What are leadership and management strategies?
Within aged care organisations, leaders and managers play an important role in upholding the rights of older people in care. They are responsible for translating the principles of rights-based care (RBC) into organisational policies and processes that enable staff to uphold rights-based values in daily practice.
Leadership and management strategies influence the provision of RBC through:
- Transformational leadership that guides organisational culture change;
- Embedding rights-based principles in governance and day-to-day practice; and
- Relational and participatory leadership that ensures staff are supported and older people are included and empowered.
Why does this matter for rights-based care?
The Aged Care Act 2024 places significant responsibility on leadership and management of provider organisations, focusing on accountability for culture, safety, inclusion, and quality of care. The governing body of an aged care provider is ultimately responsible for organisational culture, financial sustainability, and risk management. [1]
Leadership and management strategies play a defining role in shaping organisational culture and outcomes for both residents and staff. Poor leadership has been identified as a significant factor contributing to the marginalisation of individuals who are LGBTIQ+, living with dementia, or who come from diverse cultural backgrounds. [2] Poor leadership and broader organisational challenges are often underlying causes of elder abuse within aged care settings. [3]
Barriers to effective care frequently arise from inadequate leadership and management, disorganised work processes and resources, insufficient guidance, and persistent issues with collaboration and communication. [4] These challenges underscore the critical importance of strong, inclusive, and transparent leadership in promoting a safe, respectful, and equitable environment for all residents and staff.
Transformational leadership and culture change
Transformational leadership is an approach to management that focuses on achieving a shared vision rather than task delivery. It supports the implementation of complex initiatives, such as RBC, that require major changes to usual ways of working. It fosters innovation and emphasises trust which in turn improve organisational culture. [5] All levels of leadership are responsible for organisational change, including board members and administrators. [6, 7]
Implementation of RBC requires leadership to establish and uphold the culture for the organisation. [7-9] Leaders set the norms and standards within an organisation, and demonstrate a rights-informed culture through their language, beliefs and behaviours. [7, 10]
Strong, transformational leadership ensures that rights-based values are embedded throughout the organisation, through systems, structures, and processes. [11-13] Managers must ensure that the principles of respect, inclusion, and fairness underpin every aspect of care and organisational practice.
Leadership in governance and practice
RBC is upheld through monitoring, oversight, and accountability at the highest levels of an organisation. Managers and supervisors play a critical role in ensuring that the coordination and quality of care and support provided to residents meet RBC standards. [14] Their responsibility extends to overseeing daily operations and monitoring compliance with RBC principles, promptly addressing any systems failures that may arise. Boards now have clearer expectations for quality and safety oversight, reinforcing their accountability for organisational culture, risk management, and financial sustainability. [6]
Effective management also involves embracing complaints as a valuable mechanism for social regulation and organisational learning. [15] Complaints are central to residents’ rights and should be viewed as opportunities for organisational improvement rather than mere challenges to be mitigated. [15] Management must recognise and communicate that addressing complaints is fundamental to supporting RBC, as it fosters a culture of learning and improvement, and upholds residents’ rights to safety, inclusion, and quality care. [11]
Effective leadership plays a crucial role in driving practice change within aged care organisations by providing strong guidance and direction. [16, 17] Transformational leadership is essential for bridging the gap between knowledge and practical skills, for example, to ensure that principles such as Consumer Directed Care (CDC) are embedded into everyday practice. [17]
Relational and participatory leadership
Management plays a key role in safeguarding workers’ rights to a safe workplace, while ensuring RBC addresses older people’s needs. [18] By actively partnering with staff, managers promote fairness and recognition, making team members feel valued and integral to the organisation. [14, 18] For example, managers can include patient care assistants in decision-making processes, integrating their unique insights into residents’ needs. Such practices not only strengthen the culture of respect and inclusion but also enhance RBC for all residents. [16]
Leaders and managers are also responsible for addressing conflict within the facility. By managing challenges transparently and equitably, they uphold workers’ rights and maintain a respectful workplace. [19] Implementation of rights-based practices, supported by relational leadership, helps reduce staff stress and burnout, creating a healthier, more resilient workforce and a safer, more inclusive environment for residents. [14, 20]
Organisational leaders should engage with the older people in their care. Empathy and supervision provided by mentors are crucial, as they facilitate respect for residents’ dignity and encourage a culture where everyone feels valued. [19, 21]
Participatory leadership includes collaboration, inclusion, and genuine engagement with both older people in care, and staff. Organisations can implement structured activities that empower individuals and foster a shared sense of purpose. [22] For example, people with dementia can be actively involved in leadership roles within residential aged care facilities (RACFs), empowering those living with dementia while at the same time reducing stigma associated with the condition. [23]
Managers play a pivotal role in participatory leadership by being accessible to residents and their families. This openness enables residents to influence policy decisions and engage in meaningful discussions about organisational matters, strengthening their voice within the facility. [24]
Want to learn more?
The resources below support aged care managers and leaders to fulfil their obligations under RBC.
The clinical governance priority topic provides resources to support leadership and management through governance, leadership and culture.
This webinar is part of an Aged Care Quality and Safety Commission series 'governing for reform' discussing how leadership and organisational culture impact workforce engagement and retention in aged care.
The Aged Care Quality and Safety Commission has produced the Leading the Transformation flip guide on leadership.
This online article from Selmar discusses leadership pathways and workforce retention.
This review describes how effective management and leadership in aged care are essential for effective aged care worker performance, which, in turn, enables high-quality care.
What can be done?
Enable organisational change that supports RBC in practice
Aged care leaders:
- Explicitly articulate human rights as the organisation’s core ethos.
- Use language and behaviour that signals rights based expectations.
- Take visible stances on issues affecting older people’s rights.
Aged care workers:
- Use language and behaviour that respect residents’ rights and dignity.
- Demonstrate empathy in day-to-day care interactions.
The evidence:
- Support from managers makes staff feel valued and part of the team. [16]
- Managers and supervisors are responsible for the coordination and quality of the care and support provided. [14]
- Transformational leadership is described as central to translating the knowledge and skills relevant to CDC into practice. [17]
Use leadership approaches that support inclusion and transformation
Aged care leaders:
- Use transformational leadership to change organisational culture.
- Use relational and participatory leadership to empower staff and older people.
The evidence:
- Significant organisational change requires participatory leadership. [22]
- Using adaptive leadership techniques will strengthen engagement and promote self-efficacy. [25]
- Poor leadership allows for behaviours such as elder abuse. [2]
- Leadership and management tools such as complaints process, supportive structures for staff. Scenario-based learning, with debriefs and reflection tools embed RBC within a facility. [26]