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Madeleine Blight Post Graduate Certificate in Management Coventry University

M61 May 2007

1

Madeleine Blight

Managing Change or Running a

Marathon

M61

February 2007


M61 May 2007

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Acknowledgements

My grateful thanks goes to Carol, Mike and Len

Tutors, to all of cohort three for support

throughout the course and especially Kathy as

my Mentor.


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Contents

Executive Summary 4

Introduction 6

Objectives 7

Methodology 8

Change Theory 11

Group Dynamics 13

Force Field Analysis 14

Change and the Individual 15

Resistance to change 17

CSCI Overview 20

Performance Manager Audit overview 22

Conclusion 23

Recommendations 25

Action plan 25

Appendix 1 North Cornwall Homecare Structure 29

Appendix 2 Key Standards of CSCI 30

Appendix 3 CSCI Analysis 31

Appendix 4 Reflective Journal 33


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Executive summary

This assignment looks at the legislation that has driven the change to how we

deliver care to service users and the impact of the Commission for Social

Care Inspection on all teams.

The reports identified a clear need for improvements to bring our rating to

“Good”.

It has identified areas of poor performance and the changes that have been

implemented to meet the minimum care standards.

It has looked at the impact that these changes have had on the way the

service is delivered, the workload of the home care staff and the Senior’s.

The reports from the Commission for Social Care inspection (CSCI) for

Bodmin and Launceston, showed that we did slightly better in Bodmin.

Having compared the standards inspected to identify where improvements

could be made and to find why they differed even though they are all part

one team.

Comparing the CSCI reports from all the other districts in Cornwall, The

shortfalls were found to be in the same sets of standards i.e.; recording and

lack of documentation to evidence our work.

The Commissioning Care Plans (CCP's) were not covering the five headings or

giving enough person centred information.


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I found that not all my seniors are not recording and evidencing in the same

way, which, causes some confusion when the inspectors are looking for

evidence to show how we meet a standard.

I found that not all care plans contained the correct paperwork for

recording assistance with medication.

Some teams are larger giving some of the senior’s a much bigger work load,

for example one has ten members of staff in her team and one has

seventeen. Service users per team vary from twenty-two to fifty. You could

argue that the teams should be similar in size, the fact is North Cornwall is

the largest team and covers an area of 465 square miles, we are the only

district that has two inspections and the teams work in rural areas and this

makes it difficult to restructure because of the distance that staff would

have to travel to work. We also cover holiday resort areas where it is

difficult to recruit staff.

For this assignment I have explored change theory and related some of the

findings to my team and the In house homecare teams across Cornwall. I

have looked at Individual change, Group dynamics and Resistance to change.

Identifying, “Resistance” as the strongest barrier in my team.

The conclusion drawn from this assignment clearly shows that there are

training needs across the whole of the County and the way forward is for

communication across departments to create a greater understanding of job

roles and responsibilities throughout the department of Adult Social care.

My aim is to work closely with Care Management and my Seniors to minimise

paperwork used but to improve the quality by recording and evidencing well

to raise the standard of the next CSCI report.


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Introduction

The Department of Adult Social Care (DASC) has an in house Domiciliary

care service The home care teams have a Senior Home Carer and varying

numbers of home care staff to deliver personal care. The Seniors are

divided into teams across the county and headed by District Homecare

Managers (DHCM) who are registered with The Commission for Social Care

Inspection (CSCI).

When I started the Post Graduate Certificate in management I was working,

as Deputy District Home Care Manager. At this time, I was unable to

implement any change of working practice. I am now in the position of

Temporary District Home Care Manager for North Cornwall and my role has

significantly changed. I am responsible for meeting the National Minimum

Standards as Registered Manager and, if the standards are not met, my

registration could be taken away.

I lead a team of 6 full-time Senior’s and two part-time (job share) covering

North Cornwall. (Ref Appendix 1) Each Senior has a team of carers from 10

to 18 in number.

I need to ensure that my teams are meeting the Key Standards (Ref

Appendix 2) of the Commission for Social Care Inspection, therefore I am

using this project to investigate why we are failing to meet all the required


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standards and looking at ways to improve our rating to meet the National

Minimum Standards, implementing the changes necessary.

