Chief Social Work Officer's Report 2022/23

Sharon-Ann Paget

Acting Chief Social Work Officer

www.orkney.gov.uk

IMAGE: Cover photograph showing a road crossing a rocky shoreline and tidal water in Orkney, with a partially submerged boat on the right. The cover text reads “Chief Social Work Officer's Report”, “2022/23”, “Sharon-Ann Paget”, “Acting Chief Social Work Officer”, and “www.orkney.gov.uk”. The Orkney Health and Care logo appears above the photograph.

Introduction

I am pleased to present the Chief Social Work Officer’s (CSWO) annual report for Orkney Islands Council, for the reporting period 1 April 2022 to 31 March 2023.

The CSWO report provides an overview of Social Work and Social Care services, and information on statutory decisions made by the CSWO on behalf of the Council.

The role of CSWO has been held by me, Sharon-Ann Paget since March 2023. The role was previously held by Jim Lyon from June 2020 until his retirement in March of this year. I would like to take this opportunity to thank Mr Lyon for several years of dedicated service, in which can only be described as challenging times.

For the previous three years there has been a reduced template to enable CSWOs to present shortened reports for local governance structures. This was initially due to the workload implications caused by the COVID-19 pandemic but has been considered beneficial and continued post-pandemic. This ensures local reporting arrangements continue whilst having due regard to current pressures being experienced across the sector but in addition it also aligns with most recent guidance shared with CSWOs.

1.1. The Role of the CSWO

The role of the CSWO was established to ensure provision of professional advice in the discharge of a Local Authority's statutory functions as described in Section 5 (1B) of the Social Work (Scotland) Act 1968. It is expected that the CSWO will undertake the role across the full range of a Local Authority's Social Work functions to provide a focus for professional leadership and governance within these functions. The role provides strategic and professional leadership in the delivery of Social Work services.

There are also certain functions conferred by legislation directly on the CSWO by name and specific statutory responsibilities are discharged by the CSWO, mainly to decisions about the curtailment of individual freedom, the protection of individuals, and the public. This includes, for example, children in secure accommodation and welfare guardianship for adults. These decisions must be made by the CSWO or by a senior, professionally qualified Social Worker, to whom the responsibility has been delegated by the CSWO and for which the CSWO remains accountable.

In May 1995 the then Scottish Office explicitly recognised that the need for the role was driven by “the particular responsibilities which fall on Social Work services in that they affect personal lives, individual rights and liberties to an extent that other Local Authority services do not” (Circular: SWSG2/1995). Every Local Authority must have a professionally qualified CSWO as set out in Section 45 of the Local Government etc. (Scotland) Act 1994. The qualifications are set down in Regulations which state the CSWO must be registered as a Social Worker with the Scottish Social Services Council (SSSC).

The overall aim of the CSWO role is to ensure Orkney Islands Council and the Orkney Health and Social Care Partnership, receive effective, professional advice and guidance in the provision of all Social Work services, whether provided directly, in partnership with other agencies, or purchased on behalf of the Local Authority. The CSWO has a responsibility for overall performance improvement and the identification, management, and reporting of corporate risks as they relate to Social Work and Social Care services.

To fulfil these responsibilities, the CSWO has direct access to Elected Members, reporting directly to the Chief Officer, Orkney Health and Social Care Partnership; and wider through the Integration Joint Board; the full Council as required; has direct links to the Chief Executive of the Council and attends the Chief Officers Group (COG).

Elected Members have important leadership and scrutiny roles in Councils and must assure themselves that the quality of service is maintained, and risks are managed effectively. The CSWO provides professional leadership and promotes values and standards of professional practice, ensuring that only Registered Social Workers undertake those functions reserved in legislation and meet the requirements of their regulatory body and the SSSC Codes of Practice.

Any Social Worker or Social Care professional may approach the CSWO for advice.

Integration Authorities: The Public Bodies (Joint Working) (Scotland) Act 2014 provides for the delegation of certain Social Work functions by a Local Authority to an Integration Authority e.g., a Health and Social Care Partnership.

In 2016, Audit Scotland noted in its report on Social Work in Scotland, that the role of the CSWO has become increasingly complex with the introduction of Health and Social Care Partnerships. The CSWO's responsibilities in relation to Local Authority Social Work functions continue to apply to functions which are being delivered by other bodies under integration arrangements. The responsibility for appointing a CSWO cannot be delegated and must be exercised directly by the Local Authority itself.

The CSWO is a member of:

• The Integration Joint Board, as a non voting professional advisor, to the voting members.
• Orkney Health and Social Care Partnership’s Senior Management Team comprising the Chief Officer and senior managers responsible for delegated health and care services.
• The COG as an adviser for Public Protection. COG provides leadership, governance and ensures local accountability, for all aspects of public protection in the areas of child protection, adult protection, offender management (Multi-Agency Public Protection Arrangements (MAPPA) processes for sexual and violent offenders), including Multi-Agency Risk Assessment Conference (MARAC) processes in respect of risks of domestic abuse). Linking to Orkney’s community planning partnership, the COG is responsible to Elected Members, NHS Board Members and Scottish Ministers.

2. Service Quality and Performance

2.1. The Social Work Profession

Social Workers are required to work in the context of legislation, organisational rules, service structures, and hierarchies including Health and Social Care Partnerships.

Within this context Social Workers retain significant freedom in their work.

