Learning with Yumi – introducing self-management to disability services in Australia

I met Yumi on Linked In at the end of last year, when she responded to one of my posts about Wellbeing Teams. I was delighted to hear how she is supporting organisations in Austraila to move towards self-management and I was keen to learn more. In January we had a conversation (which I also recorded as a podcast) and I want to share what she is trying and learning. She has supported 13 disability providers to explore self-management with excellent results.

Yumi is the workforce advisor with the National Disability Services. In her role as workforce advisor she started the Disability Workforce Innovation Network to bring together different stakeholders involved with a disability workforce to explore how to deliver the National Disability Insurance Scheme (NDIS). It’s a completely different way of disability services being funded, mirroring policy in the UK and going from block funding to individual funding. Ofcourse, this  means a big change for organisations and their workforce.

Yumi talked to provider organisations  about their issues in delivering NDIS and their ideas and solutions. The organisations recognised that they needed to think more about workforce, and that it needed to be flexible, more responsive; more effective and efficient to deliver within the new system. NDIS means that organisations will be competing on quality, and that will be quality from the eye of the person using services. This creates some very different challenges for organisations, as it has done with personal budgets in England.

This is what Yumi said:

“So listening to them, I thought back over my time when I worked and lived in the Netherlands, because that’s where I was born and raised, and where I was a workforce advisor as well for disability services and other not-for-profit sectors. And I remember that, in the Netherlands, we had this kind of a reform as well, and what came out of it was, a bit of the same kind of models and solutions. This made it really hard for the workforce to work in this sector. But there were some new initiatives that started out of that as well. And one of them, for example, was Buurtzorg, which is, I think, one of the prime examples of self-managed teams in social care. So I just thought I should talk about Buurtzorg at one of my sessions; just a quick fifteen-minute presentation to test the waters and see if anybody would be interested in exploring something like that, or if they would, you know, say ‘That’s great, but that’s not for us. People loved it; people became really, really interested, and so that’s how I started to do more exploring, do more researching – reaching out to people in the Netherlands, including the people at Buurtzorg, to learn more and to bring that knowledge and insight to the sector here in Australia.”

I am sure that you can see that this has parallels with what we’re experiencing here in the UK. The Care Act requires that people are offered personal budgets and this is happening in a very difficult financial climate.

Yumi then ran a working group with people from different disability group providers, to explore self-management and how this could be implemented in Australia to deliver the NDIS reforms. They also introduced the ideas at a New South Wales conference and more organisations started to become interested. The questions that Yumi asked herself were:

‘How can we help organisations doing this? What kind of conversations do we need to have with them, and what kind of supports do they need?’

The organisations included big providers with thousands of staff as well as small ones. They provided accommodation and support, home care services and day services, to people with learning disabilities or who have mental health issues.

Yumi and her colleaues asked each organisation who was interested to write a business case; to put on paper what they were trying to do, why they were trying to do it; to get a sense of where they were. From this they worked with two different groups, the Early Phase and the Late Phase group. The Early Phase group were really excited, felt like they’d found something that could work for them, but who didn’t have that vision yet of what it would look like in their organisation. So Yumi  helped them to  develop a vision and a plan. The Late Phase group  had much more concrete ideas of what they wanted to trial, what it would look like, to with this group they looked at how they could monitor and evaluate what’s going well, and identify and work on what’s going not so well.

Yumi shared lots of information with the groups  from Buurtzorg and self-management. She has the advantage of being about to speak and read Dutch. She says that Buurtzorg is one of the prime examples that we know internationally, but there are quite a few others in the Netherlands who are working in similar kinds of ways based on similar principles. She was able to introduce this learning and experience to the groups through monthly webinars.

In June last year the 13 organisations from across Australia to meet in Sydney to work together on the principles and practices of self-management. Yumi says,

“You can get a lot of inspiration from Buurtzorg, but you know that you cannot just copy-paste it. What you need is the really deep understanding of the principles that this model works on, and also what the other models that we’ve found, and look at the common set of principles. Then we started the conversation with ‘How do you apply those in your own organisation? How do you create your own model?’ And I think that’s really important, that organisations realise that it’s really about how you apply these principles to design your own model. And it looks differently for all these thirteen organisations; even though they shared a lot and they got the same kind of information, all thirteen of them eventually trialled something that looked different.”

The organisations set up different practical experiements to test out the ideas and to embed the principles. For example, one organisation had a team where the team leader left, and they didn’t really feel that they wanted to put a new team leader in. It was an established team that they trusted and they supported them to self-manage. Another organisation took a team that they thought were already working in a self-managed way  and supported them to fully self-manage.

Yumi and her colleagues also provided lots of individual advice to organisations with problems and issues that they raised as they tested these new ways of working. The webinars and sessions created a Community of Practice and organisations started to support each other.

This work was evaluated independently towards the end of last year with very positive results. Over 80% of staff and managers involved when asked on a scale of 1 – 10 whether they would continue gave a 9 or 10.

Yumi says,

‘This was very powerful. People said that they started looking at this because of the National Disability Insurance Scheme coming in, based on their fear for their workforce and for their organisational viability under this new scheme. However going through all this and really looking at these principles and what it’s doing for their staff and for their clients…they said this makes sense even without a big reform like the NDIS. This just makes sense because it’s the right thing to do; it’s the right thing to do for our workforce, for the workers, and it’s the right thing to do for our clients. People said that families and carers gave back to them, that they felt like they were finally being heard; finally, they were able to co-create with the workforce, instead of just receiving something that was designed somewhere else.”

I am inspired by what Yumi and her colleagues at National Disability Services have started. Yumi and I are doing a series of podcasts to learn together and share our experiences of Wellbeing Teams and supporting self-management, and it a few weeks I will post about what they are learning about the changes this requires for managers and back office staff. I hope that we can find a way to create a similar Community of Practice to support providers in the UK to explore self-management.

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