The Commission for Social Care Inspection (CSCI) have only been inspecting

domiciliary care services since April 2004

When an inspection is carried out, the inspectors only look at a sample area

and not every standard at every inspection.

I had only been in post for two weeks when we had the last inspection and

there was a lot to take on board. The report gave me gave me a picture of

areas where improvements are required.

Where the standards were not met I needed to draw up an action plan and

work alongside the Senior’s to implement the plan.

I also needed to look at the standards not inspected last time to ensure they

meet the standards. If they do not, I will need to draw up an action plan to

meet these as well.

As part of M61 I will be;

• Examining the areas identified where work needs to be done to raise

the standards to a “three score” (there are four different levels of

the minimum standards. 0 = Does not meet the standard. 1 = Major

short falls. 2 = Minor shortfalls. 3 = standard met and 4 = standard

exceeded). (Ref Appendix 3)

• Identifying how recent changes affect the workforce and quality of

Service.

• Exploring change theory to help me identify a strategy for change

management.


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Objectives

Following the inspection process there is an identified need to change the

way that we record the delivery of care. The objectives of this assignment

are to;

• Look at how rapid enforced change has affected the group dynamics

of the care teams at ground level.

• The reaction of staff in relation to necessary change on an individual

level.

• How the seniors manage the care team, and how the care is delivered,

are there any improvements?

• What effect has the change had on internal relationships between

Homecare and Care Management?

I will be using the CSCI reports from the two teams in North Cornwall

(May to October 2006) to identify areas of poor performance in order to

address short-falls. The previous reports have shown that the shortfalls in

my own area are common to the rest of Cornwall. By using the reports from

my own area I will be able to draw up an action plan to implement the

changes necessary to raise the standard, and address any issues around

resistance from the Senior’s and individual team members.

The issue of change management therefore is an essential one for many


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levels, which include the priority of service, the means to contribute to

moving forward and creating an action plan.

Methodology

I found that the areas where change is required to meet The Commission for

Social care Inspection (CSCI) standards in our organisation are common to

many home care organisations. This indicates that in general we are not

evidencing what we do and how we deliver care and our recording of

information is not as robust as it should be. CSCI have accused us of

“putting lives at risk”. This was a very hurtful statement to hear.

In order to research this topic, I analysed and evaluated all the CSCI

reports across Cornwall and compared them with findings from the CSCI

“Time to Care?” report October 2006. The legislation comes from The Care

Standards Act 2004; this drives the inspection and links into Adult Social

Care value base.

A comprehensive literary review examines:

Group dynamics, (Kurt Lewin)

Change and the individual, (Elizabeth Kubler-Ross) and,

Resistance to change, (Yerkes Dodson).

These areas are important because they could affect the way the service

moves forward and have an impact service delivery.

Change is nothing new but how it is managed can have a significant impact on

those involved in the changes.

1 Change takes time.

2 Change is a process, not a decision.


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3 Change requires plenty of experience and practice in the new way of

doing things.(p.43.Rees.1991)

With the changes in our organisation being led by Legislation to meet The

National Minimum Care Standards, there was not an option to “Experience

and practice” the changes before implementation as they had to be

implemented within a three month time scale.

The internal audit produced by the Performance Manager was also a very

useful tool in as much as it highlighted poor performance across the county

post CSCI inspections and she reported on each of the districts individually,

which enabled District Home Care Managers to focus on their individual

teams.

The Performance Managers post was devised by the County Service Manager

(CSM) after the second round of inspections to help identify poor recording

in all districts. Her role includes, supporting the District Homecare

Managers’ (DHCM’s) in identifying areas where we are “failing” to meet the

standard to enable us to support our Senior’s through change.

Reading theory on change has led me to the conclusion that although change

is not always comfortable at the time of implementation, the majority usually

accept it.


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Theories of change.

Managing Change (2006)Chapter 1 page 34.

Frederick Taylor, 1911 (one of the most influential theorists), suggests five

simple principles of change.

1 Shift all responsibility for the organisation of work from the worker to the

Manager.

2 Use Scientific Methods to determine the most efficient way of doing

work.

3 Select the best person to perform job.

4 Train the worker to do the work effectively.

5 Monitor Worker Performance to ensure that appropriate work procedures

are followed and that appropriate results are achieved.

