‘You have got to stick to your times’: Care workers and managers’ experiences of working in extra care housing

Abstract

Extra care housing (ECH) has been lauded as an innovative model of housing with care for older people that promotes and supports independent living. The study used a qualitative design to explore how care is delivered in four extra care settings in England over 20 months during 2016-2017. This paper reports findings from semistructured interviews with 20 care workers and seven managers. The article argues that, despite being heralded as a new model, care workers in ECH face similar organisational pressures as those working in more conventional settings and, in turn, the care which they are able to provide to residents mimics traditional forms of care. K E Y W O R D Scare work, extra care housing, older people, social care, the organisation of care

Innovation in UK independent homecare services: A thematic narrative review

“…Cameron et al's ( 2020 ) paper examined if an extra‐care housing (ECH) model v could support independent living and ameliorate the effects of social isolation, poor social care outcomes and high costs of residential care. Although this model of care is promoted as being more flexible, responsive and adaptable to older people's needs, the authors highlighted that in practice, the way homecare services were organised was not innovative and mirrored standard models of homecare (Bottery, 2018 ).…”

“…Other papers explored how organisational model and size can, positively and negatively, affect working conditions, management and the sustainability of services. One outcome derived from the model of extra‐care housing was shown on the one hand to prevent social isolation (Cameron et al, 2020 ), but on the other hand, it can increase social isolation for residents with dementia, as the stigma from other residents without dementia can cause segregation (Evans et al, 2020 ). Social enterprises were claimed to have the potential to empower employees (Jones, 2009 ; Munoz, 2013 ).…”

“…Whilst Gripenberg et al ( 2012 ) warn of a ‘pro‐innovation bias’ in research, the findings suggest that investigation into innovation in homecare organisations examines both negative and positive outcomes (with studies of AT being the exception). Specifically, this review highlights how innovations can enrich care work jobs (Jones, 2009 ; Munoz, 2013 ), increase organisational responsiveness and flexibility (Cameron et al, 2020 ), promote choice (Baxter et al, 2013 ), but also generate unintended consequences such as the challenge of recruiting a diverse workforce (Westwood, 2016 ) and increasing people's dissatisfaction with care when new technologies were introduced (Doughty & Williams, 2016 ). Investigations of when innovation goes wrong or does not deliver on objectives were rare, although one paper (Munoz, 2013 ) highlighted many implementation difficulties.…”

Living with dementia in supported housing: A systematic review and thematic synthesis of qualitative research

“…The included articles were conducted in the United Kingdom and North America, meaning that the findings are reflective of those living in these regions. Additionally, segmented publication was evident in articles based on the ECHO study, with five articles uncovered in the systematic search based on the same data (Cameron et al, 2019;Cameron, Johnson, Evans, Lloyd et al, 2020;Evans et al, 2020;Johnson et al, 2020). This could potentially distort the findings of the review (Šupak Smolčić, 2013), but an effort was made to include the articles of greatest relevance to dementia.…”

Extra Care Housing: The Current State of Research and Prospects for the Future

“…However, local authorities have increased social care eligibility criteria and providers have been expected to support more residents with higher care needs (Murphy and Miller, 2008;Smith et al, Extra Care Housing: Prospects for the Future 2017). In the ECHO study, increased pressures on care workers and commissioning systems focused on completing specific care tasks reduced their ability to respond flexibly to residents' increasing care needs (Cameron et al, 2020b). Also, changes in the balance of care needs can affect relationships between residents (Croucher et al, 2007;Callaghan et al, 2009;Evans, 2009b;West et al, 2017).…”