The ways in which Social Workers relate to organisational rules and structures, is a key dimension for them in understanding the discretion and professional scope they hold, to make the best possible decisions in the best interests of the people they serve, often our most vulnerable and marginalised children, adults, and older people.

2.2 Cross Cutting Matters

Improving our approach and practice in public protection is the single most important aspect of cross cutting work across the Social Work service and with our community planning partners in children’s and adults’ services. Self-evaluation and improvement work has been further progressed during this reporting period.

Recruitment has been a cross cutting matter which is covered in detail under section 4 ‘Island and Rural Social Work – Key Challenges’ below.

There have been issues across Social Work services with the systems support resource, of the Social Work management information system, presenting challenges with information management, data collection and analysis.

2.3. Adult Social Work and Disability Services

Adult Social Work services includes services for adults, older people and all people with a learning disability. It also supports activity in relation to Adult Support and Protection (ASP) and mental health and treatment.

2.4. Adult Protection

ASP includes the:

• Complex and interconnected nature of harm.
• Value of skilled and open-minded practitioners.
• Need to build and maintain respectful relationships.
• Understanding that thresholds are not as clear cut as we might like them to be.
• Realisation that protecting means supporting, consistent high quality inter-agency work.
• Recognition that national opportunities for justice, through the court, might still be limited.

There has been continued focus on ASP in this reporting period. The Service Manager (Adult and Learning Disability Social Work) has been working closely with an external Social Work Consultant; the Chair of Orkney Public Protection Committee; the Public Protection Lead Officer, the Public Protection Lead Nurse; the Head of Health and Community Care; and the CSWO, as required, on a range of ASP matters.

Additionally, the Orkney Public Protection Committee (OPPC): ASP Quality Assurance Sub-committee considered several Initial Case Reviews (ICRs) for adults. The child protection methodology of Learning Reviews helped guide the process of these adult protection ICRs.

As reported in the previous report the OPPC has continued to deliver a series of events for refresh and introduction to ASP, some 160 members of staff from across statutory and third sector agencies having attended the sessions to date, with the series continuing during 2022. Specific training was provided to Council Officers and colleagues in Health and Police Scotland, and a course on Defensible Decision Making was provided. The Council Officer six day training course is scheduled again for January 2024 to ensure that all new permanent Adult Social Work staff are fully trained and supported to undertake the role. In addition to the two courses on self-harm, self-neglect and service refusal previously provided, multi-agency financial harm training is scheduled for September 2023.

A forum for Council Officers and key colleagues in Health and Police Scotland is being developed. In addition, Practice Awareness virtual ‘drop in sessions’ for senior social care staff and Registered Managers are commencing in late August and will run eight weekly thereafter. These will be facilitated by the Service Manager and/or Team Manager (Adult and Learning Disability Social Work).

Chronologies of Significant Events and the accompanying guidance has now been shared to all partner agencies and is now a formal part of the adult protection process.

Easy read leaflets pertaining to the ASP process are currently being developed and should be embedded by October 2023.

An Introduction to Trauma Informed Practice presentation is being developed by the Service Manager (Adult and Learning Disability Social Work) which will be available to all professionals supporting adults across the partnership and the third sector. A specific presentation for Trauma Informed Practice in ASP, will then be available to all relevant professionals who work in this area.

In 2022/23 there were 261 Police Vulnerable Person Database (VPD) referrals, an increase of 73 and 71 from the reporting periods 2021/22 and 2020/21 respectively. All three reporting periods evidence a significant increase from the referrals received across 2019/20; this is possibly related to greater public awareness and an increased focus on service management within Adult Social Work services.

In 2022/23 there were 51 ASP referrals, an increase of 20 from the previous reporting period. Of these 51, 21 were male and 30 were female. 23 of the 51 ASP referrals, resulted in investigative powers being utilised. There was a Large Scale Investigation during this reporting period.

2.5. Joint Inspection of ASP

The Joint Inspection of the Orkney partnership took place between 31 October 2022 and 11 April 2023. Records were scrutinised of adults at risk of harm for a two-year period, November 2020 to November 2022. It was recognised that the Orkney partnership was similar to all others across Scotland and was facing the unprecedented and ongoing challenges of recovery and remobilisation as a result of the COVID-19 pandemic.

The two key questions the Care Inspectorate posed were:

• How good were the partnership’s key processes for ASP?
• How good was the partnership’s strategic leadership for ASP?

The inspection reviewed processes and systems to ensure that adults at risk of harm in Orkney were safe, protected and supported. These included:

• Staff survey.
• Meetings with frontline staff and with strategic leadership.
• Scrutinising case files of adults at risk of harm for a two-year period.
• Scrutinising supporting evidence and the position statement.

Whilst the inspection findings recognised the significant work already underway and the substantial progress made, the overall two year focus on the inspection was such that the grades awarded were that of weak in respect of the two key questions. Strengths however were noted and included:

• Partnership staff worked collaboratively to support and protect adults at risk of harm.
• The partnership commissioned an independent evaluation of multi-agency adult support and protection processes in 2021. The findings had provided a baseline for some essential improvements.
• The partnership collaborated with a higher education provider to create opportunities for staff to achieve professional social work qualifications. This was an innovative way to address challenging recruitment issues.

The areas for improvement determined by the Care Inspectorate are set out below.

