Scottish Government

Short Reviews of Social Work Services in Scottish Local Authorities

Clackmannanshire Council

Overview

Though a comparatively small authority within a compact geographical area, Clackmannanshire faces considerable challenges in providing services because of the steeply increasing numbers of older people and the concentrated areas of deprivation. It has made considerable progress in raising the educational attainment of children and young people who are looked after and has a robust development programme in place for all staff. It needs to make sure that its community care services keep pace with the demands of its ageing population.

The Council's achievements include:

• a protocol allowing it to share information on all clients (if they agree) with agencies across Forth Valley;
• the smooth introduction of Free Personal Care;
• an increased rate of children looked after at home and less reliance on residential settings; and
• a higher percentage of children and young people looked after attaining Maths and English standard grades than in other authorities.

Clackmannanshire needs to take urgent action to:

• improve its very poor performance in relation to the lateness of most of its reports to the Children's Hearings, make sure that it takes action on all supervision requirements within the 15 day target and make sure that all referrals are made within five working days of the case conference (standards 2, 3 and 15);
• make sure that all children and young people who are looked after are receiving full-time education; and
• complete the resettlement into the community of people still in the Royal Scottish National Hospital (RSNH).

The authority should also give priority to:

• developing outcome measures for services designed to make sure that older people are cared for, as far as possible, at home - notably rapid response, shopping service, intensive home care packages and short-term respite beds;
• planning staffing and budgets for putting the new Mental Health Act into practice;
• developing policies and protocols for children whose parents misuse substances;
• recruiting and keeping foster carers;
• completing the throughcare strategy and improving information on young people who were looked after;
• mounting a recruitment campaign to improve staffing levels, particularly in children's services; and
• assessing the skills likely to be lost through retirement, and creating ways to keep and improve professional skills.

Community Care

Services for older people

The number of older people receiving a service reduced slightly between 2000-2001 and

2001-2002. The overall rate of older people receiving a service is comparatively low considering that Clackmannanshire faces a potential increase of the 65 and over population of almost twice the national average. Though the rate of older people in nursing homes is lower than in many other authorities, numbers have increased from 102 in 2000 to 154 in 2002. Over the same period there was a significant reduction in the number receiving 20 or more hours of home care a week from 60 to 23. The predicted population changes are likely to lead to increasing rather than reducing demands for intensive packages of home care over the next few years. There was a large reduction in the number of people in special needs housing between 2000 and 2001. However, the number recovered somewhat in 2002.

A rapid response service has been in place since April 2001 to prevent people having to go into hospital but the service also provides support for people being discharged or to prevent delayed discharge from hospital. It is delivered through a private contractor and two mobile home care teams. People can use the service if they are referred by a nurse or GP or phone it directly. It has achieved:

• no-one waiting for rapid response services;
• no blocked beds; and
• a very low rate of hospital admission.

The shopping service has not proved popular with existing clients who prefer their home helps. However, new clients are being directed to the new service which is more cost-effective. The Council is planning a household maintenance service but has not yet put it into practice.

Five extra short-break beds are available in Council accommodation for planned respite care, as well as for winter emergencies. The Council also block-buys respite beds in private care homes.

The Council has introduced Free Personal Care smoothly. They tell older people about the policy during their assessments and give them information leaflets. Crossroads and the local carers' association also provide information and advice. A Direct Payments scheme helps to make free personal care at home more accessible. From the outset, the Council has fully integrated Free Personal Care with assessment and care provision arrangements, both for care at home and in care homes.

Services for people with learning disabilities

The number of people receiving a service for learning disabilities increased between 2000-2001 and 2001-2002.

The Council has still to make arrangements for the longer-term care of a small number of people with learning disabilities still in RSNH.

The structure in the community is evolving, with day care services changing from being centre-based to being more socially inclusive. All day care staff have had person-centred training. The Council has expanded respite care and advocacy services. Staffing is changing significantly in skill mix and numbers and the Council will have to monitor this carefully to make sure the response is appropriate. A Local Area Co-ordinator is due to be appointed, and this is an important development.

Services for people with physical disabilities

19 people receive direct payments. Social workers have to give people information about the system, and leaflets are being prepared. A part-time support worker from the Lothian Centre for Integrated Living helps people using Direct Payments, and a representative from Direct Payments Scotland has been working with local voluntary organisations.

