The Influence of Care Home Managers' Leadership on the Delivery of Person-Centred Care for People Living with Dementia: A Systematic Review.

Background: Care home managers' leadership is recognised as directly influencing the care received by people living with dementia. What enables care home managers to promote and sustain person-centred care for residents is less well understood. Method: A mixed-methods systematic review synthesised evidence on care home managers' leadership on the delivery of person-centred care for people living with dementia. Electronic databases (PubMed, Scopus, Cochrane Library, CINAHL, and Google Scholar) were searched between 2009-2021. Thematic synthesis identified commonalities, facilitators, and barriers to managers enabling person-centred care. Results: Twenty-one studies met the inclusion criteria. Approaches demonstrated by care home managers that enabled person-centred care for people living with dementia included valuing and recognising staffs' work; involving residents and relatives in decision making; providing feedback to staff; promoting a positive work environment and care culture; and involving staff in organisational changes. Barriers to person-centred care were a lack of organisational support for care home managers; staff shortages; managers not having time to work with staff; manager-staff turnover; limited access to dementia training; and a lack of leadership education and training for care home managers. Conclusion: Care home managers are central to the delivery of person-centred care for people living with dementia. The review identified key resources and activities that support this work. The wide variation in leadership approach and a persistent lack of detail about the frequency of educational and organisational support demonstrate a need to explore what enables care home managers to support their staff to deliver person-centred care.