Scottish Government

Short Reviews of Social Work Services in Scottish Local Authorities

Inverclyde Council

Overview

Inverclyde Council has to cope with the major demands of population change and severe deprivation within the towns of the Lower Clyde which had to cope with the effects of:

• sharp industrial decline;
• falling employment opportunities; and
• the social problems that followed, including high rates of crime and drug misuse.

The Council's achievements include:

• a consistently high rate of people receiving a community care service across all care groups;
• introducing Free Personal Care smoothly;
• initiatives to attract and keep newly-qualified social work staff and to motivate existing staff and to improve the training and professional practice of staff; and
• in amending the registration criteria of the six-bedded unit for young people with disabilities, successfully developing an interesting way of making sure that young people have continuity of care as they progress into adulthood. (Inverclyde and Quarriers have jointly developed the unit).

Inverclyde Council needs to take urgent action in:

• making sure that all children and young people who are looked after have allocated workers;
• making sure that all children and young people who are looked after have care plans, including those who are looked after at home;
• improving its poor performance in relation to lateness of reports to Children's Panels, improve the number of referrals made within five working days of the case conference and provide information on the number of Children's Panel requirements which are carried out within 15 days (all targets should be met as soon as possible);
• making sure that all children and young people who are looked after are receiving full-time education; and
• improving the educational attainment of children and young people who are looked after.

The authority should also give priority to:

• working with the primary health care trust to find a way of reducing the waiting time for treatment services for children and young people who are looked after who have mental health needs;
• improving management information on children and young people who are looked after;
• improving information on young people up to the age of 19 who were looked after;
• renewing emphasis on recruiting social workers to children's services where vacancies and consequent stress are most evident and persistent;
• developing incentives to help fill middle-management posts;
• tackling the outstanding health and safety issues;
• identifying and tackling the problems leading to high absence levels; and
• speeding up the pace of its joint working arrangements with health.

Community Care

Services for older people

The number of older people receiving a community care service reduced between 2001 and 2002, but the rate is still higher than in many other authorities. The number of people receiving a home care service increased slightly between 2001 and 2002, and the number receiving an intensive service increased from 21 to 37. The number of people in special needs housing doubled from 832 in 2000 to 1,669 in 2002.

Over 2003-2005, the Council is introducing rapid response, intensive home care, short breaks, and comprehensive shopping, household and maintenance services.

Good progress is being made on delayed discharges from hospitals. In relation to outcomes for individuals, the Council is reviewing targets for delayed discharge and measuring the reduction of waiting times for hospital facilities. User and carer representatives are involved in the review process.

Free Personal Care was smoothly introduced. A hotline service offered public information and was very popular. Demand for residential and nursing home places has increased, and the Council is reviewing the conditions used to decide who is eligible.

Services for people with learning disabilities

The number of people with learning disabilities receiving a service is slowly increasing (from 241 in 2000 to 268 in 2002).

22 people from Inverclyde still need to be settled into the community. 12 of them have complex needs and are subject of commissioning. Inverclyde is confident that by 2005 no person with learning disabilities will be in hospital inappropriately.

There is an active training strategy for staff at Merchiston Hospital. The local authority is examining and redesigning its services for the people with learning disabilites in the community and the people being resettled.

Of the 27 people resettled between January 1999 and May 2002.

• nine people aged 65 and over went to registered care homes;
• under five people aged 65 and over went directly to their own tenancies;
• under five people aged 65 and over went to registered care homes as the first stage in moving to their own tenancies; and
• 14 people under 65 went directly to their own tenancies.

At the moment, a joint learning disability commissioning group is redesigning the services for people with learning disabilities, including:

• redeveloping the Acorn Centre in an attempt to modernise day services;
• redesigning residential services, converting present provision to individual tenancies;
• reorganising the community learning disability team (CLDT) to become more integrated with, and be more responsive to, other community services; and
• appointing a CLDT liaison nurse for primary and acute services.

At the moment, mainstream services are used for people with challenging behaviour and forensic needs, but specialist day services are also being planned for this group.

Services for people with physical disabilities

The Council is introducing Direct Payments, following preparatory work by a number of working groups. Local voluntary groups are being approached to ask if they can provide support for possible users.

