MICHIGANS LONGTERM CARE CONFERENCE Thursday, March 23rd 10:50 a.m. 12:00 p.m.

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MICHIGANS LONG-TERM CARE CONFERENCEThursday,
March 23rd 1050 a.m. - 1200 p.m.

• Coaching Supervision
• for Consumers and Others
• Paraprofessional Healthcare Institute
• Maureen Sheahan, Presenter

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Consumers as Employers

• People with disabilities and elders not are not
  primarily patients needing care, but persons
  requiring assistance to live full and independent
  lives.
• The medical model of care is being replaced by a
  social model in which the experts are the
  consumers who are in charge of directing their
  own support services.
• Although consumer-directed assistance is
  appealing to many people needing personal
  assistants, most have little or no experience as
  employers and supervisors.

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Consumers as Supervisors

• Being an employer is challenging in and of
  itself, but with consumer-directed services, a
  person with a disability is the consumer,
  employer, and supervisor.
• The integration of these three roles in a single
  individual makes consumer-directed services
  particularly complex.
• Success requires a high degree of self-awareness
  as well as excellent interpersonal and
  communication skills.

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The Challenges of Supervisors in LTC Workplaces

• Supervisors jobs are often demanding and
  stressful
• Many work in situations where they are
  under-resourced, under-staffed, and unsupported
• Supervisors must regularly deal with problems
  such as repeated lateness, no call/no shows
• Negative or uncooperative attitudes among
  employees can be demoralizing
• Often, supervisors have risen to their position
  based on merit, but have been given no training
  for the role of leading people.
• What attitudes and outlooks do these conditions
  create?

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Supervisors are Key to Workplace Success

• Supervisors whether consumers or employees in
  traditional workplaces play a critical role in
  the retention of direct care workers (DCWs)!
• Feeling valued and respected is one of the
  biggest factors affecting a workers decision to
  stay on the job or quit
• Supervisors can build the problem solving skills
  critical to DCWs success and many workers have
  not had the chance to develop them

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Supervisors Make the Difference

• Research shows
• Workers dont leave
• their jobs,
• they leave their supervisors

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Traditional Approach to Supervision

• Identify issues to be addressed
• Explain the rules clearly
• Explain the consequences of breaking the rules
• Offer possible solutions to the problem
• Request or direct the worker to comply with work
  rules
• Lets look at this approach in a sample role play.

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Traditional Approach to Supervision

• What chance do you think
• this supervisory intervention
• has of resolving the issue
• and retaining the worker?

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Coaching Approach to Supervision

• Relationships are at the heart of work with
  people who are elderly, chronically ill or living
  with disabilities
• Studies have shown that relationships that
  workers establish with consumers is what draws
  them to home health and LTC - and the quality of
  relationships with coworkers and SUPERVISORS
  keeps them there

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Supervisors Can Exemplify Quality Relationship
Skills

• Quality relationships underlie quality care
• When agencies and consumers focus on developing
  workers problem solving and relationship skills,
  they benefit through increased efficiency,
  delivery of better quality care, and a more
  positive culture
• Supervisors and consumer employers are the
  natural leaders to model and these skills

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Coaching Supervision

• Coaching supervision is an approach to working
  with DCWs that focuses on developing relationship
  and problem-solving skills
• Coaching differs from the traditional supervisory
  role by its EMPHASIS on helping the worker
  develop skills and in the respectful way the
  coach supervisor behaves toward the worker

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Lets Try it Another Way!

• Demonstration role play
• May I have two volunteers?

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Debriefing the Role Play

• What did the supervisor do?
• How did the worker react?
• What is the likely outcome of this interaction?
• What chance do you think this intervention has of
  succeeding in resolving the problem and retaining
  the worker?

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Your Experience with Supervising

• How does this role play relate to your experience
  of supervising or being supervised?
• Are there familiar aspects to the coaching
  approach?
• Have you tried to take a similar approach with
  workers you supervise?
• Have you ever had a supervisor take a similar
  approach?

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Lets Compare

• Yes, this took more time than the 1st situation,
  but
• How could the extra time
• spent initially with the coaching approach save
  time in the long run?

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What a Coach Supervisor Does

• Create a relationship with the worker
• Clearly state the problem
• Gather information on the workers perspective
• Engage in problem-solving with the worker
• Help the worker commit to action steps
• How do these 5 steps relate to the role play?

