Di Winkler's Blog

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 

The starfish and the spider

I have just finished reading a book called “The starfish and the spider: The unstoppable power of leaderless organisations” which is about the power of starfish organisations to turn industries and society upside down. In response to overcentralised industries or institutions, people rebel and create open starfish systems. The starfish model presented has a lot of relevance to a community building approach and creating movements to resolve social justice issues (e.g. young people in nursing homes).

Spider organisations

This book uses a spider analogy to describe traditional top-down organisations where the leaders want to control what’s happening, thereby limiting creativity.  In this model board and CEOs use command and control to keep order in the organisation. Each decision has to be analysed and approved by the executives and there are clear structures, rules and heirarchies. Like a spider in a centralised, top-down organisation, if you attack the head (or the leadership) the spider dies.

Starfish organisations

Starfish organisations are decentralised and based on a network with a flattened heirarchy. Starfish have no central nervous system and no brain to control things. You can chop one in half and get two new ones. In fact, each radial segment, if complete, could grow a new starfish if separated from the rest of it.

In startfish organisations there is no clear leader or heirarchy, and no headquarters.  If and when a leader emerges, that person has little power over others. The leader leads by example. 

Starfish organisations are open systems easily mutate, they are able to react, mutate at a quick pace and grow quickly. Decentralised organisation are very amorphus and fluid, Because power and knowledge are distributed, individual units quickly respond to a multitude of internal and external forces.

Conventional thinking is that to run an organisation you’d better be highly organised and structured. Starfish systems are wonderful incubators for creative, innovative or creative ideas. Good ideas will attract more people, and in a circle, they’ll execute the plan.  Institute order and rigid structure, and while you achieve standardisation, you’ll squelch creativity. Where creativity is valuable, learning to accept chaos is a must.

Ideology

Ideology is the glue that holds decentralised organisations together. Because a decentralised organisation can’t draw upon command and control to motivate participants, it needs a strong and ongoing ideology to keep them going.

Circles

Circles are important to nearly every decentralised organisation. Once you join a circle, you are an equal.  It’s then up to you to contribute to the best of your ability.  Whes circles take on more than 14 people, the bond tends to break down.

 

Resolving the issue of young people in nursing homes

The starfish organisations organisation provides a language to describe the work of the Summer Foundation.  This model describes what we are already doing and strengthens our resolve to work with people with disabilities, families, workers and partner organisations to create a movement to resolve the issue of young people in nursing homes. We are busy tapping into and stregthening existing networks and circles and creating new circles and networks of people who have knowledge and a fundamental desire to share and contribute. Working with other stakeholders is critical to our mission so we are active participants in the Victorian Young People in Nursing Homes consortium, the my future my choice advisory committee and the Victorian Coalition of Acquired Brain Injury Service Providers.  Circles we have started include the Summer Foundation Property Advisory Panel, the Network of new accommodation service providers and a series of workshops for people with a disability who want to explore getting involved in systemic advocacy.  We are also exploring ways of developing peer support networks for people with disabilities living in nursing homes and carer support networks for families of young people in nursing homes.

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

Access All Areas: Report on draft Disability Standards for access to public buildings

Last week a report was released by parliament which makes recommendations for making public buildings more accessible.

This report of the parliamentary inquiry into the draft Disability (Access to Premises - Buildings) Standards makes a number of recommendations which would help the standards better achieve their object and purpose. The draft Premises Standards are intended to make public buildings more accessible for people with mobility, vision and hearing impairments. If introduced, the Premises Standards will have a widespread impact, improving building accessibility for new buildings and existing buildings undergoing significant upgrades. In addition to providing better access to buildings, the Premises Standards are also intended to provide certainty to building certifiers, developers and managers that they are complying with their obligations under the Commonwealth Disability Discrimination Act.

The Premises Standards clarify the responsibilities of the property and building industry under the Disability Discrimination Act and provide technical details for the design and construction of buildings so that they are accessible to people with a disability.

