Di Winkler's Blog

Sam Stosur and Grayden Moore - A Faithful Friend

The Good Weekend today features Sam Stosur and Grayden Moore. Sam and Grayden were doubles partners and trained together in their teenage years. Grayden was an elite tennis player, once ranked in the top 10 in Australia. A skateboarding accident left him clutching to life with a severe brain injury. As he slowly recovered, his parents were told that the only option was for him to be admitted to a nursing home. 

While most friends fall away when someone has a catastrophic brain injury, Sam has hung in there with Grayden. 43% of young people in aged care never receive a visit from a friend. Sam Stosur has been a faithful friend and kept in touch with Grayden over the years. They email each other when Sam is overseas and Sam often organises tickets for Grayden to attend the Australian Open or Federation Cup when she is in Australia. 

Grayden spends time volunteering his time as a Building Better Lives® Ambassador raising awareness about the need for appropriate accommodation for young people living in nursing homes via media and public speaking opportunities. Grayden says “every young person should be in a place they want to live in with the support to be as independent as possible… every young person should have this choice.”

www.buildingbetterlives.org.au

Building Better Lives® is led by the Summer Foundation www.summerfoundation.org.au

 

Research into Strategies to Address Poverty: TED Long Beach 2010

One of the most inspiring speakers from Day 1 of TED 2010 Long Beach was Esther Duflo. Esther is a development economist who has applied randomised control trials (RCTs) to social policy related to poverty. She has examined a range of strategies to increase rates of child immunisation, use of mosquito nets and number of years of education using RCTs in different villages and found some surprising results. For example with child immunisation they found that the most cost effective way of immunising children was to make it easy for families to access the service (i.e. travel to the village) and provide 1kg of lentils as an incentive for families to immunise children. Providing mosquito nets for free does not decrease their use or make it less likely that recipients will pay for nets in the future. The most effective investment to increase years of schooling (in areas where worms are an issue) is a de-worming program, followed by programs to inform parents about the benefits of education.

The use of RCTs and applying the same level of rigour as used in medical research seems so obvious and logical when the results are presented. This research provides an evidence base to direct the most effective strategies and investment in addressing social issues. RCTs to examine social policy could be applied to research related to people with disabilities or indigenous people. However one of the challenges is to apply research methods in a way that is respectful and empowering for marginalised people. Randomising intervention is at odds with a community building approach that supports people with disabilities or indigenous people to develop their own solutions. Indigenous communities are diverse in their community strengths and specific social issues. In some circumstances baseline measures may need to be used so that communities provide their own control data. In the disability sector there is such a large amount of unmet need that finding a control group would be less problematic.

Practical application of social inclusion policy

The Australian Public Service Social Inclusion and Policy Design and Delivery Toolkit was launched by the Deputy Prime Minister the Hon Julia Gilliard in August 2009. The purpose of the toolkit is to change the approach to policy design and delivery so that the needs of disadvantaged people are better met. Key priorities include: homeless people; people with disabilities; indigenous Australians; communities experiencing concentrations of disadvantage and exclusion; and jobless families with children.

 

The Summer Foundation is already implementing a range of projects that utilise the principles and methodology from the social inclusion approach. The Government’s principles and methods of social inclusion developed with the advice of the Australian Social Inclusion Board verifies the strategic approach of the Summer Foundation in addressing the needs of disadvantages people i.e. young people in nursing homes. These principles include: building partnerships with key stakeholders; developing tailored services; giving a high priority to early intervention; building joined-up services; using an evidence-based approach; using locational approaches; planning for sustainability and building on individual and community strengths. The Summer Foundation will continue to use a range of innovative approaches to address the multiple barriers to social inclusion experienced by young people in nursing homes.

 

2010 is shaping up to be another exiting year at the Summer Foundation with a range of opportunities related to empowering people with a disability and their families, fostering the development of systemic change to prevent new admissions, research, evaluation of services and working with partner organisations. 

Designing homes for the whole population for their whole lives

A meeting on 27th October hosted by Ms Therese Rein and Parliamentary Secretary Bill Shorten at Kirribilli House focused on the need for universally designed homes which are built for the whole population to live in their whole lives, which would give people with a disability greater independence and more choice about where they live. Representatives at the forum included those from the building industry as well as disability organisations. Participants agreed to form a working party to focus on a national approach to universal design and achieve substantial progress in six months. This group have set an aspirational goal – all new homes will be of agreed universal design standards by 2020, with interim targets and earlier completion dates for some standards.

