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Short Reviews of Social Work Services in Scottish Local Authorities

Stirling Council

Overview

Stirling faces some local problems of deprivation and has to tackle the practical difficulties of delivering services efficiently to meet the needs of people who live in widely scattered rural communities. Children's services are well developed and have benefited from effective joint working between Education and Social Work.

The Council's achievements include:

• increasing the number of people who receive community care services;
• increasing home care support by 15%;
• improving the educational performance of children and young people who are looked after;
• an entitlement scheme, extending support services and respite care to increasing numbers of children with disabilities and their families; and
• successfully introducing Free Personal Care.

Stirling Council needs to take urgent action to:

• make sure all children and young people who are looked after are in full-time education; and
• improve reporting to children's panels, making sure the 75% target is met.

The authority should also give priority to:

• reviewing services for people with sensory impairment;
• reducing the high percentage of children who have placement moves; and
• improving information on young people who were looked after.

Community Care

Services for older people

Stirling follows a joint health care strategy with Forth Valley NHS Board and the other two councils in its area. It takes in planning of care home places and other services. The Council tested out a pilot rapid response team, and this showed that the cost of a team outweighed the benefits. A new model is being introduced to meet intensive care needs relating to rehabilitation, respite and emergency admission. It provides for intensive integrated home care and rehabilitation for up to six weeks. The Council has reorganised shopping services, following a survey of service users.

More older people received a community care service in 2001-2002 than in 1999-2000 (2,737 compared with 1,958). The number receiving 20 hours or more of home care a week reduced from 47 in 1999-2000 to 36 in 2001-02. Home care support overall increased by 15% between 2001 and 2002. Stirling Council has a higher percentage of service users needing and receiving intensive home care packages (20%) compared with the national average (13.5). These service users receive an average of 8.4 hours of home care a week - 24% above the national average. Stirling is extending mobile personal care to all areas by May 2003. Home-based respite care is being increased.

Free Personal Care was introduced successfully after widespread publicity, but detailed difficulties have arisen over:

• lack of clarity about meal preparation (in the early stages of introducing Free Personal Care);
• some independent service providers not passing on the benefits of personal nursing care payments to residents; and
• for home support, particularly in rural areas, small private providers not joining the Council's approved contract, so that some people could not get the new benefits with their current service providers.

Free Personal Care has been integrated with assessment and personal care on the same basis as other services. The Council is carrying out a study to plan for future demands for home and residential care.

Services for people with learning disabilities

A small number of people who used to be in long-stay hospitals are now in nursing homes and in a unit specially designed for small group living. Their care is regularly reviewed. A local area co-ordinator has recently been appointed. Partner agencies have agreed the structure for a joint health and local authority learning disability service under a single manager.

Community resources include:

• five shared tenancy houses for people with learning disabilities near the centre of local communities; and
• the new Riverbank Community Resource and Day Care Centre for people with learning disabilities, which is to be opened up to other care groups and for community activities.

A rural support service meets the needs of people with learning disabilities in rural areas for respite care and activities. Care for people with particularly challenging behaviour is bought in through two outside service providers. The Council is setting up a supported employment service for people with learning disabilities.

A database of service users with learning disability is shared with the health board. Assessment information is being added for the purpose of planning services. Service users are noted on the SWIFT database, which relevant NHS staff can access.

Services for people with physical disabilities

The number of people with a physical disability who are receiving a community care service has more than doubled (from 228 to 561) since 2000.

The Council is setting up a Direct Payments service for all client groups from July 2003. It has prepared publicity material for the service and will tell people their options during the assessment of their care needs.

The Council actively monitors waiting times for equipment and adaptations. Changes have been introduced to speed up the supply of equipment, and waiting times have been reduced considerably over the last two years. The situation should be further improved now that all occupational therapy posts are currently filled.

People with sensory impairment

The Council uses estimates for sensory impairment based on the population and national statistics about hearing-impaired and deaf-blind people. Services are planned on a Forth Valley-wide basis, with input from a disability steering group. There is a local Sensing Progress Implementation Group and a Forth Valley resource centre for sensory impairment is planned for next year, jointly with the Royal National Institute for the Blind. This includes contributed funding from Stirling Council.

Services for people with mental health difficulties

The number of people receiving a service has increased, but is still lower than in many other authorities.

