Impact case study database
Creating Positive Cultures in the Provision of Services for People with Learning Disabilities
1. Summary of the impact
Dr Schwabenland’s research identifies organisational cultural barriers impeding support workers from providing person-centred services for people with learning disabilities. The research has resulted in multiple impacts. Firstly, it has resulted in changes to practices and policies within the organisations participating in the research leading to demonstrable improvement in provision. Secondly, it has resulted in more enabling organisational cultures facilitated through changes in organisational practices. In addition to these, Schwabenland’s work has led to the formation of Gr8 (great) Support - an on-line network for workers; as well as enabling support workers’ views to be included into major policy consultations.
2. Underpinning research
Dr Christina Schwabenland has written extensively on topics relating to voluntary organisations. Having spent 25 years working in the sector, 11 of them heading an organisation providing services for people with learning disabilities, her research at the University of Bedfordshire explores the identification of barriers within organisational cultures; specifically those barriers that impede support workers from providing services that enable people to live the lives they aspire to.
The research project, Creating Positive Cultures, was established by Paradigm (a training and development agency for non-profit organisations providing services for people with learning disabilities in the UK). The project is supported by Schwabenland’s work at the University of Bedfordshire’s Centre for Leadership Innovation. The project was underpinned by two main theoretical orientations; firstly, the importance of action research for facilitating change (through the projects that participants chose to work on, and by the participants working together as a group during specially organised workshop days) (see 3.1 for background on the action learning approach). Secondly, the project aims were informed by the assumption that when organisational values are embedded in operational decision making an organisational culture evolves that can provide a structure able to support on-going, in the moment decision making. This culture is reflected in the kinds of practices that are, implicitly or explicitly, validated or challenged (see 3.2 for Schwabenland’s earlier work on cultures and values).
The research was carried out between November 2015 and February 2017. Nine organisations participated in the initial project, ranging in both size and location (The Aldingbourne Trust, The Brandon Trust, Wilf Ward Homes, Gettalife, Cartrefi Cymru, Cymryd Rhan, Lewisham Nexus Services, Real Life Options and Vibrance). The action research initiative consisted of five participatory workshops, individual tailored support, and two webinars. This was supported with individual interviews carried out by Schwabenland at the beginning and end of the initiative. Dr Schwabenland, Sally Warren (Director of Paradigm) and Owen Cooper co-authored a report of the main findings. The findings were presented at the launch of the report attended by research participants, national advocacy organisations and policy staff from the Care Quality Commission and supported with a small grant from the. University of Bedfordshire. Key findings were that:
Creating a positive culture means managing paradoxes;
Creating a positive culture means spending time on the things that really make a difference;
Creating a positive culture means ensuring that the values are integrated in everything we do, and to role model them throughout;
Creating a positive culture means valuing support workers and enabling them to do the best job they can;
Creating and maintaining a positive culture requires courage.
In response, Paradigm developed an on-line support group, Gr8 Support Movement. Sally Warren writes that ‘there are times when organisations limit the lives of those they support. The systems get in the way. This concern led us to develop the national Creating Positive Cultures Project to explore how organisations can best meet the needs of those they support. The first finding, that ‘creating a positive culture means managing paradoxes’ was also explored in depth in an academic article (3.4) specifically focussing on managers’ and support workers’ ability to manage multiple and competing accountabilities simultaneously.
The importance of meaningful relationships with those supported, with families and staff, where everyone feels valued was a recurring and powerful theme in the project. Finding four of the project report (see 3.3) ‘Creating a positive culture means valuing support workers and enabling them to do the best job they can’ inspired Sally to find a way of achieving this.
Dr Schwabenland has been involved in its development from the beginning, and two surveys to capture impact. The first, in autumn 2019 attracted 20 replies; respondents were asked about the impact of the Gr8 Support Movement on the way they think about their job, the way they do their job, and on their organisation.
In June 2020 Christina Schwabenland advised Paradigm on another survey on support workers experiences of Covid-19 which elicited 115 responses and is the first such survey in England. The report was launched in August 2020 (3.5). Many of the responses attest to the highly skilled nature of support work alongside frustration at the lack of recognition support workers received.
3. References to the research
Schwabenland, C. and Tomlinson, F.: “Shadows and light: Diversity management as phantasmagoria”, Human Relations, 2015, 68(12), 1913-1936
Schwabenland, C., “ Stories, visions and values in voluntary organisations”, London: Routledge, 2006:2016, (research monograph), Book Held by Institution.
