Managing stress on the NDIS frontline

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Can Quality Management help manage workplace stress and prevent burnout? It depends. Quality can address some major causes of stress — but it’s not magic.  If Quality isn’t supported by the organisational culture, it can be hard to get started. You need as many people onside as possible. Luckily, that’s what good managers do. This article offers some strategies (it’s the first Handbook chapter from NDIS QUALITY IN PRACTICE: Frontline Managers. Learn more about the course and see the accompanying video.


Leaders play a huge role in shaping the workplace culture. A culture lets people know what to expect and what’s expected, shapes how they interact, and defines their obligations and rewards. If a culture isn’t clearly defined, people can become confused and anxious. Leaders should try to promote one dominant type of workplace culture.

One theoretical model proposes four types (We simplify a model taken from Diagnosing and Changing Organizational Culture by K. Cameron and R. Quinn, (2006)):

  • Collaborative: A friendly workplace in which leaders are facilitators and customers are considered partners in the enterprise. The model is based on mutual loyalty and commitment between the organisation and its staff.
  • Creative: An exciting workplace where innovation and risk-taking are encouraged. Switched-on staff aim for innovation. The culture responds well to changes in the operating environment or market. All staff are expected to display leadership qualities.  
  • Controlling: Consistent, dependable services are all important. Roles are clearly defined within a hierarchy and processes are set. Rules rule. Reliability and uniformity are rewarded. Customers can be sure they’ll receive a certain standard of product or service. 
  • Competitive: Focuses on productivity, turnover, targets, KPIs and profits. Keeping customers happy makes good business sense. Staff are rewarded for results (and must compete with each other).

Each model has different strengths and supports different products or services. It’s a matter of finding what best suits the NDIS market. Rules, regulations and procedures help standardise service-delivery processes and provide certainty. Support work depends on a lot of personal initiative. And competiveness is a fact of life in a market with (often) slim margins. However, the most suitable culture for person-directed supports and the Quality Management philosophy is a collaborative culture.

Collaborative workplaces should be caring and friendly. That’s a good fit for support work but, too often, there’s chaos and stress. The problem is so bad that it gets a mention in the NDIS Workforce Capability Framework, which says that leaders should have the ability to:

Recognise the challenges faced by workers, be alert to signs of burnout and support them to manage their wellbeing and self-care.

Frontline managers need to manage participants’ wellbeing, staff wellbeing, and their own. Perhaps Quality Management techniques can help them do that by:

  • Reducing stressors to prevent energy depletion.
  • Building morale to nurture individual and team energy.
  • Developing a plan that addresses the causes of stress and shares the load.


We know (from neurobiology) that uncertainty, disorder, demands and certain types of change are major causes of stress. And we know (from experience) that community sector work is full of those things. Quality Management is designed to reduce uncertainty and disorder, and to help manage demands and change — so, yes, it can help reduce stress!

  • Reducing uncertainty and disorder
    All organisations need a system to manage data. Without one, uncertainty rules. The larger the organisation and the more complex the tasks, the more complex the system needs to be. The system will provide data for planning, keep track of outcomes and promote improvement. Quality Management systems gather information from all stakeholders and keep everyone informed. 
    Policies and procedures let everyone understand each other and know what’s expected. We can check the policies whenever we forget, disagree with others, or provide training. Forms prompt us to work through the steps of a process, so we can be sure everything’s been addressed. Checklists help keep track of complex tasks so that we can concentrate on the details. In short, Quality frees up mental energy that would otherwise be spent on remembering complex processes.   
    Quality Management — through Risk Management — tackles uncertainty head on. It’s linked to other processes that gather data and prevent problems from arising. Risk Management protects projects, induction processes bring new staff up to speed, intake processes guide staff to ask the right questions in the right way.
    Making sure that everyone is informed takes effort, but it does address uncertainty and disorder. Overly complex systems can bring more uncertainty, so some of that effort needs to be spent on making processes as clear and simple as possible.
  • Managing change and demand
    Constant, rapid, large and destructive changes are mentally fatiguing. Quality Management buffers against shocks and promotes positive changes — intentional and incremental improvements.
    Things don’t always go to plan, but if strategies are carefully mapped and responsibilities clearly designated, there should be fewer surprises. Ideally, planning should consider existing capabilities and capacities to prevent unreasonably heavy workloads and review processes should ensure against workload blowout — that’s Risk Management.

