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CHAPTER 6 Management

In this chapter we look 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 found performance was good with important strengths and some areas for improvement.

We found a commitment to developing and monitoring policy. This was better in children's services than in adult social care. Children's services had a very good performance management system but adult social care was not as good.

Policy review and development

The planning process in children's services and adult social care was being changed due to the coalition administration formed after the May 2007 election. Business plans were on hold, awaiting decisions from the new administration. The plans were for a single year and this created difficulties for the projection of spending on services over a three-year period. There was no single overarching social work plan setting out values, vision and aims. The vision for adult social care services had not yet been agreed, children's services had made more progress. Children's services had statements of intent that included the vision for this service.

The services were developing a broad range of policies. We found evidence of comprehensive policy development in the past two years. There was a planning model in place whereby service plans produced by each service linked to the council's corporate plan. There was a joint community care plan and a joint performance information assessment framework ( JPIAF) plan. The Mental Health Implementation Plan 2007-10 was a joint initiative with health. It included a proposed timetable for developing stages of the plan. These stages had not been achieved on time and the agencies needed to pay attention to any slippage.

We found no reference or apparent linkage to wider council equality policies, particularly the council's disability equality scheme and how that impacted in the delivery of Sections 23 and 24 of the Children (Scotland) Act 1995 and adult services for disabled people, including mental health.

There was a planning group to develop a multi-agency framework for children's and adult social care services. The council had joint chief officer group meetings for both children's and adult services. Some staff were not clear on how strategic priorities were determined. Senior council staff described the council's approach to continuous improvement as adequate and recognised that other council's had developed this further than East Lothian. There was commitment to developing this key area.

Children's services showed significant evidence of joint and multi agency working. The integrated children's services plan (For East Lothian's Children 2005-08) underpinned policies and directed the delivery of its goals. A child protection unit had been formed in 2005. This unit had made improvements to the organisation and delivery of the child protection service.

Operational and partnership planning

Our survey of some of the councils stakeholders showed:

• the majority of stakeholders who responded thought there were effective planning structures and processes for social work services that engaged all major stakeholders
• less than half thought there was good evidence of appropriate service reconfiguration on the basis of joint plans.

One stakeholder said, "We still find it difficult to see evidence of a clear strategic direction for social work services in East Lothian". By contrast another said, "Within our disability service there is clear structure and arrangements for good collaborative planning and working".

Our staff survey showed:

• the majority of respondents agreed that East Lothian had a clear set of local social work priorities
• 55% of respondents agreed their team performed well against local service targets, while 4% disagreed.

The self evaluation questionnaire said that for children's services. "Each service team produces a business plan which links into the service, departmental and corporate plan and is published on the intranet. These plans set targets and report on outcomes reflecting the higher level plans. The service plans also relate to the integrated children's services plan and support the delivery of its objectives". There were multi-agency sub-groups that linked operations to strategy by developing operational plans/policies such as the:

• Multi-agency and children's services child protection action plans
• Integrated framework for transitions to adulthood ( IFTA)
• Integrated assessment framework.

Adult social care had a similar planning structure. The self evaluation questionnaire said, "We have used our business planning system to support the ambitious programme of service re-design which has been in place since 2004. Each service within the council produces a service plan (linked to the council's corporate plan) laying out priority aims and objectives for the service. Each unit within the service produces a business plan, which details how it will help to achieve the service's aims. Each employee has an individual development plan, linked to the unit business plan priorities, and the learning and development strategy. These connect each member of staff directly to the unit and service's aims".

We read some of the aforementioned business plans. We found no mention of vision, values and aims and the financial information was limited. There was no reference to service plans. We thought the business plans we read were standalone documents covering one year only (2007-08). They said nothing about developing services or redesigning services over a longer period.

We read the review of services for children with disabilities (independent review commissioned by the authority in 2005). The review noted that services for children with disabilities had developed in an 'ad hoc' way. It identified the need for universal services to play an important role. There was a need for discussion about pooling or aligning resources. There was no identified manager with responsibility for driving forward the agenda.

The head of education services told us about the management tracker. This was an electronic system to track the progress of the many development groups. Senior managers could use the system to see if the groups were on target to deliver on their objectives.

We interviewed the authority children's reporter. She was very positive about operational and partnership planning in children's services. She said there was a real sense that East Lothian wanted to get it right and there was good communication among agencies.

The community health partnership had a number of planning groups. They were:

• the patient partnership forum
• a performance management group
• a service design group.

