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Short Reviews of Social Work Services in Scottish Local Authorities

Aberdeenshire Council

Overview

Aberdeenshire continues to make good progress in its community care services but faces significant challenges in improving its services for children. As a largely rural authority, the Council has to provide a range of services, up to modern standards, to a population spread over a large area with comparatively few sizeable communities. This means that transport and communications are constant factors in providing access to services.

The Council's achievements include:

• a much increased and now high rate of older people receiving more than 20 hours home care each week;
• carers increasingly being involved in developing services;
• introducing integrated teams composed of consultant psychiatrists, psychologists, nurses, social workers, occupational therapists, physiotherapists and dieticians to help people with learning disabilities in the community;
• introducing a specialised mental health home care service with improved capability to support people with mental health problems outwith hospital and normal home care;
• successfully introducing Free Personal Care;
• new posts to provide services for people with drug and alcohol problems and a large increase in the number of people receiving a service for substance misuse; and
• meeting all Children's Panel requirements within the 15-day target (standard 15).

Aberdeenshire Council needs to take urgent action to:

• improve its very poor performance in relation to the lateness of most of its reports to Children's Panels (84% are sent in late) and make sure that it meets the 75% target;
• make sure that all referrals are made within five working days of the case conference as only 64% met the target in 2001-02;
• make sure that all children and young people who are looked after have the opportunity of full-time education and to make sure that they know when children and young people looked after are not attending school, including those who live at home; and
• adopt the assessment tool YLS/CMI or Asset to use in all youth justice assessments to make sure that young people are receiving appropriate services.

The authority should also give priority to:

• improving waiting times for equipment and adaptations, and making sure that it has evidence that they have been checked and demonstrated;
• developing contingency arrangements for home care recruitment 'hotspots';
• improving information on people with sensory impairment and improving the assessment process for sensory impairment services;
• refocusing on services for older people;
• actively trying to sort out concerns which relate to recommendation 9 of 'The same as you' - setting up a national database;
• recruiting and keeping foster carers;
• reducing the number of children who have three or more placements;
• driving up the educational attainment of children and young people who are looked after; and
• collecting accurate information, including information on employment, education and accommodation, on all young people up to age 19 including those who are looked after at home.

Community Care

Services for older people

In planning services for older people, Aberdeenshire needs to take account of an ageing population in which the number of people aged 65 and over is expected to rise in coming years to more than twice the national rate. At the moment, a comparatively low rate of older people receive a community care service and the number receiving a service has reduced in the last two years. A high rate of older people are in private nursing homes with the number increasing from 938 in 2001 to 1180 in 2002. At the same time, a low rate receive home care and the number reduced from 1613 in 2001 to 1438 in 2002. However, numbers receiving an intensive home care service tripled from 45 in 2000 to 134 in 2002 and this is a positive development in terms of providing services for an increasing number of older people. Another positive development is that a high rate of older people are in special needs housing and numbers are increasing (from 4855 in 2000 to 6104 in 2002).

The Council provides intensive home care as part of the mainstream home care service, with 45% of all users getting a service at weekends. Preparations are in hand to modernise the home care service, for example, terms and conditions of service, and styles of working.

Despite the challenges of a scattered and rural population, the Council has built up a comprehensive rapid response service as part of the mainstream home care service. It responds to 94% of all requests within two working days or less. A joint survey of need with Aberdeenshire Council of Voluntary Organisations identified transport as an important issue. The Council's preferred response is to help with transport, but if there is no alternative, the home care service will deliver shopping. 'Care and Repair' covers one-third of Aberdeenshire, and there are good neighbour schemes for services such as gardening.

Putting Free Personal Care in place went smoothly but the national funding failed to meet the scale of need. Increased levels of staffing for putting the scheme into place also affected the overspend which the Council expects to recur this year, bolstered by increased expectations of users and carers. The information strategy involved a variety of methods including the freephone helpline, which recorded the highest usage. The leaflets and website are being revised. The policy went into existing community care systems from the start, but extra training for staff and providers aided the process.

