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Innovative Workforce Fund Final Implementation and Refection Report

National DisabilityServices

NationalDisabilityServices

INNOVATIVE WORKFORCE FUND Final Implementation and Reflection Report

2

Date when last updated: 6/9/18

Version number: 6

Organisation

Synapse

Project Name

Prototyping a novel, culturally safe workforce design to build Aboriginal and/or Torres Strait Islander participant, workforce, and community capacity under the NDIS

Contact name and position of person responsible for evaluation

Kellie Sentinella Manager Information and Capability Synapse [email protected]

Adam Schickerling National Director Strategy and Engagement Synapse [email protected]

Contact details

(07) 31377400


3 INNOVATIVE WORKFORCE FUND

Final Implementation and Reflection Report

Project Outcome Success Result outcomes indicator criteria

2.1 Service user satisfaction and empowerment

Understanding of Design of support Evidence base what culturally safe worker roles that supports the novel and appropriate meet the anecdotal workforce design workforce roles and needs of consumers implemented support means to First Peoples with complex disability (i.e., needs of consumers).

Increased self-direction (i.e., individual capability, confdence, responsibility for self, and control over decisions about supports) within a cultural context.

* Number and diversity of decisions made by consumer

* Anecdotal reports of consumers

* Increase in number and diversity of decisions made by consumer over reporting period

* Anecdotal reports of consumers in relation to self-direction

*High scores on the Resident Choice Scale (Hatton et al., 2004)

*Anecdotal reports from tenants highlighted:

• Tenants’ decisions to pursue study at TAFE, exercise more, and/or obtain employment.

• Tenants’ need for support to achieve their goals. For example, assistance with completing paperwork, liaising with the right people/organisations to progress their goals, and assistance with transport to access community.

Understanding of how the new workforce design impacts on consumer satisfaction, empowerment, and social and emotional wellbeing.

* Anecdotal reports of consumers

* Anecdotal reports of consumers in relation to satisfaction, empowerment, and social and emotional wellbeing

* High scores on the Resident Choice Scale (Hatton et al., 2004

*Anecdotal reports from tenants included the need for:

• Choice over who would be their support workers, and fexibility in staffng arrangements to match changing tenant choices.

• Opportunity for male support workers to support male tenants and female support workers to support female tenants, as determined by tenants (i.e., respect for Men’s and Women’s Business. However, this arrangement may be preferred by tenants at all times or in particular circumstances).

• A cultural connection with their support workers. For example, the support worker may be culturally connected to the tenant by way of family or community, or the support worker may connect with the tenant by yarning with the tenant about their culture (e.g., family, community).

• All support workers culturally competent (e.g., appropriately trained if non-Indigenous).

*Finalised role descriptions for Manager, Cultural Mentor, and Support Worker roles (See Appendix 1)

*Anecdotal reports from tenants revealed that tenant-driven support became a natural (rather than service specifed) process when tenants and staff had a strong connection with one another. That is, tenants reported feeling more confdent and empowered to drive their own supports once trust was developed with their support worker, and this trust was refective of a cultural connection with their support worker. This in turn resulted in greater social and emotional wellbeing.




Project Outcome Success Result outcomes indicator criteria

2.2 Worker skills and engagement

Test the redesign of support worker roles and introduction of a cultural mentor to better enable consumer self-direction within a cultural context

High engagement of First Peoples in workforce design and support implementation.

* Service model fnalised

* Workforce recruitment and onboarding

* Implementation of novel workforce design

Number of Aboriginal and/or Torres Strait Islander Peoples involved in the workforce design and service delivery

* Practice guidelines and procedures fnalised

* 10 new workers commence

Majority stakeholders involved in the workforce design and service delivery identify as Aboriginal and/or Torres Strait Islander

*Total number of Aboriginal and/or Torres Strait Islander Peoples involved in the workforce design and service delivery =# people (including tenants, staff, management, and executives) (See Appendix 6)

Understanding * Worker retention * Anecdotal reports of how the new workforce design

* Anecdotal reports of workforce

of workforce in relation to

impacts on worker engagement and engagement and social and emotional social and emotional wellbeing wellbeing. *High scores on

the measure of Job Satisfaction Questionnaire (Chou, Boldy, & Lee, 2002)

2.3 Organisational sustainability

Workforce roles drawn Number of local Majority of workforce from Community, workers involved in from the local thereby leveraging service delivery community and strengthening social capital

*Finalised service model (e.g., how the Mentor and Staff roles interact by way of service delivery) (See Appendix 2)

*Workforce recruitment and onboarding processes fnalised (See Appendix 4)

*Practice guidelines and procedures fnalised (See Appendix 3)

*# new workers commenced since implementation (See Appendix 6)

* % staff retained since commencement (See Appendix 6)

*Anecdotal reports from staff revealed:

• The intent of the novel workforce model appealed to them, and they were committed to supporting the tenants to increase self-direction (i.e., individual capability, confdence, responsibility for self, and control over decisions about supports) within a cultural context.

• All staff acknowledged the benefts of an Aboriginal and Torres Strait Islander workforce to support Aboriginal and Torres Strait Islander tenants.

• Staff reported an increase in their social and emotional wellbeing when they refected on improvements that the tenants had made, despite experiencing challenging days at work.

*# (%) local workers employed (See Appendix 6)

*# (%) staff recruited through informal networks (See Appendix 6)

Novel workforce Ongoing viability * Model can be HR data (See Appendix 6) model can be sustained post funding period

sustained over the reporting period

* Business systems

Evidence that the model can be sustained over time (See Appendix 6)

are in place to support ongoing delivery




Project Outcomes Summary © Gee, Dudgeon,

Shultz, Hart and Kelly 20132.1 Service User Satisfaction and Empowerment

Service user satisfaction and engagement is the driving force in understanding the preferences of people with a disability in an increasingly self-directed, portable and contestable market. In the context of this cohort, essential to understanding satisfaction is imbedding of practices and approaches that acknowledge the specifc cultural understanding of wellbeing, often similar but expressed in a less individualistic manner that the contemporary funding and service models more broadly available. This at times presents confict in understanding or application of reforms such as the NDIS where quality of life outcome domains overlook specifc indicators of social and emotional wellbeing and risk engagement of Indigenous communities.