In Adult Social Care we work to these principles and they link in to the

National Minimum Care Standards

However with Principal one The Homecare Managers are responsible for

meeting the standards with CSCI. The Seniors are responsible for

programming the work for the care team and take on the role of supervising

and appraising the care staff, so this theory is not “simple” in Taylor’s terms

because of the distribution of the work load in the home care section of the

organisation.

The Manager is accountable for meeting the standards of care delivered but

all team members are accountable for their own actions.


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This theory may work in a mechanistic situation but here we are dealing with

humans providing a service and receiving a service.

All team members are “best for the job” as they are all trained to a high

standard as a legal requirement for delivery of personal care.

As an organisation the care team are the front line workers and keeping

them abreast of changes without too much disruption is vitally important;

they need to feel valued and supported and receive recognition for their

efforts, the difficult part is retaining the support of the Seniors who work

with the care team and encourage them be positive with the necessary

changes. Some of the changes are directly affecting the service users

where they are losing their service. They pass on the concerns to the care

team this can lower morale. We are already struggling to manage with the

allocated budget, which has resulted in the withdrawal of low and moderate

care packages.

The care staff form a natural bond with the service users and some have

been quite distressed over the withdrawal of service.


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Group Dynamics

People are a fundamental component within any successfully developing

organisation, without people the organisation is nothing.

Alan Chapman (businessballs.com)Accessed [10thJanuary 2007]

The Group Dynamics school, originated with the work of Kurt Lewin, it

emphasises bringing about organisational change through teams or work

groups rather than individuals. The rationale according to Lewin is to

identify individual behaviour, then modify or change in the light of groups

prevailing practices. It has proved very influential in developing theory and

practice of change management. One of the best known metaphors for

change was developed by Kurt Lewin (1951), P609 Buchanan and Huczynski

(Organizational Behaviour)fifth edition. who argued for the need to

unfreeze the current state of affairs, to move to a desired new state , then

refreeze and stabilize those changes. Now in an era of constant and repeat

changes this may no longer be an option.

“Businesses are nothing more or less than organisations of people trying to

get to a jointly defined future” – Professor Howard H Stevenson, Harvard

Business School www.oursouthwest.com. Accessed May 2007

The following Force Field Analysis summarises the driving and restraining

forces relevant at this point in time:

Force Field Analysis - looking at the balance factors

Driving Forces Resisting forces


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Interface with care management ----------------- Limits of Care

Management

System.(CMS)

Caring attitudes of field staff----------------------Limited time for delivery

of care.

Commission for Social Care Inspection-------------Work load and Frustration

of seniors and care staff,

Seniors own methods of

recording.

From the analysis, the forces for change come from within and out side of

the organisation. Care management and care staff are shown as drivers, the

resisting forces coming from the limits of the CMS, at this time there is no

access to this system for the Senior’s, although they will have “Read Only”

access in the future. The care team work to a very tight time scale while

delivering care, (the average time allowed for care delivery is half an hour).

This could in effect allow the standard of care to fall as the carer are under

pressure to meet their deadlines.

The most dominant driving force is CSCI with the implementation of the

Care Standards forcing changes within the whole structure of the

department, creating resistance from all areas on the way.

Phil Harding (2004) writes; The trick in successfully managing change and

getting the commitment and support from staff is to provide these

‘motivators’ for your staff – or at least as many of them as possible.

Pride “Follow where your enthusiasm takes you”

Happiness “ A happy team is an effective team”


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Responsibility “Its amazing what you can accomplish if you do not care who

gets credit” – Harry Truman www.oursouthwest.com. Accessed May 2007.

French and Bell (1984) pointed out the most important interventions in

organisational development are Team Building activities. The team analyses

its way of doing things and attempts to develop strategies to improve.

Individual change

Even in 1970 Alvin Toffler argued that the rate of change was out of

control, he believed that there is a limit to the amount of change individuals

can handle and that too much change in too short a time is unhealthy. He

described the “disease of change” as future shock (stress and disorientation

suffered when people are subjected to excessive change).

Buchanan and Huczynski (Organisational Behaviour), fifth edition chapter

18.Page 614.

I can see that this could be the case for some of my Seniors who have been

very stressed (future shock) over the proposed changes especially when the

changes implemented have to be changed again when found not to work.

