Reflections on Culture Change from the United Kingdom

By / Posted on July 19th, 2013

Recently, change agent and founder of Evermore, Sara McKee, spent time with Green House team members and Dr. Bill Thomas.  She visited a Green House home, and dreamed about how the inspiration of The Green House model could meet the needs of elders and direct care staff in the United Kingdom.  Read her reflections below.  

In the relentless pursuit of keeping institutional behaviour at bay

Is it any wonder that the turnover of care staff is upwards of 30% in most organisations in the sector; when the opportunity to do what they really want – care for individuals – is often denied them?

Time limits, task-based activity, cost pressures – all take away the pleasure to be derived from work with such a purpose. Add to that the insecurity of having low pay with zero hours contracts, and any job role starts to look more appealing than care. This is probably why care worker posts are generally the last on the list offered in a Jobcentre.

It really doesn’t have to be this way.

With the right leadership we can achieve amazing things. We have to get the basics right (pay/conditions) and then we have to enable people to flourish. As Daniel Pink explains, people are motivated by Autonomy, Mastery & Power.

That’s what gets us up in the morning, and I’m hopeless at early mornings. Seeing the art of the possible in front of me on a recent trip to The Green House Project in the US, and I’m bouncing out of bed. Hector, my trusty hound, is finding that change in arrangements rather alarming!

My point is simply this: we will fail if we carry on trying to make the current institutions work by incremental change. As Einstein said, insanity is doing the same thing over and over again and expecting different results.

Time for a game change.

We’re taking the lessons from the Green House Project where staff have autonomy, become masters of their craft and have real power to advocate on behalf of their elderly residents. We will make sure that those in our care get to make the decisions, keep control and continue to contribute. By helping each other, we know they’ll stay active, engaged, be happy and well.

We don’t need task-based hierarchy to make things work. Let’s face it, the current system is expensive, unproductive and adds nothing to the quality of service.

We need enthusiasm, capability and energy. We need to recruit from across the age spectrum and train staff to create warm, domestic and convivial environments where really meaningful conversations take place. That way “person-centred” care and other useless jargon can be thrown away as real relationships are fostered. We do this by focusing on smaller numbers of people and enabling staff to be close to their elderly compatriots.

Less time focused on the P&L and more time on creating the place to live a happy life. My experience across various industries has shown me that if you do the right thing well, the money follows because people want to be a part of what you’re creating.
It’s not a pipe dream or an aspiration. It’s what we need to do and we intend to show how it’s done.

Big thanks to my community of colleagues in Washington, DC who continue to motivate and support me to be the game changer. And it is with them that I join in our relentless pursuit of keeping institutional behaviour at bay.