What are the characteristics of a genuinely ’competent’ Support/Care Provider?

A support organisation that I have known, respected and collaborated with over many years has been having problems. True to form, it’s leader has acknowledged the difficulties – which are intrinsically systemic – fronted up, and sought help.

We’ve been clear for years, reinforced by the evidence demonstrated by John Seddon and the Vanguard movement, that, especially in human services organisations, systemic dysfunctions are rarely corrected by apparently rational, ‘high level’, debate. Good and bright leaders engage apparently rationally when they are, in fact, bedevilled by beliefs, assumptions and enthusiasms that are pretty unshakable unless challenged by experiential evidence.

Intervention theory teaches us that profound change cannot be understood and implemented on a rational basis (discussion, classroom-based learning, etc.), but must be undertaken normatively (in the work, seeing issues personally).

The research behind this is very clear (see, The Planning of Change (1985), Warren G. Bennis, Kenneth D. Benne, Robert Chin).  It is extremely difficult, if not impossible, to change people’s assumptions through persuasion. 

The research sets out three methods to undertake a change in thinking:

  • ‐ Rational – reports, research, data, presentations, websites, meetings, conversations, etc.;
  • ‐ Coercive – do it or else / do it and you get a reward;
  • ‐ Normative – people experience something live and tangible that enables them to challenge their own assumptions.

The research conclusions are:

  1. Rational approaches rarely change peoples’ views.  Even well researched and proven statistics are dismissed as not valid if they challenge an individual’s assumptions;
  2. Coercive approaches do change behaviour, but only in the short term while attention is being paid, and do not change thinking;
  3. Normative study leads to a sustainable change in thinking and is, therefore, far more likely to lead to a change in behaviour.

Undertaking an independent inquiry ought always to be a normative experience – for us, it always is. So; spending time around the services with staff, families and the people served, and then in discussions with organisation’s leaders; we fairly quickly derived a global understanding of an institutional ‘disease’ that seems endemic in human services:

Losing sight of our purposes and principles as organisations grow and fall victim to managerialism and commercialism.

Not for the first time, we discerned that – in common with so many, initially mission and passion-led, charities and private initiatives – the organisation we were studying had lost its focus as it had grown. The marketization and commodification of ‘social care’ over the last three decades – now exposed but denied as a failed and expensive ideological flight of fancy – has dragooned associations born of common cause into the ‘business’ world. The challenge is to survive in that inappropriate and unsympathetic environment without compromising or completely losing – as so many have – the organisation’s raison d’etre and associational culture.

Then structures and systems evolve which, in this case, gives rise to dysfunctional and often warring leadership. So often we witness an unresolved tension between those who are committed to restoring an organisation’s founding roots in collaborative and person-centred relationship focused practice and those who are convinced of and plausible in their promotion of the process-driven managerialism that we have observed time and again as antithetical to effective care. Let’s make no bones about it, concepts like standardisation and scale are toxic to human services organisations. (for contemporary research, see John Seddon et al, Beyond Command and Control, Chapter 5, People-Centred Services).

The genuinely ‘competent’ care and support provider:

  • ‐ Is ‘obsessed’ about delivering better and better lives for and with the people they support
  • ‐ And is, concurrently, clear about their purpose(s) and non-negotiable principles
  • ‐ Is clear that skilled and reflective relationships are their ‘stock in trade’
  • ‐ Understands that co-produced and evolving support plans actively underpin and are fundamental to their practice;
  • ‐ Focuses on the establishment and nurturing of stable and stimulated intelligent support teams as their baseline operational KPI
  • ‐ Knows that great teams need skilled, resourceful, competent and self-reliant Team Leaders
  • ‐ Understands and invests in local, relationship-based Teams
  • ‐ And hence invests in recruiting and retaining inspiring, supporting and trusting/empowering Team Leaders to build and sustain creative and committed teams in partnership with kith and kin to continually work to deliver better lives for the people supported
  • ‐ And delegates authority and budgetary responsibility to these fulcrum leaders
  • ‐ And builds and sustains a fit, lean, and agile organisational superstructure which is servant to these objectives and infinitely resourceful and creative. I find servant leadership to be a helpful concept, alongside Peters and Waterman’s longstanding injunction to ‘stick to the knitting’.

It seems to be the case that, if we are getting it right for the people we support, we are likely to be getting the business things right too.

If we accept that relationships are at the crux of the care that most of us would want for ourselves; and we understand that robust and productive relationships are born of the relative chaos of human interactions; then it seems reasonable to infer that this cannot be organised and sustained by a small number of big fish in an ocean. No; effective relationship-based work, takes place in ponds and pools, curated by subtly competent leader fish!

While there will always be exceptions to any rule. I would assert that, as a general rule, ‘big’ human services businesses will only deliver and sustain their founding purposes and principles if they organise as a plethora of semi-autonomous ‘small’ businesses as they grow.

Bob Rhodes