2 - Chief Social Work Officer Annual Report 2022-23
North Ayrshire Council · 3 October 2023
Back to Cabinet — 3 October 2023 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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NORTH AYRSHIRE COUNCIL 03 October 2023 Cabinet Title: Chief Social Work Officer Annual Report 2022/23 Purpose: To provide Cabinet with awareness of the annual Chief Social Work Officer report which is required by the Scottish Government. Recommendation: Cabinet members are asked to note: 1. the contents of this report, in particular the successes and challenges and; 2. the skilled and compassionate interventions of our practitioners and managers 1. Executive Summary 1.1 There is a requirement for every Local Authority to appoint a professionally qualified Chief Social Work Officer (CSWO) and this is contained within Section 3 of the Social Work (Scotland) Act 1968 as amended by Section 45 of the Local Government etc. (Scotland) Act 1994. 1.2 In line with the legislation and guidance, the CSWO is required to prepare an annual report for the Council, on all statutory, governance and leadership functions of their CSWO role. 1.3 Given all social work and social care functions have been formally delegated to the Integrated Joint Board this report will also be presented to them at a future meeting. 2. Background 2.1 In 2014, the Office of the Chief Social Work Adviser, following consultation with CSWOs across Scotland, SOLACE and others, identified a more standardised approach to prepare the annual reports. 2.2 The report provides an overview by the CSWO of the partnership structures, governance arrangements and the performance of social services in the context of the demographic landscape of North Ayrshire. It looks more closely at the statutory functions of the service and the quality and workforce development within our services. The report is also forward looking, reviewing the preparation for key legislative changes that will impact on our delivery and outlining the key challenges the service will be facing in the forthcoming year.
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2.3 The report highlights the range of Social Work activity throughout the year and places that in the context of the socioeconomic challenges faced locally. 3. Proposals 3.1 It is proposed that Cabinet notes the key themes and challenges detailed in the report and that it endorses the report as set out in Appendix 1. 3.2 Anticipated Outcomes That North Ayrshire Council, the Integration Joint Board, and the Scottish Government are made aware of the positive impact of Social Work Services in North Ayrshire as well as the significant challenges that are being faced. 3.3 Measuring Impact Impact will be measured in terms of the direction and support to continue to transform the delivery of Social Work Services. 4. Implications/Socio-economic Duty Financial 4.1 None Human Resources 4.2 None Legal 4.3 None Equality/Socio-economic 4.4 None Environmental and Sustainability 4.5 None Key Priorities 4.6 This report covers matters which contribute to the key priorities around vulnerable children and adults within North Ayrshire, the Council and IJB Strategic Plans. Community Wealth Building 4.7 None
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5. Consultation 5.1 The Extended Partnership Senior Management Team have contributed to the contents of this report. Caroline Cameron Director HSCP/Chief Officer For further information please contact Scott Hunter , Chief Social Work Officer , on scotthunter@north-ayrshire.gov.uk . Background Papers Appendix 1, CSWO Annual Report 2022/2023
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/ Chief Social Work Officer Report 2022 – 2023
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Contents Introduction .............................................................................................................. 1 Demographics .......................................................................................................... 2 Locality Planning ...................................................................................................... 3 1. Governance, Accountability and Statutory Functions ................................... 4 1.1 Overview of the North Ayrshire Health and Social Care Partnership ............ 7 Visions, Values and Priorities .............................................................................. 7 2. Service Quality and Performance ..................................................................... 8 2.1 Children, Families and Justice Services ........................................................ 8 The Promise ........................................................................................................ 8 North Ayrshire Champions Board ........................................................................ 9 Supporting Unaccompanied Young People ....................................................... 10 Signs of Safety................................................................................................... 10 Stronger Families ............................................................................................... 11 Rosemount Project ............................................................................................ 11 Safe and Together Model .................................................................................. 12 Child Sexual Abuse Strategy ............................................................................. 12 Key Performance Indicators .............................................................................. 13 2.2 Adults .......................................................................................................... 16 North Ayrshire Drug and Alcohol Service .......................................................... 16 North Ayrshire Model for Enhanced Intermediate Care and Rehabilitation (eICT) ........................................................................................................................... 17 Learning Disability Integrated Community Team ............................................... 18 Care at Home .................................................................................................... 19 Red Rose House ............................................................................................... 20 Carers Team ...................................................................................................... 20 Supported Accommodation ............................................................................... 21 Money Matters ................................................................................................... 21 Mental Health Officer Team ............................................................................... 22 MARAC .............................................................................................................. 22 Self-Directed Support & Ayrshire Independent Living ........................................ 22 The Dirrans Centre ............................................................................................ 23 Older Peoples Day Services .............................................................................. 23 North Ayrshire Adult Community Mental Health Services .................................. 24
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Trindlemoss Day Opportunities.......................................................................... 25 Alcohol and Drug Liaison Team ......................................................................... 25 Short Term Support Worker Recovery Team .................................................... 25 Mental Health Social Work Care Management Team ........................................ 25 Harper House .................................................................................................... 25 2.3 Criminal Justice ........................................................................................... 26 Justice Services Locality Teams ........................................................................ 26 Electronic Monitoring of Bail .............................................................................. 26 Counsellor ......................................................................................................... 27 Refugee Team ................................................................................................... 27 Community Payback Orders .............................................................................. 27 Drug Treatment and Testing Order .................................................................... 28 Diversion from Prosecution ................................................................................ 29 Key Performance Indicators .............................................................................. 30 3. Resources ........................................................................................................ 32 3.1 Financial Pressures ..................................................................................... 32 3.2 Financial Performance ................................................................................ 33 3.3 Medium Term Financial Outlook ................................................................. 34 4. Workforce ......................................................................................................... 35 4.1 Workforce Planning – Staffing and Recruitment Issues .............................. 35 4.2 Workforce Support and Development ......................................................... 37
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1 Introduction Welcome It is a pleasure to introduce this year’s annual Chief Social Work Officer report for North Ayrshire which covers the period 1st April 2022 through 31st March 2023. I noted in my introduction last year that Social Work services remained in unprecedented times and of the value of a unified voice to ensure the role of Social Work is better understood. Upon reflection I start this year’s report in the same place. The year past has seen challenges in relation to risk, market stability and resourcing all set against the familiar backdrop of financial pressures. It is humbling to note that in these cases of adversity Partnership staff and colleagues across the health and social care sector responded with professionalism to ensure the best outcomes possible. The year past has also seen positive contributions to individuals, families and communities across North Ayrshire. Partnership staff and partner agencies have worked together with commitment and compassion to maintain service levels against an exceptionally challenging environment. I would also like to place on record my thanks to colleagues we work with across the statutory and third sector and our independent partners. We are very much stronger together. In the year ahead we will continue to ensure our Social Work services work in a way that puts our residents at the centre of their care. We will also seek to ensure that when protective measures are required, these are applied in such a way that ensures the safety of those affected and includes them wherever possible. Finally, I would also like to place on record my appreciation for the compassion and commitment displayed day in, day out by our practitioners, managers, and business support staff to ensure that Social Work and Social Care services are delivered to the best of our abilities to our communities Scott Hunter Chief Social Work Officer North Ayrshire Health and Social Care Partnership
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2 Demographics North Ayrshire is home to approximately 134,220 people, (National Records for Scotland, Mid-2021 Population Estimates Scotland) all living in its many towns, villages, and islands, with slightly more females (52.5%) than males (47.5%). 16.3% of the population are aged 0 to 15 years, 9.8% are aged 16 to 24 years, 21.5% are aged 25 to 44, 29.1% are aged 45 to 64 years of age, 13.1% ages between 65 to 74 years of age, with 10.2% of our population aged 75 years and above. The latest update of the Scottish Index of Multiple Deprivation has reconfirmed the deep structural challenges faced by many communities in North Ayrshire, despite steady progress by North Ayrshire Council in its ongoing commitment to eradicate poverty. North Ayrshire is ranked as the fifth most deprived council area in Scotland. Some of the area’s most heavily affected by deprivation are concentrated in the Three Towns and Irvine areas but areas in Kilwinning and the Garnock Valley also have above average deprivation.
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3 Locality Planning Our six Locality Planning Forums (LPFs) are one of our key mechanisms for engaging with local people. They are chaired by a member of our Integration Joint Board (IJB) and membership is made up of a range of health and social care professionals, third and independent sector representatives and local community groups. Their role is to use their knowledge of services and the local area to support and engage with local people and communities, to identify locality priorities. In all, nine priorities were identified - seven areas of concern and two areas of opportunity. Priorities of Concern: All mainland locality planning forums adopted the priorities below: • Improving Mental Health and Wellbeing • Reducing social isolation • Prevention, early intervention and recovery from drug and alcohol related harms and deaths • Recovering from the COVID experience Due to additional local concerns, other identified priorities were adopted in specific localities: • Enabling financial inclusion and tackling poverty, was adopted in the Three Towns • Enabling digital inclusion, was also adopted in Three Towns • Preventing suicides, was adopted by the LPF in North Coast and Cumbrae Priorities of Opportunity: The following priorities are shared by all Locality Planning Forums: • Capitalising on the Covid experience – continuing the legacy of the great partnership working that was developed in the early stages of the pandemic. • Developing personal self-care/ self-management, coping skills and health literacy Supporting the local priorities To help address the identified priorities, our locality planning forums will continue to play a key role in understanding and identifying local need, and continue to feed into the Strategic Planning Group, ensuring the profile of our localities is at the heart of our strategic planning process.
