Exploring dimensions of culture in good services for adults with severe and profound intellectual and developmental disabilities

Introduction: Previous research has conceptualised culture across five dimensions: ‘alignment of power-holder values’, ‘regard for residents’, ‘perceived purpose’, ‘working practices’ and ‘orientation to change and ideas. This research explored these dimensions of culture in services rated as providing good support. Methods: Participant observations were carried out over 12 months, in two services (in different organisations) that supported 12 people with

intellectual disabilities. In addition, interviews were carried out with 25 frontline staff or practice leaders and 3 senior managers. Results: Although services were rated as good initially, over time changes in quality were observed. Services differed in which areas of support were rated as good. These differences allowed exploration of the variations possible across each dimension of culture and the relationships between culture and practice. Whereas in previous research, services tended to show similar patterns across dimensions, this research revealed differences in performance across dimensions both

within and between services. For example, service A was more open to change and ideas and stronger on regard for residents whilst weaker on working practices. Service B was better on working practices but weaker on regard. Implications: This study has illustrated the complexity of the relationships between dimensions of culture. This has implications for the ways in which culture can be measured and addressed.