- 20 August 2020
- 18 min read
How We Can Improve Recruitment and Retention of Care Assistants in Social Care
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After an eye-opening comment on a previous article, we asked Care Assistant, Zuva, to expand the points she made in an article. Here’s Zuva’s take on how to improve staff retention within Social Care.
Topics covered in this article
Being Honest About What Care Work Is Actually Like Will Help Prevent High Staff Turnover
Things You Must Know If You Want To Work In Care: 5 Unexpected Challenges Of Care Work
How We Can Adequately Prepare New Staff for Care Work
It's Not All About Pay: We Need to Develop Career Progression for Care Workers
Will We Ever Solve The Problem Of Recruitment And Retention?
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Arguably, one of the most undervalued groups in our society is Care Assistants, but thanks to the recent Coronavirus pandemic we have seen how valuable they are to the Social Care sector and to people’s lives.
All over the country, thousands of people risked their lives and those of their family, to go out to work in care homes, the community, and people’s homes so they could help others stay safe and look after them during this crisis.
We expressed our gratitude every Thursday, with the rest of the nation as we would “Clap For Our Carers” – an initiative that was created to acknowledge the brilliant work that people in the NHS and Social Care do.
For those who have experienced and seen the work Care Assistants do, there is no denying the value they bring but something strange is happening.
In 2017 it was estimated that 900 care workers quit their job every day.
That is 382,500 people in a year which is almost the same as wiping out the entire population of The Bahamas.
If being a Care Assistant is so good and worthwhile, then why is it that so many people leave this line of work?
Many have deemed that the Social Care sector is in a crisis and in an effort to overcome this challenge the government launched their “Everyday Is Different” campaign to attract more people into social care.
However, if this is to be successful, we must ask the right questions and get to the root of the problem.
What is it about recruitment and retention of Care Assistants that we are not understanding?
And most importantly how can we turn things around.
Where Did It All Go Wrong?
There is a story of an American car executive who visited a Japanese car assembly line.
At the end of the line the doors were put on the hinges the same as in America.
But something was missing.
In America, one of the workers would take a rubber mallet and tap the doors to ensure they fit perfectly.
At the Japanese assembly line nobody did that.
Confused by this, the American asked at what point did they make sure the door would fit?
Their Japanese guide looked at them, smiled sheepishly and replied:
“We make sure it fits when we design it”.
In Japan they did not accumulate data and try and figure out the best solution to a problem.
They simply engineered the outcome.
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The Japanese understood that if something did not fit, it was because of a decision they made at the start of the process.
One detail missed in the beginning is enough to create an undesired outcome.
In Social Care, the outcome we see today in the form of a high staff turnover rate is because the system was built without a sound understanding of human beings and their needs: The need for security, the need for relatedness, the need for esteem; to name a few.
These were not considered.
After all human needs are what drive people’s actions.
If retention of Care Assistants is affected, it is because people’s needs are not being met.
So, step one in improving the Recruitment and Retention of Care Assistants is developing a thorough understanding of human needs and making meeting those needs a top priority.
It is also crucial to remember that needs will vary from person to person.
That is why there are different reasons as to why people leave care work.
If we closely examine how the system is set up from a Care Assistant’s perspective – we will find that it is not exactly designed to help Care Assistants thrive in the care environment.
Rather it can get in their way.
Even as early as at the recruitment phase.
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What Do You Think?
Ask questions, comment and like this article below! Share your thoughts, add your opinion in the comments below.
CommentBeing Honest About What Care Work Is Actually Like Will Help Prevent High Staff Turnover
Take a look at any typical job ad for a Care Assistant role. You will find something that reads like this:
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“Rewarding” is a term we hear mentioned a lot concerning Care Work.
Whilst it is true that aspects of Care Work can be rewarding it is also true that care work can be very demanding.
That reality needs to be spoken more of especially to people who maybe taking an interest in care work for the first time.
This is so people can make an informed decision about whether they want the job or not.
Otherwise people come into the job expecting a “rewarding” experience but soon realise that care work is not so “glamorous” and it is that dissonance that causes people to leave.
Whereas if a person knows beforehand the challenges that could arise, they proceed with the job better prepared and less likely to leave which would result in improved retention.
They may even begin to think of potential solutions.
Human beings have a psychological need for competence.
Competence promotes the pursuit of challenging and deeply satisfying experiences and when we withhold the truth from a potential Care Assistant, what we are actually doing is denying them an opportunity to exercise their capability.
Transparency builds trust which is essential in motivating people.
