Adult social care 2022 to 2023: joint statement of intent and next steps

Annex A

Update on progress with the joint Statement of Intent

In March 2021, the Scottish Government and COSLA issued a joint Statement of Intent outlining how we will work together to deliver the key foundation pillars set out in the Independent Review of Adult Social Care in Scotland.

Many of these commitments have been completed, but others are more complex to implement and require further consideration of how these changes might impact on other parts of the system. This is so that the development and implementation of these commitments is grounded in strong evidence and partnership working.

Progress on the Joint Statement of Intent published in March 2021

Commitment: Adult social care workers in Scotland will be paid at least the Real Living Wage of £9.50 per hour. Work will begin at pace to implement this commitment from May backdated to April 2021.

Completed. This commitment has now been superseded by the £10.02 (Dec 2021) and £10.50 (April 2022) Adult Social Care Pay Uplifts.

Commitment: By May 2021, develop a minimum standards framework for terms and conditions. This will lead to the establishment of core requirements for ethical commissioning which will ensure that going forward, fair work requirements and principles are met and delivered consistently.

Completed. Workstream 2 of the Fair Work in Social Care (FWiSC) Group was established in 2021 to take forward work on capturing and benchmarking current practice in the NHS and Local Authorities and also collating current terms and conditions practice across provider organisations, through a survey.

Work took place across 2021 to prioritise terms and conditions and analyse the potential cost implications of implementation. The FWiSC report, published in June 2021, set out recommendations for progressing minimum terms and conditions across the sector. There is now agreement that this work will recommence at pace.

Commitment: Develop a minimum standards framework for effective voice across the whole of the social care workforce. This will enable the workforce to respond to local conditions and address matters of importance, and support an effective collective bargaining role in the sector.

Completed. Minimum standards for effective voice have been developed by the Fair Work in Social Care group members, with work now focusing on implementation and setting quality standards for the framework.

Commitment: An end to charging for non-residential services as soon as possible.

In progress. The Scottish Government and COSLA, through the established Short Life Working Group with membership from stakeholders such as Council Directors of Finance and IJB Chief Finance Officers, have undertaken a data collection exercise to ascertain local expenditure and income related to non-residential social care charges.

Further work is now underway to develop plans to end charging for non-residential services and secure agreement to a way forward.

Commitment: Deliver shared ethical commissioning principles.

In progress. Principles have been developed and consultation with Local Government representatives and Scotland Excel has taken place, and these were included within the National Care Service consultation.

COSLA and Scottish Government have jointly agreed to develop a structured programme of work for the social care workforce, and advancing and embedding ethical commissioning principles will form a key strand of this.

This work will also closely link with the re-design of the National Care Home Contract which is currently underway.

Commitment: The overhaul of the current mechanism of eligibility criteria to ensure an approach to social care support that is based on human rights and needs.

In progress. Policy options are being developed through the Preventative and Proactive Care Programme, with the intention of testing these through our Getting It Right For Everyone (GIRFE) pathfinders.

Further engagement is now underway between Scottish Government and COSLA to understand the development of policy, impact, feasibility, cost and implications for other areas, such as self-directed support and the removal of non-residential social care charges.

Commitment: A mechanism which ensures the voices of those with lived experience are at the heart of policy development, service design and service delivery.

Completed. Scottish Government has established the Social Covenant Steering Group, the majority of group members have lived experience of social care.

The Minister for Mental Wellbeing and Social Care and COSLA's Health and Social Care Spokesperson attend these meetings to hear directly from those using services.

Commitment: Ensuring that unpaid carers are fully supported to have a life alongside caring, in order to protect their health and wellbeing and better sustain caring roles.

In progress. Working in partnership to ensure resources are targeted to effectively support carers, such as to fund information services, short breaks from caring, support towards outcomes in Adult Carer Support Plan or Young Carers Statement.

The Scottish Government has committed to the publication of a National Carers Strategy developed in consultation with unpaid carers, representatives of support organisations and Local Government.

How we will improve social care in the coming year

Embedding Human Rights and Care for people

A human rights approach has long been seen as integral to social care and we know that people want further action now to fully embed Human Rights approaches to improve care for people.

