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CHAPTER 6 Management

This area looks at three areas for evaluation:

• Policy and service development, planning and performance management
• Management and support of staff
• Resources and capacity building

Policy and service development, planning and performance management

We considered performance in this area to be adequate with strengths just outweighing weaknesses.

Strategies and plans for adult services were underdeveloped. They needed to be updated with the accompanying partnership agreement to shift the balance of care and take account of progress made following the engagement with the Joint Improvement Team ( JIT).

Structures for joint working in community care needed to be more effective and inclusive. Arrangements for developing and monitoring integrated plans for children and young people were better co-ordinated and were reasonably well advanced.

The involvement and contribution by people who use services, carers and partner organisations in service planning was not properly recognised.

Some steps had been taken to meet the geographical challenges of the area. There were some variations in services that could not be explained by geographical differences.

Steps to improve performance reporting and review were being progressed and there were early signs of these beginning to shape the agenda for improving services.

Policy review and development

Over the past year the council had introduced a best value regime and toolkit. Social work service reviews had not been routinely subject to a systematic programme prior to its introduction. There was in place a sound framework for undertaking reviews of all services over a three year period. We considered that social work services should move more quickly to agree a best value programme for the next three years which was closely allied to its service plan and care group strategies.

The social work service had recently produced its service strategy statement for 2007-2010 highlighting challenges, values, and priorities. However, it was a 'standalone' document, not showing any clear linkages to other strategies or partnership plans.

The processes and frameworks in place to implement service plans and strategies were insufficiently well developed or co-ordinated. For example,

• the council had not produced an overarching departmental plan setting out the aims, planned investment and outcomes for all of its social work services and responsibilities
• a number of strategies and plans had been produced at a corporate and departmental level. None of these captured the underpinning vision for moving social work forward in a cohesive and targeted way
• neither the corporate plan nor the individual adult joint service plans gave a clear indication of partnership working.

In recognition of the need to develop joint service planning, the council had engaged with the JIT to develop partnership working with health. Steps had been taken to develop integrated plans, initially in older people's services, and more recently across other parts of adult services. Some lacked a proper analysis of need, contained little or no financial information and did not set out timescales or proposals for redesigning services. In particular there was no joint plan for mental health.

Fieldwork visits to community care operational units showed staff enthusiasm for their day to day work but this could have been further supported through the development and implementation of locality plans which mirrored specific and measurable council wide service plans and commissioning strategies.

We noted there were a number of strategies, plans and annual reports for children and families and youth justice in place. They were generally well presented with operational staff playing a role in their implementation. The youth justice annual report was particularly commended for its breadth and level of detail. This provided a sound basis for planning and targeting services in each of the localities. The children's services plan had been developed in line with the key national policies and provided good direction for children's services particularly in relation to child protection and children affected by domestic abuse.

Some areas of resource planning in children and families services were at an early stage in progressing the recommendations of the Scrutiny Review. A report on the development of foster care services had recently gone out for consultation and was due to be presented to the council's Executive Committee. Progress had been made in services for children with disabilities with the appointment of a principal officer with a remit to develop services and a strategic plan. However we were told by staff in the service that some elements of funding had not been identified to continue with developments to date or to roll these out across the local authority area. Nor did we see any overarching strategy within integrated children's services planning that would free resources for this.

Recommendation 13
The social work service should produce a three year plan, to be updated annually, clearly setting out priorities, targets and resource implications for modernising social work services. The plan should demonstrate progress against the social work Scrutiny Review recommendations and include joint targets where these have been agreed.

Operational and partnership planning

Strong links between strategic and operational plans help to strengthen the vision for achieving improved outcomes for service users and carers. There was little evidence of team or operational plans having been produced to support this. Nor did it appear that these were included as part of the restructuring of the social work services. Senior and middle managers stated they would be giving attention to establishing a framework for producing plans once CareFirst had been fully implemented and the structure was fully operational.

We considered that operational plans would be greatly supported by the introduction of a performance management framework based on local needs and services.

Community care services

In terms of joint working with partners, and in particular NHS Highland, we noted that only older people services were funded jointly. The health and care strategic partnership ²⁹.had approved a joint financial framework with aligned budgets.

Budget monitoring and reporting on aligned budgets for both organisations followed the respective financial regulations and procedures for health and council services. There was no financial reporting to the joint strategic board. We believe it is important that the joint board monitors spend on services covered by the agreement.

We saw joint locality plans for resource release. For example in Helensburgh and Lomond the resource release from the closure of a continuing care ward (30 beds) at Jeannie Deans unit was central to the overall plan for that area. The closure plan included costed community based care services and a timescale for implementation. While appearing to move in the right direction further work was required to address the issue of shifting the balance of care. Admissions to the unit had ceased at the time of the inspection when these additional services were not yet fully in place. We were not in a position to evaluate the detail of the proposed alternative provision but we were concerned that the cessation of admissions to the Jeannie Deans Unit was carried out in advance of reprovisioning being fully in place. This could have an impact on vulnerable people needing services in the area or lead to additional pressure on carers. The advance file reading in November identified instances where carers were under significant stress whilst awaiting services being put in place for the person they were supporting.

Plans were being developed to extend joint working to mental health and learning disability services.

New impetus was evident in mental health, where there were joint plans to close continuing care beds and replace these with care home provision, supported by community psychiatric nursing input. Partners had established a planning group led by the CHP to develop a strategy for modernising mental health services and implement the obligations arising from Delivering for Mental Health (2006) ³⁰.

We considered that mental health was an area which required particular strategic focus within social work as well as in partnership. We found significant variations in what service was available. More should have been done to support and evaluate the effectiveness of the integrated mental health team. We were concerned with the level of Mental Health Officer ( MHO) cover across the area. The development of the integration agenda was being taken forward by a jointly funded officer. We were told by managers that mental health services were included later in the planned development of integrated services.

Substance misuse was an area where work had been done by the lead officer in the council to develop strategic planning processes with health. Strategic leadership was required to ensure that an integrated approach to substance misuse gained greater priority given the prevalence of alcohol problems in particular. The joint strategic partnership board had recently agreed the outline processes for development in this area.

Children's and families services

The integrated children's services plan provided the key platform for the development of children's services. Its development and implementation was overseen by Argyll and Bute's Children ³¹. Locality and themed groups took forward the development of services in specific areas.

This new additional needs group would oversee service development for children affected by disability as well as the strategic planning.

In youth justice, locality seminars brought together partners to share information on work across the area as well identify key areas for development.

Overall, we found that although some of the building blocks had been in place across services there had been limited support from members in adopting proposals. The drive for some aspects of service development therefore resulted from the political recognition of the need for change highlighted by the Scrutiny Review.

