Sickness levels within the organisation had reached an unacceptable high (over 6%). Staff were given a choice of three possible solutions to combat this problem. Following a vote in which staff were able to freely choose their preferred method of change, it was agreed to afford three extra days of annual leave per person, per annum in return for staff not claiming company sick pay for the first three days of any period of absence, rather substituting this with the extra holiday should they need to. This has resulted in a drop in sickness levels to below 2%.
What We Did
NAViGO CIC is a not for profit local social enterprise providing a whole mental health, treatment and care service for people in NE Lincolnshire. It is a membership organisation made up of staff, people who use the services, carers and the local community, all c800 with EQUAL voting rights – in itself highly novel. This essentially means the Membership ‘owns’ NAViGO and is able to use its voice to shape future services.
Example: Sickness levels within the organisation had reached an unacceptable high (over 6%). Staff were given a choice of three possible solutions to combat this problem. Following a vote in which staff were able to freely choose their preferred method of change, it was agreed to afford three extra days of annual leave per person, per annum in return for staff not claiming company sick pay for the first three days of any period of absence, rather substituting this with the extra holiday should they need to. This has resulted in a drop in sickness levels to below 2%.
NAViGO’s over-arching organisational ethos centres on compassion for both our service users/Carers AND our staff; we are an employee-led, forward thinking business which prides itself on the level of innovation we are able to instil within services that are traditionally (and rather unfairly) viewed by many as dysfunctional. NAViGO understands a happy and healthy workforce is paramount to providing quality/safe services – in fact our strapline is ‘providing services we would be happy for our families to use’ – we truly work to this philosophy.
The following outlines our acute and associated services which are all part of the NAViGO ‘family’ – full details of services can be seen at http://www.navigocare.co.uk/services/:-
We feel the best people to determine how an excellent service looks are the people that use/work within it. In terms of how our service has made a real tangible difference to the mental wellbeing of our staff, below are a few examples of the impressive outcomes we have achieved since working in this way.
• Staff survey results show some impressive statistics well above national averages and as a result we were recognised by Health Service Journal as being in the ‘Top 10 Health Organisations to Work For’.
We go the extra mile towards ensuring our staff are fully engaged in service delivery; ensuring they are listened to; they feel valued; they are treated/spoken to in a way commensurate with a productive working relationship, being able to express their views without fear of reprisal – attention to detail around all of these issues has developed a positively engaged workforce who, for the most part, are happy in their roles. Should issues arise that affect the mental wellbeing of a staff member, NAViGO has a host of different interventions in place to offer support towards recovery.
Wider Active Support
We feel it is fair to say that NAViGO is a well-respected provider locally and as such not only seeks but is sought out to work with a whole host of other organisations in a variety of settings. We feel, as an organisation, both physical and mental wellbeing go hand in hand and as such have fostered relationships with providers who are able to address our ‘whole person’ approach to maintaining excellent mental wellbeing. This view is echoed by NHS Employers who have recently published a motivational flier entitled ‘Why Staff Experience Matters.’ This explains the importance of staff health and wellbeing and reinforces our belief that there is a clear link between physical health and mental health and suggesting that by positively engaging staff in all aspects of service delivery, there is an irrefutable benefit to mental wellbeing. Suggestions by NHS Employer’s, all echoed and already adopted by NAViGO, include:-
• Investing in physical health to increase resilience, staff morale, staff absence and ultimately, staff turnover
• Having a strategic approach to staff wellbeing and recognising that this has a ‘knock on’ effect to patient care
• Highly engaged organisations have the potential to reduce staff turnover by up to 87%
• Where the organisational culture is one of engagement, positivity, care, compassion and respect for all, this provides an ideal environment in which both staff and patients will thrive
• Staff with high levels of engagement are less likely to report suffering from work related stress
Examples of our networking/partnerships working, relating to physical/mental wellbeing AND positive staff engagement (but not exhaustively) would be:-Confidential Care (external staff support network); CERTS Training; ISIS training; Community Learning Service; CAT ZERO (youth life coaching organisation); Best Training; St. Andrew’s Hospice; HMT St Hugh’s Hospital (local private charitable hospital); NLAG (Northern Lincolnshire & Goole Hospital Trust); Children’s Centres; GP Practices; Job Centre Plus (Disability Advisor); Insanity (Instantly Fit) – ‘Fitness Fridays’ taster sessions for staff; Zumba Group; Yogalates Group; In-Training; Lincs Inspire sports centre; Re-Shapers Gym; Hope Street Clinic (COPD Service); Momentum (Cleethorpes Athletics Club); Footsteps Walking Group – in-house rambling group organised by a staff member; Women’s Refuge; On-Track – Therapy and fitness (Level 3 sports massage therapist)
NAViGO, as mentioned earlier, is ‘owned’ by its membership, which consists of staff and community members, all with equal voting rights. Any changes to services, plans for additional services, staff conditions etc. are relayed to our members who then vote on key issues. Allowing our staff to do this has increased morale tenfold and given staff the opportunity to REALLY influence how the service develops.
