title: The impact of organisational culture on the delivery of person-centred care in services providing respite care and short breaks for people with dementia.
abstract: Ensuring the development and delivery of person-centred care in services providing respite care and short breaks for people with dementia and their carers has a number of challenges for health and social service providers. This article explores the role of organisational culture in barriers and facilitators to person-centred dementia care. As part of a mixed-methods study of respite care and short breaks for people with dementia and their carers, 49 telephone semi-structured interviews, two focus groups (N= 16) and five face-to-face in-depth interviews involving front-line staff and operational and strategic managers were completed in 2006-2007. Qualitative thematic analysis of transcripts identified five themes on aspects of organisational culture that are perceived to influence person-centred care: understandings of person-centred care, attitudes to service development, service priorities, valuing staff and solution-focused approaches. Views of person-centred care expressed by participants, although generally positive, highlight a range of understandings about person-centred care. Some organisations describe their service as being person-centred without the necessary cultural shift to make this a reality. Participants highlighted resource constraints and the knowledge, attitudes and personal qualities of staff as a barrier to implementing person-centred care. Leadership style, the way that managers' support and value staff and the management of risk were considered important influences. Person-centred dementia care is strongly advocated by professional opinion leaders and is prescribed in policy documents. This analysis suggests that person-centred dementia care is not strongly embedded in the organisational cultures of all local providers of respite-care and short-break services. Provider organisations should be encouraged further to develop a shared culture at all levels of the organisation to ensure person-centred dementia care.
authors.affiliation: Gateshead Health NHS Foundation Trust, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Kirkley
authors.forename: Claire
authors.initials: C
authors.lastname: Bamford
authors.forename: Marie
authors.initials: M
authors.lastname: Poole
authors.forename: Hilary
authors.initials: H
authors.lastname: Arksey
authors.forename: Julian
authors.initials: J
authors.lastname: Hughes
authors.forename: John
authors.initials: J
authors.lastname: Bond
mesh_terms: D001291:Attitude of Health Personnel; D017028:Caregivers; D003704:Dementia / Q000628:therapy*; D005260:Female; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D015279:Organizational Culture; D018802:Patient-Centered Care; D012144:Respite Care / Q000523:psychology*; D012947:Social Work; D006113:United Kingdom