What is organisational culture?
Organisational culture is the shared attitudes, behaviours, beliefs and values that influence how work is done across an organisation. [1] Organisational leadership, a significant part of organisational culture, is the way leaders set direction, make decisions and support people to achieve agreed outcomes. [1]
How can organisational culture be a barrier to rights-based care?
Poor organisational culture, including poor leadership, is a significant barrier to implementing a rights-based approach in aged care. This challenge is especially evident in efforts to prevent elder abuse and improve the dignity of risk and autonomy. [2-8]
An organisation with poor workplace culture, which might include fear of making mistakes rather than a genuine focus on residents’ wellbeing, undermines the protection of older people’s rights. It also weakens efforts to actively promote those rights in everyday care practices. [5-8] It undermines staff confidence to support older people to make informed choices, leading to overprotection and inconsistent recognition of rights. [2-4]
Leaders and managers of aged care organisations who prioritise physical safety and regulatory compliance over autonomy can reinforce a culture of risk avoidance instead of encouraging autonomy and supported decision‑making. [2-4] Poor leadership and the absence of effective safeguarding measures to protect residents create conditions that allow abuse and neglect of older people. [5-8]
How can organisational culture be an enabler of rights-based care?
A positive organisational culture with strong leadership supports high-quality care that protects the rights and autonomy of older people. [7] Without a culture that balances duty of care with human rights and strong, values-based leadership, rights-based care cannot be reliably embedded or sustained across aged care services.
Important enablers to promoting rights-based care include:
- supportive organisational culture,
- collaborative relationships and relational trust,
- trained and capable workforce, and
- leaders who are values-driven and practice a participatory leadership style. [9-14]
A supportive organisational culture characterised by trust, fairness, innovation and accountability strengthens readiness for change and continuous improvement. Environments that encourage staff reflection and learning are better able to translate rights into practice. [13, 14]
Collaborative relationships and trust between residents, families, staff, professional groups and external partners enable consistent support for autonomy and dignity. Proactive programs such as an open-door policy, allow residents and staff to openly discuss and address complex matters. Over time, this engagement strengthens confidence, improves communication, and supports responses to complex care decisions. [10]
Staff education, ethical competence, adequate staffing levels and the right skill mix support person-centred and individualised care. They also reduce reliance on restrictive practices, particularly for people living with dementia (PLWD) or complex needs. Targeted training in ethics, rights, communication and dementia care further minimises restrictive practices and abuse. [8, 13, 14]
Leaders who actively involve staff, residents, families and community advisors promote shared ownership of values and responsibilities, embedding rights into everyday practice. [9-11] Read more about participatory leadership.
What can be done?
Improve workplace culture
Organisations and aged care leaders:
Create a positive workplace culture for staff by:
- Having clear and explicit organisational policies on complex care decision‑making with the residents and staff members.
- Minimising rigid rules and routines. Support flexible working arrangements where possible.
- Recognising achievements and success more than focusing on problems.
- Innovating practices and activities.
The evidence:
- Clear, explicit organisational commitment to residents’ rights enables collaborative decision‑making. This includes embedding rights into policies, scheduled policy reviews, quality assurance processes, and everyday routines. Flexible, values‑based approaches, rather than rigid rule‑following, help organisations navigate tensions between autonomy and risk. Proactive programs such as open‑door initiatives demonstrate how systems can be designed to support dignity of risk in practice. [10, 13]
- An organisational culture characterised by trust, fairness, recognition, autonomy, innovation, and cohesion supports sustained rights‑based practice. Innovation is a key indicator of readiness for change, signalling that staff are encouraged to reflect, adapt and improve care. [9, 12]
Train aged care workers
Organisations and aged care leaders:
- Ensure that aged care workers undergo training on ethical competence and reasoning, communicating with residents, including PLWD and providing care that considers the rights of older people.
The evidence:
- Staff competence and education are essential enablers of autonomy, dignity, and safety. Training that strengthens ethical reasoning, understanding of rights, person‑centred care, communication skills, and management of behaviours associated with dementia reduces reliance on restrictive practices. [13, 14]
Improve leadership style and skills
Organisations:
- Provide opportunities for leaders to improve leadership style that aligns with values-based and participatory leadership style. Some key aspects include self-reflection, authenticity, open dialogue and balancing perspectives and empathy.
Aged care leaders:
- Reflect on current leadership style and seek training to develop more reflective and collaborative approaches. This will also enhance workplace culture.
The evidence:
- Participatory leadership creates safe spaces for dialogue, challenges entrenched assumptions and supports ‘light‑bulb moments’ that shift attitudes toward inclusion, autonomy, and dignity. Where leaders articulate a clear mission centred on rights and wellbeing, staff are more likely to align their practice with these values. [9, 11, 12]
Want to learn more?
ARIIA has developed resources about Leadership and culture and Leadership and management strategies in aged care.
Read about the Aged Care Code of Conduct to learn about behaviours that are acceptable and ethical in aged care.
Read the Aged Care Quality and Safety Commission’s tips for improving culture and conduct.