Overall, we found children's services and adult social care had good systems for operational and partnership planning. Unfortunately we found deficits in the detailed contents of some of the plans.

Involvement of stakeholders in planning and service development

Our survey of some of the councils stakeholders showed:

• Seven out of 14 respondents agreed there were effective arrangements in place to ensure consideration of potential partnerships with others in the statutory sector
• Thirteen out of 18 respondents agreed there were effective arrangements in place to ensure consideration of potential partnerships with others in the independent sector.

Children's services

Children's services planned to appoint a consumer involvement officer (July 2007).

For children's services the self-evaluation questionnaire said, "We have clear communication with partner organisations and other stakeholders and through public performance reporting. We have involved a range of partners in service development; for instance, service users, the voluntary sector, the community health partnership and carers were involved in the disability review, and foster carers are involved in children's services planning groups."

We met with some independent sector providers of children's services. All said that they had good relationships with East Lothian Council.

Adult social care

Joint planning for adult social care was redesigned in 2005. There was a chief officers group and a number of planning groups for the different service areas. We met the advocacy worker who supported service users and carers to be involved in the joint planning groups. She said that overall the system worked well. We found there was effective involvement of service users and carers in the joint planning groups for adult social care.

We held a focus group of adults with learning disabilities. A number of the delegates said that they had been involved in service planning groups.

A group of staff involved in commissioning and contracting told us that they had looked at involving service users and carers in the tendering process. People with learning disabilities and family carers had participated in the tendering for the local area co-ordination service.

A group of independent sector providers (adult social care services) said that they were not involved in the councils planning processes. They had monthly meetings with the council. One provider said these meetings were a waste of time. Another said that the council did not listen. One of the providers was a delegate at the joint planning forum that was looking a commissioning services for older people.

Adult social care was piloting the use of the UDSET¹¹ tool, as a means of getting users' and carers' experiences of the occupational therapy service. We thought this was a promising development.

Adult social care was working with the joint improvement team to look at how it could use a modified UDSET in care management reviews to make sure that service users' and carers' experiences informed service delivery, development and planning.

We were impressed with the councils efforts to engage with the gypsy traveller community.

Developing integrated services

Overall, we found the council was committed to developing integrated services.

Children's services

The formation of a Department of Education and Children's Services had helped with the development of integrated services for children and their families. Many children's services staff were based in a new building. This had improved joint working and communication.

The integration team tried to offer support to vulnerable children and families. The aim of this was to stop problems getting worse.

The child and adolescent mental health service was another example of good interagency working.

Integrated services for children with disabilities and their families were limited. Parents who took part in our focus group were confused about how agencies worked together. They experienced a lack of integration between health and social work. They thought the recent appointment of a designated social worker was helpful.

Adult social care had a number of developments to promote integrated services. Recent departmental changes had established separate planning and commissioning and business support units. Single-shared assessment was progressing and the council had recently recruited someone to work with front line staff on single-shared assessments.

Staff said working relationships with the community health partnership were good. Health and housing provided integrated equipment and adaptation services, although service users said they had to wait to get a service. The council view was that joint training for occupational therapists, physiotherapists and district nurses meant service users got home equipment quicker.

JPIAF information showed limited evidence of a mature and improving partnership between the council and health. The joint improvement team was working with community care partners to help them to develop a joint service and commissioning strategy.

Targets for delayed discharge were being met until temporary issues arose about admissions to two nursing homes. An example of effective interagency working was the discharge response team which was established by the NHS and adult social care.

The new mental health recovery team had plans for social workers and community psychiatric nurses to work together.

Range and quality of services

Our user survey showed that 88% of respondents agreed the services they got were of a good quality. This result is at the upper end of the range reported in other authorities we have inspected to date.

One user said, "On the whole very satisfied with the quality and standard of care received".

Our carer survey showed that 80% of respondents agreed that the services are of good quality. Again, this result is at the upper end of the range reported in other authorities we have inspected to date.

One carer said, "On the whole we get a very sympathetic and good quality service from my son's social worker".

A contrary view was expressed by one carer who said, "Our experience with social work had been quite positive. Unfortunately reorganisation within the department including setting up a complex care team that should have brought benefits to us i.e. an assigned social worker (we already had one!). This went badly wrong and we have not had a social worker since March 2006. This makes managing our large care package (over 20 hrs per week) difficult. There is no named person to call to report care changes or complaints and there have been no reviews. These used to happen regularly".

