Redesign care worker jobs to boost retention, says report

Care worker jobs should be redesigned to make them more compatible with employees’ commitments outside of work, a report has recommended.

The report by consultancy firm Timewise said care work was often seen as a flexible job, but actually required unsociable hours including early mornings and evenings, which made it difficult for employees to maintain a work-life balance.

It said that redesigning jobs to ensure they are compatible with employees’ non-work lives, an approach Timewise is calling “compatible scheduling”, would help solve the recruitment and retention crisis in the sector, improve care quality and save money.

‘Greater control and input’

The report is based on findings from focus groups with 51 care workers, as well as a six-month pilot with community support provider, Rathbone, in south east London.

The pilot involved using a “geographical team-based approach”. A team of 10 support workers was set up to work with 22 service users in a particular area of Lambeth.

The team had a weekly meeting built into their schedules, which was an opportunity to discuss their hours, work-life balance, and the needs of their service-users. They were also encouraged to swap and share shifts. The meeting was made possible by the reduction in travel time because of the geographical approach, the report said.

The report said that this approach had given workers “greater control and input” into their hours and there was also an improvement in the “perceived fairness” of rotas.

‘Quality of relationships’

Charlotte Gascoigne, Timewise’s director of research and consultancy, said that workers had reported an increased sense of teamwork and commitment to the company, an increased knowledge about service users and reduced travel time.

She added that the quality of care for service users had also improved.

“Service users reported greater satisfaction around the number of people who support them, the quality of support and the quality of the relationships with workers,” she said.

Although team-based scheduling was piloted with a community support provider, Timewise said the approach could also apply to a more traditional domiciliary care service.

A spokesperson said: “The key difference is not so much between domiciliary care and community support, as between those employed on guaranteed-hours contracts (as at Rathbone) and those employed on zero hours contracts.

“The latter may have less of an investment in service improvements as they feel more isolated and removed – ‘I feel like I’m self-employed’ was one comment we had from a zero-hours carer. They also have the additional challenge of wildly variable amounts of work each week, which would make team-based scheduling more difficult.”

‘New approach to commissioning’

The research also identified five key constraints that prevent care work jobs from fitting in with people’s responsibilities outside of work. These were: the unpredictability of rotas, the absence of slack in the system, unsociable hours, downtime in the middle of the working day, and the need to travel long distances between calls.

The report said that these constraints forced many care providers to give up on work-life balance for carers and instead focus on “filling the gaps” in schedules. It made a series of recommendations on how these issues could be addressed going forward.

One key recommendation was that commissioners should include “non-time specific” social tasks in care packages, such as taking clients out, shopping or housework.

The report said that the majority of social care support is commissioned around specific times of the day, such as mealtimes, which created gaps in the day and increased care workers’ unpaid downtime. It said that although this new approach would be expensive, it would avoid downtime and potentially increase quality of care.

Gascoigne added: “The whole thrust of our report is about compatible scheduling and making the schedules compatible with people’s non-work lives – obviously that doesn’t work if you’re working from 7am until 9pm but only get paid for seven of those hours.

“We are aware this recommendation would be a fairly major restructure of the way commissioning happens, but given the degree of the staffing crisis in the sector, we think there needs to be a much greater focus on job design and some fairly radical solutions need to be looked at if the sector is to attract and retain the people it needs.”

Other recommendations included:

• Commission within smaller geographical areas to reduce travel time.
• Be upfront about unsociable hours at the recruitment stage.
• Ensure open communication with workers about their work/life needs.

Sharon Allen, chief executive of Skills for Care, said: “Recruiting and retaining the right people to provide high quality, person-centred care is a priority, but also a challenge for the social care sector. This important research highlights innovative and practical ideas on how our sector might offer more flexible jobs roles to attract the right people with the right values.”