Ghosts in the care home: the nature of relationships in a home for people with learning disabilities

Abstract

This paper considers the complex task of working with adults with learning disabilities and challenging behaviour in a care home and the impact on relationships within the staff group and wider organisation. Examples are drawn from an organisational consultation to a home with a history of disputes, grievances and sick leave. The metaphor of ghosts is used to explore the processes by which the residents' own traumatic histories come to be played out by the care home staff. The paper concludes that an increased understanding of organisational processes in the residential care sector may help staff form more helpful relationships with service users and hence lead to better outcomes.

Keywords:

• process consultation
• learning disabilities
• projective identification
• containment

Acknowledgements

I am very grateful to Lydia Hartland-Rowe for her detailed comments on earlier drafts of this paper. I would also like to acknowledge Angela Eden who supervised the consultancy work and Simon Tucker who supervised the dissertation on which the paper is based.