Our staff survey showed that 59% of respondents agreed the quality of social work offered by their team has improved over the last year. Managers had the highest levels of agreement (77% of 35 respondents agreed and none disagreed).

Children's services had done a lot of reviews and audits. For example:

• a youth strategy review which led to restructuring of services between the resource and integration teams
• looked after and accommodated children' reviews that led to a number of improvements
• practice team review which led to the formation of access and long-term teams.

Children's services had developed a number of services in response to identified need, such as:

• family group conferencing
• kinship care worker
• children with disabilities team.

The children with disabilities team had 1.5 social workers and one family support worker. Some of the parents of children with disabilities we spoke to were very critical of the service their sons and daughters got.

The NIMBUS¹² information system supported staff by providing comprehensive flow charted procedures linked to policy and forms at appropriate stages. This system was being developed to provide more information links, including descriptions of services for service users.

Adult social care did commissioned service reviews to make sure services met service users' needs.

Adult social care did an audit of services for people with learning disabilities in 2005. It introduced person-centred planning to help deliver better outcomes for people with learning disabilities.

The council did a best value review of home care services in 2004. The home care service was restructured so it could provide care to people in the evening and at the weekend. The review of home care services did not mention focusing home care on the most vulnerable. It did not mention changing the duties and responsibilities of staff or introducing more flexible staff contracts.

We met with a group of practitioners who worked with people who misuse substances. They said that there were treatment services and support for heroin users but there were no services for people who used cocaine. There were no treatment services for younger people who misused drugs.

Quality assurance and continuous improvement

The council showed commitment to quality assurance and continuous improvement through a number of measures. There was strong evidence that children's services sought the views of people who used services. There were a range of groups and organisations that commented on the quality of services.

We thought the performance management system in children's services was very good.

The council had recently appointed a quality assurance officer who was to develop a self evaluation model for staff that is linked to quality indicators. This had been underpinned by a series of multi-agency self evaluation exercises in children's services. Targets for admissions to services for children were being introduced.

Children's services had done a number of audits on looked after and accommodated children and child protection. Quality assurance was well developed in child protection practice. The child protection committee had a plan to evaluate the experience of children who were registered on the child protection register between 2005 and 2006.

Reviews were a key method for monitoring quality of service for individuals. We noted that review practice varied. For example we found child protection reviews were held regularly and were efficiently recorded. Reviews for looked after children were less consistent and well organised.

Adult social care did not have a performance management framework, although one was planned for the end of 2008. The joint improvement team was supporting this work. Measures were in place to collect some key data. For example there were monthly ward by ward counts of people whose discharge has been delayed.

Mental health services had plans to employ a former service user to collect information from service users. We think this is a positive development.

Advocacy providers said advocacy services were improving. There was no advocacy service for people with physical disabilities or people with sensory impairment. The East Lothian advocacy service forum had lapsed.

Case monitoring

First-line managers had scrutinised 22% of the files we read. First-line manager scrutiny was more likely in children and family files (43%) than in adult files (5%). Only 3% of the files we read had evidence that a senior manager had periodically scrutinised it.

Complaints

The self-evaluation questionnaire said, "long-term staff sickness has led to poor performance in relation to our complaints process". Adult social care acknowledged it was not handling complaints properly. The director of community services said that she was personally dealing with all of the complaints made about adult social care services. She acknowledged that the complaints system was not fit for purpose and needed to be improved.

Recommendation 9
Adult social care should make sure that its complaints handling system is properly resourced. Complaints should be dealt with as quickly as possible. Systems should be put in place so that data about complaints can be reported accurately.

Management and support of staff

We found performance in this area was adequate with strengths just outweighing weaknesses.

We found social work services performance on recruitment and retention was mixed.

The council was the first in Scotland to win the Scotland's Health at Work gold award for healthy working lives.

Front-line staff and managers got good training opportunities. Although 1 in 4 fieldwork staff did not think so.

Future staff resources needed to be reviewed. A workforce strategy was needed. Policies about staff supervision were very good. But some staff did not get supervision. A staff appraisal system should be put in place.

Recruitment and retention

Children's services and adult social care did not have a workforce strategy.

Children's services and adult social care recruited staff in line with the council's recruitment and selection policy. This made sure there was a fair and consistent approach to the recruitment and selection of staff.

Children's services and adult social care did disclosure checks before they made appointments. They checked references, and did health checks. They made sure candidates were registered with Scottish Social Services Council if the candidates needed to be.

