Self-management over hierarchy: a masterclass with Helen Sanderson

Joe Badman: 00:00:04

I'm obsessed with learning. And from what I've discovered about you in my research in preparation for this, I get the sense that you might be cut from a similar cloth to me.

And I'm interested to know what role curiosity and learning have played in your life, just generally, but also in your career up until now.

Helen Sanderson: 00:00:24

It's got me into a lot of trouble.

Joe Badman: 00:00:27

Say more about that.

Helen Sanderson: 00:00:28

Well, so I'm a perpetual learner, learner, and sometimes my reason for doing a PhD was to structure my learning. So it's something I really wanted to explore and I need an accountability buddy to stay on track sometimes.

So that was the whole reason for doing a PhD.

And if you follow me on LinkedIn or anything, you won't see me using Dr. Helen Sanderson usually because at the time I was working in adult social care. And there is a perception, and this might be unfair, but there's a perception that if you're academically inclined, you can't be practically useful.

And I want to be practically useful from an informed way. So in some ways my approach to academia is very different to other people.

So it's not been as a traditional career move, it's been, oh, I really want to learn about that. How can I do it? And actually people thought that my master's was really, really boring.

It was quality assurance in health and social care and people barely managed to stifle their yawns when I was expl to them. But for me it's fascinating. So how do we know that we're doing a good job and what does that look like? But it was wellbeing teams.

So the getting into trouble was really wanting to learn about self management by experiencing it and then by creating an organization that was self managing.

Joe Badman: 00:01:56

So tell me about where the journey with self management started then.

Helen Sanderson: 00:02:00

So I'm an avid reader of books and still order about three books a week. And I moved Hausa a little while ago and was renovating a house. And the first thing is, well, where do you put all your books?

And it's not unusual for me to have bookcases in your bathroom because I have them everywhere. So books are a really big deal for me.

But there's a phrase, there's a phrase, I think it's a Japanese phrase that says that means you buy more books than you can read. And that's, that's what I subscribe to. Marie Kondo says you should only have about 50 books in your house. And who needs that kind of negativity?

So I'm a really, really Big fan of books.

And for my 50th birthday I bought myself a new bookcase and asked my friends and family to choose a book for me that represented something that was important to them or a book that they've loved. And just before then, I'd started to do the Alt mba, which was Seth Godin's then flagship course, which was amaz, absolutely amazing.

And the first prompt you had to do as he described it was describe a book that you loved. So I did that and I talked about John Stepper's book Working Out Loud.

And I was contacted by another student on the course called Susan Basterfield, who had also read the book. So we were connecting with our love of John Stepper's book.

Coming up to Christmas, I asked her to recommend some books for me and she recommended three. I dutifully ordered them from Amazon and one of them was Frederic Laloux book.

So when they arrived from Amazon, I looked at them and I thought, that's a really strange and slightly boring front cover. It's a butterfly. And Reinventing organizations is a really common name for a book. So I put that at the bottom of the pile.

Didn't get to reading it till March. So I got to March, started reading it and just went, oh my goodness, this is it.

This is somebody who's able to describe something that I feel but I can't put into words. And I was just blown away by it. So at that stage I was a CEO of Helen Sanderson Associates. We had a team of 12.

We had teams in Australia, Canada and the US and I just thought, I want to experience this. But sadly, as a CEO, you can't say to everybody, and now we're going to be a self managing team, which is amazingly frustrating to me.

So then I had to persuade them to read the books and we had to make a team decision about whether this was a direction of travel. People felt brave enough to try. So that's where that got started. And I, if I'm really honest, I was quite arrogant about it.

I wouldn't necessarily describe that as a, as a massive characteristic of mine, but occasionally it does peek out. And I thought, well, you know, Lou talks about clarity of purpose. He talks bring your whole self to work and self management.

And it's like, yes, I've seen Simon Sinek's TED Talk on purpose and know your why and we've done some work on that and we used to do purpose posters in our work. So I'm pretty clear on that and I'm confident the rest of the team is. And bring your whole self to work.

Well, yeah, we pretty much, you know, absolutely believe in that.

We all had one page profiles that was part of what we would teach people to do about how you bring yourself to work and obviously in the support of people with disabilities too. So I was a bit like, you know, self management. How hard can that be? Very hard. Very, very, very hard. And it.

Because I think I thought it was like putting another app on your phone.

Joe Badman: 00:05:46

Not quite.

Helen Sanderson: 00:05:47

Yeah. Here's something else to add to your repertoire in your toolbox. It's a change, the whole operating system.

What I was also unprepared for is the personal learning that, that it would require from me as well. So that was massive. But very grateful to Susan for introducing me to that book.

And then after we'd been doing that for three or four years and we got involved with Holacracy as a way to do that and Susan coached us and eventually several of us went to train as facilitators in Holacracy. It was then, well, now I'm stopping being mum to the whole of the team. I'm not investing the same kind of energy that I used to, same passion.

But not being mum freed me up to give me more energy for other things. And I loved the example of Bertzorg in the book. And I thought we could do that. How hard could that be? Oh, my goodness.

Whenever I hear myself say, how hard can that be? I know I'm in trouble, really, because it's always much, much harder than I think it possibly could be.

So we started to explore what it would take to create a home care organization that was run by self management. And it was also, I think, the other thing that spurred me on was coming up to my 50th birthday, my dad died when he was 53.

And now that I'm much older than 53, I can recognize just how young that was.

And as I was coming up to 50 and thought, well, if I only had three years like dad, and having been a consultant for 20 years and having had people say to me, we'd love to do that, Helen, but CQC won't let us. Or we'd love to do that, Helen, but we haven't got the financial bandwidth to do that.

Or we'd love to do that, Helen, but it's much too risky and our trustees won't let us or our board won't let us, I thought, well, what really would it take, you know, to do all that? And you know, as trainers and Consultants in person centered practices.

You know, can you really put all of those into place both for the people you serve and for the team? And can you do it in a self managed organization? So clearly I'm not a woman without ambition.

Joe Badman: 00:08:06

Well, so let's talk about how you expected it to go and how it actually panned out. And by how you expected to go, I mean establishing wellbeing teams. Was it as smooth as you expected? What were the bumps along the way?

Let's get into that.

Helen Sanderson: 00:08:23

So the first bump was registration with cqc.

So I needed to be the registered manager and I needed to be the nominated individual and to be a registered manager, they pretty much expected you to have experience of being a registered manager and I didn't. So when I had my interview with cqc, I almost fell at the first hurdle.

And they were not, they weren't minded at that stage to believe that that was something that I could do. Well, luckily at that stage I had friends in high places so I could talk to Sir David Behan and Andrea to say, I really want to do this.

You know, this is a problem. Can you help me figure out how to make this happen?

And of course they couldn't pull any strings, but they gave me some advice and I was able to do the research that I needed and eventually convince people that I did have the experience needed to be registered manager. So that was the very first thing.

Utterly indebted to Rachel Peacock and Making Space because they enabled us to come as part of one of their contracts with Wigan Council and work within their contract. And I got lots of support, including financial support for our first teams in Wigan and I couldn't have done it without them.

So those were the first two hurdles. Where would we start? How could we financially practically do it? And could I get CQC to believe that this was possible?

Joe Badman: 00:09:57

So in Wigan they gave you the opportunity to work within an existing contract just in one locality?

Helen Sanderson: 00:10:04

Yes. So there were at the stage then there were 12 different localities that had home care provision in Wigan.

Making space had one of those localities in Ashton. They wanted to exit from home care and invited us to take over the contract. So we transitioned with them support, which was amazing.

Joe Badman: 00:10:25

Okay, great. Sorry I threw off your thread there.

Helen Sanderson: 00:10:27

No, that's fine.

Joe Badman: 00:10:28

So that was the first hurdle, but overcome through, I suppose, relationships and learning. And what happened then?

Helen Sanderson: 00:10:36

Well, what I knew about home care is that there's a dreadful phrase, 67% churn.

So most people who work in home care, and that's mostly women, will Understandably be looking for a job that's better than the one that they currently have.

So there's lots of turnover, but because we wanted to work in a self managed way, I suspected that if you have already got experience in home care, there would be a significant amount of unlearning to do so. In home care, if you've got a problem, you phone the office kind of thing.

And we wouldn't have a manager sitting in office to answer queries because we were self managed.

So the next challenge was how could we recruit people who didn't have experience of health and care and how can we both recruit them and support and train them to be competent in this?

So if you already work in home care, yes, you have to do the care certificate again, but you'll have lots of experience that hopefully will stand you in good stead of delivering home care, but not in working in a self managed team. So we had to redesign recruitment to focus on value based recruitment.

So we believe that if you have the right heart, the right characteristics, the right values, if you were already working in customer service, that, that kind of thing, that you're likely to be the right kind of person for this job. But Carol Dweck would say you also need a growth mindset. So it's, you know, how can we recruit people with a growth mindset?

How could we recruit people with courage to try something new? How could we recruit people with compassion and curiosity because this is the work that we needed to do.

