ABSTRACT
This chapter describes the systems approach to changing practice in residential care. A residential care establishment will have two principal sub-systems, the staff sub-system and the resident or patient sub-system. The chapter examines the effect of the behaviour of care staff on residents and the relationship between care staff behaviour and organisational variables. The work on organisational processes in residential care implies that hierarchy should be reduced or eliminated and boundaries made as permeable as possible in order that flexible practice, good communication between staff, minimum specialisation among staff and close communication with the outside world is facilitated. There are several features common to systems approaches to organisational change, although different reports highlight different aspects. The systems intervention had a dual concern with care practice, and management and organisation practice. Management was asked to discuss the film with staff members and to ask the staff what their ideas were for developments within the home.