One worker - an occupational therapist or community care worker - usually assesses equipment, with one assessment. A team leader has to approve this. Most items are demonstrated, but there is no joint equipment store, and although Health can use the Social Work store, there is no reciprocal arrangement. The Council and Health colleagues are considering the effectiveness of the equipment store arrangements.

People with sensory impairment

A register of people who are blind and partially-sighted is kept. People with hearing impairment or dual sensory impairment or who are deaf-blind have their needs recorded as primary or secondary care needs, and figures are available. 68, mostly older people with hearing impairment as the main problem and 29 mostly older people who are blind and deaf receive services.

Services for people with mental health difficulties

Following a large reduction in the number of people receiving a service for mental health problems from 346 in 1999-2000 to 138 in 2000-2001, the number increased significantly to 223 in 2001-2002.

There are three community mental health teams - two for adults and one for older people - each with a Mental Health Officer (MHO) attached, plus one Forth Valley forensic team. Services are prioritised according to individual needs and an integrated day service is being developed. A working group is considering introducing an integrated referral pathway for all mental health services, linked to Single Shared Assessment. A multi-agency steering group is preparing a plan to put the new Mental Health Act into practice. There is a rolling programme of training to cover the Adults With Incapacity Act and the Mental Health Act. That said, the Council needs to take forward the planning and costing for introducing the Mental Health Act.

Tackling substance misuse

There are three specialist addiction staff in the education service, as well as a development officer. People are also supported through the Forth Valley-wide service. Clackmannanshire and Forth Valley have a tiered approach on substance misuse issues.

Residential rehabilitation is offered to people through joint funding and through assessments by the community alcohol and drug service and the community care teams. Locals Against Drug Abuse offer addiction services in two areas - Sauchie and Alloa.

70 children identified as affected by their parents' substance misuse are being supported through family centres and family assistance. The Council has got funding from the Changing Children's Services Fund for three substance misuse workers.

There is a clear staff development programme with individual staff development and training plans.

Criminal Justice Services, Childcare Services and Adult Care Services work in partnership to make sure there is a joined-up approach to the service for offenders with substance misuse needs. Their needs are identified and referred to specialist services linked to mainstream services.

Though work has progressed in relation to families who misuse substances, Clackmannanshire, with their partners, now needs to put in place a comprehensive response, in particular written policies and protocols.

Joining up community care services with health

Progress in improved joint working is measured through the Joint Performance Information and Assessment Framework (JPIAF), which has been agreed by SWSI, Audit Scotland and NHS Scotland. Annual evaluation statements were issued by the Scottish Executive and Audit Scotland to each local partnership in June 2003 and covered progress in 5 areas: joint management, joint governance, human resources, joint resourcing and Single Shared Assessment. The joint arrangements for these 5 areas, as documented in the Local Partnership Agreement, can be summarised as being well progressed and are, overall, satisfactory. It was recommended that the local partners:

• clarify the details of the membership, function and delegated powers of the Joint Future Committee and Joint Future Management Group;
• progress the developmental work on joint operational management arrangements for integrated services;
• address governance and accountability arrangements in relation to joint management arrangements and delegated/shared responsibilities, at all levels of the joint management arrangements;
• continue to develop and implement service and clinical governance arrangements and risk assessment for joint services;
• develop financial management arrangements to address strategic arrangements;
• develop financial protocols for strategic arrangements;
• agree a statement of total service strategic financial envelope for older People's services;
• agree a statement of joint resourcing strategic financial envelope for older people's services;
• include housing services in arrangements for single shared assessment, including training for housing staff and access to housing resources; and
• provide training for all eligible staff, in particular for remaining community nurses.

Joint working extends to the co-location of learning disability services, single shared assessment and joint day care services. A new hospital development at Alloa will provide further opportunities for joint working.

Under the Forth Valley Information Sharing Protocol, information on clients is shared across all client groups, if clients agree.

Working with carers

The Council has involved users and carers in consultation on developing mental health services. The Council is seeking to involve users and carers more generally when planning services, including extending user and carer representation on its Joint Future Board. It has worked with carers to develop a Clackmannanshire Carers' Strategy.

Children and Young People

Looked after children

The number of children and young people looked after increased from 89 in 2000 to 106 in 2002 and the number of children and young people looked after at home increased sharply from 31 in 2000 to 54 in 2002. Factors behind these increases are:

• awareness training by the Reporter resulted in more children being referred (with the knock-on effect of 235% increase in reports requested);
• substance misuse has emerged as a more serious problem both with parents who misuse drugs as well as young people; and
• home supervision has increased since 1999, rising from 34% of children and young people looked after at home to 50% in 2002.