So again, you know, I like to bow to my teachers and one of them is Jacqueline Fev and she worked with us to get really clear about our values.

And then we could think with another colleague called Ali Gardner about how we could design a recruitment process that would help us find these kinds of people. The prevailing thinking about recruitment is making as quick as you can, as easy as you can so that people can get into jobs.

We didn't do that because we thought if, if this was going to be a career change for somebody, why would you make a career change without a significant amount of investment in it? And you're likely to spend more time with your team than you do with your family.

So we focused on recruiting people in whole teams, teams of 12, and we would put them through with the greatest respect, a three hour workshop with us and we'd have a team of people who would do this.

So I had a co production partner whose name was Helen and she was part of the recruitment team and as we got a bit bigger, we'd have two wellbeing workers who were part of the recruitment team and we didn't ask people to do CVs, we asked them to develop one page profiles.

So we invited people to come with the one page profile and then do three hours with us and then we would phone them the next day and tell them the result of the interview and hopefully six weeks later we would be working together in induction because in,.

Joe Badman: 00:13:53

In health and social care, I mean there's still a recruitment crisis, isn't there? It's incredibly difficult to find people.

Helen Sanderson: 00:13:58

Yes.

Joe Badman: 00:13:59

The, the work is traditionally very, very difficult. You can get paid more potentially working at a supermarket.

Helen Sanderson: 00:14:05

Yes.

Joe Badman: 00:14:06

So to, yeah, to take a risk like that on the, the assumption that we will find people that are more aligned with us in terms of values and that will potentially stay here for a long period of time is that's really, really sort of backing yourselves there and putting. Yeah, sort of putting your money where your mouth is really.

Helen Sanderson: 00:14:26

So because I've done the work with Seth Godin and fundamentally Seth Godin's a marketing person and what he helped us think about was empathy based marketing. So we would think about who are the people that we want to bring into our workf for. So it's diverse.

So, so I, I looked at all the stuff about generation X, Y, Z, baby boomers etc and the NHS and adult social care generally in home care, they're baby boomers, they're women my age. So how do we bring young women into this? How do we have a diverse workforce? So if you want to bring younger people in it.

And it wasn't just younger people, it's how do we get students to come and join us. So I think fabulous first job for any student is come and work in a self managed organization.

Different experience about what work could, could be like. So then we figure out how to target students. So we would mainly use Facebook.

And of course I know that Facebook is largely used by old people like myself and not necessarily students, but we'd have different ways of contacting students like that.

We would design our marketing campaign that says, you know, come and if you're interested in your first job out of university, giving you experience in a different way of working in teams, you know, really understanding what might look like, come and join us. And we would go and talk to universities so we'd be really intentional about who we wanted and the empathy based marketing was two things.

So we thought about what might students hope be for their first job and what might their fears be and we'd try and address those. We'd also think about parents coming back into the workforce and again what might they be hoping for, what might their fears be?

And active retirees, you know, what again what might their hope?

And we'd have a campaign that was targeted at them and we'd use Facebook and analytics and paid for advertising so that we could recruit people locally. But also what we did was so doing it on Facebook we would say can you answer these three questions?

So when we're recruiting to Ashton we'd say how many miles do you live from Ashton town centre? Because we wanted people within a five mile radius. Wellbeing teams are self managed teams. What makes you think that would be for you?

And we support people to get up and dressed in the morning. What makes a good morning for you?

So we were making sure they knew that this was around personal care because the first time we did this, first time we did a recruitment workshop, it went really, really well until the end because I had not given people a clear enough message because they call well being workers that it was about supporting people to get up and dressed in the morning, have a great morning, support people with, you know, having nutritious food as well as doing what matter to them. And I'd over emphasized the well being element of it and not fully emphasized that actually it's some practical work as well.

So I learned from that mistake, got better at screening people out right from the beginning and in the end we'd have wellbeing workers doing that with us and each wellbeing team would have somebody whose responsibility with us for doing the recruitment.

Joe Badman: 00:17:43

This is absolutely fascinating and it's a perennial challenge for us in basis because we're looking for people with, to use Rutger Brachman's words, moral ambition.

Helen Sanderson: 00:17:54

Yes.

Joe Badman: 00:17:55

Yeah. And it's really, really difficult to. Yes, it's difficult to find that I think.

And one of the things I've experimented with is scare them away letters which was one of the practices I think in the loo book, wasn't it? And, and that I found really, really useful.

But I was so nervous using it for the, for the first time because it's so hard to find people and the whole purpose is to scare away people that wouldn't be a good fit. And as I was doing I was like oh no, scare away everyone. Have you experimented with that kind of thing?

Helen Sanderson: 00:18:27

Yes.

So I've been lucky enough to be headhunted two or three times to be a non exec director and two of them massive really well known charities that you'd be immensely proud to work for.

So I went through the interview process, got through the second interview and then wrote them a scare away letter and saying, I'm only interested in innovation. And if you're looking for a trustee, that's more about, you know, a safe ship, et cetera, it's not me.

If you want somebody who really wants to, you know, work alongside the people who are interested in innovation and bring ideas, et cetera, and they both said, no, thank you.

Joe Badman: 00:19:08

Well, that was the right thing to do, wasn't it? Because it wouldn't have been a good fit.

Helen Sanderson: 00:19:11

No, completely. Completely. So, yes.

But our equivalent in wellbeing teams was less scare away and more having videos of wellbeing workers talking about what the job was like. And we do things like A Day in the life of or and A Week in the life of Or. What's on your to do list? We do those kinds of things.

So try and give people a really good awareness of what the role actually is. And in the early days, I would use indeed to recruit to, but I wouldn't use the health and care pages.

I'd go on to bar staff and I'd go on to childcare and I'd go.

So any job that was about people and it was about customer service, I would say, you're looking for a customer service job, you might not have considered a role in care, but if you've got these skills and you're interested in supporting people like this, would you consider a career change and come and work with us? And that was really quite successful.

And I think in the end, we only ever had something like 30% of people who'd ever worked in healthcare before and only 10% who had done a job in home care. And the people in home care would have been the rebels and the people who are getting into trouble and they found their place with us.

Joe Badman: 00:20:29

So we've recruited teams and what happens next? What kind of scale are you working at? And where does this story end? I mean, spoiler alert, it ends pretty well, but what's the trajectory from there?

Helen Sanderson: 00:20:45

Does it end well? So with the people we recruited. So we'd recruit teams of 12.

And what I know is the six weeks where you're trying to get your DBs done, you're trying to get the references done, you are in great risk of losing people. So we would tell people the next day, the successful people would put them straight on the slack group with us.

So we'd get the new team all together on the slack group and we would have a slack sequence that Sounds really strange, wouldn't it? But at that stage there was four. We have had a team, a national team of four of us and we would have responsibilities for posting on Slack.

So we do things like, you know, being part of a wellbeing team is about bringing your whole self to work. You know, you did your one page profile as part of the recruitment process. Please tell us a bit more about yourself.

Will you post a photo of your weekend so we can see what your weekends look like? And we do that ourselves. I also know the value of getting things through the post.

So the first week after we'd recruited you, you would get in the post a gingerbread person which comes in a beautiful box and it's a celebration. I think at the time it cost me £12 per person and so you get that in the post and we'd know when they were coming out.

And then the joy for us is people would take photos of their ginger, gingerbread person and post it on the Slack group and be appreciative of getting that. The other thing is your family would see the gingerbread person. We would get photos of children eating the gingerbread person. Fabulous.

You know, so again, you doing a job with wellbeing teams, this is a whole family commitment kind of thing. So we'd see it like that.

The next two weeks later you'd get a postcard from me and on the front of the Postcard is the 12 promises we make our team team. And the postcard from me would say, I'm delighted.

Now I would have, if I hadn't been personally involved in the recruitment, I would have found out something that everybody excelled at because part of the recruitment process is people made those notes for me. I was always part of the recruitment because the only interviews that happened were interviews of me at the end.

So they got to interview me as part of the end of the recruitment. So they knew who I was.

We made notes about what was great about people and I would send a handful of handwritten postcard with one of the things I've heard about you is this so delighted that you're joining the team. These are the promises. Please, if any of these promises are not being kept, will you personally let me know? Here's my email, here's my phone number.

So I do that and then as people have finished probation, they get another handwritten letter from me in an envelope with a seal. I used to have great fun doing wax seals.

My friend Michelle, who's part of the team will say straight out of Harry Potter, but part of what we were paying attention to is telling people that they mattered, that working for us mattered. Because how can we encourage people to show the people we were supporting in wellbeing teams that they mattered unless we were communicating that.

So we'd use slack to keep in touch with people, to start building the team, sharing information. And then the first time we, we'd be together again was the first four days in the induction.

So if you join us in induction, the first thing we would do would be to give you a big piece of paper with your name on it. It's personalized to you. And I would explain or the wellbeing, the well being leaders that took over me from me. I say this is your work timeline.