• Strategic leaders should ensure the delivery of competent and effective adult support and protection key processes for all adults at risk of harm in line with their statutory responsibilities.
• Risk assessment, chronologies, investigations, and protection planning all require immediate improvement.
• Change and improvement following the independent review in 2021 needs to be accelerated. ASP should be a critical improvement priority for strategic leaders across the partnership.
• The partnership’s strategic oversight of progress should be strengthened. Effective governance and quality assurance arrangements are needed to support improvements in practice.
• The involvement of adults at risk of harm at all stages of the ASP process should be improved.
• Strategic planning and decision-making should be informed by the lived experience of adults at risk of harm and their unpaid carers.

The inspection did not in fact reveal areas for improvement that the partnership were not already aware of and thus the associated Improvement Plan contains work which was already recognised as needed and in the planning process. The Improvement Plan has been submitted to, and confirmed as acceptable by, the Care Inspectorate. Lastly, it is important to note that, despite the gradings, adult services will not be subject to additional ongoing progress reviews going forward.

2.6. Services provided by Mental Health Officers

Approximately 120 people required support by Mental Health Officers (MHOs) during this reporting period, an increase of 20 from the previous period. During this reporting period, there has been a reduction in MHOs from four to three. The three MHOs included within the reporting period provide a service 24 hours per day, 365 days per year, in addition to their substantive posts. People who did not require an MHO, were supported by a Social Worker from the Community Mental Health Team.

Table 1 below shows activity levels for Guardianship and Intervention from 2019-2023.

Table 1: Intervention and Guardianship Orders 2019-2023

Note: * indicates fewer than 5.

Compulsory Treatment Orders are intended to create individual measures for the care and treatment of a patient who requires a degree of compulsion to accept these, done by means of a care plan which may specify detention.

Short term detentions follow an assessment undertaken by a Psychiatrist, to which an MHO must consent, to secure the immediate safety of a patient and lasts 28 days.

There were 20 short term detentions during the reporting period, five males and 14 females, including less than five children under the age of 16. Less than five of these detentions took place in Orkney; 15 took place in the Royal Cornhill Hospital, Aberdeen while other detentions took place in Dudhope Young Person’s Unit, Dundee.

Emergency detentions are intended to secure the immediate safety of a patient when there is no Psychiatrist available to undertake an assessment for short term detention. They are undertaken by Hospital Doctors or GPs, with consultation with a MHO. These last 72 hours with no right of appeal and generally it is not the preferred option. There were 12 adults detained in this reporting period, all of whom were transferred to Royal Cornhill Hospital, Aberdeen, except for a small proportion who were transferred to the Psychiatric Unit, Dr Gray’s Hospital, Elgin.

There were less than 5 Mental Health Tribunals across all sites.

Table 2 below provides activity levels for mental health intervention and orders from 2019-2023.

Note: * indicate fewer than 5.

2.7. Adult Social Work Staffing Complement

• 1 FTE Service Manager (Adult and Learning Disability Social Work).
• 1 FTE Team Manager (Adults and Learning Disability).
• 1 FTE Team Manager (Adults Learning Disability).
• 7.4 FTE Social Workers (Adults).
• 2 FTE Social Workers (Learning Disability).
• 2 FTE Social Workers (Community Mental Health Team).
• 0.6 FTE Social Worker (Home First).
• 1 FTE Support Worker = 2 Part-time posts.
• 1.64 FTE Administrative Assistant.

During the reporting period, there were significant gaps in the two Team Manager posts, In March 2023, one of the Team Manager posts was filled on a permanent basis with the second about to be interviewed for, which remains vacant, at the time of writing.

2.8. Justice Services Activity

Justice services continued to deliver on their statutory responsibilities during the reporting year. Duties included preparation of court reports and risk assessments, to aid the Court in making effective sentencing decisions; reducing re-offending and protecting the public through supervision and management of offenders subject to community-based disposals; rehabilitation of offenders subject to custodial sentences; and supporting people subject to Diversion from Prosecution.

The Justice team completed various reports during the reporting period, which is considered to be representative of the size and nature of previous justice activity in Orkney prior to 2019/20 and the global pandemic.

There was a total of 70 reports completed, the subjects of which comprised 51 males and 19 females, which resulted in 60 Community Payback Orders.

Table 3 below provides details of Justice Social Work activity from 2019-2023.

Table 3: Justice Activity and Child Protection Orders from 2019-2023

Note: * indicate fewer than 5.

The figures for 2022/23 indicate a rise of 21.4% in the number of Social Work Court Reports completed from the previous year. While there is a noted rise of 53% in the number of CPO’s imposed by the Court. This was an expected rise as the Courts progressed a backlog of cases accrued during the lockdown period in 2020/21, whilst simultaneously dealing with new cases. The figures have realigned with pre-pandemic levels and it is anticipated this trend is likely to continue as there is a presumption of non-custodial sentence and greater use of community based disposals. It is recognised that supporting people within their community is both beneficial to the individual and communities. Should this trend continue however Justice services will undoubtedly see a parallel increase in resources required across services and the workforce.

MARAC is established for people who are experiencing high risk domestic abuse. MARAC is provided for Orkney through the Highlands and Islands Safe Lives service. The Service Manager (Public Protection/Criminal Justice) represents Orkney as part of the Highlands and Islands Operating Group. In the twelve months from April 2022 to March 2023, 32 MARACs in Scotland discussed 5,067 cases, an increase of 10% which equates to 442 cases from the previous year when 28 MARACs discussed 4,625 cases.

