Quality of Work in Residential long-term care services in Italy: determinants and strategies


The Covid-19 pandemic has unveiled the structural problems of the residential long-term care (LTC) sector across countries. Against increasingly complex needs among the residents, services are affected by critical working conditions - understaffing, underqualification, low pays, non-standard contracts, precarious jobs - and organisational threats - shortages and high turn-over. These features affect the physical and mental wellbeing and dignity of the workers, as well as the continuity and quality of the services.

Until recently, policy and research tended to neglect employment in LTC. The few analyses prior to the pandemic focused on contexts where LTC is more institutionalised as a policy field, e.g. the Nordic and the Anglo-Saxon countries, and where cost containment, marketisation and privatisation have appeared to worsen working conditions, contribute to the polarisation of the (care) labour market and diminish the quality of care. Our knowledge and understanding of the phenomenon is particularly limited precisely in those contexts – as the Southern European ones - where (residential) service provision is scanter, fragmented and possibly problematic. 

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Against this background, QWoRe has four objectives, and it will pursue them through the integration of multidisciplinary knowledge and approaches, a methodology that combines qualitative and quantitative research, and a strategy based on the co-production of knowledge between researchers and stakeholders

  • First, it will develop an innovative, multidisciplinary and integrated analytical framework to understand quality of work in residential LTC services. Building and elaborating on international multi-disciplinary scholarship, the project will develop a framework to theoretically apprehend how care, employment and migration regimes, service organisation and provision interact with the logics of care and with the profile and strategies of care workers in shaping working conditions and quality of work in residential care.
  • Second, it will provide an accurate and in-depth account of the quality of work in residential LTC services in Italy. A combination of secondary quantitative data analysis and analysis of regulations in the field of care, employment and migration will allow the reconstruction of the distinctive features and variations over time of the working conditions in the residential care sector in Italy
  • Furthermore, an in-depth understanding of the quality of work in residential LTC services in three Italian Regions (Lombardy, Veneto, Emilia-Romagna) will draw on the mapping the specific care regulation in these regions and through an original qualitative survey of care workers. Through fuzzy-set, comparative qualitative analysis (Fs/QCA) the project will identify the configurations of conditions (e.g. the individual, organisational, regulative factors) that are associated with quality of work outcomes
  • Finally, six organisational case studies will investigate the mechanisms and processes that are at work in determining specific outcomes. QWoRe will contribute to structuring a field of studies for understanding quality of care work and for identifying contextualised strategies for the sustainability of the sector and practices for the quality of work and wellbeing of care workers and of care users through the production and sharing of research results in the national and international scientific community and with relevant national and local stakeholders.


15th December 2023

QWoRe’s kick-off meeting, in which the research team discussed the research goalsand methodology with the Advisory board and the Stakeholders.

December 2024

At the end of the first year the research team will discuss the project’s advancement and its first results.

November 2025

QWoRe’s final meeting will take place with a presentation and discussion of the research results and implications for policies.