David Sheard has changed my mission around care homes

David S

Last week was Dementia Care Matters 20th anniversary conference. Gill and I were invited to give a keynote and I know it sounds cheesey, but it really was an honour. Not just that, it resulted in a significant change to my personal mission in relation to care homes. Before I say more about this, a confession. Gill is one of David’s biggest fans, and whilst I absolutely saw David as a kindred spirit in his values, and admired him, I felt in a bit of competition too.  Now, I am most definitely moving from any sense of competition to collaboration. This is what has changed my views –  four areas that matter and what this means to me.

1) Households Matter

David stated this in his introduction as the theme of the day. He is working with a new organisation, All of Us, who are building care homes where there are households of eight people. I didn’t know that David is as excited about households as I am. I am a big fan of the Greenhouse model where 10 – 12 people living together and it is exciting to see this move to even smaller households.

2) Relationships and Emotions matter

The great strength of David’s work, I think, is his focus on relationships and emotions. I went to an inspiring talk hosted by Sally Knocker, where managers of two very different care homes, who have used David’s Butterfly approach. I wonder what would happen if there was an opportunity to explore what person-centred practices could contribute to the Butterfly approach, and I want to explore this.

3) Colleagues matter

From hearing David speaking before, I know that he encourages colleagues to share their personal history, to share their life stories with each other. I have been working in the area of person-centred teams for longer than I want to think about (my PhD was on this in 2000) and there is a great fit between David’s focus on colleagues and person-centred team work.

4) Decision-making together matters

The speakers before us, from All of Us, provided compelling statistics about the importance at all levels of investing in staff wellbeing. The annual turnover in some care homes can be as much as 75%. The negative impact of this ripples everywhere – people’s relationships and wellbeing, as well as the 150% salary cost for employing new staff. In one of the workshops Louise  (one of the workshop leaders who has introduced the butterfly approach) talked about how significant she believes the shared decision-making in her team has been to there sense of well-being (and contributing to their CQC Outstanding rating too). I asked her afterwards whether staff did their own rotas. She thought that was a step too far at the moment, but learning from teal organisations suggest that this level of self-management can have great benefits. I am working to introduce self-managed teams in homecare, and learning from the Greenhouse model shows how powerful they are in this sector. I think teal takes this even further.

Listening to David made me realise that I need to go beyond my ideas, and my preoccupation with implementing person-centred practices with people and colleagues, and individual time. I know this is important, and I am also very impressed with the evidence from the Butterfly homes. In Butterly homes falls are much much lower than the national average, and turnover is as low as 10 percent.

So my mission has changed! On the way back from the conference Gill and I talked about how we can combine the Butterfly approach (Gill has done David’s year long course) with person-centred practices and see if the sum of each of them is greater than their individual contributions. I think this could go even further within a teal, self-managing team. I hope David will join us as a critical friend and help us stay true to his work, and see where the combination could take us. 

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