The 2004 Social and Emotional Wellbeing (SEWB) framework sets out 9 guiding principles which shape the SEWB concept and describe a number of core Aboriginal and Torres Strait Islander cultural values. Key domains of well-being have been derived from the guiding principles, some of which may have synergies with the 8 Quality of Life (QOL) domains defned in the QOL literature (Schalock & Verdugo 2013) others do not.

Namely, literature defnes Quality of Life in such a way as to overlook the importance of connection to country and connection to spirituality and ancestors as depicted below. These elements are fundamental to overall social and emotional wellbeing and not considered independent of SEWB domains.

Hist

orica

l dete

rminates Political determ

inates

Social determinates

Connection to culture

Connection to country

Connection to spirit,

spirituality &ancestors

Connection to community

Connection to family &

kinship

Connection to mind & emotions

Connection to body

SELF

Nine guiding principles that underpin SEWB 1. Health as holistic

2. the right to self-determination

3. The need for cultural understanding

4. The impact of history in trauma & loss

5. Recognition of human rights

6. The impact of racism and stigma

7. Recognition of the centrality of kinship

8. Recognition of cultural diversity

9. Recognition of Aboriginal strengths

Created by SHRG,1 adapted from Swan and Raphael

SEWB QOL - Schalock NDIS Outcome Domains & Verdugo 2013 - Thomas et al 2009

Connection to spirituality and ancestors

Connection to country

Connection to culture Physical well being Health

Connection to body Physical well being Health

Connection to community Social inclusion Home; Neighbourhood; Community

Connection to family and kinship Interpersonal relationships Love; Friends; Children; Relatives;

Connection to mind and emotions Emotional well being

Material well-being Money , work

Personal development Goals & Values; Learning; Creativity;

Self determination

Rights

Self esteem

Play

Helping




In strengthening understanding of the construct of social and emotional wellbeing, tensions sometimes arise that cause confict between understandings of individual choices vs generalisable cultural frameworks. The project has enabled signifcant learnings in exploring these tensions which extend to both perceptions of service users as well as the teams that provide culturally informed support. Satisfaction is heavily impacted by one’s connection to culture and community and as such it has been very important to recognise the barriers presented by the diversity of cultural protocols and preferences of individual tenants (e.g. differing cultural practices, language groups etc). This means that Indigeneity alone (of staff members) is not suffcient to meet such personal preferences or understanding, however providing opportunity for connection and yarning as part of the relationship with staff (without being purely transactional or service focussed) is a core determinant of satisfaction and improved safety and cultural expression. Conversely, often service users may be already connected with staff members by way of culture, family group or community and as such the context of support relationships may differ from a traditional or mainstream service user/staff relationship where concepts of professional boundaries may be more clearly defned and articulated. In fact, these tensions are the strength of an effective and culturally informed model of support.

The Synapse Innovative Workforce Design recognises that there must be support structures in place to ensure that each of the nine guiding principles of SEWB are addressed within a culturally safe methodology. The introduction of the mentoring role for the tenants and staff has been a natural and culturally informed way of ensuring there is the opportunity for discussion and for each of the tenants/ staff to have a voice and an opportunity through the relationship with the mentor, to discuss the elements of social and emotional wellbeing and how their support time can be used to address these needs.

It was originally proposed that Synapse use a combination of the following methods as an indicator of tenant SEWB:

1

2

3

Resident Choice Scale (Hatton et al., 2004)

Quantitative data regarding the number and diversity of decisions made by consumers over the reporting period

Qualitative data collected through the anecdotal reports of consumers in relation to self- direction

Case example

Upon transition to the service, Tenant B had limited connection to local community having relocated from a remote community. Due to established relationships between staff, tenants and respective families, Tenant B established relationship with a staff member’s Brother of a similar age. The Brother of the staff member started spending time with Tenant B to provide some male companionship and now routinely visits to spend time with Tenant B at home and away from home, as friends. In some traditional workplace settings, this relationship may be discouraged or considered inappropriate given the relationship with paid staff however, this is a central means by which to connect people with their communities in relationships that are meaningful, safe and equal

Case example

Tenants residing at this location frequently have limited immediate connections given relocation from communities far away. Central to strengthening community and cultural connection is the relationships that form with staff members and their families. A key element of this relationship is connection to families and friends. Frequently, gatherings and meals are shared during the evenings. More often than not, majority of paid staff visit for these gatherings, not linked to paid time or work roles but as friends and family. Central to these gatherings are often the young and adult children of staff who have established close and respected relationships with Tenants or friends of staff and tenants. It is not uncommon for unplanned gatherings of 20+ people to occur. As some tenants are of the older age group, they perceive their role is to look after and watch the kids as an important contribution to their own community and relationships. Presence of children of staff and similar would frequently be discouraged in the workplace however, this is central to forming and sustaining strong relationships and satisfaction of both tenants and staff. There have been a number of ‘friends’ that have established relationships through gatherings and through visiting tenants in their own time who have later gone on to seek employment with Synapse




Issues identifed with the Data Collection Methods Outlined below are some of the issues experienced in the implementation of the selected data collection methods. The key learning from the trialling of these methods was – if tenants are unfamiliar with and or lack capacity to make choices, then service user satisfaction and engagement cannot be measured - through tenant self-identifcation of choices made or by collating the frequency of Tenant choice and decision making. The levels of disadvantage and associated trauma previously experienced by the tenants of Warner St was signifcant and has impacted on the scope of choices which have been available to them, historically. This is something which signifcantly impacts on whether accurate data can be collected at such an early point in the tenant transition to the Synapse Cairns environment.

