that may be expected to have a fundamental effect on the operations of the Board; • inquiring of the Chief Financial Officer concerning the Board’s policies and procedures regarding compliance with the applicable legal and regulatory framework; • discussions among our audit team on the susceptibility of the financial statements to material misstatement, including how fraud might occur; and • considering whether the audit team collectively has the appropriate competence and capabilities to identify or recognise non-compliance with laws and regulations. The extent to which our procedures are capable of detecting irregularities, including fraud, is affected by the inherent difficulty in detecting irregularities, the effectiveness of the Board’s controls, and the nature, timing and extent of the audit procedures performed. Irregularities that result from fraud are inherently more difficult to detect than irregularities that result from error as fraud may involve collusion, intentional omissions, misrepresentations, or the override of internal control. The capability of the audit to detect fraud and other irregularities depends on factors such as the skilfulness of the perpetrator, the frequency and extent of manipulation, the degree of collusion involved, the relative size of individual amounts manipulated, and the seniority of those individuals involved. A further description of the auditor’s responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report. Reporting on other requirements Opinion prescribed by the Accounts Commission on the audited parts of the Remuneration Report We have audited the parts of the Remuneration Report described as audited. In our opinion, the audited parts of the Remuneration Report have been properly prepared in accordance with The Local Authority Accounts (Scotland) Regulations 2014. Other information The Chief Financial Officer is responsible for the other information in the annual accounts. The other information comprises the Management Commentary, Annual Governance Statement, Statement of Responsibilities and the unaudited part of the Remuneration Report. Our responsibility is to read all the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this Page 158
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APPENDIX 1 gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard. Our opinion on the financial statements does not cover the other information and we do not express any form of assurance conclusion thereon except on the Management Commentary and Annual Governance Statement to the extent explicitly stated in the following opinions prescribed by the Accounts Commission. Opinions prescribed by the Accounts Commission on the Management Commentary and Annual Governance Statement In our opinion, based on the work undertaken in the course of the audit: • the information given in the Management Commentary for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with statutory guidance issued under the Local Government in Scotland Act 2003; and • the information given in the Annual Governance Statement for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with the Delivering Good Governance in Local Government: Framework (2016). Matters on which we are required to report by exception We are required by the Accounts Commission to report to you if, in our opinion: • adequate accounting records have not been kept; or • the financial statements and the audited part of the Remuneration Report are not in agreement with the accounting records; or • We have not received all the information and explanations we require for our audit. We have nothing to report in respect of these matters. Conclusions on wider scope responsibilities In addition to our responsibilities for the annual accounts, our conclusions on the wider scope responsibilities specified in the Code of Audit Practice, including those in respect of Best Value, are set out in our Annual Audit Report. Page 159
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APPENDIX 1 Use of our report This report is made solely to the parties to whom it is addressed in accordance with Part VII of the Local Government (Scotland) Act 1973 and for no other purpose. In accordance with paragraph 108 of the Code of Audit Practice, we do not undertake to have responsibilities to members or officers, in their individual capacities, or to third parties. Angela Pieri, (for and on behalf of Grant Thornton UK LLP), 120 Bothwell Street, Glasgow, G2 7JS Date: Page 160
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Moray Integration Joint Board Annual Audit Report Financial year ending 31 March 2026 9 September 2026 Prepared for those Charged with Governance and the Accounts Commission APPENDIX 2 Page 161
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow GUIDANCE NOTES: Table of contents does not update automatically • Please delete or factor in any instruction slides at the start of the deck before pagination • Please populate the page numbers manually before distributing Table of contents 2 01 Headlines 03 02 Introduction 07 03 Audit of the annual report and accounts 09 04 Wider scope and best value conclusions 22 Appendices A Audit adjustments 43 B Follow up of prior year audit recommendations 44 C Audit fees, ethics and independence 51 D Client Service Review 53 E Communication of audit matters 54 Tip – Select View/Outline View, Right click and select "Collapse" and copy slide titles then paste into your table of conents Don’t forget to change the footer The contents of this report relate only to the matters which have come to our attention, which we believe need to be reported to you as part of our external audit process. It is not a comprehensive record of all the relevant matters, which may be subject to change, and in particular we cannot be held responsible to you for reporting all of the risks which may affect the Council or all weaknesses in your internal controls. This report has been prepared solely for your benefit and Audit Scotland (under the Audit Scotland Code of Audit Practice 2021). We do not accept any responsibility for any loss occasioned to any third part acting, or refraining from acting on the basis of the content of this report, as this report was not prepared for, nor intended for, any other purpose.Page 162
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Headlines01 Page 163
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Financial statements
Under International Standards of Audit (UK) (ISAs) and Audit Scotland’s Code of
Audit Practice ('the Code'), we are required to report whether, in our opinion:
• the IJB’s financial statements give a true and fair view of the state of affairs
of the IJB as at 31 March 2026 and of the income and expenditure of the
organisation for the year then ended;
• the IJB’s financial statements have been properly prepared in accordance
with UK adopted international accounting standards, as interpreted and
adapted by the 2025/26 CIPFA Code of Practice on Local Authority
Accounting;
• the IJB’s financial statements have been prepared in accordance with the
requirements of the Local Government (Scotland) Act 1973, The Local
Authority Accounts (Scotland) Regulations 2014, and the Local Government
in Scotland Act 2003; and
• the audited part of the Remuneration Report has been properly prepared in
accordance with The Local Authority Accounts (Scotland) Regulations 2014.
We are required to report whether the information given in the Management
Commentary is consistent with the financial statements and has been prepared
in accordance with statutory guidance issued under the Local Government in
Scotland Act 2003.
We are also required to report on whether the information given in the Annual
Governance Statement is consistent with the financial statements and
prepared in accordance with the Delivering Good Governance in Local
government: Framework (2016).
We have concluded that the Remuneration Report has been prepared in
accordance with requirements.
We have concluded the work on the Governance Statement has been prepared in
accordance with the relevant guidance.
We have concluded that the other information to be published alongside the
financial statements is consistent with our knowledge of the IJB.
Draft financial statements
The draft financial statements were presented for audit by the deadline of 30 June
2026. We have been supported by Moray IJB’s officers during the audit process
with effective working relationships and commitment to the audit process.
We have completed our audit work and subject to the satisfactory completion of
outstanding items outlined at page 6, we anticipate issuing an unmodified opinion.
The working papers presented for audit were a good quality, and any
supplementary working papers, sample requests and queries were responded to
effectively.
We have not identified any misstatements to primary statements, with very minor
disclosure issues amended by management, that did not warrant detailed
reporting, as noted in Appendix 1.
We have not identified any financial statements recommendations for management
as a result of our audit work on the financial statements, and there were no
recommendations for follow up from the previous audit.
We would like to take this opportunity to record our appreciation for the assistance
provided by the Chief Financial Officer and the wider IJB team, in completing the
external audit.
4
This table summarises the key findings and other matters arising from the external audit of Moray Integration Joint Board (IJB) and the preparation of the
financial statements for the year ended 31 March 2026 for those charged with governance (the Board) and the Accounts Commission.
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Headlines (2) Wider scope Under the Audit Scotland Code of Audit Practice (‘the Code’), the scope of public audit extends beyond the audit of the financial statements. The Code requires auditors to consider the IJB’s arrangements in respect of financial management, financial sustainability, vision leadership and governance and use of resources to improve outcomes. In our External Audit Plan for the year ended 31 March 2026, we documented our assessment of the wider scope risks and planned audit work. At the planning stage, we identified one risk in respect of financial sustainability. We outline our work undertaken in response to the arrangements in place and the risks identified and conclude on the effectiveness and appropriateness of the arrangements in place based on the work carried out. There remains a significant risk in respect of financial sustainability given the significant financial challenges the IJB faces over the longer term. Further details of the work undertaken on wider scope are outlined on pages 22 to 41. We have raised not raised any new recommendations for management as a result of our audit work on wider scope. We have followed up the 2 recommendations raised in our previous audit report in 2024/25 and the 6 outstanding recommendations that were not yet actioned from our 2023/24 audit report. Out of those 8 recommendations, 5 have been cleared with 3 remaining open. The results are set out at Appendix B. The clearance of the remaining recommendations will be followed up in 2026/27. Some recommendations are from the 2024/25 audit and prior and should be implemented by management. This is the fifth consecutive year that Internal Audit has issued a limited assurance opinion, reflecting ongoing weaknesses in the framework of governance, risk management and control. Five consecutive years of limited assurance is unusual, and underlying issues have not yet been fully resolved despite the steps taken so far. Several internal audit recommendations remain outstanding across multiple years. While management has taken some action, and the Audit, Performance and Risk Committee has continued to provide challenge and scrutiny, the pace of resolution has not been sufficient to close these out. The IJB should consider a refreshed approach to clearing outstanding actions with clearer ownership and realistic timescales to help ensure recommendations are actioned more promptly going forward. Integration Joint Board’s have a statutory duty to have arrangements to secure Best Value. The IJB have adequate arrangements in place to meet the Best Value obligations, and a review of Best Value has been undertaken and reported in year. This was a recommendation in our report last year to undertake this assessment, and the recommendation has now been closed. 5 Page 165
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Headlines (3) Status of Audit Work Our work is substantially complete, and at this stage there are no matters of which we are aware that would require modification of our audit opinion. This is subject to the finalisation of the following outstanding matters : • finalisation of review of disclosures and accounting policies within the financial statements and annual report In addition, the usual closing processes at the final stages of the audit process will need to be performed as listed below: • receipt of management representation letter • review of the final set of financial statements • receipt of final signed financial statements • final sign off by the engagement lead • receipt of management’s updated going concern and post balance sheet events assessment at the date of sign off. 6 Page 166
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Introduction02 Page 167
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Introduction Scope of our audit work Our work has been undertaken in accordance with International Standards of Auditing (ISAs) (UK) and the Code. This report is addressed to the IJB and the Accounts Commission and will be published on Audit Scotland's website www.audit-scotland.gov.uk in due course. This report is a summary of our findings from our external audit work for the financial year at Moray IJB. The scope of our audit was set out in our External Audit Plan dated 24 March 2026. The core elements of our audit work in 2025/26 have been: • An audit of the IJB’s annual report and accounts for the financial year ended 31 March 2026 [findings reported within this report]; • Consideration of the wider dimensions that frame the scope of public audit as set out in Audit Scotland’s Code of Audit Practice 2021 (‘the Code’) [within this report]; • Any other work requested by Audit Scotland. Responsibilities The IJB has primary responsibility for ensuring the proper financial stewardship of public funds. This includes preparing annual accounts in accordance with proper accounting practices. The IJB is also responsible for compliance with legislation, and establishing arrangements over governance, propriety and regularity that enable it to successfully deliver its objectives. Our responsibilities as independent auditors, appointed by the Accounts Commission, are set out in the Local Government in Scotland Act 1973, the Code and supplementary guidance, and International Standards on Auditing in the UK. The recommendations or risks identified in this report are only those that have come to our attention during our normal audit work and may not be all that exist. Communication in this report of matters arising from the audit or of risks or weaknesses does not absolve officers from their responsibility to address the issues raised and to maintain an adequate system of control. Adding value through our audit work We aim to add value to the IJB throughout our audit work. We do this through using our wider public sector knowledge and we invited IJB officers to our annual local government accounting workshop. Through our expertise, we provide constructive, forward-looking recommendations where we identify areas for improvement and encourage good practice around financial management and financial sustainability, risk management and performance monitoring. In so doing, we aim to help the IJB promote improved standards of governance, better management and decision making, and more effective use of resources. 8 Page 168
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Audit of the annual report and accounts 03 Page 169
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Audit of the annual report and accounts Approach to the audit of financial statements Key audit matters and significant risks The following significant risks have been identified: • Management override of controls (significant risk). No key audit matters have been identified. Internal control environment In accordance with ISA requirements, we have developed an understanding of the IJB’s control environment. Our audit is not controls based and we have not placed reliance on controls operating effectively as our audit is substantive in nature. In accordance with ISAs, over those areas of significant risk of material misstatement we consider the design of controls in place. However, we do not place reliance on the design of controls when undertaking our substantive testing. We identified no material weaknesses or areas of concern from this work which would have caused us to alter the planned approach as documented in our plan. Recap of our audit approach and key changes in our audit strategy We have not identified any changes in our approach since our Audit Plan was presented to the Audit, Performance and Risk Committee on 25 June 2026. The risks identified remain the same. 10 Key audit matters Scoping Materiality Page 170
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Our application of materiality We apply the concept of materiality both in planning and performing the audit, and in evaluating the effect of identified misstatements on the audit and of uncorrected misstatements, if any, on the financial statements and in forming the opinion in the auditor’s report. The concept of materiality is fundamental to the preparation of the financial statements and the audit process and applies not only to the monetary misstatements but also to disclosure requirements and adherence to acceptable accounting practice and applicable law. Our audit approach was set out in our audit plan. • We reviewed and updated our assessment of materiality from planning based upon your 2025/26 draft financial statements and concluded that materiality is £5.657 million (PY £5.257 million), which equates to approximately 2.5% (PY 2.5%) of 2025/26 gross expenditure. • Performance materiality was set at £4.243 million (PY £3.943 million) representing 75% of our calculated materiality (PY 75%). • We report to Officers (Management) any difference identified over £0.282 million representing 5% of our calculated materiality (PY £0.263 million). • 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 of £25,000 (PY £25,000). 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 the remuneration report for both quantitative and qualitative factors against this lower level of materiality. We will apply heightened auditor focus on 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. There is a change in materiality values since our final audit plan was communicated to you on 24 March 2026 as final gross expenditure for 2025/26 was used as the basis of the calculation. The percentage chosen for higher materiality, performance materiality and triviality remains unchanged. 11 Page 171
