Wellbeing Teams, a start-up home care service, has described how a radical new approach to working with care staff to improve wellbeing resulted in an ‘Outstanding’ CQC rating.
The service, based in Greater Manchester and Oxfordshire, was founded in 2016 by Helen Sanderson, former CEO of health consultancy HAS.
It works on self-management principles, meaning small, local teams of wellbeing workers perform many of the tasks relating to staff support, reviews and quality assurance checks normally performed by the registered manager.
Wellbeing Teams has adopted Human Learning Systems (HLS) – an approach to social intervention which understands that every person’s life is unique and complex, and so public services must also offer a bespoke response to each and every person.
All of this began when Sanderson started learning about person-centred practices, like HLS, and self-management, and identified the need to bring this into the community and home care sector. She realised that “good care should start with empowered care workers”.
“Inspired by LaLoux’s book ‘Reinventing Organisations’ we started by moving to self-management. This meant that I gave up the position of CEO and all employees were trained to manage themselves,” said Sanderson.
The CEO also took inspiration form Buurtzorg, a healthcare organisation whose nurse-led model of holistic care has revolutionised community care in the Netherlands.
Buurtzorg, which translates as ‘neighbourhood care’, frees nurses from management control and unleashes their entrepreneurial creativity.
“I wondered if we could do something like that in the UK in social care,” explained Sanderson. “I wanted to get ‘skin in the game’ and demonstrate self-management with a relational and community focus to support.”
Since its launch, Wellbeing Teams has worked to incorporate HLS principles into how it works with staff members in a number of ways:
Underpinning Wellbeing Teams’ operating model is a commitment to paying salaries that are above the living wage and enabling colleagues to work in seven-hour shifts. This is a change from the home care norm where some commissioners buy blocks of time in 15–30-minute increments, leading to working patterns that are unsustainable and working hours that often exceed what people are paid for.
Values-based recruitment was a big part of making the process more ‘human’. Wellbeing Teams believes that anyone can be trained to deliver good home care, as long as they have the values that allow for it. The system is not only about what staff can give to others, but how they can grow and develop themselves, enjoying their work, whilst also being paid fairly for it. As a result of its work in this space, Wellbeing Teams won a Guardian Public Services Award in 2018.
Wellbeing Teams seek to be ‘human’ to one another – both to the people they support and colleagues. In 2020, the turnover rate for domiciliary care services was 35%, according to Skills for Care. At Wellbeing Teams, it is less than 5%. Crucially, moving towards an HLS approach didn’t just improve staff wellbeing – essential to a good standard of care – but also meant that staff could tailor support, reflect on what each person needed and feedback to others.
Wellbeing Teams’ tips on how to put HLS into practice:
- Make it bespoke: Talk about what matters to people and what a good week looks like, and see what you can do to move towards that.
- Make every colleague matter: Wellbeing Teams share profiles of colleagues with the people they support so that they know what matters to each individual in their team.
- Build relationships: When colleagues meet people for the first time they bring a gift to show they care and start building a relationship.
- Continuously learn: Wellbeing Teams ask, each month, what is working and not working and think together about how they can change what is not working.
- Person-first approach: Wellbeing Workers are expected to find ways to ‘make people’s day’, and this is shared and celebrated with colleagues. Their mantra is “every shower should be a spa experience, and every application of cream can be a soothing massage”.
How workers within the care system can be more human to one another:
- Weekly meetings: Wellbeing Workers use highly structured meetings, based on Holacracy tactical meeting practices. Each week, they review their performance, set priorities, and raise and resolve tensions. This includes a monthly review and root-cause analysis of any incidents or complaints.
- Shared roles: Try sharing roles traditionally done by a manager amongst the team.
- Buddies: Each Wellbeing Worker has a linked colleague providing peer-to-peer support.
- Coaching: The Wellbeing Leader provides coaching support to the team.
This example of HLS is featured in the new e-book, Human Learning Systems: Public Service for the Real World.