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Short Reviews of Social Work Services in Scottish Local Authorities

Angus Council

Overview

Angus has generally made good progress with its community care services except learning disabilities where it may have difficulties achieving all the national objectives by 2005. However, in Children and Families, there are clear signs of co-operation between social services and education and, pleasingly, the Council continues to make progress in raising the educational prospects of children and young people looked after through the use of link teachers. Angus faces a particular problem in coming years because a very high percentage of its population will be above working age and the Council needs to tackle this.

The Council's achievements include:

• a consistently high rate of older people receiving a community care service while the population rises also;
• a dramatic improvement in waiting times for adaptations to properties;
• smooth and successful introduction of Free Personal Care; and
• an efficient tracking system to monitor educational progress of looked after children.

Angus needs to take urgent action to:

• improve its performance on meeting the requirements of the Children's Panel as, although the Council made considerable progress last year, its performance in meeting standards 2 and 3 is still below the targets set; and
• monitor its performance and provide information on standard 15.

The authority should also give priority to:

• increasing the rate of older people who receive home care packages of more than 20 hours each week;
• completing the development of an integrated community learning disability team and setting up a database which has details of local people with learning disabilities;
• completing the setting up of a joint local authority drug and alcohol team and providing local detoxification resources or a partnership arrangement with neighbouring authorities;
• helping reduce the number of child protection referrals and registrations by putting greater emphasis on early intervention and prevention;
• building on earlier service improvements for children with disabilities, by improving early years' support and boosting staff training;
• in partnership with the NHS, finishing the review of the needs of people with challenging behaviour;
• taking on the trained staff needed to deliver quality services particularly aimed at younger staff and promote procedures for transferring skills;
• upgrading the human resources system so that the Council can monitor staff effectively; and
• taking urgent action to improve the information kept on care leavers, so as to assess more accurately their needs and the range of support they need.

Community Care

Services for older people

Although the number of older people receiving a community care service continues to grow, fewer are receiving a home care service. The numbers receiving an intensive care package have halved between 2000 and 2002. The number and rate of older people supported in care homes continues to be high but has reduced slightly between 2001 and 2002. These apparent reductions in service are taking place while spending on community care is increasing slightly.

A rapid response team is working and is proving successful in reducing the number of blocked beds. The Council plans to improve the system still further by encouraging GPs to refer patients to the service.

The Council offers shopping and household maintenance services, with both delivering services to more people than the target set. The Salvation Army provides the shopping service on behalf of the Council.

Free Personal Care was introduced smoothly. Although it was given newspaper publicity and a help line was opened for two weeks to let people know about Free Personal Care, the Council was not overwhelmed with requests and is coping with the demand.

Services for people with learning disabilities

The number of people with learning difficulties receiving a service has fallen slightly in the three years 2000 to 2002. The Council has resettled people in the community, with a joint assessment team transferring people in long-stay beds in hospital to independent living. However, the Council is now looking at services for people with challenging behaviour. It should set up:

• a financial framework to provide a service for this group;
• an integrated learning disability team; and
• a database for people with learning disabilities.

The Council has also:

• set up client health records;
• identified learning disability nurses who carry out health checks each year on people with learning disabilities; and
• begun work on producing health-awareness videos aimed at people with learning disabilities and their families.

Services for people with physical disabilities

The number of people receiving a service for physical disability increased gradually between 1999-2000 and 2001-2002.

A Direct Payments scheme is already in operation. For a small to mid-size council, Angus is doing relatively well in the numbers of people that they have getting Direct Payments. To prepare for the changes in law on Direct Payments, they are making a part-time support post full-time.

Waiting times for equipment are reported to have improved dramatically since the recent survey. Hospital occupational therapists now have access to simple equipment for people coming out of hospital and can also arrange for simple adaptations to people's homes. The level of complaints has been significantly reduced. Work in effective partnership with housing has helped to reduce the waiting times for adaptations.

