Progressing and Managing Individualised Services

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PROGRESSING AND MANAGING INDIVIDUALISED SERVICES
UNIT AIM
The aim of this unit is to facilitate the student to consider and reflect on innovative and
creative ways to progress and manage the delivery of individualised service.
UNIT leArNINg objecTIves
By the end of this unit the student will be able to:
• examine the subject of innovation and apply this thinking to the design and delivery of
individualised services
• identify the distinct features that define innovation
• critically discuss the need for organisational redesign
• identify the factors that both support and hinder innovation in organisations
• reflect on the process of managing innovation and change
• discuss the attributes of empowerment-oriented organisations
INTroDUcTIoN
In the context of disability service provision in Ireland Individualised Services can be described
as innovative; most people with disability do not receive individualised services but rather are
catered for in groups.The vast majority of services for people with disabilities are provided
by large service agencies providing residential, day, respite and multi-disciplinary services. The
2017 NIDD Annual Report indicated that 7,530 people were availing of full-time residential
services primarily in group homes or in larger residential settings and that the majority were
over the age of 35 and had a significant intellectual disability (HRB 2018, 12).There is no doubt
that many staff work hard to individualise services for the people they support, and many
organisations strive to achieve individualisation particularly through such processes as person
centred planning or quality systems such as Personal Outcomes Measures. However, even the
most determined staff or organisations are limited in what they can achieve because of
external factors including funding structures and the lack of mechanisms for implementing the
individualisation agenda.
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This unit will explore the concept of innovation in relation to public services and the capacity
of existing disability services in Ireland to incorporate the individualisation of services.
INNovATIoN AND INDIvIDUAlIsATIoN
Innovation is usually associated with the world of business where being innovative is a valued
trait in individuals and in organisations. It conjures up ideas of future-orientation, newness,
creativity and energy. A literature review by Baregheh et al across several disciplines on
definitions of organisational innovation concluded that innovation can be defined as ‘… the
multi-stage process whereby organizations transform ideas into new/improved products, service or
processes,in order to advance,compete and differentiate themselves successfully in their marketplace’
(2009, 1334). Innovation then, involves new or improved processes, services or products, and
in the Irish context all of these are directly relevant to individualising services both for the
person and for the organisations attempting to establish them. Bessant and Tidd (2011)
suggest that innovation can occur in organisations in four different dimensions:
Product innovation: changes in the things which the organisation offers
Process innovation: changes in the ways in which products or services are created or
delivered
Position innovation: changes in the context in which the product or service is
introduced
Paradigm innovation: changes in the underlying mental models which frame what the
organisation does.
In the current context of disability services in Ireland, where individualised services are rare
the development of Individualisation of services can be seen as belonging in each of these
categories.
Product Innovation: Individualising services represents a change in the type of service
provided to people who use the service, in effect it is a new
product or service
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Process Innovation: the process of individualised service design is a new process.
Although person centred planning is part of many services’
systems, ISD is a deeper and more fundamental process which will
lever change in more traditional organisation
Position Innovation: recognition of the human rights of people with disabilities and the
passage of new legislation underpinning these rights changes the
context within which services are delivered and change the
expectations of users and their allies.
Paradigm Innovation: as IS becomes more the norm in service provision, it should lead
to a basic change in the power balance between service providers
and service users, whereby people become directors of their own
service and supports.
Westall (2007, 4) suggests that innovation in social enterprises can encompass: responses to
changing funding or other environmental factors; ways of combining principles or practices
from different spheres in new ways; alternative business models which address shortcomings
in more mainstream models and; organisations which seek to decrease their dependence on
public finances in order to reduce government failure.In the world of voluntary or community
service providers innovation can simply translate to the application of new strategies and ways
of working to promote better outcomes and quality of service delivered to the people who
use the service. Innovative strategies should also seek to empower individuals who use the
service.
feATUres of INNovATIoN
By its very nature, individualised service provision is innovative in that it challenges the
traditional way of thinking about how services are delivered to people and also challenges
people and organisations to change. Although difficult to define precisely, innovation is
concerned with change and its subsequent outcomes. Osborne (1998) suggests that there are
four distinct features that define innovation:
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1. Newness
Newness can mean literally first use, a prototype or the first of its kind. However, when
related to human services this newness is defined as being new to the person, group or
organisation. Huczynski and Buchanan (2017, 651) support this idea by defining innovation in
broad terms as being ‘… the adoption of any device,system,process,programme,product or service
new to that organisation’ and further explain that while the idea or process might have been
thought of and applied somewhere else it is ‘new in this setting’. Therefore, although being
applied in other countries and settings, real individualised service provision is new within
Ireland and the overall sector of human, social, welfare and non-profit organisations.