Health staff have direct access to minor equipment in order to reduce waiting time and support people leaving hospital. There is a new joint store for community nursing and social care equipment and there is also joint training of health and social work staff. At the moment, no one is waiting in the high or medium category for equipment. Care teams and Care managers (who also have access to housing adaptations budgets) are responsible for authorising funding for all social work equipment and adaptations.

People with sensory impairment

The Council is not aware of any deaf-blind people. The number of people with hearing impairment reflects current national rates. Services for people with sensory impairment are planned through the community care planning process. The Disability Resource Centre is moving to a new location and aims to secure a room to display new technology for helping people and to provide stronger links to the local ophthalmology clinic.

Services for people with mental health difficulties

The number of people receiving a service for mental health problems reduced between 2000 and 2002, but the rate is still higher than in many other authorities.

The Council is finding gaps in relation to the Mental Health Act, both in terms of workforce and services.

The community mental health team has supported a number of initiatives, based on its home help and homemaker service. Transitional Housing Benefit has been used to develop supported tenancies in the community. At the moment there are 34 fully-furnished supported tenancies for people with a mental disorder. There is a supported accommodation project for people with Korsakov's syndrome. Use is made of home care services to avoid people being admitted to continuing care beds in hospital.

A multi-agency resource group involving health, housing, social work and voluntary organisations keeps a shared waiting list and identifies gaps in services.

Tackling substance misuse

The number of people receiving a service for drug or alcohol problems reduced between 2000 and 2002, but the rate is still high compared with other authorities.

Partner agencies are developing joint services, using shared protocols in relation to medical emergencies. A priority for investment in rehabilitation services is the 'moving on' project for people who are stabilised on methadone. A very small number of residents from Inverclyde are referred to residential facilities, as the over-riding preference is for support in the community.

A self-help network has been set up for parents in families which misuse substances. An intervention project has been set up with a multi-disciplinary team of four professional staff for young people under 19 years of age, to support families and young people. Inverclyde has also set up a drop-in women's group for women with alcohol problems, which is open seven days a week.

More than 100 staff of statutory and voluntary organisations have been trained through STRADA training courses.

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 still being progressed. It was recommended that the local partners:

• develop, document and implement the proposed developments in joint and single operational management arrangements
• develop and put in place the joint governance and accountability arrangements for joint working as set out in the Local Partnership Arrangement and as identified in the statement
• develop and implement the appropriate joint service and clinical governance arrangements, as appropriate, for joint services
• agree a statement of intent for joint human resource arrangements
• develop an action plan for joint OD and training
• agree draft financial management arrangements and protocols
• agree a statement of a total service strategic financial envelope for older people's services
• agree a statement of a joint resourcing strategic financial envelope for older people's services
• agree a statement of a joint resourcing operational budget for older people's services
• complete the training programme for staff working with older people to support implementation of single shared assessment from May 2003
• agree and implement the joint protocol for access to resources.

On the ground, joint working structures are in place for mental health through the community mental health team which has a single manager and has led the development of Single Shared Assessment. At the moment, the existing older people's mental health team is being further developed, with the appointment of a single manager, extra investment of nursing, social work and occupational therapy staff, and the introduction of an integrated assessment and care management system.

Inverclyde has been slow to introduce information sharing because of concerns about security in electronic sharing. There are protocols, procedures and guidance for staff on sharing paper information.

Working with carers

A new carers' centre project (run by the Prince's Trust and Quarriers and Council-funded) offers a variety of support services. There is also a responsive respite service (to give carers a break). Carers benefit from a training course which includes issues such as moving and handling people. A home care review which the Carers' Council was involved in is being completed. A carers' assessment is part of the Single Shared Assessment.

Children and Young People

Looked after children

The number of children and young people who are looked after reduced from 238 to 189 between 2001 and 2002. This is due partly to a strong philosophy of keeping young people in their own home but also to changing information systems. The number of children and young people who are looked after at home reduced from 144 in 2000 to 104 in 2002, while residential placements increased from 25 in 2001 to 33 in 2002 - reflecting an increase in the number of large groups of brothers and sisters.