This approach may not yield a high number of people applying but it will at least attract people that are willing and able to stick the course.In “The Origin of Species”, Charles Darwin wrote about Natural Selection - a process whereby organisms in an environment adapt and change.
Darwin’s ideas referred to species in nature, however they are applicable to the care environment too.
Imagine a care setting where a new person comes in to work with existing “well-adapted” Care Assistants.
Because of our inherent desire to belong, this person is likely to adopt the qualities and practices of the “well-adapted” to fit in.
As Darwin noted:
“In the history of humankind, those who learned to collaborate and improvise most effectively have prevailed”.
Proximity has a powerful effect on human behaviour and if we embrace a long-term approach to recruitment, we will eventually see a care sector with low turnover because the norm is “well-adapted” Care Assistants.
All this is possible because of a single decision to be honest with people about what the reality of Care Work is.
Of course, there are other factors which affect retention, but the challenges must be known.
Things You Must Know If You Want To Work In Care: 5 Unexpected Challenges Of Care Work
I believe that how Care Work makes you feel determines whether you stay or you leave and it’s the things that you did not see coming that are likely to affect you most:
1) If you start a new job in a place you have never worked before it can be difficult to form friendships with your colleagues.
You are new and they have already formed groups of their own.
Sometimes even asking questions can feel like you are bothering people. Before you know it work can soon become a lonely place.
2) Not everyone will appreciate and value what you do.
Some people may even talk down to you.
After all you are “just a Care Assistant”.
I do not actually mean this, but you must be aware that some people will view you as just that.
The perception of Care Work being a low standard job is still very much alive.
This is something that may not bother you until you are in the presence of person who thinks very little of you and treats you accordingly.
In the case of live in care work, you might even work for people that make it clear that you are only there to do what they need and have no desire to interact with you further.
3) You may come across situations where you will witness a colleague do something wrong.
That can be quite challenging to deal with because you won’t want to offend them, but you know they have to be corrected.
Or sometimes it might be a situation that needs to be reported to the Manager. It takes courage to do that because you could get someone into trouble even though it’s the right thing to do.
It isn’t always easy to follow through with.
4) Care work is a role that requires you to connect with others.
This is one rewarding aspect of it because when you form good relationships with people that enhances your life and theirs.
But what happens when they pass away?
How do you tell their family?
But also, how do you deal with their passing?
This can be difficult because in some cases the relationship you had with them can feel like family and losing them can be tough to deal with especially if you never expected to feel sad, because it was just “work” after all.
5) There are aspects of Care Work which may conflict with your culture.
For example, your culture may not permit you to see a person of the other sex naked but you have to help them get washed and dressed.
Your culture is important to you and so is your work.
Such conflict can cause you to feel guilty and torn and sometimes you just won’t know how to do deal with it.
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ContributeHow We Can Adequately Prepare New Staff for Care Work
We have three opportunities to prepare new Care Assistants:
1. Before Recruitment
By 2005 Wendy Kopp of Teach for America had convinced more than 97,000 of the best graduates from top institutions such as Harvard and Yale to spend the first two years of their career teaching underprivileged children in some of the country’s worst schools.
Not only that but these teachers went on to make a remarkable difference to many children’s lives some of which couldn’t even hold a pencil at the age of 7.
How did she manage to get these people to work for low pay and in tough classrooms?
First, by tapping their idealistic passions and second by making the process selective.
She basically said to them:
“If you’re really good, you might be able to join our cause, but first, you have to submit to a rigorous screening and evaluation process. You should prepare yourself for rejection, because it takes a special capability to succeed in these classrooms.”
The irony is that this actually made the opportunity more attractive and thousands of graduates were interested.
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Care Employers can learn from this and exercise transparency when they place job ads for Care Assistants.
Rather than strictly focusing on the benefits of the job, this is the first chance we have to prepare a person by relaying the challenges of the job.
This is as simple as stating something along the lines of:
“There are days when this job will be difficult for you to do. It will take a lot out of you mentally and emotionally. If you can prepare for that, then we would love to hear from you. Apply below to join our team”.
At least this gives people a glimpse of what’s to come.
2. At Interview Stage
Through open conversation managers can expand on those challenges because presumably if someone has seen a job ad and proceeded to apply, they are clearly interested.
This would require changing the format of interviews.
I know a manager of a family run Care Home who gives people the choice to have the interview in an office or outside in the garden of the home.
They go for a walk in the garden and the interview is more relaxed.
It becomes a conversation rather than an “interview”.
The candidates get a tour of the home so they can begin to see what happens on a typical day.
3. Training
Allow experienced Care Assistants to take the lead and train new staff.
