University of Worcester Worcester Research and Publications

Digging deep: how organisational culture affects care home residents' experiences

Killett, A., Bowes, A., Brooker, Dawn ORCID:, Burns, D., Kelly, F., La Fontaine, Jenny, Latham, Isabelle ORCID:, O'Neill, M., Poland, F. and Wilson, M. (2014) Digging deep: how organisational culture affects care home residents' experiences. Ageing and Society, 36 (1). pp. 160-188. ISSN 0144-686X

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Organisational culture of institutions providing care for older people is increasingly recognised as influential in the quality of care provided. There is little research, however, that specifically examines the processes of care home culture and how these may be associated with quality of care. In this paper we draw from an empirical study carried out in the United Kingdom (UK) investigating the relationship between care home culture and residents’ experience of care. Eleven UK care homes were included in an in-depth comparative case study design using extensive observation and interviews. Our analysis indicates how organisational cultures of care homes impact on the quality of care residents receive. Seven inter-related cultural elements were of key importance to quality of care. Applying Schein’s conceptualisation of organisational culture, we examine the dynamic relationship between these elements to show how organisational culture is locally produced and shifting. A particular organisational culture in a care home cannot be achieved simply by importing a set of organisational values or the ‘right’ leader or staff. Rather, it is necessary to find ways of resolving the everyday demands of practice in ways that are consistent with espoused values. It is through this everyday practice that assumptions continuously evolve, either consistent with or divergent from, espoused values. Implications for policy makers, providers and practitioners are discussed.

Item Type: Article
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© Cambridge University Press 2014. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Uncontrolled Discrete Keywords: residential care, nursing homes, culture, quality of care, dementia
Subjects: H Social Sciences > H Social Sciences (General)
Divisions: College of Health, Life and Environmental Sciences > School of Allied Health and Community
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Copyright Info: Open Access article
Depositing User: Isabelle Latham
Date Deposited: 16 Oct 2019 15:36
Last Modified: 17 Jun 2020 17:32

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