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Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
1
Madeleine Blight
Managing Change or Running a
Marathon
M61
February 2007
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
2
Acknowledgements
My grateful thanks goes to Carol, Mike and Len
Tutors, to all of cohort three for support
throughout the course and especially Kathy as
my Mentor.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
3
Contents
Executive Summary 4
Introduction 6
Objectives 7
Methodology 8
Change Theory 11
Group Dynamics 13
Force Field Analysis 14
Change and the Individual 15
Resistance to change 17
CSCI Overview 20
Performance Manager Audit overview 22
Conclusion 23
Recommendations 25
Action plan 25
Appendix 1 North Cornwall Homecare Structure 29
Appendix 2 Key Standards of CSCI 30
Appendix 3 CSCI Analysis 31
Appendix 4 Reflective Journal 33
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Executive summary
This assignment looks at the legislation that has driven the change to how we
deliver care to service users and the impact of the Commission for Social
Care Inspection on all teams.
The reports identified a clear need for improvements to bring our rating to
“Good”.
It has identified areas of poor performance and the changes that have been
implemented to meet the minimum care standards.
It has looked at the impact that these changes have had on the way the
service is delivered, the workload of the home care staff and the Senior’s.
The reports from the Commission for Social Care inspection (CSCI) for
Bodmin and Launceston, showed that we did slightly better in Bodmin.
Having compared the standards inspected to identify where improvements
could be made and to find why they differed even though they are all part
one team.
Comparing the CSCI reports from all the other districts in Cornwall, The
shortfalls were found to be in the same sets of standards i.e.; recording and
lack of documentation to evidence our work.
The Commissioning Care Plans (CCP's) were not covering the five headings or
giving enough person centred information.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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I found that not all my seniors are not recording and evidencing in the same
way, which, causes some confusion when the inspectors are looking for
evidence to show how we meet a standard.
I found that not all care plans contained the correct paperwork for
recording assistance with medication.
Some teams are larger giving some of the senior’s a much bigger work load,
for example one has ten members of staff in her team and one has
seventeen. Service users per team vary from twenty-two to fifty. You could
argue that the teams should be similar in size, the fact is North Cornwall is
the largest team and covers an area of 465 square miles, we are the only
district that has two inspections and the teams work in rural areas and this
makes it difficult to restructure because of the distance that staff would
have to travel to work. We also cover holiday resort areas where it is
difficult to recruit staff.
For this assignment I have explored change theory and related some of the
findings to my team and the In house homecare teams across Cornwall. I
have looked at Individual change, Group dynamics and Resistance to change.
Identifying, “Resistance” as the strongest barrier in my team.
The conclusion drawn from this assignment clearly shows that there are
training needs across the whole of the County and the way forward is for
communication across departments to create a greater understanding of job
roles and responsibilities throughout the department of Adult Social care.
My aim is to work closely with Care Management and my Seniors to minimise
paperwork used but to improve the quality by recording and evidencing well
to raise the standard of the next CSCI report.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
6
Introduction
The Department of Adult Social Care (DASC) has an in house Domiciliary
care service The home care teams have a Senior Home Carer and varying
numbers of home care staff to deliver personal care. The Seniors are
divided into teams across the county and headed by District Homecare
Managers (DHCM) who are registered with The Commission for Social Care
Inspection (CSCI).
When I started the Post Graduate Certificate in management I was working,
as Deputy District Home Care Manager. At this time, I was unable to
implement any change of working practice. I am now in the position of
Temporary District Home Care Manager for North Cornwall and my role has
significantly changed. I am responsible for meeting the National Minimum
Standards as Registered Manager and, if the standards are not met, my
registration could be taken away.
I lead a team of 6 full-time Senior’s and two part-time (job share) covering
North Cornwall. (Ref Appendix 1) Each Senior has a team of carers from 10
to 18 in number.
I need to ensure that my teams are meeting the Key Standards (Ref
Appendix 2) of the Commission for Social Care Inspection, therefore I am
using this project to investigate why we are failing to meet all the required
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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standards and looking at ways to improve our rating to meet the National
Minimum Standards, implementing the changes necessary.
The Commission for Social Care Inspection (CSCI) have only been inspecting
domiciliary care services since April 2004
When an inspection is carried out, the inspectors only look at a sample area
and not every standard at every inspection.
