Risks to home care workers: Professional perspectives

Abstract

Care at home is fundamental to community care policy, but the simultaneous growth of health and safety regulation has implications for home care services because of the duty of employers towards home care workers. This grounded theory study set in Northern Ireland used data from 19 focus groups and nine semi-structured interviews with a range of health and social services professionals and managers to explore perspectives on planning long term care for older people. Home care workers faced a wide range of hazards in the homes of clients, who themselves were faced with adapting their living habits due to their changing health and care needs and ‘risks.’ Creative approaches were used to ensure the health and safety of home care workers and simultaneously to meet the choices of clients. Staff experienced feelings of conflict when they judged it necessary to impose their way of providing home care and thus impose their values on clients to create a safe working environment. There was variation between and within organizations in terms of the staff focus on client needs or on their employer responsibility towards home care workers. The planning of home care services must take account of both the choices of clients and the hazards facing home care staff.

Keywords:

• Home care
• domiciliary care
• health and safety regulation
• older people
• assessment
• client choice
• risk management
• self-neglect

Acknowledgements

The first author received support for this study and its dissemination through Fellowships from the Research and Development Office of the Department of Health, Social Services and Public Safety for Northern Ireland, and from the Economic and Social Research Council, London. This support is gratefully acknowledged. Views expressed are those of the authors, and do not necessarily reflect the views of the above bodies.