Children's services used the Scottish Executive's safer recruitment toolkit.

The Care Commission report on the inspection of the adoption service found the requirement to recheck enhanced disclosure Scotland checks had not been complied with. The report recommended a system should be set up.

We found children's services and adult social care had done a workforce review. Some changes had been made to the services after the review, e.g. the new community care broker posts.

The council's self-evaluation questionnaire said there would be a future comprehensive review of workforce development strategy for all adult social care and children's services.

The personnel managers told us about a re-grading exercise in 2004 as a response to recruitment difficulties. We heard about efforts to help staff such as, staff could consult a nurse at their workplace. Staff got information about stress and availability of counselling. Personnel managers told us that absence management procedures were rigorously followed in children's services and adult social care. All this had led to the council becoming the first in Scotland to win a Scotland's Health at Work gold award from for healthy working lives.

In 2006 children's services and adult social care had an overall vacancy rate that was considerably lower than the Scottish average. The East Lothian figure was 1.6% and the Scottish average vacancy rate for social work services was 8.6%. East Lothian's vacancy rate for qualified social workers was 10.9% (Scotland average 7.5%). These vacancies were in adult social care.

There was a reported reduction (April to July 2007) in sickness absence in the adult social care business group (includes criminal justice staff). Managers said this was due to shifting staff to the right business units and absence management procedures. The level of staff absence in 2006-07 in adult social care was 8.59% and the April to July 2007 figure was 6.1%. This reduction in staff absence may just have been seasonal. The level of staff absence (2006-07) in children's services was 5.36% and 2.95% for the period April to July 2007 (again possibly seasonal reduction). When we spoke with staff in older people services they said that a lot of their colleagues were off sick. Some were off sick due to stress.

Staff deployment and teamwork

Our staff survey found that 51% of staff who responded felt that there was a fair geographic coverage of services across the authority.

Staff in children's services and adult social care had job descriptions. These were used along with service plans and unit business plans to tell staff about the desired outcomes for each service/unit. This was backed up by the supervision policy. Where services had been re-designed, detailed consultation had been done with staff to make sure that individuals knew about their new responsibilities and the outcomes they were expected to deliver. The council's staff survey found that staff felt they had the right skills to perform the tasks associated with their role.

Adult social care said it was re-designing services to build a 21st century social work service. It said it was building a workforce that had the capacity to deliver on this and to sustain future improvement.

Adult social care said it had used competitive matching to fill posts in re-designed services. This had allowed it to align the skills and experience of its staff to new roles and responsibilities. This process has also gave opportunities for others to develop their careers in new directions.

Staff in children's services and adult social care had contracts of employment.

In general, staff viewed their teams positively, most staff who responded to our survey said that their team had regular staff meetings. The majority of staff respondents said these meetings were effective and purposeful.

We found a number of issues about the staff deployment to different teams. Among them were:

• Children's services managers wanted to encourage staff to move between the short-term and long-term teams. This was for staff development reasons. We heard most staff wanted to stay in the same team.
• The throughcare and aftercare team was small. It had no qualified social workers in it. There were plans to put qualified social workers in the team. Managers told us the team could not provide care leavers with the level of support they needed.
• Managers told us that the youth justice team was not able to do preventive work. They worked with young people who had committed offences.
• There was an integrated children's services manager (joint council/ NHS post). Their role was to promote integrated children's services. We were surprised that the post also carried line management responsibility for 44 staff. This seemed incompatible with the integrated children's services managers' developmental role.

Staff at all levels in children's services and adult social care said there was not enough staff. In April 2007 East Lothian had 0.62 main grade social workers per 1000 of its population. The Scottish average was 0.78 per 1000.

Overall, staffing in adult social care and children's services in East Lothian appeared to be low in relation to the size of the council's population. The rate of staff per 1,000 population was 6.3 in 2006 compared to the national average of 8.1.

Recommendation 10
The council should review the numbers of staff and managers in children's services and adult social care. The review should include how they are deployed.

Development of staff

A new staff induction pack would be finalised in August 2007 and needed to be linked in with workforce development.

Both children's services and adult social care had a training plan.

We found there was a strong commitment to training in East Lothian. In the follow-up action plan to its 2007 independent survey of staff, the council said that it had set up an employee development team. But an employee development strategy was still being written. This should eventually fit into a corporate learning management system that was also being developed.

