How provider organisations interpret regulation in the context of residential dementia aged care.

OBJECTIVE: To explore how Australian residential dementia aged care providers respond to regulation via organisational culture, level, processes and interpretation.

METHODS: Observation took place in three provider organisations. Qualitative, semi-structured in-depth interviews were conducted with aged care staff (n = 60) at three different levels of each organisation: senior management from three head offices (n = 17), facility management (n = 13) and personal care workers (n = 30) from eight residential care facilities.

RESULTS: Orientations towards regulation included the following: "above and beyond;" "pushing back;" and "engineering out." Regulation was interpreted differently depending on the level of authority within an organisation where boundaries were managed according to strategic, operational and interactional priorities.

DISCUSSION: Examining regulation within an organisational context and at different staff levels suggests ways to balance dementia care with regulatory control. Both generate stress, mitigated by culture and interdependent role differentiation.