Across the 32 Local Authorities there are a number of variants in terms of repeat cases, referral route and also percentage of cases in relation to victim gender. Records reveal the percentage of cases for male victims varies across areas with the lowest being 1.0% in Lanarkshire, and highest being in Highlands and Islands area at 7.8%. These figures do not reflect those in Orkney and over the reporting period there have been no male victims discussed. This raises the question of why Orkney figures are not reflective of those in the wider Highlands and islands area?

MAPPA are a set of statutory arrangements of which the primary purpose is to maintain Public Protection and the reduction of serious harm. The protection of children, adults at risk and other members of the public is paramount. It is a structure by which registered sex offenders, mentally disordered restricted patients and other offenders who, by reason of their conviction, pose a risk of serious harm to the public are managed through the effective sharing of relevant information, and the assessment and management of that risk.

Orkney continues to be part of the Highlands and Islands MAPPA grouping area. The number of individuals managed under the auspices of MAPPA within Orkney remains consistently low. For context, some core figures across the Highlands and Islands for MAPPA are as follows:

• Number of registered sex offenders within the Highlands and Islands area, subject to MAPPA arrangements, on the 31 March 2022 (in the community and in custody) was 284 persons.
• Number of Registered Sex Offenders notified to Jobcentre Plus was 23.

Between April 2022 and March 2023 Orkney noticed an increase in the number of individuals subject to MAPPA arrangements, with the highest number at any one time over the reporting period, being eight. This is an increase of 33% over the previous year although consideration to low numbers should be given.

2.9. Justice Staffing Complement:

• 1 FTE Service Manager (Public Protection/Criminal Justice).
• 2 FTE Social Workers.
• 1 FTE Community Placement Supervisor (Temporary).
• 0.6 Part-time Community Placement Supervisor.
• 0.2 Part-time Criminal Justice Assistant.
• 0.4 Part-time Community Placement Supervisor (Unfilled).
• 1 FTE Community Justice Planning, Performance and Information Officer.
• 0.17 Part-time Criminal Justice Assistant (Unfilled).
• 1.5 FTE Administrative Assistants.
• 1 FTE Public Protection Lead Officer.
• 1 FTE Learning and Development Officer (Public Protection).
• 1 FTE Administrative Assistant - Public Protection Committee.

This year there has been a noted increase in training opportunities for staff relevant to the justice role and risk management, with Social Work staff and supervisors undertaking a variety of training including Trauma awareness training; Spousal Assault Risk Assessment V3; Child protection basic awareness; Risk of Serious Harm Training and risk assessment specific to sexual offending.

2.10. Appropriate Adult Service

The Appropriate Adult Service in Orkney has been run as a voluntary organisation for almost 20 years in Orkney. Following a statutory change, since 2020 the service has begun transitioning over to the Local Authority. In Orkney, this transition was stalled by COVID-19, however it is expected to be completed over 2023/24. A further update on the inclusion of this service within Justice services will be provided within the next reporting period.

2.11. Children and Families Social Work

Children and Families Social Work incorporates child protection, fostering, adoption and kinship, residential childcare, continuing care, after care, children with disabilities, children’s services planning including child poverty action work, amongst other things.

While recruitment continues to challenge us there have been a number of successful recruitments to key positions. Appointments to Interim Service Manager posts for Children and Families Fieldwork and Children and Families Authority Wide Services has allowed us to continue to progress a range of developments in Children and Families Social Work including:

• The extensive Improvement Plan, implemented in response to the Joint Inspection of Children and Young People in Need of Care and Protection, has now become business as usual with core actions embedded in individual service plans.
• Learning Reviews.
• A Position Statement for the Care Inspectorate was provided in March 2023 detailing progress to date in response to the Joint Inspection of Children and Young People in Need of Care and Protection.
• Staff recruitment continues with a dedicated recruitment campaign being developed specifically for children’s services Social Workers and managers.
• Programme developed as part of Grow our Own Social Workers which has resulted in two home grown Social Work students undertaking formal qualification.
• Delivery of training and development.
• Production of practice procedures and guidance.
• Engagement in the process for the introduction of the new national Joint Investigative Interviewing model.
• Continued preparation for the introduction of the national Child Protection Guidance 2021.

2.12. Child Protection

Child protection remains the top priority in Orkney children’s services partnership with further development of procedures, protocols, training and development, and continual self-evaluation throughout the reporting period.

Child protection activity levels have not fluctuated significantly during the reporting period when considered against the size of our partnership area. Activity has changed over the most recent reporting period with less than five new registrations over 2022/23 compared to 16 in 2021/22. The large figures in 2021/22 are in part due to large family groups, with one family making almost a third of all registrations in 2021/22. The deregistration rate also increased due to large family compositions on the register at this time.

Table 4: Child Protection Registration Figures from 2019-2023

Note: * indicate fewer than 5.

2.13. Looked After Children

Looked After Children activity levels have seen fluctuations in the number of children Looked After Away from Home between 2019/20 and 2022/23. Most recently figures were at their highest in 2021/22 where the number of children Looked After Away from Home was 39 which over this reporting period reduced to 33, a reduction of 6 children. Looked After at Home figures also reduced from 13 children to 10 for the same period. In total the number of Looked after Children has reduced from 52 in 2021/22 to 43 in 2022/23.