There was a significant reduction in the number of children living with friends or relatives from 14 in 2000-2001 to five in 2001-2002.

Fostering and adoption

Since 1996, numbers of foster carers have fallen from 42 to 24, with three going to new independent fostering agencies and the rest having retired. It is doubtful whether the Council can reach its target outlined in its Children's Services Plan of 12 additional carers by March 2004, with only two extra carers so far. A small number of young people are waiting for respite places. Some brothers and sisters have been waiting for a permanent placement for some time and have been referred to neighbouring authorities' voluntary organisations.

The Council operates a payment for skills scheme and encourages carers to do SVQ level 3 or the Scottish Progression Award.

A small number of children have been registered for adoption and placed in the last year. A small number have been registered and are waiting to be placed. There do not seem to be any difficulties in recruiting adoptive parents and the Council has already met the target of three prospective adopters by March 2004.

Educational attainment

Clackmannanshire performs significantly better than other authorities in relation to the educational attainment of children and young people who are looked after with 80% of 16 and 17 year olds leaving care after having attained Maths and English standard grade in 2001-2002. This is the highest percentage in Scotland and Clackmannanshire should be given credit for this. However, there is still room for improvement as performance is still below the 100% target set by the Scottish Executive in 1999 and the 91% of the S4 cohort in the authority attaining these grades. Factors behind the comparatively high performance in Clackmannanshire are:

• designated teachers who monitor the progress of children and young people looked after and provide tailored support where needed;
• all accommodated children have personal learning plans and next session this will be extended to all children and young people who are looked after;
• detailed information is collected on attendance levels and exclusion rates (an attendance officer has contact with residential units and exclusion rates for accommodated children are lower than in many other authorities); and
• educational resources have been put into residential units (for example, computers and a lending library of computer equipment).

The Council collects attendance information only on accommodated children but it is alerted if children and young people who are looked after and living at home do not attend school. All children and young people looked after at home are currently in school. 97% of all children and young people who are looked after are in full-time education. The authority feels that progress is still needed to make adquate educational provision for accommodated children who are not in full-time education.

Throughcare and aftercare

The Council has information on 26 young people up to the age of 19 who were looked after. The information does not cover their employment status. In the last year, 10 young people stopped being looked after, seven of them being on home supervision. Over the next two years, 30 young people are likely to leave, with 17 of them perhaps eligible for financial support.

The Council has not yet finalised a throughcare strategy but has worked on a number of developments.

• The NCH Path project provides a good range of accommodation with support options. There is a four-bedded residential project, supported lodgings, or the opportunity for young people to get their own tenancies (two-person shared flats, chalet accommodation or tenancies through View Housing Association).
• A common complaints procedure with Falkirk and Stirling has been developed in relation to financial support.
• A joint protocol has been developed with Careers Scotland and the three local authorities in Forth Valley.
• Materials have been developed for young people with Who Cares? (Scotland).
• A group assesses support, income, accommodation, health and education, training and employment.
• Social work and housing staff interview young people who are homeless.

Mental health

Systems are in place to identify the mental health needs of children and young people looked after.

• The Well Chosen health improvement project with Stirling and Falkirk and the NHS trust provides for health assessments and mental health screening.
• A mental health worker employed in partnership with Stirling, Aberlour and the NHS Board provides drama therapy.
• A strong team in social work and psychological services provides significant input to children and their families where there are mental health isues and support needs. They currently deal with 40 children, 30 of whom are looked after.

At the moment, only a small number of children and young people who are looked after are dealt with by child and adolescent psychiatry.

Child protection

The number of referrals fell from 149 in 1999-2000 to 99 in 2001-2002 but the rate is still higher than in many other authorities. While the number of referrals fell, the number of children who are the subject of a case conference increased from 25 to 42 and the number on the register increased from 18 to 24.

The Council is part of the Forth Valley Child Protection Consortium, and strong working relationships are being developed across agencies. To prepare for putting the recommendations of the child Protection Review into practice, it has consulted a range of staff and held briefing meetings which have included the voluntary sector and health representatives. It is reviewing the Child Protection Committee and current practice and procedures. It has carried out service reviews of a sample of protection cases, worked with the health service in assessing babies with parents who misuse drugs, and produced public information about child protection.

There are good links between children and families staff and criminal justice with joint assessments, joint working in relevant cases and joint training.

