Methods: One hundred and forty-seven self-report questionnaires were mailed to home care workers in a community centre in Northern Ireland. Two focus group sessions were completed to obtain more detail about commonly raised concerns. Workers were asked about the following issues: reasons for considering leaving home care; working hours; supervision and support, and qualifications and training; workload pressures; client attitudes; pay; and job satisfaction.

Findings: Forty-five workers completed questionnaires and 12 participated in the focus groups. All participants were female; however, they ranged in age, experience, and qualification. Almost half of the participants had considered leaving their jobs in home care. The following reasons were given, in order of importance. Working hours: Dissatisfaction with working hours was one of the key reasons given by home care workers who had considered leaving, particularly those who did not have guaranteed hours (both quantity and timing). Supervision and support: A significant minority felt that more regular supervision and support would be useful on a day-to-day basis, but also outside of regular business hours, in times of crisis (e.g., death of a client), and during emergencies. Workload: About two-thirds of the participants reported that they 'sometimes' or 'never' had enough time to complete their tasks, and half felt that this was regularly the case. Client attitude: Some home care workers felt taken for granted by their clients and their clients' families. Pay: Less than half were dissatisfied with their pay, however, many felt that traveling expenses were poorly compensated. Job satisfaction: The majority reported high level of job satisfaction and felt that their jobs were worthwhile.

Conclusions: The retention of home care workers is a major challenge that must be addressed in Northern Ireland and other countries with home care programs, including Canada. The increasing complexity of health needs has caused a substantial change in the type of work and hours required of home care workers to perform tasks. Providing staff with guaranteed hours (and by extension, stable incomes) was considered critical to retention, and the improvement of supervision during certain circumstances such as emergencies was also suggested. The concerns identified here allow policy-makers and managers to gain insight into the perspective of home care workers and identify ways to improve retention.

Reference: Fleming G, Taylor BJ. Battle on the home care front: perceptions of home care workers of factors influencing staff retention in Northern Ireland. Health & Social Care in the Community. 2007; 15: 67- 76.

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