Frontline Practice Leadership for quality and safe services for people with intellectual disabilities - "ensuring work as expected" becomes "work as done".

BACKGROUND: Practice Leadership is a subset of frontline management in accommodation services for people with intellectual disabilities. Its influence on staff use of Active Support is well established. This study explores Practice Leadership's role in ensuring safe as well as quality support. METHOD: A secondary analysis of qualitative data from a subset of 59 accommodation services that had both strong Practice Leadership and good Active Support, from a large Australian study. RESULTS: The characteristics of strong Practice Leadership mirror many that prevent harm in services: (i) Channelling organisational intent to direct support workers, (ii) Monitoring staff implementation of plans, policies and procedures, (iii) Assessing and improving staff competence, and (iv) Reinforcing a culture of person-centred practice that supports quality of life. CONCLUSION: Seeing Practice Leadership through the lens of safety widens its scope beyond staff use of Active Support to other facets of quality support associated with safe support.