Last reviewed 9 January 2018

Jef Smith discusses the Cascading Leadership programme in social care, sponsored by the King’s Fund.

A cascade, as the word is currently used of processes occurring in organisational structures, related originally to the idea of falling water. A cascade does not have the scale or magnificence of a grand waterfall; rather, there is a series of small falls in a stream, dropping in stages down a slope. In nature, a cascade tumbles irregularly between rocky outcrops, but landscape gardeners tamed the flow and produced the elegantly measured water features which still enhance the gardens of many stately homes.

Such a controlled descent brings us closer to the use of “cascading” in modern managerial circles. Wealth is said to trickle down; ideas, it is claimed, can be made to cascade through well-regulated channels, starting at the top but reaching in due course all quarters of the organisation. Convince the most senior person, the theory goes, and they will persuade the next tier, who in turn pass the message down, and so on. It doesn’t always work as neatly as that, but the principle is fairly sound.

The programme of Cascading Leadership sponsored by the King’s Fund uses something of the same idea to spread good practice, not just vertically down single bodies, but also across sectors. Launched as a pilot in March 2016, the project has voluntary and community organisations as its main focus, but has application for providers across the whole spectrum of health and social care delivery.

The voluntary and community sector has funding problems and faces challenges as it constantly adjusts and redefines its relationship with other parts of the health and care system. Much the same could be said, from a slightly different perspective, of all care providers, whether they are private businesses or not-for-profit bodies. In this respect, the managers of residential homes and domiciliary care agencies are typical in their support needs.

For all organisations, investment in leadership is a key to success, and transmitting leadership skills — the capacity to learn new ways of working, agility in problem solving, flexibility in adapting to rapidly changing situations and people — is a vital process. For example, new ways of working with people with dementia are emerging all the time; how does the person in charge of a care home or agency communicate these to the front-line staff who deal with service users day to day, and of course simultaneously to the tiers of management in between?

Leaders in social and community services, the King’s Fund recognised at an early stage, characteristically have to carry out a wide range of tasks, including business planning, income generation, internal and external communications, management of buildings, and team member motivation and training. They easily come to feel isolated and unsupported, their confidence eroded and their capacity undermined. They often find themselves negotiating for business with much larger, perhaps public sector, organisations, where the power imbalance is very marked. All of this will sound familiar to care managers.

A key element of the programme was the attachment of successful leaders as consultants to 15 organisations. The client organisations were selected as a result of their contact with Comic Relief, which was a major funder of the scheme. Consultants were matched to clients as closely as possible, but in effect the main criteria was that they were geographically close, though not of course direct competitors.

The project was intended to be of benefit to both the client bodies and the consultants. The former were offered a development workshop where they learnt in some detail about what they could expect and how to prepare themselves. On the other side, the consultants were given professional training, initially in group sessions but then individually, with continuing support provided by members of the leadership and organisational development team at the King’s Fund. Clearly, the relatively comfortable level of funding available played a significant role in how the project was set up and carried through, but it came as something of a surprise to learn, well into the body of the report, that consultants and clients had only two meetings, a brevity of interaction criticised by many of those involved.

Evaluation of the project

The project’s sponsors commissioned an independent assessment from an organisation called m2 evaluators. Their report concluded, “Without exception, they (participants) view Cascading Leadership as a success in terms of the benefits they have gained both individually and organisationally.” Here are some key themes from the evaluation.

Participants benefitted from having time and space to plan and reflect away from everyday pressures. The client organisations gained new skills and confidence, were helped to tackle significant issues they had not had the courage to face previously, felt less isolated, developed a wider range of leadership skills, became more adept at developing partnerships and working collaboratively, and gained access to specialist knowledge in areas such as evaluation, policy development and business planning. That’s an impressive list of positive achievements; most care managers would welcome such help.

Participants repeatedly commented on one particular aspect of the scheme, the fact that the consultancy came from within the voluntary and community sector and not from outside experts. They spoke, says the evaluation, “about the advantages of working with like-minded people who shared the same passion for the work”, adding that their consultants were people “who could really understand the context for the work and who were often facing the same situations”. This is in marked contrast to feedback from workers in many organisations served by outside consultants, who experience the proffered help as negative, critical, even alienating.

Despite the overwhelmingly positive tone of the evaluation, the King’s Fund acknowledges a series of “challenges” which it proposes to tackle as the programme expands, Several of these focused on the issue of power — tensions perceived between the sponsors, the consultants, and the client organisations. Some of the clients questioned why they had been selected; did it suggest that the funder had identified them as specifically needing support and, therefore, judged to be weak? They were also dubious about their status as “clients”, fearing that that sort of language implied undue deference rather than the reciprocity the scheme claimed, an impression accentuated by the term cascading; was help just flowing down, or was the process genuinely two-way? Similarly, “consultants were urged to resist the temptation of providing the answers and solutions and creating a dependency with their client”.

The report’s brief discussion of these difficulties seems to play down the very real point that many organisations do indeed need help to function more effectively. To deny that, risks undermining the project’s central aim. Unless an organisation gets to the point of admitting that something is wrong and that outside intervention may help to put it right, the process of using a consultant will never get beyond the starting gate.

No one can deny that achieving organisational change through external consultancy is a complex process. In particular, there is a tension between the consultant’s providing direct and immediate help with a pressing problem and the client’s need to develop their own capacity for thinking and innovation, a dilemma the report highlights as “capacity building versus leadership development”. This is, of course, not a new issue; it will indeed be very familiar to any trainer or supervisor. The solution the project came up with was to respond to the immediate need as an aid to establishing a positive relationship and only then to progress to “the more challenging work of helping someone think for themselves”.

Conclusions

Cascading leadership is clearly capable of being adapted to groups other than the voluntary or community sector in which this project was based. The King’s Fund has already concluded that “some features could be replicated”. A major attraction is that compared with using external consultancy, it is relatively cheap, but it is also considerably more effective in mobilising understanding of “the context and nuances in which the work operates” and having “the potential to build connections, networks and wider learning”.

Social care obviously overlaps with and shares many of the features of the sector which was the focus of this project. Not for profit organisations providing care services will readily identify with many of the organisations that participated in the King’s Fund programme, but there is no reason why the model could not be equally effective provided to private and commercial organisations. The issue of competition will need to be carefully considered — consultants are unlikely to relish giving aid to immediate rivals for business — but this issue is not insuperable with judicious pairing of consultants and clients. Professional and trade associations such as Care England and the National Care Forum already provide arenas for a good deal of collaboration between providers who are potential competitors, so structuring a network of consultant-client relationships should not be beyond their ability.

Best of all, such a project would show to the outside world that a sector which often, not unrealistically, presents itself as the victim of a cruel market and an uncaring government is prepared to tackle the issue of putting its own house in order. To be doing so largely by mobilising resources from within the sector — though some resources from the likes of Comic Relief and the King’s Fund would certainly not go amiss — would be an added bonus.