A Preventative Approach

We know how important early intervention and a preventative approach are to help people lead healthy and fulfilling lives, and to reduce the need for unplanned care. Ten years on from the Christie Commission, there are a number of positive examples of preventative approaches across Local Government, including:

• interventions to support people to remain in their home for longer and prevent admission to care homes or hospitals,
• services for children and young people at risk of offending,
• welfare rights advisors in GP surgeries, and
• homeless prevention services.

The Scottish Government and COSLA share a strong desire to improve care for people across their life by continuing to embed prevention, early intervention and anticipatory care, with ongoing co-design and human rights at the heart of the approach. The role of services and stakeholders both within the traditional health and social care system, and outwith, must be harnessed collectively to improve individual and community wellbeing. Preventative approaches go beyond the boundaries of social care and health services. Housing, economic growth, education, leisure, community development, are all essential in delivering joined-up public health approaches to prevention and wellbeing. Investment in prevention is critical to success and there needs to be whole-system thinking about health and wellbeing across the public sector in order to improve outcomes and address health inequality.

Local services play a key role in preventing poor health outcomes and reducing demand on more costly health services, as well as helping to enhance Covid recovery and improve people's quality of life.

To support a preventative approach, people must have a strong voice in planning their own care. Their strengths and needs must be at the centre of the approach throughout, regardless of what services people interact with. To make this happen consistently, services must work together routinely to support and empower everyone in Scotland. Each person has multiple, interconnected needs and wishes (physical, mental and social). Care must take place in the most appropriate place to support a person's needs and their health and wellbeing, with each person having a voice in the care and support they receive.

This will ensure that there is:

• A clear pathway for people to access the right support and services at the right time in the right setting.
• The right culture and processes to ensure people and their carers are engaged and empowered throughout the process, and their human rights respected.
• A common language used across all services.
• A single planning process supporting a Single Adult's Plan across all relevant services.
• Information sharing in a lawful, appropriate and proportionate way.
• A Lead Professional to co-ordinate multi-agency plans.
• An assessment framework that takes a strengths-based approach. A clear understanding that the assessment determines plan and service delivery.
• Less bureaucracy, complexity and duplication, and fewer meetings

This will be supported by a strengthened focus on multi-disciplinary teams and inter-disciplinary working across the public, third and independent sectors to support people.

Getting It Right For Everyone

We also know through our engagement with the public that there is strong agreement with plans for the Getting It Right For Everyone (GIRFE) national practice model. Common reasons given included:

• A model would limit misunderstanding and confusion caused by different languages, jargon and acronyms currently used by different professionals
• It would create a more consistent system of communication and equity in care requirements
• While the aim of consistency was welcome, there was also a recognition that flexibility was required to take account of individuals and their own circumstances
• Getting It Right For Every Child was an example of a good benchmark for what currently works in children/family care across professions

As driven by implementation of the Social Care (Self-directed Support) (Scotland) Act 2013 as well as the Carers (Scotland) Act 2016, we know how important it is for families and carers to be involved in support planning and that decisions about the support people get should be focused on the outcomes they want to achieve to live a full life.

A single plan under the GIRFE national practice model, alongside an integrated social care and health record, would streamline processes and make the system easier to navigate. The aim is to reduce complexity; creating a clear and transparent process, while acknowledging the uniqueness of each individual and their situation; easing transitions; and providing continuity of care.

Working with partners we will begin to implement GIRFE, a multi-agency approach of Health and Social Care services and support from young adulthood to end of life care. GIRFE will help define the adult's journey through individualised support and access to services when it is required. GIRFE places the person at the centre of the decision making process to achieve the best outcomes, with a joined up, coherent and consistent multi agency approach regardless of the support required at any stage of life. This will draw on the GIRFEC approach that is a key part of children's services, as well as the findings of the IRASC and other recent approaches to adult social care.

We can begin to test and implement these approaches now, without legislation.

Valuing the workforce

Workforce supply is often cited as a key issue in securing improvements in social care. Workforce supply issues are long-standing and predate the pandemic and EU exit, but have become more pressured with the impact of both. There are issues in both recruitment and retention and indeed across the whole workforce journey. The impact of local labour markets means that workforce dynamics and competitor sectors vary across the country. Low, inconsistent levels of pay and poor terms and conditions particularly in some sectors, together with perceptions of social care, are some of the factors that need to be addressed both on a national level and locally.