Services for people with learning disabilities

The number of people with learning disabilities receiving a service increased a great deal from 174 in 2000 to 425 in 2002 but the rate is still low compared with other authorities.

The resettlement programme is progressing - the patients who are still in the former Ladysbridge ward that is now a care home are due to move to a purpose-built bungalow provided by Sense Scotland. Money is available but there are concerns about long-term joint funding, particularly for young people with complex needs or challenging behaviour. Some people, discharged since January 1999, have gone into care homes with nursing care, but the others are more suited to shared or single tenancy supported living arrangements.

The Council has in hand, or has planned, significant development of day, respite and advocacy services, as well as the learning disability teams. Although there are concerns about maintaining levels of joint funding and the withdrawal of traditional National Health services, particularly for people with complex and challenging needs, a lot of investment has gone into a wide range of services. This includes an impressive range of employment and training projects across the authority and respite services. Advocacy services, six care manager posts, and training are all being developed with additional funding from a number of funding streams.

Services for people with physical disabilities

The number of people receiving a service for physical disabilities increased gradually between 2000 and 2002 but the rate is still low compared with other authorities.

A Direct Payments scheme is in place, although the impact of new duties remains to be seen. Direct Payments Caledonian, a voluntary organisation, offers a support service with two dedicated part-time information and support workers.

A multi-agency monitoring and improvement group works across all age groups and includes representatives from education and an educational psychologist. The group has identified the need to improve the assessment process and this is being put into practice.

Waiting times have increased for equipment and adaptations - due to people being discharged from hospital more quickly and people with more complex needs being cared for at home. A central occupational therapy duty system is being piloted which is temporarily removing referrals for equipment and adaptations from mainstream community care systems. Occupational therapy staff, providing the equipment and adaptation service, have delegation roles similar to care managers, and senior occupational therapists can authorise spending of up to 3,000. Three teams of occupational therapy staff cover the authority. Local partners are examining proposals for a joint equipment store for community nursing and social care equipment, using social work transport, with satellite stores in GP surgeries, within a five-year timetable.

People with sensory impairment

It is estimated that about 1031 people are hearing impaired or deaf, almost 900 are hard of hearing and 70 are profoundly deaf. There may be as many as 70 deaf-blind people, with 59 currently seeking a service.

Services for people with mental health difficulties

Aberdeenshire has set up a very progressive, community-based service which appears to be significantly improving the quality of life of people affected by mental health problems in the area. They have a vision of how the service needs to be developed further and are working closely with service users, carers, and health and voluntary sector partners to agree on the way ahead. They have begun looking closely at the new statutory duties in terms of the service provision which will fall to local authorities from the new mental health legislation.

The Council has set up a specialised mental health home care service with 15 whole time equivalent posts, which retains access to mainstream home care. This service has improved the ability to support people outwith hospital and traditional day care provision. Plans are in place to expand evening and weekend access to this service as well as expanding outreach day services to areas not currently served. The core of the community service is the five Community Mental Health Teams in place across the area. Aberdeenshire claim that the development of this service and these teams has greatly reduced admissions to hospital on a crisis basis - both formally and informally.

Tackling substance misuse

Services are being developed to meet the increasing need for substance misuse services, particularly in Fraserburgh and Peterhead. The number of people receiving a service for drug or alcohol misuse has almost doubled between 2000 and 2002. The Council has introduced various posts, including one co-ordinator, six care managers, three support workers and two employment development workers in a substance misuse team. A part-time planning post, straddling the substance misuse and children's planning systems, has also been created, along with some shared criminal justice posts with Moray and Aberdeen. Drug testing and treatment orders are also being piloted.

The substance misuse team carries out rehabilitation in the community, usually at an early stage or as a holding phase. Independent providers such as Turning Point provide services and overall the focus of the services is on reducing harm and lifestyle programmes. In 2002-03, 192 people received residential rehabilitation, and some people welcomed the break from living locally. Work by local staff jointly with residential rehabilitation was seen as a crucial factor in the success of the service.