Table 5 below shows Looked After Child levels from 2019-2023.

Table 5: Looked After Children Trends from 2019-2023

The number of children referred to the Reporter has decreased from 69 to 59 from 2021/22 to 2022/23 and there has been a slight reduction in the number of Children’s Hearing’s held from 96 to 93 in the same period. This is a far greater number than was seen in 2020/21 although the figures of 2020/21 would undoubtedly have been impacted by COVID-19 lockdown and is an outlier compared to the other years.

Table 6: Children Referred to Reporter from 2019-2023

2.14. Fostering, Adoption and Adult Placement (Continuing Care) Services

Following the inspection by the Care Inspectorate on 26 September 2022, nine requirements and two areas of improvement were identified across the three areas of the service: Fostering, Adoption and Adult Placement (Continuing Care) Services. Two of these requirements were made during a previous Inspection in April 2021 and remained unmet as of 26 September 2022. In addition, two improvements made in April 2021 were made requirements on 26 September 2022.

The requirements and areas of improvement included:

• Ensuring foster carers are supported and have access to the appropriate training.
• Improve the quality of permanence planning for children; timescales are met.
• Staff are supported and feel confident in planning permanent alternative care.
• Children and young people receive quality care and support.
• Provide stability and leadership and evidence the effectiveness of the service in meeting the needs of children and young people, via the development of a culture of continuous improvement and implementing robust quality assurance of practice.
• Regular relevant training is available for staff, including formal supervision.
• Support plans reflect children, young people and their families care and support needs are accurately across the service areas and are subject to on-going review.
• Children and young people receive timely progression of plans, and be able to review their files should they wish to do so.
• A clear and specific management vision and planning is required for the service.

Areas of improvement:

• Children and young people to be aware of their rights, have their voices heard.
• Fostering and Permanency Panel members receive relevant training and support necessary for their role.

Work to address the areas highlighted commenced in March 2023 and an action plan created. The improvement journey will be progressed and reported on within the next reporting period.

2.15. Children and Families Staffing Complement

• 1 FTE Service Manager (Children and Families Fieldwork).
• 1 FTE Service Manager (Children and Families Authority Wide Services).
• 2 FTE Team Managers.
• 1 FTE Independent Reviewing Officer.
• 9 FTE Children and Families Social Workers.
• 1 FTE Social Work Assistant.
• 1 FTE Team Manager (Fostering, Adoption and Kinship).
• 4 FTE Social Workers (Fostering, Adoption and Kinship).
• 1 FTE Senior Family Support Work.
• 3 FTE Family Support Workers.
• 1 FTE Attainment Funded Family Support Worker.
• 2 FTE Administrative Assistants (Child Protection, Fostering, Adoption and Kinship).

There have continued to be significant, and at times, prolonged gaps in Children and Families staffing, including the Team Managers, Social Workers, Family Support Workers, and administrative staff across the service.

Interim staff, sourced both internally and externally, have been employed to ensure the functioning of the service and statutory duties for child protection could be met. There was significant staff turnover related to sickness absence, people leaving, short term contracts, retirement, and recruitment challenges.

This has meant, amongst other things, significant challenges associated with workforce stability and the operational delivery of Children and Families Social Work services.

There has been the creation of the Family Support Team which supports early intervention and has made a significant impact to the work of the wider teams.

2.16. Out of Hours Service

The significant challenges with the provision of Out of Hours Social Work services due to staff gaps and absence noted in the previous reporting period have continued into the current period. Vacancy levels have again impacted on the number of eligible staff available to undertake Out of Hours duties, placing an additional strain on the service.

The Out of Hours workstream set up by the Chief Officer resulted in base line scoping and recommendations to address the pressures within this area. It is anticipated that, once the permanent post of Head of Children, Families and Justice Services and Chief Social Work Officer is recruited to, the recommendations will be picked up and progressed.

2.17. Partnership Initiatives

As reported in the previous report, the Orkney Emotional Wellbeing Service led by Action for Children continues to develop and support up to 40, eight to 18 year olds annually.

The charity has a Family Practitioner who focuses on vulnerable children, young people and families affected by alcohol or drug use and is jointly funded by Action for Children and the Orkney Health and Social Care Partnership.

The Service has supported someone with alcohol and substance misuse issues, who was taking risks that adversely affected not only themselves, but their dependents, and who has, through Teen Triple P and Decider Skills work, lowered their risk taking behaviour, knows they have better mental health support and, as a parent, feels more equipped to manage situations at home.

Diversionary youth work sessions have been provided weekly in Stromness for circa 30 people with young people being involved in ensuring that what is provided is what they need and that they feel they can drop into a safe space. The diversionary youth work sessions are in partnership with the Community Learning and Development staff. Over an eight-month period, a young person who was refusing to attend school, and would not engage with services, is now attending school part-time and working to return full-time and is engaging in other activities to improve their physical and emotional wellbeing.

The Growing Up in Orkney website, commissioned by the Orkney Children and Young People Partnership (OCYPP), provides advice, support, and signposting, for children and young people. The picture below provides data from June 2022 to June 2023.

IMAGE: Infographic titled “Website Stats - June 22 to 23” for the Growing Up in Orkney website. It reports 2K users and 1.9K new users; a highest weekly number of users of 89 in August and 85 in April; 1,407 total downloads and 136 training video views for professionals; 73 Instagram followers, 98 Facebook likes/followers, 27 posts and 291 people reached; average engagement of 1 minute 27 seconds; 375 users returned after their first visit; top pages of Resources, Homepage, What Support, and Groups and Clubs; 39 content updates and 13 blog posts; and contacts consisting of live chat 9 times, email 17 times, and 17 survey responses.