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4 1. Governance, Accountability and Statutory Functions The Chief Social Work Officer is a statutory appointment by virtue of Section 3 of the Social Work (Scotland) Act 1968. The Chief Social Work Officer is appointed for the purposes of the Council's functions under the 1968 Act and under those other enactments listed in Section 5(1B) of that Act. In broad terms, those functions cover all social work and social care services whether provided directly by the council, in partnership with other agencies, or procured by the council and provided by others on its behalf. Those functions are referred to as “social work services”. The qualifications required for the post are set out in the Qualifications of Chief Social Work Officers (Scotland) Regulations 1996. The Chief Social Work Officer is required by section 5(1) of the 1968 Act to carry out the duties of the post under the general guidance of the Scottish Ministers. The Scottish Ministers issued revised and finalised guidance in January 2010. The overall powers of the Chief Social Work Officer post are:- (a) To oversee the discharge of the council's statutory social work duties; (b) To ensure the provision of effective professional and objective advice to elected members and officers of the Council in the Council's provision of social work services; (c) To secure the effective provision of social work services. The powers of the Chief Social Work Officer fall into two broad categories; service provision and corporate responsibility: Service provision • To establish and develop social work services focussed on the needs of service users, to promote the continuous improvement of those services, and to monitor and raise standards of their delivery; • To ensure the effective governance of the balance of need, risk and civil liberties in the provision of social work services in accordance with professional practice; • To provide advice on all aspects of workforce planning including safe recruitment practice, supervision, monitoring and assessment of social work students, securing of professional qualifications and continuous learning and development for staff, and supporting and advising managers in all aspects of staff supervision; • To ensure the existence of systems to both promote good practice and identify and address poor practice in the provision of social work services; • To ensure that significant case reviews are undertaken of all critical incidents either resulting in, or which may have resulted in, serious harm or death; and 2. Corporate Responsibilities
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5 Corporate responsibility The Chief Social Work Officer has the following corporate powers which require direct access to the Council's Chief Executive’, Elected Members of the Council and the Chief Officer, and the provision of forthright and independent advice to them:- • To ensure compliance with the Council’s statutory duties to prepare, publish and review plans for the provision of social work services. • To promote, communicate, support and review values and standards of professional practice, and to ensure that they are adhered to. • To establish, in conjunction with the Council's Corporate Management Team, appropriate experience and qualified cover for the post of Chief Social Work Officer during the post-holder's absence or incapacity. • To report to the Chief Executive and Chief Officer any failure in the Council's corporate policy or governance arrangements designed to reflect the proper balance amongst need, risk and civil liberties in the provision and management of social work services. • To report to the Chief Executive and Chief Officer any weaknesses and failures in the systems in place to promote good practice and identify and address poor practice in the provision of social work services. • To report and provide independent comment where necessary to the Chief Executive, Elected Members of the Council and the Chief Officer on the findings of significant case reviews and relevant performance reports and on any other social work related issues. • To provide an annual report to the Council on all of the statutory, governance and leadership functions of the role of the Chief Social Work Officer North Ayrshire continues to invest in its oversight of Social Work activity through the provision of a standalone Chief Social Work Officer, further supported by a formal Depute CSWO. The CSWO reports directly to the Director of the NAHSCP and has a direct line to the Chief Executive of the Council. The CSWO represents Social Work within a range of strategic groups including: IJB, IJB Performance and Audit Committee, IJB Strategic Planning Group, NAHSCP Health Care Governance Committee, HSCP Partnership Senior Management Team, Alcohol and Drugs Partnership, Child Protection Committee, Adult Protection Committee, Chief Officers Group, Carers Advisory Group, Children’s Services Strategic Planning Partnership; Corporate Parenting Board, Transitions Strategic Group amongst others. The CSWO also provides professional oversight as a member of the Care Home Oversight Group and the Care at Home Oversight Group. These groups continue to fulfil key governance activity in relation to the Social Care sector. These groups have worked closely in the year past to manage high risk situations in relation to market failure in the Care at Home Sector and the closure of a residential care home following poor inspection reports.
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6 The CSWO has regular contact with the Independent Chair of CPC and APC to ensure public protection oversight. The year past has seen North Ayrshire commission one learning review. As often happens, the timescale for reporting remain unclear as a result of ongoing activity with our Police and Fiscal colleagues. Professional support and guidance over the year has been offered in relation to high- risk justice cases including our first management of a lifelong restriction order, as well as in relation to Prevent activity. The CSWO also sits on the pan Ayrshire Strategic Oversight Group for the implementation of the new Joint Investigative Process. Social Work and Social Care matters are regularly reported to the IJB and Clinical and Care Governance Committee. There is a particular focus on the impact of policy and external scrutiny activity. The CSWO maintains regular calls with our Care Inspectorate strategic link to share developments and hear of national developments that support activity in North Ayrshire. The CSWO also contributes to quarterly calls with the inspectorate and the broader PSMT. The primary governance of practice matters remains the Social Work Governance Board. The board terms of reference and membership have been refreshed in the current year with the support of the professional leadership group. The board has had a full agenda of issues over the year and has provided support and governance in relation to a range of matters including: • Signs of Safety Implementation • Policy and procedure refresh across children and mental health services • Review of Self Directed Support • Unaccompanied Asylum Seeking Children • Developing Community Social Work Models • Ensuring oversight on the impact on practice of new ways of working • Demand and Capacity Issues • Guardianship and MHO developments • Developing career progression and qualification pathways
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7 1.1 Overview of the North Ayrshire Health and Social Care Partnership Visions, Values and Priorities Our Partnership includes health and social care services within Health and Community Care Services (H&CC), Mental Health and Learning Disability Services and Children, Families and Justice Services. In this report, we look back on the progress we have made, share some of our successes and reflect on some areas that have proved challenging. This report aligns with our “Caring Together” Strategic Commissioning Plan 2022- 2030. This is the first time the Health and Social Care Partnership has set out such a long-term plan for how we intend to improve services and the health and wellbeing of the local community. The plan set out our pandemic recovery intentions, as well as offering a longer-term vision for local health and social care services. Over the period of this strategic plan, the Health and Social Care Partnership will seek to: We see these priorities as interlinked, and we expect that where we see success against one priority, it’s effect will positively impact against others. People who use our services and North Ayrshire residents will experience our Partnership values in the way our staff and volunteers engage with you and how we behave. We will treat you with:
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8 2. Service Quality and Performance 2.1 Children, Families and Justice Services The Promise North Ayrshire held its first ever Promise conference on Friday 4th November 2022. This was the first conference of its kind not only in Ayrshire but across Scotland. Over 120 delegates from a variety of multi-agency partners attended while 23 Care Experienced Young People and their families attended. The conference was facilitated by two of our wonderful young people and we were delighted to have opening remarks from Councillor Macaulay, Portfolio Holder for Education and Young People, and the Minister for Children and Young People, Clare Haughey. We also officially launched Hasta Barista; our brand-new barista bar based in Meadowcroft. The day was hugely enjoyed by all and initial feedback from delegates has been overwhelmingly positive with several commenting that they felt “inspired”. March saw the commencement of two Care Experienced Youth Groups - Mini and Junior Champs - which alternate between the Three Towns and Irvine. The aim of these groups is to create safe spaces for young people, encourage positive transitions, improve wellbeing and promote positive relationships. The recruitment process for posts in HSCP has been reviewed by the team, HSCP managers and care experienced young people. This means Care Experienced Young People will have a say in posts which relate to that area. The Promise is a large-scale, complex 10-year change programme with multiple objectives and interlinked activities, across multiple partners that sets out a clear commitment for all corporate parents to have an enhanced understanding of the experiences of those who have spent time in care. Progress continued this year with The Language and Communications Subgroup focusing on: • A new North Ayrshire Will Keep The Promise Social Media Channel To reinforce that The Promise is a shared duty between corporate parents, the subgroup has decided that communications and updates around The Promise will no longer come from the Corporate Parenting Team but instead there will be a new social media channel set up for all corporate parents to post content.
