Culture in Better Group Homes for People With Intellectual Disability at Severe Levels.
In top group homes for adults with severe ID, a shared, respectful culture drives quality more than any single program.
01Research in Context
What this study did
The team visited three group homes that had a reputation for being "better." They watched, asked questions, and read records to learn how the homes worked.
All residents had severe intellectual disability. The study used qualitative case study methods. No numbers were counted.
What they found
Each good home shared the same recipe: staff and managers led together, plans were built around the resident, and new ideas were welcome.
The culture felt respectful and enabling. Staff said "we" more than "I."
How this fits with other research
Bigby et al. (2012) looked at under-performing homes. They saw misaligned values and staff doing things "to" residents. The 2016 paper flips the lens and shows the opposite culture in action.
Gerber et al. (2011) found that untreated pain or poor sleep sparks challenging behavior. The 2016 homes likely prevent some of that trouble by listening and adjusting care quickly.
van Timmeren et al. (2016) audited Dutch support plans and saw goals shift with disability level. The 2016 homes keep goals person-centered no matter the level, showing how culture can override paperwork limits.
Why it matters
You can copy the recipe even if you can't copy the building. Share leadership in team meetings. Ask residents what they want, even if they use gestures or eye gaze. Try one new idea each week and review it together. Culture is free, but it starts with you.
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02At a glance
03Original abstract
Building on cultural dimensions of underperforming group homes this study analyses culture in better performing services. In depth qualitative case studies were conducted in 3 better group homes using participant observation and interviews. The culture in these homes, reflected in patterns of staff practice and talk, as well as artefacts differed from that found in underperforming services. Formal power holders were undisputed leaders, their values aligned with those of other staff and the organization, responsibility for practice quality was shared enabling teamwork, staff perceived their purpose as "making the life each person wants it to be," working practices were person centered, and new ideas and outsiders were embraced. The culture was characterized as coherent, respectful, "enabling" for residents, and "motivating" for staff. Though it is unclear whether good group homes have a similar culture to better ones the insights from this study provide knowledge to guide service development and evaluation.
Intellectual and developmental disabilities, 2016 · doi:10.1352/1934-9556-54.5.316