Opening up closed systems - working alongside group home managers and frontline staff

​Despite new options in accommodation and support, and people trying out new things (stay tuned, we’ll write more about this in the coming months), group home accommodation (now called Supported Independent Living) remains the main model of accommodation for people with complex needs.

As of September 2021, about 25,600 people across Australia received SIL funding in their NDIS plans and there are about 4000 younger people with disability living in aged care facilities (that is a reduction from the numbers a few years ago, but still way too many people, including quite a few that are under 45 years of age). (NDIS Quarterly Report, September 2021) 

​Lorraine, a person we support, has been living in institutions and group homes pretty much all her life. Some of the experiences she had were terrible and have left her traumatised and with loads of health and well-being issues. 
 
What happened in Lorraine’s life in the last couple of years is that her world got even smaller, with her not being able to even attend a day program anymore. Now she is at home all the time and depends mostly on her group home workers to take her out, provide any stimulation at home, look at her needs and understand her ways of communicating and choice making.

If you would like to read the video described audio transcript please click here

​One of the first things we did after we got involved was to ask for her NDIS to become partly Plan Managed and then to open up to new opportunities and more transparency. Then we engaged Louise, an independent support worker, who usually visits Lorraine 3 times a week.

​Institutional care was not so long ago seen as the best option for people with complex needs. Mums and Dads were told to ‘hand over their child to a nurse and get on with their lives'. Most, but not all the institutions are now closed as they are seen, by almost everyone, as totally inappropriate. In the 1980s, group homes were hailed by many as the solutions. Family-led services emerged, quickly developing group home after group home. Some of those have now morphed into  big service providers.

Yet, many of us think, that group homes have in many ways simply replaced institutions and are not fit for purpose and do not meet the human rights of people with disability. 
 
There are plenty of resources that are available to get better at connecting and understanding the needs and wants of people with complex needs, and we will write more about this in future posts.

If you are wanting to know more now, we love to direct you to these two resources:

First, a presentation by Jo Watson, Senior Lecturer at Deakin Uni on
​“Representing the rights of persons with disability”  
​(Please note the subtiles are terrible)

 
Second, espcially if you are a worker reading this looking for some guidance on how to make more of a difference, you cannot go past this resource: Every Moment has potential:  4 learning modules that pack a punch when it comes to exploring potential. https://www.activesupportresource.net.au/

​For this post today, we want to focus on making stuff better for people in group homes, by looking at supporting and influencing group home managers and workers.

What usually don’t know what is really happening in the group home. So, our first few recommendations are about trying to work out what is actually going on:

• Visit, take time to observe, just hang out
• Enter with  a curious/enquiring mind
• Listen to the people around – other participants, staff
• Ask questions – they can be random and what you really want to know might be wrapped in a whole lot of questions you don't really care about
• Introduce someone independent into the home

​Another key to supporting people more successfully is to get to know the group home manager and workers, as they are the people who spent loads of time with the person with disability. 
 
What we know of group homes is that the quality of care and support varies, like with all services.  We also know that while the values and mission of the organisation is important, it is the values, attitudes, skills, and behaviours of the group home manager that really shape what goes on in a group home.
 
What we also know is that when we invest energy and time into frontline workers, the results are often good for people. If we build on the skills and knowledge of the workers in the group homes, most workers thrive and appreciate it and, most importantly from our perspective, care more and do more and become better workers.
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​One of the keys to supporting people more successfully is to get to know the group home manager and workers, as they are the people who spent loads of time with the person with disability.  We know it works to invest in building a relationship with group home manager and group home workers:

• Constantly share wins
• Constantly reflect back to staff the positive stuff they do
• Value their expertise and input
• Giving staff back their responsibility
• Figure out what’s important to a manager/ worker and what motivates them
• Look for opportunities to collaborate

We also know that we should invest in the longest stayers, as sadly many staff move on after too few months and all our investment in them disappears and we must start again.

​We have found working together with group home managers and worker, getting people onto the same page is important and working more collaboratively by:

• Keeping communication regular
• Having action plans and deadlines
• Having a vision and sharing that with everyone
• Creating shared agendas with people
• Building a team inspires everyone

Despite group homes being often very busy places, what keeps people working there busy is often the same day in day out (and of course loads of paperwork). There is often a distinct lack of excitement and motivation that permeates into everything that happens in the house. So, what we know works is to introduce some excitement by:

• Bring in specialists and train staff
• Acknowledge staff and what they know
• Find shared interests and nurture that 
• Work out what ‘turns staff on’ and work with that (especially if the interest is shared with the participant)
• Share good stories

​As we said above, we’ll post some more about other ways of opening up closed systems. We hope to talk about “circles” soon and we’ll also explore some other housing and support options that are becoming more readily available.