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9 • Forming a Care Experienced Youth Executive Group To give care experienced young people a platform to use their voice in front of Cabinet members and Parliament and initiate real change. The young people involved will help to support the rights of fellow care experienced young people in North Ayrshire. • A Let’s Talk About Language Day To reframe the care experience narrative, we want to partner up with health, education, and Connected Communities to launch a North Ayrshire-wide event around the clinical, stigmatising, dehumanising and outdated language that is used when referring to care experience, mental illnesses, sexualities, and disabilities. North Ayrshire Champions Board North Ayrshire Champions Board ran a summer programme for care experienced young people. Taking place during July and August 2022, a range of activities were on offer over ten days at various locations. Activities included Laser Quest, Nature Trail and Outdoor Activities and a Champs Carnival at Eglinton Park where everyone could enjoy a petting zoo, bouncy castle, and a silent disco. During October, the champs ran a Halloween Party for Care Experienced Young People, including dookin' for apples, cake decorating, arts and crafts and mummy wrapping. They also took a group of young people to Kelburn country park for the thrilling walk through the estate. The young people loved it! The targeted holiday events continued into the festive period as The Champs, in partnership with the Corporate Parenting Team, used money from The Youth Participatory Budgeting Fund, to host a Christmas meal for Care Experienced families. The families were provided a three-course meal, by Cafe Solace, and all children were invited to join in on festive activities, which included an appearance from Santa! Those that couldn't make the Christmas meal were invited to a fun filled, festive day, where there were activities like s'more making, gingerbread decorating, Christmas card making and football by lots of different partners such as Woodland Wake Up and Active Schools. North Ayrshire Champions Board have signed a three-year contract with Focus Gov to develop an app specifically for Care Experienced Young people. The app, which will be known as CE4U, will detail support, tips, and tricks and even blog posts from care experienced peers. It will be a fundamental resource, specifically for those without a key worker.
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10 Supporting Unaccompanied Young People Supporting Unaccompanied Young People - Natalie Mitchell co-produced a new welcome pack with a previous resident for young people where English is not their first language. The new pack includes basic information of what a children’s house is and what supports residential staff can offer a young person. The highlight of the pack is where a previous ex resident details his experience, how he felt and where he is now. The pack is a huge credit to the hard work of the staff and will undoubtedly alleviate stress when young people who do not speak English, come into our care. The Meadows have also sourced music tuition for 3 Vietnamese young people to participate in together. A local musician/sound engineer visits the house on a weekly basis where he facilitates a 2-hour jamming session with different instruments as well as showing them some production techniques and how to read music. Signs of Safety Signs of Safety is a strength and safety organised model of practice which has been evaluated as effective in driving cultural change. Signs of Safety states this approach, “is an integrated framework for how to do child intervention work – the principles for practice; a range of tools for assessment and planning, decision making and engaging children and families; the disciplines for practitioners’ application of the approach; and processes through which the work is undertaken with families and children, and partner agencies. Signs of Safety practice enables child welfare intervention to be the catalyst for behaviour change by families and empowers them to make these changes. It utilises plain language and embodies aspects of change identified through the Promise in working alongside families building meaningful relationships and empowering their voices within the complex relationships that often arise from the complexity associated with Child welfare child protection work.” Evaluation from areas that have implemented Signs of Safety has indicated: • Families feel more empowered and are more able to understand and address the concerns and requirements of child protection authorities. • Other things being equal, the number of children removed from families reduces relative to the number of families with whom authorities work more intensively to build safety around the children. • Practitioners report greater job satisfaction due to the clarity of the approach, the usefulness of the tools and the impact for the children and families. North Ayrshire have agreed an implementation plan to take forward Signs of Safety which will initially include bespoke training for Children and Families staff and briefing sessions took place throughout 2022 and beyond.
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11 Stronger Families The Stronger Families services was launched 1st of September 2022. This is a new initiative which will be delivered as part of a partnership between Service Access/Multi Agency Assessment and Hub (MAASH), Alcohol and Drug Partnership (ADP) and Barnardo’s. The service provides the following: • Practical and emotional support, advice and opportunities to Children, Young People and Families affected by Substance Use in North Ayrshire. • Supporting families to reduce the need for statutory intervention. • Substance use awareness, practical and emotional support improved family relationships. • Linking young people and families in with the local community • Support to access addiction services and links with recovery community. Rosemount Project From 1st April 2022 to 31st March 2023, the Rosemount Project supported 496 children, parents/carers, and extended family members. The service is committed to whole family support and endeavours to involve siblings, parents/carers, and extended family members, in the interventions and family work that the service facilitates. The ongoing implementation of the Signs of Safety framework correlates well with the ethos and role that the Rosemount Project provides, which is predicated on assisting families to develop their networks of support and empowering them to build sustainable strategies, reducing their dependence on social services in the longer-term. For the financial year ending 31st March 2023, there was a 37% increase in the number of individuals supported from the previous year (up to 496 from 314 in 2021/22). The previous year (2021/22) had seen a 12% increase in referrals from 2020/21, thus, the past year’s figures continue to reflect a growth in individuals who received some form of advice, guidance and/or practical support from the service. Again, we expect these figures to remain high with the greater emphasis being placed on engaging with family networks and upskilling families to rely on their natural resources to meet their specific needs. The Rosemount team had access to the Care Experienced Children and Young People Fund which enabled a mentoring service to be introduced to enhance prosocial support to vulnerable young people over the school period. One of our young people TC said “I like mentoring because its enjoyable and gives me a chance to do more interactive activities. My mentor is a very outgoing guy who
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12 is amazing to have a conversation with. He is also a great mentor because if I have any troubles, I can speak to him about them.” Safe and Together Model Based on domestic abuse research, the Safe and Together Model has been implemented in North Ayrshire. The model is key to realising the Pan Ayrshire vision and directs us to reframe domestic abuse “as a parenting choice”, and it shifts assessments towards a “perpetrator pattern-based” approach as opposed to solely focusing on incidents, which is crucial in the assessment of risk to a child and their non-abusing parent. The model provides a suite of assessment tools and enables practitioners to challenge and address the gender-based nature of domestic abuse through the following model principles: • Keeping the child safe and together with the non-abusing parent. This is usually the most effective way to promote children's safety, healing from trauma, stability and nurturance. • Partnering with the non-abusing parent in a strengths-based way. This approach is likely to be the most efficient and child centred way of assessing risk through mutual information sharing. • Intervening with the offending parent to reduce risk and harm to the child. Engaging and holding them accountable in a variety of ways, including connecting them to their parenting role, reduces the risks to children. We have 5 multiagency trainers accredited to deliver the Safe and Together training, in partnership with Women’s Aid as our third sector partners who also work to ensure the voices of those with lived experience are included. We have delivered Safe and Together overview sessions to over 249 staff, and more extensive training to 84 multiagency staff working at the heart of the Child welfare and child protection system. Child Sexual Abuse Strategy North Ayrshire launched the first localised Child Sexual Abuse Strategy in Scotland in Spring 2021. Progress to date, as well as what we intend to do next is available via our progress update document on the NAHSCP website. We want everyone to understand what child sexual abuse is and the many forms it can take, and we want to ensure that children and young people in North Ayrshire are safe from sexual abuse and harm. You can access the strategy via the North Ayrshire Child Protection Committee website, We regularly post on the NAHSCP Facebook and Twitter pages to raise awareness of child sexual abuse and get people talking more about the subject.
