In for the long haul

When Dick Clough became general secretary of the Residential Care
Association in October 1978, David Ennals, then health secretary,
said: “Promise me you’ll stay a while.” At the end of this month,
26 years and five months later, Clough will bow out as head of what
is now known as the Social Care Association, his promise more than
honoured.

When Clough took over, the SCA – the name changed in 1983 to take
account of the wider sector – had 3,200 members. Ten years later
this had increased by about one-third. Today the number is back
around the 3,000 mark. Members include both individuals and
corporate bodies involved in social care, which makes the
association an unusual professional forum for uniting staff and
employers.

But Clough says one of his disappointments is that he never made a
breakthrough with membership. He attributes this to, among other
things, a lack of resources for promoting the organisation and to
the fact that many who could have joined are low paid and opt to
spend their money on joining a union.

But the SCA’s financial turnover is a different matter: it
increased from just £25,000 a year in 1978 to £300,000 10
years later. Today it stands at £1.6m. This is partly due to
EU support but is also because the SCA makes money selling services
such as training, arbitration and mediation, conference management
and advocacy for residents and carers.

The SCA’s influence is often seen as disproportionate to its size.
It was one of the few consistent advocates of what is now the
General Social Care Council, having argued that it should embrace
everyone in social care rather than solely being a regulatory body
for social workers.

But it’s not just the SCA as an organisation that has been
influential in shaping events – Clough himself has played an
important part in the development of better standards within
residential care. The late 1980s were dominated by the reports of
the Wagner committee on the future of residential care, which
Clough, with his tireless lobbying, had much to do with setting up.
He was also a member of the Warner committee on staff selection, as
well as the Home Life working party on residential care standards
that produced a code of practice.

The son of Liverpool publicans, most of Clough’s family have been
in the licensing trade. So what brought him into social care?

He started his career as a locksmith’s apprentice, but decided that
he wanted a job that held some clout. At 19 he ran a boys club, and
this whetted his appetite for residential care. “I realised it was
a very powerful job – the influence you had over other people’s
lives. I also realised how easy it was to abuse it. The work was a
wonderful medium for me. I wanted to lead.”

And lead he did, eventually becoming one of the youngest people to
head a children’s home. He says he left practice at the age of 30
because he wanted to “show good practice” and saw the SCA as the
means to that end. “I wanted to show others some of the things I
believed in, and show them how”.

In the early days residential care underwent what Clough describes
as “phenomenal physical growth”. That pace continued during the
1980s, bringing with it an influx of private providers. In 1978 the
cost to government was £6m; in 1991 it had risen to
£1.3bn – the ensuing NHS and Community Care Act 1990 was less
about the ostensible objective of promoting community care and more
about putting the lid back on.

Since then residential care has taken an uncertain road, with
continued growth followed by contraction. As part of this, the
independent sector has, for the most part, replaced local authority
provision. But this has never worried Clough. Years ago he rounded
on directors of social services saying: “If you can’t do it, leave
it to someone who will.” He stands by these words today, still
sceptical about some local authorities’ commitment to residential
care.

Staff morale, though, is the lowest he has known. But he believes
that residential care will always have a future because the public
wants it and because people are afraid of what would happen if it
wasn’t available. He says: “When I’m doing advocacy now, it is not
just people worrying about a home closing because of their mum or
dad but because they are saying: ‘What will there be for me if I
need it?’.”

Clough campaigned for better standards in residential care but he
says there is a downside to the increased regulation -Êthe
tick box attitude to inspection. “There was a time when inspectors
had the duty to advise!” – and a tendency to play safe, often
through fear of litigation.

Clough says: “If you want to ensure that there is never any risk,
then residential care will produce the most highly
institutionalised model imaginable. But I believe in innovative
care and that carries with it the possibility of having to take
risks. There’s too much of a fear factor, the tendency for people
to look over their shoulders – managers, staff, inspectors.

“It worries me that staff feel unable to offer a comforting arm
around someone’s shoulder and I ask what kind of residential care
are we creating? It’s often said that ‘they’ won’t allow something
but I want to know who ‘they’ are.”

What people want from residential care differs, he adds. All want
to feel content but staff need to find out exactly what that means:
some like feeling “safe”; others want to maintain the skills that
they have always had. Finding out what it is that people want, he
says, applies to all ages using residential care. “Sometimes
expectations of people are very low and I want to see them
increased.”

For some people the work is just a job, he says, but there are
others who see it as a career. “We ask some people to perform
personal tasks that demand real skills but we have to cater for the
whole spectrum of staff. We can’t say everyone has to be good at
everything. That leads to expectations that cannot be realised.
Take one example: report writing is important but not everyone can
do it, so why not use those who can to write reports for those who
can’t?”

When Clough was interviewed for his job, one of the interviewing
panel said the successful candidate could be cut off from going
back into the field. “You realise what you are doing in applying,
don’t you?”, he was asked. Clough said that he did, and more than a
quarter of a century later he has no regrets about his answer.