Support is provided in three main ways to families who misuse substances:

• extension of the Alcohol Advisory and Counselling Service's Children and Families Project;
• Children 1st Fraserburgh Families Project; and
• Children 1st Family Group Conferencing Scheme which will become operational across Aberdeenshire in Autumn 2003.

In addition, a number of small-scale community initiatives have been supported financially:

• Adventure holidays for children affected by parential misuse;
• Production of a book of stories, poems etc, by children affected by misuse;
• Activity opportunities for children at risk; and
• A conference, plus follow-up work, for staff across Aberdeenshire North involved in services to children and families.

The Alcohol Advisory and Counselling Service now provides a Council-wide support to children affected by substance misuse, with referrals accepted from social work, health and education professionals.

Staff attend STRADA courses. Ten places on the distance-learning postgraduate certificate course in Alcohol and Drug studies at Paisley University have been funded for staff in Health, Social Work and the voluntary sectors and a further four staff are being supported for the next intake.

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. Recent evaluation of the partnership's progress in the 5 areas of joint management, joint governance, human resources, joint resourcing and Single Shared Assessment suggest that the joint arrangements are well progressed and overall, satisfactory. The local partners were recommended to:

• clarify the details of membership of the Executive, and the nature of delegated powers with respect to the Board and Executive;
• progress the corporate governance and accountability arrangements at the Aberdeenshire and pan-Grampian level;
• review the completeness and appropriateness of clinical and service governance arrangements and their joint resourcing arrangements;
• agree and implement arrangements for access to resources across agencies, based on agreed eligibility criteria and a joint protocol for access; and
• include appropriate housing staff in training for Single Shared Assessment.

On the ground, a long history of positive joint working has led to setting up 24 Health and Community Care Teams linked to GP practices to provide services for older people, people with physical disabilities and people who need palliative care. The teams are supported by local 'paired managers' one from health, one from social work. There are five Community Mental Health Teams, three Community Dementia Teams and two Community Learning Disability Teams. There is some co-location of staff at health centres and in community hospitals, but the large area and dispersed population restrict the scope for further co-location. An Information Protocol which covers all client groups is now in use throughout Grampian.

Working with carers

There are six local carer drop-in centres and there are also 10 carer support workers (four for young carers). Consultation is continuing with carers across Aberdeenshire, as numbers of carers coming forward and those being supported has grown. Through leaflets, carers learn that they have the right to their own, rather than a joint, assessment.

Carers take part in the Carers' Strategy Implementation Group and Carers' Forums. Carers are involved in developing the new carers' strategy, funding services and developing services. Carers also take part in other groups for putting strategy into practice (for example, on learning disability and mental illness).

Children and Young People

Looked after children

The number of children and young people who are looked after who live with friends or relatives more than doubled from 20 in 2001 to 46 in 2002. This was due to:

• young people being increasingly placed with family members because this is where they want to be;
• panels increasingly placing young people with their families;
• a shortage of foster placements;
• an increase in parental substance misuse; and
• the effect of Family Group Conferencing (FGC).

Around 27% of children and young people who are looked after had had three or more placements in 2002, although nearly all of these children had been looked after for longer than two years.

Fostering and adoption

No children are waiting for a foster place but the Council cannot provide respite foster placements to a number of children. Increasing demands for foster placements have resulted in a review of the approval status of foster carers as at present children are not always able to get their first request and some children are placed in residential schools for want of a placement. A recent study showed that half of the children in secure care and close support could have been placed in a specialist foster placement. Four salaried specialist foster carers are being recruited for young people who would have been placed in secure care and for young people who are on weekend leave from residential school. The Council is testing out payment for skills and respite is built in for carers who have challenging children.

Six adoption plans are being agreed and some have got potential matches. The Council has made a request to the North East adoption consortium for those not agreed.

Educational attainment

54% of 16 and 17 year olds who ceased to be looked after in Aberdeenshire attained Maths and English standard grade in 2001-02. This is higher than in many other authorities but is well below the 100% target set by the Scottish Executive in 1999 and the 97% for the full S4 cohort in the authority achieving these grades.

