10 Lessons Learned From Implementing Self-Management (Inspired By Buurtzorg)

It is a new model that incorporates nine elements all of which need to work together to ensure we meet our objectives and most importantly to ensure that we deliver on our charitable purpose.

The element that everyone wants to know more about is the notion of self-managed teams (inspired by the Buurtzorg Model), but we are always at pains to stress that without all the other necessary culture change the teams will not succeed in isolation.

There has to be significant investment in the culture change required to genuinely trust and empower our Local Care and Support Teams and everyone in the organisation, including those in a business support role need to embrace the new way of working.

New flat structure

So where are we now? Since we began our Local Cornerstone journey in 2016 there has been much activity driving change within the organisation. We have introduced our new flat structure – going from the traditional hierarchy of nine layers of management to having no management posts in the organisation.

We have divided the company into 10 Branches which run like franchises – our Branch Leaders having the autonomy to run their branch area as they see fit as long as they report back to the centre on Quality, People and Resources.

We’ve kept the key performance indicators very simple, so (for example) our People KPI involves one question being asked – how happy are you at work?

We have reduced our organisational policies and procedures drastically to ensure our policies reflect a culture where we trust people to do a great job. So, for example, we used to have 52 HR policies we now only have 7.

Our Bullying and Harassment policy which used to run to 20 pages is now one line – "Bullying and Harassment will never be tolerated at Cornerstone." What more do you need to say?

Self-managing teams

When we first introduced the notion of self-managing teams we made the decision to make this a voluntary part of the strategy. We felt that if people were forced to work in this way it would never be a success.

We wanted those who were inspired by the vision and excited to be our pioneers to become our first teams and we were pretty confident that once they told their stories about the benefits to them and the people they support of working in this way, word would spread and others would come on board.

Many of those for whom working in this way is too difficult or not attractive have moved on to work in other more traditional organisations. We now have 31 Local Care and Support Teams across Scotland and every day when I ask our team of Coaches for an update the number is rising.

10 lessons we learned

So what have we learned?

1. You need to create a sense of urgency

If you want to build momentum and inspire others to take action there has to be a sense of urgency. A useful exercise that we carried out with our Board when discussing the risks associated with the new strategy, was to work on the risks associated with not changing.

2. Change is difficult, it’s not for the faint hearted

Many people in leadership positions within Cornerstone have remarked on how challenging the change process has been. We accept that we underestimated the resistance there might be within the organisation to change of this scale. However, nobody regrets having made the changes.

On one of the initial study visits to Zorg Accent in the Netherlands the CEO there offered a pearl of wisdom which has been recalled several times during the last year – “be brave and continue to be brave when those around you doubt the journey that has been embarked upon. Surround yourselves with people who believe in the vision and who will remind you of that vision when times get tough”.

3. You can’t over communicate

We worked very hard on communication both internally and externally, for example delivering employee engagement roadshows, producing newsletters and weekly bulletins.

However nothing replaces the power of face to face conversations focusing less on the strategic aims and more on reinforcing the vision and explaining to colleagues what the change means for them.

4. You must have the right people ‘on the bus’

Leaders at Cornerstone feel strongly that it would have been very difficult to manage the change if we’d kept people ‘on the bus’ who didn’t want to be there, or those who weren’t convinced by the vision and who weren’t willing to align themselves fully with the new culture.

The organisation lost some very loyal Cornerstone colleagues as a result but when recruiting into the new posts we ensured a ‘no compromise’ approach. Change is difficult enough without the naysayers and mood hoovers undermining what we are trying to achieve.

5. There has to be a 100% commitment to the vision and the strategy

When the new strategic plan was approved by the Board it was critical from a governance perspective that the Board of Cornerstone were unanimous in their support of the strategy. In addition, when recruiting to the new leadership team the CEO had to be confident that everyone in the team was fully aligned with the new way of working.

As the number of Local Care and Support Teams grows the organisation is seeing quite clearly those who are 100% committed and those who are still to be convinced. For some the change is either too difficult or they are convinced it won’t result in better outcomes for the people they support. Some of these people are making an active choice to go and work in a more traditional care organisation.

