Dimensions of group home culture as predictors of quality of life outcomes

Organisational culture in 'better' group homes for adults with intellectual and developmental disabilities in England: A qualitative study

BACKGROUND

Previous research identifies organisational culture as one of a number of factors associated with the quality of life outcomes of group home residents' with intellectual and developmental disabilities. This study aims to elaborate on the dimensions of group home culture in settings in England.

METHOD

Participant observations and semi-structured interviews with staff were carried out in two group homes. Field-notes, interview notes and transcripts were analysed using inductive thematic analysis by a researcher naïve to the project and the previous literature. Initial coding was re-examined after sensitisation to theorised models in previous literature to identify the most parsimonious fit. The two settings were rated and compared using a five-point Likert scale for each of the dimensions.

RESULTS

The findings describe group home culture across seven dimensions. There were mixed ratings across the different dimensions reflecting inconsistencies in culture that were reflected in staff practice. The challenge in assigning a global rating of culture in group homes, which includes interactions across multiple staff and multiple residents over time, was highlighted.

CONCLUSION

The development of an observational measure of culture is highlighted as potentially helpful in understanding and responding to culture in services for individuals with intellectual and developmental disabilities.

Active Support Measure: a multilevel exploratory factor analysis

BACKGROUND

Active Support is a person-centred practice that enables people with intellectual disabilities (IDs) to engage in meaningful activities and social interactions. The Active Support Measure (ASM) is an observational tool designed to measure the quality of support that people with IDs living in supported accommodation services receive from staff. The aim of the study was to explore the underlying constructs of the ASM.

METHODS

Multilevel exploratory factor analysis was conducted on ASM data (n = 884 people with IDs across 236 accommodation services) collected during a longitudinal study of Active Support in Australian accommodation services.

RESULTS

Multilevel exploratory factor analysis indicated that 12 of the ASM's 15 items loaded on two factors, named Supporting Engagement in Activities and Interacting with the Person.

CONCLUSIONS

The 12-item ASM measures two dimensions of the quality of staff support. Both technical and interpersonal skills comprise good Active Support.

The strength of Frontline Practice Leadership in Australian supported accommodation services: Challenges confronting service providers

BACKGROUND

The strength of practice leadership predicts the quality of Active Support but it can be compromised by other demands on frontline managers. The study aimed to identify and understand differences in practice leadership over time and between organisations.

METHOD

Data collected in 2022 in 96 services from 11 organisations using the Observed Measure of Practice Leadership were compared to similar data from 2013 and 2018. Qualitative fieldnotes were analysed thematically.

FINDINGS

Practice leadership scores increased significantly between 2013 and 2018 but declined significantly between 2018 and 2022. Scores were significantly higher in organisations that had implemented Active Support since 2013 compared to later adopters. Higher scoring organisations had structures that supported frontline managers with practice leadership and that countered increasing administrative demands.

CONCLUSIONS

Establishment of support structures for practice leadership by organisations warrants further investigation together with the relative importance of each task of practice leadership.

Using Communication Assistants in Qualitative Health Research

Qualitative health research is hampered by narrow constructs of human communication that privilege participants with access to spoken and written (normative) language. With limited awareness of such things as augmentative and alternative communication (AAC) or the rights of people with complex communication access needs, qualitative research becomes a 'picker and chooser' of whose voices are included in studies and whose are not. In order for 'voices' to be heard, adaptations are required which include the acknowledgement and support of communication assistants (informal and formal) who can help provide a communication bridge between people with complex communication access needs and researcher(s). Yet little is known of who qualifies as a communication assistant nor the scope and limitations of this role in health research. Beginning with communication diversity arguments the article compares communication assistants with language interpreters before discussing practice and implications for health research.

Dimensions of group home culture as predictors of quality of life outcomes

Background

Research has shown that there is variability in quality of life (QOL) outcomes for people with intellectual disabilities who live in group homes. The aim was to examine dimensions of group home culture as predictors of QOL outcomes.

Method

The Group Home Culture Scale (GHCS) was used to measure staff perceptions of culture in 23 group homes. QOL data were available from 98 people with intellectual disabilities. Multilevel modelling was used to examine the associations between the GHCS subscales and four QOL‐dependent variables.

Results

Of the GHCS subscales, Effective Team Leadership and Alignment of Staff with Organizational Values significantly predicted residents’ engagement in activities. Supporting Well‐Being significantly predicted residents’ community involvement. None of the GHCS subscales significantly predicted domestic participation and choice making.

Conclusions

The findings suggest that strategies to improve Effective Team Leadership and Supporting Well‐Being dimensions of culture may contribute to enhancing certain QOL outcomes.