Page 72 - Demo

Chapter 370Quality of Care dilemmaAccording to CoP participants, support staff did not have much time to spare beyond their care duties. However, they also felt responsible to provide clients with optimal care and felt compelled to implement innovations that would enable them to do so better. This resulted in support staff being faced with a so called %u2018quality of care dilemma%u2019, meaning that adequately meeting clients%u2019 short term needs, by working their shifts to provide daily care and support in clients%u2019 homes, competes with serving clients%u2019 long term needs, by attending meetings and spending time outside the clients%u2019 homes, in information meetings and trainings. The moment you are very busy and work a lot of shifts, the willingness to immerse yourself in other things diminishes. You are less inclined to go to such an information evening in your free time. (Support staff worker, meeting 1C)Reducing time constraints was therefore seen as paramount to reduce this dilemma. Insights were that support staff would have ideas on how to organise this, in addition to front line managers who were working within the constraints set by higher management. Nevertheless, if managers freed up direct support staff from working with clients, they could still feel guilty as clients would be affected by facing substitute workers and unknown support staff. A lot of essential time for the client is lost. And I think that%u2019s something you often have to deal with on the work floor. (Support staff worker, meeting 1C) When implementing innovations in intellectual disability care organisations, front line managers should need to take into account the quality of care dilemma support staff have to cope with. Knowing what it does to colleagues on the floor. Who are already busy with all kinds of things and are actually tiptoeing around a staff shortage and yet another person dropping out because he or she has been struggling for too long. There is