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Key to successfully addressing the ongoing transitions being experienced in the care home sector is a transformation of the workforce. This is required in order to respond appropriately to the increasing dependency of older people moving into care homes. This article considers the policy framework surrounding the provision of care services in England and reviews the relevant research into the workforce and the changes needed if the sector is to meet the needs of vulnerable older people living in care homes. Building on present policy and practice, consideration is given to how this change could be achieved.

The purpose of this paper is to outline the first stage of an innovative developmental study addressing the educational and emotional needs of dementia care home staff using arts-based materials.

The arts workshop was developed using a mixed methods approach. This included ethnographic observation within a dementia care home, in-depth interviews with senior care home managers, a thematic analysis of focus groups and the development of a comic. At all stages, the multi-disciplinary project team collaborated closely with the care home staff. A comprehensive literature review of the policy, practice and academic background to dementia workforce education provided a contextual framework for the study. Perspectives from the medical humanities informed the project.

Despite the high prevalence of people living with dementia in care homes, there is a lack of appropriate training for the workforce that provides their care. This study found that an arts-based workshop offering an interactive mode of education was an effective way to engage this workforce. The workshop empowered participants to recognise their skills and focus on person-centred care; reflecting current recommendations for dementia care.

The workshop was delivered in a single dementia care home and therefore findings may not be generalisable. In addition, the management did not take a direct part in the delivery of the workshop and therefore their views are not included in this study.

The arts-based approach can offer a means of engaging the dementia care workforce in education linked to their experience of caring.

The paper identifies the gap in relevant education for the dementia care workforce and outlines one possible way of addressing this gap using the arts.

The paper describes the size, nature and trends in home care, including telemedicine and hospital at home, emphasising the independent sector's contribution and highlighting the importance of home care to health and social care. It identifies a funding and capacity crisis, outlines the likely impact of any further reduction and explores contributory recruitment, training and commissioning practice issues.

High turnover of staff in the long-term dementia care sector contributes to poor quality care and lack of continuity of care in the UK and many other countries. The purpose of this paper is to explore the research evidence on what care assistants report they enjoy when working in front-line dementia care jobs in long-term care facilities.

An integrative analysis was used to study research findings focusing on the front-line workforce in care homes. The literature review sought to capture key findings, including overviews of research, from studies from 1990 to mid-2014 that have considered the positive experiences of front-line care home staff working with people with dementia.

There is a great deal of research investigating care home staff's job satisfaction. Much of this highlights the importance of personal, social and managerial relationships. Common themes continue to be reported. There is potential for work on improving care assistant experiences in care homes but also a need to address long-standing inequities affecting the care home sector.

Some studies are not precise about which staff groups they are investigating in studies about care homes and many concentrate on the problems staff report. Measures of job satisfaction vary. When exploring dementia-related care not all studies are clear if care home residents have dementia or not.

Many studies have investigated the views of care assistants working with people with dementia in care homes that address happiness in their work, often reported as job or work satisfaction, and these should be consulted when developing dementia services or managing care homes. As with other parts of the social care workforce, employers and managers need to be aware of effective and acceptable workforce reforms and ways to reduce turnover.

This review suggests the value of investigating positive aspects of care work with people with dementia living in care homes. Greater attention could be paid to job satisfaction in social care more widely.

This paper highlights the need for researchers to work across disciplinary boundaries in order to capture the complexity that care practitioners have to engage with everyday in care home settings. Drawing on findings from a literature review on the complexity of loss in continuing care institutions for older people, the case is made for less victim blaming and more appreciative approaches to research. The way this thinking informed the development of a further literature review on quality of life in care homes (My Home Life) is discussed. Findings from this second study are shared by illustrating key messages with quotes from older residents, relatives and staff living, visiting and working in care homes. These best practice messages focus on: transition into a care home; working to help residents maintain their identity; creating community within care homes; shared decision‐making; health and health services; end‐of‐life care; keeping the workforce fit for purpose, and promoting positive culture. The importance of collaborative working in both research and practice is discussed. The paper is likely to be of interest to all those concerned with improving and developing evidence‐based practice in the care home sector, including users and service providers, managers, commissioners and inspectors, policy‐makers, researchers and teachers.

