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Short Reviews of Social Work Services in Scottish Local Authorities

East Renfrewshire Council

Overview

East Renfrewshire is providing high quality social work services. There are only limited areas of disadvantage in East Renfrewshire and some fairly wealthy neighbourhoods. Crime rates are very much below average. The Council does, however, have to deal with a range of local needs which are affected by population change and a predicted increase in the population of older people, which is twice the Scottish average. It has been able to invest in early intervention and this is paying off. Because of this, and because of its close working with the voluntary sector, the Council provides a good range of high-quality social work services.

The council's achievements include:

• delivering 86% of the reports requested by the children's hearings on time - this is the best performance in Scotland and the only authority meeting the 75% target;
• developing an excellent relationship with the voluntary sector generally, and in particular developing a strong and important partnership with Jewish Care Scotland;
• reducing the number of children and young people becoming looked after and reducing the number looked after in residential accommodation;
• reducing the social work staff vacancies in children's and adult services (this improved the quality and quantity of services provided) to zero within the later part of 2002-03;
• providing good support for foster carers so children can be offered a choice of carers to live with;
• developing imaginative and flexible policies for children and young people which are based around individual needs; and
• providing Free Personal care successfully.

The authority should give priority to:

• maintaining good information on young people up to the age of 19 who were looked after at home (good information is already available for those accommodated away from home);
• developing further joint working for equipment and adaptation services;
• developing a clearer strategy for sensory impairment services;
• increasing the number of shared carers; and
• improving information on young people affected by disability.

Community Care

Services for older people

Following a reduction in 2001, the number of older people receiving community care increased in 2002 to equal the figures from 2000. The number of older people receiving care at home increased in 2002 and the number receiving care for 20 or more hours a week more than doubled from 17 to 45.

There is currently no cut-off point on spending on intensive care at home but it may prove difficult to continue like this with the increase in the number of older people.

The Rapid Response Team is available 24 hours a day, 7 days a week. It has been dealing successfully with an increasing number of referrals.

The assisted shopping service uses a voluntary project to help people to go shopping. Two schemes help support people in their own homes - Mr Fixit is a home maintenance scheme fully funded by the Council and Mr Digit is a garden maintenance scheme. The Council may have difficulty funding the schemes in the future because they are so popular.

Respite care (temporary care so the main carer can have a break) is provided in many different ways, such as traditional residential breaks, a sitter service at home and a flat in a sheltered-housing scheme.

The introduction of Free Personal Care has allowed the Council to identify and help older people and their carers, before they reach crisis point. The Council publicised Free Personal by visiting care homes to give staff and residents advice, giving staff guidance and making presentations to various groups, such as carers. Free Personal Care is now included in mainstream community care systems, for example assessments and care plans. The major difficulty for the future is likely to be the predicted increase in need and its funding, as there is already a high level of private home care service purchased in East Renfrewshire.

Services for people with learning disabilities

All residents in the local long stay hospital are being resettled, with joint funding from NHS Greater Glasgow and the Council. The type of resettlement depends on the person's wishes, their families and the input from staff. Most of the local Council housing is two to four bedroom so help is needed from other housing providers to meeting requests for single tenancies. Locally people tend to leave hospital to live in shared tenancies or supported living and then to single tenancies. This will normally apply to individuals who have moved, or will move, to care homes, with extra support for social activities.

Further developments in community services include:

• an advocacy service;
• developing the Enable family advisory service into a Local Area Co-ordination Service;
• a transition team to support children and their families; and
• more individualised day support.

Services for people with physical disabilities

Following a large reduction in 2001, the number of people receiving a service for a physical disability increased in 2002, and although the figure is still below the figure for 2000, the rate remains low compared with other authorities.

A Direct Payments scheme was introduced after consulting staff and people who may use the scheme. The Council have trained care staff, produced an explanatory booklet, held an information day and carried out wide publicity. The East Renfrewshire Independent Living Service will support future users.

