Roles and resposibilities and boundaries in

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Roles and resposibilities and boundaries in

Related content 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.

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.

Summary Summary Key points Most residents in the study 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.

Roles and resposibilities and boundaries in

Gaps are often filled by staff members over-stretching their roles but such a discretionary approach can be inconsistent, inequitable and unsustainable. Some residents especially those with cognitive impairments who do not have local, involved family may need a 'ringmaster': Complexity in HWC arises from commissioning, funding, regulation and differences in the local and national policy context - this creates the potential for tensions around role boundaries.

Despite national variations in terms of HWC provision, housing support funding and care charging, similar boundaries issues arise at scheme level across the UK.

Residents with high support needs particularly value continuity and good relationships with scheme managers and staff, who work hard to deliver a seamless service, in spite of funding cuts. No single model of HWC emerged as being the best for residents: Background This qualitative study looks at how different services, providers and other key players work together in HWC schemes and the impact this has on residents' quality of life.

HWC offers older people the privacy of their own self-contained home and the security of tenancy or ownership rights, within a community setting. 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.

Rights and quality of life Most of the residents with high support needs interviewed described huge gains for their quality of life from moving to HWC.

Although they did not describe it in these terms, HWC promoted their human and other rights, especially in comparison to other care home residents and people receiving domiciliary care in the community. Grey areas and gaps In HWC, grey areas occur where it is not clear which frontline worker should do a task or how far responsibilities should stretch.

This ambiguity can lead to confusion, gaps or duplication in a number of aspects of HWC provision, including: Just under a third of residents described problems which seemed to link to roles and responsibilities.

Gaps seemed most likely to occur in certain situations, e. Other workers, relatives or neighbours sometimes fill the gaps. The care plan is agreed with your social worker and the care organisations but little odd things crop up.

The 'ringmaster' Many HWC residents are very capable of organising their own affairs. The study found examples where this role was effectively played by relatives, the scheme manager, another member of staff, or an external professional. Why is HWC so complex? The study identified a number of factors driving complexity in HWC, including: This complexity creates the potential for tensions around the boundaries between roles.

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This has been exacerbated by cuts in public funding - for example, there was some evidence of authorities and providers shunting costs from support to service charges, which can alter the way in which services are provided. How can this impact on residents?

Roles and responsibilities can be managed effectively and with little evidence of negative impact for residents in both multiple and single provider models of HWC.

However, a recurring theme across nations and models was that this was because residents were being shielded from the complexity of the organisational arrangements by the scheme manager and frontline staff who were working hard to deliver a seamless service.

Where this had been managed well, it required time and other resources to involve residents and families. Practical implications The study identified a number of practical ways in which organisations can improve the way they work across boundaries to produce good outcomes for HWC residents.

Workforce and management Frontline staff need to be carefully selected, trained, monitored and supported with good management and pay and conditions if they are to provide the stable, high quality and seamless service that older residents value.Clarifying roles and boundaries To ensure good relations between staff and the Management Committee, it is important to clarify the division of responsibilities.

The table below illustrates how areas can be split between the Management Committee's role of carrying ultimate responsibility, and the staff's role of delivering within set targets. Derek Stockley provides training and performance management consulting services. Derek Stockley conducts one day leadership courses in Melbourne, Sydney, Brisbane and Perth or London..

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