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Short Reviews of Social Work Services in Scottish Local Authorities

West Lothian Council

Overview

West Lothian is providing a range of social work services to a population that has changed a great deal. The overall population has increased sharply, mainly from people moving into the area. The proportion of children and young people has grown, and older people now account for a smaller share of the total. That picture is set to change in the period to 2016, when older people will gradually account for a much larger part of the population. The effect on service needs will continue to challenge the Council. The vision is for everyone to have ready and easy access to services that are improved by modern technology wherever possible.

The Council's achievements include:

• greatly reducing the waiting times for assessing people with physical disabilities;
• increasing the rate of home care for older people, which extends to 20 hours and over a week;
• supporting a range of foster carers to provide homes for children, some with serious problems, both from West Lothian and other areas;
• developing a range of throughcare support for young people who have been looked after by the Council, including preparing them for work and further education and getting suitable accommodation for them;
• making sure that staff are well prepared and trained to carry out their professional work in the various branches of social work service, in particular staff working with children and families; and
• successfully introducing Free Personal Care.

West Lothian Council needs to take urgent action to:

• greatly increase the number of looked after children and young people who attain Maths and English standard grades, to meet the target of 100%;
• make sure that all looked after children and young people are in full-time education; and
• work to meet standard 3 of the time intervals standards for children's hearings, particularly to achieve the target of 75%.

The authority should also give priority to:

• tackling the effects of introducing the new Mental Health Act, along with partner agencies, carers and voluntary organisations;
• developing shared assessments and recording information to help plan services that will meet people's needs;
• keeping up efforts to recruit and provide foster carers, drawing more from areas other than Livingston ;
• increasing the range and quality of services for children with disabilities, to meet local needs;
• improving recent efforts to reduce sickness absences among staff;
• recording information directly onto its information systems;
• introducing the new information system from April 2004; and
• speeding up its joint working arrangements with Health.

Community Care

Services for older people

The number of older people receiving a service continues to grow. Between 2000 and 2002, the number of people receiving a home care service reduced gradually but the number receiving 20 or more hours a week increased significantly from 28 to 55 between 2001 and 2002. Following a large drop in the number of people in special needs housing between 2000 and 2001, the number increased significantly in 2002.

In 2002, 375 people received a follow-up support service for an average of 15 days. The service was provided by a comprehensive rapid response team, made up of a team manager, two leaders (one social worker and one nurse), two occupational therapists and 16 health and care staff. It is estimated that 1,700 bed days were saved. The Council evaluates the effects of the service on a regular basis and are now monitoring year on year trends against the first year of operation.

The shopping service is being used less than expected (the service has remained static, despite advertising). Possible reasons are:

• older people prefer family members to shop for them;
• fresh food is available through the personal care service;
• people can shop on-line; and
• limited opportunities for growth.

The shopping service has been extended to people who want to use the service but who do not want to become users of social work services more generally.

After inviting contractors to tender for the contract for intensive home care services, the Council awarded three block contracts to three suppliers, covering evenings, weekends, personal care and complex needs. The Council intends to build on the review of its in-house services to create an intensive support service to meet future needs and to make sure people have consistent carers, where possible.

A new home meal service has been successfully implemented which offers a choice of menu, seven days a week (including public holidays). This service has been evaluated and has demonstrated high levels of user satisfaction.

The number of people receiving respite care services increased from 255 to 336 in 2002-2003, with less residential respite care, but more care at home. The number of people going into residential respite care went down from 152 to 110.

The introduction of Free Personal Care highlighted some issues about contracts and the need for service providers to agree to the contracts that are involved with the new scheme.

Services for people with learning disabilities

A small number of clients (some from outside West Lothian) live in health care houses and need forward discharge plans.

There are 105 people with learning difficulties in small care homes. This number is planned to fall to 85 after restructuring. Of the people discharged to West Lothian from Gogarburn Hospital, 64 of them are resettled into registered care homes with between three and six people in each unit. An 11-bedded unit (which opened before Gogarburn closed) has been restructured into an eight-person unit, and it will be further restructured into two four-person units.