People with sensory impairment

The Council provides services for 39 people with hearing impairment and 16 people who are deaf-blind. There is a sensory impairment planning group. A local accommodation development is available for a small number of people who previously went to a residential school or who were in specialist care homes outside Angus.

Services for people with mental health difficulties

Following a Tayside mental health review, the Council is appointing a new mental health planning officer to write an action plan to put the new Mental Health Act into practice and also to deal with the Adults With Incapacity Act.

Joint mental health teams provide services to people across the range of mental health difficulties. A pilot out-of-hours service for people with mental health problems is to be based at the Local Health Care Co-operative.

Mentally disordered offenders receive a service provided on a Tayside-wide basis, rather than a regional forensic service. There are procedures which govern how the service operates and there are service standards. An agreed risk assessment tool is used throughout Tayside and there is joint assessment and joint management of risk. All criminal justice staff are trained in assessing and managing risk in sex offenders and there is a multi-agency forum for assessing potentially dangerous offenders.

Tackling substance misuse

Angus has a lower than average rate of drug misuse and this is reflected in a low rate of people receiving a service for drug or alcohol misuse. However, as substance misuse is clearly a growing problem, Angus have set up a new alcohol and drugs team which includes three community nurses. With referrals to residential rehabilitation low, the Council plans to develop a community detoxification centre.

The drug action team is working on protocols for dealing with families who abuse substances. Closer links are being forged between the children's services and adult drug and alcohol services. Two social workers deal specifically with children and families where parents misuse drugs or alcohol.

Fifty-eight staff attended STRADA courses, but further training is needed to give staff specialist skills.

In terms of criminal justice, a throughcare planning group is reviewing the path people take from custody to the community. There is a local arrest referral scheme in operation.

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 can be summarised as meeting the JPIAF requirements and are, overall, very satisfactory.

The local partners were recommended to:

• develop and implement specified service and clinical governance arrangements for joint services, (where these have not already been developed);
• review the completeness and appropriateness of their joint human resource arrangements;
• review the completeness and appropriateness of their joint resourcing arrangements; and
• agree and implement arrangements for access to resources across agencies, based on agreed eligibility criteria and a joint protocol for access.

In terms of services delivered, two schemes have helped to reduce delayed discharges. A 'prevention of admission' scheme prevented 73 admissions to hospital in 2002 and an early supported discharge scheme handled 131 early discharges. There is also an intermediate care scheme, jointly run with NHS Tayside.

There are six multi-disciplinary mental health teams - three adult teams and three teams providing services for older people and people with dementia. Each has an operational service manager and team budgets join to cover mental health services. Single Shared Assessment is being put in place in July 2003. The Council and NHS partners are putting a joint strategic support unit in place under a joint manager. This will be made up of four teams:

• community care;
• contracting;
• performance and planning; and
• a children's team.

This development should be a catalyst for effective joint working by the local authority and NHS.

A high-level protocol makes sure that the Council and NHS Tayside share information. The aim is to get rid of the three operational protocols which currently exist. At present, there are problems with interaction between the various systems. The aim is to get a one shared client database using the same information and standards.

Working with Carers

There are nine voluntary organisations providing support for carers, including Crossroads, a carer centre in Arbroath run by the Princess Royal Carers Trust, and local carers' groups.

Angus has made good progress with Single Shared Assessment (SSA) for older people and other care groups. They have agreed and developed a local assessment tool which they will refine during the pilots so they can include learning disability. From August 2002 they have put in place linked health, social work and housing training programmes in all care groups from August 2002. A protocol for sharing information is in place.

Children and Young People

Looked after children

The number of children and young people looked after increased from 156 in 2001 to 176 in 2002. The number in residential accommodation also increased, mainly because of an increase of young people in residential schools (14 in 2002).

Fostering and Adoption

The number of children in foster care increased to 98 in 2003. No children are at home waiting for a temporary placement but a small number of children with specific behavioural needs are in temporary places and are waiting for longer placements. Ten children are waiting for regular respite care. It is very hard to place children under 12 with behavioural problems and if the Council cannot find a foster carer the children may need to be placed in residential care.