Criminal justice social work services were developed as part of a well established criminal justice partnership.

Recommendation 14
A framework for operational and unit plans with clear targets and priorities should be agreed and implemented by the social work service to support decision making and target setting by service managers. Locality managers in the Argyll and Bute CHP should be included in the development of joint plans.

Involvement of stakeholders in planning and service development

We saw some evidence that social work services had sought to engage with stakeholders in the planning of services.

The carers' network was funded to lead on the implementation of the carers' strategy and link carers' views back into service development and direction. Nevertheless we did not find an approach by the social work service that set out clear expectations about who should be involved in planning and how this would work in practice.

Many of the stakeholder events were for specific projects rather than as part of an overarching involvement strategy. We were told by a range of groups that they were not meaningfully involved in planning. For example, a group of service users whose support services had been put out to tender told us that they had not been represented in the selection of providers for their service. They were also unaware of opportunities for regular involvement in planning and development of council services even although some had held this role with national provider organisations.

In the self evaluation questionnaire social work services submitted a detailed list of consultation exercises conducted in a wide range of service areas but there was little or no information to measure whether partner agencies, the public or people who use services were merely given information or had been actively involved in service planning. This point was highlighted by HMIe, "All services had identified the need to improve the involvement of service users in policy development but subsequent work was still at the planning stage." ³².

There had been a providers' forum for community care services which had not met following the resignation of the then chairperson. This position had improved with more recent briefings to providers and a seminar to examine commissioning options for older people's services planned for August 2007. Equally the services had made some effort in involving staff in these developments and had held a seminar in February 2007 to inform them of plans and hear their views.

Our meetings with senior staff in the council and their partners confirmed this view as did the survey returns. The children's reporter and the head of education (secondary) commented that relationships with social work were productive but both recognised that further work was required to strengthen the provision of joint initiatives for children and young people who had been excluded from mainstream services. We were told by senior management that the education service placed considerable emphasis on school centred activity and pupil attainment that was not reflected in the outcomes for looked after and accommodated young people. The council told us that this year's figures showed improvement and were beginning to demonstrate the impact of the joint working protocols developed between the services.

We considered that the arrangements for joint working in some areas of children's and families services were reasonably well constructed. In addition, this had the potential to enable partners to support and monitor progress of jointly delivered initiatives and services in the various localities. However although we saw good evidence of partnership working, the overarching strategy group had not taken steps to address the differences in levels of service available in localities.

Recommendation 15
The social work service along with its partners should increase and support the active involvement and participation of people who use services and their representatives in strategic joint planning structures and arrangements.

Developing integrated services

We found many examples of good joint working between staff from different agencies at an operational level and some interesting integrated initiatives. In children's services the development of the integrated children's service plan had engaged key partners. However, except in older people's services, an over-arching strategic approach for adult services was just beginning to emerge. There had been substantial involvement with the joint improvement team, initiated by the council, which had supported the development of the joint health and care strategic partnership and the governance arrangements for the development of integrated services. A recent report from the Joint Improvement Team ³³.highlighted the progress made over the past two years. It comments that "increasingly the leadership and development became embedded with the partnership".

Since April 2006 when NHS Highland assumed responsibilities from NHS Argyll and Clyde co-operation in areas of joint planning and commissioning had been positive. There was, however, some way to go before this alignment could be effectively translated into improved and sustainable outcomes for service users, carers and the many voluntary organisations and community groups who either represented, or provided services to them.

Progress had been made in developing joint service plans supported by the development of joint 'writing' groups. Some stakeholders in response to our survey and in focus groups did not support the view that planning structures effectively involved them. It was not evident that partners agreed with the proposed direction of travel or that they would be contributing necessary funding. Examples included an integrated children's services' plan that did not include reference to NHS finances or to changing children's services funding, and a draft learning disability plan that made no reference to health as a partner in the provision of services (with the exception of a jointly-funded clinical nurse post for Oban).

These plans had been overtaken by the Scrutiny Review that had recommended major reconfigurations to services and structural changes to support these. Earlier in this report we noted that key partners had not been involved in this review. In reviewing plans to implement the proposed changes it was important that the service ensured that it did so in a more joined-up way with partners.

There were signs that it was beginning to do so although this still had some way to go. For example, the partners' Joint Future integration action plan for 2006/07 set out milestones for moving towards integrated teams for adult care groups. The aims and actions it contained were mainly led by social work, making little mention of the role of health services in developing outcomes. The health and care strategic partnership (that included social work, health and the voluntary sector) had also considered plans for developing joint services for older people, mental health and substance misuse. Some of this planning was still at an early stage.

The reduction in the numbers of people delayed in hospital was an example of joint partners working to positive effect to meet national targets. The RRG system for monitoring patients who had been assessed but awaiting hospital discharge had been established. This helped the council and health staff take operational decisions to improve outcomes for older people. An integrated care service plan in adult services assessed potential joint team structures in each of the localities and a performance tool measured improvements to service users. This was viewed by partners as a helpful contribution to agreeing further service integration.

Existing localised initiatives and examples of joint working at the frontline nevertheless suggested that the service and its partners had the capacity to work well together. Within children's services the FUSIONS initiative that combined the resources for new community schools and the changing children's services fund, provided the most obvious example. Four integration managers were responsible, alongside local planning groups, for identifying local need and deploying resources. Targeted services funded through the initiative included family support services, parenting programmes, personal development programmes, learning support and out-of-school supports.

These, and other FUSIONS-funded services, were well-regarded by staff and other stakeholders whom we met. However, we did not think that the service and partner agencies had taken a strategic enough overview of how localities were spending their FUSIONS funding. There were strategic and local operational plans for the initiative but these were not sufficiently specific, lacking clear targets or timescales or a record of which agency or individual would take actions forward. Although it was important that local areas responded to local needs there were imbalances in provision for which there was no clear rationale. For example it was not evident why there were no FUSIONS-funded parenting programmes in Helensburgh, or why the initiative provided financial support only in Mid-Argyll, Kintyre and Islay to help children with additional support needs attend out-of-school activities and support only in Bute and Cowal for children with additional support needs making the transition to secondary school. The planned integration of FUSIONS services under children's service managers with authority-wide responsibilities will provide a strategic overview.

There were plans under the new structure to mainstream the FUSIONS initiative and place responsibility for developing integrated services with the new posts of area children's managers. These managers were to hold a wide range of responsibilities. The service needed to keep these arrangements under review to ensure that they can deliver its aspirations and those of its partners.

