A restorative home care intervention in New Zealand: perceptions of paid caregivers

Abstract

Paid caregivers possess an essential role in home care services. However, recruitment and retention issues are extensive within this workforce, largely in relation to poor working conditions. This article primarily focuses on the qualitative data extracted from a large randomised controlled trial in New Zealand and is supported by some quantitative findings. The aim was to explore paid caregiver perceptions of a restorative home care intervention in comparison with usual home care. The purpose of the qualitative exploration was to gather rich descriptive data that highlight differences between the two services with an emphasis on the workforce viewpoint. Four focus groups were undertaken with paid caregivers, two at baseline (4 and 5 participants in the control and intervention groups, respectively) and two at 14 months (eight participants in each focus group). Focus group data were collected in December 2005 and February 2007. A general inductive approach was used to analyse focus group transcripts. Two themes emerged from both the control and intervention focus groups: relationship with older people and issues with home care service delivery. A further two themes were pertinent to the intervention group: job satisfaction and preintervention. Findings revealed the intervention had a substantial positive impact on paid caregiver job satisfaction in comparison with usual care. This appeared to be due to improved training, increased support and supervision, and more flexibility. The intervention resulted in positive changes from the paid caregiver perspective and substantially reduced turnover in comparison with usual home care. However, both groups identified the need for further improvements to their working conditions. In addition, the need to regulate this vulnerable workforce is discussed.

The reablement team’s voice: a qualitative study of how an integrated multidisciplinary team experiences participation in reablement

“…Despite the time needed, some of our participants expressed that this way of working was in-line with their professional competence and allowed them to use their knowledge and reflections in action 28. Similarly, King et al12 highlights that a restorative philosophy enables the caregivers to interact and support the older person in a meaningful way, and they describe this as holistic as opposed to a service with restrictions. In their study, Tessier et al5 confirmed that home care services should focus less on time and tasks and more on support for the individual to achieve his or her goals.…”

“…In New Zealand, King et al12 found that health care workers in a restorative home care intervention had reduced turnover rates and improved job satisfaction compared with those working in a usual home care group. This improvement was found to be a result of the enhanced training, supervision, and flexibility.…”

Quality of Care and Job Satisfaction in the European Home Care Setting: Research Protocol

“…The questionnaire on the characteristics of the home care professionals was developed on evidence-based literature on job satisfaction among care professionals in the elderly home care setting [1415161718192021212324252627282930313233343536373839404142434445464748495051525354]. This questionnaire mainly consists of pre-existing validated questions and scales: the Copenhagen Psychosocial Questionnaire [6667], the Copenhagen Burnout Inventory [68], the impact subscale of the Job Role Quality survey [69], the Intention-to-turnover scale [70], the Scheduling Dissatisfaction Scale [51], the Physical Workload Scale [71] and the Individualised Care Scale-nurse [7252].…”

Home care: An opportunity for physiotherapy?

“…A common feature of all is the presence of at least three levels of staff: managers, coordinators and support workers. Arguably, the most significant issue with home care has related to the workforce and specifically this has focused on the support worker and coordinator roles (King et al 2012, Ministry of Health 2006, Parsons 2004a, Parsons 2004b, Parsons 2004c). …”

“…Such delegation is dependent on having suitably trained support worker staff and a level of trust by the physiotherapist in the ability of the support worker to deliver the programme and respond effectively to changes in the client over time. Within the New Zealand context this is only possible as a component of a system wide quality improvement initiative that comprises robust communication between the support worker, coordinator and physiotherapist (King et al 2012, King et al 2011 to enable responsive communication of progress and the required adjustments to the intervention.…”