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Chapter 5 Delivery of key processes

We found that the delivery of key processes was weak - with the key processes showing some important weaknesses.

We saw some examples of good practice in partnership with people who use services and their carers and multi-agency working at the frontline, from a dedicated group of staff.

We found evidence of weaknesses in the availability of information on services and variation in the quality of assessment and case management.

Improvement was required in areas of risk management and accountability.

We saw some inconsistency of practice across the area that could not be explained by geography alone, leading to potential inequalities.

The effect of funding restrictions were seen across the authority.

Improved communications with people who use services and their carers was needed. A more regular review of services once they were in place was also required.

Access to services

Promotion of services

We were provided with leaflets covering a wide range of services. Written information relating to child protection, learning disability and the throughcare/aftercare of young people leaving care was well presented. Information was also available on the council website www.argyll-bute.gov.uk. Again, material on child protection was well presented online. Other support provided by social work services (alongside, in some cases, their partners) had not made full use of this potential link.

Senior managers also informed us that leaflet content was reviewed and updated regularly. However, we found no evidence of effective document control, nor any systematic review of leaflets. Leaflets from social work lacked a single, uniform style.

We heard criticism of the quality of information on services from a number of sources. For example, some members of the community care forum told us that they relied more on word of mouth, via existing contacts in social work, rather than information made generally available to the public. The impact of this on people who use services is discussed in chapter 3. Moreover, our staff survey revealed that over a third of all fieldwork staff surveyed did not agree that it was easy for people to get information about what services were available. Forty-five per cent of carers surveyed held the same view. Results from our survey of people who use services indicated that 38% disagreed that they had found it easy to get clear information about services. This level of disagreement among people who use services was a higher proportion than in almost all the other local authorities surveyed to date. Foster carers we met, on the other hand, were much more positive. They told us that the children and young people they cared for were well supplied with information. This was offset by a significant number of looked after children not having regular contact with their allocated social worker - a theme explored later in this chapter.

Although senior managers advised us that alternative formats and languages were available on request, few of the leaflets we were provided with contained this information.

Availability

In the self evaluation questionnaire, senior managers told us that eligibility criteria were in place 'for many services'. We were provided with examples relating to services for older people and children with disabilities. We also noted the intention of senior managers to review and update eligibility criteria, taking into account the redesign of social work services.

In our discussions with people who use services, and carers, we regularly came across a lack of awareness or understanding regarding eligibility for certain services. We therefore concluded that, in addition to the review and update of eligibility criteria, there was also a need to make significant improvements in communicating this to people who use services, carers and the wider public.

Recommendation 8
The social work service should establish a public information strategy, including producing a comprehensive range of leaflets and complementary web pages. Information should cover eligibility, and the range of services provided.

Responding to enquiries

We found a variable pattern of access to social work services in Argyll and Bute. This tended to reflect local circumstances - frontline staff and first line managers having been able to adapt systems of dealing with enquiries from members of the public - mainly to positive effect. Some area teams deployed an information and advice officer as the first contact - supported by qualified staff. Other, smaller offices offered a generic duty service staffed by either a children and families or community care worker at any one time. Frontline staff in these more rural areas told us that these arrangements tended to work well - occupational therapists and community care workers feeling well supported by children and families workers, and vice versa.

According to feedback from people who use services and their carers, these arrangements generally worked well at first contact. Our survey results reinforced this view - the majority of people who use services (75%) agreed that they got a good response when they were first in touch with social work services where this was within the last two years. However, significant proportions of people who use services (24%) and carers (52%) disagreed - signifying scope for improvement. The impact on people who use services is discussed in an earlier chapter.

People who used services were less enthusiastic about the response they could expect from social work during the day - 60% expressing satisfaction with the service received. The level of agreement was lower than most other authorities previously inspected. We regularly came across people who complained about telephone calls not being returned.

Out-of-hours service

The West of Scotland standby service was managed by Glasgow City Council on behalf of 12 other local authorities. This service offered telephone support and advice and attended social work emergencies in the Helensburgh area only. For the remainder of Argyll and Bute, staff in Glasgow contacted Argyll and Bute social work staff, who provided this service on a rota basis. According to first line managers we spoke to, out of hours duty could have a significant impact on individual members of staff involved - particularly in the more rural areas of Argyll and Bute where fewer qualified social work staff were located. According to staff directly affected, the distribution of qualified mental health officers ( MHOs) in Argyll and Bute meant that there were occasions when an MHO could be on call for up to four consecutive days - a combination of standby and day duty.

