Homecare and the informal information grapevine: implications for the electronic record in social care

This article explores informal information exchange in social care, and implications for formal monitoring with an electronic social care record (ESCR). Six homecare settings were studied over 14 months between 2001 and 2002. Participant observation methods were used with the recipients of homecare (n = 7) and in-depth interviews plus participant observation with formal care workers (n = 31). Allied healthcare professionals (n = 9) and homecare managers (n = 5) were interviewed, as were two family members. The findings show that assumptions about monitoring of care processes may be faulty, and that trust and negotiation are important aspects of the care delivery. Modelling of the business processes indicates that roles and responsibilities for managing a care plan may shift, with the consequence that information can be omitted from a formal record if care workers selectively withhold information from care managers. The article concludes that any formal record needs to allow for the extensive negotiation involved in needs assessment and monitoring of care plans.