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Dimensions of group home culture as predictors of quality of life outcomes
- Authors:
- HUMPHREYS Lincoln, BIGBY Christine, IACONO Teresa
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 33(6), 2020, pp.1284-1295.
- Publisher:
- Wiley
Background: Research has shown that there is variability in quality of life (QOL) outcomes for people with intellectual disabilities who live in group homes. The aim was to examine dimensions of group home culture as predictors of QOL outcomes. Method: The Group Home Culture Scale (GHCS) was used to measure staff perceptions of culture in 23 group homes. QOL data were available from 98 people with intellectual disabilities. Multilevel modelling was used to examine the associations between the GHCS subscales and four QOL‐dependent variables. Results: Of the GHCS subscales, Effective Team Leadership and Alignment of Staff with Organizational Values significantly predicted residents’ engagement in activities. Supporting Well‐Being significantly predicted residents’ community involvement. None of the GHCS subscales significantly predicted domestic participation and choice making. Conclusions: The findings suggest that strategies to improve Effective Team Leadership and Supporting Well‐Being dimensions of culture may contribute to enhancing certain QOL outcomes. (Edited publisher abstract)
Quality of practice in supported accommodation services for people with intellectual disabilities: what matters at the organisational level
- Authors:
- BIGBY Christine, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 45(3), 2020, pp.290-302.
- Publisher:
- Taylor and Francis
Background: Organisational and service level factors are identified as influencing the implementation of Active Support. The aim was to explore differences in organisational leadership and structures to identify potential relationships between these factors and the quality of Active Support in supported accommodation services. Method: Fourteen organisations participated in this mixed methods study, which generated data from interviews with senior leaders, document reviews and observations of the quality of Active Support. Results: Qualitative analyses revealed three conceptual categories: senior leaders in organisations where at least 71% of services delivered good Active Support prioritised practice; understood Active Support; and strongly supported practice leadership. In these organisations practice leadership was structured close to everyday service delivery, and as part of frontline management. Conclusions: Patterns of coherent values, priorities and actions about practice demonstrated by senior leaders were associated with successful implementation of Active Support, rather than documented values in organisational policy or procedures. (Edited publisher abstract)
Conundrums of supported living: the experiences of people with intellectual disability
- Authors:
- BIGBY Christine, BOULD Emma, BEADLE-BROWN Julie
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 42(4), 2017, pp.309-319.
- Publisher:
- Taylor and Francis
Background: Dissatisfaction with the inflexibility of the group home model has led to the growth of supported living that separates housing from support and is thought to have greater potential for better quality of life outcomes. Comparative studies have had mixed findings with some showing few differences, other than greater choice in supported living. By investigating service user experiences of supported living this study aimed to identify how the potential of supported living might be better realised. Method: Thirty-four people with intellectual disability participated in 7 focus group interviews and 6 people in an individual interview. Data were analysed using grounded theory methods. Results: Although participants experienced greater choice and control over their everyday lives, they did not feel they controlled the way support was provided and experienced restrictions on lifestyle associated with low income. Despite their use of community places and varied social connections to family, friends, and acquaintances, most experienced loneliness. Conclusions: If the potential of supported living is to be realised, shortcomings of support arrangements must be addressed by, for example, greater consistency of support worker skills, consumer control over recruitment and rostering, and more skilled support to build friendships and manage difficult relationships. (Publisher abstract)
Predicting good Active Support for people with intellectual disabilities in supported accommodation services: key messages for providers, consumers and regulators
- Authors:
- BIGBY Christine, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 45(3), 2020, pp.279-289.