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Detecting irregularities, including fraud Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, to detect material misstatements in respect of irregularities, including fraud. Owing to the inherent limitations of an audit, there is an unavoidable risk that material misstatements in the financial statements may not be detected, even though the audit is properly planned and performed in accordance with the ISAs (UK). The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below: • We obtained an understanding of the legal and regulatory frameworks that are applicable to Moray IJB and determined that the most significant which are directly relevant to specific assertions in the financial statements are those related to the reporting frameworks; International Financial Reporting Standards and the 2025/26 Local Government CIPFA Code of Accounting Practice. • We enquired of Senior Officers and the Chair of the Audit, Performance and Risk Committee, concerning the IJB’s policies and procedures relating to the identification, evaluation and compliance with laws and regulations; the detection and response to the risks of fraud; and the establishment of internal controls to mitigate risks related to fraud or non-compliance with laws and regulations. • We enquired of Senior Officers and the Chair of the Audit, Performance and Risk Committee, whether they were aware of any instances of non-compliance with laws and regulations or whether they had any knowledge of actual, suspected or alleged fraud. • We assessed the susceptibility of the IJB’s financial statements to material misstatement, including how fraud might occur, by evaluating officers’ incentives and opportunities for manipulation of the financial statements. This included the evaluation of the risk of management override of controls. We determined that the principal risks were in relation to journal entries that altered the IJB’s financial performance for the year and potential management bias in determining accounting estimates. Our audit procedures are documented within our response to the significant risk of management override of controls below. These audit procedures were designed to provide reasonable assurance that the financial statements were free from fraud or error. However, detecting irregularities that result from fraud is inherently more difficult than detecting those that result from error, as those irregularities that result from fraud may involve collusion, deliberate concealment, forgery or intentional misrepresentations. Also, the further removed non-compliance with laws and regulations is from events and transactions reflected in the financial statements, the less likely we would become aware of it. The team communications in respect of potential non-compliance with relevant laws and regulations, included the potential for fraud in in certain account balances and significant accounting estimates. In assessing the potential risks of material misstatement, we obtained an understanding of: − Moray IJB’s operations, including the nature of its operating revenue and expenditure and its services and of its objectives and strategies to understand the classes of transactions, account balances, expected financial statement disclosures and business risks that may result in risks of material misstatement. − The IJB’s control environment, including the policies and procedures implemented by the organisation to ensure compliance with the requirements of the financial reporting framework. 12 Page 172
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Overview of audit risks The table below summarises the key audit matters, significant and other risks discussed in more detail on the subsequent pages. Significant risks are defined by ISAs (UK) as an identified risk of material misstatement for which the assessment of inherent risk is close to the upper end of the spectrum due to the degree to which risk factors affect the combination of the likelihood of a misstatement occurring and the magnitude of the potential misstatement if that misstatement occurs. A significant risk can be a significant risk due to error or due to fraud. For the purposes of the ISAs (UK), the auditor is concerned with fraud or suspected fraud that causes a material misstatement in the financial statements. Two types of intentional misstatements are relevant to the auditor – misstatements resulting from fraudulent financial reporting and misstatements resulting from misappropriation of assets. As part of our consideration of risks relating to fraudulent financial reporting, we consider the potential for override of controls or other inappropriate influence over the financial reporting process, such as efforts by management to manage income and expenditure in order to influence the IJB’s year-end performance. 13 Risk title Risk level Change in risk since audit plan Fraud risk Key audit matter Level of judgment or estimation uncertainty Testing approach Status of work to date Management override of controls Significant ✓ Low Substantive Green ↑ Assessed risk increased since Audit Plan Assessed risk consistent with Audit Plan ↓ Assessed risk decreased since Audit Plan Not considered likely to result in material adjustment or change to disclosures within the financial statements Potential to result in material adjustment or significant change to disclosures within the financial statements Likely to result in material adjustment or significant change to disclosures within the financial statements. Page 173
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Significant risks and key audit matters (1) Responding to significant financial statement risks 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. This section provides commentary on the significant audit risks communicated in the External Audit Plan. Key audit matters Key audit matters are those matters that, in our professional judgement, were of most significance in our audit of the IJB’s financial statements of the current year and include the most significant assessed risks of material misstatement (whether or not due to fraud) that we identified. These matters include those that had the greatest effect on: • the overall audit strategy; • the allocation of resources in the audit; and • directing the efforts of the engagement team. These matters were addressed in the context of our audit of the financial statements as a whole, and in forming our opinion thereon, and we do not provide a separate opinion on these matters. There were no key audit matters identified. Other risks Other risks are, in the auditor's judgement, those where the risk of material misstatement is lower than that for a significant risk, but they are nonetheless an area of focus for our audit. There were no other risks identified as part of our procedures. 14 Description Audit reponse Disclosures Key observations KAM Page 174
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Significant risks and key audit matters (2) 15 Significant risks identified in our Audit Plan Commentary 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 as a significant risk of material misstatement. This relates to the elements involving consolidation, after the information is extracted from partner ledgers, to produce the financial statements for Moray IJB. We have considered the design of controls in place over key accounting estimates and judgements through performance of walkthrough procedures and planning inquiries with management. In doing this work, we have concluded there are no significant estimates and judgements within the Annual Report and Accounts. This is appropriately disclosed within the IJB’s accounting policies and in line with our understanding of an IJB organisation. Across our public sector clients, we look to understand and test the control environment over journals including target testing journals on a risk assessment basis to ensure no management override of control that could result in fraud or material error. Therefore, we have: • documented our understanding of and evaluated the design effectiveness of management’s key controls over journals within Moray Council and NHS Grampian; • considered our journals testing within the NHS and the Council (as the external auditor of both organisations); • understood how the IJB accounts were produced and whether there is an opportunity or incentive for management to override controls to show an improved IJB financial performance through financial reporting; • gained an understanding of the critical judgements applied by management in the preparation of the financial statements and considered their reasonableness; • gained an understanding of the key accounting estimates made by management and • evaluated the rationale for any changes in accounting policies, estimates or significant unusual transactions Conclusion Through our audit procedures performed, we found that there was no evidence of management override of controls. We have placed reliance upon the journals work completed on the Moray Council and NHS Grampian audits where recommendations were made on each around the journal authorisation process. As the IJB’s financial statements are prepared by merging the relevant transactions from Moray Council and NHS Grampian, we have agreed the figures to underlying joint ledger reports to confirm accuracy and completeness. We did not identify indication of fraud or inappropriate management bias that could result in a material misstatement.Page 175
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Significant risks and key audit matters (3) 16 Significant risks identified in our Audit Plan Commentary The revenue cycle includes fraudulent transactions As set out in ISA (UK) 240 (Revised May 2021), 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) Auditing standards require us to consider the risk of fraud in revenue. This is considered a presumed risk in all entities. Having considered the risk factors set out in ISA 240 and the nature of the revenue streams at Moray IJB, we have determined that the risk of fraud arising from revenue recognition can be rebutted as there is deemed to be little incentive to manipulate revenue recognition and opportunities to manipulate revenue recognition are deemed to be limited. As part of our work on material transactions and balances, we have agreed revenue balances to assurance letters provided confirming the balances at NHS and Council level as well as an assessment of the income recognition accounting policies and relevant disclosures. Conclusion Our work has not identified any issues to raise in relation to revenue recognition. Risk of fraud in expenditure As set out in practice note 10 (Revised 2022) ‘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. (rebutted) Having considered the risk factors set out in PN10 and the nature of the expenditure streams at Moray IJB, we have determined that the risk of fraud arising from expenditure recognition can be rebutted as opportunities to manipulate expenditure recognition are deemed to be limited. As part of our work on expenditure, we have agreed revenue balances to assurance letters provided confirming the balances at NHS and Council level. We have also reviewed expenditure recognition accounting policies and relevant disclosures. Conclusion Our work has not identified any issues to raise in relation to expenditure recognition. Page 176
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Financial statements – key judgements and estimates 17 As required in the IJB’s accounting policies, officers outline critical judgements in applying accounting policies and in addition, assumptions about the future and other sources of estimation uncertainty. In particular, where estimates and judgements are identified, these should be quantified. This section provides commentary on key estimates and judgments in line with the enhanced requirements for auditors. Significant judgement or estimate Summary of management’s approach Audit Comments Assessment None The note within the IJB accounting policies (Note 2 Critical Judgements and Estimation Uncertainty) confirms there are no judgements or estimates within the IJB accounts. We have confirmed there are no significant estimate or judgements within the IJB annual reports and accounts. Not Applicable Page 177
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Other key elements of the financial statements (1) 18 There were other key areas of focus during our audit. Whilst not considered a significant risk, these are areas of focus either in accordance with the Audit Scotland Code of Audit Practice (2021) or ISAs or due to their complexity or importance to the user of the accounts: Issue Commentary Matters in relation to fraud and irregularity It is the IJB’s responsibility to establish arrangements to prevent and detect fraud and other irregularity. As auditors, we obtain reasonable assurance that the financial statements as a whole are free from material misstatement, whether due to fraud or error. We obtain annual representation from officers and those charged with governance regarding the IJB’s assessment of fraud risk, including internal controls, and any known or suspected fraud or misstatement. We have also made inquires of internal audit around internal control, fraud risk and any known or suspected frauds in year. We have not been made aware of any incidents in the period and no issues in relation to these areas have been identified during the course of our audit procedures that are outside of the usual expected investigations. Accounting practices We have evaluated the appropriateness of Moray IJB’s accounting policies, accounting estimates and financial statement disclosures. There are no issues to raise. Matters in relation to related parties We are not aware of any other related parties or related party transactions which have not been disclosed. The principal related parties are Moray Council and NHS Grampian. Matters in relation to laws and regulations You have not made us aware of any significant incidences of non-compliance with relevant laws and regulations and we have not identified any incidences from our audit work. We have not identified any cases of money laundering or fraud at the IJB. Other information We are required to give an opinion on whether the other information published together with the audited financial statements (including the Annual Report), is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. Minor amendments have been made to the Annual Report that do not warrant further detail. We are satisfied that there are no material inconsistencies to report. Page 178
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Other key elements of the financial statements (2) 19 Issue Commentary Governance statement We are required to report on whether the information given in the Annual Governance Statement is consistent with the financial statements and prepared in accordance with the Delivering Good Governance in Local government: Framework (2016). No inconsistencies have been identified; we plan to issue an unmodified opinion in this respect. Matters on which we report by exception We are required by the Accounts Commission to report to you if, in our opinion: adequate accounting records have not been kept; or the financial statements and the audited part of the Remuneration Report are not in agreement with the accounting records; or we have not received all the information and explanations we require for our audit or there has been a failure to achieve a prescribed financial objective. We have nothing to report in respect of these matters. Written representations A letter of representation has been requested from the Integration Joint Board as required by auditing standards. We have not requested any additional specific representations in this letter. Going Concern In performing our work on going concern, we have had reference to Statement of Recommended Practice – Practice Note 10: Audit of financial statements of public sector bodies in the United Kingdom (Revised 2022). The Financial Reporting Council recognises that for particular sectors, it may be necessary to clarify how auditing standards are applied to an entity in a manner that is relevant and provides useful information to the users of financial statements in that sector. Practice Note 10 provides that clarification for audits of public sector bodies. Practice Note 10 states that if the financial reporting framework provides for the adoption of the going concern basis of accounting on the basis of the anticipated continuation of the provision of a service in the future, the auditor applies the continued provision of service approach set out in Practice Note 10. The financial reporting framework adopted by the Integration Joint Board meets this criteria, and so we have applied the continued provision of service approach. In accordance with Audit Scotland guidance: Going concern in the public sector, we have therefore considered management’s (senior officer’s) assessment of the appropriateness of the going concern basis of accounting and conclude that: – a material uncertainty related to going concern has not been identified – management’s (senior officer’s) use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Page 179
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Other responsibilities under the Code 20 Issue Commentary WGA return For local government audits, we are required to complete Whole of Government Accounts (WGA) work and provide an assurance statement on the WGA return as mandated by National Audit Office. The IJB will fall under its parents return (Moray Council). We will complete the relevant specified procedures and prepare and submit a partial assurance statement once we have completed all our work on Moray Council’s financial statements, and when the final guidance is received. Health board consolidation For health boards, we are required to under the Code of Audit Practice to examine and report on the consolidation schedules. The IJB expenditure for NHS Grampian was included within the health board consolidation process and this was submitted as part of our work on NHS Grampian’s financial statements in June 2026. Other returns to Audit Scotland In accordance with the Audit Scotland Planning Guidance, as appointed auditors we have prepared and submitted Fraud Returns and Current Issues Returns to Audit Scotland, sector annual reports, shared intelligence on health and social care, sector meetings and Technical Guidance Notes. There is nothing we need to bring to your attention in this respect. Page 180
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Other findings – information technology Any IT findings are reported to Moray Council and NHS Grampian as part of their Annual Audit Reports. Assessment - Significant deficiencies identified in IT controls relevant to the audit of the financial statements. - Non-significant deficiencies identified in IT controls relevant to the audit of the financial statements / significant deficiencies identified with sufficient mitigation of risk. - IT controls relevant to the audit of financials statements judged to be effective at the level of testing in scope. - Not in scope for testing 21 This section provides an overview of results from our assessment of Information Technology (IT) environment and controls which included identifying risks from the use of IT related to business process controls relevant to the financial audit. This includes an overall IT General Control (ITGC) rating per IT system and details of the ratings assigned to individual control areas. IT application Level of assessment performed Overall ITGC rating ITGC control area rating – security management ITGC control area rating – technology acquisition, development and maintenance ITGC control area rating – technology infrastructure Related significant risks / other risks Advance Business Solutions e5 system – Moray Council’s general ledger ITGC assessment (design and implementation effectiveness only) Green Green Green Green All significant risk areas eFinancials – NHS Grampian’s general ledger ITGC assessment (design and implementation effectiveness only) Green Green Green Green All significant risk areas Page 181
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Wider scope and best value conclusions 04 Page 182
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope and best value arrangements Our responsibilities under the Code extend beyond the audit of the financial statements. The Code sets out four audit areas that frame wider scope into specified reporting criteria. These are as set out below: 23 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. This includes demonstrating economy, efficiency and effectiveness through the use of financial and other resources and reporting performance against outcomes. Page 183
