When Life Gives You Lemons: How RASA Used What They Learned from the Pandemic to Improve Operations
Written by Caitlin Feehan
Relationships Australia South Australia (RASA) is a charitable not-for-profit organization that has been providing services that respond to the needs of South Australians for over 60 years. RASA employs over 280 staff and provides services from nine different offices and in many communities and schools across South Australia.
We recently spoke with Kate Brett, Executive General Manager of Operations at RASA, about how the organization has been able to manage through the COVID-19 pandemic with the help of new practices, existing systems, and an impressive and agile leadership team.
Can you tell me a little bit about yourself and what you do at RASA?
My name is Kate and I joined RASA 13 years ago as a family mediator. I later moved into regional management, managing counselling, mediation, and mental health support services across multiple sites. For the past four years, I have been working as RASA’s first Executive General Manager of Operations, managing all the regional managers and multicultural programs and playing a significant role in the design and implementation of our operational systems. What I’m particularly interested in is the intersection between people and systems, because you can have the best system in the world, but if you haven’t worked with people to explain why the system is good, your uptake will be really poor.
I have to think what I’m getting up to do in the morning is meaningful. I think a lot of people in our sector really aren’t terribly motivated by money, and I think that’s actually quite an informative thing around staff retention—it’s not necessarily that you’re paying the best wages, but that you provide a powerful and meaningful space in which people work. For me, that pretty much sits in a restorative practice framework, which is a workplace that offers both high-support and high-challenge and emphasizes the “working with” approach.
I think that’s definitely becoming more common. Whenever people talk about “the millennial generation” and what inspires or motivates them, it’s rarely money—what they want is to feel like they belong to something and that they’re making a difference.
It’s interesting, actually. As an employer, I do a massive amount of interviews, and I really enjoy working with this generation of young people. I think they’re great. They’re incredibly flexible and handle change well. They’re very open about their questions, which is ideal, because when people don’t ask questions and simply choose to silently not comply, there’s a far worse outcome. I think we have to recognize that the work environment these days is not necessarily providing the security that people once had, so our role is to coach young people to the next space, whether that’s with us or without us, and recognize that we’re part of a community of workplaces instead of an island.
What services does RASA provide?
RASA has a very integrated view of services that has the client at the centre, and that’s one of the most important factors when it comes to choosing a client information system in this sector.
The number of services we have is huge. The obvious ones are counselling, mediation, and family services, like our Child and Family Assessment and Referral Network (CFARN) service, which is for new parents who have been referred by the department of child protection to get support. Our casework services are complex and often high-trauma, like our post-care service that works with young people after they leave state care. We also have a Find & Connect service which is for what they call “the forgotten Australians”, which is also related to the stolen generation in Australia. We’ve got really interesting multicultural services, including those related to blood-borne viruses, and we currently have funding from the Office of the Chief Psychiatrist to provide virtual services to members of the non-English-speaking community. We also run a registered training organization (RTO) called the Australian Training Institute of Social Relations.
RASA has a very integrated view of services that has the client at the centre, and that’s one of the most important factors when it comes to choosing a client information system in this sector. NGOs often have multiple bodies to report to because of all the different types of services they provide, and the hazard is always that each of those services, because they’ve got different reporting requirements, will work with clients in isolation. That’s something we work very hard and very consciously to prevent. We have DOORS universal screening for all clients who come in, for example, which helps us identify risks and makes it easier for us wrap the services around the client.
How has RASA been affected by the COVID-19 pandemic?
As much as Australia has done incredibly well with limiting community infection, it really wasn’t clear what trajectory we were on. We have quite a large executive group, led by our CEO, Claire Ralfs, and we started meeting daily quite early on in the alerts around COVID. One of the things we did differently under Claire’s leadership was that we didn’t suddenly send everyone home. We’d been aware of emerging issues for some time, and one of the things we wanted to have time to do was to carefully examine which services needed to continue and how they could continue. We were also clear that we weren’t going to designate certain days of the week for different groups of workers, like saying one group will come in on Wednesday and Thursday and another will come in on Monday, Tuesday, and Friday. We worked very closely with our regional managers and HR team to get people off-site, which we did in a series of waves. We started off by social distancing with clients, then we closed our doors but continued to see clients throughout in certain services.
