In my master's thesis, I explore the role of leadership in the transformation of locked wards in social care institutions. The goal of the research is to analyse how leadership in the institutions can contribute to the changes necessary for the transition from institutional care to community care. The first part addresses the history of confinement and the operation of locked wards. I then examine “special restrictive procedures” and offer some deinstitutionalisation tools to prevent their use. Next, I focus on the phenomenon of locked doors and its opposite, the open doors strategies. In this part, I also explore the legal, ethical, and systemic foundations for the transformation of locked wards and propose community care as an alternative to confinement. In the final part of the theoretical introduction, I focus on the role of leadership in the social care institutions and its role in the process of transforming locked wards.
In the empirical part, I analyse role and function of locked wards in the institutions and for the community, the challenges faced by leadership in managing locked wards, and the role of leadership in admitting and discharging from locked wards. I was also interested in the vision of functioning of locked wards and their transformation. Additionally, I analysed the obstacles and conditions for transformation. Finally, I was interested in the forms of collaboration with other providers and stakeholder of both, institutional and community care for managing and potentially transforming locked wards. Through analysis, I found that most of the managers of institutions covered by the research do not see the complete transformation of locked wards as a feasible and desirable. However, they still note many difficulties they face in managing and coordinating locked wards as well as in admissions to them. I conclude that the development of community services and the establishment of a network of advocates for transformation, which could assist directors and representatives of institutional leadership in the process of transforming secure units are crucial for the transition to community care.
The research is empirical, qualitative, and applicative. I explained the theses of the research through seven focus groups. The population included in the research comprises all representatives of the management of special social welfare institutions that have secure units for institutional care for persons with mental health issues or intellectual disabilities, including independent units of combined institutions and institutions of the CUDV type, which have the form of specialized units. The sample is non-random, convenient, and intentional, consisting of 24 people, representatives of the management of these institutions.
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