A 'Partnership in Practice' agreement, including partners in health and carers forums, is in place for 2001-2004. There is a small team of local area co-ordinators for adults and for young people moving into adult services. The team is made up of one whole time equivalent team leader and two whole time equivalent local area co-ordinators. As well as other developments, day services are being developed to include small non-centre-based outreach groups of eight people in local areas. The aim is to have around 125 people using outreach groups. It is expected that around 110 people will still need some form of structured day care, due to challenging behaviour or profound and multiple disabilities. An increasing number of the people with profound and multiple disabilities need invasive health procedures, such as Peg feeding, suction and the administration of rectal Valium.

Interest in Direct Payments is steady, although lower than expected. This may be due to a high level of satisfaction with existing services. The Direct Payment Scheme is being independently evaluated.

Services for people with physical disabilities

The number of people with a physical disability receiving a service has increased by 10% since 2000.

Under a scheme in place since 1997, 16 people receive Direct Payments, which are automatically offered to them when they are assessed. Support is available from Lothian Centre for Independent Living. However, interest is falling and the Direct Payments initiative is being independently evaluated.

Waiting times for assessment for equipment and adaptations have been reduced from nine months to four weeks. The target time for providing items of standard equipment is two weeks, but there are waiting lists and priorities. Self-assessment is available for small adaptations, but larger ones (such as ramps) involve waiting times. Some final decisions are made by occupational therapy staff. The Council needs to develop systems to monitor and improve waiting times for all equipment and adaptations.

People with sensory impairment

There are no figures available for the number of people with a sensory impairment or for the number of people receiving a generic service, such as home care. So services are planned on the basis of national figures.

West Lothian is developing training to make staff more aware of people's sensory needs. The Council also has a link with the Royal Blind School to help young people move into adult services.

Services for people with mental health difficulties

To meet the legal duty (under the new Mental Health Act) to provide a range of community support services for people with a mental disorder, the Council has set up a joint planning process, involving an active mental health forum. 50 to 60 tenancies have been taken off the register and 170 people will be supported by the end of 2003.

There is a training café which leads to employment opportunities and the local further education college provides lifelong learning opportunities. A new high support unit has been formed to help people move from long-term hospital care towards supported living. A new Council day centre has opened and an old Health-funded centre has been refurbished in the Strathbrock Partnership Centre to double the Council's day service capacity and to increase the total capacity by a third.

The Council has not yet dealt with the practical implications of introducing the new Mental Health Act .

A joint mental health management group makes important decisions on services and management. Jointly-managed Community Mental Health Teams (which include social workers, but no therapy staff) provide services to 110 to 120 people with long-term mental health problems in the community. Development work is required on shared assessment and recording information.

Tackling substance misuse

The number of people receiving a service for drug and alcohol misuse almost doubled from 28 to 53 between the period of 1999-2000 and 2001-2002, but the rate remains relatively low.

A social work drugs team, made up of a manager and two social workers, offered brief interventions to 239 new clients in 2002. The 2002-2003 budget was increased to respond to growing demands for good rehabilitation and to meet an increase in the number of people injecting drugs, more families needing help, and improvements needed to the way information is recorded. Services are provided from three locality units, with more and more GPs taking part. Waiting lists have been reduced from five weeks to zero.

Demand for residential rehabilitation was high at first but, as part of a more flexible response which will encourage joint working, partners are developing joint criteria for using residential rehabilitation. Demand for this service is now falling, possibly because of the alternative interventions offered by the social work drugs team.

A new project is planned for families who misuse substances, through the New Opportunities Fund in association with the social work drugs team.