Meanwhile, any day now the Victorian Government is expected to invite public consultation on a draft Regulatory Impact Statement investigating the costs and benefits of mandating the following four accessibility features in Victoria’s building regulations: 

• a clear path from the street to entry level  

• wider doorways and halls  

• a toilet suitable for people with limited mobility on entry level, and  

• reinforced bathroom walls to withstand the installation of grab rails.  

It’s proposed that these features will apply to all new houses, all new ground floor units in medium density dwellings and 1 in 5 units in high density developments.

One in five Australians has a disability. This is expected to grow as our population increases.  The Australian Bureau of Statistics predicts that those in our community aged 65 years will increase from 2.3 million currently to 6.8 million in 2051. At this time, 25% Australians will be aged over 65, and almost 8% will be over 85. As people live longer, they are living a greater part of their life with a disability – on average almost 20 years. Given our aging population and the expense involved in retrofitting houses and relocating people when their home no longer suits their needs, universal design for all new housing is common sense. Universal design will future proof social housing stock and enable people to stay in their own home as they get older.

More than 15,000 public and social housing dwellings are being built under the Rudd Government’s economic stimulus plan that incorporate universal design features. This initiative consists of two stages. Stage 1 provides funding for social housing projects that are already in the development pipeline and can be brought forward to commence in 2009 and be completed before 30 June 2010. Stage 2 provides funding for social housing projects following the completion of a competitive process to be conducted by each jurisdiction to identify suitable projects in the market. The housing developed as part of stage 2 of this initiative will incorporate some minimum universal design features. In addition to these minimum requirements, the Commonwealth has set a target of achieving a higher level of adaptability in 20 per cent of the dwellings that are to be constructed through Stage 2. These dwellings should meet the Australian Standard for Adaptable Housing AS4299-1995, Class C.

The housing being built as part of the economic stimulus plan and the current focus on universal design has the potential to dramatically increase the choice of housing available to people with a disability and their families. This provides a once in a generation opportunity to address the huge unmet need for accessible housing in Australia.

The Summer Foundation Property Advisory Panel is an incubator for ideas and creative thinking about integrated supported housing for people with disabilities. The first meeting was jointly convened by the Summer Foundation and The Hon. Bill Shorten, Parliamentary Secretary for Disabilities and Children’s Services in March 2008. The Summer Foundation is collaborating with the state and federal governments, housing associations, property developers and community service organisations to foster the next generation of housing for people with disabilities that is integrated into larger mainstream or affordable housing developments. These integrated models will enable people with a disability to live in dwellings that are close to friends, family, services and their community and will therefore facilitate community participation.

A key benefit is that this model would be able to cater for changing needs. People with an acquired brain injury may become more independent over time and choose to live in their own units after a couple years of shared supported housing, whereas people with degenerative conditions may start out living on their own and eventually move to shared supported housing with a higher level of support in the same residential development.

Ideally, many people who currently live in shared supported accommodation in Australia would have the option to move into their own villa or apartment and receive individualised disability supports.  Where people need 24-hour support on call, people with a disability could live “peppered” throughout a larger apartment complex so that support could be provided in an economic and sustainable way. If this model of housing and support was readily available we may not need to build any more group homes. Most people with a disability could be supported in an integrated living model and we may have enough group homes for people who choose to live in a shared supported living environment or whose needs are too complex to support in an integrated model.

State governments have been developing a similar model of segregated accommodation and support for people with disabilities since large residential centres started being deinstitutionalised in the1980s. In Canada, integrated models of supported housing have been operating for more than 15 years. Some of the requests for submissions for the YPIRAC program asked for innovative models of accommodation and support. This national initiative was a unique opportunity to further excellence in design for the next generation of supported accommodation options for people with disabilities in Australia. However, to date, the options developed have not lived up to the hopes of many of the informants interviewed in this study. Small-scale shared housing and congregate arrangements are the main housing options being offered to this target group.

Useful links

Australian Network for Universal Housing Design

Victorian Universal Housing Alliance

The Art of Public Strategy – A Worthwhile Read

Geoff Mulan’s book The Art of Public Strategy: Mobilizing Power and Knowledge for the Common Good provides insights into the perspective of government strategy and and how to influence strategy. An early section talks in his book describes the range of models for strategy. The appropriate framework for strategy will depend on the issue and the organisation1.

