These teams internally share the duties of solve problems, adapt to changing conditions and determine strategies, without a manager taking overall responsibility.
The most commonly referenced deployment of the model is Buuurtzorg in the Netherlands, a self-described “revolutionised community care.” Since it’s beginnings 10 years ago, Buurtzorg has acquired an international reputation for improving care quality by empowering its staff, which in turn increases their job satisfaction.
While Buurtzorg was found to be more costly per ‘unit’ of care, it was also shown that the amount of time needed to support people back to good health was greatly reduced.
This could lead to an overall reduction in both health and social care costs, regionally and nationally, that could justify the initially increased investment.
The advantages
Advantages of self-managing teams across any sector of the economy have been identified as:
- Bringing more flexibility
- Increasing quality of work life
- Reducing absenteeism and employee turnover
- Increasing job satisfaction
The issue of turnover is a massive one in social care. The employee turnover rate for frontline carers has hovered around 30% for the past 5 years and shows no signs of shrinking. Skills for Care has estimated the cost of recruiting a new member of staff as £3642.
Factor in the variable costs of agency staff for absenteeism and it soon appears that the resources that could be clawed back from better workforce retention are staggering for individual care providers.
In the UK
The principle and practice of self-managing teams has been embraced by a limited number of providers across the UK. One of which is Wellbeing Teams, who have been rated Outstanding by the CQC.
Wellbeing Teams are made up of a small number of Wellbeing Workers, who deliver care in a small, specific area in ‘self-managing’ teams. This gives the teams more flexibility, and keeps decisions about people’s care close to the people themselves. In turn this frees enables staff to focus on outcomes, not a task-and-time approach; and personalisation principles are built into the model. This new way of working is also intended to fix many of the problems currently seen in the sector, from poor quality care to staff satisfaction and retention.
The model was developed by Helen Sanderson, who is the author of a number of books on person-centred practice, an advisor to the UK government on personalisation and CEO of Helen Sanderson Associates.
On the model she has developed, Helen says that “We know that there are significant problems in home care, as evidenced by high levels of complaints and high staff turnover rates. Most solutions focus on trying to get more money into the system, or trying to make it more efficient. Realistically, there are challenges with both of these approaches as the system is fundamentally broken.
Wellbeing Teams are affordable because their self-management structure reduces bureaucracy and keeps decisions closer to the people delivering care, and ample research has shown that people working in self-managing teams are happier and more productive – therefore more likely to stay.”
Use of the self-managing teams principle is growing in the UK with more care providers and local authorities implementing the model. These are predominately community care (home care, supported living services etc.) however it is clear that many of the benefits, in terms of a greater connection between decision making and the 'floor' could also apply in residential care settings too.
Resources
The internet has a number of resources on setting up self-managing teams in social care, including case studies from providers who have already done so. A good place to start if you are interested are these podcasts featuring interviews with owners and directors of UK social care providers that have implemented self-managing teams.
And here is a general guide (non care sector specific) to self-managing teams.
One of the keys to enabling self-managing teams to be successful and to flourish is the use of technology. While not absolutely essential, the use of integrated scheduling and rostering and electronic care planning systems can be a huge multiplier of the beneficial change that self-managing teams can bring. Not just in terms of increased efficiency, but also in better motivation, data to make intelligent decisions, linking up many different sources of information about clients and sharing that information within teams and other stakeholders easily, securely, fast and without fail.