Having all these pieces already in place allowed us to go straight to virtual service delivery—in fact, when I look at our delivery numbers in Tableau, there is virtually no change in the volume of services delivered during the COVID restrictions.
We were very lucky that we had digitized all our record-keeping some years ago, so we have not had paper files for probably six years, and we had already set up pilot systems with video. We had also been using our DOORS screening app and two-way messaging for some time and had migrated outcomes measures for counselling programs into the app before all this. One of the things that had been on my wish list for a while was to enable clients to register for services and provide consent remotely, so we were lucky to be able to fast-track that goal with the help of Penelope. Having all these pieces already in place allowed us to go straight to virtual service delivery—in fact, when I look at our delivery numbers in Tableau, there is virtually no change in the volume of services delivered during the COVID restrictions.
The way we decided who would and wouldn’t continue to work in the office was based on very detailed assessments that each manager and team leader did with each of their staff members. People with health vulnerabilities went home very early on, but there were other people who really wanted to continue to work in the office, in some cases for their own mental health, so we took things like that into consideration when making our decisions.
Some of our particularly traumatized clients could not use digital platforms, so we developed a COVID face-to-face request in Penelope which allowed clinicians to make requests to see clients in person and set out a safety plan for those clients and themselves. Those requests then went to their manager through an automated workflow. For the first little while, all requests also went through me because I wanted to see how often they were coming in, what type of requests they were, and which groups were commonly involved. It’s gotten more frequent as we’re opening up a bit more, and what I’m seeing is exactly what I hoped to see, which is that the requests are being made for clients with communication difficulties, children, and clients with particular vulnerabilities. Executive approval has been removed from the workflow now that we have a high-level overview of the requests coming in.
Did you notice patterns around things like which types of service providers were requesting appointments for which types of clients?
There were some services, like ones associated with the Department of Child Protection, that continued to see clients face-to-face by default because they were regarded as essential services. Outside of those, we’ve mostly been seeing people in serious domestic violence situations, people who are traumatized, people who have communication difficulties, and children. To be honest, it was really thrilling to see the level of thought and consideration that workers put into why they wanted to see specific clients, and that really confirmed that everyone is still dedicated to providing the best possible service, even during a pandemic.
We’re entering a phase where we’re starting to see clients outside of these high-risk groups who simply don’t cope well with alternate methods of service delivery like video conferencing, and thankfully we have the bandwidth to serve them now that things are calming down. I don’t think we’re too far off from opening our doors again—we’ve got a little bit to do around the front of our offices to keep clients safe and to make sure that we’re providing a responsible environment, but we’re a good way there.
RASA has invested incredibly heavily in its frontline staff, and that’s been really strategic. Over the years, particularly under the structure that Claire set up, we have moved from treating our frontline staff as receptionists to treating them as another group of professionals. They used to be referred to as Admin but are now more accurately called Client Services Officers, because they are delivering services to clients and not doing administration for practitioners. It’s actually compulsory for our client services staff to have a minimum of Certificate IV in Community Services, and if they don’t have that qualification, we put them through our RTO to get it. We really invest in our staff, and what we’ve ended up with is a front line that is incredibly agile. They are always the first to test things, like two-way message media or outcomes measures via the app, and they also do quite complex intake with clients. When we had to move our services away from the office, their competence with technology allowed us to establish a virtual frontline, which was an extraordinary thing. I mean, we managed to run regional teams of client services officers while they sat in their homes without the clients really noticing. They were still delivering screening, they were looking for flags, they were managing that client all the way through to getting clinical services.
We’ve also got Practice Manager Frontline Services now, which is a role that sits alongside our other clinical Practice Managers. These roles have been instrumental in our success over COVID, if not pivotal. They’re responsible for working across the regional teams to set and maintain the standards, and when we do new initiatives, they work with all the leaders of those teams to ensure that the proper professional development is in place to facilitate the piloting of the systems.