We were told by staff in both adult and children and families services that access and availability of housing was sometimes problematic. We heard of examples of young people ceasing to be looked after being placed in communities away from their natural support networks and the resultant breakdown of tenancy. We also heard from managers within community services that work had been undertaken with housing providers in developing a common allocation policy and the range of commissioned services to try to overcome some of these difficulties. The services should continue to ensure that service priorities are jointly addressed with partner agencies.

Within services for adults there were similar examples of good joined-up working. An integration project manager had responsibility for supporting this agenda. Developments in integrated working included:

• delayed discharge co-ordinators. These five joint-funded posts based in the localities were responsible for co-ordinating social work and health services to ensure older people did not remain in hospital longer than necessary;
• occupational therapy services. These services had recently become integrated in some parts of the authority;
• a joint equipment store in Oban. This was the first of four planned integrated stores across the authority;
• progressive care unit on Jura and new a unit planned for Mull. Planning involved a wide range of partners, including community representation;
• intensive outreach services in Oban and Campbeltown. These jointly managed services funded through resource release, offered a service to assist older people remain in their homes as an alternative to hospital admission;
• a planned integrated day service for older people in Garelochhead; and
• joint training in respect of the IoRN (indicator of relative need), single shared assessment, child protection and pilot training in the Helensburgh area for care co-ordination.

There were some instances where projects were discrete local responses to funding opportunities but we did not see evidence that senior managers were proactively measuring the difference these were making and whether they could and should be jointly core funded and rolled out.

An example of this was the social work and NHS integrated community mental health team in Dunoon which had been set up as a pilot five years previously. There had been lengthy delays in rolling this out. The historical development of the team appeared to have evolved into its current format as a result of initiatives from frontline staff. There were unresolved issues, not least of which was the precarious employment situation of the team's support workers (discussed in chapter 6). It appeared to us that there had not been enough planning and preparation before the partners established the team, little strategic oversight of it since and no evaluation of its effectiveness. If the partners' plans to modernise services for all care groups in Argyll and Bute were to have any success they needed to learn lessons from the history of this initiative.

The council and CHP had worked together to develop formal governance arrangements for staff.

Recommendation 16
In order to ensure that their proposals to develop a more integrated approach to planning and delivering services come to fruition, the partner agencies should work more closely together to develop a comprehensive and specific action plan. This must include establishing clear funding and governance arrangements.

Range and quality of services

The social work Scrutiny Review had sparked fresh impetus within the council to modernise its social work services. The process of implementation will take some time before it fully impacts on both the quality and range of services being provided.

The service undoubtedly faced geographical challenges in delivering a full range of services to some of its communities. There was evidence of some of the efforts it had taken to meet these challenges. This included an agreement - through criminal justice partnership arrangements - for neighbouring West Dunbartonshire council to deliver a service to offenders living in the Helensburgh and Lomond area. Other examples of good quality services that we encountered included:

• high quality residential provision for looked after and accommodated children. Young people that we met were positive both about the material conditions in which they lived or had lived and about the quality of care they received. Staff in these units described these as good places in which to work;
• the pilot children with disabilities assessment team in Helensburgh. We observed the good work that this team was doing and heard from parents how much of an impact this service had had on the quality of their lives and that of their children;
• the Telecare service. All those assessed as eligible had been provided with the equipment they needed; and
• the planned Ardlui respite for children with disabilities. This unit, developed in partnership with voluntary groups, will provide respite facilities for children from across Argyll and Bute.

Good practice example
The planned progressive care centres in island communities will provide individual tenancies and support to older people. The services will be delivered in partnership between housing services, NHS community services and a care provider and are designed to continue to care for and support people in their own tenancy as their care and support needs change.

However, we also found shortfalls and variations in service provision that could not be explained by geographical differences. Gaps in provision included insufficient services for children with disabilities; too few foster carers for looked after and accommodated children; not enough specialist provision for young people who had left care; no advocacy service for children and young people; too many out-of-authority placements for accommodated children, particularly children with disabilities; not enough homecare cover; too few mental health officers; and lengthy waiting lists for occupational therapy services.

Strategies were being developed to address some of these gaps in service. Commissioning from the voluntary sector had filled some of these gaps. Having identified a gap these groups had looked for ways to fund provision. They operated on a mix of social work and Supporting People funding and monies raised through fund-raising. A number commented that their fund-raising supplemented core services.

Examples of voluntary sector activities included:

• services for children with disabilities developed by parents. Groups such as Achievement Bute, and Jigsaw (Helensburgh), Autism Argyll were providing a range of support to families including respite and social activities;
• the Kintyre centre. This community regeneration project, funded until March 2008, was the sole provider of services to children with disabilities in the Campbeltown area. It offered after-school, weekend, and holiday provision and 1-1 respite;
• IDEAs (Islay Disabled Endeavours and Action). This voluntary-run centre for people with a physical or learning disability provided a lunch club for older members of the community, a resource centre offering activities and computer skills training; a dial-a-bus service; and a housing support service as well as a range of other activities; and
• HELP (Dunoon). This project helped young people to develop independent living skills and gave them support to live in their own tenancy. It supported all looked after and accommodated children returning to live in the area. The project began with social inclusion funding and was now funded through the Supporting People grant.

There is a clear place for provision developed from community initiatives. However there was no evidence that this provision formed part of an overarching plan for delivering services. There was little evidence that the social work service had undertaken a comprehensive review of unmet need and taken a strategic approach to try to meet this need.

The service's resource review groups ( RRGs) considered requests for resources for older people and were recording information on unmet need but the service was not analysing and using this information systematically to plan for future services. These groups were beginning to consider requests for resources for other adults. The service had recently rolled out the use of the indicator of relative need ( IoRN) across adult services and intended that information from this would in future help analyse gaps. It will be important that the service does this in a more systematic way than it had done previously. It is equally important that it extends this rigorous approach to children's services where requests for resources for children and young people were normally channelled through multi-agency meetings.

Some aspects of service provision had not kept pace with changed practice. For example, a high proportion of children were in residential placements and mental health services had not yet embraced the recovery model for service delivery. The service's Scrutiny Review had recognised the need for a clearer direction and for a more modernised service that used its resources to provide a developed community infrastructure. Plans to achieve this were still at an early stage.

Quality assurance and continuous improvement

In its audit of all the council's services (published February 2006) Audit Scotland highlighted that "deficiencies in the council's performance management and service planning and monitoring systems" had made it difficult to form an overall view of social work services. It noted that the social work service had been developing a performance management system for some time. Managers commented to us that progress had been hampered by the limitations of the service's IT system. Manual counts remained the norm. The intention was that new modules being incorporated into the recent version of the CareFirst system would bring improvements.

Since last year the service had developed a comprehensive reporting framework, presenting the first of these reports to the strategic management team in December 2006. However, the information was not disaggregated to team or operational unit level making its use in reviewing quality more difficult to complete. There was little evidence as yet that managers had acted on the information to make changes to the service or that they disseminated the information more widely to teams or units to help inform their practice.

