Monday, 19 September 2016

It’s a question of the frontline




In the first of a series of blogs, Vic Citarella considers the crucial role of the workforce in Fulfilling Lives for people with multiple and complex needs. Vic is keen to start a dialogue with projects on this topic. You can get in touch with him using the details below.


“The CFE and University of Sheffield 2nd annual report into the national evaluation of Fulfilling Lives: Supporting people with multiple needs programme has chapters on ‘interventions and approaches’ and on ‘working the frontline’. The report says it raises as many questions as it answers but without doubt it pinpoints the workforce and what they do as the mission critical factor in the projects. More is promised by way of research and future evaluation. That means, among other things, dialogue with the practitioners, the managers, the stakeholders and the customers of the services.

What better way to exchange views than by identifying some themes in a Blog?

A question of purpose
The evaluation reports that users of the services value the ‘sense of purpose’ that the project workers share with them. Clearly we need to know how that ‘purpose’ is articulated and shared. What is it about the mission statements, vision, values and principles that motivates and convinces the workforce that they are doing the right thing? There is a saying that: if you lose your ‘why’ then you lose your ‘way’. Well, we have to know why.
There are a number of big pointers in the annual report and perhaps foremost among them for the workforce is a purpose which includes:
  • Meaningful service user involvement
  • The concepts of open-endedness and persistence
  • Psychologically Informed Environments (PIEs)
  • Systems change
These are themes that need further probing for workforce implications.

A question of detail
Few people remember the second half of the quote: The Devil is in the details. It goes on to say: so is salvation. The problem with specifics is sorting out what is important and what gets in the way. There are some clues in the annual report that will warrant further exploration.
The projects all work through some variation of keyworkers. We know from the report that this means in practice both personal, relationship-based support and service coordination or navigation. Knowing the detail of how these twin roles are demarcated and overlap will help prepare operational job descriptions and person specifications, make for effective values and skills based recruitment and ensure appropriate support and training for the workforce.
Knowing what types of people that you want to perform what roles and tasks is about sorting through the specific details to make clear statements of what is important.
So for example it appears from the annual report that service user involvement and peer support are both important. Quite right, but what are the important details?

A question of pragmatism
Everyone wants to know how to do things – a handy guide, top tips or a readiness checklist. There is no shortage of these on the web to encourage best practices for the workforce and their managers. They may not be exactly useable off-the-shelf but a lot of general policies and procedures can be customised to the multiple and complex needs project scenario. What may be challenging is undertaking the customisations.

The annual report spells out that pragmatism, practicality and perseverance are the order of the day in projects. It flags up a number of workforce issues that will need further evaluation. Among them are:
  • People with lived experience on the frontline as volunteers and/or employees
  • Caseload management
  • Navigation and systems brokerage as emerging job roles
A question of curiosity
The annual report makes it very evident that members of the workforce are at the heart of evaluating progress with the projects. It is they who complete the two measuring tools – Homelessness Outcome Star and the NDT Assessment – with the service beneficiaries. One of the features that workers enjoy about the projects is the move away from target driven approaches. We need to know how, without the target driver, projects capture the imagination and creativity of practitioners in working alongside beneficiaries in getting as full an evaluation picture as possible.
So for example projects could share views and opinions on:
  • The skills and training required to make good use of the tools
  • The amount of time it takes to collect the data and information
  • What helps and what hinders in using the tools
  • How the data and information is useful to them in their work
  • What makes data collection less challenging
The continuing evaluation must be inquisitive about the interventions and approaches. The more we know about what works and why the better. In this way the best workforce can be recruited, trained, supported and retained. What follows is an effective service. As Einstein said: "The important thing is not to stop questioning. Curiosity has its own reason for existing.”

Vic Citarella
Company Director CPEA Ltd. 07947 680 588| vic.citarella@cpea.co.uk

Friday, 2 September 2016

If it’s good enough for Mo Farah!


