Improving home care quality: An individual‐centred approach

Abstract

This article presents evidence for important individual differences between older people concerning what they value as high quality service from home care. A case is made for improving service quality through systematically consulting each service user about their own preferences and seeking to fulfil these requests on an individual basis. This contrasts with setting uniform quality standards for all older home care clients, based on their most commonly expressed preferences. Evidence is cited from individual interviews with older home care service users and from an experiment in modifying older people's services through briefing home care staff on the preferences of individual clients. Issues in developing this approach are discussed.

Choice and control for older people using home care services: how far have council-managed personal budgets helped?

“…Reviews offer formal opportunities to council support planners and agency staff involved in devising support plans to discuss care arrangements with service users and allow users further opportunities to express choices and make changes to support arrangements. Other studies have suggested that service users need to receive home care for several weeks at least before they know what individual adjustments they most want (Colhoun, 1998;Patmore, 2001).…”

“…Where people participated in the design of their care package, this was often reported as being limited to refusing the services or providers offered (Allen et al, 1992;Baldock and Ungerson, 1994). Moreover, while research shows that flexibility is an important aspect of care valued by older people (Henwood et al, 1998;Patmore, 2001;Raynes et al, 2001;Francis and Netten, 2004), evidence suggests a history of low flexibility in home care services for this group, with some home care services strictly limiting activities to those tasks specified by care managers on older people's care plans (Patmore and McNulty, 2002). Francis and Netten (2004) found that among older people using home care services, many could not request help with tasks beyond those specified on their care plan because they were not on care workers' "job sheet".…”

Quality in home care for older people: Factors to pay heed to

“…Research on older home care customers' views on service quality has highlighted customer priorities like receiving service from familiar staff, reliable and punctual visiting, customers being kept informed about changes, and help with miscellaneous household problems like house-cleaning, changing light-bulbs or obtaining a trustworthy plumber (Henwood et al 1998, Clark et al 1998, Raynes et al 2001, Patmore 2001. This paper reports some preliminary findings from an on-going research project which explores what helps home care providers to deliver service with these characteristics (Patmore 2002, pages 1-4).…”

“…Another research aim is to discover how providers can best tailor service to the differing values and preferences of each customer. For instance one older person may prioritise familiar staff whereas another may prize help with household maintenance (Patmore 2001).…”