THE RESIDENT CHOICE SCALE

The Resident Choice Scale is a tool designed to assess service practices for promoting resident choice. It was identifed as the most suitable tool available to Synapse for the purpose of providing an indicator of tenant social and emotional wellbeing during the design and planning phase of the model (prior to implementation). Whilst theoretically this measure appeared to be a valid tool which would be capable of capturing tenant feedback regarding choice and consequently social and emotional wellbeing, several issues with the practical use of this tool were identifed in the implementation phase:

The concept of choice is often, for those who are marginalized and fnancially disadvantaged, a foreign concept and one which is impossible to articulate unless the concept of individual choice is understood in the same context. In a cultural context, choices are made in a collective context which prioritises the needs of family, cultural obligations and connection, often beyond individual needs, limiting the tenants exposure to a diversity of choices. The tenant cohort in this case (prior to their move to Synapse Cairns) have experienced very few opportunities to exercise choices over many aspects of their lives. For some tenant’s meaningful choice has not been recognised throughout their lives or post injury due to extreme levels of poverty and more basic human needs such as housing, safety, food etc remaining the predominant focus. The tenants have all relocated from restricted or institutionalised environments (aged care, hospital settings, homelessness, secure dementia units or situations of domestic violence) where the environment had enforced compliance to accept the circumstances dictated by the environment around them. Even in instances where choices may have been available, individuals had limited recognition of these from which to compare their personal understanding of choice. This meant that what might seem a simple matter of identifying where a choice was made would be very diffcult if not impossible as the concept is something which is not familiar or comfortable for them, given the previous living situations and backgrounds.

All current tenants have Guardianship orders in place which removes the opportunity to make choices regarding housing, fnances, who they form relationships with, healthcare and medical interventions. Not only does this reinforce the lack of opportunity to makes choices it also meant that the Tenants were unable to provide formal consent to undertake the

Resident Choice Scale. Each of the Adult Guardians were approached for permission for the Tenants to participate in research via the Resident’s Choice Scale however permission for this data to be disseminated publicly was not provided in any case.

The tenant cohort consists of people who have sustained brain injuries, who have complex needs, many of which have dual diagnosis with concurrent complex mental health issues and or post-traumatic stress disorder making a formal assessment process utilising the Resident Choice Scale inappropriate given the historical context and individual backgrounds.

The mentoring sessions were identifed as a culturally safe method of initiating a yarn to address the SEWB domains without the somewhat intrusive approach of the Resident Choice Scale and without the added complication of Guardianship permissions.

The Mentoring format was altered to be inclusive of the nine guiding principles that underpin SEWB to ensure that each of these were addressed. The mentoring sessions provided a safe space where confdence and trust were established and questions could be asked through a culturally safe methodology with a trusted person.

Refection following transition enabled Synapse to identify the challenge in tenants recognising and articulating their needs within a ‘service’ context which impacted decision making and choice opportunities. Synapse recognized the need for a different way for the tenants to articulate their support needs through experiences and activities that were familiar and in response developed an image based resource (external to this project) – the “Yarn Up Cards” to provide a visual prompt in the form of images of Aboriginal and or Torres Strait Islander people engaging with supports in a cultural context to assist in the mentoring and support planning processes. This resource provides a way of being able to frame the mentoring conversation around the identifcation of supports within a cultural context. It is recognised that the capacity to identify and make choices is something which could become familiar over time with continued supported opportunities for self- determination however it is anticipated that this would be a long-term process of several years and not something which could be expected within the frst year of transition to Synapse Cairns.




Quantitative data regarding the number and diversity of decisions made by consumers over the reporting period

This method of data collection was also reviewed over the course of the project and adjustments were made to the data collection methods, incorporating this into a culturally safe methodology by including a prompt for each of the items in the mentoring session format. The issues around tenant choice and decision making outlined as in the summary of the Resident Choice Scale were also present and were found to impact upon the tenants being able to articulate a choice and make a decision. The number and diversity of decisions may be an accurate way of measuring social and emotional wellbeing in a mainstream population where there is a sense of entitlement and confdence around asking for services and a history of individual service user’s having the opportunity to express their needs and in response to this to have their needs satisfed or positively reinforced. For the tenants involved in this project - decision making and choice has not been a part of their lives in a cultural context which favours collectivist decision making or in an imposed, institutional context. Individual decision making may not have been encouraged and may, at times have been met with negativity or indifference.

Success of Quantitative methods of measuring service user satisfaction through the mentoring program

A successful method of measuring service user satisfaction was through the mentoring sessions as this provided a culturally safe environment and a trusted person with which to conduct the evaluation at three points in time:

Evaluation 1: December 2017

Evaluation 2: April 2018

Evaluation 3: August 2018

The service user satisfaction evaluation questions and the results are outlined on the following page.




SERVICE USER EVALUATION QUESTION 1:

The service user feels comfortable in expressing cultural needs with the mentor

December 2017

Always or almost always

Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70%

April 2018


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70% 80%

August 2018


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%




SERVICE USER EVALUATION QUESTION 2:

The service user feels connected to the things that are most important to them including culture, country and family

December 2017


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60%

April 2018


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70% 80%

August 2018


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%




Success of Qualitative methods of gathering information

Observation and recording of anecdotal information and decision making were an effective way of capturing some signifcant and defning moments where tenants have started to initiate making choices and demonstrate initiative to make things happen. These methods are very effective at capturing information in a culturally safe way through observation and yarning during the mentoring sessions rather than through direct, closed questioning.

