The impact of leadership and management approaches on the delivery of excellence in social care services

Abstract

This research examines the impact of leadership and management approaches on the delivery of excellence in social care. It focuses on four residential care homes with nursing, operated by a national Third Sector provider of services for disabled people. The purpose of the study was to investigate how services defined quality and to examine the extent to which leadership and management approaches facilitated staff engagement in quality improvement and contributed to 'Good' or 'Excellent' Care Quality Commission ratings. This multi-method, qualitative study was underpinned by a phenomenological research philosophy. Data collected from semi-structured interviews with managers and care supervisors was triangulated through the analysis of opinion data from rating questionnaires completed by frontline nursing, care staff and non-care staff. Data was analysed using methods adapted from Interpretative Phenomenological Analysis. The study did not establish a clear association between leadership and management approaches and the achievement of a 'Good' or 'Excellent' CQC rating. The collaborating organisation's comprehensive operational policy framework and ethos of service user empowerment appeared to be higher determinants of service quality than leadership and management approaches. However, findings did indicate that, where leadership and management approaches help followers to feel valued and psychologically safe, managers can engage staff successfully in the quality improvement process. An unexpected outcome of the study was that it identified a possibility that an individual's leadership and management approaches may change when they are highly stressed, causing a negative impact on their followers, the working environment and the service culture. It was beyond the scope of this research to take forward an exploration of these issues. However, it provides the opportunity for further research to examine the ways in which managers respond to high stress levels, how followers are affected when managers are overly stressed and the overall implications for staff welfare and service quality in the social care context.