Fragmented time and domiciliary care quality

Abstract

Purpose The purpose of this paper is to examine the marketization of domiciliary care, its consequences for employment practice, specifically fragmented time, and the implications for care quality. Design/methodology/approach Focus groups and face-to-face or telephone interviews were conducted with care commissioners, service providers and care workers across Wales. There were 113 participants in total. Findings These demonstrate fragmented time’s negative consequences for service providers, care workers and, ultimately, care quality. Research limitations/implications No care recipients were interviewed and care quality was explored through the perceptions of other stakeholders. Social implications For policy makers, tensions are evidenced between aspirations for high-quality care and commissioning practice that mitigates against it. Current care commissioning practices need urgent review. Originality/value The research extends the definition of fragmented time and integrates with a model of care quality to demonstrate its negative consequences. Links between employment practice and care quality have only previously been hinted at.