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Skills a Supervisor Needs to Carry Out the Steps

• Pulling Back Managing Your Responses
• Actively Listening
• Understanding Your Own Personal Style and those
  of Others
• Presenting the Problem without Blame or Judgment
  to Hold the Worker Accountable

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Managing Our Responses

• Our emotional responses to what others
  communicate verbally and nonverbally often
  get in the way of our ability to listen with full
  attention
• We are rarely able to control the behavior of
  others, but we can control our own internal
  responses
• Shifting our internal responses makes it possible
  to listen more attentively
• The result is more effective and positive
  communication
• The first step in shifting our internal responses
  
• to someones words or tone of voice
• is to become consciously aware of those responses

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• Pulling back is the ability to gain emotional
  control in stressful settings. It generally leads
  to more effective communication and more positive
  supervisory outcomes
• Practical pull-back strategies can help us both
  in the moment and longer term
• Pulling back does not mean being soft or
  condoning poor behavior. It makes it LESS LIKELY
  that a supervisor will be manipulated.
• What do you do in emotionally stressful
  situations
• to keep yourself focused on your values, goals
• and long-term hopes and not your immediate
  reaction?

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Truly Listening

• Once weve gained awareness and control of our
  emotions, we can listen attentively, and make a
  conscious choice to
• Keep pulling back from negative judgments and
  stereotypes
• Remain CURIOUS about the other person, and
• Stay OPEN to possible changing our opinion
• We listen well when we bring our FULL attention
  to the conversation
• Traditionally, supervisors often focus on the
  worker as the problem. A Supervisor Coach focuses
  on the problem as something the worker is
  experiencing along with you and can help you
  solve.

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Listening as a Supervisor

• Coaching Supervisors assume that a more complete
  story always lies behind the fragments they
  initially learn
• Finding out more of a workers story does NOT
  require counseling skills
• Coach Supervisors 1st task is to LISTEN ACTIVELY
  TO THE WORKERS PERSPECTIVE! The worker feels
  respected and valued. The Supervisor learns the
  root causes of the concern being discussed
• Coach Supervisors in workplaces need to be clear
  about professional boundaries when speaking with
  workers about their lives

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Presenting the Problem

• An important part of respecting, caring for and
  believing in workers is holding them accountable
• A Coach Supervisor communicates to the DCW
• I believe in you and I believe you can do this
  job well. Therefore, Im going to hold you to
  it.
• Accountability begins with letting workers know
  what you expect of them in their jobs and how
  they are expected to do it
• The next step is to promptly present the problems
  to the worker when they arise and involve the
  worker in problem solving

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Presenting the Problem

• Three rules for presenting the problem
• Be clear and direct about what the problem is
• Use objective language that is free from blame or
  judgment
• Indicate belief in the workers ability to
  resolve the problem

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Objective Language

• Expresses neither blame nor judgment
• Statement of fact, not opinion
• Describes specific behavior rather than
  characterizing or generalizing about the person
• Opposite of subjective language, which carries
  blame, judgment or opinion
• Most people use subjective language unconsciously

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What is Objective Language?

• Subjective You are always getting here late you
  must not be committed to this job
• Objective Ive noticed that youve been between
  10-20 minutes late several times this week. Is
  there something that is making it difficult for
  you to arrive on time?
• Remember-
• Using objective language takes practice!

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Belief in the Workers Ability

• Supervisors convey to workers that they believe
  in them through voice, tone, and body language
  as well as what is said
• Coach Supervisors are clear about the problem,
  without blaming, while showing care for the
  person and indicating that the problem is not all
  the supervisor sees
• For example
• Youve been on time every day for 3 weeks and
  then this past Friday you were more than 20
  minutes late on Tuesday and Friday. You have been
  extremely reliable up till now, and that makes me
  wonder if something unusual is happening for you
  to cause this problem.

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What Does it Take to Be a Coaching Supervisor?

• What skills do you need to enhance to be an
  effective Coaching Supervisor?
• Why is it important to you to develop these
  skills and take the Coaching approach to
  Supervision?

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Resources for Coaching Supervision

• Paraprofessional Healthcare Institute
• Coaching Supervision Curriculum
• Employing, Supporting, and Retaining Your
  Personal Assistant A Curriculum for People with
  Disabilities
• www.directcareclearinghouse.org
• www.paraprofessional.org
• Maureen Sheahan, PHI Michigan Practice Specialist
  
• [phone] - msheahan_at_paraprofessional.org