I had only been in post for two weeks when we had the last inspection and
there was a lot to take on board. The report gave me gave me a picture of
areas where improvements are required.
Where the standards were not met I needed to draw up an action plan and
work alongside the Senior’s to implement the plan.
I also needed to look at the standards not inspected last time to ensure they
meet the standards. If they do not, I will need to draw up an action plan to
meet these as well.
As part of M61 I will be;
• Examining the areas identified where work needs to be done to raise
the standards to a “three score” (there are four different levels of
the minimum standards. 0 = Does not meet the standard. 1 = Major
short falls. 2 = Minor shortfalls. 3 = standard met and 4 = standard
exceeded). (Ref Appendix 3)
• Identifying how recent changes affect the workforce and quality of
Service.
• Exploring change theory to help me identify a strategy for change
management.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Objectives
Following the inspection process there is an identified need to change the
way that we record the delivery of care. The objectives of this assignment
are to;
• Look at how rapid enforced change has affected the group dynamics
of the care teams at ground level.
• The reaction of staff in relation to necessary change on an individual
level.
• How the seniors manage the care team, and how the care is delivered,
are there any improvements?
• What effect has the change had on internal relationships between
Homecare and Care Management?
I will be using the CSCI reports from the two teams in North Cornwall
(May to October 2006) to identify areas of poor performance in order to
address short-falls. The previous reports have shown that the shortfalls in
my own area are common to the rest of Cornwall. By using the reports from
my own area I will be able to draw up an action plan to implement the
changes necessary to raise the standard, and address any issues around
resistance from the Senior’s and individual team members.
The issue of change management therefore is an essential one for many
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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levels, which include the priority of service, the means to contribute to
moving forward and creating an action plan.
Methodology
I found that the areas where change is required to meet The Commission for
Social care Inspection (CSCI) standards in our organisation are common to
many home care organisations. This indicates that in general we are not
evidencing what we do and how we deliver care and our recording of
information is not as robust as it should be. CSCI have accused us of
“putting lives at risk”. This was a very hurtful statement to hear.
In order to research this topic, I analysed and evaluated all the CSCI
reports across Cornwall and compared them with findings from the CSCI
“Time to Care?” report October 2006. The legislation comes from The Care
Standards Act 2004; this drives the inspection and links into Adult Social
Care value base.
A comprehensive literary review examines:
Group dynamics, (Kurt Lewin)
Change and the individual, (Elizabeth Kubler-Ross) and,
Resistance to change, (Yerkes Dodson).
These areas are important because they could affect the way the service
moves forward and have an impact service delivery.
Change is nothing new but how it is managed can have a significant impact on
those involved in the changes.
1 Change takes time.
2 Change is a process, not a decision.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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3 Change requires plenty of experience and practice in the new way of
doing things.(p.43.Rees.1991)
With the changes in our organisation being led by Legislation to meet The
National Minimum Care Standards, there was not an option to “Experience
and practice” the changes before implementation as they had to be
implemented within a three month time scale.
The internal audit produced by the Performance Manager was also a very
useful tool in as much as it highlighted poor performance across the county
post CSCI inspections and she reported on each of the districts individually,
which enabled District Home Care Managers to focus on their individual
teams.
The Performance Managers post was devised by the County Service Manager
(CSM) after the second round of inspections to help identify poor recording
in all districts. Her role includes, supporting the District Homecare
Managers’ (DHCM’s) in identifying areas where we are “failing” to meet the
standard to enable us to support our Senior’s through change.
Reading theory on change has led me to the conclusion that although change
is not always comfortable at the time of implementation, the majority usually
accept it.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Theories of change.
Managing Change (2006)Chapter 1 page 34.
Frederick Taylor, 1911 (one of the most influential theorists), suggests five
simple principles of change.
1 Shift all responsibility for the organisation of work from the worker to the
Manager.
2 Use Scientific Methods to determine the most efficient way of doing
work.
3 Select the best person to perform job.
4 Train the worker to do the work effectively.
5 Monitor Worker Performance to ensure that appropriate work procedures
are followed and that appropriate results are achieved.
