Workplace stress and how to avoid it

Social care staff are no strangers to stress, which sometimes hampers their ability to provide care. Ray Braithwaite offers some practical pointers to staff

Stress is the biggest threat to service delivery that exists in social care today. In total, workplace stress is costing the economy more than £3.7bn annually, while social care staff lead the field in experiencing most stress at work.(1) It appears then that the very organisations meant to care for the most vulnerable in society are failing to care for their own staff. Yet managing stress is not solely the responsibility of the organisation; health and safety legislation says that all employees are duty bound to ensure their own welfare.

The Health and Safety Executive (HSE ) has set a target to substantially reduce workplace stress by 2010. It has established a  set of management standards it expects organisations to achieve by this date.(2)

These standards were first published in 2001, yet in 2004 the Employers’ Organisation, which represented local authorities until its demise in March 2006, reported that stress was the single most important cause of sickness absence at work and it appears the situation in social care has not improved.

If we consider some of these management standards it is evident there are several factors preventing the reduction of stress in social care.

● Demands: the organisation provides employees with adequate and achievable demands in relation to the agreed hours of work.
Problem: there are never enough social care staff to meet the demands placed upon them.

● Control: wherever possible, employees are consulted about their work patterns and have control over the pace of their work.
Problem: the pace of work is oft en frantic and increases with additional bureaucratic burdens.

● Support: the organisation has policies and procedures to support staff , and staff know how to access the required resources to do their job.
Problem: many workplaces still consider aggression a part of the job, something staff have to learn to cope with.

● Relationships: the organisation promotes positive behaviours at work to avoid conflict and ensure fairness.
Problem: bullying at work remains high.

● Role: the organisation ensures, as far as possible, that the diff erent requirements it places upon employees are compatible.
Problem: conflict will always remain as the profession continues its struggle with factors such as social care versus social policing.

● Change: the organisation provides employees with timely information, consultation and opportunities to influence change. Problem: change is a constant factor as legislation and the demands of society fluctuate.

To be pessimistic, we may never be rid of stress factors in social care but perhaps they can be managed more effectively.

Identification is the key and HSE will provide organisations with a formal method to achieve this identification.(3) It proposes using a staff questionnaire and focus group approach where staff are given the opportunity to discuss the findings and identify possible solutions. But this should not be used as the sole indicator of stress but rather alongside other methods such as sickness and absence data, staff turnover and productivity levels. Other approaches for identifying stress levels before they become an issue include individuals raising the issue with their manager, discussion within regular team meetings and supervision.

Informal talks with staff can provide a subjective appraisal of stress levels. Occasional staff inventories of how people are feeling, periodic snapshot appraisal of staff morale and the use of staff suggestion schemes can also help.

The identification of stress within ourselves or colleagues may be the starting point. Once identified, action must follow. Sometimes low cost or even no-cost solutions can be forthcoming – for example, regular supervision with a discussion of organisational goals and where the staff member feels they fit into these.

Other ideas include:
● Personal development plans.
● Incorporating the risk assessment process as part of everyday considerations.
● Include discussion of role and change in supervision and team meetings.
● Identify some opportunities for having fun and/or celebrating success throughout the year.
● Discuss how team members work together and encourage positive relationships.
● Develop a written policy for dealing with unacceptable behaviour in the workplace.
● Talk about how decisions are made and see whether there can be more staff involvement.
● Identify specific skills held by team members and how they would like to use them.
● Establish a “buddy” system.
● Identify achievable goals and suitable time frames and include regular discussions of levels of stress or emerging pressures and how these may be addressed.

Sometimes, where cost becomes an issue, the only action available may be the formal passing on of information up the hierarchy that unacceptable levels of stress have been identified. This becomes important to reduce the stress on the immediate line manager and to ensure accountability is achieved.

Within social care, it is particularly important that the workplace culture be both supportive and worker focused and to achieve  this, managers must take a lead in eradicating workplace bullying.

The establishment of Dignity at Work policies can help. So too can the establishment of the zero tolerance approach to all forms of violence at work and a good example of just what may be achieved with this approach can be found in Leicestershire social services department. Here, in 1997, 1,200 assaults were recorded against social care staff. But following a proactive zero tolerance stance this figure had been dramatically reduced to 400 assaults in 2006.

The human cost of experiencing work-related stress is too high a price to pay simply for a job to be done. These costs however take on a different value when we know they exist within social care organisations. Now is the time for us all to take action.

What stress can do
High stress levels may show as:

● A feeling of powerlessness.
● Inability to concentrate.
● Irritability and flashes of anger. Rapid changes of mood.
● Loss of confidence.
● Sleeplessness.
● Increases in alcohol and tobacco use.
● Hyperactivity, anxiety and panic attacks.
● Depression.
● The onset of physical symptoms such as migraines, high blood pressure, glaucoma, stomach conditions and some cancers.
● Suicidal feelings.

RAY BRAITHWAITE was a social worker and manager for nearly 20 years before becoming a freelance trainer in managing aggression and reducing stress at work. His latest work Stress at Work and How to Reduce it – A Managers’ Guide and a Training Manual are due to be published this month by Pavilion.

TRAINING AND LEARNING
The author has provided questions about this article to guide discussion in teams. These can be viewed at
www.communitycare.co.uk/prtl and individuals’ learning from the discussion can be registered on a free, password-protected training log held on the site. This is a service from Community Care for all GSCC-registered professionals.

ABSTRACT
This article examines the reasons for tackling work related stress including the financial and human costs. It considers specific difficulties posed by the HSE Management Standards designed to substantially reduce workplace stress by 2010. It goes on to propose solutions and identify options available to all workers to deal more effectively with the stress inherent within the field of social care.

REFERENCES
(1) HSE, Why Tackle Work-related Stress? 2006
(2) HSE, Tackling Work-related Stress: a Manager’s Guide to Improving and Maintaining Employee Health and Well-being, HSE Books, 2002-3
(3) HSE, Overview: the Management Standards and the Five Steps to Risk Assessment,

This article appeared in the 4 January issue under the headline “Feeling the pressure”