A North East consortium of authorities has been set up to arrange permanent placements. A database has also been set up to match children with families more quickly and more effectively.

Six children are waiting for adoption - aged between four and seven. All have been approved within the last year. There are not enough adopters to meet demand, but the consortium has improved the situation. Some children are adopted outside the council area.

Educational attainment

Because fewer than five 16 to 17 year olds stopped being looked after in Angus in 2001-2002, statistical information on how many attained Maths and English standard grade is not available. However, information provided directly by the Council suggests that, this year, 19 children and young people who are looked after were eligible for standard grades and 11 sat exams. These 11 sat 58 standard grades and attained 48.

A link teacher has been in post for four years to help raise the educational attainment of looked after children. She receives referrals from carers and family placement teams, tracks the children and young people through the system and raises their profile in educational establishments. Pupils are tracked using educational software and exam results are analysed. The link teacher goes to residential school reviews and manages the tuition fund. This gives extra input to children and young people who are looked after. She also has an aftercare role arranging careers information and further education.

Throughcare and aftercare

A database of information kept on young people leaving care provides limited information and the Council knows that it needs to tackle this. However:

• in the last two years, 57 young people who were looked after and accommodated were 16 or over;
• of young people accommodated on their 16th birthday, the service was in contact with 71% after one year and 69% after two years; and
• 76% of young people accommodated on their 16th birthday are in stable accommodation at age 18.

All young people leaving care are assigned independent-living resource workers. An initial groupwork package sets out social skills and provides emotional support, information on health, drugs, alcohol, housing, careers and educational opportunities. Supported tenancies are available when this programme has finished.

Mental health

To identify and meet the mental health needs of children and young people looked after:

• a medical assessment is carried out, if recommended by a doctor;
• any psychiatric treatment usually involves a 16-week wait but it can be brought forward in emergencies;
• if a child is not ill, but is disturbed, school nurses may monitor families or problematic situations;
• carers are offered three or four sessions of training a year about health matters;
• specialist advice is offered where mental health issues affect a child's placement in education and substitute care, especially for children with autistic spectrum disorders and trauma following abuse; and
• primary care workers, education, social work, health visitors and GPs are offered consultations on mental health.

Child protection

The large increase in the number of child protection registrations over the last year has had a very big effect on workloads. The Council is investigating the causes of this increase, in particular links with alcohol, drugs and domestic abuse. An increase in child protection referrals is not related to any change in thresholds of concern.

A high percentage of children are returning to the child protection register - a third of children on the register in 2002 had been on it before. The reasons for this include:

• the child protection review may have heightened staff anxiety;
• drug and alcohol misuse seems linked to re-registration;
• a number of large incoming families registered elsewhere have moved into the area; and
• pressure on resources means that action to take children off the register is taken less quickly.

Recent developments in child protection are:

• the Barnardo's Hopscotch project which focuses on children whose parents misuse drugs and alcohol; and
• five new posts authorised to assess risk, investigate, and work with families affected by drug or alcohol, make initial contact and manage child protection registrations

The Angus joint commissioning and management group for children's services is considering a range of bids to make to the Changing Children's Service Fund for child protection services.

Children with disabilities

A multi-agency specialist team, reinforced by fieldwork teams when necessary, provides for children who need intensive services. In conjunction with Angus Council, NHS Tayside has set up a co-ordinator post for children with complex needs. This is funded through the Changing Children's Services Fund.

In terms of services:

• children who have serious health problems and who need medical support can get respite care in a unit in Dundee which is managed by Tayside University Hospitals Trust;
• a two-bedded respite unit in Angus provides a break for 16 children (it has received funding from the Scottish Executive to add an extra two bedrooms);
• social care officers are employed to provide practical services; and
• children's services and adult services are working hard together to make sure that appropriate services are available to children at key points during their move to adult services.

Working of children's hearings

A quarter of referrals met standard 2 (referral within five working days of a case conference) in 2001-2002. This reflects the staffing difficulties in that year. Since then, performance has significantly improved with 87% of referrals meeting the target in 2002-2003.

