Our opening post this week is by Dennis Holmes, Deputy Director of Adult Social Care. His first ‘deputy blog’ post reflects on the changes he has seen in social care.
Dennis and colleagues will be sharing their thoughts on a more regular basis about changes in health and social care in Leeds.
Dennis Holmes, Deputy Director of Adult Social Care
Talk in the office the other day about arrangements for the forthcoming Long Service Awards got me thinking. The awards are for those incredibly loyal people who have worked in social care in Leeds for 25 years or more. That takes us back to 1988 and made me think, among many other things, about changes in social care that we’ve seen in that time. It occurred to me that there have been times when change has happened quickly, usually in reaction to a new piece of legislation; other changes come about more gradually – almost imperceptibly, as social care develops and evolves, as trends sneak in and become established practice.
I too date back more than 25 years as my career in (then) social services started in 1981. I’m terrified to admit that’s 32 years, so I’ll have to keep pretending I was very young when I started! And yes, I have seen a few changes! For instance, the unions UNISON was NALGO and GMB was NUPE (well worth looking those up on the web – if only for the banners!!)
Back in the day, ‘social services’ of course meant both adults’ and children’s. For adults, the council provided services pretty much to anyone who wanted them. People who are now community support workers were then ‘home helps’. People ‘put their names down’ on a waiting list to go into council homes for older people (‘HOPS’). The health service was responsible for placing people into nursing homes the costs of which were met by the DSS (Department for Social Security)!!!
Children’s services operated in a very different environment to that which colleagues work in today. Back then many more children were taken into care often for reasons that would shock us deeply today, such has having poor attendance at school or for committing crime. In many instances children were made subject to Local Authority ‘parental resolution orders’, which permitted a panel of councillors to decide whether a child should continue to live with their family. ‘Care’ often took the form of large institutions, even for babies and infants, where children were ‘put’ for ‘their own good’. And, in many instances, tragically, children would stay in those places for the rest of their childhood.
Adult residential care would be similarly unrecognisable today. People with a learning disability lived in large institutions, usually referred to as ’hospitals’ such as Meanwood Park Hospital (or ‘The Colony’ as it was referred to by local people). If deemed mentally ill, people would be placed at High Royds. Care homes for older people were equally institutional. Thirty years ago Leeds had over 60 ‘HOPs’ – most of these were ‘home’ to 50 residents or more. Dormitories for a dozen people were common; some were ‘improved’ when residents were allowed curtains around their beds for privacy.
Home helps chiefly provided cleaning and shopping, including cleaning up after the ‘bath nurse’ had been. There was no such thing as adult safeguarding as we would understand it today – this is a recent concept, even though we may think it has been around for ever.
And there was no such thing as commissioning within social care. In Leeds we have taken a while to arrive at our own model of commissioning, which is so much more sophisticated than ‘purchasing care’ (a concept which itself was only introduced in the early 90’s). Today, we commission by helping people decide what outcomes they want and then work with providers to come up with packages of care that deliver the required outcomes at a price the city can afford.
When I look back to where we were in social care when I started, I’m bound to say that despite the obvious challenges we face (and will continue to face in the future), and the obvious failings that social care has experienced in recent times (which, despite our best endeavours and efforts will probably continue to experience, we are all only human after all), we really are in a much better place.
Anyway, enough nostalgia, time to forget ‘a Flock of Seagulls’ and embrace Clean Bandit.
Change in the foreseeable future rests in our ‘Better Lives’ vision, through which we have attempted to put a framework in place that will see us through the next couple of years. After that we can expect a shift in gear as we see the Royal Assent of the Care Act, which will revolutionise the way Adult Social Care is arranged for the future and then in 2015 we have the next general election.
I believe that if we keep our Better Lives vision at the centre of everything we do, social care for people in Leeds will continue to be transformed for the better and strengthened.
Until next time,