Care home managers are in a “no-win” situation when faced with staff shortages. Many care home providers will see high agency figures as a measure of poor leadership, which can affect bonuses and ultimately career progression; the Care Quality Commission (CQC) will view shortfalls in staff retention as a measure of poor quality under Regulation 18. Often this leaves care home managers filling shift gaps themselves and working long stints without a break.
Recruitment and retention of experienced, dedicated staff is an essential element of a care home’s overall standard of care, but the care home sector continues to experience high staff turnover and a deficit that is being filled largely by agency staff, or in some cases, not filled at all.
The Communities and Local Government (CLG) Commons Select Committee cites low pay, lack of career progression and “non-existent” training opportunities as contributing factors to a high staff turnover, with nearly half of care workers and a third of nurses working in adult social care leaving positions within the first year (CLG Committee, 2017). These figures are worrying but do seem to capture the reality of the situation for most care home managers.
An ageing workforce
Recruitment challenges are only set to deepen as the population continues to age, which will not only place a higher demand on services but will also reduce the proportion of working age members of the population. As of June 2017, the UK population exceeded 66 million and nearly 12 million UK residents were aged 65 years and over, with a large, 1947-born, cohort aged 70 years (ONS, 2018). In community and care homes, the impact of retirement will hit first and hardest, so assessing the age demographic of the workforce is imperative (Dean, 2017).
Care home providers need to plan early and provide policies that promote positive attitudes towards ageing workers, by offering schemes for flexible retirement and encouraging care workers and nurses to stay in the profession longer. Making provisions for diversity in the workplace, in which the contribution of all its staff members are valued, can be measurably linked to good care (Kline, 2014).
Negative attitudes toward ageing workers were highlighted in a recent tribunal case in which an 88-year-old hospital secretary became the oldest person in the UK to win an age discrimination case (Baska, 2019). One of the factors behind the success of this case, was evidence of inadequate training. Concerns over lack of training may place significant levels of stress on your workforce, no matter the demographic, and are directly linked to the retention of staff. CLG Committee figures suggest 24 per cent of care home staff are administering medication without training and a further 27 per cent have not been provided with any dementia training at all (CLG Committee, 2017).
Focus on flexibility
All care homes are geographically “fishing in the same pond” when recruiting staff; waiting for the “perfect” candidate to walk through the door will prove to be an unfulfilled fantasy. What we need is a positive focus on diversity, a flexible approach to the workplace and a transferable training programme that will deepen ethical messages and provide a structured career pathway.
Guest blogger Vickie Wylde RGN,
former care home manager
Baska M. (2019) NHS secretary becomes oldest person to win age discrimination case. People Management 8 February 2019. https://www.peoplemanagement.co.uk/news/articles/secretary-oldest-person-win-age-discrimination-case
Communities and Local Government (CLG) Commons Select Committee. (2017) Major reform of social care funding and provision needed. London, UK: UK Parliament. https://www.parliament.uk/business/committees/committees-a-z/commons-select/communities-and-local-government-committee/news-parliament-2015/adult-social-care-full-report-published-16-17/
Dean E. (2017) Surge in number of NHS staff applying to retire. Nursing Standard 31(19): 7–8. PMID: 28094657; DOI: 10.7748/ns.31.19.7.s3
Kline R. (2014) The snowy white peaks of the NHS: a survey of discrimination in governance and leadership and the potential impact on patient care in London and England. London, UK: Middlesex University Research Repository.
Office for National Statistics (ONS). (2018) Population estimates for the UK, England and Wales, Scotland and Northern Ireland: mid-2017.