Leading a Team of Care Home Professionals - Case Study Example

 Leading a Team of Care Home Professionals Case Study The phenomenon of leadership has been researched upon extensively, it is a vital feature of human beings and due to this valuable attribute certain changes occur for betterment of society and humanity as a whole. This change usually driven by the leadership qualities of individuals gives us a new purpose, it re-aligns our objectives and goals making us work even harder and become more committed to our jobs. Additionally it inspires us to learn and adopt the best practices of individuals and other industries, making us more efficient and successful in the field of healthcare. This case study is a reflection and practical comparison of my own experience as a professional homecare provider and the contemporary leadership theories. My work would draw upon the observations and self experiences resulting in identification of primary leadership traits and qualities required to lead a team of homecare professionals. As discussed above much work has been done on leadership and its theories although practical amalgamation of these theories with desired attributes in a homecare professional has not been worked upon much, hence making the paper unique and valuable for homecare providers and individuals leading a team of homecare professionals. 1) Contemporary Leadership Theories 1.1. The trait theory of leadership This theory suggests that successful leaders have unique traits or personality characteristics, those characteristics cannot be learned by others and may be bestowed upon these leaders by genes or possessed by them by birth. Countless attempts have been made to document and observe new leadership attributes present in politicians, artists and soldiers of early era and business leaders later on. The notable big five framework devised by Costa & McCrae in 1992,explain through scientific finding that the five common abilities were found in successful leaders; these qualities are openness, Conscientiousness, Extrovert-ness, Agreeableness and Neuroticism. All five of these qualities on a scale can reach from minimum to maximum and may exhibit a certain leadership style. For example the quality of openness can be maximum when the individual is highly inventive and explorative to it can be minimum if extreme cautious approach is exercised. This trait approach helped in recognizing and identifying many traits that laid foundation to further research and studies although the view that unique traits cannot be learned attracted much criticism in the modern age. The profession of homecare regardless of the field requires certain traits and as many researchers believe core traits are part and parcel of the inherent personality, similarly homecare professionals possess certain traits learned through experience or practice although by no means are these professionals born with such qualities. In light of the big five, openness is discouraged and leaders require their team mates to adhere according to the stipulated policies, medical literature and practices of their own profession. A more scientific and cautious approach is adopted although the explorative nature of homecare provider can lead to diagnosis of an underlying disease resulting in early medical treatment. In terms of conscientiousness, the leader must train the subordinates to adopt a highly organized approach as opposed to a care-free or easy-going approach. Similarly the homecare provider must be extrovert and instil trust in the subject, experience reveals that many patients exhibit shyness and adopt an introvert approach in expressing their feelings or defining their need. In such cases the provider must communicate effectively and gather as much information as possible in order to effectively help the patient. In homecare practice agreeableness is based on contingent situation although the profession requires friendliness and high level of compassion but considering the health and needs of the patient it is recommended that all the demands of the patient are hard to meet sometimes leading to harmful situations, such as patient asking for an increased dose of medication as opposed to doctors prescribed quantity. The fifth factor, neuroticism is extremely vital for this profession and the leadership must train and build confidence in their team members, nervousness in homecare providers can lead to disasters and result in harm to the patients. Leaders can utilize the above mentioned traits and devise their training programs and practices accordingly in order to develop more effective teams of homecare providers (See Table 1). 