Waterstone Client Stories: Sandra Ketchen, CEO, Spectrum Health Care

At Waterstone Human Capital, our focus on helping organizations build high performance cultures means that we get to work with some truly exciting organizations across a variety of industries. The one thing that connects them all: a transition or event that is causing them to refocus on their culture and their people.

Spectrum Health Care is one great example. We recently sat down with Spectrum’s CEO, Sandra Ketchen, to learn more about the organization’s experience working with the Waterstone team on their culture journey.

(Note: this discussion has been edited for length. To view the full conversation, click here.)

 Waterstone Human Capital (WHC): Tell us a little about Spectrum Health Care.

Sandra Ketchen (SK): At our core we are a home care company. We have about 3,000 staff out in the field supporting more than 80,000 home care visits a week – that’s nurses and personal support workers (PSWs) going into peoples’ homes. The majority of that work happens within an hour of the Greater Toronto Area (we have small operations in other parts of the province as well as in Montreal) and in total we service 25,000 or more unique clients every year.

WHC: Talk a bit about the work that you’re doing with the Waterstone Culture Institute and why you’re so committed to the culture journey.

SK: It’s not about fixing something that’s broken, it’s about building on the great culture that was here already. If you think about the home care sector in Ontario, there’s a lot of change and transformation coming. We wanted to take the opportunity to assess where we’re at and what would make us even stronger, because our business really is all about people.

We view culture as a competitive advantage and we want to be able to attract, grow, and retain staff because happy staff are going to give better experiences to our patients in their homes as they’re providing care, which is really the most important thing.

WHC: It sounds like you’re really focused on fine-tuning your culture – keeping what’s great about your current culture and looking for areas you can change to better position Spectrum for the future.

SK: This is about stepping up to our next level – what else do we want to be really great at? It’s about driving leadership to different levels, about driving innovation and collaboration, and really making sure we’ve got the leadership and the culture underneath (and throughout the organization) that’s going to help us work through the transformation that’s coming to us.

If you think about care, home care, or just care in general, and the amount of care that’s going to be required in the next five to 10 years, we’re going to be challenged to deliver it with the workforce that we have. We need people who can start thinking about innovation and collaboration in ways that we might not have thought of before. That’s really what we’re trying to bring to life.

WHC: What has surprised you most about your culture journey so far? 

SK: I don’t know that surprise is the right word, but the level of engagement that we’ve seen. This is a very distributed workforce… Of our 2,500 frontline staff, many are out on their own going to their patients’ homes every day, so they don’t necessarily see each other every day. It’s hard to rally messaging and engagement when you’ve got a distributed workforce like that. I think for us what’s been surprising is how quickly we’ve been able to capture the hearts and minds of people, that there’s interest, that there’s intrigue, that people are coming back and that they’re engaging with the surveys we’re asking them to engage with.

People want to be involved, whether they’re in the executive suite or our frontline PSWs and nurses.

WHC: Why did you choose to work with a firm like Waterstone for this project?

SK: One of the reasons is the recipe. When we first met Nicole [Bendaly, Executive Director of the Waterstone Culture Institute] and the team, it was really clear that there’s a process that is followed to get from Point A to Point B, and it’s a process that has a track record. It was like a roadmap that we could follow, one that had already been travelled upon with the experience of other people.

Number two is when you’re looking to drive change or implement transformation in a business, I think it’s always a good idea to have that external voice keeping it real for the leadership team – one that’s engaged, maybe pushing us and challenging norms (or things we thought were norms), forcing us to think a little bit outside the box. I find it’s oftentimes more successful when you have a third party, an independent party, come and push you to get to those outer limits.

WHC: What has your experience with the Waterstone team been like?

SK: Honestly, it’s been fabulous. I first met Nicole when she presented to a small group on what this process and journey are all about. Her passion for the subject was clear right out of the gate and we’ve seen that passion carry on – whether it’s with her, or with her team. Everybody is all-in to support whatever is needed to make this happen – whether it’s cadence and follow up, whether it’s ideas, whether it’s us bouncing things off them in terms of what might work here or what might work there. There’s a great level of, not just engagement but I would say enthusiasm for helping us make this happen.

WHC: You’re still in the middle of your culture journey, but how has Waterstone helped set you and your team up for success so far?

SK: When you think about transforming an organization with more than 3,000 people, or trying to drive shifts in culture, that’s not for the faint of heart. It’s sort of overwhelming when you think about how you’re going to start, so that formula or recipe that Waterstone came to us with, it gave us a map that we could understand and that we could follow.

They were very helpful in getting us benchmarks, to really understand what our frontline and office staff think about our culture. I think it reinforced what we thought we knew, but it taught us a few different things as well. The process helped us clarify: What was it that we needed to shift? What did people value the most? Where did they want to take this?

They’ve helped us engage all the voices in the organization to get the right answers about what the shifts are going to be. They’ve helped us formulate some thinking and some groups around what the actions might need to be and then, importantly, the ongoing check-in on the process and that accountability model that is critical in something like this.

WHC: What’s the next step in your culture journey?

SK: In the short term, we’ve identified the first three shifts we want to make based on the input from our broader team. We have organized teams with champions around those three shifts, and those teams are comprised of everybody from management and leadership down to our frontline nurses and PSWs, because the voice of everybody really matters in something like that. Those teams are in the midst of coming up with their solutions and recommendations.

Within this calendar year we’ll be making some decisions around what the investments are going to be, and we’ll be making those investments for the next six to 12 months – just being thoughtful about how do we do it, that we’ve got the follow through, and that we’re getting the shifts in culture that we’re looking for. Part of that will be testing by pulse surveys and checking in with people on a regular basis. Is it working? Is something transforming? And course correcting if needed.

This is a journey. This isn’t a “one and done” thing.  We want to make sure that once we get through these first three shifts we test it again – what else could we be doing, and where else could we be taking this?

WHC: What advice do you have for other organizations looking to undertake a similar project?

SK:  This isn’t for the faint of heart and you’ve got to be really committed to it.

It has to be a top down and bottom up approach; it can’t be one or the other, it really has to be both. It has to be seen as something that is important from the leadership team. We talk about this all the time, whether it’s in town halls, meetings, our leaders talking to our frontline staff. And at the same time, we need to have our frontline folks be out there and be champions on behalf of this as well. So, it’s got to be top down and bottom up.

The second thing is that you must have patience. This isn’t a “six months and it’s done” kind of thing. It doesn’t happen in just a quarter. We’re looking to commit to a long game here – this is about who we want to be on a journey that’s going to take us 5, 10 or more years.

The last thing I would say is that we’re very specific not to call it a project. This is not a project. We call it a journey, and we’ve called it our Ignite journey. So that gives you a sense of something that we can drive physical representation around, something that when people hear the word Ignite, they kind of instinctively already know what it is, and something that will be with us for a very long time.


No matter where a company is in their culture journey, the team at Waterstone can help – from assessing, measuring and transitioning culture, to ensuring organizations have the right leaders in place to take their culture and performance to the next level. Schedule a meeting with our team today and find out how we can help.