A range of initiatives is in place to improve educational attainment and these should be built on.

• The pupil progress monitoring system (PPMS) provides feedback on individual children and enables learning support staff and subject teachers to offer extra help, catch-up classes or homework clubs to those who are falling behind. Some young people are on a reduced timetable and get extra tuition in some areas, including English and Maths.
• A partnership with further education colleges provides full-time education on two sites. Vocational courses prepare young people for the transition from school to work.
• The Successmaker programme identifies gaps in skills in English and Maths in S1.
• Schools are represented at all Looked After Children (LAC) reviews.
• Foster carers and residential staff can access training on education.
• An education report is being developed which will be part of the care plan for all children and young people who are looked after but at first for those who are away from home.

However, five looked after children receive only part-time education and social workers do not always know when a child or young person who is looked after at home has been excluded or when they are not attending school.

Throughcare and aftercare

The Council is collecting information on young people up to 19 who were living away from home. However, the Council also needs to develop information on young people who were living at home.

There is a good range of accommodation for young people from tenancies through to Foyer accommodation. Some young people stay with foster carers until they are 18 or over. There are five supported lodgings. Barnardo's provide an outreach service for those age 16 and over who are leaving care and also hostel accommodation.

Mental health

A recent health survey identified shortcomings in the service and a Child and Adolescent Mental Health Service (CAMHS) strategy for Grampian is now being prepared.

There is an outreach service for younger children. Jointly with Aberdeen, the Council is developing a project for a multi-agency team to deliver services to children with complex needs. It is planned to link with New Community schools who will pick up children with mental health problems and fast track them to a specialist team or be supported to work with them.

Basic mental health awareness training is available to all staff.

Child protection

The number of referrals reduced between 2000 and 2002 but the rate is still high compared with other authorities. The number of children subject to a case conference and the number of registrations increased over the same period. 61% of children who were taken off the register in 2002 had been on the register for more than 18 months. Reasons given for the high rate are that:

• the figures reflect work with some large families with chronic problems of substance misuse and mental health;
• it took a long time to stabilise these families; and
• 60% of the young people involved were not on statutory orders and attempts were made to keep them in their families.

The Council has taken a number of child protection initiatives, including:

• holding a joint external audit of the three Child Protection Committees in the North East;
• providing new shared guidance for social work and housing staff; and
• putting the recommendations of the report 'Getting Our Priorities Right' into practice.

Children with disabilities

The Council has consulted parents and developed services according to their needs. A range of services are available, including:

• the 'Home from Home' scheme, which provides foster placements; carers can go to children's own homes (but there is a waiting list for this service);
• DIY clubs which run at the weekend;
• children's services respite staff who work with children in their own homes;
• voluntary organisations which provide one-off care packages;
• Willowbank, which provides for adolescents with profound needs who may need physical handling; and
• various organisations which run play schemes.

Childcare workers are working with colleagues in community care to make sure that the transition process to adulthood is improved, following a number of complaints from parents.

An estimated 430 children with disabilities receive a service but more children may be recorded as, for example, child protection cases. The Council does not know how many children are affected by disability and needs to do further work in this area.

Working of children's hearings

64% of referrals were made within five working days of the case conference in 2001-2002 (standard 2). 81% of referrals met the target in 2002-2003. The chair of the conference now notifies the Reporter direct, in writing.

16% of reports were submitted within 20 working days of the date of the request in 2001-2002 (standard 3). This disappointing performance is put down to staff vacancies and sickness, multiple requests for reports and problems of offshore working. Cases are put in order of priority but there are no written guidelines. 30% of reports met the target in 2002-2003.

All supervision requirements met standard 15 in 2001-2002 (the local authority to give effect to supervision requirements with no condition of residence within 15 working days of the date of issue by the children's hearing).

Youth Justice

Children involved in, or at risk of, offending are referred to Family Group Conferencing (FGC) which is provided by Children 1st. Feedback from families and staff has been positive.

