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From the traditional care provider to the community care concept - steps of change

1.Introduction and Questions

 

May be this title sounds a bit powerful in your ears and rises the impression that my lecture is a summarized report of a successful process of change, experienced and evaluated by the speaker, who knows „how to do it“ and „how it works“: to analyse the own history and tradition, to learn through experience, to turn -with permanent reflection- to progressive concepts, to initiate significant steps of change and all this in times, which prove to be stormy and insecure .

A pleasant idea, but it’s far away from our and my reality. A reality which is determinate through irritation, the fast and sometimes unbearable change from hope to despair, which is more likely to rise questions than to provide future-orientated and safe answers. Questions like „What is the right strategy?“ and „What is the right operation?“, „What should we do and how can we perform it?“ „Which are our targets ?“ „What about the available resources?“ „Who can give us which kind of support?“ It`s an amazing step of the progress, -nothing in generally to complain about- but alive, with all chances of development and risks to fail.

What can you expect from this lecture, if it’s not the report of a successful experience, not the presentation of a perfect product?

I’d like to invite you to come „backstage“ with me, to take a look behind the scenes of the Ev. Johanneswerk. I invite you to visit the workshop, where our work with handicapped people lies on the workbench. The work piece is no longer a „blank“, because we deal with it for forty years now, and with success. Sometimes it runs excellent, sometimes less. Sometimes we have a rich harvest, sometimes we run at a loss. The years have left marks: material fatigue, malfunction and failure and also mental demand , change of environmental factors -all this needs a careful revision. Manager, developer, mechanics and user are regarding the product and discuss the important steps, the essential changes. At first sight it doesn’t seem to be an unusual or new situation. The forty years of work with handicapped people the Johanneswerk can look back at, required several times adjustment and repair. Sometimes parts of the system had to be changed, or the whole structure needed a major overhaul. In some cases it had to be extended by recently developed modules.

If we take a closer and more distinguished, different look at the situation today, we realize that we have to deal with an essentially new one this time. The radical change of the economical, social and political environment throughout Germany and Europe calls the whole system of social security contributions and specially the support for handicapped people in question. No doubt -our know-how and our experience might help to manage the situation. But to rely only on the traditional methods, strategies and procedures is not sufficient for this complex process of re-newel. Neither selective repairs, nor a complete overhaul can perfectly meet the demands . It’s not enough to revise the concepts, to adapt or to improve them. It`s also not enough to modernize the buildings, to reduce the flat-sharing units or to decentralize the living-units.

The point is, not to extend or improve our offers, but to alter the complete system. We need a basically new adjustment, which has to express itself in our concepts and structures.

 

 

2. Steps of Change

 

2.1. Reflection and Definition of our Position

The realization of those facts leads me to the first important step in the process of change, we started to go at the Johanneswerk (For example to create a model/ business-philosophy) and -in my opinion- have to extend . At first sight this step is slowing down the process of change and removes the speed. A step which resists the demands for quick and pragmatic solutions, which costs the „men of action“ among us a lot of patience. Therefore it’s a difficult step, which doesn’t fit in our fast-moving times. But it’s necessary to take it, to root and establish our work and therefore making it safe. It’s the process to reflect and re-define our position. (First step).

In the Ev. Johanneswerk - particularly in the area of working with handicapped people - we find ourselves at this state.

To reflect and re-define our position means:

  • We need „open eyes“ and a clear view for the specific feature of the changes concerning the environment and the paradigm – of those already existing and those being on the way.
  • we need to observe those changes and developments critically out of different points of view and lines of thought. We have to understand and evaluate them referring to our own clearly defined position and convictions.
  • this process requires a self-critical check, description and evaluation of our location, our identity, our concepts and offers, our tradition and our state of development.
  • it’s important that we put a lot of time, energy and activity -according to our own reflected significant position- into this process of change.

 

This doesn’t mean to be rigid. We want ourselves and our system being called into question. We are open to changes, - but plausible ones. Relying on values and convictions we bring them into this process of change and we are not unreflected open to all directions.

 

2.1.1.First Realizations

Summarizing I’d like to describe our process to reflect and define our location.

“Perhaps You might not hear too many new thoughts concerning the subject, but I’m sure You never heard them from me”.(Heiner Geisler).

I want to introduce You to the specific problems we have to deal with and to answer at the Johanneswerk.

I’d like to emphasize that it’s my subjective point of view I’m introducing You to here and now. But being someone who is essentially involved in this process, I’d like to add my thoughts to the internal discourse of Johanneswerk.

Now we are focused on the system of the work with handicapped people in the Johanneswerk. To describe it, I use the metaphor of a tree. In my opinion a tree is an instructive example, how a living organism organizes itself referring to its environment. It’s a very different organism, but not too difficult to use it as a metaphor.

