Discovery – exploring and discovering the positive capacity present in the organisation through engagement with large numbers of organisational members.
Approaches for leading through change
In this section, we provide an overview of four approaches that can be used to support people through a change process.
Appreciative inquiry
What is it?
Many approaches to change begin with identifying the ‘problem’ to be solved and working backword to understand its causes and how can it be addressed. In contrast, Appreciative Inquiry focuses on appreciating and then giving leverage to an organisation’s core strengths, and treats change as a mystery to be embraced rather than a problem to be solved (Cooperrider and Srivastva, 1987). It focuses on the exploration and discovery of moments of excellence and an openness to seeing new potentials and possibilities from that collective knowledge. It is sustained by the belief that social systems evolve in the direction of the positive images that individuals hold about them – looking forwards and extending ‘that which is going right’.
When is it used?
It is suited to changes which require the development of networks of relationships between participants across multiple organisational boundaries. Additionally, the exploration of positive experiences, capabilities and visions for a better future may act as a powerful mobilising force, focusing participants’ energies on action towards shared goals.
In relation to social care change, Appreciative Inquiry fits well into the principles of encouraging shared learning and partnerships and seeking positive engagement from people accessing services, carers and other stakeholders.
Stages in appreciative inquiry
Dream – coming together to share findings, positive feedback leads to the development of a vision (of a better world), purpose (to create the vision), and strategy (towards this end).
Design – once a dream has been agreed, redesign is undertaken in order to realise it. Sources of resistance are reduced to the extent that the dream is widely shared by participants.
Destiny – transformative effect of changes in the way that people think and talk about the world results in realisation of the vision. The organisation is created anew through organisational members connecting and co-creating and so mobilising the potential for change. (Adapted from Cooperrider and Sekerka, 2006, pp.225-6).
Case study: Exploring co-production in Kirklees through Appreciative Inquiry
SCIE supported Kirklees to work collaboratively with people who use services, carers, the local authority, wider statutory and voluntary and community sector organisations to establish arrangements which support effective co-production and an action plan.
Kirklees defines co-production as:
“A way of working whereby people and decision-makers, or people who use services, carers and service providers work together to create a decision or service which works for them all. The process is realistic, value driven and built on the principle that those who use a service are best placed to help design, evaluate and influence it.”
SCIE facilitated a virtual gathering involving a combination of officers and practitioners from Kirklees Council, the clinical commissioning group, the voluntary sector, and people who use services and carers. A key purpose of the session was to work together appreciatively to think about what they want to achieve through co-production and how they can work together to achieve it.
An overview of the approach and key findings is presented below in the drop-down boxes.
Appreciative enquiry stage
Themes discussed
Discovery
What is really great about the Kirklees community? What is really good about working with each other? Examples of how this works? What skills do we have already? What things do we need more of?
Strong foundation of co-production on which to build Good examples of integrated ways of working Lack of high-quality information and advice Hard-to-navigate social care system
Dream
What would really good co-production look like? How would you feel if it was working well? What kinds of outcomes would it bring about? What would people say about co-production?
Development of a single framework for co-production Focus of co-production on the whole person and whole community Focus on prevention through co-production Pool of people who want to be involved in co-production
Design
Who would need to be involved? How would we make decisions? What resources would we need? What would our priorities be?
Getting the basics right is a priority Ladder of co-production that helps people understand how to get involved Ambition to focus on the whole system, not just social care Co-production arrangements should ensure the council and partners are held to account Involving people in strategy and designing services Providing a forum for two-way information sharing Involvement of all people with different backgrounds and different needs
Delivery
What do we do next? What actions do we have? How do we sustain this?
Create a care account that allows people to identify and select services Design a single point of access that reflects needs of people who use services Design fit-for-purpose forms and processes with people
Key actions agreed
- Create a care account that allows people to identify and select services
- Design a single point of access that reflects needs of people who use services
- Design fit-for-purpose forms and processes with people
Participants provided feedback about how they felt that the session allowed them to own the discussion, and that there was lots of space for new ideas.
For more information
Watch An Appreciative Inquiry into Adult Social Care about the value of adult social care and read.
Look at the resources provided by the AI Commons, a free virtual community for AI practitioners.
Watch An Appreciative Inquiry into Adult Social Care about the value of adult social care and read the report
Action Learning Sets
What is it?
Action Learning Sets (ALSs) are structured sessions which enable small groups to address challenging and complex issues. They are used to stimulate critical reflection on real-life, work-based problems the answers to which are unclear (Revans, 1980, 1982, 1998). Rooted in experience-based learning theory, this widely-adopted group approach to problem-solving emerged in response to the assumption ‘only that which can be observed and measured counts as knowledge’ (Whitehead and McNiff, 2013).