The framework offered a potentially useful monitoring tool to measure outputs and performance against targets. There was no social work or corporate quality assurance framework although the service had begun to consider how it could evaluate the quality of the services it delivered. It still had some way to go to embed a performance-based culture among its staff group.

There were exceptions. The criminal justice social work service had a well-established performance framework (used across the criminal justice partnership) that included

• reports on key performance indicators;
• assessments by service users and supervising social workers on completion of statutory orders of the impact of the service;
• feedback from beneficiaries of community service; and
• regular case file audits.

Criminal justice staff received individual and team feedback from these exercises. This was a positive approach although in chapter 5 we have suggested that the service may need to do more to ensure these quality assurance arrangements are sufficiently rigorous. In order to encourage staff further to improve services criminal justice managers had introduced an annual prize for good ideas.

In adult services a joint performance reporting framework was being developed incorporating the NHS Highland balanced scorecard approach and the community care outcome measures ³⁴. Its use was too recent to have had an effect on evaluating service delivery and trends.

Within the area of child protection there had also been some quality assurance activity. The child protection committee had carried out a self-evaluation exercise. There had been an evaluation of case conference processes from a parent/carer perspective and a programme of case file auditing was in place. Notwithstanding these steps we found that in the small sub-sample of seven child protection cases we examined there was no evidence in five of these cases that a first line manager had scrutinised the file regularly. None of the sub-sample contained evidence that a senior manager had periodically examined the file.

Less than three in ten case files in our overall sample contained evidence that a first line manager had regularly scrutinised the file and only 6% had evidence that a senior manager had examined it periodically.

The service's quality assurance team had recently reviewed the complaints procedure to make sure that they recorded complaints and concerns better. Themes were reported on a monthly basis. Managers acknowledged that they needed to do more to embed the process into a quality assurance framework. We thought that the service could also make more systematic use of issues that its independent reviewing officers and advocacy providers identified.

Management and support of staff

Performance on this measure was judged to be adequate with strengths just outweighing weaknesses.

Argyll and Bute had achieved improvements in the recruitment and retention of staff, but we found that there was room for further improvement.

Patch-based service provision and management, coupled with shortcomings in strategic capacity and performance management, had led to staff and teams with similar roles developing quite different ways of going about their work.

Supervision was good in criminal justice but weaker in other parts of the service, and annual development planning for staff was not systematically followed through or strongly linked to service priorities. The overarching training strategy needed to be complemented by training strategies linked to service plans.

Recruitment and retention

In common with other authorities Argyll and Bute faced a staffing crisis, and in 2004 had a 25% vacancy rate for qualified social workers. The senior management team gained approval from elected members to embark on a four-strand workforce initiative:

• 'growing our own' - supporting unqualified staff to gain a range of qualifications including DipSW;
• offering enhanced recruitment packages;
• re-aligning senior social work posts, and
• enhancing support for frontline staff.

The level of vacancy was reduced to less than 10% within a year. The latest figures from the council suggested that this achievement had been sustained in relation to qualified field workers. Indeed, the same figures suggested that the overall vacancy rate was significantly lower in every category from 2005 through to 2006.

Staff and managers told us about workload pressures in teams and only 27% of survey respondents agreed that the authority was able to recruit sufficient staff. We considered, after discussion with staff during fieldwork, that this perception of staff shortages was more to do with staff sickness absence than recruitment.

Sickness absence figures reported to the council's executive in June 2007 revealed the level of stress-related sickness absence in the social work service had increased by 15% in the preceding year. Managers were trained in attendance management to improve application of the policies. It was particularly commendable that access to stress reduction training and techniques was made available to all staff grades. However, it was too early at the time of the inspection to detect any positive impact of these measures on this serious trend.

Managers in residential and day care services were concerned that the proposed pay and grading model (single status) would have a significant impact upon service delivery as it would particularly affect their ability to recruit and retain catering and cleaning staff in the future due to better conditions being available with other employers.

There had been good overall progress on the four-strand initiative and success of "Grow Our Own" in particular. However, the authority had some way to go to achieve a workforce planning strategy that made the necessary 'whole system' connections. Middle managers told us that the council could still do more to support the successful recruitment of staff, by working collaboratively to introduce more attractive 'welcome packages', including temporary housing, and to speed up their processes for actioning vacancies. Managers should consider how they would utilise special measures to attract recruits from other authorities if disparities in terms and conditions with existing staff were created.

We saw further evidence that a more systematic approach to the retention of staff was being developed. The introduction of an induction programme for social work staff was a key element of this approach but was it not consistently deployed. As suggested in chapter 4, the service should consider general familiarisation with this programme, not least because it set out Argyll and Bute's ethical framework for the provision of social work services and reinforces the council and SSSC³⁵.codes of conduct.

As previously stated, the service should embark on a 'root and branch' review of the policy of employing some staff on temporary and zero hours contracts. We heard numerous claims by a range of staff that they had been working a regular pattern of weekly hours for well over 12 months but the local authority did not consider that this merited a permanent appointment, despite the fact that services depended on these regular arrangements. We considered that the local authority could have incorporated action on this into the strategy on staff retention. Criminal justice staff that we met also commented about the difficulty in recruiting and retaining community service work supervisors as the service did not offer permanent contacts or guarantee a set number of hours of employment. They stated that this had led to long waiting lists before people who had been sentenced to community service could begin working to complete their hours ( discussed in chapter 3).

Recommendation 17
The social work service should review its practice in relation to staff working regular weekly hours whilst being employed on zero hours contracts.

Staff deployment and teamwork

A recurring theme from the fieldwork evidence was the differences in practice that had developed over the years in each of the four localities. Individual staff with responsibility for a particular service, or teams which had the same broad remit, worked in distinct ways from each other. We saw examples where these met local needs, such as duty arrangements. We found that these differences existed in child care, criminal justice and community care teams. Neither frontline staff nor managers were clear about the rationale or the potential implications of going about similar duties in different ways and we found no evidence that senior management had conducted an analysis of the impact of these differences. In criminal justice, for example, varying practice in relation to home visits had implications for a consistent risk assessment processes and compliance with National Standards as well as wider policies which expect workers to be mindful of the family or significant others linked to the offender.

The new management structure shifted from management by locality to council-wide responsibility for particular service areas. The potential therefore existed to develop regularisation of duties and functions. Where differences remained there should be systems which generated and measured evidence of their continued value and advantage.

