Phases
This study comprises two main phases: regulatory mapping and case study fieldwork.
Phase I: Regulatory Mapping
This mapping includes:
- Government/not for profit/private ownership
- Funding mechanisms
- Quality/accreditation mechanisms
- Employment regulation and enforcement
- Workforce structure and profiles
As part of this mapping we have interviewed representatives from aged care funding/procurement bodies; regulatory agencies, including employment enforcement agencies and care quality accreditation agencies; peak aged care provider organisations; unions and aged care advocacy organisations.
We have been using this mapping to illuminate the national contexts that are shaping job quality and care quality in aged care.
Phase II: Case Studies
We undertook nine in-depth organisational case studies with aged care providers in Australia, New Zealand and Scotland. Many of these providers had multiple sites which were included in our case studies. We are also drawing on existing case studies undertaken in Canada as part of a Canadian-led study led by Professor Tamara Daly. The empirical fieldwork was completed during 2018 and 2019.
The case studies have included both residential and home care providers. Teams comprising three to five researchers from diverse backgrounds and countries have visited each site. We have used a rapid ethnography (RE) methodology to gather data in these case studies. In RE researchers collect data from multiple sources over a relatively short period of time. The data collected includes interviews, participant observations, shadowing of a handful of frontline workers, informal discussions and document reviews. Through an RE approach we draw practical and theoretical links between the ‘everyday’ life of aged care work and the organisational conditions, and the policy and regulatory context in which the work is done.
A key feature of this approach is that the research team includes ‘insider’ (local) and ‘outsider’ researchers (from another country) in each case study.
Our ongoing analysis of data from the case studies is helping us identify how national policy settings impact on service provision at the organisational level and how providers’ organisation of care supports decent working conditions and relationship-based care. Through the case studies we have been identifying innovative or promising policies and practices that support both decent work and good quality care.
Case study
This example from New Zealand describes a model for paid monthly meetings for home care workers that recognises their knowledge of individual clients, reduces worker isolation and improves client care.
This New Zealand home care provider views regular home care workers’ meetings as an essential investment to improve client careTeam leaders hold monthly meetings for home care workers caring for clients in the same geographical area. Workers are paid for their time and travel costs to attend the meetings. The one-hour structured meetings are held in a local office/venue so home care workers have regular face-to-face contact with others working with the same group of clients, as well as team leaders, rostering staff, managers and support staff. This helps reduce workers’ sense of isolation, provides them with support and helps them feel connected to their organisation. These meetings are based on two-way information sharing, problem-solving and discussion. Workers can flag non-urgent client issues, request client reviews, and raise health and safety issues with team leaders. This regular face-to-face contact fosters strong connections between the home care workers and team leaders, which the leadership team sees as fundamental to supporting good quality care.