Social care workers have been the real heroes of the pandemic. Many have shown great bravery and commitment in delivering care services to their clients during such a difficult time.
Politicians and the public have – for the first time – realised the extent of the challenges care providers and their staff have faced over the past year.
As we come to the end of the third lockdown, there are workforce issues that need to be addressed both locally and nationally to enable care home providers to continue delivering outstanding services to clients.
Ceridian and The Care Show have brought together a high-profile panel of care leaders to discuss the way forward as care homes vaccinate staff and residents, welcome visitors once more and re-build their businesses in the ‘new normal’.
- Genevieve Glover, HR Director, Barchester
- Jeremy Richardson, CEO, Four Seasons Health Care Group
- Sanjeev Kanoria, CEO, Advinia Healthcare
- Rahim Manji, Head of Human Resources, CHD Living & CHD Care at Home
- Robert Kilgour, CEO, Renaissance Care
- Andy Cole, CEO, Royal Star & Garter
- Jim Thomas, Head of Workforce Innovation, Skills for Care
- Rachel Moffat, Enterprise Account Executive at Ceridian
- Tim Stokes, Head of Sales EMEA at Sterling
- Liam Richardson, Head of Content, Closer Still Media
The panel agreed that developing a strong work culture in their care home organisations has been critical to their pandemic response and staff engagement and productivity going forward.
Andy Cole, CEO of Royal Star & Garter, said the charity’s values had played an important role with a focus on how staff can work as a family with residents, and harness courage in delivering care.
“All year we’ve been seeing incredibly courageous people stepping forward and doing things that they never thought they would be – for example our HR team ran our testing and vaccination programme brilliantly,” he said.
Four Seasons Health Care has been striving to create a more inclusive, open and non-hierarchical culture. “We’ve focused on a different strategy of making sure we put people first and really support operations,” said CEO Jeremy Richardson.
Advinia Health Care started a cultural change programme after acquiring 22 care homes from Bupa in 2018. Chairman Sanjeev Kanoria said: “We have significantly changed the culture. Everything used to happen at the head office level, and yet having an operationally focussed team is so crucial to making a service organisation work. There is now much more manager and employee empowerment.”
Genevieve Glover, HR Director at Barchester, cited the famous Peter Drucker quote that “culture eats strategy for breakfast” and pointed to her organisation’s movement towards a more collaborative culture, with better support of frontline services.
Recruitment and Retention
The panellists’ experiences of the recruitment market have been mixed. Glover outlined a positive picture with over 7,000 staff recruited across 246 care homes and hospitals in the past year. Barchester has also slashed its agency spend. A people strategy, launched in 2018, put a focus on nurse recruitment and retention, and engaged with data from exit interviews and focus groups among current staff to good effect.
Advinia Health Care found recruitment and retention harder as the ‘lock down’ year progressed. Kanoria said: “We feel that Brexit has had a big impact. I’m wary of where we’re going if the Government doesn’t take proper steps in managing the recruitment of staff from Europe. It remains a critical source of staff for many of the care homes and hospitals in this country.”
Robert Kilgour, Chair of Renaissance Care, based in Scotland, agreed. He said a quarter of its staff are not from the UK and the company had to “make them feel welcome and loved” as the country went through Brexit. “Training more staff is great but it takes years to do. In the interim we need to be able to bring in nurses and senior carers from abroad,” he said.
Rahim Manji, Head of Human Resources at CHD Living, commented that care businesses typically lose a lot of new staff within the first six months of starting. He said: “We’re creating an employee model that looks at the staff journey from day one. What does that onboarding process look like? What systems do you have in place to support new staff?
“Managers can act as mentors consistently reinforcing your mission and your culture and your values and getting people on board with that.”
Rachel Moffat, Enterprise Account Executive at Ceridian, agreed with the importance of onboarding. She explained that the chosen system needs to be able initiate the onboarding process as soon as an employee is hired whilst also ensuring all the background checks have been completed.
Research suggests that there are three important factors in the retention of care workers and boosting their productivity, said Jim Thomas, Head of Workforce Innovations at Skills for Care.
Firstly, a positive culture. Secondly, good supervision and management structures. And, thirdly, high quality learning and development processes.
Thomas said: “If you get those three things right, you see a reduction in moving and handling mistakes; you see a reduction in safeguarding referrals; you improve retention and, at the same time, staff are more flexible about when and how they are prepared to work.
“The challenge I put to colleagues is that those are your cost savings.”
