Surviving or Thriving in a Consumer Directed World - Governing and Leading Organisational Change in Social Care

13/04/2023 Surviving or Thriving in a Consumer Directed World? © Carrie Hayter Consulting

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Surviving or Thriving in a Consumer Directed World? – Governing and Leading Organisational Change

Shaping Our Future National Respite and Community Care

Conference, 23 October 2014, Sydney

Director Carrie Hayter Consulting


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Workshop Outline

• Personalisation of Social Care– Narratives and Research– Perspectives of different stakeholders and actors

• Challenges – Chief Executive Officers, Managers and Boards– Questions for the future

• Opportunities – Creating Personalising Services – Co-production or Co-design – Service User Organisations

About Carrie Hayter Consulting

13/04/2023

• Personalised Support – Translation Research and Evaluation– A Handbook for community care services , Empowering People,

enhancing independence, enriching lives with Alt Beatty Consulting for NSW Government

– Education, Coaching and Mentoring– Person Centred Practice and Thinking (managers and support workers)– Cultural Diversity and Cultural Competence– Ageing and Sexuality (managers & front line workers)– Consumer Directed Care (Managers and Support Workers)– Living Life my Way (Service Users)

– Strategic Planning

Surviving or Thriving in a Consumer Directed World? © Carrie Hayter

Consulting 4

13/04/2023Surviving or Thriving in a Consumer

Directed World? © Carrie Hayter Consulting

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What is a personalised service ?


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Source: downloaded from http://lwdp.org.uk/more_info.asp?current_id=296


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Shifting Policy Landscape –Personalisation

Passive Clients

Active Service Users

Block funding

Individualised funding

Rigid large inflexible,

bureaucratic services

Flexible responsive

services


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The rise of the ‘Consumer’

Consumer asPurchaser

Citizen

Social and political rightsEconomic

purchasing power

Relationship between client and

professional

Client Citizen – Consumer

Active or passive

subjects?

Mechanisms for enacting ‘choice’ and ‘voice’

Market mechanisms via competition (LeGrand, 2007)

Managing self interest

(LeGrand, 2007) and voice mechanisms

Enable ‘choice’ through ‘voice’

mechanisms (Simmons et al 2011)

Diversity of policy

mechanisms


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Personalisation Narratives

• Personalisation works, transforming people’s lives for the better.

• Personalisation saves money.• Person- centred approaches reflect the way

that people live their lives.• Personalisation is applicable to everyone.• People are the experts in their own lives

(Needham, 2011: pg 7).


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The Lucky Ones

Source: downloaded from https://au.tv.yahoo.com/x-factor/#page1/?_s_ref=9JI102jjS&kw=x%20factor&creative=55215366484


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FEAR

Source: downloaded from http://blogs.indiewire.com/theplaylist/5-things-you-might-not-know-about-alfred-hitchcocks-psycho-20120615


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Personalisation for Organisations


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What are the three things about personalisation that wake you up

in the middle of the night?


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Downloaded from http://imaginationstationtoledo.org/content/titanic/


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Transition Challenges

• Block funded and individualised funded operating in parallel universes

• How does our organisation navigate these two systems?– Can block funded services become more

personalised?– Does a personalised budget mean personalised

support?– How do we manage the self interest of staff?


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How can we make block funded services more personalised ?


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Personalisation and Carers

• Formal care system would not exist without informal carers• Access to personalised budgets

– Conservatism of carers and the risks of personalisation (Needham, 2011)

– The traditional model gives them security and comfort• Choice and comfort for service users may not necessarily bring

choice and comfort for carers• Voices of carers not being recognised and heard (Carers NSW,

2014) • Mainstreaming of carer support funding

– Access to appropriate support?– Planned and regular breaks


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Hearing Carers’ and Service Users’ Voices

• Voice – Having more say in

services and getting access to support

– Individual or collective voice (Simmons et al, 2011)

– Voice can go beyond the confines of choice• Relationships• Connections (Simmons et al,

2011)

– Exit (Hirschman, 1970)

• Voice mechanisms – Complaints– Surveys– Political activity through

voting or lobbying– Participation in

representative bodies or groups (Simmons et al, 2011)

– Creating engagement frameworks and structures


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Challenges for Organisations

• Strategic Questions – How will we exist in the future?– What will our organisation look like?– How will we operate in a changing market of care?

• Supporting Staff and Volunteers– Skills and Roles

• Engaging the people who use services


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Commissioning Services

• Shaping services to meet service users interests and preferences – What if people want to keep attending group

based programs? • Commissioning is a multi-agency function – Partnerships

• Commissioning by service users – Co-operative Models


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Financial Challenges

• Individualised Budgets – Are the rates for units set by the NDIS going to

cover all the costs?– Do we set our costs at this rate?– How do we monitor these costs?

• Micro- Financing– What should the individualised budget pay for and

what should be paid for by the service user?


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Workforce Challenges

• De-skilling of workforce (Cortis et al, 2013)–Exploitation of workforce

• What skill sets do our workforce need in this changing space?

