MICHIGAN’S LONG-TERM CARE CONFERENCE Thursday, March 23rd 10:50 a.m. - 12:00 p.m.

1. MICHIGAN’S LONG-TERM CARE CONFERENCEThursday, March 23rd 10:50 a.m. - 12:00 p.m. Coaching Supervision for Consumers and Others Paraprofessional Healthcare Institute Maureen Sheahan, Presenter (c) Paraprofessional Healthcare Institute

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

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

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

5. Supervisors are Key to Workplace Success • Supervisors – whether consumers or employees in traditional workplaces – play a critical role in the retention of direct care workers (DCWs)! • Feeling valued and respected is one of the biggest factors affecting a worker’s decision to stay on the job or quit • Supervisors can build the problem solving skills critical to DCWs success; and many workers have not had the chance to develop them (c) Paraprofessional Healthcare Institute

6. Supervisors Make the Difference Research shows: Workers don’t leave their jobs, they leave their supervisors (c) Paraprofessional Healthcare Institute

7. Traditional Approach to Supervision • Identify issues to be addressed • Explain the rules clearly • Explain the consequences of breaking the rules • Offer possible solutions to the problem • Request or direct the worker to comply with work rules Let’s look at this approach in a sample role play. (c) Paraprofessional Healthcare Institute

8. Traditional Approach to Supervision What chance do you think this supervisory intervention has of resolving the issue and retaining the worker? (c) Paraprofessional Healthcare Institute

9. Coaching Approach to Supervision • Relationships are at the heart of work with people who are elderly, chronically ill or living with disabilities • Studies have shown that relationships that workers establish with consumers is what draws them to home health and LTC - and the quality of relationships with coworkers and SUPERVISORS keeps them there (c) Paraprofessional Healthcare Institute

10. Supervisors Can Exemplify Quality Relationship Skills • Quality relationships underlie quality care • When agencies and consumers focus on developing workers’ problem solving and relationship skills, they benefit through increased efficiency, delivery of better quality care, and a more positive culture • Supervisors and consumer employers are the natural leaders to model and these skills (c) Paraprofessional Healthcare Institute

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

12. Let’s Try it Another Way! • Demonstration role play • May I have two volunteers? (c) Paraprofessional Healthcare Institute

13. Debriefing the Role Play • What did the supervisor do? • How did the worker react? • What is the likely outcome of this interaction? • What chance do you think this intervention has of succeeding in resolving the problem and retaining the worker? (c) Paraprofessional Healthcare Institute

14. Your Experience with Supervising • How does this role play relate to your experience of supervising or being supervised? • Are there familiar aspects to the coaching approach? • Have you tried to take a similar approach with workers you supervise? • Have you ever had a supervisor take a similar approach? (c) Paraprofessional Healthcare Institute

15. Let’s Compare… • Yes, this took more time than the 1st situation, but… • How could the extra time spent initially with the coaching approach save time in the long run? (c) Paraprofessional Healthcare Institute

16. What a Coach Supervisor Does • Create a relationship with the worker • Clearly state the problem • Gather information on the worker’s perspective • Engage in problem-solving with the worker • Help the worker commit to action steps How do these 5 steps relate to the role play? (c) Paraprofessional Healthcare Institute

17. Skills a Supervisor Needs to Carry Out the Steps • Pulling Back – Managing Your Responses • Actively Listening • Understanding Your Own Personal Style – and those of Others • Presenting the Problem without Blame or Judgment to Hold the Worker Accountable (c) Paraprofessional Healthcare Institute

18. Managing Our Responses • Our emotional responses to what others communicate – verbally and nonverbally – often get in the way of our ability to listen with full attention • We are rarely able to control the behavior of others, but we can control our own internal responses • Shifting our internal responses makes it possible to listen more attentively • The result is more effective and positive communication The first step in shifting our internal responses to someone’s words or tone of voice is to become consciously aware of those responses (c) Paraprofessional Healthcare Institute

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

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

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

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

23. Presenting the Problem Three rules for presenting the problem • Be clear and direct about what the problem is • Use objective language that is free from blame or judgment • Indicate belief in the worker’s ability to resolve the problem (c) Paraprofessional Healthcare Institute

24. ObjectiveLanguage • Expresses neither blame nor judgment • Statement of fact, not opinion • Describes specific behavior rather than characterizing or generalizing about the person • Opposite of subjective language, which carries blame, judgment or opinion • Most people use subjective language unconsciously (c) Paraprofessional Healthcare Institute

25. What is Objective Language? • Subjective: You are always getting here late; you must not be committed to this job” • Objective: I’ve noticed that you’ve been between 10-20 minutes late several times this week. Is there something that is making it difficult for you to arrive on time? * Remember- Using objective language takes practice! (c) Paraprofessional Healthcare Institute

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

27. What Does it Take to Be a Coaching Supervisor? • What skills do you need to enhance to be an effective Coaching Supervisor? • Why is it important to you to develop these skills and take the Coaching approach to Supervision? (c) Paraprofessional Healthcare Institute

28. Resources for Coaching Supervision Paraprofessional Healthcare Institute • Coaching Supervision Curriculum • Employing, Supporting, and Retaining Your Personal Assistant: A Curriculum for People with Disabilities www.directcareclearinghouse.org www.paraprofessional.org Maureen Sheahan, PHI Michigan Practice Specialist (248) 376-5701 - msheahan@paraprofessional.org (c) Paraprofessional Healthcare Institute