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 still being progressed. The local partners were recommended to:

• consider the future remit of the Joint Future Steering Group and how high level political and NHS leadership will be maintained;
• implement joint management arrangements and make real the innovative service clusters that are proposed;
• develop a fuller scheme of accountability and delegation in line with the proposed single management arrangements and service clusters;
• consider joint policy on service/clinical governance and the joint handling of complaints in line with the proposals for innovative joint services;
• review the guidance published on 1 January 2003 in relation to Part 2 of the Community Care and Health Act in order to consider whether there is scope for further delegation/pooling etc;
• submit a joint OD/training plan;
• provide details of the remit and membership of the Joint Staff Forum;
• further develop financial management arrangements to address operational arrangements and financial protocols for operational arrangements; and
• agree a statement of a joint resourcing operational budget for older people's services.

On the ground, a single manager is proposed for primary care services (not including GPs, dental services or children services). This appears to have had a positive effect on the system. There are joint working arrangements in community mental health teams, mental health day care services and community rehabilitation acquired brain injuries services (CRABIS). A new care home provides two new 20-bed units, run by the Council with health staff. An intermediate care facility is proposed for older people, with some mental health after-care proposed within a new care home.

Information is held on paper and is shared when needed. An electronic solution to sharing information is being piloted in the Strathbrock Partnership Centre. A protocol has been agreed on sharing information. It is hoped that an electronic information version of Carenap will be available by January 2004.

Working with Carers

Services and support to carers include day care, enhanced personal care, respite care and Direct Payments. Carers of West Lothian, jointly funded by the Council, NHS and Princess Royal Trust for Carers, provide advice, information, support and advocacy. In assessments, carers' views are recorded as a matter of routine and any unmet needs or differences of opinion are highlighted. The service does not seem to have attracted any criticism from the 600 to 700 known carers. Carers of West Lothian are also involved in planning services.

A West Lothian respite directory has been produced and a three-year Outreach Team has been set up to work with West Lothian's 'hidden' carers (estimated to be between 2,000 and 3,000). The Community Fund provides financial support for the team.

Children and Young People

Looked after children

The number of children and young people who are looked after increased between 2001 and 2002. A local investigation found that:

• drug and alcohol misuse was a major reason for children being looked after; and
• young people were also being looked after and accommodated for longer than before.

Numbers have since reduced - in February 2003 there were 192 children and young people being looked after at home, 200 with foster carers, friends or relatives, and 37 in residential accommodation. This change is due to the effect of early intervention initiatives, such as Surestart. Respite care services have been developed and community respite care can be offered for six days a week from 7am until 10pm if it is needed. Family centres provide respite for children aged five and under.

Fostering and adoption

A total of 18 children are currently waiting for a foster place. Of those children:

• eight are in foster care awaiting transfer to another placement;
• six with particular difficulties are in residential accommodation; and
• Fewer than five are at home, but the Council is able to meet emergency provision where this is needed.

Twice a year, the Council runs local campaigns to recruit foster carers, but experience shows that most carers are recruited by word of mouth. There are 85 carers at any one time and, although this number usually meets the needs, some children have been waiting a few months. Problems can arise in matching children to carers, as half of all West Lothian's foster carers are in Livingston. A number of carers have more placements than they are approved for. West Lothian frequently provide places to Edinburgh and other authorities.

Two years ago, the Council introduced a programme to pay foster carers for their skills. Carers come in at level 1 and can move to level 2 after about two years if they attend training and have positive reviews. Their fee will then be doubled. There are a few specialist carers at level 3.

Fewer than five children are waiting for an adoption placement. The rest have been linked. The Council has a service agreement with St. Andrew's Adoption and Scottish Adoption Agency.

Educational attainment

Fewer than five 16 to 17 year olds stopped being looked after in 2001-02 in West Lothian, so no figures are available on their educational attainment. The Council has set a target of 50% achievement by 2005.

The Council has taken a number of measures to improve the attainment of children and young people looked after, namely:

• it has provided joint training for staff on the joint social work and education policy for children and young people who are looked after;
• a teacher with special responsibility for children and young people who are looked after is targeting attainment in S3 and S4 in each secondary school;
• an alternative flexible curriculum has been introduced for children and young people who are looked after;
• the attendance and exclusion rates of children and young people who are looked after are being tracked;
• the extended curriculum officer encourages schools to include children and young people who are looked after in study school, after-school clubs and summer schemes;
• secondary schools have depute head teachers responsible for social care; and
• the policy on exclusions has been rewritten.