Moving forward, Richardson believes care home recruitment will benefit from social care’s higher profile. “A light has been shone on social care and it’s indicated that it’s an interesting sector where the work is really rewarding. We have to harness the good things that have come out from this difficult year,” he said.
Pay and Benefits
Renaissance Care is offering its staff a pay rise of more than 2% this year, despite the extra costs of the pandemic. Kilgour said: “We’re giving our staff over double what the UK government has given to nurses. It’s the most we can afford as a private company but I think you have to value your staff and show them you are a people business.”
Recruitment in Scotland may be easier, he said, because of a Carers Living Wage, which is higher than the National Living Wage and workers are entitled to it from 18 and not 25.
Cole warns that it is the overall reward package that compromises social care’s efforts to retain staff. “We find great nurses, we train them up, but then they realise they can work for an NHS hospital for similar money but a much better package – its frustrating and a continual challenge,” he explained.
Skills for Care’s Thomas said that care home recruitment and retention will only improve if terms become competitive with the public sector. “I say to my colleagues in Government, if you want the integration of services to work open up the NHS pension scheme to everyone in social care. It doesn’t go down very well,” he commented.
Richardson said the sector needs to reframe the offer. “There is no point getting involved in a race to either the bottom or the top on pay or benefits. I don’t want someone who is wondering whether to stack grapefruit or deliver care to people. It’s about culture. If you create the right working environment, give the right level of support, then people can do the work they want to do and be the best versions of themselves.”
Differentiating themselves in the market and offering greater flexibility on how care homes pay their staff can be as important as what they pay, said Ceridian’s Rachel Moffat. “Higher rates of pay are just not possible for some care businesses so there is a need to look for other benefits. The ability to pay staff on demand (giving them access to their wages as they earn them) for example, can be a real added benefit to attract staff,” she said. Where payment in arrears is not uncommon, we are finding this is a great incentive for employees to pick up additional shifts, in the knowledge that they will receive their money as soon as they have worked their shift.
Staff Wellbeing and Vaccinations
Staff wellbeing has been a massive priority of the past year. Glover said Barchester took their already robust framework for staff physical, mental and financial wellbeing to “another level” during the pandemic. From making wellbeing services as visible as possible, and promoting peer support, through to providing hardship loans and offering hard-pressed members of staff a free meal when they arrived at work.
She said: “Managing the impact of the pandemic on the mental health and wellbeing of our staff will run not just for the next few months but for years – and we will provide that framework.”
When it comes to vaccination, the panel agreed that encouraging – rather than forcing – existing staff is way forward. Kanoria blamed the media for the reluctance of some staff, and said it was responsibility of care home providers to explain the benefits and placate the fears.
Richardson said Four Seasons is supportive of vaccinations but won’t mandate it among existing nor new staff. “We have to be careful that we don’t end up vilifying those people that have been putting themselves on the line for the past 12 months,” he said.
Both Barchester and Renaissance Care require new starters to have been vaccinated. After running surveys to identify concerns, Glover said only 6% of their staff are unsure over whether they to be vaccinated. She said: “Quality of care comes first and with that the safety of our residents and patients. Feedback on our approach is positive and only a small minority of staff are refusing.”
The Future of Social Care
The Conservative Government promised social care reform over four years ago. The care home sector is desperate for a more sustainable funding model to be developed, with better integration of services and improved access for vulnerable people.
Kilgour said the social care sector needs a fully funded 10-year plan like the NHS, with workforce development a central theme. He has been involved in recent meetings with Ministers and said there is an appetite in both the Department of Health and Social Care and The Treasury for change.
Cole is optimistic but fears that the emerging Integrated Care Systems may just be “a rebadged model of what we already have”. He said: “ICS’s need to be well thought through. They have got to be fundamentally changed, and that means getting social care properly in and equally represented on their boards.”
Manji calls for greater professionalisation of the social care workforce with a national framework that recognises and promotes the transferability of skills. “We need to create an identity for social care workers so they have a sense of belonging to a wider community and their skills are recognised,” he said.
Richardson is concerned about the timing – reform needs to happen now. “The catalyst for change is there,” he said. “But people have short attention spans, so my plea to government is carpe diem.”
Glover added that care businesses need to consider how they are going to engage with technology going forward, and Manji identified the importance of getting synergy between different platforms.
Kilgour urged care homes to place positive news stories in media and rebuild their business and occupancy rates. “All of us together must drive this forward and keep the pressure on the Government,” he said. “If we relax a little, so will they. We need to keep the pressure up because it’s critical to getting a fair deal for our staff and residents going forward.”