Unions and worker cooperatives have long represented distinct approaches to building worker voice. This paper draws from observations of the work of the “Co-op Exploratory Committee” of 1199SEIU, the nation’s largest union local, which is seeking to expand the development of unionized worker cooperatives. Described by Martin Luther King, Jr, as his “favorite” union, 1199SEIU has a storied history of organizing frontline healthcare workers and includes large numbers of women of color and immigrant workers among its membership. Since 2003, it has also represented workers at Cooperative Home Care Associates, the nation’s largest worker cooperative. Drawing from discussions among union officials, co-op leaders, and rank-and-file union members about the potential role of unionized worker cooperatives within the labor movement, the paper examines the creative tension between stakeholder and democratic logics in efforts to expand this model. It argues that continued union decline, heightened interest in economic alternatives, and systemic frailties exposed by Covid-19 may create new opportunities for building unionized worker co-ops at scale.

The purpose of this paper is to identify lessons and implications on the theme of decent work in social care. This has long been highlighted as integral to improving social care for the elderly. The COVID-19 pandemic experience reveals lessons and implications about the systemic absence of decent work in one place, Scotland, in care homes. The main lesson and implication is a need for change beyond the focus on levels of pay and systemic advocacy of decent work as it is conventionally understood.

Data was collected using qualitative, semi-structured interviews with 20 care workers in care homes.[AQ4] A range of care system institutional stakeholders was also interviewed. A range of care system institutional stakeholders was also interviewed.

Decent work in social care may only be progressed to the extent that a culture change is achieved, transcending the institutional stasis about who owns and engages with progressing decent work.

This is a study in one place, Scotland, with a small sample of frontline care workers in care homes and representatives from a range of institutions.

Effective culture change for decent work in care homes needs to be a higher research priority. More explicit culture policies can be a mechanism by which overall decent work and system change may be catalysed and sustainably secured together. Explicit culture change is here set out with respect to operational, institutional and national domains.

There needs to be social policy and political support for situating decent work to be part of a broader culture change around care work with the elderly. A culture-oriented change plan as well as new resourcing and structures can together ensure that the nadir of the pandemic experience was a historical turning point towards transformation rather than being just another low point in a recurring cycle.

The situating of systemic decent work progress within a broader culture change, and modelling that culture change, are original contributions.

Long‐term care in general, and care homes in particular, have never enjoyed high status as a place to live and work. This remains the case. In large part this marginalised position is due to the continued failure to value the contribution that care homes make to supporting frail and vulnerable older people. In order to promote a more positive vision of what can be achieved in care homes, this paper argues for the adoption of a relationship‐centred approach to care. The need for such a model is described, and how it might be applied using the ‘Senses Framework’ is considered. It is argued that adopting such a philosophy will provide a clearer sense of therapeutic direction for staff working in care homes, as well as more explicitly recognising the contribution that residents and relatives can make to creating an ‘enriched environment’ of care.

Using participatory action research, this paper explains how the Service Employees International Union and community groups collaborated to organize home care workers in Oregon. The tactics used include policy borrowing and tinkering, a ballot initiative, coalition building, lobbying, and legislative politics. This approach to organizing low-wage human service providers has important implications for other unions. Home care workers are similar to many other human service providers because the funding stream for their jobs is public. In essence, they are quasi-public sector employees. The tactics employed by the SEIU may serve as a “handle” for organizing other human service workers, who are employed by nongovernmental organizations, but are paid through federal, state, and local government funds.

A three‐year in‐depth study has examined three models to improvecare in residential homes for older people in England. The study showed that each aimed to provide a ‘home for life’ for residents. Using multi‐source data gained from a range of qualitative and quantitative methods involving residential home managers, care staff and extensive review of documentation related to key care functions, inhibitors and enhancers to the achievement of this aim were identified. Inhibitors were lack of available top‐up funding to meet increased care needs, care staff's inadequate knowledge of behaviour‐disordered residents, workload, cross‐sector barriers and environmental problems. Among the enhancers were flexible regulation, up‐skilling of care staff, care staff's achievement in palliative care, perceived avoidance of hospital admission, and sound practice‐led relationships with nurses. The implications for practice are of relevance to policy makers, educators, community health and social care professionals, and older residents, their relatives and representative organisations.