Tag Archives: health care

Risk Aversion or Risk-Taking?

Positive Risk-Taking logo

We all work with risk; we all have to make risk decisions, and sometimes those decisions involve the challenge of taking risks. Part of overcoming the challenges resides in our awareness of our own mindset in relation to risk. I have a simple 5-step approach to helping me make the challenging decisions… in work as well as in life.

Click on the following link to access a free webinar that provides 40+ minutes of training in the challenges risk can present, and an introduction to my 5-step approach:

https://app.webinarjam.net/register/21360/99e6026a97

This webinar condenses 30+ years of my experience working in and alongside health and social care services, and 60+ publications around the subject. Risk is something we should embrace from a positive perspective, and this webinar develops this mindset.

Podcast Episode 063: Truly meeting the need

Person-centred (2009)
Person-centred (2009)

Within the context of service-centred working can a meeting ever be person-centred?

In this episode I outline experiences of ward rounds and community reviews that are frequently presented by the services as being person-centred, but are clearly service-centred.

Our use and misuse of language is more often than not a reflection of our values and ultimately a reflection of what we deliver as a service, so it needs careful attention.

Attendance at meetings does not equate to involvement in meetings. So what will it take to make service meetings, particularly client reviews more genuinely person-centred? I present four messages to guide us towards this aim.

For the full content of this episode click the links to iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/063-truly-meeting-the-need/id867043694?i=344569092&mt=2

“If you had to identify, in one word, the reason why the human race has not achieved, and never will achieve, its full potential, that word would be ‘meetings’.” [Dave Barry].

Targets, what targets?

Person-centred (2009)
Person-centred (2009)

How can we make more effective use of targets as a means of developing best practice? Perhaps a more pertinent question is: ‘Can we make effective use of targets at all?’

Nothing drains passion more effectively than constant demands for information to meet apparent targets, asked without consultation or explanation, and with no meaningful returns in the form of useful feedback. Auditing everything has become an industry – but to satisfy what? The function of co-ordinating care, specifically the Care Programme Approach (CPA), has become a focus for quantitative returns that seemingly have little to do with the quality of the working relationships and everything to do with numbers and signatures. As many service users, carers and practitioners will testify, presence at a meeting and signing a form does not necessarily reflect influence, involvement or even truthful agreement with the documented outcomes. Yet, the bureaucratic process keeps requiring the numbers with no apparent reciprocal benefits for practitioners and teams.

I wouldn’t argue against the need for auditing practice; but it does appear from conversations with many practitioners that there are widely differing perceptions about priorities between the management of services and the deliverers of services. Anecdotal sources suggest that most practitioners feel they only receive feedback from audit sources when things go wrong, and that good practice is not confirmed or highlighted when it happens. If practitioners, service users and carers were asked to define the parameters of what needs to be audited, there would be some disagreements between them but the priorities would probably look a lot different from what currently occurs. Most people in the real world are concerned about relationship-building in order to support people to be more self-reliant through identifying and working with their own strengths. Audit needs to be of practice and for practice, with a focus on sustaining current good practice. But that would only put an awful lot of middle management and auditors out of a job, for their focus is ‘change’ for its own sake; as long as the merry-go-round keeps moving they will have a purpose.

See ‘The Art of Coordinating Care’ publication for a detailed framework on delivering a service user-focused, strengths-based, bureaucracy-busting approach to real practice. It has been developed as a reflection of what good practice looks like, but will challenge all practitioners to step up to the mark to deliver values-based personalised services based on working with people’s strengths. Failure to do this leads to the alternative… the more usual current situation of an over-regulated system driven by the need to satisfy the politicians and public that if anything goes wrong ‘it will never happen again’. What the current system can ensure will never happen again is the enjoyment and creativity fuelled by the passion of people who want to make a positive contribution to service users lives.

Feel free to add your own comment about any issues raised above.

“Bureaucracy destroys initiative. There is little that bureaucrats hate more than innovation, especially innovation that produces better results than the old routines. Improvements always make those at the top of the heap look inept. Who enjoys appearing inept?” [Frank Herbert].

Strengths-Based Practice

OMOpen Mind was a fabulous social care focused magazine for which I published a number of articles between 2000-2012. The following article was first published in OpenMind 126, Mar/Apr 2004) and was reproduced with their kind permission on my website at Practice Based Evidence.

It remains just as pertinent to practice today as it ever was, so I provide the link here to the strengths-based article. It focuses on the importance of principles, and the need to change the focus of our language in health and social care services to ‘go beyond  the alphabet of negativity’…

http://practicebasedevidence.squarespace.com/storage/pdfs/OpenMind-StrengthsBasedPractise.pdf

Podcast Episode 030: Age of experience

TheStrengthsRevolution_albumart_2-2One of the main challenges of the widely recognised ageing population is how we tap into the deep well of resources in older people, as well as identifying more resources in order to support older people with specific needs.

This episode will explore the idea of ‘care capital’ from the perspective of contributing through voluntary work. An emphais is placed on the baby boomer generation, with a wealth of skills and talents alongside a desire to contribute something back into society.

What do others gain from our charitable contributions? The flip side of that coin is that we also gain enormously from making contributions of time and effort; not least the protective factors that come from structured physical and psychological activity. There are a multitude of opportunities in local communities, but our more flexible way of thinking about work should also be reflected in more flexible ways in which we may be able to shape our voluntary contributions, so that we tap into the strengths of the many. A good neighbour befriending scheme is identified as one personal example.

For the full content of this episode click on the links to iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/030-age-of-experience/id867043694?i=320358977&mt=2

“Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.” [Mark Twain].

Podcast Episode 023: Wanda Rusiecki Interview Part 2

TheStrengthsRevolution_albumart_2-2In this second part of the interview Wanda Rusiecki talks about the work she does as a case manager with specific service users, ‘getting on the healthy side’ and supporting people to exercise more control over their own lives. She recognises the real reasons behind the cynacism and mistrust that some people come with, and how the focus on the conversation and humble listening helps to create a different experience of services for many people.

The issue of ‘time’ is discussed; it is the service user’s time, so we need to ask how they want to make best use of it, rather than succumbing only to systems needs that serve more bureaucratic requirements. Helping people to search for satisfaction also brings greater satisfaction in the work for practitioners.

Wanda also reflects on working alongside the criminal justice system through court order treatment, the importance of integrating mental and physical health care to be truly holistic, and the role for peer services employing service users to tap into their experience and talents.

For the full content of this episode click on the links to iTunes and Sound Cloud (or go to Stitcher Radio):

https://itunes.apple.com/gb/podcast/strengths-revolution-steve/id867043694

https://itunes.apple.com/gb/podcast/023-wanda-rusiecki-interview/id867043694?i=318839498&mt=2

https://soundcloud.com/stevemorgan57/023-wanda-rusiecki-interview