There is some excellent learning and development practice across the country but it is important to have more consistency of access to quality support, while also reflecting the local context. Individuals must have both access to and the time needed for learning.

The Scottish Government and COSLA have a long-standing commitment to the principles of Fair Work for the social care sector. We are fully committed to improving the experience of the social care workforce, including increasing levels of pay and improving terms and conditions, as part of a wider Fair Work approach, recognising and valuing the work that they do. The Scottish Government has provided funding of £200 million to Local Government to support investment in health and social care and deliver a £10.50 minimum wage for all adult social care staff in commissioned services from 1 April 2022.

In March 2022, the Scottish Government and COSLA published in partnership the National Workforce Strategy for Health and Social Care. The Strategy outlines our shared vision for a sustainable, skilled workforce with attractive career choices where all are respected and valued for the work they do. Our tripartite aim of Recovery, Growth and Transformation supports both the NHS Recovery Plan and recovery of our Social Care services and workforce. It also sets out the actions we will take in partnership with the workforce and across the sector to achieve the Strategy's vision. The Strategy looks at the whole workforce journey and how we can plan for, attract, train, employ and nurture our Health and Social Care Workforce. This is the first time we have articulated a workforce strategy for our Health and Social Care workforce in this way.

Staff wellbeing support is paramount, to allow individuals to provide the level of care needed, to feel valued, and to support staff retention. The pandemic has placed unrelenting pressure on people for over two years. The Wellbeing Fund for Adult Social Work and Social Care is a £1 million fund designed to support projects which look after the wellbeing of staff working in Adult Social Work and Social Care across the public, private and voluntary sectors.

Social Work profession

Investing in the social work profession is crucial to ensuring quality service provision and enabling social workers to work with people to transform their lives. Social work is inextricably linked and crucial to the success of social care. There is a shared ambition to drive improvements across the social work workforce. The Setting the Bar report, published by Social Work Scotland, revealed a strong sense of a proud, values-led profession, concerned with making a positive difference to people's lives. However the report also highlighted challenges around workloads and caseloads; the ability of social workers to work with people in the way that they have been trained to do; difficulties in undertaking enough preventative work; and concerns that the unique contribution of the profession is not clearly enough understood and valued.

The Scottish Government and Local Government, along with other partners, will seek to develop a package of measures to invest in our current and future social work workforce. It is expected that the package of measures will include improving pre/post social work qualifying education and development, rewarding the attainment of knowledge, qualification and skills and scaling up and implementing good practice and social work improvement.

Work has already begun on several key projects to support the social work workforce including the development of an Advanced Practice Framework to support social workers to progress through different career phases. The Social Work Education Partnership (SWEP) is undertaking vital work to future proof Social Work Education and ensure that the profession has a workforce of skilled, knowledgeable social workers. We are also progressing proposals for a Centre of Excellence (CoE) to ensure a more co-ordinated and consistent approach to quality improvement, research and evaluation.

In addition, we are scaling up work across Scotland to ensure a mandatory supported year for Newly Qualified Social Worker's first year in practice and, in collaboration with key stakeholders, we have developed a programme of trauma training and implementation support for social work services.

As well as measures to support the social work profession, and to continue to deliver the type of improvement the social care workforce requires, a Social Care Workforce Programme of work is being established that will take forward four initial key areas of focus:

• Workforce planning
• Ethical Commissioning
• Learning and Development
• Fair Work in Social Care

Workforce planning

A Scottish Government/COSLA project group has been established to deliver against the commitments set out in the National Health and Social Care Workforce Strategy as agreed between COSLA and Scottish Government. This will directly support planning capacity for recovery, for example by undertaking workforce modelling and projections to better understand what additional workforce supply is required to meet the current and future demand. A further working group will also focus on Adult Social Care recruitment, retention and international recruitment, helping to secure a workforce that is both diverse and representative of the communities we serve. We expect elements of the work to include:

• Publication of indicative projections for the Health and Social Care Workforce growth
• Obtaining a national picture of workforce planning capacity, methodology and capability in local authorities/ Health and Social Care Partnerships, for planning Social Care services
• Improving the quality of the workforce data, including the demographic data we collect, and to progressively improve the quality of analysis we undertake from data collected, at different geographic levels
• Development of a suite of tools to support workforce planning capability across Health and Social Care providers
• Understanding and analysing local workforce plans 2022, in turn helping to inform national workforce plans

Fair Work in Social Care

Fair Work supports and enhances other improvement work, ensuring those who work in care are offered fulfilment, security, opportunity, respect and effective voice.

