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The purpose of this paper is to describe the employment conditions of social care personal assistants (PAs) in England. In England, disabled adults have been able to directly employ people to meet their care or support needs for a number of years, little is known about the employment conditions of people who are directly employed.

PAs were recruited mainly through third sector and user led organisations. A total of 105 social care PAs took part in a semi-structured telephone interview, which on average was an hour long. Interviews were fully transcribed. Quantitative data were analysed using SPSS (v.24) and qualitative data by NVIVO software.

The paper focuses on employment conditions: contracts, pay, pensions, national insurance, overtime, holiday and sick pay, etc. Access to training and support are also described. Though PAs enjoyed considerable job satisfaction, many did not enjoy good employment conditions. Though employer abuse was uncommon, many PAs could arguably be described as exploited. Occupational isolation and lack of support to resolve disputes was striking.

Though this may be currently the largest qualitative study of PAs in the UK, it is nonetheless relatively small and no claims for generalisability are made, though the geographical spread of the sample was wide and recruited from multiple sites.

PAs are an effective way of establishing relationship-based care, and confer direct control to disabled employers. Many PAs experienced high job satisfaction. However, lack of regulation and oversight creates considerable potential for exploitation or abuse. This may make the role less attractive to potential PAs in the medium term.

Social care PAs may be a very effective means of achieving genuinely person-centred care or support for many people. However, PAs do not always appear to enjoy satisfactory conditions of employment and their role is largely unregulated. Growth and long-term sustainability of this emergent role may be jeopardised by these employment conditions.

Little is known about PA working conditions. This study suggests that much more needs to be done to improve these.

The purpose of this paper is to investigate the relationship of leadership styles (paternalistic, authentic and democratic) with relationship-based employee governance and open service innovation.

Data were collected using a structured questionnaire from 422 medical professionals working in the Malaysian healthcare sector.

Results of several statistical analyses showed that the three leadership styles positively influence relationship-based employee governance and open service innovation. Results also confirmed the mediating role of relationship-based employee governance in the relationships between the three leadership styles and open service innovation.

This research used a cross-sectional study design; use of a longitudinal research design in future research can provide a better interpretation of the underlying causality. A policy insight can be drawn from this research to generate awareness about effective leadership styles and the role of relationship-based employee governance in the successful implementation of open service innovation in the Malaysian healthcare sector.

This paper contributes to leadership, open innovation, and organizational governance literature by highlighting how leadership styles affect relationship-based employee governance and open innovation. It also offers policy insights to practitioners in the Malaysian healthcare sector on how to enhance open service innovation outcomes.

This paper aims to report on the findings of a qualitative study that explored the views and experiences of young people leaving care during the first phase of the Covid-19 pandemic in Northern Ireland.

A qualitative approach was adopted involving semi-structured interviews with 24 care leavers 18–25 years old from across the region. Interviews were conducted remotely online or by telephone and explored young people’s lived experiences during the pandemic including their views on the formal support services and how best to provide ongoing for support care leavers during the pandemic.

Study findings highlight how known adversities for care leavers are exacerbated during the pandemic, having a detrimental impact, particularly on their emotional well-being. The response of the state as a corporate parent in mitigating the impact of the pandemic was found to be inadequate; with a need for much clearer communication, transparent and prompt decision-making and targeted specialist mental health services. The account given by the young people also highlighted the importance of participation and relationship-based practice to build on the young people’s resilience in the context of high levels of social isolation and limited access to informal support systems.

This research, based on the views of care experienced young people themselves, is the first study in Northern Ireland to report on the impact of the Covid 19 pandemic on care leaving. As such it makes a contribution to this emerging international field of study and, given the persistence of the pandemic, provides empirical findings and a social justice perspective of ongoing relevance to policy and practice with young people leaving care.

Achieving meaningful participation and co-production for older people in care requires radical approaches. The purpose of this paper is to explore an innovation where learning interventions were introduced into care settings and older people matched to community-based learning mentors to develop partnerships. The authors explore how the concept of learning might be used as a paradigm to raise the quality of care in institutionalised settings using a co-productive and relationship-based approach to promote wellbeing.

A structured evaluation drew on qualitative data captured from interviews with older people (n=25) and learning mentors (n=22) to reflect on the potential benefits and challenges involved when introducing learning interventions in care settings. This was contextualised alongside data captured from stakeholders (n=10) including a care home manager, social care and education commissioners, trustees and project staff to assess the interdisciplinary contribution of lifelong learning to quality improvement.

Introducing learning interventions to older people within care settings promoted participation, advocacy and relationship-based care which in turn helped to create a positive culture. Given the current challenges to improve quality in care services, drawing on a paradigm of learning may encourage older people to retain their independence as care homes strive towards a person-centred approach. Promoting social activities and leisure using learning was found to foster closer working relationships between older people and the wider community. These had a levelling effect through reciprocity, using an asset based approach. There were benefits for the care provider as the partnerships formed enabled people to raise both individual and collective concerns about care and support.

Raising and sustaining the quality of support for older people requires input from the wider public sector beyond health and social care. Purposeful engagement with other disciplines such as learning and leisure offers the potential to realise a more sustainable model of user choice, person-centred support and user involvement. Being engaged through learning can nourish membership in the community for marginalised populations such as older people living in care homes.

A case study is reported of a relationship-based early intervention (EI) service for children with complex needs in New Zealand. The purpose of this paper is to explore parent and professional views and perceptions about the key characteristics of a relationship-based EI service.

This qualitative study involved interviews and observations with 39 participants (10 children, 11 parents and 18 professionals).