Between 13 and 16 children and young people who are looked after do not have an allocated worker, but all child protection cases are allocated. All children and young people who are accommodated have a care plan, but not all children and young people who are looked after. Information systems do not allow the Council to say how many children and young people do not have a care plan or to identify how many placements children and young people have had. This is important management information and the Council must improve its information systems if it wants to make sure that children and young people who are looked after are receiving good quality services.

Fostering and adoption

No children are waiting for temporary foster placements, but some young children are in residential units to keep them with their brothers and sisters until a foster placement can be found for the whole family group. The Council are able to meet most of the demand for foster placements, but some carers are looking after too many children and there are difficulties placing older children.

There are currently five children waiting for adoption. Most children are placed out of the authority through the West of Scotland consortium.

Educational attainment

38.5% of 16 or 17 year olds no longer being looked after attained Maths and English standard grade in 2001-2002. This low percentage falls well short of the 100% target set by the Scottish Executive in 1999 and is far below the 94% for the full S4 cohort in the authority achieving these standard grades. The Council has adopted some measures to improve educational performance, including:

• providing computer access for looked after and accommodated children;
• providing homework materials;
• appointing a link teacher to work between the residential units and schools, and identifying those young people who need extra support and help;
• reporting to social workers when young people do not go to school; and
• carrying out reviews every 12 weeks for accommodated children and reporting regularly to residential units on young people's progress.

However, most of these measures are directed only at young people in residential units and the Council needs to do more to improve the educational attainment of all looked after children.

Not all young people are receiving full-time education but the Council cannot say how many are not. It needs to improve its information on the educational position of children and young people who are looked after.

Throughcare and aftercare

Inverclyde has some information on young people who stopped being looked after in the last two years and is developing this information.

The Council provides a range of accommodation options for young people. A service run with Barnardo's helps vulnerable young people find housing. Supported carers are available in suitable cases. There is also a four-bedded unit for young people being prepared for independent living.

Mental health

Mental health needs are identified at Looked after children (LAC) reviews and through schools. Children and young people who are looked after and accommodated have access to dedicated health clinics within six weeks, but there are waiting lists of up to 18 months for services to meet identified needs, mainly because of a shortage of psychiatrists in the primary health care trust. Services have been redesigned to provide therapeutic nursing, and the number of referrals has been limited.

The youth justice team includes a psychiatric nurse.

Child protection

The number of child protection referrals and the number of children subjected to a case conference reduced significantly between 1999-2000 and 2001-2002 and rates are now relatively low. The number of registrations has increased but the rate is still lower than in many other authorities. Following a Best Value review of local child protection services, the Council introduced a more consistent approach to deciding what a referral is and for deciding on conditions for registration. Teenage pregnancies are no longer automatically investigated by the police and social work as a child protection matter, so this may have contributed to the drop in the number of referrals.

Social work, with their partner agencies, are preparing a response to the recommendations of the Child Protection Review. The Council already produces an annual report but will issue a fuller report in future. All social workers in the child protection team have taken (or will take) certificated training.

Children with disabilities

At the moment, 184 children receive services (including 30 young carers). 18 children are waiting to be offered a service. 22 young people are receiving residential respite care, and six are receiving shared care. Barnardo's provide a befriending service to nine young people and a sitter service for 14 young people. The Council also provides holiday services, play schemes, parent support groups and support groups for brothers and sisters.

Every month, the Council carries out 20 to 25 future needs assessments.

The Council has a six-bedded unit where young people can stay up to the age of 25, without having to move when they reach adulthood. The young people living in the unit are currently 18 to 19. Before they are 25, the Council will assess whether they are able to move into the community or whether they will need long-term care. It is expected that as the residents become older the nature of the accommodation can change with their developing needs.

Working of children's hearings

Only 15% of referrals met standard 2 in 2001-2002 (referrals made within five working days of the case conference). This is the lowest figure reported for any council. Inverclyde proposes an action plan to make sure referrals go through more quickly.

Only 36% of reports met standard 3 (all reports submitted within 20 working days of the date of request). Dropping success in meeting the standard is said to be due to problems with lack of social work staff in the last two years.

