Table 3.

Key quotes by managers and staff in long-term care mapped to the LEADS framework.

	Lead self	Engage others	Achieve results	Develop coalitions	System transformation
Management	“I can’t ask somebody else to pour their heart and soul into care and not be willing to do the same. So I think the only way to like walk the walk, right?” AB “I also like to assist in feeding when I can. … if I walk down and I see someone sitting and their whole plate of food is there … and the staff are busy running around … It’s not in my scope but it gives me a chance to assess someone. … and staff will sometimes come up and give me some information.” AB “Staff eating with [residents] makes them feel like it’s a home.” ON	“Last year was really focused on staff engagement … for us I think honestly just talking to them all the time, connecting with them. I’ve tried to be as transparent as possible with our staff and accessible to them.” AB “I think we all need to lead and be a mentor … just to support people in their autonomy within their job and to recognize that they have an opportunity to bring forward an idea that will be supported by the people in the seats who can say, yes, we have the money or no, we don’t.” ON “It can’t always be management-led. So that’s why we’re really trying to build our leaders in the community, empower them, give them the tools that they need, support them, but they are taking the lead.” NS “… the toughest times are when we do our most learning. They need someone. They need consistent leadership… they needed that leadership to pull them through and that’s become very evident.” AB	“I think that culture has to come from management and foster downwards. … so for example, by having meetings and saying, ‘You guys have a voice’ but I’ve also said …’if you have a problem, you come with a solution or you come willing to look at a solution.’ … so they start feeling empowered that they’re part of it too.” BC “Surveys are fine, but if they’re just shoved in a drawer, you’re just dashing people’s hopes, and actually, instead of encouraging somebody, it’s just having the opposite effect.” BC “We talk about this in our site quality team meetings too is how do we capture … those moments of happiness and satisfaction and sense of well-being, and we don’t have that answer yet.” AB	“Each year when we set out goals … they’re almost always relationship focused … we started with community engagement.” AB “I helped put a satisfaction survey protocol in place with sampling and training … to make things a little bit more valid and reliable … but what we’re finding is that it really doesn’t get at what people want – they’re wanting to know the experience. … so what I’ve done this past year … we got a community innovation grant and I approached … [local faculty of nursing] students to … gather narratives … and that’s our process of actually coming up at this lived experience.” AB “Students are great – they bring in new ideas.” NS
Staff	“From my perspective, a leader is somebody who comes to see you and works with you, right? … they come into the unit and see what their staff is dealing with right from the PSWs to housekeeping.” ON “management encourages you to spend as much time with people.” BC		“I noticed that the level of needs at [wing X] during the three years that I was there deteriorated considerably, so the staff was getting busier and busier, but the levels did not. So what they did is pulled a half a staff member from here and put it there … the manager was very happy to let me know that this is what was done and she was pleased with that.” BC “I think when they feel like they’re being supported they feel heard, because people are here, they want to be here. They’ve chosen healthcare for the most part because they really do want to look after people.” BC		They say resident-centred, I say stop [just] saying the words and let’s truly be resident centred. The resident bill of rights is really the only regs you need because it covers everything” ON