Command and control strategies

Classic models of strategy are based on high levels of power and knowledge. Command and control strategies assume that the world is knowable; that the tools for action lie in the hands of the state; and that the primary means of action is command (law, directive etc.). In these models what matters most is how those at the top of the pyramid map and respond to the environment – their ability to marshal information, to maintain control, and to monitor results.

Emergent strategy

Assumes that the state is powerful but that it lacks the knowledge to act wisely. It therefore needs to learn quickly as events unfold in unexpected directions.; action therefore requires persuasion and influence and alignment of the action of others and learning is vital. Strategy should focus on creating the conditions for systems to organise themselves. For those at the top, the priority is to be ad hoc, opportunistic and not to become trapped by formal plans.

Insurgent strategies

A third category is for those without power who believe they have the knowledge and know what needs to be done. These are insurgent strategies. NGOs campaigning for change, will often use these strategies, which involve greater use of guile and feints, or operating behind enemy lines, or turning weaknesses into strengths.

Evolutionary strategy

A fourth model of evolutionary strategy assumes a low level of power and little concentration of knowledge (power and knowledge are both diffused). Some see bottom-up, evolutionary and organic change as inherently better than any other kind. What matters is to assist through communication, encouraging co-operation and trust and growing mutually reinforcing behaviours an actions. It is essential that we are opportunistic and are too tied to formal plans.

At the Summer Foundation the command and control approach is a poor fit for most of our work. We are not the decision makers regarding policy and are not in a position of power. In growing our organisation, obtaining funding and working out how to influence government policy and practice I think that the emergent strategy fits.

An insurgent strategy is used to campaign for change in the human services policy and practice related to young people in nursing homes.

However we are also implementing an evolutionary strategy. Supporting, informing and empowering people with disabilities and their families is key to resolving this issue. It is essential that we are involved at the grassroots level that our whole strategy is based on our work with people with a disability.

 

There is much more to this book – it is a worthwhile read it you aims to influence government policy.

 

Mulgan G. The Art of Public Strategy: Mobilizing Power and Knowledge for the Common Good. New York: Oxford University Press Inc; 2009.

 

Indigenous Women's Bush Camp

I recently spent an amazing week as a guest at an indigenous women’s bush camp with the women of four language groups near Fitzroy Crossing. The indigenous women of the Fitzroy valley have an annual bush meeting.  There were over 100 women at the camp.

What I loved about my time at this camp was the opportunity to spend time in an indigenous community and listen to women discuss and describe the issues in their lives and the progress they are making to rebuild their families and communities. I also learnt a lot about community building and addressing issues from a grassroots or bottom up approach which appears to be a more logical and effective way of resolving issues related to social injustice.

These women know a lot about community building to address community health issues.  I first met June Oscar and Emily Carter through a film produced by some friends called ‘Yajilarra’.  Yajilarra tells the story of June, Emily and the other women of Fitzroy Crossing who lobbied to restrict the take-away alcohol sold at Fitzroy Crossing.  These women were sick of children, women and older people feeling unsafe in their community. They successfully lobbied so that take away full strength alcohol is no longer sold in their community. This has made a dramatic difference to a whole range of local health issues e.g. less alcohol hospital admissions, dramatic reduction of violence etc. Full strength alcohol is still available within the pub and light beer is available for take-away.

Indigenous communities are losing their culture through grog – they become disconnected with their land, their culture and their family. Substance abuse sometimes means that children and young people do not have the brain function to be able to carry their family’s stories or be leaders in their communities. Programs to address this try to bring young people back to their culture and work with them on other skills such as parenting. One initiative involves a mobile playgroup which includes indigenous songs, stories and looking for bush tucker.

When women thrive all of the community thrives – this is also evident in many developing countries where it is usually the women who make the most of Micro Enterprise Lending opportunities and start their own business so that they can feed and educate their children.

I came away inspired by what a group of women are working together to achieve for their children, their family and their communities. Part of me is also jealous of their strong sense of belonging and connection to extended family and the land. Many of the grandmothers at the camp had little choice but to be the primary carer for their grandchildren because some parents are either not alive or not able to care for their children because of issues related to substance abuse. However, I also got a glimpse of how an indigenous community may have functioned before the scourge of alcohol abuse, with a whole range of relatives providing care for each child e.g. ‘it takes a community to raise a child’. In western culture we tend to be a little isolated in our nuclear families. Indigenous women and communities have a range of strengths that they can use to make a significant difference and rebuild their communities.