Up to six children and young people who are looked after are not in full-time education. A senior social worker monitors care plans, including the educational part.

Throughcare and Aftercare

The throughcare and aftercare team becomes involved with young people when they are 14 ¹/ ₂. Looked after Children materials are used until they are 16, and their records are the basis for their 'pathway plan' for the next two to three years. This becomes a moving-on plan once suitable accommodation is found. Young people have the opportunity to complete their own plans. The throughcare manager is responsible for putting the plans into action.

By working with voluntary organisations, the Council can offer a range of accommodation for children who have been looked after including:

• supported accommodation, with associated outreach services;
• special lets;
• emergency accommodation;
• short secure tenancies; and
• emergency supported accommodation.

There is also a supported landlady project and a rent deposit guarantee scheme.

The 15 to 24 scheme for supported employment is operated by three support key workers for young people with special needs and those leaving care. Children and young people who used to be looked after and who are homeless can use the scheme.

Mental health

To help meet the mental health needs of children and young people who are looked after:

• a nurse has responsibility for their general health;
• to overcome the history of long waiting lists for CAMHS services, new appointments have been made to vacant posts, including some with a specific responsibility to support young people;
• the Young Person's Healthy Living Project (with Children 1st) is directed to excluded and minority groups; and
• a community psychiatric nurse has been seconded to the youth housing team for throughcare.

Child protection

The number of children referred for child protection and added to the child protection register reduced in 2000-2001, but increased again in 2001-2002. A review of the children who had been on the register for more than two years resulted in such cases reducing to nine (10.7% of the number on the register). This reduction accounted for some 20% of the children removed from the register in February 2003.

The Council is taking action to introduce the recommendations of the Child Protection Review, including:

• setting up a series of seminars to make staff aware of up-to-date research;
• revising how information is recorded and drawing up plans for sharing information across agencies;
• advertising a job auditing and reporting on work each year;
• preparing a multi-agency protocol on assessing risk and need of newborn babies born to parents who abuse drug or alcohol (all babies who come through the special care unit will be subject to inter-agency assessment); and
• making it easier for children to get contact information, through the work of the children's rights officer and the local child protection inter-agency group.

Children with disabilities

The specialist disability team (made up of one senior social worker and four social workers) works with 200 children from 189 families - an increase from 120 families in 2001/2002. The number of children is expected to increase further as a result of the expected rise in population and longer life expectancy for disabled young people. Particular increases are in children with very complex needs and children with autistic conditions.

The Council cannot find suitable placements in Scotland for some children with very complex needs. Expensive care packages for children with complex special care needs have led to less respite care being offered. The Council currently provides 11,000 hours of respite care at home to around 60 children.

Working of children's hearings

All referrals are made within five working days of the case conference (standard 2). 57% of reports are submitted to the reporter within 20 days (standard 3). This performance is better than many other authorities, but well short of the 75% target. Despite taking on locum staff, the shortage of social workers last year affected the level of reports that could be submitted on time. All supervision requirements with no condition of residence are given effect within 15 working days of issue by the children's hearing (standard 15).

Youth Justice

The Council is following up various intervention projects, many of which are bought in from voluntary organisations (the last three below are for persistent and serious offenders). The projects are:

• group work based on particular issues (for example, parents' group, anger management, self awareness);
• a restorative justice project from SACRO (referrals come through the Reporter);
• social inclusion funded projects;
• the ECHO project which offers individual-focused work with young people who are persistent or serious offenders;
• Barnardo's Lighthouse Project work with young people who show sexually-aggressive behaviour; and
• intensive support (24 hours a day, seven days a week) packages including intensive care and education support packages and residential and community care packages.

