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Four key approaches to change SeCtion one
• Family: questionnaires were sent to all family contacts and the members of the Friends of Acorns and two drop in sessions offered for people to share their views directly
• Staff team: two focus group sessions were undertaken with all staff (including night staff) required to attend one of the focus groups
• External stakeholders: Manager A contacted the team manager of the social work team, the clinical lead within the dementia team and the older person’s commissioning lead in the local authority.
Within all of these the same questions were asked:
• What is good about Acorns?
• What is not good about Acorns?
• What resources have we got to make things better in Acorns?
A pure Appreciative Inquiry approach would have only asked about the positives, however Manager A wanted to understand also what stakeholders saw as the priority for change and therefore questioned about what was not working so well. The responses to different questions were written on postcards, with different colours for each stakeholder group. The change team spent half a day going through the feedback and theming the different responses to each question so that they could gain an overall picture of what was seen as good and what could be used to make it better. The aims of the initial brief from the organisation regarding the environment and filling the vacancies had also been raised by most stakeholders. Feedback regarding the practice in the home had been mixed, with many people supporting the current approach and being wary of any change. There were quite a few concerns raised regarding the potential for the housing association to change the caring culture of the home.
Deciding how to change
The second stage of Appreciative Inquiry is ‘Dream’ in which stakeholders come together to develop a ‘vision’ of how the service can be better, a ‘purpose’ to create the vision and a ‘strategy’ of how to move to this vision. Key to the process is that the ‘Dream’ has to be shared – by the key stakeholders. If they do not share the vision then there is a danger that there will be resistance from stakeholders that will prevent the dream being achieved. Ideally, the change team wanted to hold an event to which all the residents, carers and staff would be invited. However, when they thought through the practicalities and cost of holding such an event they realised that it would not be possible. Most of the people living in the home would find a gathering with so many people a difficult experience. Furthermore from the ‘Discovery’ phase it looked as though there were few relatives who would actually want to participate.
The change team therefore decided to invite a sample of staff, relatives and the friends of Acorns to a workshop to develop a ‘Dream’ which would then be shared with the wider range
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