Following extensive consultation, during which over 130 submissions were received, the recommendations made by the Parliamentary inquiry for improvement of the draft, include:

• requiring access to the common areas of apartment blocks;
• improving access and safety features on all stairways;
• clarifying and limiting some of the exemptions in the current draft; and
• ensuring a timely and effective review process on the implementation of the standards.

Adoption of the Premises Standards would be accompanied by changes to the Building Code of Australia to ensure consistency.

Access all areas report

Influencing and Informing Policy Decisions: Three Lenses

Earlier this week I was at the Communities in Control conference http://www.ourcommunity.com.au/control/control_main.jsp, which was very practical and inspiring.  Alison McCleland (Department of Planning and Community Development) spoke on ‘How to persuade government with hard and soft data’ which provided some clear practical advice on influencing government policy.

Alison referred to useful a journal article by Brian Head (2008) entitled The three lenses of evidence-based policy. Following is an outline of the practical tips contained in the article by Brian Head.

Policy decisions emerge from politics, judgement and debate, rather than being deduced from empirical analysis. Policy debate and analysis involves an interplay between facts, norms and desired actions, in which ‘evidence’ is diverse and contestable. There are three types of evidence or three perspectives that are especially relevant in the modern era:

•    Political knowledge
•    Scientific knowledge
•    Practical implementation knowledge or ‘What works?’

These different bodies of knowledge provide a range of evidence to inform and influence policy rather than determine it.

 

Political knowledge

This is the know-how, analysis and judgement of political actors.  This involves:

•       Considering and adjusting strategies or tactics
•       Undertaking agenda-setting
•       Determining priorities
•       Undertaking persuasion or advocacy
•       Communicating key messages and ideological spin
•       Shaping and responding to positions of accountability
•       Building coalitions of support
•       Negotiating trade-offs and compromises

 

Policy seen through the political lens, is about persuasion and support rather than about objective veracity.

 

Scientific knowledge

This is the product of systematic analysis of current and past conditions and trends, and analysis of the causal inter-relationships that explain conditions and trends.  In relation to policy review and assessment, there is a range of disciplinary and cross-disciplinary knowledge.  Inter-disciplinary approaches have some to the fore in recent decades for addressing multi-layered social problems. Researchers are sometimes naïve about what policy analysis will be seen as relevant and about how to communicate and package their research outcomes effectively to inform government policy.

 

Practical implementation knowledge

This knowledge focuses on program effectiveness and the ‘practical wisdom’ of professionals in their ‘communities of practice’ and the organisational knowledge associated with managing program implementation. These managers and professionals wrestle with everyday problems of program implementation and client service.

 

Getting an issue on the government agenda

For governments, problems and issues become seen as worthy of investigation owing to a confluence of circumstances such as:

•    A perception of crisis or urgency
•    The role of political mandates and priorities
•    The role of expert judgement and advice (consultants, inquiries etc.)
•    Organisational and issue histories
•    The changing context of social values and public opinion

 

Policies related to young people in nursing homes

The issue of young people in nursing homes is currently on the national government agenda.  However there is a risk that once the current five-year $244 million initiative finishes in July 2011, that 700 Australians under 50 will continue to be admitted to aged care each year.

What evidence do we need to take to government? (Alison McClelland, 2009)

1.     Highlight issues and focus policy debates
2.     Describe the impacts of existing policies
3.     Consider new policies and programs through evidence from our service experience about what works

 

No one organisation is able to do all of the work or provide the range of information required to effectively influence policy, practice and funding related to the issue of young people in nursing homes. In order to resolve the issue of young people in nursing homes we need to develop a ‘policy network’ or ‘policy community’ that includes participants that are able to provide knowledge from all three of the ‘lenses’ outlines above.

The Young People in Nursing Homes Alliance has been effective in raising public awareness, developing relationships with state and federal politicians and getting the issue on the government agenda. The Summer Foundation is undertaking a range of studies to provide an evidence based to influence policy, practice and funding.  Through the Building Better Lives initiative (buildingbetterlives.org.au), the Summer Foundation is also engaging a community of practice to provide government with the practical knowledge and experience of what works for this group of people.

