Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or Adaptive Leadership Challenge

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Reablement and Wellness for Regional Assessment Services in Australia –

A Technical Problem or an Adaptive Leadership Challenge?

Community Options Australia Regional Assessment Services Subcontractor Forum

Carrie Hayter,Managing Director

Carrie Hayter Consulting 29 July 2015,

Sydney, Australia

Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter

Consulting

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Outline • Why reablement and wellness?– Research– Research evidence and gaps

• Reablement and Wellness as a leadership challenge– Technical problem and an adaptive leadership

challenge (Heifetz & Linksy, 2002)• All stakeholders & actors

• Adaptive leadership Framework– Starting conversations with you as leaders

Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie

Hayter Consulting

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Problem or an Adaptive Leadership Challenge? © Carrie Hayter Consulting 3

Wellness Reablement Restorative

• Building on the strengths

• Outcomes for people – outcome or goal focused

• Right balance between ‘doing with’ rather than ‘doing for’

• Looks at appropriateness of services

• Identifies what a person can do and wants to do in the future

• Time – limited targeted interventions to regain function, confidence or capacity to resume activities

• Evidence-based interventions led by allied health workers that allow a person to make a functional gain or improvement after a setback, or in order to avoid a preventable injury.

Defining Wellness, Reablement and Restorative Approaches

Source: Australian Government Department of Social Services (2015) Living Well at Home: CHSP Good Practice Guide, pg 11-13

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Why reablement and wellness?• Research - UK, Australia and New Zealand

– Improved health and welling for older people (Lewin at al, 2013, Parsons et al, 2013, Parsons et al, 2014)

– Reduces people’s dependence on paid supports (King & Parsons, et al 2012, Lewin & Alfonso 2013, Lewin & De San Miguel, 2013)

– Role of assessment is critical (Department of Family and Community Services, Ageing, Disability and Home Care, 2012)

• Further research– People with dementia (Alzheimer’s Australia NSW, 2014)– Engaging carers and service users in their reablement and wellness

(Wilde & Glendenning, 2012)• Australian changes

– Outcomes and benefits

Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge?

© Carrie Hayter Consulting

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Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter Consulting

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Consulting

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Difference between Technical Problems and Adaptive leadership

Technical problems are well defined.

Their solutions are known and those with adequate expertise and organisational capacity can solve them.

(Heifetz & Linksy, 2002)

Adaptive leadership challenges are entirely different. The challenge is complex

and not so well defined; and the answers are not known in advance

Problems that require us to learn new ways (Heifetz & Linksy, 2002)

Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie

Hayter Consulting

02/05/2023 Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter Consulting

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Technical Problems or Adaptive Leadership?

Technical Problems• Inappropriate referrals• Issues with the portal

– Algorithms in the portal and the outcomes it leads to

– Monitoring assessors workloads

Adaptive Leadership• Receiving enough referrals

to make our business model viable– How do we manage this?– How do we look for other

revenue streams? • Service providers

understanding of reablement – Want long term clients and

don’t understand reablement

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Seven ways to know if you have an adaptive leadership challenge

1. If the solution requires working in a different way than you do now…

2. If the problem AND the solution require learning…

3. If the solution requires shifting the authority and responsibility to the people who are affected….

4. If the solution requires some sacrifice of your past ways of working or living.. (eg losses)

5. If the solution requires experimenting before you’re sure of the answer…

6. If the solution will take a long time…

7. If the challenge connects or challenges people’s deeply held values….(Heifetz & Linksy, 2002, 2009)

Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership

Challenge? © Carrie Hayter Consulting

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Shifting Policy Landscape –Personalisation

Passive Clients

Participants or ‘consumers’

Block funding

Individualised funding or fee

for service

Monopoly Providers

‘Market of Care’



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Shifting Paradigms in AustraliaOld

• Block funded • Dependency model • Services for life• Multiple Assessment Models • Multiple entry points for

older people and their allies • People navigated multiple

systems to get care outcomes

New• Fee for Service • Wellness, restorative Model• Short term focused • National Assessment

Framework • One entry point – My Aged

Care • Economic rationing of

supports



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Get on the Balcony

Give the work Back

Think Politically

Orchestrate the conflict

Manage your

hungers

Anchor Yourself

What’s on the line

Hold Steady

Adaptive Leadership Elements

Source: Heifetz & Linsky (2002)Reablement and Wellness for Regional Assessment Services in


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Picture downloaded from: https://janeaustensworld.wordpress.com/category/regency-etiquette/page/2/

Getting on the Balcony

Picture downloaded from: https://www.youtube.com/watch?v=qSvyDLTdlyU

What is your team saying about their role?What is their story?

What is the ‘song beneath the words’?What is your inner voice saying about the changes?

Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive

Leadership Challenge? © Carrie Hayter Consulting

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Think Politically 1. Find Partners

2. Keep the Opposition Close

3. Accept Responsibility for your piece of the mess

4. Acknowledge their losses and accept casualties 5. Model the behaviour (Heifetz & Linksy, 2002)Picture downloaded from: www.twitter.com

What is your responsibility as a team leader?What is Community Options Australia’s responsibility?

What might be the losses or casualties?How does your organisation manage the financial and

reputation risks of this new model?Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter

Consulting

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Give the Work Back • Solutions are achieved when

“the people with the problem” go through a process together to become “the people with the solution”.

• Take the work off your shoulders….place it where it can be addressed by the relevant parties.

What are the main issues your team faces as a Regional Assessment Service Sub-Contractor?

Who do you need to engage in the solutions?Reablement and Wellness for Regional Assessment Services in


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Anchor Yourself• Don’t confuse one’s self

with one’s professional role• Identify a truly trustworthy

confidant who can really tell you what you NEED to hear

• Do not use allies as confidants

• Find a sanctuary for retreat, rejuvenation and personal reflection

Who are your confidants? How can they support you?

How do you look after yourself?Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter

Consulting


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Summary

Regional Assessment Services• Technical problem and adaptive leadership

challenge• Time • Engaging people in solutions More Research • Who benefits?


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References and Resources Leadership • Heifetz, R., & Linksy, M., (2002) Leadership on the Line: Staying Alive through the

Dangers of Leading, Harvard Business Review Press, Boston Massachusetts

• Heifetz, R., Grashow, A., & Linksy, M., (2009) The Practice of Adaptive Leadership – Tools and Tactics for Changing your Organisation and the World, Harvard Business Review Press, Boston Massachusetts

• Goleman, D. (1998). Working with Emotional Intelligence London Bloomsbury.

• Covey, R., (1996) The 7 Habits of Highly Effective People, Simon and Shuster, New York– https://www.stephencovey.com/7habits/7habits.php

• Cambridge Leadership Associates– http://cambridge-leadership.com/

https://www.stephencovey.com/7habits/7habits.php




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References and Resources Reablement and Wellness

Alzheimer's Australia NSW. (2014) The Benefits of Physical Activity for People living with Dementia, Sydney , Alzheimer's Australia NSW downloaded from https://nsw.fightdementia.org.au/nsw/news/the-benefits-of-physical-activity-and-exercise-for-people-living-with-dementia

Australian Government Department of Social Services (2015) Living Well at Home: CHSP Good Practice Guide, pg 11-13, downloaded from https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reform/commonwealth-home-support-programme/living-well-at-home-chsp-good-practice-guide

Glendinning, C. (2012). Home care in England: markets in the context of under-funding. Health & Social Care in the Community, 20(3), 292-299. doi: 10.1111/j.1365-2524.2012.01059.x

King, A., M. Parsons, et al. (2012). "Assessing the impact of a restorative home care service in New Zealand: A cluster randomised controlled trial." Health and Social Care in the Community 20(4): 365-374.

Lewin, G., & Vandermeulen, S. (2010). A non-randomised controlled trial of the Home Independence Program (HIP): an Australian restorative programme for older home-care clients. Health & Social Care in the Community, 18(1), 91-99. doi: 10.1111/j.1365-2524.2009.00878.x

Lewin, G. F., H. S. Alfonso, et al. (2013). "Evidence for the long term cost effectiveness of home care reablement programs." Clinical interventions in Aging 8: 1273-1281. Lewin, G., K. De San Miguel, et al. (2013). "A randomised controlled trial of the Home Independence Program, an Australian restorative home-care programme for older adults." Health & Social Care in the Community 21(1): 69-78.

https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reform/commonwealth-home-support-programme/living-well-at-home-chsp-good-practice-guide




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Reablement and Wellness (Cont)

Parsons, J. G. M., N. Sheridan, et al. (2013). "A Randomized Controlled Trial to Determine the Effect of a Model of Restorative Home Care on Physical Function and Social Support Among Older People." Archives of Physical Medicine and Rehabilitation 94(6): 1015-1022. Ryburn, B., Wells, Y., & Foreman, P., (2009) Enabling Independence: Restorative Approaches to Home Care Provision for Frail Older Adults, Health and Social Care in the Community, Volume 17 (3), pp 225- 234, see pg 22

Senior, H. E. J., M. Parsons, et al. (2014). "Promoting independence in frail older people: A randomised controlled trial of a restorative care service in New Zealand." Age and Ageing 43(3): 418-424.

Wilde, A., & Glendinning, C. (2012). ‘If they’re helping me then how can I be independent?’ The perceptions and experience of users of home-care re-ablement services. Health & Social Care in the Community, no-no. doi: 10.1111/j.1365-2524.2012.01072.x

References and Resources


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More Information Carrie Hayter

Email: [email protected]@carriehayter

Slideshare: Carrie Hayterwww.carriehayter.com

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

mailto:[email protected]

Government & Nonprofit

Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or Adaptive Leadership Challenge