2.2 Worker Skills and Engagement The engagement of the Cairns staff team has been consistently strong and an integral part of the workforce model. The engagement framework of the Innovative Workforce Model is one which is based on principles of participatory leadership and one which is relational – the relationships between the staff and the tenants is what drives the model and creates a sense of responsibility within the team both to each other, to the tenants and the organisation as a whole. The Cairns team over the duration of the project maintained a strong sense of commitment and engagement. This was apparent through the sense of community and the willingness of the staff to share their own personal stories and sense of family connectedness with the tenants and other staff. Cultural events and community days have been an important part of the Cairns model.

The staff and tenants have lead these events, inviting family and friends to celebrate and sharing this with the organisation has created a strong connection between each other and have shared the experience with Synapse as a whole. The staff, by involving family members recreated a sense of community which is something that many of the Cairns service users have not had the opportunity to experience since leaving their families from their communities prior to sustaining a brain injury. The staff were connected to the work they’re doing, they believe it is important, they are engaged and connected with the tenants facilitating better outcomes for the service users.

Case example

Tenant C moved to the service from a remote community. Tenant C was at risk in community without necessary supports or opportunity. Tenant C’s family were very supportive about his opportunity to have his own home but reluctant for him to move as his income was relied upon by family. Tenant C was not involved in fnancial matters due to family members managing his fnances and never having a bank account. As a result, Tenant C had very little money as his income was relied up by the family to make ends meet while living in relative disadvantaged circumstances. After moving to the service, Tenant C has for the frst time had access to money and had ability to purchase items for himself that he had not previously had the opportunity to purchase. This level of choice and decision making was very foreign. Although choice has improved, Tenant C is frequently approached by family and friends that are aware of his access to money and signifcant support is needed to help Tenant C not give his money to others that are in need of it. A strong workforce with understanding of these issues is very important in order to understand the family and cultural obligations that can compromise decision making at times and how this can be managed.




Issues identifed with the Data Collection Methods

Measuring worker satisfaction and engagement was initially intended to be completed via the staff completing the Job Satisfaction Questionnaire (Chou, Boldy & Lee, 2002) at regular intervals. There were many elements of this model that required review and innovation in the methods used to ensure that the methodology was chosen to ft with the needs of the cohort – not for the cohort to adapt to the requirements of an assessment tool.

Measuring the level of worker satisfaction and engagement was one of the methodologies reviewed during the implementation phase after the change in the initial Synapse Management and the appointment of a non-Aboriginal and or Torres Strait Islander Manager. Whilst in the overall operation of the program continued without any noticeable changes, as time went on there appeared to be a reluctance to engage in a formal Job Satisfaction Questionnaire. This may be in part due to history in previous work situations where job satisfaction feedback had been met with retribution and or no response. Given the challenges which are present in sustaining Aboriginal and Torres Strait Islander staff in the workforce it is reasonable to assume that many staff may have had negative experiences and were not comfortable in this methodology at such an early stage in the employment relationship. This became obvious as the project progressed and following the early departure of the Manager who had been an Aboriginal and Torres Strait Islander person who, in many cases had attracted the staff to the job in the frst instance. During the regular staff workshops this was discussed and the staff were invited to suggest their preferred way of measuring job satisfaction. The overwhelming feedback was that the staff would like this to become a part of the mentoring sessions – with a trusted person that is familiar to them. This feedback was imbedded into the mentoring session framework and discussions around job satisfaction then became a part of these sessions. The evaluation questions and the results from the staff responses were collated for three points in time:

Evaluation 1: December 2017 at the commencement of the Mentoring program

Evaluation 2: April 2018 after the commencement of service delivery and the realities and challenges of the role were realised

Evaluation 3: August 2018 following NAIDOC week, Reconciliation Action Week and several Tenant and staff hosted cultural functions at the site




STAFF SATISFACTION EVALUATION QUESTION 1:

How supported staff feel in their role

December 2017


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

April 2018


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70%

August 2018


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%




STAFF SATISFACTION EVALUATION QUESTION 2:

How confdent staff are in their skills to perform the role

December 2017


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70%

April 2018


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60%

August 2018


Often

Sometimes

Never

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%




Successful engagement of the workforce has been gauged through: • Observed staff involvement in sharing their own culture at Cairns

cultural and community events

• Qualitative information from the staff gathered through regularyarning

• Social events initiated by the staff team, many of these which havefallen outside of work hours e.g. Friday afternoon barbeques withstaff, families and tenants at the Cairns site

• Natural relationships have been formed between communitymembers and tenants whereby the tenants have developed naturalrelationships with community members and Support Worker’s familymembers and these have become a part of the tenant’s paid andunpaid support network

• High rate of Aboriginal and or Torres Strait Islander representationand retention in the workforce, see diagram below.

Aboriginal and or Torres Strait Islander representation 21% in the Synapse Cairns workforce

Aboriginal and Torres 79% Strait Islander

Non Aboriginal and or Torres Strait Islander

79%

7%

14%

0%

Support Workers’ length of service

0 - 3 Months

4 - 6 Months

7 - 9 Months

10 - 12 Months

Case example

At commencement, signifcant planning was undertaken to prepare for adverse situations that may arise from time to time. One such example was the potential of family members and friends coming to visit intoxicated or the potential that tenants may be approached by family members to provide money, food etc. In discussions with team members at recruitment, scenarios were discussed around how staff may manage this situation if it arose. A number of younger female staff identifed that they would be unable to ask the family member to leave as it would not be appropriate given their younger age to be providing direction to an elder. Staff identifed that it would not be appropriate to contact police however they would contact an elder in community that could come to help them. This example provides some context as to the pressures that have potential to impact staff capacity to fulfl what may ordinarily be considered standard operating practices. This highlighted the need to consider carefully different types of support for staff not previously considered for such instances. This also further impacted on considerations about the types of work hours some staff might work to best support their own safety and access to support.