1.2 The Path Goal Theory The leader in this particular theory satisfies and motivates its subordinates by exhibiting a behaviour adjusted according to the changing circumstances and contingencies. Certain behaviours were identified in this regard by the theorist Robert House (1971); these behaviours are directive path goal clarification behaviour, achievement behaviour, participative behaviour and supportive behaviour. This theory has situational flexibility as it allows the leader to adjust their leadership style according to the situation or circumstances faced in working environment, attributes of workforce and exhibited performances towards achievement of goals. Leading a team of homecare professionals requires the leader to be multifaceted; it is vital that the team members understand their objectives and individual roles and perform their duties accordingly as suggested in directive path goal clarification behaviour. The adjustment of behaviour depends on the circumstances and the exhibited behaviour by the team member, the profession requires a thorough approach and patience as the subjects tend to become difficult or sluggish with anger and frustration due to their medical condition hence it is important for the leader to recognize and reward achievement behaviour. The leader may not participate in routine job but leading by example or participative behaviour can be shown by treating colleagues and subordinates with respect and empathy. A supportive behaviour from the leader can do wonders in this job, there were instances were leaders were consulted by their subordinates on urgent basis and a prompt response helped them resolve a patient’s issue effectively. 1.3 Motivational Theories Fredrick Winslow Taylor coined the idea that employees are motivated by the monetary gains and that work should be simplified in order to increase production efficiencies, workers should be trained and paid according to the items produced. This theory was somewhat mechanical and an alternate was provided by Elton Mayo who argued that workers are not motivated by money and that social needs are equally important, other factors identified by Mayo were communication, involvement from manager and cooperation within teams. Another interesting point of view was given by Abraham Maslow who categorized certain psychological needs that employees tend to fulfil in order to remain satisfied with their status in society and at work. These five needs were classified as physiological needs, safety needs, Social needs, esteem needs and self actualization; according to Maslow as one need is fulfilled, the employee makes efforts to fulfil the next one wanting to go upwards in the structure (See Figure 1). Another important theory on motivation was provided by Fredrick Herzberg who in extension to Maslow’s theory added that employers can add certain factors by which employees can be kept motivated, factors like democratic way of working, job content and other surrounding factors to the job. The motivation theory provides the most concrete relevance to the professions related to homecare and there is an inevitable need to address job enlargement, job enrichment and empowerment issues. The routine of a homecare worker is repetitive and mechanical with less autonomy to make decisions or empowerment as a bad decision can lead to fatal accidents. Most homecare providers work individually, there social needs at work are not fulfilled as a result the quality of services if gone unregulated can result in lethargic work behaviour and carelessness. To keep employees motivated and dedicated to their work, leaders in homecare need to encourage team activities, frequent trainings, outbreaks and ensure that variety of assignments are handed out to homecare providers (Sullivan-Marx & Gray-Miceli 4). In order to maintain a courteous and caring attitude towards patients the professionals in this field need to value their jobs and the contribution they are making in order to make the life of subjects easier. The job includes work in shifts hence a proper work life balance should be kept in consideration when designing the homecare provider’s roaster. Additionally the provider may serve in patient’s home, nursing home, children facilities, hospices and rehab centres, this magnitude of change is an opportunity for the leader to assign various tasks and responsibilities to the provider hence enlarging and enriching job to some extent. Training programs related to basic healthcare and additional areas such as emergency responses, CPR, CRB can be valuable for employees, providing them with an enhanced scope and enhancing their expertise for the future. Furthermore training and certification courses related to relevant legislations, policies and practices should be offered to the employees with certification for first aid a mandatory requirement for all. These planned activities should not only enhance the performance of the provider but also make them value their jobs further. 2. Role of a Leader in Home Care 2.1 Strategic Leadership Home care settings bear a rather sophisticated service model as compared to other healthcare organizations. The leaders in the home care settings are expected to go an extra mile and provide a highly compassionate care with extensive use of problem solving skills and innovation. Since the profile of the patients vary greatly as compared to other healthcare organizations therefore it is difficult to levy standard strategic practices in the hospice settings. In care homes, mostly patients are elderly people with end-of-life health conditions where most of them suffer from chronic diseases such as dementia, leading to lower self-esteem. In such conditions, the patient becomes highly dependent on the carer and emotionally fragile simultaneously. Due to these conditions, even the carer needs necessary support and motivation to have his/ her goals aligned with organizational objectives. Therefore, a great deal of responsibility levies on the organizational leaders in care homes to ensure that necessary practices such as compliance to health and safety procedures and other legalities, are duly performed with organizational objectives being met with high service provision to the residents while keeping the workers and carers motivated at their current job (O’Hanlon-Nicholas). Ensuring that all these areas are well-taken care of, requires an extensive use of strategy management. The leaders are expected to have a strategic plan in place which can act as a guideline for future practices and may also help out in terms of deviation from standard practices. 