The development of the Person-Centred Situational Leadership Framework: Revealing the being of person-centredness in nursing homes

Aims and objectives: To implement and evaluate the effect of using the Person-Centred Situational Leadership Framework to develop person-centred care within nursing homes.

Background: Many models of nursing leadership have been developed internationally in recent years but do not fit with the emergent complex philosophy of nursing home care. This study develops the Person-Centred Situational Leadership Framework that supports this philosophy. It forms the theoretical basis of the action research study described in this article.

Methods: This was a complex action research study using the following multiple methods: nonparticipatory observation using the Workplace Culture Critical Analysis Tool (n = 30); critical and reflective dialogues with participants (n = 39) at time 1 (beginning of study), time 2 (end of study) and time 3 (6 months after study had ended); narratives from residents at time 1 and time 2 (n = 8); focus groups with staff at time 2 (n = 12) and reflective field notes. Different approaches to analyse the data were adopted for the different data sources, and the overall results of the thematic analysis were brought together using cognitive mapping.

Results: The Person-Centred Situational Leadership Framework captures seven core attributes of the leader that facilitate person-centredness in others: relating to the essence of being; harmonising actions with the vision; balancing concern for compliance with concern for person-centredness; connecting with the other person in the instant; intentionally enthusing the other person to act; listening to the other person with the heart; and unifying through collaboration, appreciation and trust.

Conclusions: This study led to a theoretical contribution in relation to the Person-Centred Practice Framework. It makes an important key contribution internationally to the gap in knowledge about leadership in residential care facilities for older people.

Relevance to clinical practice: The findings can be seen to have significant applicability internationally, across other care settings and contexts.