Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-27T06:28:09.233Z Has data issue: false hasContentIssue false
  • English
  • Français

Commissioning social care for older people: influencing the quality of direct care

Published online by Cambridge University Press:  01 February 2013

HELEN CHESTER ,
JANE HUGHES  and
DAVID CHALLIS
HELEN CHESTER
Affiliation:
Personal Social Services Research Unit, University of Manchester, UK.
JANE HUGHES*
Affiliation:
Personal Social Services Research Unit, University of Manchester, UK.
DAVID CHALLIS
Affiliation:
Personal Social Services Research Unit, University of Manchester, UK.
*
Address for correspondence: Jane Hughes, Personal Social Services Research Unit, University of Manchester, Oxford Road, Manchester M13 9PL, UK. E-mail: jane.hughes@manchester.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

The delivery of personalised support to vulnerable older people is largely contingent on those staff who provide direct care. These care workers play an invaluable role in supporting vulnerable older people that may have increasingly complex needs either at home or in care homes. Internationally, concern has been raised both about the recruitment and retention of care workers; and their skills and competencies because of their importance in the delivery of quality care services. Using both primary and secondary data, this paper explores commissioning and contracting arrangements for domiciliary care and care home provision in England and their influence on the recruitment and retention of staff in these services. The implications of the findings are discussed in the context of two factors which influence continuity of care, a proxy for quality services for older people: training opportunities for staff and factors affecting the supply of labour from which direct carers are traditionally recruited. It is suggested that some of the drivers of quality in the provision of care may not be susceptible to the influence of commissioners and providers. Nevertheless, training may aid the recruitment and retention of care workers and provide one way in which they can promote a higher standard of care for older people.