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope conclusions This section of our report documents our conclusions from audit work on the wider scope areas set out in the Code. We take a risk-based audit approach to wider scope work. Within our audit plan we identified one significant risk in respect of financial sustainability. Wider scope area Our risk considerations and focus Significant risk identified - final stage Wider scope conclusion Financial Management The arrangements in place at the IJB to ensure sound financial management, accountability and the arrangements to prevent and detect fraud, error and other irregularities No Due to costs pressures and the non-delivery of all required savings during 2025/26, both partner organisations required to provide significant additional funding contributions totalling £7.2 million to enable the IJB to achieve financial balance. The IJB were transparent on the expected outturn, with monitoring reports highlighting the expected overspend position, ensuring the partner authorities were aware they would need to provide additional funding. The IJB have made improvements to the year end reporting of savings by including a full analysis on the outcome of the in-year savings plan, alongside confirmation of whether savings have been recurring or non-recurring in nature. Financial Sustainability The projected financial position of the IJB in the medium to longer term and the relevance and appropriateness of assumptions applied to financial plans that will allow the council to effectively deliver services in the future Yes The 2026/27 budget, approved in March 2026, included upfront deficit funding from both partner authorities and enabled the IJB to set a balanced budget. The balanced budget includes an expectation that the IJB will deliver a significant level of savings totalling £5.718 million. Looking ahead, the IJB forecasts a funding gap of £39 million by 2030/31, representing a significant increase from previous projections. As the IJB currently holds no general reserve balance, future financial shortfalls would require additional support from partner authorities. In this context, the successful delivery of transformation and service redesign will be critical to addressing the projected funding gap and supporting the IJB's long-term financial sustainability. Vision, Leadership and Governance The effectiveness of the IJB’s governance arrangements and the arrangements in place to deliver the vision, strategy and priorities set by the IJB No The IJB have governance arrangements in place that are appropriate and operate effectively however, for the fifth consecutive year, Internal Audit has issued a limited assurance opinion, indicating that weaknesses in governance, risk management and internal control arrangements remain. While progress has been made in addressing these issues, the IJB should look to address known issues which will strengthen the overall control environment and achieve a higher level of assurance in future years. The IJB is progressing the implementation of an organisational restructure, which includes the appointment of a permanent Chief Social Worker from August 2026. Use of Resources to Improve Outcomes How the IJB demonstrates economy, efficiency and effectiveness through its use of financial and other resources No The IJB’s performance is showing a general trend of improvement against the national indicators with many indicators also performing above the Scottish average. However the majority of local indicators are below the IJB’s own set target. The IJB have performed a review of progress against the Scottish Government’s Best Value Framework during 2025/26 which provided assurance that the IJB were meeting their Best Value obligations. No risks identified Other risks identified. Significant risk identified. 24 Page 184
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial management (1) 25 Wider scope area Wider scope audit response and findings Conclusion Financial management No risk identified Financial Performance The 2025/26 budget and savings plan was approved by the IJB Board on 27 March 2025, in line with required timescales. The final revenue Budget for 2025/26 was £213.843 million which included £15.638 million for set aside services. The funding provided totalled £212.843 million and built into the 2025/26 funding assumptions is projected savings of £9.469 million. The IJB expect £8.279 million of these savings to be recurring in nature. Overall, the IJB predicted an overall budget deficit of £1.000 million, with the intention to fund the deficit from earmarked reserves. Throughout 2025/26, there were several adjustments to the 2025/26 Revenue Budget. All budget revisions were reported to the IJB. The table below shows the IJB’s outturn position for the year. It is important to note this outturn position is after the IJB received additional funding from the two partner authorities, plus further funding from the Scottish Government which is included within earmarked reserves at year end. Prior to receiving the additional funding from partner authorities, the IJB had a £7.2 million deficit for 2025/26. As a result, the final revised budget position for 2025/26 was £229.318 million. The IJB had total expenditure of £226.308 million, resulting in an underspend against the final budget of £3.010 million. Note: Strategic Funds relate to additional Scottish Government funding for Integrated Joint Boards. For Moray IJB, this generally relates to additional funding received via NHS Grampian and Moray Council. The IJB required significant additional funding contributions from both partners in order to achieve the year-end outturn position. The IJB was predicting a significant overspend throughout 2025/26, which peaked at £8.78 million. The overspend of £7.2 million was fully funded by the partner authorities, with Moray Council providing £3.4 million and NHS Grampian £3.8 million. 2025/26 Financial Outturn Revised Budget (£m) Actual (£m) Variance (£m) Core Services 194.859 200.211 (5.352) Strategic Funds & Other Resources 14.367 6.005 8.362 Set Aside 20.092 20.092 - Total 229.318 226.308 3.010 Page 185
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial management (2) 26 Wider scope area Wider scope audit response and findings Conclusion Financial management (continued) Financial Performance (continued) The main overspends within core services were as follows: • Mental Health - The service was overspent by £0.654 million due to the ongoing use of agency locums, additional purchase of care costs within care homes and care at home and unachieved savings. • Older People Services and Physical & Sensory Disability – The overspend of £1.933 million primarily related to overspends for home care and permanent care due to the increase in clients receiving nursing care rather than residential care. • Admin and Management- The admin and management budget reported an overspend of £1.030 million, mainly due to interim staffing arrangements and the vacancy target for Moray Council not being met Financial Performance - Savings To balance the 2025/26 budget, the IJB intended to make savings of £9.469 million in 2024/25, with progress on the savings plan reported as part of the budget monitoring reports presented to the IJB Board. Each saving is broken down by project and continues to be reported on a RAG basis. Throughout the year, the IJB made it clear they would not achieve all planned savings and where savings were not fully achieved, it was expected that partner authorities would need to provide additional funding to meet any in year deficits. The year-end outturn report, presented to the IJB Board on 25 June 2026, provides an overview on the savings delivered during 2025/26: The monitoring reports taken to the Board made it clear early in the year that savings would not be delivered. The IJB must ensure that its savings plans are realistic and based on what is able to be delivered. The IJB did not deliver all planned savings in 2025/26 and required additional funding from partners to meet the in- year funding deficit. Actual (£m) Savings delivered 4.343 Savings delivered through reduction in overspends 1.031 Savings not delivered 4.095 Page 186
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial management (3) 27 Wider scope area Wider scope audit response and findings Conclusion Financial management (continued) Financial Performance – Savings (continued) Of the £4.343 million of savings delivered in year, the IJB expect £3.660 million to be recurring in nature, with the remaining £0.683 million being non-recurring savings. In response to our previous audit recommendation, the IJB now include confirmation on whether savings were recurring or non-recurring in the both the Annual Accounts and the year-end outturn report. We have also confirmed that the year-end outturn report has been updated to include an appendix showing the complete 2025/26 savings plans, confirmation of the amount of savings achieved in 2025/26 and final RAG rating for the delivery of the savings. This is the same level of detail that is included in the quarterly monitoring reports and enables a full comparison to be drawn across the financial year. Financial Management Arrangements The IJB’s financial performance is monitored through regular budget monitoring reports to the Board, which provides members and senior management with timely and accurate information on the current and projected year-end financial position. The monitoring report clearly sets out any budget revisions, the forecast outturn position and any significant variances. Members are provided with opportunities to review, challenge and scrutinise financial performance, supported by real-time financial information from Moray Council and NHS Grampian systems. The IJB continues to commission services from both partner organisations, with the management of services operating under their respective financial governance arrangements. The IJB’s Financial Regulations were reviewed and approved by the Board on 29 May 2025. The IJB has established a Budget Savings Oversight Group, chaired by the Chief Officer and supported by the senior management team and project management officers. The Group meets monthly to monitor progress against savings programmes, with a particular focus on high-risk and high-value savings initiatives. The individuals responsible for preparing and reporting financial information are qualified, experienced and have significant knowledge of the organisation. However, due to the small size of the finance team, staff absences could create capacity pressures. The IJB have responded to our previous audit recommendation, with the year end outturn report showing a final savings analysis for the financial year, alongside confirmation of whether savings have been recurring or non- recurring in nature. Page 187
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (1) 28 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability Significant risk: There is a risk that transformation and savings plans to address financial pressures for medium to longer term are not sufficient to address future funding gaps and increasing deficits. Short Term Financial Planning – Budget Setting 20267/27 The IJB’s main source of funding comes from the contributions received from the two partner authorities. The IJB undertakes an annual budget process which forms part of the wider medium term strategy process. This includes discussions taking place between management, Moray Council and NHS Grampian regarding funding requirements. The 2026/27 Revenue Budget was presented to the Board in March 2026 alongside an updated Medium Term Financial Framework covering 2026/27 – 2030/31. The budget for 2026/27 is £233.766 million which included £20.092 million for set aside services. The 2026/27 budget is £7.458 million higher than the final outturn position for 2025/26. The funding provided from the partner authorities totalled £228.048 million. Built into the 2026/27 funding assumptions is projected savings of £5.718 million. The budget include details of all savings on a project-by-project basis, and the expected savings to be delivered for each project. The budget confirms the IJB expect £5.428 million of these savings to be recurring in nature. The budget is reflected in the table below: For 2026/27, the IJB has adopted a revised funding approach that includes £9.0 million of planned deficit funding from Moray Council and NHS Grampian. In contrast to previous years, where deficit support was considered during the financial year if required, funding has been provided at the outset of the financial year and enabled the IJB to set a balanced budget. The approach acknowledges the recurring nature of current financial pressures and provides greater financial stability to both the IJB and partner authorities. The IJB agreed the 2026/27 budget in line with required timescales. The upfront deficit funding provides short-term financial stability, enabling the IJB to set a balanced budget while progressing savings and transformation initiatives to support longer-term sustainability. 2026/27 Budget £m Total Budget 233.766 Total Funding (228.048) Savings Identified (5.718) Total - Page 188
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (2) 29 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability (continued) Short Term Financial Planning – Budget Setting 2026/27 (continued) The level of savings the IJB require to produce in year is significant. As outlined, the IJB did not deliver all planned savings for 2025/26 and were the full £5.718 million of savings not fully achieved during 2026/27, it is expected that partner authorities will need to provide additional funding to meet any in year deficits. The IJB will need to closely monitor savings delivery during 2026/27 via the Budget Savings Oversight Group. The savings programme focuses on the IJB's strategic themes of Building Resilience, Home First and Partners in Care, alongside a number of already implemented cost reduction measures. Key savings include reviews of care packages and commissioning arrangements, review of out-of-area placements, vacancy management and reductions in overtime. The savings programme is intended to support financial sustainability while progressing service transformation and redesign. 2026/27 Revenue Budget Monitoring The IJB will present the Quarter 1 revenue monitoring report to the September 2026 Board Meeting. We have been provided early sight of the report which provides an update on the IJB’s performance against the 2026/27 budget and shows detailed forecast projections for the remainder of 2026/27. Important context for the report is that it has been prepared without recognising the additional £9 million of planned deficit funding agreed by the partner authorities. The budget position at the end of June 2026 is an overspend to date on the Core Services budget of £1.615 million, and an overspend on the Strategic Funds budget of £0.358 million. Looking ahead, the IJB are forecasting a budget deficit of £8.975 million (3.8% of the IJB budget) for financial year 2026/27. This position is within the parameters of the deficit funding from the partners authorities, meaning the IJB are projecting to break even when including the anticipated £9 million of funding. The progress towards the IJB’s savings plans is included as part of the monitoring report and is reported on a RAG basis. At the end of June 2026, the IJB were predicting: - Expect to achieve £4.1 million of savings (rated green) - £1.6 million of savings are at risk of not being achieved (rated amber or red). As all intended savings will not be delivered in 2026/27, the IJB are in the process of identifying new savings which will help to reduce the overall projected deficit. The IJB will need to deliver significant savings to address the projected funding gap in 2026/27. The IJB are projecting to break-even in 2026/27 when additional deficit support funding is included in the current projections. It is unlikely that the IJB will deliver all required savings in 2026/27 and will review alternative options to help reduce the projected deficit. Page 189
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (3) 30 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability (continued) Medium Term Financial Strategy The updated Medium Term Financial Framework (MTFF) 2026/27 – 2030/31 was approved at the IJB Board meeting on 26 March 2026. The financial pressures for 2026/27 and beyond are significant, with the total funding gap for the period currently projected to be £39.020 million. The summary position reflected in the table above highlights the significant financial challenges facing the IJB and the need for continued close monitoring of its financial position. Future funding assumptions are dependent on the successful delivery of recurring savings and transformational service redesign to ensure services remain affordable, sustainable and aligned to the IJB’s strategic priorities. The MTFF assumes that current financial pressures will be mitigated through these measures; however, ongoing economic uncertainty, including potential reductions in future funding, pay award pressures, inflation, cost of living impacts and supply chain challenges, could increase the projected cumulative funding gap and place further pressure on the IJB’s financial sustainability. To achieve long-term financial sustainability, the IJB must successfully deliver its savings and transformation programme to reduce funding gaps and support the continued delivery of key services and strategic priorities. Failure to achieve planned savings and transformation outcomes could result in significant financial pressures and increase the risk to the IJB's financial sustainability in the short to medium term. 2026/27 £m 2027/28 £m 2028/29 £m 2029/30 £m 2030/31 £m Estimated Budget Requirement 228.048 240.001 243.344 247.257 251.615 Total Funding (228.048) (230.656) (233.453) (237.446) (242.642) Budget Deficit - (9.344) (9.891) (9.811) (9.973) Page 190
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (4) 31 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability (continued) Reserves Reserves are an important indicator of an organisation's financial resilience and overall financial health. As at 31 March 2026, the IJB held £3.010 million in reserves, all of which were earmarked for specific purposes. During 2025/26, earmarked reserves increased by £1.560 million. The IJB general reserves balance is nil, meaning future overspends would need to be fully met by the partner authorities, as all available reserves are earmarked. There is no general reserves balance available which would provide flexibility or resilience against unforeseen financial pressures. While the 2026/27 budget does not rely on the use of general reserves, the absence of an uncommitted reserve balance limits the IJB's ability to respond to emerging risks and funding uncertainties. The IJB should therefore seek to rebuild a sustainable level of general reserves over the medium term to strengthen its financial resilience and support long-term financial sustainability. The IJB does not hold any general reserve balance at 31 March 2026, and the level of reserves is at an unsustainable level. Therefore, any overspend in 2026/27 will need be met by partner bodies. Page 191
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (5) 32 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability (continued) Transformation Plans The IJB faces a significant and growing cumulative funding gap over the next four years, with the latest MTFF identifying a substantially larger shortfall than the previous iteration. This increases the financial challenge facing the IJB over the medium term, will require continued focus on delivering sustainable savings and operating within available resources. As a result, the IJB must balance the need to achieve financial sustainability with its responsibility to deliver quality and safe services and meet its strategic priorities. As part of the management restructure, the IJB is establishing a Transformation Board to strengthen oversight of service redesign and delivery of the savings programme. This work is being aligned with the Budget Savings Oversight Group and reflects the significant financial challenges facing the sector, including the wider financial pressures across Integration Joint Boards and the limited prospect of additional funding. The Transformation Board will oversee a programme of longer-term change, with a focus on identifying sustainable efficiencies and alternative models of service delivery. Key areas under consideration include workforce planning and organisational structures, opportunities for greater multidisciplinary and integrated working, the future configuration of bed-based services, and a review of care allocation and eligibility thresholds. The programme will also support a strategic shift towards prevention and early intervention, with particular emphasis on reducing demand for higher-cost services and supporting more individuals, including children and young people, to receive care and support within Moray wherever appropriate. These changes are intended to improve outcomes while ensuring services remain financially sustainable. Given the scale of the financial challenge, continued progress in delivering transformation and service redesign will be essential to achieving planned financial benefits and reducing future funding pressures to support medium to long term financial sustainability. Members should maintain oversight of the transformation programme to monitor progress and ensure planned benefits are realised. Page 192
