The Shortage of Domiciliary Care Staff

The success of caring for an increasing older generation is threatened by the shortage of care staff.

As a provider of domiciliary care since 1980 I have seen many of the ups and downs of the care industry. Many of these downs relate to the recruitment and retention of domiciliary care staff. This is due in part to legislative factors whereby mature people who have brought up their own families, looked after older parents, cared for a dying spouse no longer come forward to become carers because of the training required, the CRB requirement, and this is not a criticism of these requirements, therefore the care industry has had to rely more and more on foreign workers and younger workers.

Much has been written about the need to raise the perception of the work that domiciliary care staff do, to give the work increased status and initiatives have been suggested to do this such as registration. A further idea is to increase the hourly pay rate that care staff are paid to encourage a more professional attitude to the role.

Both of these ideas are idealistic. In the short term the role of a care worker will not be enhanced enough to encourage other people into the sector and although many may continually seek to raise the hourly pay rate of care staff, this is not going to happen to any significant degree as many of the growing number of older people who will need care will need to have their care funded by government departments.

So how can we raise the value of care work and encourage people into the profession? Is it possible to solve the problem?

I think so. I believe one of the answers is to give to care staff the simple feeling of job satisfaction, a job being well done. If you feel good about the work that you do, you stay in the job longer, build a loyalty to the people you care for and by definition give the people you care for a better service.

As the television program of a few weeks back demonstrated, hourly care staff are more often then not, allocated to their clients by care workers time availability e.g. Mary has to pick her children up from school so she could do that "pop in" visit at 2.30pm, their proximity to the job where cover needs to be put in e.g. Mandy does an hour in that location, she could squeeze in another visit on Tuesday, Wednesday and Friday, and we will find someone else to do the other days. Hypothetical examples but reality on a daily basis.

My company provides live-in care staff services only and works to the objective that we will provide our clients with a roster of liked, live-in care staff so that after a short period of time, they have regular staff returning to them. To encourage the staff to visit a client for the first time and to go and live with that client for a fortnight, we find out everything we can about the person we are going to care for. How they live, what they have done in their lives, their work, their families, how they want their care worker to behave in their home, what their interests were and what are they now. In addition to our own care assessment we ask the person or their family to write their own care plan as to their requirements and expectations.

We encourage a care worker to try that client by giving them the "person" factor, the thought that here is a person to be valued, a person who has lead a life possibly different from their own and a person from whom they can learn from and enjoy the time they spend with them. Our clients are not always easy to care for and we do not always get it right but our care staff retention is good and currently we have new care staff waiting for a vacancy in order for them to start work.

Our live-in care service is continuous, 365 days a year and many of our clients we have been privileged to care for many years. A person dying at home means we have succeeded in delivering the service that the particular client wanted, the chance to stay in their own homes.

Our care staff do get job satisfaction whereas prospective staff we interview who have come from hourly care backgrounds, both agency and residential care home working backgrounds continually tell us that the reason for leaving is no job satisfaction, no time to get to know the client, no time to talk or learn from them.

The cultural change that needs to occur to ensure that our increasing older generation are able to be cared for is that the perception of what caring for an older person means has to be substantially changed. Government and the media should shout from the rooftops the interesting working life that can be found in caring for older people. Television programs, magazines, newspapers should give examples of the lives that older people have led, educate younger people in this way to view older people as people who can enhance their own perception of their own lives or quite simply are interesting people to have a working relationship with.

Foreign care workers are currently used with very little knowledge of how an older person has lived; therefore conversation is reduced to mundane small talk about the weather or last night's television. Some foreign care workers come from countries where the life expectancy is around the age of forty and as such they have never actually met a person who has lived to be age eighty!

Everyone has an interest in ensuring that our older generation, and indeed our younger disabled people, have access to the best care possible which means receiving care from interested, enthusiastic and "well trained" care staff. The definition of "well trained" however does not just encompass the practicalities of caring but the "spirit of caring" is necessary and interest in the person being cared for is fundamental to that ethos.

Angela Gifford, 30 July 2009

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