The attraction, recruitment and retention of care sector staff is one of the biggest challenges facing care providers and has been for many years. While several sectors in England face similar issues, the care sector faces unique challenges in relation to its workforce. Academic and care sector partnership working offers an exciting way of developing practical and evidence-based solutions through combining academic expertise and rigour with the practical and lived experience of people living and working in care.
This feature shares the findings of a recent study focused on recruiting and retaining nurses and care workers in care homes (the REACH study). The study was led by an academic and care partnership called NICHE-Leeds, in collaboration with the National Care Forum (NCF) and University of Hertfordshire and Northumbria University. The findings are based on evidence gathered through 153 research papers and publicly available information from care organisations, interviews with care home staff and regular consultations with care sector stakeholders.
An overarching finding from the research is that multiple strategies are needed for staff to join and stay in care work. Many care providers will instinctively understand that the decision to work in care will be influenced by a mix of factors informing decisions to join, stay or leave care work, and the findings confirmed this. Therefore, when it comes to sustaining the care workforce, this research highlights that a single, one-size-fits-all solution does not work.
The findings showed the following strategies demonstrably help with improving staff recruitment and retention:
- Conducting effective job interviews.
- Providing career development opportunities.
- Rewarding and recognising staff.
- Promoting work-life balance.
- Having caring conversations.
More about each strategy is described as follows.
Effective job interviews
Successful staff retention starts early during recruitment, which means the interview stage is a key opportunity to start building a connection with job applicants. Our research shows it is important to give applicants a warm and professional welcome, and for interviews to be led by staff who are trained (or experienced) in conducting interviews. During interviews, it is important to a) set realistic expectations of what the job involves, and b) assess an applicant’s suitability and their values and motivations. This helps both the organisation and the applicant have confidence in their decision to either offer or accept the job, and for new recruits to understand the job role.
Career development opportunities
Care work is complex and skilled, and the study reports that opportunities to learn and develop will help with:
- Preparing staff for the work they do.
- Building job satisfaction, and a commitment to stay.
- Promoting quality of care.
Managers have a key role in providing frontline staff with the access, time, and support needed to undertake development and learning opportunities. For new starters, comprehensive inductions help staff to settle in, and start building care work-related knowledge, skills and values. Comprehensive inductions include training, being paired with an experienced colleague (sometimes referred to as ‘a buddy’), regular supervision and activities focused on building positive attitudes towards people receiving care.
For staff at early career stages, formal courses, being mentored and on-the-job learning provide staff with support and build motivation and confidence. For experienced staff, having opportunities to refresh knowledge, undertake advanced learning on specific topics and mentor early career staff helps them to feel empowered, respected and valued. Supporting staff to pursue additional qualifications can also lead to promotions.
Rewarding and recognising staff
When staff feel rewarded and recognised, they are more likely to stay because they feel valued, listened to, respected and adequately compensated.
Different ways of rewarding and recognising staff include:
- Relational strategies: These involve a) praising good work and encouraging staff, b) listening to staff views and opinions and c) managers stepping in to work alongside frontline staff when they need help.
- Wellbeing strategies: These focus on promoting staff wellbeing and encouraging self-care. For example, providing access to support for mental health.
- Financial strategies: These include paid time off, employee perks (e.g. retail discount cards) and salary increases.
- Opportunities for career development (aforementioned).
The research showed that managers have a key role in putting these strategies into practice and ensuring inclusivity, with all staff having equal access to these strategies.
Promoting work-life balance
When staff have personal circumstances, such as caring responsibilities at home or health needs, flexible working options (e.g. short shifts) help staff to manage their personal commitments around work. When offering flexible working, it is important to offer this to all staff in a way that is fair and inclusive. This helps with promoting work-life balance, improving job satisfaction and commitment, and reducing staff sickness-related absence.
The following organisational conditions support with offering flexible working options:
- Organisational policies focused on staff wellbeing and flexible working.
- Senior staff trained in putting policies into practice.
- Managers spending time speaking to individual staff to understand personal circumstances.
- Having adequate staffing levels for covering shifts.
Caring conversations
Regular and informal caring conversations between managers and frontline staff provide opportunities for acting on constructive feedback. These conversations help to improve staff performance, emotional wellbeing and job satisfaction.
The nature of caring conversations includes:
- Praise and encouragement for frontline staff.
- Discussing ‘in the moment’ issues (e.g. incidents, residents and co-worker issues).
- Managers raising concerns and providing constructive feedback.
For this to work well, it is important all staff feel included, and for managers to be present/available, approachable and to role model supportive working environments. Adequate staffing levels are also needed to ensure staff have the time and space needed to carry out caring conversations.
How and why do these strategies work?
These strategies are connected and work collectively to improve job satisfaction. Loyalty starts building at the job interview stage. At this stage, a psychological contract between a job applicant and the care organisation is starting to build, and setting accurate expectations of care work at this phase will help towards securing future commitment.
Then, once staff start work, giving them a positive experience at work will be reciprocated with employee commitment and loyalty. Providing staff with career development opportunities, reward and recognition, work-life balance and caring conversations will give staff a positive experience at work. Caring conversations and opportunities for career development will also support staff to feel empowered. For these strategies to work well, it is crucial to have leadership support and for staff to feel a sense of inclusion and equal access.
Input from multiple stakeholders
Practice and policy stakeholder input is needed to put these strategies in place. At a care organisation level, different staff roles contribute towards these strategies working well in practice – staff conducting job interviews, management staff, human resource staff and frontline staff working in a buddy/mentor role. Care users and family and friends can also contribute; there was evidence of care users and family/friends contributing during the job interviewing stage.
National policy input can also support, for instance, with staff accessing career development opportunities and making the most of the Learning and Development Support Scheme funding (despite some of the administrative complexities reported by care providers). It can also support with financial ways of rewarding and recognising staff (e.g. increased pay, better sick pay).
Comment from NCF
Get involved with research
The full academic report can be accessed here and a shorter and more accessible version can be accessed here. NICHE-Leeds has several ongoing social care research projects. All are carried out in partnership with people receiving care, their family and friends, and social care staff. To get involved or find out more, email [email protected]
Does your organisation’s experience align with the research findings? Comment on this feature or join the conversation to share your thoughts.
Dr Reena Devi is Associate Professor in Applied Health and Care Research at the University of Leeds.
Email: [email protected] LinkedIn: @Reena-Devi