Forming nursing home practices that support quality care for residents. A qualitative observational study

Abstract

Background Residents of nursing homes are increasingly frail and dependent. At the same time, there are increased demands for quality of care and social life for individual residents. In this article, we explore how care workers provide quality care, including meaningful activities and social life in shared living rooms in nursing homes. Methods An ethnographically inspired design was applied, and a purposive sample of six units for long-term care in three nursing homes in Norway was included in the study. Data were collected by participant observation, including informal conversations with the staff and residents, and the data were analysed using thematic analysis. Results The analysis identified three main themes: working within the given frames, forming practices, and organising activities. The empirical findings demonstrate that care takes place within given frames of architecture, culture, and resources, focusing on meeting residents’ physical and social needs and aiming for a social life. Conclusions The results of this study illustrate that nursing home practices are focused on residents as a group. However, care workers take advantage of personal skills and resources to work towards person-centred care within the given frames. The quality of care is recognised in terms of how care workers meet individual residents’ needs. The quality of care seems highly related to the competence, capability, and skills of individual care workers.