How to use this Toolkit

The long term objective of this project is to promote strong universal services for Aboriginal people which will lead to increased mutual trust and respect, increased access/engagement of Aboriginal people in the health sector, and better health outcomes for Aboriginal people. The Toolkit relies upon an Aboriginal concept of health in which health is recognised as determining all aspects of life. It is ‘not just the physical well-being of the individual, but the social, emotional, and cultural well-being of the whole community’ (National Health Study, Working Party 1989, A National Health Strategy, Canberra).

The Koolin Balit Victoria Government Strategic Directions for Aboriginal Health 2012 – 2022 states that services to Aboriginal people should:

  • be of high quality regardless of who provides them;
  • be inclusive of the needs of Aboriginal people;
  • afford Aboriginal people the same rights as other members of the community;
  • provide equal and equitable access to services that respond to clients’ needs and requirements;
  • be culturally responsive, providing a safe and welcoming environment that is professional, courteous, inclusive, respectful and non-judgemental;
  • foster meaningful engagement with the community and understand local circumstances and cultural context;
  • provide client centred services and promote client responsibility through informed decision making and choice;
  • work in partnership with other service providers to provide the required suite of coordinated services to meet the needs of clients and potential clients;
  • meet or exceed any prescribed service standards;
  • be transparent and accountable; and
  • strive for continuous improvement.

The Building the Blocks of Cultural Competency Toolkit has been developed to assist health and human service agencies across Melbourne’s North West region to participate in a whole of agency review to determine the extent to which these criterions are met and to implement organisational change.

Building the Blocks of Cultural Competency has four key components:

1. SECURING THE COMMITMENT OF GOVERNANCE BODIES/DIRECTORS AND SENIOR MANAGEMENT

Building cultural competency requires a commitment from governance and high level management to dedicate resources towards driving change across the organisation. Securing this commitment necessitates that governance bodies are culturally aware, informed, understanding of the issues impacting upon Aboriginal health, and responsive to the barriers in accessing services that Aboriginal people experience.  While Aboriginal community controlled organisations generally have a majority of board members that are also Aboriginal community members, for mainstream service providers without Aboriginal community representation at a governance level, making culturally informed decisions can be a challenging process. Where possible governance groups should take steps to rectify this by:

  • participating in cultural awareness training;
  • actively pursuing Aboriginal representation on the Board;
  • inviting Aboriginal representatives to present at Board meetings;
  • engaging an Aboriginal community representative or Aboriginal community agency for consultative purposes;
  • requiring regular reports to the governance body on workplace cultural competency reforms including performance monitoring and quality improvement processes.

2. IDENTIFYING AREAS FOR CULTURAL COMPETENCY REFORM

The following steps provide a process for identifying cultural competency deficits which can be addressed through workplace reform.

Step 1

Assess internal service user data credibility

Service user data is critical to determining the extent to which Aboriginal people are accessing services. However, research conducted by the PCP’s in the NWMR found that many health and human service agencies  did not feel confident that their staff were accurately collecting this information. Section B of this Toolkit provides training resources to support frontline workers to ask all people using their service whether they are of Aboriginal and/or Torres Strait Islander origin and to respond to any client questions or concerns appropriately.

Step 2

Undertake a desktop analysis of data to determine the uptake of services by Aboriginal community members

Section A of this Toolkit provides information on:

  • the size and demographic characteristics of the Aboriginal population within Melbourne’s North West region;
  • the projected growth of the Aboriginal population; and
  • the identified health needs of Aboriginal people.

Cross referencing this information with internal service user data will provide some insight as to whether the number of Aboriginal people accessing the agency is proportional to the demographic population of the Aboriginal community.

Step 3

Assess staff cultural competency to determine workforce training needs

Staff cultural competency is influenced by a number of factors including workplace policy regarding the provision of cultural awareness training for staff, past experiences of cultural awareness training, and the extent to which staff formally or informally engage with the community. Section K of this Toolkit provides a sample staff survey to determine the extent to which staff routinely ask service users about Aboriginal and/or Torres Strait Islander identity; have knowledge of Aboriginal history, culture, perspectives, barriers, cultural events, and Aboriginal community controlled agencies/programs.

Step 4

Review feedback from Aboriginal and Torres Strait Islander service users about their experiences of engaging with the service

Consumer feedback from Aboriginal service users is critical to determining whether staff are providing a culturally responsive service. If this information is not currently collected consider conducting interviews or focus groups with Aboriginal service users to explore their experiences of:

  • engagement with reception staff and health staff;
  • identification of Aboriginal and/or Torres Strait Islander status;
  • whether health needs were holistically addressed;
  • assessing cultural needs and cultural issues impacting upon the client’s health;
  • the length of time to access services;
  • appropriate referral pathways;
  • follow-up appointments;
  • provision of accessible health information; and
  • barriers and enablers to access.
Step 5

Review Aboriginal community engagement activities

Building trust through community engagement is key to supporting access to services, however meaningful engagement must be based on principles of cultural safety, community ownership, and community accountability. A review of past activities should include feedback from any partnering Aboriginal organisations as well as an analysis of activity evaluation outcomes. The review should address whether the activities were successful in engaging the community; what were the enablers and barriers to success, and whether appropriate community consultation informed the development of the activity. Further information regarding community engagement is provided at Section H of this Toolkit.

Step 6

Conduct a cultural audit

A cultural audit is a review of an organisation’s documents, policies and procedures to promote a culturally responsive and inclusive workplace that is welcoming and respectful of Aboriginal and Torres Strait Islander culture and supports the recruitment and retention of Aboriginal staff. The auditing tool will assist to document areas for improvement and will inform the basis of an Action Plan for implementation. Auditing tools are provided at Section K of this Toolkit. Where possible the audit should be conducted with input from an Aboriginal consultant or Aboriginal community organisation.

3. DEVELOPING AND IMPLEMENTING AN ACTION PLAN

Identifying cultural competency deficits will generate an Action Plan detailing areas for improvement. The Action Plan could take the form of a Reconciliation Action Plan, an Aboriginal Employment Strategy, or a Strategic Plan to implement the building blocks of cultural competency across the organisation.

By embedding cultural responsiveness as a core value of the organisation, it is incorporated into every aspect of service delivery, workplace, and workforce management. The Action Plan will guide this process and should include objectives, strategies, responsibility, priority, timing, and budget allocation. The Action Plan should be informed by Aboriginal community consultation and staff consultation. It should provide performance indicators with measurable targets, include processes to incorporate Aboriginal consultation into decision-making processes, and support the effective and culturally appropriate exchange of information between the organisation, staff members, Aboriginal organisations, and Aboriginal community members.

4. MAINTAINING CULTURAL COMPETENCY

Building cultural competency is not a one-off activity but a continuous process of performance monitoring and quality improvement. Developing policies is the start of this process, but ensuring that policies are implemented and operating as intended are critical to ensuring the sustainability of the project. Accordingly the Action Plan must also include processes for regular review and performance monitoring that includes feedback from Aboriginal service users. Information on continuous quality improvement is provided as Section I of this Toolkit.