Systems are in place for monitoring and improving waiting times for equipment and adaptations, and extra funding is being used to reduce waiting lists. Social work manages the budget for permanent adaptations to Council property, resulting in an obvious reduction in some waiting times.

No authorisation is needed for stock equipment. Non-stock equipment which has to be ordered and temporary adaptations are authorised by the manager of Assessment and Care Management. All equipment is demonstrated except for powered riser and recliner chairs, where the contractor does so, followed by the occupational therapist who carried out the assessment.

The development of the joint equipment store for social-care and community-nursing equipment is progressing, together with improved access across Health and Council organisational boundaries.

People with sensory impairment

The information currently available on individuals with sensory impairments is unreliable and the Council is reviewing the way it is collected. Services for people with sensory impairments are being developed as needs are recognised, by recording of unmet needs on an individual basis and through the Community Care Advisory Group and the joint planning process. Services are currently being reviewed with statutory agencies, the voluntary sector, users and carers, as a step to developing a joint strategy for developing services. The ScoD standards are followed and East Renfrewshire believes it is meeting all the recommendations set out in the Royal National Institute for the Blind UK document "Progress in Sight".

Services for people with mental health difficulties

The number of people receiving a service for mental health problems increased from 146 to 234 between 2000 and 2002.

A Departmental Implementation Group is examining what services need to be developed to put into practice the Mental Health Bill, and Health will consider providing community support services for offenders with mental health difficulties.

As there are two health partners, there are two joint planning structures. Both have agreed on priorities and the action plans are nearly complete.

Offenders with mental health difficulties are included in current and planned services, and the protocols of the care programme approach are followed for all these offenders before they leave prison. The Service Manager for Criminal Justice is responsible for calling meetings to assess risk.

A forensic strategy group is already in place, as is a forensic team for offenders with mental health difficulties. The team is planning to raise awareness of this issue by making presentations to criminal justice staff.

Tackling substance misuse

The number of people receiving a service for substance misuse problems has more than tripled from 59 in 2001 to 194 in 2002.

The Substance Misuse Team has recently been established with health partners and it is planning to provide equal access to services across East Renfrewshire.

Rehabilitation in the community is the preferred method of rehabilitation and a range of services are offered, for example, counselling, family support, access to prescribing and specialist services.

Priority is given to urgent referrals. Families with children can also be seen very quickly, with referrals automatically passed to children and families' managers. The Council is identifying longer-term need through the Children First service to families, the Drug Testing and Treatment Order scheme and the Young Person's Advisory Service.

All staff in the substance misuse team have received training in the past year, and STRADA training is available as appropriate.

Joining up community care services with health

The Council is progressing joint arrangements for the Joint Future agenda, but using joint resources is a problem because of the different approaches within the two health boards. The Council has identified the Joint Future outcomes which it wishes to achieve for individuals who need joint community care services, for example more person-centred approaches to assessing needs and delivering services.

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 being well progressed and are, overall, satisfactory. The local partners were recommended to:

• implement the joint management arrangements, as already identified in the full Local Partnership Agreement e.g. the proposed single line management arrangements for specialist older people's services within the Levern Valley locality, and the co-location of staff in the Intermediate Care Team for older people;
• further develop joint service and clinical governance arrangements for joint services, as already identified in the full Local Partnership Agreement;
• submit details of the remit and membership of a Joint Staff Forum, which was omitted from the Local Partnership Agreement;
• take steps to further develop financial management arrangements (both strategic and operational), financial protocols (both strategic and operational), an agreed statement of a total service strategic financial envelope for older people's services, and an agreed statement of a joint resourcing strategic financial envelope for older people's services; and
• further develop elements of the process of assessment to be implemented to ensure a holistic framework for Single Shared Assessment. (Access to resources across agencies should include access to appropriate health services by staff in other agencies).

The Council has developed joint services for older people, with the two health boards in the area, each of which takes a different approach to joint services. Setting up a local single Community Health Partnership would help to develop services even more. The Council has:

• set up joint planning groups for mental health services;
• reached agreement on priorities; and
• drawn up action plans.