All new recruits to the organisation have to demonstrate their commitment to the strategy, the vision and the new culture. Cornerstone has seen many examples of where ‘working in a self organised team’ has been cited as the reason for people applying for jobs within the organisation.

6. The third principle does exist

Many books about organisational change will refer to the ‘third principle’. The principle is that you will have a third of your workforce who are immediately on board, excited, inspired and raring to go. You will have a third who want to sit back and watch and let others go first before they’re convinced of the need to change and you will have a third who are absolutely resistant to change and in some cases actively undermining what you are trying to achieve.

The leaders at Cornerstone made the initial mistake of putting all their energy into trying to convert the latter third. However they learned quite quickly that their energy was better placed in supporting and encouraging the first third. These people were their Local Cornerstone champions, the pioneers who built the momentum required for others to follow.

7. You can’t do it alone

We recognised very early on in the journey that we needed the support of others to make Local Cornerstone a success. For example commissioners of services, regulators, the people they support and their families. An important part of the strategy was to take time at the initial stages of implementation to meet with key stakeholders and to seek their support.

Some families were resistant to change. The main concern raised by families was “where do we go if something goes wrong and there is no manager to call?” Seven family members (Cornerstone supports over 3,000 people) asked for written reassurance from the CEO.

Interestingly several of these family members are now on board with the new strategy; the key learning is that if staff members are not happy with the proposed changes their reaction (whether intentionally or not) rubs off on family members visiting the service.

Once Cornerstone staff make a decision to become a Local Care and Support Team it appears that their enthusiasm and confidence reassures families that things either won’t change too much or even better still that the change may result in an even better quality of life for the person they care about.

8. You need an organisational appetite for risk

An appetite for risk is something that is often lacking in organisations concerned with the delivery of public services. Understandably where the care of vulnerable people is concerned there needs to be an element of risk aversion.

Cornerstone did a lot of work in the early stages of planning around the organisational risk profile. They were able to define what having ‘pioneering’ as an organisational value meant in practice and they worked hard to ensure they had people in key decision making positions who had an appetite for risk.

One of the work-streams at the project development stage was on ‘risk’ and all the way through year one there has been a project risk register and issues log which ensures proper management of risk whilst at the same time acknowledging the need to try new things and to embrace working in a different way.

All organisational policies and procedures have been reviewed to ensure they reflect the new culture of empowerment and trust.

9. You must always acknowledge when you get things wrong

The very nature of the testing of a new model means that Cornerstone started the journey without necessarily having all the answers. The importance of the teams making local decisions and being given the permission to do things their own way resulted in not all the answers coming from the top of the organisation (as in a normal hierarchical structure).

The leadership team are encouraging team members to make decisions and to develop tools and ways of working that best meet the needs of the people they support rather than ‘the business’. Based on feedback and capturing what works well and not so well Cornerstone has acknowledged that it is ok to alter the plan based on that feedback and any other lessons learned during the test phase.

10. If you share your story you can inspire others to be confident enough to take action

This has worked well both internally and externally. With 31 Local Care and Support Teams (at the time of writing) it appears that the momentum is gathering and that the organisation has reached the tipping point that they imagined would happen sometime during year one.

A lot of this is down to the first few teams sharing their stories about the benefits for them of working in this new way but more importantly the benefits for the people they support.

Cornerstone has successfully compiled a mailing list of over 140 people and organisations who are interested in Local Cornerstone and through the distribution of a regular newsletter they are sharing their stories more widely to inspire others to change.

Through speaking at seminars, events and conferences and by hosting study visits and compiling blogs and podcasts Cornerstone is actively promoting their Local Cornerstone journey to assist them in meeting their overall ambitious goal of transforming social care in the UK.

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Edel Harris joined CornerstoneScot, one of Scotland's largest charities, as Chief Executive in May 2008 having previously been Deputy Chief Executive of Aberdeen Foyer. Edel is also a Director of the Aberdeen Football Club Community Trust, Director of Scottish Council for Development and Industry (SCDI) and served as the first female President of Aberdeen and Grampian Chamber of Commerce.