Criminal Justice

Structure

City of Edinburgh, East Lothian, West Lothian, Midlothian and Scottish Borders operate as a partnership for delivery of criminal justice social work services. The work of the Consortium is overseen by a Convenor's group, composed of elected members from each authority. An inter-council justice forum of service managers and planning officers has responsibility for co-ordinating strategic and service planning and reports to an Extended Joint Liaison group, consisting of Directors/Heads of Social Work. Individual service managers take responsibility for particular areas of service development.

Workload

Across the Consortium, there has been a significant increase in demand for core services over the past year, with social enquiry reports rising by 16%, probation orders by 25% and community service orders by 32%. While all constituent authorities have experienced an increase, there are variations. West Lothian has seen a 23% increase in social enquiry reports, Midlothian an increase of 64% in community service orders, and East Lothian a rise of 31% in probation orders. Performance is generally good and improved in some areas although in others less so and is a reflection of the increases in workload coupled with earlier staffing difficulties. East Lothian, for example, had particularly acute staffing problems last year but has been making considerable efforts to improve performance on the submission of SERs.

Effective practice

The Consortium assesses the risk/needs presented by offenders using LSI-R, the Scottish Executive's risk assessment framework and the Dunscore risk of custody scale. There is a general move towards integrating structured offence focused programmes, including those for young offenders, using a modular approach into probation work in the teams. Specialist programmes are in place for issues such as drugs misuse, including West Lothian's DUO programme and the Scottish Borders' Turning Point module. The Consortium plans to submit programmes such as the Scottish Borders' "Time to Change" programme for accreditation.

Future service developments include plans both to widen the range of community service placements affording direct contact with recipients and opportunities for female offenders (as well as extending availability at weekends). Increased use of community service as a high tariff disposal requires recruitment of the appropriate staff. There are also implications for delivering this service in rural areas. The value of the relationship between staff and offenders undertaking community service is recognised and pro-social modelling training has been delivered to community service staff.

Bail services are being developed across the Consortium and the Drug Treatment and Testing order scheme has extended to Midlothian.

Public protection

The work undertaken with sex offenders by criminal justice teams is supported by the Community Intervention Service for Offenders (CISSO). The Consortium intends to identify and introduce an appropriate risk assessment tool for use with sex offenders such as TayPrep 30. A joint police protocol for working with sex offenders has recently been reviewed. Edinburgh's Resettlement team supervises a sizeable proportion of registered sex offenders and other high risk offenders seeking to resettle in Edinburgh at the end of long prison sentences. Voluntary assistance for other ex-prisoners is provided by Edinburgh, West Lothian, and Midlothian in partnership with SACRO. Some councils access Employment services through Apex for those on supervision.

Services to mentally disordered offenders are planned through the Lothian and Borders Mentally Disordered Offenders' Group, attended by all authorities. A medium secure facility has been developed in Edinburgh, with dedicated social work services on site.

Much of the supported accommodation across Lothian and Borders is located in Edinburgh and forms a resource for other authorities in the Consortium area. There have been significant developments in the provision of such accommodation, including focusing the Albrae project on high risk offenders and a planned intensive supervision service in partnership with a voluntary organisation.

Quality assurance

The authorities use a variety of methods to monitor and evaluate their work and are at different stages of carrying out Best Value reviews of their services. The councils have developed different approaches to meeting the information needs of criminal justice services.

Human Resources

Structure of the workforce

Between 2000 and 2002, there was an increase of around 20% in the numbers of whole time equivalent fieldwork staff working with children and in staff classed as generic. There were also increases in the social worker posts (main grade and first line managers), totalling 19 whole time equivalent staff.

In the same period, fieldwork staff vacancies went down from 27 to 17 whole time equivalent, a pattern matched for social work staff, with a fall in vacancies from 18 to nine whole time equivalent.

The latest figures provided by the Council but not yet confirmed suggest that, between October 2002 and the end of June 2003, vacancy levels for social work posts have increased significantly, rising to 23 whole time equivalent, representing 18% of their establishment.

