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Managing change
in an ever-changing sector

Robin Miller explores new research and resources to aid change management in an ever-changing social care.

I have to admit it, I felt slightly out of my comfort zone. Which is ironic because I was about to take part in a Twitter event on organisational change for social care managers.

Steve, from the communications team at the Social Care Institute for Excellence (SCIE), one of our partners in a new venture in this area, said that a good way to get discussions going on issues like this is to join a pre-arranged Twitter group. As I sat there at five o’clock, I wasn’t sure if anyone would join us.

I needn’t have worried. The ‘event’ was very successful and it turns out there’s a great appetite to learn about organisational change. Care and support is changing all the time. I think it’s important to respond to this developing world by looking at the way that organisations are managed. It’s exciting because this sees the introduction of new policies and resources taking on the views of local people and communities, and also sees people embracing technological change. There’s never been a better time to look at organisational change in social care.

Until now, there haven’t been many resources to support organisational change. At the University of Birmingham, we’ve produced a resource, Managing organisational change in adult social care, in partnership with SCIE and the University of Middlesex. The original research on which the resource is based was funded by the National Institute for Health Research’s School for Social Care Research.

A two-way street

Organisational change must be a two-way street and a social media meeting was a good way to introduce it, because with ‘change management’ you don’t want to preach to people. Take the case of Bharat who is the subject of a case study within the new resource.

Bharat is responsible for overseeing a radical change in practice which will support and enable service users and their families to rely more on their own resources, and to use direct payments to supplement those resources. To remove barriers between caring specialisms and to take out some management costs, a new generic social care team has started up, managed by Bharat. It sees three teams come together, with all the cultural issues that brings with it.

Through his case study we learn that Bharat was challenged by a colleague when he selected the ‘Lean’ process for organisational change. Lean is drawn from the automobile industry and, therefore, the colleague suggested it’s not appropriate for social care. As a result of this challenge Bharat ran a workshop that enabled them all to modify the Lean approach to work more effectively within the social care setting they operate.

Lean looks at an organisation’s ability to do more work with fewer resources. All the way through we hear Bharat’s reflections on how it’s going. He says, ‘While you can’t build a new culture in a day, we’ve made a good start. When we collected stakeholder perspectives this year, there were fewer differences between groups.’

Tools and approaches

Bharat’s is just one example from the resource, which provides a set of tools and approaches to access when undergoing a change process. During the research stage, SCIE and the two universities spoke widely to managers and people who use services. As a result we’ve created four, particularly useful, case study scenarios of managers in different social care contexts, together with a compilation of change approaches. There is also an accompanying film, embedded on the site.

The other scenarios look at Alex, the manager of a care home for older people, owned by a housing association; Carl, the manager of a new recovery hub within an NHS mental health trust; Denise, the manager of a residential care home for people with learning disabilities, which is closing down.

The reality of the situation

Managing change is a day-to-day reality for most social care professionals. Social care never sits still. Over the course of their careers, senior social care professionals, including, managers will have built up a set of practice-based skills and experiences about what has worked in the past. This knowledge can be applied to future ‘change situations’. However, there’s more. I think that we need to expect (and support) frontline social care practitioners to act as practice leaders, akin to clinical leaders in the health sector.

Bharat’s colleague may have a valid point when raising their eyes to the ceiling and suggesting that some attempts at change management are, ‘just another restructure.’ Restructuring can have a role to play, but only as a support to changing culture and practice, and not as in the end in itself. No-one is saying that this isn’t complex. Although some issues can be resolved quickly and easily in the right circumstances. A tweet came in during the event I mentioned above from social care blogger Rich Watts (@rich_w). He said, ‘Sometimes an hour over coffee can be the source of many positive effects.’

However, although social care providers and managers often have the skills to lead change, they sometimes don’t also have a language or the practice frameworks to help them communicate and reflect on what they do.

In the resource’s accompanying film, Tony Waterfield, Senior Practitioner at Solihull Metropolitan Borough Council, said, ‘People can really benefit from online learning like this. They can remind themselves about how change can feel and they can find out how managers can be supported to adjust to change, and to recognise the vast wealth of skills they and their workforce possess.’

Slowly (and collaboratively) does it

Another point that staff make about organisational change is that it’s done at breakneck speed, as if someone on high wants it all happening five minutes ago. Richard Humphries, Assistant Director of Policy at the King’s Fund (@RichardatKF) joined in the Twitter event and said, ‘Sustainable change takes much longer than electoral/financial cycles.’ I couldn’t agree more.

Policy initiatives can be helpful but they can often disrupt too. We need stability and funding certainty. The people we serve, along with their carers and frontline staff, are at the centre of social care and need to be at the centre of change.

Why organisational change is important

SCIE’s Ewan King warned in a Guardian article recently that the worst case scenarios he was tasked with looking at as a researcher 18 years ago are now the norm. So, I think it’s only right to say that it’s time we got on with this. There I go, trying to get it done overnight.

The final word to wise comes from Ian James, Director for Communities and Adult Social Care at Solihull Metropolitan Borough Council. Ian said, ‘Often we make the job more difficult for ourselves by failing to recognise the human instinct to resist change and by focusing on the process of change rather than the experience.’ This new resource is designed to help people overcome some of the barriers to starting the process of organisational change.

I shouldn’t have been concerned about attendance at the Twitter event. Its success only went to reassure me, as our research for the resource did, that there is a great willingness out there to embrace organisational change in social care.

Robin Miller is Senior Fellow at the University of Birmingham’s Health Services Management Centre. R.S.Miller@bham.ac.uk @RobinHSMC

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