Monthly Archives: April 2015

When the weather is bad… a glimpse of the future?

Blog by Geoff Mark

I think Billy Connolly once said that in Scotland there is no such thing as bad weather, just the wrong clothes…

I don’t think we have a blueprint to transform care at home overnight and for what it’s worth, I’m not sure there is one. However, it seems obvious that simply working harder at getting more out of our current approach won’t be the answer as I have observed that the things that produce good results seem to happen almost in spite of our current approach rather than because of it. A new approach is needed to be able to connect what is most important for people. A new approach is also needed for the staff who support them so that they can recognise, value and make the most of the capabilities of themselves and the people that they support, using resources flexibly to create incentives to make the most of wider support networks and communities.

I can see that it all might sound a bit idealistic. However, I see most of the potential for a new approach in situations when it is obvious that our traditional approach won’t work and this is usually when we have severely bad weather. It happens 2 to 3 times a year and I’m always impressed by how services and communities respond. Care staff go above and beyond, walking across the fields in the snow, providers negotiate provision directly with service users and families, communities rally around, farmers clear roads and so much more. It happens time and time again.

I’m not suggesting for a minute that we could sustain all this indefinitely or that there are no risks in these situations, but there is something about recognising the commitment of care staff and care providers to the people they support. We need to make sure that this commitment is valued and reinforced by enabling staff to directly respond to what’s most important for the people that they support, while facilitating engaging wider networks of support. Equally, wider support networks and communities are more likely to respond if there is a clear opportunity to make a difference to the people who require support.  If this were in place perhaps we could sustain better outcomes and if more resources were available, we would be more likely to use them effectively.

So there’s the challenge – can we find a way to focus on what produces good results in the context of the challenges we face? I don’t think it will be easy because if it was easy, we’d be doing it, but I do think there must be a better way of approaching the whole thing.

Advertisements

The journey continues with Dumfries and Galloway…

We are currently working in Dumfries and Galloway on a programme that aims to support team leaders from five external home care providers and one in house provider, to develop and implement new skills to embed person-centred practices into the customer journey.

The theme for our third day together was the team.  It makes sense that in order to deliver great person centred support team members need to be person centred in their relationships with each other. A person-centred team is a team that has a clear sense of purpose, knows what’s important to and how best to support team members and identifies and uses team members’ gifts and strengths. The goal of a person-centred team is not just to get along however but to be aligned and through that get results.

A Clear Sense of Purpose

If you don’t have a clear direction of travel any path will do!

Person-centred teams have a clear, compelling and shared sense of purpose that is closely aligned with the mission of their organisation.

We started by asking team leaders to think ahead & if their services were truly personalised what would they look like?  What if person-centred thinking tools were embedded as typical practice & all reviews were person centred reviews, leading to outcomes people wanted to achieve? What would your service look like, what would the stories be?

We did this using an exercise called Front Page News which got our team leaders to imagine their organisation had made the front page of the newspaper in three years time. What is the headline that will make people stop & pick up the paper? What are four stories that describe what’s happening and what are people saying about their organisation? This helped them to visualise what success would look like and how the future could be.

Team leaders also referred back to the one-page strategy generated by the leadership team right at the start of this process.

Image 6

Identifying success moved onto developing a team purpose. A team purpose is a statement which affirms who you are and what you stand for as a team, a statement that will be inspiring and uplifting for the team and keep the energy focussed on helping people get better lives. A clear sense of purpose is the foundation for team members knowing what they want to achieve and is more likely to lead to exceptional performance.

We asked our participants to start with timed talk. During this activity they worked in pairs giving full attention whilst one person talked uninterrupted for 3 minutes about what they thought was the purpose of their team, then to swap roles for another 3 minutes and then finally to discuss together to come up with a shared purpose statement in 3 minutes. This can be a useful tool for team leaders to encourage all team members to have equal opportunity to share their thoughts and ideas.

The act of co-producing the teams’ purpose helps its members to buy into ownership of the ensuing work and outcomes. The team purpose is a grounding element that should remain constant and team leaders can then rely on the purpose statement to refocus the team during confusing or chaotic times.  When making decisions the team can check will the decision move us towards or away from our purpose.

Knowing what’s important to and how best to support its team members

Last time we met, the team leaders spent some time developing their own one-page profiles. We also asked them to start the process of developing one-page profiles with members of their team and today they quality checked these. This meant checking that the information on each one-page profile was specific, detailed and useful. To find out more on one-page profiles and getting them right, click here for a poster that explains more.