So we'd show you ours and we'd invite you to map your timeline from your first job, whether it's voluntary or paid. Mine was I worked in a hair salon as a Saturday girl right up to where we are now. And then we'd have a what does this tell us about your skills?

And then what does this tell us about your hobbies and interests? And then we would have what's worked and not work for you in each of these jobs that would all be on this big piece of paper.

So we'd give people half an hour to do that, put them out in the room, go and look at them. But I'd also ask, what's your next career move?

So from the moment you start work with us, we're asking you what you want to do next and we're trying to figure out ways in the roles that people took to support them in what they wanted to do next. So we never assumed we'd have people for a long, long time.

But we always wanted them to look back at wellbeing teams and say that helped me got this next role so that mattered to us. So then we would. And it's great.

So when you hear that from each other, it's like if you and I went out drinking for three nights and had lots of engaging conversations, I'd probably stand a chance of finding some of that out that we learned about people in half an hour. So we'd get people to share that with everybody. But then we'd use it to create to do two things. One is to update your one page profile.

So we want to give a message to that we keep, we're always updating our one page profiles. We're always learning new things about ourselves and each other and we would use it. I forgot what I was going to say. Oh yes, I'll pause.

So we'd use it to update one page profiles and we'd use it to create team agreements. So with team agreements they are behavioral statements about how we want to show up together.

So it might be things like we talk directly to each other if we've got an issue not about each other. So those kinds of statements.

So every team co created their team agreements but we do it by saying if you look back at what's not worked for you in your previous roles, what team agreement would make it less likely that what hasn't worked for you wouldn't show up in this team?

And if you look at what has worked for you, what team agreement would you like to suggest that would make it more likely that that would show up in this team?

So by the end of day one, you'd have shared your work history with people, you've updated your one page profile, you'd have co created your team agree with the rest of your team. And then we had to do all the other stuff which is health and safety training and lifting and moving training and all of that.

So we did all that in the three days. But we also did this is what it's like to be part of a self managing team.

Let's look at the roles and choose the roles that you want to take within the team. Let's look at how tactical meetings work and at the end of four days you'd have experience of what a tactical meeting looked like.

So we tried to balance bringing your whole self to work work self management and the skills that you need to do this job really well and how we sign you off in probation too and the self management aspect of that.

So I think one of the brave things was genuinely believing that if we found people with the right hearts with, with the, and I love your, your moral statement there, that we could teach them quickly enough how to deliver great care. And that's what we believed.

Joe Badman: 00:28:00

So ultimately wellbeing teams were rated as outstanding by cqc.

Helen Sanderson: 00:28:07

Yes.

Joe Badman: 00:28:08

If you're still here, my assumption is you're finding this conversation useful, recording these interviews because we think it's important to share stories of people who are leading and designing more human impactful and relational public service services. And we'd like as many people as possible to see them. If you think you can help us with that, then I'd be so grateful if you did one of three things.

You can just like the video and that'll help other people to find it in future. You can leave us a comment and let us know why you stuck around or you could subscribe to the channel.

And honestly, I've got no good reason for that other than it would cheer me up. Okay, back to the interview. Why are you not doing it now? What happened after that?

Helen Sanderson: 00:28:52

My two values are courage and curiosity, and they both led to the development of wellbeing teams.

My courageous optimism believed that if we could show commissioners a new way of delivering services that not only serve people well from a home care perspective, but paid extra attention to their well people's well being that was also focused on people being part of their communities and connecting them to communities, that we might be able to have a different contract with commissioners. So the way that we were commissioned is on time and task. We were commissioned for half hour, half hour slots of service.

And I think home care is a feminist issue. I think that it's not okay to employ people for zero hours contracts in home care or short.

So people, people might say, well, we don't employ people on zero hour contracts. We employ them on contracts, but then they're usually 16 hours and most people want full time work. So you're always looking to pick up more shifts.

And for me it's like only paying firefighters when they're out fighting a fire, you know. So our commitment was to pay people for whole shifts.

Now if you work in adult care and you're supporting people with learning disabilities or people with mental health issues or older people living in care homes, they're all full shifts. But for some reason in home care this is accepted practice and I wasn't prepared to do that.

eeded to be up and dressed by: 11:30

Of course, you know, the lunchtime visits didn't start till 12, so we would have an hour and a half where we weren't being paid to deliver a service, but we were still paid paying colleagues to do that and the same in the afternoon as well. Another standard practice in home care is not to pay people to attend meetings, but meetings are the heartbeat for me of self management.

So everybody was routed on to attend a tactical meeting for an hour and a half every week. And therefore we weren't delivering a service and we weren't getting paid for our service. So that was a challenge too.

And when we were working in Thurrock, we were working with the local authority and the local authority was employing the staff. So we didn't have the financial responsibility of doing that, but we were doing everything else really.

And what we would do both in all of our teams would be if we in our weekly meeting. So let's imagine you were a key worker for say four or five people that we supported.

You would come to our meeting and some of our teams like in Oxford, were virtual and we didn't have an office but making space were very generous and they had to us and they had our risk space that they let us use use.

So we'd have a big poster when we came, when people came into the office and we'd have an on track, off track, way off track board, which is a brilliant idea from Andy Brogan and you'd come in with stickies of the names of the people that you were supporting.

And what you do is you put the sticky on track, off track or way off track, depending on where you thought the people you supporting were in relation to their well being. So you might decide that that Lucy Flanagan was, was way off track. So, so we come in, everybody's that we have a snapshot of how everybody's doing.

I mean multidisciplinary team meetings could, could look like that, this snapshot and then everybody that was way off track as part of the meeting we'd go, what can we do around that?

So we'd be able to say, because the team knew what resources were available, we'd able to say we have 3.5 wellbeing hours we can allocate take next week. How can we use these hours to support the people who are way off track and bring them onto just off track or not off track at all. So we do that.

So in Thurrock we had two wellbeing teams, but because the local authority had in house home care, they were able to do an evaluation to compare the two teams in Thurrock and the other teams and they found that you were 500% less likely to go into hospital if you were supported by a wellbeing team than you were other home care. And I think it's because we're able to invest well being hours according to who we thought needed it.

But of course if you're a local authority, the health teams, the funding of the hospitals are making a saving here. But of course it's not a real saving because. Yeah, but it's a difference.

So part of the reason why wellbeing teams don't still exist is because the difference we were able to evidence that we were making like that the sickness was much lower than other teams, retention was much higher. They don't have an impact on the budgets of the people who commission the services.

So we couldn't convince commissioners that this service should be commissioned differently. And we weren't prepared to do it just time and task and not pay people full shifts. And the other thing is the shift patterns are so important.

So teams would do their own shifts. So you knew you had a two week rolling rotor when you're doing zero hour contracts or when some of your contract is secure. 16 Hours.

But the rest you're always saying, you know, you know, can I have more hours? And you don't know where the hours are coming from. How can you go and see your kids football match on a Sunday?

Joe Badman: 00:34:41

Why is it that example that sort of causes emotions to sort of swell up?

Helen Sanderson: 00:34:45

Because work is really miserable for lots of people and it's really lonely for lots of people.

And I think part of my, my motivation for this and the motivation for the book that I'm engaged in at the moment that I'm sure we'll talk about is, is it doesn't have to be like that. There are things that we can do. And knowing what your shifts are means that you can plan your family time in a different way.

And if you're always trying to pick up extra hours and you don't have any regularity with your shift patterns, you can't organize your family life and spending time with your family in the way that you might really want to. So we tried to, to figure those kinds of things out together.

Joe Badman: 00:35:30

Yeah. And it creates strange incentives and a weird dynamic between the team as well, doesn't it?

That sort of runs counter to all the things that need to be in place to be able to self organize and bring your whole self to work.

Helen Sanderson: 00:35:43

The two things that really matter to me, the two questions that we really wanted to answer is can we support people in a neighborhood and pay attention to their well being and their, their presence in the community and not just the time and task stuff we were commissioned to do.

Can we do that and can we work with teams in a way that they can bring their whole selves to work, they can learn and grow through work and they can use their talents and gifts really in a different way. So that was what was driving me.

So to use practices that mean that you don't know when you're going to see your family next, or you can't organize your family time or just fulfill your hobbies and interests or own commitments to your community, you know, is completely counter to that. So. Yes.

Joe Badman: 00:36:34

Yeah. You mentioned about how people that you were working with were, what do you say, 500% less likely to, to go into hospital.

Helen Sanderson: 00:36:45

It was the thorough evaluation. Yeah.

Joe Badman: 00:36:47

Yeah, so I'm interested in measurement because I think the, the sort of paradigm by which the public sector is organized and managed is, I think, broken. And lots of people would agree with me, I think, or certainly lots of people that we know and that we work with.

And there is a deeply entrenched belief that management through KPIs is useful.

And there is an enormous amount of research that would suggest that the more KPIs you place on a service, the more it, it creates a situation where people, yeah, massage information to the point of meaninglessness and before you know it, the tail wags the dog and we forget why we're doing the work in the first place. So I'm interested to, to know what, what did you need to be able to see what metrics were important to you.

