How Successful Implementation of Small Communities Benefit Residents and Staff

One of the most effective ways to ‘de-institutionalize’ and develop a relationship-centered culture in your nursing home is to divide a large institution into neighborhoods (designated areas with consistent staffing and closer community relationships, often created without remodeling) or households (attached or detached households with a limited number of residents, a shared kitchen and a family room). A neighborhood or household has a caregiving team that partners with the residents to manage their community.

In these smaller communities, relationship-centered care is a natural outgrowth of the deep connections that form between residents and staff. With a decentralized structure, caregivers and elders are empowered to create each day according to the needs and desires of their communities’ residents and staff.

PHI consulting services supporting small communities can help your organization to:

• Engage staff, residents and families across your organization in the process of moving to small communities.
• Build leadership and communication skills necessary for the small community model to be successful.
• Improve the ability of self-managed teams to work together with residents to manage the day-to-day activities within their community.
• Deepen relationships that are the foundation of quality caregiving.

Planning and Implementing Neighborhoods or Flexible Households

Implementing a small community design affects every aspect of a traditional organization. Roles and reporting structures must be redefined; and competencies and communication skills must be honed as people learn a new way of being within the organization. Particularly challenging is the design and support of work teams as an organization moves towards a model where decision making rests in the hands of the residents and their caregivers. Equally difficult is the definition of the new roles and leadership skills required by the neighborhood coordinator and organizational leadership. Predictably, a higher level of skill building in communication and collaborative problem-solving across the entire organization is essential to the success of the transformation.

PHI offers many supports and services to assist you as you move through the neighborhood or household transformation process. These services are customized to your particular needs and stage of culture change, so please talk with your PHI consultant concerning which services would be best for your organization.

Planning and Design Consulting

The first stage of transformation involves examining how your organization is functioning , and envisioning a future of self-managed small communities. How do you get from where you are to this new vision? PHI can help you by:

• Conducting an assessment of your organizational culture
• Facilitating a strategic planning process that engages staff across the organization in creating a vision and a change plan
• Working with you to clarify organizational structures and roles that support your change goals

Building Skills for Managing Neighborhoods and Households

In a small household model, teamwork is fundamental. Leaders need new skills in participatory management, and self-managed work teams must learn to work together to manage an array of new responsibilities. In these areas, PHI offers several training programs, including:

• Leadership skills for neighborhood coordinators and other key staff
• Communication, self-awareness, and self-management skills necessary for building empowered, accountable self-directed work teams
• Collaborative problem-solving skills within the team and across the community at large

Building Skills for Individualized Caregiving

One of the hall-marks of culture change is empowering residents, so that they are no longer treated as passive “patients.” A number of techniques have been developed for engaging residents and families in care planning and in delivering personal care according to the preferences of individuals. In this area, PHI offers training programs on:

• Person-directed care planning, including “I” format care plans
• Person-directed caregiving practices: Using a train-the-trainer format, PHI will ensure that you have the institutional knowledge and capability to train both incumbent and new staff to develop the core competencies for individualized personal care