Wellbeing Policy – We operate a Health and Wellbeing Policy which includes provision for:-
• An in-house Occupational Health service
• Reasonable adjustment to roles in order to facilitate a return to work
• An external Confidential Care Line available 24/7, 365 days per year where our employees can get confidential information, support and counselling
• Employment Specialist services available to all staff around their roles and remaining in work – SEE CASE STUDY BELOW
• We provide IAPT (Improving Access to Psychological Therapies) services in two local venues. This is also available to our staff teams along with other alternatives such as Psychology. NAViGO will also pay for the first 6 sessions of any alternative solution such as physiotherapy or counselling etc.
• Cancer Champions amongst our staff
• Campaigns on health related issues including smoking cessation, heart disease, inactivity at work (Get Britain Standing)
• Providing and actively encouraging take up of on-site Flu vaccinations for all staff
Reiki – We are asked by staff and service users for Reiki to be available as an alternative therapy. NAViGO went further than this, offering to engage with a local Reiki Master to train staff and service users in delivering Reiki. The courses were funded 50% for NAViGO and 50% by participants who gain a qualification allowing them to practice outside of the work environment, in return for, once qualified, delivering Reiki sessions to colleagues and service users. This has proved extremely successful and a huge morale boost for everyone concerned.
Zumba/Yoga/Instantly Fit – NAViGO offers a variety of fitness groups, available to both its Membership and the general public. The advantage here is three-fold – staff/service users receive this at a reduced rate as a Membership benefit; the health value is obvious in terms of increased exercise whilst the facilitator/local community are engaged in joint activities which help to break down stigma around mental health.
Netball – NAViGO has its own netball team which plays in local tournaments – our Chief Executive is a keen participant joining with staff and service users on a weekly basis
Footsteps Walking Group – this is an example of a staff member organising a positive external activity for colleagues to enhance physical/mental wellbeing.
All of the following are available to staff as direct benefits of working for NAViGO:-
Agenda for Change Pay Rates – NAViGO has maintained or bettered Agenda for Change pay rates for its staff
Service Related Holiday entitlement – all staff receive and entitlement to 5.4 weeks annual leave plus bank holidays upon joining; this increases to 5.8 weeks + BH after 5 years’ service and 6.6 weeks + BH after 10 years
NHS Fleet solutions – lease car scheme (salary sacrifice/tax savings)
Cycle Scheme (salary sacrifice/tax savings on cycle purchases – not to mention the fitness!)
Mileage Allowance – very competitive mileage allowance for staff using own vehicles for business purposes (providing business insurance is in place)
Comms Team – NAViGO has its own internal Communications Team who expertly keep all staff up to date with organisational changes, additional benefits, staff events etc – an informed workforce is a happier one.