They know the job, they know what it’s like working in that particular place and they probably even know when to avoid the manager and which colleagues gossip the most.
Ok I joke but my point is only a person who has lived and breathed something can teach you effectively.
A person or Manager who has never been a Care Assistant handling the training won’t cut it.
That is like a fish trying to teach a monkey how to climb a tree.
In Care Work the things that matter and make a difference are those seemingly minute details.
As it stands Mandatory Training for Care Work focuses a lot on things like COSHH and so many other regulations.
It is time that we simplified training by focusing on what actually happens on the job.
The job is more than just attending to a person who needs care.
The job also involves knowing how to work well with your colleagues and knowing how to take care of yourself.
This stuff matters because ultimately it affects the quality of care given towards a person.
That is what new care staff need to be prepared for.
Allowing Care Assistants to take the lead in training newcomers kills two birds with one stone.
A common reason why people end up leaving Care Work is because of lack of career progression.
It's Not All About Pay: We Need to Develop Career Progression for Care Workers
If low wages were the main reason why people leave Care Work, we wouldn’t have anyone doing Care Work in the first place because how much you will earn is something you are told in the beginning.
There are many people who work as Care Assistants and are content with the money.
Increasing the wages is a good idea and I am sure people would welcome that but equally we need Career Progression.
You become a Care Assistant and then maybe a Senior Care Assistant and then what?
When we seek progression what we are trying to satisfy are our needs for fulfilment, growth and greater responsibility.
There isn’t much to care work in terms of job tasks.
So, it doesn’t take long before the work becomes repetitive and a person feels stagnant.
Everyday is Different? I beg to differ.
So, if Care Assistants were given the responsibility of training others, that’s taking a step in the right direction as it adds a new dimension to Care Work.
How else can we improve career progression in care work?
Well interestingly a lot of care business owners or consultants started off as care workers.
So how about we highlight these possibilities to people.
How about we start looking at care work as a stepping stone to that end goal?
Laying a new path for people.
Running a care business might not be everybody’s dream but there are many other ventures that can come out of experiencing Care Work.
Rather than expecting people to come into Care Work and stay for a long time, we could actually encourage people to leave except they will be leaving to enhance the sector in a different area.
Managers would take on more of a coaching role and have these conversations with new care staff and set plans to move people forward.
Encouraging people to solve problems and giving people the freedom to do so is how we can begin to prepare our future “business owners and consultants”.
At a company named as one of Brazil’s Best Places to Work, Brasilata; employees sign what’s called an “innovation contract”.
Management challenge employees to come up with ideas for how to create better products, improve processes etc Employees are known as “inventors”.
This identity has fuelled Brasilata’s business success as the “inventors” continue to come up with exceptional ideas but most importantly employee satisfaction.
At Brasilata being an “inventor” is a source of pride and strength.
This may seem counterintuitive considering we want to stop people from leaving but consider this: At present Care Work is not seen as a respectable career.Some people might even say “it’s a last resort for people who are down on their luck” or just a job to do when all else fails.
So for example if a person comes into care work knowing that after three years, they would have developed the insight and skills to be able to run a care home this will shift a person’s mindset from Care Work being “just a job” to it being a learning opportunity.
Care Work will no longer be a stagnant job with no prospects.
It becomes something which has purpose and purpose is the motivation that drives people towards a satisfying future.
Wouldn’t this do wonders for the reputation of Care Work?
Imagine the Social Care sector becoming known as the place where people flourish, people feel proud to be a part of it and most importantly they are happy to come to work.
We would see more people come into the Sector not because they don’t have any other option but because they genuinely want to be here.
Three years may not be a long time but it’s better than people leaving after a few months because they are disgruntled.
We would see an increase in young people joining because now they have direction.
Research conducted by PwC revealed some of the frustrations young people who work in care have:
• I don't see any opportunities to progress where I'm working so I may as well go and do something else
• There are no examples of a great career story. There’s no one to aspire to
• I’ve never had a conversation about where I want to get to
What we have perceived as a lack of interest in Care Work may actually be lack of clarity.
Will We Ever Solve The Problem Of Recruitment And Retention?
Absolutely Yes!
People have been waiting for a change and it is encouraging to know that the government is ready to facilitate change.
In a wonderful speech to an audience at the Royal College of Physicians, Health and Social Care Secretary Matt Hancock said:
“My job is to make the system work for those who work in the system and work hard to make the system work."
Mr Hancock spoke of 7 lessons that have come as a result of the Coronavirus pandemic and lesson one was valuing people:
“And when I say people, I mean all of our people: care workers, porters, cleaners, clinicians and leaders.”
The government recognises that the system is flawed.