The average length of stay in social work posts is five years, with only one appointment from outside the department in the last seven years to a first-line manager post. Main gaps are in senior social worker posts in older people's services, in children and families (five vacancies out of 68 staff) and in personal care workers. Turnover of staff is high in some areas of work (in 2002-03, Children and Families saw 11 new staff join the section and 12 leave). There are difficulties in recruiting older staff and as a result their workforce were relatively young and new to the work, with more than half in post for four years or less.

The Council developed a reshaped package for all senior and main grade social workers, which was discussed with the trades union. This package has now been approved and will be introduced.

They were actively exploring teams with a different mix of skills, including education welfare officers, community education workers and others.

Support for staff

In 2002, over 14,000 days were lost in the social services department through illness. The Council has acted to deal with the problem by:

• confirming its Investors in People status;
• providing all social workers with mobile phones and access to free counselling;
• seeking early medical advice, to manage absences better; and
• regular briefing sessions by senior managers with staff, to deal with the high levels of stress and psychological problems.

Working towards a more highly qualified workforce

All staff have work plans setting out their training and development needs. Features of how these needs are met include:

• an Intranet site ('Access Learning'), listing resources on training and development;
• the Social Policy Learning and Development Strategy and Plan 2002-2003, giving staff in various categories clear guidance on the training they need, together with course programmes;
• mental health and child protection training that meets high standards of practice; and
• meeting targets for placements (this is linked to succession planning and regular secondments to meet service needs, which are also actively viewed as opportunities for staff development).

Preparation for registration

The Council does not know how many staff already have the level of qualifications needed to register with the Scottish Social Services Council. At the time of the report, it had written to 180 eligible staff, encouraging them to register, but there had been a low take up. A manager passport scheme is being developed, based on the main skills needed for all manager posts. The local authority expects that around 31 staff will need to be registered in the first phase.

Race Equality

In West Lothian, 1.4% of the local population are from a minority ethnic group, compared with 2% for Scotland as a whole.

A Race Equality Scheme for the Council (2002-2005) has been produced and a detailed action plan sets out the issues it needs to develop further. A corporate working group on equality is in place. The group monitors the race equality scheme and provides an opportunity to share good practice.

Use of Information Communication Technology(ICT)

Social Services Department

The Council has made significant progress to give social work staff access to the Intranet and Internet. All social work staff now have access to the Intranet and nearly 80% to the Internet. Staff complete Personal Development Plans (PDP) on-line and use the on-line Access Learning to choose courses and training. The relatively young workforce are familiar with using ICT and managers report they are keen to develop its use further.

Partnerships

There are good examples of ICT being used by the department and in partnership with others, Examples include the following:

• The smart homes project. The Council has provided new smart homes and extended technology to a number of others. The smart housing project was originally tied into changes the Council was making in residential care and with community houses. It includes a one-stop shop type of call centre for older people. The aim is now to link the project into the whole range of other supports for older people in the community.
• Single Shared Assessment, putting in place the technology to support the electronic assessment.
• The Strathbrock project, which will be much wider than the Single Shared Assessment. It aims at a shared process of referral, screening, prioritising, assessment, service commissioning and review. It will bring together health, housing, education, social work, GPs and community health workers. This initiative may be an excellent example for effective joint working.

Progress is being made on protocols for sharing information and on systems to give planning partners joint access to shared information.

Background Profile

West Lothian is a diverse geographic area, with a mixture of communities, villages, towns, older burghs and a new town. During its rapid growth - particularly in the Livingston area - it has attracted a considerable number of people who commute to Edinburgh. By 2016, the area is expected to grow slightly, compared with a fall nationally.

There are relatively well-off areas close to Edinburgh but there are also deprived areas, especially in the former mining areas of the south west, where there are higher levels of unemployment and households on low incomes.

Spending for every person on social work in West Lothian for 2001-2002 was 229, compared with the Scottish average of 267.

Expected population change

Community Care

Expenditure on community care has grown steadily in the period 1999-2002.

Children and Young People

Expenditure on children's services has shown a comparatively small drop then a slight increase in the period 1999-2002

Criminal Justice

Human Resources

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