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Short Reviews of Social Work Services in Scottish Local Authorities

Dumfries & Galloway

Overview

As a predominantly rural area with widely scattered communities and a large shoreline, Dumfries and Galloway has to cope with persistent challenges to make most effective use of available resources to provide the whole range of social work services. Its task is complicated by persistent problems in recruiting and keeping staff, particularly professional staff.

Dumfries and Galloway has made major strides in bringing together its children's services across education and social work. It now needs to reap the advantages of sharing a common boundary with the health board and strengthen its arrangements for joint working with health.

The Council's achievements include:

• high rates of older people receiving home care of more than 20 hours each week, with numbers rising markedly in recent years;
• high rates of children and young people looked after by friends, relatives and foster carers;
• guidelines for children and young people who are looked after showing what they can expect of schools, which add to the Council's other initiatives; and
• successfully introducing Free Personal Care.

The Council needs to take urgent action to:

• work jointly with health partners to develop mental health services which can more readily identify and meet the needs of children and young people looked after;
• make sure that all these children receive full-time education; and
• improve performance in achieving standards 2, 3 and 15 to support children's hearings and make sure that the targets are met.

It should also give priority to:

• services for people with physical disabilities, making sure - with health partners - that there is joint access to equipment and adaptation services, wherever possible;
• continue to build on improvements and developments in waiting times for equipment and adaptations, including ways to make sure that scarce professional resources are used to best effect;
• tackle the problems of steeply increasing numbers and design preventive protection services for children under 12;
• tackle the problems of an ageing workforce, particularly senior management, by introducing forward planning, and recruiting and promoting younger staff;
• put in place Supporting Frontline Staff policies and, in particular, take a more active approach to managing;
• prepare for duties under the Race Relations (Amendment) Act and develop much more robust information on the ethnic background of service users; and
• speed up the pace of its joint working arrangements with health.

Community Care

Services for older people

The number of older people receiving a service increased from 6,504 in 1999-2000 to 7,088 in 2001-2002. The number receiving home care reduced but there was a significant increase (from 45 to 136) in the numbers receiving 20 or more hours of home care each week over the same period.

By introducing a comprehensive rapid response service, the Council has prevented admissions to hospital and saved bed days. The shopping service has been extended through Better Neighbourhood Services funding but there are still not enough funds to meet demand. Care and repair and gardening services are available to Council tenants.

It is likely that some older people will be using private services. Currently, home care packages are bought by the hour but the Council would like to find a more flexible approach. Overnight care is provided on an individual basis.

The Council introduced Free Personal Care, supporting this with information leaflets. The small numbers involved make it difficult to decide if Free Personal Care has stimulated extra demand for services.

Services for people with learning disabilities

Following a reduction in the number of people receiving a service for learning disabilities in 2000-2001, the number increased in 2001-2002 but only to 2000 levels.

The Council has resettled 118 people into the community since 1995. Of those remaining in long-stay NHS beds, 13 need continuing care for complex and challenging needs and 10 are to go to community units. A small number of patients may stay on in hospital. The financial framework is in place and the Council is confident it will complete the resettlement programme by 2005.

The local joint strategy encourages new support providers to develop day activities and to provide a thorough range of health and social care services. Four community teams have been set up, each with a physiotherapist, an occupational therapist and a psychiatrist. Day services are mainly based in buildings and more services are needed to be taken into the community. Two pilots involving local area co-ordinator posts are a step in this direction.

The Council is reviewing a database for people with learning disabilities. Service users and their carers only think a register is helpful if it leads to improved outcomes.

Services for people with physical disabilities

Following a reduction in the number receiving a service for physical disabilities in 2000-2001, the number increased from 1116 to 1,462 in 2001-2002. However, this was at a slightly lower level than in 2000.

Twenty-five people received Direct Payments in 2001, but an audit of the system highlighted that its structure was weak. The Council is developing a new service under a project leader and this will extend across all client groups, including children's groups. The Council has contracted a voluntary organisation to provide support to service users.