One critical area that was not identified in the three lenses outlined by Head (2008) was a community building approach to influencing government policy that empowers the target group involved.  A grassroots approach to resolving social justice issues was a recurring theme throughout the Communities in Control conference. In order to resolve the issue of young people in nursing homes we need to work with people with disabilities and their families as empowered partners.  We need to start by finding out what young people in nursing homes and their families care about.  Once we know what they want to work on, we need to give people with disabilities and their families agency and control over their destiny.  We need to work with them, get them to select a problem they want to fix and resource them to resolve it.

 

Head, B. (2008). The three lenses of evidence-based policy. The Australian Journal of Public Administration Vol 67, No.1 pp. 1-11

Young people in nursing homes - what progress is being made?

What progress is being made with the $244 million COAG Young People in Residential Aged Care Program?

This question was asked in February 2009 and FaHCSIA have recently provided some answers.

Number of people out of residential aged care

 

State/Territory	Achieved as at December 2008 (Cumulative data)
NSW	2
VIC	19
QLD	25
SA	17
WA	3
TAS	1
NT	1
ACT	2
TOTAL	70

(Senate Budget Estimates Questions on Notice, February 2009 Question No. 223)

How does this progress compare to the targets that have been set?

The targets for the COAG Young People in Residential Aged Care Program include:

• Net reduction in the number of younger people with disability under the age of 50 in residential aged care of between of between 425 and 689
• Between 402 and 446 people under the age of 65 to be provided with services to assist them in moving out of residential aged care to more age-appropriate supported accommodation (Senate Budget Estimates, 26 February 2009)

So the aim of this initiative is to move at least 402 people out of aged care and half way through the initiative 70 people have moved.  Clearly the last half of the initiative needs to focus on getting all the planned  new supported accommodation services built and running.

How much of the $244 million has been spent?

For the first year, 2006-07, funding was $4,190,136. That was the Commonwealth’s contribution and would have been matched by states and territories. For 2007-08, the amount was $14,179,231, and that also would have been matched. Then we are into the current financial year $28,287,400 (February 2009). So, in February 2009, $93,313,534 was spent including the contribution from both the state and federal governments (Senate Budget Estimates, 26 February 2009).

What evaluation is taking place?

FaHCSIA have contracted Urbis to conduct a mid-term evaluation.  Given that mid-term was December 2008, this report is overdue. 

Given that there appears to be limited independent research to evaluate this significant investment of public funds, I have initiated two studies to examine the outcomes of this initiative and inform policy and future expenditure. These studies are part of my PhD at Monash University.

Evaluation of National Young People in Residential Aged Care program: We are currently conducting an independent study to evaluate the progress of the current national Young People in Residential Aged Care program.  This study involves interviewing a range of stakeholders in each state about the progress of the initiative. This report will be available in September 2009.

Transition outcome research:This study obtains a baseline measure of health and well being for young people living in aged care and then examines the health and well-being of this group two years later when some have move to alternative accommodation and support options and others remain in aged care. Given the slow progress of people moving out of aged care this study will not be completed for another two years.

 

Build for Life

On 24 April, the Victorian Government announced its commitment to regulate for accessible housing. In the next few months the Government will 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.

These features will make these dwellings ‘visitable” by people with mobility impairments rather than ‘habitable’. While the Government hasn’t committed to the full universal design standard the Victorian Universal Housing Alliance has been advocating for, or to universal application of the standard, this is substantial progress towards universal design.

Build For Life

Victorian Universal Housing Alliance

Social Housing for People with a Disability

The social housing being develop as part of the national stimulus package provides a tremendous opportunity to dramatically increase the amount of housing for people with a disability. There will be little scope for accessible design in phase one of this social housing initiative, because it will focus on the completion of developments that already have planning approval.  However the federal government has a set a target stipulating that 20% of new dwellings built in phase two be accessible - Australian Standard for Adaptiable Housing AS4299-1995, Class C. Nation Building - Social Housing Initiative Guidelines

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, public transport, services and their community and therefore will facilitate community participation.  This is an important step towards the social inclusion of people with disabilities. This initiative will increase the number and range of housing options available for people with a disability.