A joint substance misuse team is already in place. A joint locality service for adults with learning disabilities is being explored, although extra resources will be needed. A strategic group looks at needs and current services available to adults with physical disabilities. A joint Best Value review is proposed.

A Combined Assessment Form (CAF) is used by East Renfrewshire and both health boards. It includes a declaration for information sharing which people must sign and there is a jointly agreed information-sharing protocol. Paper based systems are used at the moment, but electronic methods will soon be available through Modernising Government Funds 2 (MGF2). Joint procedures for staff are being prepared, giving access to certain services across different agencies.

Working with carers

A wide range of services for carers is funded, for example, the East Renfrewshire Carers Project, the Family Advisory Service provided by Enable for people with learning disabilities, and the Age Concern Dementia Project which provide day-care and services to support carers. Work is being undertaken to identify hidden carers, through their contacts with general practitioners and nurses. Carers are encouraged to ask for carers assessments, and about
20 separate carers assessments were completed in 2002.

Carers and service users are directly involved in planning and assessing services, for example the Community Care Advisory Group, developing the scheme for Direct Payments and the Mental Health Forum. The East Renfrewshire Carers Project is developing a strategy for carers.

Children and Young People

Looked after children

A very low rate of children in residential accommodation is thought to be due to:

• 100% staffing levels in children's services;
• investment in early intervention;
• young people over 15 and those with difficult behaviour being successfully fostered;
• carers not operating at full capacity and being given respite;
• close working with children's hearings and reporters; and
• alternatives to residential schools - e.g. the Quarriers 'Quest project'.

Statistics suggest an increase in the number of children in residential accommodation but this is because the number given in residential schools in 2001 did not include those with special needs who were jointly funded by education and social work.

Fostering and adoption

There was a large increase in the number of children who were fostered between 2001 and 2002. However, the placement of a number of large family groups may have been a contributory factor.

No children are waiting to be fostered. The Council offer children a choice of foster placements and can also offer short-term placements to neighbouring authorities who have no foster carers available. However, the Council need to increase the number of shared carers. Publicity has included posters, newspaper articles, meetings, stalls in supermarkets, and website information and the Council are part of the West of Scotland Consortium.

There is a generous fee structure. Carers are paid twice the CoSLA rate and community carers who foster young people with challenging behaviour get an extra 130 a week. Carers are paid for up to eight weeks if they do not have a child to look after and there is the possibility of extras payments.

Usually only one child is adopted each year. The consortium deals with adoption and children who are placed outside East Renfrewshire. Many children from other areas are fostered in East Renfrewshire.

Educational attainment

Fewer than five 16 to17 year olds ceased to be looked after in 2001-2002 in East Renfrewshire so no figures are available on their educational attainment. A high percentage of young people who live with foster carers sat English and Maths this year and many are expected to stay on at school and go on to higher education. A number of initiatives have been put in place to improve educational attainment. These include:

• allowing learning support workers and psychologists to assess children in S3 and S4;
• running Easter schools before children sit their standard grades (and providing transport to the schools if necessary);
• inviting children and young people to supported study sessions;
• providing computers for children and young people who are looked after; and
• providing tuition for specific children, including those in residential schools (residential schools have been paid to do specific pieces of work with young people).

Fewer than five young people were not in full time education. All other young people are receiving full-time education, including those who are supervised at home.

The council have had their own education form for 2 years which is completed for all children and young people who are looked after. Some children may also have an individual learning plan.

Throughcare and aftercare

A small team provided throughcare services. Information is available on 19 young people receiving a service who were looked after away from home up to age 19 - some have their own tenancies, some are living at home, and the others are in various forms of accommodation. A new throughcare assessment framework is being piloted.

