The development of domiciliary care: What does the future hold?

Leece, Janet

doi:10.1080/09503150308416924

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…On the other hand, there will also be less informal caregivers as the population ages and diversifies, which will ultimately lead to an increase in the need for more paid caregivers (Polivka 2005). The consumer population's support needs are becoming more complex, such as being more dependent with their activities of daily living and personal cares (Leece 2003). The use of home‐based and residential care services is also predicted to increase as the population ages (Binstock et al .…”

Section: Introductionmentioning

confidence: 99%

The providers’ profile of the disability support workforce in New Zealand

Jörgensen

Parsons

Reid

et al. 2009

Health &Amp; Social Care in the Community

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To understand one of the predominant groups supporting people with disabilities and illness, this study examined the profile of New Zealand paid caregivers, including their training needs. Paid caregivers, also known as healthcare assistants, caregivers and home health aides, work across several long-term care settings, such as residential homes, continuing-care hospitals and also private homes. Their roles include assisting with personal care and household management. New Zealand, similar to other countries, is facing a health workforce shortage. A three-phased design was used: phase I, a survey of all home-based and residential care providers (N = 942, response rate = 45%); phase II, a targeted survey of training needs (n = 107, response = 100%); phase III, four focus groups and 14 interviews with 36 providers, exploring themes arising from phases I and II. Findings on 17,910 paid caregivers revealed a workforce predominantly female (94%), aged between 40 and 50, with 6% over the age of 60. Mean hourly pay NZ$10.90 (minimum wage NZ$10.00 approx. UK3.00 at time of study) and 24 hours per week. The national paid caregiver turnover was 29% residential care and 39% community. Most providers recognised the importance of training, but felt their paid caregivers were not adequately trained. Training was poorly attended; reasons cited were funding, family, secondary employment, staff turnover, low pay and few incentives. The paid caregiver profile described reflects trends also observed in other countries. There is a clear policy direction in New Zealand and other countries to support people with a disability at home, and yet the workforce which is facilitating this vision is itself highly vulnerable. Paid caregivers have minimum pay, are female, work part-time and although it is recognised that training is important for them, they do not attend, so consequently remain untrained.

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Section: Introductionmentioning

confidence: 99%

The providers’ profile of the disability support workforce in New Zealand

Jörgensen

Parsons

Reid

et al. 2009

Health &Amp; Social Care in the Community

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“…1994, Neysmith & Aronson 1996). Home care staff need greater knowledge and skills because of: the increasingly complex medical, nursing and social needs of people to be met at home (Leece 2003); greater regulation of health and safety, confidentiality and risk management (Green 2000, Health and Safety Executive 2001, Department of Health 2003, King & Schwehr 2003); and the ever‐increasing public expectations of service quality (Noelker 2001). The increasingly complex personal care needs of service users produce role conflicts for staff (Arts et al .…”

Section: Introductionmentioning

confidence: 99%

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

Fleming

Taylor

2006

Health Soc Care Community

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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.

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“…In the decades after the Second World War, the home help service continued to develop but with the voluntary sector taking a major role. Leece (2003) describes how the home help service in this period 'developed around a housework model which traditionally stopped short of intimate care tasks ' (p. 19). It was still generally expected that the responsibility for supporting ageing relatives would lie with (mainly female) relatives.…”

Section: Domiciliary Care For Older People: the Backgroundmentioning

confidence: 99%

“…It was still generally expected that the responsibility for supporting ageing relatives would lie with (mainly female) relatives. Where families could no longer look after their elderly relatives, it was assumed that voluntary organizations would provide support or failing that, the older person would go into residential care (Leece, 2003;Smith, 1985, 1998).…”

Section: Domiciliary Care For Older People: the Backgroundmentioning

confidence: 99%

‘What matters is what works’? How discourses of modernization have both silenced and limited debate on domiciliary care for older people

Scourfield

2006

Critical Social Policy

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Policy statements about the care of vulnerable older people repeatedly emphasize the desirability of keeping people at home. An enduring problem in implementing this strategy is the ongoing crisis within the quasi-market in domiciliary care. The government announced in 2004 that it wanted a new vision for adult social care. In such circumstances, it could be argued that, in order to achieve home care services that are stable, flexible and better placed to integrate more effectively with health agencies, local authorities should significantly expand in-house provision. Despite exhortations from ministers to think the unthinkable, such a proposal is actually ‘unsayable’. This article discusses how discourses of modernization exclude ideas that imply an expansion of directly provided social care. Such discourses have so much invested in the shedding of what it regards as outmoded ‘welfarist’ baggage, they are blind to proposals that could improve the lives of older, vulnerable citizens.

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The development of domiciliary care: What does the future hold?

Cited by 6 publications

References 9 publications

The providers’ profile of the disability support workforce in New Zealand

The providers’ profile of the disability support workforce in New Zealand

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

‘What matters is what works’? How discourses of modernization have both silenced and limited debate on domiciliary care for older people

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