The decrease in hospital recovery time created a transition to more care being performed in the home. There is a need to balance care needs from both demand and supply characteristics. This research sets out to address how the presence or absence of informal caregiver(s) impacts on resource allocation decisions made by home and community care case managers. This research used a mixed methodologies approach employing both semi-structured interviews with frontline workers and secondary data analysis of the Central and Toronto Central LIHN Resident Assessment Instrument for Home Care (RAI-HC). Overall total average hours of formal services did not differ between care recipients depending on the presence or absence of a caregiver. It is evident from the responses provided by the participants that street-level bureaucracy plays a large role in service allocation decisions. That is, decisions are being made based on diverse idiosyncratic observations, opinions and feelings.

The decrease in hospital recovery time created a transition to more care being performed in the home. There is a need to balance care needs from both demand and supply characteristics. This research sets out to address how the presence or absence of informal caregiver(s) impacts on resource allocation decisions made by home and community care case managers. This research used a mixed methodologies approach employing both semi-structured interviews with frontline workers and secondary data analysis of the Central and Toronto Central LIHN Resident Assessment Instrument for Home Care (RAI-HC). Overall total average hours of formal services did not differ between care recipients depending on the presence or absence of a caregiver. It is evident from the responses provided by the participants that street-level bureaucracy plays a large role in service allocation decisions. That is, decisions are being made based on diverse idiosyncratic observations, opinions and feelings.