Guest Blogger Cedi Frederick, former social care Chief Executive and now Managing Director of Article Consulting Ltd challenges the sector to invest in coaching for Registered Managers 
 
      Cedi (Cedric) Frederick                                                                       

It’s generally accepted that the job of the Registered Manager is the toughest in social care bar none! No other job comes with the relentless pressure, the ever increasing expectations and in real terms the ever decreasing resources; be that people or money!  At its best it’s hugely rewarding, but at its worst it can break even the most resilient of individuals.  In 2013 in a response to the growing number of Registered Manager vacancies, the CQC imposed tough penalties on organisations who failed to fill the 2,439 Registered Manager vacancies that existed and miraculously between November 2013 and April 2014, 1395 manager vacancies were filled, with 470 registration applications lodged with the CQC.  I wondered then, as I wonder now how many of those appointments were really up to the toughest job in social care and how many of those managers appointed then are still Registered Managers today?


I have led many management and leadership workshops and training sessions for Registered Managers and there’s a slide I always use to illustrate the expectations placed on them.  It shows the faces of Oprah Winfrey, Mahatma Ghandi, Margaret Thatcher, Anita Roddick, Winston Churchill, Richard Branson, Albert Einstein and…...Paul Daniels! So, the ideal Registered Manager needs to have Oprah’s empathy, Ghandi’s wisdom, Thatcher’s toughness, Roddick’s entrepreneurial spirit, Churchill’s leadership, Branson’s business savvy, Einstein’s brains and like Paul Daniels, a Manager needs to be able to pull rabbits out of hats!  A lot to expect of one person?  Yes, it is, but we’ve seen how a great Registered Manager can turn a failing care home around, but we’ve seen how a home that was previously well run and delivering great outcomes can slowly fail following the appointment of a Manager who is not up to the job!


Skills for Care and the National Care Forum are doing great work to support Registered Managers to improve their management and leadership skills and knowledge.  They are to be applauded for their efforts, as are the organisations that invest in their Managers training and support.  But it’s not enough.  Care providers need to invest as much, if not more in Managers’ emotional and psychological well-being as they do in their managerial competencies.  I believe that thousands of Managers are burnt out and struggling to get through each day in a job that has changed beyond all recognition.  Many are of an age where they’re just holding on, hoping to see out their careers without a major incident in their homes that would threaten their future employment at a time when they believe that changing career would be virtually impossible.

 If it's good enough for Mo!


So, how should organisations respond?  By providing every Registered Manager with a Personal Performance Coach.


It would be inconceivable that a top sportsman or woman could maximise their performance and achieve the highest success without a coach.  More and more executives including CEO’s are benefiting from coaching, so why aren’t organisations who are increasingly recognising that their success rests on the shoulders of their Registered Managers considering the benefits of coaching for this crucial group of staff.  The guaranteed return on that investment?  More resilient, more confident, less fearful and less stressed Managers, better able to handle the constant pressure they face, more likely to become better leaders, better able to manage change and deliver transformation.  Personal coaching, alongside more formal management and leadership training will improve a Manager’s performance which will lead to greater staff engagement, greater trust and confidence between a Manager and their staff which in turn leads to lower staff turnover and sickness and ultimately better service delivery.


Depending on the needs of the individual Manager, a coaching programme could take from a few weeks to a year or more.  These 1-1 sessions could be held face-to-face, over the phone or even online with Managers expected to undertake some personal work between sessions. A coach is a catalyst for change in an individual.  They don’t do the work, but they hold their client to account for doing the work themselves. 

Providing a Registered Manager with a coach may save an organisation thousands of pounds per home each year.  Why wouldn’t they do it?

If it’s good enough for Mo Farah!