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13 North Ayrshire have established a sub-group to take forward the implementation of the National Child Protection Guidance locally. Representation within the group includes social work, universal early years and education. Work within this group will be reported into the Pan Ayrshire Child Protection Implementation Group. A Pan Ayrshire workshop took place in October in Irvine in the form of a World Café event. Practitioners from across Ayrshire were invited to this session with the main aim being to process map current child protection guidance and procedures and establish a workplan for each locality. The workshop was facilitated by Mark Inglis (HoS Children, Families and Justice Services South Ayrshire), Moira McKinnon (Independent Chair East Ayrshire) and Kirsty Calderwood (CPC Lead Officer North Ayrshire). Key Performance Indicators Child Protection 2014 – 15 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022- 23 Child Protection Concerns 825 889 810 972 920 849 885 756 570 Child Protection Investigations (CP1s) 443 402 406 538 374 447 443 432 375 Child Protection Initial Conferences 101 82 74 103 126 123 121 119 76 Pre – Birth Conferences 32 30 15 36 43 41 29 34 17 CP Initial/Pre- Birth Conferences 4 7 4 9
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14 Looked after Children 2014 – 15 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022- 2023 Children newly accommodated in North Ayrshire 91 81 64 63 69 84 63 49 61 ** Where the number of children accommodated = the number of children either admitted into any placement type except “At Home with Parents”/”With Friends/Relatives” OR moved from “At Home with Parents”/”With Friends/Relatives” to any other placement type 2014 – 15 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022- 23 Foster Carers 85 97 100 103 104 98 103 99 96 Permanency Planning 2013 – 14 2014 – 15 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021- 22 2022- 23 Number of permanency plans approved 25 38 22 37 35 - 30 10 21 19 Adoption – approved and placed 3 15 13 10 10 10 3 8 5 7 Adoptions granted 9 3 15 13 8 7 8 4 5 5 Permanence orders approved 27 7 11 16 14 7 11 3 7 7 Permanence orders granted 12 14 6 9 12 9 8 0 1 2 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022 – 23 Children Subject to Compulsory Supervision Orders 497 462 435 395 393 351 342 298 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022 – 23 Children with Compulsory Supervision Orders Terminated 167 152 147 157 140 102 101 102
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15 Emergency Placements 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022 – 23 Child Protection Orders 12 15 25 (17 family groups) 32 39 11 18 Secure Placements 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022- 23 Number of secure placements 1 0 1 4 1 2 0 Justice Services 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022 – 23 Number of reports submitted to the courts (CJSW reports, Section 203, Short Notice CJSW & Supplementary CJSW) 826 754 763 430 606 606 Number of home leave and background reports submitted 102 (44 leave reports, 58 background reports) 114 leave reports – 49 background - 65 151 (66 leave reports, 85 background reports) 114 (39 leave reports, 75 background reports) 93 (30 leave reports, 63 background reports) 91 (28 leave reports, 63 backgroun d reports) Unpaid Work Requirements 480 403 360 94 172 313 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022 – 23 Level 1 Mappa 142 155 153 181 163 152 172 190 Level 2 Mappa 14 4 7 2 7 10 14 27 Level 3 Mappa 1 1 2 1 5 3 7 2
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16 2.2 Adults North Ayrshire Drug and Alcohol Service The North Ayrshire Drug and Alcohol Service (NADARS) has continued to demonstrate high levels of performance by meeting national and local standards and targets, such as access to treatment waiting times, provision of alcohol brief interventions (ABIs), the roll-out of Naloxone supplies and increasing patient choice regarding Opiate Substitution Therapy (OST) medications. The team continues to identify new ways of working to provide a more agile and streamlined service and further improve performance. This work has been evidenced by the delivery of early intervention services in the delivery of Alcohol Brief Interventions (ABI) in both priority (Primary Care, A&E and Antenatal) and wider settings. 2020-21 2021-22 2022-23 Target set by Scottish Government – Priority Settings 3,420 3,420 3,419 Total ABI delivery in Priority Settings (Ayrshire & Arran) 5,920 5,776 4,699
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17 2020-21 2021- 22 2022- 23 Target set by Scottish Government in Wider Settings 856 856 855 Total ABI delivery in Wider Settings (Ayrshire & Arran) 1,025 1,017 1,207 The North Ayrshire Drug and Alcohol Service has continued to focus on delivering actions and improvements to support the ‘National Mission’ in relation to the reduction of drug and alcohol related harms. Key activities include: • Continued roll out and expansion of the Medication Assisted Treatment (MAT) standards with access to MAT support now being available 5 days a week. Regular progress reports have been submitted to the Scottish Government and an agreed MAT Improvement Implementation Plan is in place. • Increased support to individuals following a Non-Fatal Overdose. • Increased promotion and supply of Naloxone. • Steering Group meetings arranged to focus on improvement actions to ensure that there is increased support for individuals with ‘co-existing mental health and drug and/or alcohol use. • The roll-out of a new Alcohol and Drug Liaison Service across Ayrshire and Arran. • Compliance with all Alcohol and Drug ‘Access to Treatment’ waiting times standards. • Continued promotion and availability of drug and alcohol related training. • Promotion and delivery of Alcohol Brief Interventions (ABI) across priority and non-priority settings whilst continuing to meet the ABI national standards. • New pathway and processes formally approved by the North Ayrshire Alcohol and Drug Partnership (ADP) to support individuals into, during and after external Residential Rehabilitation placements. • Support to Phoenix Futures to open a new residential rehabilitation facility in North Ayrshire to support families affected by drug and alcohol use (Harper House officially opened in November 2022). North Ayrshire Model for Enhanced Intermediate Care and Rehabilitation (eICT) The North Ayrshire Model for Enhanced Intermediate Care and Rehabilitation (eICT) utilises multidisciplinary holistic interventions to focus on providing high-quality care and support, through proactive early intervention and preventative action. They aim to assist patients presenting with falls, frailty, low grade infections and general functional decline to avoid hospital admission where possible and facilitating early discharge home from hospitals.
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18 The North Ayrshire Enhanced Intermediate Care Team brings together the expertise of dedicated Physiotherapists, Occupational Therapists, Technical Instructors, Dieticians, Community Psychiatric Nurses, Pharmacists, Admin workers, Rehabilitation Nurses, Advanced Nurse Practitioners, and Intermediate Care GP with special interest into one single multidisciplinary and interdisciplinary team; focused on problem-solving for patients in their own homes across all of mainland North Ayrshire. The seven-day rehabilitation service facilitates early discharge from hospital and provides a rapid alternative to acute hospital admissions. The Enhanced part of the team addresses medical and clinical issues that limit a patient’s ability to engage in rehabilitation via a shared care model with the patients registered GP. Learning Disability Integrated Community Team The Learning Disability Integrated Community Team continue to support a broad range of assessment and treatment options within the community. This includes psychological therapies (Beat it /Step Up), further development of the anti-psychotic monitoring clinic (in the form of offering home visits to ensure inclusion) and ongoing group-work to improve health. The differential diagnosis pathway continues to reduce the amount of full intellectual assessments that were required previously. All patient facing staff are trauma informed; in addition, there are a cohort of staff who are trained to trauma enhanced and specialist level (Safety and Stabilisation). There is also the recent
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19 formation of a local steering group with acute/primary colleagues to improve Menopause information and care in the North Ayrshire population. The team are also key to the establishment of the new Intensive Support Service, being established to respond to the recommendations of the Coming Home report, and create greater scope for the provision of high levels of multi-disciplinary support within the community (beyond the scope of the existing community team), with the intention of maintaining people in their homes. The team also work with individuals who remain in assessment & treatment inpatient but are delayed discharge, meaning they are fit for discharge but remain in hospital due to difficulties with appropriate community placement provision. Also linked to the Coming Home report, the service is working towards the implementation of a Dynamic Risk Register, as specified by Scottish Government, and intended to aid in the oversight of individuals admitted to hospital settings, or at risk of this. Service managers are also linking into Ayrshire wide discussions regarding the implementation of annual health checks for people with learning disabilities within primary care, as mandated by Scottish Government. Care at Home The Partnership’s inhouse Care at Home service was inspected by the Care Inspectorate in May 2022 and received gradings of Very Good across all indicators: • How well do we support peoples’ wellbeing? • People experience compassion, dignity and respect • People get the most out of life • People’s health and wellbeing benefits from their care and support • How good is our care and support during the Covid-19 pandemic? • Infection prevention and control practices are safe for people experiencing care and staff • Leadership and staffing arrangements are responsive to the changing needs of people experiencing care The positive comments made by people experiencing support or by their relatives/representatives evidenced that the ethos and value base within the service focussed on positive relationships, respect and the delivery of a high-quality service that met people's needs and desired outcomes. This is an exceptional achievement for the Care at Home service during what has been one of the most difficult times for health and social care providers. In 2023 a review was undertaken of the frontline Care at Home role which has been in recognition of the ongoing development of the services delivered by this staff group. From May 2022 until December 2022 a team of representatives from Care at Home service undertook an exercise which has resulted in a re-evaluation of the Care at Home role. This has been a positive development for the Care at Home service, who support some of the most vulnerable people in our communities by delivering high quality person- centred services.
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20 Red Rose House Red Rose House officially opened on the 28th of October 2022, along with neighbouring facility Roslin House. North Ayrshire Provost Anthea Dickson cut the ribbons to celebrate the opening of the facilities in Stevenston in front of Elected Members, staff of North Ayrshire Council and North Ayrshire Health and Social Care Partnership, as well as invited guests from charities Hansel and the Mungo Foundation, who provide care and support at the facilities. The respite centres, which are situated adjacent to the Lockhart ASN Campus in Stevenston, provide a comfortable, home from home experience for respite guests and a much needed, valued and deserved break for families and carers. Each facility is equipped with eight ensuite bedrooms with homely furnishings and mood lighting, as well as activity rooms, hi-tech sensory rooms, games and TV rooms with comfortable sofas, and a kitchen area where guests can eat together or learn cooking skills. The centres also boast fantastic outdoor space with landscaped gardens for guests to enjoy, with a water feature, BBQ areas, musical equipment and a heated hang-out den for teenagers. Carers Team The Carers Team report 1,736 carers registered with our commissioned carer service Unity on 31st March 2023, 1,517 are adult carers and 219 are young carers aged 18 or under. This is a 25% increase from last year. For the reporting year, Social Work staff offered 449 Adult Carer Support Plans, and 94 were accepted with 56 completed. NAC Education staff reported 171 Young Carer statements returned and 161 were completed. Over 3 times more than 2021/2022. The National Carers Strategy was published in December 2022 which sets out a range of actions to guide North Ayrshire Health & Social Care Partnership in our carer duties under the Act and ensures carers are supported fully in a joined up and cohesive way. In North Ayrshire progress is continuing at pace for expanding the reach of carer services, improving carer identification, and increasing access to information, assessment, and support for young and adult carers. To improve carer services increased recurring investment was approved through governance structures which enforces the commitment to continuous improvement for carer support.
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21 The reprovisioning of the commissioned carer service is the main activity to report. The tender process commenced in October 2022 to seek a dynamic and creative strategic partner to be more present and visible to deliver a sustainable and expanded carer service. North Ayrshire Health & Social Care Partnership have engaged with the market and conducted prior interest procurement activities. Plans are on schedule with the successful supplier commencing May 2023 for a 3-year term. Supported Accommodation The development of supported accommodations across several areas of North Ayrshire has concluded, with all accommodations now open and final service users moving in. The portfolio of supported accommodation for mental health, learning and physical disabilities includes: • Bessie Dunlop Court (Dalry) • Bute Walk (Largs) • St. Michaels Wynd (Kilwinning) • Caley Gardens (Stevenston) Service providers are now in operation within the accommodations: • Cornerstone (Dalry) • Enable Scotland (Largs), • The Richmond Fellowship Scotland (Kilwinning) • Key Housing (Stevenston) Money Matters Our Money Matters Team once again supported the most vulnerable people in our communities, accessing entitled benefits to the incredible sum of £18,429,833.91, an increase of almost £1 million pounds from 2021-22. This was achieved against a backdrop of ongoing welfare reform and a complex benefits system.