Keywords

workforcecontinuityqualityolder peoplesocial care
Type
Articles
Information
Ageing & Society , Volume 34 , Issue 6 , July 2014 , pp. 930 - 950
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alzheimer's Society 2011. Support. Stay. Save. Care and Support of People with Dementia in Their Own Homes. Alzheimer's Society, London.Google Scholar
Bainbridge, I. and Ricketts, A. 2003. Improving Older People's Services – An Overview of Performance. CI (2003)14, Social Services Inspectorate for Department of Health, London.Google Scholar
Banaszak-Holl, J. and Hines, M. A. 1996. Factors associated with nursing home staff turnover. The Gerontologist, 36, 4, 512–17.Google Scholar
Brand, C., Hughes, J. and Challis, D. 2012. Towards understanding variations in social care for older people in England. Social Policy and Administration, 46, 7, 705–26.Google Scholar
Brannon, D., Zinn, J. S., Mor, V. and Davis, J. 2002. An exploration of job, organisational, and environmental factors associated with high and low nursing assistant turnover. The Gerontologist, 42, 2, 159–68.Google Scholar
Cangiano, A., Shutes, I., Spencer, S. and Leeson, G. 2009. Migrant Care Workers in Ageing Societies: Research Findings in the United Kingdom. University of Oxford, Oxford.Google Scholar
Castle, N. G. and Engberg, J. 2005. Staff turnover and quality of care in nursing homes. Medical Care, 43, 6, 616–26.Google Scholar
Challis, D., Darton, R., Johnson, L., Stone, M. and Traske, K. 1995. Care Management and Health Care of Older People: The Darlington Community Care Project. Ashgate, Aldershot, UK.Google Scholar
Challis, D., Clarkson, P., Hughes, J., Chester, H., Davies, S., Sutcliffe, C., Xie, C., Abendstern, M., Jasper, R., Jolley, D., Roe, B., Tucker, S. and Wilberforce, M. 2011. Community support services for people with dementia: the relative costs and benefits of specialist and generic domiciliary services. Expert Briefing Paper, Personal Social Services Research Unit, Manchester, UK.Google Scholar
Challis, D., Sutcliffe, C., Hughes, J., von Abendorff, R., Brown, P. and Chesterman, J. 2009. Supporting People with Dementia at Home: Challenges and Opportunities for the 21st Century. Ashgate, Aldershot, UK.Google Scholar
Chester, H., Hughes, H. and Challis, D. 2010. Patterns of commissioning, contracting and care management in social care services for older people in England. British Journal of Social Work, 40, 8, 2523–37.Google Scholar
Chilvers, D. 2003. The case for specialist home care for people with dementia. Journal of Dementia Care, 11, 1, 20–1.Google Scholar
Cm 849 1989. Caring for People. HMSO, London.Google Scholar
Cm 4169 1998. Modernising Social Services. The Stationery Office, London.Google Scholar
Cm 4818-I 2000. The NHS Plan: A Plan for Investment, a Plan for Reform. The Stationery Office, London.Google Scholar
Cm 6737 2006. Our Health, Our Care, Our Say: A New Direction for Community Service. The Stationery Office, London.Google Scholar
Cm 7432 2008. High Quality Care for All: NHS Next Stage Review Final Report. The Stationery Office, London.Google Scholar
Cm 7881 2010. Equity and Excellence: Liberating the NHS. The Stationery Office, London.Google Scholar
Commission for Rural Communities 2008. The Personalisation of Adult Social Care in Rural Areas. Commission for Rural Communities, Cheltenham, UK.Google Scholar
Commission for Social Care Inspection 2008. Social Services Performance Assessment: Analysis Tool 2007–08 Version 2.1. Commission for Social Care Inspection, London.Google Scholar
Department for Environment, Food and Rural Affairs 2005. DEFRA Classification of Local Authority Districts and Unitary Authorities in England: A Technical Guide. Department for Environment, Food and Rural Affairs, London.Google Scholar
Department of Health 2000. A Quality Strategy for Social Care. LASSL (2000)9, Department of Health, London.Google Scholar
Department of Health 2007. Commissioning Framework for Health and Well Being. Department of Health, London.Google Scholar
Department of Health 2008. Transforming Social Care. LAC(2008)1, Department of Health, London.Google Scholar
Department of Health 2009 a. Working to Put People First: The Strategy for the Adult Social Care Workforce in England. Department of Health, London.Google Scholar
Department of Health 2009 b. Commissioning for Personalisation: A Framework for Local Authority Commissioners. Department of Health, London.Google Scholar
Department of Health 2009 c. Contracting for Personalised Outcomes: Learning from Emerging Practice. Department of Health, London.Google Scholar
Department of Health 2009 d. Living Well with Dementia: A National Dementia Strategy. Department of Health, London.Google Scholar
Department of Health 2009 e. Transforming Adult Social Care. LAC (DH) (2009)1, Department of Health, London.Google Scholar
Department of Health 2009 f. Joint Commissioning Framework: National Dementia Strategy. Department of Health, London.Google Scholar
Department of Health 2010. A Vision for Adult Social Care: Capable Communities and Active Citizens. Department of Health, London.Google Scholar
Department of Health 2011 a. Commissioning Framework for Dementia. Department of Health, London.Google Scholar
Department of Health 2011 b. Handbook: Using the Dementia Commissioning Pack. Department of Health, London.Google Scholar
Department of Health 2011 c. Case for Change – Community-based Services for People Living with Dementia. Department of Health, London.Google Scholar
Department of Health and Department for Education and Skills 2006. Options for Excellence – Building the Social Care Workforce of the Future. Department of Health, London.Google Scholar