Work to progress these aims will continue, including:

• Development and implementation of a job evaluation scheme which will define typical worker roles
• A review of differentials and identification of appropriate rates of pay
• Identifying implementation options for enhanced pay, considering how differentials can be addressed
• Developing proposals to ensure pay linked to progression and development, including qualifications and experience
• Identifying implementation options for any changes to terms and conditions in commissioned social care services
• Launching identified Effective Voice Standards that supports the workforce opportunity for effective voice in their local workplace

Personal Assistants (PAs)

We recognise the importance of Personal Assistants (PAs) who offer bespoke personalised and flexible care, enabling those with support needs to remain healthy and at home for longer.

A Programme Board was set up in August 2021 to fully understand the wider issues which affect PAs, including advice and training to PA employers; offer support, development, and optional registration; and to promote the value of the role.

Learning and Development

A working group jointly led by NES and SSSC has been established to consider the required learning and development and support that members of the workforce require, ensuring national standards can be delivered and implemented and there are clear career progression routes available across and within social care. This work will take place in close conjunction with workforce modelling, recognising that quality learning and development requires a steady baseline of workforce supply. We expect to focus on:

• Continued support and review of the newly implemented induction framework
• Development and launch of a national learning offer to complement and enhance local arrangements and CPD support
• Review of existing progression routes and identification of opportunities to improve existing programmes
• Developing recommendations that support clear and accessible national career pathways (social care/hybrid) and supporting development pathways
• Creation of transferrable qualifications
• Review of leadership development support and identifying opportunities to enhance and develop further support for existing and emerging leaders, aligned to workforce planning needs
• Reviewing and assessing how progression and qualifications can be aligned to pay through recommendations
• Developing recommendations of alternative training opportunities out with traditional routes and opportunities that could be further developed, such as established career pathways through Modern Apprenticeships

Ethical Commissioning

Ethical commissioning and procurement standards will reflect the values we expect in social care and social work and allow us to focus on those important issues that will affect how care is planned, designed, sourced, delivered, and monitored. They will also recognise the workforce by developing minimum fair work standards, promoting enhanced terms and conditions and will contribute to climate resilience/climate change adaptation in future by taking account of the irreversible impacts of climate change.

Engagement has begun to develop and agree national ethical commissioning principles that can be applied consistently and legally across all areas that promote and accelerate fair work. We will draw on existing expertise including Scotland Excel and improvement bodies to contribute to this work.

We will continue to work together to develop and agree national ethical commissioning principles, which could include:

• person-centred care first
• human rights approach
• full involvement of people with lived experiences
• fair working practices
• high quality care
• climate and circular economy
• financial transparency, sustainable pricing and commercial viability
• shared accountability

Ethical commissioning will be a critical part of the delivery of care and progress towards better outcomes. We have set up a working group to explore areas of good practice and how they might be expanded, as well as understanding barriers within current commissioning and procurement arrangements. The Scottish Government has provided funding this year to Coalition of Care and Support Providers in Scotland (CCPS) to provide cross-sectoral support to organisations and people looking to improve how social care is commissioned and procured.

Valuing people who provide unpaid care

The pandemic has underlined the importance of unpaid carers, but it has also put further strain on them as the amount of care they had to provide increased, often with reduced support or access to breaks from caring when public health guidance meant these services had to stop or reduce operations. As Scotland adapts to living with COVID, it is more vital than ever that we support unpaid carers to continue providing care for their loved ones as part of a balanced and fulfilling life.

As a short-term measure, the Scottish Government provided an additional £4 million to organisations supporting unpaid carers at the start of 2022. This included £3 million for local carer centres, helping them to expand their vital support to unpaid carers in communities across Scotland.

Local government is delivering an additional £20.4 million of local carer support in 2022-23, bringing the total investment in implementation of the Carers Act to £88.4 million per year. Alongside this, a £500,000 fund was established in April 2022 to help local carer organisations improve their capacity to support unpaid carers in their areas. The Scottish Government has also expanded the voluntary sector Short Breaks Fund to £8 million for short breaks 2022/23 from £3 million the previous year, enabling more families and young carers to take a break from caring. As a longer term measure, the National Care Service Bill includes proposed legislation to establish a right to breaks from caring for anyone who needs that support.

