Regional and Rural Peer Support Teams

Regional and Rural Peer Support Teams
Organisation: Amicus Group Inc
Contact: Shayne Scott

This project trialled self-directed teams in rural and remote service delivery areas in order to meet the aims of the NDIS for the benefit of participants and of direct support staff.


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The Context

Over the past seven years, Amicus, a disability service provider based in Central Victoria, has been transforming its service delivery model. Originally, Amicus operated primarily as a centre-based day service. Now, 90% of the organisation’s clients choose their own individualised support and all of Amicus’ services are delivered one person at a time. Amicus’s services and dispersed workforce are operational 24 hours a day, 7 days a week, 365 days a year.

The Problem

Amicus is committed to providing individualised, flexible support and to working with one person at a time. This tailored service model - in conjunction with a period of rapid growth - was not optimally supported by the organisation’s traditional hierarchical structure. Top down decision-making limited the choice and control for participants, their families and support staff. In addition, direct support staff in regional and remote areas experienced isolation and organisational coordination and communication was not as efficient, responsive and effective as it could be.

The Solution

Following research, Amicus settled on a team model that could support maximum decision-making and control for the person with a disability and greater work satisfaction for direct support staff. They decided to trial self-directed teams with six to eight teams, where middle management decision-making is replaced with coaching and mentoring. This trial was undertaken in order to encourage greater frontline decision-making between participants and support staff around individual outcomes. 

Expected Impact

For employees, it was hoped the model would give them the opportunity to maximise and develop skills and improve coordination and communication by developing their processes and capacity to support self-direction.

At the end of the project employees in self-directed teams have taken a more proactive role. They appreciate the mentoring and support from their coach and team members, as well as from the organisation. Team members have a greater sense of working towards a common goal and share a sense of achievement when participant goals are met. One employee described this change as: “We see where we are going instead of slugging along”. Teams also experience better communication all around - within the team, with the organisation, and with participants, families and other service providers. As the team’s confidence grows - along with the trust of management and access to the required IT structures – it is anticipated that teams will take on further responsibilities. 

For participants and families, the model aims to increase the flexibility, responsiveness, responsibility and accountability from the staff by building trust and rapport with their direct support teams and by increasing their confidence and ability to determine and control their own supports.

The results of the project show that participants and families were indeed feeling that they were self-directing their supports to a greater extent and that they experienced greater choice and control under the new model. Supports are now also more tailored and better meeting their needs. Improvements have also been noticeable in the area of coordination and communication, but ongoing improvement is needed.

Stage and Spread

The trial was launched in April 2017 by redesigning the way four existing teams operated. By the end of the project in June 2018 eight self-directed teams were established, including one comprising Karen refugees to deliver disability services to the Bendigo Karen community and two rural teams. A total of 96 participants are being supported within a self-directed team model involving 55 employees. Team composition and models vary. For example, some teams tested a model without a team leader and others with a team leader. The teams are supported by two dedicated coaches.

 

Lessons and Insights

Amicus has learned a dominant influencing factor impacting on the success of a self-directed team hinges on the effective communication skills of team members. The initial training resources used to establish the first project teams were reviewed and changed to include a greater focus on effective communication to address this skill gap that was observed within the first teams, and also to ascertain if this would shorten the ‘establishment time’ of the teams establishing their communication and coordination strategies. Also, a stronger focus has been made by the coach to support the teams to develop effective communication skills and strategies as a core team foundation.

During the project the organisation experienced significant growth. It on-boarded 50 new participants and recruited 80 new employees. If the self-directed teams had not been in place, it is likely that Amicus would have incurred costs and increased their overhead by employing additional Service Coordinators. Amicus expects that when teams and coaches are fully functional, coaches will be in a position to support a greater number of teams. This will allow the organisation to grow without growing management overhead expenses. 

The project also demonstrated that rates of sick leave were lower amongst staff within self-directing teams compared to support workers not involved in self-directing teams. The lower rates of sick leave within self-directed teams will also improve organisational viability.

Roadblocks and Risks

Undertaking this project during the NDIS transition was challenging for staff. Teams had just started working in a more self-directed way when the majority of the participants they support transitioned to the NDIS. This resulted in major changes that these newly formed teams struggled to cope with. In this period they needed considerable support from their coach. The intent for the Self-Directed Team Coach was for this role to be disassociated with corporate operational aspects of the organisation, however changes due to the NDIS transition and the resulting organisational growth made it difficult to achieve this intended outcome during the project period. However, it is expected that this can be achieved now that practically all their participants have moved to the NDIS. 

It is clear that Amicus is only at the beginning of their journey in transforming to a self-directed team based organisation. The next key action Amicus needs to take is to develop a clear operational framework for their self-directed team model to guide the transformation of the rest of the organisation.