Delivering Personalised Home Care for People with Dementia: An Investigation of Care Providers’ Roles and Responsibilities

Context: Home care agencies are a critical part of the social care system in England; however, little is known of how they perceive their role in delivering personalised care or their approach to supporting people with dementia.

Objectives: To investigate the perception of home care managers of their capacity and capability to provide care for people living with dementia with a focus on specialist care, and the challenges of delivering personalised support.

Methods: A qualitative study employing semi-structured interviews (May-October 2018) of ten independent home care managers in England.

Findings: Three themes were identified. First, managers aimed to provide responsive care, assessing individual needs and family circumstances, including addressing social and emotional needs in keeping with a model of personalised care. Second, in responding to commissioning processes, managers found prescriptive specifications constrained delivery of responsive home care. Sharing assessment and care planning with commissioning teams helped managers personalise client care but created tensions. Third, workforce preparedness was a priority, with life skills and experience valued above qualifications. Agencies used different service models, with only a few referring to specialist dementia roles or services. However, all were aiming to increase understanding of dementia across their teams as part of their approach to personalisation.

Limitations: It was not possible to interview home care workers who may have given alternative viewpoints.

Implications: Home care agencies could be supported to deliver personalised home care for people with dementia by taking greater responsibility for assessment and care planning, thus encouraging outcomes that include wellbeing and social goals. Developing a valued and skilled workforce will be essential to achieve this.