In practice, Quality Management doesn’t always achieve those aims. Its success depends on the organisation, its Quality system, how an initiative is implemented and the culture of support for the system and initiatives. That, in turn, depends on how well people understand Quality Management and their system. If people don’t understand how it works, it can easily become the opposite of what it aims to achieve — more demands, more uncertainty, and more stress. Fortunately, there are ways to fix it.

What can managers do?

Your organisation must have a Quality system — but maybe it’s not working well or isn’t supported at all levels. What’s the best way forward? If the tools are blunt, we need to sharpen them.

The simplest solution is probably to understand Quality better — well enough to help make our Quality systems more practical, accessible and effective. The more we understand it, the more strategies we can implement. Some of the following strategies might suit your current situation.

  • It’s not wrong or right; it has strengths and weaknesses
    A ‘culture of Quality’ doesn’t mean uncritically believing in Quality or your system. All systems have weaknesses and limitations. A culture of Quality will mean identifying and strengthening the points at which the system is likely to fail — that’s Risk Management! Training, more regular reviews, secondary risk treatments, and closer monitoring are all ways to make the system stronger.
  • Let’s learn about this together
    Your success is limited by other people’s understanding. Helping others understand might be helping yourself. Centring conversations on shared objectives and strategies can reduce resistance and encourage helpful conversations and teamwork. 
  • Improve the system from within
    All systems can be improved. Your team might be able to identify improvements that would make your work easier and more meaningful. They might not feel free to tell you. Staff resistance might indicate a lack of understanding or genuine problems with processes, such as lack of clarity, outdated legacy items, or unsuitable materials. Consulting with staff is an essential part of the Quality philosophy and the compliance requirements — and it just makes good sense.
  • Do it the best way until a better way comes along
    Not everyone will come on-board. But if you agree with the goals of Quality Management, and if the processes make practical sense, why not push on regardless? You’ll set a great example and establish expectations — and you’ll have the satisfaction of working methodically towards those goals.


Higher morale leads to better outcomes for everyone. For workers, health factors improve as job satisfaction increases — better sleep, healthier lifestyle choices and higher levels of dopamine, serotonin and oxytocin. That results in less absenteeism and increased staff retention, more productivity and greater attention to detail, increased teamwork and happier work relationships. For managers, that means smoother day-to-day running, more value from limited training resources, better cooperation and fewer internal struggles.

Morale building is about incentives and rewards. What do workers want? Well, pay-rate is important, but workers value other rewards too:

  • Work-life balance: Worrying about work outside of work hours erodes home-life and wellbeing. Dedicated workers can be the worst affected by workplace stress.    
    Small initiatives can significantly reduce stress: allowing workers some control over workhours, limiting after-hours emails and phone calls, managing risk, resolving disputes and incidents, and promptly responding to feedback and queries.
  • Mission and vision, team goals and innovation: Workers need to feel like they are achieving something good. Once it their work becomes routine — no matter how important it is — that sense of achievement can fade into the background. Mission statements and motivational campaigns might attract or distract for a while, but workers are more influenced by their peers and supervisors. Setting specific goals can keep a sense of teamwork, purpose and achievement alive.
    If workers are involved in the goal-setting process, they won’t perceive goals as imposed tasks. But do make sure that goals address Quality issues such as identifying risk and opportunities for improvement.
  • Recognition and Leadership Opportunities: Worker consultations are a great way to gauge capability. From there you can plan training and encourage excellence. Although face to face is best, consultation might include phone calls, questionnaires and written feedback opportunities. 
  • Communication and Trust: Workers and managers need to trust each other. Listening is a great start. Open lines for feedback and prompt, positive responses are essential. Don’t forget to let people know how important their contributions are.
    The Capability Framework recognises that many issues are ambiguous and complex. If there’s no right answer, work with others to find the best answer.
  • Teamwork: Support workers delivering services in people’s homes often feel isolated, unsupported, and cut off from a team. Simple solutions, like group chats, can make a huge psychological difference.
    Establishing team goals sets up opportunities to recognise team achievements, discuss outcomes and develop strategies to improve work conditions.  
  • Professionalism: According to a recent survey, workers perceive support work as having low status, high levels of responsibility and stress, and few career opportunities. They might be right — at least, in part — but it needn’t be that way. The NDIS is still finding its feet, so today’s managers have a huge say in what the sector will look like tomorrow. They can build a more capable and stable workforce by encouraging professionalism, reducing avoidable stressors, and recognising talent.
  • Job Satisfaction: Dissatisfaction can cause you all sorts of problems! The sooner you start a conversation, the better:
    • Express the problem in the language of Quality — gather data, aim for greater efficiency and higher outcomes, address risk or promote improvement.
    • Gather feedback and other data to better understand the problem.
    • Set team goals (if that’s appropriate) based on the data.
    • Engage staff in developing strategies and monitoring success.   