I think that repositioning how you treat and talk about frontline staff is huge. You’re not just changing the terminology, you’re changing the dynamic and making sure people get the credit they deserve. That second part is often an afterthought, so it’s great to hear that you’re fully committed to it.
Well, it works for everybody. We’ve got these extraordinarily talented, competent teams, and we get a lot of really talented graduates applying for those roles now. Interestingly, in reference to our other conversation, the wages haven’t changed, but the reason it works for us is because of this incredible competence and our ability to respond to situations like this, and because we have an incredible talent pool. We’ve got team leaders who started in client services, so they take that in-depth knowledge of the systems into their teams. They understand the importance of those systems and have a really good understanding of the overall work of the organization because they can see the whole system and how broad and complex our service delivery really is. We tend to find that the people who’ve come from those roles are often very effective clinicians.
How were protocols around COVID-19 communicated to your staff? I know you said that you had been anticipating the pandemic for a while, but how did you disseminate that information down from the executive level?
I think it’s very easy as an exec to fall into the trap of thinking you always have to have an answer, but that doesn’t reassure people. The reason we didn’t get panic in response to our communications was that we agreed that we would communicate often and frequently through multiple platforms. We also agreed that we would not be afraid to say ‘I don’t know yet’ when people asked questions, as long as we assured them that we would keep talking to them and keep them updated.
This is where the organization really impressed me. There was a very strong focus on communication with our staff from very early on, and we used well-designed resources, like the COVID drill on our website, to keep our staff in the loop. We also shared information through SharePoint and email, and Claire would make regular videos for the staff. On top of that, I ran webinars with our HR General Manager every week for leaders at all levels of the organization, from senior client services to coordinators to team leaders and managers. These webinars gave us a platform to provide live updates on what was happening and what the COVID committee was doing and gave everyone a chance to ask questions. We also ran a consultation group with staff around how they felt about using video technologies and how they thought clients felt about it.
I have to give huge kudos to the whole executive team here. I think it’s very easy as an exec to fall into the trap of thinking you always have to have an answer, but that doesn’t reassure people. The reason we didn’t get panic in response to our communications was that we agreed that we would communicate often and frequently through multiple platforms. We also agreed that we would not be afraid to say “I don’t know yet” when people asked questions, as long as we assured them that we would keep talking to them and keep them updated. Once people trusted that we would continue to provide information, you could hear their questions getting less and less panicked.
The level of communication that all the managers and team leaders maintained when we had to start catching up through Microsoft Teams was extraordinary. They were all having daily half-hour huddles for their staff and even hosting fun events, like a regional managers’ virtual cocktail hour.
In many of the staff consultations and catch-ups that I was a part of, people said that there’s so much they’ve learned from this and that they’d like to carry on with some of the new practices. One example of that was our Acute Response Team, which we designed with the help of practice managers across the organization. It’s run through Microsoft Teams, and how it works is that we have senior staff and practice managers rostered onto a schedule to be “on call” throughout the week. We trained all staff on how to use it so that anybody who’s working with a client can request help at any time of the day by typing into the private live chat and getting immediate support to manage the situation. Just last week, I was called on to join a call where a client was actively threatening suicide. I was able to support the practitioner through live chat and then engage with Mental Health Triage and the ambulance service while he stayed on the line with the client and provided therapeutic support. We haven’t had more than a two-minute turnaround in getting a response from a senior clinician since the team was created.
Would you say that this process, now that that’s established, is more efficient than the regular process for intake of a client who is under that kind of distress?
Yes. It’s a very good example of an initiative that was designed as a result of COVID-19 but that staff are really keen to continue.
What are some other practices that you’re thinking of keeping?
We’re still trying to figure out how and where to integrate video and telephone counselling. We realize that it’s never going to become our main form of service delivery, but I think it’s helped staff understand that clients are more open to looking at different modalities and that there are certain circumstances where face-to-face services may not be the best option, like for clients who are agoraphobic.