2. relationship to Invention
Osborne explains that innovation will always entail adopting and implementing new ideas and,
in some instances, may also involve actual invention and discovery. When applied to
individualised service provision, this quite simply means that while the overall philosophy and
approach can be adopted in a general sense, the application of the approach will be unique to
each person and will require ‘inventing’ and ‘discovering’ ways to work effectively with the
person.
3. Process and outcome
The work associated with innovating is a process, or a set of actions. The results of this
process, of innovating, should result in innovative outcomes. Both process and outcome are
key. Aspects of quality and quality services in disability services is now becoming more
concerned with the outcomes in people’s lives as opposed to outputs,such as numbers served
and finances allocated. The innovative nature of individualised service provision is clearly
concerned with process, through implementation, and with outcomes as they apply to the
positive changes that should occur in each person’s life as a result of implementation.
4. change/Discontinuity
These relate to the transformation of the idea into reality; the change, and the impact of the
innovation on the organisation concerned; discontinuity. Osborne makes a clear distinction
between development and discontinuity. Development usually occurs within the parameters
of the organisation and, while change occurs, this change is assimilated into the overall make
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up of the organisation. Discontinuity, on the other hand, refers to change occurring in the
actual configuration of the organisation or what is known as a paradigm shift, whereby the
whole purpose, or raison d’etre, of the organisation is re-shaped and re-designed. He suggests
that innovation, as opposed to development, is one form of change which ‘… represents a
break with the past.What has been acceptable or adequate for the provision of public services will
no longer be so – their provision will require new structures or skills’ (Osborne 1998, 5).This may
involve establishing new organisations.
Voluntary and community groups (also termed the Third Sector or Civil Society) are often
characterised as being more flexible, innovative and more able to respond to ‘hard to reach’
populations than statutory providers. (See for example the UK government 2010 policy
document Building the Big Society) However, research by Osborne et al (2008) indicates that
the capacity to be innovative is not inherent to voluntary and community organisations, but
rather is contingent on government policy which encourages or discourages innovation. As
noted the vast majority of disability services in Ireland are delivered by this sector on behalf
of the state and the capacity of these organisations to deliver the innovation inherent in the
development of individualised services is at least open to question.These organisations have
been characterised by Conaty (2012) as ‘hybrid’ being almost fully dependent on state funding
while at the same time retaining their individual culture and ethos. Nonetheless, the culture
and ethos of organisations will also impact on their capacity to be innovative and this capacity
varies over time. Osbourne et al (2008, 53) suggest a typology of innovation and activity for
voluntary and community organisations which provide a useful framework for viewing
disability services in Ireland and their capacity to deliver the innovation of ISD. These are:
Traditional organisations: which provide specialist services but without any
significant element of change or innovation
Developmental organisations: which incorporate incremental changes in their services
Innovative organisations: which change the paradigm of their services and/or their
skills base.
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cHAlleNges for orgANIsATIoNs IN DelIverINg INDIvIDUAlIseD
servIces
Many, if not the majority, of disability service providers in Ireland fall within the traditional or
developmental types and this poses challenges for such bodies in responding to and
incorporating the changes required for the individualisation of services. Many of these
challenges are similar to those posed by the introduction of person centred planning.
O’Brien and Mount (1987) consider the challenges to organisations when deciding to adopt
person centred planning as the main focus of service delivery and suggest that such
approaches entail organisations redesigning themselves.They suggest that for this to happen
the organisation must:
1. Identify what works in individual initiatives
This requires ongoing evaluation and working in partnership with each person in order to
discover not only what works effectively for the person but also to identify any common, but
unique, approaches that can be used with other people.
2. create efficient ways to continue doing what works
Rather than attempt to prop up practices that have been maintained simply because of
tradition or culture, it is preferable to build on good practice that has been previously
identified.This in turn influences organisational culture.
3. Tell the story of the changes and their implications
Person centred and individualised services are, first and foremost, concerned directly with
people and their lives.Taking note of, recording and remembering people’s stories as defined
by their outcomes is a powerful tool for influence and change. Ideally, encouraging and
supporting people who have benefitted from such a service to tell their own stories is even
more powerful and is evidence of real ownership of the process.
