By Richard Humphries,
Visiting Professor, University of Worcester
The job that today we call director of adult social services has evolved over five decades, tracing the sweeping arc of social care history that in modern times had its origins in the 1948 National Assistance Act, documented more fully in my book Ending the Social Care Crisis – a new road to reform. It seems remarkable now that this remained the legislative foundation of adult social care until the Care Act 2014. The officers heading up the new local authority welfare departments were largely unqualified with a very limited range of statutory powers and duties, reflecting the opening lines of the National Assistance Act “…an Act to eliminate the Poor Law” (under which many of them used to work). There was a separate children’s department and mental health was usually part of the remit of the local authority medical officer of health, a much more influential position.
It was not until the 1970s that the Seebohm reorganisation brought together most services for children and adults – what was then termed ‘the personal social services’ – into a single unified local authority department. Out of that was born the post of director of social services (DSS), whose new departments quickly became the biggest and fastest growing part of local government. It was a massive role, embracing responsibilities for children and family services, older and disabled people, including individuals with mental health and learning disabilities. For a while they enjoyed the biggest real-terms budget increases we have ever seen (despite recent claims to the contrary), but the spending tap was soon turned off after the oil price explosion and resulting economic crisis in the mid-1970s (sounds familiar?).
The director’s role expanded further in the early 1990s, when the community care reforms transferred out-of-control national social security spending on residential care to local authorities, possibly the biggest single act of devolution from central to local government there has ever been in modern times. For DSSs, these changes were a game changer, requiring them to manage a market in a ‘mixed economy’ of care, not just traditional range of in-house domiciliary, day and residential services. The idea was to remove the perverse incentives that discouraged care at home, unleash the creativity of a new breed of care managers who would devise individualised packages of care and, crucially, get spending under control. But it wasn’t long before the gap between demography-fuelled needs and cash-limited budgets led to rationing and tighter eligibility criteria. Fewer people received more intensive packages of care as the acuity and complexity of their needs began to rise. The job was getting tougher.
The next big challenge was Every Child Matters in 2003, which pushed the integration of children’s services across social services, education and health. The ensuing Children Act 2004 required every upper-tier council to create a new post of director of children’s services, to be responsible for children’s social care as well as education and school services. In effect, this meant adult services became a separate department headed by the new role of DASS (in most places taken by the existing DSS). It ended the Seebohm vision of a family-oriented service for all ages (and thus illustrating one of Walter Leutz’s five laws of integrated care that ‘your integration is my fragmentation’).
Reflecting on how these policy currents have helped to mould what the director’s role has become today, three major shifts are apparent. First, the DASS role is much bigger than it used to be. Adult safeguarding, mental capacity and deprivation of liberty safeguards, not to mention market shaping, have expanded the statutory remit well beyond what was envisaged back in the 1970s. Austerity-driven streamlining of corporate structures means DASSs can now find themselves with senior responsibility for a range of services – anything from crematoria to community development, public health to housing. The DASS has also become a gateway into a range of local authority functions. Some DASSs have become ‘twin-hatters’, with responsibility for children’s services as well as adults’. These changes underline the importance of the wider extended councillorship of ADASS to embrace those with senior responsibilities for adult social care at below the level of DASS. The sheer span of these roles places a premium on the skill of DASSs in appointing and developing their top teams.
A second shift is that the role has become much more outward facing, operating in what Reith lecturer Atul Gawande has called the century of the system. There is a limit to what organisations can do on their own, as the current NHS crisis testifies. Effective adult social care depends on working well with a variety of public services, such as housing, the benefits system, criminal justice and the NHS. The need for DASSs to become effective system leaders has been heightened by the brave new world of integrated care systems and the opportunities for local government to shape their work and priorities.
System leadership demands a profoundly different skill set and outlook not required of first-generation directors in the 1970s – the third shift. It is no longer enough to manage a single organisation providing a traditional range of services through a hierarchical, procedure-driven management style (though the need for transactional skills has not disappeared; financial acumen and a grip on the budget remains a key ‘P45’ test). The role is fundamentally about leadership as well as, but not instead of, management. It involves using ‘soft power’ – influencing, collaborating and developing trust across a web of inter-dependent relationships spanning organisational and sectoral boundaries. This mindset is about creating the conditions for innovation and finding new solutions to old problems, especially when money is in short supply, rather than the reductionist mantra of ‘doing more of the same with less’. An indispensable part of the skill set is to recognise and harness the value of co-production with people who have lived experience of social care.
The demands and expectations placed on today’s DASS are formidable and, as ADASS has pointed out in its advice note on the role, are not reflected in the existing best practice guidance, which is now 17 years old, overtaken by the Care Act and other new legislation, the impact of Covid-19 and the prospect of a fresh wave of austerity. It is why this guide is so important.