certain limits. In these and other ways the government tries to enhance efficiency within the home care. However, this is only possible up to a certain limit. The number of clients that receive home care has increased during the last few years. The growth of budget, however, increased only slightly. Therefore, the home care organizations claim that the limit has been reached and that the only way in which they can manage financially is by a decline in quality of care.
Quality
As in hospital organizations, home care organizations spend a lot of energy on quality programmes. The idea is that everyone in the organization, in every function, is aware of his or her contribution to external quality. Besides these internal processes, most home care organization are a member of the National Association of Home Care. To enable this membership every organization has to fulfill certain quality demands.
Home care organizations claim that the quality of home care is threatened and that the expectations are contradictory. On the one hand they are expected to change from an organization in which the professional decides 'what is good for the client' into an organization in which the client decides what is good for him or her. On the other hand they do not have the necessary resources. There is a gap between the quality, accessibility and the amount of home care that can be delivered and the scarcity of the financial resources. This situation results in waiting lists, a rationing of home care and increased work load for the employees.