4. re-allocate organisational resources and re-negotiate organisational
position to expand application of what is effective
As discussed, innovation creates change and discontinuity. In this instance discontinuity is
concerned with leaving behind the practice of traditional service provision and re- establishing
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the organisation as one that has experienced a paradigm shift.The re-negotiation referred to
by O’Brien and Mount is concerned with the re-negotiation of purpose that will take place
with service users, their families, funding authorities, staff, community and other stakeholders.
With successes, more people will receive a self-directed and individualised service.
5. Innovation: working with and within the organisation
Irrespective of whether a service or organisation is person centred or working towards an
individualised approach for people, the make-up and culture of the organisation will often
dictate whether innovative actions are welcomed. An organisation may not necessarily be
operating effectively at present but it may, nevertheless, possess the qualities that support
innovative thinking and action.
For large disability service providers there are several internal and external challenges in
moving towards individualisation.Magito-McLaughlin et al (2002) highlight that person-centred
services create opportunities for new forms of support from an array of sources and
opportunities for participation in inclusive communities. These opportunities present
challenges to the governance and structures of existing organisations in:
• Managing conflicting priorities; especially in managing the need for the agency to be
compliant with regulations and standards for group-based services and the attainment of
individual outcomes
• Individualising plans while serving large numbers of people
• Providing adequate staffing
• Ensuring adequate transportation
• Coordinating services across teams and environments
Being innovative or having an ethos which encourages creativity and responsiveness in an
agency is not in itself sufficient. Bearing in mind the finding by Osborne et al (2008) noted
above that the capacity of organisations to be innovative is contingent on government policy,
it is important to be aware of the policy environment within which disability service providers
operate in Ireland.The external policy, funding and legislative environment has a key role to
play in the extent to which agencies can progress towards IS.The Next Steps Project which
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is hosted by the National Federation of Voluntary Bodies (NFVB), aims to promote the
individualisation of services among its member organisations.The project includes 23 disability
service providers and uses a case study approach whereby each agency works on a particular
individualisation project and shares ideas, learning and solutions. The project identifies 8
building blocks which need to be addressed in order to progress with individualisation,
including issues which are internal and external to the organisation (NFVB 2015):
1. People being involved in decisions that affect their lives
2. Family leadership and engagement
3. Staff and management development
4. Community involvement and inclusion
5. Reconfiguration of budgets
6. Reconfiguration of service provision
7. Gathering and sharing evidence of change in people’s lives
8. Valued roles in families and communities
While several agencies in Ireland have undertaken work to develop some individualised
services they do so in the absence of clear government plans, systems or funding to achieve
widespread individualisation of services, relying on sourcing funding from within their own
resources, grant-aid or families. Kendrick (2017, n.p.) suggests that the current policy of deinstitutionalisation in Ireland is actually hindering the more widespread development of IS
relying as it does on the replacement of large institutions with what he terms ‘small congregate
and mini-institutional models’ i.e. group homes. The challenges facing disability services, people
with disabilities, families and the State in achieving individualisation identified by Kendrick
include the following:
National Policy and Plans for Individualisation.
Lack of clear government leadership, policy and targeted plans for the development of IS
supports alongside the closure of institutions for disabled people. The HSE is actively
progressing the Transforming Lives programme whose vision is ‘To contribute to the realisation
of a society where people with disabilities are supported; (a) to participate to their full potential in
economic and social life, and (b) to have access to a range of quality personal social support and
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services that enhance their quality of life and well-being’ (HSE 2016,16). The working group on
one of the programme’s six priority strands of activity – Implementing Policy – focuses on the
three core policies of Time to Move on From Congregated Settings, New Directions and
Progressing Disability Services for Children and Young People. However, there appears to be
little in terms of concrete targets for the individualisation of services beyond the
individualisation of funding for school leavers. And in this area the funding is usually allocated
to an agency to provide a service to the person, rather than to the person themselves. It
remains to be seen what recommendations will emerge from the Department of Health It
remains to be seen whether, or the extent to which, the recommendations of the Task Force
on Personalised Budgets will be implemented or piloted by government. This will be a key
determinant of how IS will be enabled to develop in Ireland.
funding
Funding to the voluntary disability service agencies is based on an incremental system
whereby the non‐capital allocation in the current year is used as the basis for the allocation
in the following year. Adjustments to this baseline are made for new services, salary
adjustments, and overall changes in the health services budget. In recent years funding for
services for school leavers have been based on an individual assessment of need conducted
by the HSE and an associated funding allocation to a specific service provider. The block
funding of agencies in this way means that services are provided to groups of people and it
poses the very real challenge for agencies of ‘unbundling’ of these funds so that individualised
supports can be developed. Kendrick (2017) proposes that an incremental approached should
be adopted to increasing funding for IS including:
1. A policy and programme to incrementally unbundle funds from group-based services
solely into individualised options as opposed to mini congregate models.
