scholarly journals Ethnicity at work: the case of British minority workers in the long-term care sector

2014 ◽  
Vol 33 (2) ◽  
pp. 177-192 ◽  
Author(s):  
Shereen Hussein ◽  
Jill Manthorpe ◽  
Mohamed Ismail

Purpose – The aim of this paper is to explore the effect of ethnicity and separate this from the other dynamics associated with migration among members of the long-term care workforce in England focusing on the nature and structure of their jobs. The analysis examines interactions between ethnicity, gender, and age, and their relations with “meso” factors related to job and organizational characteristics and “macro” level factors related to local area characteristics. Design/methodology/approach – The paper analyses new national workforce data, the National Minimum Data Set for Social Care (NMDS-SC), n=357,869. The paper employs descriptive statistical analysis and a set of logistic regression models. Findings – The results indicate that labour participation of British black and minority ethnic (BME) groups in long-term care work is much lower than previously believed. There are variations in nature of work and possibly job security by ethnicity. Research limitations/implications – While the national sample is large, the data were not purposively collected to examine differentials in reasons to work in the care sector by different ethnicity. Practical implications – The analysis highlights the potential to actively promote social care work among British BME groups to meet workforce shortages, especially at a time where immigration policies are restricting the recruitment of non-European Economic Area nationals. Originality/value – The analysis provides a unique insight into the participation of British BME workers in the long-term care sector, separate from that of migrant workers.

2017 ◽  
Vol 37 (3/4) ◽  
pp. 134-147 ◽  
Author(s):  
Caroline Murphy ◽  
Thomas Turner

Purpose The undervaluing of care work, whether conducted informally or formally, has long been subject to debate. While much discussion, and indeed reform has centred on childcare, there is a growing need, particularly in countries with ageing populations, to examine how long-term care (LTC) work is valued. The purpose of this paper is to provide an overview of the way in which employment policies (female labour market participation, retirement age, and precarious work) and social policies (care entitlements and benefits/leave for carers) affect both informal carers and formal care workers in a liberal welfare state with a rapidly ageing population. Design/methodology/approach Drawing the adult worker model the authors use the existing literature on ageing care and employment to examine the approach of a liberal welfare state to care work focusing on both supports for informal carers and job quality in the formal care sector. Findings The research suggests that employment policies advocating increased labour participation, delaying retirement and treating informal care as a form of welfare are at odds with LTC strategies which encourage informal care. Furthermore, the latter policy acts to devalue formal care roles in an economic sense and potentially discourages workers from entering the formal care sector. Originality/value To date research investigating the interplay between employment and LTC policies has focused on either informal or formal care workers. In combining both aspects, we view informal and formal care workers as complementary, interdependent agents in the care process. This underlines the need to develop social policy regarding care and employment which encompasses the needs of each group concurrently.


2016 ◽  
Vol 29 (4) ◽  
pp. 354-357
Author(s):  
Jullet A. Davis

Purpose Globally, in 1980, approximately 5.8 per cent of the world population was 65 years old and older. By 2050, this number will more than triple to 16 per cent. From a leadership perspective, there is at least one challenge (among many others challenges) to consider. This paper (viewpoint) aims to provide support for the growing need for academically prepared managers. Design/methodology/approach This paper is a viewpoint which presents several characteristics of the long-term care (LTC) field that support the need for academically trained leaders. Findings LTC leaders in all countries must be sufficiently versed in numerous management areas to provide leadership when called on by those assigned to their care. Given local area variations in population needs present across all countries, it may be unwise to advocate for national, countrywide standardization of requirements. Yet, older adults accessing LTC services should expect a minimum level of knowledge from all of their providers – not just those who provide direct, hands-on care. However, similar to those who provide direct care, leaders should receive competency-based education with specific attention to effective communication skills, team-based approaches to care delivery, information technologies and population health. Originality/value Although much of the extant literature focuses on the delivery of care to older persons, there is a dearth of literature addressing the role of LTC leaders in light of global aging. Establishing a minimum level of academic training and increasing transparency focused on the positive experiences of elders residing in LTC facilities should help dispel the notion that placement in an LTC facility reflects filial failure.