2.2 Application of Best Practices Application of best practices is of fundamental value in care homes due to higher degree of reponsibilty on the leadership and carers working in this setting. Best practices define the scope of basic guidelines which act as the standards against which the quality of current procedures can be measured. Best practices can be of various types such as industry norms, government-defined procedures, organizational practices etc. In care homes, it is important to identify the need of the patient/ resident and then apply the best practices accordingly. It is also important to take care of the fact that the care homes have flexible working requirement (Best Practices Preview). Every elderly patient is different with unique requirement therefore standard set of procedures will be difficult to apply on resident as well as carer. In such circumstances, it is important that leaders have multiple set of procedures which can be applied accordingly ensuring the well-being of the resident. However, necessary supervision is equally important in such scenarios where multiple guidelines are present to ensure that the carer is aware of the practices to follow in relevant circumstances. Best practice related to administration, business and financial management, marketing and business development, client services customer’s services, internal human resource management, risk management and compliance, quality management, and state regulations, can be standard however resident management can be flexible in nature. 2.3 Change Management In care homes and hospices settings, it is important that the leadership must be aware of the organizational requirements for change in fundamental policies and procedures and must incorporate these changes accordingly. During this change management, leadership needs to adapt to the changes required by involving its own workforce. The overall paradigm of current care homes needs to be changes from “caring for” to “caring about” (Wild 1). Furthermore, all levels of management must be involved in this change management from home managers to basic carers in order to ensure that the concept and ideology of remedial care home is adopted by all. Furthermore, it is also important that current policies and procedures ensure that same organizational resources are used differently but with more efficiency and effectiveness. Gaining support on the cause of change management also provide necessary economies of scale (Wild et al 5). Also, new business development is a fundamental part of change management since the overall organization would be restructuring. In the given change management scenario, the role of leader would be of a change agent; someone who would initiate the change, support it and make it clear for others to adopt. 2.4 Training & Development Where National Health Services have promulgated many reforms for training and development of health care workers, it is significant to ensure that these reforms are equally applied on care home workers too (Moiden 24). Due to the working model within which these care home workers are operating while dealing with highly difficult patients who not only have physical health disorders but also psychological issues, it is important that necessary training according to national standards must be provided to them (British Geriatrics Society 3). In such circumstances, a huge responsibility is levied on industry leaders in care homes with reference to education and training of these workers. Other than on-job training, formal education and necessary courses are of fundamental importance which is the sole responsibility of care home leaders i.e. home managers etc. 3. Necessary Skills for Leaders in Care Homes In the hospice settings, the role of leaders varies from a traditional leader in other healthcare settings. In traditional health care organization, the leader has a primary responsibility of ensuring the well-being of the patients along with carrying out organizational procedures in the most effective and efficient manner. However, in care homes, the leader is rested with another fundamental responsibility other than these traditional duties: caring for dignity, independence and rights of the elderly residents. Care homes are a replacement of the actual home so elderly patients who are already having a lower self-esteem due to increased dependence over others (Moiden 155). Therefore, the responsibility of the leaders increases in these settings. Previous experiences in care homes has helped in developing an understanding that an ideal care home leader is expected to be responsible for physical and emotional well-being of the residents. Furthermore, ensuring that the team