Serving Elders Around the World

Can staff exchanges help providers learn from other societies’ and cultures’ experiences?

by Maggie Flowers

Date: 29 June 2010

AAHSA members highly value shared learning. It allows members to grow and learn from one another by sharing their experiences serving older adults.

Some members of the International Association of Homes and Services for the Ageing (IAHSA) have taken shared learning one step further. Via staff exchanges, representatives of these organizations learn firsthand about the issues facing their peers in other countries, and their processes for providing high-quality care and services to older adults. These providers are connecting, making friendships and sharing their experiences.

It all started in 2005, when Andrew Larpent, chief executive of Somerset Care Group in Taunton, England, met Norah Barlow, chief executive of Summerset Retirement Villages in Wellington, New Zealand at the IAHSA conference in Norway. The similarity in their organizations’ names got them thinking about other potential similarities, and how they could benefit their work.

They decided to exchange a staff member for a month to see how things operate in another country. They saw this as an opportunity to learn about each other’s business environment and look at ways that this knowledge could be shared.

The participants went as observers, so there were no issues related to work visas or licensing. Each observer’s role was to absorb as much as possible about how aged care is provided in another country and gain insight into how this new knowledge would help their organization.

“The challenges of providing high-quality care services for older people are similar in many parts of the world,” notes Larpent. “Learning from one another is one of the great opportunities offered by the IAHSA Global Network.”

So far, Somerset Care Group has sent two employees overseas. One went to New Zealand and the other to Australia, with a counterpart from each country coming to England to see the inner workings of Somerset Care Group. All have returned with renewed energy and commitment to the missions of their organizations.

The First Exchange: A Learning Experience
Somerset Care Group designed its staff exchange program to be “an opportunity for the personal development of a bright, younger manager with aspirations towards more senior roles within our organisation to broaden her experience,” says Larpent.

Vicki Mitchell, homes manager at Frith House, Somerset Care Group, was that aspiring young manager. She responded to an ad for a marketing competition and won. She spent five weeks at Summerset Retirement Villages in New Zealand in 2006.

Mitchell says it was an eye-opening experience. Somerset Care Group is a care home (its equivalent in the U.S. would be a skilled nursing community) and Summerset Retirement Villages is similar to a continuing care retirement community in the U.S., so the residents in New Zealand were younger and more independent then the residents at Mitchell’s community. The differences taught her not only about Summerset’s services but, more generally, about different levels of care.

She was able to work in the high-dependency unit for people with dementia. Mitchell found the experience so enlightening, she brought their dementia training kit back with her to help Frith House. She says it had quite an impact on her work to look at their policies, procedures and care plans: “I always refer back to that experience. It really did inspire [improvement of] care at Frith House.”

Upon her return she made a presentation at Somerset’s annual managers’ conference. “I really enjoyed the trip. It has increased my creativity, customer focus and presentation skills,” says Mitchell.

One of the most enduring lessons Mitchell brought home was the value of being more open to the social side of residential care. Her time in New Zealand inspired her to implement more activities for the residents in England. Now her organization hosts regular tea and chats with the staff and residents. The conversations at the teas helped create opportunities for the residents to play a larger role in the organization. In fact, they now participate in the interview process for new staff and in staff orientations.

“We want the residents to run the home and tell us what they want. This is their home at the end of the day,” says Mitchell.

After Mitchell’s return to England, Summerset Retirement Villages sent Chris Hogan, national audit manager, to England, where she too had an inspiring visit. She saw Victorian-era homes that have been retrofitted to suit the needs of the residents and newly built homes with state-of-the-art amenities.

Hogan learned that the issues facing the English organization were not that much different from those they faced in New Zealand. Both had recruitment and retention issues and worked to maintain a high standard of care. She was able to compare the standards, skill base training and delivery of care while meeting many of the residents, later bringing that information back to New Zealand.

“We learned how much we all have in common really, how alike the systems were and where New Zealand stood on the world stage,” says Norah Barlow, chief executive officer of Summerset Retirement Villages.

The Second Exchange: Australia and England
Ian Hardy, chief executive at Helping Hand Aged Care in Adelaide, SA, Australia, met Larpent and learned about the previous staff exchange. Helping Hand already had international connections in Oslo for its research center, so it understood the importance of learning outside one’s own borders.

The similar missions and structures of Helping Hand and Somerset Care Group made a staff exchange a perfect opportunity to learn from one another.

Hardy sees several benefits to Helping Hand participating in exchanges. First, it is a great development opportunity for the staff member who is involved. He or she gets to see how comparable work is done in a different social and regulatory environment. The staff member comes back with lots of new knowledge to help the organization grow.

The second benefit for the organization is the knowledge the participant brings back to the entire staff. While only one employee may be able to travel abroad, everyone can improve the quality of his or her work based on the information brought back.

“They gain a fresh perspective, which helps us to understand the challenges and the opportunities which exist amongst the not-for-profit fraternity throughout the world. It’s good for them to understand that we have our frustrations here, but so do other countries. We all meet challenges and overcome them as well,” says Hardy.

In 2008, Helen Rex, registered area manager for the Taunton base at Somerset Care at Home, spent four weeks in Australia learning about the operational procedures of Helping Hand. The organization coordinated a full program of events for Rex to learn how Helping Hand works. She visited their communities, including a day center established for Vietnam veterans.

Rex gained insight into the type of services provided in rural areas, along with the related funding sources and other issues involved. Having to serve a community spread out across Australia’s great distances was an eye-opening experience for someone used to England’s denser settlement.

“It makes you realize,” says Rex, “that it doesn’t matter where you go, there are the same problems—recruitment, retention, funding—it’s the same worldwide.”

Lessons Learned and Replication
The most important lesson to remember when creating a staff exchange is that there must be some structure in place to allow an entire organization to learn from one person’s experience.

While Summerset Retirement Villages values the staff exchange it participated in, its managers would create a clearer way for the whole organization to benefit from any future exchange.

“We didn’t allow the value to flow down through the organization,” says Barlow. In the future, “I would ensure that more were aware of the opportunity and that we had a lot more feedback.”

Mitchell agrees that the sharing of information was one of the most important parts of her exchange. It is imperative that the person who does a staff exchange is outgoing, and is constantly thinking about how to bring the knowledge gained back to his or her own organization.

Hardy suggests that managers not overlook any interested staff person but be sure the person selected understands his or her organization’s own operations, is intellectually open and is not judgmental. Most importantly, make sure that person shares the experience with the full staff upon his or her return. Such a conversation helped Helping Hand create an interesting dialogue.

“It’s very important for organizations to be outward-looking and not assume we have all of the answers ourselves,” says Hardy. “There are always things to learn.”


Maggie Flowers is the services manger for the International Association of Homes and Services for the Ageing (IAHSA).

Somerset Care Group, Taunton, England
Contact: Andrew Larpent, chief executive, or +44-1823-448150.

Summerset Retirement Villages, Wellington, New Zealand
Contact: Norah Barlow, chief executive, or +64-04-904-4300.

Helping Hand Aged Care, Adelaide, SA, Australia
Contact: Ian Hardy, chief executive, or +61-8-8366-5400.