32% of reports were sent in within 20 days of the date of request (standard 3) - again the performance was due to staffing difficulties. Between April 2002 and October 2002, the situation changed and 42% of reports were sent in within 20 days; in January and February 2003, 51% of reports were sent in within 20 days.

No information is available for performance on 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 hearing).

The Council needs to build on the progress made already if it is to meet the targets set. In particular, it needs to start monitoring progress on standard 15.

Youth justice

A persistent offender's team was formed in 2001 and works with young people who have committed five offences within six months. The team use the assessment tool YLS.

A restorative justice service, which operates in partnership with two local voluntary organisations, has been running since August 2002. There have been 32 referrals from the Reporter and the service has worked with 39 victims. The service has been developed along similar lines to the national SACRO scheme. A monitoring group is available and an external evaluation is being made.

Criminal Justice

Structure

Angus, Perth and Kinross and Dundee operate as a partnership for delivery of criminal justice services. Management direction for the partnership is provided by a team of senior officers from the three authorities, answerable to a steering group which includes an elected member and a chief officer from each council. A partnership development manager has been appointed to co-ordinate and oversee service development.

Workload

There has been a small increase (3%) in demand for main services across the partnership as a whole, although there are variations between the authorities. Both Angus and Perth and Kinross have had an 8% rise in probation orders and Perth and Kinross has seen community service figures rise by 13%. The group are experiencing some pressures, because these increases in workload coincide with a very difficult time for recruiting and keeping staff.

Effective practice

The partnership uses a structured assessment to assess the risk and needs presented by offenders and to decide on the level of intervention. The risk assessment tools that are used are similar across the group, but are not identical. However, all members of the grouping indicate that they intend to adopt a nationally-agreed framework for risk assessment when this becomes available. Structured offence-focused groupwork is available across the partnership and to all residents of East Port House. Programmes which deal with people who misuse substances and those which deal with young people's offending behaviour are also available in each of the authorities. The partnership has successfully submitted a joint bid with Northern Partnership to the Scottish Executive for funding to develop a women's programme for accreditation. There is a commitment to undertake a best value review of programme provision and to use this as a basis for future developments.

Services to women offenders are also being developed by identifying more Community Service work placements which meet their needs. There are presently women-only Community Service squads in Dundee and light duties resources available in Perth. In Angus, women subject to Community Service are offered individual placements, with mixed gender teams operating only following requests from women offenders to be placed in such teams. A training programme for Community Service staff is being discussed, to include offence and harm risk assessment. The programme will involve training in pro-social modelling skills.

Other developments include:

• extending the Drug Treatment and Testing Order (D.T.T.O) scheme to Tayside Courts; and
• setting up an arrest referral scheme across the partnership.

While the D.T.T.O scheme clearly has healthy levels of uptake and confidence from sentencers, compared to other schemes there was a very high proportion of two and three year Orders. While each case must depend on its merits and on the individual sentencing decision made in Court, the grouping should continue to liaise effectively with the judiciary to manage the scheme in terms of making sure that there is enough ongoing treatment.

To promote the social inclusion of offenders, the partnership has also contracted an Employability scheme from Apex. The partnership is also developing its service to the prisons in its area, including risk assessments on all prisoners in the Open Estate and on those coming up to the time of release on licence or order from HMP Perth. For next year, the partnership aims to introduce a new prison throughcare service.

Public protection

The Tay Project continues to provide services to sex offenders across the partnership. The Project now offers an extra programme for sex offenders who are in denial about their offending. It has also extended the range of training it offers, including training earlier this year for Police across Scotland on its risk assessment tool, TAYPREP 30. The partnership aims both to seek validation for this tool and accreditation for its Induction programme for sex offenders.

Quality assurance

The partnership has started to review its data systems to make sure that information on needs, processes and outcomes is available on a regular basis. The partnership aims to set up an integrated approach to assessment of quality and to monitoring and evaluation.

