Facilitating “Ageing Well and Independently at Home" Through Establishing a Career Pathway for Ireland’s Home Support Workers

Short Summary: Ireland, like other prosperous nations, has an ageing population who predominantly want to age well at home. However, home support services are struggling to recruit and retain home support workers. This scoping review of the international research literature drew together evidence and best practice to develop proposals for a comprehensive career pathway encompassing career structures, training and workforce development. The Issue/Challenge: Globally, healthcare systems are undergoing transformation, with a notable transition away from traditional institutions towards provision of integrated care and support in home settings. The challenges of delivering safe and sustainable models of home-based care and support are an international concern, particularly in relation to building workforce capacity and capabilities. In many nations, home support workers have historically lacked entitlements, access to training, and opportunities for career progression, resulting in high turnover, recruitment and retention challenges. In Ireland, these challenges have led to a mounting 'waiting list lottery' affecting over 6,000 vulnerable and elderly individuals. Aims and objectives: The aim was to produce recommendations for a career pathway for support workers in home care in Ireland based on the international research evidence. The research question was: “What is the evidence to inform the development of a career pathway for home support workers in Ireland?” Target Audience: This research is likely to be of interest to an international audience of health policymakers, commissioners of home support services, home support service providers, educators and training providers, as well as home support workers, clients and family caregivers. Stakeholders and their Contribution to this Research: National stakeholder consultations on the Green Paper include policymakers, service organisations, researchers, digital health/AI specialists, and voluntary organisations. Initiative/Intervention: A scoping review following Joanna Briggs Institute methodology was performed using structured searches of electronic databases (Web of Science, PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, Social Care Online, and Social Sciences Citation Index) and grey literature (Sept-Nov 2023). Inclusion criteria and methods/relevance grading were applied. Data were analysed thematically and interpreted using a “what, works for whom, when and why” framing. Results and Impact: The 261 included articles highlight the global significance of the issues. Four overarching themes were identified: 1. Attract and develop a competent and motivated workforce, 2. Enhance working lives and retention, 3. Utilise career pathways for quality and impact, 4. Invest in data and digital for integrated home care and support. Drawing from the evidence, a Green Paper was developed outlining proposals and actions for change. The impact so far is to raise awareness of the challenges and create a shared vision for collaborative action. Learning for an International Audience: A career pathway for home support workers is essential for growing workforce capacity and skills, improving working lives and retention, and achieving the policy goal of providing home support for aging populations. Next steps: Advancing the Irish home support sector based on the proposals, necessitates collaborative action by policymakers, commissioners, employers, regulators, education and training organisations as well as the involvement of home support workers in plans for change. Funder: Leading Healthcare Providers Skillnet