Introduction: Personal Support Workers (PSWs) regularly enter private dwellings to care for clients. The work is low-paid, insecure and physically and emotionally demanding. In Ontario, the ‘assisting occupations in support of health services’ occupation ties with ‘motor vehicle and transit drivers’ for the worst rate of lost-time workers’ compensation claims (8% according to the Workers Safety & Insurance Board). Materials and Methods: This qualitative research included in-depth, semi-structured interviews with 16 key informants in government, industry, and advocacy organisations. Data were coded thematically, and analysis drew on Interpretive Policy Analysis. This research was approved by a university Research Ethics Board. Results: We found work conditions for PSWs worsened during the pandemic. Worldwide PPE shortages led to conserving PPE so that PSWs often had to use the same mask for all sites they visited in a day. A shortage of workers led to creation of rapid PSW education programs and caused elevated concern about training adequacy for complex care needs. Remote assessments limited supervisors’ ability to evaluate client conditions or home environments. Taking public transportation between client homes, others living in the home, and clients themselves, were seen as increasing risk of exposure to COVID-19. Participants described that PSWs may feel morally obliged to work despite the right to refuse unsafe work. Conclusion: Some emergency policies had unintended consequences that elevated risk for workers and their clients.
Elevated occupational safety risks for home care workers: Policy gaps in a pandemic