Why are some employers more successful than others in retaining their workforce? Good Practice from Residential Care Providers January 2013

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1 Why are some employers more successful than others in retaining their workforce? Good Practice from Residential January 2013 Written by ekosgen Published by Skills for Care

2 CONTEXT The funding of social care, demographic change and personalisation are just some of the issues transforming the delivery of care services within the adult social care sector. Yet at the very time the sector is rapidly evolving, some organisations are grappling with high rates of staff turnover. As the body supporting workforce development, Skills for Care has a strong interest in the retention of the adult social care workforce. Its ongoing work on this issue shows that whilst the overall level of staff turnover within the sector is high, some organisations are very successful at retaining their staff. Skills for Care therefore commissioned a study to find out what it is that these organisations do that encourage their staff to stay with them. The researchers consulted managers in 80 organisations with high levels of staff retention, covering the main service areas (residential care, residential care with nursing, domiciliary care, day care and community care) and different sectors (private, voluntary and statutory). The headline message is that there is no single practice that guarantees retention, but rather it is a combination of human resource practices, the management of the organisation and its culture and values that together can have a major influence. This case study draws on the consultations with managers in the residential care sector to illustrate some of the good practice in relation to staff retention which emerged during the research. RECRUITMENT Good retention levels begin with successful recruitment. It is important that potential employees have a good understanding of what their role would entail and the hours they would be expected to work. This helps ensure that people who share the values and principles associated with delivering high quality care (e.g. being compassionate, treating clients with dignity, promoting their well-being) are recruited and minimises the possibility of taking on staff who leave because they find that the job or the company does not suit them. The example below demonstrates how one residential care provider re-designed its recruitment practices to address an increase in staff turnover levels: Wessex Regional Care is a registered provider of residential (and domiciliary) care operating in the South East. It currently employs 120 staff across its homes and services. Historically, the level of staff turnover has been fairly steady, although in 2012, 27 employees left the organisation. Wessex Regional Care used the financial savings from a director s restructuring to pay to procure specialist HR advice. As a result, it overhauled its entire HR systems from recruitment right through to an exit interview. It now follows a three-part recruitment process: (i) Application form (ii) Numeracy test (iii) Interview, including interaction with service users. 2

3 Short-listed applicants are invited to an interview. Using Skills for Care s toolkit Skills for life a practical guide for social care employers, Wessex Regional Care has designed a numeracy test that closely relates to the numeracy skills applicants will need in the job. Following a formal interview, Wessex Regional Care asks each applicant to meet some of its service users. The interaction between applicants and service users is assessed by both managers and the service users. Wessex Regional Care believes that this is an essential component of the recruitment process. Not everybody comes across well in interviews, but the interaction with clients provides them with an opportunity to highlight their interpersonal skills and compassion together with providing an insight into their personal attributes, values. Equally, applicants who look good on paper and have all the right qualifications don t always have the values and care skills that Wessex Regional Care is looking for. The HR manager said, We can train people and give them opportunities to do qualifications, but what is crucial is getting somebody with the right interpersonal skills. ORGANISATION OF WORK Three-quarters of managers in the residential sector think that the way in which hours of work are organised, including shift arrangements, is important in retaining care workers. This was highlighted as being particularly important when employers try to accommodate people with disabilities in their workforce public transport may not always be available when staff is expected in work. As the three examples below illustrate, there is no single approach that is best different methods work well in different organisations with all of them allowing for some flexibility to enable employees to swap or change hours on occasions. Trident reach the charity has a number of residential care homes in the Midlands catering for the elderly, young people and those with learning difficulties. One such care home, located in Shropshire, organises the provision of 24 hour care into three shifts. The evening shift, which starts at 9.30pm and finishes at 7.30am, includes a waking night shift and a sleep-in. The care home in Shropshire employs 19 care workers, all of whom work the three shifts none of them work only days or nights. Weekend working is also shared between staff, with each member scheduled to have every third weekend off. On weekend one, staff will work early on a Saturday and late on Sunday, and on weekend two, they work the reverse. The rota is produced on a six-weekly cycle so staff are fully informed of their shift patterns six weeks in advance. Staff can swap shifts with each other if they need to, informing managers of the proposed changes. The care manager of Trident reports that care being provided during unsociable hours is not an issue because of the roster system. No one works unsociable hours all the time and staff are able to plan [their personal lives] ahead because the roster is produced well in advance. 3

