Practice leadership and active support in residential services for people with intellectual disabilities: an exploratory study.
Practice leadership lifts active support only when the whole management system is strong.
01Research in Context
What this study did
The team visited group homes for adults with intellectual disabilities. They watched how front-line managers coached staff and how staff helped residents cook, shop, and join activities.
They also rated the wider management of each service. The goal was to see if strong day-to-day leadership made staff give better active support.
What they found
Good on-the-floor leadership only helped when the whole house was well run. If top management was weak, even great practice leaders could not raise support quality.
Most homes started with low practice leadership, so there was room to grow.
How this fits with other research
Bould et al. (2019) later tracked the same homes over time. Their larger study confirms the 2014 picture: practice leadership and trained staff are the two biggest levers for better Active Support.
Lemons et al. (2015) gave us the ruler. They built and tested a quick observational tool that now lets you score practice leadership in real time. The 2014 findings were the first hint that the construct mattered; the 2015 paper made it measurable.
Friedman (2018) looked at a different lever—DSP continuity. That paper shows keeping the same support worker also lifts client quality of life. Together the studies say: fix the system (leadership + management) and keep the staff.
Why it matters
You can coach a house manager to give better practice leadership, but only if the wider organisation backs them. Before you train, check pay, policies, and paperwork are solid. Pair leadership coaching with management audits; the combo is what moves active support scores.
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02At a glance
03Original abstract
BACKGROUND: We hypothesised that a key factor determining the quality of active support was 'practice leadership' - provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. METHOD: Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. RESULTS: There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. CONCLUSIONS: A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities.
Journal of intellectual disability research : JIDR, 2014 · doi:10.1111/jir.12099