In Adult Social Care we work to these principles and they link in to the
National Minimum Care Standards
However with Principal one The Homecare Managers are responsible for
meeting the standards with CSCI. The Seniors are responsible for
programming the work for the care team and take on the role of supervising
and appraising the care staff, so this theory is not “simple” in Taylor’s terms
because of the distribution of the work load in the home care section of the
organisation.
The Manager is accountable for meeting the standards of care delivered but
all team members are accountable for their own actions.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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This theory may work in a mechanistic situation but here we are dealing with
humans providing a service and receiving a service.
All team members are “best for the job” as they are all trained to a high
standard as a legal requirement for delivery of personal care.
As an organisation the care team are the front line workers and keeping
them abreast of changes without too much disruption is vitally important;
they need to feel valued and supported and receive recognition for their
efforts, the difficult part is retaining the support of the Seniors who work
with the care team and encourage them be positive with the necessary
changes. Some of the changes are directly affecting the service users
where they are losing their service. They pass on the concerns to the care
team this can lower morale. We are already struggling to manage with the
allocated budget, which has resulted in the withdrawal of low and moderate
care packages.
The care staff form a natural bond with the service users and some have
been quite distressed over the withdrawal of service.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Group Dynamics
People are a fundamental component within any successfully developing
organisation, without people the organisation is nothing.
Alan Chapman (businessballs.com)Accessed [10thJanuary 2007]
The Group Dynamics school, originated with the work of Kurt Lewin, it
emphasises bringing about organisational change through teams or work
groups rather than individuals. The rationale according to Lewin is to
identify individual behaviour, then modify or change in the light of groups
prevailing practices. It has proved very influential in developing theory and
practice of change management. One of the best known metaphors for
change was developed by Kurt Lewin (1951), P609 Buchanan and Huczynski
(Organizational Behaviour)fifth edition. who argued for the need to
unfreeze the current state of affairs, to move to a desired new state , then
refreeze and stabilize those changes. Now in an era of constant and repeat
changes this may no longer be an option.
“Businesses are nothing more or less than organisations of people trying to
get to a jointly defined future” – Professor Howard H Stevenson, Harvard
Business School www.oursouthwest.com. Accessed May 2007
The following Force Field Analysis summarises the driving and restraining
forces relevant at this point in time:
Force Field Analysis - looking at the balance factors
Driving Forces Resisting forces
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Interface with care management ----------------- Limits of Care
Management
System.(CMS)
Caring attitudes of field staff----------------------Limited time for delivery
of care.
Commission for Social Care Inspection-------------Work load and Frustration
of seniors and care staff,
Seniors own methods of
recording.
From the analysis, the forces for change come from within and out side of
the organisation. Care management and care staff are shown as drivers, the
resisting forces coming from the limits of the CMS, at this time there is no
access to this system for the Senior’s, although they will have “Read Only”
access in the future. The care team work to a very tight time scale while
delivering care, (the average time allowed for care delivery is half an hour).
This could in effect allow the standard of care to fall as the carer are under
pressure to meet their deadlines.
The most dominant driving force is CSCI with the implementation of the
Care Standards forcing changes within the whole structure of the
department, creating resistance from all areas on the way.
Phil Harding (2004) writes; The trick in successfully managing change and
getting the commitment and support from staff is to provide these
‘motivators’ for your staff – or at least as many of them as possible.
Pride “Follow where your enthusiasm takes you”
Happiness “ A happy team is an effective team”
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Responsibility “Its amazing what you can accomplish if you do not care who
gets credit” – Harry Truman www.oursouthwest.com. Accessed May 2007.
French and Bell (1984) pointed out the most important interventions in
organisational development are Team Building activities. The team analyses
its way of doing things and attempts to develop strategies to improve.
Individual change
Even in 1970 Alvin Toffler argued that the rate of change was out of
control, he believed that there is a limit to the amount of change individuals
can handle and that too much change in too short a time is unhealthy. He
described the “disease of change” as future shock (stress and disorientation
suffered when people are subjected to excessive change).
Buchanan and Huczynski (Organisational Behaviour), fifth edition chapter
18.Page 614.
I can see that this could be the case for some of my Seniors who have been
very stressed (future shock) over the proposed changes especially when the
changes implemented have to be changed again when found not to work.