A range of accommodation options have been developed. A throughcare flat is available for up to four young people, with young people given their own tenancies when they have lived in the flat for six months or longer if they need more support. A service is being developed with housing and Quarriers for all vulnerable children, including those who were looked after, to prevent them having to go to Glasgow for accommodation. Six flatlets will be available for young people who are no longer looked after, with support provided and there will also be 20 scattered flats, with floating support from Quarriers staff. The council have been flexible in negotiating packages for individual young people to provide continuity of care, for example, through reassessing carers to become supported carers and even helping one young person to return to their foster placement during holidays from university.

The Council has developed a resource pack of practical advice for young people.

Mental health

Children and young people who are looked after away from home have a medical assessment which includes screening for mental health, but services are not always available to meet the needs identified and are not available for those who are looked after at home (most of the children and young people who are looked after in East Renfrewshire). Specialist services are sometimes bought in.

Young people can fall between the child and adult systems. Proposals for a specialist assessment and service for this group are being developed. The service will be for all young people aged 16 to 20 who need it, not just for children and young people who are looked after.

Foster carers can receive training on emotional distress, depression, substance misuse and so on. They also get training from the Scottish Institute of Residential Child Care.

A counselling service has been commissioned based around the New Community school clusters.

Child protection

There are low rates of referrals, children subject to a case conference and children on the register. The number of children on the register has been falling gradually.

Child protection schemes include:

• appointing a child protection co-ordinator;
• reviewing the membership of the Child Protection Committee;
• revising policies and procedures;
• preparing a professional development plan for a better understanding of child protection;
• developing a common (health, education and social work) assessment framework for all children in need;
• issuing public information leaflets; and
• holding seminars with councillors on the Child Protection Review.

Children with disabilities

139 children with disabilities are receiving a service, a significant increase on recent years. The pre-school community assessment team identifies children aged 0 to three with disabilities. The team deals with 70 children.

There is no firm information on children affected by a disability. A carers' project works with young people living with someone with a disability.

Following a Best Value review of services, an action plan has been developed for children with disabilities.

There is a transition team and one of the two workers in the team goes to future needs assessments if this is needed. There are about 12 to 14 new future needs assessments a year.

There are outreach services, a youth counselling service and improved early years services. A playscheme and out-of-school care is jointly funded with education.

Working of children's hearings

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

86% of reports were submitted within 20 working days of the date they were requested (standard 3). East Renfrewshire are the only authority to meet the target of 75%.

All supervision requirements with no condition of residence were given effect within 15 working days of the date of issue by the children's hearing (standard 15).

Youth justice

Youth justice services are being developed. Staff currently deliver offence-focused programmes on an individual basis. A familiarisation day for a wide range of staff working with children will encourage multi-agency working. Specific training on offence-focused group work is also planned. New community school staff who have contact with young offenders will also receive training. Negotiations with SACRO have recently led to the appointment of a part-time member of staff to develop a restorative justice service.

At present, staff use the YLS/CMI risk assessment instrument with all new referrals. Work has begun on identifying appropriate instruments to assess risk of harm. A particular concern is the significant number of young people committing youth disorder offences who are misusing alcohol and drugs. A worker employed by the Renfrewshire Council on Alcohol is now based in the Children and Families team and voluntary and sessional staff are also providing help and support. Intensive support and supervision services are paid as and when needed from Includem for persistent offenders who may be at the point of going into residential care. Individual offenders are assessed to see whether the aims of the intervention were achieved. This sort of work involves a lot of contact between Includem and local authority staff. At the other end of the spectrum, the Council's Community and Leisure Services have commissioned the YMCA to do outreach work with young people at risk of offending.

An audit of youth offending is being carried out. When completed, the authority will have a clearer picture of the number of persistent offenders and the services they need to provide. A considerable amount of work remains to be done to establish a comprehensive, strategic approach to providing youth justice services.

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, the numbers of whole time equivalent fieldwork staff across all user groups rose slightly and the number of whole time equivalent vacancies stayed the same, except for staff who work with children and generic workers which increased slightly. In the same period, the number of vacancies for whole time equivalent social work staff for adults and children and generic staff rose slightly but stayed the same for offenders.