Children with disabilities

Services are currently provided for 40 children with disabilities. The budget to Crossroads has been doubled to provide services to disabled children. Children and families social workers send reports to all future needs assessments and attend where necessary.

Working of children's hearings

Only 23% of referrals were made within five working days of the case conference (Standard 2) in 2001-2002. Factors behind this performance are:

• an increase of 235% in requests for reports but no corresponding increase in staffing (vacancy levels were at 50% at the time of the inspection); and
• questions over the figures which only included cases where the decision to refer to the Reporter was clearly referred to in the case conference minutes. In other cases, a referral would already have been made but this would not be recorded as meeting the standard.

The Council intends to review its reporting procedures and expects to achieve a significant improvement in how it complies by the next reporting period.

In relation to standard 3 (all reports will be sent in within 20 working days of the date of request), the authority claimed a return of 35%, which did not match the SCRA figure of only 9%. The Council blamed staffing problems, both their own and at SCRA who frequently send reports in bursts. However, efforts to tackle early allocation might help to improve the situation.

75% of supervision requirements with no condition of residence were given effect within 15 working days of issue by the children's hearings (standard 15). Staffing problems were given as the reason for supervision requirements not being given effect on time. However, a commitment to intervention, often with resources in place by the time of the hearing, showed that good practice is being masked by delays in recorded allocation of the case.

Youth Justice

Youth justice workers work in partnership with the police and community education and aim to deliver a staged intervention depending on the level of offending. There are a range of youth crime projects.

• Barnardo's Freagarrach for 16 to 18 years olds (funded by Criminal Justice Services).
• An in-house service for 12 to 16 year olds.
• A partnership with Aberlour to deliver a restorative justice service.
• The Matrix project for 8 to 12 year olds provides intensive support to families whose children are at risk of offending. It does this by reducing risk factors and improving protection. An external evaluation showed a positive effect on offending and anti-social behaviour, physical health, parental management and support, and school attainment and behaviour. The project is a partnership between Clackmannanshire Matrix and Barnardo's.

Criminal Justice

Structure

Clackmannanshire, Falkirk and Stirling operate as a partnership for delivering criminal justice social work services. Responsibility for the strategic planning and monitoring of services across the Forth Valley partnership lies with a strategic management group which meets on a quarterly basis. An operational management group meets on a two-monthly basis.

Workload

Demand for core services has risen across the partnership over the past year, with social enquiry reports increasing by 19%, probation orders by 12% and community service orders by 31%. While all three authorities have experienced an increase, there are variations. Clackmannanshire has seen an increase of 49% in social enquiry reports, and 110% in probation orders, while Falkirk has seen community service orders rise by 42%. This reflects a general upward trend over recent years. Staff have been placed under increasing pressure as a result. In spite of this, the three authorities have performed well in relation to prompt submission of social enquiry reports.

Effective practice

The group uses different tools to assess the risk and needs presented by the offender. Falkirk and Clackmannanshire make use of the Scottish Executive's risk assessment framework while Stirling use the tool LSI-R. The partnership has yet to consider the use of a consistent framework across the authorities. Similarly, varied structured offence-focused programmes are delivered in each authority. This includes a recently-developed programme for people convicted of racially-motivated offences. A review of the first completed programme is currently being undertaken and it is hoped that a second run of the programme will begin in the autumn. Stirling operates groupwork based on the Constructs programme. Clackmannanshire concentrates on individual work, although it will consider groupwork services next year, possibly in partnership with Stirling. Falkirk provides a combination of individual work and groupwork. The Grouping works closely in partnership with SACRO. While these developments are encouraging, there is still evidently some way to go in developing consistent services across the partnership.

The group's Fast Track Assessment and Treatment project continues to offer a service to drug misusing offenders, which has been extended. Referrals, orders and the conversion rate have remained high. Analysis of assessments, and compliance and completion rates is to be undertaken to evaluate the effectiveness of the Project.

Services to young offenders throughout the partnership continue to be provided through Barnardo's Freaggarrach Project.

Recent developments include services specifically tackling the needs of female offenders. Stirling provides a lifeskills programme while Falkirk has started a weekly informal 'drop-in' session, as well as formal individual sessions. Both Falkirk and Clackmannanshire have set up dedicated women offenders community service groups.

