‘A lot of us in social care have found our value-base stretched severely’

The Queens Cross Network in Dudley used to be a traditional day centre for people with disabilities. They were bused in, given a lunch, some activities to do and sent home again.

Alan, a service user and volunteer at the centre for 25 years, says he remembers those days and “such exciting things like stamping prescription pads and joining plastic pieces together”.

He wasn’t the only one thinking: “there’s got to be more to it than this”.

These days Queens Cross is a different place. The staff team has supported service users to play a much more active role in managing the centre. Alan and five others set up ‘Disability in Action’, a user-led group, which now has over 70 members and runs many of the services, including a café, gardening team, reception and public relations.

“We basically just grew into an organisation that challenged ideals and perceptions at the time – and we’re still doing it. We’re a family here, we care for and about each other,” says Alan.

“We’ve avoided a whole gambit of cuts, so we must be doing something right.”

‘A decision of necessity’

The centre almost didn’t make it. Dudley’s adult social care budget has shrunk from £125m to £90m in the last six years, effectively forcing the council to scrutinise every service. A year ago, the future of Queens Cross and four other centres was in the spotlight, with the council needing to find £880,000 in savings from this area of care alone.

In the end Dudley closed one of three centres used by people with dementia on the basis it could accommodate service users at the other two. To make up the rest of the savings, the council outsourced its transport fleet of mini-buses that took people to the centres.

Matt Bowsher, the council’s chief officer for adult social care, admits it was a tough call. The in-house transport service was well valued because the drivers were “highly experienced” in working with people with disabilities and there was more time and flexibility to fetch people.

“It was a decision borne out of necessity, rather than the quality of the previous arrangements. But it was either keep the transport infrastructure or have no centre for people to go to,” he says.

Queens Cross survived, he adds, because of the way in which it has evolved. Bowsher sees the service as a key part of the council’s wider offer of preventative services. He fears its closure could have contributed to a rise in social isolation, carer breakdown and loss of confidence among clients.

“In terms of a medium to long-term plan, that makes no sense, but you have to go to that centre and experience it to understand the value of it,” he says.

‘The best team’

The service users at Queens Cross speak of a place that has “changed and saved lives”.

For Linda, it helped her out of a dark place. She worked for 25 years as a clinical support worker in the NHS, but became wheelchair dependent after developing a rare condition that attacked her nervous system. She says she’s totally reliant on others and wouldn’t be able to cope at home alone because she “can’t even boil a kettle” on her own now.

“I fell into a deep depression [after developing the condition]. I came up to the centre one day out of the blue, I was in tears to one of the workers, I said I needed to get out.

“The centre saved my life – when I’m here I just mingle, the people here are wonderful.”

“She mothers them all,” says Marlene, whose daughter attends Queens Cross. “Linda’s helped turned a light on down here, it’s not that it wasn’t on already, but she’s made it burn brighter.”

For Alan, Queens Cross is the place where he learned how to handle money and improve his numeracy and literacy skills. It’s also where he met his wife – “we were the first service users here to get married, they did a mini wedding reception for us”.

“It’s the people you care about…they become your right hand, particularly if you’ve been here as long as I have,” he says. “But they also help you to challenge the way you live. I’ve done things now I never used to do, even something as simple as going to a rock concert.

“A lot of my heroes are rock stars – Johnny Rotten, John Lennon – visionaries in their own way. I thought ‘right if they can change things, then so can I’. So with the help of the Queens Cross team, who are the best team anywhere in my opinion, I did it.”

‘Stretched and tested’

Bowsher says the relentless pressure to cut costs has seen some councils simply put “a red line through all preventative services” in their savings plans for this year, a trend he says is “deeply worrying”. He says Dudley is working hard to maintain a prevention focus and examine “how we can create different solutions” and work with communities.

Yet he knows plenty of valued services are under pressure in the current financial climate. Dudley’s voluntary sector has been particularly hard hit in recent years, suffering a £1m funding cut last year and a further £2m this year. Bowsher says cutting council funding for a charity that supports victims of domestic abuse was one of the toughest decisions he’s made.

“It’s very hard for a victim of domestic abuse to go and find help and often when people do, they ping-pong in and out of services for some time because they’re under a huge amount of pressure to return to the abuser – that means patience, understanding, continuity is needed.

“Shutting anything that helps contribute to fixing that…that’s a day where you look yourself in the mirror at the end of it and think, this is not what I signed up to do. A lot of us who do this job have found our value-base stretched and tested very severely.”

Bowsher says the list of services affected goes “on and on”, particularly those organisations that were getting relatively nominal sums. He knows the loss of this wider support could have implications for the council’s statutory services too.

“I’m sure that in and amongst the additional 400 or so folk we’ve had contacting social care this year, there will be people who were having their needs met in that way before,” he adds.

‘Real chaos’

Demand for social care services is set to rise too. The council is starting to see the impact of NHS England’s Transforming Care programme, which aims to help move people with learning disabilities and autism out of long stay hospitals and into the community.

Bowsher says the programme is “absolutely right” in terms of its principles and getting people out of assessment and treatment units, but he worries the NHS has failed to provide funding to get the right community support in place.

The council has also seen a significant rise in social isolation and mental health problem.

“We’ve always had people who have lived chaotic lives and need specialist support – the phenomenon of hoarding is not a new thing. But I think what we have seen is a consistent increase in people who are living in that way and coming to the system at a point of real chaos.”

Without a dramatic shift in the funding for councils, there are no easy answers. Bowsher admits there are days when staff come into the office “overwhelmed and not feeling that they’re making a difference”. But, he says, there’s also a huge amount of creativity, passion and commitment to supporting people. Keeping a sense of hope among the workforce is important, without ignoring the very real impact difficult decisions are having on people’s lives.

“For the foreseeable future our job is about prioritising, understanding the impact, listening to voices and doing the best that we can, but knowing there will criticism,” he says.

“You are only as good as you are willing to hear that stuff. I find it very worrying when organisations shut the door, a siege mentality develops. I think the minute you stop listening and responding, then you are going to miss something really important.”