2. A policy and programme to allocate ‘new’ monies exclusively for individual funding
3. The provision of ‘bridging’ funding for services in the process of moving away from
congregated services to IS.
He proposes that even if a small percentage of agency budgets was allocated to the first two
of these each year, over time this would build to a significant shift in the balance of support
provided to IS.
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Agency capacity
The level of experience of developing and maintaining IS among Irish disability service
providers is limited and will take time to grow.Also, agencies need to decisively adopt a policy
and strategy aimed at individualising services for each person they serve. This requires an
agency culture that values and encourages innovation and is dependent on the ethos, history
and leadership of each agency. Huczynski and Buchanan (2007) have considered the elements
of innovation that are found in organisations and have identified those qualities that both
promote and inhibit innovation.
Dimension
Promoting Innovation
Inhibiting Innovation
challenge
People experience challenge, joy and meaning in work
and invest high energy
People are alienated, indifferent, unchallenged, and are
apathetic
freedom
People make contacts, give and receive information
freely, discuss problems, make decisions, take initiative
People are passive, rule-bound, anxious to remain
within their well-established boundaries
Idea support
People listen to each other’s ideas, ideas and suggestions
are received in a supportive way by bosses and colleagues
Suggestions are quickly rejected with counter
arguments, usual response is to find faults and obstacles
Trust and openness
High trust climate, ideas can be expressed without
fear of reprisal or ridicule, communications are open
Low trust climate, people are suspicious of each other,
afraid to make mistakes, fear having their ideas stolen
Dynamism and
liveliness
New things happening all the time, new ways of
thinking and solving problems, full speed
Slow jog with no surprises, no new projects or plans,
everything as usual
Playfulness and
Humour Debates
Relaxed atmosphere with jokes and laughter, spontaneity
Many voices are heard, expressing different ideas and
viewpoints
Gravity and seriousness, stiff and gloomy. People
follow an authoritarian pattern without questioning
conflicts
Conflicts of ideas not personal, impulses under
control, people behave in a mature manner, based on
psychological insight
Personal and emotional tensions, plots and traps,
gossip and slander, climate of ‘warfare’
risk Taking
Decisions and actions prompt and rapid, concrete
experimentation is preferred to detailed analysis
Cautious, hesitant mentality, work ‘on the safe side’,
‘sleep on the matter’, set up committees before
deciding
Idea Time
Opportunities to discuss and test fresh ideas that are
not part of planned work activities, these chances are
exploited
Every minute booked and specified, pressures mean
that thinking outside planned routines is difficult
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INNovATIoN AND cHANge
As discussed, innovation is responsible for both change and discontinuity within organisations.
Despite this differential, the introduction of real individualised service provision within the
organisation will require that change occurs on a number of levels and across a number of
dimensions. Kotter and Cohen (2002) in their publication, The Heart of Change, present
stories of people who have changed their organisations in many different fields.They have built
an interesting, useful and easily understood change model around this process. This approach
may be of assistance in reflecting on ways to introduce quality, person centred, truly
individualised services for the people who use services.
At the core of this work is the belief of the authors that ‘… people change what they do less
because they are given analysis that shifts their thinking than because they are shown a truth that
influences their feelings’ (Kotter and Cohen 2002,2). Basing their work on this premise, Kotter
and Cohen present an eight-stage process that addresses change issues effectively.
step 1: Increase Urgency
Rather than simply inform people of the need to change the authors believe that it is far more
effective to create a sense of urgency so that people feel motivated to take action. Even if
there is a certain reluctance on the part of others to engage in the process, for whatever
reasons, even valid ones, raising a sense of ‘need to’ as opposed to ‘want to’ motivates others
to action.
Creating this sense of urgency is best achieved by showing people the need for change.
Producing clear evidence, sometimes of the most ordinary kind, can produce excellent results.