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – financial sustainability (6) 33 Wider scope area Wider scope audit response and findings Conclusion Financial sustainability (continued) Audit Scotland - Review of Integration Joint Boards In February 2026, Audit Scotland published Integration Joint Boards: Finance Bulletin 2024/25 which provided an independent analysis over the finances of Integration Joint Boards for financial year 2024/25. Key findings from the report included: • Financial pressures across IJBs continue to outstrip funding growth, requiring difficult decisions on service redesign, reduction and prioritisation. • Reserve levels across the sector continue to decline, with many IJBs holding little or no contingency reserves to manage emerging financial pressures. • Reliance on partner funding to support deficits is increasing, despite partners facing significant financial challenges of their own. Several items raised in the Audit Scotland report are consistent with the issues that Moray IJB are facing and there is an understanding that shape of service delivery will have to change in order to deliver services in a more sustainable manner. Moray IJB are facing several of the issues raised in the Audit Scotland report and are reviewing how they can provide services in a more sustainable manner. Page 193
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – vision, leadership and governance (1) 34 Wider scope area Wider scope audit response and findings Conclusion Vision, leadership and governance No risk identified Governance Arrangements The IJB has established governance arrangements in place and operates through a committee-based governance structure, with delegated responsibilities assigned to a number of committees to support the oversight and delivery of services. The governance framework currently comprises three committees: the Integration Joint Board, the Audit, Performance and Risk Committee, and the Clinical and Care Governance Committee. The IJB have also established an Operational Governance Group to strengthen operational oversight. We have attended all Audit, Performance and Risk Committee meetings during 2025/26. The IJB is progressing the implementation of an organisational restructure. The restructure is intended to provide greater clarity in senior management roles and increase organisational stability through the creation of permanent posts where appropriate. Recruitment is underway for a Head of Strategic Planning, Commissioning and Transformation to strengthen leadership capacity in this area, and a new Chief Social Work Officer has been appointed from August 2026. There are transition arrangements in place to support a smooth handover from the outgoing Chief Social Work Officer, who has been carrying out the role on an interim basis from May 2024. Governance Statement The Governance Statement details the composition and governance structure of Moray IJB and how that supports the achievement of the organisation’s priority themes. From review of the Statement, we are satisfied that it reflects the key findings from audit, scrutiny and inspection, including details of the limited assurance Internal Audit opinion issued for 2025/26 (see Internal Audit section at page 36 for further detail). We conclude that the Audit, Performance and Risk Committee effectively challenge and scrutinize reports presented and ensure effective decision making. The Council have appointed a permanent Chief Social Work Officer from August 2026. Page 194
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – vision, leadership and governance (2) 35 Wider scope area Wider scope audit response and findings Conclusion Vision, leadership and governance (continued) Risk Management The Strategic Risk Register was subject to review during 2025 and the updated version formally approved by the Board in May 2025. It is reviewed monthly by the Senior Management Team. Following agreement by the Board on 25 September 2025, the Strategic Risk Register is subject to review by the Audit, Performance and Risk Committee before being submitted to the Board for approval, providing additional scrutiny and assurance within the governance process. The most recent risk register presented to the Board in March 2026 included one “very high” risk identified by the IJB as follows: • 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. This risk and the mitigating actions the IJB are implementing in response are in in line with our findings reported in the financial sustainability section of this report. The IJB are reporting risk management updates to the Audit and Risk Committee on a regular basis, with effective scrutiny and challenge provided. The very high level risk is consistent with previous years and continue to be assessed and reported at regular intervals. Page 195
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – vision, leadership and governance (3) 36 Wider scope area Wider scope audit response and findings Conclusion Vision, leadership and governance (continued) Internal Audit Internal audit services for the IJB are provided by Moray Council's Audit and Risk Manager, who has held this role since 2022 and has been reappointed to continue providing services until 31 March 2028. The Audit, Performance and Risk Committee receives quarterly internal audit reports, including audit findings and follow-up reviews, providing members with assurance over the effectiveness of internal controls. Since 2021/22, internal audit have provided the IJB with a limited assurance audit opinion. This has continued to be the case for 2025/26, with the internal audit opinion confirming that “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.” Therefore, this is the fifth year in succession that Internal Audit have provided a limited assurance opinion to the IJB. Fundamentally, this indicates there are weaknesses in the framework of governance, risk management and control. We note that the Chief Internal Audit has confirmed that “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 internal audit reviews have continued to identify significant findings, with several recommendations outstanding and requiring revised implementation timescales or further follow-up. Furthermore, the development of a single case recording system also remains a key priority for the Service. Given the continued limited assurance opinion, outstanding audit recommendations and ongoing replacement of the CareFirst system, our previous audit recommendation relating to internal audit activity remain valid until there is clearer evidence of sustained improvement. The IJB have an effective internal audit function in place to assist with assurance over governance framework, risk and internal controls. This is the fifth consecutive year in which Internal Audit has issued a limited assurance opinion. While progress has been made in addressing these issues, the IJB should establish and deliver definitive improvement plans to strengthen its control environment and achieve a higher level of assurance in future years. Effective Audit, Performance and Risk Committee challenge and scrutiny is paramount when dealing with five years limited opinions Internal audit recommendations have accumulated over a number of years, highlighting the need for the IJB to ensure that agreed actions are implemented promptly and effectively. As progress remains outstanding in several areas, our previous recommendation remains valid. Page 196
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – use of resources (1) 37 Wider scope area Wider scope audit response and findings Conclusion Use of resources to improve outcomes No risk identified Strategic Planning The IJB have an approved Strategic Plan (2022-2032) which sets out the ten-year vision, priorities and direction for health and social care services across Moray. The Strategic Plan is the IJB's overarching strategic document that sets out what it wants to achieve, why change is needed, and how health and social care services will be delivered and transformed across the life of the plan. The IJB will be undertaking a review and refresh of the Strategic Plan during 2026/27, with an aim to approve the updated version in March 2027. To supports the delivery of the Strategic Plan, the IJB have an approved Strategic Delivery Plan 2025-2028 which sets out the key transformation and improvement activities required to achieve its strategic priorities. The Plan links actions to the IJB's strategic themes and objectives, identifies lead officers and timescales, and is regularly monitored by management and governance groups. Progress is reported to both the Board (every six months) and the Audit, Performance and Risk Committee (quarterly). Performance Reporting A performance report is published annually which outlines the IJB’s annual performance against the strategic priorities of the Health and Social Care Partnership and evidencing some of the key achievements and challenges faced by the IJB. Furthermore, the report provides details on the IJB’s performance in relation to the Scottish Government’s core suite of national integration indicators which allows comparisons to be made over time and against Scotland as a whole. Our review of the 2025/26 performance report highlights that out of the 19 national indicators reported: • 15 indicators were showing as green (IJB performance has improved from last year), • one indicator was showing as amber (performance is similar to last year) • two indicators were showing as red (performance is worse than previous year. • there was one indicator that data is not available for reporting. The table on the following page provides detail on the IJB’s performance across several of the national indicators. There are clear links between the Strategic Plan and Strategic Delivery Plan with a clear set of actions laid out in the Strategic Delivery Plan. We have obtained assurance that appropriate performance monitoring and reporting arrangements are in place at the IJB, and where indicators are worsening, the IJB then agree upon actions that need to be taken to improve performance. Page 197
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – use of resources (2) 38 Wider scope area Wider scope audit response and findings Conclusion Use of resources to improve outcomes (continued) Performance Reporting (continued) Source: 2025/26 Annual Performance Report Moray continues to face significant demographic, workforce and financial pressures. An increasing older population, coupled with a declining working-age population, ongoing recruitment challenges and limited housing availability, is placing growing demand on services. Although pressures within adult social care are evident across the local government sector and are not specific to the IJB, these factors increase the risk of difficulties in maintaining sustainable service provision within the area. The IJB will need to ensure that it is able to continue to deliver safe and effective adult services considering the challenging financial background faced alongside a growing aging demographic. This will require wider transformation of the IJB which is outlined within the Financial Sustainability section of this report. National Indicator Scotland Avg. (25/26) 2024/25 2025/26 Trend 1. Percentage of adults able to look after their health very well or quite well 91% 92% 93% 2. Percentage of adults supported at home who agree that they are supported to live as independently as possible 74% 72% 75% 3. Percentage of adults supported at home who agree that they had a say in how their help, care or support was provided 64% 59% 65% 8. Percentage of carers who feel supported to continue in their caring 32% 28% 29% 9. Percentage of adults supported at home who agree they felt safe 75% 70% 77% 12. Emergency admission rate 11,470 6,096 7,434 14. Readmission to hospital within 28 days 104 61 72 17. Proportion of care services graded 'good' (4) or better in Care Inspectorate inspections 83% 73.8% 86% Page 198
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – use of resources (3) 39 Wider scope area Wider scope audit response and findings Conclusion Use of resources to improve outcomes (continued) Performance Reporting (continued) The IJB have an agreed set of local performance indicators, with updates reported to the Audit, Performance and Risk Committee. Performance is reported in a RAG status, and all but one indicator (A&E attendance rate) has been assessed as red at Quarter 4, meaning the IJB is performing worse than target by more than the agreed tolerance. The table below shows the performance of each indicator as at March 2026: Source: Quarter 3 and 4 – Performance Report (Adult Services) Overall, performance during Quarters 3 and 4 of 2025/26 was mixed. Encouraging progress was evident in reducing delayed discharges, unmet care needs and advancing key strategic priorities. However, significant challenges remain in relation to hospital readmissions, access to psychological therapies, workforce absence and ongoing demand pressures. Despite these challenges, progress across the Strategic Delivery Plan and a number of measurable service improvements demonstrate continued efforts to improve outcomes and support sustainable service delivery. The IJB's performance is below target across all reported local indicators. Although there are some emerging improvements, significant challenges continue to impact performance and achievement of expected outcomes. Target 2024/25 2025/26 Trend A&E attendance rate per 1000 population all ages 21.4 22.0 21.9 Number of Delayed Discharges (including code 9) at census point 26 40 34 Number of bed days occupied by delayed discharges (incl. code 9) at census point 850 1,149 1,004 % Emergency readmissions to hospital within 7 days of discharge 3.7% 3.9% 5.2% % Emergency readmissions to hospital within 28 days of discharge 7.4% 7.4% 10.4% % of patients commencing Psychological Therapy Treatment within 18 weeks of referral 90% 65% 41% NHS Sickness Absence (% of hours lost) 4% 4.9% 6.6% Council Sickness Absence (% of calendar days lost) 4% 8.2% 8.5% Page 199
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Wider scope audit – use of resources (4) 40 Wider scope area Wider scope audit response and findings Conclusion Use of resources to improve outcomes (continued) Performance Framework Development The IJB have undertaken a review of the performance management framework during 2026 and is nearing completion. The revised performance framework has been strengthened through enhanced performance and budget scrutiny arrangements. A key change 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 will be presented three times per year to the Audit, Performance and Risk Committee. The IJB have also introduced quarterly meetings with the Chief Executive and Section 95 Officer at Moray Council and Chief Executive and Director of Finance at NHS Grampian with a focus on Performance and budgets. The ongoing refresh of the Strategic Plan is expected to support the development of SMART objectives and associated performance measures, which will be incorporated into future reporting. A refreshed performance management framework has been undertaken with enhanced performance and budget reporting and scrutiny. Page 200
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Best value conclusions 41 Under the Code of Audit Practice, the audit of Best Value in Integration Joint Boards is fully integrated within the annual audit work performed by appointed auditors and their teams. As part of our integrated wider-scope annual audit work, we as appointed auditors use a risk-based approach to assess and report whether the IJB has made proper arrangements for securing Best Value and how the body demonstrates that it is meeting Best Value responsibilities. The principles of best value are embedded within the wider scope work we perform, and the judgements made within the wider scope work allow us to make an assessment over Best Value. Conclusion Integration Joint Board’s have a statutory duty to have arrangements to secure Best Value. To achieve this, Integration Joint Boards should have effective processes for scrutinising performance, monitoring progress towards the strategic objectives and holding partners to account. The IJB have arrangements in place to secure Best Value, as demonstrated in the Annual Governance Statement. We consider these arrangements as part of our regular wider scope work and have provided our conclusions. In our previous audit, we recommended that the IJB should undertake a formal review of the Best Value assurance framework and complete an assessment of the arrangements to secure Best Value, with the outcome of the assessment reported to the Audit, Performance and Risk Committee. During 2025/26 a review of progress against the Scottish Government’s Best Value Framework was undertaken and provided assurance that the IJB were meeting their obligations. This was reported to the Audit and Risk Committee in June 2026. Page 201
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|© 2025 Grant Thornton UK LLP Commercial in Confidence Appendices 42 Page 202
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow A. Audit adjustments (1) Impact of adjusted misstatements During the course of the audit, there were no adjusted non-trivial misstatements which were made that require reporting within our Annual Audit Report. Impact of unadjusted misstatements During the course of the audit, there were no unadjusted non-trivial misstatements which were made that require reporting within our Annual Audit Report. Impact of unadjusted misstatements in the prior year There was no unadjusted misstatement identified in the prior year audit. 43 We are required to report all non-trivial misstatements to those charged with governance, whether or not the accounts have been adjusted by management. Misclassification and disclosure changes The table below provides details of substantive misclassification and disclosure changes identified during the audit which have been made in the final set of financial statements. This list of misclassification and disclosure changes reflects presentational adjustments to the financial statements which have no impact on the Council’s reported financial position. Page 203
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow B. Follow up of prior year recommendations (1) 44 We have identified the following issues in our prior year wider scope work, which resulted in eight recommendations being reported in our 2024/25 Annual Audit Report. We have performed additional work in year to obtain assurance whether the recommendations have been closed and resolved in the current year or whether the issue still exists and the recommendation remains open and/or in progress. Five out of eight recommendations have been cleared with three remain open. Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Closed 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. Recommendation: 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. 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 The IJB continues to have no general reserve balance and all reserves held at 31 March 2026 are earmarked for specific purposes. No reserves balances are being used in 2026/27 to balance the budget. In the absence of general reserves balances, the IJB are looking at alternative mechanisms to balance the budget, via savings delivery and transformation. Whilst the IJB would like to build up a working general reserves balance, we acknowledge that this is unrealistic in the medium term, and immediate focus is on managing future predicted deficits. Recommendation closed. [Red] Recommendation is open [Amber] Recommendation is in progress [ Green] Recommendation is closed Page 204
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow B. Follow up of prior year recommendations (2) 45 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Closed 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. Recommendation: The IJB and Council need to secure permanent positions for the both posts to provide certainty over the future direction of the IJB. Recruitment has been successful for the appointment of a permanent Chief Social Work Officer, The candidate will be commencing in the role in August 2026. The IJB have now appointed both a permanent Chief Officer and Chief Social Work Officer. The IJB have transition arrangements in place to support a smooth handover from the outgoing Chief Social Work Officer, Recommendation closed. Page 205
