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Abstract Background Intellectual disability services have and continue to experience changes in service provision. This has an implication for leadership in practice as the quality of leadership has a direct influence on staff practice and care provided. Aim To design, deliver, and evaluate a leadership programme for nurse and social care managers in Ireland. Design An accredited programme was designed based on evidence from literature, practice, and national expertise. A cross-sectional survey was used to collect information on the attitudes and behaviour of participants before commencing and after completing the programme. Data from the questionnaires were analysed using SPSS and open-ended questions were analysed using content analysis. Setting Intellectual disability services. Participants 102 participants completed the programme and survey. Methods Pre-post survey and reported using the CROSS guidelines. Results Participants’ expectations were rated highly, and all items scored higher in the post-survey. Qualitative data was overall positive regarding opportunities for more time to work through each aspect of the programme. The key learning was through the forum day where participants shared their group projects. Conclusions Overall, the programme was positively evaluated and through engaging with the programme participants’ perceptions moved from seeing leadership as mostly task-oriented to realising that qualities such as good communication, person-centredness, advocacy, supporting, role modelling, and empowering are key to leadership.

Background: Intellectual disability services have and continue to experience changes in service provision. This has an implication for leadership in practice as the quality of leadership has a direct influence on staff practice and care provided. Aim: To design, deliver, and evaluate a leadership programme for nurse and social care managers in Ireland. Design: An accredited programme was designed based on evidence from literature, practice, and national expertise. A cross-sectional survey was used to collect information on the attitudes and behaviour of participants before commencing and after completing the programme. Data from the questionnaires were analysed using SPSS and open-ended questions were analysed using content analysis. Setting: Intellectual disability services. Participants: 102 participants completed the programme and survey. Methods: Pre-post survey and reported using the CROSS guidelines. Results: Participants' expectations were rated highly, and all items scored higher in the post-survey. Qualitative data was overall positive regarding opportunities for more time to work through each aspect of the programme. The key learning was through the forum day where participants shared their group projects. Conclusions: Overall, the programme was positively evaluated and through engaging with the programme participants' perceptions moved from seeing leadership as mostly task-oriented to realising that qualities such as good communication, person-centredness, advocacy, supporting, role modelling, and empowering are key to leadership. [ABSTRACT FROM AUTHOR]

Background: The strength of practice leadership predicts the quality of Active Support but it can be compromised by other demands on frontline managers. The study aimed to identify and understand differences in practice leadership over time and between organisations. Method: Data collected in 2022 in 96 services from 11 organisations using the Observed Measure of Practice Leadership were compared to similar data from 2013 and 2018. Qualitative fieldnotes were analysed thematically. Findings: Practice leadership scores increased significantly between 2013 and 2018 but declined significantly between 2018 and 2022. Scores were significantly higher in organisations that had implemented Active Support since 2013 compared to later adopters. Higher scoring organisations had structures that supported frontline managers with practice leadership and that countered increasing administrative demands. Conclusions: Establishment of support structures for practice leadership by organisations warrants further investigation together with the relative importance of each task of practice leadership. [ABSTRACT FROM AUTHOR]

Background: As practice leaders, frontline managers observe staff working, provide feedback and use organisational structures to improve staff skills and focus on service‐user quality of life. This qualitative study explored the experiences and barriers for frontline managers providing practice leadership to staff in community services for adults with learning disabilities. Methods: Audio‐recorded data was collected during semi‐structured interviews with 14 frontline managers, transcribed and analysed using thematic analysis. Findings: Three themes emerged reflecting participants' experiences of barriers to their work as practice leaders, focusing on stable staff teams, 'admin' and paperwork, and developing staff, each with sub‐themes. Conclusions: Results reflect existing research and suggest new challenges relating to progress in personalisation. Frontline managers experience barriers to providing practice leadership due to contextual and individual factors described in the themes. Successful implementation of policy initiatives, for example, Transforming Care requires further research on the impact, development and provision of practice leadership for support staff. should recognise these factors influencing frontline managers and ensure suitable policies and training to support practice leadership. Accessible summary: Management for staff working with people with learning disabilities is important to help staff work well and support people to do the things they want to do.Staff need managers who are around to watch them do their work and guide them to do as well as they can.We asked managers, in Southern England how they worked with staff and what got in the way of them being around to watch staff and support them to feel confident do a better job.Managers told us they have to spend too much time doing paperwork and staff are hard to recruit, leading to people with learning disabilities having lots of new different staff which makes it hard to develop good stable relationships. [ABSTRACT FROM AUTHOR]

