The other keyworkers in care homes: implications of including domestic staff in social care workforce strategies and practices relating to Covid-19 recovery

Ancillary or domestic workers in care homes are key to infection control, routine cleaning and housekeeping tasks; they engage with residents; and assist care workers providing personal care. In general, information available depicts the ancillary workforce as: low paid, but facing high risks; comprising many shielded workers, unsure about coming to work; once at work, uncertain about their safety; and worried about residents and their own families contracting Covid-19. The picture, however, lacks clarity, with ancillary workers presented as both much loved by residents, but also possible sources of contagion. These competing views encourage the development of evidence-based policy-making and workforce strategies. This 10-month study addresses the following research questions over 2 phases: How have ancillary workers experienced the pandemic, in particular its impact on their work role, personal safety and mental health, organisational commitment, and workplace support? How have work practices been changing during the pandemic from the perspective of ancillary workers, their managers, HR managers, residents and staff? Has the treatment of ancillary workers been perceived to impact care quality in homes according to multiple perspectives? How can policy and practice be developed to ensure ancillary workers are better prepared, supported and equipped to deal with future waves of Covid-19 and beyond as services are reopened and reset? How did demographic features of the ancillary workforce - BAME background, migrant, socio-economic status - impact on work-related experiences of the pandemic, with implications for staff safety and wellbeing? What does documentary analysis of care homes policies and other sources, for example Care Quality Commission (CQC) reports, tell us about support of ancillary staff? What international evidence is available about practices of supporting ancillary staff in care homes? What would be are the elements of a co-produced good practice model for managing and supporting ancillary staff in care homes in the Covid-19 context? Phase 1 will include interviews with: 50 ancillary staff; 15-20 care home and Human Resource managers; 8-10 residents and relatives. We will examine care home documents: inspectors reports, staff handbooks, job descriptions, to develop a comprehensive picture of the work context. Drawing upon our networks, we will interview people in different types of care homes, and with different personal/employment characteristics, to examine how management practice reflects variety of ancillary staff and activity in the Covid-19 context. In Phase 2, we will use findings from Phase 1 to co-produce a good practice model for employing and supporting ancillary or housekeeping staff in care homes relevant to policy making in Covid-19 and social care. We will get feedback from stakeholders and finalise a consensus model that increases support for these staff in recovery or reorientation of care home services. Study outputs will include: a detailed report on experiences and treatment of ancillary staff during the pandemic from different stakeholder perspectives; and a coproduced good practice model for policymakers and for care home providers. We will publicise our resources to managers responsible for HR, care home managers, wider care home sector; and produce policy options for national social care policymakers.