Opinions
27 Feb 2022

Domiciliary care workers should not be forgotten in wellbeing discourse

In February’s edition of The Home Page, Professor Mike Robling, Director of Population Health Trials, Centre for Trials Research at Cardiff University, argues that domiciliary care workers require just as much attention as those in residential care homes when it comes to reform of health and wellbeing policy.

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The COVID-19 pandemic has delivered a shock to all parts of UK society and put substantial strain on health and social care sectors. So much has happened - successive waves, protective measures, people dying, people ill and people afraid. The impact upon carers themselves has received much attention, particularly in the media. However, in social care a stronger emphasis on residential care homes means that relatively little has emerged about those caring for clients living in their own homes.

Whatever pressures may have already existed for those working in domiciliary care, the pandemic will only have made it worse. In many cases, domiciliary care workers will now experience a more isolated pattern of working, with fewer opportunities to gain support from other team members. Throughout the pandemic, they have continued to provide essential and often personal care, but at what cost? A substantial workforce employed across a large number of organisations are spread throughout all sections of the community. A relatively hidden workforce compared to others, but essential and visible to their clients.

To better understand the health needs of domiciliary care workers we are using anonymised information drawn from healthcare records. In Wales, the regulator Social Care Wales has shown foresight by enabling professional registration data to be added to this health data. That means we can understand the health of the workforce more precisely than ever before without compromising individual’s confidentiality. We can track health over time and see whether current or future support for domiciliary care workers makes a difference.       

Our work in Cardiff has shown that there are important mental health concerns for many domiciliary care workers. This may resonate with many in the sector and our data adds much-needed detail about this. We will explore further why some carers are more affected than others – not just for mental health but for physical health too. Any differences we find may be affected as much by the care worker’s own personal, social and community circumstances as their work environment. 

Effective solutions to support care workers are more likely if they draw upon carers’ own experience, including sharing good existing practice. This may include changes to team working and organisation, more appropriate PPE or staff training that reflects the everyday reality of domiciliary care. Working with carers, using locally grown solutions and using existing data offer efficient routes to tackling challenges that are likely to extend beyond the end of current pandemic.

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