Organisational design according to Mintzberg (1983) is defined as the “ways in which labour is divided into distinct tasks and then its coordination is achieved among these tasks”. Organisational design comprises of the component parts of an organisation such as the employees, the information and the technology and how they are integrated together. The relationship between the different parts of the organisation is a social construction. This social construction needs to be adequate to meet the goal of the organisation, in the case of social care organisations it needs to serve the service users best.
“[Social care is] a profession committed to the planning and delivery of quality care and other support services for individuals and groups with identified needs.”
Organisational design is used achieve the vision or mission of the organisation. The vision is defined by the managers and leaders of the organisation and the design is formulated around this vision. It is important to design an organisation around an agreed goal; this can be problematic if leaders cannot agree on a goal or they have different understandings of the goal. The Minister for Health, Mary Harney has a view of privatisation of service and more reliance on community involvement than state involvement in individuals care (such as care of the elderly) which conflicts with the policies in place for an equitable health care system (O Doherty, 2010). In many ways organisational structure and culture are interlinked and both must be addressed when examining organisational design. The design is often difficult to change because of the culture of agreed norms, values and expectancies within the organisation. Organisational design is integral in creating efficiency and effectiveness in the organisation therefore it is important in all organisations to implement a structure. Drucker (1999) argues that as situations vary there are no clear guidelines that can be given to identify the best structure to use and mangers must use their own judgement regarding which design to choose. The structure must however coincide with the service users needs and not what the organisation believes should be the structure.
Having an identified structure in an organisation is important to contribute to its functions. There are a number of designs outlined that managers may choose from but mangers need to acknowledge elements of the organisation when deciding which model to choose. These elements include: the specialisation of work, the chain of command, the span of control required, degree of formalisation required etc. Bureaucracy is the evident design applied in modern society. This may be influenced by Scientific Management and the military structure from history. The bureaucratic design is controlled and involves standardisation. Hierarchy is an important element of bureaucratic organisations, with departmentalisation and sub-groups evident. Having too many levels of hierarchy however can slow the decision making process within organisations, particularly social care organisations (Jones, 2007). The Quality Assurance in the Social Care sector report (2010) identifies also that an organisational design which values low levels of hierarchy is the best approach for effective communication between staff.
According to Kolb (1988) reflective practice and supervision is an important element in social care work. As an organisation adopts a more bureaucratic style the level of good supervision declines (Ruch, 2005). It is important to recognise that supervision in the context of social care works requires the supervisor supporting and guiding the employee towards best professional practice. Supervision involves reflecting on practice and recognising strengths and weaknesses of the employee in a positive way so as to improve the overall service for the service user. The lack of acknowledgement of the function of supervision in this way may be detrimental to the overall organisational goal. Social care workers are not to be seen as bureaucrats simply there to carry out tasks assigned by management but as individual problem solvers with skills for decision making (Thompson and Thompson, 2008). Therefore it is important to have an organisational design in social care organisations which incorporates supervision.
The health service in Ireland has undergone fundamental changes since EU pressure began in 1973. The Commission on Health Funding (1989) recognised that the health board system was failing due to management and administration and many layers of hierarchy and a new system needed to be implemented. Other recent reports also outline the need for changes and the need for clarity of decision making in the health care system such as the Quality and Fairness – A Health system for you (2001) report. It was outlined that the health boards operated as separate entities which led to inconsistency and did not address best practice. The Health Service Executive (HSE) was formed in 2005; it joined the former 11 health boards together. It consisted of three main parts: the National Hospital Office (NHO), the Primary Community and Continuing Care (PCCC) and Population Health. Unfortunately the HSE was not fully planned or organised. It underwent another organisational structural change in 2008 when the NHO and the PCCC were joined together under one manager.
The Health Information and Quality Authority (HIQA) was established in 2007, it incorporated the Social Services Inspectorate (SSI) to work in collaboration with the HSE. HIQA can be viewed as an affixed type of organisation, quality should have been built into the organisations structure but instead HIQA was set up to add in quality into the services provided by inspecting the level that the standards are upheld. This shows that organisation design is an important issue to be addressed. Equally important is the setting of a vision or a goal. The HSE’s budget plan is only up until 2014. Although the Quality and Fairness – A Health system for you (2001) report outlined what needs to be done, some issues are still outstanding.
The human element in social care organisations must be taken into consideration when applying a structure. Maslow’s (1943) theory of needs acknowledge that human need for self-actualisation is important for their well being. This would imply that organisations would need to involve employees in the decision making process within the structure as self actualisation means being involved in problem solving. Argysis (1957) argues that bureaucracies did not allow for this decision making process. Likert (year) also identifies that using design which involves open communications and trust is best used. There are arguments against this style of involving employees in decision making such as those by Vroom (1973) and Feidler (1967) who value the contingency style of management. Job satisfaction is difficult to access and achieve in service organisations. It is evident that work specialisation does not lead to job satisfaction in social care area; staffs need to be able to change their roles and rely on teams and supervision. The impact of staff burnout in social care is prominent.
In the Roscommon Child Care Case recently reported there are clear problems with the structure of the organisation. During the period when the health professionals were working with the families the legislation in the child care area was changing with the introduction of the Child Care Act 1991 and Children First National Guidelines for the Protection and Welfare of Children, 1999 and new implementations arose. The staff were not trained in the new developments. If they had been trained then the Roscommon Child Care incident perhaps intervention would have occurred earlier. One of the objectives of the Quality and Fairness (2001) report was to protect children and the need for early intervention. The family in the Roscommon case were known to the HSE since 1989 and the children were not taken into care until 2004. The lack of continuing professional development (CPD) was highlighted as a reason why the mistakes of the past were not learned and as to why new legislation was not implemented in this case. This can be seen as a failure of the system as well as the culture to provide CDP (Roscommon Child Care Case, 2010 4.16). The report also recognises the need for organisational change and identifies that the HSE has implemented systems of child protection in some areas but this highlights the need for it to be implemented across all organisations (Roscommon Child Care Case, 2010 5.1)
Within social care work the need for interagency work is fundamental to provide the best service possible for the service users. However the communication between the agencies needs to be clear and consistent to ensure that the best service is provided and essentially that children are safe and protected (Julius et al, 1980). Julius outlines that the structure of the organisation may hinder the interagency work and it is important to recognise this in work. The structure and culture of the organisation have an impact on the behaviour and attitudes of employees. The structure must be designed so that the employees behave in a manner that best benefits the goal of the organisation, in the case of social care it would be to best serve the service users.
When restructuring fails it leads to confusion and turmoil among those affected such as the managers, staff and service users. Models of design will unavoidably need to be changed according to the period of time. Organisations need to plan for the future, make predictions regarding changes that may need to be made by identifying opportunities and threats. Financial issues, new technology and changing population may require an organisation to change its structure. The structure needs to be examined to ensure that it is fulfilling its purpose and that is especially true in social care work where the impact of failure can lead to serious harm or even death to individuals.
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