Seventy-two per cent of staff respondents to our survey agreed that they had got adequate training to fulfil the responsibilities of their job, including 20% who strongly agreed, while 16% disagreed. However, 26% of fieldworker respondents disagreed.

We found children's services and adult social care front line and managers staff got access to an impressive range of staff training. Some examples were:

• Social care staff did Scottish vocational qualification SVQ assessments and related academic courses, including HNC in social care and the registered managers award. The qualification rate for staff in residential services for older adults had improved dramatically over the last three years (October 2006 59%, July 2007, 70%).
• Staff in children's residential units were well qualified. Audit Scotland reported that 75% of these staff were qualified (2005-06). East Lothian Council was ranked 4th out of 28 local authority services in Scotland.
• Both services had systems to make sure the needs of newly-qualified workers were met. Staff were helped to meet the post registration training and learning requirements. Staff got adult protection and child protection awareness training. Children's services staff did the social work practice development module at the University of Dundee.
• Children's services staff were encouraged to take part in a work shadowing initiative. This helped staff to share skills and knowledge with staff in other sections of children's services, and for example health visitors.
• In children's services, all senior social work managers (and most middle managers) had the child protection certificate and relevant management qualifications. Managers could join monthly action learning sets.
• In adult social care, all senior social work managers, and some middle managers, had gained, or were studying for postgraduate qualifications. These qualifications included:
  • Master of Science
  • Master of Business Administration
  • Certificate in Social Work Leadership.

From our interview with representatives from drug action team, we were concerned that there was not enough emphasis given to substance misuse training. There was training on the policy Hidden Harm. Practitioners in adult social care said they needed training on direct payments, risk assessment and manual handling.

The learning and development training plan, revised in June 2007, had plans for joint training for adult social care and children's services. Training was linked to key joint priorities agreed by children's services and adult social care and was meant for all levels of staff. Our survey found that 72% of staff who responded thought they got adequate training.

We thought the supervision polices for children's services and adult social care were excellent documents. They set out staff responsibilities under the Scottish Social Services Council codes for employer and employee. They had a clear statement of supervision functions, and a template for frequency, duration and monitoring of supervision for different types of staff.

Sixty-six per cent of staff who responded to our survey said that they got adequate levels of supervision. Fieldworker respondents were the most positive group at 85%. However our survey also found that less than half of staff who responded were satisfied with current arrangements for annual appraisal. There was no formal staff appraisal system. Thus staff in children's services and adult social care got no formal evaluation and feedback about how they were performing.

Recommendation 11
Children's services and adult social care should develop a formal staff appraisal system. They should work with the corporate human resource section to do this.

A group of first-line managers in adult social care told us that they did not get regular formal supervision. Residential and day services staff in adult social care also told us that the supervision policy had not been fully implemented for them. Adult social care should make sure the supervision policy and employee development scheme is fully implemented for all staff.

Resources and capacity building

We found performance in this area was adequate, with strengths just outweighing weaknesses.

We found that the links between the operational service plans and the financial plans needed to be improved. However, there were strengths in overall budget management and control.

Financial management

Financial Plans

In recent years, the authority had set its social work services budget higher, on average, than the Grant Aided Expenditure ( GAE) level. In 2006-07 the budget for social work services was 8% above GAE, 6% higher than in the previous year. For social work services as a whole, outturn was slightly higher than budget in 2004-05 (£0.1m), and in 2005-06 (£0.8m). These overspends were relatively small and were due to overspends within adult social care, partly offset by underspends within children's services.

In 2006-07, social work services exceeded the budget by £0.5m, but within that figure there were overspends on assessment and care management (£0.9m) and services for older people (£0.3m) within adult social care. Offsetting these areas of overspend were favourable variances on staff vacancies in adult social care and children's services. At the time of our inspection, an overspend of £0.3m was anticipated within adult social care for 2007-08 and children's services anticipated a balanced budget at the end of the financial year.

Budgeted spend on children's 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%. Senior managers told us this was due to lower demand for children's services in East Lothian, compared to similar Scottish local authorities, and to a higher percentage of older people living in the area, particularly people over 85 with high care needs.

We found room for improvement in the way the service linked financial plans and operational service plans. There were 2007-08 group strategic and unit operational plans covering children's services. The strategic plan set out the key objectives for the children's services group. This plan linked to the corporate objective of 'delivering the best in health and social care'. The key objectives of the group were to be achieved through measures in the various unit operational plans. The group strategic plan listed a number of key activities and the actions required to achieve each objective. The plan also had timescales, the lead officer responsible for each action and progress to date. The unit operational plans were structured in the same way as the group strategic plan. They also had details of the total budgeted allocation for the group and operational units. However, there were no direct links to the specific resources required to achieve the key objectives in the group strategic plan and unit operational plans.