Senior managers informed us that public perceptions of this service were 'variable', admitting that during periods of high demand, there had been delays in accessing the West of Scotland service. Around three in ten service users and carers who responded to our surveys agreed that they had received a good response out of hours (a lower rate of satisfaction from service users than in most other authorities to date).

Both police and local GPs had voiced concerns about delays in response from the West of Scotland service. Senior managers had attempted to 'streamline the process' by giving GPs the direct contact telephone numbers of locally based social workers on out of hours duty. Police officers we spoke to were positive about the response they could expect from social work colleagues in Argyll and Bute, once the matter had been referred on locally.

In March 2006 Glasgow published its best value review of the service with an associated action plan covering many of the main areas of concern. Many of the review's recommendations mirrored those contained in a 2003 review of the service. The SWIA inspection of Glasgow City Council social work services ²¹.expressed concern about the lack of progress in this area, recommending quicker progress in implementing the recommendations of the best value report. Equally, we considered that senior managers in Argyll and Bute, as members of the West of Scotland standby service, had a responsibility to ensure that the intended improvements were taken forward, keeping the partnership with West of Scotland standby service under review.

Day-to-day planning and resource allocation

Day-to-day planning, priority setting and allocation

We came across some examples of effective operational planning in teams. This was reflected in the results from our survey, where the majority (66%) of staff agreed that their team had a plan that provided them with a clear direction in carrying out their day to day jobs. Equally, there was an acceptable level of awareness of service priorities - a majority of staff surveyed (64%) agreed that they were equipped with a clear set of local social work priorities.

Generally most operational managers we met were reacting to the impact of the financial moratorium, imposed on social work services in January 2006. One senior manager admitted that the financial crisis that had faced the council had achieved the desired results of reducing delayed discharge and priority waiting lists for free personal care but had resulted in the imposition of a cumbersome system of financial control.

Across the social work service, we were consistently told that the moratorium had had a significantly greater impact on community care services across Argyll and Bute. In community care, managers gave an account of frontline staff having to deal with criticism and complaint from people who used services and carers and the consequent effect on staff morale. There was a perception, expressed to us from various quarters, of community care staff having to continually 'chase the money' - one that was not evident in children and families teams. In looking for the reasons for this, we identified a number of factors, including:

• a higher volume of referrals and corresponding number of requests for finance in community care
• differences in levels of delegated authority between community care and children and families services
• less complex processes involved in allocating resources in children and families services.

In relation to the latter point, we found community care services operating a system of resource review groups ( RRG) in each of the four localities. The RRG dealt with free personal care requests on an inter-agency basis, allocating care home places and care at home packages, based on a single shared assessment. Those requests for a service not referred on to the head of service for approval were reviewed weekly or four-weekly and were prioritised in line with agreed policy. Once a decision was referred to the head of service for decision, managers and practitioners were unclear of the reasons behind decisions. There was also a lack of clarity in how decisions were communicated. This added to the sense of frustration with the process.

In contrast, children and families staff faced a less formal process in accessing parallel resources. In circumstances where consideration was being given to accommodating a child, a multi-agency planning meeting was expected to have been convened, in order to consider the child's needs and, subject to the approval of a service manager, plan the admission. Where a placement out of Argyll and Bute was being considered, referral to the joint management resource group ²².( JMRG) was necessary. However, given that almost all admissions to foster care and residential homes for children were unplanned, decisions were being taken by service managers or, in some cases at team leader level.

These respective approaches carried advantages and disadvantages. The Scrutiny Review ²³.had given an account of managers describing their approach to need and demand as operating on a '…first come, first served basis', routinely leading to '…budgets being exhausted early in the financial year'.

Despite the greater administrative burden in community care, some practitioners and first line managers spoke about how scrutiny from RRGs had raised the standard of written single shared assessments. There was perceived to be a greater sense of joint ownership between health and social work.

On the other hand, unplanned admissions of looked after and accommodated children were not being monitored effectively, with no apparent effort made to understand how or whether they could have been avoided.

Recommendation 9
The social work service should review the system of allocation of resources for care packages at a local level. Building on existing practice, this should include the further development of inter-agency arrangements, and a scheme of delegated financial authority.

In conclusion, therefore, we considered that the resources allocation processes in both children and families and community care required review.

Criminal justice staff and managers reported that the moratorium had had no impact on the services that they delivered. The ring-fenced budget for these services was managed by the criminal justice partnership manager.

