The Guardian, in November last year, tells story of Jean. Jean works for a home care agency in the north of England. She starts work at 6.30 am, and completes 23 calls in 12 hours. She drives 20 miles between appointments, and is not paid for her travel time, and earns £64.80 before tax. Jean is on a zero hours contract. She does not know how many appointments she will have each week, and therefore how much she will be paid. Her list of appointments comes through on a Friday. How can we change this and enable carers in home care to flourish?
Wellbeing Teams have five core values: Compassion, Responsibility, Curiosity, Creativity and Flourishing. How would these show up in the daily life of the team? Central to this is the context in which the teams operate and most importantly the headline purpose of the team which is ‘to support and connect older people with their community’. We arrived at ten key features of living the values, what matters to us as an organisation, to help make this explicit.
On Friday I had a deadline and a challenge. Could we describe what we are trying to achieve with Wellbeing Teams in just 250 words following a set format of questions? We were applying for the Dragons Den equivalent of social innovation, for a Global Innovation conference at Yale University. Here is version 12.
Talk of being ‘values based’ abounds: values based recruitment, values based leadership, values based coaching, values based strategic planning; it would seem that lots of organisations are now doing ‘it’ and that ‘it’ is the thing to do. So that’s great – isn’t it?
Thinking about the values underpinning Wellbeing Teams I wanted to make sure I understood what they really are, and to separate the truth from the hype. I asked Jackie LeFevre for help. Here is some of her wisdom on values, and how we worked together to develop the 5 core values of Wellbeing Teams.
It seemed like a great way to get my thoughts organised, and inspired me to do my own. I love planning for a new year, and I liked how she balanced work with other areas in her life. Because I love my work so much I need to have an equally strong focus and intention on other areas of my life, so creating a mind map that covers all areas of my life felt right for me. I also wanted to make sure that I was paying attention to my overall wellbeing, so I used the Five Ways to Wellbeing to structure this.
Watch the video below or read the rest of the post to see what came out of this exercise as my areas of focus for 2017.
I chose to explore three work areas as my focus for 2017.
My biggest priority is moving forward with Wellbeing Teams, my new model for living well at home.
We have four getting started at the beginning of the year, across Devon, Doncaster and Dumfries (two teams). By the end of 2017, I want to have learned from these and extended the number to at least 10 teams. Our fabulous partners in Devon, Love2Care, want to get to 12 teams by the end of the year as well, and if they achieve that (and I am confident they will!), this alone would take the total to 16. We have teams starting in Scotland and England, and it would be brilliant to have teams in Wales too.
The numbers matter because my aspiration is to demonstrate that Wellbeing Teams can happen at scale across the UK. Demonstrating a different way of supporting people at home is key, but making an impact nationally is really important to me too, so we can show that it is possible to improve more people’s lives, more of the time. I am looking at social franchising as a possible way to do this.
We are just waiting for the final sign-off on an opportunity to work with patients and staff across several hospitals in one area, as the lead organisation for improving the patient and staff experience.
We will be working to make sure that both patients and staff feel known as individuals and that their voices are listened to, through embedding one-page profiles and Working Together for Change. This is a great opportunity to build on the work we have been doing in two hospitals in 2016.
I was delighted that our work with Landermeads Care Home was cited by CQC in their report that rated them as Outstanding. It said “the provider had worked with an internationally-renowned external service to produce one-page profiles for both people who use the service and staff. People who use the service, relatives and staff we spoke with told us they found the profiles helpful.”
In 2017 I want to build on this with Ros and her team, and see if we can take some of the concepts from self-managed Wellbeing Teams into a care home environment. I am also working with a leading thinker in dementia care to develop a new way of supporting other registered managers in care homes to keep developing and improving how they support people and staff.
Using the Five Ways to Wellbeing in my mind map helped me to move into 2017 thinking about how to do more of what matters to me, and what I need to do to stay healthy and well. Here are some examples of what I want to do:
My Dad died when I was 21 and I always wanted to know more about his life, and have a record of this to share with my children.
I spent Christmas with my ‘big family’, my mum and sisters and our families. We are going to work on capturing Mum and Dad’s life histories this year, and some of our own as well, as a family project.
I love learning, and last year I started two courses that I did not finish and want to go back and complete them this year – podcasting and Theory U. I am also halfway through e-learning on Compassionate Communication too, which I find really useful both for my personal and professional lives.
I have been reading Thich Nhat Hanh’s book ‘Savor – Mindful Eating, Mindful Life’. This year instead of my usual resolution to eat and drink less, I am going to try to eat and drink mindfully.
I started Parkruns this year – 5k runs that take place at local parks every Saturday morning. I want to go from doing them on an ad-hoc basis to including them as part of my typical week. I did well with my yoga practice in 2016, but this dropped off in November, so getting back to weekly yoga is important to me this year too.
I volunteer through Community Circles, both as a Community Circle facilitator, and chair of the trustees. I want to help the organisation to scale up – for us to build internationally and to find funding for over 20 Connectors in the UK in 2017. If you’re looking for a way to contribute in 2017, get in touch – we are always looking to hear from people who would like to join us!
It’s exciting to have ideas about what I want to experience, achieve, and new habits to build, but staying focused right through to December 2017 is much more of a challenge for me. Over the last year I have updated a ‘Now page‘ on my blog site, that describes what I am currently doing or working on. I will post a monthly update on my Now page sharing how I am getting on. Going public with the areas I want to focus on makes me feel more committed and determined, and a bit vulnerable too. I hope that your plans for 2017 are exciting, and that we can stick at them together!
