Carer Perspectives on Digital Communication and AI-Enhanced Handovers in Domiciliary Care: A Mixed-Methods Needs Assessment

Background Effective communication during shift handovers is a fundamental component of safe and continuous care in domiciliary settings. Despite growing adoption of digital tools, evidence on how frontline carers experience documentation burdens, handover failures, and technology expectations remains limited. This study sought to identify the communication challenges, digital readiness, and feature priorities of domiciliary care workers in the United Kingdom, as a basis for informing the design of AI-enhanced care summary tools. Methods A mixed-methods needs assessment was conducted using a structured online survey distributed to domiciliary and social care workers across multiple UK regions. Twenty-one responses were collected from carers, support workers, team leads, and nurses. Quantitative data were analysed descriptively. Open-ended responses were subjected to thematic analysis using an inductive approach, producing four primary themes. Results The dominant handover challenge reported was informational discontinuity — 65% of respondents did not know what the previous carer had done. Four themes emerged from qualitative data: (1) documentation as burden, (2) informational fragmentation at handover, (3) unmet technology expectations, and (4) invisible workforce needs. Strong appetite for AI-assisted summarisation was evidenced by high demand for condition-linked prompts (57%), medication reminders (52%), and team communication tools (43%). Notably, 90.5% of respondents wanted wellbeing support integrated into any future platform. Conclusions Frontline carers in domiciliary settings experience significant and addressable communication failures at shift handover. These findings support the development of lightweight, carer-centred AI tools that prioritise structured summarisation, reduce cognitive burden, and integrate workforce wellbeing. Design principles derived from this needs assessment informed the conceptual architecture of CAREi, a human-centred care platform intended for CQC-regulated domiciliary care agencies.