Department of Health, Skills for Care and Skills for Health 2010 a. Working to Support the Implementation of the National Dementia Strategy Project. Scoping Study Report. Skills for Health and Skills for Care, Leeds, UK.Google Scholar
Department of Health, Skills for Care and Skills for Health 2010 b. Working to Support the Implementation of the National Dementia Strategy Project: Mapping Existing Accredited Education/Training and Gap Analysis Report. Skills for Health and Skills for Care, Leeds, UK.Google Scholar
Department of Health, Skills for Care and Skills for Health 2011. Common Core Principles for Supporting People with Dementia. A Guide to Training the Social Care and Health Workforce. Skills for Health and Skills for Care, Leeds, UK.Google Scholar
Department of Health, Social Services and Public Safety 2011. Review of the Social Services Workforce 2011. Department Health, Social Services and Public Safety, Belfast.Google Scholar
Dr Foster Intelligence 2008. Key Indicators Geographical System. Available online at http://www.drfoster.co.uk/localgovernment/kigs.asp [Accessed 24 April 2008].Google Scholar
Evans, S. and Huxley, P. 2009. Factors associated with the recruitment and retention of social workers in Wales: employer and employee perspectives. Health and Social Care in the Community, 17, 3, 254–66.Google Scholar
Field, A. 2009. Discovering Statistics Using SPSS. Sage, London.Google Scholar
Forder, J., Knapp, M., Hardy, B., Kendall, J., Matosevic, T. and Ware, P. 2004. Prices, contracts and motivations: institutional arrangements in domiciliary care. Policy and Politics, 32, 2, 207–22.Google Scholar
Forder, J. and Netten, A. 2000. The price of placements in residential and nursing home care: the effects of contracts and competition. Health Economics, 9, 7, 643–57.Google Scholar
House of Commons All-Party Parliamentary Group on Dementia 2011. The £20 Billion Question: An Inquiry into Improving Lives Through Cost-effective Dementia Services. Parliament, London.Google Scholar
Howe, A. L. 2009. Migrant care workers or migrants working in long-term care? A review of Australian experience. Journal of Aging and Social Policy, 21, 4, 374–92.Google Scholar
Hughes, J., Bagley, H., Reilly, S., Burns, A. and Challis, D. 2008. Care staff working with people with dementia: training, knowledge and confidence. Dementia, 7, 2, 227–38.Google Scholar
Hussein, S., Manthorpe, J. and Stevens, M. 2010. People in places: a qualitative exploration of recruitment agencies’ perspectives on the employment of international social workers in the UK. British Journal of Social Work, 40, 3, 1000–16.Google Scholar
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. 1963. Studies of illness in the aged: the index of ADL. Journal of the American Medical Association, 185, 12, 914–9.Google Scholar
Kennedy, P. 2003. A Guide to Econometrics. Fifth edition, MIT Press, Cambridge, Massachusetts.Google Scholar
Korczyk, S. 2004. Long-term Workers in Five Countries: Issues and Options. AARP Public Policy Institute, Washington DC.Google Scholar
Manthorpe, J., Iliffe, S., Clough, R., Cornes, M., Bright, L. and Moriarty, J. 2008. Elderly people's perspectives on health and well-being in rural communities in England: findings from the evaluation of the National Service Framework for Older People. Health and Social Care in the Community, 16, 5, 460–8.Google Scholar
Manthorpe, J. and Stevens, M. 2010. Increasing care options in the countryside: developing an understanding of the potential impact of personalisation for social work with rural older people. British Journal of Social Work, 40, 5, 1452–69.Google Scholar
Mozley, C., Sutcliffe, C., Bagley, H., Cordingley, L., Challis, D., Huxley, P. and Burns, A. 2004. Towards Quality Care: Outcomes for Older People in Care Homes. Ashgate, Aldershot, UK.Google Scholar
National Online Manpower Information Service 2008. Official Labour Market Statistics. Available online at https://www.nomisweb.co.uk/Default.asp [Accessed 23 April 2008].Google Scholar
Netten, A., Jones, K. and Sandhu, S. 2007. Provider and care workforce influences on quality of home care services in England. Journal of Aging and Social Policy, 19, 3, 81–97.Google Scholar
Office for National Statistics 2012. Counties, Non-metropolitan Districts and Unitary Authorities. Available online at http://www.ons.gov.uk/ons/guide-method/geography/beginner-s-guide/administrative/england/counties/index.html [Accessed 27 July 2012].Google Scholar
O'Kell, S. 2002. The Independent Care Homes Sector: Implications of Care Staff Shortages on Service Delivery. York Publishing Services, York, UK.Google Scholar
Rothera, I., Jones, R., Harwood, R., Avery, A., Fisher, K., James, V., Shaw, I. and Waite, J. 2008. An evaluation of a specialist multiagency home support service for older people with dementia using qualitative methods. International Journal of Geriatric Psychiatry, 23, 1, 65–72.Google Scholar
Ryan, T., Nolan, M., Enderby, P. and Reid, D. 2004. Part of the family: sources of job satisfaction amongst a group of community-based dementia care workers. Health and Social Care in the Community, 12, 2, 111–8.Google Scholar
Skills for Care 2008 a. The State of the Adult Social Care Workforce in England, 2008. Skills for Care, Leeds, UK.Google Scholar
Skills for Care 2008 b. National Minimum Dataset for Social Care. Available online at http://www.nmds-sc-online.org.uk/ [Accessed 21 January 2008].Google Scholar
Stone, R. 2004. The direct care worker: the third rail of home care policy. Annual Review of Public Health, 25, 521–37.Google Scholar
Ware, P., Matosevic, T., Forder, J., Hardy, B., Kendall, J., Knapp, M. and Wistow, G. 2001. Movement and change: independent sector domiciliary care providers between 1995 and 1999. Health and Social Care in the Community, 9, 6, 334–40.Google Scholar