To know that the work you were doing was, was helpful and, and meaningful.

And that could be both for the organisation and people's experience of work, but also for you as a provider to be able to know that you were doing a good job in the community. What were you thinking about and what were you paying attention to?

Helen Sanderson: 00:38:04

So, as a service regulator with cqc, there were metrics that we had to track. And I think the difference is I mentioned to you the on track, off track, way off track board. Next to that, we had our data board.

So the metrics that CQC expected, we would be entering them by hand, so they were transparent for the whole team. And then every month we would have part of our team meeting would be an after action review.

So we'd look at the metrics and say, which ones of these are concerning to us? So one that might be concerning to us might be the number of medication errors would be hugely concerning to us, of course.

And we'd say, you know, out of our metrics this month, these are the ones that feel worrisome. You know, let's use those for our after action review and see if we can get underneath what's going on here and whether things we can do about that.

And I remember when we had our CQC inspection, inspector said to me, you've got a very healthy number of medication errors. I said, yes, yes, I know. I can tell you exactly what that number is over the last year.

I said, but what I can also tell you is that's an accurate number. I'm absolutely convinced that we haven't missed any and people haven't been too scared to admit them to us.

And we have reviewed why these have happened, both individually with people and collectively as A team. So some metrics were gifted to us as ones that we needed to collect. What mattered to us was the changes that people wanted to make in their lives.

And big fan of Toby Lowe and his work and the concerns about tracking outcomes around individuals.

But what we wanted to do was rather than mapping outcomes against an outcome framework and then reporting them as data, we would do that individually with people. So say if we were working with you, one of the conversations so adult social care would have given us, you know, why we were able to support you.

So they might say, we want to make sure, you know, please make sure Joseph is taking his medication three times a day. Okay? But we'd also say, help us learn about you, what matters to you. What's a good day look like? What does a bad day look like?

What's working in your life right now? What's not working for you? If you could do anything at all, you know, what would you like to do? What would a great day look like like?

And some of those questions, you know, when we say to people, if you could do anything, what would you like to do? People, what. What are you talking about? These are not the kind of conversations that we're used to, to having.

And so usually it was the things that are going well, is there anything that we can do more to make that more likely? And the things that aren't going well for you, could we do anything about it?

Sometimes it's really small things like, you know, I love watching the birds, you know, out the window. I can't get out and put the bird seed out, and I can't make sure or it gets bought either. Can you figure those kind of things?

So of course we could do that. That was great.

But things like, well, one person was in quite a lot of pain and of course the GP and the nurse had done loads of things to try and monitor her pain and stuff. So she said, well, if anything was possible, I would have less pain.

So we thought that's not really something we know a lot about or could do something about. But. But we also use something called the support sequence.

So once we knew what someone's outcome was, we would put it through the support sequence or have that conversation. And the purpose of the support sequence is generate ideas. So the first thing in the support sequence, is there anything you can do for yourself?

And then is, can technology help? Is there anything we could change about your home AIDS adaptations? That's the OT and me, you know, anything we could buy that would. Would help.

Is there a way that friends or family can help. Is there stuff going on in the community, both online communities and the physical community, that that could help you with your outcome?

Or is it stuff that we could. Part of the universal offer is the stuff that health could offer you or is going on in adult social care and then could other paid support help?

So with this woman, when we got to technology, call her Val, we were thinking, could technology help with pain? So we looked at that and one possibility is using a VR headset. So the distraction element of that, so we, we had a lending library of tech stuff.

So we got hold of a VR headset. I mean we had like robot cats for people who miss their pets desperately but couldn't have a cat.

So, so we had from jigsaw puzzles and adult coloring books, you know, low tech stuff right over to, to Alexa's and VR things. So we worked with her to have a VR headset. She, if you met her, she had, she has a elephant tattoo on her shoulder, she loves elephants.

So we were able to set her up with safaris and things like that to do with animals that she loved and she'd use her VR headset every day. And she said it really helped with the pain.

But what we would have said is on a scale of 1 to 10, you know, so if 10 is, well, we would say, what does 10 look like for you? Because she knew she wasn't going to be pain free.

She said, but if I could get to this amount, so on the pain score, it'd be X and I'd be experiencing only for this amount of time during the day and 0 is this. So on a scale of 1 to 10, a bit like solution focused therapy.

So you say what 10 is and you say where you are now and you say what the midpoint would be and then our work is to get you as close to the midpoint and beyond. So that's how we would think about outcomes and that's how we'd measure them.

And we, but we'd measure them by asking the person what 10 look like from their perspective, where they are now halfway. And that's how we'd measure outcomes.

Joe Badman: 00:44:12

I mean, these are the things that you couldn't even, you couldn't even imagine commissioning in a commissioning contract because they're so specific to the individual.

And it just sort of speaks to how the time and task model that we're talking about just is incompatible with the kinds of need that exists in communities.

Helen Sanderson: 00:44:34

Absolutely. So because we weren't able to shift that, our attitude was how can we make People's day.

How can we take the half hour slots that we're given and make a difference in our half hour slots?

Now a practice that commissioners are likely to deny happens, but we know happens because obviously as a home care organization, we spoke to lots of other home care organizations is, is working the shifts so that you don't quite have enough time to get from one visit to another. Because often home care providers are not paid for travel time or the money that they're paid for travel time.

They add on to other things so it doesn't appear as paid travel time. And obviously we didn't do that.

So when my mum was receiving home care, the pressure was to just do 20 minutes of operation, half, half an hour visit. So you've got 10 minutes to try and get to the other person on time so that you're not backing up. And that is really, sadly, really common practice.

Of course it's also a massive safeguarding risk because there's a reason that you've been given a half hour test and nobody looks at it like that. Sorry, that sounds a bit respectful. I'm not convinced that that's being examined in the way that ideally it should be.

That practice of shrinking the amount, of course that people are, the amount of time people should have, but with our team members. So I, I created pamper packs for team members and I did lots of research on which nail varnishes dry the quickest. It's Rimmel 62nd.

Joe Badman: 00:46:18

Take notes.

Helen Sanderson: 00:46:19

Yes, I know it's very important as a woman who's not wearing nail varnish and this was a thing for me. So you have a pamper pack which, a beautiful panka pack which had four colors of remote nail varnish, a nude and a bright one, etc.

It also had a moisture lotion that you could use for foot massage and hand massage. We had the most beautiful life story books created for people.

So it's a mainstream life story book and we had covers created for people with well being life story books and wellbeing teams on it. And they were gifted to everybody that we supported.

So our attitude was, would be if you have five minutes left at the end of your shift, you do not disappear off to the next person because I know in five minutes I can paint your fingernails or I can paint your toenails or I can give you a hand massage or I can give you a foot massage or we can write something in your life story book together. And, and that was expected.

And on, on our Slack channel we had a make make people's day channel and we would encourage and support and reinforce people posting photos there with people's permission of the things they've done to make people's day. Beautiful pictures of nails, photos of people, people dancing or clips of people dancing and stuff.

But that was what we, our, our metrics are, you know, are we making people's day? How many photos of do we have showing up there? You know, how are we doing on the outcomes that really matter to the people?

How many community groups are we currently setting up or supporting people to get to so very, very different things that we were paying attention to?

Joe Badman: 00:48:00

Well, I think this work really, really does prove the point that it's possible to run a completely different kind of home care organization that is successful from, from the perspective of the people that actually matter, namely the citizens living in communities that we're there to support. And you really have proved a point that self management can work in even the most challenging or seemingly most challenging circumstances.

I want to talk a little bit more about that because I think the learning around self management and what that looks like in practice is universal.

Could be applied to, to any of the folks that are watching this, people that are running teams and local authorities or working in the voluntary sector.

So what do you consider to have been the sort of keystone practices or routines, things that you would do with teams to enable them to self manage sort of consistently over longer periods of time?

Helen Sanderson: 00:49:01

I think there's three things when I look back are the things that I think made some of the biggest differences and I think talking to my colleagues as well. I know particularly that Michelle would say this too because she would say that actually tactical meetings are the beating heart of wellbeing teams.

And I think for self management. So with tactical meetings we would start off by looking at metrics.

So we'd look at the CQC metrics that we were collecting, we'd look at how people were doing as I described with the on track, off track, way off track board. We would do a minute of mindfulness, it's not part of self management per se. And we'd do a feelings check in.

So we'd get people to tell us how they were feeling using a feelings word. And then after some updates the rest of the meeting would be raising and addressing tensions.

And in holacracy terms, attention is described as something that's getting in the way of you to doing your best work or something that you've seen that think could make our work better. And this was written into probation. So to pass probation with Us, you had to actively show up in team meetings and you have to raise tensions.

You can't just sit there as a passive recipient. And we also did rounds.

So we had structures like rounds and time talk that made sure we heard from everybody and we had roles with clear role definitions and what good looks like. So I think it's there that we would look at what was getting in the way and what we would need to do differently.