For equipment and adaptations, standard waiting times are in place for assessments by occupational therapists (OTs) and they are monitored regularly. Standard waiting times vary from two weeks (level 1) to 13 weeks (level 3) although adaptations which involve more than one department will take longer. Services are affected by a shortage of qualified staff and pay differences between occupational therapists in the NHS and social work. While there is an agreement in place which allows social work to accept assessments for equipment and adaptations completed by NHS occupational therapists, this does not always work the other way round. This needs to be resolved with further development of the joint equipment store. However, there is some evidence that some people are accessing services more quickly.

People with sensory impairment

In 2002-2003, 320 people with a hearing impairment received a service and of those seven were deaf-blind. Currently, there are 164 hearing impaired open cases and nine people who are deaf-blind who are open cases. There is a need to develop stronger links for older people with sensory impairment to the sensory impairment teams.

Services for people with mental health difficulties

The number of people receiving a service for mental health problems increased from 146 in 1999-2000 to 213 in 2000-2001.

The Council acknowledges that local services rely too heavily on the NHS. Partners have mental health strategies for adults and for older people, which are to be developed into a costed development plan. The plan to introduce the new Mental Health Act has not yet been completed. It is estimated that a full information system will take two years to put in place so that health and social care can share information. To help joint working, there is a joint commissioning post, a joint manager and integrated mental health teams with a single budget.

Tackling substance misuse

The number of people receiving a service for drug and alcohol misuse more than doubled from 20 to 45 between 2000-2001 and 2001-2002 but the rate is still quite low.

Services for people who misuse substances have historically focused on adults. A social worker for substance misuse is now attached to a health substance misuse team whose manager makes decisions on resources. Community drugs rehabilitation services have been set up and are contracted to Turning Point. A multi-agency project for children who are victims of substance misusers is funded from the Changing Children Services Fund and involves staff from social services, teachers and health. The effect of the project is likely to influence the future development of services.

The Council knows that it needs to tackle the issue of residential rehabilitation services.

75% of criminal justice staff receive training in STRADA 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. Recent evaluation of the partnership's progress in the five areas of joint management, joint governance, human resources, joint resourcing and Single Shared Assessment suggest that the joint arrangements are still being progressed. The local partners were recommended to:

• identify what the joint management arrangements will be beyond the single area pilot that is currently in operation. That might mean alternative arrangements or a detailed action plan to move forward on the basis of single managers;
• develop the shape of joint services at the frontline and how these will be jointly managed;
• agree the level of delegation to be given to the Partnership. This should be resolved as swiftly as possible in order to allow further delegation to be progressed;
• develop a scheme of delegation that will apply to the full chain of joint management arrangements once the full chain of joint/single management arrangements is known and agreed;
• develop the comprehensive governance checklist into agreed policies to underpin the working of the partnership at all levels;
• further develop financial management arrangements (both strategic and operational), financial protocols (both strategic and operational), and an agreed statement of a joint resourcing operational budget for older people's services;
• agree and implement a plan for joint training of appropriate staff in social work, health and housing;
• agree an action plan, with timescales, for steps to be taken towards the implementation of SSA during 2003-2004, including arrangements for assessors to access services across social work, health and housing; and
• develop and agree a joint protocol for Information Sharing between local partner agencies.

On the ground, joint teams are set up for mental health and learning disabilities services. Plans are in place for taking forward joint services for people with physical disabilities and older people. Mental health services are mainly managed on a regional basis but in a pilot project a Local Health Care Co-operative manager is responsible for services for older people and people with physical disabilities.

There are named social workers and care co-ordinators linked to GP practices. The future use of occupational therapists is being reviewed to promote the development of independent living and home support.

Before the introduction of an electronic system for information sharing, a temporary system is being set up with a shared database to use in the pilot areas on Single Shared Assessment for older people, and for the Mental Health Act.

Working with Carers

A number of new services have been developed for carers, including GPs becoming involved in identifying carers, community support workers being placed in hospitals, and counselling services. A handbook has been produced for carers. Carers believe the respite care available is not enough to meet their needs, although the Council argues that the respite care provided is underused.

Staff have been trained in relation to the Carers' Act and offer carers an assessment. The Council does not know the numbers of carers offered an assessment at present but figures will be available when the new electronic system for information sharing comes in.