2.3 Organisational Sustainability This model is designed to respond to the particular needs of a specifc cohort. The recruitment and learning and development practices were directly informed by the feedback received. This process allows for the development of practices that capture the natural way of doing things, in a way that makes sense and feels comfortable and safe for the particular cohort. The overall objective is to build on what works well and if something is not working, seek feedback and change it so that it does. This way of working creates effciency and sustainability within the organisation – the organisational resources utilised for recruitment are the resources which will attain the desired outcome, they are used effciently, not wasted in trialling practices that don’t work for the specifc cohort or designing methods which are not culturally safe and comfortable for the people involved. This model of practice will always result in culturally safe methods of practice regardless of which cultural cohort the model is designed to respond to. This is because each element of the design from the recruitment and ongoing learning and development is informed by feedback from the specifc cohort, leading to the development of practices which are culturally safe and responsive and sustainable organisationally.

Case example

Tenant A is of an older age group. As such Tenant A is considered to be an elder to younger staff. At times, many younger staff found diffculty in best supporting Tenant A as they were uncomfortable providing direction to an elder. This had some implications given the behaviour support needs of tenant A are signifcant. Additionally, it is often acceptable for an elder to provide direction to others and it may be considered disrespectful for such direction not to be followed. This at times may create a confict between promoting choice, decision making and independence rather than ‘doing for’.




3.1 Refecting on implementation a. Engaging stakeholders: What were the most useful strategies you used to engage and communicate about

the project? How/why were they successful? What would you do differently?

It was clear in the initial stages of implementation of this model that the effectiveness of the model would hinge on the depth of engagement of the staff and tenants. Regardless of how strong the theoretical concept underpinning the Innovative Workforce Model – if the staff and tenants did not have a deep understanding and belief in the intent of the model and were not engaged with the overall program then it would not have necessary contributions to be an effective or iterative learning process.

Participatory leadership strategies were used as the principle engagement method and practice throughout all elements of the Innovative Workforce Fund project design and implementation. The key focus of this approach is on building relationships, trust and connection that ensures all voices contribute to emergence of solutions and ideas of the collective, through each stage of workforce development throughout the employee lifecycle, from the initial point of contact with candidates through to advertising, recruitment, induction and ongoing learning and development of the team.

The engagement strategy for the workforce model is characterised by:

• A clearly articulated vision and purpose – every team member must know what the organisation stands for and represents. This was communicated through discussion from the outset during the initial engagement at information sessions. The vision and purpose formed the foundation in guiding the communication with the team and all stakeholders.

• Development of each team member as a leader– the manager is accountable for ensuring that team input drives decisions and learnings as opposed to implementing decisions in a top down approach. This has been particularly important and focused due to the incumbent of the management position being a non-Indigenous person.

• Strong connection and relationships among team members - the organisation demonstrates and shows that it places equal value on relationships not infuenced by role. In a cultural context, this acknowledges the inherent knowledge and connection that infuences tenant and staff perception and understanding of good outcomes.

• The team connects with each other in a way that acknowledges, respects and utilises knowledge, community connection, cultural understanding and difference.

• Conversational, inclusive and participatory processes which draw on the contribution of the team through story catching/telling being the foundation of collective decision making

• Team members are the right ft for the organisation – they share the same passion which drives a desire to be connected to new ways of understanding and responding to disparity in outcomes for vulnerable communities, self-motivation, persistence, consistency, resilience and action

Examples of the participatory engagement strategies used to communicate with the team during different stages of the workforce design process were:

Participatory approach to Communication

Information Sessions were implemented as part of the recruitment process and as an alternative to the traditional recruitment process. As with traditional recruitment practices the position would typically be advertised online or via a local newspaper and candidates would then apply for employment without the opportunity for any direct communication or engagement with the employer. In order to recruit candidates who understood the service model, whose values and motivations aligned with Synapse, who would be motivated and have a good understanding of the outcomes of the service Synapse recognised that the recruitment process would need to be adapted, tweaking traditional recruitment practices to achieve a different outcome. Applicants were invited to come along to an information session and a barbeque on site to learn about the service, to meet the tenants and to talk to the staff team and gain an understanding uniqueness and innovation of the service delivery model.




During the information session, a conversational format was used to communicate and generate discussion about the overall vision of the Cairns support model in the frst instance. The Synapse team spoke about the 9+ years history of the project and need within community, shared stories about the most defning moments and some of the success stories from a human rights perspective for some of Australia’s most marginalised people with a disability. Equally, the information session was targeted at conveying the need for a strong team that could help craft the next stage of the project journey and collectively lead the way forward. Importantly, candidates were engaged in discussion about the potential barriers and risks the organisation may face and a strong foundation formed for expectations of leadership, reciprocity and ownership. This process was an important way of screening those who were genuinely drawn to the opportunity to make a difference, be fexible in their thinking, open with knowledge and willing to contribute to developing knowledge of others. These were fundamental requirements to support the continued evolution of the project in an authentic and meaningful way. The excitement and emotional investment in the vision, shifted the focus from the typical approach in many workplace selection processes, which is often a focus on the technical skills and competencies and aspects of recruitment eg pay rates, shift allocations etc which are often the main topic of discussion at a recruitment information session. The focus on addressing disparity for Aboriginal and/or Torres Strait Islander people with disability through a preference for community leadership and cultural knowledge was central to connecting with candidates that both understood and has commitment to establishing and evidencing a new approach to service provision and job design. Job Application forms were available for completion at the information sessions and assistance from the Synapse team was also made available for candidates to complete the applications. Information sessions created effciency in the screening process ahead of selecting suitable candidates for the next stage of the recruitment process – group interviews.

Group Interviews were conducted as an alternative to the traditional one on one interview process. The group interviews were based on a yarning format with group discussions based around specifc examples and scenarios, which were gleaned from actual experiences a Synapse staff member may experience during the course of their work. The scenarios were an important method of facilitating communication among some of the quieter, less confdent candidates. This style of interview provided the opportunity to screen the candidates for the specifc values, skills, awareness and knowledge which are important in performing the role in a culturally specifc context and was a culturally appropriate alternative to the traditional selection criteria approach. Additionally, this approach enabled facilitation of conversation about cultural impacts and barriers that the team may themselves encounter and how they might approach managing these within a non-indigenous organisation. These conversations were invaluable in uncovering various risks and potential issues that had not been obvious prior.