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22 Mental Health Officer Team The Mental Health Officer Team is now a standalone team within the Community Mental Health Service, covering across the Health & Social Care Partnership. Providing the service as a distinct team has enabled a clearer role definition, consistency of approach and parity of esteem across the partnership. The addition of social work assistants has also allowed for appropriate delegation of work, with guardianship reviews now being a key component of their role. This means that guardianship reviews will be undertaken as planned, timeously and on a recurring basis. MARAC MARAC (Multi-Agency Risk Assessment Conference) launched across North Ayrshire in August 2022. MARAC is a local meeting where representatives from statutory and non-statutory agencies meet to discuss individuals at high risk of serious harm or murder as a result of domestic abuse. The meeting provides a safe environment for agencies to share relevant and proportionate information about current risk, after which agencies agree actions to reduce risk and increase safety. The primary focus of the MARAC is to safeguard the adult victim. However, the MARAC will also make links with other processes and agencies to safeguard children and manage the behaviour of the perpetrator. MARACs are attended by a range of adult and children’s services including Police Scotland, Women’s Aid, local authority and health services. Eight MARACs took place between August and March 2023 with an average of 18-20 cases discussed per meeting. Self-Directed Support & Ayrshire Independent Living Self-Directed Support & Ayrshire Independent Living: In this reporting year, as part of the Scottish Government Source Return, the Self-directed Support team submitted the following figures demonstrating how people have directed their support. Option 1: 198 Option 2: 152 Option 3: 2602 Option 4: 116 This shows traditional options continue to be offered or accessed most with 85% of people receiving Option 3, where support is chosen, arranged and directed by the Health and Social Care Partnership. From a national perspective, there have been several directives and influencing factors (below) to encourage North Ayrshire Health & Social Care Partnership to keep SDS at the core of how we offer and deliver care and support. • Revised Self-directed Support Guidance published November 2022 • Consultation has been ongoing on the draft Self-directed Support Improvement Plan 2023 – 27 (pending publication). • Revised Self-directed Support: Framework of Standards now including Standard 12 Access to Budgets & Flexibility of Spend published August 2022
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23 • National Care Service Bill (paused at Stage 1 with proposals to improve the way social care is delivered). North Ayrshire Health & Social Care Partnership has agreed a contractual extension on a pan Ayrshire basis to continue to commission independent advice and information services from Ayrshire Independent Living Network (AILN). In the calendar year 2022 AILN reported supporting 433 people (373 active) with 34% resident in North Ayrshire. 173 new referrals were received with 43% from North Ayrshire. AILN continues to strengthen their offer through national and local improvements such as work on the National Model Agreement for SDS Option 1 – Direct Payment, Personal Assistant Programme Board developments, local peer mentor groups, dementia befriending project, Personal Assistant employer and HNC Social care student training at Ayrshire Colleges. Events have also been arranged to improve Personal Assistant’s health & wellbeing, and funding has been secured for AILN policy and website improvements. The Dirrans Centre The Dirrans Centre, Kilwinning delivers personalised community-based rehabilitation supports. The team continues to provide support to our clients and provide a combination of centre-based, and community supports using learning from outcomes achieved during the pandemic. This blended approach ensures person-centred interventions to maximise independence, self- management of long-term conditions and assisting with building sustainable links in the local community. Older Peoples Day Services North Ayrshire Health and Social Care Partnership’s Older Peoples Day Services temporarily closed early in 2020 due to the COVID-19 Pandemic, delivering alternative supports during this time such as outreach and befriending services. A review of Day Services was undertaken in 2021 and this identified the need for an alternative Day Services model which would be an enhancement to the traditional building-based Day Services model for Older People in North Ayrshire. This included opportunities to build on some of the learning from during the pandemic to meet the outcomes of people in North Ayrshire. Older People’s Day Services had successfully re-opened by the end of August 2022. Alzheimer’s Scotland commenced a new contract for the delivery of Day Services in
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24 March 2023. This will see an enhancement of Day Service delivery for Older People in North Ayrshire including a flexible and responsive service which will be operational across 7 days providing up to 63 full day placements on a weekly basis. North Ayrshire Adult Community Mental Health Services North Ayrshire Adult Community Mental Health Services. Despite several challenges, the service has had a very successful year: • Throughout the year, our mental health services have been active contributors to the Scottish Government engagement of the National Secondary Care Standards for Mental Health Services consultation. • Throughout the year, our mental health services have also been active contributors to the Scottish Government Delivery of psychological therapies and interventions: national specification. • The development of supported accommodations across several areas of North Ayrshire has all but concluded, with all accommodations now open. This includes Bessie Dunlop Court in Dalry, Bute Walk in Largs, St Michaels Gardens in Kilwinning, and Caley Gardens in Stevenston. All accommodations apart from St Michaels Gardens were delivered in partnership with the Learning Disability service. • The Nethermains supported living facility in Kilwinning has also had additionality added with a renovation of 2A Nethermains to add space for an additional 2 individuals, the first person moved into this facility in March 2023. • The development and implementation of pathways and care pathways within and across services remain ongoing such as the development of the ‘Co- occurring Mental Health and Substance use Pathway’ with North Ayrshire Drug and Alcohol Service (NADARS) and the ‘Transitions Pathway’ with Child and Adolescent Mental Health Team (CAMHS). • The Housing First Community Psychiatric Nurse (CPN) continues to work with our partner agencies within the Housing First Team, working closely with Addictions Social Work and with the support of a commissioned response service, the first of its kind in Scotland. We have revised some aspects of this role to include an educational component for housing staff. • The college well-being and liaison role continues to work extremely well within Ayrshire College and is across the 3 campuses, one in each partnership area of Ayrshire. There has been agreement across the 3 partnership areas to continue the funding of this post through until March 2025. This is extremely positive for Ayrshire & Arran in light if the fact that Health Improvement Scotland (HIS) met with us as they develop a framework for supporting students, they were extremely impressed with the role we have developed and will be adding many aspects of our model to the framework for other authorities to develop similar roles. The service has also been working with our communities, primary care and third and independent sectors in consultation, design and investment for transformation and is now successfully progressing into our second year of funding for mental health and wellbeing in communities.
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25 Trindlemoss Day Opportunities Staff and customers have been involved at Trindlemoss Day Opportunities in a collaborative art project with Glasgow School of Art with the aim of creating a range of outputs reflective of the changes experienced over the past couple of years, as well as people's hopes for the future. There was a final handover session at Trindlemoss in October 2022 where, Victoria and Claire of Glasgow School of Art, spoke to invited guests about their work on the project and the collaborative journey they have undertaken throughout it. Alcohol and Drug Liaison Team A new Alcohol and Drug Liaison Team was launched in August 2022. This new team replaces the previous Alcohol Liaison Team as well as the Non-Fatal Drug Overdose Pathway and operates 7 days a week from 9am -7pm. Priority for the team is the implementation of the MAT standards, 5 of which is pertinent to the team. The model being used is under continual review and a proposal has been made to introduce an Advanced Nurse Practitioner within the team using established funding. Short Term Support Worker Recovery Team Short Term Support Worker Recovery Team – as a fantastic addition to the Mental Health Social Work Team the Support Worker Recovery Team was developed to offer short term support to individuals with Mental Health difficulties. The service has been invaluable in facilitating timeous discharge from hospital support and preventing unnecessary admissions. It has also supported the service in the short term, with unmet need whilst awaiting appropriate packages of care. Mental Health Social Work Care Management Team Mental Health Social Work Care Management Team - The Mental Health Social Work Care Management Team became a standalone team within the Adult Community Mental Health Service. The new focus aims and objectives of the team promotes service users being assessed earlier and supported to engage in the most suitable care and treatment to meet there needs. This has endorsed prevention and early intervention enabling independence & enablement. Harper House Harper House, the new National Specialist Residential Family Service for Scotland, opened on the site of the former Seabank Nursing Home in Saltcoats. Developed and operated by Phoenix Futures and funded by the Scottish Government, the service offers
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26 safe, structured support for the whole family to address problematic drug and/or alcohol use, improving both mental health and quality of life. Families stay together at the service, meaning that parents remain the carers of their children at the same time as taking part in the programme. Alongside this, specialist childcare staff provide support to children and parents. NAHSCP looks forward to continuing to work in partnership with Phoenix Futures to ensure the new service will become a valuable source of support for families affected by substance misuse not just in North Ayrshire, but from across the country. 2.3 Criminal Justice Justice Services Locality Teams A member of the Justice Services Locality Teams has received a Multi-Agency Public Protection Arrangements (MAPPA) Multi-Agency partnership Award from the Surrey and Sussex Strategic Management Board (SMB) meeting. Please see feedback below from Surrey and Sussex Probation Service. “Lisa’s work throughout the management of this case has been exceptional, she has worked alongside partnership agencies to actively manage the risks the service user poses. Lisa continued to work tirelessly alongside Adult social care, mental health, police, and children’s services to ensure the victim was protected. Her management and continued input to this case long after her official involvement ended has been crucial to continued public protection and her contribution much valued by the West Downs MAPPA panel. Lisa attended our SMB last week where she received the above award in recognition of her excellent multi-agency work.” Electronic Monitoring of Bail Electronic Monitoring of Bail is a new service which was introduced at Kilmarnock Sheriff Court on 17th May 2022. As with Bail Supervision, this service has been designed to reduce individuals being remanded in custody and monitoring of the individual within the community through radio frequency monitoring of a personal identification device which is fitted around the ankle. Suitability assessments are undertaken by Justice Social Work staff who are based within the Court.