• Managing Change –Education and reflective practice

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Visionary Leadership Creating Shared Values and Beliefs

Outcomes for individuals

Community Focus

Empowered and Valued staff

Individual and Organisational

Learning

PartnershipsSource: Williams and Sanderson (2005)


Consulting


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Personalisation – Opportunities • Co-production or Co-design• Working with people for planning and designing or co-producing services

– Challenging how staff work and governance structures – http://www.ndti.org.uk/uploads/files/Personalisation_-_

dont_just_do_it_coproduce_it.pd– http://homecaretoday.org.au/

• What does our organisation do well?– Marketing – Front-line staff selling your services – Management supporting front-line workers

• Exiting the market– Managing transitions

http://www.ndti.org.uk/uploads/files/Personalisation_-_dont_just_do_it_coproduce_it.pd

http://www.ndti.org.uk/uploads/files/Personalisation_-_dont_just_do_it_coproduce_it.pd

http://homecaretoday.org.au/



People Leading the Way

Village to Village Network BostonBeacon Hill Village • Grass roots movement created by

older for older people• Member basedhttp://www.beaconhillvillage.org

Village to Village Network http://www.vtvnetwork.org/

• Australia -Wavertonhttp://wavertonhub.com.au/

My Choice Matters • Ideas and resources for

people to have more voice, choice and control

• Run my projects• Become a leader http://www.mychoicematters.org.au/• Community Disability

Alliance Hunter – Planning Cafes

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http://www.beaconhillvillage.org/

http://www.beaconhillvillage.org/

http://www.vtvnetwork.org/

http://www.vtvnetwork.org/

http://www.mychoicematters.org.au/




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Personalisation – Opportunities for Boards

• What skills do we have on our board?– What skills do we need on our board in the

future?– How can we attract new board members?

• How can we engage our boards in the change process?– How do we connect with service users and

involved them in strategic planning?

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Reflective Practice

– What have you tried?– What have you learned?– What are you pleased about?– What are you concerned about?– What do you need to do next?

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Source: Adapted from Helen Sandersonson and Associateshttp://www.helensandersonassociates.co.uk/reading-room/how/person-centred-thinking/person-centred-thinking-tools.aspx


Consulting


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Support for Organisations

• NDS consultancy services – http://

www.nds.org.au/news/article/2745

• NDIS Pricing for Payment and Supports – Costings

http://www.ndis.gov.au/providers-5

• Home Care Today http://homecaretoday.org.au/Education resources, information and audit tools

• Benchmarking• http://www.nfpbenchmarki

ng.com.au/




http://www.nfpbenchmarking.com.au/




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Conclusion

• Changing cultures of organisations– Start the conversation now– Strengths, Weaknesses, Opportunities Threats– Engage all stakeholders– Get support with the process and systems

• Reflective Practice – Learning and reflecting on what we do


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References Cortis, N., Meagher, G., Chan, S., Davidson, B., & Fattore, T. (2013). Building an Industry of Choice: Service Quality, Workforce Capacity and Consumer-Centred Funding in Disability Care. Sydney Social Policy Research Centre

Carers NSW. (2014). The NDIS One Year In - Experiences of the Carers in the Hunter trial Site Sydney Carers NSW

Glendinning, C. (2008). Increasing Choice and Control for Older and Disabled People: A Critical Review of New Developments in England. Social Policy and Administration, 42(5), 451-469. doi: 10.1111/j.1467-9515.2008.00617.x

Hirschman, A. (Ed.). (1970). Exit, Voice and Loyalty Responses to the Decline in Firms, Organisations and States Cambridge Massachusetts: Harvard University Press

Le Grand, J. (2007). Choice and Competition In J. Le Grand (Ed.), Delivering Public Services through Choice and Competition - The Other Invisible Hand (pp. 38-62). New Jersey: Princeton University Press.


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References Needham, C. (2011). Personalising Public Services Understanding the Personalisation Narrative Bristol, UK Policy Press

Simmons, R. (2011). Leadership and Listening: The Reception of User Voice in Today's Public Services. Social Policy & Administration, 45(5), 539-568. doi: 10.1111/j.1467-9515.2011.00790.x

Moran, N., Glendinning, C., Wilberforce, M., Stevens, M., Nettens, N., Jones, K., Manthorpe, J., Knapp, M., Fernandez, J., Challis, D., & Jacobs, S. (2013) Older people’s experience of cash-for-care schemes: evidence from the English Individual Budget pilot projects, Ageing and Society 33, pp 826-851

Needham, C. (2011). Personalising Public Services Understanding the Personalisation Narrative Bristol, UK Policy Press

Simmons, R. (2011). Leadership and Listening: The Reception of User Voice in Today's Public Services. Social Policy & Administration, 45(5), 539-568. doi: 10.1111/j.1467-9515.2011.00790.x

Simmons, R., Birchall, J., & Prout, A. (2011). User Involvement in Public Services: ‘Choice about Voice’. Public Policy and Administration, 27(1), 3-29. doi: 10.1177/0952076710384903

Williams, R., & Sanderson, H., (2005) What are we learning about person centred organisations?, downloaded from Home Care today www.homecaretoday.org.au


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More Information

Carrie Hayter Email: [email protected]

Twitter@carriehayterSlideshare: Carrie Hayter

Linked in http://au.linkedin.com/pub/carrie-hayter/34/536/517/

mailto:[email protected]

Government & Nonprofit

Surviving or Thriving in a Consumer Directed World - Governing and Leading Organisational Change in Social Care