No return was offered for standard 15 (the local authority to give effect to supervision requirements with no condition of residence within 15 working days of issue by the children's hearings). When fully staffed, the worker who wrote the report undertook the supervision and maintained continuity with the young person. From 2001, it has not been possible to have an allocated worker identified before the hearing and it has not always been possible to allocate a worker within the time standard.

Youth Justice

A youth crime audit from February 2002 identified a number of gaps in services, particularly for more serious and persistent offenders, but the Council is now dealing with this. Work has been done to identify the relatively small number of high tariff persistent young offenders who are responsible for a significant percentage of local crime. Persistent offending is defined as three offences over a six-month period. A group of 13 young people was recently identified in this way and offered an intensive service, either with the Gap project or the Matrix project (which deals with a younger age group). The Matrix project also aims to offer long-term support to the families of children who are persistent offenders if it is felt that the family circumstances could be contributing to the offending.

The Gap project, which was developed in partnership with NCH, works with 14 to 18 year olds whose offending puts them at risk of moving into residential care or secure accommodation, or eventually into prison. There have been some referrals back from the courts during the past year. The project offers young people the opportunity to examine their offending and other ways of behaving through groupwork and individual work, including restorative justice. After initial assessment, an action plan is negotiated in consultation with the young person and parents or carers, setting out what it aims to achieve. By way of evaluation, the Council reviewed 27 referrals from April 2001 to March 2002 and found that:

• half of the 18 young people followed up at six months had not re-offended;
• 72% of the 11 followed up at 12 months had not re-offended; and
• three of the four followed up at 24 months had not re-offended.

For younger, less serious offenders, a police warning scheme is used a lot. 80% of the young people warned do not re-offend within the next 12 to 18 months. This warning system means that young people who go to a children's hearing are likely to be more serious offenders.

Criminal Justice

Structure

Inverclyde, Renfrewshire and East Renfrewshire operate as a partnership for delivery of criminal justice social work services. Management direction for the partnership is provided through a senior management forum, comprising of heads of social work services and criminal justice service managers from each of the authorities. A minute of agreement which will form the constitutional arrangements has been drafted and is currently subject to approval by the respective Councils. A grouping co-ordinator was appointed in May 2003.

Workload

The last year has seen a 31% increase in demand for social enquiry reports across the partnership and a 53.8% increase in probation figures. There are variations among the constituent authorities, with Inverclyde experiencing a 52% increase in social enquiry reports, and Renfrewshire a 43% rise in probation orders. This increase in workload is creating pressures for staff. While the authorities assist each other to cope by sharing staff where possible, their capacity is stretched.

Effective practice

The grouping uses the assessment tool LSI-R to measure the risk/needs of the offender and the level of intervention appropriate in each case. There are plans to collate the data to offer a profile of offender risk/needs across the grouping. Despite the workload pressures, the authorities continue to strive to deliver a robust and effective probation service. Most of those on probation in Renfrewshire and approximately half of those in East Renfrewshire attend the structured offence-focused programme, "Constructs" as the core of their order. This is co-delivered by staff from both authorities. Inverclyde intends to adopt the same approach, though its progress has been hampered by the loss of its criminal justice premises through fire.

The grouping wide Drug Treatment and Testing Order scheme became operational in January 2003, and has received 84 referrals since, resulting in 27 orders. All but one client recommended for an order received one.

Public protection

Services to High Risk offenders are provided through the Pathways Sex offender project which is piloting the Community Sex Offender groupwork programme currently being prepared for accreditation. Project staff assess the potential risk posed by the offender by using the Matrix 2000 (sex offender) assessment tool. The grouping does not yet use a more generic risk of harm tool, such as the Scottish Executive's risk of harm framework, but intends to do so. Each authority has established joint police and social work protocols with their relevant police division. Services to mentally disordered offenders who are considered a high risk will shortly be available from a central community forensic mental health team.

Future possible developments are for more consistent provision of throughcare and the extension of the arrest referral service across the grouping.

Quality assurance

Community service and court services are currently being examined as part of a Best Value review which is nearing completion. Further areas of service delivery will be examined incrementally thereafter. The grouping also intends to develop a common monitoring and evaluation system for all its criminal justice activity and establish a performance management framework across the grouping.