The Learning and Development framework focused on open and consistent communication between the Manager, Support Workers and Tenants and a refective work environment where staff are comfortable and feel safe to express concerns, fears, ask questions and identify areas for professional improvement. The varied approach to attract suitable workforce with the required values and fexibility in thinking increased the likelihood that some candidates may require focussed development around some role specifc technical skills. The Learning and Development approach has therefore been iterative to ensure it is responsive to the needs identifed by the staff and that the content was tenant centred. During each team workshop, the staff were encouraged to openly identify areas of concern and development opportunities to improve practice. Many of these were tenant specifc refecting a clear focus on individuality to a tenant’s cultural preferences and circumstances.

Tenant feedback was also used as a source of information to guide the improvement of the learning and development framework and identify opportunities for workforce development. These continue to be identifed through ongoing thematic analysis of the information provided during the Tenant mentoring sessions.

The standard mandatory training items required for legislative compliance were still undertaken but delivered in a modifed way - in a face to face group discussion context and based around practical application of the subject matter. One of the consistent themes of feedback from the workforce was the need to revisit training content to ensure multiple opportunities to reinforce the information delivered through refection on current experiences as opposed to large amounts of information and development in preparation for commencement.




The Mentoring Program within this model was of critical importance in the retention and sustainability of the team. Whilst it was preferable for Aboriginal and Torres Strait Islander tenants to be given the option of being supported by an Aboriginal and Torres Strait Islander staff member it is recognised that it is not always possible. This is where the importance of the mentoring function is realised. Where there are limited options for Aboriginal and or Torres Strait Islander candidates in the workforce, the mentoring function provides a safeguarding mechanism to ensure that there is the opportunity for staff and service users to refect on the service user’s engagement with culture and how support time could structure in order to create opportunities for connection with family, culture and country.

Open conversation among all team members in a safe environment during monthly mentoring workshops was an important way of identifying the level of understanding and application of the program among the staff. The SUPPORT WORKERs were able to articulate what they wanted from the mentoring program personally and professionally, recognised the need and purpose of the mentoring program and what needed to be done to build trust in the mentoring process, making best use of the mentoring resource available and maintaining connectedness to the broader outcomes of Cairns and Synapse. The staff were asked to inform the way the mentoring program was formally rolled out – when, where and frequency of the mentoring sessions. Through the mentoring program the support team and the Manager had the opportunity to engage support from the Mentor, and work through any personal events and circumstances which have the potential to affect the way support was provided to tenants and the staff successfully sustaining employment.

As the mentoring component was introduced after initial commencement, its design and implementation was informed entirely by learnings to date. These learnings included team refections on the ‘best and hardest’ experiences of each team member since their commencement. This provided both a collective understanding of the complexities of the roles, cultural and tenant context as well as creating a shared story of the way forward and how best to focus the mentoring resource for greatest impact.

b. How appropriate was your initial concept? What/did you change or adapt along the way and why?

The initial concept in the structure of the Workforce Design with separation between the Support Worker and Mentor roles, remained in place throughout the project duration. In the initial design of the workforce model, Synapse sought to recruit culturally specifc leadership from an Aboriginal and or Torres Strait Islander candidate to the position of Manager. It was initially anticipated that the Manager would be the key link to embed a cultural perspective in the service model. During the interview process Synapse staff sought to recruit someone who could articulate the impact and importance of cultural connection and understanding as a key component of social and emotional wellbeing. Due to a change in leadership, a non-indigenous leader was appointed in order to secure the technical and industry specifc knowledge required to support and coach a team with diverse experiences that were less focussed on industry practice and content knowledge. From this change in leadership, it became clear that the cultural leadership came from within the team from a grass roots level through the Support Workers and the Manager having complementary but not overlapping skills – the Manager with the technical, disability specifc skills and the Support Workers with the community knowledge and practical experience. The skills needed for the operational management role were centred around specifc technical, practice and operational knowledge in supporting people with neurocognitive disorder, coupled with a culturally informed perspective on service provision.




3.2 Refecting on impacts and outcomes

What are the top two or three things you have learned from doing this project?

There were many key learnings from this project the most signifcant were:

• The importance of processes which support the harvesting of feedback from the team to continually inform the service delivery processes and the ongoing development of the capability matrix (to sit alongside the Position Descriptions). The development of the workforce model was an iterative process which remained (and remains) responsive to the needs of the tenant and the oversight of the Advisory Committee. Provision of culturally informed support is essential to improved outcomes for tenants. However culturally informed support is only possible where organisational practice and values adequately preference recognition of Aboriginal and/or Torres Strait Islander strengths as evidenced in workforce practices.

• The importance of recruiting staff whose values align with the vision of the model, who are motivated to achieve the outcomes of Cairns – having the right person in the right seat results in stronger alignment and commitment to the overall vision.

• Cultural knowledge must be valued as central, safeguarded and preference as a core competency. This value needs to be embedded in aspects of workforce design, recruitment, onboarding and ongoing support to ensure leadership opportunities based upon strengths and not hindered by technical defcits that can be strengthened. A large proportion of available/potential workforce in an Indigenous context are often engaged from alternative sectors or in many cases may be individuals without employment, or for whom this may be their frst employment, see below. Recognising cultural knowledge as central also requires understanding of the often complex social circumstances and complexities that often work to frustrate employment success. As such, understanding of performance measures requires fexibility to ensure performance assessment is equally considerate of skills and competencies that align with the context.

50% 20%

30%

Support Workers’ previous experience

Had worked in Disability Sector

Had worked in aged care / mental health

/ youth justice / homelessness

Had no prior experience




Have there been any outcomes that have surprised you?