I look forward to watching the progress of the women at Fitzroy Crossing, they have a whole range of health, education and economic challenges but they have identified their priorities, are getting organised and working together to create a future for their children and their communities. It is exciting to watch and hopefully will become a model that inspires other indigenous communities to develop a similar approach to their specific issues and challenges.

Here are some of the things that I took away from the 5 days at the camp that I think are also relevant to the marginalised people that we work with - young people in nursing homes and their families.

The first step to resolving a social justice issue and empowering people is to listen to the people at the grassroots and ask:

What are the issues that are real at the moment?
What can we do to support you with the issues that matter to you?

The voices of marginalised people matter and they will be heard.

The people in a marginalised community have the answers to the issues that concern them.

We need to build coalitions to work together – that’s when change happens.

Mission Driven Governance

I have just read an interesting article from the Stanford Social Innovation Review, which talks about mission driven governance. Given that the Summer Foundation is less than four years old, we are still working out our board culture and trying to find a balance between a ‘command and control’ focus and looking at ‘performance and impact’. I found this article really useful in the way it articulates the need to balance the legal aspects of governance with the behavioural elements to be a very effective board.

Following is a summary of the key points made in the article:

The prevailing governance model is fundamentally adversarial, pitting board members in a never-ending struggle with executives. This model may ensure that the legal requirements of oversight and compliance are met, but does little to advance the organisations goals. An alternate and more effective framework is one where board members and executives work together to advance the organisation’s mission. The inability of boards of directors and non-profit executives to keep their organisations focused on clearly articulated mission is a significant and overlooked governance problem. 

Legal perspective 

An adversarial model emphasises that the board’s function, as overseers of the organisation, with a focus on making sure that bad things don’t happen. This often results in a boardroom dynamic that looks something like “Let’s look for what is wrong with proposal x”. Accountability and oversight are absolutely necessary in achieving and maintaining public trust and the organisation’s legitimacy, and therefore are necessary elements of good governance. But there are many examples where governance structures that were adequate from a legal perspective still produced bad outcomes. In fact, it is not unusual to observe the simultaneous presence of poor governance and legally adequate accountability. 

Behavioural perspective 

An alternative focus encourages boards to make sure that good things happen. From the behavioural perspective, the goal of governance is organisational success as defined by the organisations mission (not accountability) and it is preoccupied with performance (not structures and controls). To produce good outcomes people have to work together, taking advantage of individual strengths. Consequently, the ideal relationship is based on trust, not rules. The primary role of the board is not oversight, which often creates a climate of conservatism and risk aversion; it is a group decision making that is robust and open to opportunities. The behavioural perspective often manifests itself in a cooperative dynamic that looks something like this “If proposal x will make us better, lets figure out a way to do it.” The legal perspective focuses on control. The behavioural component focuses on performance. 

The key to improving corporate governance is to incorporate both approaches into a single framework. The legal and behavioural perspectives exist in tension, which help explain the conflicted feelings board members and executive members bring into the boardroom. These tensions can’t be eliminated – they are an inherent part of organisational life – but if both perspectives are embraced, the tensions can be made more productive. 

	Legal perspective	Behavioural perspective
Goal	Accountability	Success
Preoccupation	Structures and controls	Performance
Means	Relationship based on rules	Relationship based on trust
Primary activity	Oversight	Group decision making

Summary from article by Fisman, Khurana & Martenson in the Stanford Social Innovation Review; Summer 2009; 7,3; pp 36-43

Construction of New Service in the ACT

The ACT government announced yesterday that work has begun on a new home for four disabled people under 65 who are living in Canberra nursing homes.  The development of this service is part of the COAG $244 million Young People in Residential Aged Care program. As part of this initiative $6 million will be spent on the Young People in Aged Care program in the ACT. The house has been jointly funded by the ACT and Federal Governments. There are currently 17 disabled people under 65 in the ACT aged care facilities. 

Disability Services Minister John Hargreaves is quoted:

"Now we have this facility though, we can move forward into the future and construct more as we go down the track and therefore it will give people the opportunity of choice."

