CIVIC DISABILITY SERVICES
A research process for the importance of human connection
Civic Disability Services are a not-for-profit that was initially formed by parents as a way to support and foster the growth of their children with disabilities, ranging from intellectual, physical, and psychosocial, in a safe and inclusive environment. Progressively, the organisation came to cater to people with disability of all age ranges, extending and developing their framework of services in order to offer opportunities for the quality of life that each and every person rightfully deserves. These people are known as Civic's clients.
Closely supported by the National Disability Insurance Scheme (NDIS), Civic extends a range of service offerings, from Supported Independent Living, to employment, to centre-based community programs, and much more.
Who are Civic?
PROJECT OVERVIEW
Focus
The task was to examine the Supported Independent Living (SIL) aspect of the organisation in which existing problems or structures within this area can be rethought and improved.
SIL is where clients can opt to live in shared group homes where they have round-the-clock assistance by support staff.
Process
I was able to work with the stakeholders (lead Service Designers) and was given access to the artefacts of their own preliminary research. This helped inform the research objectives, focus on user groups of the organisation, and with the synthesis of research findings, I provided recommendations to the business in a presentation and research report.
Logistics
This work was executed over a 7-week period. As this was a fully remote project, all interview, research, and presentation work was conducted in a virtual capacity.
What was the design problem?
The Civic stakeholders supplied a human-focused statement that they brainstormed prior to my project involvement. This was the backbone of my research process.
Once a stakeholder interview was performed, this helped develop deeper comprehension of the problem statement in the context of SIL, which provided solid foundation to the research approaches, analysis, and recommendations that followed. There was detailed overview of the Circle of Support, which essentially represents the client's support network. This includes the Practice Leader, of which the design problem places emphasis on. The discussion unveiled some significant factual considerations upfront:
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Client’s Circle of Support network is generally characterised as “paid” support (e.g. Practice Leader and Support Worker) and “unpaid” support (e.g. family, guardians, and friends)
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Client should have healthy balance of independence and grounded support from their network
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Civic has a relatively transactional model in service delivery that is looking to be re-shifted
RESEARCH OBJECTIVES
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Understand people that are critical to Circle of Support, including Practice Leader, Support Worker, and “unpaid” supports
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Understand the layers of the client’s wellbeing (e.g. mental, emotional, physical, and social) and how this impacts the support and care provided to them
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Investigate the time-pressed and overloaded nature of the Practice Leader and how this impacts their quality of work for the client
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Understand the communication workflow and hierarchy within the house
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Explore how to enhance and empower the client and their experience regardless of who is in their Circle of Support
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Rethink the term “connection” and its application to the Practice Leader/Circle of Support relationship
Ready, set, research!
So, who are our users?
To kick off, it was time to empathise with the focus groups and understand a little more about them.
Practice Leader
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“The heartbeat of the accommodation site”
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Oversees upwards of 5 clients (within one house), including facilitation of doctor’s appointments, NDIS/Support Coordination interactions, and finances.
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Manages all the Support Workers, including rostering, shift requirements, and other administrative tasks as required
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May manage multiple houses simultaneously
Support Worker
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“On-the-floor”, providing hands-on support to clients where required
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Can be in abundance at a single house, often supporting multiple clients simultaneously and can be allocated as a second support to a client (depending on severity of disability)
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Senior Support Workers can intervene to assist Practice Leader in particular circumstances (e.g. sick leave)
Client
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Person being cared for SIL
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80% with intellectual disability/cognitive presentation of some description; others include congenital, neurodiversity, psychosocial, and co-morbid/physical
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Diverse in culture and ages
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Are happiest when they are in a positive environment, especially with good supports
Unpaid Supports
This group can consist of parents, relations, friends, guardians, direct relations, or anyone close enough to the client. They are not workers but are still highly significant in forming the base of the client’s Circle of Support. For this project, unpaid supports were not active participants. Parents were the most discussed about throughout the project and comprise the majority of the unpaid supports.
User Interviews
I had the opportunity to contact and organise interviews with some of the support staff at Civic, including Practice Leaders, Operations Managers, Support Workers and other staff who have at some point been in these roles.
Insight Cards
The Civic Service Designers provided access to these artefacts they created, which essentially captured the sentiments of clients and what they would like to see change in the quality of the service.
Civic Conversations
I was able to join a real-time meeting between one of the Civic Service Designers and various Civic support staff who discussed a key question: What should we address when talking about the Circle of Support?
Service Safari
This was an opportunity to observe a couple of clients and workers in their Civic house in real time. In this session, myself and my designer colleagues were allowed to interact and ask questions about their experiences.
All the synthesis!
Affinity mapping
The key points from the combined research were sorted into themes, before further dissecting to see if there were any intersectional links between the data.
"Chain of Causation"
This is an artefact I created to combine aspects of user personas and opportunities, drawing inspiration from all the research material. The data implied that there was a "top-down" approach to the problem which I attempted to visually communicate.
Key findings & insights
After careful dissection, it was apparent that the undercurrent of the problem was a combination of communication and quality of care. This revealed that communication etiquette, clarity, and regular face-time between all parties really matters when enhancing client wellbeing.
How can we solve these problems?
