Staff behaviours that promote positive co-worker relationships in health and social care settings: A scoping review with implications for long-term residential care.

Background: Co-worker relationships in long-term residential care play a crucial role in enhancing quality of care. Collaborative relationships among co-workers are consistently linked to positive outcomes in these environments. However, the current evidence on co-worker relationships in long-term residential care is largely descriptive and lacks insights into the behaviours that influence these relationships positively or negatively. Gaining a deeper understanding of these behaviours would support the development of interventions aimed at promoting effective co-worker relationships. Aim: This scoping review aims to map evidence on staff behaviours that foster positive co-worker relationships and collaboration in health and social care settings, and to interpret these findings for their relevance to long-term residential care. Design/Methods: We conducted a scoping review to assess the volume, scope and quality of research on co-worker relationships in long-term care, following established guidance. We used the COM-B behaviour change framework, which proposes that behaviour arises from three interacting components: capability (the skills and abilities required to act), opportunity (external factors that enable or hinder action), and motivation (internal processes that direct behaviour). We extracted data from primary studies in broader health and social care settings and mapped findings to COM-B categories. This enabled us to identify behaviours influencing relationships and highlight theories and interventions with potential relevance for long-term residential care. A consultation with long-term care managers was also undertaken to assess the practical relevance of the findings. Results: Forty-two papers identified behaviours that mapped on to COM-B components: capability (social competence), opportunity (time, space, culture), and motivation (willingness). Consultation with long-term care managers supported the relevance of these findings, highlighting leadership as the most critical factor influencing co-worker relationships. Managers highlighted the importance of leadership behaviours and emphasised the value of strengthening communication and relationship management skills within teams. Conclusion: By drawing together evidence across health and social care settings, this review advances understanding of how positive co-worker relationships are built and sustained in long-term care residential settings. Our findings position leadership behaviours, not structures or hierarchies, as key mechanisms that shape the relational environment in which care is delivered. Despite this, leadership research in long-term residential remains underdeveloped with few studies specifying actionable behaviours or testing their effects. The practical behaviours we identify offer a foundation for developing relationally focused workforce interventions. Progress depends on coordinated support from employers, commissioners, and policy-makers, along with research investment to evaluate how behavioural approaches can improve staff experiences and improve care quality.