They are ready to “bust bureaucracy” and take other measures which will allow “carers to care” rather than get in their way.
There is hope.
Let me know in the comments your thoughts on Care Assistant Retention and what I've said - let's chat there!
Oh, and please Like this article to let me know you enjoyed it - thank you!
About this contributor
Self Employed Live In Carer
I believe the UK Social Care sector has the potential to thrive and to help make that happen I believe in empowering Carers. I write about health and wellness for live in carers at my blog Caring For The Carer. When I’m not writing, you can find me in my kitchen perfecting my sweet potato and chicken curry recipe.
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Log In Subscribe to commentHeidi Baxter-Phillips
Heidi Baxter-Phillips
one year agoA well-written article, thank you. I am the Health and social care apprenticeship assessor for a college in the southwest. ... read more
A well-written article, thank you. I am the Health and social care apprenticeship assessor for a college in the southwest. In the last 5 years I have had a very low intake for both the level, 2 and 3 adult care diplomas, and it seems the main theme coming through isthat no one wants to work in care, or if they do, they know it will be temporary. It is so difficult to see how recruitment and retention can be improved and maintained, i hope it can.
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Hello Heidi, Thank you for your comment and input. I also thank you for at least still having hope even though things don't look great in care. I first wrote this article in 2019 and I was highly op... read more
Hello Heidi, Thank you for your comment and input. I also thank you for at least still having hope even though things don't look great in care. I first wrote this article in 2019 and I was highly optimistic about the Government effecting change. Looking back now - I realise I was incredibly naïve. At that time Matt Hancock was Health Secretary. Love him or hate him... He had his head screwed on about one thing... Rather than focusing on improving things in the NHS and Social Care sector - Why not focus on creating a healthier society so that less people need to depend on those services As a way of reducing the pressure on the NHS. That got me thinking... How can we apply the same logic to recruitment and retention of Care Assistants? Rather than trying to attract people to come into what IS a dead end soul crushing industry and expecting them to stay under the guise of "being good people who are entering a rewarding career" Settling for... Rubbish wages Zero appreciation Zero progression Any self respecting person can see that is a bad deal. The young people you've spoken to Heidi, are right. (Now, I must make it clear that the act of helping another individual is not what is bad. But the system under which people are forced to work is what's wrong.) Instead why don't we create an environment where people come to thrive. How do we accomplish that? It's in the hands of the people. By the people I mean anyone who is NOT Government. We need to come together. We've got to quit waiting on the Government and the gangsters at CQC to do anything about this. Any change we want to see is on us And not all the "people" by the way... because some people seem quite happy with this fiasco I'm talking about the people like you Heidi and like me who can see the issue and want things to improve The people that are not afraid to challenge the status quo The people that are not afraid to take back our power The people that are not afraid to stand up for what's right in spite of the Draconian laws The people who truly want to see a thriving Health and Social Care Sector with people that are happy to come to work It's for sure NOT going to be a job for the faint hearted It's for sure NOT going to be a job for people who shake in their puss n boots afraid of the backlash from Government It's for sure not going to be a job for people that play it safe sitting on the fence afraid to speak up And just for the record I'm not saying this to criticise anyone of these people I say this because I've been there I too, was afraid once upon a time and I believed the same garbage they do... That the Government knows what's best for society and that the Government cares and that the Government will make things better Bla bla bla That's until I realised that I was being just as bad as those behind this rotten system by choosing to believe in the Government and doing nothing else. Care workers are depressed. Some being pus
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Care workers are depressed Some being pushed as far as committing suicide All because they came into something wanting to be of service and do the best they could And instead are thrown to rot in t... read more
Care workers are depressed Some being pushed as far as committing suicide All because they came into something wanting to be of service and do the best they could And instead are thrown to rot in the pits of hell If that's not reason enough to act then I don't know what is. This isn't a rant but simply stating the truth because the quicker we get to the truth the quicker we can get to solutions. We need to have the how figured out yet First we need to find the who... Who are the people willing to build a new Health and Social Care system?
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Thank you Zuva, Your passion spurns me on and once again am hopeful that with individuals such as yourself, change for the better can or will happen. Change for the whole sector looked after individ... read more
Thank you Zuva, Your passion spurns me on and once again am hopeful that with individuals such as yourself, change for the better can or will happen. Change for the whole sector looked after individuals and the carers within.