We also advise that senior managers should satisfy themselves that the staff skills mix in fieldwork teams, particularly the ratio of qualified to unqualified social work staff, met the current and future needs of the service. Many stakeholders - carers, community groups and partner agencies - told us that they felt that social workers were over-burdened, and their impression was one of high staff turn-over and high sickness absence. Sixty-three per cent of managers in our survey disagreed that their workload was manageable within their contracted hours. We heard from one frontline manager that staff shortages over a long period had led to them carrying a bigger caseload than the staff they managed, in order to protect staff well-being. Inspectors both saw and heard about instances where unqualified staff were holding cases or undertaking assessments where the complex circumstances pointed to the need for a qualified social worker to have lead responsibility for the case. We were aware of arrangements to oversee such cases, including the counter-signing of reports for outside bodies. We were nevertheless concerned that the variable frequency of line management supervision, together with qualified staff being under pressure from their own caseload, could have exposed both staff and service user to increased risk and disadvantage.

Recommendation 18
The social work service should ensure that team leaders have clear criteria about what work requires the professional skills of a qualified social worker and that which other staff can appropriately carry out. An audit process should be put in place to ensure that these criteria are applied consistently.

There were no written guidelines on what work was allocated to unqualified staff. We were told that the role of care co-ordinator ( SVQ-qualified) was being introduced for some cases of adults with learning disabilities, to allow social workers to care manage more complex cases. We heard from staff that MHOs were not able to devote as much time to their care managed caseload because of increased pressure from statutory duties and it had proved impossible to recruit qualified workers to substance misuse posts. These service pressures, if not closely monitored, could have an effect on the level of responsibility expected from unqualified staff.

Regarding administrative support, 45% of staff in our survey agreed that there was sufficient administrative support for frontline staff in their team. This result was among the lowest of local authorities inspected to date. Managers were least likely to agree that this was the case. Administrative staff told us that vacant posts had been frozen pending the administrative services' review, although some officers had been told that agency staff could be employed temporarily. Mixed messages in the different localities about the permitted use of agency staff was also raised as a problem in home care. All staff felt supported by the social work teams they worked with. Some administrative staff had been included in both team meetings and development days and felt that this had made an appreciable difference to service efficiency and team spirit for all team members.

Development of staff

Argyll and Bute had a training strategy for 2006-07 which set out overarching aims, as well as short-term and long-term objectives. The strategy stated commitments to goals that should have been completed. These included conducting a training needs analysis, developing training plans aligned to service plans and becoming an approved SVQ accreditation centre. This ambitious programme did not take account of there being only one full-time training officer and undertakings of this magnitude would exhaust the capacity of this resource very quickly.

Staff were generally positive about the training opportunities afforded them by the department with most describing training as plentiful.

There were some positive experiences of training described to us by staff:

• learning disability services involving service users in sharing and sometimes delivering staff training;
• staff in joint services having reciprocal access to the in-house training events of each organisation.

Prioritised and forward-thinking training plans are essential to the effective implementation of service plans. Decision-making and funding of training applications were not clearly linked to service planning priorities.

We were also told by staff that training in skills or procedures essential to their remit was sometimes not made available early enough. For example staff involved in pathway planning for young people told us that they had to wait for training while already carrying out the work.

Annual performance development reviews ( PDRs) had featured in performance management and planning since 1998 but we found patchy accounts from staff as to whether they had had a PDR. Forty-five per cent of staff in our survey agreed that PDR helped them to do their job better. Some staff told us that it had been some years since their last PDR, while others could not relate their personal development plans to service plans or priorities. Under-performance by line managers in this area clearly had a knock-on effect in limiting staff development planning. The primary aims set out in the PDR to develop mutually beneficial links between service plans and staff development plans were not being realised.

The social work service re-launched PDRs at the beginning of 2007 by retraining staff, in order to reinforce or re-invigorate these fundamental aims, but it was too early to detect any improvement. If this was to be successful it was critical that line managers fulfilled their obligations regarding annual appraisal of staff, that service managers developed training strategies on the basis of their service plans, and that the two processes were strategically and practically intertwined.

There were good examples where this approach had achieved good coverage and positive outcomes, where valuable lessons can be learned. These included

• multi-agency child protection training events - similar events are planned for adult protection;
• the use of pooled resources to deliver Getting Our Priorities Right parenting assessment to a range of stakeholders;
• 'mini change management' by FUSIONS;
• substance misuse training strategy; and
• staff in criminal justice being paired with a specialist in high risk offender supervision to deliver structured intervention.

Recommendation 19
The social work service should develop an over-arching strategy for workforce planning, including staff support and development. Training priorities should be aligned with service plans and clearly linked to supervision and appraisal processes.

Sixty-one per cent of staff agreed that they receive an adequate level of supervision, with field workers and managers least likely to agree. This figure was among the lowest when compared to local authorities inspected to date. Some staff told us that they received supervision which was regular and thorough, while others experienced supervision as mainly allocation and review of work with little discussion of professional or personal development.

Staff shortages or sickness were given as reasons for quite common shortcomings in the frequency of supervision. There should be contingency planning which offers staff more than "an open door" during prolonged periods of staffing difficulties.

Some MHOs were supervised in generic teams. The service needed to ensure that Mental Health Officers ( MHOs) had access to supervision from a qualified MHO in accordance with national standards.

Managers in criminal justice had made recent changes to supervision arrangements to ensure that there were opportunities to discuss forthcoming case reviews. Criminal justice was also the only part of the social work service which had strong evidence of file auditing and linked performance management by first-line managers.

The supervision policy set out the responsibilities of supervisors but these did not include any reference to case-file scrutiny or any other evidence of performance monitoring in preparation for supervision. With the re-launch of CareFirst and clearer expectations about supervision notes being noted in case-files, the social work service should take the opportunity to amend the supervision policy to include guidance on direct and indirect performance monitoring.

Resources and capacity building

Performance in this area was adequate with strengths just outweighing weaknesses.

Financial planning was based on sound practice. There were gaps in the financial planning and scrutiny as adult services moved increasingly to joint arrangements with health. The spending moratorium had meant that some devolved financial responsibilities had been reassigned.

The management information system was being relaunched to take account of improvements in the system but there was no routine use of information gathered.

Asset management planning was not fully developed.

Contracts were in place with all service providers and a monitoring process had been developed although links to a clear commissioning strategy had still to be established across most service areas.

Financial plans

In recent years, the social work budget was set at a level that was, on average, slightly less than the grant aided expenditure (gae) level (excluding the remoteness and distant islands and special island needs allowances). Outturn was slightly higher than budget in 2004/05 (£0.8m), and in 2005/06 (£0.3m). This was mainly due to overspends within children and families and adult resources. These were partly offset by underspends within other adult services.