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow B. Follow up of prior year recommendations (3) 46 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Open 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. Recommendation: The IJB should have 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), resulting in the Internal Audit Manager giving a limited assurance opinion. This is the fifth year in succession that Internal Audit have provided a limited assurance opinion. We note that the Chief Internal Audit has confirmed that “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 internal audit reviews have continued to identify significant findings, with several recommendations outstanding and requiring revised implementation timescales or further follow-up. Furthermore, the development of a single case recording system also remains a key priority for the Service. Given the continued limited assurance opinion, outstanding audit recommendations and ongoing replacement of the CareFirst system, this recommendation remains valid until there is clearer evidence of sustained improvement. Recommendation remains valid. Revised Target Date: 31 March 2027 Page 206
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow B. Follow up of prior year recommendations (4) 47 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Closed Performance Report - Recommendation: 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. The performance reporting 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 The IJB have updated their performance reporting during 2025/26, and performance indicators give a clear reflection of current performance. Performance information is also clearly set out in the Annual Accounts. Recommendation closed. Open – ongoing work Financial Sustainability - Transformation - Recommendation: 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. Savings plan in place for 2025/26 covered two financial years and the savings plan in place for 2026/27 will again be over more than one financial year. Transformation plans are also part of the savings plan for future years in conjunction with the Medium Term Financial Framework. The IJB has developed savings plans that incorporate a programme of transformation and efficiency measures to help address its financial challenges. Continued focus on accelerating the pace of transformation, alongside robust delivery and monitoring of savings plans, will be critical to achieving financial balance and reducing the risk of financial instability in the medium to longer term. Recommendation remains valid. Revised Target Date: 31 March 2027 Page 207
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow B. Follow up of prior year recommendations (5) 48 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Open Vision, Leadership and Governance – Internal Audit – Recommendation: 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 becomes regular. Significant progress has been made, however there are still concerns with the recommendations being implemented following audits. Internal audit reviews have continued to identify significant findings, with several recommendations outstanding and requiring revised implementation timescales or further follow-up. The 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, then weaknesses in control and governance frameworks will remain. The lack of response to previous recommendations is one of the reasons for the limited audit assurance opinion issued by Internal Audit. Whilst we recognise the IJB have agreed an approach to monitoring existing recommendations, focus must be given to implementing these recommendations. Recommendation remains valid. Revised Target Date: 31 March 2027 Page 208
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow B. Follow up of prior year recommendations (6) 49 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Closed. 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. Recommendation: 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. Recurring and non recurring savings have been reported throughout 2025/26. The outturn report includes savings details. The IJB’s savings tracker now clearly indicates whether savings are non- recurring in nature, with all other identified savings assessed as recurring. This can be seen in the 2026/27 savings tracker reported as part of the 2026/26 budget paper. The 2025/26 outturn report, which was presented to the June 2026 Board meeting, provided a full breakdown of the savings delivered on a project basis, reflecting the same information that has been presented in the monitoring report during the year. This reflects an improvement in the reporting of the savings position. Recommendation closed. Page 209
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow B. Follow up of prior year recommendations (7) 50 Recommendations from the wider scope audit Assessment Issue and risk previously communication Management update on actions taken to address the issue Auditor conclusion Closed 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. Recommendation: 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. Self assessment reported to Audit, Performance & Risk 25 June 2026. During 2025/26 a review of progress against the Scottish Government’s Best Value Framework was undertaken and provided assurance that the IJB were meeting their obligations. This was reported to the Audit and Risk Committee in June 2026. Recommendation closed. Page 210
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow C. Audit fees, ethics and independence 51 Independence and ethics We confirm that there are no significant facts or matters that impact on our independence 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. We have complied with the Financial Reporting Council's Ethical Standard and confirm that we, as a firm, and each covered person, are independent and are able to express an objective opinion on the financial statements. We confirm that we have implemented policies and procedures to meet the requirement of the Financial Reporting Board’s Ethical Standard. 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 and network firms). In this context, there are no independence matters that we would like to report to you. As part of our assessment of our independence, we note the following matters: Matter Conclusion Relationship with Grant Thornton We are not aware of any relationships between Grant Thornton and Moray 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 Entity or investments in the organisation 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 Moray IJB. Contingent fees in relation to non-audit services No contingent fee arrangements are in place, note that there are no non-audit services provided. Gifts and hospitality We have not identified any gifts or hospitality provided to, or received from, a member of the organisation's board, senior management or staff. Page 211
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow C. Audit fees, ethics and independence (2) 52 Fees and non-audit services The tables below set out the total fees for audit and other services charged from the beginning of the financial year to the current date, as well as the threats to our independence and safeguards have been applied to mitigate these threats. None of the below services were provided on a contingent fee basis. For the purposes of our audit we have made enquiries of all Grant Thornton teams within the Grant Thornton International Limited network member firms providing services to Moray IJB. The table summarises all non-audit services which were identified. The Annual Audit Report will be considered by the Audit, Performance and Risk Committee on 24 September 2026. The fee has not changed from the amount set out and agreed in our Audit Plan. External audit fee Fees for other non-audit services Service Planned Fees Final Fees External Auditor Remuneration - Baseline £37,830 £37,830 Pooled Costs £1,300 £1,300 Contribution to Performance Audit and Best Value £7,050 £7,050 Sectoral cap adjustment (£10,700) (£10,700) 2025/26 Audit Fee £35,480 £35,480 Service Fees £ We confirm that for 2025/26 we did not receive any fees for non-audit services Nil The fees reconcile to the financial statements (round £’000 in the financial statements): • Fees per financial statements £35,000 • Total fees as above £35,480 This covers all services provided by us and our network to Moray IJB, its directors and senior management and its affiliates, that may reasonably be thought to bear on our integrity, objectivity or independence. Page 212
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow D. Client Service Review 53 Client service We take our client service seriously and continuously seek your feedback on our external audit service. Should you feel our service falls short of expected standards please contact Joanne Brown, Head of Public Sector Assurance Scotland in the first instance who oversees our portfolio of Audit Scotland work (joanne.e.brown@uk.gt.com). Alternatively, should you wish to raise your concerns further please contact Mark Stocks, Partner, 8 Finsbury Circus, London, EC2M 7EA. If you feedback relates to audit quality and we have not successfully resolved your concerns, your concerns should be reported to John Gilchrist, Audit Scotland Quality and Appointments in accordance with the Audit Scotland audit quality complaints process. Transparency Grant Thornton publishes an annual Transparency Report, which sets our details of the action we have taken over the past year to improve audit quality as well as the results of internal and external quality inspections. For more details see 2025-transparency-report.pdf. Grant Thornton publishes an annual Audit Quality Report, which sets out details of the actions we have taken over the past year to meet our audit quality framework and provides a forward look on our plans for the future. For more details see audit-quality-report-2026-final.pdf. Page 213
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow E. Communication of audit matters with those charged with governance The Audit Findings Report 54 RECOMMENDED CONTENT – entities OTHER THAN PIEs Guidance note The requirements here are relevant to entities that are not PIEs. For PIEs, delete the slide. Red text may not be applicable and should be either deleted or amended as appropriate. 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 Findings, outlines those key issues, findings and other matters arising from the audit, which we consider should be communicated in writing rather than orally, together with an explanation as to how these have been resolved. Respective responsibilitiesAs 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. Distribution of this Audit Findings report Whilst we seek to ensure our audit findings are distributed to those individuals charged with governance, as a minimum a requirement exists for our findings to be distributed to all the company directors and those members of senior management with significant operational and strategic responsibilities. We are grateful for your specific consideration and onward distribution of our report, to those charged with governance. Our communication plan Audit Plan Audit Findings 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 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 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 Page 214
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|© 2026 Grant Thornton UK LLP Commercial in Confidence Core Core Purple Core White Primary Bright Purple Dark Purple Secondary Teal Coral Neutral Dark Mid Light Yellow Our communication plan Audit Plan Audit Findings 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 Expected modifications to the auditor's report, or emphasis of matter E. Communication of audit matters with those charged with governance The Audit Findings 55 RECOMMENDED CONTENT – entities OTHER THAN PIEs Guidance note The requirements here are relevant to entities that are not PIEs. For PIEs, delete the slide. Red text may not be applicable and should be either deleted or amended as appropriate. 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 Annual Audit Report, outlines those key issues, findings and other matters arising from the audit, which we consider should be communicated in writing rather than orally, together with an explanation as to how these have been resolved. 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. Distribution of this Annual Audit Report Whilst we seek to ensure our audit findings are distributed to those individuals charged with governance, as a minimum a requirement exists for our findings to be distributed to all members and those members of senior management with significant operational and strategic responsibilities. We are grateful for your specific consideration and onward distribution of our report, to those charged with governance. Page 215
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© 2026 Grant Thornton. 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 International Ltd (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. GUIDANCE NOTES: Please ensure every presentation has a back page with disclaimer Page 216
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 24 SEPTEMBER 2026 SUBJECT: 2025/26 AUDITED ANNUAL ACCOUNTS BY: CHIEF FINANCIAL OFFICER 1. REASON FOR REPORT 1.1 To submit to the Committee the Audited Annual Accounts for the year then ended 31 March 2026. 2. RECOMMENDATION 2.1 It is recommended that the Committee consider and scrutinise the Audited Annual Accounts for the financial year 2025/26 and the letter of Representation and recommend approval to the Moray Integration Joint Board. 3. BACKGROUND 3.1 The Unaudited Annual Accounts for 2025/26 were submitted to the meeting of the Moray Integration Joint Board (MIJB) on 25 June 2026 prior to submission to external audit (paragraph 7 of the Minute refers). 3.2 The Annual Accounts have been prepared in accordance with International Financial Reporting Standards and the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014 and the Local Government in Scotland Act 2003. 4 KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The audit undertaken by the Board’s External Auditors, Grant Thornton is now complete. The External Auditors have expressed unqualified opinions in respect of the financial statements, the remuneration report, the management commentary and the annual governance statement. The Independent Auditor’s Report to the Members of the MIJB and the Accounts Commission is included within the audited Annual Accounts and can be found on page 58. The audited Annual Accounts are attached at Appendix 1. Item 11. Page 217
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4.2 Attached at Appendix 2 is the letter of representation to the External Auditors from the members of the MIJB, for approval by Committee to be signed following this meeting. 4.3 The audit process highlighted changes to be made to the accounts which in the main were presentational and in parallel with expectation following external audit inspection. 4.3 The Auditor’s Annual Audit Report to the MIJB and the Accounts Commission is the subject of a separate report to this meeting. The report sets out the responsibilities of Grant Thornton as the independent auditor and presents a summary of the findings arising from the 2025/26 audit. The report confirms there are no unadjusted misstatements in the annual accounts to report to those charged with governance. 4.4 The Audited Annual Accounts are presented to this meeting for consideration and approval. Thereafter, the Chief Officer, Chief Financial Officer and the Chair of the Board will sign the accounts prior to submission to Grant Thornton 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” The Audited Annual Accounts have been completed within the statutory timescales and are being presented for consideration and sign off. (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. (c) Financial implications The adjustments and revisions made to the Annual Accounts following the external audit had no financial impact on the MIJB. (d) Risk Implications and Mitigation There are no risk issues arising directly from this report. The work undertaken by Grant Thornton provides assurance to the Board that the Annual Accounts for 2025/26 give a true and fair view in accordance with applicable law and the 2025/26 Code of the state of affairs of the MIJB as at 31 March. (e) Staffing Implications None arising directly from this report. (f) Property None arising directly from this report. (g) Equalities/Socio Economic Impact Page 218
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None arising directly from this report as there is no resultant change in policy. (h) Climate Change and Biodiversity Impacts There are no direct climate change and biodiversity implications as there has been no change to policy. (i) Directions None arising directly from this report (j) Consultations In preparation of the Annual Accounts, consultations have taken place between finance staff of both Moray Council and NHS Grampian who are in agreement within their areas of responsibility. The Chief Officer has been consulted and comments have been considered. 6 CONCLUSION 6.1 Following a completed external audit process and an unqualified opinion being received. The Audited Annual Accounts are presented here for scrutiny and to recommend the MIJB approval and formally sign off. Author of Report: Deborah O’Shea, Chief Financial Officer Background Papers: With author Ref: Page 219
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Moray Integration Joint Board Annual Accounts 2025/26 Moray Integration Joint Board APPENDIX 1 Page 220
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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 221
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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 ..................................... 46 MOVEMENT IN RESERVES STATEMENT ........................................................................ 47 BALANCE SHEET .............................................................................................................. 48 NOTES TO THE FINANCIAL STATEMENTS ..................................................................... 49 Note 1 Significant Accounting Policies ............................................................................. 49 Note 2 Critical Judgements and Estimation Uncertainty .................................................. 50 Note 3 Events after the Reporting Period ........................................................................ 51 Note 4 Expenditure and Income Analysis by Nature ........................................................ 51 Note 5 Taxation and Non-Specific Grant Income ............................................................. 52 Note 6 Debtors ................................................................................................................ 52 Note 7 Usable Reserve: General Fund ............................................................................ 53 Note 8 Agency Income and Expenditure .......................................................................... 54 Note 9 Related Party Transactions .................................................................................. 55 Note 10 VAT .................................................................................................................... 57 Note 11 Accounting Standards That Have Been Issued but Have Yet To Be Adopted .... 57 INDEPENDENT AUDITORS REPORT…………………………………………………………...58 Page 222
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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 223
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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 224
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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 225
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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 226
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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 was due to be published by 31 July this year and has been published on the Moray HSCP website, following 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 Table 1 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 227
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Moray Integration Joint Board Annual Accounts 2025/26 6 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 228
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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 229
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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 230
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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 Clinical and Care 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. Where appropriate, progress against agreed actions and assurance regarding improvement activity are subsequently reported through the Clinical and Care Governance Committee, Audit, Performance and Risk Committee and the MIJB. 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 Page 231