250,000 has been allocated to Crossroads to support carers and provide care at home.

Children and Young People

Looked after children

The numbers of children and young people looked after increased from 227 in 1998 to 356 in 2002. The number of children living in kinship placements increased gradually between
1999-2000 and 2001-2002 with 62 children currently placed with friends or relatives.

The number of children in residential accommodation has fallen gradually. After introducing community measures to provide alternatives to residential and foster care, the number of children over 12 who were looked after has reduced from 165 in 1997 to 141. The number of children under 12 has increased sharply over the same period, from 95 to over 200. This means that more preventive services will be needed for younger children. The rise was probably caused by increased drug and alcohol misuse and the fact that children are staying in care longer. More information will be available when a new performance framework for children and young people looked after is in place later in 2003.

Fostering and adoption

14 children who are at home, with emergency carers and in residential placements, have been waiting for a few weeks for foster placement. A small number are under five, a small number are aged five-10 and nine are over 10. There is a high rate of children in foster care, placements having increased to 152 in 2003. There are 70 carers but there is a geographical mis-match, with more carers in the West than in the East. 15 foster carers receive enhanced rates of pay. The Council advertises for carers in the press, in supermarkets, in GP practices and so on. A very small number of children are in foster placements outside the region.

There are 13 children in seven adoptive placements, pending their adoption. The number of children living with kinship carers increased from 35 in 2000 to 54 in 2002. Six children are in approved placements with relatives.

Educational attainment

In Dumfries and Galloway, 55% of 16 to 17 year olds who were no longer looked after in 2001-2002 had attained Maths and English standard grade. This was the fourth highest rate in Scotland - but below the 100% target set by the Scottish Executive in 1999 and the 94% of the S4 cohort in the authority attaining such grades. Initiatives aimed at increasing the educational attainment of children and young people who are looked after include:

• research about young people's and carers' expectations of education carried out by an educational psychologist;
• new guidelines which positively discriminate in favour of children and young people who are looked after in all schools;
• appointing a co-ordinator for children and young people who are looked after;
• providing computers, musical instruments, even driving lessons, for older children and young people looked after, following bids from staff and foster carers; and
• producing guidelines for children and young people looked after outlining what they can expect from primary and secondary schools.

28 children and young people looked after are getting part time education; none are without educational provision.

All children and young people looked after have care plans, but educational needs are not always written on a care plan format.

More children and young people looked after are now staying on at school and going on to university.

Throughcare and aftercare

Information is collected on all the young people between 16 and 20 who were accommodated, including those now at home. It includes their employment and education status. A young person's link worker has recently been appointed. A range of accommodation is being developed.

• Housing associations provide accommodation and offer some 24 hour support.
• A supported lodgings scheme offers 20 placements to young people, with varying degrees of support.

Mental health

The local child and adolescent mental health service (CAMHS) is well resourced, with teams in each of the Local Health Care Co-operatives. 50% of children and young people who are looked after have some input from the CAMHS team. However, difficulties in accessing services mean that some children have to be placed in specialist services. The Council plans to develop joint budgets with health to meet the needs of children.

Child protection

A high rate of children are referred for child protection inquiries. Referrals doubled from 160 in 2000 to 364 in 2002 - attributed to the death of Kennedy McFarlane. Rates of cases referred to case conferences and registrations are also high and increased in 2000-2001. Quite a high percentage of cases are taken off the register in less than six months. There is a tendency to register to try and find out more about the case and after three to six months staff may become more confident about the family and take them off the register. The new CPC will investigate how the register operates.

A range of child protection initiatives that have been taken include the following.

• A review of the Kennedy McFarlane and Dylan Lockerbie cases identified the need for a performance and quality system. Proposals for change are now being sought.
• A review of the role and responsibilities of the CPC outlined improvements which are now being taken forward.
• Assessment and referral teams were set up for child protection. The assessment team scrutinises referrals, examines the numbers on the register and assesses the quality of individual child protection plans.
• Protocols have been developed with the police and health for sharing information.
• An action plan has been adopted to put into practice the recommendations of the Child Protection Review. Training programmes allow frontline workers to pick up on the messages from the CPR.
• All staff including criminal justice and community care staff completed four days of inter-agency training in 2002.
• The police, criminal justice and children and families share information about individual dangerous offenders.
• A service has been introduced for drug abusing pregnant women.

