Implications of care staff shortages

I reviewed this paper with my Care Locker ‘hat’ on, with a particular interest in the sections on care home staff recruitment and retention. The independent care homes sector: implications of care staff shortages on service delivery by Stephen O’Kell. Joseph Rowntree Foundation, 2002

The sample was small – 18 care home leaders interviewed – but replicable, and feedback was consistent (and remains consistent with much of what I hear repeated now).

The paper was written in 2002, and there have been considerable structural changes since then: my purpose in reading this was to discover what challenges care home managers face, since The Care Locker aims to address this particular problem.

Two lots of statistics jumped out at me, and I shall endeavour to get them updated:
– One in seven men and one in three women will spend at least a year in an institution before they die (Evans, 1999);
– A typical nursing home makes barely 50p per day per bed.

Over a decade on from this paper, the need for care isn’t diminishing. But as less and less local authorities want to provide care, there can be little incentive to make the investment needed in care facilities by the private sector (which needs to make a profit). I’m sure there will be charities that step up to the plate, but the economics of it are precarious.

The paper noted the artificial divide between health and social care. I think this is a very valid point, and one still applicable today. I am also aware that there are moves from inside government, largely drive by a data and digital agenda, to join things up. So I’m hopeful on this front, but will research further.

Other issues raised by the paper are:
– a lack of workforce planning, something I’m looking at closely, and will research further (please do feel free to comment on this – I’m up for some debate);
– a lack of management ownership – I’m not sure about this, and will look into this further;
– a general valuing of academic skills over caring and practical ones. This is very much on my agenda, and something I feel there is room to address. (I’m conscious that the NVQ has now now become a minimum standard.)
The authors noted as key points in staff retention:
– private health care as part of their package. (Am I alone in finding this somewhat ironic?)
– pension schemes.
– inexpensive staff accommodation.
– free education and training (the paper notes two thirds of staff being inadequately trained, and an increasing tendency towards asking carers to take on more medical tasks)
– higher salaries (the paper also notes a lot of movement amongst carers for a few pence more per hour – and given low wages in the sector, I find this unsurprising. Some care workers find it hard to make ends meet).
– free meals.

I am looking further into these as part of The Care Locker’s commitment to recruiting and keeping the best staff.

The paper noted the number of foreign workers coming to work as carers, as this group of people are prepared to work for low salaries (because low salaries in the UK are higher than at home). This comes with its own set of challenges, not least as the paper notes that they don’t stay and that this is unsustainable. This is an area I shall research further as well.

Overall: an interesting paper that threw up some more challenges for me, and some ideas around the things I need to make happen at The Care Locker in order to really make a difference.

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