Managing workloads

Staff and managers in criminal justice services reported that there were no unallocated social enquiry reports or unallocated cases. Audit Scotland's most recent published statistics (2005/06) largely reflect this - indicating that the service submitted 98.9% of reports to court by the due date and that staff interviewed those sentenced to probation promptly following sentence (seeing 89.3% within one week).

Performance in respect of community service was less positive. Statistics for the period 2005/06 show that it took slightly longer than the national average for people on community service orders in Argyll and Bute to complete their orders. From the accounts of staff it appeared that performance had worsened. Although staff and managers stated that all those placed on an order had an allocated worker (a criminal justice assistant) there could be a wait of several months before people could begin their work placement. Staff described the situation in some parts of the authority as 'dire' and commented that this was due to a shortage of work supervisors ( discussed in chapter 6).

Individual workloads were considered to be manageable by most of the whole staff group (75%) who responded to our survey. More specifically, however, a majority of managers (63%) and just under half (48%) of field workers disagreed with this view. The implementation of the revised management structures proposed by the scrutiny review may begin to address some of the workload concerns.

Senior managers informed us that a workload management tool was in place. The children and families' social workers we spoke to considered that workload management was still being 'rolled out', but those with experience of the system (the minority) were positive.

Criminal justice social workers we met confirmed that they found the tool helpful to highlight pressures and enable workers and their managers to take decisions about priorities. There was no such tool used in community care.

In terms of monitoring the level of unmet need, children and families' first line managers described how they were required to draw any unallocated cases to the attention of the relevant service manager who in turn regularly discussed the issue of waiting lists with the head of service. This approach was justified on the basis that there were relatively few unallocated cases in children and families.

Waiting lists were not evenly distributed across Argyll and Bute. For example, we discovered particular difficulties in allocating children and families cases in Helensburgh, Dunoon and Rothesay. Waiting lists for occupational therapy ( OT), on the other hand, were high everywhere, and whereas high priority OT cases were normally allocated within a week, lower priority work could be on the waiting list for up to two years. We found no evidence that this type of management information was being systematically applied in such a way as to address waiting lists, either at team or service-wide levels.

Managers needed to improve reporting and monitoring of unallocated work across social work services.

Recommendation 10
Building on existing management information, social work senior managers should strengthen reporting and monitoring of unallocated work. From this, there should be a clear set of actions designed to ensure that service priorities are being consistently met, and that any unmet need is clearly and accurately drawn to the attention of elected members.

Transition planning

There was evidence of poor practice in relation to the transfer of case responsibility. Of the 45 relevant case files we read, only 22% contained the necessary transfer summary - this result was significantly lower than most local authorities inspected to date. For young people leaving care, managers told us that throughcare and aftercare services were inadequately resourced, and the progress of the young people not always sufficiently well monitored. Despite this the service performed well in terms of the number of previously looked after children and young people who were economically active. The service performed well below the national average in pathway planning. Equally, there was an acceptance on the part of managers that the management of transitions, and the case transfer from one part of the social work service to another, required improvement. This was also borne out from our file reading. In the 10 case ²⁴.files looked at where transition was featured, we found that:

• in four cases, there was no evidence of involvement from the person using services or their carers
• in three cases, there was no record of involvement from other agencies normally involved in transition planning
• six of the ten files contained evidence that the transition had been well handled.

Assessment and case management

Assessment of need

In a number of respects, assessment practice in Argyll and Bute was consistent with that found in other local authorities to date, in that:

• most (85%) case records contained an assessment
• most (84%) had been completed in the last 12 months
• the type or level of assessment was in keeping with the needs of the service user in most (89%) of these cases.

We evaluated the quality of the assessments on file according to our 6-point scale. In doing so, we found that a majority (52%) of the assessments contained in 88 applicable files were rated good or better. This result was significantly lower than most of the local authorities inspected to date.

In examining the quality of criminal justice practice we used a file reading template designed specifically for criminal justice social work services (one used in the national programme of criminal justice inspections). Findings here largely mirrored those in the wider sample. Half of the social enquiry reports we read were of good quality (i.e. they provided a good assessment) and there were no poor reports. However, there was substantial room for improvement in the remaining half of the sample.

In view of this, the standard of assessments across the service areas required improvement.

It was too early to see any comprehensive benefits that may have been derived from the additional training delivered to staff on care management and assessment as a result of concerns expressed following the advance file reading in November 2006.