Guest Blogger Cedi Frederick, former social care Chief Executive and now Managing Director of Article Consulting Ltd challenges the sector to invest in coaching for Registered Managers 
 
      Cedi (Cedric) Frederick                                                                       

It’s generally accepted that the job of the Registered Manager is the toughest in social care bar none! No other job comes with the relentless pressure, the ever increasing expectations and in real terms the ever decreasing resources; be that people or money!  At its best it’s hugely rewarding, but at its worst it can break even the most resilient of individuals.  In 2013 in a response to the growing number of Registered Manager vacancies, the CQC imposed tough penalties on organisations who failed to fill the 2,439 Registered Manager vacancies that existed and miraculously between November 2013 and April 2014, 1395 manager vacancies were filled, with 470 registration applications lodged with the CQC.  I wondered then, as I wonder now how many of those appointments were really up to the toughest job in social care and how many of those managers appointed then are still Registered Managers today?


I have led many management and leadership workshops and training sessions for Registered Managers and there’s a slide I always use to illustrate the expectations placed on them.  It shows the faces of Oprah Winfrey, Mahatma Ghandi, Margaret Thatcher, Anita Roddick, Winston Churchill, Richard Branson, Albert Einstein and…...Paul Daniels! So, the ideal Registered Manager needs to have Oprah’s empathy, Ghandi’s wisdom, Thatcher’s toughness, Roddick’s entrepreneurial spirit, Churchill’s leadership, Branson’s business savvy, Einstein’s brains and like Paul Daniels, a Manager needs to be able to pull rabbits out of hats!  A lot to expect of one person?  Yes, it is, but we’ve seen how a great Registered Manager can turn a failing care home around, but we’ve seen how a home that was previously well run and delivering great outcomes can slowly fail following the appointment of a Manager who is not up to the job!


Skills for Care and the National Care Forum are doing great work to support Registered Managers to improve their management and leadership skills and knowledge.  They are to be applauded for their efforts, as are the organisations that invest in their Managers training and support.  But it’s not enough.  Care providers need to invest as much, if not more in Managers’ emotional and psychological well-being as they do in their managerial competencies.  I believe that thousands of Managers are burnt out and struggling to get through each day in a job that has changed beyond all recognition.  Many are of an age where they’re just holding on, hoping to see out their careers without a major incident in their homes that would threaten their future employment at a time when they believe that changing career would be virtually impossible.

 If it's good enough for Mo!


So, how should organisations respond?  By providing every Registered Manager with a Personal Performance Coach.


It would be inconceivable that a top sportsman or woman could maximise their performance and achieve the highest success without a coach.  More and more executives including CEO’s are benefiting from coaching, so why aren’t organisations who are increasingly recognising that their success rests on the shoulders of their Registered Managers considering the benefits of coaching for this crucial group of staff.  The guaranteed return on that investment?  More resilient, more confident, less fearful and less stressed Managers, better able to handle the constant pressure they face, more likely to become better leaders, better able to manage change and deliver transformation.  Personal coaching, alongside more formal management and leadership training will improve a Manager’s performance which will lead to greater staff engagement, greater trust and confidence between a Manager and their staff which in turn leads to lower staff turnover and sickness and ultimately better service delivery.


Depending on the needs of the individual Manager, a coaching programme could take from a few weeks to a year or more.  These 1-1 sessions could be held face-to-face, over the phone or even online with Managers expected to undertake some personal work between sessions. A coach is a catalyst for change in an individual.  They don’t do the work, but they hold their client to account for doing the work themselves. 

Providing a Registered Manager with a coach may save an organisation thousands of pounds per home each year.  Why wouldn’t they do it?

Monday, 1 August 2016

Social care work - at the butt end of downward mobility

Vic Citarella postulates that investment in the social care workforce will improve social mobility

One factor that contributes to divisions or unity between people is the nature of the labour market. Work features large in how we see ourselves and how others see us and our families. It is integral to our identity. It is about the pay-off from hard work that politicians talk of when they use the language of social mobility. They usually mean better paid and more secure jobs lead to the 'good things' in life. It is those jobs that enable mobility and which, for politicians, can only go one way - upwards. When people identify themselves as downwardly mobile, it is then that they get angry and lash out at governments, officialdom, the establishment, outsiders and eventually each other. When a majority of people who perceive themselves as downwardly mobile are given any plebiscite the result is predictable. In the case of the referendum on membership of the EU an outcome exacerbated by the perceived comparative upward mobility of many immigrant workers. 