Warren, S., Cooper, O. and Schwabenland, C.: “ Playing Your Part in Creating Positive Cultures”, 2017, London: Paradigm: formal report of the project presented at a launch event on 22/2/17. Publication partially funded by a BMRI small grant. Available at: https://paradigm-uk.org/2020/04/02/playing-your-part-in-creating-positive-cultures
Schwabenland, C. and Hirst, A.: ‘Hybrid Accountabilities and Managerial Agency in the Third Sector’, Public Administration, 2020, 98: 325-339 DOI: 10.1111/padm.12568
Warren, S. and Giles, J.: Don’t ever call us unskilled again! Report of the survey into support workers’ experiences of working through the Covid-19 pandemic, 2020, London: Paradigm: Available at: https://paradigm-uk.org/2020/08/05/dont-ever-call-us-unskilled-again/ Dr Schwabenland is credited as acting in an advisory capacity to this report
4. Details of the impact
Schwabenland’s research aimed to pilot ways of creating internal cultural change. It examined those policies and practices impeding support workers in taking risks that could result in new ways of supporting people with learning disabilities, and has led to multiple positive impacts for voluntary organisations. These include: (i) impact on organisational cultures, (ii) impacts on practice, and (iii) impact on organisational policy. The research examined those policies and practices impeding support workers in taking risks that could result in new ways of supporting people with learning disabilities. The methodology utilised a ‘bottom-up’ approach, with each organization choosing an area of internal practice they wanted to change.
Impact on organisational cultures
Through participating in the project several organisations identified internal policies that were not ‘fit for purpose’, creating new ones that embed their values more overtly. For example, the Aldingbourne Trust, a voluntary organisation supporting people with learning difficulties, has designed a new staff recruitment process that now ‘tests out’ commitment to the values of great support (these were distilled after many conversations with over 350 people with learning disabilities [5.4] and include adventurous, friendly, encouraging, supportive of my loving, connecting, advocating, respectful and resourceful) as well as candidates’ ideas of how they might take risks to implement them. This has reduced the time needed to complete the recruitment process, leading to more appropriate staff appointments and better staff retention (5.1). Lu Dash, the Head of Support write that ‘this process has brought fresh new minds into the Trust, that have not been blunted by years of “we do it this way in. social care”’. (5.1) Another organisation, Getta Life, has redesigned its staff induction process, embedding these values more overtly; leading to demonstrably improved performance. (5.2)
Impact on practice
Participants from the original nine organisations have made significant changes to practice, developed throughout the workshops. These include more user involvement in creating and testing internal policies (Cartrefi revised their Holidays policy), increasing user decision making in daily recordings (Wilf Ward Trust and Aldingbourne Trust), and using new technology to provide evidence of achievements that can be used in individual service planning (Wilf Ward Trust) (The participants discuss these achievements in a video: 5.3).
One of the key findings from the research was the importance of valuing and supporting staff. This has led directly to the establishment, by Paradigm, of the Gr8 Support Movement, in March 2018 (5.4a and b). The Gr8 Support Movement is an on-line network facilitated through Facebook. A small subscription allows access to the network; members can write and read comments, participate in webinars (on topics such as human rights, supporting people who are dying, supporting people in exercising greater sexual choice and independence). Paradigm’s director writes in her testimonial that ‘28 organisations have joined the movement from across the UK which means that over 10,000 Support Workers have access to The Gr8 Support Movement. Paul Richards, The CEO of Stay Up Late has said about The Gr8 Support Movement, ‘It's not just a “resource”. It’s a movement of positive change.’ (5.4a). All the initial subscribers have renewed their subscriptions in the succeeding years.
Paradigm has quantitative evidence of numbers of subscribers, discussion threads, views, as well as qualitative evidence. The evidence provides information about the kinds of practice interventions that support workers have made because of exchanging information and ideas. These include a cooking club that supports to cook more healthy and adventurous foods, and where supported people can ask questions about their medication; this is important because many people with learning disabilities are over-prescribed.