4 Alexandra Homes is a specialist, residential care service for adults with Aspergers Syndrome and Autistic Spectrum Disorders located in Bristol. Currently employing 35 care workers, it produces a static rota system a year in advance, which they think has a positive effect on their retention. This is supplemented by a cover rota system, which is designed to plan cover for staff holidays, illness or other absences. The staff check the cover rota and identify which, if any, extra hours they want to work. The manager of Alexandra Homes states, We ve never had a situation where we ring care workers at home and ask them to come in at short notice, it just doesn t happen. So our staff are under no pressure to work extra hours. Friary House is a care retirement home located in the South West that is staffed by 23 care workers. It provides 24 hour care, which is organised into four shifts of varying durations. The morning shift is six hours, followed by two four hour shifts to cover the afternoon and evening. The night shift is the longest and lasts 10 hours. Friary House employ some staff who work set hours each week and some who work shifts. Those working shifts are on a two-weekly rota and have alternate weekends off. Friary House tries hard to match hours of work to people s preferences and personal lives, although hours of work are discussed at interview and it is made clear to all staff that at times they will have to work unsociable hours. There is flexibility in the system and Friary House has put in place a formal process to allow staff to swap shifts and obtain authorisation from senior managers. Overall, staff benefit a rota system that is well-designed, fair, yet flexible and thus boosts staff morale and motivation, whilst service users benefit from the continuity of care that the rota helps to engender. COMMUNICATION Effective communication is key to staff retention. The research suggests there are two elements to this: Encouraging staff to be involved and/or informed about the day-to-day running of the organisation; and Encouraging them to contribute to the longer-term development of the organisation. The two examples below illustrate one organisation s approach to improving communication between staff and managers, and another s use of a formal staff council to give staff an input into decision-making. Wessex Regional Care is a registered provider of residential (and domiciliary) care operating in the South East. It currently employs 120 staff across its various homes. Following a spike in staff turnover, senior managers sought to understand why this was occurring. Through the exit interviews, they were surprised to learn that their communication with staff was not as effective as they had thought. In particular, care workers felt that their concerns were being ignored and that their opinions were not valued. To ensure an open and transparent communication system, Wessex Regional Care has therefore made the following changes: (i) High visibility of senior managers: All staff have a line manager for supervision with whom they can share ideas and go to for advice or guidance. In addition to this, senior managers attend staff team meetings. Wessex Regional Care manager says, We are trying to make sure that we are not a faceless organisation. We want to make sure that senior managers have a high profile in the organisation. 4

5 (ii) Regular, direct contact between senior manager and individuals: At least once a month, a senior manager visits each site and make sure that they speak to every employee. It gives them an opportunity to catch up with staff and helps make them feel that they can talk about anything. (iii) Unannounced visits: In the past, senior managers used to visit the different sites when there was a problem. Now they regularly makes unannounced visits. A senior manager from Wessex Regional Care states, It s beneficial to them to know that we can turn up anytime and expect the same level of care to be delivered as if it was a CQC inspection. The ad hoc visits take place at any time, although senior managers are careful not to convey the impression that they are mini inspections. Importantly, they provide the opportunity for staff to interact with senior managers, and to feel comfortable with them to raise any issues they may wish to. (iv) Involvement in decision making: Staff are encouraged to contribute to the running of the organisation and its goals. For example, when one of the care homes was being refurbished, care workers met the architect and gave their opinions on the changes they would like. Wessex Regional Care manager says, Essentially, it s about making sure that decision making isn t top heavy. Jubilee House Care Trust, located in Hertfordshire, is an established charity that provides residential care and other support services to adults with a learning disability. Employing just over 40 care workers, the charity prides itself on its approach and commitment to listening to its staff. It established a staff council nearly 10 years ago, which includes nominated representatives from each unit. The council has regular meetings and sets the agenda to discuss any issues that it feels are important. In the past this has included the role of bank workers and whether uniforms should be introduced. The CEO of the charity and the Human Resource Manager also attend council meetings. In addition to the staff council, Jubilee House Care Trust organises full staff meetings every quarter which serve a number of purposes. They allow staff to catch up with each other, discuss key decisions, reflect on the performance of the organisation over the past three months, and, periodically, its longer term aspirations. Coinciding with its 35 th birthday, the most recent meeting included a brainstorming session in which staff considered the options for rebranding the charity. Not all meetings take place on site; Jubilee House Care Trust makes a concerted effort to organise away days to encourage innovation and to support staff motivation. COMMUNICATION TRAINING The vast majority of residential care providers regard training to be a key factor in recruiting and retaining staff. The training opportunities that they provide are seen to distinguish them from other providers and enhance their reputation as a good employer. Training is also seen to boost the skills, knowledge and confidence of employees, all of which improve the quality of care. Below are examples of how training needs are assessed and provided by two organisations: one which is relatively large and one which is a family-run business. 5