Carol works in the care sector visiting clients in their own homes for which she receives the National Minimum Wage and 7p a mile mileage. She has been doing it for three years, but says she is increasingly thinking of leaving because in her view the industry is getting worse. She says that the central frustration in her working life is not the pay, but that her employer schedules three half-hour visits every hour, meaning she is constantly late for each appointment and feels that she is short-changing the clients. This blog describes how Wellbeing Teams are trying to change Carol’s experience.
This short animate describes how a Wellbeing Team supports Norma and Jean – but it is only half the story.
Wellbeing Teams offer a fresh approach to home care, that is different in two ways: how people are supported and how the team works together. The ‘wellbeing’ in Wellbeing Teams stands for both people supported and for team members, you cannot do one without the other.
For the team this means being self-managing. As Daniel Pink, in his provocative book about motivation called Drive, says
“Ample research has shown that people working in self-organized teams are more satisfied” than those working in traditional teams.
This blog describes eight ways that self-managing Wellbeing Teams are structured and supported, providing the other half of the story.
Dora was dressed in a purple cardigan and had a beautiful lilac tint to her hair. She is in her eighties, and her daughter was on holiday, and Geraldine was making sure that Dora had a mid-day meal. I was accompanying Geraldine on her visits that day, and chatted to Dora about her grandchildren, whilst she ate her cooked salmon and vegetables. Dora’s daughter had arranged for Dora and Geraldine to go out for lunch as her favourite pub the next day.
“Remember not to wear your uniform” were Dora’s parting words as we left.
Geraldine is a qualified nurse and wears a nurse uniform and smart jacket, her colleagues in Caring Hands also wear a uniform of a navy tunic and trousers. Last week we explored the issue of uniform with the new wellbeing team.
The wellbeing team was partway through their induction and had shared their personal histories, and we had explored what matters to each of us. One of the underpinning principles of a wellbeing team, is to ‘bring the whole self to work’. As we started our discussion about uniforms, we looked at the reasons why Caring Hands chose to have uniforms:
“families like us to look smart and professional’
“it is easy for people to recognise their carer”
We were clear that it is not a hygiene issue, often stated as a reason for having uniforms, as people are expected to wear disposable aprons and gloves if necessary.
In my early working life I was an occupational therapist and wore the familiar green trousers and white tunic on hospital wards. When I worked with people with learning disabilities, no one wore a uniform, as the medical model had been replaced with a values based model known as ‘normalisation.’
Sally Knocker from Dementia Care Matters is very clear that “a uniform is seen by many as a symbol of power and control, reinforcing a sense of “us and them”.
Uniforms can convey a professional distance that as James, one of the wellbeing workers pointed out, is at odds with our principle of bringing the whole self to work. It would seem strange to be encouraging the wellbeing team to talk about what matters to them, be prepared to share their interests with people and yet expect them to dress the same and hide that individuality.
We explored how we could still inspire confidence and look professional to families and individuals, without wearing a uniform.
Being a tribe and being recognisable
People like to feel like they belong, are part of a tribe or a group that stands for something. Part of me loves the seduction of smart branded cars and uniforms. I personally would prefer not having to think about what to wear in the morning, and this was a benefit of wearing a uniform as an OT.
My friend’s mum is supported by a premier home care company, who have colourful branded cars and uniforms. I asked her what her mum thought about it. She said,
“I don’t think mum would want to be identified as someone who is receiving services with a branded car or uniform. If she was out with the person she would prefer people to assume that they are a friend.”
I think this was behind Dora’s request to Geraldine not to wear a uniform when they went for lunch in the pub.
When I tweeted about uniforms last week, Sally made a point I had not thought of:
At the end of our discussion the question we were left with was:
Can we combine an easy way for people to recognise us, whilst also expressing individually and being warm and approachable?
We decided that having a smart dress code, but wearing our own clothes was important. We explored the poloshirt with logo idea – but this is simply a different kind of uniform.
We agreed that we wanted a jacket, that everyone would have, in the same colour with a discreet logo of the wellbeing team. This would be a way for people to recognise us initially for the first few visits as required. We would wear it between visits, but not if we were supporting someone in the community.
I am keen to hear what people think about uniforms and home care. Please share your views.
Skills for Care tell us that values based recruitment and retention is about finding and keeping people who have the right values, attitudes and behaviours to work in social care. As we started to design our workshop day to recruit the first self-managing team in homecare in Lancashire, I started to understand that this was more complex than I had imagined.
We needed to move from an implicit understanding about the principles and values we wanted to recruit to, to make them explicit and ‘live them’ throughout the whole recruitment process. We needed to consider two areas, how the team organises itself, and the work that it does. We are modeling the new team on ‘teal’ principles, and in summary these are self-management, bringing the whole person to work, and evolutionary purpose. These reflect how the team is organised, and the work that we want the team to do, is to work with older people in their own homes, to co-design their support with them, and deliver this in a person-centred way. What does all this mean for values based recruitment?
In traditional homecare the first conversation is usually called the assessment. The purpose is to find out what the person’s needs are, and to do a risk assessment before the service starts. The conversation will be dictated by the paperwork.
How can we change this conversation from needs and risk, to what matters to the person, and learning about their priorities? Can we have paperwork that is person-centred, and yet still fulfills the expectations of regulators? This is what we are exploring with the new team of Wellbeing Workers. We want the first meeting to be a conversation, and the paperwork seen as the record of a conversation, not a form to fill in.