The Personal Social Services Research Unit in England (PSSRU) has a deserved reputation for the excellence of its social services research over the past decade and has been highly influential in shaping successive UK governments' policies in relation to social care. There is no question that this book is a major contribution to its output. It provides a detailed account of collaboration between the PSSRU and Cheshire Social Services Department in England, in which the PSSRU supported the Department in creating, developing and implementing a comprehensive set of performance indicators for older people. A total of 143 indicators were developed, that collected information on need, supply, practice process, service process and outcome. The book is an account of how this was done. Even though it builds on the ‘production of welfare’ approach long advocated by PSSRU, it is a considerable intellectual and operational achievement. Whilst it would no doubt be possible to construct a model like the one described in this book in a university, the challenge here has been constructive engagement by academics with managers and practitioners running services for older people. Rationales for each indicator are explored, indicators defined, specified and linked with other indicators to develop a comprehensive performance management system, and information systems established to collect and analyse the specified indicator information. The encountered difficulties and the strategies deployed to overcome them are described in depth. There is also a very detailed appendix offering a full description of each of the indicators.
Over the years, I've read a number of papers and books by the main author. They have invariably been stimulating and challenging. I was therefore surprised that I did not enjoy this book as much. It is certainly not the absence of scholarship, for the volume is impressively researched and a wide range of studies are well deployed to support the arguments. Nor are the intentions behind the book to be faulted. Who would dispute the value of having high quality, reliable information about the performance of services relative to resources, and their impact on older people who receive them? One problem is the book's readability. It is not badly written, but it is extremely thorough. Reading a chapter at a time requires some degree of self discipline. There are no short cuts, and most readers will probably struggle to understand the later chapters, particularly the last unless they are acquainted with earlier parts of the book, although the last is a little livelier and more interesting than others.
Perhaps, though, the more important problem is contextual. The publication of another important PSSRU book, Case Management in Community Care (Challis and Davies 1986), came at a time when hard questions were being asked in the United Kingdom about the value and purpose of social work. The PSSRU approach outlined in that book was highly influential. Case, or as it later became, care management, enabled Social Services Departments to develop process-based approaches to social welfare which subsequently paved the way for performance culture. Whilst this may have helped to ‘save’ social work from a worse fate at the hands of a largely unsympathetic right-wing government at that time, and certainly addressed some of the criticisms that were being levelled at social work, the cost may have been rather high. Managerial culture has, over the last 20 years, established a clear hegemony in British professional social work. Whilst this may have been a good thing in some respects, it has also produced new problems. With the implementation of care management, social workers metamorphosed with variable pace and success from advocates to gatekeepers. Performance management has led to standardisation, and standardisation seems to be leading to increasing reliance on ‘recipe’ approaches to data collection – pushing aside real professional skills, values, practice-based experience and knowledge. Social work today faces a different set of threats and challenges, but Performance Indicators in Social Care for Older People seems to offer the same, though more sophisticated, solutions to essentially the old problems.
It may be unfair to expect a book to rescue social work from its difficulties. There are, however, other more practical questions to ask. One of these is the book's potential readership. People working in Cheshire Social Services, certainly, but elsewhere the kinds of people likely to read it will be middle and senior managers working in local authority social care settings. Operational staff will probably be less interested than those responsible for audit, management information and performance. Academics may also find it useful if their interest is in performance management in large organisations. The readership is unlikely to be large. Costs are likely to be a consideration. Quite apart from PSSRU time, the successful implementation of the system in Cheshire would have represented an extremely heavy investment of time and financial resources. No cost data are given in the book. The extent to which the system is ‘future proofed’ is another. Although the authors do consider the responsiveness of the system developed, the widely expected ‘bonfire of performance indicators’ by the government, and focus on a smaller suite of outcome based indicators will be a challenge to any local authority thinking of replicating Cheshire's model. This is a meticulous book, and an important account of a successful collaboration between a university research team and a social services department, but ultimately one that is ‘more of the same’ rather than much that is new.
