“I don't want to take any risks even if it's gonna mean this service‐user is gonna be happier”: A thematic analysis of community support staff perspectives on delivering <i>Transforming Care</i>

Clifford, Adam; Standen, Penny; Jones, Jo

doi:10.1111/jar.12495

Cited by 8 publications

(8 citation statements)

References 15 publications

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“…Clifford et al. (2018) note that the ability to balance safety and quality of life needs was a barrier to guideline implementation. The current research supports this, as often staff were well‐intending, however, reverted to a harm minimization approach when faced with conflicting demands.…”

Section: Discussionmentioning

confidence: 99%

“…Research has suggested that staff‐related barriers to implementation are sometimes driven by staff perceptions and concerns. Risk management research has illustrated that staff are concerned about the therapeutic relationship within risk management (Downes et al., 2016), a lack of guidance, support (Reddington, 2017), and the ability to balance safety and quality‐of‐life needs (Clifford et al., 2018). Downes et al (2016) found that mental health nurses believed that while risk assessment could aid professional decision‐making, some expressed concerns that the process could be dehumanizing, while others did not agree with the role of positive risk taking within recovery.…”

Section: Introductionmentioning

confidence: 99%

“…Clifford et al. (2018) found that even when clinicians endorse the concept of PRM, in practice, they still use risk‐averse approaches due to uncertainty and worry. Downes et al.…”

Section: Introductionmentioning

confidence: 99%

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Positive risk management: Staff perspectives in acute mental health inpatient settings

Just

Palmier‐Claus

Tai

2021

Journal of Advanced Nursing

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Aims To explore inpatient staff's understanding and implementation of positive risk management. Background Risk management is an essential skill for staff working in acute mental health inpatient settings. National policies advocate the use of positive risk management as a form of collaborative, recovery‐focused risk management. However, little is known about how staff understand, operationalize, and use positive risk management in practice. Design Qualitative reflexive thematic analysis study. Methods The authors recruited a purposive sample of healthcare professionals working in acute inpatient settings (N = 16) in 2019 across three National Health Service Trusts in the North‐West of England. Participants completed semi‐structured interviews which were analysed using reflexive thematic analysis. Results The analysis generated three themes: (a) within staff barriers; (b) within service user barriers; and (c) delivery in practice. Conclusion Understanding and implementation of positive risk management was dependant on multiple factors, including staffs’ beliefs about mental health, levels of worry and anxiety, and amount of experience and seniority. Staff were more likely to use positive risk management with service users that they perceived as being trustworthy and less risky. Use of positive risk management was reliant on the support practitioners received, how able they were to view situations from multiple perspectives, and the degree to which they felt able to prioritize positive risk management. Impact Although staff expressed the desire and intention to practice positive risk management, the current study highlights challenges around operationalization and implementation. The authors discuss the clinical implications of the findings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Positive risk management: Staff perspectives in acute mental health inpatient settings

Just

Palmier‐Claus

Tai

2021

Journal of Advanced Nursing

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“…Questions on the interview schedule were open, and technical language was avoided to minimise confusion (Smith & Osborn, 2015). Questions were designed following consultation of the issues related to TC obtained via systematic review of literature such as that written by Taylor et al, (2017) and Clifford et al, (2018).…”

Section: Alternative Non-nursing Profession Such As Occupational Therapymentioning

confidence: 99%

‘It's a good thing we're doing, we just need to be better at it’. Forensic intellectual disability nursing experiences of Transforming Care: A multi‐perspectival interpretive phenomenological analysis

Hudson

House

Robson

et al. 2021

Research Intellect Disabil

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The broadcast of the Panorama TV documentary featuring Winterbourne View (BBC, 2011) highlighted abusive practice towards people with an intellectual disability and/or autistic spectrum disorder in an inpatient service located in southern England. Criminal convictions for staff members followed (Hill, 2012), as did national condemnation (Morris, 2011) which led to political pressure and a subsequent inquiry into the care at this service (Flynn & Citarella, 2012). The resulting enquiry revealed deficiencies in safeguarding practice, commissioning of care and service regulation with people detained in questionable out of

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“…Failure to do so leads to feelings of oppression, powerlessness, stress and exhaustion (Quilliam et al , 2018). Clifford et al (2018) identified that collaborative risk taking and decision-making is likely to empower staff to use more values based and less restrictive strategies which is encouraged across legislation (DH, 2014; HCHL, 2019).…”

Section: Introductionmentioning

confidence: 99%

Proposal of a service delivery model for supported living community forensic services

Wark

Gredecki

2022

LHS

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Purpose Following serious case review, the Transforming Care agenda (DH, 2015) highlights the need for adults with learning disabilities, autism, mental health issues or behaviors that challenge to be supported within communities rather than hospitals. Poor or absent leadership has been identified as contributing to serious cases of abuse in health-care settings [Department of Health (DH), 2012]. This paper aims to focus on identifying the elements required for good leadership and service delivery in community forensic services (CFS). Design/methodology/approach The perspectives of 12 support workers working in CFS were obtained through semi-structured interviews. Findings Thematic analysis identified two predominant themes, namely, authentic leadership and effective team practice. A culture of trust and learning occurs when teams are well led. This culture leads to consistent practice which benefits services users and reduces risk of poor practice. Analysis suggests a framework for service delivery which is complimented by aspects of the Total Attachment model. Research limitations/implications The data set was collected from the same organisation and views may have been aligned to existing organisational policy. However, the sample was taken across different teams and geographical locations to collate more generalised experiences of team dynamics. The lead researcher works for the organisation and this dual role may have affected the candour with which individuals shared information during interviews. Practical implications Using a model to understand the functional dynamics of teams within CFS may support leaders and practitioners to improve service delivery. Social implications Improving service delivery within CFS may increase opportunity to meet the Transforming Care Agenda. Originality/value This paper examines staff perspectives and the application of theoretical frameworks to propose a unique service delivery model for supported living within CFS.

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“I don't want to take any risks even if it's gonna mean this service‐user is gonna be happier”: A thematic analysis of community support staff perspectives on delivering Transforming Care

Abstract: Recommendations are provided for how staff perspectives should inform Transforming Care in interests of service-users.

Cited by 8 publications

References 15 publications

Positive risk management: Staff perspectives in acute mental health inpatient settings

Positive risk management: Staff perspectives in acute mental health inpatient settings

‘It's a good thing we're doing, we just need to be better at it’. Forensic intellectual disability nursing experiences of Transforming Care: A multi‐perspectival interpretive phenomenological analysis

Proposal of a service delivery model for supported living community forensic services

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