Caring for the carers: culture is crucial – As published in Caring Times

At Ridouts, we advise providers about how they can challenge draft inspection reports, Warning Notices, Notices of Proposals and Decisions – we challenge CQC’s findings; the incorrect facts; and the incorrect interpretation of facts and judgments.  In addition, we are often asked how a provider can counter what staff have told CQC during an inspection which, a provider feels, is inaccurate.

I’m not talking about the staff member that gets caught off guard by a CQC inspector and makes an ill-thought through comment or does not provide the best response they could have if they were given enough time and found themselves  in a less pressured situation; I’m talking about those staff who see the CQC inspector as an opportunity to “off-load” and tell them everything that is wrong with the home.  This can come as a surprise to many providers.  Why would staff say such things when it could adversely affect the Home’s stability and ultimately, in the worse situation, the staff member’s job?

Well, whether the comments are factually correct or not, a provider should be concerned about why a staff member made the comments in the first place – this is a sign of a more fundamental issue.

At the heart of every business are people, and this is heightened even more so in the care sector. It does not matter how good your policies are or whether you’ve got the best technology or equipment, if the people delivering the care are not happy (and this can be for a number of reasons) then they will disengage and eventually leave.

Skills for Care estimated that in 2016/2017, there were 90,000 vacancies in adult social care at any one time, with the turnover rate for registered nursing roles sitting at 32.1% and care workers at 33.8%.  Such figures are very concerning.  Why is staff recruitment and retention so difficult?

We know social care funding is a big factor but people do not enter the sector for the money.  If I can be as bold as to say there appears to be two camps that people fall into; those who enter the sector for the intrinsic values the work provides and those who do it as there are low barriers to entry.  Either way, motivation is key if a provider is to retain a satisfied workforce.

Job satisfaction and culture are two different, but related, aspects.

The Outcome of the Well-Led KLOE specifically looks at the culture of the home.  CQC will ask staff about the culture of the service and how the visions and values of the service are developed, discussed and put into practice.  Culture is key, but staff are also key; not only in caring for the service users but also as representatives of the home, the organisation and its values.

If there is a strong culture and people behave in a way that is consistent with the provider’s vision, then they will drive the home forward.  They will be motivated to do well and one hopes, also have job satisfaction along the way.

Additional motivating factors need to be considered so staff do not feel that they are just a commodity – giving people the opportunity to undertake training to grow and develop and feel that the organisation is investing in them; that there is career progression; that they get meaningful feedback on the work they do; celebrating success; and one of the simplest motivating factors,  recognition.

CQC will try and “tap staff up” for information so it is important that staff feel valued.  However, it’s all well and good to have a “vision” but if you don’t practice what you preach, having a snappy marketing tagline is not going to get you very far.  There cannot be a mismatch between what you say you will do, and what you stand for, and what really happens in practice.

Retaining the right staff will be good on a number of levels; quality and continuity of care for service users; a reduction in the costs of replacing staff, both in time and money; and a pleasant workplace as well as home for others.

I dread to sound like CQC but, good outcomes can only be achieved with good inputs.  If you get it right then you are more likely to see staff comments in inspection reports saying “This is a great place to work” rather than “It’s terrible here, you should see what goes on…”


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