title: Types and patterns of safety concerns in home care: staff perspectives.
abstract: BACKGROUND
  Quality health care in the home is dependent on having a safe environment to provide care. This analysis is based on the data from a larger study aimed at understanding key issues in the delivery and receipt of home support services from the perspectives of home support workers (HSWs), older adult clients and family members. This analysis focuses on HSWs perspectives of safety.
  
  
  OBJECTIVE
  To explore the types and patterns of safety concerns staff encountered in home care settings.
  
  
  METHODS
  In-depth, semi-structured interviews were conducted with HSWs. The analysis included topic and analytical coding of workers' verbatim accounts.
  
  
  METHODS
  Interviews were completed in British Columbia, Canada.
  
  
  METHODS
  A total of 115 HSWs participated. The average age was 50 years, and the average tenure in this sector was 11.5 years. Fully, 71% of workers had completed at least some college-level education, and 69% of workers were born outside of Canada.
  
  
  RESULTS
  Workers identified four types of safety concerns: physical, spatial, interpersonal and temporal. We developed a conceptual model of HSW safety that demonstrates the: types of safety concerns; the multi-dimensional and intersectional nature of safety concerns and the factors that intensify or mitigate safety concerns.
  
  
  CONCLUSIONS
  Our study identifies numerous HSW safety concerns, each requiring tailored interventions and strategies. Where multiple concerns intersect, the complexity and precarious nature of the home care workspace is revealed. The identification of mitigating and intensifying factors points to future interventions.
authors.affiliation: Department of Sociology-ANSO Building, University of British Columbia, Vancouver, BC, Canada. catherine.craven@ubc.ca
authors.forename: Catherine
authors.initials: C
authors.lastname: Craven
authors.forename: Kerry
authors.initials: K
authors.lastname: Byrne
authors.forename: Joanie
authors.initials: J
authors.lastname: Sims-Gould
authors.forename: Anne
authors.initials: A
authors.lastname: Martin-Matthews
mesh_terms: D001955:British Columbia; D004777:Environment; D005190:Family; D006282:Health Personnel; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008875:Middle Aged; D061214:Patient Safety; D011787:Quality of Health Care / Q000458:organization & administration*; D012931:Social Environment; D013997:Time Factors