A Barnardo's restorative justice project is targeted at those who have two to four incidents of offending and referrals come from the Reporter and the Procurator Fiscal. The sessions with young people are evaluated.

Barnardo's New Directions project works with 14 to 18 year old persistent or serious offenders who have committed five or more offences in the last 12 months or are on indictment or on summary for serious offences. Referrals are mostly from social work but the police can also refer. An individual action plan is developed for all young people and is reviewed every three months. The young people who undergo the programme have an average number of 15 offences in a year and 30% do not re-offend. Overall there has been a 75% reduction in offending.

The youth strategy team offer a group work diversion programme and intensive support which is delivered in partnership between social work and health. There have been 34 referrals for intensive support. Group-work is done in schools. Intensive support is evaluated using a Matrix approach and offender behaviour information.

Criminal Justice

Structure

Aberdeen, Aberdeenshire, Moray and Highland operate as a partnership for delivery of criminal justice social work services. Management of services across the grouping is overseen by a Joint Committee, supported by a Joint Officer's group. Operational managers, who meet regularly, have responsibility for all aspects of service delivery and individual lead role responsibility for developing particular aspects of policy and practice. The grouping also operates within the wider umbrella of community planning which includes representation from Police, Procurators Fiscal, Sheriffs, NHS as well as the island authorities.

The partnership has benefited from funding as one of the Scottish Executive's "Pathfinder Initiative" areas. This aided authorities to merge as a partnership, delivered high quality training, and contributed towards a learning culture among staff.

Workload

Over the past year, there has been a small increase (4%) in demand for core services across the partnership as a whole, though some constituent authorities have experienced significant rises. Aberdeen has seen an 18% increase in social enquiry reports and a 21% rise in probation orders, while Highland's probation orders have grown by 43% and community service orders by 17%. Despite workload increases, performance has generally remained high although there are evidently areas of pressure. Moray has seen an improvement to 100% of SERs submitted on time during 2003 (data as yet unpublished). However, reduction in staff in some areas coupled with increase both in volume and complexity of the workload has had an impact.

Effective practice

The Scottish Executive risk assessment framework is in use across the partnership. Other available risk assessment tools have been reviewed and the partnership is keen to see agreement to a national approach to this. Further initiatives include involvement in the development of the structured offence-focused programme, Constructs, for the accreditation panel. Aberdeen has also updated its pack for use in work with substance misusers and this will be introduced across the partnership. In addition, the partnership has successfully submitted a bid in partnership with Tayside for funding to develop to accreditation standard a programme for women offenders. In support of these developments, training in case management and cognitive behavioural interventions has been delivered to social workers. Reflecting the particular needs of female offenders, the partnership has also developed individually tailored packages for those subject to Community service or supervised attendance orders. Pro-social modelling training has been delivered to Community Service staff across the partnership.

Services to young offenders have been developed individually in each council area reflecting the Joint Committee's emphasis on the need for inter-agency working and cross cutting council services. In Aberdeenshire, young offenders, women offenders and those with mental health problems will be targeted as part of a social inclusion pilot.

The Drug Treatment and Testing Order scheme has just completed its first operational year and is now well established. Although there has been a substantial uptake, numbers appear to have reached a plateau and this may reflect recent staff vacancies.

Work in respect of domestic abuse has been funded by two authorities with the intention of this being rolled out across the partnerships.

Public protection

Services to sex offenders are provided through the partnership's joint sex offender project. The Scottish Executive's risk assessment framework is now used across the council areas and, in addition, project staff and those at the social work unit at Peterhead have undergone training with Northern and Grampian Police respectively in use of the tool Tayprep 30. A bid has been submitted to the Executive, in collaboration with Tayside and Dumfries & Galloway, to have the Joint Sex Offender Project programme prepared for accreditation.

Quality assurance

Development of monitoring and evaluation measures continues. The partnership reviewed the suitability of the quality assurance system as part of the Pathfinder initiative and submitted subsequent findings to the Scottish Executive. The partnership has continued the development of quality assurance systems e.g. SERs through the work of a Pathfinder Practice Development Group.

