King's College London

Background

Care workers who help people to live at home (‘homecare workers’) may be asked to support them with healthcare interventions, such as pressure sore prevention and looking after wounds. Yet homecare workers often do these tasks without training, support or supervision. With rising pressures on health services and older people choosing to live at home with complex multi-morbidities, there is a growing need for homecare workers to have the skills and knowledge to support certain healthcare interventions. This provides an opportunity for homecare workforce role expansion at the interface of health and social care. This work is particularly timely, given the launch of the new Skills for Care ‘National Workforce Strategy’ for adult social care in July 2024, and the Department of Health and Social Care’s ‘Care Workforce Pathway’, both seeking expansion of the care workforce.

Aims of the study

This work aims to evaluate the positioning of homecare workers as proxy healthcare professionals, including the appropriateness, acceptability, impact of, and appetite for this. The key questions this work will address are:

RQ1: what is the available evidence around healthcare delegation in homecare?

RQ2: how and to what extent are healthcare tasks delegated to homecare workers, by whom, and why?

RQ3: how is this perceived by, and what are the experiences of homecare staff, people using homecare services, and other key stakeholders involved in managing and delegating healthcare tasks?

RQ4: is there an appetite for homecare workforce role expansion and what is needed to support this?

Timescale

30-months, from 1 March 2025 to 31 August 2027

Funding

NIHR Health and Social Care Delivery Research (HSDR), in response to a call for research to evaluate the organisation, delivery and quality of home care services.

Methods

This mixed-methods study will use complementary and triangulated methods to answer our RQs across four phases of work. Phase 1) a scoping review of national and international literature; phase 2) consultations and survey work; phase 3) in-depth qualitative work with homecare providers; phase 4) cross-cutting co-design workshops to develop practical outputs for homecare providers, focusing on impact and knowledge mobilisation. The research will involve diverse participant groups in terms of key EDI characteristics.

Anticipated impact and dissemination

We will produce practical resources for homecare providers, including interactive vignettes on healthcare delegation for homecare staff training. We will also develop accessible summaries and key messages from our findings including an infographic, and updated evidence-based information contributing to the ongoing dialogue around workforce expansion and career development pathways. We will be working closely with a science communication agency to ensure our findings are accessible, inclusive, and useful.

In addition to the people below, the project team includes: Pat Brown (Co-I; independent consultant); Alan Richardson (Co-I; PPI representative); and a Research Associate.