Human Resource

Structure of the workforce

Between 2000 and 2002 there was an increase in the number of whole time equivalent fieldwork staff working across all client groups. While the number of whole time equivalent staff increased by more than 30, the social work staff establishment has stayed about the same. Within that period, fieldwork staff vacancies rose and fell. For social work staff, the picture has remained constant with all vacancies being for adult services.

Latest figures provided by the Council but not yet confirmed suggest that, between October 2002 and the end of June 2003, vacancy levels have increased significantly, rising from just five to 16 - four in Children and Families and 12 in Community Care. This represents 14.5% of the workforce.

The age profile of the workforce reflects that of the ageing population in Inverclyde. Across the teams around 50% of the staff are currently over 45.

Middle management posts are increasingly difficult to fill.

New contracts for home care staff have allowed the Council to introduce more flexible working arrangements, particularly during holiday periods.

Support for staff

The Council has made progress in tackling some of the major difficulties facing frontline staff by:

• introducing a corporate policy on managing stress;
• providing in-house training on dealing with difficult and confrontational situations;
• providing modules on managing change for a range of in-house courses.

The Council still has to tackle some health and safety issues. Not all social workers have mobile phones.

Within social services, 15,116 days have been lost each year through sickness absences - with the highest levels in residential childcare units.

The Council is devoting considerable investment to training staff. Major features are:

• a training plan for managers and staff, which takes account of national and local priorities;
• Information and Communications Technology (ICT) training delivered by a central unit for all staff;
• training for staff to become fully qualified social workers;
• encouragement of senior staff to take MBA and MSc courses;
• a very low drop-out rate on courses, reflecting the commitment of staff and the quality of training; and
• an induction manual, recognising the importance of encouraging and motivating staff in their first weeks.

The Council offers a financial package for students going into their final year. It involves sponsoring students for the final -two to three months of their course, employing them as soon as their course finishes and upgrading their salary as soon as they are officially qualified. In return, new staff are expected to stay in post for two years. Inverclyde takes a relatively large number of students, to make the most of this scheme to recruit new workers.

Other initiatives for staff include moving them up the salary range and also extending the range for experienced social workers.

Preparing for registration

The Council is looking at the qualifications of its staff who fall within the first phase of registration for the Scottish Social Services Council.

Race Equality

In Inverclyde, 0.9% of the local population is from a minority ethnic group compared with 2% for Scotland as a whole.

The Council's Race Equality Scheme aims to introduce practices to make sure that it follows the principles of equality, equal opportunities and social justice. An Action Plan shows the steps the Council takes to tackle race discrimination and to promote race equality.

Social work and housing services have put in place a Race Equality Scheme specifically tailored to social work and care services. Its main aims are to:

• include race equality in the broad range of activities within social work services; and
• make sure that the use made of its services by different ethnic groups reflects the number of members of the ethnic groups in the community, or that there is an acceptable and appropriate reason if this is not the case.

Client information on clients' ethnic origin is collected manually.

Use of Information Communication Technology (ICT)

Social Services Department

With an authorised budget, the Council has begun to replace its information systems, including those designed for social work. The pace of change is gradual. All fieldwork staff have access to e-mail. There was evidence of a clear policy on using ICT, but so far little evidence of real progress.

Partnerships

The Council has agreed protocols with the local NHS trust and they are now sharing information in relation to all community care groups. The next phase is to share information on children.

Background Profile

The social and economic situation of Inverclyde varies considerably between different parts of the Council area. The rural southern parts are mainly well off and have low levels of unemployment. The coastal towns, which make up most of the population, have experienced a decline in shipbuilding and heavy engineering. They include areas of severe social, economic and health deprivation.

Inverclyde is experiencing a shift of population from the urban coastal area towards the south of the Council area. Together, these social, economic and population factors present considerable challenges for delivering social work services.

Spend for every person on social work in 2001-2002 was 301, significantly above the Scottish figure of 267.

Expected population change

Community Care

In the period 1999-2002 expenditure on community care services rose steadily.

Children and Young People

Expenditure on children's services increased steadily in the period 1999-2002.

Criminal Justice

Human Resources