Creating a collaborative workplace culture takes planning and leadership, time and effort. But it can save you time and effort later down the track, prevent headaches, and make the most of limited resources. That’s not all:

Teambuilding: Consulting workers will help them feel less isolated and provide a sense of purpose. Just starting can have a good effect, provided workers aren’t left hanging!

If contact time is a problem, use questionnaires to gather data. Let workers know that you’re gathering information to support them effectively. Let them know it’s not an exam and give them room for honest self-reflection.

  • Risk and opportunity: Start with the data you already have available, even if they are rough estimates. Let the data direct the discussion. Where are the gaps in understanding? Where do people feel less confident? Where are people having more success? Include worker and participant queries, feedback, incidents and near misses in your assessment. Be willing to change your understanding as more data comes in.
    Consultations can reveal need on several levels. Workers may be able to identify specific areas that need attention. You might also be able to interpret the responses more broadly. For example, vague answers might suggest need, stress, or lack of motivation — it’s worth gently checking in.
  • Leverage: A well-constructed plan is likely to find greater support — especially if it addresses critical concerns such as: compliance, risk, professionalism, improvement, job satisfaction and better outcomes. Competence displayed in the planning stage inspires confidence that you’ll deliver the later stages efficiently and effectively.
    Planning also establishes an expectation of professionalism. Workers will see that you’re focussed on team and participant needs, and that you expect them to do the same.
  • Ease of implementation: A well-developed plan will use limited resources more effectively, whether training is formal or informal. Clear objectives make implementation more directed, intentional and appropriate to worker and participant need. With careful planning, you might be able to achieve multiple objectives simultaneously. (We address planning in the Promote Understanding lesson module).
  • Monitoring: Don’t neglect the monitoring stage in your planning. If you’ve set clear objectives, the outcomes of training will be easier to monitor — you and your team will know exactly what to look for.
  • Peace of mind: The more capable and loyal your team, the fewer fires to put out — and the more help when you need it.

Conclusion: Don’t let the perfect be the enemy of the good.

Quality Management can’t do everything. It can’t replace worker sensitivity. It can’t alleviate the stress of dealing with people’s wellbeing, and making critical decisions. It doesn’t give foot massages. 

But let’s ask: can it reduce uncertainty and disorder? Can it help manage change and make sense of the demands (some of them, at least)? If so, it can reduce the overall level of stress and preserve some energy for those critical moments.

There are pressures — such as insufficient time and funding — that increase stress and limit how much a system can do about it. The question is: when the work gets tough, should we abandon good tools or sharpen them? Quality Management tools getter ‘sharper’ the more you use them.

A well-constructed plan is more likely to receive support — at all levels. It will inspire confidence and set expectations. And a well-supported plan is more likely to succeed. Engaging workers in identifying problems and planning solutions helps them understand what those expectations mean for them — what professionalism means and how collaboration works. Be patient; a collaborative culture might be strange to them

As managers, you have a lot of influence over what tomorrow’s workforce looks like. Focusing on Quality Management concerns is key to building professionalism and improving staff retention. As pioneers, you might not receive all the support you’d like. Your system won’t be perfect and there’ll always be room for improvement. That’s what Quality is designed to do — one step at a time, using data to develop strategies for incremental improvements.