Public protection

Across the three authorities, a groupwork programme for perpetrators of domestic abuse continues to be available in partnership with SACRO. Demand and completion rates are high. Services to sex offenders are also delivered in partnership with SACRO. The group is one of the pilot areas for the Community Sex Offender Groupwork Programme (C-SOGP) currently being prepared for accreditation. TayPrep 30 is used to assess the risk posed by sex offenders and the group also intends to adopt the tool Risk Matrix 2000 to meet the demands of C-SOGP. The Supported Accommodation service also continues to provide accommodation, support and monitoring of high risk offenders in partnership with SACRO and has now been extended across the group. A protocol is to be developed with the police for assessing and managing all high risk offenders.

The Criminal Convictions Enquiry Unit, based in the Stirling criminal justice office, and employed by the local authority, continues to provide a service to all Scottish local authority criminal justice services, providing criminal records checks for all offenders subject to court reports. The future of the Unit is time-limited, dependent on the development of ISCJIS, the information system being developed for all agencies in the criminal justice system.

Quality assurance

For 2003-2004, the criminal justice management group will focus in greater detail on showing effectiveness. Monitoring tools have been developed for use across the service, caseload inspections are planned and monitoring and examination of support programmes are ongoing.

Human Resource

Structure of the workforce

Between 2000 and 2002, both the numbers of whole time equivalent fieldwork staff and vacancies across all services have stayed much the same. However, there has been a slight increase in vacancies in services for children.

In the same period, numbers of whole time equivalent social work staff across all services have also stayed the same with a slight reduction in numbers in services for children. There is a rise in vacancies in services for children (from three in 2001 to six in 2002) but otherwise the numbers of vacancies have stayed the same.

Latest figures provided by the Council but not yet confirmed suggest that, at the end of June 2003 there were 38 social workers (whole time equivalent including vacancies) compared with 29 in October 2002 and that the number of social work vacancies was six compared with seven in October 2003.

Difficulties in attracting new staff are due to the incentives offered by other authorities and the view that a smaller authority could not offer enough prospects of promotion. The Council also has problems recruiting home support staff, but since the bulk of this work is carried out by the private sector, the shortfall is not quite so important.

Support for staff

A development programme involves all staff in managing performance and identifying training needs. ISO 9000 was developed within Social Services - firstly in older people's services, residential units and childcare residential services, and now extended to criminal justice and childcare generally. Social Services have kept this Kitemark since 1998-1999.

Most managers have now been on courses on managing absence, including how to handle 'return to work' discussions. There is a re-deployment procedure for staff who need to move for medical or other reasons. Sickness levels appear to be higher in staff working in adult care services, among staff at Ludgate in particular.

New staff go on induction courses developed through ISO, including a formal induction session followed by self-led work.

Working towards a more highly qualified workforce

The Council supports staff by encouraging them to analyse and act on their training needs. In particular:

• social services has its own training strategy linked to the corporate strategy - each post is linked to training matrix which is based on skills;
• the Council offers relief staff the same opportunities as permanent staff;
• the Council encourages staff to adopt a needs-led approach to training with specific links to delivering services; and
• minimum time-scales are set for formal supervision of staff.

Preparing for registration

The Council has set out qualification levels expected within each subsector and deadlines for their achievement. The Council is ahead of Scottish Executive targets and continues to put resources into making sure that staff reach the SVQ levels given.

Race Equality

Of the local population, 0.8% are from a minority ethnic group compared with 2% for Scotland as a whole.

A corporate joint working group has produced a Race Equality scheme. The early focus across the Council is on auditing and improving its information on the ethnic background of employees and service users.

By early 2004, the Council should have awareness packs in place and have delivered relevant training to all staff.

Use of Information Communications Technology (ICT)

Social Services Department

A new human resources system allows staff to access data from area offices. Electronic reporting is widely used in the social work department.

Partnerships

The Council is a partner in a project to put the single shared assessment on an electronic basis. A protocol to share data is to be introduced to Forth Valley authorities and NHS trusts for data-sharing across all client groups.

Background Profile

Clackmannanshire is a compact mixed rural and urban area, with most of the population concentrated in Alloa, Sauchie and Tullibody. Despite recent job losses, the manufacturing sector still provides a lot of local employment.

There are pockets of severe deprivation, particularly in South and East Alloa and Tullibody. There has been a recent increase in crime, though the rate is still lower than for Scotland as a whole.

Spending for every person on social work in 2001-2002 was 278 - above the Scottish average of 267.

Expected population change

Community Care

Expenditure on community care has risen steadily since 1999.

Children and Young People

G21

Expenditure on children's services increased in 2000-2001, but in 2001-2002 dropped to 1999-2000 levels.

Criminal Justice

Human Resources