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27 Counsellor Using Covid-recovery money, Justice Services have been able to fund a Counsellor via the Scottish Association for the Care and Resettlement of Offenders (SACRO) to provide 1:1 support for those experiencing isolation and anxiety to assist service users who, by virtue of their offending, are excluded from many of the other social and personal support routes that we take for granted. Although this service is still in the initial stages the 6 monthly report highlights a good level of engagement with this service along with positive feedback from service users. “Explained why I’m feeling the way I was and gave me hope.” “I would highly recommend counselling…. been a fantastic help at such a difficult time.” “Made things seem clearer about what would help me moving forward.” Refugee Team The Refugee Team have employed two-Family Wellbeing Support Workers who commenced their positions in January 2023. These new staff members will assist with the rise in Ukrainian families arriving and resettling in North Ayrshire who require sensitive, safe, and empowering support. In addition, North Ayrshire HSCP secured Home Office funding through North Ayrshire Council to provide a dedicated nursing resource for Ukrainian Displaced People (UDP) arriving in North Ayrshire. The small team, which will consist of a manager, two staff nurses and a bilingual liaison officer, will offer health assessments and screening to migrants, and facilitate their access to mainstream services such as primary care and health visiting. Community Payback Orders The latest Government statistics on Community Payback Orders (CPOs) (2021-22) show that North Ayrshire had the highest of the Ayrshires with 420 CPOs, however, was the lowest of the Ayrshires at 45.8 per 10,000 population. In comparison, East Ayrshire had 412 CPOs and sits at 48.8 per 10,000 population and South Ayrshire had 367 CPOs and sits at 48.7 per 10,000 population. The Scottish average is 31.5 per 10,000 population. There was a steady decline in the number of Criminal Justice Social Work Reports (CJSWs) from 2015-16 until 2019-20 where there was an indication of a slight upward turn. 2020-21 saw a significant decline, thought largely to be due to the result of COVID- 19, however, numbers rose again in 2021-22 by 40% from the previous year. The latest Government statistics on CJSWs for 2021-22 reveal North Ayrshire to be the lowest of the Ayrshires at 66 per 10,000 population. In comparison, East Ayrshire sits at 90.9 and South Ayrshire sits at 67.3. The Scottish average is 59.7 per 10,000 population. Our Justice Services continue to have a positive impact on the local community through the Community Payback Order (CPO) unpaid work scheme. For the tenth year we have continuously over-achieved against targets for CPO level 1 and level 2. 2022-23 saw 116
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28 out of 117 level 1 CPO’s completing within timescales and 129 out of 135 level 2 CPO’s completing within timescales. The targets set for unpaid work are pan-Ayrshire targets. Drug Treatment and Testing Order The graph below provides an illustration of Drug Treatment and Testing Order (DTTO) assessments and impositions from 2015 until 2023. Assessments requested were at their highest from 2017-2019, at 62 annually. A slight decrease was noted in 2020, however once again this number rose again the following year. We have recently noted an increase of assessment requests for individuals who are remanded in custody, which has proved to be challenging for DTTO staff in gauging intrinsic motivation to change. There is a high correlation between the number of assessments submitted and DTTO’s imposed and notably 100% of assessments considered to be suitable resulted in a DTTO. Partnership working across Ayrshire with NHS Addiction Services continues to be extremely effective and local implementation of the MAT (Medically Assisted treatment) Standards is encouraging service user stability at earlier stages on the Order.
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29 Diversion from Prosecution Diversion from Prosecution (Diversion) has been available since 1997, initially assessed and delivered by Justice Services within each locality. However, referrals from the Procurator Fiscals (PF) were low and it was agreed to develop a more structured service across the Partnership to coordinate more directly with the Crown Service. Since the integration, referrals have increased significantly, particularly in the past two years with a drive to increase Diversion nationally and in response to specific Justice outcomes in the updated national alcohol and drug policy ‘Rights, Respect and Recovery’. The numbers of PF assessments requested in 2022-23 has risen by 110% from 2017-18, which has resulted in an overall 68% rise in the number of Diversions imposed for allocation since 2017-18. The continuous increase in Diversion numbers is significantly impacting on current staff capacity. In the past, Diversion would last approx. 6 - 8 weeks and generally be for first offences, so that the intervention would be offence focussed, whereas recently a change in PF referral criteria places the focus on less serious offences rather than whether it is a first offence, so that many cases presenting in the past year have had a longer offending history and more complex needs. This is resulting in both a longer period of intervention and more time spent in providing support for a range of difficulties and accessing relevant support services. A continued increase in successful completions demonstrated that the service and staff have adapted to these challenges and are achieving positive outcomes.
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30 Key Performance Indicators MHO Service Mental Health (Care and Treatments) 2003 2014 – 15 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 - 22 2022-23 Emergency Detentions 29 24 44 44 54 54 81 There have been a total of 96 requests 92 Short Term Detentions 72 75 87 69 74 67 134 There have been a total of 171 requests (of which consent was given to 134, with the other 37 being assessed but consent not given) There have been a total of 127 requests (of which consent was given to 108, with the other 19 being assessed but consent not given) Compulsory Treatment 40 54 25 52 38 51 59 There have been a total of 70 new CTOs granted (of which 27 had been Interim CTOs, with 14 of these moving to full CTO following a further Mental Health Tribunal) There have been a total of 60 new CTOs granted (of which 17 had been Interim CTOs, with 12 of these moving to full CTO following a further Mental Health Tribunal) Warrants Undertaken 1 3 1 2 1 6 6 4 4
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31 Criminal Justice Act Scotland 1995 2014 – 15 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022- 23 Compulsion Order and Restriction Order 4 4 4 4 4 3 3 2 0 Compulsion Orders 4 6 5 6 2 6 6 3 3 Hospital Directions 1 1 1 1 1 1 1 0 0 Assessment Orders 1 2 2 2 2 2 2 6 5 Treatment Orders 1 1 2 2 4 2 2 6 2 Transfer for Treatment 0 3 3 3 2 1 3 1 1 Adults with Incapacity Act (Scotland) 2000 2014 – 15 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022- 23 Private Welfare Guardianships 291 255 (60) 287 (67) 367 (92 new) 411 (58 new) 272 (67 new) 314 (57 new) 402 (102 new) 371 (99 new) CSWO Guardianships 47 59 (19) 52 (21) 46 (8 new) 40 (16 new) 64 (24) 71 (24) 91 (26) 85 (27 new) Financial Intervention Order (LAG) 58 53 41 & 21 in process 57 26 31 n/a MHO Report PWG Application 86 68 96 100 38 104 75 156 139 Adult Protection 2015 – 16 2016 – 17 2017 – 18 2018 – 19 2019 – 20 2020 – 21 2021 – 22 2022- 23 ASP Referrals (AP1) 697 654 512 457 568 558 643 722 ASP Investigations (AP2) 91 65 53 88 108 132 102 72 ASP Case Conferences 73 48 40 47 66 64 40 41 Protection Orders 6 4 4 1 0 3 1 0 Adult Concern Reports 1349 1446 1609 1838 2335 2215 2070 2370
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32 3. Resources 3.1 Financial Pressures The Scottish Government published an updated Medium-Term Financial Strategy (MTFS) in May 2022 which covers the period to 2026-27. It compares the funding and spending scenarios to assess the scale of the challenge. It was published alongside the Resource Spending Review for the same time period. The role of the MTFS is to set out Scotland's fiscal outlook over the coming years, including financial opportunities and risks that may impact on the fiscal position. In line with the recommendations of the Budget Process Review Group, the document does not set out new spending plans or explain how prioritisation decisions will be made to meet policy objectives. These decisions are made in the Scottish Government budget. Three factors determine the available funding for the Scottish Budget: • UK Government spending decisions: through the Barnett formula, the change in the Scottish Government’s Block Grant each year is determined by the change in the UK Government’s spending on areas devolved to the Scottish Parliament. • Relative growth in Scottish Government and UK Government devolved tax revenues: under the Fiscal Framework, if Scottish devolved tax revenue per person grows relatively faster than in the rest of the UK, the Scottish Budget is better off and vice versa. This means that Scotland’s budget is influenced not only by tax policy and economic performance in Scotland, but also by tax policy and economic performance in the rest of the UK. • Relative growth in Scottish and UK social security expenditure: under the Fiscal Framework, if Scottish devolved social security expenditure grows relatively faster than in the UK, the Scottish Budget is worse off. If UK expenditure grows relatively faster, additional funds are available within the Scottish Budget. Again, this means that Scotland’s budget is influenced not only by policy changes within Scotland, but also what happens in the rest of the UK The MTFS notes that the funding available to Scottish Government is expected to grow steadily (by 14%) over the next four years to 2026-27, with slightly higher growth from 2025-26. In real terms the growth would only be 5% due to the effect of inflation. However, much of the growth relates to the Social Security block grant, driven by increased demand. Excluding this implies real terms growth of only 2% across the whole four-year period. The Scottish Government MTFS models three scenarios (a central resource funding outlook and an upside and downside scenario, indicating plausible alternative funding paths) and outlines the immediate and longer-term pressures on public spending which need to be considered when developing spending plans to ensure that they meet the needs of a changing population and build resilience for the future
