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Four key approaches to change SeCtion one
Starting the Change
To begin the change process Manager A met with key stakeholder groups to gain their initial perspectives about both the content (i.e. what the change should be) and the process (i.e. how the change will be achieved). This stakeholder engagement included:
• Spending a day in the home talking to the residents and observing their interactions with staff
• Being present on a Sunday afternoon in the home (when many of the families visit) talking to the relatives and then staying on to talk with the night shift
• Attending a staff meeting
• Meeting with the chair of the Friends of Acorns
• Consulting with her line manager in the Housing Association
On the basis of these discussions and her previous knowledge Manager A developed a Power Interest Grid of these stakeholders (Diagram A2). The tool recommended that people with low power should be monitored or informed of the change but not necessarily engaged within it. Manager A however reflected that in social care it is often the people who will be most affected who have least influence and it is vital that they are given a voice within the process. This highlighted for her the importance of thinking through how to put people living in the home at the centre of the process. She therefore secured funding from the housing association to commission a local advocacy group for older people to help support their engagement and representation. She also reflected that night staff are often excluded from such discussions, and therefore ensured that a member of night staff was able to participate in the change team (Diagram A2).
Diagram A2: Power-interest Grid applied to Acorns
High Power
Housing association Care management team
Care staff working in the day Engaged families
Low Power
Less engaged families
Care staff working at night People living in the home Friends of Acorn Home
Low interest
High interest
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