The elements of the tree must work perfectly coordinated and as a result it can stay healthy and bear fruits. Further on the conditions of environment and ecology must fit in. Perhaps we can learn from this tree in our work with the social- ecological system of the help for handicapped people. I like to explain the elements of the tree and my conductions for the work with handicapped people in the Ev. Johanneswerk:

 

Explanations

1.Roots

Each tree needs roots to provide him with water and nutrients. And the roots also care for the necessary support of the tree. In this metaphor the roots mean the basic attitudes, convictions and values for our view of human beings and society. They build the fundaments and standard for all our activities and steps in the system of help for handicapped people. We need basic outlooks for which we can stand offensive, convinced and trustworthy -addressing insiders and outsiders. The basic attitudes give us support in discussions and confrontations. From this point of view we introduce our diaconic or charitable and social- political ideas. And we also make up our demands.

Convictions are leading us in our structures, concepts and activities. They gives us orientation in a stormy, unsafe and helpless time. Referring to their help we can navigate, decide and determine operational and strategic targets. They are a frame, we are obliged to, which gives us the chance to develop and on the other hand sets us helpful limits. It’s an obligation which doesn’t allow anything at anytime.

 

2.Ground

The position and the quality of the soil influences the development, growth and health of the tree deeply. It’s a significant factor of environment. It’s also essential that the tree can reach a sufficiently rich source of water. In our application we focus on the question: Which are our sources of strength? What feeds our business „work with handicapped people“? What is our motivation? What carries us?

 

3.Trunk

The trunk carries and supports the treetop. The bigger and more powerful the top is, the stronger has to be the trunk. The trunk is the metaphor for the material and non-material substance, for the resources of our business „work with handicapped people“.

 

4.Fruits

First of all the customer is interested in the quality and sort of the fruit. The quality of the fruit depends essentially on the health and quality of the tree. In my metaphor the fruit stands for the direct services we offer to handicapped people, the results and processes of those services. It’s decisive that the tree bears fruits, which are tasty und nourishing , substantial for the customer. We have to realize, that it is the customer, who decides, which fruit he prefers and if it fits his taste . In the history of the institutional work with handicapped people in Germany the people with a handicap had no choice, no alternative to the prevailing offers. They could not decide. Those days of traditional work with handicapped people are gone, I hope so!

 

5.Branches

They describe the characteristically form of the treetop and of the whole tree. Growing they build the shape of the tree. They bear leaves and fruits and carry the nutrient fluid. Branches mean in my picture the complete structure of the system concerning the work with handicapped people. Professional structures, concepts, methods, buildings, structures of organization, financial and personnel ones.

 

6.Leaves

Leaves are essentially important for the life of the tree, it’s health and growth. And this refers also to the quantity and quality of the fruits. The tree breathes and feeds itself through the leaves. The leaves take light, air and water from the environment and change them to nutrients. In this process they produce glucose, which the tree needs as a source of energy and as building material. The molecules of the sugar form a chain and create wood pulp . It’s the main component of the wood and therefore of the trunk and branches. The tree dies without leaves. In my picture the leaves stand for employees, the staff.

 

7.Bark

The bark is made of two important elements: the surface is the protective casing. The inner layer of the bark provides through small channels the tree with nutrients from the leaves and ground. The bark must be flexible, so it can extend if the tree is growing to broadness. It´s trunk and branches grow each year a new layer of wood. The bark has to guarantee the required processes of exchange: the communication between the elements and parts of the system. The bark is the picture for the leadership and management of a business. That’s my tree. It’s growing in the Johanneswerk-forest.

 

3. Specific Questions and Consequences

 

What kind of questions are the results of our reflections concerning our system of „work with handicapped people“?

 

Roots

We -the business Johanneswerk- are obliged to the following basic values and acceptances:

  • the human rights of the United Nations
  • the civil rights of the Bundesrepublik Deutschland
  • the business-philosophy of the Johanneswerk with it’s specific image of men and society:
  • human being -including the handicapped person- is an individuum, god´s creature and his image, therefore he or she is unique and unmistakable.
  • the human being -including the handicapped person- has a dignity -inborn, untouchable, lifelong and never losing it’s value.
  • the human being -including the handicapped person- has the right to develop his personality freely.
  • Under the law all human beings are equal, that means it’s not allowed to discriminate someone because of his or her handicap.
  • each human being -including the handicapped- person lives related to individualism and community.
  • first of all the handicapped person is the user of our services of support being an equal partner and member of society.

What kind of questions are the results of this reflection?

  • How important are those values for our daily routine?
  • Do we discus them, take them seriously and put them into action?
  • Didn’t we replace already this basic values through others?
  • How relative are the values regarding the need to finance our services and to profit from our offerings if it comes to decide what we perform and how we do it?
  • Do only the performance-orientated passages of our social-law influence our conceptional ideas and activities?
  • How can we find a balance between our basic values and unfavourable environmental factors and constraints ?
  • How can we succeed in living those basic values without standing on the edge as a „social romantic“ and at least loosing the track?