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33 The Resource Spending Review, which was published at the same time, sets out the multi-year portfolio spending envelopes. The risks to the resource spending outlook include the following: • Spending pressure from increased demand from an aging population • Demand-led nature of social security expenditure • Public sector pay • Inflationary pressures From 2016-17 to 2022-23 the Health and Social Care Portfolio has risen by £5bn and by the end of the spending review period in 2026-27 the total rise will have been £6.9bn. The RSR also outlines the underlying growth in the size and cost of the public sector workforce, even since before Covid. Some of it relates to the devolution of new functions, but the RSR notes that the growth is not sustainable. The approach from 2023-24 onwards will be to contain the total cost of the public sector pay bill at 2022-23 levels – so increasing salary costs will need to be balanced by reductions in workforce numbers. The Scottish Budget for 2023-24 highlighted: • Investment of over £1.7 billion in social care and integration and lays the groundwork for the introduction of the National Care Service. • The National Mission on drugs is supported by increased investment to £160 million, to reduce the avoidable harms associated with drugs and alcohol. • Investment of £290.2 million over the coming year to tackle CAMHS and psychological therapies, waiting times backlogs, and deliver improved community- based mental health and wellbeing support for children, young people and adults. 3.2 Financial Performance Financial information is part of the performance management framework with regular reporting of financial performance to the IJB. This included an integrated approach to financial monitoring, reporting on progress with savings delivery, financial risks and any variations and changes to the delegated budget. There were significant financial challenges during the period due to the impact of the pandemic. This resulted in additional costs being incurred, fluctuating service levels and partial non-delivery of the transformation programme and associated savings. From month 4 the projected position for 2022-23 was an underspend. This demonstrates the continued focus on the financial position, tight financial controls, planned progress with savings delivery in many areas, and the focus on ensuring that the pandemic impacts were captured and funded appropriately. From the outset of the pandemic the IJB acted very swiftly to respond and developed a mobilisation plan detailing the additional activities to support our response, alongside the estimated financial impact. Financial returns were submitted to the Scottish Government
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34 on a regular basis, on the premise that any additional costs aligned to mobilisation plans would be fully funded. Funding was provided by Scottish Government in advance of the 2022-23 financial year to cover Covid-related costs in delegated services and surplus funding was recovered later in the year. It is not currently anticipated that any additional funding will be made available in 2023-24 for this purpose. The overall financial performance against budget for the financial period 2022-23 (after adjusting for new earmarked reserves) was an overall underspend of £3.719m. This consisted of £3.170m of underspend in social care services and £0.549m underspend in health services. This position includes the budget being held on behalf of the IJB by the Council for debt repayment. This £2.321m was allocated at the period-end which completely cleared the outstanding debt to North Ayrshire Council (£1.486m 2021-22). 2022-23 has been another challenging year for the partnership. Whilst we are optimistic that we may be over the worst of the direct impact of the pandemic, its long-term impact is not as well understood. We expect our services to face on-going challenges, including supporting those who have not been able to access a health and social care professional due to demands and restrictions, and addressing the rise in poor mental wellbeing in our communities. Our health and social care services should reflect and respond to the needs of local people. To support this, we will help to build greater capacity in our communities and provide more ways for service users and local people to share their views with us to help shape services. We are fully committed to planning and designing services together with local people, our staff and our key partners including acute health services, housing, community planning and the third and independent sectors. Growing evidence suggests that the pandemic has had negative socio-economic effects that have led to increased health inequalities and contributed to an increase in both poor mental wellbeing and mental health. The IJB, through the refreshed Strategic Plan, outlines the belief that together we can transform health and social care services to achieve the joint vision for the future “all people who live in North Ayrshire are able to have a safe, healthy and active life.” Moving into 2023-24, we are working proactively to address the financial challenges, while at the same time, providing high-quality and sustainable health and social care services for the communities in North Ayrshire. 3.3 Medium Term Financial Outlook A Medium-Term Financial Outlook (MTFO) is a critical part of the strategic planning process. The financial context for public services remains very challenging and so it is vital that the IJB’s strategic ambitions are set against the financial resources which are anticipated to be available.
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35 The MTFO provides key information on the possible financial position of the IJB over the next three years (2023-2026). It identifies the financial challenges which will be faced by the IJB enabling the IJB to see the impact of current and future decisions on its medium- term financial health. The MTFO will also be used to identify pressure points and inform decisions which are required to ensure the Partnership remains financially sustainable. There are a range of factors which influence the financial planning of the IJB. These are considered through the MTFO and include the following: • Demographic changes • Local priorities • Workforce challenges • The UK and Scottish Economy • Policy and Legislation • Cost and demand pressures • Available funding Based on the projected budget pressures, three scenarios have been developed which align to the Scottish Government Medium-term Financial Strategy – best-case, medium- case and worst-case. In 2023/24, the actual funding levels have been applied across each of the three, with the possible scenarios applied for 2024/25 and 2025/26. Against each of the three scenarios, sensitivity analysis has been used to demonstrate what the impact would be in 2024/25 and 2025/26 if the funding were to increase or decrease by 5% or 10%. For 2024-25, the forecast budget gap ranges from a deficit of £1.140m in the best-case scenario to a shortfall of £5.854m in the medium-case and a shortfall of £11.699m in the worst-case. These figures are after adjusting for the saving of £1.252m which was planned on a non-recurring basis for 2023/24 through the use of reserve balances. For 2025-26, the forecast budget gap ranges from a breakeven position in the best-case scenario, to a shortfall of £3.876m in the medium-case and a shortfall of £11.031m in the worst-case. The MTFO will be revisited ahead of the 2024-25 budget exercise. 4. Workforce 4.1 Workforce Planning – Staffing and Recruitment Issues The year past has continued to see the practicalities of the national shortage of qualified Social Workers take effect in North Ayrshire. In line with the rest of Scotland we experience this most acutely within the Children and Families workforce. Locality teams have experienced shortages over the year that have been mitigated through careful deployment of resources in a collegiate way. The CSWO has a requirement to be
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36 notified if workforce sufficiency drops below 75%. This is to ensure proper oversight of risk management and appropriate professional support is offered to operational colleagues. The year past, within a Justice Services context, continued to offer challenges as a result of changes in the vetting process that is driven by Home Office colleagues in relation to current and future access to Police systems. Within North Ayrshire we are appreciative of the support of local Polce Scotland collegues and have successful co location for a number of our public protection teams. We will continue to work closely on this issue to support safe and timely sharing of information whilst the national picture continues to emerge. Reassuringly North Ayrshire Chief Officers Group is sighted on this issue and is offering support to develop our position. We have been mindful of our engagement with our practitioners in various forums and how this links to the Setting the Bar research, highlighting the three key reasons Social Workers leave the profession are unmanageable workloads, lack of work life balance, and high administrative workload. With this in mind, work over the year has been heavily focussed on the three areas research tells us high performing Social Work agencies do well: Caseloads: The “Setting the Bar” report published by Social Work Scotland makes reference to well established research which outlines that optimum caseloads for Social Workers in Children and Families should be 12 and in Adult Services between 20 and 25. The key skill of Social Work professionals requires them to have the time to build relationships and trust, undertake person-centred assessments, plan for the future and arrange or provide appropriate support. Excessive workloads make it difficult for case holding social workers to achieve their best practice and support people effectively in what are often challenging and complex situations. Work within Children and Families has been undertaken to scope out what is required to set the bar in North Ayrshire which has been supported by the Partnership and the impact of this will be reported in next year’s report. I anticipate similar work to be forthcoming from Adult Social Work Services in 2024. Supervision and Support: The post covid environment continues to see the deployment of hybrid ways of working. This brings a range of professional and personal challenges as public issues enter the private home of practitioners and managers. As a result we have reviewed our Supervision practices with clear commitments to move back to professional supervision and away from the beurocratic casework management approaches so prevalent. Professional Development: In the year past we have taken deliberate decisions to reshape our strategic approach to the professional development of the workforce. This means withdrawal from the Learning Network West on 31st March 2024. As a result we have seen our internal resource begin to reshape itself and begin to establish relationships with universities and colleges. This encomapsses SVQ, degree level, post graduate and post qualification contexts. Alongside this we have been reshaping our
