1000 paper cranes: nurturing ‘love’ at the frontline to eliminate no shows

Over the last couple of months, there have been a number of high profile stories of no-shows and support cancellations splashed across social media and quickly picked up by prime time TV current affairs. Not only is this a PR nightmare, it’s evidence of a serious lack of service reliability across the industry.

I spent some time as a CEO of a provider in the Hunter during trial site roll out and the number one KPI I established was a zero cancellation rate. As I conveyed to the leadership team at the time, the number one thing that keeps me up at night is "What’s going to happen with Nicky when I'm gone?" Every time a support worker doesn’t turn up or a provider cancels a shift, they send the message that they can't be counted on now and certainly not once I’m no longer around.

NDIS has prompted promises from providers of supporting participants in fulfilling their dreams and aspirations… but in the meantime they fail to show or cancel at the last minute. As I articulated to a room full of providers this morning, rather bluntly I admit, don't talk to me about higher order needs until you turn up when you say you will.

Typically, providers respond with solutions involving better rostering systems or different combinations of permanent part time and casual staff. Let me be clear: unreliability is not an operations issue. It's a relationship issue. When support workers and participants have strong, compatible relationships, no shows just don't happen. There is greater commitment to maintain that relationship from both sides.

The challenge is, how do you support the development of loving relationships between support workers and participants? For starters the concept of ‘love’ at the front-line is one we're afraid of in disability supports - it reeks of inappropriate and unprofessional codependency - right? Wrong! 

Let me clarify what I mean by ‘love’. Nicky has two support workers; Kim and Wendy. Their ‘love’ for her (and our family) is a reflection of compatibility and a commitment to Nicky’s wellbeing. Kim showed her love for Nicky by folding her 1000 tiny paper cranes. Based on the legend that folding a person 1000 paper cranes brings them good health and fortune. This gift from Kim sits in a glass jar by Nicky's bed as a reminder that she is cherished. Wendy is a meticulous organiser. Our linen closet is filled with immaculately folded towels and sheets (including fitted sheets - it's a miracle!). On returning from a weekend away recently when Wendy had been supporting Nicky I came home to the most gloriously organised Tupperware drawer. It oozed love!

The challenge for providers is two-fold; firstly, how to match participants and support workers and secondly how to manage the fact that when you do a great job in matching participant loyalty is to the support worker, not the provider. It certainly is in my case – I would go to the ends of the earth for Kim or Wendy.

The solution to the first challenge is to ensure opportunities for participants to select their own staff. Staff need to share their interests and have the skills to facilitate relationships rather than be a paid friend. The solution to the second issue is about becoming an employer of choice and includes developing a high-trust work environment. In the words of Richard Branson “Employees come first. If you take care of your employees, they will take care of the clients.”

I have been very deliberate in the curation of Nicky’s support team to ensure we have fewer, higher quality relationships. Our relationships with Kim and Wendy are comfortable, honest and most importantly reliable. In over 3 years we've never had a no-show or last minute cancellation. Sure, from time to time we've needed to adjust schedules to fit each other in but it's never been a big deal or left us in the lurch. And most importantly, I know that Nicky has a team who could and would step in for me in the unlikely event I couldn't.