Exploring working relationships between primary care and directly employed home care workers

Increasing numbers of older people directly employ care workers to help them live independently at home using cash for care schemes or pay for the services of a worker using their own money.  Despite the longstanding nature of these arrangements, little is known about how these workers, their older employers or family carers employing these workers on behalf of an older person negotiate relationships with primary care professionals.  For example, what happens if community nurses express concerns about the quality of a worker’s performance?  Who undertakes responsibility for training and supervising directly employed workers in tasks such as catheter care? While there are an increasing number of studies reporting on the experiences of those working as, or employing, these types of worker, very little is known about the triadic relationships between workers, people employing them, and other health professionals. The presentation will describe the early stages of a new exploratory study designed to explore working relationships between primary care and directly employed home care workers from the perspective of older people, family carers, primary care professionals and directly employed workers themselves.  The aim is to develop evidence based guidance and resources to enhance communication, and facilitate co-ordination of care between the older people receiving care and support and their family where applicable, directly employed care workers, and NHS professionals to promote the wellbeing of older people.  The presentation will highlight some of the methodological challenges in negotiating access to study participants and analysing data from different sources.