The essence of the method is people being prepared to understand the limitations of their own knowledge, to develop new ideas through insights received from questioning by others and to test those ideas in action and reflect upon the results.
This approach is formulated as: L = P + Q + R, where:
- L = Learning
- P = Programmed knowledge (the formal knowledge and skills that people have been trained in through external and in-house training)
- Q = Questioning (to create insight into what people see, hear or feel)
- R = Reflection
When is it used?
ALSs have significant potential in continuing professional development teams by offering group members a way of developing skills in active listening, inquiry and advocacy with the aim of gently challenging peers about the nature and possible causes of the problem they are seeking to understand.
In relation to social care change, ALSs provide a means through which key change leaders can reflect on how they can respond to issues and improve their future practice. In doing so they can help to achieve the principles of social change in practice and create both personal and organisational resilience. Clear and agreed values within the ALS help to keep the focus on achieving positive change with others and frame the interactions between set members.
The Action Learning process
A typical ALS includes the following steps:
- Each member reports briefly on recent work events.
- Members choose who will speak about a situation they are currently facing at work.
- The presenter describes the situation, problem or challenge.
- Set members ask open questions to help the presenter gain insight and be open to new solutions – set members do not give advice, pass judgement or talk about their own situation; rather they help the presenter review options and decide on action.
- Set members reflect on the group process and share their own individual learning.
- The presenter initiates changes in the workplace.
- At the next set meeting the presenter reports on the action they have taken, and any further issues.
(Adapted from Revans, 1980)
Case study: Surrey County Council
SCIE was commissioned by Surrey County Council as an improvement partner to support the Council’s delivery of a comprehensive plan for adult social care which aims to transform experiences and outcomes for people who use services, their carers and families. In support of this vision, a new strengths-based practice framework was implemented which focused on supporting people to maintain their independence earlier and for longer. SCIE developed an Action Learning approach to work with team managers and assistant team managers all of whom are critical to the success of the framework. The aims of the Action Learning Sets were for the participants to:
- develop the skills, confidence and capabilities to lead excellent strengths-based practice
- ‘learn by doing’ – testing out, and reflecting on, new approaches and techniques
- explore effective ways to test and embed the operating models and ways of working associated with the new framework
- build strategies for supporting team members to develop excellent strengths-based practice.
An overview of the approach is provided in the drop-down boxes below.
Key components:
- Welcome and about the programme in Surrey
- Strengths-based approaches – input from SCIE
- Outline of good practice from another area + case studies + reflection
- Helping and hindering factors group work + feedback
- Supervision group work activity
- Strengths-based stories
Key components:
- Presentation of problems to work on + feedback on how it relates to helping and hindering factors
- Providing guidance and examples from other areas
- Guidance on the Action Learning format
- Choosing problems to work on – in tables
- Group work session 1: clarify and define the problem
- What does this problem mean in the context of your team?
- What is working well? What is not working well?
- What does this mean for people who use services and their families?
- What does this mean for people who work in the service?
- What are the barriers to improving practice and outcomes?
- What will help to overcome these barriers?
- Group work session 2: develop an action plan
- Participants were asked to develop action plans containing actions to work on in between sessions 2 and 3, using provided templates.
Key components:
- Reviewing work so far
- Recapped on action learning process / principles
- Two identical group work sessions with different people as ‘focus person’:
- Each member of a group has 20 minutes to work with colleagues on the outcome of their individual action
- They present what happened
- Participants ask clarifying questions
- Participants discuss the work that the member of staff has completed with a view to offering positive criticism
- Focus person responds with what they have learned
- One of the group records learning
- Feedback from each groups
- Next steps
Appreciative learning and action learning sets: Jason Schaub video
Watch What is Action Learning (School for Social Entrepreneurs, 2016).
Open Space Technology
What is it?
Open Space Technology is a flexible approach to bringing together large groups of stakeholders to discuss an issue or topic of shared interest. It evolved from the observation that most participants valued the informal sessions within seminars more than the formal programme sessions. Whilst it provides a clear question or questions to be considered, the participants are able to identify what is most interesting and pressing areas for discussion within these questions. It therefore provides an equitable and emergent approach to setting agendas and priorities. Within Open Space there are no keynote speakers, pre-announced schedules of workshop, panel discussions or market places of sponsoring organisations.
When is it used?
Open Space Technology is a helpful way to understand the different perspectives of stakeholders at the beginning of a new initiative or at the point of a review of an existing programme. It provides an opportunity to build a shared understanding and to encourage those with an interest to commit their expertise and resources. The approach seeks to address common dilemmas that are faced by facilitators of large groups. These include:
- Voice – how to encourage as much participation as possible without being overwhelmed by perspectives
- Process – a structure for the discussion is needed to ensure that there is focus and tasks are complete, but too much structure will limit the freedom to explore nuances
- Egocentricity – people need their views and ideas to be heard and considered, but if participants hold too tightly to their personal view they will not be open to new ideas and opportunities.