The Scottish Government and COSLA are committed to ensuring that the importance of unpaid care is recognised and that people who provide care in this way get the support they need. The Scottish Government will publish a Carers Strategy with an immediate focus on ongoing COVID-19 recovery and a longer-term purpose of improving carer support in a meaningful and sustainable way. The strategy will focus on carers and their needs, setting out how policies across the Scottish Government can work together with local government and the Third Sector to support carers, including access to training and breaks from caring. The strategy will reflect extensive engagement with those with lived and living experience, including unpaid carers.

Community Wealth Building and supporting the Third Sector

Together, we will apply the principles of community wealth building to all of this work:

• progressive procurement – developing local supply chains of businesses likely to support local employment and keep wealth within communities
• fair employment and just labour markets – using anchor institutions to improve prospects of local people
• shared ownership of the local economy – supporting and growing business models that are more financially generative for the local economy
• socially just use of land and property – developing the function and ownership of local assets held by anchor organisations, so local communities benefit from financial and social gain
• making financial power work for local places – increase flows of investment within local economies by harnessing and recirculating the wealth that exists

We know that new organisational and delivery models are developing across the country, including community-based organisations, co-operatives and new, innovative models. We want to encourage and support people to be active in their own communities and to support and grow business models for adult social care that ensure communities can thrive. We will engage proactively with partners to understand what is already working locally and to consider what support people and places need to do things differently.

Strengthening Integration, Planning and Performance

The 2018 Audit Scotland Health and social care integration: Update on progress review of integration progress, and the 2021 Independent Review of Adult Social Care both found that there is much about adult social care support in Scotland that is 'ground-breaking and worthy of celebration', including the integration of health and social care which enables joined-up and collaborative working. Integration Authorities have been addressing some significant, long-standing, complex and inter-connected issues in health and social care. High-quality leadership is a critical part of the success of integration, and in the areas where integration is most embedded, partners are able to work constructively towards achieving their objectives. Improving understanding of each other's priorities and working cultures helps partner organisations progress towards integration.

A review of Integration Joint Board Strategic Commissioning Plans has been undertaken and, in partnership, we will review existing guidance to further strengthen planning and commissioning processes.

Annual Performance Reports (APRs) and associated guidance will also be reviewed in collaboration with partners. We will work with stakeholders to consider whether to amend legislative requirements to help ensure the APR process can draw on the most appropriate and timely data. We want to see a clear focus on enhancing reporting and more meaningfully measuring the achievement of outcomes.

We will continue our engagement with third and independent sectors, including the Coalition of Carers in Scotland, Partners for Integration and the ALLIANCE, with a focus on enhancing reporting and measuring the impact of outcomes, and supporting carers in their role on Integration Joint Boards.

We intend to work with a broad range of partners to develop and improve our broader approach to planning, improvement and self-assessment in adult social care and social work. We want to consider how we can best plan for the short, medium and long term, ensuring that the needs of our people and staff are met and that our models of care meet the needs of people. We are keen to explore how we understand the needs of our people, model demand for the future for the whole system and ensure that we have the workforce capacity and capability to meet that need.

The Framework for Community Health and Social Care Integrated Services outlines a number of organisational development enablers, including collaborative leadership, clarity of vision, well-developed relationships, and culture and values, that enable successful delivery of integrated services. The Framework also outlines the need for 'shared accountability across all of the partners for the delivery of change'. We intend to work with all partners in the coming months to develop a self-assessment process to understand progress with the Framework and secure improvement.

To ensure this is embedded we will also need a comprehensive approach to sharing good practice and collective learning. We currently have the 'good practice' website, providing examples of service planning, engagement and delivery of community-based services, aligned to the Framework. We will co-design the approach to collaborative learning with our partners, consider different models, enhance current networks and where needed, build new ones.

