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Saurav Chopra

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How care home staff wellbeing affects care quality

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Care home staff provide invaluable support to sick, elderly and vulnerable people, but the rewards in this industry are often in kind. A challenging and often underappreciated profession, those who enter this sector do so because they feel compelled to pursue something purposeful and giving.

Care staff work in hard, emotionally demanding roles with no relent. Often at the brunt end of verbal and sometimes physical abuse from their often angry and troubled charges, the day-to-day job can, over time, take its toll on even the most professional and resilient of people.

It’s unsurprising then that the sector has suffered with not only attracting quality talent but in retaining talent too. The repercussions of a revolving door affect on those in care – those who naturally seek comfort and support in the carers they have come to rely on and trust – is palpable; sometimes resulting in regression of progress as the caregiver withdraws.

It’s unsurprising then that the sector has suffered with not only attracting quality talent but in retaining talent too.

In this context, the implications are profound. Emotional well being in the workplace isn’t simply an optional extra, a ‘nice-to-have’. It energises and dictates whether an employee is able to perform to the best of their abilities. And in the care home environment, this co-relates directly to the quality of care delivered to the people who need it the most.

The resourcing quagmire

Several issues are responsible for this resourcing quagmire. Uncompetitive pay, unsociable working hours, hard physical graft and considerable levels of day-to-day stress have all in part contributed to the care sector’s ever-dwindling talent pool. Then there’s the perception of care work – a tough yet uncredible career compared to other healthcare disciplines that is losing out on the very talent it so desperately craves.

While this talent deficit puts extra pressure on overstretched staff to meet demand, care home organisations strive to temper the resourcing issue by commissioning bank staff to support existing teams; an expense they can ill-afford.

It’s not hard to see why the care sector is historically mired by high staff turnover and low morale. And although the solution isn’t simple, this much is clear: more needs to be done to position care work as a serious and attractive profession, on par with other more ‘respected’ healthcare disciplines.

At the same time, the industry needs to optimise the way in which care practitioners deliver care and, more importantly, deploy urgent measures to both attract talent and prevent it from leaving. Research indicates that staff engagement might just hold the key to achieving this.  

The worth in well being

In light of the UK’s apparent productivity slump, the topic of staff happiness and engagement has become all the more relevant. Innovative, forward-thinking businesses now understand the importance of investing in employee well being, not only for achieving a better balance sheet but for building a better business. Yet operations within the care sector are still yet to follow.

One study showed that three in four UK heathcare professionals would avoid working for organisations with a poor reputation of employee engagement and satisfaction. Excellent salaries, an opportunity to develop and progress a career, a culturally supportive work environment and evidence of a continuing investment in staff are some of the important things considered by candidates who are seeking a new role in this field.

Healthcare organisations that fail to make themselves attractive to new and existing talent are naturally afflicted by regular resignations and sluggish recruitment.

“Quality control is critical in this sector,” commented Josh Stamp, Business Director at Esland Care, a care home business that looks after children and young adults with emotional and behavioural difficulties.

“The success of a vulnerable child’s ability to flourish and grow under our care is made possible only by the provision of qualified and experienced caregivers. These are professionals who invest time providing practical and moral support to young people, with progress tangible only over time once trust has been established.

“High labour turnover and disengaged staff is hugely disruptive for our children. It’s therefore critical to ensure that caregivers feel genuinely engaged and valued in what they do so that continuity and quality of care is maintained.”

A report earlier this year by the Care Quality Commission attributed the poor standard of care delivered in care homes to the increasing reliance on agency staff.

An ever-changing flux in staff disrupts continuity and quality of care, and the important personal bonds that would ordinarily develop between caregiver and their charges fail to develop as rotas change.

Further failures to integrate bank staff into the culture of the existing workforce – a process vital to instilling a sense of value of, and appreciation for, the crucial role they play in the bigger picture – breeds further disconnect between contractor and care home, fostering a cold, transactional work dynamic devoid of any real passion and genuine care for the job at hand.