 

Ground

What kind of questions are the results of this reflection?

  • Where are our sources of power providing our system of work with handicapped people?
  • Do we have the right location for our tree?
  • Is our tree rooted in the natural source of ground water or runs our water from an artificial container (like for example the national social security contributions)?
  • What feeds our motivation for the work?

 

 

Trunk 

The trunk supports the treetop bearing the branches, leaves and fruits, that means our material and non-material substance must be able to carry our organisation, our employees /staff and our services. If this is not the fact, we have either to support the trunk or to prune back the treetop. In this process we have to consider that the trunk is growing slowly, layer by layer to be strong. The overweight of the treetop can directly be influenced by the pruning. What kind of questions are the results of this reflection?

  • What are our consequences if the proportion between our material/ non-material substance and our organisation (treetop) is unbalanced?
  • Is this solution to prune back the treetop in the case of emergency a future-orientated step? At first sight it relieves the trunk but it doesn´t support the nescessary growth, the building up of the trunk.
  • What can we do to support the process of growth -which is a slow and organic process?

 

Fruits, branches, leaves, bark

We can look back into a forty-years tradition of central and stationary work with handicapped people, this attempt was extended by decentralised living-units (external living- flats) and ambulant offerings. Within this frame we offer step by step specialized and distinguished, different services. We opened up the earlier closed special worlds mentally handicapped people lived in for the persons inside and outside. We tried to normalize the conditions of life for mentally handicapped people. We made our efforts to give mentally handicapped persons an active support concerning their right of self-determination, their right to take part in the life of society, their right of equality. In some areas we were successful in some areas not. We still offer main importantly stationary services. We know that this fruit is increasingly not corresponding to our customers needs and expectations. We need and want open and community- care- orientated offers and concepts. We want an alternative to our traditional institutional structures. We decided to go this way, but we knock against the limits of our extant structures -in spite of already executed changes. What kind of questions are the results of this reflection?

  • How can we succeed in reorganizing and modernizing our system of work with handicapped people with our burden of traditional adjustment, with our old buildings, with their need for refurbishment, with a reduced material substance, with very difficult social-political and economical conditions of environment?
  • Do we have sufficient know-how, sufficient material and non-material substance to develop community-orientated concepts and services and to put them to disposal?
  • How can we manage to be accepted on the market of social services, known as a supra regional and traditional offerer with our new regional community-orientated direction?
  • Can we be successful in finding cooperative partners in the community? What about our role in community- orientated networks? Can we manage to connect a part of our stationary services to a network of self-help, honorary posts, neighbourhood, ambulant and open services?
  • Do we succeed in financing this new way?
  • Which way do we have to follow to go on developing the structures of organization, we’ve changed during the last two years through a process of total reorganization?
  • How can we manage it to motivate our employees/staff, specially those who are committed to the traditional stationary structures and to help them to be with us?
  • Where’s the point and in which way do we have to change and to develop further our culture of leadership and management? 

     

4. Résumé

I hope, my lecture gave you a small inside into the fact, how much irritated our system of help for handicapped people is in this time of upheaval . Many issues are called in question, even many principles. And we have to find the answers. I hope, we ask the right questions. It is plain, that yesterdays solutions are not really helpful. On the contrary yesterdays solutions are today’s problems. Perhaps we are forced to change radically. I know that You -our European neighbours- have in parts experienced and managed similar developments and processes of change. You are some steps ahead and we’d like to learn from Your experiences. I wish that our tree „work with handicapped people“ remains a tree and doesn´t turn into a leaf in the wind, driven by changing trends and turbulences. I wish that our tree can also bear good and nourishing fruits, which can help to improve living conditions for handicapped people. I wish that we succeed in keeping this tree alive and to strengthen and support it’s health and growth. I wish that we show enough courage/pluck in this process of reorientation and uncertainty. That we dare to take steps of change and not get stucked in analysing the risks or jump on the spot until we die. I´d like to close my lecture quoting some verses from Eva Strittmater: Be faithful to yourself.  If you want to be faithful to yourself you must be able to detach. There are two different approaches to life The first: to seek security The second: to rise above time, destiny and all. You have to feel positive about risk: You work without rope It doesn´t matter if you get hurt outside The inside remains safe. This is the position of the seeker and finder: Not focused on security but on sense They can refrain from nearly everything -but not from their own model of the world”.

 

This is the transcript of a presentation by Mr. Ronald Hampel/Ev. Johanneswerk Bielefeld / 17.10.03

 

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This Knowledge Centre was developed by EASPD, the European Association of Service Providers for Persons with Disabilities with the support of the European Commission and in particular the Active Citizenship Program and the PROGRESS Program.