Perceptions of providing safe care for frail older people at home: A qualitative study based on focus group interviews with home care staff

Background: Providing safe care is a core competence in healthcare. The concept usually refers to hospitals but, consistent with the increasing importance of integrated care, the provision of safe care needs to be extended to the context of home care, and more research is needed concerning home healthcare providers’ perspectives in this context. Aim: The aim of this study was to describe care providers’ perceptions of providing safe care for frail older persons living at home. Method: A qualitative methodology was chosen. In total, 30 care providers agreed to participate. Data were collected through five focus group interviews and analysed using a phenomenographic approach. Results: Three themes regarding care providers’ perceptions of providing safe care emerged from the data: ‘safe care is created in the encounter and interaction with the older person’, ‘safe care requires responsibility from the caregiver’ and ‘safe care is threatened by insufficient organisational resources’. The findings show that providing safe care is an endeavour that requires a holistic view among the care providers as well as effective collaboration within the team, but insufficient competence or a lack of time can make it difficult to safeguard the psychological and existential needs of older persons. Conclusion: Providing safe care in home environments encompasses more than just risk reduction. The findings highlight the importance of establishing and integrating team-based and person-centred care into home care settings. Traditional communication structures for inpatient care also need to be adapted to the cross-disciplinary work in municipalities. Care providers should be given the opportunity to develop and maintain their competences and to prioritise relationship-oriented care