Observing staff during their interactions with residents enabled Leena Berlin Hallrup and colleagues to build up a picture of how they operate in a complex and stressful work environment

Despite the general move to support people with learning disabilities in their own homes or in home-like settings, many institutional settings still exist and little research has been carried out on the role of the care workers who work in them. In this study, participant observations over a 16-month period describe care workers’ experiences of working in an institutional care setting in Sweden, and 18 care workers were interviewed. The three main themes to emerge from the thematic analysis were: care workers were engaged in creating a family-like atmosphere; they were engaged in making the everyday ordered and structured; and they were exposed to stress factors.

It became evident that care workers need additional support, training and opportunities for reflection to handle their complex work situation