Computer share vouchers (salary sacrifice/tax savings on IT equipment purchases)
Private healthcare insurance at low cost
NHS Pension scheme – NAViGO has both Pension Trust (final salary) and NHS contributory schemes (5% employee up to 14% NAViGO)
Home electronic solutions – salary sacrifice on purchasing white goods with resulting tax savings
Member discount benefits – if you join NAViGO membership you can get discounts on a host of local restaurants, subsidised fitness and gym membership, hairdressing and beauty, carpet fitting, building merchants, car maintenance, legal advice, household removals, family holidays – the list is very extensive! Total reward statements can be viewed on line via our ESR portal.
Food discounts – within our own retail units; through The Company Shop which offers major discounts on a host of different branded foods/household products and more recently through very competitive discounts provided by our local butcher
Subsidised Meals – staff on our in-patient wards receive free meals and eat with our service users; staff visiting one of our four on-site cafes get 50% discount (cafes are run by staff members working alongside service users to develop workplace skills with a view to re-joining the labour market). Everyone in every team has access to free hot beverages whilst in office.
Family Fun Days/Christmas Party/NAViGO Quiz – each year we operate a daytime event open to all of our staff and their families plus the general public aimed at traditional family fun. We further offer a subsidised party for all staff and Tukes members at Christmas time. The NAViGO Quiz is a fun event for staff but has a serious theme – the evening raises money for us to help our friends at the Demir Kapija Institute in Macedonia (referred to earlier in this document).
Team Building – Teams within NAViGO are actively encouraged to organise their own team building days – these have included Paint Balling, Quizzes and Paint a Pot.
Charitable Aims – NAViGO has its own charitable arm (The Gardiner Hill Foundation) which is a local charity which established to enhance and enrich the lives of people with mental health problems and promote good mental health. We also support other local charitable events such as MacMillan Coffee mornings, our local Hospice ‘Sleepwalk’, have entered a NAViGO team in Race for Life all of which are in support of our own staff who have personal reasons for being involved.
Looking Back/Challenges Faced
Moving away from Public Services to become an employee led mutual has been a great challenge in itself. On the whole there are very little changes we would make to how we did this and what we have achieved since we made the move bears testament to the multiple benefits – we truly feel blessed with having had the ability to make this decision. However, if we had to pinpoint one thing we would do differently it would be to not underestimate the length of time it would take us to change the staff culture and the levels of stress and anxiety this would cause due to resistance to change.
Having moved directly out of NHS services it was a huge challenge to change staff mentality away from being part of a Public Service. When you are a social enterprise everything you do has a consequence that can be felt throughout the organisation – it IS important that we pay attention to our spending and what we spend money on, it IS important that we do not allow sickness to impact on service delivery etc etc. We have had to instil that change throughout the organisation both in terms of attitude and operational objectives. If we had to do the move all over again we would tackle this issue much earlier and much more stringently to avoid problems later down the line.
The challenges in terms of our staff group were:-
Despite NAViGO’s every effort to break down barriers around stigma towards mental health, we still find, even within our own staff group, some people may not want to access our services if they become ill for fear of confidentiality, the stigma they perceive is attached to having a mental health condition or may not even disclose they are suffering as they imagine this may adversely affect their employment. We have put many avenues in place to combat this issue including investing in the external Confidential Care support network and ensuring there are staff representatives available if people feel they do not want to discuss with their line managers.
We have also signed the Time to Change Pledge and actively publicise communications/correspondence across the organisation – this year we held ‘cuppa and a chat’ events to talk about mental health throughout our services.
• Changing staff attitudes and practice
The lengthy process of suggesting/showing staff better ways of working – changing long-standing Public Sector attitudes was a large piece of work. Giving staff more rights and powers and exposing them to service users’ views in courses, daily interactions and seminars; involving service users in all mechanisms to run the services; offering a clear philosophical statement and message all caused anxiety on some level or other due to acceptance of changing practice. This has been, for the most part, overcome through reinforcement of positive messages, evidencing the benefits of change through evaluation, ensuring good communication so staff feel included in service developments (and therefore valued).
