Exploring relationships in care homes : a constructivist inquiry. Vol.1.

Relationships are an integral part of living, working and visiting in care homes. However, few studies have considered relationships as their main focus of enquiry, and there has been a relative dearth of work that has included the perspectives of residents, staff and families. This study sought to redress this imbalance. Using a constructivist approach the nature and types of relationships between residents, staff and families were explored in three homes through a combination of methods including participation, observation, interviews and focus groups. Data collection and analysis occurred concurrently and three types of relationships were identified: pragmatic relationships, which had as their primary focus the instrumental aspects of care; personal and responsive relationships that engaged more fully with the wider needs of individual residents; and reciprocal relationships that sought to recognise the contribution of residents, staff and families to creating a sense of community within the homes. More detailed analysis revealed a number of factors that helped to shape the relationships with each home including: the personal motivations and values of staff; leadership style; teamwork, and the input of residents and families. Findings from the thesis enhance our understanding of the importance of, and dynamics contributing to, relationships within a care home setting. These insights are considered with reference to current notions of person centred and relationship centred care and a framework for promoting a relationship centred approach is ii presented. Implications for policy, practice and education are considered and recommendations made