Friday 23 March 2018
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Stability and continuity prerequisites of quality?

Des Kelly OBE, executive director of the National Care Forum, reflects on the latest NCF workforce survey arguing that it is essential that we are better able to understand the reasons that people leave so that we can take the necessary actions to improve staff stability and continuity of care

NCF published its annual survey of personnel statistics last week. Our 11th consecutive survey, the largest ever, covers a total of 64,805 staff employed across 70% of our membership. The findings largely reflect the trend of recent years with indications of a workforce that is getting older (49.5% of staff are aged over 45); better qualified (70.8% have, or are working towards QCF level 2) and with an average staff turnover rate that is showing slight improvement.

However such surveys always generate more questions! A key purpose in building this benchmarking data is to assist with the operational challenges and thereby to improve the quality of care and support services. Buried in the detail of the statistics are some intriguing findings and I wanted to reflect on just a few of them here.

Protecting the frontline
The proportion of staff employed in Head Office/admin appears to have been reducing and this year stands at 3.5%. It has been gradually reducing in each of the last 5 years and appears to be 4% lower than survey results published in 2010. Similarly the number of staff employed in training (at Head Office) has also been slowly falling and now stands at only 0.2% of the staff complement.

Although cautious that we are not comparing identical employers year on year, the size of the survey should give some confidence in the findings. I am assuming that both these developments are the result of efforts by providers to manage the context of ever tighter funding pressures against rising staff costs in order to protect front line staff.

Attracting younger people to work in social care
It is a concern that a mere 12% of the workforce is under 25 and only 19% are 25 to 34 years of age. This represents a significant absence of talent, ability and diversity. The social care sector urgently needs a strategy to attract many more young people to work in the sector.

The National Skills Academy graduate management scheme was an excellent initiative to bring young graduates to the sector but after several successful years developing the scheme now looks likely to be a casualty of cutbacks by the Department of Health. The Skills for Care developed I Care Ambassadors – a brilliantly simple idea of training young care workers to work with schools and colleges acting as ambassadors for working in the care sector – but there are not enough of them.

There have been efforts to invest in apprentices, which again are a great way to develop, support and train young people in order to get them established on the career ladder. We must make more of the job security and job satisfaction as well as the stability the social care sector can offer together with the training and career opportunities available amongst the best employers.

Understanding the reasons that people leave
Retention of staff is arguably every bit as essential and being able to recruit – some might say it’s even more important because the fewer staff that leave the more efficiently we are using our resources. I worry that we readily associate high staff turnover rates with the care sector as though it is an inevitable consequence of the nature of the tasks and responsibilities. The average turnover in our survey is 18.4% (care home settings) and 22.1% (home care) which indicates movement both up and down in the last 12 months. Across the care sector as a whole the average is probably at least another 10%.

However it is the churn rate which really throws up the scariest figures around staff stability. Once again our survey found that 38% leave within 12 months of joining and a staggering 65% within two years, and furthermore these proportions have risen in each of the last three years. Why? Analysis of the reasons that workers give for leaving doesn’t really help much. The largest proportion is lost in the phrase ‘personal reasons’, 28% ‘unknown’ and almost 9% dismissal. Career development accounts for 7.3% and competition from other employers a further 6.7%. Thereafter all the reasons for leaving are quite small percentages.

This leads me to believe that there probably isn’t a single answer and that a combination of factors results in the decision to leave. So, although ‘pay’ only represents 1.2% when it is added to ‘nature of the work’ and ‘conditions of service’ it becomes 5.2%. We have to better understand the dynamics at play if we are to reverse a disturbing trend.