Abstract

Background: Co-worker relationships in care homes influence quality of work life and quality of care for residents. In care homes collaborative co-worker relationships are consistently linked to positive outcomes. To date, the evidence around co-worker relationships in care homes is mostly descriptive and lacks insight into how relationships are established and what influences them. Better understanding around how co-worker relationships are established would enable workforce researchers to work with the sector to develop interventions designed to facilitate collaborative co-worker relationships.

The aim of the scoping review was to understand what is known about co-worker relationships and their applicability to care homes. We synthesised evidence from broader health and social care settings, which allowed us to draw on theories and find interventions potentially useful for a care home context.

Methods: A scoping review was undertaken to understand what promotes co-worker relationships in health and social care settings, and to determine the volume, scope and quality of research in this field. Review methods followed scoping review guidance. Data were analysed using thematic analysis.

Findings: 42 papers were included in the review. Three key findings offer suggestions about co-worker relationships in care homes. First, collaborative co-worker relationships depend on the personal values of individuals i.e., being willing to build respectful relationships and having positive attitudes (caring, kind, and compassionate) towards colleagues. Second organisational structures such as: supervisor role modelling and collaborative cultures help staff to work in ways that they are able to express their personal values when working with their colleagues. Evidence described however, suggests that because of the complexity of health and social care environments, difficult workplace interactions can occur even amongst supportive and collaborative teams, and that to some extent difficult workplace interactions are part of everyday working life. Our third key finding highlights the importance of social competence for staff when navigating their workplace relationships. In this review socially competent individuals understood the rules of communication and were able to avoid difficult interactions and resolve conflict caused by their dynamic environment. This was achieved by being tactful, and carrying out careful surveillance of the environment i.e., observing colleagues from a distance, and deciding when the best time to approach, absorbing the atmosphere and adjusting behaviours to suit the situation. Social competence also includes considering other co-workers' perspectives concerning a situation, learning from past experiences, and applying it to social interactions.

Discussion: To date studies have focused on promoting effective leadership and employing values based recruitment for promoting quality. We offer an additional perspective suggesting social competence as being important for staff to navigate the complex and dynamic work environments they experience on a day-to-day basis. In the absence of a good leader, social competence helps staff to adapt to difficult situations and protects their working relationships. This review is important and timely, and will assist care home managers to consider how to promote and improve effective team working. It will also provide the foundations for informing future research aimed at improving co-worker relationships in care homes for the benefit of residents.

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