If you want your staff to truly practice a person-centred approach, your philosophy needs to extend beyond direct care, writes Andrea Petriwskyj.
All aged care service providers recognise the importance of person-centred care. It is one of the foundations of all practice expectations. Certainly, there are gaps in practice, but work continues to support improvement at the point of care because it is seen as so fundamental.
Given that, we find it concerning that many organisations still struggle with the concept of centreing their business – not only direct care – around the people at its heart.
We have previously shared in Australian Ageing Agenda how important it is to develop person-centred organisational focus in strategy, policies, processes and philosophy (AAA magazine Nov-Dec 2022). But how does this approach help to support person-centred direct care?
Person-centredness not just for the direct care workforce
One of the things we have continually heard over the years is that staff and people using care services often feel that person-centred care is constrained by their organisations and the system.
While many rules and processes are in place for everyone’s wellbeing and safety, it remains that some are in the provider organisation’s interests, to the detriment of the client, and staff, experience.
Some common examples we hear about are:
- unclear, or very proscriptive, guidelines that hamper flexibility and responsiveness to individual needs and requests
- rostering strategies that prioritise efficiency over individual needs and realities – for both those providing and receiving care – and client loads that are geared to units of service rather than quality of relationships
- quality management processes focused on compliance at the expense of ideas and improvement
- decision-making, direction-setting and creation of processes that purport to value expertise but ignore lived experience.
To support person-centredness at the point of care, the person must be at the centre of the ecosystem that impacts that care.
Care providers control many factors at play in that system. Some of these factors may appear to be tangential to or removed from the client experience – for example, systems or processes for client management, finance, staff management and authority, or staff communication or collaboration.
But these all have impacts down the line – on staff time, morale, and confidence, on client trust or frustration, and on the ability to meet real-time, dynamic, and evolving client needs.
While usually these decisions and processes do not exclude staff and client perspectives deliberately, their perspectives simply are given no role. Business efficiency, risk management, and financial performance are the main, or sometimes the only, drivers.
The issue is that this approach separates – both philosophically and practically – the outcomes for the business from the experience of the business.
However, these should not be seen as separate. The staff and client experiences have a significant role in business success and sustainability as both a provider and an employer.
It is therefore not enough to train direct care staff in a person-centred approach, or even for your organisation to support a person-centred care philosophy. Having, and putting into practice, a person-centred mindset is an issue for every part of the organisation.
How well do you understand the perspectives of your staff and clients?
The concept of client and staff experience is nothing new, and all organisations should have ways of exploring these. But do your measures of experience, service quality and satisfaction include those things that are real priorities for your stakeholders? Do you know what these priorities are?
We often hear from people using care services that while they may have good relationships with the staff delivering their care, they experience negative impacts of organisational processes, sometimes to the point where they consider leaving that provider, or consider ceasing care services altogether.
It is important to look at the breadth of issues you are considering to be part of the client experience and ensure these reflect the lived reality. The same applies to understanding the experiences of staff.
The second issue is what you do with this knowledge. What mechanisms are there for staff and clients – or other stakeholders – to inform and influence your organisation on the things that matter to them? How wide and deep is the reach of that influence? In other words, where, across your whole business, are their voices heard and what impact do they have?
It is worth taking a deeper look at what areas of your organisation are, and are not, responsive to the real experiences and needs of the people at its centre. Some of the issues with care may not be solved with a focus just on direct care itself; however, we often find that the person-centred, open and responsive philosophy extends only to direct care operations.
Share with us
We are continuing to have conversations with people using care services, providers and care staff about what is needed to support truly person-centred care practice among the home care workforce. We would love to hear your views.
Join the conversation about the future of the person-centred home care workforce on our Engagement Hub. We are also running free webinars for providers – including one on this very topic – and releasing a podcast series for the personal care workforce, so visit the COTA Queensland website for updates and links.
Andrea Petriwskyj works on the Home Care Workforce Support Program at COTA Queensland. She works with stakeholders to support the development of a sustainable, skilled, and person-centred home care workforce. COTA Queensland works with consortium partners Skills Hubs and Skills Generation on this Australian Government-funded program.