Kotter and Cohen (2002, 36) suggest producing ‘valid and dramatic evidence from outside the
organisation’ that proves change is needed.
step 2: build the guiding Team
By creating a sense of urgency, people tend to be more responsive and will offer assistance,
of varying kinds and will be willing to work together even in the short term. However, while
this is a positive result, it is important to ensure that the right people are in place to drive the
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change. This can be achieved by showing ever increasing enthusiasm, commitment and
evidence that the team is viewing the change as a long-term project. Setting this type of
example, modelling, instils trust and encourages teamwork.The authors also suggest ensuring
that meetings and other associated activities are structured in ways that minimise frustration
and increase trust. Identifying and adopting new and creative ways of working represent a key
challenge in this step.
step 3: get the vision right
All sound leadership and effective change projects require a vision and, as Kouzes and Posner
(2003) suggest leaders inspire a shared vision and clearly state what can be.The importance
of setting a clear direction for the team, and ultimately for the organisation, cannot be over
stated. Kotter and Cohen (2002) pose an interesting challenge by proposing that the vision
should be so clear and precise that it can be communicated to others in one minute or
written up on one page.While visions are highly important, they must then be supported and
structured by creating sound and relevant strategies that will make visions a reality for people
and the organisation.
step 4: communicate for buy-In
An area where many envisioned change efforts falter is when the leaders and guiding team do
not successfully communicate the change and vision to others. There is a danger that such
teams become ‘specialised’ and remain aloof from the remainder of the organisation. Instead,
the change needs to be communicated broadly to all stakeholders so that there is complete
understanding and buy-in. The ultimate goal of this work is ‘to get as many people as possible
acting to make the vision a reality’ (Kotter and Cohen 2002, 83). They stress that such
communication should be kept simple, to promote understanding and also heartfelt, so that
others will clearly see and sense commitment. It is imperative that the change team address
concerns, worries and fears and that methods of communication are those favoured by
stakeholders.
This step requires what Raines and Ewing (2006) call the Titanium Rule. Most people are quite
familiar with the Golden Rule;‘do unto others as you would have them do onto you’, meaning
that the best approach to working with others is to treat other people as you like to be
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treated. However, treating people in the way that we like to be treated is not necessarily the
best approach as it does not take into account how the other person likes to be treated.
Raines and Ewing (2006) put forward the case for the Titanium Rule which is, quite simply,
treating others as they like or wish to be treated.Applying this rule entails getting to know
others as individuals and learning about their preferences. Once we know about preferences
we can adjust our style of communication and support to match those preferences. The
authors stress that ‘Practicing the Titanium Rule requires a shift in thinking. It requires empathy,
awareness, and understanding. It involves finding ways, based on what we know about another person,
to make stronger connections by adapting, experimenting, and changing the way we do things.’
(Raines and Ewing 2006, 34).The Titanium Rule can act as a key guiding principle not just in
communicating for buy-in, but also in the broader focus of person centred and individualised
service provision.
step 5: empower Action
In this step Kotter and Cohen stress that empowering people is not just about presenting
people with new authority and a new set of responsibilities and then letting them simply get
on with the work. Empowering people is concerned with removing barriers so that they can
work towards change without meeting organisational obstacles at every point. Some of these
obstacles, whether real or perceived, will have been identified in the previous step.
It may also be helpful in empowering people to find others within the broad organisation who
have direct experience of innovating and change. Encouraging these people to tell their stories
and anecdotes can inspire and motivate people, as well as reassuring them that their current
challenges are not totally unique.
The word ‘empowerment’ is one that is very much associated with the provision of disability
services and it can be quite an emotive term;‘power’ elicits thoughts and opinions concerning
rights and inequality.Although many organisations refer to empowerment in their vision and
mission statements, objectives and strategic plans, this does not alter the fact that the balance
of power remains in the hands of the organisation as opposed to the people who make up
the organisation as users of the service or as employees. Conaty (2012) in his detailed case
study of one large disability service provider noted a distinct imbalance in power between the
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various stakeholders. He stated ‘This power asymmetry was characterised …. by the exclusion of
service users, their carers or advocates from the strategic, control and decision-making mechanisms
of the organisation but more importantly from ownership and governance. Other than “Heads of
Departments” and “Sector Managers”, staff were also poorly represented in the strategic, control and
decision-making mechanisms.’ (Conaty 2012, 299). It is likely that this pattern of power
distribution is equally true for many other large disability service providers in Ireland.