What is really interesting about this quote is that the ACT government is making an ongoing commitment to this target group and building the capacity of the disability sector in the ACT to met future demand.  This is in contrast with other jurisdictions that seem to see this as a once off initiative that will create alternatives to the current cohort of younger people in aged care but do not appear to be committed to developing services to meet future demand.  This statement also reflects the fact that the ACT government have been actively involved in creating alternatives to young people living in nursing homes for many years.

ABC News article

Media release

Appreciative inquiry

One of the key goals of the Summer Foundation is to enable young people in nursing homes and their families to be informed, make choices and tell their stories. It is essential that we engage people with disabilities and their families and collaborate with them to resolve the issue of young people in nursing homes. How do we do this in practice?

 Appreciative inquiry is a process I read about recently which is highly relevant to a community buildng approach to resolving social justice issues. This process, developed by David Cooperrider (Case Western Business School) is based on getting all stake-holders together to ask each other meaningful questions.

 It brings together people from all levels of an organisation and pairs up participants, each person interviews his or her partner. Questions are designed to encourage people to open up to each other and, in the process break down any hierarchical differences.

People begin to see each other as individuals. After interviewing each other, participants form circles where they are encouraged to dream and brainstorm. During the brainstorm every idea – regardless of who came up with it – is given credence.

 Appreciative inquiry draws upon knowledge from the edge of the network. Because everyone feels they have been heard, participants become more likely to support a new plan. This approach is based on the assumption that the best knowledge is often at the fringe of an organisation e.g. people with a disability, disability support workers and families.

Catalyst or CEO

Following is my summary regarding leadership in a ‘starfish’ organisation from The Starfish and the Spider, (Brafman & Becktstrom 2006). The leaders of ‘starfish’ organisations are described as catalysts rather than CEOs. CEOs create order and structure; catalysts thrive on ambiguity and apparent chaos. A CEOs job is to maximise profit. A catalyst is usually mission-orientated.

The catalyst leader model is ideal for community building or creating a movement. It reflects the staff culture at the Summer Foundation and spurs me on to focus more on building relationships rather than structure and control. We are working through issues like governance, risk management and financial monitoring, which is more challenging in a decentralised organisation than a traditional top-down structure. Most of our work involves partnerships with people with disabilities, families and other organisations – these relationships are based on a shared ideology (i.e. people with a disability have inherent value and belong in the community). Engaging individuals and organisations as genuine partners makes a ‘top-down’ or ‘command and control approach’ impossible and inappropriate. As we listen to others and include their ideas, our projects evolve and mutate into a better version of our initial proposal or solution. 

A catalyst is an inspirational and collaborative figure who spurs others to action, they develop an idea, share it with others and lead by example. They empower people and then get out of the way. A catalysts most important relationships are based on trust and understanding. Values are a stronger building force than authority. Its about relationship – Catalysts ask people “what keeps you up at night, what brings joy, tears of joy in your eyes”. Catalysts constantly map relationships – map out all the people we know who might contribute. Identify people in our networks who could become advocates.

Catalysts don’t try to persuade people but rather rely on a more subtle technique: meeting people where they are. When people feel heard, when they feel understood and supported, they are more likely to change. They don’t prescribe a solution, assume a peer relationship and listen intently. You don’t follow a catalyst because you have to – you follow a catalyst because he understands you. When we give advise to someone, we automatically create a power heirarchy. In meeting people where they are, catalysts can inspire change without being coersive. 

Being a catalyst requires a high tolerance for ambiguity. That’s because a decentralised organisation is so fluid that someone who needs order and structure would quickly go mad. A top-down heirarchy and structure can be repressive to the catalyst. Put them into a structures environment and they might suffocate. But let them dream and they will thrive. If you turn a catalyst into a CEO, the entire network will be in jeopardy. This ambiguity creates a platform for creativity and innovation. Starfish organisations need ambiguity to survive. If someone came in and tried to implement order and structure, they might be able to get better measurement and tracking, but they would kill the starfish in the process. In the command and control environment, you can closely track what everyone is doing, but being watched and monitored makes employees less likely to take risks and innovate.

CEO	Catalyst
The boss	A peer
Command and control	Trust
Rational	Emotionally intelligent
Powerful	Inspirational
Directive	Collabotative
In the spotlight	Behind the scenes
Order	Ambiguity
Organising	Connecting

Brafman, O. & Becktstrom, R, (2006) The starfish and the spider: The unstoppable power of leaderless organisations