And I think one of the things from our inspection report that really made me delighted was a quote from a wellbeing worker who said this was somebody who had actually worked in home care before. And she said, you know, I've worked in home care before.

But the massive difference here is, is it's not just that you're asked for your opinion, you are expected to share it. So it's an expectation that we're all in this together, all figuring out how to address the challenges that we experience.

So I think tactical meetings, raising and addressing tensions that are live for people is a really, really important feature of self management. But equally you don't need to be a self managing team to use tactical meetings. So that was part of it.

The other one was clarity of roles and clarity of what good looks like. And I think that's really important. I regularly ask people on webinars and things, when was the last time you looked at your job description?

Joseph, when was the last time you looked at your job description?

Joe Badman: 00:51:47

I don't think I have one.

Helen Sanderson: 00:51:50

Okay, you're slightly. Well I know that most people have a job description when they are, but nobody looks at again unless there's a dispute.

So how do you know you're doing a good job? Well people say, well my manager tells you, okay, so this is a challenge, isn't it? If you're working in a self managing team.

But even if you're not working in a self managing team, is your manager there all the time watching you work, Working unlikely. So you can't rely on your manager giving you feedback all the time. So how do you know you're doing a good job?

So for me, the nerdy part of me spends a lot of her time taking job descriptions and deconstructing them into roles for people that I'm working with. So you'd have the role title, so it might be coach for example. And then the purpose of the role, purpose really, really matters obviously.

So connecting the purpose to that role, back to the purpose of the team or the organization and then what would you see me doing in that role? So what's my daily weekly monthly tasks, what are the key tasks for delivering it? And then the next column is what would good look like.

So that might be metrics, metrics that matter. Or it might be examples that I can give you or it might be stories that I can you tell tell you. So then you're much clearer.

So in my ideal version of the world, and actually I'm working with several organizations to do this, so we wouldn't have job descriptions in the traditional way, we would have role descriptions.

So in the job advert you'd say this job comprises of seven roles and you'd list them and in the information that goes out with the role you would have your job descriptions. And then in interview you, you'd be asked a question for each of those roles.

And then in induction you would play a part with your manager in personalizing your induction related to the roles and your confidence in delivering the roles. So you might, you know, look at all of the roles and say okay, the two that I feel least confident in are these two.

And then if you were my manager we, we would co create what I needed to do, what the manager needed to do to enable me to get to competence. You then use them in, in the probation sign up off so you've got metrics about what good looks like.

We'd want to feel confident that they were all felt deliverable by you and I was confident in it. And then in our one to ones we'd use them as confirmation practices.

So confirmation practices developed by Andy Brogan I think are massively important. I think this is the new way we should be doing one to ones and I've been doing some research on that recently.

So if it was you and I and you were my manager or you were doing doing, were you my buddy for a self managing team? I would rate myself one to five on each of my roles and you would say to me, Helen, which role do you want to focus on?

This might be one with the lowest score and we talk about that and you would have a set number of questions. So luckily you don't need to have a coaching qualification to do this.

You read out these questions and in the end I will have come up with a action that I've set myself that means that next time we do confirmation practices I'm confident it would have made a difference in my score. But then and we'd look at what support I might need.

So you might message me next Tuesday to say Helen, your action was this, you know, is it in your diary? Have you Done the thing that you said you were going to do by them kind of thing.

So we do that, but then you delete all your scores and the next month we start again. So it's not like performance management where you're keeping track of scores. It's right now, today. How do I feel about my roles?

Which role do I want to focus on? Which one I don't want to improve on?

So confirmation practices based on clear roles would be my other thing, and my third one would be team agreements. In my perfect view of the world, not only would recruitment start include roles, but it would also include team agreements.

So you'd be saying, saying, joseph, the team that you've applied to join, they have these team agreements. Which two of these agreements do you feel really confident that you'd be able to live? And which two do you think might be more challenging for you?

And then when we get to your induction, we'd say out of these team agreements you mentioned in interview that these two will feel more difficult. Let's look now at what it would take for you to feel more confident.

So that might be some learning about compassionate communication, for example, or it might. So we'd figure out together what it would be, and that would form part of your induction.

And then to pass probation, we'd be looking at both of those things when you pass probation. And in one to ones, we'd be doing two things. One is, how are you doing in delivering your role?

And the other is how are you doing in delivering your team agreements? Because unless we're paying attention to how are you doing in delivering your role role, and how are you showing up with your colleagues?

This is where the psychological safety issue.

Joe Badman: 00:56:57

Well, that's where I was going to go next. Because for all three of those things to have a snowball's chance in hell of functioning, there has to be psychological safety completely.

And for people that don't know what that means, I think the simplest, at least the way I describe it is the simplest way of saying this is it's the feeling that you can stick your neck out in front of your coffee colleagues and nobody's going to reach over and chop your head off. It's a belief that people have positive intent, I think. And yeah, and that we're trying our best.

And maybe there are some better descriptions than that. But I think at its heart, that's how I think about it.

Helen Sanderson: 00:57:37

Absolutely.

So Amy Emerson, who defined psychological safety, would say, it's the shared belief that you can, can, you know, share ideas and problems and mistakes in the team and it won't have a negative impact on you, so absolutely chopping your head off. She might not have gone quite as far as that, but, you know, the spiritual, the spirit of that is the same.

So when I was approaching my 60th birthday, having, you know, wellbeing teams lasted for four years, took me a couple of years to get over that, if I'm really honest. Coming up to my 60th year, things, thinking what.

What feels really important now, and if I could shift the dial on anything or stand any chance of just moving the dial, anything, what would be the most important one to do? And it. It was psychological safety. And my. My biggest.

The place where I'd like to see that making the biggest difference is the nhs, because if you look at Francis report and other similar reports, the thing psychological safety, the evidence is where there's high psychological safety, there's high patient safety, and where there's low psychological safety, we know, you know, awful things happen. Really. Really. Sadly, just. Just as. As difficult as that is. Not as difficult as people dying, of course, but.

But the other part of that, that doesn't get the same amount of attention is when I was preparing for my TED Talk, I'd read some research by Professor Michael west in which he said that if you work in the NHS, you're 50% more likely than working in anything else to experience the damaging effects of stress on your health. On your health.

Joe Badman: 00:59:18

Yeah. It's a bit ironic, isn't it? Working in the National Health Service, the.

Helen Sanderson: 00:59:21

Organization set up for our health, one of the biggest employers on the planet, is having a detrimental effect on people's health. Health. Why isn't this a national scandal?

So if we can do something about psychological safety, it would make the NHS a healthier place to work and it would mean that we had less patient incidents, accidents and deaths. Sadly, that feels worth working to. The other thing is, doesn't require money. No, not. You know, it's not like if we had.

If we could build thousands more hospitals, everybody would be healthier. This is the different.

Of course, it requires some money to help people learn how to do this, but it's not on the same kind of scale as other things that we'd like to invest in the NHS for. So I thought that would be it.

Now, I'm a very ambitious woman, but I know moving the dial on, that is a big ask, so I thought, what's the one thing that I could contribute?

And over the last two years, I've been doing lots of learning around psychological Safety, attending lots of courses around it, doing lots of reading around it and there's lots of things that say this is really, really important to do. But the OT in me says there's not enough that says how you do it. And most of my work in person centered practices have been pract.

How do you do this tomorrow? What does it take to make this happen? Is, is sort of how my, how I'm hardwired.

So I thought well, what I could do is see if I could persuade a publisher to publish a book around psychological safety in practice. What could we do? Because my background is also self management and most of the books on psychological safety say this is what the leader needs to do.

And, and whilst leadership is really important and they also say everybody's leaders but you know, most of the literature is here's what the leader needs to do.

So I think how can, so my thinking behind this is how can we shift the narrative a little bit to it takes a whole team to create a psychological safe space. The leader has an important role there.

But actually rather than, than relying on some kind of leadership heroics, could we introduce practices that make this more likely to happen on an everyday basis? Even with people who wouldn't describe their leadership skills as amazing?

Because most people in health and care haven't had leadership training, have got into leadership positions because they've been great clinicians.

So a lot of the leaders that the other books are talking about are, are possibly in slightly different places and I care mostly about the nhs, about education and social care, but I couldn't persuade a publisher to let me write a book just for those three areas.

But they would let me write a book on psychological safety in practice that's for everybody and will have a liberal sprinkling of examples from health, social care and education.

Joe Badman: 01:02:16

So there's me trying to explain ham fistedly psychological safety as you're about to explain that you're writing a book on the subject. I am 100% going to edit that section out because I will look very foolish.

So what are some of the practices that you think universally can be applied? I'm really interested in this because I even notice in my own organization that sometimes the presence of psychological safety ebbs and flows.

Sometimes it's very present, it feels very safe and feels like, you know, we can challenge each other in a, in a really helpful and productive way and then sometimes less so because you know, people are having a hard time, myself included. So what are some of the practices you think are universally applicable?

