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The purpose of this paper is to compare home care workers' views of their employment conditions by provider type – private for-profit vs public and non-profit – using the case study of Ireland.

An online survey was distributed to care workers (n = 350) employed by private for-profit, public and non-profit home care providers in Ireland. Returned questionnaires were analysed statistically in R using chi-squared tests to systematically compare key aspects of employment conditions.

Analysis shows that conditions are perceived to be significantly worse for those employed by private for-profit providers (and to a lesser extent non-profit organisations) compared to the public provider. There are wide disparities between public and private sector conditions in terms of contracts, pensions, unsocial hours pay and travel time allowances. The main area of convergence is in relation to employer support, where although the public sector performed better, the difference between the three provider types is smaller.

Relatively little research compares working conditions in private for-profit providers vs public and non-profit providers in Ireland and other countries. The findings can be understood in the context of marketisation reforms and may partly be explained by a lack of regulation in Ireland's home care sector and low unionisation rates amongst care workers employed by private for-profit providers.

Strategic socio-political views are notably scarce among contemporary discourses on the causes of abuse of vulnerable older people in care and nursing homes. This paper aims to catalyse higher order consideration and discussion of one socio-political characteristic that has relevance to the issue of abuse, that is, the market-like environment in which care and nursing homes in England operate. In doing so, the paper argues that the now firmly established but imbalanced “quasi-market” of care that has developed over many years fosters conditions under which both poor care and abuse are more likely to occur. The evidence presented in the paper focusses primarily on the rise to dominance of for-profit care home provision and the contraction of public sector provision. The paper does not examine in detail the characteristics and market presence of the not-for-profit sector because it has not held a numerically significant market share either historically or contemporarily.

Outcomes of the marketisation of the care home sector that has its origins in the political landscape prevailing in 1979 and thereafter, along with the concurrent development of its regulation and oversight, are narrated and analysed. From this, a mythos of the motives behind the transition to a market-like economy that has taken place over four decades is developed and used to explain how prevailing market conditions contribute to the perpetuation of poor care and abuse.

In the opinion of the author, there are identifiable consequences arising from the evolution of the current care economy that dispel the beliefs that providing care by means of current market-like arrangements is advantageous, that the independent regulation and monitoring of such a market is unproblematic and effective, and that the “consumers” in this market are exercising personal choice, in accord with classical economic theory.

The paper offers the opportunity for the reader to consider how the development of a “quasi” market of care and nursing home services that has come to be dominated by for-profit private providers, and that is subject to ineffective oversight, may have contributed to conditions where abuse is more likely to occur and endure.

This is a conceptual paper that explores the consequences of the creation of the market-like economy of care in which care and nursing homes now operate and suggests that it is time for prevailing market conditions to be re-visited and subjected to remedial strategic intervention.

Care of older persons in their own homes has in recent years received much attention in Ireland. The proponents of domiciliary care draw on both economic and quality of life arguments, many of which are identifiable in policy documents since the 1950s. However, little detailed analysis of the evolution of the formal care services for older persons, and the shift in emphasis from institutional to domiciliary care, has been presented. The paper aims to focus on the issues.

Using archival, administrative and policy sources, the authors traced the changing nature of formal care policies in Ireland, and analysed changes in key organising principles and features, including subsidiarity, the role of the Church and the basis of entitlements (residual vs universal).

The first type of formal care to emerge was institutional, and did not adhere to the subsidiarity principle as it was mostly delivered by the State. Subsidiarity came to the fore more clearly with the establishment of the earliest home care services by religious and voluntary organisations. The current trend towards cash‐for‐care (home care packages) is arguably a modern‐day manifestation of the arm's length attitude that the subsidiarity principle recommends the State take.

The fact that care services are increasingly delivered by private sector companies and informal carers operating in the grey market increases the complexity of the care regime and therefore makes the task of developing social care regime classifications more complicated; it also means that regulation of the care sector in Ireland is a particularly urgent task that is yet to be undertaken in a comprehensive manner.

The policy challenges involved in attempts to regulate the complex care mix are considerable.

The paper utilises both historical methods and policy analysis to highlight the changing meaning of key concepts such as subsidiarity.

The purpose of this paper is to present findings from a research project designed to determine the qualifications held by those staff who had perpetrated abuse in private sector care and nursing homes for older people during a 12-month period.

A self-completion, postal questionnaire was issued to the safeguarding teams of all local authorities in England with adult social care responsibilities to determine the qualifications held by staff who were proven to have perpetrated abuse in these facilities.

