Senior manager decision‐making and interactions with frontline staff in intellectual disability organisations: A Delphi study

Abstract

Very little is known of the activities of the most senior managers in organisations providing social care in the community to people with intellectual disabilities. Yet the importance of the focus and activities of senior managers in directing and supporting staff practice and staff experiences is likely to be central to an organisation's functioning and support provided for staff and service users. This study employed Delphi methodology with a panel of 11 senior managers, mostly chief executives, managing small to very large organisations providing support for people with intellectual disabilities, in the UK. Answering three rounds of questions, senior managers described their face‐to‐face and non‐face‐to‐face contacts with staff and decision‐making. Narrative data were subject to quantitative and thematic analysis. In the last round, themes were subject to quantitative analysis. Most contacts between senior managers and staff were in formal structured contexts and all managers used social media to promote the organisations' ambitions regarding good practice. The panel focused upon accessing and understanding the informal aspects of their organisations and staff factors. Decisions were both short‐term reactive and long‐term strategic and an effort to link these was felt to improve organisational functioning. A framework for understanding senior managers' activities emerged showing two sources of demands and opportunity, extra‐organisational focused upon meeting legal and regulatory demands and intra‐organisational focused upon understanding and influencing informal staff practices/experiences and cultures within their organisations.

A multiple case study investigating changes in organizations serving residents with intellectual disabilities and challenging behaviours

“…This study has value for researchers and practitioners, as the ecological perspective provides insight into recent studies on implementing and maintaining active support in various services, which have concluded that hands-on training and managerial leadership seem to be crucial organizational aspects (Beadle-Brown, Bigby, & Bould, 2015;Bigby & Beadle-Brown, 2018;Bigby, Bould, Iacono, Kavanagh, & Beadle-Brown, 2019;Deveau & McGill, 2016a, 2016b. As Bould, Beadle-Brown, Bigby, and Iacono (2016) (Deveau and McGill, 2019;Deveau, Gore, & McGill, 2020;Olivier-Pijpers, et al, 2018;Schippers, 2019;Tournier et al, 2020;Walker, 2012). During organizational changes, continuous discussions on aligning staff attitudes with the organizational vision, staff training in positive attitudes and reduced restraint use, and sufficient information about residents' needs to enhance resident-staff bonding are also necessary (Olivier-Pijpers, Cramm, & Nieboer, 2019;Philips & Rose, 2010;Walker, 2012).…”

“…As Bould, Beadle‐Brown, Bigby, and Iacono (2016) stated, implementing a new vision or support service is often supported by training and practice leadership, as well as performed through generally good management and proper working relationships. In practice, organizations’ long‐term commitment to change, translated into managers’ and psychologists’ practice leadership, with guidelines and information for staff and a focus on transparency in working relationships, is important for managing challenging behaviours (Deveau and McGill, 2019; Deveau, Gore, & McGill, 2020; Olivier‐Pijpers, et al, 2018; Schippers, 2019; Tournier et al, 2020; Walker, 2012). During organizational changes, continuous discussions on aligning staff attitudes with the organizational vision, staff training in positive attitudes and reduced restraint use, and sufficient information about residents’ needs to enhance resident–staff bonding are also necessary (Olivier‐Pijpers, Cramm, & Nieboer, 2019; Philips & Rose, 2010; Walker, 2012).…”

“…This created a “messy” situation that negatively impacted management of challenging behaviour. Research indicates support from managers and psychologists through practice leadership, with frequent formal and informal staff contact, is vital for improving management of challenging behaviours and building a coherent team culture, leading to staff receiving and sharing guidance on how to provide support in line with residents’ behaviours (Deveau & McGill, 2019; Deveau, Gore, & McGill, 2020; Olivier‐Pijpers, et al, 2018; Olivier‐Pijpers et al, 2019; Tournier, Hendriks, Jahoda, Hastings, & Embregts, 2020).…”

“…budget cuts, self-organising staff teams) led to changes within staff teams and how they functioned, as indicated in the focus groups and meeting records. (Deveau & McGill, 2019;Deveau, Gore, & McGill, 2020;Olivier-Pijpers, et al, 2018;Olivier-Pijpers et al, 2019;Tournier, Hendriks, Jahoda, Hastings, & Embregts, 2020). changes (Deveau & Leitch, 2020;Ravoux, et al, 2012;Tournier et al, 2020).…”

Challenging behaviour around challenging behaviour

“…Yet, by giving participants a personal experience of development through dialogic inquiry this intervention appears to have narrowed the gap between the school's philosophy and its practice.It influenced informal interactions and formal educational practices, thus creating a link between internal practices and outcomes that the school's external bodies use in commissioning specifications and inspection protocols. Creating coherence between informal practice and external expectations is an area of emerging research in leadership and culture change in the field of intellectual disability(Deveau et al, 2019). When we choose to see through a systemic lens, addressing challenging behaviour legitimises the consideration of interactions across the whole system, the rationale for which has been clearly demonstrated in the enduring legacy of Bronfenbrenner's seminal work(1979).…”