Data and Digital and Technology Enabled Care

The Independent Review of Adult Social Care highlighted the need to address gaps in national provision for social care and social work and had a specific recommendation on how improved data and digital infrastructure are critical to helping people live fulfilling, independent lives; enabling professionals to support those people; facilitate ethical and collaborative commissioning; underpin regulation and improvement programmes; support workforce planning; and facilitate research and intelligence. Many of the other recommendations set out in the Review are premised on the need for good quality data and digital infrastructure.

The January 2022 Audit Scotland Social Care Briefing highlighted various issues with data in social care. These included an inability to share data between organisations and major gaps in information needed to inform improvements in social care. Together, we are committed to improving data and digital to deliver broader benefits in order to inform improvements and decision-making.

Initial work is in hand on data improvement – looking at consolidating current data, tackling barriers to sharing management information between organisations and improving workforce information with an initial focus on the success of national recruitment campaigns. We will work together to make improvements to the data available and how it is used.

We are committed to continuing to work in partnership to deliver both our refreshed Digital Health and Care Strategy and forthcoming Data Strategy. These strategies set out how we will work together to improve the care and wellbeing of people in Scotland by making best use of data and digital technology.

Key current priority areas include the transition to digital telecare across Scotland by 2025, and the Digital Social Care programme which is designed and delivered with sector stakeholders.

Strengthening Improvement in Social Care Support and Community Health

There is evidence of many improvement programmes across national and local government and in public bodies such as Health Improvement Scotland (HIS) and the Care Inspectorate (CI), as well as in provider organisations that seek to deliver better outcomes for people. Much of this is innovative and person-centred.

We are committed to ensuring that improvement work is co-ordinated, joined up, and enables more positive and consistent outcomes for people accessing care and support across Scotland. We will work together at a national and a local level to ensure improvement work is informed by a cohesive system of reporting that shows what difference is being made, and to enhance the capacity and expertise to the scale needed to drive forward systematic improvements in the care people are receiving.

An overarching National Improvement Programme for Social Care and Community Health will be developed to ensure that improvement across the system is evidenced by data on experiences and outcomes for people who use services, the people that care for them and the workforce. A National Improvement Steering Group, jointly chaired by CoSLA, SOLACE and the Scottish Government, will provide leadership across all relevant sectors in recognition of the complexity of the system and the need for a genuinely collaborative approach to improving services for people.

Strengthening Regulation and Scrutiny

The current system for scrutiny, inspection and regulation in Scotland have been in place for 10-20 years during which time the delivery of social care support services and the skills requirements of the social care workforce has changed. The need to review current arrangements has been highlighted by, among others, the Independent Review of Adult Social Care, The Promise and the Muir Review.

The Independent Review of Inspection, Scrutiny and Regulation (IRISR), announced in September 2022, will explore how regulation and inspection of social care services can support improved outcomes and experiences. It will look at ways to ensure a human rights and person-centred approach is central to the inspection and regulation process and will consider how this can be applied across linked services. The Review will be chaired by Dame Sue Bruce and is due to report in June 2023.

Self-Directed Support

The Independent Review of Adult Social Care confirmed the importance of Self-Directed Support (SDS) but noted that there have been challenges in its implementation. The reasons for these challenges are multiple and complex; nevertheless we continue to be committed to fully embedding the principles of SDS across social care so that people consistently experience choice, control and flexibility in the way they access support.

We have published revised SDS statutory guidance, the first comprehensive review since it was originally published. This will support greater personalisation of services and empowerment of individuals to exercise greater choice and control over their support.

Building on the publication of the refreshed guidance, we will continue supporting the building of capacity to improve the implementation and delivery of SDS across Scotland at both a local and a national level. We will, with key stakeholders convened through the SDS National Collaboration Group, develop and publish a successor to the SDS Implementation Plan 2019-2021 in early 2023 to cover 2023-2026.

Care Homes

We recognise that for many, a care home is the place they call home. We have worked with our partners to develop a framework and vision that would maximise the health and wellbeing of people living in care homes, ensuring that people living in care homes experience high quality health and social care wherever they are living in Scotland. Collaborative work is well underway on My Health, My Care, My Home: A framework for people living in care homes.

The framework will focus on enabling multidisciplinary teams to provide four main pillars of support to care homes:

• Prevention;
• Anticipatory care, supported self-management and early intervention;
• Urgent and emergency care; and
• Palliative and end of life care.

Having a skilled workforce and effective technology have been identified as the key enablers to the framework, and examples of best practice from around Scotland are being used to influence the framework's recommendations.