With all the clever, automated technology prominent in the world, there is no real substitute to a very human problem other than simply communicating more directly and having regular face-to-face interactions to keep human connection ablaze. This can be achieved by remove existing barriers, then apply some practical strategies to the process that are currently ineffective.
Give practice leaders assistance!
Practice Leaders have way too much administrative backlog to handle on any given day, which reduces their ability to develop any face-to-face connection with their key people.
Hire an administrative assistant to work closely with Practice Leaders. They could also learn to be more involved in the more formal undertakings of the Practice Leader (e.g. communicating with NDIS and clinicans), and even represent the Practice Leader in such conversations where the Practice Leader cannot be present. They can be a conduit between Support Worker and Practice Leader in instances where a speedier interaction is required.
With full awareness that not-for-profit organisations operate under budgetary constraints, the assistant can be a part time/casual worker, so they are utilised only when needed (e.g. days with lots of meetings or paperwork processing). Alternatively, the assistant could be hired in a voluntary capacity, incentivised by potential employment opportunities within Civic or merely motivated by an act of goodwill. Lastly, the administrative assistant can be someone undertaking a student placement in the social services/disability sector, which is win-win for all.
Benefits:
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Practice Leader feels less overwhelmed, with time freed up and workload reduced leaving opportunities for improved interaction with clients and other supports
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Not overloading or assigning additional work to essential staff like Support Workers, as they are most effective in their current roles
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Encourages an environment of deeper trust, setting an example of reaching out for help when required
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Assistant receives industry experience
Be present!
Practice Leaders need to harness opportunities to humanise relationships beyond an email or a phone call, which is a much desired gesture from the clients and their families.
Schedule time (with the help of the assistant!) with client, families, and even Support Workers for frequent face-to-face catch ups - no exceptions! Primary method of contact can be via phone, as this is a more direct and universal communication device that eliminates confusion or any “lost in translation” moments. Organise catch ups on a fortnightly basis, as this offers a happy medium of regularity - not too little or too much time in between. Be as creative as desired with catch ups. For example, within each client/Circle of Support group, each party gets a turn at choosing the outing/recreation.
Benefits:
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Removes the transactional aspect of service, where clients and their families will feel valued beyond the financial contribution they make to Civic
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Opportunity to get to know people on a social level, including their interests and hobbies (which can be taken into consideration in the catch ups!)
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Renders Practice Leader less authoritative and more involved
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Ensures the client is being surrounded by their key people, increasing sense of comfort, sociability, and care
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Everyone feels heard
Know where to go!
Support Workers (and all staff, for that matter), should understand where to turn in times of need. The support hierarchy must be clarified.
Create a clear and detailed escalation matrix which shows who to contact - when and how. This may require some organisational meetings to determine and understand the roles and responsibilities required by the escalation contacts (e.g. if not Practice Leader, escalate to Operations Manager if the issues or requests are X, Y or Z). Review the escalation matrix frequently. This can be through regular house team meetings or casual catch ups. This can be an opportunity to openly discuss any issues that arise with the matrix.
Maintain visibility of the escalation matrix. For example, this can be printed out and placed in a common area of the house so it is easily accessible to all staff.
Benefits:
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Removes structural ambiguity
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Makes it easier to identify escalation points
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Support Worker will be better informed of who to go else to engage in cases where a primary contact point is unavailable, which ultimately translating to better client service
What were the stakeholders' thoughts?
A full presentation was conducted to the Service Designers, outlining my research and recommendations for the business. The feedback was as follows:
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Impressed with communication and presentation style
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Surprised by research findings, particularly in the comments and perceptions of some Practice Leaders and Support Worker
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Intrigued by "Chain of Causation" diagram, as it visually highlighted the problem in clear sequence
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Particularly interested in admin assistant solution, as the company has been considering a similar approach
Final thoughts & reflections
Snippets of my project learnings.
Research limitations
Although there was substantial data to navigate the project, I feel the process could have been enriched by some quantitative research to understand specific demographic data (e.g. age range, cultural, and/or socioeconomic factors) to provide more targeted output for the client.
With the understanding that this may not have been possible, interviews with clients and/or “unpaid” supports to understand their perceptions would have unveiled their side of the problem more clearly rather than upholding assumptions.
Analysis
There was some difficulty comparing Civic to similar NPOs/support services such as ‘Circle of Hope’ and ‘Disability Services Australia’ - although surfaced information around service offerings and key objectives can be located, drawing distinctive parallels or differences through targeted user/organisational research would have been insightful.
Logistics
Originally, I had planned to interview a Support Worker but due to unforeseen events, that was no longer viable. Because there were no other Support Worker interviewees available by then (due to scheduling capacities), our stakeholder promptly organised an Employment Coordinator who was previously a support worker to jump in. This meant that there were scheduling and scripting adjustments to be made.
I understand more than ever how to be resilient and adaptable in instances of abrupt change.
Industry Education
Having exposure to the disability sector made me aware of the incredible yet hard work that is carried out, both in support and service delivery. It reinforced my passion for human-centred design and heightened my empathy to a significant degree.
The most important outcome is that all parties directly involved in client care have a genuine investment in their support. As our tech-enabled world flourishes, people still appreciate, crave, and benefit from the old-fashioned approach: "treat me like a human."
