Page 41 - The Deep Seated Issue of Choice

THE DEEP SEATED ISSUE OF CHOICE
DEEP ORGANIZATIONAL CHANGE
team; embed previous department leaders in households where they mentor the
household staff and their peers.
- Build community, commitment and self-led teams: In the household community of
residents and staff, the residents should make decisions and the staff, working as a self-
led team, facilitate those decisions as much as possible.
- Cross-train staff for multiple roles: versatile workers, cross-trained in roles they choose,
and blended-roles prepare staff to serve the resident with “immediate responsiveness and seamless service
In conclusion, Norton states - “Versatility, blended roles, the team approach and cross training all assure that ‘it’s not my job’ is never heard.” (Norton, 2008, p 24)
In The Power of Circles: Using a Familiar Technique to Promote Culture Change, Norton details the technique: “The Learning Circle is a common-sense approach for both conducting meetings and facilitating less formal gatherings in a way that encourages high involvement of all stakeholders in planning and implementing culture change, engenders mutual respect among participants, builds a sense of community and facilitates both personal and organizational transformation.” (Norton, 2003)
These strategies of deep organizational redesign support the development of strong interdependent relationships between residents, staff and families. In Relationship: The Heart of Life and Long Term Care, Pioneer Carter Catlett Williams firmly states her conviction: “Relationships are not only the heart of long-term care, they are the heart of life. And life ought to continue, wherever we live.” Building on the belief that care giving is not charity, but rather a relationship, she explains: “Care giving is not one person doing a favor for another or giving to another who is simply a recipient. Rather, it is a relationship in which there is give and take and a bond that is made, person to person. Moreover, it is a living and growing bond which both participants shape and nourish.” Williams further notes “Systems that grow out of greater resident decision making, development of community and a more normal environment encourage healthy, meaningful relationships.” (Williams, 1999)
The outcomes of this deep organizational design are further described in Close to You: How
choices and relationships flourish in the Household Model, as:
- Staff are able to be more responsive to life in the household as it unfolds and can
solve problems and make decisions on the spot.
- Genuine personal relationships are encouraged between individuals, both staff
and residents.
- Daily household life decisions are made by the residents.
- Individual residents direct their own lives.
- Self-led teams report directly into households instead of departments, moving
decisions close to the resident. This allows a quick and seamless response, even
to complex issues.
- Staff know residents well enough that they can recognize and respond to needs
before they become problems.
- Residents have trust in staff that haven proven loyalty through relationships.
- Embarrassing or difficult situations can be more easily and comfortably dealt
with.
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