Is the disability sector’s approach to support worker engagement wrong?

Employee engagement surveys are increasingly becoming the norm in the human services sector. However, while it is encouraging that boards and executives have gained an interest in metrics like eNPS, the focus of many organisations is just an incremental change in this score that often can’t be differentiated from chance. Empathia Group believes that an engagement survey won’t benefit an organisation unless it drives immediate change with large effect sizes.

Organisations likely have limited time to get this right. By 2024 we will need an additional 83,000 workers, and many organisations already report extreme difficulty finding the right people. Organisational turnover can be as high as 40% in our sector, and we know that this is antithetical to meaningful person-centred outcomes. Having the data to make effective, immediate decisions will become a competitive advantage for organisations that get it right.

There have been some limited attempts to attain a genuine understanding of the engagement levels of the support worker workforce. The NDS Engaging the Workforce for Disability was a concerted attempt to gain a decent sample size. The methodology was robust and psychometrically validated, yet we failed to see significant changes in workforce engagement or structures of our workplaces. Unfortunately, the report is limited in identifying direct interventions that will have tangible outcomes for people.

Empathia Group is of the view that many engagement surveys fail to have a tangible impact because they focus on domains that are of only secondary importance to front-line workers, miss crucial factors or conflate key issues with less important problems. We also see that tools fail to understand that many organisations provide the same offer, with the same structure, and minimal wage, development or training variances. For us, it is more important to understand your position in this mix, rather than an absolute improvement between years.

Empathia Group has seen that some issues are essential to support workers. While hygiene factors such as salary and benefits are important – it is difficult to vary them under the SCHADS. While mission is key to organisations, they can seem more or less identical from the support worker perspective. Empathia Group finds that there are some unique NDIS elements that make a real difference:

  • Do support workers feel that the behaviour support plan is adequate to address the customer’s needs?

  • Do support workers feel that new staff receive an adequate induction, with sufficient shadow shifts and training?

  • Do support workers think that their roster is managed fairly?

  • Do support workers feel that their supervisors can safely manage the needs and behaviours of their customers?

  • Do support workers feel that person-centred outcomes are being deliberately pursued and achieved for their customers?

  • Do support workers feel that their supervisor adequately manages their clients’ dignity and risk concerns?

What we realised is that these questions are highly specific to the sector. You need to have worked in a placement to understand how crucial these issues can be, especially in the context of an identical offer between providers. It is also likely why psychometrically validated tools often fail to lead to tangible outcomes. Since they are predicated on a broader offering, they simply lack the specificity to capture these crucial issues.

It’s not just us who is starting to think this way. Much of the literature in our space can feel purely anecdotal, without reference to effect size. A promising set of research is being published by Lincoln Humphreys, Christine Bigby and Teresa Lacono at La Trobe. They are undertaking research to quantify the impact of organisation culture on actual quality of life (QoL) outcomes . The research is fascinating in that it identifies relatively few determinants of QoL outcomes from a cultural perspective. Their methods, including factor analysis (essentially using Eigenvalues to determine non-overlapping determinants), led to a psychometrically valid assessment of culture. They then set about to predict QoL outcomes using their culture scale. They reported a fascinating finding that we will lift straight out for impact:

“Only Effective Team Leadership (γ = 22.02, z = 2.74, p = .006) and Alignment of Staff with Organizational Values (γ = −25.11, z = −2.06, p = .040) significantly predicted engagement in activities”

For us, this is extremely surprising, given that their culture scales assess many different domains. However, for those interested, Emma Bould, Julie Beadle-Brown, Christine Bigby, Teresa Lacono produced an excellent study into effective front-line leadership (practice leadership, as they term it) that provides genuine guidance for organisations looking to differentiate themselves.

These findings from the literature aren’t surprising to us at Empathia Group. There is very little that differentiates providers given the cost model and the constraints from the QSC. However, one thing that does vary considerably is the effectiveness of the front-line supervisor. Indeed, while many organisations are setting about maximising these spans of control, they appear to be a significant determinant in engagement, culture and actual outcomes for the people we support.

As organisations seek to optimise away from supervisory relationships, the literature points in the opposite direction. There is, unfortunately, an enormous amount of variation in performance and culture between SIL settings. It is dedicated, engaged, and present supervisors that disproportionately influence team behaviour and culture. While the P&L incentivises less supervisor engagement, it may be one of the few dimensions that organisations can reliably lean on to improve their engagement and performance.

Empathia Group has also observed a major variation in supervisor effectiveness. We have seen settings where front-line supervisors continuously optimise to minimise their contact with staff. However, we have also seen supervisors constantly engaged, always seeking opportunities to improve staff performance and genuine instances of active support. You’ve likely known both kinds of supervisors. Our position is that the latter is crucial, but often poorly incentivised by the organisation’s culture. The degree to which your organisation facilitates and rewards these frontline supervisors is likely a significant determinant of your culture, engagement and client outcomes.

 

Turnover

Empathia Group knows that many people work as support workers while pursuing their education, so many turnover instances are unavoidable. Conflating this turnover with people who leave for other organisations limits your ability to understand where you can make an impact. When we isolate staff moving to another organisation and using some new metrics we identified, we can start making actual predictions about intention to leave, turnover and burnout. With this information, you can make genuine changes to your program that will allow you to gain an engagement edge and compete in the sector.

If you think differently about the disability sector and are interested in sustainable competitive advantage, drop us a line.

Empathia Group has designed an NDIS specific engagement survey focused on frontline staff. Click through on the link below to find out more.

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