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Home help services in good shape

Is it possible to create a sustainable and attractive home help service? Yes – researchers into working life at the University of Borås all agree. Together with staff and management within the City of Gothenburg’s home help services, they are onto something.

“For health and care workers to stay with home help services in the long run, we need to create the right conditions for the physical, social and organisational working environment,” says Katrin Skagert, senior lecturer in occupational science. Maria Wolmesjö, docent and senior lecturer in social work agrees. “If the people working in and leading the organisation are provided with the right support and conditions, of course this is possible, we noticed this in the early stages of the project,” she adds.

At the beginning of 2016, the City of Gothenburg established an action plan to improve the working environment within home help services, in a bid to promote good health and prevent illness, to reduce the levels of sick leave, to hold on to existing staff and attract new. A few months after the decision, Katrin Skagert and Maria Wolmesjö together with research colleagues at the Institute of Stress Medicine and Karolinska Institutet were awarded SEK 4 million from AFA Insurance to monitor, support and evaluate the implementation of the action plan over a period of three years.

The action plan covers all of Gothenburg's home help services, and two city districts: Östra Göteborg and Askim-Frölunda-Högsbo have been chosen and included in the research project. A one-year pilot study is being conducted in the two districts, where staff are allowed two paid hours of physical activity per week during work time. In addition, a new digital staff planning system is being introduced for setting timetables and planning work.

But physical activity – isn’t that a given within home help services?

“Yes, absolutely. It is a complex organisation, with health and care workers moving between different homes, and where work tasks vary depending on the needs of the service user. Often it can be both physically and psychologically demanding, so it is important to strengthen the body through exercise and physical activity,” says Maria Wolmesjö. In line with an aging population, more qualified and advanced care is being conducted in the home, which places increased requirements on the skills of health and care workers. The same staff also help with dressing wounds, managing medication, transportation, hygiene, helping the service users get dressed and undressed, making meals and housework such as cleaning and laundry. Furthermore, they motivate and involve their service users in different activities. So, in other words, it is easy to see that the work can be challenging in many ways. “The objective is that health will become a regular work task for the staff, even once the pilot project is over. Research shows that we feel better when we are active, however time needs to be allocated for this,” says Katrin Skagert.

Meeting incredibly motivated people

The research project began in 2016 and in the early stages of the research the duo saw that good potential exists for changing the working environment within home help services. Maria Wolmesjö explains further: “We have conducted a number of ‘Future Workshops’ together with staff, management and health coaches, where we address work environment issues at different stages and where the organisation itself identifies and reflects upon both problems and solutions. We meet incredibly motivated people who want to change and who have thoughts, ideas and visions that are completely feasible.

Time and resources are just some things that are in demand, as well as timetable alterations that simplify the work, even distribution between easy and difficult care shifts and the possibility to involve service users in physical activity. The time constraints and stress experienced are generally viewed as a barrier, however several creative ideas, both large and small, arose during the future workshops. These are now being tested in the organisation and will be monitored by the researchers. “It is important to highlight that change is possible and that the motivation exists. Of course, there are some people who aren’t motivated, but as researchers we are focusing on those who are. We will make it possible for people to make conscious choices that improve the working environment,” says Katrin Skagert.

Morning exercises good for team spirit and solidarity

Morning exercises were one tangible proposal for physical activity that arose during the future workshops. As a rule, the staff convene at the start of their shifts to go through the timetable, and so this creates an opportunity for a few minutes of joint morning exercise. “It is a way to warm up for the day and it also creates camaraderie; we have seen that it is important to team spirit and solidarity,” says Maria Wolmesjö.

The conversation often turns to change and influence. It is clear that this motivates the researchers in their work. A positive change within home help services can mean a lot for many – staff and their managers, service users and their relatives.
“Personally, it is super exciting to see how research can be beneficial; I’ll be really chuffed if we can contribute in some way,” laughs Katrin Skagert.
“We can both talk about this for hours,” she continues. This is a pure matter of gender equality, as for the most part this applies to women with low salaries – women who risk becoming poor pensioners if they don’t keep up their work. If we can reduce the levels of sick leave, that would be fantastic”.

Maria Wolmesjö and Katrin Skagert will continue to monitor work with the action plans. The health profiles collected will be analysed and new research questions will be identified for continuing process. The next step will then be to interview health and care workers and managers to find out about their work experiences and how they can overcome any obstacles. Other municipalities have already been in touch to find out more about the research project.
“We hope that the ideas from this project will spread further to other organisations. The result will be presented in academic journals and in a comprehensive report that can be used in worker skills development and leadership training for managers,” concludes Maria Wolmesjö.

Text: Rebecca Lindholm
Illustration: Karolina Lilliequist
Photo: Suss Wilén
Translation: Semantix