The coping cycle Table 18.1 p614

Elizabeth Kubler-Ross (1969) argued that we deal with loss by moving

through a series of stages, each characterized by a particular emotional

Response;

Denial: unwillingness to confront the reality; “this is not happening”;” there

is still hope that this will go away”


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Anger: turn accusations on those apparently responsible; “why is this

happening to me?”,”why are you doing this to me?”

Bargaining: attempts to negotiate, mitigate loss; “what if I do it this way?”

Depression: the reality of loss or transition is appreciated, ”it’s hopeless,

there’s nothing I can do now”; “I don’t know which way to turn”

Acceptance: coming to terms with and accepting the situation and its full

implications; “what are we going to do about this?”; “how am I going to move

forward?”

Elizabeth Kubler-Ross’s theory was dealing with loss through Bereavement,

however the same changes in the work place can affect people in the same

way, grieving for the past and “how it used to be” and the feeling that people

are not going to be able to “cope” with the changes.

Individuals in my team have come through these emotions and are now at the

stage of moving forward and even showing enthusiasm.

(Ref Appendix4)

The chart (Fig 1.) shows Pressure and performance – the inverted-U function

from healthy pressure to the point of breakdown. Can organizational change

induce such pressure? According to Claydon and Doyle (1999) P615 OB. over

60% of managers said that people in their organisations were suffering from

initiative fatigue.

The Yerkes-Dodson hypothesis argues that human task performance is

increased by arousal, stimulation and pressure. The hypothesis also argues

that, if pressure continues to mount, the individual will eventually reach a

point, which they become stressed and exhausted and performance will start

to fall.


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Healthy pressure

Fig. 1

Pressure and Performance -

The Inverted U Function

The chart shows Pressure and performance – the inverted-U function from healthy pressure to the point of breakdown. (Yerkes. R & Dodson. J 1908) (Buchanan and Huczynski)

Resistance to change

This is an inability or unwillingness to discuss or to accept changes that are

perceived to be damaging or threatening to the individual.

“ Its not the strongest species that survive, nor the most intelligent, but the

ones who are the most responsive to change” – Charles Darwin.

Damage to health

Breakdown

State of arousal

Exhaustion

Optimal performance

Performance level


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www.oursouthwest.com. Accessed May 2007.

Resistance to change is the greatest barrier that I am faced with. Some of

the workers in the home care teams in my district see CSCI as the “enemy”

who “dream” up standards to make life difficult for them.

“The main dangers in this life are the people who want to change everything

or nothing” – Lady Nancy Astor. www.oursouthwest.com. Accessed May 2007.

Documentation in daily record sheets has been the area that has most

affected the home care team. They are required to demonstrate that while

delivering the care as per care plan, they also have to show that they are

respecting the service user’s choice individuality and diversity. The main

concern for the team is the lack of time to deliver the care as specified in

the care plan and then to document all relevant information from personal

care to meals prepared. I have to constantly remind the care teams that

with out the documentation to evidence that we are giving the service user

the best possible care in their preferred manner we will “fail” the relevant

standard. The morale of the teams has suffered when the reports were

published. People who come into the care profession are generally very caring

individuals and their priorities are the care and welfare of the service users.

It is very hurtful to get a report stating that the service users are “at risk”

by lack of documentation when they are prioritising the care needs of the

individuals. As we are a large organisation we need to be seen to lead the way

in quality home care and we are in the public eye and when we do not meet

standards we are subject to criticism in the media.

Arthur Bedeian Buchanan andHuczynski(Organizational Behaviour), fifth


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edition. Page 618. Cites four common causes of resistance to organisational

change;

Parochial self-interest Change moves us out of our comfort Zone, it could

mean loss of power, status or security. For my team of Senior’s, proposed

changes could make them question their ability to cascade the information to

their teams without causing too much stress.

Misunderstanding and loss of trust. We are more likely to resist change if

we do not understand the reasons behind it, If there is open communication

when change is introduced with a clear understanding of why the changes are

being implemented it is more likely that the teams will accept them.

Contradictory assessments. We differ in the way we perceive and

evaluate change, Our personal values determine which changes are welcomed,

promoted and succeed or fail. Bedeian points out that contradictory analysis

of change can lead to constructive criticism and improved proposals.

Resistance can in some instances lead to more effective forms of change. In

my experience where there has been resistance, after discussion there has

been a compromise, on how the changes have been implemented, this has led

to building of trust within the team.

