Effective Human Resources Business Models in the Domiciliary Care Sector in Surrey

1
Effective Human Resources Business Models in the
Domiciliary Care Sector in Surrey

• Sarah Pearce March 2007

2
The Surrey Context

• Rising numbers and proportion of older people
• Decreasing numbers and proportion of people of
  working age
• Impact of shortage of domiciliary care workers on
  service capacity to meet rising demands
• High cost of living, low unemployment
  competition for workers around NMW

3
We asked Domiciliary Care Owners and Managers
about

• Business Development and Service Operations
• The Workforce
• Training and Qualifications

4
Domiciliary Care in Surrey

• 101 registered providerssample 20
• 11 provide only short dom care visits
• Rest provide short visits either staff to
  care/nursing homes or live-in care
• 1 provides only live-in care
• Short visits range from 85 2,500 hrs pw
• 75 users are older people
• Older people are main client group for most
  providers
• Children are sole client group for one

5
Business Development and Service Operations

• 14 out of 18 report growth of 10 - 400
• Two thirds provide additional services
• Most anticipate further growth and
  diversification e.g. live-in care
• New services needed to support Dom care?
• Most business support provided internally
• Technology vitally important over 50 use
  integrated software systems
• 25 use manual systems to schedule work

6
Unique Selling Points (USPs)

• Providing good quality services
• Being good employers
• Managing and developing the business
• Effective management practices
• behaviours training effective care workers
• high quality services

7
Challenges and Opportunities

• Recruitment and Retention
• Training
• Local authority financial constraints and
  controls
• Direct Payments
• Potential for live-in care services
• Service integration new types of services

8
The Workforce

• Job insecurity lack of guaranteed hours
• 50 providers employ all care workers on zero
  hours contracts
• Impact of LAs commissioning strategy on care
  workers employment status
• What makes best business sense?
• Use of permanent contracts doesnt always mean
  providers have contracts for set volumes of
  service

9
Recruitment

• Majority of care workers recruited locally
• Recruitment from within outside EU
• Word of mouth and local papers
• 13 providers dont anticipate need to change
  current recruitment strategy BUT recruitment
  retention future challenge
• For 5 recruitment is a problem now
• What about future commissioning plans?

10
Staff Turnover

• Turnover in Domiciliary care is hard to calculate
• Unreliable and inconsistent data
• Providers report more new recruits than workers
  lost
• Most commonly cited length of service 2yrs
• Impact of business consolidation in Surrey?

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Why do Care Workers Leave?

• Reasons associated with the job pay, job/work
  isnt right, stressful work, grass is greener,
  poor management
• Reasons associated with external factors family
  commitments, moving, change of work direction,
  just filling in, to go on to HE
• Messages from Research. Care workers dislike job
  insecurity, lack of guaranteed work, pressure to
  work at non-social times, short visits, unpaid
  travel time,split shifts, poor pay and terms, low
  status of care work

12
Why do Care Workers Stay?

• Good management, pay and conditions, job
  satisfaction, good training and development
• Messages from Research It is important to Care
  Workers to have good relationships with clients,
  good and accessible managers, training,
  flexibility to do what your client needs/wants,
  clear contract, opportunity to undertake NVQ, be
  involved in decisions about clients/work, staying
  with the same clients, being able to say no,
  opportunity for progression, clear career path.

13
Career and Progression Pathways

• Lack of a career pathway is not a reason for
  people leaving the industry
• But for people who do want a career opportunities
  are limited
• Two thirds services provide opportunities/pathways
  for progression
• Larger organisations can provide more and more
  varied opportunities
• What do we mean when we talk about a career in
  care?

14
Developing the Domiciliary Care Workforce

• Most induction provided internally
• Majority of NVQ training provided externally
• Average of 31 care workers hold NVQ Level 2 and
  9 NVQ Level 3
• Most provide additional training for care workers
  e.g. dementia care
• Most providers pay for training
• Only 40 pay for time spent on training

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Developing the Domiciliary Care Workforce 2

• Problems with staff development time,
  resistance by some staff, costs quality of
  training, staff turnover
• Employers encouraging achievement of NVQs
• Over 50 enhance pay for workers who have
  achieved an NVQ by average of 13

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Conclusion

• Domiciliary care providers in Surrey appear to be
  developing and expanding their services and many
  seem to recruit, retain, manage and develop their
  workforce effectively
• But insufficient evidence to conclude that
  particular HR models and practices either
  facilitate or hinder business success.

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Recommendations

• Obtain reliable and consistent data to measure
  staff turnover and business success
• Obtain feedback from service users and from care
  workers
• Ensure workforce implications of commissioning
  strategies feature in discussions with service
  commissioners