The coping cycle Table 18.1 p614
Elizabeth Kubler-Ross (1969) argued that we deal with loss by moving
through a series of stages, each characterized by a particular emotional
Response;
Denial: unwillingness to confront the reality; “this is not happening”;” there
is still hope that this will go away”
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Anger: turn accusations on those apparently responsible; “why is this
happening to me?”,”why are you doing this to me?”
Bargaining: attempts to negotiate, mitigate loss; “what if I do it this way?”
Depression: the reality of loss or transition is appreciated, ”it’s hopeless,
there’s nothing I can do now”; “I don’t know which way to turn”
Acceptance: coming to terms with and accepting the situation and its full
implications; “what are we going to do about this?”; “how am I going to move
forward?”
Elizabeth Kubler-Ross’s theory was dealing with loss through Bereavement,
however the same changes in the work place can affect people in the same
way, grieving for the past and “how it used to be” and the feeling that people
are not going to be able to “cope” with the changes.
Individuals in my team have come through these emotions and are now at the
stage of moving forward and even showing enthusiasm.
(Ref Appendix4)
The chart (Fig 1.) shows Pressure and performance – the inverted-U function
from healthy pressure to the point of breakdown. Can organizational change
induce such pressure? According to Claydon and Doyle (1999) P615 OB. over
60% of managers said that people in their organisations were suffering from
initiative fatigue.
The Yerkes-Dodson hypothesis argues that human task performance is
increased by arousal, stimulation and pressure. The hypothesis also argues
that, if pressure continues to mount, the individual will eventually reach a
point, which they become stressed and exhausted and performance will start
to fall.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Healthy pressure
Fig. 1
Pressure and Performance -
The Inverted U Function
The chart shows Pressure and performance – the inverted-U function from healthy pressure to the point of breakdown. (Yerkes. R & Dodson. J 1908) (Buchanan and Huczynski)
Resistance to change
This is an inability or unwillingness to discuss or to accept changes that are
perceived to be damaging or threatening to the individual.
“ Its not the strongest species that survive, nor the most intelligent, but the
ones who are the most responsive to change” – Charles Darwin.
Damage to health
Breakdown
State of arousal
Exhaustion
Optimal performance
Performance level
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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www.oursouthwest.com. Accessed May 2007.
Resistance to change is the greatest barrier that I am faced with. Some of
the workers in the home care teams in my district see CSCI as the “enemy”
who “dream” up standards to make life difficult for them.
“The main dangers in this life are the people who want to change everything
or nothing” – Lady Nancy Astor. www.oursouthwest.com. Accessed May 2007.
Documentation in daily record sheets has been the area that has most
affected the home care team. They are required to demonstrate that while
delivering the care as per care plan, they also have to show that they are
respecting the service user’s choice individuality and diversity. The main
concern for the team is the lack of time to deliver the care as specified in
the care plan and then to document all relevant information from personal
care to meals prepared. I have to constantly remind the care teams that
with out the documentation to evidence that we are giving the service user
the best possible care in their preferred manner we will “fail” the relevant
standard. The morale of the teams has suffered when the reports were
published. People who come into the care profession are generally very caring
individuals and their priorities are the care and welfare of the service users.
It is very hurtful to get a report stating that the service users are “at risk”
by lack of documentation when they are prioritising the care needs of the
individuals. As we are a large organisation we need to be seen to lead the way
in quality home care and we are in the public eye and when we do not meet
standards we are subject to criticism in the media.
Arthur Bedeian Buchanan andHuczynski(Organizational Behaviour), fifth
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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edition. Page 618. Cites four common causes of resistance to organisational
change;
Parochial self-interest Change moves us out of our comfort Zone, it could
mean loss of power, status or security. For my team of Senior’s, proposed
changes could make them question their ability to cascade the information to
their teams without causing too much stress.
Misunderstanding and loss of trust. We are more likely to resist change if
we do not understand the reasons behind it, If there is open communication
when change is introduced with a clear understanding of why the changes are
being implemented it is more likely that the teams will accept them.
Contradictory assessments. We differ in the way we perceive and
evaluate change, Our personal values determine which changes are welcomed,
promoted and succeed or fail. Bedeian points out that contradictory analysis
of change can lead to constructive criticism and improved proposals.
Resistance can in some instances lead to more effective forms of change. In
my experience where there has been resistance, after discussion there has
been a compromise, on how the changes have been implemented, this has led
to building of trust within the team.