• A staff change during the early stages of the project resulted in the appointment of a non-Aboriginal or Torres Strait Islander candidate to the position of Manager – initially this had no observable effect on the engagement and SEWB of the support team and no observable impact on the Tenants. Synapse observed that a non-indigenous manager also had positive impact on the openness and willingness to communicate, learn and share. A non-indigenous leader enabled the staff team to assume leadership of cultural competency and mentor irrespective or role or perceived hierarchy. During this time, the Mentor worked closely with the Manager and the Support Team in order to ensure there was time for refection regarding any concerns regarding the new Manager and that the needs of the staff and tenants in terms of opportunities for cultural connection were articulated and discussed during the group mentoring workshops.

Were there outcomes that you expected to see, but didn’t?

• Another outcome which was surprising and not anticipated in the conceptual development phase of the model was the involvement and the importance of the presence of families and community members. The development of natural, unpaid supports through the involvement of Cairns community members is something that was not orchestrated but came out of an organic process, initiated by the staff and created an environment which is supported and focused on the wellbeing of the staff and tenants. A sense of community reinforces the feeling of safety, family provides psychological and emotional support and a way of connecting people with natural support networks. Creating a psychologically and culturally safe environment for the support team and the tenants allows for the emergence of the natural and organic sense of community and the natural cultural protocols which exist within communities to surface and operate in this environment.

In terms of outcome that were expected but not seen, there were not. However, there were surprises in the extent to which the appointment of a non-Aboriginal and Torres Strait Islander did not detract from the cultural leadership and capability of the team, but perhaps enhanced it. It was expected that there would be an adjustment period after the non-Indigenous Manager was appointed. However, the team adjusted and took total leadership in arranging cultural events (eg NAIDOC and Reconciliation events) that otherwise would likely have been led, arranged and coordinated by

the Manager (if Indigenous). The absence of this Indigenous Manager provided the opportunity for the team and tenants to lead these events, some attracting 60+ community attendees and demonstrating leadership in their approach to their role in supporting the tenants and each other. Some challenges were initially experienced with some staff of an older generation, but the leadership of the younger team members proved invaluable to bridging the fears and disconnect that may have resulted from Non-Indigenous management.




90

How did you measure success? How well did this capture project outcomes? Is there other information that would have provided a better understanding of outcomes?

The success of this project was gauged through a variety of methods, qualitative and quantitative.

a. Qualitative measures:

• Anecdotal evidence captured through yarning with staff team

• Anecdotal evidence captured through yarning with the tenants

b. Quantitative measures:

Human Resource Data:

• The number of applicants who applied for Support Worker positions and attended the information sessions – there was an overwhelming response to the information session and the number of enquiries received. Interestingly, the information sessions also attracted a number of community members attending to hear about the service and the work of the organisation in Indigenous community, including some attendees that did not have any interest in seeking employment. This was a positive indicator of the interest and support in community that supports increased referrals for potential employees.

• A reduction in the need to advertise for applicants – Synapse has had need to advertise only once for the support worker role, all staff have been recruited through word of mouth and connections with existing staff members or known presence in community. This is not the experience of most Non-Indigenous employers in the Cairns Region, see below:

Number of staff appointed from unsolicited applications versus applications in response to an advertisement

85%

Nu

mb

er r

ecei

ved

80

70

60

50

40

30

20

10

0

No. received

No. appointed

29%

5% 9%

Unsolicited Response to Advert

Source of applications received




• A reduction in the need for restrictive practices - some of the tenants transitioned to Cairns from locked mental health, aged or disability facilities. Historically behaviour was “managed” through very restrictive practices. Synapse is not a locked environment and for many of the tenants who has previously been subject to restrictive practices, a change in the way of working has meant that people are not locked inside or outside their homes. The staff and environment has created a situation whereby restrictive practices as a response to behaviour would be completely out of context.

The tools for quantitative analysis in measuring the project outcomes in the Evaluation and Learning Plan were originally identifed in the design phase of this model prior to implementation. The Resident Choice Scale (Hatton et al., 2004) and the Measure of Job Satisfaction Questionnaire (Chou, Boldy & Lee, 2001). The aim of using these tools as measures was to maintain standardised way of quantitatively gauging the level of self-direction of the tenants and job satisfaction among the staff. However, in practice the use of these scales proved to be a blocker to the fow of conversation, created a formality in the discussions with staff and tenants that many found intimidating. Synapse refected on this and sought feedback from the staff instead choosing to instead leverage from a more organic method of measurement, relying on the observation and evaluation of what was already occurring naturally. Upon refection, a specifcally developed, internally validated tool used to capture the level of self-direction and determination of the tenants and the level of job satisfaction and connection to the organisation among staff would be particularly useful moving forward. The Advisory Committee function would play a signifcant role in the development and implementation of such a tool and this is something Synapse will consider moving forward.

Synapse plans to develop an evaluation tool, informed by the Synapse Cairns Advisory Committee to ensure that a future tool is available, effective and able to be delivered in a culturally safe framework.

Case example

Tenant A transitioned from a locked mental health facility (mainstream) in Townsville after a period living in hospital due to unavailability of housing. Tenant A was disconnected from country and community having lived in a remote community approx. 20-hour drive from Townsville. Tenant A had little if any control over decisions or environment and no access to cultural connection. Following transition to Cairns, Tenant A spent considerable time very upset, saying she wanted only to go home to country. Given the service does not have locked doors, Tenant A frequently left the site in a very emotional state refusing to return, requiring signifcant staff resources to monitor whereabouts and ensure safety 24/7. Tenant A had been prescribed signifcant amounts of medications to stabilise moods that resulted in very little expressive language, engagement with others or physical activity. Over initial weeks, Tenant A reconnected with family members travelling through or residing in Cairns as a key regional hub of Far North Queensland. Family and friends were found through staff connections to family, chance meetings in community and recognising familiar faces that Tenant A otherwise had not spoken of. Tenant A now has many connections in her local community and has not left the site beyond instances in the initial month. No doors have ever been locked and Tenant A requires signifcant less monitoring or supervision. Tenant A was also able to reconnect through her home community through shared relationships with staff online. These connections are enabled only through relationships in community, between tenants and staff.