Running an Open Space event
Open Space has four central principles:
- Whoever comes is the right people
- Whatever happens is the only thing that could have
- Whenever it starts is the right time
- When it’s over it is over
It begins with sharing the overall theme (or question) for the event. The facilitators encourage an open discussion with all the participants in which those attending share what are the important topics to consider related to that theme. From these contributions, a series of topics emerge which then form the basis of small group discussions chaired by one of the people who initially suggested each topic (with help of one of the facilitators if necessary).
The small groups are run on the ‘law of two feet’. This means that participants are able to move between groups as and when they choose, and not at pre-determined times. Participants stay only in discussions if they are interested, learning or contributing.
During the event, facilitators bring back learning to a central point for collation and sharing. When it appears that discussions are coming to an end, then participants may be asked to prioritise the actions that they think are most important.
Open Space events emphasise the autonomy and responsibility of participants in making the event a success.
Case study: Exploring the experiences of people living with cancer in Morecambe Bay
The NHS in Morecambe Bay held three Open Space events as part of an initiative to improve the experiences of people living with and beyond cancer. Advertised publicly, they were attended by people with lived experience and by professionals from the NHS and voluntary organisations. They initially asked: ‘When frequent hospital visits stop, what sort of support and follow-up care helped, or if it was available, would have helped you and others affected by cancer, begin to “feel more like yourself” again? Looking to the future, how do you begin to get the most out of life again? What support might be helpful?’.
At the start of the events, attendees were asked to write their initial responses / ideas / questions on large sheets of paper. With the help of attendees, these initial thoughts were then grouped into common themes. The themes were in turn divided over two rounds, creating an agenda for the afternoon. Each theme was then allocated to a discussion zone in the room, each with a flip chart to record key points from the conversation. Attendees moved to and between the topics being discussed, spending as much time as they wished to contribute, ask questions or observe. After two rounds, attendees were asked to view the flipcharts and use three voting stickers to indicate which topics and statements they felt were most important. Professionals attending the event were invited to vote in the same way using different coloured stickers.
The key themes that were identified through the events were: information, clinical and professional support, shared decision-making, health and wellbeing, peer support, control, and return to normal. These themes were then considered within the development of the local cancer strategy.
For more information
Watch Open Space Technology
World Café
What is it?
World Café provides a structure and environment which hopes to ensure that participants feel relaxed and comfortable and therefore are confident to share their opinions openly. The hope is to create a physical and social space to enable those present to have a ‘good conversation’. It is based on the assumptions that humans want to talk together about things that matter to them and, when they do talk about these matters, they can create collective power.
When is it used?
World Café brings together small or large groups to have a conversation about an issue which is of shared interest. It can enable different experiences or perceptions to be shared to support a collective understanding, to generate new ideas and solutions to common problems, and to encourage the development of networks and collaboration.
Running a World Café
The environment in which the event is held is seen as a vital enabler of ‘good conversation’ through making participants feel welcomed, valued, relaxed and safe. An event can be organised within an actual café or within another space with tables, drinks, music and attractive decoration to make it feel ‘hospitable’.
The café is run on the principles that the contribution of all participants matters and that each person should take responsibility for listening and engaging with other participants. Questions are set for each table with participants moving periodically between tables to discuss another topic. The discussions are recorded on the table cloth (or a flip chart) with a facilitator of the table providing an overview of what had previously been discussed. Over a number of rounds, a collective understanding is developed of each question. Towards the later stages, it is common for the facilitator to ask for the discussion to consider next steps for this issue.
At the end, the main themes and suggested actions are shared for further discussion and agreement.
Case study: The Older People’s Engagement Network
The Older People’s Engagement Network (OPEN) is a charity which held community consultation forums to bring together older adults, typically aged 60 and over, and often in their 80s and 90s, as well as local social and health service commissioners. The latter would present an overview of planned services for the city (e.g. transport, social care, housing, regeneration). Attendees would then engage in roundtable discussions, headed by an OPEN facilitator, who would then feedback comments and questions to the commissioners in front of the entire group. A single forum would typically last 90 to 120 minutes, including refreshments and a light lunch, provided by OPEN, at no cost to attendees.
To explore older people’s experience of engaging with these community consultation forums, researchers invited them to participate in World Cafes. These were co‐designed with members of OPEN and older representatives who inputted on the questions to be asked. At each of the two forums, three or four rounds of discussion took place guided by these questions. The discussions were not facilitated by members of the research team, in line with World Café method values of democracy and participant empowerment but instead facilitated by self‐elected table hosts.