Budgeted spend within the council on children's and families services during the three years to 2006/07 averaged 19% of the social work budget, compared to the Scottish average of 23%. Conversely, the percentage budgeted spend on older people was higher than the Scottish average over the same period, 54% against the national figure of 48%.

Indicative spend on home care services increased in the three years to 2006/07, during which time there was a slight decrease in care home spend. However, this trend was reversed in 2007/08 where the care home budget increased and the home care budget was reduced. Given that the service started from a low base in the provision of home care services, we would have expected to find the balance of funding to continue to shift from care home services to home care.

In general, we found the links between the operational service plans and the financial plans to be lacking. There was a 2007/08 service plan for community services as a whole which included summary service plans for children and families, and adult services (integrated care and community support). These plans did not contain appropriate financial and other resources information to support the aims and objectives of the services. The plans contained lists of priorities, and the activities required to meet each priority, there were no direct links to the specific financial and non-financial resources required to achieve the targets set out in the service plans. We were advised by managers that future budget reporting would show budgeted and actual spend for each service priority.

The head of finance advised that there was a three year budget projection for 2007/08 onwards, but that this was not service specific. The council was in the process of working with external consultants to produce a more structured financial strategy which was planned to cover the next five financial years and take account of future demographic trends. There were long-term capital plans in place for general services (including community services) and housing.

Recommendation 20
The social work service should ensure that service plans are clearly linked to, and supported by, available resources and identified in detailed financial plans.

Budgetary control

The services performed budget monitoring on a monthly basis and reports, including year-end forecasts, were submitted to the Strategic Policy Committee (quarterly), and the strategic management team and departmental management team more frequently. The departmental management team comprised all heads of service within community services, the director and relevant spokespersons (members). Budgetary control reports were discussed and cleared at this forum before going to the strategic management team and then to committee.

Finance officers provided budget monitoring reports to budget holders every month and these were issued within two weeks of the month end. Detailed staff cost reports were also provided each month, listing individual employees. Budget holders did not have on-line access to budget monitoring reports but they were of the opinion that the financial information they received provided sufficient detail to allow them to investigate and identify reasons for variances.

Budget holders had a nominated finance officer whom they could contact for advice on financial management at any time. Not all budget holders met regularly with community services finance staff to discuss the reasons for variances, the projected year end outturn or the action to be taken to address potential overspends. The requirement for meetings depended upon inherent risk of budget area, budget size and any other control issues.

The reports produced for committees provided details of the year end forecast position for community services. Explanations for major variances and the action to be taken to address overspends were succinct. The council operated a traffic light approach to variance monitoring at cost centre level and the report included a separate schedule showing variance explanations for all forecast outturn variances greater than £25,000. This schedule provided members with a fuller understanding of the overall monitoring of the services.

Budget holders met with community services finance officers in October each year to discuss the budget for the forthcoming year. This did not take place in 2006 due to the moratorium on social work services spending. At the time of our inspection, budget holders had yet to receive details of their particular budgets for 2007/08 albeit that this was two months into the 2007/08 financial year.

Budgetary control was generally well managed and we considered the financial skills applicable to the social work service to be adequate in terms of quantity and quality. There appeared to be excellent working relationships between strategic finance, community services finance staff and budget holders. We understood that budget monitoring guidance had been provided to budget holders more than two years previously. However, no further training had been provided, although budget holders could request advice on budgetary control matters from community services' finance officers at any time. We thought that it was important that updated training should be made available to staff.

There was no strategy aimed at addressing the long-term financial pressures affecting the service, although the council had made additional resources available until 2008/09 to address cost pressures in relation to free personal care and delayed discharges.

The operational delivery on behalf of the older people's partnership was managed through the joint implementation group ( JIG), which was attended by the senior financial managers of both health and the council. The JIG considered proposals for the spend of any new resource release and ring fenced delayed discharge revenue and thereafter made recommendations to the strategic partnership group. An imminent practical application of the financial framework was in the partnership's development of joint single management and specifically in support of new integrated adult care teams being established in six geographical areas. However, we noted that budgetary control information was only provided in relation to services provided jointly with the NHS to members who were part of the Joint Strategic Partnership. It is essential that not only officers, but also elected members received regular financial monitoring information, thereby enabling the members to adopt joint ownership and control of the financial arrangements of the partnership.

Community services had successfully addressed the reduction in Supporting People grant from £16.6m in 2003/04 to £12.2m in 2007/08 (i.e. a 26% reduction). The reduction in funding together with the need to ensure contracts were in place with all providers, prompted the council to re-tender mental health and learning disability services which provided savings of £0.4m-£0.5m per annum.

Capital expenditure and planning

The council had a five year capital plan for 2006/07-2010/11 which was approved in December 2005. However, the plan was not informed by the asset management plan ( AMP) as the council had still to fully develop its asset management strategy which would lead to the production of an AMP. Consequently the council was in the process of revising its approach to capital planning and management. The council's progress in this was generally in line with many other councils. They used benchmarking to measure impact; affordability, deliverability and risk were considered for all capital projects. Projects were categorised and monitored under the headings of asset sustainability, service development and strategic change. In addition, the new approach would also include consideration of the revenue consequences of capital projects within the option appraisal section. The new approach had still to be implemented fully and appropriate training rolled out.

Capital plan monitoring reports were presented on a quarterly basis to the strategic policy committee which provided a forum for discussion and review of the capital programme. The report provided members with details of capital expenditure against budget for each service and a summary of project performance in terms of cost, timescale, benefits and risk for each service using traffic light analysis. Where project performance had been identified as requiring corrective action, a separate report was prepared by the relevant head of service which gave details of individual projects and any action being taken to address the issues.

Control over capital expenditure was good and we found reports to management and to members were clear and comprehensive.

Elected members' role

Elected members are the ultimate decision makers within the council. Reports on which they base their decisions should therefore be clear, complete and unambiguous.

We were generally satisfied with the quality and frequency of finance-related reports to members. We considered that the content of reports was sufficient for members to adequately interrogate the data and ask informed questions, bearing in mind that members also attended departmental management team meetings where budgetary control reports were also discussed.

Financial skills within social work services

The budgetary control responsibility for the social work services element of the community services budget was allocated mainly, but not entirely, to officers at service manager level and above. Training was not mandatory for all budget holders, although community services finance staff required to be informed of new employees who were budget holders in order that a finance officer could be assigned to them. Budget holders could request ad-hoc financial training throughout the year from community services finance staff. We comment earlier on the need to ensure up to date training for staff.

The financial skills applicable to community services staff were considered to be satisfactory and the budget holders we met were very satisfied with the support from community services finance staff, and with the data supplied by them.