Low tolerance for change. We differ in our ability to cope with change,

we each have ideas about our own abilities and strengths, some may doubt

their ability to cope with the change, their anxiety and apprehension may

lead them to oppose even potentially beneficial changes. Some of my seniors

were very anxious about the changes being implemented as were some care

team members. These anxieties were addressed through supervision and

team meetings and I feel that there is a more “comfortable feel” to the


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changes that have been implemented.

Overview of CSCI inspection May-October 2006

There were two inspections carried out in this period for Bodmin and

Launceston (which make up North Cornwall district) each are inspected

separately. The first round in May 2006 was the second since they were

implemented in 2004.

The inspection for Bodmin identified six 3’s and nine 2’s.

Launceston scored eight 3’s and seven 2’s

(Ref Appendix 3)

This showed improvement on the first inspection, but there was still work to

be done. The Agencies were classed as “adequate”.

There was a lot of positive feedback from the inspectors, some of the

comments included -

What the service does well:

� Provides a reliable and effective service for service users within the

community.

� There s an ongoing structured programme of training for staff.

� All service user’s surveys and comments received prior to the

inspection showed that the service is reliable.

What has improved since the last inspection?

� The local Management structure has been reviewed and a part time

deputy manager has been appointed to assist the registered manager

(this is where I came in).


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� Improved policies and procedures.

� There is an effective system for quality assurance in place.

� Risk assessments have been introduced.

What they could do better:

� The care needs assessments, have improved since the last inspection,

however they are not providing sufficient information for the

providers of care.

� Risk assessments should be should be developed further.

� A separate risk assessment should be undertaken where moving and

handling tasks are identified.

This overview shows where improvement is required to raise the standard to

a three score.

The Inspection in October 2006, (my first one as Temporary District

Homecare Manager), has shown further improvement. The Bodmin agency

was now classed as ”good”, Launceston remained “adequate” but with little to

do to raise the standard with only two 2’s to raise to 3’s.

These reports show that there is a clear need to improve interface with

Care Management to ensure consistency in the care needs assessment.

Kurt Lewins – The Group Dynamics School emphasises group working and has

proved influential in developing theory and practice of change management.


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The Performance Managers Audit.

This audit looked into North Cornwall as a whole district and provided useful

information on a very basic level to help construct an action plan for the

specific areas where change was required. It also provided findings for each

separate Seniors venue commenting on their individual work.

This caused stress for some of my senior’s as they were (in their words)

being “blamed” for not meeting the standards.

As Alvin Toffler’s theory, 1970 Future Shock, (Pan Books, London) that the

rate of change was out of control. The “disease of change” causes stress. My

Seniors feel that the changes have been “too much in a short space of time”.

The audit is much more in depth than the CSCI report, it has proved to be

extremely valuable and has saved managers a tremendous amount of time,

now all DHCM’s are working in the same way with a more consistent approach

to recording evidence for future CSCI inspections.

The relationship between the Homecare service and Care Management has

been quite strained at times due to lack of understanding of CSCI standards

and how to meet them.

Care Management have not been subject to CSCI inspections and therefore

do not identify with the difficulties facing the homecare service even

though they are a key factor in helping achieve the standards.


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Conclusion

As my post is temporary until July 2007, I have a lot of work to do in a

short space of time therefore I have to concentrate on my time management

and set myself targets. My performance is monitored by the CSM through

Supervision on a monthly basis and monthly DHCM meetings where we

discuss progress and support each other and share ideas.

I need to have a good relationship with my team to enjoy success and show

my commitment to the imminent changes we are about to embark on, I will be

spending time at their venues to encourage and support them through this

time of major change. I had an extra meeting (Ref Appendix 5) with my

seniors to look at all the paperwork used and make decisions as a team as to

what to continue with and what is no longer needed. As expected there was

some disagreement with reluctance to change but on the whole we came to

an agreement that we would perform better as a team if we were all

evidencing our work in the same manner. The team are still very concerned

about how we are going to meet the CSCI standards. There is a feeling of

“as soon as we meet standards they will change again”. The roll out of Cold

Harbour (the new IT system being introduced), will make recording and

evidencing a lot easier and will cut time spent on hand writing reports;

information will be available via the computers for all Seniors and this will

help to improve the service delivery and reduce the stress levels. They are

quite excited about this element of change and some of the paperwork

issues will automatically be resolved when we have gone “live” hopefully in a

few months time.

