Making sense of varying standards of care: the experiences of staff working in residential care environments for adults with learning disabilities

Abstract

Accessible summary To find out why standards of care might vary in residential homes for adults with learning disabilities, this study describes the experiences of six care workers currently working in residential homes. Each care worker took part in an interview where they were asked to talk about their jobs in detail. Three things were found to be important aspects of care workers experiences: the quality of their relationships with others; their levels of motivation for their work; and their feelings about the environments they worked in. The study discusses how each of those things can lead to variations in care standards. Summary Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have been made to understand variations in care standards, there remains a need for more research in this area. Additionally, little attention has been paid to understanding support staff experiences of working in residential services and to developing a more theoretical understanding of the role they fulfil. Using interpretive phenomenological analysis (IPA), this study aimed to examine front‐line staff members' experiences of working in residential care for people with learning disabilities. Six experienced front‐line care workers (four female, two male) took part in semi‐structured interviews. Data were analysed according to the principles of IPA, and three superordinate themes were identified as being central to participants' experiences of their work roles: Degree of Positive Relationship Reciprocity; Value Congruence and Intrinsic Motivation; and Experiences of Environmental and Organisational Constraints. Results are discussed in relation to the existing literature on care standards and the factors associated with abusive or neglectful practices, and in terms of their contribution to theory and applied practice.

Detection and prevention of abuse of adults with intellectual and other developmental disabilities in care services: A systematic review

“…positive attitudes towards residents, acknowledgment and attendance to difference, recognition and respect for service-user preferences, intrinsic motivation, confidence to challenge bad practice and having a positive relationship with senior colleagues, whereby staff felt listened to and valued (Bigby et al, 2012;Bigby & Beadle-Brown, 2016;Calcraft, 2007;Gillett & Kroese, 2003;Hutchison & Kroese, 2016).…”

“…Protective (Bigby et al, 2012;Bigby & Beadle-Brown, 2016;Calcraft, 2007;Cambridge, 1999;Furey et al, 1994;Hutchison & Kroese, 2016;Jones & Kroese, 2006;Rees & Manthorpe, 2010;Rytterström et al, 2013). Protective factors created a caring culture characterised as coherent, respectful, enabling for service-users and motivating for staff.…”

Social inclusion in the neighbourhood and the professional role identity of group home staff members: views and experiences of staff regarding neighbourhood social inclusion of people with intellectual disabilities

“…Creating a safe environment is an important condition for discussing these topics and it is therefore important that service providers invest in developing and maintaining strong relations within the teams working in a group home (e.g. Hensel, Hensel, & Dewa, 2015;Hutchison & Kroese, 2015). Team cohesion is a strong determiner for staff members' motivation and greatly influences how staff members perform (e.g.…”

“…Team cohesion is a strong determiner for staff members' motivation and greatly influences how staff members perform (e.g. Hutchison & Kroese, 2015).…”

Understanding elementary teachers' perceptions of students of color and low socioeconomic status students

“…As key developers in the IPA methodology, the recommendation for novice researchers was three to six participants, which should "provide sufficient cases for the development of meaningful points of similarity and difference between participants, but not so many that one is in danger of being overwhelmed by the amount of data gathered" (Smith et al, 2009, p. 51). This was commensurate with current IPA studies in which purposive sampling with three to six participants was used (Gauntlett, Bickle, Thomas, Collings, Heaslip, Eccles, 2017;Hutchison & Kroese, 2016;Nel & Fouche, 2017;Smith et al, 2009). Smith, Flowers, and Larkin (2009) contended that homogeneity may vary between studies depending on the participants' availability, willingness, and openness to discussing the investigated topic.…”