Sharing information with people who use services was mixed. In our survey of people who use services, around half (53%) agreed that they had seen written assessment of their needs. This result was reflected in comments we received during our fieldwork.

Community care

A single shared assessment tool (CareNap) had been adopted by social work and health in Argyll and Bute. We met with health and social work staff who were committed to the implementation of single shared assessment and who demonstrated a good understanding of the assessment process and identified benefits to them and to people who use services.

One of the difficulties we heard about across the authority was that an electronic version of CareNap was not readily available to all frontline health staff or that suitable computers were not available in workplaces. The methods of overcoming this were said to be time consuming, according to some frontline staff we met. The partners had responded to these concerns. The council and the CHP had recently agreed to jointly use Care Assess (when it is fully implemented), initially on a restricted basis.

In Dunoon we heard about an emergency 23 hour assessment bed in the local hospital where health staff initiated the assessment of the service users' needs with social work staff contributing to or completing the assessment to ensure completion within the 23 hour period preventing hospital admission.

We heard from the joint mental health planning group that a person-centred multi-disciplinary patient assessment tool had been delegated to health staff to develop and design and was out for consultation. We understood that this piece of work had taken a long time to complete and had not made use of the experience of staff in the learning disabilities' day services who had been using a similar approach for some time. It was agreed that this group of staff would be included in the consultation but we considered this to have been a missed opportunity. Staff within the council said that progress had been frustrated by the delay.

Children and families

The self evaluation questionnaire prepared by the council stated that there were revised assessment and care planning frameworks for children affected by disability and youth justice being embedded into practice. In addition to this, the children in need assessment tool was in the process of being updated to an inter-agency single shared assessment tool. The revised tool was being piloted in one locality at the time of the inspection.

The new assessment tool for children with disabilities included eligibility criteria and a carer's assessment. It was linked to a model of staged intervention and aimed to prevent crisis through accurate assessment. The intention was therefore to address some of the difficulties the council had experienced and reduce the need for expensive crisis placements. We met parents who were very positive that their needs and those of their children had been well assessed using this method. Workers from the pilot assessment team and other frontline staff were also positive.

Care planning and review

There was a care plan or equivalent in the majority (74%) of files read. Almost all (93%) care plans had been completed within the last 12 months and the care plan addressed most of the risks and needs identified in the assessment in most (79%) of the cases. These figures were comparable with other local authorities inspected. No statistical difference was found to exist between community care and children and families files.

From our surveys, nearly 40% of the people who use services disagreed they had been given a clear plan to describe the services they were due to receive and 43% of carers who responded disagreed that there was a clear plan that described the services that the person they cared for would receive. In community care services, we heard evidence from a number of sources of delays in sharing information. For example, we heard from independent providers that they regularly received referrals with no assessment. These results were reflected in our fieldwork where we came across a wide range of opinions. Several groups of carers and people who use services expressed disappointment at the lack of regular contact and written information from their social worker. On the other hand, individuals we met as part of our observation of social work practice were generally satisfied with the way information had been shared with them.

In our small sub-sample of criminal justice cases we found evidence of good planning in all the cases we read but found that these plans tended to drift over time. In just under half the cases there had not been as much contact with the person being supervised as there should have been and staff had not always carried out required visits to people's homes to check on their living arrangements. In chapter 6 we describe the quality assurance arrangements in place in criminal justice social work services. In view of the findings of this (albeit small) sample the service needed to revisit these quality assurance arrangements to ensure they were robust enough.

In children and families, residential staff told us that it was common for them not to receive completed assessments when young people were admitted - given that the majority of placements were unplanned. Foster carers, on the other hand, held positive views about the information they received at the beginning of a placement. In our observations of practice we found care plans to be lacking in detail and not linked with assessment. We were concerned that there were gaps in permanency planning for young people, including clear analysis of work with parents who misuse substances.

Recommendation 11
Service managers should ensure that all care plans including looked after and accommodated children and adults have clearly targeted outcomes which are monitored and reviewed.

Risk management and accountability

At the outset of this inspection, senior managers made the following claim:

'The safety and protection of all individuals is a prime consideration for the social work services and we manage risk in a structured and robust manner.'²⁵.

There was evidence of significant effort in introducing a range of policy and procedural initiatives, across a number of partnerships. These included:

• child protection procedures and a number of associated protocols
• adult protection procedures (in the process of being introduced at the time of our inspection)
• adults with learning disabilities: a policy for managing behaviours that challenge services
• Committed protection - aimed at minimising risk posed by serious sex offenders.

