Battle on the home care front: perceptions of home care workers of factors influencing staff retention in Northern Ireland

Abstract

The provision of home care services is a key component in avoiding inappropriate admission of older people to institutional care and preventing delayed discharge from hospital. However, there is a growing problem of retention of home care workers (HCWs), creating problems for delivering this increasingly essential service. The present study was based in a health and social services trust in Northern Ireland, and was designed to explore the growing problem of retention of HCWs from their own perspective. The cross-sectional survey design used a convenience sample and questionnaires were completed by 45 HCWs (response rate = 45 of 147, 31%). Responses to most questions were on five-point ordinal scales. Focus groups in which 12 HCWs participated were used to explore emerging themes. The variables studied were HCWs' perspectives on: (1) reasons for considering leaving; (2) working hours; (3) supervision and support, and qualifications and training; (4) workload pressures; (5) client attitudes; (6) pay; and (7) job satisfaction. The main reasons given by HCWs for dissatisfaction and considering leaving were (in rank order): (1) irregular and antisocial hours; (2) lack of management support; and (3) workload pressures. Commitment to caring seemed to be the reason why pay did not feature more highly for those who did not leave. Home care workers are being required to provide care for people with evermore-complex health and social care needs, and in an environment increasingly regulated in terms of quality and risk. This makes it an increasingly demanding job, which does not seem to be recognised in the training and working conditions of HCWs. The most significant factors identified give scope for service managers to improve the retention of HCWs.

The provision of emotional labour by health care assistants caring for dying cancer patients in the community: A qualitative study into the experiences of health care assistants and bereaved family carers

“…As paid, yet unqualified carers, concerns have been raised that HCAs operate in a confusing and blurred state, where they may be undervalued by qualified nursing staff, while being expected by informal carers to perform tasks which they are not qualified to do (Devlin & McIllfatrick 2010), leading to the possibility of stress (Fleming & Taylor 2007). While recognising problems arising from M a n u s c r i p t 11 the variation in HCAs' roles in the UK, (Bach et al 2008), our study shows that HCAs are able to work with the ambiguity of their role by 'getting on with whatever needs doing', thus enabling them to develop relationships with family carers and act as liaisons between family carers and health professionals.…”

Factors Explaining the Job Satisfaction of Home Care Workers Who Left Their Older Care Recipients in Israel

“…A study (Fleming & Taylor, 2007) conducted in Northern Ireland found that 44% intended to leave home care work; the main reasons for their intentions to leave were irregular working hours, lack of organizational support, and workload pressures due to being required to provide care for people with complex health and social care needs. High workload, sense of pressure, and quality of relationships with the care recipients were found to be crucial factors connected with job dissatisfaction (Kiefer et al, 2005;Piercy, 2000).…”

Job satisfaction and quality of life among home care workers: a comparison of home care workers who are and who are not informal carers

“…Additionally this can also function as a significant predictor of quality of service performance (Spector, 1985). Many Taiwanese studies have investigated staff job satisfaction among individuals working in hospitals, nursing homes and schools as nurses, educators, social workers and home care workers; significant factors associated with job satisfaction include individual characteristics and the work-related context (Hwu et al, 2003;Chung and Huang, 2005;Lin and Tseng, 2005;Chen et al, 2007;Lin, 2007;Xin, 2007;Yu et al, 2008;Chou et al, 2010) Consistent findings in Western literature suggest several factors or key dimensions related to job satisfaction among home care workers (Donovan, 1989;Donovan et al, 1993;Crown et al, 1995;Denton et al, 2002;Moyle et al, 2003;Fleming and Taylor, 2006;Ejaz et al, 2008;Sherman et al, 2008). Such factors fall into two main categories: the individual characteristics of the workers and job-related factors regarding work conditions.…”