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Moray Integration Joint Board Annual Accounts 2025/26 10 MANAGEMENT COMMENTARY (continued) 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 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 232
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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 233
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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 234
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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 235
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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 236
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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 237
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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 238
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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 239
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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 240
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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 241
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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 242
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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 243
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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 244
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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 245
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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 246
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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 247
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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 248
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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 249
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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 secure economic, efficient and effective use of 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 250
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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 251
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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. No taxable benefits were paid to the Chair or Vice-Chair during the year and therefore, no disclosure is required. 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. Page 252
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Moray Integration Joint Board Annual Accounts 2025/26 31 REMUNERATION REPORT (continued) 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 253
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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. 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 Page 254
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Moray Integration Joint Board Annual Accounts 2025/26 33 REMUNERATION REPORT (continued) 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 255
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Moray Integration Joint Board Annual Accounts 2025/26 34 ANNUAL GOVERNANCE STATEMENT Executive Summary This Annual Governance Statement outlines the governance framework operated by the Moray Integration Joint Board (MIJB) during the financial year and the assurances received regarding its effectiveness. During the year, Internal Audit concluded that only limited assurance could be provided on the MIJB’s governance, risk management and control environment. This represents the fifth consecutive year in which a limited assurance opinion has been reported. Whilst governance arrangements remained in place throughout the year, a number of significant weaknesses continue to impact the overall effectiveness of the control environment. The recurring issues relate primarily to the implementation of recovery plans, completion of agreed implementation actions and the consistency of assurance reporting. Although progress has been achieved in several areas, improvements have not yet been sufficient to support a higher level of assurance. The MIJB recognises that continued limited assurance over an extended period presents a significant governance concern. Consequently, the MIJB is unable to conclude that governance arrangements were operating effectively in all material aspects during the year. A strengthened governance improvement programme has been established with clear accountability, milestones and reporting arrangements. A significant element of this improvement programme has been the establishment of the Corporate Assurance and Governance Group (CAG). Approved by the Senior Management Team in June 2026, CAG provides corporate oversight of governance, risk management and internal control arrangements, including monitoring progress against internal audit recommendations, identifying cross-cutting risks and barriers to improvement, and supporting a more structured approach to organisational assurance and escalation. Regular scrutiny will be undertaken by the Audit, Performance and Risk Committee to ensure sustained progress throughout 2026/27. 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. Page 256
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Moray Integration Joint Board Annual Accounts 2025/26 35 ANNUAL GOVERNANCE STATEMENT (continued) 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 May 2025 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 257
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Moray Integration Joint Board Annual Accounts 2025/26 36 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 258
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Moray Integration Joint Board Annual Accounts 2025/26 37 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 259
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Moray Integration Joint Board Annual Accounts 2025/26 38 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 260
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Moray Integration Joint Board Annual Accounts 2025/26 39 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 261
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Moray Integration Joint Board Annual Accounts 2025/26 40 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 262
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Moray Integration Joint Board Annual Accounts 2025/26 41 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 263
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Moray Integration Joint Board Annual Accounts 2025/26 42 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 2024/25 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 264
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Moray Integration Joint Board Annual Accounts 2025/26 43 Area for Improvement Identified in 2024/25 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 265
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Moray Integration Joint Board Annual Accounts 2025/26 44 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 266
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Moray Integration Joint Board Annual Accounts 2025/26 45 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 267
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Moray Integration Joint Board Annual Accounts 2025/26 46 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 268
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Moray Integration Joint Board Annual Accounts 2025/26 47 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 269
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Moray Integration Joint Board Annual Accounts 2025/26 48 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 and the audited annual accounts were authorised for issued on 24 September 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 270
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Moray Integration Joint Board Annual Accounts 2025/26 49 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 271
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Moray Integration Joint Board Annual Accounts 2025/26 50 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 272
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Moray Integration Joint Board Annual Accounts 2025/26 51 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 and the audited accounts issued on 24 September 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 273
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Moray Integration Joint Board Annual Accounts 2025/26 52 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 274
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Moray Integration Joint Board Annual Accounts 2025/26 53 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 275
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Moray Integration Joint Board Annual Accounts 2025/26 54 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 276
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Moray Integration Joint Board Annual Accounts 2025/26 55 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 277
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Moray Integration Joint Board Annual Accounts 2025/26 56 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 278
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Moray Integration Joint Board Annual Accounts 2025/26 57 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 279
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Moray Integration Joint Board Annual Accounts 2025/26 58 INDEPENDENT AUDITOR’S REPORT Independent auditor’s report to the members of Moray Integration Joint Board and the Accounts Commission Reporting on the audit of the financial statements Opinion on financial statements We certify that we have audited the financial statements in the annual accounts of Moray Integration Joint Board for the year ended 31 March 2026 under Part VII of the Local Government (Scotland) Act 1973. The financial statements comprise the Comprehensive Income and Expenditure Statement, Movement in Reserves Statement, the Balance Sheet and notes to the financial statements, including material accounting policy information. The financial reporting framework that has been applied in their preparation is applicable law and UK adopted international accounting standards, as interpreted and adapted by the Code of Practice on Local Authority Accounting in the United Kingdom 2025/26 (the 2025/26 Code). In our opinion the accompanying financial statements: • give a true and fair view of the state of affairs of the Board as at 31 March 2026 and of its income and expenditure for the year then ended; • have been properly prepared in accordance with UK adopted international accounting standards, as interpreted and adapted by the 2025/26 Code; and • have been prepared in accordance with the requirements of the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003. Basis for opinion We conducted our audit in accordance with applicable law and International Standards on Auditing (UK) (ISAs (UK)), as required by the Code of Audit Practice approved by the Accounts Commission for Scotland. our responsibilities under those standards are further described in the auditor’s responsibilities for the audit of the financial statements section of our report. We were appointed by the Accounts Commission on 18 May 2022. Our period of appointment is five years, covering 2022/23 to 2026/27. We are independent of the Board in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK including the Financial Reporting Council’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. Non-audit services prohibited by the Ethical Standard were not provided to the Board. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion. Conclusions relating to going concern basis of accounting We have concluded that the use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Page 280
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Moray Integration Joint Board Annual Accounts 2025/26 59 INDEPENDENT AUDITOR’S REPORT (continued) Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the Board’s ability to continue to adopt the going concern basis of accounting for a period of at least twelve months from when the financial statements are authorised for issue. These conclusions are not intended to, nor do they, provide assurance on the Board’s current or future financial sustainability. However, we report on the Board’s arrangements for financial sustainability in a separate Annual Audit Report available from the Audit Scotland website. Risks of material misstatement We report in our Annual Audit Report the most significant assessed risks of material misstatement that we identified and our judgements thereon. Responsibilities of the Chief Financial Officer and Moray Integration Joint Board for the financial statements As explained more fully in the Statement of Responsibilities, the Chief Financial Officer is responsible for the preparation of financial statements that give a true and fair view in accordance with the financial reporting framework, and for such internal control as the Chief Financial Officer determines is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the Chief Financial Officer is responsible for assessing the Board’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless there is an intention to discontinue the Board’s operations. The Moray Integration Joint Board is responsible for overseeing the financial reporting process. Auditor’s responsibilities for the audit of the financial statements Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the decisions of users taken on the basis of these financial statements. Page 281
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Moray Integration Joint Board Annual Accounts 2025/26 60 INDEPENDENT AUDITOR’S REPORT (continued) Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities outlined above to detect material misstatements in respect of irregularities, including fraud. Procedures include: • using our understanding of the local government sector to identify that the Local Government (Scotland) Act 1973, The Local Authority Accounts (Scotland) Regulations 2014, and the Local Government in Scotland Act 2003 are significant in the context of the Board; • inquiring of the Chief Financial Officer as to other laws or regulations that may be expected to have a fundamental effect on the operations of the Board; • inquiring of the Chief Financial Officer concerning the Board’s policies and procedures regarding compliance with the applicable legal and regulatory framework; • discussions among our audit team on the susceptibility of the financial statements to material misstatement, including how fraud might occur; and • considering whether the audit team collectively has the appropriate competence and capabilities to identify or recognise non-compliance with laws and regulations. The extent to which our procedures are capable of detecting irregularities, including fraud, is affected by the inherent difficulty in detecting irregularities, the effectiveness of the Board’s controls, and the nature, timing and extent of the audit procedures performed. Irregularities that result from fraud are inherently more difficult to detect than irregularities that result from error as fraud may involve collusion, intentional omissions, misrepresentations, or the override of internal control. The capability of the audit to detect fraud and other irregularities depends on factors such as the skilfulness of the perpetrator, the frequency and extent of manipulation, the degree of collusion involved, the relative size of individual amounts manipulated, and the seniority of those individuals involved. A further description of the auditor’s responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report. Reporting on other requirements Opinion prescribed by the Accounts Commission on the audited parts of the Remuneration Report We have audited the parts of the Remuneration Report described as audited. In our opinion, the audited parts of the Remuneration Report have been properly prepared in accordance with The Local Authority Accounts (Scotland) Regulations 2014. Page 282
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Moray Integration Joint Board Annual Accounts 2025/26 61 INDEPENDENT AUDITOR’S REPORT (continued) Other information The Chief Financial Officer is responsible for the other information in the annual accounts. The other information comprises the Management Commentary, Annual Governance Statement, Statement of Responsibilities and the unaudited part of the Remuneration Report. Our responsibility is to read all the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard. Our opinion on the financial statements does not cover the other information and we do not express any form of assurance conclusion thereon except on the Management Commentary and Annual Governance Statement to the extent explicitly stated in the following opinions prescribed by the Accounts Commission. Opinions prescribed by the Accounts Commission on the Management Commentary and Annual Governance Statement In our opinion, based on the work undertaken in the course of the audit: • the information given in the Management Commentary for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with statutory guidance issued under the Local Government in Scotland Act 2003; and • the information given in the Annual Governance Statement for the financial year for which the financial statements are prepared is consistent with the financial statements and that report has been prepared in accordance with the Delivering Good Governance in Local Government: Framework (2016). Matters on which we are required to report by exception We are required by the Accounts Commission to report to you if, in our opinion: • adequate accounting records have not been kept; or • the financial statements and the audited part of the Remuneration Report are not in agreement with the accounting records; or • We have not received all the information and explanations we require for our audit. We have nothing to report in respect of these matters. Page 283
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Moray Integration Joint Board Annual Accounts 2025/26 62 INDEPENDENT AUDITOR’S REPORT (continued) Conclusions on wider scope responsibilities In addition to our responsibilities for the annual accounts, our conclusions on the wider scope responsibilities specified in the Code of Audit Practice, including those in respect of Best Value, are set out in our Annual Audit Report. Use of our report This report is made solely to the parties to whom it is addressed in accordance with Part VII of the Local Government (Scotland) Act 1973 and for no other purpose. In accordance with paragraph 108 of the Code of Audit Practice, we do not undertake to have responsibilities to members or officers, in their individual capacities, or to third parties. Angela Pieri, (for and on behalf of Grant Thornton UK LLP), 120 Bothwell Street, Glasgow, G2 7JS Page 284
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Moray Integration Joint Board Annual Accounts 2025/26 63 Page 285
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The integrated health & social care partnership of
Moray Council and NHS Grampian
Moray Council Offices, High Street, Elgin IV30 1BX
Judith Proctor
Chief Officer
Moray Council Offices
High Street
Elgin
Moray
IV30 1BX
Email: hscmchiefofficer@moray.gov.uk
Website: www.hscmoray.co.uk
10 September 2026
Confidential
Grant Thornton UK LLP
Level 8
120 Bothwell St
Glasgow
G2 7JS
Dear Grant Thornton UK LLP
Moray Integration Joint Board
Financial Statements for the year ended 31 March 2026
This representation letter is provided in connection with the audit of the financial
statements of Moray Integration Joint Board (the “IJB”) for the year ended 31 March
2026 for the purpose of expressing an opinion as to whether the IJB’s financial
statements give a true and fair view in accordance with International Financial
Reporting Standards and the CIPFA/LASAAC Code of Practice on Local Authority
Accounting in the United Kingdom 2025/26 and applicable law.
