Lessons from our launch

We wanted our launch event to reflect the values of our new business and had high expectations when we walked into building 10 of the University of Technology Sydney on a sunny Tuesday morning. Spoiler alert: it was even better than we had dared to hope for.

We had 30 participants from organisations across Australia providing diverse views on what’s on the minds of purpose-driven service providers. Here’s a detailed overview of the day’s learnings and activities for everyone who wants to recap or could not make it this time. We explored different perspectives on Purpose, Self-organising teams and Safe & Quality Services.

 Purpose

Helen Sanderson of Wellbeing Teams UKHSA and Community Circles started the day by sharing from her broad experience with rethinking organisational models and work practices to improve services and jobs in social care. Now, who doesn’t love to hear about other people’s failures?! And Helen shared freely from both her professional and personal experiences, so that all present wouldn’t have to make the same mistakes, or at least feel less silly when they do. Helen draws inspiration from a wide range of sources and people she meets through her work with government and service providers, but as a ravenous reader, she also draws inspiration from the works of Seth GodinFrederic Laloux and Jeffrey Pfeffer. Her message was loud and clear: if only 1 in 10 people are engaged at work, work is literally (slowly) killing you and if filling out forms and checklists has become your job, something is very, very wrong.

The story of Wellbeing teams (and her other ventures) show there is a better way. If you are willing to take the time and work with your staff to develop and improve your service there is a different way of working that leads to great outcomes for clients and staff AND an organisation that gets an outstanding rating from the regulator for safety and quality. The key learning here was that every organisation will have to figure out their own framework and operating rhythm. It’s not easy, but it can be done.

Caroline followed up with the Australian context, explaining how we’ve entered a Volatile, Uncertain, Complex and Ambiguous (VUCA) world and have to make the most of it. Self-organising teams are a proven approach for organisations to successfully engage with our ever-changing and increasingly fast-moving environment. Because, in the words of Aaron Dignan (Brave New Work): “Everyone who has worked in a company that is command-and-control, bureaucratic, or hierarchical for more than a few years agrees: the way we’re working isn’t working …..the call for change is clear: our organizations need to be more open, fluid, adaptive, decentralized, and empowering.” 

She quickly added that self-organising teams are not a new concept, having been around since the early 1990’s. These teams are built on practices that emphasise empowerment, job enrichment, job enlargement and worker involvement in decision-making. Dutch author Wouter Hart explains it best in his book ‘Lost in Control’. He talks about organisations working from their Purpose and not letting systems dictate what is best for them and their clients.

We then asked people to form a line across the room to show how far they felt they had progressed towards self-organising teams and what do you know, it was a fairly representative line of our experience with the Australian market. Many are exploring it and a substantial number of organisations have already started implementing these teams.

Setting up self-organising teams

After a very tasty morning tea break, Helen shared practical tips and experiences that, judging by the questions and nodding heads clearly resonated with the everyday lives of the audience. Her pro-tips? So glad you asked:

1.      Very clearly define roles and agree the tasks with the person performing them

2.      Everyone (incl. the CEO) has a wellbeing buddy, looking out for them

3.      Be transparent about what ‘good’ (success) looks like

4.      Use data and technology at every opportunity

5.      Have a ‘storyteller’ who shares insights and experiences

6.      Have tactical meetings every week

7.      Choosing team members carefully based on values as it is about what a person believes much more than what they know; skills can be taught.

8.      Have a ‘how we work’ handbook instead of endless policies that no one reads

If nothing else, take a look at these excellent tools for person centred practices that are freely available on her website: http://helensandersonassociates.co.uk/person-centred-practice/

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Yumi continued with the Australian context, sharing what Australian organisations are doing in the self-organising team space already. She explained that there is a lot of variation in how self-organising teams are set-up and that there is no one-size-fits-all formula for success, however frustrating and ambiguous that might be for the more risk-adverse organisations. Just to show that self-management is more than just scrapping a few management layers, Yumi also highlighted the following considerations for any organisation thinking of starting with self-managed teams:

1.      Make sure to have an organisational framework and culture that supports the concept or you’re done before you even get started.

2.      Arrange coaches and peer support and avoid trying to just add these tasks to people’s workload, others have tried and it doesn’t work this way.

3.      The back office, even if they themselves don’t operate as a self-managed team, need to be aware and supportive of what the teams need to function, which is a bit of structure, but most of all flexibility to do things slightly differently.

4.      Training and development requires more than a 1-hour lunch & learn session, this is serious business and that means training in joint decision making, new systems, running effective meetings, communication, peer support, mindful practices and even coaching/mentoring for executive and coaches.

5.      Technology is never the winning solution, but often an important support to enable remote and flexible working and should be treated as such, explore platforms like Slack, Loomio and even Microsoft teams to support communication and collaboration within and between teams.

After more table discussion and sharing of experiences and practices followed by a sunny and yummy lunch (all that was left went to OzHarvest), it was time to shift focus towards Quality and Safeguarding, which turned out to be much more interesting and diverse than it sounds!

