22 February 2020
It is a sad fact, but a fact nonetheless that Adult Social Care has one of the highest staff turnover rates of all professions. The staff turnover rate of directly employed staff working in the Adult Social Care sector was estimated by Skills for Care as standing at 30.8%. This is equal to 440,000 people leaving jobs over the year. The turnover rate has been increasing steadily by 7.6 percentage points since 2012/13 The staff turnover rate in domiciliary services is even higher, standing at 38.8%. (Skills for Care, October 2019).
Skills for Care also estimate that the current vacancy rate within social care nationally stands at around 7.9%. This has the implication of existing staff working harder with the potential for burnout which feeds into the turnover rate. Something of a vicious circle.
National figures also indicate that 66% of applicants are recruited from within Adult Social Care itself which would suggest that whilst skills and experience are being retained by the profession people are continually moving to organisations and employers who may be perceived as having more attractive terms and conditions.
There are many and varied reasons for this high turnover: lack of Government investment leading to low pay, a perceived lack of social standing as a career, use of Zero Hour Contracts, little opportunity for progression and in domiciliary care the sense of isolation from lone working. All of these, among others, have been cited by the 34% of people who have totally quit the sector as reasons for doing so.
We know from talking with people who use services that the things they value above all else are knowing the people who provide support, building relationships of trust and mutual respect with people which in turn leads to confidence and increased self-esteem all of which is clearly impossible if staff are stuck in an ever revolving door of leaving and joining. That revolving door has to stop.
Conditions such as these chip away at any psychological contract people may have with an organisation and as such any kind of brand loyalty risks being low. By the same token this presents a challenge for any provider who takes quality outcomes for people who receive support seriously and who wants to see people genuinely progress and build and grow their lives.
It’s not news that Adult Social Care is ridiculously underfunded. People, quite rightly, have ever increasing ambition and expectation for their lives, Commissioners are demanding more for less and the Care Quality Commission continue to tighten criteria in terms of what quality support should look like. The economic, commissioning and regulatory reality can be exhausting for providers who genuinely want their total focus to be upon seeing people realising ambition and moving on to greater independence in real, meaningful and purposeful ways – in other words, in a way that makes sense to that individual.
This is the challenge You First, like all providers, face. We have seen our staff turnover rate fall dramatically through the implementation of various initiatives and the purpose of this blog is to share some of those current and future strategies with you.
You First has taken the basic premise of NHS England’s Individual Service Design and adapted this into our Design4Life! tool. We have done this for a very simple reason – people don’t want services; they want lives like everyone else. They also want to live lives on their own terms, free from outside interference and from people who “think they know best.”
Design4Life! is a very powerful tool in delivering genuinely person-centred support as it captures not a list of needs but rather a very clear strengths-based picture of who the person is. Design4Life! captures the narrative of an individual’s life story, it details the gifts each person brings to the world and lists their hopes, dreams, goals and ambition. In other words, it describes the individual holistically and they life they want. It also details what, in the opinion of the person enquiring about support, the character, traits and experience an ideal Support Worker would have and this keys into a vital part of You First’s approach to support which is matching.
Social care has its foundation in relationship. This is what underpins quality social care. The engagement between the customer and Support Worker is key to the customer genuinely building and growing their life. The process of empowerment, enabling, growing, building self-esteem, confidence and progression, has its root in effective engagement that is built on trust and mutual respect.
Design4Life! informs the matching process. Customers, in a way they feel comfortable with and that works for them, are involved in the selection of their team. Therefore, we use the term “Micro-Team” because this is a team that is dedicated to that individual. Team members may work with that person only, or a few people, but they will always form part of a dedicated team. This ensures that people are supported by people of their choosing, people they know and people they trust.
This relationship must work both ways. For some customers and indeed for some team members, the approach to matching needs to be experiential, however feedback from both informs how that relationship is growing and whether it benefits all concerned. This ensures positive outcomes for the person and a genuine sense of job-satisfaction for the team member.
I talk of all You First employees “working with the Social Enterprise”, never using the phrase “working for”. This feeds into my wider strategy of all team members, as well as customers, being involved in the running of the business. Too often in social care, because of managerial reaction to a high turnover rate, support staff especially are viewed as dispensable. They are not – they are our infrastructure in that they deliver our “product”. Quality of support is intrinsically connected to how supported, valued and involved each individual member of staff feels. You First has been focusing upon this in detail in recent months and through Micro-Team Meetings, One-to-Ones, Locality Meetings, the Training Calendar, the Staff Board, Buddy Scheme, virtual communication software, On-Call support, embedding Mindfulness into the organisation and regular communication from senior team members we have seen teams and the individuals within those teams become increasingly empowered through an ever increasing quality of staff experience.
Building upon the reality of staff involvement You First has set its intention, very deliberately, toward establishing Self-Managed Teams. This will be a slow and careful process, an evolution as opposed to a revolution, but it is a definite goal and it is a natural progression to how we provide quality outcome-based support.
Self-Managed Teams will ensure that power and control truly rest with the person. They will further enhance those relationships of trust as team members accountability to people will be clear and the innate skills of each team member will be used to their fullest, therefore developing staff and supporting them to reach their full potential. Customers and staff will flourish as a result.
This approach works to keep the organisational structure flat, meaning that renumeration for support staff can increase and thus reward people genuinely for the skills, support, empathy and experience they bring to the role. You First is determined to keep the managerial layers that often work to distance both people and team members as few as possible so that relationship flows through the entire organisation truly benefitting all that are involved.
As opposed to creating masses of senior posts our intention is to reward tasks that need to be undertaken. When a team member steps up to write a Life Story or complete a Design4Life!, they will be financially rewarded for this. This further enhances the team/customer relationship, develops the skills and knowledge team members have and empowers all involved.
These are just some of the steps You First is currently taking or will take this year to continue to maintain a consistent, confident, competent and capable workforce that delivers genuine individualised outcome-based support.
Valuing People, all people, in real and tangible ways is a key aspect of recruitment and retention.