Helen Sanderson: 01:03:01

That's that's such a great point because it means that senior managers, HR departments, OD departments cannot create psychological safety for an organization. It's created team by team, team. And it can be broken in a moment or diminished in, in a moment. So. So it's so important and it can be a bit fragile.

And I think unless we have these kinds of practices that I'm going to explain, you know, really embedded into it. So I think that there's five foundations, and I think the first foundation is mattering.

And one of the books that inspired me recently was by Zach Mercurio, and it's called the Power of Mattering. And it's none of those books. You go, oh, my goodness, yes, of course, of course. And so I think the first foundation is.

Is mattering because unless you believe you matter, you're not going to think your voice matters, you know, and psychological safety is evidenced by people being prepared to speak up. So. So I think that's critical. And for me, that's about noticing. It's about appreciation, it's about recognition, and it's about celebration.

So I did a webinar on this yesterday, so this is all really fresh for me. So thank you for asking. So yesterday I was sharing with the people who join me on the. On the webinar. And this is part of my Working out loud stuff.

So, so my, my. I like to look confident.

I've learned a lot about why being vulnerable is important, as you know, that competence and vulnerability, I need to pay attention to, to both of those.

So I've intentionally, with this book, decided to work out loud, invite people to join me on the journey, testing out the practices, giving me the feedback, you know, sharing of the practices with me. So that rather than like academic research, you research them three years, you then produce your paper, but it's like three years out of date.

So I want to share as I'm going. So I was doing that yesterday. So we were talking about noticing practices. So Zach gives a lovely story about a woman who has a noticing notebook.

And she works in an area where the whole organization's engagement scores are really, really low, but hers are off the charts high. And Zach Quinn had a conversation with the. And the team felt like this woman really, the supervisor really got.

So of course, a great researcher as he is. Zach said to the woman, what is it that you're doing? And she has a battered moleskin journal.

And on a Friday, she would reflect on the conversations she'd had with her colleagues, write their names and what she'd noticed. So maybe Somebody going away for a weekend or somebody son doing a tournament or something, or something that some people were struggling with.

She'd do that on a Friday, on a Monday, she'd put in a phone when she was seeing the people, people and making sure she brought it up. That's all she did. But of course, people felt seen in a completely different kind of way. So there are practices like that.

The second one is appreciation.

And Zach makes it really clear that appreciation isn't great job, Joseph, that we need to be really specific, like what was the context, what did you do and what was the impact on me? And appreciation is about who you are as a person person in the way that Zach describes it. And recognition is what you've done.

So, you know, thinking differently about both of those. I'm a huge fan of the 5 Minute Journal. So my morning practices are 5 Minute Journal and doing my morning pages.

And I say to people I do morning pages. I'm not surprised. I am such a huge fan of morning pages.

But I've said to people on the webinar yesterday, and anybody watching and listening to this, the best £25 that you will spend on your happiness is buying a five minute journal. Three minutes in the morning, two minutes in the evening.

So it asks you to write down three things that you appreciate and research tells us that's really, really good for our mental health. And at the end of the evening, the two minutes include what have you learned today?

So, so I encourage people to do that because noticing and appreciation is also about you noticing who you're appreciative of and what you're appreciative of and what you've learned. And then it's not a big step to go to telling the person.

So there's, there's something called the 21 day challenge around appreciation, which I'm in week three for and I've done in the past. But it's a really good. It's like dry 21 days of appreciation. You know, it shows you that you can make it into a habit and keep going with it.

And it's before you do your first email of the day, you send 12 minute appreciation to somebody. So it might be actually recognition that you did this and it made this difference to me, or it might be appreciation.

One of the things I appreciate about you is your courage to do X, Y and Z. So that's a great thing to do. And one of my friends, friends, Sam in the village, I did an appreciation of her.

She's new to the village and She's a great person to know. So I did a specific appreciation and she messaged me back and said, you know, she said it had made her day.

But what she also said was, I'm sure lots of people think these things but don't say them. And that's what this is the stuff that you naturally think about people or Write in your 5 minute journal. This makes you say it out loud.

So practices like that and then there's things like shout out Thursdays and wins of the week and doing appreciation checkouts at the end of meetings. So one of the seven practices is at the end of a meeting and we do this in our meetings, say as a round.

So a round is uninterrupted, giving each person good attention. What's one thing you've appreciated about the meeting today? And people go around and say, and we encourage people to be specific.

So not it's been a lovely meeting. It's like, you know, I appreciate it.

We spend 10 minutes wrestling with, with this issue here because this is going to be really helpful for me or that we were brave enough to consider this issue once people are in the swing of that.

Braver is what's one thing you've appreciated about the time we spent together in this meeting and what have you appreciated about the contribution of the person on your right? You can still do this if you're on Zoom or teams.

So I might say Joseph, I appreciated that you asked that really insightful question because that helped me think about it in a different way. We don't say Joseph's a lovely person. It's what specific contribution did you make?

And that helps us practice being able to identify contributions and giving people appreciation. So if that feels new to your team, that's, that's a lovely way in really.

So that, that's the first of the five foundations is about mattering and it also then encompasses, as far as I'm concerned, bringing your whole self to work.

Because the more that we know about each other and can trust each other and the more you can have conversations about what matters and, and a greater sense of belonging and trust. So that's the first one. The second one is voice. So practices for making sure we hear every voice. I'm fascinated by meetings.

So a lot of my early work is how do we make the hour and a half you spend in meetings really, really worthwhile.

The nerdy part of me gets people to say let's calculate the cost of this meeting and let's ask ourselves whether we got two and a half grands worth of value out of this meeting.

And when organizations are cutting costs, you know, why aren't we having these conversations about how much meetings cost and are we getting this value out of them? And there's a push, you know, so what we see on LinkedIn is don't do that meeting, make it shorter, et cetera.

We've just extended our team meetings by half an hour because we see it as a great opportunity to learn together. So in our team meetings, we've got an extra half an hour.

And we're doing things like practicing, using nonviolent communication, compassionate communication, getting better at doing that, going deep in our understanding of psychological safety. I digress. So voice.

So I think that there are some meeting practices like rounds, lime time, talk, like liberating structures that if we just automatically use those in meetings, we would make sure everybody's voice got heard. So practice around voice. And then after voice, it's clarity. So one of the most stressful things for people is not knowing what's expected of them.

You have heard my rant about job descriptions. So the keystone practice for me around clarity is roles.

So moving from job descriptions to role descriptions so you know exactly what's expected of you and what good looks like and if we know that about each other, because not only have you not looked at your job description that you never had in the first place recently, you know, most teams have never seen the job descriptions of their colleagues unless they're doing exactly the same job. So how do you know what you can expect from each other?

So if you've got role documents that describe everybody's role and what good looks like and what you can expect, respect of each other, and if everybody has those, you're going to be in a different position to be able to bravely say, we haven't got a role for this, you know, and I feel like this keeps falling through the cracks or even to say, I can see this is your role. Could we have a conversation about how that's going?

Because this not happening is in the way that I understand it is getting in the way of me doing my work. So. So it supports that kind of bravery and candour. So clarity about roles, Being clear about roles is one thing.

The next one is about our connections with each other. And that's where team agreements for me is the keystone role there.

So we need clarity about how we've agreed to show up, and we need clarity about how we work together. The thing with team agreements is also about practicing them. So for.

For five years, I would think that the act of co creating team agreements was enough? Of course it's not enough.

And now I've got six implementation practices that I work with on people to use and one of them is creating scenarios and practicing what we do.

So let's imagine in your team, you have a team agreement that says if we've got an issue with somebody, if we've got a problem, we talk directly to the person person, not about them, or we bring it up in a team meeting. So that's what we do. And for very many reasons, people don't feel comfortable doing that. So we would then create a scenario around that.

So we say the scenario might be, let's imagine you're brewing a lovely cup of Earl Grey tea in a beautiful mug. That's because the conversation I've just had before I came here was about tea.

Let's imagine you're brewing up together and you overhear two people in the coffee and area having a conversation about one of your colleague. And you can hear from the tone that it's negative. And although you can't quite catch everything, you're thinking, oh, that's not what we've agreed.

What do you do now? There's a great book called the Upstander Book that's about helping people shift from being bystanders to upstanders.

And it says there are reasons why people don't. Don't do that. And one is called avoidance. You think, think that's not my job, it's the manager's job. Another is unconscious.

You actually aren't paying attention to that in a way that makes you think we shouldn't be doing that. So it just sort of washes over you. And the third one is about feeling uncomfortable. I don't know what to say.

So I think team agreements address both of the first two. We collectively agree that this is how we're going to work as a team.

Stops it being the manager's job, stops you being able to avoid it, because we're looking at these on a regular basis. But the avoidance thing, well, what do you do?

So we'd say, okay, let's have this as a scenario within the team and in the team meeting, say, what would you typically do around that and what do we think we should do? If we're living this team agreement and we agree together, how are we going to do that?