Though findings with respect to qualified nurses who had perpetrated abuse when considered in isolation were inconclusive in numerical terms, the proportion of all nursing and care staff who had perpetrated abuse, and who held either a professional or vocational qualification was high.

Responses to the postal questionnaire represented 21.8 per cent of local authorities with social services responsibilities, yet the data secured suggests that care providing staff who have received recognised training are disproportionately represented among those proven to have perpetrated abuse.

Findings indicate that recognised training for those who provide care in care and nursing homes is of limited efficacy in the prevention of abuse.

The purpose of this paper is to present some of the findings from an empirical, mixed methods research project that reveal underreporting and active concealment of abuse in private sector care homes.

Semi-structured interviews were undertaken with 36 care home personnel. An anonymously completed questionnaire was also used concurrently among newly appointed staff in newly opened care homes, to elicit additional quantitative and qualitative data.

A significant number of respondents reported awareness of acts of abuse that had not been reported within the care home or externally to the authorities. Some respondents were aware that where occurrences of abuse had been reported, no subsequent action was taken, and external authorities were not always involved in responses to abuse. A significant number of respondents were aware of deliberate strategies used to deter reports of abuse to external agencies.

Though the research draws upon the experiences of only 36 care home personnel through interviews, and 94 questionnaire respondents who had witnessed occurrences of abuse, data suggest that a significant proportion of abuse in care homes remains unreported.

The research has revealed staffs’ experiences of underreporting of abuse in private sector care homes. Findings indicate that changes are required to current methods of scrutiny of occurrences of abuse in care homes and the strengthening of incentives to report it.

The purpose of this paper is to present findings from two research projects undertaken between 2015 and 2019 that reveal continued underreporting and sometimes active concealment of abuse in private sector care homes for older people in England.

An anonymously completed questionnaire was used among newly appointed staff in 11 newly opened care homes to elicit both quantitative and qualitative data relating to the reporting of occurrences of abuse within the care homes in which they had previously worked. In total, 391 questionnaires in total were returned, 285 of which indicated that respondents had witnessed the perpetration of abuse on at least one occasion.

A significant number of respondents indicated their awareness of acts of abuse that had not been reported within the care home(s) in which they had worked, or externally to the appropriate authorities. Some respondents were aware that where occurrences of abuse had been reported within care homes no subsequent action was taken, or that external authorities were not always involved in responses to abuse. A significant number of respondents described strategies that had been used to deter reports of abuse to external agencies and to conceal its occurrence from the statutory regulator and service commissioners.

Though the research draws upon the experiences of only 285 questionnaire respondents who had witnessed episodes of abuse, data suggest that a significant proportion of abuse in care homes remains unreported.

The research has revealed experiences of continued underreporting and concealment of abuse among staff in private sector care homes. Findings indicate that a strengthening of incentives and protections extended to the staff who should report abuse are essential, and that changes to current methods of external scrutiny to which care homes are subject are required.

The purpose of this paper is to present some of the findings from an empirical, mixed methods research project that reveal the importance of the personal value frameworks held by individual staff in the prevention of abuse of older people in private sector care homes.

Semi-structured interviews were undertaken with a sample of 36 care home personnel, including proprietors, care managers and care staff.

A significant number of respondents identified the importance of personal value frameworks among staff providing care as a potential contributory factor in the prevention of abuse of older people.

Though the research draws upon the experiences of only 36 care home personnel through interviews, data suggest that the personal evaluations of staff towards those in their care is a significant contributory factor to the occurrence of abuse.

The research has identified individual staff value frameworks as a causal factor in the occurrence of abuse. The research also confirms that the perceptions of “values” among respondents directly involved in the provision of care are at odds with common understanding of “values” often cited elsewhere in connection with staff recruitment and training as a means of preventing the occurrence of abuse.

The purpose of this paper is to present findings from face-to-face interviews undertaken with 16 care and nursing home managers employed in homes situated in two English local authorities. The research sought to explore managers’ perceptions of the role of contract monitoring in the prevention of abuse.

Semi-structured interviews were undertaken with 16 care and nursing home managers.

Though personnel employed by the local authority who conducted contract monitoring were generally thought of positively by care home managers on a personal level, their effectiveness was perceived to be limited as a result of their lack of experience and knowledge of providing care, and the methods that they were required to use.

Though the research draws upon the experiences of only 16 care and nursing home managers in two local authorities, data suggest that current contract monitoring activity is of limited utility in determining the true nature of care and the presence of abuse.

Unusually, the paper explores care and nursing home managers’ perceptions of contract monitoring processes in terms of how they perceive their effectiveness in preventing abuse.