Organisations which are committed to designing and delivering individualised service with and
for people must fully appreciate the nature and importance of empowerment and recognise
power imbalances among stakeholders.
Hardina et al (2007) propose a number of distinct attributes that the empowering
organisation possesses.The authors explain that these attributes ‘…incorporate skills associated
with traditional models of management as well as skills and basic principles associated with feminist
management.’ (2007,11) Empowerment-orientated organisations:
• create formal structures to support the participation of clients in
organisational decision-making. Such organisations place programme beneficiaries
on their board of directors and may create additional structures such as advisory panels
and task groups for client participation in decision making.
• create partnerships with programme beneficiaries in which all parties
(clients, staff, and board members) are equal participants. Effective partnerships
are based on the notion that all parties are treated equally and the best way to reduce
the harmful effects associated with hierarchies is to eliminate much of the social distance
among staff, clients, and board members.
• Involve clients in service delivery in order to decrease personal feelings of
powerlessness and to improve the quality of, and access to, services. The
participation of clients in the development of new programmes helps ensure that the
organisation can provide services that truly are responsive to the needs of programme
beneficiaries.
• explicitly develop policies, programmes and procedures that can be used to
bridge cultural, ethnic, gender, and other demographic barriers to effective
service delivery. Such organisations use a number of strategies to ensure that services
are provided in a manner that is consistent with the cultural norms and values of
programme beneficiaries.
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• Have senior managers who are ideologically committed to the empowerment
of both staff and programme beneficiaries. Often real empowerment is a function
of whether or not the CEO creates opportunities for participation by clients and staff.
Managers should be committed to the personal and professional development of staff and
must be able to make sustained efforts that increase client access to services and increase
programme responsiveness.
• engage in specific strategies to increase the psychological empowerment and
motivation of workers. Empowerment in organisations often involves giving employees
more autonomy or control over how they do their jobs and allowing them to problemsolve. Psychological empowerment is the term used to describe worker self-perceptions
of their ability to perform the job, as well as the ability to influence organisational
decision-making.
• Promote the use of team-building and collaboration among staff members.
Teamwork that encourages collaboration also promotes social interaction among group
members which in turn fosters commitment and develops positive attitudes.
• encourage staff to advocate for improvements in services and policies. One
method that such organisations use to improve service effectiveness is to encourage staff
to advocate for changes in organisational policies as people feel empowered when they
are able to successfully advocate for other workers or clients.This, in turn, helps improve
the quality of service delivery and effectiveness.
• recognise that management approaches can only produce effective outcomes
when a consistent funding base is available to maintain the organisation. In
order to effectively implement empowering approaches, organisations must have the
support of their funders and it is important that these funding sources support the
organisation’s philosophy and mission, particularly in terms of client and community
participation in decision-making.
• Involve clients,community constituency groups,and staff members in ongoing
evaluation of services and programme renewal. Empowerment evaluation is the
term used to describe the process for bringing clients or community residents into the
programme assessment process. This method is used to conduct agency evaluations as
well as projects that involve community-based collaboration.
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• Act to increase their own political power as well as the political influence of
programme beneficiaries. Leadership roles within the organisation prepare people to
become political activists and provide a greater sense of inclusion in mainstream society
for low-income people. Real empowerment is achieved through political action and the
creation of local organisations. Activism and lobbying by members of the client group
provides a powerful constituency base for the organisation.
• Acknowledge the limitations of participatory management approaches and
take pro-active measures to balance inclusion in decision-making with tasks
associated with organisational maintenance.This style of management is subjected
to a number of limitations and the empowerment-oriented manager will need to create
inclusive participatory decision-making structures but reserve the ability to respond to
situations that require immediate solutions.
Hardina et al (2007) conclude by stressing that empowerment-oriented organisations will use
many of these strategies to deliver services or to advocate for social change.The absence or
presence of one or more of these characteristics may not be sufficient to include or exclude
the organisation from consideration as ‘empowerment-oriented’.
step 6: create short-Term Wins
Kotter and Cohen believe that it is highly important to identify short-term wins and
acknowledge milestones that have been successfully reached. Such recognition instils
additional motivation, improves momentum and appeases any critics.These short-term wins
do not need to be substantial, but should be visible, timely and hold clear meaning for people.