And ideally you'd be using compassionate communication and making a request. But sometimes it's just saying that feels outside of our team of agreement to me. You know, can we agree not. Not to do that. Yeah.

Two things happen if you're the kind of person that is likely to have those conversations, it diminishes, I think, the likelihood that you're going to do that because it reinforces that that's not okay. And you think your colleagues are going to call you out.

If you're the colleague that thinks you might hear that and not know what to say, You've got your script now.

Joe Badman: 01:15:49

Yeah.

Helen Sanderson: 01:15:49

And you also know that your colleagues are going to expect you to you to do that because that's what you've agreed. So I think that's part of the power of team agreements. One team I've been working with have got, we give each other feedback regularly.

I don't like the term regularly. It's not specific enough. Their team agreement says something a bit more robust than that.

But let's imagine, you know, we give each other feedback on a monthly basis in some form or other. We've had a couple of reviews of our team agreements. This is the one we keep getting stuck on.

So last year I did my training as an immunity to change coach and you can do that on a one to one basis or you can do that in teams. So I spent an hour with them and the immunity change process gets you to look at what you're saying you want to do.

So your improvement goal for the whole team is we give each other feedback in the way they describe. So we put their team agreement there. And then I said, what are you doing or not doing in relation to that?

What we're doing is avoiding any opportunity to give feedback, giving it in a really vague way, so it probably can't be heard very well. So listing the behaviors that people are doing or not doing in relation to team agreement. And then it's talks about a worry box and assumptions.

And what are your big assumptions? By the time we got to the big assumptions, our big assumptions are if we give feedback, we might not be giving it well and that might do harm.

Or is one assumption and the other assumption is if we give each other negative feedback, we'll damage relationships. And so sometimes the reasons why we do things aren't necessarily skill based. One of those was skill based.

They're about what we believe about the world and people, et cetera.

So then we were able to do some experiments where we could take the team through several stages of structuring ways of giving feedback and asking people to check in. Does this make me feel more anxious? Am I worried that I'm damaging a relationship here? And then keeping coming back.

So now they're a team that does a much better job of giving each other feedback. So I think team agreements that say here's how we're committed to showing up with each other.

Other then involves practicing how we do that as well as things like team agreement of the month, getting confirmation practices around team agreements. How am I doing living the team agreements and reviewing them.

But some and then when we find out what we're not doing what we say we're committed to but actually not doing with your behavior sometimes what's underneath that is a belief that we hold that we need to do so that's foundation is all about our connections with each other and how we can what we can do to support that. And for me the keystone practice absolutely is team agreements and then the next one's growth.

How do we work together in a way that we're growing and learning individually and collectively and things like after action reviews. So if we normalize looking at mistakes through a lens of how can we use this to learn together, obviously that's going to be really helpful.

And I love Kagan and Leahy, Robert Kagan and Lisa Leahy from who wrote the book An Everyone Future, which really talks about bringing your whole self to work in a brilliant way. And Kagan has an amazing quote at the beginning that Sundays people do two jobs. Their first job is the one they're paying for.

The other job is hiding and not showing off flaw showing who we are trying to create good impressions all the time. And I think the bringing your whole self to work is part of that. But there's different layers, layers of depth that we can know each other.

So if you were in my team, Joseph, you'd know what I'm currently working on in terms of my immunity to change. You'd know what my growing edge is and I'd be asking you for feedback around my growing edge.

So when we think about bringing our whole selves to work, for me it's kind of like a no grow spectrum. So sharing what we know about ourselves with each other.

One page profiles manuti me that kind of thing right up to grow is how am I wanting to grow and develop as a person. So I see bringing your whole self to work like that.

So for me, growth the fifth of the foundations is about how do we grow as a team and learn from mistakes but how do we support each other to grow as individuals. I think the workplace should be a place where we grow and involve as people.

Joe Badman: 01:20:28

I think I absolutely love everything that you've just Shared.

I, I think all of this is so, is so foundational and it blows my mind that most organizations just pretend like all of these things are just not an issue and we just sort of put on a professional mask and just march onwards and never really get round to making any progress on these things. One of the things that is a really real bugbear for me is decision making.

And particularly in large organizations where we're talking about large sums of money, where decisions have really material impacts on people's lives. In communities the way decisions often get made is mind boggling.

Go from one meeting to the next, somebody who is the, you know, the hippo, the most senior person in the room, highest paid person in the room, in the room, who's very frazzled, maybe hasn't had time to read the papers, is then put in, in a room of people where they're expected to be able to make a quick decision and look really competent in, in, in doing so and has to often engage in face saving activities where they're sort of pretending like they know what's going on and what the right thing to do is and then that decision gets made and it triggers off a whole bunch of action and words and often it's not the right thing.

And I don't remember in all the time that I was a manager and a leader in the public sector, I don't remember anybody ever talking to me about what does making a good decision look like, what's the practice of doing that? So I'm interested in how do you think about decisions? How do they get made?

Helen Sanderson: 01:22:14

Not consensus decisions.

Joe Badman: 01:22:16

I mean it's crazy, isn't it? I mean we sort of either default to that or pretend like we're going to make a decision democratically when that's not the right thing to do.

Often no.

Helen Sanderson: 01:22:24

And what it does is it lowers every decision to the lowest common denominator in terms of risk. So you'll get no brave decisions if you're relying on consensus decision making.

And it almost feels like that's an unacceptable thing to say because surely we want to make decisions together, et cetera.

So because I'm schooled in Holacracy and that's been so powerful for us in relation to self management, the roles that we're talking about, talking about before come with decision making rights. So everybody in my team knows the decisions that they're responsible for.

And you'll know that the advice process is very popular in self management terms. So I can ask advice if I want to hear other people's opinion before a decision is being made.

And I think sometimes majority decisions are the right things to do.

But I think the important thing is before you make a decision in a team meeting, one, have you heard from everybody's input doing around and two, before you've done that, have you clarified how the decision is going to be made? So it's a bit like saying the decision that's in front of us is about how this amount of money gets spent. I want to hear everybody's views on this.

But I'm clear that the decision, the final decision is mine to make within my role. But I want to hear your advice or we've got a decision to make at least about this money.

I want to hear the pros and cons of the approaches that we've been looking at. We're going to make the decision by a majority in this situation or this.

I want to hear people's advice because then I'm going to suggestions, I'm consulting with you.

And then this decision is being made outside of this room by somebody else and I'm going to take that information to that decision making forum and then bring you back what happens as a result of it. So it's clarity about what's the most important, important. What's the most, what's the relevant decision making process here? Is it one person?

Is it consensus? And usually, you know, is it, you know, a majority vote or it, you know, what, what is it?

And then being clear about that before the decision's made, before you ask people's opinion.

Joe Badman: 01:24:31

Yeah, and there's, I mean, there's incredibly coherent writing on all of these processes. And I would really encourage people, people to look at it if decision making is a sticking point for their organizations.

Because I think at least in the work that we do in local authorities, there's enormous ambiguity around who's able to make decisions and how the process is going to work.

And people spin their wheels for so long to the point sometimes where the nature of the problem that we're trying to address has changed because we've taken so long to make a decision on this. Sorry, go ahead.

Helen Sanderson: 01:25:07

And I think it relates to experiments as well. So how do we shift from absolute things to experiments and what's safe to fail kind of thing.

So I think we both have challenges around making decisions and don't automatically see is there something here we can test out before we make a bigger decision around it.

Joe Badman: 01:25:28

I think that's exactly it. There's a big difference between fail safe and safe to fail. Yes, And I think that often we're striving to make things fail, safe.

And that results in very low levels of risk taking.

Helen Sanderson: 01:25:45

And.

Joe Badman: 01:25:47

Yes. Or sticking to the status quo. But that is often not the right course of action.

And we should be looking for opportunities to test things in a small way that if. If we fail and many things will fail, it's safe enough to do that.

And we can learn from that and we can integrate that learning into what we decide to do next.

Helen Sanderson: 01:26:06

And that's where I think Charles Handy's donut is so helpful because it says, you know, here are core responsibilities. Don't experiment with medication. You know, that's. That's not something anybody can experiment with.

Don't experiment with different ways of supporting people to stand up. You know, you do what's in the plan. But then here is a really big area, area of space where you can use creativity and judgment.

And this is where we need to be doing experiments. And these experiments won't all work. Well. They will work because I'll teach you something. Won't all be successful.

But because they're in this area of creativity and judgment, that's okay. But let's be clear. You don't experiment here. This is below the waterline. And I don't think those conversations are had either. Enough.

Joe Badman: 01:26:49

It's not. The world that we work in. Work in is full of ambiguity.

Helen Sanderson: 01:26:55

Yeah.

Joe Badman: 01:26:55

And we need to. Or at least I try and think about this when we're recruiting to basis, we need to recruit people that are tolerant of a certain amount of ambiguity.

But there are certain things where ambiguity is really unhelpful.

Helen Sanderson: 01:27:05

Yeah.

Joe Badman: 01:27:06

And we just need to be clear what's okay and what's not okay.