We confirm that to the best of our knowledge and belief having made such inquiries
as we considered necessary for the purpose of appropriately informing ourselves:
Financial Statements
i. We have fulfilled our responsibilities for the preparation of the IJB’s financial
statements in accordance with the International Financial Reporting
Standards and the CIPFA/LASAAC Code of Practice on Local Authority
Accounting in the United Kingdom 2025/26 ("the Code"); in particular the
financial statements are fairly presented in accordance therewith.
ii. We have complied with the requirements of all statutory directions affecting
the IJB and these matters have been appropriately reflected and disclosed in
the financial statements.
iii. The IJB has complied with all aspects of contractual agreements that could
have a material effect on the financial statements in the event of non-
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compliance. There has been no non-compliance with requirements of any regulatory authorities that could have a material effect on the financial statements in the event of non-compliance. iv. We acknowledge our responsibility for the design, implementation and maintenance of internal control to prevent and detect fraud. v. We are satisfied that the methods, the data and the significant assumptions used by us in making accounting estimates and their related disclosures are appropriate to achieve recognition, measurement or disclosure that is reasonable in accordance with the Code and adequately disclosed in the financial statements. vi. Except as disclosed in the financial statements: a. there are no unrecorded liabilities, actual or contingent; b. none of the assets of the IJB has been assigned, pledged or mortgaged; and c. there are no material prior year charges or credits, nor exceptional or non-recurring items requiring separate disclosure. vii. Related party relationships and transactions have been appropriately accounted for and disclosed in accordance with the requirements of International Financial Reporting Standards and the Code. viii. All events subsequent to the date of the financial statements and for which International Financial Reporting Standards and the Code require adjustment or disclosure have been adjusted or disclosed. ix. The financial statements are free of material misstatements, including omissions. x. Actual or possible litigation and claims have been accounted for and disclosed in accordance with the requirements of International Financial Reporting Standards. xi. We have no plans or intentions that may materially alter the carrying value or classification of assets and liabilities reflected in the financial statements. xii. We have updated our going concern assessment. We continue to believe that the IJB’s financial statements should be prepared on a going concern basis and have not identified any material uncertainties related to going concern on the grounds that: a. the nature of the IJB means that, notwithstanding any intention to cease its operations in their current form, it will continue to be appropriate to adopt the going concern basis of accounting because, in such an event, services it performs can be expected to continue to be delivered by related public authorities and preparing the financial statements on a going concern basis will still provide a faithful representation of the items in the financial statements b. the financial reporting framework permits the IJB to prepare its financial statements on the basis of the presumption set out under a) above; and Page 287
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c. the IJB’s system of internal control has not identified any events or conditions relevant to going concern. We believe that no further disclosures relating to the IJB's ability to continue as a going concern need to be made in the financial statements. xiii. The IJB has complied with all aspects of ring-fenced grants that could have a material effect on the IJB’s financial statements in the event of non- compliance. Information Provided xiv. We have provided you with: a. access to all information of which we are aware that is relevant to the preparation of the IJB’s financial statements such as records, documentation and other matters; b. additional information that you have requested from us for the purpose of your audit; and c. unrestricted access to persons within the IJB from whom you determined it necessary to obtain audit evidence. xv. We have communicated to you all deficiencies in internal control of which management is aware. xvi. All transactions have been recorded in the accounting records and are reflected in the financial statements. xvii. We have disclosed to you the results of our assessment of the risk that the financial statements may be materially misstated as a result of fraud. xviii. We have disclosed to you all information in relation to fraud or suspected fraud that we are aware of and that affects the IJB and involves: a. management; b. employees who have significant roles in internal control; or c. others where the fraud could have a material effect on the financial statements. xix. We have disclosed to you all information in relation to allegations of fraud, or suspected fraud, affecting the financial statements communicated by employees, former employees, analysts, regulators or others. xx. We have disclosed to you all known instances of non-compliance or suspected non-compliance with laws and regulations whose effects should be considered when preparing financial statements. xxi. We have disclosed to you the identity of the IJB's related parties and all the related party relationships and transactions of which we are aware. xxii. We have disclosed to you all known actual or possible litigation and claims whose effects should be considered when preparing the financial statements. Page 288
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Annual Governance Statement xxiii. We are satisfied that the Annual Governance Statement (AGS) fairly reflects the IJB's risk assurance and governance framework and we confirm that we are not aware of any significant risks that are not disclosed within the AGS. Management Summary xxiv. The disclosures within the Management Summary fairly reflect our understanding of the IJB's financial and operating performance over the period covered by the IJB’s financial statements. Approval The approval of this letter of representation was minuted by the IJB’s Board at its meeting on 24 September 2026. Yours sincerely Judith Proctor Chief Officer (Signed on behalf of Moray Integration Joint Board) Page 289
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 24 SEPTEMBER 2026 SUBJECT: CORPORATE ASSURANCE AND GOVERNANCE GROUP UPDATE BY: INTERIM CORPORATE MANAGER 1. REASON FOR REPORT 1.1 To provide the Committee with the first assurance and progress update from the Moray Health and Social Care Partnership Corporate Assurance and Governance Group (CAG), including the current position on internal audit activity, outstanding and overdue actions, and any matters requiring escalation. 2. RECOMMENDATION 2.1 It is recommended that the Committee: i) Note the establishment and role of CAG in strengthening oversight of internal audit recommendations and supporting improvement from the MIJB limited assurance position; ii) Note the current position of 6 audit areas in progress, comprising 45 actions, of which 35 are complete, 10 remain open, including 5 that are overdue; iii) Take assurance that the CAG, working in conjunction with Internal Audit, is providing structured oversight, challenge and follow-up of outstanding actions; iv) Note the position relating to the 4 outstanding CareFirst actions and the external dependencies affecting their completion; and v) Note that there are currently no matters requiring escalation to the Committee. 3. BACKGROUND 3.1 Internal Audit issued a limited assurance opinion in relation to the Moray Integration Joint Board (MIJB), reflecting variability in the consistent application of controls, delays in implementing and closing audit actions, and the need for more Item 12. Page 291
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developed monitoring and oversight arrangements. The opinion did not indicate an absence of controls, and improvement activity has continued since the audit period. 3.2 The CAG was formally adopted by the Moray Health and Social Care Partnership (MHSCP) Senior Management Team (SMT) in June 2026 to provide corporate oversight and assurance across governance, risk management and internal control. Its remit includes monitoring internal audit actions, challenging delays, identifying cross-cutting risks and barriers, and escalating any significant matters through SMT to the Audit, Performance and Risk Committee. Accountability for delivery remains with the relevant Service Managers and lead officers. 3.3 The CAG held its first meeting on 7 August 2026. The Group reviewed the audit dashboard, the status of current recommendations and the evidence required to support formal closure. This first report to Committee has been developed in conjunction with Internal Audit to support a consistent and transparent view of progress. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 The August 2026 audit dashboard records the following position: Measure Position Audit areas monitored 6 Total audit actions 45 Completed actions 35 Open actions 10 Of which are overdue 5 Overall completion rate 77.8% Diagram 1 Diagram 2 Page 292
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Diagram 3 Note: Dashboard charts display rounded percentages. The completion rate of 77.8% is therefore presented as 78% within Diagram 2. 4.2 The actions are distributed across Complex and Challenging Needs, Children's Services Commissioning, CareFirst, Out of Area Placements, Residential Care, and Procurement and Creditor Payments. Two audit areas are now fully complete and will be formally reviewed and signed off by Internal Audit in accordance with Internal Audit review arrangements. The remaining actions have identified owners and continue to be monitored through CAG. Audit areas recorded as complete remain included in the dashboard until completion has been formally reviewed and accepted by Internal Audit in accordance with its planned review timetable. 4.3 The dashboard provides a single corporate view of progress and supports more consistent challenge, evidence-based closure and early identification of delay. The Group will continue to refine the dashboard and reporting arrangements with Internal Audit as the assurance process becomes embedded. 4.4 Four actions remain outstanding within the CareFirst audit. These relate to access controls, records held outside the core system, and retention and deletion arrangements. Although actions within the direct control of MHSCP have progressed, final implementation depends on the replacement CareFirst system, Mosaic, associated data migration and wider ICT and supplier activity. 4.5 There is a direct link with the Residential Care audit. Recommendations relating to the digitisation of financial assessments, records and performance information are dependent on the same replacement system and programme timetable. Any delay to Mosaic implementation will therefore affect delivery of outstanding actions across both audits and extend the period during which interim arrangements remain necessary. 4.6 In light of the delay to the programme, Internal Audit will review the current implementation dates and, where necessary, agree formal extensions to align them with the approved Mosaic implementation, migration and post- implementation assurance timetable. The CAG will maintain specific oversight, seek evidence that interim controls remain effective and ensure that revised Page 293
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dates, responsibilities and dependencies are clearly documented and agreed with Internal Audit. 4.7 Delayed implementation: overdue actions may extend exposure to previously identified control weaknesses and slow improvement in the overall assurance position. 4.8 External dependencies: delivery may be affected by partner, supplier, ICT or legal dependencies that are not wholly within MHSCP control. 4.9 Evidence of completion: actions cannot be treated as formally closed until sufficient evidence is available and completion is agreed through the appropriate Internal Audit process. 4.10 Sustained governance: improvement from limited assurance requires consistent application of controls, clear ownership, timely updates and continued management attention, rather than closure of actions alone. 4.11 CAG considers that these risks are currently understood and subject to active monitoring. No current control failure requires escalation; however, revised implementation dates and any associated extensions for the CareFirst and Residential Care actions will require formal agreement and ongoing monitoring through CAG, with reporting to the Committee. 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” Effective corporate assurance and timely completion of audit actions support good governance, delivery of the MIJB Strategic Plan and public accountability. (b) Policy and Legal The report supports the MIJB governance and internal control framework. No direct legal implications arise from this report, although individual audit actions may relate to statutory, regulatory or information governance requirements. (c) Financial implications There are no direct financial implications arising as a direct result of this report. Effective implementation of audit recommendations supports sound financial control, appropriate use of public resources and reduction of avoidable financial exposure. (d) Risk Implications and Mitigation The key risks are possible delay in completing actions, inconsistent application of controls, dependency on partner or supplier delivery, and insufficient evidence to support formal closure. These are monitored through CAG, identified action owners, six-weekly oversight, challenge of revised Page 294
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timescales, liaison with Internal Audit and escalation through SMT where required. (e) Staffing Implications There are no direct staffing implications arising as a direct result of this report. Delivery of audit actions and provision of evidence remain responsibilities within existing service and management arrangements. (f) Property There are no property implications arising as a direct result of this report. (g) Equalities/Socio Economic Impact An Equalities Impact Assessment is not required as the report relates to governance and assurance arrangements and does not propose any service change. Impact assessments will be considered in the delivery of relevant individual actions. (h) Climate Change and Biodiversity Impacts There are no direct climate change or biodiversity implications arising from this report. (i) Directions None arising from this report. (j) Consultations This report and the underlying audit dashboard have been reviewed by Internal Audit. The current position was considered by CAG on 7 August 2026 and is reported through SMT to the Audit, Performance and Risk Committee in accordance with the agreed assurance route. 6. CONCLUSION 6.1 The establishment of CAG provides a more structured and transparent approach to the oversight of internal audit actions and supports the work required to improve the assurance position following the limited assurance opinion. The first reporting cycle shows that 35 of 45 actions are complete, with 10 remaining open and 5 of those overdue. Particular oversight will continue to be applied to the 4 outstanding CareFirst actions due to their importance and reliance on wider partner, ICT and supplier dependencies. There are currently no matters requiring escalation to the Committee. Author of Report: Sonya Duncan, Interim Corporate Manager Background Papers: Corporate Assurance & Governance Group Terms of Reference; CAG August 2026 meeting note; SMT Audit Dashboard - August 2026 Page 295
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REPORT TO: MORAY INTEGRATION JOINT BOARD AUDIT, PERFORMANCE AND RISK COMMITTEE ON 24 SEPTEMBER 2026 SUBJECT: COMMUNITY SUPPORT SERVICE IMPLEMENTATION PLAN – PROGRESS REPORT BY: SERVICE MANAGER, PROVIDER SERVICES 1. REASON FOR REPORT 1.1 To update the Committee on progress against the Community Support Service implementation plan arising from the Care Inspectorate inspection. The updated implementation plan is attached at Appendix 1 and provides the detailed position against each action, including completed activity, work in progress, responsible leads and target dates. 2. RECOMMENDATION 2.1 It is recommended that the Committee: i) consider and note the progress made against the Community Support Service implementation plan, as detailed in Appendix 1; ii) consider and note that substantial progress has been achieved, including completion of care plan migration and audits, strengthened complaints and incident learning, improved staffing and visit monitoring, established Practice Governance oversight, enhanced staff communication and completion of a range of training and quality assurance actions; iii) consider and note the actions that remain in progress, particularly outcome-focused reviews, governance development, staff survey learning, the quality assurance framework, skills matching, information management, lone-working guidance, workforce wellbeing and positive behaviour support awareness; iv) consider and note the management controls and revised timescales recorded in Appendix 1 for outstanding actions; and Item 13. Page 297
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v) instruct the Service Manager for Provider Services to continue monitoring delivery through Practice Governance arrangements and provide a further exception report where significant slippage or new risk is identified. 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. A further unannounced inspection took place between 17 and 19 June 2026 and was completed on 22 June 2026. The inspector considered previous findings, registration and service information, observed practice, reviewed records and gathered evidence from six people using the service, three family members, six staff and managers, visiting professionals and 39 questionnaires. 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. The June 2026 inspection provides updated context and confirms that the improvement trajectory had translated into stronger outcomes and assurance across all four evaluated key questions. 4. KEY MATTERS RELEVANT TO RECOMMENDATION 4.1 Appendix 1 sets out the detailed implementation plan and status of each action. Overall, the plan demonstrates a positive trajectory, with the majority of inspection-related actions and a substantial proportion of wider service- improvement actions completed or embedded. Governance oversight is provided through Practice Governance meetings, using action trackers, audit reports and management review to monitor delivery and address exceptions. The subsequent June 2026 inspection provides independent assurance on delivery: all four key questions were evaluated as 4 – Good, compared with the earlier position of Good for wellbeing and Adequate for leadership, staffing and care planning. Table 1: Care Inspectorate evaluation outcomes Area Rating How well do we support people’s wellbeing? 4 – Good Page 298