This activity constituted some evidence of a structured and systematic approach to the assessment and management of risk. Our survey of staff revealed 80% of staff agreeing that they had clear guidelines to follow when dealing with risk either to or from people who use services. Despite this, however, the application of policy and procedure was inconsistent.

Indeed, recent inspection and consultancy had revealed significant areas for improvement in the way the social work service dealt with risk. The Scrutiny Review, for example, had revealed:

'…a complex and fragmented system of accountability...within adult services. From interviews carried out and from experience working with managers within adult services, there emerged an element of confusion as to who is accountable for what parts of the service'.²⁶.The revised management structure aims to address these concerns.

In their inspection of the performance of partner agencies in child protection, ²⁷. HM inspectors of education found the recognition and assessment of risk and need across the partnership to be adequate. More specifically, the standard of social work assessment of risk was inconsistent, despite the application of a standard risk assessment tool.

In the course of our reading of case files, we came across 24 cases where the protection of the person using services was an issue. Of the files read, only one out of six adult files and seven out of 18 children files contained an up to date risk assessment. Only one of the six adult files and five of the 18 children's files included a risk management plan.

In adult services, there was a reliance on the single shared assessment format to deliver risk assessment where appropriate. In children and families, there was no evidence of a systematic or standardised approach to risk assessment, other than that used in child protection.

Since the service upgraded CareFirst seven months previously, criminal justice staff had had little or no access to the system, including some who were unable to view the service's client index system. This meant that they were unable to check whether people they were working with (who might potentially pose a danger to others) or their families were known to other parts of social work service. Other staff in turn could not readily check what work was underway with people subject to orders. Managers stated that the service would be resolving this issue soon by installing new software that would afford access to the client index system but there were no immediate plans to allow greater access to the system for criminal justice staff.

We therefore concluded that there was significant need for improvement in this area.

We were also concerned to find major gaps in IT access that had an adverse effect on the flow of essential information.

Recommendation 12
The social work service should develop and implement a systematic and comprehensive approach to the assessment and management of risk, building on the work carried out to date in relation to child protection, adult protection and criminal justice services.

Partnership with people who use services and their carers

Involvement in care planning and service delivery

During our inspection, we came across a number of groups of carers and people who use services. These included young carers, parents of children with disabilities and people who used mental health support services. We also learned about service user representation on groups such as the community care forums. In some parts of Argyll and Bute, the role of the local area coordinator (in learning disability services) came in for particular praise, as a means of promoting the views and interests of people who use services and their carers.

Good practice example
The Youth Justice Co-ordinator, in partnership with FUSIONS, hosted annual "reducing youth offending" seminars in six localities across Argyll and Bute to promote partnership working. The seminars were attended by a wide range of representatives from local agencies and community groups and were a focus to raise awareness and promote shared ownership of actions. Those attending reviewed the progress of recommendations from the previous year's seminar, considered the analysis of data on offending for their area, and developed a local action plan to address specific localised issues or emerging trends.

In criminal justice services, some effort had been made in 2004 and 2005 to monitor and evaluate the views of people who had been subject to supervision. There was no evidence of similar recent activity in other areas of social work services.

Despite some appreciation for the support provided by Argyll and Bute Council and other bodies in facilitating such activity, we detected a general level of frustration arising from this type of activity. These views were echoed in the results from our surveys. For example, less than half the staff surveyed (44%) agreed that the experience of carers was fully taken into account in planning services.

However, evidence that the experiences of people who use services and their carers had been taken into account in service delivery were more encouraging, in that:

• case files revealed evidence that the views of individuals had been taken into account in almost all (94%) cases
• a majority (67%) of carers agreed that they had been fully involved in deciding what help or services the person they care for should receive. A similar proportion (55%) felt consulted and listened to
• a majority of people who use services (66%) agreed that they had been fully involved in deciding what help or services they should receive, although less than half (41%) felt that they had not been given choices about the type of service they receive.
• the Carers' networking board had developed a revised carers' self assessment which could be completed by a social work or health assessor or on a self assessment basis as the determinant for accessing carers' support.

Inclusion, equality and fairness in service delivery

Overcoming barriers to equality and fairness

As stated earlier in this chapter, the quality of information to the general public on the range and availability of services required improvement. This lack of basic information could impact on those affected by obstacles arising out of disability, geography, ethnic minority status, culture and language, despite the reported availability of translation and interpretation services.