Helen Sanderson: 01:27:09

Yeah.

Joe Badman: 01:27:09

And that gives us the boundary within which we can make some progress. Because without those boundaries, the ambiguity becomes intolerable.

Helen Sanderson: 01:27:18

Yes.

Joe Badman: 01:27:18

We get. We get stuck. I think.

Helen Sanderson: 01:27:21

So. One of the ways that organizations think they're managing that is through policies and procedures.

So when I started, actually when I had my interview to become a registered manager, I was required to share all my policies and procedures. And I think I'd put whistleblowing policy in with another one that related to duty of candor. And I was told there had to be two.

Two separate policies by CQC at the time.

So there's very strong expectations by both local authorities, if you're in a contract with local authority and CQC that these 150 policies and procedures are the ones that you need to have. And of course, if you've got 150 policies and procedures, they're like this.

And most policies and procedures are written with here's what the senior management team need to do. So it's like for everybody in the organisation kind of thing.

And usually if you join an organization, you're given the policies and procedures and you are asked to sign them, that you've read them. How stupid is that? How stupid, you know, why do we think worse than that?

There are organizations that sell policies and procedures to organizations and give them updates every month. And I know that's going to get me into a lot of trouble, but.

So one of the things I obsess about is, first of all, we need to separate policies from procedures. Our policies are, this is what matters to us in our organization, so it's closer to values.

These are statements that aren't going to change, it matters to us.

So think about anti bullying, harassment policy alternative, that we're kind to each other, it matters to us that we're kind to, to each other, you know, so whatever those statements are, and then procedures obviously are how we operationalize what matters to us. So back to experiments.

If your procedures haven't changed in the last three years, that means you've learned nothing, or it means that you are learning stuff but not recording it in a way that gets shared with everybody. Or, or it means that people are going under the radar doing stuff because they think some of this is nonsense and not telling anybody about it.

So in all of those ways. So one of my criteria for organizations is how many changes have you made to your procedures over the last year for evidences that you're learning?

And not many people can do that. So we have a playbook.

And in year one of wellbeing teams, our place book changed six times, had to be edited six times because we were learning such a lot. But can I show you this?

Joe Badman: 01:30:05

I would love that.

Helen Sanderson: 01:30:06

So this here, this known as the Green Book of well being teams. And it's thin, isn't it? And it's not densely written, it's even got pictures in it.

Because what I did was I took every policy and procedure that I was expected to have by CQC and by the local authority. And first of all, I stripped out it to what do well being workers? What do my colleagues who are delivering care need to know?

And then for each patient, this is the medication one and it says what you need to know and then it says what you need, what you must do, what you must not do, and get in contact with the person's linked wellbeing worker or the wellbeing leader on the same day, if so, and we gave people beautiful bags which had their PPE in it. And it also meant that they could have this in it. So if they needed to check anything, it was to hand.

And this is a small, non frightening coloured book which is essentially the distillation of the procedures that we needed to have as a wellbeing team.

So in the same way that I am obsessed, as you've heard of killing job descriptions and going to roles, this is what procedures should look like and it should change every year and ours did. Because unless we're saying, is there a better way that we could do this? Or so a tension might come up that related to something in here.

And we didn't say, well, actually we just published this and we can't change it for two or three years. We would say, let's do an experiment, let's see what this tells us and then we can issue an update here.

So I have a big thing about policies and procedures because people need to be clear what's expected of them. Organizations think that being clear, that clarity is around job descriptions and policies and procedures. That's not true. That's absolutely not true.

We need to have other ways of doing that.

Joe Badman: 01:31:57

I'm very now excited to know what's underneath the table. So I can see some other colorful things under there. What else have you got?

Helen Sanderson: 01:32:04

You invited me to bring resources related to learning. These are my feelings cards from non violent communication or compassionate communication. And each card has a feeling listed on it.

So feeling safe, feeling confused, feeling irritated, feeling shocked, feeling satisfied, feeling worried. I'm a big fan of Brenny Brown and was one of her trainers for Dare to Lead.

And Brenny quite rightly says that our emotional literacy is limited to anger, angry, sad, glad. And it'd be enormously helpful if we had a wider range of ways of describing our feelings. Because feelings are data.

And once we, as Marshall Rosenberg from NBC said that if you can identify what your feeling is and name it, and the whole mindfulness community believe in this as well, it's so important we can then do something about the feeling if it's not a positive feeling. And that might be asking for something that we need from somebody else or it might be asking what we need for ourselves.

So Kirsten Neff's work around compassion and self compassion, you know, really does that. So I think being able to describe feelings, because if I say to people that I know, sometimes my partner, how are you feeling? I'll get Good.

Okay, fine. And I'm going. And the irritating part of me says they're not feeling words. So in. And I choose to get better. I want to keep getting better at this.

So in our team meetings, we have a feeling. Words.

Oh, the noticing thing that I didn't tell you and I regret that is the first thing about noticing that is done in some hospitals somewhere has actually come from aviation is the easy way into this is if you start a shift or start a meeting with just saying whether you're red, amber, or green, you know, and green is, I'm feeling good, I'm not feeling stressed. You know, I'm fully present and able to contribute. Amber is I'm feeling a bit stressed and a little bit distracted.

Red is I'm feeling a bit overloaded. And if you started your meeting with just. Are you read amber or green today? Green, green, green, amber, red.

And then those of you who are amber, is there anything that we can do before we start the meeting that helps you, or is this something to be dealt with outside meeting? And the same for red. So showing people that we.

That you're noticing your sense, how you're feeling, and that you're able to share that with other people.

And then feelings literacy, either with cards or we have a sheet that lists feelings and needs in the beginning of a meeting, after our moment of mindfulness, we will say, choose two words, describe how you're feeling, and do that. And so that's why that's there. And then the last one. I am bowing to all my teachers here. Erin Dignan. Exactly. Excellent book. Brave new work.

Joe Badman: 01:35:00

It's wonderful. Yeah.

Helen Sanderson: 01:35:01

You know what these are then, don't you?

Joe Badman: 01:35:02

I do, I do. But these are fantastic.

Helen Sanderson: 01:35:04

So these attention and practice cards. And Aaron has a huge range of tensions on his cars with things like, you know, the it is out of date.

And so stuff around structures as well as feelings so people don't feel their work is meaningful. Our purpose is unclear. We change slow in the outside world. We're a culture of thinking, of leader, not enough recognition or reward.

And then he has a range of practice cards, which are solutions that create a user manual to me for every member of the team. And we've talked about getting your whole self to work and how important that is. Invite teams to create and edit their own roles.

These are not randomly selected, as you know, as you can imagine. Replace. Is it perfect with. Is it safe to try take turns or speak in rounds to hear all voices during meetings and calls.

So I've been working with Some colleagues on a range of tension cards that are interpersonal tensions that relate to psychological safety. And we've got 44 of them.

And what I used to do, okay, last year is when I was working with teams to help them develop teams agreements, we'd use the tension cards and then we'd spend a while wordsmithing good team agreements. And I had a set of six tests for great team agreements. But the danger is a bit like back in the day with person centered planning.

You spend all your time developing a great plan and not all the energy in implementing it. So what I've learned is you can get a good enough set of five or six, six team agreements in an hour and a half in a team meeting.

If you're using these tension cards related to interpersonal relationships, psychological safety, because on the back I've given you three potential team agreements that you can either say, I like number one the best as a team, or let's amalgamate two or three so it stops the need for doing, you know, lots of wordsmithing and you can start. So, so that's something that I'm pleased that we've worked on, that.

I'm confident now that any team, particularly if they've got the tension and team agreement cards, can get going with team agreements and have a good set after an hour and then spend half an hour looking at the six practices around putting team agreements into action and get started with that and then go.

Joe Badman: 01:37:32

Well, Helen, this conversation has been so unbelievable educational for me. And part of me doing this podcast is a selfish endeavor because I get to learn from people that I admire.

And honestly, I've found this so useful and I'm convinced that other people listening will find it equally useful. How can people find out about the work you're doing on the book? When's that going to come out? How can they find out about your work more generally?

Helen Sanderson: 01:38:00

Thank you. I'd love to be able to say, come onto our website. Well, you can, of course.

So, Helen Sanderson Associates.com and there's obviously a form you can fill in there if you're interested in specific information. But I'm trying to show up on LinkedIn a lot. I believe in working out loud.

When I was leading wellbeing teams, I made myself made myself do a two minute film of what we've learned every week and posted it on LinkedIn because I feel some sort of moral compulsion to be sharing what we're learning. So if you're on LinkedIn, come and find me there. I'm Helen Sanderson. And that's where I'll share information about what I'm doing.

I've got a series of six more webinars that relate to the book sharing what we're doing as I'm learning about it. I'll be posting about that there. So, yes, please come and find me on LinkedIn. That'd be wonderful.

Joe Badman: 01:38:48

Thanks so much. I'm so grateful to you.

Helen Sanderson: 01:38:49

Thank you. Thank you for inviting me.