Posted: 19 March 2018
Neil Taylor, Director, Care & Community Services at Jewish Care reflects on how an organisation's culture can affect the care being provided.
“Culture Eats Organisational Structure for Breakfast”
[Sandie Keene, Past President ADASS 2013]
I believe we need to spend a little more time on understanding the individual culture of each of the organisations that we lead. We tend to spend much of our time, in particular regulated services, thinking about systems, processes, and policies and procedures to ensure we are ‘doing things in the right way’ rather than thinking about whether we are ‘doing the right thing’ as leaders. When we think about improving the delivery of services, our instinctive response is to check whether the structure is right, whether the hierarchy ensures the correct lines of responsibility and accountability. This will always be important to ensure that everyone understands their role in relation to their colleagues, managers and all our stakeholders. It will act as a reminder as to the boundaries and parameters within which we operate, it will enable effectiveness, communication and planning.
Leaders need to take the opportunity to reflect on their team’s values, belief systems and behaviours. A more ‘structured’ way to consider these issues is to understand the organisational culture of our services and as a leader, we should be responding to and directing the ‘way we see and do things around here’. Traditions, history and structure contribute to building culture, which in turn, gives an organisation a sense of identity. The organisation’s legends, rituals, beliefs, meaning, values, norms and language determine how things are ‘done’.
Each service, home, team or resource has a unique history, some have decades of history, many are created by professionals and some were created by families or volunteers embedded in their communities. Some are the merger of two staff groups, others are rooted in and guided by professional codes of practice and others have had to operate in more entrepreneurial environments.
In trying to understand the specific challenges that certain services have to contend with, I have as a leader tried to encourage managers to profile the staff group, their length of service, to understand where staff came from before they joined the organisation. I have encouraged managers to understand their staff’s literacy levels, appreciate their cultural diversity, the individuals’ learning and development records, all with a view to trying to develop a greater insight into the makeup of a staff group and to unpick why a staff group behaves in a certain way, why relationships may be the way they are between staff and volunteers, not to mention relatives and carers.
Recent experience in one of resources demonstrated how a working culture, created 20+ years previous, lasted over a very long period of time and impacted on the quality of care being provided, to the detriment of the residents/clients. My personal experience of not sufficiently appreciating the importance of understanding and managing the right balance between ensuring volunteers felt they had a real stake in the service I managed, while on the other hand, ensuring they operated within professional boundaries and saw themselves as an integral part of the team, meant I didn’t deliver as much change as I would have set for myself.
Much of current social policy is being directed towards the aspiration to integrate health and social care more effectively. This will require two working cultures, with different languages, different modus operandi coming together – trying to reconcile the differences between the medical model with the social model of care. We know this difference manifests itself within my organisation, whether it be the way nurses, social workers or staff with a care background interact with each other. It is not a coincidence that the codes of conduct which provide the framework in which professional groupings operate, differ. Understanding these norms will put us in a far better position to lead our organisations in the future.
In a recent conversation with a colleague as to how we enhance the customer experience, we found ourselves violently agreeing that, while training on good customer techniques is necessary, an appreciation of the impact of issues of power, class, wealth, culture, language etc. on the relationships between staff and our customers are conceivably far more important than anything else.
Different staff will not provide an outstanding customer experience. Perhaps our customer service training should focus entirely on promoting emotional intelligence across the organisation?
At Skills for Care’s recent annual conference focusing on the challenges of recruiting, developing and leading a sustainable service, Andrea Sutcliffe Chief Inspector for Adult Social Care at CQC emphasised the importance of services being rooted and connected to their local communities. A leader’s commitment to a positive, values led, and aspiring culture that reflects and celebrates the diversity of the local community may well successfully contribute to attracting and retaining passionate, values driven and skilled people.