Author(s):  
Karen Christensen ◽  
Mariya Bikova

The ageing population and long-term care policies of the Organisation for Economic Co-operation and Development countries have put pressure on social care work, creating patterns of difficult ethical situations. This article contributes to contextualising such situations by applying a ‘micro-ethics’ perspective and a theoretical framework that connects micro-ethics to macro-sociological contexts, and combines the concept of ‘moral distress’ (of healthcare professionals) with feminist ethics. Based on two case studies from an ethnographic study of Norway’s long-term care, findings demonstrate how ethically difficult moments connect with structural factors, including bureaucratic, managerialist and de-professionalised models of social care work, and new relationships between older people and their families.


2020 ◽  
Vol 40 (11/12) ◽  
pp. 1301-1317
Author(s):  
Manuel Aguilar-Hendrickson

PurposeSpain departed from the Southern European tradition of residual long-term care services with the 2006 reform. The paper aims to present the main traits of the reform and its implementation, explores the reasons that may explain why the reform happened and to which extent and why it fell short of expectations.Design/methodology/approachThe article draws on available literature on the reform and on administrative data to present a complex and nuanced view of the reform process and its limits.FindingsThe reform was actually a measure to enhance and rationalize a preexisting process of social care services development, rather than the creation of a completely new care system. A rapid increase in female labor market participation since the 1990s and the looming demands of a late baby-boom and the subsequent fertility crash appear to be two key factors that explain both the previous development and its bolstering by the reform. The budgetary constraints of the Great Recession and governance problems, linked to a complex and sometimes dysfunctional multilevel governance arrangement, help to understand why the reform bogged down. Nevertheless, the overall balance is more nuanced, and significantly more services are provided 12 years after the reform.Originality/valueWhile many assessments of the reform have been negative, putting it into a larger context of social care development, the 2006 Dependency Act has contributed to a significant increase in expenditure and coverage. The impact of budgetary restrictions has been important, but other factors, such as governance arrangements, may explain more of the problems of the implementation.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 181-181
Author(s):  
Franziska Zúñiga ◽  
Magdalena Osinska ◽  
Franziska Zuniga

Abstract Quality indicators (QIs) are used internationally to measure, compare and improve quality in residential long-term care. Public reporting of such indicators allows transparency and motivates local quality improvement initiatives. However, little is known about the quality of QIs. In a systematic literature review, we assessed which countries publicly report health-related QIs, whether stakeholders were involved in their development and the evidence concerning their validity and reliability. Most information was found in grey literature, with nine countries (USA, Canada, Australia, New Zealand and five countries in Europe) publicly reporting a total of 66 QIs in areas like mobility, falls, pressure ulcers, continence, pain, weight loss, and physical restraint. While USA, Canada and New Zealand work with QIs from the Resident Assessment Instrument – Minimal Data Set (RAI-MDS), the other countries developed their own QIs. All countries involved stakeholders in some phase of the QI development. However, we only found reports from Canada and Australia on both, the criteria judged (e.g. relevance, influenceability), and the results of structured stakeholder surveys. Interrater reliability was measured for some RAI QIs and for those used in Germany, showing overall good Kappa values (>0.6) except for QIs concerning mobility, falls and urinary tract infection. Validity measures were only found for RAI QIs and were mostly moderate. Although a number of QIs are publicly reported and used for comparison and policy decisions, available evidence is still limited. We need broader and accessible evidence for a responsible use of QIs in public reporting.