• Having staff skilled and flexible enough to work in this mode
Time spent on nurturing, training, involving, clarifying standards, not tolerating anything beneath those standards; being explicit around actions v consequences. Ensuring fairness and equity built into working practices. Again positive reinforcement and ensuring good mental wellbeing is supported throughout the organisation to build coping strategies around new methods of working.
• Sickness Entitlement – staff were initially suspicious of the reasoning behind the new sickness arrangements and needed proof this would be beneficial both for themselves and for the organisation. Evidence from reduced sickness levels was able to justify this move and the provision of a ‘thank you’ hamper positively reinforced this message.
Pushing the Boundaries – Ownership:
NAViGO continues and always will continue to push the boundaries of how mental health services are delivered and how staff are involved in the delivery of those services. This attitude is not simply held at the head of the organisation but is embedded within the very fabric of our organisational culture. Each and every employee working for NAViGO is proud of the organisation and what it stands for in some way. Our staff survey results evidence that over 78% of our workforce would recommend NAViGO as a place to work and 81% would recommend the service to family and friends. By ensuring integration, choice, support, fairness, equity, validation and inclusion for our staff teams we will continue to reduce stress in the workplace.
We actively promote prevention techniques around all manner of health related issues including alternative stress release methods. Traditionally, Grimsby and the local area has a culture of high levels of drinking and smoking, linked to the high levels of deprivation; Especially bearing in mind NAViGO’s practice to recruit local people wherever possible, we continue to challenge this by innovative ways of tackling traditional issues – Reiki training is a good example of building up resilience.
Health and wellbeing are extremely high on NAViGO’s agenda and are embedded in the organisational culture; we see ensuring staff and service users wellbeing as being fundamental to having a happy, positive and productive workforce.
NAViGO allows its workforce to participate in the development of future services and to offer ideas towards that innovation. By being included at every level, staff motivation, morale and ultimately wellbeing is maintained.
Health and Wellbeing Events:
NAViGO participates in local health and wellbeing events and encourages its staff to do so. For the first time this year we are organising our own community event aimed at staff, service users and carers. This will become an annual occurrence which we will build on year on year. To date participants can expect support around accessing complimentary therapies, healthy eating, fitness coaching, mindfulness, help and support with caring responsibilities and much more.
NAViGO as an organisation is continually monitored for its compliance with CQC standards as a matter of course. However, we take evaluation of our services very seriously indeed as we view this as a way of evidencing that our methods REALLY work. With this in mind we engage in the evaluation methods shown below. Although some of the evaluation methodology relates to patient experience rather than staff mental wellbeing, we feel the two go hand in hand and you cannot have a quality service without a well-motivated and happy workforce hence we have included these in our answer:-
• Friends and Family Tests – evidence that our service users and their Carers’ are happy with the services received
• Staff Surveys – we engage in an annual staff survey (conducted by an external body) to evaluate the morale of our workforce. Our results to date have been well above the national average in almost all categories and have resulted in NAViGO being identified at one of the ‘Top 10 Organisations to work for’ by Health Service Journal
• Best Companies – this year NAViGO has registered to take part in the Best Companies accreditation. This entails a separate external questionnaire aims at our staff, our working practices and our leadership. Once analysed we hope to be awarded a Michelin style mark for our service delivery (3 being the top one). This also gives us automatic entry into the Sunday Times 100 Best Companies Award.
• ISO9001 – NAViGO has started the process towards gaining ISO9001 accreditation. We see this as being essential towards evidencing our quality nationally/internationally and being an excellent tool with which to streamline operations, offering consistency/higher morale for our staff
• MSNAP – Memory accreditation shows we are almost 100% compliant with MSNAP and AIMS– we shared 1st place for response times and for Dementia diagnostic referrals nationally
• PREMS/PROMS – Patient Reported Experience Measures (PREMS) and Patient Reported Outcome Measures (PROMS) feedback is positive, borne out by testimonials received.
