Policy and Practice Note: Policy, Safety, and Regulation with Regard to Ontario Home Care Clients and Personal Support Workers

In light of COVID-19 and elevated concerns for the health of older Canadians receiving care, this Policy and Practice Note explores the confluence of the current home care policy landscape and the organisation of personal support worker (PSW) work, and highlights the need to consider governance of PSW work generally, and in-home and community care especially. PSWs are currently not professionally regulated, nor is there a central site documenting location, education, or any form of verification of the PSW workforce. Home care PSWs often provide physical care in isolated settings with no in-person supervision. In home and community health care, complaints about PSWs can be scattered among different service providers or client files not linked to or searchable by PSW name. This policy note explores how these factors and the currently unregulated status of PSWs affect home care safety in general as well as in the context of COVID-19, Ontario’s decentralised home care system, and efforts towards professional regulation.

Workload, workplace violence and harassment, and well-being of personal support workers in home and community care

Demand for home and community care services has continuously increased in Canada and elsewhere in the last few decades due to aging of the population and healthcare policy changes shaped by budgetary limitations. As a result, home and community care organizations are having trouble hiring adequate numbers of healthcare workers to meet the escalating demand, the result being increased workload on these workers. Another stream of literature has shown that care recipients and their family members, frustrated with the limited ability of healthcare workers to provide adequate care because of increased workload, might resort to violence and harassment. Bringing these two streams of literature together, we examined the relationships among three variables : workload ; workplace violence and harassment ; and well-being of personal support workers (PSWs). Using structural equation modeling, we analyzed a 2015 Ontario-wide survey of 1,347 PSWs employed in the home and community care sector. The results indicate that workload is negatively associated with extrinsic and intrinsic job satisfaction, and this relationship is mediated by violence and harassment and by stress. Specifically, workload is positively associated with violence and harassment at work, which in turn is positively associated with stress, which in turn is negatively associated with extrinsic and intrinsic job satisfaction. Our study contributes to the literature by examining the impact of a work environment factor, workload, on the well-being of PSWs. This approach makes it possible to expand the current literature’s focus on psychological processes at the individual level to a more contextual approach. Furthermore, the results have important implications for home and community care organizations as well as for the healthcare sector in general. The well-being of PSWs is critical to retaining them and to ensuring the quality of care they provide their clients. Thus, their workload should be lowered to a more manageable level to help minimize the violence and harassment they experience.

Racialized Immigrants In Canada’s Changing Labour Market: An Investigation Of The Effects Of Precarious Work On Black Caribbean Women

This research undertakes an examination of the employment opportunities and experiences of black Caribbean women in Canada, particularly within the context of the growing trend towards precarious jobs—casual, part-time and low paying—in the restructured Canadian labour market. The specific purview of this study is the labour history and employment experience of a representative group of black Caribbean women who work as Personal Support Workers in nursing homes across the Greater Toronto Area. A main concern of the study is to understand the ways in which precarious work affects these women’s settlement and integration experiences, particularly their ability to gain economic independence; this, in turn, affects a number of variables related to their, and others, perception regarding their status and place in Canada. By focusing on the case of Personal Support Workers, the study aims to shed light not only on the employment experiences of black Caribbean women in this sector but also to examine more closely the policies and employment practices that create labour market “niches” or labour “segregation” along racial and gender lines.

Racialized Immigrants In Canada’s Changing Labour Market: An Investigation Of The Effects Of Precarious Work On Black Caribbean Women

This research undertakes an examination of the employment opportunities and experiences of black Caribbean women in Canada, particularly within the context of the growing trend towards precarious jobs—casual, part-time and low paying—in the restructured Canadian labour market. The specific purview of this study is the labour history and employment experience of a representative group of black Caribbean women who work as Personal Support Workers in nursing homes across the Greater Toronto Area. A main concern of the study is to understand the ways in which precarious work affects these women’s settlement and integration experiences, particularly their ability to gain economic independence; this, in turn, affects a number of variables related to their, and others, perception regarding their status and place in Canada. By focusing on the case of Personal Support Workers, the study aims to shed light not only on the employment experiences of black Caribbean women in this sector but also to examine more closely the policies and employment practices that create labour market “niches” or labour “segregation” along racial and gender lines.