“Let the people you’re supporting be how you learn”: a grounded theory study on quality support from the perspective of disability support workers

Abstract

PurposeQuality disability support is fundamental to the lives of many adults with acquired neurological disability. However, little is known about the factors that influence the quality of paid support. This study is part of a larger project to develop a holistic understanding of quality support, grounded in the experience of people with acquired neurological disability, close others, and disability support workers. The current study focuses on the support worker perspective.MethodsFollowing constructivist grounded theory methodology, interviews were conducted with 12 support workers. Grounded theory analysis was followed to develop themes and subthemes and build a model of quality support.ResultsFive key themes, with fifteen subthemes emerged to depict factors influencing the quality of support. The five themes are: being the right person for the role, delivering quality support in practice, working well together, maintaining and improving quality support, and considering the broader context. Findings emphasise the importance of the support worker recognising the person as an individual and respecting their autonomy.ConclusionsCritical to quality support is centring the needs and preferences of people with disability, improving support worker working conditions and supporting people with disability and support workers to build effective, balanced working relationships.IMPLICATIONS FOR REHABILITATIONDelivering quality support in practice relies upon the support worker recognising, centring, and respecting the autonomy of the person with disability.To deliver quality support, support workers need to feel valued, be committed to the role and actively work to maintain and improve the quality of support provision.Quality support provision is facilitated by the support worker and the person with disability effectively balancing boundaries and friendship, and in turn building a quality working relationship.