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Blog 10: Why is changing care culture so difficult?

Updated: Apr 27, 2022

Intro to the series

Step Change Design focuses on encouraging care settings to take a fresh look at their care culture and care practices in order to engage actively and meaningfully with their outside spaces with their residents. In this monthly series we explore ways to make the most of the outside spaces around your care setting and help your residents benefit from stepping outside and enjoying meaningful activities there, as and when they choose. www.stepchange-design.co.uk



Bright Copper Kettles CIC - Step Change Design Blog 10
The Care Culture Handbook

Over the course of these blogs one theme underpins all the subjects we have taken a look at: the influence of care culture on how well the outside space is used by residents at the care setting.


When we were carrying out the observations for our research it took us several visits to the care homes in our study to really notice the effect of the routines, habits, beliefs and attitudes on what did and did not take place at the care setting.


It was only when we stepped indoors and observed the practices going on all around us that the penny dropped about how straightforward (or otherwise), the act of going outdoors was.



We noticed that it was largely down to the beliefs and attitudes of the care setting whether or not the outside space was actively used, or even valued.


The problem is that things like routines, habits, beliefs and attitudes are located in the setting’s ‘culture’, somewhere that is largely outside of the conscious awareness of the people working in the setting. And this is where the difficulty lies. To use your outdoors more, requires you to become aware of things that you are no longer aware of: the habits and norms that caused you all to think that not using your outside space is normal! At Step Change Design, we get this paradox and so our work is about bringing into your consicious awareness the subtle practices that cause you to overlook the value of the outside space you already have and to embed new habits that help you to step over the threshold with your residents more often.


Everything has its own unique ‘culture’, or way of doing things. Your home, workplace, neighbourhood and local community and even the country as a whole. It’s not a static thing but changing and evolving all the time. We all influence culture and are all influenced by it too. The interesting thing is that we can find it very hard to see the culture we are a part of as it operates very subtly and largely subconsciously. If we were consciously aware of our workplace culture, for example, then we would find it hard to carry out our job. To be competent and effective at what we do (and how we do it) requires that we don’t actually think about it at all, it’s just the ‘way we do things here!’

Bright Copper Kettles Blog - Step Change Design Map Tool triggers conversations
Step Change Design Map Tool triggers conversations

However, as we described in our earlier blogs, if a care setting wants to improve its practices, and make progress to greater person-centred care and to engage more meaningfully and actively with its outside spaces, then it needs to take a deeper look at its care culture. This means in practice that staff at the care setting (across all levels) have to ‘wake up’ to what they do and ‘take notice’ of all the things that they do but that they haven’t normally thought about.


This is not easy to do but is a key skill that managers who wish to take their care setting on a culture change journey need to develop and deploy. We acknowledge from our own management backgrounds that changing behaviour and practices can be a difficult activity to undertake, not least because it requires a long term approach and to ensure that everyone is ‘on board’, all of the time. It also requires stamina and good communication skills to agree a shared vision and then support staff to acquire new skills and experiences more in line with where you want everyone to be, as a care setting.


Step Change Design Ltd - Bright Copper Kettles blog

Be inspired by Step Change Design’s new infographic that shares key statistics from their study to help you step outside with residents more. https://bit.ly/2WZQ240



Connect with Step Change Design on Twitter Debbie Carroll @stepchgdesign

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