How This Organization Is Transforming The Social Care Sector In Scotland
The Scottish social care sector is subject to a fast changing and challenging external environment, leading many care provider organisations like Cornerstone to seriously consider options for change. I want to share a story with you that started in 2016 when Cornerstone was coming towards the end of a three year strategic planning period and we were starting to think about the future.
With the emphasis on austerity and the resulting public service funding crisis, the social care sector in the UK has become an industry that in many cases has lost the focus on the person requiring care and support.
Time and tasks have become the order of the day with often stressed, low paid workers following a schedule that has more in common with a manufacturing production line. The power sits with the commissioners of the service who are under enormous pressure to work within very restricted budgets.
The trading of a commodity to the lowest bidder is commonplace and the price of that commodity to include a decent rate of pay for the person delivering the care, has become increasingly rare. Like most social care organisations Cornerstone had spent the previous 3 years responding to budget cuts, trying to be as efficient as we could be.
But when you are sitting at a Board meeting discussing whether or not you can afford to pay social care colleagues, who do amazing work every day across Scotland, a living wage – you know something needs to change.
I drove home from work that night reflecting on our Board discussions about how we were waiting on everyone else to do something about the situation we were in – the commissioners of our services, our trade association, local and national politicians...
I was fed up with attending meeting after meeting; conference after conference where we all talked about the need to change, but nobody seemed to actually be doing anything about it.
So with the support of Scottish Enterprise, I and other senior colleagues took 3 months out of the business and carried out an extensive piece of research looking at successful business models from other countries of the world. We decided not only to look at other health and social care organisations but to study and visit inspiring private sector businesses such as South West Airlines, Timpsons and the Whitbread Group.
I read as many books and papers as I could including a book called Reinventing Organisations by Frederick Laloux. One of the case studies within that book is of an organisation in Holland called Buurtzorg – which translated from the Dutch means Neighbourhood Care. Our visit to Buurtzorg – which translated from the Dutch means Neighbourhood Care. Our visit to Buurtzorg inspired a lot of what was to follow.
We carried out some market research with the people we support, families of people we support and also held focus groups with people in the age range 25 - 45 years who had never had any involvement or connection with social care or social work services more generally.
It was fascinating that the aspirations and expectations of those already in the system were so much lower than those who were approaching the market research as consumers with no point of reference. Our research and more importantly our conversations with the people we care for, tell us that individuals who require care and support really don't ask for much;
- They want to be supported by a small team of people who know them well and share their interests;
- They want to be supported by professional people who understand their disability or condition;
- They want caring and empathetic people in their lives who use their imagination and creative skills to design services around each unique person;
- And, families in particular need practical help and advice to navigate the system.
So we pulled all of research together and Local Cornerstone was born.
Goal and objectives
Our ambitious goal for Local Cornerstone is not only to improve the way Cornerstone does things to ensure we are in a position to continue to provide great care and support to even more people for many years to come, but also to take our learning and share our stories to transform social care in the UK.
Local Cornerstone has four objectives:
1. To continue to put the person at the centre of our activity and assist them to live the life they choose
Our ship wasn’t broken. Despite all the pressures, like many other care organisations we were continuing somehow to provide good quality care and support. However the ship was rocking and creaking and we recognised that if we wanted to continue to meet our charitable purpose – to enable the people we support to live a valued life – a life they choose – we needed to have a serious rethink about how we did things.
We were delivering on our contracts and doing that well but there were serious limits to us being able to do all the additional things that allow people with disabilities and other support needs to live a valued life. There was never enough time, there was no additional budget, and there were so many policies, procedures, rules and regulations which meant we were spending far too much time on paperwork and bureaucracy – valuable time that should be spent with the people we support.
Our charitable purpose is at the forefront of all we do at Cornerstone – it’s our compass, and yet with all the challenges we were facing in 2016 it was losing its vitally important place in guiding our business decisions.
2. To strive to do more than we are contractually obliged to do
Cornerstone was not established solely to be a provider of contracts on behalf of local government. These important contracts became the vehicle upon which we could deliver our charitable purpose. However in recent years, as you will all understand, our contracted care often provides just the minimum and there is less and less opportunity to genuinely place the person at the centre and provide a truly person-centred service. This is one of the things we hope Local Cornerstone will address.
3. To genuinely value social care as a profession
This is one area that we feel really passionately about. Lots of people and organisations say they value the profession but their actions and behaviours fall short of the rhetoric. Power needs to be felt within local communities where one of the most intimate of transactions is delivered by people who are trusted to do a great job. To this end Cornerstone has introduced a flat operating structure of up-skilled, professional carers working in neighbourhood self managing teams operating within a culture of empowerment and trust.
We are changing our culture to remove hierarchy, replace traditional management with a coaching approach and by stripping out unnecessary policies and procedures we are trusting people to do the right thing. We only recruit and retain the very best people by hiring for values. We are improving staff retention and happiness by demonstrating our appreciation of the wonderful work our colleagues do and by allowing team members to manage their own workload.
We are changing our culture to remove hierarchy, replace traditional management with a coaching approach and by stripping out unnecessary policies and procedures we are trusting people to do the right thing. @CornerstoneScot @Edelharris
By reducing our central overheads and as a result of a significant investment in technology we have managed to do all of this in a financially sustainable way. Conversations about paying our colleagues the Living Wage have become irrelevant.
4. To use our charitable income to do some amazing things that enable the people we support to live a valued life
A key part of Local Cornerstone is the establishment of the Cornerstone Foundation. We have separated out our contracted work from our charitable activity and based on a model we saw in the States we have created the Foundation to raise and more importantly to distribute funds to our Branches and Teams, the people we support and families.
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.
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I’d long read articles and books concerning progressive organisations with a quiet envy. Envious and also slightly mystified as to how these businesses actually made it happen - when did the opportunity for such a significant change ever appear. All these transformative, adaptive, downright off-the-wall ways to revolutionise the way we do business - they all read well, really well - but I couldn’t get my head around how to take those first few radical steps.