Latest unconfirmed figures suggest that, at the end of June 2003, the social worker establishment (whole time equivalent including vacancies) was 56 compared with 53 in October 2002. The number of social work vacancies was 12 compared with 4 in October 2002.

At the time of the annual review visit, the Council reported no vacancies in children and families services or for occupational therapists. That said, the Council expressed concern that the volume of referrals, notably to occupational therapists, was increasing. The Council considered that job satisfaction was high across the whole staff group because of the small size of the authority and the opportunity this gave staff to be involved in pieces of work, which they would not have otherwise have been involved in. However, fewer professional staff are replying to adverts and there is a concern that the attractive packages neighbouring councils are offering could lead to a higher staff turnover.

Most of the qualified social workers are aged 36 to 50. Across all service groups, 28 staff are over 61 and over half of these work in home care.

Support for staff

The Council support staff by:

• providing an independent counselling and support service;
• running focus groups with front-line staff;
• identifying high risk clients in the system;
• giving all social work staff access to mobile phones when needed;
• developing a new shift pattern so home care staff have access to a manager (currently by phone);
• appointing local general practitioners to act as occupational health advisors; and
• testing a flexible working scheme for social workers.

Absence management is tackled actively and sickness and absence figures are discussed at all senior management meetings. The policy is focused on involvement at an early stage, with Personnel taking action after four absences in a year, when formal counselling may be put in place. Most absences are certificated by a doctor, not a member of staff. Disciplinary action can be taken even if the worker is medically certificated on the grounds of breach of contract.

Working towards a more highly qualified workforce

The Council has a performance and development scheme in place for staff, and information from the scheme is used in the training strategy.

The Council was one of three local authorities who jointly funded a part time lecturer at Paisley University and has recruited three trainees who will work towards the DipSW through this course. These trainees will be employed in children and families services. The second group is being recruited now and will return to posts within priority areas.

Preparation for registration

The Council has taken a number of steps to prepare its staff for registration with the Scottish Social Services Council and to ensure their compliance with the Codes of Conduct for Employers. This has included having meetings with staff and giving all staff copies of the codes. The Council is exploring the possibility of setting up its own accredited SVQ assessment centre.

Race Equality

3.8% of the local population were from a minority ethnic group in 2001 compared to 2% for Scotland as a whole. The percentage of the population who are from a minority ethnic group has increased significantly from 2.4% in 1991.

A corporate Race Equality Scheme is in place. The Community and Leisure Service is responsible for equal opportunities. Monitoring of progress against its three-year action plan is done by the corporate management team on a quarterly basis.

Developments include:

• preparing to host a community conference in September 2003;
• carrying out research work on community learning; and
• holding cultural training sessions for staff.

One of the main considerations for the social work department is the low number of people from minority ethnic groups who use the services. There are not enough local providers and some people have to travel to Glasgow.

Using Information Communications Technology (ICT)

Social Services Department

There is no formal ICT strategy for social work. All social work staff have access to computers and to e-mail. Managers have access to the Internet and decide on staff requests to use it. Staff are currently preparing to introduce an upgraded OLM computer system.

Partnerships

There are no formal protocols for sharing information, and Single Shared Assessments are currently paper-based. The situation will change significantly when the new computer system is introduced and improved information sharing will make partnership working easier.

Background Profile

East Renfrewshire contains extremes of both wealth and poverty. It has a number of affluent neighbourhoods and poverty indicators are low but there are pockets of deprivation. There was a 15% increase in service sector jobs between 1995 and 2001, many of which were in public and other services.

Spend per head on Social Work in 2001-2002 was 191, significantly below the Scottish figure of 267.

Expected population change

Community Care

Expenditure on community care rose gradually over the period 1999-2002.

Children and Young People

Expenditure on children's services has been broadly stable in the period 1999-2002.

Criminal Justice

Human Resources

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