Residential care facility's staff plays an important role in the daily lives of residents; unfortunately these facilities are usually faced with organizational obstacles and lack of information that prevents them from taking proper care of residents (Smith, 1998). This organizational behavioral case study is about a residential care facility which is part of a parent company that runs six different residential care facilities. The management of the company observed, this residential care facility facing serious problems. Turnover rate was high, performance was poor and economic losses were high.
In order to diagnose and solve the problem; parent company conducted a culture survey in all of its residential care facilities in which each member was bound to participate. The results were satisfactory for all residential care facilities except this care facility which showed totally negative results.
Looking at this serious situation; management hired a new manager in April 2012 which was the third entry in same year. However, this time the management did not bring someone with nursing residential management background. In contrast, they hired a person with pure management background in the health and community centre. This new manager was assigned with the responsibility of bringing a positive change in the culture of residential care facility; and improving its performance and economic condition.
Organizational Culture before Change
The new manager worked to find out the cultural problems of the residential care facility. She observed that the environment of the facility was not friendly at all. Staff members, leaders and residents including their family members were facing lot of problems. Following is the list of the cultural problems that were noticed by the new manager:
Employees Satisfaction Level: Employees were highly dissatisfied, had lot of complaints and were working with a very low morale.
High Turnover: The turnover rate was very high at all levels of the facility; that included nurses, team leaders, senior levels and also management.
Low Quality Care: Continuous changing of staff members, team leaders and managers had badly affected the quality of clinical care and they didn't know what type and stage of clinical care was required for residents.
Absenteeism and Frequent Sick Leaves: Absenteeism was very high and taking sick leaves was very common. Surprisingly, the staff was not responsible enough to call and inform that they will not be performing their duty. Agency staff was highly used but there no system for brokering staff so other organizations were approached for solving the problem.
Community: A pastoral service was available for staff, family and residents but was only used by residents on referral base.
Lack of Reporting and Monitoring: There was no proper monitoring system for looking at the contractors from podiatrists, pathologists, dieticians and others. Moreover, in contrast to other residential care facilities, this facility did not have any culture of reporting facts, despite the fact that there was system to report everything.
Irresponsible Attitude: No, notes were made in the files of the residents regarding regular activities so there was no history of any problems or clinical issues for which they were treated.
Low Occupancy: Due to poor performance, unhygienic conditions, irresponsible staff and lack of quality of care; residential facility suffered low occupancy and 10% beds remained vacant.
Management/Leadership Styles within the Organization
Looking at the various problems and worst condition of the facility; new manager decided to bring an appropriate change in the culture of the organization. She realized that the staff members, team leads, residents including their family members; all needed proper attention and monitoring. She came up with new strategies and worked hard to change the culture of the facility so that the behavior of the employees can be altered.
In order to do so, she used the participative style change management strategies and formulated new management style for the facility. Literature also supports the idea of using participative style in order bring a successful change (Nakata and Saylor, 1994)
According to Atchison (1998); the staff structures at residential care facilities are usually hierarchical which prevents the staff members from providing quality care to the residents. Therefore, the first and most important step taken by the new manager was the removal of restrictions and barriers that prevented the staff, leads, residents and others from approaching managers.
Unlike before, when managers were not approached and complaints were taken to the Department of Health and Ageing (DHA); she invited everyone to openly communicate with her and share their concerns, problems and issues. Moreover, in order to create good and frank relationships between the people of the facility; she started the family and staff fun days. This gave the room to staff members, residents and their family members to meet each other and have fun with each other. They not only developed good relationships but also started feeling a sense of community.
She changed the traditional laissez-fair leadership style in which managers had given freeness to staff for running facility. Indeed she started a proper regular system and enforced accountability so that all staff members and other employees perform their duties with responsibility. She knew well that the delegative leadership is not the right choice at a place like residential care facility. It always results in low productivity and poor performance that cannot be tolerated in health care.
Organizational Culture after Change
Robbins (1986) gave the idea that in order to bring change in an organization; the management should promote new culture and encourage staff to adopt the changes. Since the new manager was good at management and finance and did not have affiliations with anyone in the facility; she succeeded in bring a positive change in the organization. With the help of consulting, communicating and sharing, she was able to manage different sectors of the facility; that included from health services to fundraising. Her management and leadership style brought following changes in the organizational culture.
Employee Satisfaction Level: Reports showed that the number of complaints from employees drastically reduced with the passage of time and now they feel satisfied working in the facility. A noticeable change was also observed in their behavior towards work.
Attendance: An impressive improvement was also seen in the attendance of employees. Sick leaves reduced by 52%, agency staff usage decreased by 50% and employees started taking responsibility of acknowledging and informing about their work.
Occupancy: Improvement in working attitude and performance of staff also brought improvement in the occupancy of the facility. The vacancy rate shifted from 10% to 3% only in a period of 7 months, which positively impacted the economic condition of the facility.
Community: Manager started family and staff fun days which helped in developing relationships between the staff members, residents and families as they all worked and had fun together.
Employee Attitude: Proper attention to staff and continuous monitoring gave a feeling of responsibility to them and serious & responsible attitude was seen in their performance.
Monitoring and Reporting: New management revived the culture of monitoring and reporting everything; including the staff's conditions and clinical aid given.
Improved Quality Care: Improvement in the attendance, sense of responsibility, behavior towards work and staff to resident relations ultimately improved the quality of care at the facility.
Motivation: A Tool for Improving Performance within the Organization
Motivation plays a critical role in encouraging employees to work effectively and efficiently. It is very difficult for an organization to achieve its goals if it does not motivate its employees. There are several ways through which employees can be motivated. For instance, their performance should be monitored and good word rewarded. Their concerns must be listened and recommendations valued. Literature highlights that the participative style of management that helps in fostering change should be portrayed by a motivation to achieve goals through cooperation of staff (McNeese-Smith, 1999).
Robbins (1986) claimed that in order to promote new culture within an organization; management should also involve staff in the process and develop their trust and consensus. New manager also followed this approach and arranged a survey for the performance motivators of staff members. All staff members took part in the survey and the results showed that the staff needed changes in the following areas:
Future planning of staff
Revised Vision and Mission Statement
This survey gave a feeling of motivation to all staff members and also helped manager in identifying the motivators for individuals which were planned to be used in the action plan of next 12-18 months.
Job Satisfaction and Reward Management
Another attempt by new manager for motivating employees was the introduction of new leadership program that included training courses and diplomas for the staff members on the expense of company. It also included awarding certificates, revived education, building knowledge of staff and increasing the capacity of floor staff. This was also important for the better performance of the facility as according to Smith (1998), the education levels for residential staff is often low and have poor work practices.