- Publisher:
- Taylor and Francis
Background: There is strong evidence about the effectiveness of Active Support. Recent research has established predictors of good Active Support as staff training, practice leadership, and service setting size. This paper explores features of organisational leadership and structures predictive of Active Support. Methods: Multilevel modelling with data from surveys, observations and interviews was used to identify predictors of Active Support at the levels of service users (n = 253), services (n = 71) and organisations (n = 14). Results: Good Active Support was predicted by: (1) positive staff perceptions of management, (2) prioritisation of practice and Active Support by senior managers, (3) strong management support for practice leadership, (4) organisation of practice leadership close to everyday service delivery, and (5) concentration of practice leadership with frontline management. Conclusion: These findings extend understanding of predictors of Active Support and provide indicators of service quality, with important implications for service providers, service users and those monitoring the quality of services. (Publisher abstract)
The home environments and occupational engagement of people with intellectual disabilities in supported living
- Authors:
- ASHLEY Danielle, FOSSEY Ellie, BIGBY Christine
- Journal article citation:
- British Journal of Occupational Therapy, 82(11), 2019, pp.698-709.
- Publisher:
- Sage
Introduction: Social inclusion for people with intellectual disabilities includes engagement in the occupations of daily life. Given the focus on people with intellectual disabilities living independently with support, identifying the qualities of their home environments is integral to understanding the possibilities for engagement in occupations of daily life and better quality of life outcomes. In turn, this can inform the types of person-centred supports, such as active support, necessary to enable increased engagement for people with intellectual disabilities. Method: A case study methodology and mixed methods were utilised to develop an in-depth understanding of the home environments of six people with intellectual disabilities in supported living, and their experience of how these environments impacted their occupational engagement both at home and in their community. Semi-structured interviews and observation of participants’ home environments, using the Residential Environment Impact Survey – Short Form, were completed. Findings: Participants valued the opportunity to be self-reliant and live in their own homes. They had adequate means to engage in basic daily activities; however, their homes lacked expression of their occupational identity, and they had minimal occupational opportunities and demands, resulting in limited occupational engagement. Conclusion: For people with intellectual disabilities, it is important to increase opportunities for participation in valued occupations that foster social identities, and to provide adequate environmental supports and demands, to enable sustained occupational engagement and social inclusion. (Publisher abstract)
Comparing costs and outcomes of supported living with group homes in Australia
- Authors:
- BIGBY Christine, BOULD Emma, BEADLE-BROWN Julie
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 43(3), 2018, pp.295-307.
- Publisher:
- Taylor and Francis
Background: Supported living is perceived as more flexible than group homes for people with intellectual disability. This study identified costs and factors associated with quality of life (QOL) in supported living and compared this with group homes. Method: Thirty-one residents in supported living participated in a survey incorporating measures of service user characteristics and QOL. Participants in supported living were compared to a sample of 397 people in 96 group homes, and QOL outcomes compared for a matched sample of 29 people in supported living and group homes. Results: QOL differed little, supported living was cheaper, and 30–35% of both groups had similar support needs. Being younger, having autism, better health, family support, and participation in structured activities were associated with better outcomes in supported living. Conclusions: Supported living holds potential for group home residents, but greater support is required in domains such as health and interpersonal relationships. (Edited publisher abstract)
Implementation of active support over time in Australia
- Authors:
- BIGBY Christine, BOULD Emma, BEADLE-BROWN Julie
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 44(2), 2019, pp.161-173.
- Publisher:
- Taylor and Francis
Background: Research indicates the value of active support in achieving good outcomes across a number of quality of life domains for people with intellectual disabilities. However, implementation is not easy, and little research has explored why. The study aimed to identify some of the factors that impact on implementation of active support in supported accommodation services. Methods: Data on the quality of active support, staff training and practice leadership were collected through staff questionnaires, observations and manager interviews, for between two and four years across six organisations. Results: Active support improved over time for more able people with intellectual disability, but not for people with higher support needs. There was a weak positive correlation between active support and (1) practice leadership scores, and (2) the percentage of staff reporting active support training. Conclusions: It is important to recognise the influence of practice leadership and staff training on the quality of support and ensure provision for these in funding schemes. (Edited publisher abstract)