• Star Wards – this is a service user-led quality evaluation tool for which we are accredited as excellent in both of our in-patient areas (Acute & Older People’s)
• Quality Reviews – conducted by our in-house Performance Team who analyse statistics, service user information, complaints, compliments etc to evidence our performance levels, producing comprehensive Quality Accounts annually that map progress
• Annual Reviews – Carried out by our Communications Team, our Annual Reviews offer a round-up of the previous year and highlight areas of excellence
• PDR’s/Supervisions – NAViGO firmly believes in staff supervision and an annual Performance Development Review for each and every staff member. Objectives for the year are set by our Membership and feed in to both team and personal objectives set in order to ensure the Memberships views/needs are seriously addressed
• In-patient discharge questionnaires – these are a mandatory survey completed by each service user on discharge from one of our in-patient units. Ensuring questionnaires are completed and reviewed also keeps us in touch with how our service users feel about the care they receive and gives us the ability to make changes when necessary. The results are compared to 26 Mental Health trusts (40% of the total number of trusts in the UK) and NAViGO performed excellently.
• Positive About Disabled People – this is annually reviewed and re-accredited
• Mindful Employer – this is annually reviewed and re-accredited
We are very proud of our methods of service delivery and in the fact that we know the changes we have made in traditional mental health service delivery really work in terms of increasing staff morale, improving patient outcomes and on cost savings – for example, the reduction in sickness benefit costs mentioned earlier.
We are only too happy to share our experiences with others and positively welcome the chance to host a pro-active all-systems learning event around developing a pro-active approach to the management of workforce mental wellbeing. We hope to bring about a step-change in the way mental health staff are consulted and treated worldwide and see this as ‘hand in glove’ towards improving not only staff wellbeing but also patient safety/experience.
Examples of what we have done already along these lines promoting our working methods as a whole are:-
• We have had over 150 organisations visit us in the last three years
• Consultation events with a host of Health Trusts Nationally around our methods of service delivery/staff engagement
• Consultation events on setting up employment and support services similar to ‘Tukes’
• We have recently attended and spoken at a Conference in Canada around our WHISe Project (combining physical and mental health evaluation for Schizophrenia service users, tackling the huge inequality in longevity (up to 20 years) between those with Schizophrenia and those without). This is something our staff are very passionate about and it is their innovation that has brought about this new service any improvement we can make on statistics will have a positive effect on job satisfaction.
• Working internationally with Demir Kapji, a mental health hospital in Macedonia, assisting in staff training to improve service delivery and their mental wellbeing
• Working internationally with mental health organisations in both Antigua and Barbuda around adoption of our RESPECT training solution in dealing with challenging and difficult behaviour. Learning RESPECT techniques within an organisation can reduce levels of violence and aggression as service users are less stressed, ultimately staff suffer less trauma as a result.
• We are presently in discussion with Councils outside our region who want to work with Tukes/NAViGO on setting up a host of different community projects
• We are working additionally with three general hospital trusts around avoiding admitting older people to hospital and issues regarding the Francis inquiry and general hospitals and different models of care.
• We also have contacts and projects with several universities, internal research into non-invasive treatments and contacts and projects with numerous other not for profit organisations nationally.
• We host monthly management development days the content of which is disseminated through supervisions etc to keep staff involved at all levels
• Our forthcoming Health and Wellbeing event (3rd July) is another example of sharing good practice around wellbeing
We continue to try to reach as many organisations as possible and being successful in securing a Positive Practice in Mental Health Award would mean the ability to promote our innovation, bringing about positive changes in treatment on a much wider basis. Several large MH trusts and councils for example already are mentored/supervised by us for Respect training and this continues to grow nationally, especially bearing in mind the Government agenda around abolishing prone holding techniques.
Is there any other information you would like to add?
Since winning this category in 2015 we have continued to promote staff well being and maintained all that we outlined in our submission. We have now commenced interdepartmental sports events which service users are included in, netball and rounder’s tournaments, a sports day is planned for the near future.
we have supported other trusts and organisations with advice on how to support their own staffs mental well being and are committed to share good practice.