Dave Hill is first to admit that Essex council spends far too much money on fire fighting, to the detriment of early intervention. But the council is on a mission to turn things around. In January, it became the latest authority to announce plans to merge children’s and adults’ services. It is now in the process of creating two separate divisions with responsibility for commissioning and delivering “people” services (or social services, education and housing).
Hill, formerly director of children’s services (DCS), has been tasked with heading up the commissioning side. He says the new structure will give the council greater freedom to combine budgets and innovate, which should in turn allow it to shift the funding balance in favour of early intervention. As chief of the new people commissioning directorate, Hill will hold both statutory posts of DCS and director of adult social services (DASS), but he will no longer hold line management responsibility for those delivering the services.
Dave Hill will be speaking at Community Care’s Supporting managers in social work conference on 17 September in London.
He will be discussing how leaders and managers can support frontline staff through periods of change.
Although a strong advocate of her work, Hill dismisses Professor Eileen Munro’s concerns about the impact of merging the DCS and DASS posts. In her review of child protection in England, Munro said merging the roles could result in a failure to focus on the needs of the most vulnerable children, given the breadth of responsibility involved. “You’ve got to look at the structure and circumstances of each council,” argues Hill. “Essex is huge and when I joined one guy ran the whole children’s social care service. It was a nightmare. How could he possibly know if the cases were all being handled properly? Now it’s not just about who’s in that senior job – it’s about the whole structure.”
Hill is a social worker by background and a member of the board of the College of Social Work. He trained as a generic social worker and has managed both children’s and adult services in the past, but after spending the last 13 years in children’s services admits this is his area of expertise. However, he does not anticipate this being a problem: “I’ve got some fantastic people around me, so I’m not trying to do this alone. And if you’ve got the right leadership skills, you can set out a vision for any service.”
In his new role, Hill says he is “uniquely placed” to control budgets across health, adult social care and children’s services. “We’re trying to see things through a different lens; people live in families and communities, so instead of just dealing with the child, we also look holistically at, say, the mum’s mental health problems or the dad’s alcohol misuse. The process doesn’t see a child or adult service user, it sees a family.”
Hill argues that this approach to commissioning allows the council to innovate to meet service users’ needs in a more efficient way. The key, of course, is understanding that need in the first place. To do this, Essex is undertaking ethnographic work with its service users; for example, it intends to commission a new service for learning disabled adults, so Hill says the team will talk to people with learning disabilities and find out their ethnographic or life stories. After that, they might get the service users to shoot a short video, which will be shown to staff from frontline social worker to chief executive level, to help ensure that service user experiences are at the heart of everything the council does. “We’re trying to make commissioning much more dynamic,” says Hill. This approach is being combined with a greater emphasis on the importance of direct work with families.
Direct work with service users
Essex’s child safeguarding services were rated inadequate in 2010 after Ofsted noted failures in initial and core assessments, child protection enquiries and child protection plans – but its safeguarding services are now rated adequate. Hill says the restructure should drive further improvements, allowing social workers to spend more time with people, rather than on paperwork. “We’re taking Professor Munro’s work at its word and saying social workers are there by and large to work with people, face to face. Of course you have to write things down, there can’t be no bureaucracy, but at the moment our social workers spend two-thirds of their time on paperwork and a third on direct work with people – and our aim is to flip that ratio round.
“We’ve looked at our computer systems and decided that, although we have to record some things, there are many fields we don’t need, so we’ve taken those out and condensed the data we do collect.”
Early intervention: the vicious cycle
Hill says this emphasis on direct work is one of the ways the council intends to break out of the vicious cycle of fire fighting and bringing high volumes of children and adults into care – at a huge cost – rather than investing in early intervention and support. For example, the council has brought in four new teams of 38 social workers to work intensively with families to try and keep teenagers who are not at immediate risk of harm out of care.
“We have lots of teenagers coming into our care and we don’t do any better than their parents and then, when they get to 18, we hand them back. And I thought, this is mad – and it’s costing us a lot of money. So we said we need a team that works with families and young people at the point at which they’re at risk of coming into care.” More than 120 social workers applied internally for the 38 positions. “They said doing that face-to-face work was why they came into social work in the first place.”
And it appears to be working. When Hill joined Essex less than two years ago, there were 1,630 children in care; now the number is below 1,300. And given it costs around £80,000 per year to keep a child in care, it was a “no brainer”, says Hill. It could work equally well in adult services, he adds, suggesting that older people’s services could benefit from social workers breaking into the cycle of automatically putting older people into residential care after a fall or operation. “It’s an example of something we do to people because it’s the only option that appears to be available. But we’re better off having people living within their communities for as long as possible.”
Hill is up front about the need to save money, although he insists it is not a matter of prioritising cuts over services. Essex has had to reduce its budget over the last four years by £365m. That’s council-wide, but 80% of the council’s money goes on people services. Over the next three years, another £215m will have to be shaved off that bill. In this context, Hill says getting into a position where they could spend more money on early intervention was a challenge. “It’s difficult to find ways of investing if you don’t already do it. [The money] was all tied up. We had 1,630 kids in care; I couldn’t just one morning go ‘right, send 100 kids home and we’ll use that money elsewhere’.”
The intensive work to keep more children out of care has helped, he says, but so too have social impact bonds. “We have £5.1m coming in through a social impact bond and that’s not costing the council any money. So we’ve contracted Action for Children to deliver multi-systemic therapy with families and that is all paid for by socially-minded entrepreneurs. If that keeps 60 young people a year out of care for us over four years, at the end of that period they’ll get back £6m. So they make a profit and we don’t have to come up with the upfront investment – and we save nearly £18m in care costs.” Some of those savings can be invested back into early intervention, “so we slowly change the mix so that most of our services are early intervention and support and we’re doing the minimum of fire fighting”.