Collaborative management in the face of government response to COVID-19? Evidence from care home staff and stakeholder experiences in West England.

Luke Bradbury

Picture credit: https://socialvalueportal.com/support-national-effort-covid-19/resources/news/social-value-in-action/support-national-effort-covid-19/

As a student on the MSc Public Management course at INLOGOV and having worked part-time in care for a number of years, I felt my final dissertation project was an opportunity to investigate the impact of COVID-19 on adult social care and the implications of government intervention. The works of organisations such as SCIE (Social Care Institute for Excellence) have already shown that inaccurate government guidance – combined with years of underfunding – resulted in the sector being ill-prepared for dealing with a pandemic and that care policy and practices had to rapidly adapt to unforeseen circumstances with limited support.

This case study aimed to explore this in the context of two care homes in West England during the early months of the pandemic. It was also interested in the role of collaborative management between care homes and their surrounding communities including local authorities, charities, businesses etc. ‘Collaboration’, in this context, took some influence from Helen Sullivan and Chris Skelcher’s conceptualisation of a collaborative agenda governing the (often mutually) beneficial cooperation between different public bodies and community agencies. One might consider how care homes may have banded together with their own local communities to ensure they still had the means to provide quality care in the face of COVID-19. Indeed, recent research by Fiona Marshall et al. has shown that, where government support was scarce, many care homes formed resource networks with external stakeholders such as local businesses, dentists, veterinaries, and domiciliary care agencies to source vital materials including personal protective equipment (PPE), electronics, toiletries, bedding and even food.

This study used semi-structured interviews and recruited five participants via a combination of snowball and non-probability purposive sampling. This included two deputy care home managers representing two different care homes in West England as well as a carer, a local parish councillor, and a co-owner of a local chemicals firm. The latter two participants were recruited as active members of the local community for one of the two participating care homes (or ‘external stakeholders’). Thematic analysis and grounded theory-based coding was then used to interpret the data.

The analysis firstly uncovered a strong dissatisfaction with the central government response to COVID-19 amongst all participants. Care staff spoke about how the implementation of the Coronavirus Act forced them to take on extra patients from hospital without an effective COVID-19 testing system in place and that inconsistencies between government guidance and company policy led to confusion amongst managers. Practices were forced to adapt; for example, adhering to stricter infection control measures and taking on extra care duties such as virtual GP consultations. External stakeholders also spoke about how these circumstances encouraged some level of collaboration within the community and a desire to assist local care organisations; for instance, a parish council was enabled to collaborate with the local chemicals firm and local school to source PPE such as goggles and hand sanitizer which could then be distributed to care providers.

Despite this opportunity to establish a resource network, collaboration between the two care homes and their surrounding communities was not evidenced as Marshall et al. had found previously. This was attributed to two main reasons. Firstly, resource dependency was less prevalent because effective internal management within both care homes meant they already had a sufficient supply of PPE. As one of the deputy managers recalled, the manager for her home made the decision to stock up on PPE and to lockdown early, therefore minimising the spread of the virus. The second reason was down to external circumstances that aided both care homes. Since both operate within rural areas of West England, they occupy less densely populated regions than care homes within inner city locations and therefore surrounding transmission rates remained relatively low. The implication is that locality largely eliminated the need to establish support networks with external stakeholders because they were not experiencing the same level of devastation seen in many other care homes. This was corroborated by staff who felt ‘fortunate’ compared to what they were seeing on the news.

These findings indicate the importance of effective management but also the extent to which contextual circumstances may or may not have necessitated collaborative networking between care homes and their surrounding communities during the early months of the pandemic. Whilst collaboration was less necessary here, the background coordination of parish council and local actors to produce a ‘safety net’ of resources did highlight the potential of localised collaboration and intervention in times of crisis. Perhaps, had such coordinated localised governance been enabled within the surrounding communities of less fortunate care homes, they may have been spared some of the devastations of the pandemic. Regardless, there is certainly a strong call for greater support towards the care sector for government and policymakers to consider – particularly in terms of clearer guidance, increased funding, and enabling localised governance to support care organisations.

Luke Bradbury graduated from the MSc Public Management in September 2021.

Handforth and the acoustics of local democracy

Kevin Harris

“Underlying the democratic ideal of government by consent of the governed is… the consent of the governed to behave themselves” (Jacobs, 2004, p. 211)

What might Jane Jacobs have had to say about recent challenges to democracy – like the prorogation of the UK parliament, the assault on the US capitol, Myanmar, and the fraught tragi-comedy of Handforth Parish Council’s infamous committee meeting? The expectation that the governed should behave themselves surely extends to those elected to govern. But our representatives sometimes disregard this, dismissing codes of conduct and protocols, as the Committee on Standards in Public Life has found. In my limited experience as a community council clerk I witnessed some of the consequences, having had to ensure on one occasion that police were on hand for a full council meeting, following a reported threat of disruption. It’s not so fanciful to see a connection between the villages of Washington DC and Handforth, Cheshire. Nonetheless, there may be a positive indirect consequence for local democracy, which I shall come to.