Parents appreciated the knowledgeable, well-trained professionals who invested time in getting to know (and love) children and families and family practices, worked together in harmony and valued the contribution that parents made to their child’s progress and achievement. Professionals described the key characteristics of the service in terms of the range of therapies offered by the service, the focus on a strengths-based and family-focussed approach, play-based assessments, acceptance and value of family practices (including responsiveness to Maori and bi-culturalism), appropriate and respectful places to meet and greet families and work with children, and recruitment and retention of humble professionals who identified with the ethos of the model. Observable social processes and structures within the delivery of the model include respectful professional interactions and relationships with children and families, integrated professional working, effective and timely communication between professionals and families, pedagogy of listening, waiting and personalisation, engaged families and actively participating children.

This case study emphasises the significance of professional love and relational pedagogy to EI services and the value of this to improving parent-child relationships and children’s long-term outcomes.

This paper aims to present a digest of the main discussion points and key findings from a recent Social Care Institute for Excellence report on risk enablement and safeguarding in the context of self‐directed support and personal budgets.

The paper explores how the personalisation agenda and adult safeguarding can work together in policy and practice and addresses some of the frontline concerns about empowerment and duty of care.

Evidence on how self‐directed support and personal budgets can be used to enable people to take positive risks while staying safe and emerging practice is examined. It suggests that person‐centred working in adult safeguarding, along with the mechanism of self‐directed support planning and outcome review, can support the individual to identify the risks they want to take and those they want to avoid in order to stay safe. It is clear that if frontline practitioners are overly occupied with protecting organisations and individuals from financial abuse, this will impact on the capacity of those practitioners exercising their duty of care at the front line. This means that practitioners are less able to engage with individuals to identify safeguarding issues and enable positive risk taking. Defensive risk management strategies or risk‐averse frontline practice may then result in individuals not being adequately supported to make choices and take control and, therefore, being put at risk. Practitioners need to be supported by local authorities to incorporate safeguarding and risk enablement in their relationship‐based, person‐centred working. Good quality, consistent and trusted relationships and good communication are particularly important for self‐directed support and personal budget schemes.

The use of “risk enablement panels” and “personalisation and safeguarding frameworks” are two ways to address some of the issues in practice.

For many of the current leadership theories, models, and approaches, the answer to the question posed in the title, “Is leadership more than ‘I like my boss’?,” is “no,” as there appears to be a hierarchy of leadership concepts with Liking of the leader as the primary dimension or general factor foundation. There are then secondary dimensions or specific sub-factors of liking of Relationship Leadership and Task Leadership; and subsequently, tertiary dimensions or actual sub-sub-factors that comprise the numerous leadership views as well as their operationalizations (e.g., via surveys). There are, however, some leadership views that go beyond simply liking of the leader and liking of relationship leadership and task leadership. For these, which involve explicit levels of analysis formulations, often beyond the leader, or are multi-level in nature, the answer to the title question is “yes.” We clarify and discuss these various “no” and “yes” leadership views and implications of our work for future research and personnel and human resources management practice.

This conceptually‐focused paper looks at particular changes implemented in the UK National Health Service. The specific context is the creation of a new organisational form: the primary care group, which brings together general practitioners and other primary care staff in a given locality. The paper attempts to examine the consequences, for the development of these groups, of the shift from competition (in the internal market) to relationships based on collaboration and partnership. The broad policy objectives envisage much greater emphasis on working in partnership, participating in strategy and planning (via new health improvement programmes), developing joint working, and promoting the integration of service delivery. A relationship marketing perspective is explored as one way of conceptualising the development of new relationships between primary care groups, health authorities, local authorities, trusts and other agencies and the paper suggests that relationship marketing offers a way of facilitating policy change.

For health and social care services to become truly person-centred requires a fundamentally positive mindset from professionals and care workers, and a willingness to take some risks. The purpose of this paper is to explore how this will apply to delivering dementia services, where almost all of the initial impressions are of deficits, disability and disadvantage.

The co-authors combine their knowledge and experience of supporting and developing staff working in dementia services. The concept of positive risk-taking is explored within the legislative framework of the Mental Capacity Act 2005, Safeguarding and the Care Act 2014.

Practitioners face a range of challenges when it comes to supporting people living with dementia to take risks through exercising personal choices and making their own decisions. However, the concept of positive risk-taking applies equally to people living with dementia who have or who lack mental capacity in relation to their decision making.

This paper places positive risk-taking within a context of strengths-based, values-based and relationship-based working. Practical tips are offered for putting positive risk-taking into practice.

The purpose of this paper is to explore and examine the different word-of-mouth (WOM) acceptance and diffusion in social brand communities according to the level of self-monitoring.

A web-based experimental design was used. The design consisted of three-mixed design of 2 (type of social networking sites) × 2 (type of online brand communities) × 2 (self-monitoring). ANOVA analysis was conducted.

Findings indicate that the differences in acceptance and diffusion of WOM according to online brand community type, and there was a significant three-way interaction effect. Specifically, people who have high propensity to self-monitor showed greater WOM acceptance in a consumer-driven community in either type of social networking sites while people who have low propensity to self-monitor showed greater WOM diffusion in a consumer-driven community only in interest-based social networking sites.

An important implication is that the social networking sites where brand communities can be placed should be chosen with the full consideration of different desires consumers have in terms of their level of self-monitoring to increase WOM effects.

This paper proposes the self-monitoring tendency as the key factor that predicts WOM effects with revealing the optimal combination of types of social networking sites and online brand communities that is most preferable for consumers with different self-monitoring level.