Safe and Quality Services: The UK and Australia experiences

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Helen set the scene by explaining that now more than ever, accountability keeps coming up in conversation’s she’s having about wellbeing and self-management. Her organisation has documented in detail how things work and the background to practices. Throughout her various teams these are some of the practices that ensure that both staff and participants stay healthy and safe:

1.      Flipping the classroom and letting staff learn skills in a way that works for them

2.      Use and develop ‘what-if’ scenario cards based on incidents, complaints and the organisational values that prepare people to deal with unforeseen circumstances

3.      Confirmation practices to ensure everyone is focused and regularly reflects on the core elements of their role

4.      Share failures and successes on ‘Failure Fridays’

5.      Do a 5-minute staff satisfaction survey EVERY month on Peakon

None of these practices alone create a culture of wellbeing, inclusion and safety, but the combination of it all indicates a golden thread for all to see and adhere to as ‘the way we do things around here’. It also helps to create certainty for leaders who still carry the responsibility for what goes on, but no longer get to make decisions on day-to-day matters. The documentation and application of these practices have resulted in Wellbeing Teams being rated ‘Outstanding’ by the UK Care Quality Commission (see here for the full inspection report).

Alan provided the Australian context, mainly from an Aged Care and NDIS perspective. Despite all that has been done to improve quality and safeguarding, there are still too many reports of avoidable deaths and seriously harm and injure to people needing support and the workers supporting them. There are two Royal Commissions which will be looking at abuse and neglect, everyday media coverage of major scandals in both sectors and providers being under review and shut down. It’s very clear as providers and as a community, we need to do much better in quality and safeguarding. The question is, what does that look like? Perhaps something like this:

  • Find a balance between systems and purpose driven approaches, always putting the participant at the centre and making processes serve their needs before anything else

  • Design purpose into policies and procedures by asking frontline workers what in your policies, procedures and practices hinders their effectiveness and:

a)      Cull what adds no or little value.

b)      Keep the policy and procedure formats simple. Elaborate formats result in unnecessary words.

c)      Begin with purpose: What does this policy do for people supported or for workers?

d)      Say things simply.

e)      Resist the temptation to copy from other organisations, unless they are using the purpose-driven approach.

f)       Use videos.

g)      Be aware of what the Standards actually require. For example, the NDIS Practice Standards have requirements about the supervision of workers. But they do not say that that supervision must be provided in a hierarchical supervisor – peer supervision is still supervision.

  • Create meaningful performance indicators that make sense to everyone in your organisational context, not just some generic metrics that only finance and the CEO sometimes glance at

  • Treat incident management as an opportunity to learn instead of a potential risk to hide

 

Safe and Quality services: Preparing and passing audits

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The final speaker for the day was Alex Carbonetti, the most straightforward and non-scary NDIS auditor the audience had ever met! After Helen’s sharing the image and story of how her heart rate was much higher for a whole month while preparing for her CQC audit, Yumi started by interviewing Alex with some prepared questions, but after a full day of interaction and engagement, the room needed no further prompting and soon took over the role of interviewer asking for Alex’ views on some of their key questions, like:

What do you actually look for?

Evidence of outcomes for the people you support. Under the new NDIS Quality and Safeguards the focus is on outcomes, not policy documents and checklists. People always think that it is all about procedures, policy and impressive handbooks, but I want to see how these get used in real life and result in good outcomes for the people you support. What use is a manual if it’s only collecting dust? Evidence could be anything. It could be a document, written instructions, data, review reports. Anything that shows me how the organisation applies policy in practice.

What has changed since the introduction of NDIS?

I am seeing a much stronger focus on and awareness of the need for and benefits of frameworks and structures that actually work in real life. Another thing is more rigorous training. Some go a bit overboard, thinking that training is the solution to all their woes, which it isn’t but it’s much better than not doing any training at all. I also look to see if organisations are giving their clients the dignity of risk, to make their own choices, even if that means a conversation about the Duty of Care and what has to weigh heaviest in each individual case.

Have you seen any real good practices to share?

In Australia? Not really. Not yet at least. I get really inspired by hearing what Helen is doing in the UK and by some of the stories I heard today, but let’s not pretend that we’re anywhere near that level yet, but we’re moving in the right direction all the same. At the end of the day, it’s all about servicing clients, not the Commissioner, a fact that (larger) organisations often seem to lose sight of.

What happens to registration if a corrective action is assigned?

That depends if it is a minor infraction or a series of major breaches. In case of the latter your business can, and will, be shut down. It hardly ever happens instantly, we give plenty of time to make improvements, but there is the odd case where we find things so bent out of shape that closing them down is the only option. Generally speaking, most businesses fix their mistakes and do better.

Do you have any tips for us?

1.      If you start a business from a previous role, wanting to do it better, don’t think you can stay on the front-line, it doesn’t work that way

2.      The Standards don’t ask for policies, they ask for documents, which is a completely different thing

3.      If you feel that your auditor is unfair or biased, make a complaint, we are only human and should work with you collaboratively and collegiately

4.      Get serious about data on performance and delivery, it’s the best evidence you can provide AND make sure you use this data to improve your service

5.      Simple things often work just as well, auditors are not impressed with complexity, quite the opposite really!

Wrapping up

We ended the day with a speed-date exercise that got everyone to share their most valuable insight of the day in 2 minutes and then making a start with their own experimental roadmap for change as individuals or as an organisation.

Initial feedback told us that participants felt the same way we did after a full day of learning and experience-sharing; there is so much potential to do things better and so many great examples to follow already out there! There’s really no good reason to not give it a try.

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We were both impressed and inspired by the level of collaboration and sharing of information and experiences that happened in just one day with this small group of people. We like to think that this is representative of the wider social care community and can’t help to get excited about all the things we’ll get involved with moving forward. To be continued for sure!