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37 pathways to Social Work, broadening this offer to all HSCP staff, building capacity in relationship to sponsored places and also seeking to offer a traineeship option. Retention: Professional activity has been heavily focussed on the workstreams above and the expression of intent that retention and quality of experience are key to stable workforces. The work described above and underway in other areas such as SDS and transitions are designed to reshape how we deliver Social Work with a clear focus on core values and ethics. More importantly it has, at its core, a desire to see services evolve and allow our skilled staff to make more of a difference to people’s lives. 4.2 Workforce Support and Development A number of Staff well-being sessions ran during January and February 2023 facilitated by KA Leisure with events taking place at venues across North Ayrshire. Activities included: • Stress Less sessions • Menopause Awareness sessions • Mental Health sessions • Weight Management sessions • Standing/Chair Yoga • Keep Fit Low • Standing Pilates • Dance Taster sessions • Gentle Movement • Gym Induction sessions • Signposting • Free health checks on the Activator Bus The new Staff Wellbeing Centre at Ayrshire Central Hospital officially opened on 29 September 2022. The centre makes up part of the existing building for the Gallery Dining Room at Ayrshire Central Hospital and is a place for all health and social care staff to take a much-needed pause and relax. The staff wellbeing centre is now available as a rest and sanctuary area and is available for all clinical and non-clinical staff from across our entire health and social care system. The area will be a quiet space separate from patients and the public. North Ayrshire have achieved Carer Positive Employer – Exemplary Level, with the award presented on the 29th of March 2023. Well done to all involved and thank you to the hard work of Kerryanne Owens, Kimberley Mroz and her team. The award demonstrates the support the Council provides for its employees who are working carers, through a combination of practical support and policy, awareness raising and training and
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38 an active Carers Network. Carer Positive is operated by Carers Scotland on behalf of the Scottish Government. The Carer Positive commitments recognise those employers who offer the best support to carers, allowing them the flexibility they may need to deliver caring responsibilities. The ‘Exemplary’ Level 3 Award is the highest accolade given to organisations who go above and beyond in their caring commitments to colleagues and who demonstrate innovative and creative approaches to supporting and involving carers across their organisation. The Arran workforce has been developed to provide solutions to service delivery issues. In 2022/23 a new Health Care Support Worker (HCSW) was appointed to support our multi-disciplinary team. A new nurse practitioner will provide care to people needing urgent and unscheduled care, while there is also a new Grade 4 entry level post for the residential/nursing home. Work has started to develop a new model of working for Arran AHP team (Occupational Therapy and Physiotherapy team). In addition, several wellbeing days have been held at Arran Outdoor centre for all health and social care staff on Arran, as well as providing access to wellbeing vouchers for holistic range of practitioners and interventions. A jointly delivered (with mainland colleagues), online mindfulness group has reconvened, post-COVID – offering the opportunity for joint working between Occupational therapy and Psychology. Enhanced Learning and Development Support for Care at Home saw engagement take place across 2022/2023 with a range of Care at home teams to discuss the training plan and consider the training which will be required for each role within the service and to meet Scottish Social Services Council (SSSC) registration conditions. A 5-year training plan has been devised for a • Care at Home Assistant • Senior Care at Home Assistant • Care at Home Manager • Team Manager There have also been new training courses devised which were bespoke to the Care at Home Service. Practice Reflective Improvement (PRI) Dialogue sessions encourages greater levels of reflection on cases with an element of child protection. North Ayrshire Child Protection Committee and North Ayrshire Health & Social Care Partnership continue to accept referrals for Practice Reflective Improvement Dialogue sessions. PRI Dialogue has been in place for over a year now and feedback from both participants and facilitators is showing the value of these sessions: “It is really helpful to hear reflections from different perspectives – it makes it easier to understand the context of decision making and broadens ideas extrapolated from reflection” (Participant)
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39 “It (PRI) validated the great work being done and the care and love practitioners have for their jobs and the children and families they work with. It showed that everyone believes in aiming for the best outcomes for young people. It also gave people permission to evaluate their own practice and talk about it openly. The difference it made was, there were no judgements made on the choices taken. It allowed people to see the different ways services work and raised the levels of mutual respect for the work we all do.” (Facilitator)
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40 Independent Care Providers who provide care services on our behalf Where we commission care and support from independent and 3rd sector Providers services based within the North Ayrshire area, we monitor these services via the Contract Management Framework. The Framework focusses on ensuring a joint approach to evaluating the quality of care and where appropriate provides an approach to supporting Providers to progress improvements. We use a range of methods to monitor performance, including: • Formal Contract Management meetings on a 6 monthly basis and an Annual Joint Evaluation of Contract to ensure that services are safe, effective and most of all, that they meet people’s needs • Review of compliments, complaints and feedback from staff, carers and people who use services • Information that we collect, before visits, from the provider or from our records • Local and national information, for example, Care Inspectorate reports • Visits to providers, including observing care and support and looking at records and documents The information below represents how those service which are registered with Care Inspectorate and are based in North Ayrshire are currently performing. Registered Services – Minimum Grades across all themes – Care Service Subtype 2 Weak 3 Adequate 4 Good 5 Very Good 6 Excellent Grand Total Adoption Service Not applicable 0 0 0 1 0 1 Adult Placement Service Not applicable 0 0 0 2 0 2 Care Home Service Older People 1 8 6 2 0 17 Care Home Service Children & Young People 0 2 4 4 2 12
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41 Care Service Subtype 2 Weak 3 Adequate 4 Good 5 Very Good 6 Excellent Grand Total Care Home Service Children & Young People 0 1 2 0 0 3 Care Home Service Mental Health Problems 0 1 0 0 0 1 Care Home Service Respite Care and Short Breaks 0 0 2 0 0 2 Child Minding Not applicable 0 9 61 52 3 125 Day Care of Children Not applicable 1 5 42 17 0 65 Fostering Service Not applicable 0 0 1 0 0 1 Housing Support Service Not applicable 0 1 6 7 2 16 School Care Accommodation Service Not applicable 0 0 1 6 0 7 Support Service Care at Home 0 1 12 9 0 22 Support Service Other than Care at home 0 0 7 0 1 8 Grand Total Not applicable 2 28 144 100 8 282
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42 Inspection of Local Services Our Children and Families Service were subject to a Joint Inspection of Services for Children and Young People at Risk of Harm in North Ayrshire which was published on the Care Inspectorate website here - Report of a joint inspection of services. In support to the inspection, please find a link to a video the Young Inspection Volunteers have produced for children, young people, and their Families – YouTube video It is a very positive report for children’s services and one we can be proud of. The report recognises the very strong evidence of partnership working and the clear commitment and dedication of staff working across various agencies to reduce risk of harm, develop positive relationships and improve wellbeing outcomes for our children and young people. The report also references the wide range of innovative work the partnership has driven forward, our strong leadership and coherent and shared vision to make positive change. In particular, the report highlights the swift, collaborative, strategic and deliberate action we took to protect children and young people from harm during the pandemic. Overall, the key strengths highlighted in the report as follows: • Recognition and initial response to risk and concern to children was a strength. Staff took timely and appropriate action to keep children safe. • Overall, key processes for assessing and managing risk for children at risk of harm were well established and working effectively. • Effective oversight and scrutiny of child protection performance was provided by the Chief Officers Group and Child Protection Committee. • Partners had a well-established approach to gathering and using performance data to inform and support improvement activity. The report outlined there were two areas for further improvement: • The partnership should further develop its review of outcome data to demonstrate the difference services are making in keeping children safe. • Continued attention was needed to ensure all children and young people are meaningfully involved in decisions about their lives and in the development of future service provision. The Partnership also received 7 further inspections; 2 announced and 5 unannounced. The inspection reports for these can be found - Inspection Reports.
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43 Inspection Date Service Number Service/Unit Wellbeing Leadership Staffing Environment Care & Support 11 - May - 22 CS2007142325 The Meadows 3 0 0 0 0 01 - June - 22 CS2008192560 3T, NC & Arran CAH 5 0 0 0 5* 01 - June - 22 CS2008192553 Irvine, GV & CA 5 0 0 0 5* 21- July - 22 CS2003001160 Canmore 4 0 0 0 0 25 - July - 22 CS2003001167 Montrose House 3 3 3 4 3 16 - February - 23 CS2008177877 Anam Cara 5 5 0 0 0 27 - February -23 CS2007142322 Achnamara 4 0 0 0 0 *Within Care and Support, Inspections for Three Towns, North Coast and Arran as well as Irvine, Garnock Valley and Community Alarm were graded relating to how good is our care and support during the COVID-19 pandemic. This was introduced as an additional key question to the Quality framework during the COVID-19 pandemic by the Care Inspectorate. The Care Inspectorate use a six-point scale to grade inspections: 1 Unsatisfactory Major weaknesses – urgent remedial action required 2 Weak Important weaknesses – priority action required 3 Adequate Strengths just outweigh weaknesses 4 Good Important strengths, with some areas for improvement 5 Very Good Major strengths 6 Excellent Outstanding or sector leading