2005 ◽  
Vol 48 (5) ◽  
pp. 643-653 ◽  
Author(s):  
Chris Holden

Internationalized providers of care services face competing incentives and pressures relating to profit and quality. Case studies of corporate providers of long-term care in the UK demonstrate that their mode of organization has important implications for both user choice and the organization of care work. French Les fournisseurs internationalisés sont soumis à des pressions et à des incitatifs concurrentiels pour produire des profits et de la qualité. Des études de cas portant sur les fournisseurs institutionnels d'assistance à long terme au Royaume-Uni révèlent que leur mode d'organisation a d'importantes répercussions tant au niveau du choix des bénéficiaires qu'au niveau de l'organisation du travail d'assistance. Spanish Los prestadores transnacionales de servicios se enfrentan con incentivos que compiten entre sí y con la tensión entre calidad y ganancia. Se estudian unoscasos de prestadores de cuidados de larga duración en el Reino Unido. Estos demuestran que el modo de organización tiene consecuencias importantes, tanto para opciones abiertas al usuario como para la organización de los cuidados.


2019 ◽  
Vol 34 (4) ◽  
pp. 258-267
Author(s):  
Lisa Yamagishi ◽  
Olivia Erickson ◽  
Kelly Mazzei ◽  
Christine O'Neil ◽  
Khalid M. Kamal

OBJECTIVE: Evaluate opioid prescribing practices for older adults since the opioid crisis in the United States.<br/> DESIGN: Interrupted time-series analysis on retrospective observational cohort study.<br/> SETTING: 176-bed skilled-nursing facility (SNF).<br/> PARTICIPANTS: Patients admitted to a long-term care facility with pain-related diagnoses between October 1, 2015, and March 31, 2017, were included. Residents discharged prior to 14 days were excluded. Of 392 residents, 258 met inclusion criteria with 313 admissions.<br/> MAIN OUTCOME MEASURE: Changes in opioid prescribing frequency between two periods: Q1 to Q3 (Spring 2016) and Q4 to Q6 for pre- and postgovernment countermeasure, respectively.<br/> RESULTS: Opioid prescriptions for patients with pain-related diagnoses decreased during period one at -0.10% per quarter (95% confidence interval [CI] -0.85-0.85; P = 0.99), with the rate of decline increasing at -3.8% per quarter from period 1 and 2 (95% CI -0.23-0.15; P = 0.64). Opioid prescribing from top International Classification of Diseases, Ninth Revision category, "Injury and Poisoning" decreased in prescribing frequency by -3.0% per quarter from Q1 to Q6 (95% CI -0.16-0.10; P = 0.54). Appropriateness of pain-control was obtained from the Minimum Data Set version 3.0 "Percent of Residents Who Self-Report Moderate to Severe Pain (Short Stay)" measure; these results showed a significant increase in inadequacy of pain relief by 0.28% per quarter (95% CI 0.12-0.44; P = 0.009).<br/> CONCLUSION: Residents who self-report moderate- to severe pain have significantly increased since October 2015. Opioid prescriptions may have decreased for elderly patients in SNFs since Spring 2016. Further investigation with a larger population and wider time frame is warranted to further evaluate significance.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marie Beaulieu ◽  
Julien Cadieux Genesse ◽  
Kevin St-Martin

Purpose Among the ten Canadian provinces, Quebec has experienced the most significant excess mortality of older persons during COVID-19. This practice paper aims to present the chronology of events leading to this excess mortality in long-term care facilities (LTCFs) and a comprehensive analysis of the phenomenon. Design/methodology/approach Documented content from three official sources: daily briefings by the Quebec Premier, a report from the Canadian Armed Forces and a report produced by Royal Society of Canada experts were analysed. Findings Two findings emerge: the lack of preparation in LTCFs and a critical shortage of staff. Indeed, the massive transfer of older persons from hospitals to LTCFs, combined with human resources management and a critical shortage of permanent staff before and during the crisis, generates unhealthy living conditions in LTCFs. Originality/value To our knowledge, this paper is the first to analyse official Quebec and Canadian statements concerning COVID-19 from the angle of quality of life and protection of older adults in LTCFs.


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