I do not propose to re-measure the hole that Handforth councillors dug themselves into. The episode was referred to by the Society of Local Council Clerks as “superficially amusing” while it exemplifies syndromic bullying behaviours. At the same time, if the celebrated Jackie Weaver has entertained many, there seems little doubt that she was out of order. The puzzle that remains unsolved (for me, at least) was posed parenthetically by David Allen Green in a heavily-commented post: “who can exclude a disruptive chair if the chair is disruptive?” I refer my right honourable friend to the quotation I gave earlier.

For those of us who have been keen to see a higher profile for parish and community councils, the Handforth incident is Fate’s Reminder to be careful what you wish for. And for all the comment generated – much of it showcasing a forensic fascination with regulatory niceties – what has struck me is how little of it acknowledges how local people have been forsaken by the institution designed to represent them.

There are two elephants in the zoom. One is the alpha male whose sense of power tramples his sense of responsibility (‘trump’ might be a better verb to use, but for the entangling of metaphors). The SLCC calls for “a dramatic strengthening of the standards regime”. Hmm, how dramatic would you like?

The other is democracy’s reliance on an impenetrable bureaucratic skin. It’s hard to see how the regulatory framework can be reduced, and Handforth may have given cause to extend it. But its effects can be countered, and there are all sorts of devices for that. As a clerk I wanted councillors to host, in turn, one each month, an informal reception (refreshments of course) immediately before each council meeting, inviting all residents from their zone (ward). And keep doing it. A few people we didn’t know, would have come. In time, the democratic return on investment would surely be visible in terms of the numbers who stayed on for at least part of the meeting, those who raised issues, and those who voted at the next election.

I failed to persuade my management group of any virtues in this idea, but had I stayed longer in post I think I could have got this and similar notions established. Democracy needs diligent ongoing maintenance, not frantic last-minute repairs.

To me, a key point about town and parish councils – now sometimes called ‘ultra-local councils’ – is that among their powers is a rather special informal convening power. They are able quickly, and usually a-politically, to bring together agencies (including principal authorities, police, health, schools etc), local businesses, community groups and residents to focus on specific local issues and get them sorted. This is oddly under-appreciated, not least by principal authorities. And it points to the need, when talking about democratic revitalisation, to ensure reference to the community sector, which can function as a democracy sandpit, default care provider, lightning-conductor for issues, and social responsibility conscience for councils.

Well, we now have a parish council in England that has become a huge embarrassment to its residents. The technology made a difference: Jackie Weaver’s performance would have been impossible in a face-to-face meeting. Meanwhile, councils in all tiers apparently have reported increased participation through online meetings. Bryony Rudkin offered insightful councillor’s reflections on the comparison with face-to-face meetings, on this channel recently. Now the government is under pressure to remove, permanently, the legal requirement for councils to meet in person.

I observe that public debate over the past year, in and out of lockdown, has acknowledged the reality that many families do not have anything like adequate technology to participate in a virtual society: so at least that argument doesn’t have to be made, does it? How then are hybrid meetings going to function against the risk of exclusion (the affluent signing in from home, with their intimidating bookshelf-backdrops; the rest huddling round a phone on threadbare broadband)? Do we expect those who would not have been likely to attend a formal council meeting before, and who cannot participate online, suddenly to be so excited at the prospect of a Weaveresque fracas that they’ll be queuing at the door?

There will have to be guidance for hybrid meetings, for all tiers. I’d like to see strong recommendation that councils fund community centres to host large-screen streaming. Community development workers will want to set these up anyway – refreshments, creche, homework corner, publicity; and someone on hand to give a little introduction and explain procedural necessities, to ‘sub-chair’ participation from the ‘annexe’, and provide feedback to officers. Councillors and officers should be encouraged to participate from these locations.

Forget the Handforth cacophony, maybe this is a chance to improve the acoustics of local democracy.

Kevin Harris is a PhD student at INLOGOV, researching into democratic voice and community action in local councils. He was previously a community development consultant and Chief Officer at Queen’s Park Community Council in London (2017-2019).

Photo source: https://www.swingdebates.com/news/handforth-parish-council/

References

Committee on Standards in Public Life, 2019. Local government ethical standards:  a review. Committee on Standards in Public Life, London.

Jacobs, J., 2004. Dark age ahead. Random House, New York.