Low tolerance for change. We differ in our ability to cope with change,
we each have ideas about our own abilities and strengths, some may doubt
their ability to cope with the change, their anxiety and apprehension may
lead them to oppose even potentially beneficial changes. Some of my seniors
were very anxious about the changes being implemented as were some care
team members. These anxieties were addressed through supervision and
team meetings and I feel that there is a more “comfortable feel” to the
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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changes that have been implemented.
Overview of CSCI inspection May-October 2006
There were two inspections carried out in this period for Bodmin and
Launceston (which make up North Cornwall district) each are inspected
separately. The first round in May 2006 was the second since they were
implemented in 2004.
The inspection for Bodmin identified six 3’s and nine 2’s.
Launceston scored eight 3’s and seven 2’s
(Ref Appendix 3)
This showed improvement on the first inspection, but there was still work to
be done. The Agencies were classed as “adequate”.
There was a lot of positive feedback from the inspectors, some of the
comments included -
What the service does well:
� Provides a reliable and effective service for service users within the
community.
� There s an ongoing structured programme of training for staff.
� All service user’s surveys and comments received prior to the
inspection showed that the service is reliable.
What has improved since the last inspection?
� The local Management structure has been reviewed and a part time
deputy manager has been appointed to assist the registered manager
(this is where I came in).
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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� Improved policies and procedures.
� There is an effective system for quality assurance in place.
� Risk assessments have been introduced.
What they could do better:
� The care needs assessments, have improved since the last inspection,
however they are not providing sufficient information for the
providers of care.
� Risk assessments should be should be developed further.
� A separate risk assessment should be undertaken where moving and
handling tasks are identified.
This overview shows where improvement is required to raise the standard to
a three score.
The Inspection in October 2006, (my first one as Temporary District
Homecare Manager), has shown further improvement. The Bodmin agency
was now classed as ”good”, Launceston remained “adequate” but with little to
do to raise the standard with only two 2’s to raise to 3’s.
These reports show that there is a clear need to improve interface with
Care Management to ensure consistency in the care needs assessment.
Kurt Lewins – The Group Dynamics School emphasises group working and has
proved influential in developing theory and practice of change management.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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The Performance Managers Audit.
This audit looked into North Cornwall as a whole district and provided useful
information on a very basic level to help construct an action plan for the
specific areas where change was required. It also provided findings for each
separate Seniors venue commenting on their individual work.
This caused stress for some of my senior’s as they were (in their words)
being “blamed” for not meeting the standards.
As Alvin Toffler’s theory, 1970 Future Shock, (Pan Books, London) that the
rate of change was out of control. The “disease of change” causes stress. My
Seniors feel that the changes have been “too much in a short space of time”.
The audit is much more in depth than the CSCI report, it has proved to be
extremely valuable and has saved managers a tremendous amount of time,
now all DHCM’s are working in the same way with a more consistent approach
to recording evidence for future CSCI inspections.
The relationship between the Homecare service and Care Management has
been quite strained at times due to lack of understanding of CSCI standards
and how to meet them.
Care Management have not been subject to CSCI inspections and therefore
do not identify with the difficulties facing the homecare service even
though they are a key factor in helping achieve the standards.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Conclusion
As my post is temporary until July 2007, I have a lot of work to do in a
short space of time therefore I have to concentrate on my time management
and set myself targets. My performance is monitored by the CSM through
Supervision on a monthly basis and monthly DHCM meetings where we
discuss progress and support each other and share ideas.
I need to have a good relationship with my team to enjoy success and show
my commitment to the imminent changes we are about to embark on, I will be
spending time at their venues to encourage and support them through this
time of major change. I had an extra meeting (Ref Appendix 5) with my
seniors to look at all the paperwork used and make decisions as a team as to
what to continue with and what is no longer needed. As expected there was
some disagreement with reluctance to change but on the whole we came to
an agreement that we would perform better as a team if we were all
evidencing our work in the same manner. The team are still very concerned
about how we are going to meet the CSCI standards. There is a feeling of
“as soon as we meet standards they will change again”. The roll out of Cold
Harbour (the new IT system being introduced), will make recording and
evidencing a lot easier and will cut time spent on hand writing reports;
information will be available via the computers for all Seniors and this will
help to improve the service delivery and reduce the stress levels. They are
quite excited about this element of change and some of the paperwork
issues will automatically be resolved when we have gone “live” hopefully in a
few months time.
