scholarly journals The informal culture of a direct care staff team supporting people with intellectual disabilities who present with behaviours that challenge

2021 ◽  
Vol 26 (3) ◽  
pp. 160-168
Author(s):  
Faye Banks ◽  
Amy Fielden ◽  
David O'Sullivan ◽  
Barry Ingham
Keyword(s):  
Intellectual Disability ◽  
Direct Care ◽  
Care Staff ◽  
Service Users ◽  
Direct Care Staff ◽  
Content Type ◽  
Disability Service ◽  
The Uk ◽  
The Impact ◽  
Informal Culture

Purpose Research into culture within intellectual disability services, has predominantly focussed on small group homes in Australia. The current investigation aimed to explore the transferability of the dimensions of culture identified in the literature, to a residential Intellectual Disability service in the UK. The purpose of this study was to better understand the impact of informal culture upon the behaviour of direct care staff, particularly around managing behaviour that challenges. Design/methodology/approach Semi-structured interviews were conducted with direct care staff. Interview transcripts were analysed thematically using template analysis. Findings Themes regarding leadership, perceptions of managers, team functioning, and relationships between direct care staff and service users, were identified, corroborating the existing literature. Additional themes relating to being aware of the risks posed by service users, and the emotional impact of behaviour that challenges, also emerged. Originality/value To the best of the authors’ knowledge, this is the first qualitative study to explore informal culture within a community residential Intellectual Disability service in the UK.

Can active support improve job satisfaction?

2016 ◽  
Vol 21 (2) ◽  
pp. 54-60 ◽  
Author(s):  
Jennifer A Rhodes ◽  
Sandy Toogood
Keyword(s):  
Job Satisfaction ◽  
Intellectual Disabilities ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Content Type ◽  
Repeated Measures Design ◽  
Before And After ◽  
People With Intellectual Disabilities ◽  
The Impact

Purpose – Active support (AS) influences the way staff support people with intellectual disabilities to take part in everyday activities. Changes in work practices may affect job satisfaction. The impact of AS on job satisfaction has not, however, been widely studied. Job satisfaction is linked with levels of staff turnover and the overall quality of services provided to people with intellectual disabilities (Coomber & Barriball, 2007; Hatton et al., 2001). The purpose of this paper is to describe an evaluation of job satisfaction amongst 38 direct care staff working in intellectual disability services before and after AS was implemented. Design/methodology/approach – A single group, repeated-measures design was used. In total, 38 members of direct care staff received AS training. Data on job satisfaction were collected before, and after, AS was implemented. In total, 19 members of staff took part in a follow-up 12 weeks later. Findings – There was a significant increase in reported job satisfaction following the implementation of AS. Subscale analysis revealed that the most significant increases in job satisfaction were related to areas directly targeted by AS, including satisfaction with skill level and satisfaction with amount of time spent with service users. Originality/value – Implementing AS may provide an added benefit for direct care staff, who feel more satisfied at work. While a significant number of papers have been published focusing on the benefits of AS, no papers have specifically looked at the impact that the intervention can have on job satisfaction.

Consumer behaviour analysis and non-adoption of behavioural interventions: implications for managerial action

2019 ◽  
Vol 24 (3) ◽  
pp. 101-107
Author(s):  
Konstantinos M. Ntinas
Keyword(s):  
Well Being ◽  
Behavioural Economics ◽  
Working Environment ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Behavioural Interventions ◽  
Content Type ◽  
Perspective Model ◽  
The Cost

Purpose Direct care staff may be resistant to the use of behavioural interventions. Whilst some research suggests that resistance to the cost of behavioural interventions is one factor of influence, there is lack of research exploring why staff are influenced by the cost. The purpose of this paper is to explore this issue. Design/methodology/approach In this paper, the phenomenon of resistance is analysed with the help of behavioural economics and of the behavioural perspective model (BPM). Findings The resistance to the cost of behavioural interventions is correlated with the low quality of the working environment and ways in which staff might attend to factors which protect their own well-being. Practical implications Services might need to focus on the ways in which behavioural interventions protect staff’s well-being. Originality/value This paper explores the use of the BPM and of behavioural economics as conceptual tools for the analysis of the factors leading to non-adoption of behavioural interventions.

Direct care staff knowledge about medication for individuals with intellectual disabilities

2019 ◽  
Vol 13 (3/4) ◽  
pp. 144-151
Author(s):  
Amanda Sawyer ◽  
Johanna Lake ◽  
Yona Lunsky
Keyword(s):  
Intellectual Disabilities ◽  
Psychotropic Medication ◽  
Medication Use ◽  
Medication Administration ◽  
Psychotropic Medications ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Content Type ◽  
Adults With Intellectual Disabilities

Purpose The majority of adults with intellectual disabilities (ID) are prescribed at least one, if not multiple medications, with psychotropic medications being the most commonly prescribed. Direct care staff play an important role in psychotropic medication administration and monitoring, yet little is known about their knowledge and comfort with medication. The paper aims to discuss this issue. Design/methodology/approach A 15-item survey, focusing on self-reported knowledge and comfort with psychotropic medication, was completed by 152 direct care staff employed at three agencies providing residential services for individuals with ID across Ontario. Findings In total, 62 per cent of staff respondents reported that psychotropic medications were among the top medications regularly taken by the individuals they support, with behaviour listed as the most commonly reported reason for taking this medication. The majority of staff reported monitoring medication, however, the frequency of monitoring varied considerably. Generally, staff reported feeling comfortable and knowledgeable about medication use, but, most reported a desire for additional medication training. Originality/value This is the first Canadian study to examine staff knowledge and comfort regarding medication use, and the first study to assess PRN (“as needed”) as well as regularly administered medications.