Scottish Government launched the Framework this summer and are keen to work with partners to create a learning community for all care homes to share the excellent practice that exists. This will link into existing work around ongoing learning.

Adult support and Protection

The Adult Support and Protection (ASP) Improvement Plan continues to undertake activities focused on assurance, governance, data & information, legislation, policy and guidance, practice improvement and prevention (2019/20-2023/24). This includes a review of ASP data for improvement at local and national level, updating of national guidance including the ASP Code of Practice and learning reviews (published July 2022), development of practice resources and training on undertaking ASP processes.

Additionally, the ASP Improvement Plan includes the ASP joint inspection programme. This provides both a level of scrutiny and assurance that adults at risk of harm are being supported and protected, and also assists in identifying further improvement action, if necessary. Phase 1 of the programme involves the inspection of adult support and protection arrangements in 26 local partnerships across Scotland. These partnerships are those that were not inspected as part of the Care Inspectorate's ASP thematic inspection report, published in July 2018.

Resilience, business continuity and pandemic planning

Social care and social work have experienced significant and enduring pressure during the pandemic. This is now being prolonged by the cost crisis. People who work in the sector have shown huge resilience and commitment to the people they support. We want to continue to promote a culture of resilience in social care and social work delivery in Scotland, so that it can respond and recover effectively but also react quickly to potentially disruptive incidents and future shocks. There is real partnership commitment to this work across the public, independent and third sector.

Across adult social care and social work we want to work with partners to develop our preparedness, with particular focus on assessment of risk and mitigation so that we can be responsive and act quickly to avoid issues arising. As a first step we will work together to identify priority areas of work, leading to a framework which will set the strategic direction for resilience and business continuity. This will include winter planning, surge planning and broader business continuity.

We have already worked together to improve our management information to ensure we understand the risks currently held within our health and social care system and regular monitoring and oversight is in place to assess risk and put in place mitigations. This requires further development and streamlining to ensure we can collectively respond to ongoing pressures and future events.

Our collective understanding of the good practice and the risks in the care home sector has also developed further, initially based on information gathered to better manage pandemic pressures. This has given us greater collective insight into the pressures experienced by care homes and how those might be mitigated both at local and national level. Oversight and support for care homes at local level has been extremely valuable throughout the pandemic and Scottish Government will continue to fund local partnerships to provide this support. The focus now will be on supporting care home stability and improvement and ensuring that care homes have easy access to expertise where they need it.

Ensuring smooth transitions for people across health and social care services continues to be challenging and creates significant pressure across our services. To ensure that people are getting the right care at the right time we will continue to support evidence based practice and make sure that it is embedded in everything that we do. In the coming year we will:

• Have a clear focus on admissions to hospital and gain a better understanding of how we can ensure the right care is being provided in the right place
• Support implementation of My Health, My Care, My Home to embed anticipatory care for people living in adult care homes and explore how we can avoid unnecessary admission to hospital from care homes
• Work with partners in social care and health to review oversight and assurance arrangements
• Support local partnerships to deliver the Discharge without Delay programme of work, including 'Home First Principles' and 'Optimising Discharge' activity
• Review processes for Adults with Incapacity to ensure that the best outcomes for people are being achieved, alongside further improvement work
• Develop further support and updated guidance for additional aids and adaptations that people may need to ensure that they can live well in their own homes, such as short term wheelchair loans as well as other equipment and adaptations
• Review the impact of the Community Living Fund in each HSCP

The pandemic continues to present an ongoing threat to the wellbeing of our people. The cost crisis has added another dimension to the challenges people are facing. We will continue to provide support for people and across the sector while these threats remain. This will be done in a proportionate way, retaining the option to scale up and down as the ongoing situation requires. Guidance will be regularly updated to ensure it is consistent with the current context, and we will continue to work together to ensure that that clear arrangements are in place to deal with the threat of a Variant of Concern or any other pandemic related issues.

With the Care Inspectorate, we will also ensure the implementation of the new Health and Social Care Standards to deliver strengthened residents' rights in adult care homes as a crucial step towards delivering "Anne's Law".

We know that much of the pressure in social care and social work is related to workforce availability, so the actions to be taken on workforce will be critical in ensuring we can support people in a resilient system.