Battle on the home care front: Perceptions of Home Care Workers of factors influencing staff retention

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, creating problems for delivering this increasingly essential service. This study was based in a Health and Social Services Trust in Northern Ireland (NI) and was designed to explore the growing problem of retention of Home Care Workers from their own perspective. The cross-sectional survey design used a convenience sample and entailed questionnaires completed by 45 Home Care Workers (response rate 45/147; 31%). Responses to most questions were on five-point ordinal scales. Focus groups in which 12 Home Care Workers participated were used to explore emerging themes. Variables studied were Home Care Workers’ perspectives on: (1) Reasons for Considering Leaving, (2) Working Hours, (3) Supervision and Support & Qualifications and Training, (4) Workload Pressures, (5) Client Attitudes, (6) Pay, and (7) Job Satisfaction. The main reasons given by Home Care Workers for dissatisfaction and considering leaving were (in rank order): (1) irregular and anti-social 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 ever more 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 Home Care Workers. The most significant factors identified give scope for service managers to improve the retention of Home Care Workers.