 

The team leaders then practised using information from their one-page profiles to put together a team one-page profile. We used a team foundation poster displaying the team purpose and information about each participant. This is a visual summary of the team’s individual one-page profiles that captures each person’s top 3 appreciations, important to and how best to support statements. The team one-page team profile records what people appreciate, like and admire about the individual team members enabling colleagues to consider the gifts and strengths of each other as they go about their everyday work and allocate roles and tasks based on these. We then capture what is important to us as a team.

Image 14

The groups then developed a set of team agreements, things that everyone in the team will sign up to so as they work more effectively together.

We finished the day by working through the Stress and Support tool. This is a particularly useful tool in supervision sessions and requires each person in the team to reflect on the following questions: What makes me most stressed? How do I usually react to being stressed? What helps: What can I do? What I would like you to do.

Image 15

So over the next three weeks the team leaders will be focussing on developing person centred teams by developing their team purpose together, creating a team foundation that reflects what’s important to the team as a whole and using this to develop agreements/ground rules for the team to best support each other.

“Alone we can do so little; together we can do so much.” Helen Keller

Our new Care at Home project

We want to share our experiences with you over the next few months. We are working with representatives from Dumfries and Galloway Commissioning Unit as well as support home care provider organisations in Dumfries and Galloway to explore how we can develop, implement and deliver a truly personalised service to people using home care services. The work that we are doing together aims to support team leaders to develop and implement new skills to truly embed person-centred practices into the customer journey.

AAAA

The programme is being led and co-ordinated by a leadership team who co-developed the design of the project with us. We met in early March 2015 to create a one-page strategy. For an example of a one-page strategy that we previously produced with Dimensions, see here.

At that meeting, the team clearly identified what success looks like for customers, colleagues and the organization. This helped to identify which person-centred practices will help to achieve this, and to put a system in place that will help to track how well we are doing. A simple system of writing the quality measures on a whiteboard so that they serve as yardstick, and as a place to start the next meeting from, was put into action. There are also plans to begin working on a communication strategy at the next meeting.

This week we began working with team leaders from the home care providers and commissioners and spent two days together. We spent time sharing the overarching vision developed by the leadership team and communicated through the one-page strategy, so starting with the end in mind – our vision of success

We began introducing some of the key person-centred practices, as identified on the one-page strategy, which we believe will help everyone to deliver success. Feedback from participants was that they felt supported and empowered that the leadership team would be updated on progress as we go along, as leadership team meetings were set to happen at regular intervals between training for the team leaders.

As we collect feedback on how things are progressing for the team leaders, the leadership team are going to be responsible for:

  • Problem-solving issues that are stopping team leaders from being successful, for example anything is policies or procedures that are getting in the way.
  • Celebrating success and communicating this internally and externally.
  • Measuring progress (We will feed into the leadership team how many one-page profiles that meet quality standards are in place so as have clarity in terms of how we are delivering and measuring in line with the one-page strategy).

AAA

So what were the person-centred practices that were identified as being key to success?

Firstly, we looked at one-page profiles and explored how they are developed through good conversation with all those working in the organisation, and also people using the services and their allies.

We also looked at how we use one-page profiles to enhance the choice and control people who use services have around deciding who will provide their support. Given the single most powerful thing we can do if we are to improve a persons quality of life is to ensure they are supported by a person they connect with and who connects with them, the team leaders embraced this idea and acknowledged we have to better pay attention to this even though we may not be able to do it to perfection.

The team leaders loved the idea of having rich information that the organisation will have around each person they support, which is co-developed with the customer and their allies especially:

  • Their one-page profile – to help them get to know the person well, and know how they want to be helped
  • The ‘what you must do’ list for each visit, and a list saying what it would be really good to do if staff have time
  • Using one page profiles for matching

The second day of training was spent focusing on supporting managers to build their capacity, competence and confidence using five different approaches to developing one-page profiles with staff (see Helens blog for more info on the 5 ways). We then explored together how this would support making this happen at scale in their organisations and simply become typical practice. All of the team leaders threw themselves into this and discussed how this idea of good conversation can be a real help in terms of shifting cultures.

While we were there, we made a short video of the time that we spent with the team leaders:

We will let you know how the team leaders get on between now and our next day together on the 14th April. Each team leader now has their own one-page profile which meets quality standards and they are each going to support two of their colleagues to develop their one-page profile and come back to let us know how they went on with that.

We look forward to sharing the learning!

Gill Bailey & Emily McArdle