members are aware of the necessary policies, instructions and practices along with organizational objectives is also one of the fundamental responsibilities of the leader. For this purpose, individual guidance, meetings, staff supervision, are effective steps to follow. In addition to that, a leader is expected to be a supervisor of the staff performance. Any digression from procedures compromising organization and residents’ wellbeing is leader’s responsibility and necessary mitigating actions are also fall under the same scope. Other than these basic responsibilities, an ideal leader is expected to assist carers through assessment and reviews and also provide necessary assistance to the relatives of residents as well. Ensuring that the organization’s processes adapt to the needs of the elderly residents is also the key duty of leader. For this purpose, necessary planning, implementation and then change management are the areas which require leader’s attention (Harvath et al. 192) In addition to these resident responsibilities, a care home leader is expected to be well-versed with other management areas such as health and safety procedures in case of fire, other emergencies i.e. resident falls, along with food hygiene, housekeeping, drugs administration, infection control, compliance to directions of home managers, maintenance of relationships with the community and volunteers, and assets management i.e. building and equipment management. 4. Recommendations Like other segments of healthcare sector, care homes also require effective leadership. Where an ideal leader is expected to be well-versed with the relevant practices related to effective resident, staff and asset management along with public relations, he/ she is also expected to be an effective human resource and business manager. Prevailing practices have shown that the leaders in care homes are following an autocratic model of leadership instead of democratic one whereas the organizational environment in care homes requires relevant flexibility (Moiden 49). Secondly, carers also tend to lose motivation since they have to deal with patients with chronic conditions such as end-stage dementia or Alzheimer where carer fails to identify any value addition since patients show little responses to care provided. Hence, in such scenarios where workforce is susceptible to lack of motivation, it is important that the leader provide necessary supervision and guidance, introducing measures for staff motivation and also stays abreast of the current practices in care homes so that staff can be further facilitated with the guidance provided (Hingley & Cooper 87; Cubbon 32). Employee’s training, assistance, safety and rewards are the areas requiring special attention. Leaders are further responsible to demonstrate that the management is committed to the well-being of its residents. This ideology is required to be reflected in all the policies and procedures and also from the actions of the leader. Furthermore, commitment to overall organization and human safety is another important area requiring attention. Employees and residents both need to feel secure while staying in the care home. Necessary meetings and follow-ups along with reporting of concrete measures on the subject matter will eliminate the concerns of the workforce and resident’s relatives on the subject matter. Where UK government has initiated My Home Life program, it is the responsibility of the leaders to adhere to the guidelines provided in this program in order to introduce best practices into organizational policies (British Geriatrics Society 7). Elderly patients in care homes expect dignity, identity, independence and power of decision making along with necessary assistance. It is the responsibility of a leader to ensure that these expectations are met. Secondly, mitigating barriers in operations’ efficiency and effectiveness, employee’s training and guidance also define a large area of leader’s responsibilities. Hence, development of resources, empowerment of employees, stress mitigation in residents and employees, change management, maintenance of momentum by being proactive, creating community relationships, and ensuring well-being and satisfaction of residents, relatives and employees defines the scope of leader’s responsibilities in care homes. Appendix A Table 1. The Big Five Factors: Openness Cautious Exploratory Conscientiousness Easy going Organized Extraversion Reserved Outgoing Agreeableness Unkind Friendly Neuroticism Nervous Confident 1 2 3 4 5 Figure 2. Works Cited “Best Practices Preview”. Inhomecare. 2010. Web. 22 Nov. 2012. “Best Practice Themes”. My Home life. 2010. Web. 22 Nov. 2012British Geriatrics Society. Quest for quality. 2011. Web. 22 November 2012. Costa, P.T.,Jr. & McCrae, R.R. Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) manual. Odessa, FL: Psychological Assessment Resources. 1992. Cubbon M. 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Using an adapted model of care to manage change. 4 Apr. 2012. Web. 22 Nov. 2012 Wild, Deidre, Ala Szczepura and Sara Nelson. Residential care home development. May 2010. Web. 22 November 2012. Wong CA, Cummings GG: The relationship between nursing leadership and patient outcomes: a systematic review. Journal of Nursing Management, 15.5 (2007): 508-521. . Read More