Improving Client Service Quality: Supervisors Mastering the Art of Integrating Facts with Values

What Works & What Doesn't
Typography

Most systems improvement initiatives usually have tremendous energy and initial impact, but are challenged with sustaining the improvement.  My research, based upon my experience as a consultant, working within the system, and conducting analysis of research, suggests that middle level managers or supervisors are the key actors in implementing and maintaining the momentum of change.  Sustainable change depends upon program managers because they are typically the “keepers” of organizational values.  Therefore, to improve the level of client service quality and create sustainable change systems need to invest in defining the organizational culture, and training with middle level managers and supervisors, and then give managers and supervisors enhanced decision-making capacity.

This reform has started to take shape over the last few years with many agencies within the child welfare system reexamining their purpose, mission and desired outcomes, which typically , focus on maintaining children in their own homes whenever safely possible.  This outcomes-driven approach has created social reforms and improvement efforts characterized by values of strengths-based, family support practice, child safety and family stability values.  Agencies, both government and non-government, have recognized that this approach starts with intentionally building the internal culture around these values and that the “keepers” of this internal culture are the program managers and supervisors.

Standardized Risk and Safety Assessment Tools or the Art and Foundation of Social Work

Beyond the organizational and system values and culture are the competencies required to deliver quality services.  System reform champions have emphasized that standardized risk and safety assessment tools with proper training are some of the ingredients in the remedy for years of poor casework.  As such, many states have adopted many of these standardized risk and safety assessment tools.  Outside evaluators have studied the question of whether these tools serve any value and have generally concluded that there is ample research evidence demonstrating the effectiveness of these instruments. Yet, many are concerned that by focusing on these tools the field is reducing the art and the foundation of social work to its lowest common denominator.  System reformers have concluded that it is the combination of the standardized tools and proper training to case managers and supervisors that will increase quality and create sustainable change. Anecdotally, caseworkers have concurred with this notion through a preference for the actuarially based tools, noting that they improve consistency, reduce guesswork and help to justify their front-line decisions to their supervisors.

Comparing the notion of standardized tools to what occurs in other professions, we find that most other industries would be appalled with allowing the delivery of services without standards and quality professional development on these standards.  I’ve concluded that agencies that want to remain in compliance with state and federal guidelines for placement prevention and timely reunifications must adopt this approach because it will increase the quality of service and those organizations that will be successful will gain a superior level of quality among its supervisors.

Most systems improvement initiatives usually have tremendous energy and initial impact, but are challenged with sustaining the improvement.  My research, based upon my experience as a consultant, working within the system, and conducting analysis of research, suggests that middle level managers or supervisors are the key actors in implementing and maintaining the momentum of change.  Sustainable change depends upon program managers because they are typically the “keepers” of organizational values.  Therefore, to improve the level of client service quality and create sustainable change systems need to invest in defining the organizational culture, and training with middle level managers and supervisors, and then give managers and supervisors enhanced decision-making capacity.

This reform has started to take shape over the last few years with many agencies within the child welfare system reexamining their purpose, mission and desired outcomes, which typically , focus on maintaining children in their own homes whenever safely possible.  This outcomes-driven approach has created social reforms and improvement efforts characterized by values of strengths-based, family support practice, child safety and family stability values.  Agencies, both government and non-government, have recognized that this approach starts with intentionally building the internal culture around these values and that the “keepers” of this internal culture are the program managers and supervisors.

Standardized Risk and Safety Assessment Tools or the Art and Foundation of Social Work

Beyond the organizational and system values and culture are the competencies required to deliver quality services.  System reform champions have emphasized that standardized risk and safety assessment tools with proper training are some of the ingredients in the remedy for years of poor casework.  As such, many states have adopted many of these standardized risk and safety assessment tools.  Outside evaluators have studied the question of whether these tools serve any value and have generally concluded that there is ample research evidence demonstrating the effectiveness of these instruments. Yet, many are concerned that by focusing on these tools the field is reducing the art and the foundation of social work to its lowest common denominator.  System reformers have concluded that it is the combination of the standardized tools and proper training to case managers and supervisors that will increase quality and create sustainable change. Anecdotally, caseworkers have concurred with this notion through a preference for the actuarially based tools, noting that they improve consistency, reduce guesswork and help to justify their front-line decisions to their supervisors.

Comparing the notion of standardized tools to what occurs in other professions, we find that most other industries would be appalled with allowing the delivery of services without standards and quality professional development on these standards.  I’ve concluded that agencies that want to remain in compliance with state and federal guidelines for placement prevention and timely reunifications must adopt this approach because it will increase the quality of service and those organizations that will be successful will gain a superior level of quality among its supervisors.

