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The emergence of residential aged care facilities (RACFs) within the Ghanaian health-care system has raised eyebrows because, hitherto, the concept of nursing homes had largely been perceived as an anomaly. The purpose of this study is to understand this emerging phenomenon and the activities of care provided within two facilities in the nation’s capital, Accra.

The study draws on participant observations and in-depth interviews with purposively sampled 15 residents in the two facilities and eight caregivers. The data were analysed using thematic approach.

The study found that the daily forms of care mostly performed for the elderly were intimate and non-intimate physical, medical, emotional and spiritual and end-of-life care. The bulk of activities of care were performed in the morning.

The study reveals that the changing landscape of health-care facilities in Ghana to include RACFs indicates RACFs have come to stay to provide different forms of care to older persons who otherwise were cared for by the family.

While scholars have researched the impact of specific total quality management (TQM) aspects on innovation performance (INP), empirical evidence on how the former, as a composite construct, influences the latter is rare. To add, empirical evidence on the mechanism through which TQM passes to affect innovative behaviour (INB) and, then, INP is limited. Essentially, scholars have requested that future research look at the boundary conditions that support the adoption of TQM activities in businesses. Although the banking sector has experienced a number of transformations, there is still a need to raise the standard of service provided to bank customers. This research sheds more light on this subject.

This research tests the hypotheses in Ahinful et al.’s (2023) conceptual model using responses from 260 top- and middle-level bank managers by applying Smart PLS. Organisational support and team member exchange were used as potential control variables for the mediator, while slack resources and bank size were applied to the target endogenous latent construct. Mediation and moderation effects were estimated using the variance accounted for (VAF) and product indicator approaches, respectively. Sig. level was set at 5%.

This study found that TQM and INP had a positive and significant connection (ß = 0.303, p = 0.000), and INB partially mediated this connection (VAF = 40.92%). However, government regulation (GOV; ß = 0.055, p = 0.365), market dynamism (MKD; ß = 0.063, p = 0.434), competitive intensity (CMP; ß = 0.069, p = 0.297) and technological turbulence (TUR; ß = 0.011, p = 0.865) all failed to moderate the TQM–INB connection, although the expected positive directions of these moderation relationships were established.

This research provides empirical evidence on the TQM–INP connection, how this connection may be mediated and how the TQM–INB connection may be activated. It also sheds light on novel ways in which service quality in the banking sector may be improved. Upcoming research may explore other control variables in their research. Since the moderating relationships were unsupported, this avenue is open for further research, particularly in other banking settings across the globe.

Practical lessons for bank consultants, regulators, customers, employees and managers are deliberated.

This research is novel. It is the first to test the hypotheses in Ahinful et al.’s (2023) conceptual model. This study advances the theoretical frameworks and existing knowledge within the TQM, innovation and performance management fields.