The 2007-08 group strategic and unit operational plans covering adult social care were still being finalised. The head of corporate finance told us that links between service plans and financial plans would be part of the overall process of writing the new administration's corporate plan. Individual service plans would be then be produced. A three year financial plan would be written and linked to service plans, once the results of the national spending review was announced by the Scottish Government.

The council had not produced any financial plans for the medium-term. Managers told us that the council had an informal financial strategy.

There were no medium or long-term capital plans for general services and housing.

Recommendation 12
The council should make sure that service plans are clearly linked to and supported by available resources as identified in detailed financial plans.

Budgetary control

Overall, we found that below departmental management team level, the service managed budgetary control well. In adult social care services financial management and support was provided by a separate community care finance unit that was established in 2003. In children's services, financial management and support was provided by staff from the corporate finance and IT department.

There were good working relationships between budget holders in adult social care and children's services and relevant finance staff. Budget holders said that they had got financial management training during 2006. They could get advice on budgetary control matters from an appropriate finance officer at any time.

Children's services did monthly budget monitoring. Adult social care did weekly budget monitoring. We found the corporate management team did not regularly discuss revenue budget monitoring. The community support management team often considered budgetary control reports. In addition, there were regular meetings of the community services budget group (which included elected members) at which there were detailed discussions on revenue budgets. We reviewed the minutes of children's services senior management group from October 2006 to May 2007, and found budget performance was not discussed regularly. We also reviewed the minutes of the Education and Children's Services management team from August 2006 to August 2007. Budget issues were discussed regularly but the discussions were not very specific.

At the meeting of the departmental management team in February 2007, the director of education and children's services said that more time should be spent discussing budget issues and more financial information should be fed in to the team every three months. He added that the finance manager should attend these meetings. There was an education and children's services budget group which included elected members. The group met regularly to discuss revenue budgets but no minutes were taken at these meetings. To make sure managers in children's services know about the financial issues in their service, revenue budgetary performance should be discussed regularly at senior management meetings that are attended by finance officers.

Finance officers made monthly monitoring reports for budget holders in children's services. In adult social care budget holders got extra weekly budget monitoring information from the community care finance unit. Some budget holders got detailed staff lists each month, although others could ask for these at any time. Budget holders got monitoring reports electronically via a link to the financial ledger reporting tool. This should have allowed the viewer of a report to "drill-down" to individual transactions. The budget holders we spoke to said that they did not use this facility but requested further information from finance staff. Budget holders felt that the reduction in the number of financial ledger codes made it difficult to quickly see the reasons for variances against budget. They said that finance staff were good at providing more detail where required.

Budget holders in adult social care and children's services met regularly with finance staff to discuss budgetary matters. Most budget holders said that they had been involved in the annual budget preparation process. They were able to use their local knowledge in identifying cost pressures and areas for savings. Budget holders said that they would like to see more transparency between the future trends information they provide to finance staff and the final budget allocations ( i.e. evidence of anticipatory budget planning). In addition, budget holders in adult social care were concerned about the closure of the community care finance unit. They felt the finance unit had strengthened the budgetary control system and improved the quality of financial information in adult social care.

In terms of financial performance reporting to elected members, the director of corporate finance and IT sent quarterly budget monitoring reports to the cabinet. The financial performance of individual service departments, including children and families and adult social care, was included but the year-end forecast position was not provided. We noted that reports gave limited explanations of major variances and the actions required to fix overspends. However, as stated previously, finance officers told us that, elected members were involved in the appropriate budget groups that meet regularly to discuss the revenue budgets for adult social care and children's services.

Recommendation 13
The council should improve finance related reports to members. This should include provision of year-end forecasts, improved variance explanations and clarity on future actions required to address variances.

The main forum for the management of joint working with NHS Lothian was the East Lothian Community Health Partnership ( CHP). Financial monitoring of jointly provided services, was done by the joint finance group. Recently, the group had discussed resource transfer details. No joint financial reports went to elected members.

Due to the reduction in supporting people funding, the council had agreed to provide extra money to bridge the funding gap. A review of services was done to find savings.

Recommendation 14
The council should address the lack of discussion of revenue budgetary performance at senior management meetings in children's services. It is essential that managers know about the financial issues in their services. Finance officers should attend senior management team meetings.

