How organizational factors interact to influence the quality of care of older people in the care home sector

Abstract

Article:Burns, D., Killett, A., Hyde, P. et ReuseUnless indicated otherwise, fulltext items are protected by copyright with all rights reserved. The copyright exception in section 29 of the Copyright, Designs and Patents Act 1988 allows the making of a single copy solely for the purpose of non-commercial research or private study within the limits of fair dealing. The publisher or other rights-holder may allow further reproduction and re-use of this version -refer to the White Rose Research Online record for this item. Where records identify the publisher as the copyright holder, users can verify any specific terms of use on the publisher's website. TakedownIf you consider content in White Rose Research Online to be in breach of UK law, please notify us by emailing eprints@whiterose.ac.uk including the URL of the record and the reason for the withdrawal request. To examine how organizational factors affect good care and mistreatment of older people in care homes. Methods:Eight residential care homes for older people (including private sector, local authority and NHS providers) took part in a participatory observation-based study of organizational factors affecting care quality. ResultsGrouping organisational factors into infrastructure, management and procedures, staffing, resident population characteristics and culture we show the context sensitive nature of interactions between these factors. These interactions could enhance care quality where factors combined positively. Conversely, they could amplify difficulties where one factor came to undermine another, thereby limiting care quality. ConclusionsThis analysis provides empirical insights into how and why similar sector-wide changes to care provision have differential effects at the care home level. It indicates the situated and unpredictable ways in which organizational factors interact, implying the need for locally contextualised quality assessment and improvement actions.

Facilitators and inhibitors of transition for older people who have relocated to a long‐term care facility: A systematic review

“…Long‐term care facilities require staff with knowledge, skills and values to meet the needs of older people, who can deliver excellent care, and who are committed to helping create an enriched care environment. The influence of organisational culture on the quality of care is known (Dixon‐Woods et al, ; Killett, Hyde, Burns, Gray, & Poland, ; Van Beek & Gerritsen, ) as is the impact of how staff are organised, managed and supported on resident outcomes (Choi, Flynn, & Aiken, ; Flynn, Liang, Geri, Dickson, & Aiken, ; Spilsbury, Hanratty, & McCaughan, ). We need to know more about how organisational culture influences transition following relocation and the impact for residents’ psychosocial well‐being (e.g., mood, life satisfaction, feeling connected, confidence and coping) and physical well‐being (e.g., mobility, mastery of new skills).…”

“…Long-term care facilities require staff with knowledge, skills and values to meet the needs of older people, who can deliver excellent care, and who are committed to helping create an enriched care environment. The influence of organisational culture on the quality of care is known (Dixon-Woods et al, 2014;Killett, Hyde, Burns, Gray, & Poland, 2013;Van Beek & Gerritsen, 2010) as is the impact of how staff are organised, managed and supported on resident outcomes (Choi, Flynn, & Aiken, 2011;Flynn, Liang, Geri, Dickson, & Aiken, 2010;Spilsbury, Hanratty, & McCaughan, 2015).…”

How do care home staff understand, manage and respond to agitation in people with dementia? A qualitative study

“…The impact of structural and procedural factors on staff well-being and care practices has previously been documented qualitatively 34–37 and quantitatively. 24 38 Consistent with this, staff here indicated that they internalised a culture of scrutiny and fear from within and outside of care homes.…”

The use of non-pharmacological interventions for dementia behaviours in care homes: findings from four in-depth, ethnographic case studies

“…3 In view of the changing emphasis from antipsychotic medications to NPIs, this study investigates the use of NPIs to work with individuals experiencing BPSD on a day-to-day basis in care homes. The organisational factors in care settings have been found to influence care practices [28] therefore care home contexts are important. Examining how NPIs (some of which are the focus of efficacy research) are used to manage BPSD within care home environments is necessary to find out how current practices manifest within these organisational settings.…”