My team have also had to adapt to me as their new manager and as my style
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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is very different from my predecessor it has also taken time for them to get
used to my style; as a new manager I am very focussed on policy and
procedure and working “by the book” which adds to the pressure that they
have been under.
I plan to carry out robust supervision and appraisal with my seniors to help
them to prioritise their workload, plan their activities and manage their
time. The Staff are a vital resource and effective supervision is the key to
good service delivery.
With the uncertainty of my post my personal aim can only be to support my
team through this time of change encouraging them to learn from this
experience, having read the recommended literature for this course I have
gained an understanding of organisational behaviour and the need for change
in this ever changing world which I will endeavour to cascade to my team of
seniors. At the onset of change it is important to look at all aspects and how
the change will affect not only the service users but the whole of the
organization As we are dealing with the public it is vital to make the right
decisions regarding changes to care delivery and the cost implications.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Recommendations
Having looked at the CSCI overview, it has identified areas where there are
training needs among the seniors, and this is common to the rest of the
county:
Training on Risk Assessments, Appraisal and Supervision, Equality and
Diversity, file building and evidencing work through documentation.
This training is now in progress as a priority, the Seniors are participating in
a “First line Management” course through the learning and development
department which should also help them achieve the aims of Adult Social
Care.
Activity Planning
Images of organisation (2006)
Beckhard and Harris 1987-70-1 refer to this as a process of getting from
here to here; they state that “The activity plan is the road map for the
change effort, so it is critical that it is realistic, effective and clear”
The Five characteristics of an effective activity plan
1 Relevance – activities are clearly linked to the change goals and
priorities.
2 Specificity – activities are clearly identified rather than broadly
generalised.
3 Integration – the parts are closely connected.
4 Chronology _ there is a logical sequence of events.
5 Adaptability - there are contingency plans for adjusting to
unexpected forces.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Action Plan to Improve CSCI results
Goal
Target Group Outcomes Duration/
Dates
Lead
Standardization of
Recording tools/forms
Improved quality
assurance
Seniors and
Home Carers
Design of seniors
Tool kit
Introduce and motivate seniors
to accept.
Training on new forms etc.
Implementation of Cold Harbour
Regular updates
April 06
From --- 2007
CSM
DHCM
Improved communication
with Care Management
through DHCM
attendance at
Fieldworker events
All DHCMs,
Seniors and
Home Carers
Care
Management and
Case Co-
Coordinators
Comfortable working
environment
Higher standards
Greater consistency of
commissioning care plans.
Ongoing
June 2007
next
inspection for
North
Cornwall
All staff through
line managers
Care Management
Improved training Supervision & Seniors more competent in April 2007 DHCM Training
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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programme Appraisal
Equality &
Diversity
Risk
Assessments
supervising Home Carers,
identifying performance issues
& motivation. Improved
prioritising of workloads and
time management.
Book Seniors on Introduction
Level followed by Foundation
Level.
(Managers Workshop available
from October 2007)
Safe working environment
onwards
From May
2007
Co-ordinator
DASC Learning,
Training &
Development Unit
PCT
Updating of all relevant
Polices and Procedures
All staff Policies & Procedures updated
and available electonically
Ongoing from
2006
Finance Admin.
Managers in
consultation with
relevant groups
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Appendix 1
The Structure of North Cornwall Home Care;
County Service Manager
I
District Home Care Manager
I
Senior Senior Senior Senior Senior Senior Senior
Home Carers 14 14 10 13 17 17 10
This structure shows that each team varies in size, it could be argued that
some of the seniors have a higher workload than others; this is in fact true
however the rurality of the locations dictates the number of potential care
staff and service users. The workers are also used in more than one team
when there is sickness or holiday cover required.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
30
Appendix 2
The Key Values of CSCI.
1. To put the people who use Social Care first and to act in their best
interest at all times.
2. Support Service Users to live independent lives with dignity and
respect.
3. Respect peoples rights and choices
4. Improve services and remove Bad Practice.
5. Stand up for the rights of service users.
6. Help those who work in Social Care to make the service better.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
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Appendix 3
CSCI ANALYSIS AND OVERVIEW 2006
Each district was inspected against the same core standards and regulations.