Recommendation 15
The council should make sure that elected members get regular financial information about joint council/ NHS services. Appropriate officers should also consider such data at their joint meetings.

Capital expenditure/planning

The council approved a three-year capital investment plan for the years 2006-09. However, in March 2007, a report about the capital investment plan for the financial year 2007-08 showed that, the council had not set revenue budgets for 2008-09 or 2009-10. Thus the capital investment plan could not extend into these years as there were no means to establish whether the borrowing implied was affordable. The report acknowledged that, although the capital investment plan covered only 2007-08 activities, it included some projects that would take more than one year to complete. Therefore, the council was effectively committed to expenditure from 2008-09 onwards, the financial consequences of which would have to funded from general services and housing revenue account balances in future years. There was no asset management plan. The overall approach to the writing of the capital investment plan was that it was developed and updated from the previous capital investment plan.

Capital investment plan monitoring reports were not presented to elected members to allow review of the progress of the capital programme. The head of corporate finance said that capital investment plan monitoring reports would be given to elected members from September 2007.

Therefore, at the time of our inspection, control over capital expenditure appeared inadequate, as monitoring reports were not given to members and plans did not extend into future years.

The council should write a capital plan covering at least three years, which should be based on an estimate of future available capital funding. The plan should also give the full cost of each capital project.

Income

Managers told us that the council charged for services if it this was reasonable. The charging policy was based on COSLA (Convention of Scottish Local Authorities) guidance to councils on charging policies for social care.

Resource management

Asset management plan ( AMP)

The head of corporate finance said there was no corporate AMP and that this would be written after the new administration's corporate plan was written. The schools estates AMP, which was at an advanced stage of development and would be used as a template for the corporate AMP. There was no timescale to get the corporate AMP written. No AMP had been written for social work services. The service should set a deadline to write an asset management plan that meets the requirements of the corporate asset management plan when this is written.

Risk management

The senior risk and insurance officer gave us information about the development of the corporate risk framework. The council had taken a departmental approach to the roll-out of risk management but had not yet reviewed social work services. A corporate document entitled Risk management - a manager's guide was issued by risk management services in 2005. A draft risk management policy for social work services had been written in 2007. It still had to be formally adopted by the appropriate management teams and by elected members.

There were strategic risk evaluation documents and associated risk matrices for adult social care (including criminal justice) and children's services (February 2005 and December 2004 respectively). The risks evaluation documents identified the strategic business risk that threatened the achievement of each business objective. The risk matrices contained an assessment of each strategic business risk in terms of likelihood and impact. The overall risk score was transferred to the risk evaluation document. The risk evaluation documents had descriptions of the key planning processes in place to control the risks. However, both strategic risk evaluation documents were incomplete.

The senior risk and insurance officer said he had contacted the head of children's services about updating risk evaluation documentation. Also, he planned to work with social work services to review strategic risks, and identify, document and assess key operational risks.

Health and safety

The community services health and safety policy was approved by the community services joint consultative group in September 2005. It had not been updated since 2005. There was no similar health and safety policy for children's services. The corporate joint health and safety committee met regularly. From our review of recent minutes of this committee, we noted the existing corporate health and safety policy (1998) was being updated. There was a community services health and safety sub-group which met quarterly. Minutes of this sub-group were reported to the community services joint consultative group. There was no similar health and safety sub-group for children's services.

Management information systems

There was an integrated client-based management information system for collecting a range of social work data. But it was not consistently used by staff. The services' information system 'Carefirst' was underdeveloped and its potential had not been fully realised. Some staff thought Carefirst was unhelpful. In particular staff in adult social care had made limited use of the system for routinely managing information and for aggregating key episodes for planning purposes. Management information systems were being improved in adult social care but they could not record unmet need. The systems could not generate information that would influence budget and resource allocation processes. Information sharing between adult social care and health for completing single shared assessments was minimal. Staff could not access joint electronic data storing and retrieval systems.

In children's services things were much more encouraging. We have already commented on children's services very good performance management system. This helped managers to plan and redesign services and helped them take decisions about addressing pressures.

There were good links between corporate IT and management information staff in adult social care and children's services. Managers acknowledged that Carefirst had not been fully maximised. Corporate IT was helping social work managers to investigate options for replacing the current system. We wondered if the council should look at making better use of the Carefirst system they had rather than buying in an expensive new system.

