Green House Blog

Keep it Simple: How We’ll Take Aged Care Challenges

Evermore Founder Sara McKee writes about what she learned at the recent Green House conference about how we can tackle aged care challenges by keeping it simple, and the importance of celebrating differences. (Reposted from Evermore Blog)

I recently attended the annual Green House  conference in Fort Lauderdale. It was fantastic to be in a T-shirt in November – having left rather chillier conditions back in Manchester.  It was also great to be with hundreds of believers from across America who are delivering a better way of living in older age, every day.

I was the only English person at the conference alongside fellow international explorers from Panama, Brazil, Bermuda, Israel and Singapore. However, if you take the vast expanse that is the United States, then it felt truly multicultural with folks from Alaska to Colorado, Pittsburgh and Arkansas.

Whilst the language of the conference was English, this multicultural dimension made us all recognise our differences in culture, approach and, indeed, language. We may all be speaking the same words, but do we really understand each other’s meaning?

James Wright delivered a challenging keynote on diversity and inclusion, highlighting our scientifically proven hidden biases. He explained how we operate on an unconscious level which makes us have implicit preferences.  A book he referenced about the topic is ‘The Hidden Brain’ and I’m going to read it to find out more.

One example he gave was how we make assumptions based on accent. He said that coming from South Carolina, he’d trained out his southern drawl as that made him sound stupid in the eyes/ears of others. Good News for me was that he said the English accent was universally seen as the smartest sound!

He was keen to point out that it doesn’t make us racists or any particular “–ists” – it simply is how we’re made! His mission is to move from talking about equality to equity – a discussion deserving of a blog of its own.

What can we learn from all of this?

We had gathered at this conference, many colours, ages and backgrounds to talk about the challenges we all faced with an ageing population and a shrinking workforce. Yes, we had similar challenges, we could share experiences and our different solutions. And yet we were not all the same.  That’s where it felt we had real strength. If we celebrated our differences and built on our joint appetite for collaboration, we could continue to innovate and create new opportunities for living well in older age.

James shared this clever video which reinforced the point for me: “Be together, not the same

My take away from the conference – Keep it Simple:

  • Simplify our approach to engaging with customers – what matters to you? Not what’s the matter with you!
  • Simplify our language – let’s get rid of the jargon. We talk about ‘convivium’ at the heart of our family households, yet it’s hard to say and even harder to spell – so let’s talk about sharing our life together and breaking bread.
  • Be consumer driven – let’s develop and deliver services that are focused on what our customers want. Sounds obvious, but often feels like rocket science in the world of aged care.
  • Translate connectedness, meaning, purpose and exercise into everyday activities. Not make each element someone’s task.

I’ve come back from the conference feeling re-energised and determined to maintain our international collaboration as we can all learn and build new world thinking together.

Reflections on Culture Change from the United Kingdom

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.

Dr. Bill Thomas Speaks to an organization in England about Culture Change

Dr. Bill Thomas recently spoke to a group in England about the potential to change the way “aging” is viewed in society. Below is a reflection from Sarah McKee, the Chief Operating Officer of the organization who received Dr. Thomas’ wisdom

Sara McKee, Chief Operating Officer, Anchor

Nothing less than a radical transformation of the way we care for older people is needed if we are to meet the challenges of the 21st century. So I’m incredibly excited to be working with Dr Bill Thomas as we focus on creating happy living for older people in England.

With 100 care homes and around 900 retirement housing properties in either ownership or management, Anchor is England’s largest not-for-profit provider of housing and care to older people. We provide services to more than 40,000 customers and we’re thrilled to be working with Dr Thomas as we evolve to meet changing needs, expectations and demographics.

It’s not news that the population is ageing but the scale is truly remarkable. For example, figures released for International Older People’s Day (1 October) by the Office for National Statistics revealed that the number of centenarians in the UK has seen a five-fold increase in the last 30 years. The major contribution to the rising number of centenarians is increased survival between the age of 80 and 100 due to improved medical treatment, housing and living standards, and nutrition during their lifetime.

These changing demographics require a different approach. It was somehow appropriate that Dr Thomas visited the UK to speak at an Anchor conference on 11/01/11, as many colleagues went away feeling that his visit had marked a new start in the way we care for older people. At the event, Dr Thomas spoke to colleagues from Anchor locations across England about The Green House project, which is reinventing care homes in America.

The Green House Project creates small communities for groups of older people and staff to focus on living full and vibrant lives. The model is a radical departure from traditional care homes. It is based around households of seven to 10 older people, supported by a ‘Shahbaz’, a versatile worker who provides a wide range of assistance including personal care, activities, meals and laundry.

Dr Thomas stressed at the event that, while building design played a part in the concept, the important difference from traditional homes was in the way individuals work with the older people. He stressed the importance of building relationships, really understanding older people’s needs and helping them to be meaningfully occupied – playing a full part in the way the home runs.

“Ageing is not primarily about decline,” he told the attendees, stressing that enabling older people to play an important part in the way a home is run helps them remain independent and happy.

At Anchor, we’re doing a great deal of work to ensure we really understand the individual life stories of our customers, so we can provide really person-centred care. But I know that we’re just getting started with the transformation that’s needed. Even Dr Bill, who has decades of experience, still calls himself a “beginner”.

Dr Thomas stressed that regulators in the US had been persuaded of the merits of his approach when they saw the positive outcomes for older people. I’m confident that regulators in the UK will take the same view. And while it had been challenging at first, perseverance had paid off. “All you have to do is keep putting one foot in front of the other and keep learning and growing,” he told attendees.

Attendees then broke into smaller groups to discuss how the approach could apply both in existing Anchor care homes and in new homes that we plan to build.

At Anchor, we are embarking on exciting development plans for new properties across the south of England, as part of our drive to grow the organisation. The properties will be developed by 2015 and we have been seeking sites on which to develop retirement villages, care homes and smaller extra-care properties.

Starting with a blank sheet of paper gives us an exciting opportunity to develop something completely new and we’re doing just that with West Hall, our exciting new development being constructed in Surrey. We are also keen to develop our thinking in our existing care homes and there are small, incremental things that can be implemented today in every care home in the world which would make a real difference to older people.

Dr Thomas has been an inspiration. I’m excited to be working with him, as I know are my colleagues across Anchor. What really resonated for me after his visit is the passion it inspired in our people to change ageing – and deliver new ways of making older people happy.