Friday, 20 January 2012

"Don't Swear In Front of the Children" - Leadership Thinking

                Leadership has become a common theme in social care and the need for effective leadership is important in all areas of business but what does effective leadership actually mean?

                A search on Amazon for ‘Leadership’ bring up the option of quite a few thousand books and among these will be many different theories and techniques on leadership but one important aspect of leadership is only given cursory mention and that is acting as a role model.

                Anybody who has studied Neuro-Linguistic Programming (NLP) will be familiar with the concept of modelling. The theory here is that it is possible to replicate the excellence of others by observing and replicating what they do (in terms of behaviour and physiology), how they do it (such as internal thinking etc) and why they do it (beliefs, motivations etc.), if these can be replicated then it should be possible to achieve the same success.

                This theory is very revealing especially if we look at it the other way around!

                At an instinctive level how do we learn? For the moment ignore all the different theories on learning styles etc and think about the basic, primeval way in which we learn. We learn by observing and replicating behaviour. This is how we do it from the moment we are born. We emulate the behaviour of our parents and we often develop the same beliefs and ideals that surround us as we grow up. As parents we often try to control the way that we behave in front of the kids to ensure they do not emulate some of the less desirable adult traits or use of language.

These instilled values, beliefs and behaviours may change as we interact with others at school and as our interactions with others influence our lives, we seek the best models to emulate to improve our lives.

                As a simplistic illustration how often do we see people who have been bullied become bullies themselves? Obviously this is a vague generalisation and certainly not true in many instances but it always seems to make sense because that is how, at a basic level, we understand learning behaviour and the idea that a successful behaviour (e.g. bullying without being caught doing it) can reap benefits in our lives.

                It is this basic, instinctual level of learning that is so important in the workplace.

                Effective leadership means acting and behaving in the way that you want your staff team to act.

                The ‘do as I say don’t do as I do’ style of leadership is inevitably doomed because of the unconscious instinct to replicate the behaviour of those in immediate authority.  When a boss tells staff to do this and that and work harder then disappears into his office for a rest what do the rest of the staff do? Chances are that they, too, stop working or at least slow down the pace at which they work.

                Whereas a leader who is enthusiastic and seen to be working hard is likely to inspire the same in their team with little need to actually express that ethic in words.

                Effective leadership is leading by example, being a role model to all staff and if we are to improve leadership skills across the care sector we need to focus on imparting the skills needed to be an effective role model  across the many and varied organisations that provide care.  

Thursday, 5 January 2012

62% of Care Users Extremely or Very Satisfied

           The recently published final report from the Health & Social Care Information Centre, entitled “Personal Social Services Adult Social Care Survey, England 2010-2011” actually paints a fairly good picture of social care and is perhaps worth highlighting to counter the general negative reporting we usually see.

            The survey, which had 61,115 respondents, found that 62% of those who responded were extremely or very satisfied with the care and support services they received, 28% were fairly satisfied, 7% neither satisfied or dissatisfied and just 3% said they were dissatisfied.

            Given that we are trying to achieve a person centred culture it seems odd that the constant criticism of the care system does not seem to be wholly reflected in the views of those who use care services.

            The survey also asked about individual’s quality of life. In this just over a quarter of the people who responded (26%) stated that their quality of life was so good it could not be bettered, 31% responded as it being good and 33% as alright with only 7% responding their quality of life was bad and 3% so bad that it could not be worse.

            We should also be singing the praises of social care workers. The survey asked “How happy are you with the way the staff help you?” A staggering 69.2% responded “I am very happy with the way the staff help me, it’s really good”.

            The overall picture of social care service delivery in England is a positive one.

            Yet more work needs to be done. The survey does not, unfortunately, fully identify where any differences in care delivery may occur. The responses are broadly uniform across the country and in terms of demographics the level of dissatisfaction with care services appears age related with younger people more likely to be dissatisfied and, I suspect, more detailed research would be needed to discover if this is because services are that much poorer for younger adults or whether it is purely because of age.

            We also need to be able to pick out what is the best practice that can be disseminated. What is being provided to the 62% who are extremely or very satisfied with their care package that can be translated into the care packages of the remaining 38% of care service users.

            We need to be able to identify what it is that makes care users happy with the way care workers help and support them, so we can disseminate this good practice throughout the social care workforce.

            Perhaps more importantly we need to raise the profile of this survey to show that the social care delivered in England is good, that the people who count – i.e. those who use the care and support services – are broadly happy with the service being received.

            Yes we do need a fundamental review of social care in the UK but we must be careful not to throw the baby out with the bath water and we should take the time to recognise that the bulk of care and support provision is good.

Tuesday, 3 January 2012

It's not just about who pays for Social Care but How We Talk About It

                Politicians of all parties have a tendency to view social care as a matter of cost. The endless consultations we have had over the past few years have focused on how social care is paid for and who should pay for it.

Yet it is not just a matter of cost but of how society views its provision care and support for those who need it.

To really improve the social care system society first needs to start changing the discourse of social care. Public views and opinions are always based on the way politicians and the media talk about different issues and social care is no exception. Those who have no contact with the social care system could be forgiven for thinking that social care is delivered in a completely haphazard manner, leaving all those who need it at risk and that care and support is delivered by individuals who are completely incompetent or, worse, evil people who prey on the vulnerable.

This view is very far from the truth yet it is a persistent cloud that covers the areas where social care shines and it is this cloud which needs to be blown away before we can make any real progress in improving social care.

Firstly we need to tackle the image of working in social care.

Social care workers are low paid, work unsociable hours and receive little reward for the work they do – yet they do it. But the entire workforce is often told it needs to ‘professionalise’.

Imagine the effect on any workforce that is constantly bombarded with the implication that they are unprofessional. Think of the impact on staff morale and performance. If you were to hear that phrase used about you, how would you feel?

To add to that there is the constant comparison of social care workers to the retail sector in terms of wages and conditions. Yet how can the two types of work be realistically compared? In truth the closet comparison would be to that of Healthcare Assistants in the NHS but that, perhaps, would raise to many questions in relation to pay and conditions.

The portrayal of social care workers as unprofessional and low paid naturally has an impact on recruitment and retention in the sector. What incentive do younger people have to enter social care other than as a last resort job?

Pay and conditions are not going to change overnight, the way the system works at present means that many care providers are small businesses who do not have the funds to improve wages without making cuts in other areas of care provision or, and lets be blunt, cuts in their profits but it is time to really start talking up social care workers and making realistic comparisons about the work they do.

Politicians also need to tackle the perception of haphazardly delivered care, yes there is a postcode lottery where care and support provision depends on the Local Authority that delivers it but are those services so significantly different from one area to another? If so, then surely we need Government intervention, to discover why and to take action to rectify this and to be seen to do so publicly. Too often, in recent years, there has been a tendency for Government to brush of social care delivery as the responsibility of local authorities yet, in truth, social care is still funded by central government and they should take responsibility for it.

Perhaps the hardest issue to tackle is that of the risk of abuse. We need to be constantly vigilant in the fight against adult abuse but the public also needs to be informed of the reality of vulnerable adults and abuse. Abuse is not limited to social care workers, in fact in home care abuse is far more likely to be committed by family members than by care workers but it is where a care worker has committed abuse that is far more likely to hit the headlines.  In many cases it is the social care worker who identifies and reports abuse committed by others yet such work goes unreported.

How social care is viewed depends on how social care is talked about and it should now be time to start talking about social care openly and honestly, identifying the real issues, talking about them and taking action to deal with them.