Institutional closure and the resilience of

long term staff

Sue GatesSenior ResearcherDonald Beasley

InstituteP O Box 6189Dunedin NEW ZEALAND

Presentation to the 41st Annual Conference of ASSID

4-7 September 2006 Canberra AUSTRALIA.

2006

Kimberley Institution Levin

LEVIN

The Kimberley CentreLarge facility ex-air-force base - opened July 1945 Home for backward children “The patients which the department (of Health)has at Levin are children who are mentally deficient but not insane, including some who are adult in years but have remained childish mentally. They require protection from the hazards of normal life but live and work satisfactorily in an institution”.

Dominion newspaper, 29 August 1945

1945 The Levin Farm Mental Deficiency Colony 1957 The Levin Hospital and Training School 1977 The Kimberley Hospital

The Kimberley Centre• In its heyday residents numbered 1200+• Residents have been liberated in small numbers over past 20 years

• Government announcement made May 2002 for complete closure of Kimberley by 2006.

• Minister of Disability Issues asked DBI to conduct research - research team started complex consultation & ethics considerations August 2002.

• Research started proper in December 2002 when residents numbered 349

Demographic detail349 residents in Kimberley as of December 2002

Male 214 [61.3%] 43 Maori residents

Female 135 [38.7%]Total residents by age: <16 0 %17-27 4 1.128-38 90 25.839-49 145 41.650-60 94 26.9 >60 16 4.6

Purpose of the research

• To compare the lives of residents in Kimberley Centre and community services;

• To identify and changes in adaptive behaviours & daily functional skills among residents during the resettlement phase;

• To describe the experiences of family/whanau of the resettlement process;

• To identify the outcomes and impact of resettlement for Kimberley staff & their families;

• To identify any issues of service quality & service gaps within community services for the residents.

Kimberley Centre StaffDecember 2002, Kimberley Centre a major employerin the Levin area.

340+ - staff - including management, registered nursing staff, *psychopaedic nurses, psychopaedic assistants, administrative and maintenance staff

200 approximately Maori staff large % of staff untrained and unqualified many staff long term employees at Kimberley - not uncommon for 3/4 generations of families to have worked at Kimberley

Kimberley Centre Staff

Build an impression of the culture of support and how it had changed over time;

Discover how staff saw their role and what they valued about their work;

Find out the strengths and weaknesses of institutional care; and

Determine the impact of the closure on their quality of life and the residents they cared for.

A pre & post questionnaire, individual interviews(regarding their resident & personal) & focusgroups were held with staff to,

Who are the Kimberley Centre staff?

• Management and Administration• Clinical Nurses (non-villa)• Registered Nurses (on the villas)

• Enrolled nurses• Psychopaedic Nurses• Psychopaedic Assistants• Maintenance staff

Staff Questionnaire• Pre and post closure questionnaire designed to determine staffs’ experiences of the closure

• Pre questionnaire sent to all staff with an invitation to complete

• 30 staff completed and posted questionnaire back

Staff Questionnaire30 replies from 340+ staff

9 male staff and 22 female staff replied (7 Maori)

Management 2Team leaders 2Registered nurse (general) 1Enrolled nurse 1Registered Psychopaedic Nurse 3Senior Psychopaedic Assistant 3Psychopaedic Assistant 9Health Assistant 1Day Activities staff 5

Staff QuestionnaireLength of service at Kimberley in years 0 - 4 6 staff 5 - 9 610 - 14 515 - 19 420 - 24 525 - 29 230 - 34 1• One staff didn’t note length of service• 6 Psychopaedic Assistants had length of service over

7 years - one had 21 years of service.

Initial findings from the Questionnaires

A strong emotional attachment to the institution - durable historical and familial links to Kimberley.

18/30 respondents had extended family working at Kimberley at the present time and throughout its existence.

Pervading cynicism/disbelief that Kimberley would close - staff had been told frequently over the last 20 - 25 years years that Kimberley was closing and it never happened.

Because of this cynicism many staff felt the management was handling the proposed closure very poorly and had little regard for the staff working back in the villas/wards.

Initial findings from the Questionnaires

This denial of the pending closure also showed around seeking future employment - 80% of respondents were not actively looking for a new job at the time of completing the questionnaire.

Just over half of the respondents definitely wanted to keep working with people with intellectual disabilities. 23% did not want to work in the field and 20% were wavering.

Effects of closure on staffs’ families? Most stated there were good and bad effects. 36% stated there were some negative/very negative effects on their families, while 16% said the effect for their families was probably for the best or much better overall.

Initial findings from the Questionnaires

Staff worries for the future %Finance 73Loss of work 46Missing the residents 46Loss of work 46Lowered standard of living 43Moving away 30Missing other staff 26No skills/experience for another job 13Boredom 10Loss of work for their children 10

Initial findings from the Questionnaires

One staff person with considerable education in

the field stated that her major worry was,

“…my years working in an institutionmay not be viewed favourably. Ibelieve this should not disadvantageme…”

Initial findings from the Questionnaires

How did staff see the future for the residents?

• 43% believed that residents would have an improved or much improved quality of life in the community.

• 33% believed that residents would have a poor or much poorer quality of life.

• 16% were unsure• 1 staff stated they didn’t care!• 1 staff said there wouldn’t be any difference!

Focus Groups*3 Focus Groups - total 10 staff

*All participants had worked for 20+ years in Kimberley;

*In senior nursing or management positions;

*Had started as young people without experience or qualifications in the field;

Focus Groups’ initial findings

• A large number of entertaining stories about working for Kimberley in its halcyon days;

• Kimberley - a “centre of excellence” visited by many overseas experts;

• Significant changes in philosophy and practice over 61 years;

• Genuine affection/attachment to residents;• Concern about loosing contact with residents;

• Not knowing about residents’ lives, eg “…What if they are ill or die?”…

Focus Groups’ initial findings

* Disturbing behaviour of some staff and the code of silence around abuse - the “Kimberley cringe”

* The loss of competent staff, because of other abusive staff;

* The less than honest management of the deinstitutionalisation process.

Informal ‘chats’ with staff working in the

villas* Not enough information about “what is happening” for residents and for them;

* Very upset about how residents were leaving the institution;

* Felt the management did not understand their relationships with residents or appreciate their considerable knowledge of a resident and left them out of the planning.

Informal ‘chats’ with staff working in the

villas* Felt persecuted by community disability services;

* Did not want to work for community disability services;

* Felt their skills and knowledge were undervalued by both management and disability services;

* Commitment to the job waning - “who cares?” - lack of job satisfaction;

* Significant concerns about how the residents with particular health and behaviour needs would be properly attended to in community services.

Resilience!Many stakeholders have been

resilient

long term staff PA’s families residents researchers!