A joint mental health strategy group - including service users and carers - is preparing a plan for the services needed to support people in the community, as set out in the new Mental Health Act. The plan will include arrangements for accommodation and support, short breaks and a proposal to review rehabilitation services.

Rehabilitation and forensic services are linked, although it is difficult to get NHS rehabilitation beds. A court liaison system is well established and currently 11 mentally disordered offenders receive services that are monitored or co-ordinated through the care programme approach.

Tackling substance misuse

Partner agencies take an integrated approach to service planning and delivery for the whole of Forth Valley, matching levels of service to individual needs. Information sharing is well developed and is based on Single Shared Assessment (SSA). There are local access points for this in every community through the 'Signpost Forth Valley' service.

Stirling uses residential rehabilitation for a relatively low percentage of people with substance misuse problems and intensive care needs. The main approach is community-based, and these structured services meet the needs of most people. The very small number of people who need more than community services can provide are referred to and can access residential services. Referrals to the family support service, where support can be provided for substance misuse and other problems, have increased sharply in recent years.

Partner agencies provide integrated care, backed by common policies and protocols for people who misuse substances. They identify the needs of children and adults through their existing work in the community, and they share data electronically for planning services, using the Forth Valley Geographical Information System (GIS). A three-year support service is being developed for families of drug users.

Partner agencies also offer an extensive alcohol and drug counselling and support services for offenders.

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:

• articulate how they intend to develop joint operational services management, how resources will be achieved and how it will relate to crucial service interfaces such as LHCCs;
• consider the shape of front line joint services and of how these will be developed and what joint management/co-ordination arrangements should apply;
• agree a full scheme of governance and accountability including delegation to apply at all levels of the joint management arrangements.
• continue to develop and implement service and clinical governance arrangements and risk assessment for joint services.
• develop further financial management arrangements to address strategic arrangements and financial protocols for strategic arrangements;
• agree a statement of a total service strategic financial envelope for older people's services;
• agree a statement of a joint resourcing strategic financial envelope for older people's services;
• involve housing staff in training; and
• increase access to health resources by other staff.

A local partnership agreement came into effect in April 2003, providing a protocol for information to be shared with Forth Valley Health Board. A 'personal core data service' draws on information gathered in community care assessment forms. Only authorised users can access the information and they have to have the informed consent of the service user. All social work teams have access to the computer system and to training.

Working with Carers

Carers are offered an assessment as part of the shared assessment procedures. Carers and service users are involved in strategy groups.

In October 2002, the Council commissioned the local Community Care Forum to identify specific carers' issues and to develop a carers' self-assessment tool. This work will be the basis of the local carers' strategy. Although the project was delayed due to recruitment difficulties, it is now progressing well.

Children and Young People

Looked after children

The number of children and young people who are looked after is quite low at 7.5 per thousand population. There are currently 150 children and young people who are looked after. The rise in residential placements between 2001 and 2002 has been reversed in 2003.

41 (44%) of children looked after away from home in 2002 experienced three or more placements. This is partly explained by moves from crisis placements to longer-term arrangements. However, it is the fourth highest percentage of all councils in Scotland and the Council should tackle this as a matter of priority.

Stirling has found increasing demands placed on its services by the needs of a small number of younger children who needed residential care.

Fostering and adoption

No children are waiting for a foster placement, but some who are already placed are waiting to be moved to a more appropriate placement (for example, with their brothers and sisters or to move on from temporary placements). Some children are placed in neighbouring Falkirk or Clackmannanshire.

Stirling works with Falkirk and Clackmannanshire to recruit foster carers, making use of job sections of local newspapers. They have boosted the total number of carers from 35 to 45, including new carers for children with disabilities. A 'payment for skills' scheme has three payment levels and the Council is thinking about introducing a professional salaried level. The success rate is high for keeping foster carers.

No children are waiting for adoption. Stirling's adoption service standards have been published by BAAF and have attracted national interest. Local targets have been introduced to reduce the length of the adoption process.

Educational attainment

In Stirling, 62.5% of young people leaving care in 2001-2002 attained standard grade Maths and English, compared with 94% of the S4 cohort in the authority and the 100% target set by the Scottish Executive in 1999. While there is still some way to go, this represents significant achievement. The Council reports that:

• the attainment of children in residential placements, including secure units, remains a concern and an in-depth audit is planned;
• the majority of children and young people looked after in Stirling Council schools are achieving a level appropriate to their age; and
• the number of exclusions have dropped and the attendance levels have improved for children and young people who are looked after.

