Tuesday, 24 May 2022 – What Do Assistant Directors Do?

There is a job ad in the Guardian for Assistant Director, Commissioning and Partnerships in the adult social care service of Hammersmith & Fulham Council, specifically to commission services to promote independent living for disabled residents; salary £85,521.  The ad says:

“This is an exciting opportunity for an experienced leader who is not afraid to think differently.  Gone are the days of traditional approaches, we (sic) know this because Hammersmith & Fulham is a leading light on co-production with residents and is better for it.”

 

Is it?  On 19 May, the Adult Social Care service sent me the procurement strategy for the peripatetic home care service “to support residents to enhance independent living, allowing residents to remain in their home and local community for as long as possible…” for the next five years at an estimated cost of £100,886,923.

Domestic home care services are notoriously problematic for London boroughs because the service is so expensive (adult care services accounting for about 19% of London boroughs’ entire budgets) and, on the wages this budget entails, it is hard to recruit and keep carers willing to travel from house to house to provide domestic caring duties.  Scandals abound about carers not even being paid the national minimum wage with the national adult social care sector on the brink of collapse forcing the current Tory Government to raise National Insurance Contributions to keep up with the growing costs.  In 2020, a tribunal found that contractors commissioned by Haringey Council breached wage rules by paying some care staff less than half the legal national minimum wage because commissioned private care providers didn’t pay for the time it took to travel between residents’ homes.  This doesn’t even take into account the cost to the carer of travelling such as for a car and petrol or public transport costs; not cheap in London.

Another case saw carers required to sleep over at residents’ houses and not paid for this time, with the agency, Sevacare, commissioned by Haringey, paying £3.27 per hour for live-in care.

Enfield Council, on average, pay even less than Haringey and so any qualified and experienced care worker willing to do the job can easily hop over the border and work for slightly more money meaning Enfield care providers find it hard to hold on to carers with any experience or qualifications, not boding well for the quality of care they can provide their residents.

These are outer-London boroughs.  Inner-London boroughs like Hammersmith & Fulham have additional challenges.  It is naturally more expensive to live in Zones 1 and 2, exacerbated by Government schemes to cleanse inner London of poor people: hits including “Brexit”, “Hostile Environment”, “Bedroom Tax”, “Benefit Cap” and “Right to Buy”.  The cognitive dissonance between not wanting to live amongst poor people but wanting them to care for our elderly and disabled relatives, cleaning our spaces and making our morning bagels mean that we have fewer of our neighbours dedicating their careers to peripatetic care and choosing to live in Fulham or Holland Park.  Paying £19.32 per hour as quoted in the procurement strategy report (which states is a 4% increase on last year) of which about 38% is kept by the care agency, recruiting and retaining carers is a historical problem for Hammersmith & Fulham Council.

And it was in the last commission.  However, we learn from the job ad that Assistant Directors for commissioning these services are now not afraid to think differently.  The procurement strategy report addresses the historical problems in recruiting and retaining care staff in the borough but celebrates a new and innovative approach.  Instead of commissioning one agency in three distinct geographical areas across the borough, the report explains that this commission will include two agencies each in six areas!  Where there were problems in recruiting enough carers from three agencies, with twelve it will be easier to spread the burden.  Genius!  Yeah, that’s the problem: not enough care agencies.

The procurement strategy report otherwise doesn’t include a strategy to include at least the council’s procurement policy-required 10% social value contributions such as training, careers education, carbon emission savings and so forth except to leave it to the market to see what they come up with.  10% of a £100m contract is £10m worth of training and carbon savings in a sector already so underfunded even a Tory Government has acknowledged and reacted to it.

When I worked at Enfield Council, I was a member of the panel on promoting economic development for the North Central London Partnership on Adult Home Care.  The report, led by Islington Council, made recommendations such as commissioning councils co-ordinating care agencies to recruit local residents to reduce travel, use the councils’ underspent Apprenticeship Levy to pay for apprenticeship courses for existing staff and new entrants to the sector to help them train and progress in a career rather than be restricted to the lowest level and lowest paid jobs.  And simply paying carers more.  I don’t know what happened with those recommendations after Enfield sacked me.

On 20 May, I replied to the Social Care Programme Lead who sent me the report in which to add my comments on social value:

“Hi [Programme Lead],

“I’ve read the report and it’s a bit unclear what the strategy for social value is.  The report says you will be asking for £10m of social value, that local recruitment and staff churn is the “main” market issue and it’s otherwise unclear what social value measures could be proposed by bidders.”

 

She replied today:

“Hi Paul – I didn’t want to specify what areas of social value Providers should focus on to allow them opportunity to be innovative in their bids.  The nature of the service is very people focused so I suspect it will largely be around recruitment, training and community benefits.  We’re also hoping some SME businesses [Small to Medium Enterprises] will bid as well as the larger providers so what they can offer will vary considerably.

“Do you have any advice on how to improve this section [of the report]?”

 

Hmmm…  Do I have any advice?  Perhaps revisit that job ad and be more truthful?  Say we’re looking to recruit an Assistant Director for commissioning that has no ideas whatsoever and relies instead on the innovation of the care sector, particularly small care agencies that have time and again abused their staff and been taken to employment tribunals.  And, otherwise, recruit an AD that makes no effort in the five years since the last commission to design, improve and direct the services using the resources available and wasted in the council such as the Apprenticeship Levy, co-ordinate employment across neighbouring boroughs to ensure carers can work locally and earn the same thus reducing the time, expense and car journeys, and subsequent carbon emissions, from travelling between homes.

However, perhaps advice on their own recruitment was not what she was referring to.  Instead, I shared some of these other ideas with her.  If she acts on this advice, I wonder if she’ll chalk this up to “co-production” or, instead, say how great her department is in the next expensive job ad in the Guardian when they advertise £85,521 for another Leading Light paid by Council Tax payers trying to live on below minimum wage.