1. Lived experience
Firstly, an important initiative by Scottish Government, highlighted in HWL December bulletin is the focus on co-design to inform future service needs.
The National Care Service recently invited applications for a Lived Experience Experts Panel, to understand the changes that are needed and checking that changes are possible and practical. This is what co-design means – working alongside the people who use and deliver health and social care services to ensure everyone get a future organisation that works for all.
“The complexities of getting this right should not be underestimated. People with experience of the current system, whether in receipt of health and care support or delivering it, are the experts. We particularly need to hear those voices.” Kevin Stewart, Scotland's minister for social care.
2. Future trends
Secondly, the recent Resolution Foundation Who Cares and Reimagining Care Commission reports both highlight care workforce needs and issues where a co-design ethos will be a critical factor in driving meaningful change that is embedded in the culture of care homes.
Jobs in social care have many positive aspects of working in the sector, including the ability to form deep personal connections with clients, job security, and greater levels of flexibility and autonomy than are possible in many low-paid jobs. But there are many challenges too. Pay is low – and likely unlawfully low for many workers in the domiciliary sector once their travel time is accounted for.
This, along with funding constraints and the particular demands of the Covid period, have contributed to a staffing crisis which is having serious negative knock-on effects on workload and safety.
Employees owning their own co-design process and doing it to themselves with their colleagues just need the confidence and skills to navigate their way through a change journey. And if the experience is enjoyable, rewarding and productive it’s more likely colleagues will come on board. That’s what we created the HWL Ripple co-design toolkit to do.
In their shoes
It’s late and you’ve just finished a long shift, working overtime as a colleague is sick and you’ve a handover to make. This isn’t an ideal moment to start thinking about change. So, we’ve built the HWL Ripple co-design toolkit that’s adaptable to real workplace constraints including:
In-house. Workers can’t take time out for off-site workshops, so change sessions need to happen in the workplace as employees are always on call.
Mini-breaks. Employees may only be able to grab half an hour over a coffee break with colleagues and don’t have the luxury of taking time out for 2-3 hour workshops.
Mindset. Change sessions need to be fitted into the working day as staff often aren’t very receptive or energised after an exhausting shift.
Tools need to work for impromptu drop-in sessions, idea-pinboards in staff areas, or as takeaways, so staff can think quietly during breaks or personal time.
Shift workers. It’s often not possible to get the care team together at the same time as employees are on shift rotas and ideas need to developed with contributions at different times.
Care workers are time poor and work in a stressful, emotionally intense settings so we wanted to make change fun and involving. In all workplaces there are employees who are ‘champions’ – the drivers of change; ‘agnostics’ – those who go with the flow; and ‘saboteurs’ – sceptics who resist change.
So, changes designed to improve working practice can’t rely on managers imposing top-down approaches and expect them to be adopted. The HWL Ripple co-design toolkit is designed to be inclusive and generates group enthusiasm.
People leave their manager not their job
In many organisations often the personalities and hierarchies get in the way of change, leading to resistance and friction. We wanted to find a way through this, removing barriers to encourage effective and rapid collaboration between leaders, managers and staff.
Co-Design for Care: HWL Ripple toolkit - inspirational, accessible and easy to use
Co-design can crack wicked problems in care
Co-design theory and practice has been adopted by industry in change consulting, in a TRL context, and in public service transformation. However, it’s not particularly familiar to care home sector leaders and if used by external consultants is often perceived as expensive and challenging to commission.
To understand where co-design can drive improvement by empowering employees, HWL has identified four key challenges care homes face:
Recruitment - Care workforce recruitment and attraction - enabling care home providers to better recruit staff
Retention - Care provider capacity building - enabling care home providers to develop, upskill and increase the value and motivation of their employees
Effectiveness - Care provider operational effectiveness – enabling care home providers to improve service delivery, scheduling and commercial impact
Wellbeing - Care patient improved experience – enabling care home providers to improve customer experience and improve customer satisfaction
HWL has invested in the development of a Co-Design approach tailored to the healthy ageing market that harnesses a raft of existing, proven innovation and change tools in a structured, flexible framework that makes co-design inspirational, accessible and impactful.
The approach - known as the HWL Ripple Co-design Toolkit - has been successfully used in a a diverse range of care home environments - from small independent homes, medium sized groups and corporate villages - with powerful results as evidenced by our interview with care managers.
Hear about co-design from one of partner care managers: