Compatible flexibility': the answer to social care's recruitment crisis?
For those of us who have long been concerned about the state of social care, it’s a relief to see the sector so high on the political agenda. But while much of debate has centred on how future care will be funded, there is another critical issue: how to attract and retain enough care workers to keep the system working in an age of austerity.
There are 1.5 million people working in the social care sector in England, of which 82% are women. The combination of an ageing population coupled with the associated increase in the number of people with care needs means that by 2025 a further 1 million care workers will be needed. Add to this the fact that, at 27%, staff turnover in the social care sector is more than twice the average for other professions in England, and it’s easy to see the scale of the problem care providers face.
Why are care workers leaving in such high numbers? The problem seems to be that although care work is billed as a local and family-friendly job, the reality is very different. Unpredictable rotas, unsociable hours, large chunks of downtime in the middle of the day and the need to travel long distances between clients all take their toll.
Our new report highlights a potential solution to this: compatible flexibility. That means designing jobs and schedules for care workers that are compatible with the rest of their lives.
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We ran a pilot with Rathbone, a London-based community support provider, to test whether a different approach to scheduling could address some of these issues. We divided up the geographical area covered by Rathbone and created a team of 10 care workers, who were then responsible for supporting a total of 22 service users in a particular area for six months. This reduced their travel time, which enabled us to create time in their schedules for a weekly team meeting, which helped to reduce their sense of isolation and improve teamwork. The meetings also enabled care workers to share more information with each other about clients and their needs, which in turn improved the quality of care.
The regular meetings also gave the team a chance to discuss their work-life needs. A skeleton rota was produced by the team manager, and care workers could negotiate this among themselves at the meeting. They felt they had more input into the schedules, rather than being handed a rota every week. They also became more aware of other people’s needs – both of other team members and service users – which improved their perceptions of the fairness of the system.
There are some key things care providers need to do if they are to deliver truly compatible flexibility for their staff. Firstly, given the high dropout rate between people applying for care work and actually starting the job, it’s imperative that employers are open at the recruitment stage about the need to work some early mornings, evenings and weekends. We also recommend that schedule coordinators communicate as openly as possible with each of their care workers about their particular work-life needs. Most importantly, care workers must have more input into their schedules.
There are some clear learnings for policymakers, too. While upskilling care workers is important, care quality may be compromised just as much by constant change of personnel as by lack of skills. If care providers are to retain more staff by designing jobs that are compatible with their non-work lives, some sector-wide initiatives will be needed. These should focus on understanding the effect on staff of unpredictable schedules.
Care providers gave us four reasons why staff rotas are so unpredictable: changes requested by care workers, changes requested by service users, vacancies and maintaining necessary workforce cover. But we need to investigate the relative importance of each of these, so solutions can be devised to reduce the overall unpredictability of the rotas.
Improving the predictability of scheduling is our number one recommendation for more successful attraction and retention of staff. Many care workers have no idea from week to week what their schedule will be – or, if they work on zero hours contracts, how many hours they will have, and how much they will earn – and so find it very difficult to plan their lives.
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We also recommend that local authority commissioners consider how they might reduce travel time, such as by commissioning care across a smaller geographical area, and eliminate downtime, for example by balancing tasks clustered around mealtimes with work that is not time-specific. This could include tasks with clients – such as taking them out, shopping, housework, having a conversation – or other local work such as domestic cleaning or tasks in residential homes. We’re calling on social care providers and policymakers to change the way the sector operates, and make it work better for care workers. That is going to require radical thinking, more research and widespread action.
Charlotte Gascoigne is director of research and consultancy at Timewise
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