General Medicine · Medical Literature
Organisational opportunities for person-centred care in residential aged care: a focus group study with managers and staff
Abstract
Objectives To explore organisational opportunities for person-centred care in residential aged care facilities from the perspectives of managers and staff. Design A qualitative study using focus group discussions and inductive thematic analysis followed by a deductive interpretation guided by a theoretical framework. Setting Residential aged care facilities providing long-term care for older people in Sweden. Participants A total of 23 participants were recruited using purposive sampling and participated in five focus groups. Participants included assistant nurses, occupational therapists, physiotherapists, registered nurses, social service managers and healthcare managers working in residential aged care. To be included, participants had to have experience of working in residential aged care. Results The analysis generated two interconnected themes. The inductively developed theme, Creating foundations for person-centred care, described organisational conditions perceived as necessary for enabling person-centred care in residential aged care. Three subthemes highlighted the importance of establishing a safe and supportive environment, maintaining continuity of care and ensuring responsiveness to older persons’ desires and needs. The deductively developed theme, Turning foundations for person-centred care into action, interpreted these organisational foundations in relation to the three routines of the University of Gothenburg Centre for Person-Centred Care framework: initiating, working and safeguarding the partnership. Partnership was understood as a way in which organisational foundations could be enacted in everyday care, rather than as a separate inductive finding. Conclusions Person-centred care in residential aged care was described to require organisational conditions that support safe and supportive environments, continuity of care and responsiveness to older persons’ preferences and needs. The findings suggest that workforce stability, man
Clinical relevance
This study addresses a critical gap in the evidence base for person-centred care (PCC) implementation in residential aged care facilities (RACFs), a setting serving a highly vulnerable population of older persons with complex, multimorbid needs requiring continuous 24-hour support. Despite PCC being widely endorsed as the standard of care in long-term care settings, the specific organisational conditions that enable its delivery remain poorly operationalised. By capturing frontline and managerial perspectives across multiple professional disciplines, this work provides actionable insights for healthcare administrators and clinicians seeking to embed PCC systematically rather than aspirationally.
Key findings
1. QUALITATIVE STUDY — NOTE: This is an inductive/deductive qualitative focus group study (n=23 participants across 5 focus groups); no quantitative effect sizes, confidence intervals, p-values, NNT, or NNH were reported in the abstract, and none are fabricated here. 2. Thematic analysis generated two interconnected overarching themes: (1) 'Creating foundations for person-centred care' and (2) 'Turning foundations for person-centred care into action,' reflecting both organisational prerequisites and their enactment in daily practice. 3. Three subthemes identified as organisational prerequisites for PCC: (a) establishing a safe and supportive environment, (b) maintaining continuity of care, and (c) ensuring responsiveness to older persons' desires and needs. 4. The deductive interpretive layer applied the University of Gothenburg Centre for Person-Centred Care (GPCC) framework, whose three routines — initiating, working, and safeguarding the partnership — were identified as the mechanism through which organisational foundations are translated into everyday caregiving actions. 5. Partnership (a core GPCC construct) was conceptualised not as a discrete finding but as an enacting mechanism through which safe environments, care continuity, and responsiveness to preferences are operationalised at the bedside. 6. Purposive sampling captured a multidisciplinary workforce (assistant nurses, occupational therapists, physiotherapists, registered nurses, social service managers, and healthcare managers), strengthening the applicability of findings across RACF professional hierarchies; the abstract notes workforce stability and manager engagement as implied structural enablers (full conclusion text was truncated in the supplied abstract).
Practice implications
Healthcare managers in RACFs should prioritise structural investments in workforce stability — including reduced staff turnover, consistent assignment models, and adequate staffing ratios — as these are foundational prerequisites for achieving continuity of care and genuine responsiveness to residents' individual preferences, both of which are necessary preconditions for PCC. Organisations seeking to implement PCC should formally adopt a structured framework such as the GPCC model, embedding its three routines (initiating, working, and safeguarding partnership) into care planning documentation, handover protocols, and staff orientation, rather than treating PCC as an informal cultural aspiration. Multidisciplinary leadership alignment — engaging assistant nurses, allied health professionals, registered nurses, and managers in shared PCC governance — is essential, as siloed professional practice undermines the safe and supportive organisational environment identified as a core enabler in this study.