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Keeping the humanity in human services: opinion

As the Final Report of the Royal Commission into Aged Care Quality and Safety, tabled in March this year, noted, “culture is the key determinant of an organisation’s performance and ability to meet its objectives.”1

After eighteen months of ‘survival mode’ it’s hard to overlook the human cost of ongoing urgent, unreasonable expectations on our frontline workers. 

The impacts of extreme burnout are taking their toll on personal wellbeing as voluntary staff turnover rates soar across healthcare and human services.

Our nurses, aged care and disability support workers bring their whole selves to work, not just a ‘work self’. In order to prevent disengagement, burnout and staff turnover, we need to actively address the emotional and practical wellbeing of frontline workers.

In times of extreme stress, workplace culture becomes the key determinant of success. A strong, positive culture turns an institution into a place where people feel supported and valued.

Humanity is now the single key ingredient for effective leadership across healthcare, aged care and disability.

Managing culture in a crisis

Over the last few years in the course of my culture work, I’ve spoken with hundreds of disability support workers [DSWs] about their experiences of workplace culture.

In disability, the customer (or NDIS participant) is not looking for a transaction. They are simply looking for a trusted relationship with someone who will deliver a quality, human service. The customer is entitled to dignity, support and respect – and so are their support workers.

It’s fair to say that the disability sector has been in turmoil for the last eight years as a result of the NDIS and then the pandemic. However, some CEOs have supported their employees far better than others.

So, what are the practical culture lessons from the disability sector?

  • A leadership of listening. Those CEOs who were prepared to be on the front foot of change and actively listen to their frontline workers and managers are the leaders that now have stronger, more connected teams. How did they do it? Picking up the phone and calling people just to see how they’re going; asking questions and listening for the answers; being seen physically on site at the point of service delivery.
  • Visible gratitude. Little things mean a lot when it comes to culture. People remember unexpected acts of gratitude. Simple things like handwritten thank you cards, a thank you phone call, bunches of flowers, or, in one case, a ‘thank you’ wellbeing hamper was sent to every employee with a card from the CEO. Find ways to make your employees feel proud that they work for you. Make it personal by sharing what their contribution means to you personally. People are hungry for recognition, particularly when they’re working in understaffed conditions day after day.
  • Embed your cultural foundations. Reconnect with the organisation’s vision, mission and bring your values to the front of the conversation with stories. The human brain loves stories. Shared storytelling drives engagement, builds belonging and transforms a group of people into the team. Those organisations that are thriving now are those who constantly share individual success stories and relate it back to “why we’re here”.
  • Structure all communications to reinforce trust. The CEO and the leadership team must be seen to trust each other. HR and marketing must work as one team to ensure clarity, consistency and frequency of messaging across the entire business. In the absence of meaning, people always make up their own version of the truth. So explain every ‘what’ with a ‘why’. How you use technology to communicate also matters. Don’t expect people to check five different platforms just to stay on top of their work.
  • Lived experience in governance. Too often, boards in this sector are weighted towards finance and legal experience rather than lived experience. Directors have a responsibility to have a first-hand understanding of how services are actually being delivered. Two Royal Commissions (in aged care and disability) have now made this point self-evident. In my experience, the healthiest cultures have highly engaged boards with diverse skillsets, strategic thinking capacity and deep lived experience.

The elephant in the room: Frontline poverty

Frontline quality in the delivery of human services is contingent upon a culture embedded in values – and we cannot address workplace culture without addressing working conditions.

In July 2020, a study of 357 disability support workers found that, “20 per cent of respondents could not pay a bill, their mortgage or rent or actually went without meals”.2

Across disability, aged care and nursing, people are undertrained, undervalued and under paid. As one RN recently described it, “We are the working poor. I work with women who are retiring with nothing and their super will be grossly inadequate.“

With all three sectors currently seriously understaffed and facing massive workforce shortages well into the future, will we be just recruiting more people into a lifetime of financial distress?

Economic drivers alone will never deliver high quality outcomes or even basic humanity. It’s time we applied the humanity we expect from our frontline workers to their working conditions.

Fran Connelley is a culture and communications specialist with over 20 years experience in the non-profit sector (www.cultureandcommunications.com.au).

[1] Final Report | Royal Commission into Aged Care Quality and Safety, p133

[2] Kavanagh A, Dimov S, Shields M, McAllister A, Dickinson H & Kavenagh M (2020). Disability support workers: the forgotten workforce in COVID-19, Research Report. Melbourne:The University of Melbourne

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