6 Located in the Midlands, Barleyfield House employs 16 care workers and offers respite care, primarily to adults with learning disabilities. Barleyfields is part of Coverage Care services a not-for-profit organisation which is highly committed to training and commits a large proportion of its revenues to staff development. Each staff member has an individual training portfolio, their training is stored on a training matrix which can be accessed by them, the HR manager and head office. The training matrix specifies the training needs of each individual and reminds them (and managers) when training needs to be renewed. The HR manager uses the training matrix to devise a training plan, which sets out the short to long term training needs of the organisation. Following a review of the skills and capabilities of its staff across its 16 services enables the organisation to plan its long term goals, Barleyfield House has found that it might not have a sufficient number of care managers to meet future demand. It has therefore arranged for some members of staff to attend aspiring manager courses. On this and other related courses, Barleyfield House aims to make the accessibility of training as simple as possible. Staff can undertake formal courses over a period of time to suit their needs and are given opportunities to shadow existing managers, putting in to practice what they have learnt in their day-to-day roles. A manager from Barleyfield House says, This means staff get the benefit of training and experience they aren t expected to become managers straight away. Responding to the care needs of its clients, Barleyfield House also organises specialist training for its entire staff. In 2012, for example, staff attended a course on autism, which took place once a week for 12 weeks. At the end of the 12-week course, all staff reported that they had a better insight into why people with autism behave the way they do. Castlehaven Care, based in Shropshire, is a family run business offering respite and residential care for adults with varied learning difficulties including autism, downs syndrome and associated mobility, physical and behavioural problems. Even though Castlehaven Care is a small organisation, it is very committed to training its staff, not only for their career development but to ensure that client needs are met fully. The care manager says, There is no excuse not to be trained in this company. We make it a selling point. Training gives people insights staff come up with new ideas after they ve been on courses. The care home has formed relationships with local providers who provide training at QCF units at Levels 3 and 4 (staff are already qualified to Level 2). Training is said to be client-centred and driven by their needs. However, if care workers wish to undertake a specific course, managers will try and organise it for them and pay for it. Some courses are only attended by a few members of staff, but if they are rated to be excellent, the company ensures that all staff have an opportunity to benefit from the learning. Courses covering legislation or policy changes are generally confined to senior care workers or managers, but they are expected to share that learning with their colleagues 6

7 OTHER FACTORS AFFECTING RETENTION Alongside recruitment, communication, the organisation of hours of work, and training, there are a whole host of other factors that support staff retention. These include terms and conditions of employment, and the degree to which employees have the autonomy to decide how to provide care. Other factors are more intangible like the style of management or the culture of the organisation. What is important is that staff feel supported in their role, that they can approach line/senior managers easily, and that they have time to develop positive relationships with clients. Overall, these factors help to motivate staff and this is important as high levels of staff motivation minimise or greatly reduce the likelihood of staff leaving. Delivering social care is often equated with long hours and not enough staff, leading to stress, high levels of absenteeism, and anxiety amongst care workers. Alexandra Homes has specifically sought to address this as explained in the following quotation: We have high staff-client ratio. We provide a lot of supervision, so staff aren t stressed or anxious about working with challenging residents. They don t have stress. They come in, do their job and go home. They don t go home and worry about work. Many care workers are attracted to the sector because of the satisfaction they receive from providing care to those who need it. Study findings indicate that staff are more likely to be motivated and satisfied if the organisation is committed to delivering high quality care and meeting the needs of clients. The manager from Castlehaven Care reported: We have weekly meetings with clients about what they want to do. We make a big fuss of them in all important events, like birthdays. We even try to track down long lost relatives, bring them in from other countries. The client centred approach we take is key factor in keeping staff. Team-work and camaraderie have also emerged as important factors affecting retention. Castlehaven Care makes a conscious attempt to make the work-place enjoyable: We try and make it so this is a place where you want to go to work. We try and create a really good, positive atmosphere, and try and make this as nice a place as possible. We don t ask staff to do anything we haven t done ourselves. Further Skills for Care resources relating to Retention and Recruitment can be found at: andretentionstrategy/recruitment_and_retention_strategy.aspx 7