Training Supervisors to be Supervisors: Correctly integrating values with facts

Training Supervisors to be Supervisors: Correctly integrating values with facts

What needs to change is the current focus on supervisors having compliance responsibilities that reflect the context and environment in which many child protective service agencies function.  Supervisors must shift to assume the responsibilities of being the “keepers” of the system and the organization’s values and of coaching case managers to correctly interpret the facts that are gathered from assessment tools.  This is where the supervisor’s role is so critical — as the keeper of the agency’s principles, goals and action plan related to family support. This notion is supported through research into the effects of helping caseworkers to distinguish between facts and values. Patrick Grim, a philosophy professor at NYU Stony Brook, uses this distinction as a way to examine the question of values. Dr. Grim says that it would be possible to have a complete factual picture of the universe without knowing the first thing about values — without even knowing which facts are important.  Facts provide the reality of a situation, and a general context, but without values they are like a room painted in one color — nothing is distinguished. Distinguishing values implies that we ask questions such about which facts are important, why they are important and in what order of priority.  Facts cannot predict the future but can help to forecast what could happen.  Values guide us toward a decision that reflects our desired outcomes.  The questions of what we should do are questions of value, which should help us in making an ethical decision.  For decades, professional social workers have depended upon supervision as a means to provide mentoring, guidance and oversight, together with emotional and social support, as well as content information, highlighting an agency’s goals, professional development, task assistance, reinforcement of the profession’s ethics and principles and compliance management. Decision-making as it relates to child protection is a process requiring a supervisor to do all of the above directly and indirectly, to serve families through other professionals.  Competent, comprehensive and goal-oriented supervision has been an essential element for maintaining good practice.

Returning to lessons from the past, looking prior to the heavy emphasis on compliance, we see that quality of service also depended upon the role of supervisors.  The traditional role of supervisors was informed by academics such as Alfred Kadushin, who highlighted three functions of social work supervisors: administrative, educational and support of the caseworker.   From this perspective, it seems obvious that any approach to supervision should enhance caseworker strengths and their understanding of the agency’s values, and not be concerned simply with compliance.  Agencies are now saying that the emphasis should be on how supervisors can support staff as they apply the facts to the higher good — that is, looking for every way possible to keep children safe in their own homes and their own communities, while simultaneously maintaining regulatory standards of care.

Quality of service depends upon supervisors assuming critical organizational roles with seven specific tasks in the transmission of values:

  1. Identifying qualified candidates for agency employment
  2. Training caseworkers on preferred practices and evidence-based approaches
  3. Maintaining and ensuring standards of quality
  4. Managing relationships with agency administration
  5. Managing relationships with community partners
  6. Managing staff through organizational change
  7. Communicating the message and details of organizational change on a regular basis to staff

Although I’ve concluded that sustainable system change depends upon investments in the middle manager and supervisors, the agency plays a critical supportive role and administrators should prioritize an important set of questions:

  • Is the agency’s top leadership committed to the notion that quality supervision means more than compliance?
  • Do the supervisors fully understand the agency’s principles, values and strategies related to the reform/improvement effort?
  • What is the communication strategy to reach them with this information?
  • Are supervisors emphasizing quality, evidence-based and goal-oriented practice?
  • Do supervisors have the most current data about clients that will inform caseworkers and other front-line staff?
  • Is there a reasonable supervisor-casework ratio so meetings occur at least every month?
  • Are the supervisors the functional intermediaries between the agency administration and front-line practice?
  • Do the supervisors have the capacity to align the relevant facts and guide the caseworker toward a decision based on the agency’s values?
  • Can the supervisors in the agency be characterized as advocates (for the agency’s desired outcomes), ambassadors (carrying the message to the staff, to the community, to families and to the administration) and advisors (transferring knowledge and skills to staff based on the supervisory responsibility to be a “keeper of the values” and mentor)?

Any reform or systems improvement strategy provides public and private agencies with an opportunity to change the conversation and the results, in the human services arena.  However, the agency must ensure that the desired values are embedded at all levels. There is a danger that agencies will confuse slogans about change in the human services with real systemic improvement, in the same way that charisma can be mistaken for depth of character. Any reform strategy should not be seen as a numbers game where we encourage a “race to the finish.” The endurance of a reform strategy is based in large part on a unique type of practice that can be taken to scale. Maintaining the reform principles is a developmental process in which supervisors play the critical roles of introducing the change effort to staff, guiding them through the challenges and opportunities that lie ahead and rewarding activity that is emblematic of the effort.  High-quality, assertive supervision of front-line service delivery, using the facts of a situation, together with the emphasis on transmission of values as outlined above, will lead an agency toward its goals.

Paul DiLorenzo, ACSW, MLSP, has been working in child welfare and youth development programs for over thirty years.  He currently works for a national foundation.  In addition, he volunteers and has served as a board member for several local and statewide organizations.