The section on education in care plans has been improved by developing a school report format, and this is done for all child care reviews.

While there has been real and significant progress, it is a concern that eight children and young people who are looked after are not in full-time education. The Council is aware of the circumstances and needs of all eight children and why they are not in full-time education, and it is working on a multi-agency basis to improve this. The children are all in part-time education.

Throughcare and aftercare

All young people who have been accommodated have aftercare reviews, and there are systems in place for assessing their needs. The Council encourages foster carers to carry on caring for young people for longer, and will pay them until the young person is 21. Shared flats are available for people leaving care and there is a supported accommodation scheme. The Council has launched a recruitment campaign for carers for a supported accommodation scheme.

Mental health

The health needs, including mental health needs, of looked after children are identified through a review process.

The Well Chosen project, funded through the Children's Health Improvement Fund, aims to improve the health of children and young people who are looked after and accommodated in the Forth valley area. A comprehensive health assessment by a community paediatrician is offered to all children and young people when they become looked after and accommodated. The initial health assessment focuses on lifestyle issues and includes mental health screening. Recommendations are made to meet the child's health care needs (including mental health needs) and the recommendations form part of the child's care plan.

Child protection

Over the past year, the number of case conferences and the number of children on the child protection register has increased significantly in relation to the number of children referred. 9% of children on the register have been on it for more than 18 months. The percentage of children who have been on the register for less than six months has increased from 23% to 50%.

The Child Protection Committee has set up a group to drive forward the recommendations of the Child Protection Review. Education and social work services currently have separate child protection guidance. The guidance should be integrated and work is planned to do this.

The Council has introduced an integrated assessment tool that can be applied at different levels of assessment. Every social worker has this on their personal computer and it is currently only used by Social Work. There are plans to develop a multi-agency shared assessment tool, but it is not clear if this will be based on the social work materials.

A number of staff have benefited from STRADA training and there have also been local initiatives to help in the case of children with parents who misuse substances. The Family Support and Community Childminding Provision is a multi-agency project funded by the Changing Children's Services Fund to provide support and day care to pregnant women and young mothers who have drug and alcohol problems. The two-year action plan contains five main aims:

• better management of drug use;
• keeping postnatal appointments;
• reducing the number of children requiring special care;
• reducing the number of children on the Child Protection Register; and
• reducing the number of children who need to be looked after away from home.

Children with disabilities

The Council has shifted resources from residential respite care services for a few families to community-based services for more families. It has set up a team to help children and families affected by disability. There is now a multi-agency and multi-disciplinary Short Breaks Referral Group, improving quality assurance by bringing information together.

The Council offers a service for short breaks and family support in partnership with NHS Forth Valley. All children with a disability were allocated 10 sessions of play a year, mostly during the school holidays. Transport is provided and activities emphasise involving the children in society. Some children with additional support and respite needs also receive enhanced community-based respite care.

By March 2003, 185 children had received 10 sessions and 34 had received enhanced community-based respite care. A longer-term aim is to reduce the use of expensive specialist respite care and redirect savings to increase the spending on home and community-based support and respite care. In 2001-2002, community-based support and respite care increased by 20%, with a corresponding reduction in spending on residential respite care.

The Council continues to evaluate the changes as part of the 'Both Sides of the Coin' initiative.

Working of children's hearings

100% of referrals now meet standard 2 (referral within five working days of a case conference) and 100% of supervision requirements meet standard 15 (the local authority will give effect to supervision requirements with no condition of residence within 15 working days of issue by the children's hearings).

In 2001-2002, only 9% of reports met standard 3 (reports submitted within 20 working days of date of request) - a very poor performance and the lowest reported rate in the country. The Council has improved this year and there is now a 40% success rate for standard 3. This still falls well short of the target of 75% and the Council should re-double its efforts to achieve this target.

Youth Justice

A youth justice strategic plan for Stirling has been completed by a youth justice strategy group, a sub group of the Stirling Children's Community Planning Partnership. There are links to a strategic group planning services for young offenders across Central Scotland. At present these services are developing at different paces across the three authorities, with some variation in service models.