All front-line fieldwork staff had access to computers as did unit managers in day care and residential establishments. They were able to open and send emails and to access their electronic diaries at home. Staff could use NIMBUS, which continually updated the services' policies and procedures and could be used to download public information leaflets and forms for service users and carers.

Information sharing between children's services and education was better now that both were in one department. There was no direct link between education's electronic system and children's services electronic system. Key performance and management information ( e.g. educational attainment for looked after children) was collated from both systems. A manual record matching the information was produced. The electronic Caresafe system (part of Carefirst) held the local child protection register. Health staff in key locations could access the child protection register held by the City of Edinburgh.

Electronic information sharing between the local authority and health was at an early stage. The data sharing partnership had only recently been established. No agreement had been reached about developing a multi-agency data store. New joint planning arrangements were in place and each of the joint planning groups was charged with developing local care strategies.

Partnership arrangements

We found some evidence that adult social care and children's services worked with key partners to develop and implement joint strategies and business plans. Progress was mixed. In children's services there were sound arrangements for involving education, police and health. Adult social care had not made so much progress. The newly formed community health partnership worked with the joint planning groups. There was an agreed programme for writing joint strategies and commissioning plans for the main community care groups. However, it will be some time before these are written.

Partnership arrangements seemed to be working well where there was involvement key agencies, service users and carers and the independent sector. Children's services and their partners should invest more commitment and resources to meet the needs of care leavers. We give the evidence for this in the chapter three.

The emerging arrangements between adult social care and health, most notably the East Lothian CHP, were beginning to demonstrate a more co-ordinated approach to strategic planning. The involvement of the joint improvement team was a positive development. However, the CHP needed to negotiate more autonomy and devolved authority from NHS Lothian to assist it to plan and deliver the various Lothian wide care strategies. Some independent community care providers expressed dissatisfaction with the quality of their partnership with the council. They also complained about poor communication. They did not believe they were sufficiently consulted or involved in strategic planning. They also felt that their representation on the community care providers forum was too restrictive.

The general manager of the CHP said more integrated health and social work services, "makes good sense for a population the size of East Lothian". The council's head of adult social care said the same thing.

Commissioning arrangements

Commissioning services had tried to make sure that there was a balance between meeting assessed need and securing efficiencies in service procurement. This was not always possible without agreed joint care strategies. Information about increasing demand for services and new innovative ways of providing services was piecemeal. We found little or no strategic links to how and when services would be modernised over the longer term.

In general, commissioning and contracting operated within the council's procurement framework. Learning from Care Commission reports and complaints should be more systematically built into commissioning activities for all care groups.

The council and the Care Commission were trying to rationalise contract monitoring and contract compliance. This was to avoid duplication of effort. The council and the Care Commission did not yet have a written agreement (memorandum of understanding) about how the two agencies would work together.

There were no overarching commissioning strategies for children's services or for adult social care services. Strategies were being developed in some areas, most notably for community care services. Joint planning groups would develop capacity and commissioning plans early in 2008. There was some commissioning of services for individual children. Very little planned commissioning had been generated by managers in children's services. The main commissioning driver was service reviews. These tended to be uncoordinated with little association to a specific programme of long-term strategic change.

East Lothian had three council-run care homes. It was working with the joint improvement team to determine the required future capacity for care home beds and the shape of this service.

About 25% of adult social care services were delivered by independent sector providers. Sixty to seventy per cent of the adult social care budget was used to purchase services from external providers. There was very little evaluation of outcomes. Care brokers was an encouraging development. They arranged and purchased care packages and maintained contact with providers. However, their role did not include reviewing home care packages. Care managers did not review home care packages either.

The system of spot purchasing did not have continuous review of quality or standards. Private community care providers told us that they had implemented their own quality assurance procedures and that these had been given to service managers in adult social care. We learned that some independent sector providers had full contracts while some only had service level agreements. We found there was no effective evaluation of these agreements. We heard from independent providers and from operational managers that there was no consistency in approach. Some projects and initiatives were monitored regularly. But some purchased services had not even had an annual appraisal.

Managers in children's services acknowledged they were still learning about tendering and contracting. They had a system of annual appraisal of service level agreements. A review of targets, quality and outcomes was routinely done as part of the process for renewing contracts.

Overall, children's services and adult social care had made good use of external consultants to assist in service reviews and write joint care strategies.

Recommendation 16
Joint commissioning strategies for children's services and for adult social care services should be written. They should have agreed and costed action plans for medium to long term implementation.

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