From the surveys we conducted as part of this inspection, there was an indication ²⁸.that, in general, the best possible outcomes in terms of independence and social inclusion were not always being achieved, in that:

• a majority (69%) of people who use services agreed that social work services had helped them lead a more independent life. The level of disagreement (23%) was more than 10% higher than any of the local authorities previously inspected, where the level of disagreement varied from 3% to 13%
• a majority (57%) of people who use services agreed that social work services had helped them feel part of the community. Again, disagreement was in the higher range when compared with the local authorities inspected to date.
• less than half (42%) of the 57 people who responded to a question about racial or cultural background agreed that social work services understood important matters about racial or cultural background - a level of agreement 10% lower than that recorded in most of the authorities previously inspected.

In relation to this last point, managers claimed that '…culturally sensitive services are consistently delivered to meet the specific needs of service users'. We were told about staff being '…trained to work with minority ethnic groups in a culturally sensitive manner that can be equally applied to our small and remote rural and Gaelic speaking communities'.

In direct discussion with staff, we heard that in some of the more remote areas of Argyll and Bute, people who use services were put at a particular disadvantage. This included difficulties in maintaining contact for looked after and accommodated children, and issues for people detained under the Mental Health (Care and Implementation) Act - the suggestion being that thresholds for being detained were lower than elsewhere. In our staff survey, over a third (37%) did not agree that there was a fair geographic coverage of social work services within Argyll & Bute. This was similar to other rural authorities inspected to date.

We also saw positive steps being taken, for example by criminal justice staff working in Oban alongside Jobcentre plus to help offenders overcome the barriers to employability and link them into work through improved support and access to information.

Multi-disciplinary working

Safeguarding vulnerable people

According to the inspection carried out by HM inspectors of education (referred to earlier in this chapter), the child protection committee in Argyll and Bute had '…clear processes in place to ensure that services are well coordinated and for ensuring that procedures are applied consistently'. HM inspectors identified partnership working between services to be a key strength, providing supportive interventions and responses for children, young people and their families.

In relation to the protection of vulnerable adults, senior managers were of the opinion that the newly formed adult protection committee had made a 'good start…already seeing the impact of this in relation to multi-disciplinary working with a number of vulnerable adults'. It was too early in the process for the inspection team to evaluate this impact.

In criminal justice services, the high risk offender forum met every four months. This multi-agency group which included a range of stakeholders including housing services, was viewed as a positive way of monitoring and reviewing high risk offenders and policies in relation to them.

Effective multi-disciplinary working

A number of examples of effective multi-disciplinary working are spread throughout this report, as well as areas where improvement was required. For example:

• The children's reporter described effective joint working between education and social work services around pupil support units in schools - particularly where there was a social worker linked to the school
• FUSIONS was generally regarded as having a positive influence on joint working at the point of service delivery - bringing together education and social work frontline staff in a number of localities under an area integration manager
• The North Argyll joint equipment store - the first of four stores to be integrated - provided a comprehensive ordering, collection, delivery, cleaning and re-cycling service, accessed by frontline staff in both health and social work. Both the manager and staff were very enthusiastic, and were able to demonstrate tangible improvements in service delivery, and plans to improve the service yet further
• We observed a community care team meeting which comprised of colleagues from community health and a local voluntary provider as well as social work staff. The meeting held a number of purposes: allocating work, progressing updates on current cases and information sharing on policy and procedural matters
• In substance misuse we observed an example of the advantages of co-locating health, social care and voluntary sector agencies. These agencies worked together to support people to address their substance misuse providing rehabilitative support in overcoming barriers to employment and homelessness, as well as other social exclusion issues
• The Drug and Alcohol Action Team funded two temporary social work posts. These post-holders had a 'bridging' role with social work child care where service users had dependent children. Partner agencies told us how valuable the role had been in optimising collaborative working relationships.

Backing this up, we found positive attitudes to multi-disciplinary working in Argyll and Bute, in that:

• a majority of staff agreed that their team had a good working relationship with education (62%), housing (68%) and other social work services (68%)
• most staff (77%) agreed that they had a good working relationship with health services
• there was evidence of multi-agency working, with clearly stated roles and responsibilities, in a majority (70%) of files read.

Managers and frontline staff we spoke to working in the more remote communities in Argyll and Bute described the development of positive multi-disciplinary links. However, other social work staff we spoke to (in one of the more populated areas) described the reluctance of a small number of health staff to refer concerns regarding children directly to the social work service and how they were taking steps to address this.

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