Purpose: This article aims to analyse the relationship between staff burnout and resistance to change as well as the implications for leadership., Design/methodology/approach: The Job Demands Resource Model, the Social Exchange Theory, and the Model of Socially Induced Burnout were used to analyse the relationship of burnout with resistance to change., Findings: Leadership support is essential in reducing the influence of job demands on staff and on overcoming burnout so that resistance to change is prevented., Originality/value: This lies on the development of a leadership approach based on the factors that influence burnouted staff against change., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Organisational and service level factors are identified as influencing the implementation of Active Support. The aim was to explore differences in organisational leadership and structures to identify potential relationships between these factors and the quality of Active Support in supported accommodation services. Method: Fourteen organisations participated in this mixed methods study, which generated data from interviews with senior leaders, document reviews and observations of the quality of Active Support. Results: Qualitative analyses revealed three conceptual categories: senior leaders in organisations where at least 71% of services delivered good Active Support prioritised practice; understood Active Support; and strongly supported practice leadership. In these organisations practice leadership was structured close to everyday service delivery, and as part of frontline management. Conclusions: Patterns of coherent values, priorities and actions about practice demonstrated by senior leaders were associated with successful implementation of Active Support, rather than documented values in organisational policy or procedures. [ABSTRACT FROM AUTHOR]

Background: There is strong evidence about the effectiveness of Active Support. Recent research has established predictors of good Active Support as staff training, practice leadership, and service setting size. This paper explores features of organisational leadership and structures predictive of Active Support. Methods: Multilevel modelling with data from surveys, observations and interviews was used to identify predictors of Active Support at the levels of service users (n = 253), services (n = 71) and organisations (n = 14). Results: Good Active Support was predicted by: (1) positive staff perceptions of management, (2) prioritisation of practice and Active Support by senior managers, (3) strong management support for practice leadership, (4) organisation of practice leadership close to everyday service delivery, and (5) concentration of practice leadership with frontline management. Conclusion: These findings extend understanding of predictors of Active Support and provide indicators of service quality, with important implications for service providers, service users and those monitoring the quality of services. [ABSTRACT FROM AUTHOR]

Background: Active Support, now widely adopted by disability support organizations, is difficult to implement. The study aim was to identify the factors associated with good Active Support. Methods: Data on service user and staff characteristics, quality of Active Support and practice leadership were collected from a sample of services from 14 organizations annually for between 2 and 7 years, using questionnaires, structured observations and interviews. Data were analysed using multilevel modelling (MLM). Results: Predictors of good Active Support were adaptive behaviour, practice leadership, Active Support training, and time since its implementation. Heterogeneity, having more than six people in a service and larger organizations were associated with lower quality of Active Support. Conclusions: In order to ensure that Active Support is consistently implemented, and thus, quality of life outcomes improved, organizations need to pay attention to both service design and support for staff through training and practice leadership. [ABSTRACT FROM AUTHOR]