Depending on the findings within the inspection visits and feedback from surveys some
evidence was then used against additional standards.
Order of
Inspection
1st 2nd 3rd 4th 5th 6th 7th
Standard St AustellPenzance Truro Kerrier Caradon Bodmin L’nceston
1 3
2 3 3 3 2 3 2 2
3
4
5
6 3 3 3 3 3
7 3 3 2 2 2 2 2
8 3 3 2 2 2 2 3
9 3 3 2 2 2 3
10 3 3 2 2 2 2 2
11 3 3 3 3 3 3 3
12 3 3 2 2 2 2 2
13 3
14 3 3 2 2 1 2 2
15 3
16 2 2 2 2 2 2
17 3 3 3 3 3 3 3
18
19 3 3 2 2 2 3 2
20
21 3 3 3 3 3 3 3
22 3 3 3 2 2 2 3
23
24
25
26 3 2 2 3 3 3 3
27 3 3
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
32
User focused standards Managers and staff Standards
Personal care standards Organisation and running of the
business
Protection standards
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
33
Appendix 4
Reflective journal No 9 Extra Seniors Meeting
Name: Madeleine Blight
Date: 30th January 2007
This meeting was held to identify all paper work used by the seniors and to
work together sharing ideas.
It was the first meeting that I have held in my new position where all the
seniors were able to attend and I was pleased to be able to meet with them
all for some team work. All the seniors brought samples of the paper work
that they used, some of these were new to me and had been introduced over
the years some times with out previous paper work being withdrawn. I
already knew there were going to be different forms used but was amazed
at how many different forms there were.
Two of the seniors have been in position for many years and were able to
explain the introduction of the forms that they use, some of the seniors
were not recording absenteeism or back to work interviews, this made me
realise that I would have to make sure that from now on I will need to
ensure the relevant procedures are followed.
The meeting went reasonably well, however some of the seniors do not want
to change forms that they are comfortable with. There were some heated
exchanges but on the whole there was agreement that it would be beneficial
if everyone shared their ideas and decided as a team how to document and
evidence their work for future CSCI inspections.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
34
Reflection
I see this meeting as a success, I feel that the seniors respect my aims and
are willing to work hard on achieving our shared goals. There was compromise
over some of the forms especially where the long standing seniors are
concerned, there will be changes in documentation when we have “Cold
Harbour” up and running and so there is little point in making life more
stressful at this time by changing more than necessary.
Conceptualisation
I kept the afternoon totally free for this meeting so that we could have
plenty of time and had an open agenda, this worked well as it gave people
time to debate issues with out a timed slot, I felt that this would make sure
that views were aired and taken on board by all the team. All items were
documented in the minutes for future reference.
Conclusion
I have learnt a lot from and about my team from this meeting, it highlighted
the need for stability among them and I have realised where I need to
monitor performance. I will be more aware of the issues facing them as
individuals at supervision, and hope to use this to improve performance.
Attended meetings with my colleagues and County Service Manager (CSM) that identified
areas requiring change. I chaired meetings with my team of seniors to cascade information
to address our own shortfalls and attended meetings to support the care teams and listen to
their concerns.
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
35
References:
Alan Chapman (BusinessBalls) < http://www.businessballs.com> accessed [10th
January 2007]
Buchanan, D & Huczynski, Organisational Bahaviour 5th Edition (2004).London
Pearson.
Burns B, Managing Change, forth edition (2004) London Pearson.
Commission for Social Care Inspection "Time to Care" Report 2006.
Commission for Social Care Inspection (2006). Local inspection Reports
Department of Health, National Minimum Care Standards 2000.
Handy C “understanding Organisations” 4th Edition Penguin Books.
Ellwood A, Homecare Audit 2006/07.
Rees F, How to lead work teams. 1991.Pfeiffer & Company.
Morgan G, Images of Organisations (2006) London Sage Publications.
www.Our south west.com
Madeleine Blight Post Graduate Certificate in Management Coventry University
M61 May 2007
36
Bibliography:
Buchanan and Huczynski 5th Edition.
Images of Organisations, 2006. Gareth Morgan.
How to Lead Work Teams, Fran Rees. 1991.
Managing Change, Burnard Burns 4th Edition.
Understanding Organisations, Charles Handy 4th Edition.
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