Whose responsibility? Roles and responsibilities in housing with careWHOSE RESPONSIBILITY? BOUNDARIES OF ROLES AND RESPONSIBILITIES IN HOUSING WITH CARE

Imogen Blood, Jenny Pannell and Ian Copeman
Joseph Rowntree Foundation, 2012

This study explores the boundaries of roles and responsibilities in HWC and how they impact on older residents' quality of life, particularly those with high support needs.

Housing with Care (HWC) offers older people the privacy of their own self-contained home and the security of tenancy or ownership rights, within a community setting. They can choose to access care and support (usually with staff on site 24/7), company and social activities, and other facilities, such as a restaurant. However, there is an enormous variety of models on offer from not-for-profit, public and private sector providers, sometimes delivering different services in the same scheme. Some are run independently by private companies or charities, but many schemes are commissioned by local authorities. Sometimes commissioning decisions or other circumstances result in a change in who is providing what at scheme level.

Our study focused on the impact of this complexity on older people's quality of life, and the boundary contests which can arise from it. Our fieldwork covered all four nations of the UK and included tenants and leaseholders, and private sector as well as not-for-profit providers.

Most residents reported very positive experiences of HWC, but a third described problems linked to roles and responsibilities, from building maintenance to increasing care needs.

Ambiguity around the boundaries between job roles can lead to confusion, gaps or duplication.

Gaps are often filled by staff members over-stretching their roles, but such a discretionary approach can be inconsistent, inequitable and unsustainable.

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