In the first article of this series, we focused on the need for PMOs to become digital to stay valuable for their organization and continue to improve and adopt industry trends; and to be more equipped to support their organizations' digital transformations. We explored the PMOs landscape today and what is expected of them to do and not do to transition to digital and how the internal readiness and external readiness preparation play an essential role in ensuring success in digitalize themselves and be ready for their organizations' digital shift. In this second article, we explored what it means to be a product-based and differentiate the areas of focus for a product based vs. a project-based organization. Further, provided the required elements for a successful transformation and explained the details for each of these elements. Leveraging an organization transformation journey to illustrate the challenges and benefits from a product-based model, and explored what changes the new model needs to implement to ensure success, and what are the expected outcomes and measures. Finally, the success of the new model relies on the orchestration of the various functions namely the EPMOs/PMOs after they are reinvented, as well as propose a new oversight function to be setup to support the product-based organization in the digital landscape. In this third and final article, the authors will showcase a case study of TD Bank and their journey in achieving success in transforming from a project-based organization to a product-based. We will explore the steps that TD's leadership has taken through multiyear planning, delivering, and sustaining each stage of their evolution. The case will feature the drivers to the change, the components that changed and the components that remained, the outcome as results, successes, and challenges. The final objective of sharing TDs journey is to allow organizations and individuals involved in Digital transformation, Product based transformation, the sustainability of Agile, and improving DevOps to reflect on their journeys and be more prepared to respond to continuously evolving ways of work imposed by clients, internal stakeholders, and competition. [ABSTRACT FROM AUTHOR]

Accessible summary: We looked at staff working with people with a learning disability and challenging behaviour. We tried to find out if managers' help their staff to work better.We looked at how often staff saw their manager and if their manager tried to help their staff to work better or spent more time doing office work.We found out that when managers helped staff to work better, staff feel better about their work. Even when staff did not see their manager very often, other staff were helping them to do their work better.Organisations need to decide who will help staff to work better, and this will also help staff to feel better about their work. Introduction: Research has shown a positive relationship between practice leadership (frontline management focused upon supporting staff to work better) and better staff experiences of working with people with learning disabilities who may show challenging behaviours. However, little is known regarding the impact of frequency and accessibility of frontline managerial support upon staff experiences, or upon the provision of practice leadership. Current policy and practice in England may lead to frontline managers being responsible for more fragmented services, thus influencing the accessibility of managerial support and practice leadership for staff. The current study investigated the impact on staff experiences of frequency of contact with service manager and of practice leadership. Methods: A single point in time survey of 144 staff measured: characteristics of service users, frequency of contact with manager, practice leadership and staff experiences, for example burnout, teamwork and job satisfaction. Results: Practice leadership was positively associated with more frequent contact with the manager. Better staff experiences were associated with more frequent contact with the manager and practice leadership and negatively with challenging behaviours. Conclusion: The associations between practice leadership, manager contact and better staff experiences suggest further research, and organisational action is needed to provide management support for staff. [ABSTRACT FROM AUTHOR]

Background: Research indicates the value of active support in achieving good outcomes across a number of quality of life domains for people with intellectual disabilities. However, implementation is not easy, and little research has explored why. We aimed to identify some of the factors that impact on implementation of active support in supported accommodation services. Methods: Data on the quality of active support, staff training and practice leadership were collected through staff questionnaires, observations and manager interviews, for between two and four years across six organisations. Results: Active support improved over time for more able people with intellectual disability, but not for people with higher support needs. There was a weak positive correlation between active support and (1) practice leadership scores, and (2) the percentage of staff reporting active support training. Conclusions: It is important to recognise the influence of practice leadership and staff training on the quality of support and ensure provision for these in funding schemes. [ABSTRACT FROM AUTHOR]

Background Studies incorporating staff-rated or observational measures of practice leadership have shown that where practice leadership is stronger, active support is better implemented. The study aim was to compare measures of practice leadership used in previous research to determine the extent of their correspondence.Method A subset of data from a longitudinal study regarding 29 front-line managers working across 36 supported accommodation services in Australia was used. An observed measure of practice leadership, based on an interview and observation of a front-line manager, was compared with ratings of practice leadership completed by staff. The quality of active support was rated after a 2-hour structured observation.Results Correlations between staff-rated and observed measures were nonsignificant. Only the observed measure was correlated with the quality of active support.Conclusions This study provides evidence to support using an observational measure of practice leadership rather than reliance on staff ratings. [ABSTRACT FROM AUTHOR]

