John Burton has long been fighting for a forward-thinking and conscientious care management system. Leading Good Care, his most recent publication, dives into the heart of the care world’s many problems, and resurfaces with compelling advice on how to take on a social care leadership role with integrity and pride. John has worked in social care since 1965 as a practitioner at all levels, and is now an Independent Social Care Consultant.
In Leading Good Care, I set out and recommend a positive and hopeful vision of social care. My subtitle – the task, heart and art of managing social care – is both realistic and idealistic. The task requires serious, disciplined, hands-on, and hard work. The heart signifies that this work is emotional and personal, and that care is a human relationship. And the art of managing care engages your skills, your imagination, your culture and creativity.
I write at a time when we should be learning the lessons of a command- and-control culture, but, as always, we are in danger of replacing yet one more set of instructions with another. It was a do-as-you’re-told, top-down, target driven culture that led to the atrocities of Stafford General Hospital and Winterbourne View. This ‘delivery’ culture was also characterised by the extraordinary selection and subsequent dominance of some of the most senior managers who recruited and protected each other and bullied their way to the top. Desperate to mend health and social care before the next election, politicians go on believing that it can be ‘fixed’, and the same old delivery culture believed that Jim could fix it for them. Then, they recruited Sir James Wilson Vincent Savile, OBE, KCSG to ‘manage’ a secure psychiatric hospital where he abused patients. They gave him free rein to prey on hundreds of victims in many other care settings, while being honoured, protected, sponsored and used by the Establishment that he so assiduously courted. Like Savile, celebrities and members of the Establishment have used their sheltered and safeguarded positions of authority to abuse the trust given to them by children and adults alike. They acted with impunity, while those who protested were ignored, silenced, threatened or punished and those who survive are only now being heard. The officials who colluded in concealing these crimes can still redeem themselves by exposing the truth about perpetrators in power. Abuse and exploitation are endemic in a top-down social care system that demeans, disempowers and damages the people who most need its help.
When you become a social care manager, you too may feel that in order to keep your job you will have to do as you’re told, put up with what you know to be wrong, get high marks in your inspections, and convince your employers and regulators that you are in every way a thoroughly compliant employee. Indeed, this has been the problem with developing leadership in social care. For several reasons (some shared with the health service) social care has become a top-down, rule-orientated, highly competitive and bureaucratised service. Compliance and delivery are the watchwords; if you don’t comply and you don’t deliver, you are likely to be regarded as a failure. The truth is that this top-down system has been a disaster and managers have been left dealing with the perpetual and tragic failures of such a regime. Hitherto, the response to these failures has been to do more of the same, thereby only making matters worse.
It doesn’t have to be this way. Leading Good Care encourages you, as a leader, to work out your own principles and set your own standards; you will take responsibility for your service and its task; you will encourage leadership in your team and assertiveness in the clients of your service. Ultimately, you must take the path that will help you embrace the leadership role you have been given and take the lead. Taking the lead means making decisions and sometimes being wrong, and then learning and moving on. It means taking the authority to lead and being given the authority to lead by your staff and your clients.
John Burton has worked in social care since 1965 as a practitioner at all levels, and as a manager, writer, trainer, researcher, inspector and consultant. Learn more about Leading Good Care by John Burton here.
The problem is that, with many care homes, financial gain is a priority, not care. Yes, the business has to be financially viable, but when you have private and equity investors wanting a cut, finance overtakes clinical decisions. Personally, I would like to see owners and managers undertaking CPD, as their professional colleagues have to. I am a nurse, studying for an MSc in International Hospitality Management. Acknowledging clients/residents and employees as customers, and working to improve their experience is vital. Hopefully, empowering your employees will help prevent further cases of abuse.