By Tony Stein, Chief Executive, Healthcare Management Solutions (www.hcsolutions.co.uk)
As someone who’s been operating care services for over two decades now, you’d think that I’d have got used to the challenges that the sector constantly throws our way. I’ve lost count of the times that we thought that things couldn’t get any worse, and believed that finally, the governmet would have to take action to help resolve some of the long- term challenges. Well, I’m sad to report that things are getting worse rather than better.
WHY IS IT SO HARD TO RECRUIT?
Those reading this will be all too familiar with the issues of recruitment and retention in the care sector. It’s not just difficult to achieve full employment, it’s pretty much impossible, so why is this?
Caring is hard work, but it is a wonderfully rewarding occupation. Those who find their way into caring, often, stay. Spending your days in someone else’s home, ensuring that their needs are met, that they are happy and cared for is a privilege that beats sitting in an office or on a checkout in many ways. So, why is it so difficult to recruit staff?
First and foremost, the pay isn’t great. Psychologically, paying some- one the National Minimum Wage sends a powerful message about how you value their service.
In relative terms, you can argue that the pay is no worse than in many other occupations, however the responsibility is huge, the skills needed are extensive, and the pressure to meet the increasing needs of regulators, commissioners, and other agencies intense. Providing personal care is not, in itself, the problem. It’s the processes for delivering and recording that care that are incredibly hard. Remember that recording what you’re doing all day is not so difficult if you’re involved in a mechanistic or repetitive process. You can tick a pre-flight checklist off each time you prepare to take a plane off the ground (petrol, tick, two wings, tick, passengers, tick – you get the drift), that’s easy. When you’re deal- ing with people, every single interaction is different and how you record that interaction requires an element of judgement. If you get it wrong the consequences can be severe, leading to significant consequences not just for the carer involved, but also for the service and all its stakeholders.
THE GOVERNMENT AND REGULATORS DON’T HELP
Operators are told that they need to ensure that they’re doing all they can to support the mental health and well-being of care workers who do this amazing work. You then see the Scottish government instigating a police investigation into every single Covid-related care home death, which makes those who experienced first-hand the trauma of seeing those in their care succumb to the virus, feel like criminals. We have the CQC publish a league table of care home covid deaths which, without understanding and presenting the underlying causes, serves absolutely no useful purpose except, again, serving to make those working in these services feel like they’ve been publicly shamed.
Why would anyone want to subject themselves to this for Minimum Wage?
More recently, the government decided to make the Covid-19 vaccination mandatory for all care home workers. I shan’t dwell upon the fact that it was only a few months ago that everyone was told that achieving an 80% rate of vaccination within the service provided an acceptable level of protection for those living and working there. We predict that by the time we get to the 16th of September – the latest date by which a care worker could receive their first vaccination in order to have had their second in time for the 11 November deadline – we will have 4% of our workforce unvaccinated. For us, that means we’ll have to lose
around 106 members of staff. These are team members that we’ve invested time and money into, in recruitment and training. If we can’t replace them, we’ll have to attempt to fill the gaps with agency workers at up to double the cost. I wonder if the government will foot that bill?
WHAT’S THE SOLUTION?
So, as an operator, what do we do?
Well, we could increase pay. Providers serving the private pay part of the market are already paying the National Living Wage and more, because they can afford to. Those reliant on local authority fees are, sadly, not so fortunate. We’re anticipating a LA fee increase of 2-3% next April. Those LA’s that choose to pay more may well balance the books by placing fewer people into care which, at a time when the elderly population is increasing, simply means more unmet need and, for the operators, more empty beds.
We could look to bring in workers from overseas. There are many who claim that Brexit has added to the staffing problem. It would be helpful if the government would add entry level care workers to the shortage occupation list.
We need to make caring an attractive career choice. This needs help from everywhere. It needs operators to treat their staff with respect, pro- vide them with decent facilities, training, and support. It needs the regulator to act more intelligently around inspection. To stop making carers feel inadequate, intimidated, and guilty when things occasionally go wrong. It needs governments to stop trying to shrug off blame for the pandemic deaths onto carers who did everything in their power to protect the people that they support and to stop pushing a university degree as a must-have if children are to have any prospects. Vocational jobs are vital to a healthy society. It needs for the public to start to appreciate those doing this incredibly worthwhile job. We need educators to promote the value of caring for others so that more see this as a genuine career choice.
In conclusion, things are tough just now but if they are to get any better within the foreseeable future, we need things to start to change right now. This means more action and less words.