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08 / Relationship with 'the office'

Updated: Dec 1, 2023

The team working for a homecare agency typically consists of the homecare workers who visit clients, and a small group of people who coordinate and manage the operation from an office. The relationship between homecare workers and 'the office' is incredibly important in ensuring quality of care for clients as well as the wellbeing of individual team members.


It has not been possible to find any research-based material, or any other kind of material for that matter, about the relationship between home care workers and ‘the office’. This post is therefore based on my personal experience of working for three different homecare agencies, at each of which there was a slightly different dynamic between care workers and the office.


'Them' versus 'us'


The development of a ‘them’ versus ‘us’ attitude can be detrimental to the relationship between care workers and the office. It must be very difficult to avoid a degree of this creeping in, given that, ultimately, staff in the office are responsible for managing care workers from a human resource perspective: ensuring there is somebody to attend every client visit, reshuffling rotas when someone calls in sick, etc. Inevitably, there is a risk here that care workers end up being thought of like pieces on a playing board: only thought of kindly when they do as instructed, with the constant potential to be a nuisance when they create unexpected work for the office.


This mindset is probably common to an extent in all human resource settings, no matter the industry. However, given the intimate and intrinsically social nature of the work being carried out by care workers, it is vital that we go into each client’s home with a positive attitude about our work. If the only time a care worker hears from the office is to ask them to cover a shift, or to tell them they should be doing something differently (as is common with ever-changing care needs), this can produce a negative attitude in homecare workers which, in some cases, spills over into their work with clients. After all, the time they spend with clients is, from a pay perspective, the only time they are actually ‘at work’.


To avoid this, I think of the work that I do with clients as an entirely separate entity to my relationship with the office. When I am with clients, I give them my all; they have nothing to do with the way my job is managed by others. Quality of care is why the relationship between the office and home care workers is so important. How can that relationship be nurtured?


Proactive employee recognition


Acknowledging when a care worker does something well would make the world of difference. Every homecare agency has to read visit notes and, in these, it is possible to pick up on little things that care workers have thought to do which have made a real difference to their client, as well as longer-term things, like the development of a great relationship between a particular client and care worker. In an admin role, I spent a year reading all of the visits notes for one homecare agency and made a point to feedback the positives as well as the negatives to the office.


Instead of vaguely encouraging care workers to let the office know when a colleague has done something good (unrealistic given that we usually work alone!) all involved could benefit from a proactive system of employee recognition by the office.


Office staff participating in client visits


All office staff should do some client visits on a regular basis, as standard. This would do wonders for overall quality of care, as well as relations between care workers and the office.


I have encountered office staff who treat the prospect of having to cover a client visit like it is the plague. This is implicitly disrespectful to all of the homecare workers whose work they oversee, via the suggestion that they are, somehow, ‘above’ such work, which plays into common - damaging - perceptions of care work.


From a care quality perspective, nothing frustrates me more than when the person in the office who is supposedly responsible for managing a client’s care package has very limited or no knowledge at all about said client or the care they require. If care plans are not made available to workers ahead of visits, this can mean going into the home of a new client with practically no information about what you are expected to do there, and no extra time in which to work things out. Quality of care? What quality of care?


A lack of knowledge on the part of office staff can happen when one person is expected to be responsible for more clients than they can realistically have a good working knowledge of. This is symptomatic of for-profit care providers which prioritise financial growth above quality of service.


Usually, it is also to do with the fact that office team members are not expected to participate in client visits on a regular basis. Let’s imagine that a field supervisor, or care coordinator (whatever their job title may be) were to do one care visit a month to each of the clients they oversee, be that shadowing a care worker on shift, or doing it on their own. They would soon come to know where everything is kept in each house, specifically what to keep an eye out for in terms of maintaining standards, what small, unexpected challenges face care workers at each visit, and so on.


As a result, office staff would be able to helpfully answer questions from care workers regarding each client’s care, directly improving both carer and client experience. Such an approach would also mean office staff become a genuine extension of the homecare team, engendering positive relationships and mutual respect between the office and carers.

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