Objectives: Research shows practice leadership to be a factor in the successful implementation of active support. The aim of the study was to explore differences in staff practice, associated with the presence of a practice leader in a shared supported accommodation service. Methods: Quality of support and engagement for 189 service users with intellectual disability from 58 services were collected during a 2 h observation using the EMAC-R and ASM. The practice leader was present in 19 services (n = 59) and absent in 39 (n = 111). An Observed Measure of Practice Leadership was administered during a second visit to each service. Results: When the practice leader was present, levels of engagement and active support were statistically higher (p < 0.01). Although measured at a different time, observed practice leadership was also higher in services where the practice leader was present during the first observation. Conclusion: The level of observed practice leadership and presence of the practice leader appear to be associated with better quality of support. This finding provides further evidence of the importance of systems for supporting, monitoring, modeling, and improving staff practice for effective implementation of active support. [ABSTRACT FROM PUBLISHER]

Purpose – The purpose of this paper is to provide a commentary on Rhodes and Toogood’s article on the possible relationship between Active Support training and staff job satisfaction. Design/methodology/approach – Rhodes and Toogood unusually and importantly include outcomes for both frontline staff and service users following an Active Support intervention. This commentary builds upon this approach by drawing on ideas recently raised by Deveau and McGill (2015). Findings – A number of important themes are identified including the mutuality of direct support staff (DSS) and service user experience, the significance of considering both the formal and informal aspects of organisational culture and the value of employing a complexity theory perspective. Originality/value – Effective public services require an understanding of the factors influencing the behaviour of public service staff. In intellectual disability services, positive outcomes can only be obtained through a broader appreciation of the drivers of DSS behaviour, especially the roles played by culture and leadership. [ABSTRACT FROM AUTHOR]

Background Improving staff performance is an issue in services for people with intellectual disability. Practice leadership, where the front line leader of a staff team focuses on service user outcomes in everything they do and provides coaching, modeling, supervision and organisation to the team, has been identified as important in improving staff performance. To date this finding is based only on self-report measures. Methods This paper describes and tests an observational measure of practice leadership based on an interview with the front-line manager, a review of paperwork and observations in 58 disability services in Australia. Results The measure showed good internal consistency and acceptable inter-rater reliability. Practice leadership was associated with staff practice and outcomes for service users. The observed measure of practice leadership appears to be a useful tool for assessing whether leadership within a service promotes enabling and empowering support by staff. It was found to discriminate higher and lower performing services in terms of active support. Conclusions The measure had good reliability and validity although some further testing is required to give a complete picture of the possible uses and Conclusions The measure had good reliability and validity although some further testing is required to give a complete picture of the possible uses and reliability of the measure. The measure is potentially useful in contexts of both research and service development. The confirmation of previous findings from self-report measures that practice leadership is related to the quality of staff practice and outcomes for service users has implications for policy and practice in terms of the training of managers and structures for organisational management. [ABSTRACT FROM AUTHOR]

Aim This paper reports on the outcomes of a locally designed educational programme to support leadership capability of junior registered nurses. Background The Developing Leader Programme is an in-house programme delivered in three face-to-face workshops, comprising self-directed reflective and application activities. Method Surveys were used to evaluate self-perceived leadership capability over a 9-month period. The survey comprised a Leadership Capability Instrument adapted from two existing tools. Participants completed surveys at the commencement of the programme, after the third and final workshop and approximately 6 months afterwards. In addition, examples of descriptive accounts of programme activities submitted by individual participants were included to enrich data. Results Of 124 participants, 79 completed surveys at the first workshop, 28 at the final workshop and 31 were returned 6 months after completion of the programme. Mean scores for each area of leadership capability significantly improved throughout the duration of the programme ( P < 0.001). Participants also indicated a willingness to enact leadership behaviours through reported activities. Conclusions Survey responses indicated that participants perceived improved leadership capability after completing the Developing Leader Programme. Implications for nursing management Early educational intervention to facilitate the development of leadership skills as well as clinical skills in junior registered nurses can assist with how they interact with the team. Participation of junior registered nurses in a locally designed leadership programme can assist them to develop leadership behaviours for everyday practice. [ABSTRACT FROM AUTHOR]