3. Service Improvements in Children’s Services: Joint Inspections

The Joint Inspection of Children and Young People in Need of Care and Protection in Orkney took place between August and October 2019, published February 2020. It concluded that the inspection partners cannot be confident that Orkney Partnership will be able to make the necessary improvements without additional support and expertise.

A robust action plan was created to deliver the recommendations from the report and a project management approach was adopted to oversee and drive the work. This included bringing in additional staff resources to provide extra support, experience, and capacity to deliver the identified improvements.

The findings of the Care Inspectorate first and second Progress Reviews were covered in the previous reporting periods. A Position Statement was provided to the Care Inspectorate in March 2023. The work on this statement is detailed in the information below for this reporting period with feedback anticipated in May or June 2023.

3.1. Progress Review Summary

Chief Officers, senior leaders and partnership representatives met in person, with the Care Inspectors to discuss the findings of the second Progress Review, prior to its publication, from which there were five areas of positive note:

• Leaders were working hard to address the findings of the full inspection and the first progress review.
• Membership of key groups driving improvements had been refreshed and additional capacity and resources had been identified to support change.
• Young people’s views were beginning to influence strategic developments.
• Practitioners were similarly committed to improving their own practice and outcomes for the children and families with whom they work.
• There was compelling evidence that what the Partnership has accomplished to date is resulting in increased safety for children and there are early signs of increasing confidence from families.

There main summary areas of the Care Inspectorate feedback following the Children’s Services Partnership Position Statement:

• The Care Inspectorate recognised that the Position Statement was produced alongside responses to both the recent fostering and adoption and the ASP inspections, and acknowledge the work that this has required.
• The second progress review had highlighted eight areas where further improvements were anticipated, and the Care Inspectorate stated that it was encouraging to hear of the progress being made.
• Specific feedback is provided for each of the eight areas identified as requiring further improvements.
• The Position Statement is provided alongside the Care Inspectorate feedback for ease of reading.
• The feedback summarised that the Position Statement had outlined several developments and progress towards the eight areas of improvement arising from the second progress review and acknowledged that there remains work to be done across many of these. It was noted that the further progress that they had hoped to see had been affected by staffing changes and challenges outlined. The Care Inspectorate stated that it will be important that the senior leaders now in post really drive forward demonstrable improvements for the benefit of the children and young people and their families in Orkney.

Although there is much still to do on the improvement journey, the future monitoring of this will be done via the link inspector, and Orkney’s Children’s Services will be inspected through the normal cycle of inspections once more.

3.2. United Nations Convention on the Rights of the Child

The United Nations Convention on the Rights of the Child (UNCRC) was ratified in 1991 and came into force on 15 January 1992 but has not been incorporated into UK law.

Although it declares inalienable rights it does not provide for any mechanism of enforcing those rights in the domestic UK Courts. The UK Government is bound by the UNCRC. The Scottish Government has brought a Bill forward to incorporate the UNCRC direct into Scots Law.

This would give Scottish citizens the right to assert UNCRC rights in the Scottish Courts. It was passed as a Scottish Bill in March 2021 seeking to confer duties on public authorities to be compatible with UNCRC requirements, which would be enforceable in the Scottish Courts. However, in October 2021, the Bill was blocked by the Supreme Court from becoming an Act after the UK Government successfully challenged it in court for going beyond the powers of the Scottish Parliament. The Bill has been on hold since then.

The Bill expects that local authorities will have in place appropriate and effective policy, practice, and procedure, which are capable of delivering the rights contained in the UNCRC.

The UNCRC places the child at the centre which requires a paradigm shift in approach, viewing the child as an independent person and not an object of concern or protection. There is a fundamental need to accept the child’s right to express their views.

The Partnership is currently revising strategic planning arrangements and UNCRC rights for Children and Young People will be concerned as part of that.

3.3 The Child as a Rights Holder

Article 12 of the UNCRC (respect for the views of the child) details that every child has the right to express their views, feelings and wishes in all matters affecting them, and to have their views considered and taken seriously. This right applies at all times, for example during immigration proceedings, housing decisions or the child’s day-to-day home life.

Article 12 also gives considerable weight to children as autonomous beings. It is not sufficient to exclude their views by adopting an adult centric position. There must be reasoned decision making based on evidence, if children are to be excluded from expressing their views. Uninformed speculation about what is not known or what might be, will not do.

Legal opinion states that where there is no material to infer parental harm, the views of the child who wants parental involvement may have particular weight. As such, a blanket approach would not be conducive to the child, therefore any variation should be justified on a case-by-case basis.

3.4. Staff Engagement

The partnership, led by Chief Officers, met with the Children’s Services workforce on 30 May 2022 to discuss the final draft second Progress Review report. There was very good attendance with over 70 people at one point, in reflective discussion, sharing the findings of the review and allowing Chief Officers and leaders to thank the workforce for their efforts and continued contributions.

4. Island and Rural Social Work – Key Challenges

As with previous reporting periods, the Orkney Health and Social Care Partnership continues to face three significant barriers and challenges which impact on each other:

• Recruitment and Retention.
• Capacity.
• Funding and Resourcing.

