Enhancing responsiveness of Ireland’s home support services through the lived experience of older adults: The Attune Project

Background Population ageing is increasing demand for home support services that enable older adults to live independently in their homes and communities. In Ireland, significant policy reforms are underway to introduce a statutory home support scheme aimed at ensuring equitable access to high-quality, regulated services. Central to these reforms is service responsiveness, defined as the ability of health and social care systems to recognise and respond to the evolving needs, preferences and circumstances of service users. Despite its importance, the lived experiences of older adults are not consistently captured or integrated into policy or service design. The Attune Project aims to examine responsiveness in Irish home support services from the perspective of older adults and identify opportunities to strengthen responsiveness across the system. Methods The Attune Project will use a participatory multi-method design. 1) A systematic rapid review will examine how responsiveness in home support is conceptualised and measured internationally. 2) A national survey will examine experiences of home support among older adults aged 65 years and over, using paper-based and electronic formats and incorporating both structured and open-ended questions. Approximately 2,000 paper-based surveys will be distributed nationally through voluntary and community sector partners, alongside national electronic recruitment, with a target of at least 200 completed responses. 3) In-depth interviews with a purposive sample of approximately 36 participants will explore experiences and perceptions of responsiveness in greater depth. 4) Focus groups and stakeholder consultations with home support workers, providers, and voluntary and community sector stakeholders will explore operational perspectives and factors influencing responsiveness. Patient and Public Involvement will be embedded throughout via a Service User, Carer and Advocacy Panel (SCAP), whose involvement has informed the study development and will contribute to inform the interpretation and recommendations. Engagement with policy owners will support the relevance and application of findings. Expected Contribution and Dissemination The study will adhere to relevant ethical and data protection standards. Findings from the different study components will be considered together to develop a comprehensive understanding of responsiveness in Irish home support services. Findings will inform policy recommendations, responsiveness indicators and a practical framework to support more responsive home support services. Dissemination will include academic publications, policy outputs, stakeholder engagement and accessible public-facing materials to support knowledge translation and service improvement.