During Healthier Working Lives, ethnographic researchers completed deep conversation and captured rich data from 6 care homes across Scotland. During these conversations, we found that some of these homes were having real success in retaining their workforce – especially impressive within the context of a national “care crisis” and widespread workforce shortages.
Our ‘Care Stories’ impact project involved a deep, focused secondary analysis of this data around this issue of retention. We wanted to highlight the ‘little things’ that these organisations and individual managers were doing to have such success in retaining their staff and summarise and illustrate these in a way that could be shared publicly and with other organisations. First, we produced a summary briefing paper, containing specific examples of the existing ways that these care homes are prioritising the welfare of their workforce through practical, professional and mental health support.
Some of the key findings from this initial analysis were:
(i) Although the adult social care sector has experienced problematic recruitment and retention challenges for decades, strategies do exist for managers seeking to improve retention outcomes for their workforce - including older staff who are most at risk of leaving their role.
(ii) Staff's ability to develop rapport with residents strongly affects motivation, job satisfaction and attitude. Retention outcomes and job satisfaction improve significantly when staff are supported in prioritising spending more time with residents over other competing tasks.
(iii) Staff expressed deep importance in recognition from management through small incentives and other tokens of appreciation - such as shopping vouchers; staff discount cards; free meals or snacks while on shift; and all-staff events. These gestures make staff feel 'valued' and 'seen' in their work, and encourages strong work ethic.
(iv) Prioritisation of staff's mental health - demonstrated by management-supported well-being initiatives - positively influences the perception of what makes a 'rewarding' work environment and improves the quality of care given to the clients. Specific examples included mindfulness courses, massage chairs in the staff rooms, or free reiki and yoga classes. Managers who proactively reinforce these benefits, and ensure they are utilised, experience improved staff retention.
(v) Accommodating individual staff needs, offering flexibility with shift patterns or employment contracts, and providing autonomy over individual schedules is directly associated with higher retention. Conversely, staff who experience a lack of adaptability from management feel this negatively impacts their personal life, as well as their long-term employment prospects.
(vi) Managers who identify and nurture the individual interests and career aspirations of their workforce tend to experience slower turnover and higher engagement of staff. Dedicating adequate time and resources for professional development, training, and upskilling of team members was felt to be beneficial for organisation finances, as well as workforce retention.
(vii) Care homes are already leading the way in developing and trialling new approaches to improve work practices, as well as recruitment and retention outcomes - such as moving towards Values-Based Recruitment. These existing positive approaches are often missing from discussion on the future and sustainability of the adult social sector, but highlighting workforce-led innovation and voice can help to start address this.
We then worked over the next few months with graphic designer Kevin Streicher, who took turned these ideas and narratives into hand-drawn digital illustrations. His in-depth collaborative process ensured that all the tiny details from the various participating care homes were captured in a meaningful, subtle way – from the flowers each care home had outside, the gnomes that sat in the garden of one home, or the sheep residents could see from the window of another. It was of the utmost importance to all involved that these illustrations were inclusive, realistic and truly represented the demographics and experiences of the workforce as captured in the data – while also ensuring that the images weren’t so specific that they couldn’t be shared more widely with other organisations. We have since turned these images into postcards, posters and flyers which will be shared at relevant events and by various local organisations. Physical copies of these will also be sent back to all participating care homes in Scotland, hopefully acting as a positive reminder of the meaningful outcomes that came from sharing their experiences and ideas with us.
If you are interested in sharing the full version of the Care stories policy briefing paper, summaries or any of the associated illustrations within your organisation, please contact: caitlin.bawn@kcl.ac.uk.