Leadership in the care home sector.

LEADERSHIP IS VIEWED as a complex phenomenon involving leaders, followers, situations and the variables that impact on them (Yura, Ozimek and Walsh 1981). A grasp of proficient leadership skills and concepts enables leaders to understand and control events more effectively in the work place. The area of leadership is well researched, but literature related to the elderly care home sector is scarce. While nursing leadership develops, what literature there is focuses on higher level leadership with little at lower levels where care is delivered. The time has surely come for leaders to think carefully about the quality of support provided to staff working in the elderly care home sector. Clients’ physical needs are being met according to the health and safety at work legislation, but promoting a balance between the personal and work lives of staff demands understanding from leaders. It is paramount that nurses and care assistants providing frontline care are satisfied with the complex interaction of work, family and social life (Nazarko 1996), so clinical leaders can improve their working lives by considering their psychosocial needs (Binnie 1998). Leaders therefore must create and maintain environments that support and motivate staff (Barnum and Mallard 1989) in order to have an effective workforce. This study uses a case study approach to investigate whether current leadership styles in the elderly care sector promote a balance between personal and work lives for healthcare workers, and so optimise care provision. Method This study was carried out at two sites; one in the private sector and one in the voluntary sector. The sample was purposive and consisted of 18 participants; three nurses and seven carers from the private care home unit, and two nurses and six carers from the voluntary organisation. All participants had been in service for at least six months. Structured and semi-structured interviews were undertaken and participant observation data were collected to increase the study’s reliability and validity by having a mixed approach. Literature review, knowledge and experience were used to inform the research methods. The important issues that emerged from the structured interviews informed the areas to be explored in the semi-structured interviews. Due to the study’s explorative nature, ethical approval was sought from the local ethics committee. Access to the subjects was agreed with the care home matrons and, due to competition in the elderly care sector, declarations of confidentiality were signed with both organisations. Written and verbal consent was obtained from participants and confidentiality and anonymity were assured. Structured interviews were used to discover what experience interviewees had of particular topics or situations and to broaden the data. They also identified important issues. The results helped develop the semi-structured interview schedule for key informants. Interviews were tape-recorded, transcribed and transferred to disk, and the data managed using Ethnograph software (Seidel, Friese and Leonard 1995). Weber’s (1995) framework was used to analyse the content of the semi-structured interviews. A participant observation approach was adopted as it emphasises the importance of human meanings, interpretations and interactions (Jorgensen 1989). Data were recorded using the molar approach (Polit and Hungler 1999). After three months in each setting, staff