Human Resource

Structure of the workforce

Between 2000 and 2002, the numbers of whole time equivalent fieldwork staff increased substantially in services for adults and children but in other services numbers remained the same. Vacancies rose across all services, particularly in services for children and offenders.

In the same period, numbers of whole time equivalent social work staff increased slightly in services for children but otherwise stayed the same. Vacancies rose significantly in services for children and offenders but otherwise stayed the same.

Latest figures provided by the Council but not yet confirmed suggest that, at the end of June 2003 there were 144 social workers (whole time equivalent including vacancies) compared with 110 in October 2002. The number of social work vacancies was 17 as compared with 11 in October 2003.

Staffing pressures include the following:

• because qualified social workers become more difficult to recruit, mental health joint teams tend to depend more on staff with nursing qualifications;
• the relatively large number of inexperienced staff increases the supervision needed;
• a reported short supply of qualified occupational therapists; and
• at least 80% of social work staff are in the 50 to 54 age group.

Support for staff

The Council has taken a number of steps to improve support for front-line staff. It has set up:

• training programmes to support staff of different levels in dealing with difficult or violent situations (people working alone are directly linked to a community alarm team);
• regular monitoring of absence statistics (days for each employee lost through sickness have fallen from 13.5 days in 2000-2001 to 12.9 in 2001-2002; home care and justice teams have rates slightly above average, with home care staff most likely to be on long-term sick leave);
• a pilot physiotherapy scheme to provide prompt access, assessment and treatment for staff; and
• family-friendly policies.

The Council has a policy on managing stress.

Efforts to improve staff qualifications should be helped by the recent introduction of the appraisal system, which is currently being extended to all staff.

While recognising the need for urgent decisions because of the time it can take to achieve Scottish Vocational Qualifications, the Council has still not moved quickly enough to draw up plans for registration. Much of this is due to problems with the appraisal system. However, the Council now needs to take urgent action. A proposal to set up a joint assessment centre with health colleagues is currently being evaluated.

Working towards a more highly qualified workforce

Staff in residential homes and in learning disability services are below target for qualifications. However, the Council has changed the training team's structure and it should be able to put the performance management system into practice correctly so this raises training standards.

Preparing for registration

While recognising the need for urgent decisions because of the time it can take to achieve Scottish Vocational Qualifications, the Council has still not moved quickly enough to draw up plans for registration. Much of this is due to problems with the appraisal system. However, the Council now needs to take urgent action. A proposal to set up a joint assessment centre with health colleagues is currently being evaluated.

Race Equality

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

Angus Council has developed a platform for its work on Race Equality. Recent activities include:

• auditing and gathering data on the ethnic background of service users;
• assessing all social work functions and policies;
• providing training and information packs to staff;
• providing guidance to staff on providing support to asylum seekers;
• preparing for a survey on the housing needs of black and minority ethnic service users; and
• using multi-agency panels through the Health Improvement and Community Safety Group.

The Council is now finalising its Race Equality Scheme following consultation.

Use of Information Communications Technology (ICT)

Social Services Department

Just over one-third of staff (including all office staff) have PCs and access to the Intranet. The emphasis is on building up a structure and the Council does not yet have a strategy for developing ICT in social work.

Partnerships

A high-level protocol for sharing information across Tayside covers all care groups. The Council plans to turn all the local authority protocols into one, making possible a single assessment tool. Information is shared about children with disabilities, but detailed protocols have not yet been devised for specific care groups.

Background Profile

Angus is made up of a mix of rural and urban communities. It also has some advantaged and some deprived areas. There is relatively high employment in agriculture and in the production and construction industries.

There are also areas of disadvantage within the Council, with Arbroath having one of the highest unemployment rates of any travel-to-work area in Scotland.

The spending per person on social work in 2001-2002 was 248, lower than the Scottish average of 267.

Expected population change

Community Care

Expenditure in community care has risen gradually in the period 2000-2002.

Children and Young People

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

Criminal Justice

Human Resources

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