I can say we’ve learned a lot about when video and telephone counselling is not a good idea, and how video is actually very different from face-to-face. Video conferencing is deceptive in the sense that it appears to be very similar to face-to-face interaction, but we’ve had some really interesting clinical discussions about the exact reasons why it’s not and how that can be both a benefit and a hazard.
I saw on your website that RASA was offering services free of charge until the end of June. Did you see an increase in people requesting services during this time? Were they mostly existing clients?
It’s been a combination of both. We’ve seen a large increase in requests for assistance from migrant communities, because they often did not have access to effective mental health support even before all this. The dissemination of information often gets interrupted, which can be confusing. People in migrant and Aboriginal communities are doubly vulnerable in uncertain economic periods because many are on gig work and may not be eligible for JobKeeper payments. The impact on families in those economic situations has been huge.
Occurrences of domestic violence also surged during lockdown, so people living in those situations have been hugely impacted, and in many cases, their circumstances have changed dramatically. Something we heard from people with very controlling partners, for example, was that things actually settled down a bit during lockdown, because they were not going anywhere and were constantly visible. That’s obviously not a real solution, though, and I think what we saw most was an intensification of the violence, especially considering the increase in alcohol consumption during lockdown.
There have also been really peculiar effects in the gambling space because hotels were shut down, so poker machines were also shut down. It’s hard to tell from the data what impact that had, because online gambling isn’t nearly as closely monitored as traditional gambling, which has legislation around poker machines and casinos, so it will be difficult or even impossible to get accurate and reliable data around this. I wouldn’t be surprised if our gambling help services suddenly get flooded with a new wave of online gamblers.
Did you have to cancel any of your services or programs in the wake of the pandemic?
We didn’t cancel any of our services, but there were absolutely components that we had to modify. Let’s use the example of men’s behavioral change groups—David, the practice manager in that area, had to work really hard to find methodologies for managing things differently, but none of those clients were left without services. In situations where we couldn’t run a group, we continued to provide resources and reach out to the individuals affected.
Do you have a plan for returning to work?
We do, and we’re in the middle of it at the moment. As I said, we continued to see clients face-to-face throughout the pandemic as specific requests came in from workers, but those requests have become less detailed and no longer require executive sign-off. Every regional manager has a plan and every individual staff member has a plan. The regional managers worked hard to assess the urgency of each of our programs and determine which ones needed to return to in-person service delivery first. They had to take into account whether programs were actually working better through other means and consider whether to keep running them that way instead. They’ve been really good at self-assessing that.
We’ve got a very digitally literate team—every team leader uses Tableau, and so do our client services teams and even many of our workers, so they can see their own work and get a lot of detail around that. About 50 staff members are actively using it. RASA has got a very strongly democratized approach to information, so there are no surprises for workers, and they know we’re not collecting information about them just to “catch them out” down the road. The idea of getting workers to feed a machine that’s going to punish them is not something that works for anyone. Obviously, there’s information that is confidential and cannot be shared with all workers, but we like to make things available to as many people as possible. So, like I said, this kind of self-assessment about how well things are working has being really effective.
We’ve established three waves for workers returning to work, which are based on factors like the workers’ comfort with technology and whether being in isolation is affecting their mental health. I don’t think we’ll be able to return to pre-COVID working anytime soon, because while some of our workstations are fine and have the appropriate distancing, some of them don’t. Even in the final stage of our “return to work” plan, there will be people who continue to work from home, at least part-time.
What advice you have for other service organizations like yours around managing through COVID and setting up a plan for returning to work?
I would say there are two things that are really important: one is communicate, communicate, communicate, and the other is don’t be too attached to your plan. As much as we all feel like our competence is based on producing this perfect plan with all these well-defined pieces, we’ve got to be willing to work with the mess a bit. When you communicate openly and centre your plan around the success of your programs, the wellbeing of your workers, and the needs of your clients, it’s a lot easier to work with the mess.