Commentary on “The effectiveness of psychodynamic interventions for people with learning disabilities: a systematic review”

2013 ◽  
Vol 19 (1) ◽  
pp. 25-28
Author(s):  
Hilary Brown
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Learning Disabilities ◽  
Intellectual Disabilities ◽  
Family Members ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Content Type ◽  
People With Intellectual Disabilities

Purpose – This paper is a commentary on “The effectiveness of psychodynamic interventions for people with learning disabilities: a systematic review” by Chris James and James Stacey. The purpose of this paper is to illustrate the thesis that standardised ways of evaluating health care interventions may have the inadvertent effect of undermining the case that people with intellectual disabilities should be offered the same opportunities to address their emotional and mental health difficulties as other citizens. Design/methodology/approach – The commentary argues that while the evidence base focuses on the outcomes of orthodox one-to-one interventions, sometimes broader “contextual reformulation” and systemic interventions are called for. However, family- or service-based interventions tend not to feature in studies. Findings – The commentary illustrates these issues by discussing two case studies, which demonstrate how relational issues tend to be unhelpfully focused on the person with intellectual disabilities to the detriment of family members or direct care staff, who may be struggling to make sense of the person's behaviour or distress. Originality/value – The commentary supports the argument put forward in the longer paper and also argues for mental health services to be offered on a non-discriminatory basis to people with intellectual disabilities and to their family members. But it also suggests that one of the additional impacts of service level psychotherapeutic interventions is to re-establish respect for the work of direct care staff whose work is often presented as if it is little more than domestic drudgery when in fact it involves negotiating and responding to people and their issues with great sensitivity and balance.

Training Direct-Care Staff to Provide Communication Intervention to Adults With Intellectual Disability: A Systematic Review

2017 ◽  
Vol 26 (4) ◽  
pp. 1279-1295 ◽  
Author(s):  
Larah van der Meer ◽  
Tamyra Matthews ◽  
Emily Ogilvie ◽  
Alice Berry ◽  
Hannah Waddington ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Social Validity ◽  
Direct Care ◽  
Care Staff ◽  
Communication Intervention ◽  
Sufficient Evidence ◽  
Positive Outcomes ◽  
Direct Care Staff ◽  
Feedback Reliability ◽  
Training And Support

Purpose The aim of this review was to summarize and evaluate studies on training direct-care staff to provide communication intervention to adults with intellectual disability. Method Systematic searches identified 22 studies. These were summarized and evaluated in terms of (a) participants; (b) settings; (c) training aims and procedures; (d) research designs; (e) reliability, integrity, and social validity; (f) outcomes; (g) generalization and follow-up; and (h) certainty of evidence. Results A total of 437 staff and 254+ adults with intellectual disability participated. Staff training most frequently involved combinations of verbal instruction, role play, modeling, practice, and feedback. Reliability was assessed in 18 studies with acceptable standards for most of these studies. Treatment integrity and social validity were assessed in 1 and 3 studies, respectively, with positive outcomes. Generalization and maintenance were assessed in 5 and 8 studies, respectively, with predominantly positive outcomes. Most studies reported positive outcomes for staff and positive or mixed outcomes for the adults with intellectual disability. Certainty of evidence was rated as conclusive in 1 study, suggestive in 14 studies, and inconclusive in 7 studies. Conclusions There is sufficient evidence to conclude that direct-care staff can be taught to provide effective communication intervention to adults with intellectual disability. Professionals involved in providing training and support to direct-care staff could expect positive outcomes from multicomponent training programs that include opportunities for practice and feedback.

scholarly journals DEMENTIA-FOCUSED PERSON-DIRECTED CARE TRAINING IN THE NURSING HOME: FIDELITY AND OUTCOMES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S380-S380
Author(s):  
Joann P Reinhardt ◽  
Orah Burack ◽  
Verena Cimarolli ◽  
Audrey Weiner
Keyword(s):  
Nursing Home ◽  
Clinical Symptoms ◽  
Intervention Group ◽  
Well Being ◽  
Direct Care ◽  
Care Staff ◽  
Direct Care Staff ◽  
Care Needs ◽  
Model Versus ◽  
The Impact

Abstract To address the behavioral health of nursing home (NH) residents living with dementia, training direct care staff (DCS) is essential, for the well-being of both residents and staff. We evaluated a training for DCS focused on providing care for persons with advanced dementia who are at-risk of not having care needs met, largely due to communication deficits. Staff were trained in promoting comfort and reducing distress through person-directed care (PDC), deeply knowing each resident, and anticipating needs. Subsequent fidelity interviews with staff showed a higher number of PDC practices utilized by staff in the intervention communities compared to usual care. We also compared the impact of the PDC model versus a traditional model of NH care on resident clinical outcomes, finding a significant interaction where those in the intervention group had fewer clinical symptoms over a 6-month period. Implications for training in the NH setting will be discussed.

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