The majority of words written about staffing issues in the aged care sector concentrate on staff to resident ratios. What appears to be missing is a discourse on the degree to which staff are aligned with the objectives or vision and mission of the organisation providing the aged care services. Consequently, little appears to be written about the level of personal leadership that needs to be demonstrated by all staff in aged care organisations.
Personal leadership is that demonstrated by each and every employee regardless of their position in an organisation. Andrew Larpent, the CEO of Southern Cross Care (SA & NT) (Larpent, 2014):
Leadership starts with the individual employee and it is a basic quality that is sought when any newcomer joins an organisation. Leadership development does not start when one becomes a manager. Leadership starts at the bedside. The example set by care staff in terms of personal presentation and conduct of daily activity is where they display leadership behaviour that has the greatest effect on the quality of service and on the quality of life of those they support.
The importance of personal leadership should not be underestimated. It is reported (Corporate Leadership Council, 2009) that in organisations with high levels of engagement, employees are likely to expend more discretionary effort (57%), are 9 times less likely to leave, and the organisations in which they work are likely to experience an average three-year revenue growth of 20.1% as compared to an industry average of 8.9%.
So what are the ways in which we can generate personal leadership in aged care, regardless of whether the staff member in question is a registered nurse, care worker, chief executive officer, maintenance manager, board member, administration officer, or indeed any other role?
Line of sight
For all levels of an organisation there needs to be a clear line of sight (Figure 1) between the vision for the organisation and the personal rewards that provide incentives for the individual to demonstrate personal leadership.
Figure 1: Line of sight
Where are we going?
Completing these steps gives the organisation a clear picture of what it wants to be (vision), how it plans to reach that goal (mission), and the mechanisms of control to be used over the journey (corporate governance).
With reforms directing the aged care sector to provide a greater degree of flexibility in the choice of services available, and driving home care to include an enabling approach and greater transparency of the costs of services, reviewing the vision and mission and revising the corporate governance framework may be necessary. Communicating the vision and mission clearly to staff is definitely necessary.
How are we going to get there?
These steps involve the creation of an agreed pathway to achieving the corporate vision (Strategy), establishing the numbers which will be measured as the barometer of our success (Key Result Areas), and cascading those measures down to individual tasks (Processes and Procedures).
An object of the reforms in aged care is to offer much greater freedom of choice to residential and home care clients alike. The organisations that will prosper are those that recognise they need to make strategic choices about the segments they wish to market to, and therefore the services they will offer. Additionally, the requirements to be much more transparent about the charges made for the services places greater responsibility especially for home care workers to be able to explain the services and the charges. (Did I mention the word ‘sell’?)
Those strategic choices of segments – and, therefore, services – directly affect the attitude, skills and knowledge required of staff. Furthermore, new processes and procedures are required to procure and deliver the new services at an acceptable level of risk.
Almost all staff, at one time or another, will be affected by the reforms in the work they do.
Who is going to help us?
These steps involve providing people with the attitude, knowledge, and skills necessary to execute the processes and procedures (training), assessing their capability to apply the training in the workplace (assessment), and providing people with the long-term support they need to grow and take on new responsibilities (competence development).
The training and recruitment requirements to develop a workforce which thrives in the new environment that will be established by the reforms, are significant. In some cases, it is very likely that organisations will be asking people to do tasks they feel very uncomfortable with. For example, it is probably fair to say that the preferred thinking styles (Kobus Neethling, 2014) of carers is people-centric with a high preference for empathetic thinking. It is less likely that they will have a high preference for analytical thinking styles. Yet, in many cases we will be asking carers who provide home care to master an Excel spreadsheet so they can explain the costs of a client’s choices. It is not that they will not be able to do it, just that they will feel uncomfortable doing it. And they will feel extremely uncomfortable ‘selling’ additional or different services.
The change process itself will put pressure on employee retention rates as people who are uncomfortable with the new tasks they are being asked to do or are uncomfortable with the level of support they need look for alternative employment.
Personal Rewards, Individual Adoption and Personal Leadership
Personal Rewards for a job well done are about more than just remuneration; they also involve non-monetary rewards and recognition, role clarity, and an understanding of development pathways within the organisation.
Individual Adoption focuses on motivating each person within an organisation to be part of the corporate vision, to sign on and engage in the organisation’s journey, while Personal Leadership encourages individuals to take the organisation’s goals beyond rhetoric and turn them into a reality for both themselves and their colleagues.
And this is where the opportunity lies. The opportunity lies in forging a common understanding of what individuals want to do with their lives, and how their working life can support their hopes or ambitions. By creating alignment between what the individual wants or needs and what the organisation seeks to achieve (vision) and the manner (mission, strategy, process, procedure) by which it wishes to achieve it, a powerful sense of purpose can be unleashed within each individual.
It is not necessary to leave building this alignment to chance. It can be done as a large scale transformation programme (revolutionary change) or as a series of small scale steps redesigning the recruiting and performance management system (evolutionary change).
A common component of both the revolutionary and evolutionary scale change is the need to identify personal barriers and corporate barriers to achievement of both the individual’s and the organisation’s vision, and correct those which do not put at risk other important measures of individual and organisational success. An individual barrier to success could be as simple as punctuality or as complex as getting a qualification. A corporate barrier to success could be as simple as being clear about the purpose and accountability of a role or as complex as creating a culture where achievement is favoured over effort.
A side benefit of this approach is that some people will recognise that they are not willing or able to overcome or remove their personal barriers within the environment that the organisation provides, or that the organisation is unable to remove a barrier which prevents them from reaching their goal. These individuals will leave. Although this decreases the retention rate, this turnover of staff is beneficial in the medium term for both the individual and the organisation. My experience is that more people stay than leave in normal circumstances, and that the ‘right’ people stay.
Driving Personal Leadership through a Line of Sight in Aged Care
Properly executed, the Line of Sight gives each individual within the organisation – from the board down to the newest recruit – a clear picture of how their role contributes to the organisation’s success, what they need to do to maximise their contribution, and how they need to act to maximise their own personal effectiveness.
This creates an engaged, productive, and motivated workforce comprised of individuals who each take personal accountability for their actions.
The reforms in aged care mean that people’s roles will change. It means that extra training is required to ensure people have the appropriate attitude, skills and knowledge to execute their revised roles.
However, training is not enough. Removing the barriers to transferring that learning back to the workplace is of fundamental importance. If you build a programme that does just that, you will begin to see your staff demonstrating the personal leadership necessary for a successful future – both for themselves and your organisation, and consequently for the clients, guardians, and relatives in the market you aspire to serve.
Corporate Leadership Council. (2009). Manager Guide for Improving Engagement. CORPORATE LEADERSHIP COUNCIL.
Kobus Neethling. (2014, September 19th). NBI Adult Instrument – Example Report. Retrieved from Whole Brain Thinking: http://www.thewholebrain.com/index.php?option=com_content&view=article&id=73
Larpent, A. (2014, May 22nd ). Leadership matters – from bedroom to boardroom. Retrieved from Australian Ageing Agenda: http://www.australianageingagenda.com.au/2014/05/22/leadership-matters-bedroom-boardroom/