Community, Culture and Co-production
When our family moved to the beautiful Isle of Whithorn our friends and neighbours said that ‘if incomers make it through three winters they probably stay!’ Well, 16 years later the Isle is still our safe haven – and to be honest, where else would you want to live?
We moved here from the Midlands and soon felt at home - not only because of the familiar stone dykes surrounding the fields, but more importantly because of the local sense of community and the local culture created by residents and our regular visitors.
I originally joined Scottish Care as a consultant to support Reshaping Care for Older People in Dumfries & Galloway in August 2013. Since then, a small team has been developed to support a range of different R&D activities and now Health and Social Care improvements. For this blog, I’m going to focus on one unique element of our work – and, after all,  we all need a bit of culture!
Research has demonstrated that organisational culture is now a major factor in the success of any organisation or partnership. In D&G, all four partners (the NHS, Social Services, Third and Independent Sectors), have started to work together to improve the culture of our partnership. We believe that this is will help to underpin how the partnership is able to co-design, co-produce and co-deliver sustainable care and support services in the future.
Measuring and changing Organisational Culture
Working with Human Synergistics UK, a representative sample of over 2500 individuals from across our partnership completed a questionnaire called the Organisational Culture Inventory ® or OCI. This phase of our work generated two important results:
- our ‘current culture’ – where we are now, and
- our ‘ideal culture’ – where our partnership wants to be in the future
The OCI measures what is expected of members of organisations and helps us understand how different team members feel in their work role. Results are plotted on an OCI Circumflex which shows the distribution of results across 12 different ‘styles’. For example, Style 12, (‘Self-Actualising’), is where ‘Members are expected to gain enjoyment from their work and produce high-quality products/services’.
 These 12 styles are grouped into three important clusters:
- constructive styles (shown in blue),
- aggressive/defensive styles (shown in red) and
- passive/defensive styles (shown in green).
The circumflex shown below illustrates the OCI Research Benchmark, the culture of the most successful organisations and partnerships – notice all the blue!
Our partnership results have highlighted differences between different sectors and between different groups of staff – all of which have helped inform our improvement plan. Team members, from all partners, have become accredited in the use of these tools and are working together with colleagues from all localities to create improvements.
Measuring and changing leadership styles
We believe that ‘Culture happens. Leaders and managers can let it happen or they can manage what happens. It is a choice.’ We want to harness and improve the leadership across all sectors, to move us closer to achieving the ideal overall culture for the partnership.
An important element of our improvement plan is already well underway, lead by our IJB members. Research has demonstrated that to be truly effective and efficient leaders we need:
- a better understanding of ourselves
- a better understanding of our own way of thinking and how resulting behaviour is perceived by others
- an appropriate balance between ‘task’ and ‘people’ orientation.
The Life Styles Inventory (LSI) enables leaders to do just that, comparing self-reflections and feedback from our colleagues. Two cohorts of IJB members and senior leaders from across the partnership have already engaged in this process.
Working together
The LSI and OCI work together to help us identify improvements at an individual and at an organisational level. Creating the ideal culture begins with each one of us – we all need to ‘take a good, hard look in the mirror’ and see how we can improve. Is what we’re doing helping the partnership to achieve that long-term vision of our ideal culture? If not, we need to adjust our way of thinking and/or our own behaviours. Remember ‘Leaders and managers can let it happen or they can manage what happens. It is a choice.’ In fact … its our choice. Ignoring ineffective behaviours or ‘walking by’ won’t get the job done for HSCI.
As a partnership we have to be honest with each other to identify and change those things that are no longer fit for purpose. This could include a range of different things that need to be changed such as:
- improving our understanding of each others’ roles and responsibilities
- enhancing the way that our meetings are structured and who is invited to attend those meetings (and whose voice is not heard)
- the way we treat, listen to and respect each other
- sharing information across all appropriate partners to support the efficient delivery of care and support services
Focusing on the ‘tasks’ of creating new models of care, developing early intervention strategies, delivering sustainable intermediate care etc.  is, of course, vital. But this important work relies on all four sectors working together as equal partners to co-design, co-produce and co-deliver sustainable care and support services in the future. And to do this well we all need a bit of culture!
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Dr. Sue Newberry, Regional Integration and Improvement Manager, Dumfries & Galloway