Background We hypothesised that a key factor determining the quality of active support was 'practice leadership' -- provided by the first-line manager to focus staff attention and develop staff skills in providing direct support to enable people with intellectual disabilities to have a good quality of life. This exploratory study focused on what levels of practice leadership were found and its role in explaining variation in active support. Method Relevant aspects of management, including practice leadership, were assessed by questionnaires administered to staff in residential settings alongside observational measures of active support and resident engagement in meaningful activity. Relationships between these variables were explored using regression and post hoc group comparisons. Results There was wide variation, with average levels of practice leadership being low, though improving over the period studied. Practice leadership had a significant impact on active support, but was fully mediated by the effect of quality of management. When the quality of management was higher better practice leadership did produce a significant difference in active support. However, higher quality of management on its own did not produce better active support. Conclusions A number of limitations are acknowledged and further research is required. Practice leadership appears to be an important factor in enabling staff to provide active support but as part of generally good management. Given the rather low levels found, attention needs to be given to the training, career development and support of practice leaders and also to how to protect their time from their many other responsibilities. [ABSTRACT FROM AUTHOR]

A system of evidence-based periodic service review (PSR) was implemented in specialist health services for people with challenging behaviour, to support the adoption of a positive behavioural approach. The extent and accuracy of PSR implementation, its impact on staff knowledge and attitudes, and its value as a practice leadership tool were assessed. The results indicated that PSR was implemented regularly, scoring was based accurately on tangible evidence, and increased scores over time indicated service improvement in line with PSR principles. Staff generally welcomed PSR as a quality monitoring tool, and greater knowledge of the rationale and process for PSR was associated with more positive attitudes. Managers regarded PSR as a valuable aid to practice leadership and had used innovative implementation methods to maximise its acceptance by staff teams. The style of management and need for support from the wider organisational structure are discussed as critical factors in successful implementation. [ABSTRACT FROM AUTHOR]

paterson k., henderson a. & trivella a. (2010) Journal of Nursing Management 18, 78–83 Educating for leadership: a programme designed to build a responsive health care culture Aim To describe a leadership programme that progressively builds nurses capacity from the commencement of their employment to assist with the development of ‘others’. Such an approach ultimately contributes to the creation of a team responsive to changing health care needs. Background The literature supports the relationship between positive leadership attributes, good nursing care and patient outcomes. Despite this, nurses are not routinely encultured into effective leadership practices early in their career, but rather they are ‘added on’ at a later stage according to organizational need. Key issues The effective education of leadership practices in this programme is largely dependent on an inclusive and embedded approach to learning. This is achieved through targeting staff early, enhancing their responses to clinical interactions in a structured and supported approach, and challenging their beliefs about capacity to influence through leadership. Conclusions Clinical leadership education needs to directly link with clinical areas to engage staff at the commencement of employment, and support them through their career trajectory, so that a systematic pathway of professional development is fostered. Implications for nursing management Clearly delineated progressive pathways for leadership development are essential to encourage lifelong reflection and learning that directly impacts on health care quality. [ABSTRACT FROM AUTHOR]

Background: Disability support organisations have embraced Active Support, but it has proved difficult to embed in services.Aims: This study aimed to identify the factors associated with increases over time in the quality of Active Support.Method: Data were collected on the predicted variable of the quality of Active Support, and predictor variables of service user, staff and service characteristics, including practice leadership, and composition and size of services from 51 services in 8 organisations over 2-7 time points. Data were analysed using multi-level modelling.Results: There was significant linear change in Active Support scores (group mean centered at the organisational level) over time. Individuals with lower support needs received better Active Support and those with higher support needs experienced greater increases over time. Stronger practice leadership and more staff with training in Active Support were significant predictors of the quality of Active Support. Larger services with seven or more individuals and where there was a very heterogeneous mix of individuals were associated with lower quality of support.Conclusions: Ensuring strong practice leadership, and staff training in Active Support that emphasises the principle of adapting support to each individual's level of ability and preferences are key to delivering high levels of Active Support. [ABSTRACT FROM AUTHOR]