Appreciative conversations around our Kitchen Tables
By Caroline Maries-Tillott
I was already aware of the benefits of ‘Positive Psychology’ before attending Appreciative Inquiry (AI) training.
I have a strong Quality Improvement background, and I have focused a lot on the importance of changing culture before, and was familiar with the leading thinkers who advocate the impact of positive psychology like Martin Seligman – they drew my attention initially to the power that positive wording and framing can have.
Inspired by what I’d learned before, coupled with the enthusiasm of the trainer, Suzanne Quinney from Appreciating People, I could immediately see how AI could benefit staff in the nursing home sector. I decided to use my newly acquired skills in a number of Kitchen Tables we had planned for National Kitchen Table Week 2017 in Walsall Borough Nursing Homes.
My first thought was how can I translate this into the care home sector? It is quite a challenged sector and I was aware there could be a tendency for conversations to become negative and focus on the many challenges people face every day.
So, in preparing for National Kitchen Table Week, I decided to think about kind of questions that I would like to be asked at a kitchen table myself; questions that would help people feel positive and appreciated, and to feel safe to open up. This involved me considering the tone of the questions, the words I use to reframe negative to positive, and how open the questions were so people could talk unhindered….you can find my list of questions here.
I wasn’t really prepared for the amazing, positive benefits arising from these conversations. The AI questions that I had developed elicited positive and often very poignant conversations with staff which were both insightful and extremely humbling. It occurred to me that staff were not used to talking about what was good and going well.
Care Home work is physically and emotionally demanding, there is much negative press, and staff turnover is extremely high in this sector. The kitchen table conversations provided a welcome opportunity for teams to support and value each other and improve morale and strengthen personal and team resilience.
As care home staff spoke, they shared personal accounts, which were powerful examples of great practice… real gems. The nature of care home work meant that only a select number of staff were able to attend – homes still need to deliver essential care, so it was really important to capture the examples of excellence and feed those back to the managers and other team members.
Post it notes proved to be an excellent way of capturing the mass of feedback from 7 or 8 different homes across the week. We ended up with a mountain of them. Myself and the case management team from Walsall Healthcare Trust worked together to pull them into some kind of order.
It soon became clear that feedback aligned closely to the Care Quality Commission (CQC) inspection domains – SAFE, CARING, RESPONSIVE, EFFECTIVE and WELL LED. Our Kitchen Table Week themes were then fed back to our Care Home managers to share more widely, which provided yet another opportunity to recognise, share and celebrate excellence!
Since then I have refined my Appreciative Inquiry approach and am using it more and more in my Quality Improvement (QI) work. Improving safety culture is a core element of any QI project and AI is a perfect vehicle to support the development of a positive safety culture and we’ve found kitchen tables to be a very useful way to connect people.
I now regularly invite Care Home staff to identify their strengths (individual and collective) by asking them to select their own ‘strengths card’ – a pack of cards with an image on one side and strengths like resilience, creativity, caring, organised on the other – one for themselves and one that they feel represents the care home. These conversations often start with some hilarity and awkwardness (it’s so un-British to shout about our strengths isn’t it?!). However, everyone soon overcomes their reticence and enter into the spirit of the event – recognising the value of AI.
When asked why they select certain strengths, staff come out with some wonderful stories. I’ve found too that others involved in the conversation pick up on the positivity and the conversations and examples just flow.
This strengths-based approach has been a particularly useful in helping to prepare staff for forthcoming CQC inspection visits – when asked for examples of being Safe, Caring, Responsive, Effective and Well Led, staff can start to make the link between examples of everyday practice and how that links with Quality inspections. They can then view the inspection process as an opportunity to be actively involved and showcase the great work that they do and the improvements that they have made.
Using AI provided an opportunity for staff in nursing homes to recognise and celebrate the amazing care that they deliver on a day to basis to society’s most frail and vulnerable people.
Staff leave feeling buoyant, valued, supported and empowered which is the essence of Appreciative Inquiry and a Kitchen Table.
To learn more about Positive Psychology;
The Happy Secret to Better Work – Ted Talk from Shawn Achor
Martin Seligman’s work; The Pursuit of Happiness
Nuns Prove Happiness Leads to Longer Lives (Seminal large scale study of health benefits of happiness)
If you’d like to learn more about Appreciative Inquiry, Caroline’s training was facilitated by Appreciating People. Visit their website for more information; www.appreciatingpeople.co.uk