This month’s ‘Cut out and keep’ is brought to you by Lindsay Rees, Head of Social Care Content for Skills for Care partner Quality Compliance Systems (QCS), the leading provider of content, guidance and standards for the social care sector. She looks at the important topic of workforce planning in the context of residential care, crucial in ensuring the right staffing levels are available to meet service users’ needs.
In the complex world of social care, there are many variables to consider when developing an effective workforce plan. It can be challenging, but here is some guidance, much of it gleaned during my 17 years working as a senior leader in adult social care.
Before you can start your workforce planning, you need to understand dependency, which varies over time and can change dramatically. The slow creep of increase in needs is often something that is difficult to capture and deal with.
Ask yourselves the following questions: How much time does it takes to meet the needs of the people you care for? Do you assess this regularly? Are you confident that the level of care being charged for is appropriate for the level of care being given?
If the care needed regularly exceeds the hours planned, then only so much can be absorbed. Care becomes rushed, needs are not met, staff feel like they are failing, and team morale will rapidly decrease.
Dependency should be an ongoing process, reviewed at least monthly or when an individual’s condition changes. Consider the following for each individual service user:
■ How many staff members are needed to support them with washing and dressing?
■ How long does washing and dressing take each day?
■ What equipment is needed to support the service user’s needs?
■ Does the service user need assistance with comfort/hygiene during the day and night? How often do they need help in a 24-hour period, and how long does each episode of assistance take?
■ Can they be left alone in their room or in communal areas without supervision or monitoring? How much one-to-one time is required to support their needs?
■ Do they need assistance with eating and how long does this take?
■ Do staff need support with management of risk of falls, or can they manage this independently? Is assistive technology in place for immediate response?
■ Do they have specific needs that take more time? If so, are specifically trained staff available to support them?
■ Does the service user need significant emotional support and interaction?
2. Establishment hours
Do you have enough care hours planned in the day to effectively provide high quality care? By walking the floor regularly at different times of the day and night, the manager responsible for staffing levels can assess the quality of interactions and determine if the needs of service users
are being met.
■ Assessment of staffing levels should be an ongoing process, reviewed at least monthly, or when service users’ needs have changed. Consider the following when assessing establishment hours:
■ Do the service users appear well cared for?
■ Do the service users appear happy?
■ What do the staff think of the care they provide?
■ Organise unannounced night visits by management at regular intervals
■ Review indicators for quality of care and response to service users’ needs
■ Review service users’ and relatives’ opinions through surveys and feedback
■ Review visiting professionals’ opinions through surveys and feedback
3. Skill mix
Have you got the right people to give the best care? Understanding your dependency and establishment hours is critical to get this right. There are of course certain things that only a trained person can do, like giving an injection, and this must be understood and planned for. Skill mix in a more general sense is more of a challenge.
Consider the challenges in all areas of the business and assess where there is overlap. For example, consider whether allocated care hours are being used for housekeeping, and whether there are enough people on duty at mealtimes who are trained and able to assist people.
Appropriately trained staff who can work in multiple different areas are a valuable resource. Carefully map and understand their time and allocation to provide a clear picture of skill sets needed for each shift and ensure consistent provision 24/7.
4. Effective deployment and allocation
Sometimes the solution is not more staff, it is better leadership. Do you have a clear understanding of what staff do, and when? The only way to do this is to walk the floor, speak with staff and visit your service users. Consider the following:
■ Do you use an effective allocation of duties record for each shift?
■ Do people turn up on time for work? Are breaks managed effectively?
■ Is the start time for the shift ideal for the service users’ current needs?
■ Are care plans up to date? Are team leaders effective?
■ Do staff have the equipment they need to deliver care efficiently?
5. Building a rota
The rota needs time to plan well and deserves to be respected due to its critical role in ensuring a work-life balance for your team. In my early nursing years, the rota was called the ‘off duty’. That’s because it’s what we all looked at to see when we were off – when we could spend time with family and friends, rest and recharge our batteries. It can be challenging for managers as it needs to be accurate, well planned and shared well in advance. Any changes must be communicated to the people the changes affect.
6. Absence management
Sickness is an unavoidable part of life. It must however be measured and managed. If not, team morale and quality of care will suffer. Return to work interviews, completed diligently and with compassion, are the simplest way to get traction on reducing short term sickness and
understand what support staff may need.
7. Holiday management
Staff need holidays, but it again these must be measured and managed so staff aren’t all away at the same time. A holiday planner calendar is a must and should be organised well in advance.
8. Staff recognition
It’s important to know how your staff are feeling and to recognise and thank them for a job well done. One-to-one discussions, staff meetings and surveys all help with this, while rewards and recognition schemes are also important.
Smart digital care management systems are building feedback into their products both for staff and service users, and it is something to consider as we continue to embrace the digital era in social care.
9. Agency staff
If you are short of staff, you may need agency workers to help provide safe and quality care. Embrace them, treat them as your own, make sure you have a great induction for them. Block book the best, and feedback about those who don’t meet expectations.
10. Recruitment, retention and onboarding
The process itself is complicated, regulation heavy and takes a long time. When you have a significant number of hours to fill there is often a snowball effect, as more people leave due to the challenges of being under-staffed.
To avoid this, recruitment should be always-on: services should be constantly looking to attract people. Actively stay on top of the reasons why staff are leaving through measurement and management.
A new recruit is valuable, and their first interactions with your service can make or break their experience. A robust onboarding induction is therefore essential and is fundamental to effective workforce planning.
There is an array of resources in the QCS system to help address many of these challenges – see here for a full list. Start a free trial now to access these policies.