Human Resource

Structure of the workforce

Between 2000 and 2002, the numbers of whole time equivalent fieldwork staff increased slightly across all services with corresponding increases in vacancies.

In the same period, numbers of whole time equivalent social work staff also increased slightly across all services with no vacancies shown in services for adults or offenders and slight rises in vacancies in services for children and generic workers.

Although they are not yet confirmed, the Council's latest figures suggest that, at the end of June 2003, the social worker establishment (whole time equivalent including vacancies) was 288.98 compared with 196 in October 2002. The number of social work vacancies was 27.1 as compared with 7 in October 2003.

The pressures come from:

• filling vacancies in North Aberdeenshire, despite the number of social workers having trebled in areas such as Peterhead over recent years;
• filling posts in home care which need just a few hours a day (the Council is reviewing its support structure within home care); and
• filling posts in residential childcare.

The Council allows home care staff to work beyond 65 if there are recruitment difficulties and is considering whether to expand this to other staff categories.

Support for staff

The results of a staff survey helped shape the council's support package. This includes:

• family-friendly policies;
• staff supervision;
• programmes on recognising and dealing with stress;
• access to independent counselling; and
• a course on challenging behaviour.

The Council has a draft absence management policy emphasising early intervention. This still has to be approved by the Council. Generally, absence rates are low but more common among home care staff than other staff members.

Working towards a more qualified workforce

A joint social work and housing training strategy is in place. The Employment Development and Review Scheme (EDRS) feeds into the training and corporate service plan. A range of courses is available for staff working in residential settings, managers in social work and health, returners and home carers. A corporate pilot programme aims at supporting women into management (the Chrysalis programme).

Preparing for Registration

The Council has taken a number of steps to prepare staff for registration in October 2003 with the Scottish Social Services Council and to make sure that it complies with the Codes of Conduct for Employers. The Council is supported in the task by personnel colleagues and has meetings arranged with the Scottish Social Services Council to make sure individual staff and the Council are clear about the process and responsibilities. The Council admits there will be a number of challenges in getting staff to the required level of qualification but is gathering more detailed information that will form a baseline.

Race Equality

Of the local population, 0.7% are from a minority ethnic group compared with 2% for Scotland as a whole. The Council could not identify the ethnic background of 10% of children and young people who were looked after in 2002 because the form for recording does not reflect all ethnic groups.

Under the Race Equality Scheme, a corporate Equality Strategy Group has responsibility for issues on race equality. It is made up from representatives from all services. An early focus for Aberdeenshire Council has been on gathering information on service users which will be used to identify and tackle the needs of black and minority ethnic groups.

A training plan is set out in the Race Equality Scheme.

Use of Information Communications Technology (ICT)

Social Services Department

There is no formal ICT strategy for social work. Personal computers are provided whenever possible and staff can apply for access to the Internet. There are information-sharing protocols in place for community care and children's services covering the three local authorities and Grampian NHS. A range of service information is available on the consortium website Grampian Care Data.

Partnerships

Under Modernising Government Funds 2 (MGF2), the North East consortium is developing electronic information-sharing for the Single Shared Assessment. Until this happens, all partners will continue with existing systems, with tools developed to allow for information sharing across different systems.

A new corporate ICT system has been developed but will not be implemented before 2006. When implemented, it will mark a major step to modernisation.

Background Profile

Most people in Aberdeenshire live in small towns and there are a few larger communities ranging from 10,000 to 18,000 people, mainly around the coast. There is a scattered rural hinterland. The number of jobs rose by 14% between 1995 and 2001. Average earnings were 3% lower than those for Scotland as a whole.

Spend for every person on social work in 2001-2002 was 217, below the Scottish average of 267.

Expected population change

Community Care

Expenditure on community care was stable during 1999-2001 but rose significantly in 2001-2002.

Children & Young People

Expenditure on children's services has risen very gradually in the period 1999-2002.

Criminal Justice

Human Resources

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