Abstract
Home care provision has been viewed as a low-skilled routine task, that can be organized to increase efficiencies in the face of shrinking social care budgets and growing demand. However, the delivery of care is complex, requiring a more personalized approach, with a focus on emotional and relational skills of care workers. The tension between these extremes is played out at different levels within the sector, and is manifest in many different types of localized tensions. To explore this issue, this paper sets out to answer the question “How do care organizations manage tensions in the delivery of care?” and carried out a systematic review of research on tensions within social care. A number of tensions are identified in the literature which are manifest at different levels including government, organization and care worker. The review further shows how these tensions are managed in different care regimes, through both structural and practice-based approaches.