My team have also had to adapt to me as their new manager and as my style


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is very different from my predecessor it has also taken time for them to get

used to my style; as a new manager I am very focussed on policy and

procedure and working “by the book” which adds to the pressure that they

have been under.

I plan to carry out robust supervision and appraisal with my seniors to help

them to prioritise their workload, plan their activities and manage their

time. The Staff are a vital resource and effective supervision is the key to

good service delivery.

With the uncertainty of my post my personal aim can only be to support my

team through this time of change encouraging them to learn from this

experience, having read the recommended literature for this course I have

gained an understanding of organisational behaviour and the need for change

in this ever changing world which I will endeavour to cascade to my team of

seniors. At the onset of change it is important to look at all aspects and how

the change will affect not only the service users but the whole of the

organization As we are dealing with the public it is vital to make the right

decisions regarding changes to care delivery and the cost implications.


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Recommendations

Having looked at the CSCI overview, it has identified areas where there are

training needs among the seniors, and this is common to the rest of the

county:

Training on Risk Assessments, Appraisal and Supervision, Equality and

Diversity, file building and evidencing work through documentation.

This training is now in progress as a priority, the Seniors are participating in

a “First line Management” course through the learning and development

department which should also help them achieve the aims of Adult Social

Care.

Activity Planning

Images of organisation (2006)

Beckhard and Harris 1987-70-1 refer to this as a process of getting from

here to here; they state that “The activity plan is the road map for the

change effort, so it is critical that it is realistic, effective and clear”

The Five characteristics of an effective activity plan

1 Relevance – activities are clearly linked to the change goals and

priorities.

2 Specificity – activities are clearly identified rather than broadly

generalised.

3 Integration – the parts are closely connected.

4 Chronology _ there is a logical sequence of events.

5 Adaptability - there are contingency plans for adjusting to

unexpected forces.


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Action Plan to Improve CSCI results

Goal

Target Group Outcomes Duration/

Dates

Lead

Standardization of

Recording tools/forms

Improved quality

assurance

Seniors and

Home Carers

Design of seniors

Tool kit

Introduce and motivate seniors

to accept.

Training on new forms etc.

Implementation of Cold Harbour

Regular updates

April 06

From --- 2007

CSM

DHCM

Improved communication

with Care Management

through DHCM

attendance at

Fieldworker events

All DHCMs,

Seniors and

Home Carers

Care

Management and

Case Co-

Coordinators

Comfortable working

environment

Higher standards

Greater consistency of

commissioning care plans.

Ongoing

June 2007

next

inspection for

North

Cornwall

All staff through

line managers

Care Management

Improved training Supervision & Seniors more competent in April 2007 DHCM Training


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programme Appraisal

Equality &

Diversity

Risk

Assessments

supervising Home Carers,

identifying performance issues

& motivation. Improved

prioritising of workloads and

time management.

Book Seniors on Introduction

Level followed by Foundation

Level.

(Managers Workshop available

from October 2007)

Safe working environment

onwards

From May

2007

Co-ordinator

DASC Learning,

Training &

Development Unit

PCT

Updating of all relevant

Polices and Procedures

All staff Policies & Procedures updated

and available electonically

Ongoing from

2006

Finance Admin.

Managers in

consultation with

relevant groups


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Appendix 1

The Structure of North Cornwall Home Care;

County Service Manager

I

District Home Care Manager

I

Senior Senior Senior Senior Senior Senior Senior

Home Carers 14 14 10 13 17 17 10

This structure shows that each team varies in size, it could be argued that

some of the seniors have a higher workload than others; this is in fact true

however the rurality of the locations dictates the number of potential care

staff and service users. The workers are also used in more than one team

when there is sickness or holiday cover required.


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Appendix 2

The Key Values of CSCI.

1. To put the people who use Social Care first and to act in their best

interest at all times.

2. Support Service Users to live independent lives with dignity and

respect.

3. Respect peoples rights and choices

4. Improve services and remove Bad Practice.

5. Stand up for the rights of service users.

6. Help those who work in Social Care to make the service better.


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Appendix 3

CSCI ANALYSIS AND OVERVIEW 2006

Each district was inspected against the same core standards and regulations.

