Resources and quality of care in services for the elderly

Aims: To investigate the association between resources of the workplace and the quality of care in municipal long-term care. At the municipal level, the resources comprised the proportion of care workers with a long period of professional training and the relative availability of care-giving manpower. At the level of the organizational unit, the resources comprised aspects of the psychosocial working environment. Methods: A survey of 7,500 care workers in 36 municipalities in Denmark was performed. Quality of care was measured by seven standardized questions in a questionnaire. Data on the psychosocial resources of the workplace were aggregated responses from the care workers to questions from the Copenhagen Psychosocial Questionnaire. Data on the training and relative availability of care workers were derived by combining information from payroll lists and data available from government databases. Results: There was a positive association between psychosocial resources at the level of the organizational unit and the quality of care provided by the individual care worker. There was no association between the level of professional training of the municipal workforce of care-givers and the quality of care provided by the individual care worker. There was a complex relationship between the relative availability of care-giving manpower at the municipal level and the quality of care provided by the individual care worker. Conclusions: Improving the psychosocial working environment of care workers is one key to securing sufficient caring staff for the long-term care sector; increasing manpower or increasing the proportion of highly trained staff are not in themselves such keys.