3.3 Refecting on legacy: how sustainable are the innovations demonstrated?

a. Are you planning to continue with any of the practices or initiatives you tested during the project? Which practices and what will it require to continue with this approach?

Synapse will continue the current practices which have infuenced the success of this project including:

• The mentoring program in the context of Synapse’ Brisbane Community Living Program. Synapse will develop a mentoring program adapted to suit the needs of the staff and tenants. The Cairns model is fuid enough that it enables innovation and adaptability and provides the support within the framework to enable this to happen. The Cairns model was designed according to cultural specifcation in the way it was rolled out. The Synapse Brisbane Community Living Program will be different as it should in any context. The model provides the framework which guides the development of a place-based model responsive to the specifc needs of the cohort. Adapting the mentoring program to suit the cultural context and the needs of the tenant and staff cohort ensures portability of the model in any context.

• The participatory approach to implementation of the model is one which Synapse has seen value and will extend this approach as an engagement practice for the entire organisation for the purposes of future recruitment, learning and development and change management.

b. Please explain how the changes you undertook can be sustained within the NDIS pricing framework?

In order to respond to the need for a culturally informed workforce under the NDIS particularly in rural and remote communities and across different cultural contexts there must be a workforce model which delivers service user satisfaction and can be sustained organisationally through the employment of local people, while also acknowledging the skill shortages that may exist.

Although the comparative rate of unemployment is high among the Aboriginal and Torres Strait Islander population compared to the mainstream population, the cohort represent a small proportion of the total population. NDIS pricing does not make it viable in many circumstances for the workforce to travel in and out of remote locations. It must be recognised that in order to create a sustainable and effective culturally competent workforce in rural and remote communities additional organisational resources are required to implement and drive this model. The model will however, address many of the challenges which traditionally create barriers in organisational capacity to provide culturally safe services and will build a sustainable local resource for rural and remote communities. The model was successful in:

• attracting culturally competent local staff

• retaining local staff

• providing learning and development which responds to the specifc needs of local workforce in a rural/remote setting

• providing a safeguarding mechanism through the mentor function, to ensure that there is opportunity for cultural refection and embedding of opportunities for cultural connection for the staff in performing their work role and for the tenants in getting what they need to ensure their SEWB from support

Through the identifcation and separation of the traditional Support Worker functions and allocating a culturally safe resource to this (the Mentor), there is greater capacity to sustain a culturally safe workforce and it is anticipated that the mentoring function will over time, reduce the number of support hours required by the participant as it improves the SEWB outcomes, builds the capacity and self-determination of the tenant, decreasing the reliance on support hours.




The mentoring function potentially needs to be recognised (from a participant perspective) as core to capacity building and the only means by which culturally informed support to coordinate and connect with service. Both mentoring and support co-ordination aim to build the capacity of the participant/service user in order to increase self- determination. Support Co-ordination as a line item under the NDIS is defned in the price guide as the provision of assistance to strengthen a participant’s abilities to coordinate and implement supports and participate more fully in the community. NDIS funding for Support Co-ordination covers the functions of the mentor under this framework. These needs in a cultural context must be recognised during the NDIS planning process as necessary and ongoing capacity building activities from a participant perspective to ensure culturally relevant access to services and supports.

In an accommodation context however, there must be additional attention paid to the associated costs of provision of such mentoring and the additional costs of strengthening technical skills in order to establish workforce supply. The cost of mentoring provision to staff is essential to wellbeing and staff retention however requires a specifc skill set over and above the support provided in a traditional workforce. This is a very important element for any non-indigenous organisation to attract, maintain and value the wellbeing of employees as well as uphold commitment to cultural safety. Given Indigenous workforce shortages, high prevalence of disability and the often smaller size and fnancial viability of Aboriginal and or Torres Strait Islander controlled organisations, it is often likely that Aboriginal and or Torres Strait Islander controlled organisations may not have capacity to deliver services into regional and remote areas. This increases the risk of non-indigenous organisations providing services that are not resourced to be truly culturally safe or informed. This workforce model provides one example that may provide application in various contexts that further safeguards cultural safety.

c. Is the approach you trialled suitable to be replicated or adapted by other disability service providers? If yes, what types of service providers would be most likely to beneft and what would they need to do?

There is a need for a fexible and replicable workforce model which could be sustained in an NDIS environment. It is predicted that this need will become particularly apparent as the NDIS roll out continues in rural and remote locations – the need for choice and control for service users in being able to select culturally safe and informed support services will become more apparent as the number of NDIS participants increases but the Aboriginal and Torres Strait Islander run/ culturally competent services and consequently workforce in rural and remote communities remains extremely limited.

This model, is one which has the capacity to be rolled out by any disability service provider within any cultural context. The cultural capability of the workforce model is enabled by the Mentoring function which provides the cultural lens and a way of connecting people with culture and ensuring that Service Users and localised staff have the opportunity for increased self-determination.

The model would be best replicated by service providers who are:

• positioned in rural and remote communities where it is • where there are community members with community not fnancially viable to bring staff from other areas knowledge and skills but no experience in the workforce

and/or the disability sector• where there is a need to build cultural competency

within the local workforce • Where there are issues of sustainability of a culturally informed workforce

As reported, the proportion of the Cairns workforce who did not have experience working in the disability sector was 50% of the total workforce. Despite this, Synapse has been able to sustain and increase the workforce numbers. The Cairns service has increased its capacity for service provision. The number of tenants has steadily increased over the last 12 months. This indicates that the capacity of the model to build individual capability and learn new skills is strong and continually developing.

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