Depending on the findings within the inspection visits and feedback from surveys some

evidence was then used against additional standards.

Order of

Inspection

1st 2nd 3rd 4th 5th 6th 7th

Standard St AustellPenzance Truro Kerrier Caradon Bodmin L’nceston

1 3

2 3 3 3 2 3 2 2

3

4

5

6 3 3 3 3 3

7 3 3 2 2 2 2 2

8 3 3 2 2 2 2 3

9 3 3 2 2 2 3

10 3 3 2 2 2 2 2

11 3 3 3 3 3 3 3

12 3 3 2 2 2 2 2

13 3

14 3 3 2 2 1 2 2

15 3

16 2 2 2 2 2 2

17 3 3 3 3 3 3 3

18

19 3 3 2 2 2 3 2

20

21 3 3 3 3 3 3 3

22 3 3 3 2 2 2 3

23

24

25

26 3 2 2 3 3 3 3

27 3 3


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User focused standards Managers and staff Standards

Personal care standards Organisation and running of the

business

Protection standards


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Appendix 4

Reflective journal No 9 Extra Seniors Meeting

Name: Madeleine Blight

Date: 30th January 2007

This meeting was held to identify all paper work used by the seniors and to

work together sharing ideas.

It was the first meeting that I have held in my new position where all the

seniors were able to attend and I was pleased to be able to meet with them

all for some team work. All the seniors brought samples of the paper work

that they used, some of these were new to me and had been introduced over

the years some times with out previous paper work being withdrawn. I

already knew there were going to be different forms used but was amazed

at how many different forms there were.

Two of the seniors have been in position for many years and were able to

explain the introduction of the forms that they use, some of the seniors

were not recording absenteeism or back to work interviews, this made me

realise that I would have to make sure that from now on I will need to

ensure the relevant procedures are followed.

The meeting went reasonably well, however some of the seniors do not want

to change forms that they are comfortable with. There were some heated

exchanges but on the whole there was agreement that it would be beneficial

if everyone shared their ideas and decided as a team how to document and

evidence their work for future CSCI inspections.


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Reflection

I see this meeting as a success, I feel that the seniors respect my aims and

are willing to work hard on achieving our shared goals. There was compromise

over some of the forms especially where the long standing seniors are

concerned, there will be changes in documentation when we have “Cold

Harbour” up and running and so there is little point in making life more

stressful at this time by changing more than necessary.

Conceptualisation

I kept the afternoon totally free for this meeting so that we could have

plenty of time and had an open agenda, this worked well as it gave people

time to debate issues with out a timed slot, I felt that this would make sure

that views were aired and taken on board by all the team. All items were

documented in the minutes for future reference.

Conclusion

I have learnt a lot from and about my team from this meeting, it highlighted

the need for stability among them and I have realised where I need to

monitor performance. I will be more aware of the issues facing them as

individuals at supervision, and hope to use this to improve performance.

Attended meetings with my colleagues and County Service Manager (CSM) that identified

areas requiring change. I chaired meetings with my team of seniors to cascade information

to address our own shortfalls and attended meetings to support the care teams and listen to

their concerns.


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References:

Alan Chapman (BusinessBalls) < http://www.businessballs.com> accessed [10th

January 2007]

Buchanan, D & Huczynski, Organisational Bahaviour 5th Edition (2004).London

Pearson.

Burns B, Managing Change, forth edition (2004) London Pearson.

Commission for Social Care Inspection "Time to Care" Report 2006.

Commission for Social Care Inspection (2006). Local inspection Reports

Department of Health, National Minimum Care Standards 2000.

Handy C “understanding Organisations” 4th Edition Penguin Books.

Ellwood A, Homecare Audit 2006/07.

Rees F, How to lead work teams. 1991.Pfeiffer & Company.

Morgan G, Images of Organisations (2006) London Sage Publications.

www.Our south west.com


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Bibliography:

Buchanan and Huczynski 5th Edition.

Images of Organisations, 2006. Gareth Morgan.

How to Lead Work Teams, Fran Rees. 1991.

Managing Change, Burnard Burns 4th Edition.

Understanding Organisations, Charles Handy 4th Edition.

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