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How good is our leadership? 4 – Good How good is our staff team? 4 – Good How well is our care and support planned? 4 – Good 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. 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. The June inspection confirmed that people continued to benefit from staff who knew them well, meaningful activities and timely health support. It also identified the need to improve advance communication to people when staffing or visit times change and to make contingency records clearer where service disruption requires alternative arrangements. 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. The later inspection found substantial improvement in quality assurance, regular auditing and provider oversight. The two requirements made on 11 February 2025, covering robust quality assurance and care planning/review—were both assessed as met, albeit outwith the original timescales. Page 299
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5. KEY IMPROVEMENT ACTIVITY 5.1 The implementation plan at Appendix 1 is structured across outcome-focused service delivery, change management, communication, high-quality service delivery, budget, systems, workforce development and specific Care Inspectorate actions. Progress has been monitored through Practice Governance, with supporting audit evidence and action tracking. 5.2 Strong progress has been achieved in outcome-focused service delivery. All support plans have been transferred to Birdie and audited, management audit arrangements have been established, and weekly reporting is used to check visit delivery and service consistency. The programme of outcome-focused reviews remains in progress and requires further work with co-ordinators and the Community Learning Disability Team before the December 2026 target date. 5.3 Communication arrangements have been strengthened. East and West staff meetings are scheduled every six weeks, weekly staff updates are established, and the 2026 survey of people using the service has been completed with results prepared for governance review. Individual and staff engagement activity is now embedded, although further work is required to strengthen staff response rates and ensure survey learning is consistently reflected in the improvement plan. 5.4 Quality assurance and service-delivery controls have improved substantially. Staff quality assurance activity, medication processes, incident reporting, complaints learning, staff supervision, training needs analysis, visit monitoring and care plan review arrangements are now established. The Care Inspectorate actions relating to staffing deployment, incident learning, medication competency, training oversight, visit monitoring, care planning and audit arrangements are recorded within Appendix 1 as completed or met. This is corroborated by the June inspection, which found the previous areas for improvement on complaints handling, staffing oversight and reliable visit assurance, and pre-commencement care planning had been met. The earlier requirements on quality assurance and personal planning were also met outwith timescales. 5.5 A number of actions remain in progress. These include the outcome-review programme, governance workstream, integration of staff and individual survey findings into service improvement, completion of the quality assurance framework, staff skills matching, T-drive information management, lone-working guidance, a Community Support Service health and wellbeing framework and positive behaviour support awareness. These actions have identified leads and are subject to continuing oversight through Practice Governance. The June inspection retained one previous area for improvement because, although regular supervision and team meetings were in place, attendance at meetings remained poor and meetings had not yet been fully incorporated into shift patterns. It also identified two new areas for improvement: ensuring notifiable incidents, accidents, concerns and staff absences are reported to the Care Inspectorate in line with guidance; and improving accessible out-of-hours support, particularly at weekends, to protect staff safety and wellbeing. Management advised the Page 300
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inspector that a wider business case for out-of-hours support was to be submitted. Outcome-focused daily recording, management communication, advance notice of staffing changes and contingency planning also require continued development. 5.6 The position at 24 September 2026 provides reasonable assurance that the service has responded positively to the inspection findings and has embedded stronger systems of oversight. Appendix 1 remains the controlling record for implementation, with completed actions retained as evidence and outstanding actions monitored to completion. Any material delay, deterioration in performance or emerging risk will be escalated through established governance arrangements. This assurance is strengthened by the June 2026 ratings of Good across wellbeing, leadership, staffing and care planning, together with confirmation that both prior requirements and three relevant previous areas for improvement had been met. Assurance remains qualified by the outstanding team-meeting action and the two new areas for improvement on statutory notifications and out-of-hours support. 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 The June inspection highlights a specific compliance implication: the service must ensure that all notifiable incidents, accidents, causes for concern and staff absences are notified to the Care Inspectorate in accordance with the March 2025 notification guidance. This should be incorporated into governance checking and management assurance. 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 updated inspection adds risks associated with failures to make statutory notifications, limited out-of-hours management support— particularly at weekends—poor attendance at team meetings, inconsistent advance communication of rota changes and incomplete contingency Page 301
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detail. Mitigation should include a notifications control and audit trail, escalation and approval of the out-of-hours business case, incorporation of meetings into shift patterns, and monitoring through Practice Governance. The principal residual risks relate to completion and sustained embedding of the outstanding implementation actions, particularly outcome reviews, quality assurance development, survey learning, workforce wellbeing, lone-working guidance, information management and positive behaviour support awareness. These risks are mitigated through named leads, target dates, Practice Governance oversight, audit evidence and escalation of exceptions. Appendix 1 provides the detailed control record. (e) Staffing Implications The June inspection found that the service remained short staffed despite recruitment, with relief staff supporting continuity. Staff were positive about their work and training, but accessible out-of-hours support and regular, well-attended team meetings require further action; these matters have implications for staff safety, wellbeing, learning and retention. 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 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 Page 302
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7. CONCLUSION 7.1 The implementation plan demonstrates substantial and measurable progress since the Care Inspectorate inspection. Key controls relating to care planning, staffing and visit monitoring, medication competency, complaints and incident learning, staff supervision, training oversight, communication and audit arrangements have been completed or embedded. A smaller number of actions remain in progress and require continued management attention. The detailed position, including action ownership, progress, target dates and latest updates, is set out in Appendix 1. Continued oversight through Practice Governance provides assurance that outstanding actions will be monitored to completion and that any significant exception will be escalated appropriately. The June 2026 inspection provides further independent assurance through Good ratings in all four evaluated areas and confirmation that both previous requirements were met. Continued oversight must now explicitly include the outstanding team-meeting area for improvement and the new actions on Care Inspectorate notifications and accessible out-of-hours support. Author of Report: John Campbell, Service Manager Background Papers: Available on request Ref: Page 303
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APPENDIX 1 COMMUNITY SUPPORT SERVICE IMPLEMENTATION PLAN Action Status Cancelled Overdue; Neglected Unassigned; Check Progress Not Started; In Progress; Assigned Completed Actions from Care Inspectorate Code Action Title Action description Due Date Latest Status Update Status Progre ss Status Icon Assigned To CSS SIP 25- 28 Cat8.1 To ensure that people and their families have confidence in the service, the provider should review complaint handling procedures. To do this the provider should, at a minimum, evidence how the outcome of complaints has informed wider service improvement and ensure records in relation to complaints are available to all those who need them 1. Front line resolution log set and information passed to all support staff 2. FLR and complaints to be discussed at PG and actions/learning added to SIP 10 Jun 2026 FLR log set up with guidance and templates in place for PG. 29/04/2026 monitored through Practice Governance 100% WD CSS SIP 25- 28 Cat8.2 Some people did not have regular staffing, which meant the consistency of their support was affected, particularly when usual staff were on annual leave. The provider agreed to review staffing deployment to ensure all people experienced stable and consistent staffing. 1. Looker report to detail consistency and allow for deeper dive into situation. 2. Actions from looker report to come to PG 10 Jun 2026 01/04/26 First looker report to aid audits produced and will be checked through at PG on 02/04/26 08/06/26 staff supervision increased with most staff having received 2 x supervision to date and any outstanding has been booked. 15/07/2026 – Following CI inspection this area for improvement has been met. 100% 100% WD Page 304
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APPENDIX 1 CSS SIP 25- 28 Cat8.3 Although incidents were communicated to senior staff, learning was not consistently shared with the wider staff team. This would reduce the likelihood of reoccurrence. We highlighted this to leaders and will review improvements at future inspections 1. Incidents reviewed at PG and actions logged with learning shared to wider teams through weekly email /team meetings 10 Jun 2026 01/04/26 Tracker now in place through PG 29/04/2026 disused at Practice Governance ongoing. 01/06/26 disused at PG as ongoing on agenda 15/07/2026- following inspection this area for improvement was met. 100% 100% WD CSS SIP 25- 28 Cat8.4 The feedback from these surveys, did not feature in the SIP. We encouraged leaders to develop this further, to ensure feedback from people, and staff, could drive forward improvement. We highlighted our self-evaluation tools, which leaders may wish to use to support ongoing improvement. 1. Once surveys are completed responses will be collated and published 2. Outcomes/develop ment highlighted on the service Improvement plan 3. 10 Jun 2026 Staff surveys we did not get a good response publishing the responses would have compromised confidentiality. Actions to be taken forward 11/08/26 IMatter survey information to be included. 50% WD CSS SIP 25- 28 Cat8.5 Medication audits were completed regularly, identifying areas for improvement, and resulting in improved medication practice. However, further improvement was required to ensure people benefitted from effective quality assurance Leaders had reviewed how they monitor, and assure, staff competency. However, further work was needed to ensure this practice was consistent for all staff 1. Using mock ups for competence as part of QA for staff 2. Update at PG who has completed competency using scenarios and outcomes form that 10 June 2026 29/04/2026 Medication management competency quality assurance 01/06/26 agreed medication company tool at PG meeting 15/07/2026 – Following inspection this area for improvement has been met. 100 % WD CSS SIP 25- 28 Cat8.6 it was not clear how the service identified which staff required additional training. This meant there was a risk that people could receive support from staff who did not have the necessary skills and knowledge to support them well. The provider agreed to review training arrangements to ensure all staff have appropriate skills to meet people’s needs. We will review this at future inspections 1. Mandatory training and ongoing additional to be document on yearly TNA 2. Staff Training logged on electronic system 3. Skills set out on each individual care plan 10 June 2026 01/04/26 – TNA updated and sent to senior management. Training updates almost complete on electronic system. 29/04/2026 Training logged completed on electronic system, skills matching being completed on system 01/06/26 al training records in place on Birdie monthly reports from Performance Officer. 15/07/2026- Following inspection this area has been met. 70% 100% WD Page 305
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APPENDIX 1 CSS SIP 25- 28 Cat8.7 Although a digital staff management system had been introduced, this was not effective and leaders could not evidence that people consistently received their planned care. As a result, leaders could not assure themselves that visits were delivered on time, increasing the risk that missed or undelivered care could go unnoticed 1. Ensure parameters for visit times are set on system 2. Looker report to focus weekly on visits out with of these times. 3. Discussion at PG around instances and reasons for variance 10 Jun 2026 01/04/26 – Unable to set parameters on this system however PVA reports can be audited to check on compliance this will be discussed along side other audit reports on PG agenda Regular weekly and monthly reports are coming in being audited for any actions. Audit reports available for viewing. This is a standing item on the practice governance agenda and decisions recorded and actions on log 100% WD CSS SIP 25- 28 CAT 8.8 While plans were accessible, they were not consistently updated. Some care plans did not always contain essential information, such as risk assessments, finance care plans, decision making care plans and accurate information on people’s support times. This placed some people at unnecessary risk of inconsistent support. 1. All individual support plans being reviewed and updated on Birdie 2. All Plans once on to be printed and put into individual folders 3. Monitor that work 10 Jun 2026 01/04/2026- 9 plans complete and 3 being worked on out of 61. Each one audited as it goes on. 29/04/2026 44 plans completed onto Birdie – 20 of these to be audited. 01/06/26 60 Plans completed – 6 to be audited 15/07/2026 – Following inspection this area has been met. 50% 70% 100% WD CSS SIP 25- 28 CAT 8.9 Care plans were not reviewed when people’s needs changed. For example, when one person was prescribed a support aid, the plan did not detail how staff should support them to use this 1. Each individual review to be audited for QA and for follow through into support plans and RA 2. Actions from these audits to be logged and discussed through PG 10 Jun 2026 01/04/26- Each individual plan being audited and actions noted , discussed with individual workers and tracked through PG 29/04/2026 17 reviewed and audited 08/06/26 all completed 100% WD CSS SIP 25- 28 CAT 8.10 ) Review current audits and checks to ensure these meet the services needs. B) Review the frequency of current audits and checks and implement a plan to ensure these are carried out on time, by suitably skilled individuals. C) Ensure leaders regularly quality assure people’s experiences and staff practice Feedback, to appropriate people, the outcomes of quality assurance and actions taken to address any concerns raised 1. Establish audits required 2. Agree best and most practical format to store information 3. Archive all other formats not in use 10 Jun 2026 01/04/26- First set of Audit reports produced to be discussed at PG 01/06/26 6 Audits to complete out of 60 15/07/2026 – Following inspection this area has been met. 100% WD Page 306
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APPENDIX 1 CSS SIP 25- 28 CAT 8.11 a) Ensure people and, where appropriate, their family/appointed representative are involved in the planning of their care. B) Ensure that care plans contain all necessary professional guidance and are reviewed at least six monthly, or sooner, when people’s needs change. C) Ensure that care plans and risk assessments are based on people’s needs and identified goals. D) Ensure that progress towards meeting peoples identified goals is recorded. E) Ensure that people have a formal six-monthly review, which should involve social work input on an annual basis. F) Ensure people and, where appropriate, their family/appointed representative have input as to who should attend reviews 1. All new packages to detail involvement from others 2. All new packages reviewed at least by week 6 from commencing. 3. Invite and record invite to social work and others to review and record attendance or not. 10Jun 26 01/04/26- This is being checked through audits on full Personal plan , RA and review tracker held by admin and reviewed at PG. 01/06/26 All plans have been added to the electronic system 244 have been audited with 6 remain to be completed. 01/06/25 one new support package care plan in place – six weekly period to assess needs. 01/06/26 48 care and support reviews have been carried out 7 reviews are booked for June. 2 review meetings unable to take place due to non- engagement 1now has advocate who is working with individual and professionals to arrange review. 1 individual ongoing anxiety to work with social work to arrange review- new social worker being allocated. 4 review meetings due July. 17/05/2026- Following inspection this area has been met 100% WD CSS SIP 25- 28 CAT 8.12 a) Implementing structured and regular supervision for staff. B) Establishing structured and regular staff team meetings 1. Use current contracted hours for team meeting monthly. 2. Supervision session planned within 48 hours of QA being completed. 3. This to be audited after each one and feedback directly back to coordinator, broader actions to brought to PG 29/04/2026 – Supervision tracker in place recorded 45 SW staff. 33 first quarter supervision has been completed. 2 x staff on LTS and 2 x staff just returning from LTS will be booked for supervision. Identified difficulties with relief staffs’ availability to discuss at PG on 30/04/2026 01/06/26 34 staff supervision completed 5 staff long term absent, 3 new staff 2 have had first supervision 1 absent and 2 staff left 6 supervisions outstanding 08/06/26 supervisors are up to date while some OA are outstanding. 100% WD Page 307
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