The university has worked with Paradigm to develop mechanisms to capture the impact of the Gr8 Support Movement, including an initial questionnaire and, in autumn 2019, a more in-depth survey. The findings suggest that the Gr8 Support Movement site has made a significant difference. One person wrote that ‘I changed the way I was doing my job completely. I understood what real person-centred support plan means what are the most important things to focus on’ (5.5). The findings demonstrate that being part of the network reduces feelings of isolation, with 75% saying they joined ‘to be part of a national movement promoting the role of support workers’. The findings also reveal that 75% also said they joined to ‘learn about better ways of working and to try them out’(5.5).
During the Covid-19 lockdown the Gr8 Support Movement published a story a day for 100 days on workers’ experiences of providing support, often remotely, dealing with fears and anxieties about death, loneliness and confusion (see 5.6). In order to consolidate this work Paradigm asked Schwabenland to work with then on ways of using the network to support workers coping with Covid-19 and its implications for service provision. This resulted in a survey of support workers experiences which elicited 118 replies and is the first such survey carried out in England. (5.6) In her testimonial (5.4) Warren writes that Christina’s guidance and support with developing the snapshot survey made the survey possible. Christina’s academic research skills enabled us to step back and think about what information we wanted to capture so that we could gather information on the impact on Support Workers working through a pandemic. Without her academic knowledge and skills we could have ended up with a lot of information that didn’t provide the evidence that was needed to tell the story’.
Informing Policy
As a result of Dr Schwabenland’s work, Paradigm’s consultations with national policy and regulatory bodies has informed supported care policy. These include the Care Quality Commission (CQC), the Adult Social Care Policy Team, Strategy, and Intelligence Directorate, for advice on the development of the CQC Policy Position on Supported Living, the Head of Inspection South Region (CQC) and the Association of Directors of Adult Social Services from the South West Region on transforming social care (5.4).
The Gr8 Support network provides a conduit through which support workers voices can be heard. For example, during the 2019 government consultation on revising the Code of Practice of the 2005 ‘Mental Health Capacity Act’, Gr8 Support workers’ views were collected and submitted as evidence. Several of their suggestions, including the need for greater independent advocacy and a streamlining of processes have been included in the final revised legislation (although implementation is currently postponed. (5.7)
Following the release of the report Don’t ever call us unskilled again Paradigm have provided evidence to the Hollins parliamentary enquiry into the needs of people with learning disabilities during the pandemic (5.8).
5. Sources to corroborate the impact
Sources to corroborate the impact
5.1 Letter from Aldingbourne Trust (one of the original participants) about how they have redesigned their recruitment processes to ensure they embed the organisation’s values, and the impact this has had on employing support workers, provided as PDF 5.1)
5.2 Letter from Gettalife on changing induction procedures, provided as PDF 5.2)
5.3 Immediate impact of action research project on participants’ internal policies and practices: Video made by Paradigm 12 months after project ended interviewing participants about the impact the project had had on their practice (4.1.1)
And a similar discussion:
5.4 a) Below is a link to the Gr8 Support Movement:
b) Letter from Director of Paradigm, provided as PDF 5.4b), about the impact of the project on decision to establish an on-line network, Gr8 Support Movement alongside web analytics for the Gr8 Support Network (currently 165 members) including numbers of views, postings, event organised through the Facebook site, information about members including two local authorities) reach and significance. Also link to YouTube clip where Sally Warren discusses the Gr* Support Movement with support workers: https://www.youtube.com/watch?v=hKeeA8trT5Q
5.5 Results of Survey Monkey questionnaire to 1) original participants 2) support workers subscribed to GR8 Support Movement and 3) managers of affiliated organisations on the impact the original project and the founding of the network has had, provided as PDF 5.5).
5.6 Analysis of survey on worker’s experiences of supporting people through Covid-19 lockdown. The report is available at
https://paradigm-uk.org/2020/08/05/dont-ever-call-us-unskilled-again/ (4.1.3)
The resource that promoted the need for a more extensive survey:
https://paradigm-uk.org/2020/06/10/lets-talk-about-when-someone-is-ill-or-dies-from-coronavirus/
And 100 Stories of Gr8 Support: March – July 2020, provided as PDF 5.6).
5.7 Reference to the revised Code of Practice to which the Gr8 Support. Network gave evidence
5.8 Reference to the call for support. To the Hollins enquiry into the needs of. support workers and people with learning disabilities during the Covid-19 pandemic.
Additional contextual information
Grant funding
Grant number | Value of grant |
---|---|
RES16115 | £1,600 |