Organisational Structures and Processes Associated with Good Active Support

Introduction: Use of Active Support leads to higher quality support and increased engagement for people with intellectual disabilities in group homes. It has proved difficult to implement. Many propositions but little evidence exists about the organisational factors associated with good Active Support. We aimed to identify and categorise these and develop a predictive model of those associated with good Active Support.
Methods: Data about resident characteristics, quality of active support, strength of practice leadership, staff and organisational characteristics and senior staff perceptions were collected in 2017 from253 individuals in 71 services, from 14 organisations. Qualitive organisational data were analysed thematically, transformed into categories and developed into a 4-item scale which was subsequently analysed using hierarchical linear modelling.
Results: Good Active Support was predicted by higher levels of adaptive behaviour, small size of group homes, stronger practice leadership, more positive perceptions of management by staff, and a higher score on the 4-item scale of senior leadership focus on practice and organisation of practice leadership. The model explained 19% of variance between individuals, 64% between services and 88% between organisations.
Implications: These findings reinforce the importance of front-line practice leadership to the quality of support and point to the significance of a strong commitment to practice by senior managers and the way practice leadership is organised.