What’s left is simply a tick-box, punching-the-hours approach to care work that yields little engagement in staff and defeats the purpose of what working in care is all about. 

A culture of inclusivity

As part of our own general study into the subject of employee happiness, we analysed some of the world’s ‘best’ companies – organisations that were deemed as desirable places in which to work. And of course we discovered that the best performing teams consisted of staff that had a shared vision and strong sense of purpose.

Employees cared about the work they did, were made to feel that their contribution mattered and, moreover, they clearly understood how their role advanced the business. 

Until the care industry’s talent pool is rejuvenated by a fresh intake of highly qualified staff and care home organisations work hard to make a positive cultural shift in staff engagement, the use of agency resourcing to plug this skills gap issue must be coupled by a strategy for creating an inclusive and collaborative work environment that brings cohesion to piecemeal teams. 

Up-skilling talent

“The demand for quality caregivers far outstrips supply, which is why it’s important to up-skill existing staff,” continues Stamp.

“Providing continuous training and support through technology and mentorship programmes so practitioners can evolve into specialisms yet become more multi-disciplinary in their roles will ease some of the operational pressures that care homes face. Instilling best practices and a career development programme will also go some way in asserting care work as a serious and rewarding profession.”

As part of its employee engagement programme, Esland have invested in a new training suite so its staff can receive more training and support, and the mandatory NVQ Level 3 training that candidates must undertake in order to become a carer is fully funded.

A number of incentives have also been rolled out for its 160 staff, including a pension scheme, competitive salaries that rank the organisation as one of the best paying employers within the industry, and the implementation of a voluntary benefits provided by Perkbox which gives staff discounts on recreational, practical and salary-sacrifice benefits. 

“Where historically we were facing the repercussions of a revolving door issue, we are now starting to see the positive effects of our staff engagement scheme in terms of feedback and staff retention, “ said Stamp.

Happiness metrics

Staff happiness and engagement is captured via a comprehensive survey, which analyses how employees feel about all aspects of their job: from job security and personal growth, to line management and internal comms.

Once the data has been collated, weak areas are identified and a plan is built around this to ensure problems are effectively managed. Improved internal communications and access to support has been crucial to creating a positive and inclusive work culture. And while employee incentive schemes and benefits cost money, the overall affect of a work environment blighted by low staff engagement is infinitely costlier, Stamp argued.

“Some of the challenges we encountered when building on our engagement scheme was in identifying the most relevant and cost-effective benefits to include as part of the package. The implementation of more creative benefits are governed by how practical it is to rollout, so priorising is important.

The implementation of more creative benefits are governed by how practical it is to rollout, so priorising is important.

“We had to think about resourcing in order to accommodate the additional extra two-days holidays we granted for our staff. So alongside careful planning, it’s always worth developing close and trusting relationships with a handful of bank staff who know your organisation and the nuances of the job so that continuity or care is maintained.”

“Another thing to note is never underestimate the value and impact of small random acts of kindness. Granting the odd early finish or day off in return for excellent work, or gifting a signed birthday card are tiny gestures that speak volumes about how much you appreciate your staff. Incorporating ways to support employees to get the most out of life (in and out of work) is really important.

“These don’t require huge infrastructural processes or changes – just an element of consideration, which costs nothing. ”

Little goes a long way

We’ve discussed how competitive remuneration, training and support are key to attracting talent in a sector deprived of quality caregivers. But creating meaningful engagement in staff – permanent or otherwise – all starts from an intention to be inclusive and caring.

Another thing to note is never underestimate the value and impact of small random acts of kindness.

Enforcing the relevant processes and infrastructure for open communication and inclusivity will foster a strong sense of team in a field where exclusion and disengagement is virtually the norm.

Instilling a sense of value, worth and appreciation for caregivers provides a firm and stable platform for creating a well-motivated workforce and, more importantly, driving excellence in care and fresh talent to an industry in desperate need of quality candidates.

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