Income

As part of the 2007/08 revenue budget setting process, the council reviewed and made amendments to the charges made to people who use social work services. This took into consideration COSLA guidance to councils on charging policies for social care. We were advised that the council charged for all services for which it could reasonably levy a charge. The council had not made provision for repayment of amounts previously charged for food preparation. It was noted that it only made such a charge when a service user could prepare his/her own food but chose not to do so.

Resource management

Asset management plan ( AMP)

The council had developed its own asset management system ( AMS) which included details of the ongoing programme of condition surveys of council properties. The condition survey of social work buildings needed updating following on from the rolling programme of refurbishment of these properties. Although the council's AMS was a good starting point in its approach to producing an AMP, it was still being developed at the time of our inspection. In April 2007, the strategic management team ( SMT) requested appropriate officers to meet and agree a framework for taking forward asset management and report back to the SMT in June 2007. We understood that a draft corporate asset management plan had not yet been completed.

It was difficult to be clear about the capital needs and optimum use of the assets of the service without an AMP that facilitated the production of a capital plan and which was linked to the service priorities and objectives. However, it was recognised that the council was still developing its approach to asset management planning and was in the process of implementing its asset management framework.

Risk management

At the time of the inspection, the council was in the process of developing risk management procedures in line with a nationally agreed standard. At a corporate level, the risk management group ( RMG) was the focal point for promoting risk management amongst managers and members as well as progressing risk management procedures. The RMG reported to the strategic management team. The council had a governance and risk manager who was responsible for further developing the council's risk management framework in addition to assisting the council in its implementation.

An internal audit review of risk management in December 2006 identified a number of weaknesses in the council's approach to risk management and the RMG was given the task of progressing the action points detailed in the report and reporting progress to the audit committee on a quarterly basis. Community services were at an early stage in responding to these recommendations. The service was reviewing its risk register which had not included control measures. In completing the register the service should take note of the guidance provided by the governance and risk manager.

Health and safety

The council's corporate health and safety plan was produced annually. The progress of the achievement of the plan was reported to the corporate health and safety group. The community services health and safety objectives were set out in an action plan. The implementation of the plan was driven by the community services health and safety committee which met on a quarterly basis and reported progress to the departmental management team and corporate health and safety group.

The effectiveness of health and safety arrangements was monitored by the audit and inspection process. However we were concerned that in some areas there were no written risk assessment of activities. For example in criminal justice written work site assessments were not always completed.

The council ran personal safety courses for staff and most of the fieldwork staff we spoke to were very positive about these courses. However we found the lone-working policy and that on violence towards staff had not been revised since 1996 and were not fit for purpose. We heard from staff that there was no clear policy in relation to ensuring staff safety when they worked beyond office hours. Other staff expressed concern about health and safety hazards due to inadequate storage facilities in some offices, leading to administrative staff working with boxes stacked around their desks.

Recommendation 21
All policies concerned with the safety and well-being of staff should be reviewed and up-dated at three yearly intervals as a minimum standard.

Management information systems

Argyll and Bute was an early user of the CareFirst system. It was relaunched in 2006 to take account of system upgrades; the intention was that it became the primary source of information. A formal project plan managed the implementation.

Staff were developing systems for the collection and analysis of information but generally this was in relation to statutory performance requirements. Staff in planning and performance had worked with frontline and middle managers to establish an agreed suite of performance reporting and quality measures and were in the process of implementing these. Work had been undertaken to streamline these requirements and those of the national performance framework to reduce the burden on staff who input information. The social work service were at the early stage of agreeing and defining core sets of data and providing training in the use of the system as a management tool.

There was not a culture of using information for planning and improvement or for targeting support and resources more effectively. The social work service and establishments made limited use of the information generated for administration, planning and monitoring. The system was not yet sufficiently developed to give managers a comprehensive overview and much information was collected manually with no clear reporting on outcomes. Information from CareFirst did not play a major role in identifying trends, and providing benchmark and comparative information for officers to use in planning for improvement. We were told by planning staff that managers had identified a number of reports that were to be produced using the "Business Objects" reporting tool. Overall we did not find that analysis and evaluation of statistical data held within CareFirst played a significant role in the self-evaluation and continuous improvement of services. Earlier in this report we identified that there was no systematic approach to recording need or unmet need.

A number of establishments had no or limited access to computer systems including email and the internet. We heard that the hardware was available for service provision units but that the installation was not planned until later in the year - after staff had been trained in the use of the system. It was important that the roll out to service provision units was carried out within the agreed timescales in order that staff do not remain dislocated from the range of information shared online. Administrative staff spoke of their work being frustrated by changed access to CareFirst and difficulties this created in carrying out their work. Administrative staff had some responsibility for collating information from CareFirst but changes in the system meant that in some teams the administrative staff had limited or no access to the system.

In chapter 5 we highlighted the limited access criminal justice staff had to the CareFirst system and recorded our concerns about the potential impact of this on information-sharing. Managers told us that the situation had arisen because of difficulties in reaching an agreement between the service and the criminal justice partnership that used a different version of the CareFirst system (the Carejust system). We were not convinced that the service was affording the issue sufficient priority.

We heard from quality assurance staff of plans to include information on commissioned services to provide a resource database for staff and improve the level of easily accessible information for staff.

We saw some clear commitment to address access and usage of management information but remain concerned about the coverage of the system across the area, accessibility for staff and the accuracy of information recorded.

Recommendation 22
The social work service needs to move more quickly to remove any unnecessary barriers to information-sharing. This should include affording all social work staff appropriate access to electronic case records.

Partnership working

Senior staff told us that the climate for change was in place and were positive about the future of strategic partnerships.

In children and families services key partnerships were managed through Argyll and Bute's children - an interagency planning group. The themed and locality groups included representation from a range of partners who were working to move forward an agreed agenda. This generally offered a coherent approach to development of integrated policy and strategy at a locality and council-wide level. Interagency performance measures with planned quarterly reporting had been agreed but not yet implemented.

Good practice example
A recent HMIe report into child protection services in Argyll and Bute highlighted the role the social work service and its partners had played in engaging the community in child protection issues. They had developed child protection guidance for voluntary and community groups and had included them in training events.

Some key strengths were evident in partnership working between social work, education, police and children's reporter. This was less well developed with voluntary sector and provider organisations. "Joint working with partners is not robust - unilateral decisions are made re funding with no impact analysis on corporate objectives" and "I believe plans are probably based on analysis of need …. But I am not sure it is carried through to practice".

In community care progress was slower. The transfer of health services to NHS Highland, and the creation of the Argyll and Bute CHP with co-terminous boundaries with the council and its localities were seen as key factors in enabling change. The Argyll and Bute strategic partnership agreement (August 2006) improved the previous governance arrangements between the NHS and the council. The partnership group had broad representation including elected members, chief executive and other senior managers from across the council. Partnership arrangements for older people's services were the most advanced.

