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.
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.
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.
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. Research shows that common organisational benefits of self-directed teams are: (1) higher participant satisfaction resulting in business growth, (2) higher job satisfaction resulting in lower absenteeism and turnover, (3) stronger overall organisational focus on quality resulting in fewer incidences (4) lower overheads and (5) increased innovation and collaboration.
For employees, it is hoped the model gives them the opportunity to maximise and develop skills and improve coordination and communication by developing their processes and capacity to support self-direction.
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 trial was launched in April 2017 by redesigning the way four existing teams operated. This soon increased to seven as participant demand grew. By 2018, three new teams had been formed - one a split off from an existing team, one comprising Karen refugees to deliver disability services to the Bendigo Karen community and one in Maryborough. Team composition and models vary. For example, some teams are testing a model without a team leader and others with a team leader. A dedicated coach works across all seven teams.
Though the trial has yet to be completed and fully evaluated, the benefits are clear. Staff members in self-directed teams has taken a more proactive role. They appreciate the mentoring and supporting 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. These benefits have resulted in the team generating new ideas. For example, innovative solutions around community inclusion, supporting complex clients and self-rostering have been noted and these new approaches have already improved participant outcomes.
Initially, some participants wanted to be supported by a strong team member with whom they were already familiar. However, as participants got to know all team members, they appreciated the experience of working with a consistent and functioning team.
At the time of writing, teams are not yet fully self-directing - members still seek regular feedback and approval from their coach. 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. The team coach and staff needed additional training to develop a full understanding of new service pathways and funding structures under the NDIS.
Undertaking this project during the NDIS transition was challenging for staff. However, given that the NDIS is already a disruptive change that requires new approaches, the self-directed teams and the organisation used the transition as an opportunity to radically rethink how they deliver support. Lack of clarity from the organisation on the industrial relations implications of this new model was an issue.
External auditors focused on highly detailed, prescriptive policies and procedures as paramount instead of building the capacity and capability of frontline workers to make good decisions in each individual and unique situation. NDIS planners often focus on day services as allocation of time, rather than thinking in relation to participant outcomes.