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Reablement and Wellness for Regional Assessment Services in Australia –
A Technical Problem or an Adaptive Leadership Challenge?
Community Options Australia Regional Assessment Services Subcontractor Forum
Carrie Hayter,Managing Director
Carrie Hayter Consulting 29 July 2015,
Sydney, Australia
Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter
Consulting
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Outline • Why reablement and wellness?– Research– Research evidence and gaps
• Reablement and Wellness as a leadership challenge– Technical problem and an adaptive leadership
challenge (Heifetz & Linksy, 2002)• All stakeholders & actors
• Adaptive leadership Framework– Starting conversations with you as leaders
Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie
Hayter Consulting
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Problem or an Adaptive Leadership Challenge? © Carrie Hayter Consulting 3
Wellness Reablement Restorative
• Building on the strengths
• Outcomes for people – outcome or goal focused
• Right balance between ‘doing with’ rather than ‘doing for’
• Looks at appropriateness of services
• Identifies what a person can do and wants to do in the future
• Time – limited targeted interventions to regain function, confidence or capacity to resume activities
• Evidence-based interventions led by allied health workers that allow a person to make a functional gain or improvement after a setback, or in order to avoid a preventable injury.
Defining Wellness, Reablement and Restorative Approaches
Source: Australian Government Department of Social Services (2015) Living Well at Home: CHSP Good Practice Guide, pg 11-13
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Why reablement and wellness?• Research - UK, Australia and New Zealand
– Improved health and welling for older people (Lewin at al, 2013, Parsons et al, 2013, Parsons et al, 2014)
– Reduces people’s dependence on paid supports (King & Parsons, et al 2012, Lewin & Alfonso 2013, Lewin & De San Miguel, 2013)
– Role of assessment is critical (Department of Family and Community Services, Ageing, Disability and Home Care, 2012)
• Further research– People with dementia (Alzheimer’s Australia NSW, 2014)– Engaging carers and service users in their reablement and wellness
(Wilde & Glendenning, 2012)• Australian changes
– Outcomes and benefits
Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge?
© Carrie Hayter Consulting
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Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter Consulting
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Consulting
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Difference between Technical Problems and Adaptive leadership
Technical problems are well defined.
Their solutions are known and those with adequate expertise and organisational capacity can solve them.
(Heifetz & Linksy, 2002)
Adaptive leadership challenges are entirely different. The challenge is complex
and not so well defined; and the answers are not known in advance
Problems that require us to learn new ways (Heifetz & Linksy, 2002)
Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie
Hayter Consulting
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Technical Problems or Adaptive Leadership?
Technical Problems• Inappropriate referrals• Issues with the portal
– Algorithms in the portal and the outcomes it leads to
– Monitoring assessors workloads
Adaptive Leadership• Receiving enough referrals
to make our business model viable– How do we manage this?– How do we look for other
revenue streams? • Service providers
understanding of reablement – Want long term clients and
don’t understand reablement
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Seven ways to know if you have an adaptive leadership challenge
1. If the solution requires working in a different way than you do now…
2. If the problem AND the solution require learning…
3. If the solution requires shifting the authority and responsibility to the people who are affected….
4. If the solution requires some sacrifice of your past ways of working or living.. (eg losses)
5. If the solution requires experimenting before you’re sure of the answer…
6. If the solution will take a long time…
7. If the challenge connects or challenges people’s deeply held values….(Heifetz & Linksy, 2002, 2009)
Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership
Challenge? © Carrie Hayter Consulting
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Shifting Policy Landscape –Personalisation
Passive Clients
Participants or ‘consumers’
Block funding
Individualised funding or fee
for service
Monopoly Providers
‘Market of Care’
Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership
Challenge? © Carrie Hayter Consulting
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Shifting Paradigms in AustraliaOld
• Block funded • Dependency model • Services for life• Multiple Assessment Models • Multiple entry points for
older people and their allies • People navigated multiple
systems to get care outcomes
New• Fee for Service • Wellness, restorative Model• Short term focused • National Assessment
Framework • One entry point – My Aged
Care • Economic rationing of
supports
Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership
Challenge? © Carrie Hayter Consulting
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Get on the Balcony
Give the work Back
Think Politically
Orchestrate the conflict
Manage your
hungers
Anchor Yourself
What’s on the line
Hold Steady
Adaptive Leadership Elements
Source: Heifetz & Linsky (2002)Reablement and Wellness for Regional Assessment Services in
Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter Consulting
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Picture downloaded from: https://janeaustensworld.wordpress.com/category/regency-etiquette/page/2/
Getting on the Balcony
Picture downloaded from: https://www.youtube.com/watch?v=qSvyDLTdlyU
What is your team saying about their role?What is their story?
What is the ‘song beneath the words’?What is your inner voice saying about the changes?
Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive
Leadership Challenge? © Carrie Hayter Consulting
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Think Politically 1. Find Partners
2. Keep the Opposition Close
3. Accept Responsibility for your piece of the mess
4. Acknowledge their losses and accept casualties 5. Model the behaviour (Heifetz & Linksy, 2002)Picture downloaded from: www.twitter.com
What is your responsibility as a team leader?What is Community Options Australia’s responsibility?
What might be the losses or casualties?How does your organisation manage the financial and
reputation risks of this new model?Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter
Consulting
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Give the Work Back • Solutions are achieved when
“the people with the problem” go through a process together to become “the people with the solution”.
• Take the work off your shoulders….place it where it can be addressed by the relevant parties.
What are the main issues your team faces as a Regional Assessment Service Sub-Contractor?
Who do you need to engage in the solutions?Reablement and Wellness for Regional Assessment Services in
Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter Consulting
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Anchor Yourself• Don’t confuse one’s self
with one’s professional role• Identify a truly trustworthy
confidant who can really tell you what you NEED to hear
• Do not use allies as confidants
• Find a sanctuary for retreat, rejuvenation and personal reflection
Who are your confidants? How can they support you?
How do you look after yourself?Reablement and Wellness for Regional Assessment Services in Australia - A Technical Problem or an Adaptive Leadership Challenge? © Carrie Hayter
Consulting
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Summary
Regional Assessment Services• Technical problem and adaptive leadership
challenge• Time • Engaging people in solutions More Research • Who benefits?
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References and Resources Leadership • Heifetz, R., & Linksy, M., (2002) Leadership on the Line: Staying Alive through the
Dangers of Leading, Harvard Business Review Press, Boston Massachusetts
• Heifetz, R., Grashow, A., & Linksy, M., (2009) The Practice of Adaptive Leadership – Tools and Tactics for Changing your Organisation and the World, Harvard Business Review Press, Boston Massachusetts
• Goleman, D. (1998). Working with Emotional Intelligence London Bloomsbury.
• Covey, R., (1996) The 7 Habits of Highly Effective People, Simon and Shuster, New York– https://www.stephencovey.com/7habits/7habits.php
• Cambridge Leadership Associates– http://cambridge-leadership.com/
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References and Resources Reablement and Wellness
Alzheimer's Australia NSW. (2014) The Benefits of Physical Activity for People living with Dementia, Sydney , Alzheimer's Australia NSW downloaded from https://nsw.fightdementia.org.au/nsw/news/the-benefits-of-physical-activity-and-exercise-for-people-living-with-dementia
Australian Government Department of Social Services (2015) Living Well at Home: CHSP Good Practice Guide, pg 11-13, downloaded from https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reform/commonwealth-home-support-programme/living-well-at-home-chsp-good-practice-guide
Glendinning, C. (2012). Home care in England: markets in the context of under-funding. Health & Social Care in the Community, 20(3), 292-299. doi: 10.1111/j.1365-2524.2012.01059.x
King, A., M. Parsons, et al. (2012). "Assessing the impact of a restorative home care service in New Zealand: A cluster randomised controlled trial." Health and Social Care in the Community 20(4): 365-374.
Lewin, G., & Vandermeulen, S. (2010). A non-randomised controlled trial of the Home Independence Program (HIP): an Australian restorative programme for older home-care clients. Health & Social Care in the Community, 18(1), 91-99. doi: 10.1111/j.1365-2524.2009.00878.x
Lewin, G. F., H. S. Alfonso, et al. (2013). "Evidence for the long term cost effectiveness of home care reablement programs." Clinical interventions in Aging 8: 1273-1281. Lewin, G., K. De San Miguel, et al. (2013). "A randomised controlled trial of the Home Independence Program, an Australian restorative home-care programme for older adults." Health & Social Care in the Community 21(1): 69-78.
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Reablement and Wellness (Cont)
Parsons, J. G. M., N. Sheridan, et al. (2013). "A Randomized Controlled Trial to Determine the Effect of a Model of Restorative Home Care on Physical Function and Social Support Among Older People." Archives of Physical Medicine and Rehabilitation 94(6): 1015-1022. Ryburn, B., Wells, Y., & Foreman, P., (2009) Enabling Independence: Restorative Approaches to Home Care Provision for Frail Older Adults, Health and Social Care in the Community, Volume 17 (3), pp 225- 234, see pg 22
Senior, H. E. J., M. Parsons, et al. (2014). "Promoting independence in frail older people: A randomised controlled trial of a restorative care service in New Zealand." Age and Ageing 43(3): 418-424.
Wilde, A., & Glendinning, C. (2012). ‘If they’re helping me then how can I be independent?’ The perceptions and experience of users of home-care re-ablement services. Health & Social Care in the Community, no-no. doi: 10.1111/j.1365-2524.2012.01072.x
References and Resources
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More Information Carrie Hayter
Email: [email protected]@carriehayter
Slideshare: Carrie Hayterwww.carriehayter.com
Linked in http://au.linkedin.com/pub/carrie-hayter/34/536/517/