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.

Education and training must extend beyond initial qualifying courses into post qualifying professional development throughout a social worker's career if practice is to be most effective in meeting clients' needs. In the United Kingdom a Framework for Post Qualifying Education and Training was introduced from 1990. Revised frameworks have been put in place from autumn 2007 in each of the four home countries of the UK. This paper reflects on lessons learned in implementing these post qualifying frameworks in Northern Ireland. Within the overarching theme of relevance to practice, issues are drawn out under three main themes: (1) partnership working between employers and universities including the importance of leadership from policy makers and senior managers; (2) assessing competence including providing an Independent Assessment Route to increase access and to benchmark professional standards; and (3) meeting service needs including specifying learning outcomes to cover a range of practice contexts and accrediting employer-based programmes. Meeting service needs more closely is identified as a key issue driving the new Northern Ireland Post Qualifying Framework introduced in 2007.