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As we approach the end of 2020, is it perhaps too early to ask what we have learnt from the year in hindsight?
From bushfires and floods to the pandemic, it has been the year nobody saw coming. Numerous inquiries are underway to identify how the sector and the government has responded to crisis after crisis, the most prominent of course being the Disability Royal Commission. All of this comes on top of the ongoing work of improving the quality of our disability services.
In some ways though, what we have learned is that our best intentions are not always enough. The safeguards we have currently in place have not always allowed us to ensure that the people we support are having their needs met. But if there is a silver lining in the chaos of 2020, it might be that it will force us all to reflect on our practices- both the good and the bad.
I’ve been fortunate to have worked as a qualified support worker for 14 months early in my career. For over the last 25 years, I have performed roles on boards, in banks and as an auditor. As you can probably imagine, many of the conversations I am a part of centre around commercial imperatives and finance. But I still rely on my experiences on the frontline to inform these conversations. It was there I learnt the practical realities of how disability organisations work, and where things go right and wrong.
In general, I believe the most resilient organisations have the following features in common:
- Undertaking individualised and proportionate risk assessments
- Ensuring robust safeguards are in place
- Ensuring that Boards and Execs have the data they need to drive decision making
- Factoring testing systems and experiencing some failure into the budget
Above all else, best-performing organisations have as a central tenet, a willingness to understand and learn from the experiences of all stakeholders- from participants to the workforce. They are able to tune inwards for answers, and have ways of presenting what they learnt to decision makers in the organisation.
Assurance mapping - understanding where risk and protection live
In a risk management context, ‘assurances’ are the protections that the organisation has against particular risks. Providers need to map out these assurances and how they correspond to risks the organisation faces.
Assurance maps need to be formed with significant contributions from participants and the frontline workforce. This does not have to be an expensive or complex process. It is a matter of ensuring that the contributions are gathered through the data you already collect.
For example, providers need to collect some basic information about any new people they support. These templates can start by asking people about their expectations, goals, supports and gaps in support, before going on to get the mundane but essential information about NDIS funding. By analysing the gaps in supports, we can identify the biggest risks people face. By exploring their goals, we can understand what we need to do in order to improve the quality of our services.
For a long time, many management teams have been tempted to let ‘contagion event’ sit unaddressed in the ‘extremely’/’highly unlikely’ part of the risk matrix. This is understandable, but it has also meant that certain assurances were never put in place, despite all the necessary information sitting within the organisation. Who knew that the majority of support workers held jobs in aged care and disability supports across multiple agencies, thus amplifying the risk of cross-infection? The workers did. And likely, so did many of the people they support.
Participants and frontline staff can also identify factors that increase the risk that someone will experience abuse or neglect. For example, how often restrictive practices are being used as ‘quick fixes’ for more substantial problems. After an incident, it is common for the question ‘why didn’t we see this coming?’ to be asked in the boardroom. We are forced to be reactive, when we haven’t gathered the information we need to be preventative.
Internal education
Frontline workers often hold significant insight into risk, gaps and policy and procedure effectiveness. It is wasteful to be unaware of their expertise. In organisations with diversified expertise, we are often reluctant to peek over the lanes we are meant to be sticking too. But organisations perform best when there are systems in place to ensure internal learning.
The best performing frontline workers and team leaders can play a role in training other staff. They can also help mentor people through complex situations and identify when someone is underperforming in their current role.
Education is also essential at the board and senior management level. Current inquires are exploring whether decision makers in organisations are being trained in the human rights approach. The organisation’s workforce can also help decision makers understand what is needed in practical terms.
Taking immediate action
The crises we have faced this year have highlighted the need to ensure that our risk assessment processes are up to scratch. In some ways, this is a big and ongoing project. But there are also steps you can take straight away, including:
- Encouraging executive teams and boards to learn from internal and external case studies.
- Ensuring all levels of the organisation to complete the NDIS Worker Orientation Module, and other training done at the frontline.
- Putting systems in place that allow participants and frontline staff to sense-check policies and practices.
- Involving the frontline workforce in developing strategies for when extremely impactful events occur.
- Considering what can be learnt from organisational failures.
When quality and safeguarding is at its best, we focus on feedback reliance not robotic compliance. We focus on what there is to learn, and those learnings input everything we do.