Children with disabilities

The Council provides a service to 215 young people (including brothers and sisters of disabled young people), including the summer activity scheme, after-school care, respite and more specialist support. Respite is provided partly through Quarriers.

Children with special needs are included in mainstream schools for their education. The remaining special school closes in 2004. About 20 families with children with disabilities move into the area each year to get inclusive education, increasing the demand for services.

A strategic review of services for children with disabilities and a Best Value review of respite services are being adopted as a basis for developing services, performance indicators and quality assurance.

Children and families social workers do not attend future needs assessments. They are told about them but are unable to staff them.

Working of children's hearings

70% of referrals were made within five working days of the case conference in 2001-2002 (standard 2).

13% of reports were submitted within 20 working days of the date of request (standard 3). Limits on the existing information system meant that the Council had to rely on a manual system. This unacceptably low performance is because of a period of acute staff shortage.

No information is available on how many supervision requirements with no condition of residence were given effect within 15 working days of issue by the children's hearing (standard 15). The Council must review urgently its procedures to make sure that it meets the targets.

Youth Justice

The multi-disciplinary youth justice team is in children's services and is staffed by people who are seconded from the police, health (CAMHS), SACRO, social services and education. It works with young people up to age 18. The YLS/CMI tool is used for all young people where there has been a request for an Initial Assessment Report or Social Background report. A child and adolescent mental health worker and psychologist assess the risk of harm.

'Offending is Not the Only Choice' is used with individual young people assessed as persistent or high risk offenders (or both).

Under development are restorative justice, parenting and mentoring programmes.

Criminal Justice

Structure

Dumfries and Galloway is not in a criminal justice grouping with any other authority. As a small authority this has created difficulties of economy of scale and slowed the development of initiatives.

Workload

Workload has increased over the last year, with a 3% increase in SERs submitted and a 10% increase in probation orders. This reflects an overall upward trend over recent years. In addition, over the past year, the three sheriff courts have decided to request Restriction of Liberty order assessments in all but a small number of cases where a social enquiry report is requested. This increase in workload has created pressures for a small workforce dispersed over a largely rural area. The authority intend to conduct a review of how staff are utilised.

Effective practice

The authority uses an assessment model incorporating LSI-R, Dunscore and the Scottish Executive risk guidance framework to measure the risk/needs presented by offenders. Development of this model emerged from the authority's work as part of the Getting Best Result's "Pathfinder" initiative. The model has been incorporated into the IT system and linked to a social enquiry report template. The authority has also created a two tier system of social enquiry reports, with full reports completed only when an offender is assessed as medium or high risk. Shortened versions are submitted in low risk cases. All offenders placed on probation previously attended a core modular offence-focused programme. Over the next year the authority intends to review this programme and to provide different programmes and levels of supervision more closely linked to the individual's assessed risk and need. It has established a profile of service users as a first step.

The authority has plans to introduce an induction programme for all those on Community Service Orders but this has been delayed by staffing difficulties. There are also plans to undertake a review of Court services. Currently in process is a review of services to the increasing number of allegedly illegal immigrants detained at the ferry ports of Stranraer and Cairnryan and subsequently appearing before the Court.

Negotiations for the prison based social work contract at HM Prison Dumfries were completed in February 2003 and that has allowed the service to provide a more robust service for those held there.

Public protection

The authority has established joint protocols with Dumfries and Galloway Constabulary in respect of High Risk offenders forming the basis by which risk assessment and management plans are undertaken. Following the Scottish Police Force's decision to adopt the sex offender risk assessment tool, TayPrep 30, most criminal justice staff have been trained in its use. Due to economies of scale, the authority cannot sustain a specialist sex offenders project. Supervision of such offenders is undertaken by local staff on an individual basis.

Quality assurance

The service's current IT system is outdated and information is supplemented by a number of service wide databases which allow monitoring of activity. The service recognises that there are gaps in the systems for evaluation and it intends to develop a framework as part of the current phase of its Pathfinder initiative.

