Managers' Perspectives of an Effective Health and Social Care Worker in the Independent Sector: An Ethnographic Study

Abstract

Aim: This thesis presents an ethnographic investigation into the perceptions of managers in the independent health and social care sector regarding the characteristics of effective health and social care workers. The study investigates the managerial perspective of the values, skills, knowledge, and functional behaviours regarded essential for providing high-quality care services to adults who may be at risk. Using an ethnographic methodology, the study seeks to glean rich and nuanced insights from managers who play a central role in moulding and supervising the Health and Social Care workforce. Background: Health and social care workers require a variety of skills and knowledge for them to be perceived as effective by their managers. The skill and behavioural requirements range from the practicalities of supporting people with their daily living tasks, including clinical support, to high levels of emotional intelligence to support the sociological, psychological, and emotional wellbeing of people who access health and social care services. Health and social care frontline workers require a sophisticated level of emotional intelligence with positive, personal attributes such as patience, kindness, empathy, and compassion. Methodological approach: An interpretive, ethnographic design was adopted for the study incorporating symbolic interactionism with social constructionism as a lens with which to analyse the outcomes from the research question. Individual, semistructured ethnographic interviews were conducted with ten managers (n=10), and 18 two focus groups were held in which participants were asked to identify the characteristics that, in their opinion, constitute an effective frontline worker. The leadership focus groups included eleven managers in total (n=5 + n=6) therefore twenty-one participants in total (n=21) plus field notes thus achieving triangulation. The data was analysed using Ricoeur’s thematic analysis framework. Findings: Communities of practice are naturally inherent in well performing teams. On a service level this is brought about through the behaviours of effective frontline workers, creating cultures of effective communication and continual, shared learning to enhance the lives of their service users. One may suggest a culture of experiential learning begins through the metamorphic, liminal experience of integrating staff members into the organisational culture. Liminality is present in the experience of individual workers, teams and the ‘living organisation’. It is a catalyst, in which processes happen spontaneously, leading to consideration of 21st century healthcare and compassion in caring; essential for the transformative, person-centred healthcare required in contemporary practice. Recommendations: Recommendations included the development of a professional identity through communities of practice, an educational push towards enhancing staff self-actualisation, and the cultivation of organisational culture, all of which would lead to compassionate care with a focus on facilitating service user safety and happiness.