A rapidly changing homecare service sector implies difficulties to control safety and health risks for staff and to guarantee standardised deliveries of services to recipients. This study aimed to describe staff perceptions of safety climate and practices in homecare service teams, and suggestions for improvements. A second aim was to identify if and how the appraisals of safety climate were related to individual perceptions of safety, mental strain and adverse events/injury. A convergent parallel mixed methods design was used. Nursing assistants and care aides (133 in total, representing 11 work teams) in the north of Sweden replied to a survey and participated in focus group interviews. Results were analysed with ANOVA (inter-team differences) and by qualitative content analysis. Significant diversity was identified between the teams in five of seven dimensions of safety climate. Important areas for improvement were: a need to define and agree on criteria for a safe working environment; leadership prioritising safety at work; and management able to provide trust, support and time. A prerequisite for these agreements was improved authority and communication between all parties involved. The safety climate dimensions were related to personal perceptions of safety and mental strain and, partly, to adverse events/injuries.
Keywords: health services research; injury; mental strain; quality improvement; risk management; safety climate; teamwork.