Delivering Care at Home: Emerging Models and Their Implications for Sustainability and Wellbeing, 2018-2020

Homecare is sometimes characterised by poor employment practices which hamper good care, leading to degrading work practices and high turnover. The sector faces rising demand / staff costs, reductions in public funding and rationing of care by LAs, with more people making private arrangements, often without support . Experts claim home care needs a ‘relationship-centred approach’, innovation including greater use of technology and skilled workers, yet the UK lags behind developments in other nations. Few studies have examined homecare provision and the social relations in which it is embedded. Specifically, how approaches to care, the use of technology and job design inter-relate in innovative provision and affect sustainable wellbeing, has not been adequately researched. This study contributes new knowledge by investigating the potential of innovative models of homecare to foster sustainable care relations, use technology and create job quality, by asking: What innovative home care models are emerging in different local and national UK contexts? What capacity do innovative home care models in the UK have to support sustainable wellbeing, and through which mechanisms is this achieved?Our programme focuses on the care needs of adults living at home with chronic health problems or disabilities, and seeks sustainable solutions to the UK's contemporary 'crisis of care'. It is distinctive in investigating sustainability and wellbeing in care holistically across care systems, work and relationships; addresses disconnection between theorisations of care in different disciplines; and locates all its research in the context of international scholarship, actively engaging with policy partners. It will fill knowledge gaps, contribute new theoretical ideas and data analyses, and provide useful, accurate evidence to inform care planning, provision and experience. It develops and critically engages with policy and theoretical debates about: care infrastructure (systems, networks, partnerships, standards); divisions of caring labour/the political economy of care (inequalities, exploitation); care ethics, rights, recognition and values (frameworks, standards, entitlements, wellbeing outcomes); care technologies and human-technological interactions; and care relations in emotional, familial, community and intergenerational context. Our team comprises 20 scholars in 7 universities, linked to an international network spanning 15 countries. Our programme comprises integrative activities, in which the whole team works together to develop a new conceptual framework on sustainable care and wellbeing, and two Work Strands, each with 4 linked projects, on 'Care Systems' and 'Care Work & Relationships'. 'Care Systems' will: (i) study prospects, developments and differentiation in the four care systems operating in England, N. Ireland, Scotland & Wales, comparing their approaches to markets, privatisation and reliance on unpaid care; (ii) model costs and contributions in care, covering those of carers and employers as well as public spending on care; (iii) assess the potential of emerging technologies to enhance care system sustainability; and (iv) analyse, in a dynamic policy context, migrant care workers' role in the sustainability of homecare. 'Care Work & Relationships' will: (i) develop case studies of emerging homecare models, and assess their implications for sustainable wellbeing; (ii) focus on carers who combine employment with unpaid care, filling gaps in knowledge about the effectiveness of workplace support and what care leave and workplace standard schemes can contribute to sustainable care arrangements; (iii) explore how care technologies can be integrated to support working carers, ensuring wellbeing outcomes across caring networks; and (iv) investigate care 'in' and 'out of' place, as systems adapt or come under pressure associated with population diversity and mobility. Each project will collaborate with our international partners. These scholars, in 26 collaborating institutions, will ensure we learn from others about ways of understanding, measuring or interpreting developments in how care is organised and experienced, and keep up to date with latest research and scholarship. Our capacity-building strategy will build future scholarly expertise in the study of sustainability and wellbeing in care, and ensure our concepts, methods, and research findings achieve international standards of excellence. Universities in our partnership are contributing 5 UK & 12 overseas PhD studentships, enabling us to form an international early career scholar network on sustainable care, supported by our senior team and partners. Our impact strategy, led by Carers UK, involves leading UK and international policy partners. Informing policy, practice and debate, we will co-produce analyses and guidance, enhance data quality, promote good practice and engage decision-makers, policymakers, practitioners in the public, private and voluntary sectors, carers, people with care needs, and the media. Our Advisory Board of leading academics, policy/practice figures and opinion formers will guide all our work.