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Nat Gomes
Nat Gomes
4 years agoI totally agree! When the health sector managers understands that the point is in "internal marketing", turnover will drop a ... read more
I totally agree! When the health sector managers understands that the point is in "internal marketing", turnover will drop a lot. Many managers put the responsibilities of wrong procedures on cares and they just d'ont look at themselves and d'ont recognise their leadship handicaps. A real manager must go "on the front" pulling his team... not "on the back" puching them. I call it "put yourself in someone's shoes"... it's challenging but it works!!!
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Karen Sweeney
Karen Sweeney
4 years agoSpot on, in addition as someone else pointed out people leave bad managers regardless of other incentives. Plenty of scrutiny ... read more
Spot on, in addition as someone else pointed out people leave bad managers regardless of other incentives. Plenty of scrutiny on frontline staff...who regulates senior managers?
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That’s right Karen. Carers are not always respected and are sometimes the first to blame if something goes wrong. If anything is to change for Care Assistants the whole system needs to be looked at b... read more
That’s right Karen. Carers are not always respected and are sometimes the first to blame if something goes wrong. If anything is to change for Care Assistants the whole system needs to be looked at because I have heard of some managers being tough on Care Assistants because CQC is tough on management.
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Blessing Lorraine Posi
Blessing Lorraine Posi
4 years agoI concur with all you have mentioned. However, I would like to add on retention of HCA. Being a HCA ... read more
I concur with all you have mentioned. However, I would like to add on retention of HCA. Being a HCA could sure be a rewarding experience but it all depends with the company or rather, the manager you're working under. I found, working in care was so rewarding when given the chance to interact with service users but then, the routine are very much orchestrated to the point you are left with mo time to know the service users better, and there's a whole lot more that happens behind closed doors that deters people from staying in care jobs. Like you have mentioned, the role of the carer now os one that os perceived to be the one for doing all the 'dirty' and go home. Care os no longer what care should be or what it used to be; it's all targets and measures and mostly, paperwork.
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I agree with you Blessing. Care is rewarding when you’re in a supportive environment i.e good company/management and getting to interact with the people who need care. I can relate 100% to that from t... read more
I agree with you Blessing. Care is rewarding when you’re in a supportive environment i.e good company/management and getting to interact with the people who need care. I can relate 100% to that from times when I am doing well at work it’s always to do with that. Care is about forming positive relationships but like you said it’s become about targets and measures. Do you still work in Care?
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Paula Watts
Paula Watts
4 years agoA very well written article and one with which I agree. I train approximately 120 carers a week. The carers ... read more
A very well written article and one with which I agree. I train approximately 120 carers a week. The carers who have positive experiences are the ones with good managers. A good manager will produce a good outcome in any industry, It all comes from the top. Carers are sent to train on their much needed days off or directly off a night shift. Society doesn't see caring as the most highly skilled job. Not only do carers have to comply with all the health and safety legislation but also the humanistic laws. Hours worked are unreasonable with some now doing 14 hour shifts. In my safeguarding training I say you have to look after the carer. Take your days off you need them so you can deliver a good service to the people who need you. Mistakes are made through tiredness and fatigue. The carers take the rap. CQC need to be far more powerful and stop changing the goalposts. People over paper. If people are well cared for this will show in their over all wellbeing. Too much time filling out what tasks are covered often leaving residents lonely and feeling neglected. Carers should receive incremental pay for training as many now do tasks that were initially done only by qualified nurses. That's a lot of responsibility and accountability for someone with an NVQ 2 or 3. I meet some wonderful carers who remind me of the donkeys in the Indian brick factories. They take more and more and when they drop they are replaced. Good carers leave the industry to be replaced by some who should never work in care. Value these amazing people
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Thank you for your comment Paula. It’s very useful to have your comment as you have a background in training. Very well said. It’s clear that there’s a lot of issues in Care work each one having a kno... read more
Thank you for your comment Paula. It’s very useful to have your comment as you have a background in training. Very well said. It’s clear that there’s a lot of issues in Care work each one having a knock on effect on the other. From your perspective do you think the training for Care Assistants could do with changing?
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Matt Farrah
Matt Farrah
4 years agoA really fine article. Brilliantly explained and illustrated. All care assistants and those recruiting or hiring them should read this!
A really fine article. Brilliantly explained and illustrated. All care assistants and those recruiting or hiring them should read this!
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Thank you Matt, I really appreciate that. May I ask what ideas you liked most?
I agree that we need to talk openly about the challenges of care work, and not just the rewarding aspect. I agree that painting the whole picture will help with retention. If jobseekers are presented ... read more
I agree that we need to talk openly about the challenges of care work, and not just the rewarding aspect. I agree that painting the whole picture will help with retention. If jobseekers are presented with this and not simply an idealised notion they will be better equipped at the outset of their career and job.
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