The Council is proposing to set up a youth justice team comprising a team leader and three workers. The team will be drawing on the experience of the children and families team, previously responsible for this area of work. Links are also being made with the criminal justice social work service.

Barnardo's (Scotland) is a major service provider and is involved in planning and delivering youth justice services through their Freagarroch and Matrix projects. Connect Services also provide educational programmes in the field of substance misuse and deliver a programme jointly with Freagarroch for persistent young offenders.

The YLS risk assessment tool is being introduced across the authority. The need, however, for other more specialised tools to use with particular groups of young offenders has been identified.

For the future the authority will need to establish a clear role for the youth justice team and ensure close working relationships with other key services and agencies.

Criminal Justice

Structure

Clackmannanshire, Falkirk and Stirling operate as a partnership for delivery of criminal justice social work services. Responsibility for the strategic planning and monitoring of services across the Forth Valley partnership lies with a strategic management group which meets on a quarterly basis. An operational management group meets on a two monthly basis.

Workload

Demand for core services has risen across the partnership over the past year, with social enquiry reports increasing by 19%, probation orders by 12% and community service orders by 31%. While all constituent authorities have experienced an increase, there are variations. Clackmannanshire has seen an increase of 49% in social enquiry reports, and 110% in probation orders, while Falkirk has seen community service orders rise by 42%. This reflects a general upward trend over recent years. Staff have been placed under increasing pressure as a result. Nevertheless, the three authorities have performed well in relation to prompt submission of social enquiry reports.

Effective practice

The grouping uses differing tools to assess the risk and needs presented by the offender. Falkirk and Clackmannanshire make use of the Scottish Executive's risk assessment framework while Stirling use the tool, LSI-R. The partnership has yet to consider the use of a consistent framework across the authorities. Similarly, varied structured offence-focused programmes are delivered in each authority. This includes a recently developed programme for those convicted of racially motivated offences. A review of the first completed programme is currently being undertaken and it is hoped that a second run of the programme will commence in the autumn. Stirling operates groupwork based on the Constructs programme. Clackmannanshire concentrates on individual work though groupwork provision will be considered next year, possibly in partnership with Stirling. Falkirk provides a combination of individual work and groupwork. The Grouping works closely in partnership with SACRO. While these developments are encouraging, there is still evidently some way to go in developing consistent services across the partnership.

The grouping's Fast Track Assessment and Treatment project continues to offer a, now extended, service to drug misusing offenders. Referrals, orders and the conversion rate have remained high. Analysis of assessments, and compliance and completion rates is to be undertaken to evaluate the effectiveness of the Project.

Services to young offenders throughout the partnership continue to be provided through Barnardo's Freaggarrach Project.

Recent developments include services specifically addressing the needs of female offenders. Stirling provides a lifeskills programme while Falkirk has initiated a weekly informal "drop in" session in addition to formal individual sessions. Both Falkirk and Clackmannanshire have established dedicated women offenders community service groups.

Public protection

Across the three authorities, a groupwork programme for perpetrators of domestic abuse continues to be available in partnership with SACRO. Demand and completion rates are high. Services to sex offenders are also delivered in partnership with SACRO. The grouping is one of the pilot areas for the Community Sex Offender Groupwork Programme (C-SOGP) currently being prepared for accreditation. TayPrep 30 is used to assess the risk posed by sex offenders and the grouping also intends to adopt the tool Risk Matrix 2000 to meet the demands of C-SOGP. The Supported Accommodation service also continues to provide accommodation, support and monitoring of high risk offenders in partnership with SACRO and has now been extended across the grouping. A protocol with the police for assessment and management of all high risk offenders is to be developed.

The Criminal Convictions Enquiry Unit, based in the Stirling criminal justice office, and employed by the local authority, continues to provide a service to all Scottish local authority criminal justice services, providing criminal records checks for all offenders subject to court reports. The future of the Unit is time limited, dependant on the development of ISCJIS, the information system being developed for all agencies in the criminal justice system.

Quality assurance

For 2003-2004, the criminal justice management group will focus in greater detail on the demonstration of effectiveness. Monitoring tools have been developed for use across the service, caseload inspections are planned and monitoring and examination of support programmes are ongoing.