4.1. Recruitment and Retention

Recruitment from within our local communities remains a challenge; due, amongst other things, to population size, varied career choices and the challenges of dual relationships in living in small island communities.

There is now, what can only be described, as a crisis in the recruitment and availability of Social Workers, and other professionals, which is experienced across most of Scotland. Some initiatives we have engaged with to try to address our challenges include:

• Registered with the SSSC, return to practice scheme.
• We have noted interest with the NHS Education Scotland National Care Service Directorate migrant worker initiative.
• Specific recruitment campaigns and encouraging current staff members to share their stories of what it is like to work in Orkney on Social Media has been developed.

Throughout 2022/23, Orkney College has delivered short ‘Introduction to a Career in Care’ courses which guarantees everyone who completes the course to get an interview with either the Council or Third Sector.

4.2. Capacity

The capacity of small Councils and Health and Social Care Partnerships can present challenges for undertaking the range and scope of all requirements expected of any such organisations.

As per previous reporting, operating in smaller health and care systems presents challenges and opportunities, which can hinder or enhance innovation and transformation. In Orkney, the small-scale nature, for example, of our operational Social Work services can lead to speedy and effective new service delivery models and practice being introduced and embedded.

Conversely, it does however mean a small number of distinct Lead Officers are involved in delivering a range of diverse and complex change initiatives, including drafting, reviewing, and updating policies, guidelines, protocols, and procedures; new working practices; evidence-based research approaches; new legislation; and social policy changes, while at the same time running safe and effective frontline services and managing increased demand.

As per the previous reporting periods, balancing strategic planning and operational delivery is a challenge generally and is intensified in rural and island settings particularly when faced with the staffing issues mentioned above.

Work was progressed throughout 2022/23 to develop proposals for consideration by the Integration Joint Board for approval to add additionality to support services. Further information will be provided in the next iteration of this report.

4.3. Funding and Resourcing

The challenge facing Social Work and Social Care services relates to the climate of public funding including savings requirements. This can jar between the challenges of available resources and funding versus public demand and expectation.

Successful management of demand, amongst other things, depends on the development of preventative and community-led approaches to ensure support is received in the right way, at the right time, thus reducing the demand for urgent and high-intensity support later.

As mentioned previously, work across the Orkney Health and Social Care Partnership occurred during 2022/23 to identify gaps and to develop proposals for additional roles which could support and strengthen services. Progress of this work will be presented in the 2023/24 report.

5. Resources

The main financial issues reported throughout the year were:

5.1. Children and Families

Social Work services have been experiencing high levels of vacancies and sickness absence for a considerable length of time, including key leadership and management roles, all of which has had a significant impact on the service’s ability to deliver effective and statutory social work services to children, young people and their families. Unfilled positions combined with significant recruitment challenges has resulted in the need to employ locum staff.

Most importantly, the statutory requirement to provide social work services for children and young people, particularly in the field of child protection, requires the ability to respond to need quickly. Temporary arrangements to ensure this capacity have incurred significant, additional, unfunded expenditure.

There are also additional costs for residential care within Orkney due to the children’s house being at full capacity. The requirement for placements outwith the local authority area have also increased for children who require a more specialist service, that cannot be provided in Orkney.

5.2. Adult Social Care Services

Pressure on adult social care services was growing prior to the pandemic; that pressure has continued to grow with increased referrals for all forms of adult social care. A stark example of this is that it has not been possible to resume pre-pandemic planned respite care levels as adults in crisis, for a variety of reasons, have required immediate and unplanned support. People delayed in Hospital have been very variable in both number and cause but are often due to the lack of legal powers being in place to enable future arrangements to be put in place. This regularly places undue pressure on Hospital services, and can occur at any point during the year. Setting aside the legal impediments re discharge, work in this area is ongoing regarding other discharge opportunities. This has included exploring discharge to a Care Home until a community care package is ready however, in most instances, this has not been met with agreement from service users and their families.

5.3. Older People

There is a continued reliance on agency staffing due to recruitment issues and long-term sickness absence within residential Care Homes and supported accommodation. COVID-19 and Norovirus continues to have sporadic impacts on all the Care Homes and supported accommodation services.

It is evident families seeking short breaks are continuing to do so, predominantly when a crisis point has been reached and significant help is required. Whilst there is no formal evidence, it seems likely this is at least in part brought on by the cessation of short breaks during lockdown. The usage of short breaks continues to be monitored.

Regarding staff vacancies, recruitment relating to social care staff continues to be an ongoing process. Services continually endeavour to recruit and retain staff however as elsewhere in the UK, they are finding it difficult to recruit from a limited available workforce. Services rely at present on the use of additional hours from permanent staff members, Relief staff and locum workers to backfill any vacancies they may have. As noted in previous reports the workforce is ageing and much of the work is physically demanding despite modern day equipment. Workforce planning will remain a key element of activity in the forthcoming year.

5.4. Care at Home

The demand for Care at Home continues to grow as the ageing population is continuing to increase and people can remain in their own home. This is in respect of all care at home provision; in-house, third sector and as Self-Directed Support. Once an assessed need has been identified and agreed, budget availability cannot be a deciding factor on provision of service due to the current eligibility criteria.

