Staffing adequacy, supervisory support and quality of care in long-term care settings:: staff perceptions

Aim. This paper is a report of a study to explore relationships between perceived care quality, self-assessed professional skills, and the perceptions of the quality-related factors. Background. The work in long-term care is more demanding than in the past. The quality of care is strongly related to the well-being and job satisfaction of staff. Those emerge in part through a perception of resources allocated to caring and also through a perception of the quality achieved. Method. Data were collected in Finland in 2002 using a questionnaire sent to the nursing staff working in 112 wards in 40 long-term care institutions monitoring their care with the Resident Assessment Instrument System. Institutions were invited to participate the survey. The response rate was 70.2% (n = 1262). The respondents represented 3.8% of nursing personnel working in long-term care institutions. Findings. Staff members who perceived staffing levels as inadequate and supervisory support as insufficient had lower perceptions of their own professional skills and the quality of care. Perceptions of empowering support behaviour were more strongly associated to self-assessed skills and to perceived care quality than perceptions of skills-oriented support activities. Staff members with short professional training, older staff members and staff members with long work experience in the unit had lower perceptions of their professional skills than other groups. Conclusion. The perception of adequate staffing and of sufficient supervisory support, especially empowering support increases the probability of perceiving the care quality as good. If supervisors concern themselves with staff members' perceptions, they can better identify the staffing needs and also the support needs of personnel.