Partnership arrangements for mental health and substance misuse were at an early stage. Social work had an opportunity to play a full role as partner in both but the emphasis needed to be on a greater degree of joint strategic planning and investment.

In terms of the financial framework of the partnership, budgets were aligned rather than pooled and any council budget allocation to the partnership was controlled centrally. The council budget allocation to the partnership for older people services in 2007/08 was £22.9m. The process of aligning the budgets in respect of mental health and learning disability was at an early stage.

Joint budget monitoring reports in respect of the Partnership were considered at the Joint Implementation Group ( JIG). There was no evidence of budgetary control and financial monitoring being discussed at partnership board level.

The criminal justice social work service was managed as part of a well established partnership. The service had given full support to the partnership with regular attendance at meetings from the senior manager and designated elected member.

The residual housing and homelessness strategies, following stock transfer were managed by the head of community regeneration within the community services directorate. They were at an early stage of assessing the impact of the stock transfer in delivering key aspects of these strategies. The departmental management team was the locus for discussion of joint issues relating to housing matters that were raised from social work services. The services needed to keep under review the impact of the transfer on access to appropriate housing across the area.

Stakeholders had more criticisms to make about relationships at a strategic level. Although some groups we met were positive about relationships with officers within the council others spoke of an historically poor relationship between the voluntary sector and the authority with one group describing the relationship as based 'more on conflict resolution rather than partnership'. A few voluntary groups believed that the recent appointment of a dedicated monitoring officer within the service had led to improvements in these working relationships. Some groups commented that funding was markedly short of what they needed to offer reasonable service.

One key partner commented in our survey that "service reviews did not involve staff from partner agencies and structural changes within the authority" and "there was a tendency to put self-interest ahead of partnership interest". Recent activity showed this being refocused but it was too early to say if this would be sustained. However some partners were positive about the future with the period immediately before the inspection seen as a period of positive direction.

Contracting and commissioning

Commissioning of services should be based on matching needs with resources in order to deliver choice and quality. Social work services were at an early stage of introducing a contract monitoring and review framework. Monitoring information gathered during the recent tender for supporting people services was used to inform commissioning decisions. However we found that commissioning decisions were not generally informed by the results of contract monitoring, care commission inspections or the complaints procedure. Some information on demand and supply was available, but this had not been systematically gathered in order to be of use for any strategic purpose.

Commissioning

Providers welcomed the move to centralise commissioning, which they thought would improve on a previous position where service development was initiated without funding sources being identified. Council service managers believed that there had been a general improvement in commissioning and purchasing and welcomed the tendering process as it gave the authority better control of contracts.

A fairly robust system was in place to commission new initiatives and service provision but it appeared restrictive in its use and again demonstrated little continuity with long term planning to assist with the redesign of services. There were exceptions to this, most notably the tendering process for sustaining Supporting People funded services in learning disability and mental health and the intent by the council to market test home care, day care and residential care for older people. The latter was a good example of how a suite of plans for closing NHS hospital beds linked to costed community alternatives could stimulate partners to jointly move the redesign agenda forward, in this case, to meet the needs and aspirations of a growing number of older people.

The commissioning of services for learning disability and mental health Supporting People services was initiated mainly by a need to reduce the budget following a redistribution of allocated funding from the Scottish Government. The exercise as well as saving £400,000 in the view of the council, streamlined the process and in some areas extended the choice of provider. The process was well structured but care managers and service providers did not follow agreed processes of communication with service users which left them uncertain about future levels of support.

Providers (including those that had been unsuccessful) were positive about the tendering process. They viewed it as transparent and fair. "It had allowed small providers to be 'in the game'."

The authority to commission individual service contracts was delegated to service managers and could include individual packages above £50,000. However, there was no corresponding link between these and an overarching commissioning strategy.

Most services for children with disabilities were either externally purchased residential placements or those purchased from local organisations. Plans were at an early stage to develop a commissioning strategy for children with disabilities. The new management and staffing structure aimed to support the changed pattern of service delivery. The council should consider partnership arrangements with local organisations in developing the strategy.

Joint planning and commissioning between health and social work was at an early stage. The implementation of recommendations of the joint future partnership service plan for older people (January 2006) was delayed by the Scrutiny Review and had led to uncertainty for social work staff and service providers. This had since been taken forward with a presentation on commissioning delivered to staff in February 2007 and a joint meeting with stakeholders scheduled for August 2007 with the intention of beginning to develop a commissioning strategy for the council.

The Advocacy plan was developed by the health board. The council did not have a service level agreement in place for advocacy services or a clear approach to the involvement of service users in the development of the commissioning strategy.

The strategic plan for mental health services was still at a very early stage of development. The tendering for Supporting People services, mentioned earlier, therefore did not take account of any planned future service direction.

As in children's and families services, the strategy for decommissioning adult services, where service planning indicated a move to a different type of service, was at an early stage.

Recommendation 23
The social work service should move more quickly to develop commissioning strategies across each service sector.

Contracting for services

A comprehensive process was in place for the approval of providers. The processes for contracting and review of services were being developed. These appeared more clearly linked to adult care services than children's and families services. Commissioning priorities were mentioned as part of this process but there were few linkages to appropriate strategic planning reports in service areas.

The Supporting People services for people with mental health problems or learning disabilities were funded from three different sources and created a challenge for providers to marry the requirements of the different funds. According to one provider who had secured one of the new tenders it was unusual for a block contract to have expected payments from the independent living fund built into the core funding of the contract. They would welcome a clearer partnership approach from within the council in terms of reporting and invoicing requirements.

The quality assurance team gathered information from staff and service user questionnaires to inform this tender exercise. Forty-one per cent of service users responded to the initial questionnaire. A report on the process showed a clearly managed process with separate groups of staff scoring on quality and finance. The social work services aimed to build on this experience by extending the approach to a planned tender for older people's residential services.

All providers we spoke to had a signed contract and most had an identified monitoring officer. Some service providers had no guarantee of the level of business after the first year. One provider described a contract that did not specify the services to be purchased or potential service users. In developing partnership arrangements with providers the council needed to be clearer in defining the services it wished to purchase.

Block purchase or pre-placement agreements were in place with the majority of approved providers although some contracts did not clearly specify the monitoring requirements for providers. We heard from some providers that there were variations across the localities on the level of service purchased from them highlighting again the issue of variations of approach by practice teams.

The contract monitoring process relied primarily on feedback from people who use services, care managers and a self evaluation by providers. This process could be improved if supported by more regular site visits to providers.

The quality assurance team was at an early stage in translating information gathered from their quality review of services to inform future practice.

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