My understanding is that employment in the UK post the crash of 2008 is strong and has recovered. Today, after the recent turmoil, there remain a growing number of work opportunities and a shortage of applicants in many sectors. However my view of the labour market is of one that has polarised in many parts of the UK. Polarised between the low paid, low skilled often temporary and part-time workforce and the higher skilled and permanent, full-time workforce. The former characterised by the largely female social care workforce and the latter by ICT professionals. Jobs and opportunity in the middle range of skills and reward are evaporating - in manufacturing, construction and critically the more clerical professions. The consequence is that workers have to set their sights higher or accept supposed lower status work. 

Such divergence in the labour market is one root of the current discontent and in my view social care is at the butt end of it. Much of social care is seen as unpleasant work, poorly paid and not requiring skills. It is viewed as work for women and girls not worthy of more than minimum pay. Social care - along with flipping burgers, waiting tables, cold-calling and stacking shelves - is what the displaced workforce in the middle, who are unable to attain higher, see before them and they don't like it. They recognise themselves as being downwardly mobile and will vote accordingly in their droves.

The current social care workforce is upwards of 1.5 million and the demand will soon exceed well over 2.0 million people. This is a significant number and nearly doubles when the NHS equivalents are added in. This is not work that can easily be automated or undertaken off-shore like much clerical work. It is work that requires hands-on skills, heart in the right place attitudes and an astute awareness of context and circumstances. In short it is not low skilled work at all but, nonetheless, has the low skills status. It therefore seems to me that there is a win-win for the country in a concerted effort to up the status of social care work. A first win in that we have the workforce that befits all our aspirations for ourselves and our families that need social care. Our willing dependency on family care would be supplemented, enhanced and supported instead of stretched to breaking point. A second win in that the schism in the wider labour market is repaired as people increasingly seek social care employment as a route to upward mobility. Having social care jobs with status, reward and recognition will go a long way towards reconciling social discontent. There is a third win around the reliance of some social care employers on an immigrant workforce - their contribution would be valued at the same time as the dependency reduced. 


How does a country boost the standing of a workforce you may ask? 

  • Political leadership - lets have a Department of Health and Social Care with a minister to make real the paper policies of integration
  • Professionalisation - lets demand a social care workforce that is competent, qualified and aspirational
  • Personalisation - lets either commit fully to a consumer/user-led approach to the social care market or parallel the NHS with a National Care Service as suggested in 2009. The alternative is that market forces will entrench a two tier workforce. The privately funded care workforce having just low status over the very low of the publicly funded one.
  • Pay - lets be honest and openly evaluate the rewards allotted to a care worker in respect of what they do. Lets challenge traditional job evaluation criteria that determine pay rates.
  • Prices - let the market do its work and limit the local authority to inducing variety and policing local standards. We could move more rapidly towards a position where a local authority only makes the social care purchases when they have permission from the Court of Protection. Otherwise the actual purchase is undertaken directly by the customer or their agent albeit, in full or part, with public money.
  • Public relations - lets get more media savvy about working in social care.
One way or another this will cost the service user more money in fees. Government will need to do more than the current tinkering around the edges that has gone on since at least 1990 when the country moved decisively away from a municipal model of social care provision. It will need to pull levers and apply brakes. The cost to us all will either be more tax or different use of current taxes. The incentives though are substantial:
  • People being able to purchase a safe social care service at transparent levels of quality and affordable price
  • Protection for those lacking capacity
  • A motivated workforce recognised for its skills
  • Social care work as a badge of upward mobility and a unifying force in communities. 
The time is right for the social care workforce to move from butt end to front end of labour market thinking. If not we are destined to have a social care workforce that churns within itself, is riddled with self-deprecation and is scorned by the upwardly mobile. It will remain at the wrong end of an unequal society to all our detriment.