These wins can be achieved quite cheaply and without enormous effort by clearly setting
easily achievable goals or milestones in the planning phase and highlighting these once they
have been reached. Other forms of short-term wins will include unexpected and unplanned
outcomes that contribute to the success of the change, recognition from an external source
and collaboration with similar projects and organisations in the wider environment.
step 7: Don’t let Up
In essence, this step is concerned with keeping the sense of urgency alive. Although shortterm wins may have been achieved and everybody has a clear sense of direction and vision,
there is still the danger that a certain level of complacency will creep in as the change project
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become customary. As with all of the stages in this model, this step requires the leader and
the team to be constantly pro-active in maintaining urgency around the project. Some of the
material for this urgency may come from the short-term wins by creating comparisons
between what people are experiencing now and what others are still experiencing through
traditional forms of service provision.
step 8: Make change stick
Rather than assume that change, in this case the introduction of individualised services, will
simply become part of the organisation’s culture almost by osmosis, it is crucial to ensure the
solidity of change by creating a new and supportive culture which will provide a sound
foundation for growth. In the early stages this may involve the creation of ‘bureaucratic shields’
(Kendrick 2002) to protect the innovation of individualised services (2002, 10) Over time,
however, when the innovative practices have become more established and stable, such shields
need to be removed and the bureaucratic structures changed so that they are supportive of
individualised service provision.
Kotter and Cohen (2002) propose a number of ways of achieving this including making the
change a distinct and central part of the recruitment, orientation and induction process of
new employees, so that these people will make this change an integral part of their work.They
also suggest that when people are being promoted within the organisation, those who act and
work in support of the change should be offered influential and visible positions.
MANAgINg INDIvIDUAlIseD servIces effecTIvelY
Menefee (2009) in his Core Competencies Model (CCM) identifies the core practice
competencies and associated skill sets that are necessary for effective human services
management.While each of these competencies are important in any form of human service
delivery, they become particularly so when considered in relation to the delivery of
individualised service.
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As a key stakeholder and driver of individualised services, the manager must first consider the
competencies and skills they possess as the committed manager is the first form of resource
that is available to design, deliver and promote individualised service provision. The
competencies required of the manager of individualised services include:
Advocate: Advocating on behalf of service users, staff members and other key
stakeholders.The skills required in advocacy include
communication, representation, lobbying, testifying and clearly
expressing the viewpoints of others.
supervisor: Supervision represents best practice in managing and supporting
others effectively and entails directing and guiding the delivery of
services while attending to the socio- emotional needs of staff at
the same time.
facilitator: This includes all the strategies the manager uses to encourage staff
in their efforts in accomplishing the vision, mission and goals of the
organisation. Such encouragement is of particular importance
when supporting staff to apply the same efforts for each individual
service user.
Team builder: Managers depend extensively on teams to deliver services to
people and will use a variety of types of teams to do so.The
manager must understand group processes and must have the skills
to support teams and individual team members in differing and, at
times, challenging environments.
resource This involves the manager acting as a resource administrator
Administrator – whereby the resources necessary to operate the agency and to
leveraging and provide the service are both acquired. Leveraging
Managing resources: resources entails identifying and securing the correct inputs
such as human, financial, physical and information and once this has
been achieved, these inputs, or resources, need to be managed
effectively
Menefee (2009) also highlights that managers need to secure and manage revenue which also
requires developing relationships and networks and harnessing influence with potential
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funders and supporters. These activities, in turn, require the manager to use skills such as
research and proposal writing, marketing and public relations for application both in the
internal and external environments.
sUMMArY
The focus of this Unit is on sustaining and managing individualised services which can be both
challenging and invigorating particularly for organisations, managers and staff working in
traditional service environments. ISD represents an innovation in the context of Irish disability
services. It represents a break from traditional ways of providing services to individuals which
are supported by organisational structures, monitoring systems and funding streams. It
challenges existing organisations to adapt and change, and the factors which help and hinder
in this process are explored in this Unit. We looked at factors within the external
environment and those which are internal to organisations in this regard.The challenges which
are internal to organisations include becoming an empowerment-orientated organisation,
protecting the innovation of ISD from intrusive bureaucracy, re-configuring budgets, and
ensuring that sufficient staff with the right attitude and skills are in place. Kotter and Cohen’s
change model was discussed as a useful way of introducing organisational change to facilitate
ISD. Finally the skills needed by managers to effectively manage and deliver individualised
services was explored.
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Progressing and Managing Individualised Services
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