As the number of older people living in Assisted Living Facilities (ALFs) increases, it is surprising that so little is known about the workers who support them. This book provides an account of a study funded by the United States National Institute on Aging which looked at the experiences of direct care workers employed in ALFs in Georgia. Although some providers of housing for older people in the United Kingdom (UK) are increasingly using the term ‘assisted living’ to describe the support they provide, the nearest equivalent to frontline workers in assisted living in the UK would be workers employed in extra care or supported housing, where they are also a neglected group in employment research.

This edited book is organised into a series of chapters in which different members of the research team discuss issues such as how the workers came to work in ALFs, job satisfaction, and recruitment and retention. The study was a mixed methods one and this transfers well into book format: for example, in one chapter multi-level modelling is used to consider variation in job satisfaction and staff turnover, while in another grounded theory is used to analyse the workers' relationships with residents. Interestingly, the results from the multi-level modelling show considerable variation at facility level with some locations finding it easier to retain staff than others. This is an important message as too often commentators argue that high vacancy and turnover rates are intrinsic to the nature of care work, rather than something that can be mediated by good recruitment policies and efforts to make sure staff feel valued. In other chapters, interviews with care workers are used to give a vivid picture of participants' working lives. I was particularly struck by the chapter on universal workers in which participants described their daily work. Unlike the UK, there is no separation between care work and domestic work. and the accounts given by the workers in which they switch from helping residents bathe, to cleaning, to doing laundry gives an impression of care as a production line in which there are comparatively few opportunities to offer a personalised service. The chapter on relationships with residents shows, however, that it is the time spent ‘sitting down and talking’ together that offers study participants the greatest professional and personal satisfaction.

The book also illustrates the universality of some themes in research looking at workers giving direct care. The issues of poor pay and the racism experienced by workers from minority ethnic groups resonate with experiences reported elsewhere. Having worked as a care worker myself in care homes and in a hospital, I was also vividly reminded of the sense of cohesion and conflict that could operate among, and between, shifts. The employers' perspective is not neglected either and the emphasis on recruiting workers with ‘heart’ reminds me of those employers in our own (ongoing, UK) Department of Health-funded longitudinal study of the adult social care workforce who talked about the need for a ‘caring nature’ as an essential requirement for the job, often prizing this above experience or qualifications among potential recruits. The final chapter draws the themes of the book together and ends with some suggestions about how to improve recruitment and retention and job satisfaction as a way of improving the quality of support given to residents.

While the readership for this book is likely to consist mainly of researchers interested in the workforce employed to support older people, it would be a shame if it did not reach a wider audience. This is a work of real scholarship and many of the individual chapters would help students undertaking dissertations or theses in this area. It would also be of interest to policy analysts concerned with long-term care. It is often said that the traditional monograph has become less common now that researchers tend to concentrate their efforts on, for example, a web-based report and a series of journal articles. However, Ball and colleagues have shown that this format can still offer a valuable resource for all those interested in workers in long-term care settings.