This demand coupled with the ageing workforce, associated staff absences and an ongoing vacancy issue, has led to the need to support the in-house service with a significant number of locum staff. Scottish Government in recognition of this national issue has provided recurring funding to try to address the care at home service provision shortfall. Despite the approval of increased pay scales of Care at Home staff by the Integration Joint Board these pressures remain.

The creation of the Home First team and additional Occupational Therapy assessments to reduce the number of people that require two staff in relation to moving and handling has created some capacity, although the service will be considering other mechanisms over the coming year to make Care at Home more sustainable including ways to improve recruitment.

5.5. Year End Position

The revenue expenditure outturn statement in respect of Social Care for financial year 2022/23, had a balanced position as shown in Table 7 below:

Table 7: Indicative Budget to Full Year Spend

The additional allocations can be broken down as follows in Table 8, budget summary to allow a balanced position:

Table 8: Budget Summary

Table 9 – Usage of Reserves

At a meeting with the Parties (NHS Orkney and Orkney Islands Council), it was suggested that a three-year savings target be applied which would give the Integration Joint Board a set figure to work towards over a three-year period. In total there was a savings target of £4.2 million to be achieved by the end of 2022/23 which was split as follows:

Table 9: Partner Savings

Regarding financial year 2022/23 the savings applied from NHS Orkney for services commissioned is now £2.4 million. Within the Orkney Islands Council settlement there has been a recognition of the exceptionally difficult second year of the pandemic and the acute pressure services have been under to maintain existing provision, therefore, no efficiency savings were requested in setting the 2022/23 budget.

5.6 Sustainability Challenges

Due to medical advances and improved quality of care, individuals who require or are in receipt of complex care (also known as long term care or continuing care) have substantial and ongoing health and social care needs. These can be the result of chronic illness, disabilities or following hospital treatment. Social care services were previously more general in nature but there is an increasing requirement for specialist input as individuals have the rightful expectation to receive care whilst in their own homes.

Although this challenge is not unique to Orkney, our older population is increasing faster than the national average. In addition, significant numbers of our working age population are leaving the islands and so fewer people are available to provide the care and support required with the predicted levels of chronic illness and disabilities.

People in the older age group are most often in need of health and social care services. The National Records of Scotland have produced population projections for Orkney.

The graph below illustrates the percentage change in projected population by age group between 2018 and 2028. The 0 to 15 age group is projected to see the largest percentage decrease (-11.5%) and the 75 and over age group is projected to see the largest percentage increase (+37.4%). In terms of size, however, 45 to 64 is projected to remain the largest age group. This will have a significant impact on how we deliver services in the future.

IMAGE: Bar chart titled “Orkney Islands — Percentage change in projected population by age group, 2018 and 2028”. It shows projected changes of -11.5% for ages 0 to 15, -0.3% for ages 16 to 24, -0.8% for ages 25 to 44, -8.9% for ages 45 to 64, +10.2% for ages 65 to 74, and +37.4% for ages 75 and over.

Table 10: Percentage Changes in Population from 2018 to 2028

Alongside the challenges, the contribution older people make to our society needs to be recognised. People over 65 years of age deliver more care than they receive – acting as unpaid carers, child minders, and volunteers. Their contribution, as wise, experienced, stable, citizens overall, to our communities and our society as a whole is considerable, providing continuity and stability in our social fabric.

6. Workforce

There continues to be significant difficulties in recruiting to, and in retention of, certain posts within our Social Work and Social Care services. With a limited labour pool available and increasing demand, recruitment within our adult Social Care services and Children and Families Social Work services has been a continual activity. From 2020 continuing into 2021 and 2022/23, we have needed to recruit agency Social Work and Social Care staff to Orkney for both short and medium periods of time to ensure continuing safe delivery of service.

As mentioned earlier, work has been ongoing to identify potential additional posts which will support and strengthen services. Further details will be provided in the next report.

6.1. Staff Development

During this period, training was evenly split between face-to-face practical sessions and online training sessions.

The following staff training and developments have been completed as identified within Strategic Inspection, detailed in Table 12 below:

Table 12: Training and Developments

Child Protection Basic Awareness and General Workforce training has been regularly run by the Learning and Development Officer (Public Protection) since being recruited into post in February 2023. Further update will be provided in the 2023/24 CSWO report.

Studio 3, Crisis Management training, was not delivered during this time. Promoting Positive Behaviours was identified as an alternative course and delivery will be reported upon in the 2023/24 CSWO report.

Other training delivered to Social Care staff included Basic First Aid, People Handling, Practical Medication Training and Epilepsy Awareness. Mandatory and existing training courses continue to be available for Orkney Health and Care Staff.

All frontline care staff were required to complete NHS Orkney COVID-19 Infection Control PPE Training in addition to the mandatory iLearn course. The complete programme will be refreshed by all staff every 12 months.

A full training programme with accompanying training calendar is being progressed by the Learning and Development Officer (Public Protection) to alert staff across all sections and agencies of training opportunities.

Table: Staff sponsored by Orkney Health and Care to undertake a qualification as part of their role (and commenced this qualification between 1/4/22 and 31/03/23).

Note: in the HNC Social Services and SVQ 3 courses – there were employees from Orkney Health and Care attending the course, but their fees were covered by SAAS funding so while an agreement was in place to sponsor any remaining balance, there was no need to do so.

Sharon-Ann Paget

Acting Chief Social Work Officer

Orkney Islands Council / Orkney Health and Social Care Partnership.

Date: 30 August 2023.