Key elements of home care workforce capability to provide integrated home care to older people: scoping review.

Kumar, Sunil; Siddiqui, Nazlee; Andrews, Sharon; Agaliotis, Maria · BMJ Open · 2025

review · Level V

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Abstract

The demand for home care services has increased with the growth of the older population. Currently, home care workers (HCWs) are experiencing challenges such as poor working conditions, high turnover, fragmented services and dissatisfied clients, which are indicative of limitations on HCWs' ability to provide quality integrated home care to older people. Therefore, we conducted a scoping review to identify the key elements that affect the capabilities of the HCWs in providing quality integrated care to older people in their homes. Scoping review. PubMed, PsycINFO, Scopus, CINAHL, Cochrane, Analysis & Policy Observatory, Australian Association of Gerontology (Australia), WHO, Trove (Australia), Social Care Online (UK) and Google between January 2014 and August 2025. Studies were included if they focused on the analysis of HCWs' experience in providing care to older people within home settings and were published in the English language between January 2014 and August 2025. 19 studies met the inclusion criteria out of 2844 retrieved articles. Most studies were conducted in North America (n=8). Qualitative studies were the most commonly reported (n=16). The findings of the studies were combined and categorised into four themes using a narrative synthesis approach. The four themes identified were HCWs' capability through (1) collaborative practice, (2) education and training, (3) structural conditions at work and (4) personal attributes. This scoping review on home care for older people highlights four interconnected pillars that shape HCWs' capabilities. This review provides valuable insights to inform the standards and policies to strengthen HCWs' capabilities across these domains. Future study is needed to explore the measures taken by agencies to understand and address key elements of HCWs' capability.

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