Human Resource

Structure of the workforce

Between 2000 and 2002, there were large increases in the numbers of whole time equivalent fieldwork staff and social work staff across all user groups. This was partly due to the restructuring of services which introduced:

• three operational managers instead of one and new senior social work posts, in children's services; and
• senior practitioners in older people's services and learning disability services.

In the same period, the numbers of whole time equivalent vacancies rose significantly for fieldwork staff with adults, children and offenders and for social work staff for adults and children. There were no vacancies for social work staff with offenders or generic social workers.

Latest figures provided by the Council but not yet confirmed suggest that, at the end of June 2003, there were 127 social workers (whole time equivalent including vacancies) compared with 132 in October 2002 and that the number of social work vacancies was 21 as compared with 19 in October 2002.

Areas where the Council is under greatest pressure are:

• all senior managers are above 50;
• it is difficult to recruit occupational therapists because of NHS competition;
• 75% of care staff are over 55;
• a combination of an ageing workforce and flattened management structure will put pressure on the department to find new managers;
• the travelling time over a widely scattered rural area;
• geographic factors which affect how flexible staff can be; and
• within childcare, the services are now almost up to establishment. However, a full establishment barely meets the demand for the service.

Managing absence is a problem for managers who cannot move staff. There is the view that staff find it difficult to return to work if coming back to the same job. Absence levels are viewed as high in children's services

Support for staff

The Council has a corporate induction process and a range of policies around harassment and bullying. It needs to update the staff support handbook and supervision policy but this has not yet happened.

Working towards a more highly qualified workforce

The Council's formal development strategy is designed to take account of departmental needs. There is also a learning directory with health. Frontline managers are encouraged to take SVQ 4. The Council has run the SVQ 4 in conjunction with Health for the past two years. Funding to kickstart this training came from a joint bid for money from 'Learning Together'.

The Council offers student placements to its own staff. It is sponsoring four to six students, using money from Changing Children's Services Fund and is considering the possibility of doing something similar for adult services, including occupational therapists.

The Council is beginning to think about using literacy and numeracy funding to set up a taster project so people can experience working within the social services sector, particularly in home care.

To help ease recruitment problems, the Council is considering combining with local major employers (including the private sector). It is a member of the Recruitment and Retention Advisory Board which has been set up to help would-be employees find jobs for partners as well in hope of attracting both to the area. The Council has also recruited some social workers from South Africa and Australia, with variable success because of cultural problems and inconsistent staff quality.

Preparing for registration

The social services department uses a learning directory managed jointly with health staff. It will review the content in light of the training needs analysis and use it as a tool to encourage staff to work towards the qualifications they need for registration. A visit from a Scottish Social Services Council representative is planned for the Autumn.

Race Equality

Of the local population, 0.7% are from a minority ethnic group compared with 2% for Scotland as a whole.

The Council has yet to respond fully to its duties under the Race Relations (Amendment) Act. A lead officer has not yet been appointed. With the new client information system, it should have more robust information on the ethnic background of service users. It also plans to carry out an overdue review of its policies in light of the Act.

Use of Information Communication Technology (ICT)

Social Services Department

The department has a strategy for IT development and a new 'Blue Sky' system is being developed to provide much better management information and client recording.

Partnerships

Protocols are in place for sharing information on mental health and for children. These protocols are to be extended to other client groups. A new system is being designed which will promote information sharing with health and it is based on developing SSA for older people and for children's services.

Background Profile

Dumfries and Galloway is a mainly rural area and has a local economy which largely depends on agriculture and fishing, associated industries and tourism. Most of its population is concentrated in comparatively small country towns, with a scattering of people in more remote inland areas and on a wide coastline.

Average earnings are 9% lower than those for Scotland as a whole. There are pockets of particularly high unemployment.

Spend for every person on social work in 2001-2002 was 254, compared with 267 for Scotland.

Expected population change

Community Care

G24

Expenditure on community care increased significantly in the period 1999-2002.

Children and Young People

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

Criminal Justice

Human Resources

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