Human resource

Structure of the workforce

Between 2000 and 2002, the numbers of whole time equivalent fieldwork staff rose substantially overall, with most of the increase found in children's services. The number of vacancies among whole time equivalent fieldwork staff reduced overall.

In the same period, numbers of whole time equivalent social work staff increased slightly in services for children and offenders.

The latest figures provided by the Council but not yet confirmed suggest that, at the end of June 2003 the social worker establishment (whole time equivalent including vacancies) was 59, and was also 59 in October 2002. The number of social work vacancies was 10.5 at June 2003, compared with two in October 2003.

A special recruitment campaign has helped to reduce frontline vacancies in children's services in 2002. The Council is now concentrating on keeping existing staff. Stirling recently reported 10.5 whole time equivalent vacancies at 30 June 2003, a very sharp increase. Pressures in community care have arisen as a result of a shortage of occupational therapists, but agency staff are used to fill short-term gaps. Other pressures are in residential and day care, partly because of the age of staff and the difficulty of attracting new recruits to rural areas. Attracting practice teachers and staff with specialist skills (such as Mental Health Officers) was a problem until incentives were introduced (for example, a bursary of 2,000 to new social workers, one-day study leave allowance, and a new senior practitioner grade).

Support for staff

The Council supports frontline staff in a number of ways, including:

• more frequent supervision, especially for newly-qualified workers;
• panic buttons for lapels and cars;
• mobile phones which can record text on visits; and
• the Council-wide Code of Conduct, setting out expected standards of communication and conduct in challenging meetings.

Working towards a more highly qualified workforce

The Council has a Community Services Professional Development Plan, a Children's Services Professional Development Plan and a Stirling Employee Development Programme. In children's services, staff are encouraged to take professional training. All staff have a supervision and workload management policy and framework that they and their line manager use to assess progress and training needs. A Professional Staff Development Officer assesses all training needs in social work services.

In community care, a similar procedure has yet to be introduced.

Stirling Council has played a lead role in chairing the Forth Valley SVQ and Practice Teaching Consortium. It is also involved in the Tayforth Consortium.

Preparing for registration

Preparing for registration with the Scottish Social Services Council, the Council has had discussions with staff groups and elected members and has checked where it is in relation to individual aspects of the Codes of Conduct for Employers. Registration will be in 2004 for relevant staff.

Race Equality

The Council's Race Equality Scheme sets out arrangements for its duties under the Race Relations (Amendment) Act. Service areas are focusing strongly on the audit and review of their functions. After that, they will review services. The Community Services' Race Equality Scheme Action Plan reflects views and experiences from minority ethnic service users and service providers.

Use of Information Communication Technology (ICT)

Social Services Department

The Council has given access to personal computers and the Internet to all social work staff who need them in the course of their duties. Stirling has an information strategy for children's services, and intends to invite tenders for a contract to provide an information system for children's services. A 'virtual schoolbag' scheme allows looked after children free access to Internet work stations. The Council will evaluate the scheme and decide on its future.

Under the MGF1 e-Care national project, the Council and NHS Forth Valley have developed an e-Care Store, front end application and information sharing protocol. The store enables health and social care professionals in pilot areas to:

• maintain common assessment information, with secure input and updating;
• find patient and client population information; and
• receive automatic email notice of some changes.

A draft plan has been developed for integration with the social work system, SWIFT. This is being refined in line with the national MGF2 e-Care project.

The Council is now working with its two neighbouring councils (Falkirk and Clackmannanshire) and NHS Forth Valley as part of a partnership group under the national MGF2 e-Care project, to develop an expanded multi-agency store. This is dealing with the wider needs of the Single Shared Assessment agenda.

Partnerships

An information exchange protocol has been agreed between Stirling Council and NHS Forth Valley.

Background Profile

The area is part urban, part rural. Over half the population lives in four major centres in the south west, and the rest live in the extensive rural area.

Besides light industry and agricultural activity, the area relies heavily on the service industry for employment. Stirling has a below-average rate of drugs misuse.

Spending for every person on social work in 2001-2002 was 232, compared with a Scottish average of 267.

Expected population change

Community Care

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

Children and Young People

Expenditure on children's Services has progressively increased in the period 1999-2002.

Criminal Justice

Human Resources

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