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Title: Strangers in the house : the impact of domiciliary care for older people
Author: Raithby, Michele
ISNI:       0000 0004 8499 2077
Awarding Body: Royal Holloway, University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2016
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This thesis critically examines the operation of domiciliary care for older people, applying a realist evaluation framework to the open system of provision and receipt of care in home settings. It thereby scrutinises conditions that enable or constrain good quality care in the home, from the perspectives of key agents within an inner city Local Authority Social Services Department. The provision of domiciliary care is placed within its historical context, from the period following implementation of care management to current models of personalisation and citizenship. A multi-method case study approach is adopted to analyse qualitative and quantitative sources of data from semi-structured individual interviews, group interviews and content analysis of written and electronic case recording. Older people (n=24) are interviewed for their views of receiving services from the Local Authority, managers of domiciliary care agencies (n=10) to provide their perspectives on the local market contexts, and the three locality care manager staff teams on their roles as assessors and commissioners of services. Drawing on models of professional discretion, distinct practice contexts across the constituent care management locality teams and associated provider agencies are compared. From this, mechanisms leading to discrepancies between policy production and practice implementation are proposed. To conclude, the thesis critically appraises interactions between negotiation and exercise of control and choice by the core triad of older people using domiciliary services, care management staff, and provider agencies. Methodological issues of empirical research on routine delivery of services are examined, tracing development from effectiveness paradigms and forging a synthesis between empirical welfare service evaluation and the interpretation of interlocking mechanisms in the complex construction of care services in the home.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Older adults ; Community care ; Home care services ; Evaluation