Staff and case management: Commissioning home care for older people
Home care staff
Staff are crucial in helping people to be cared for at home, making it possible for service users and their unpaid carers to take part in decision-making and restoring their faith in their own resources and their sense of control over their lives. 
Staff morale needs boosting: better pay, training and management that gives them the confidence to do more and be more flexible are all important. 
Practice example 3 shows how care can be improved by enhancing staff conditions and increasing the flexibility that staff have in their caring role.
In many areas, service provision is so complex that individual service users cannot find out what is available and what they may be entitled to. The main factor in whether a user takes up a service is whether they have a person to help them with investigating and following up referrals, such as a family member, a general practitioner or other professional. Many older people do not have such an advocate, and would benefit from a case manager who can navigate health, social care, housing and educational matters on their behalf. 
Practice example 4 shows how an advocate helped a centenarian to have a ‘good death’.