Kevin Pudney and Malcolm Rose have worked in the care sector for over 20 years. Their most recent job is part of a European project aimed at improving training and development in business and ‘speeding the time to competency’. More information on the research project is available on the Prolix website (www.prolixproject.org). The project was conducted in partnership with Social Care Institute of Excellence. The social care sector in UK was chosen to test the new systems developed as part of the project. The researcher spent 3 years in Suffolk working with 6 care homes owned by The Partnership In Care (TPIC) group. The Social Care Institute of Excellence (SCIE)  is responsible for this social care ‘test-bed’ and will assess the impact of the project.
What’s the problem?
Statistics from the Labour Force Survey show that Care Assistants and Home Carers report higher than average levels of stress related illness caused or made worse by the work they do. The PROLIX project aimed to develop systems that would help improve working lives of managers and staff at the homes. The project was not about work related stress, but the researchers recognised that there were factors present that can be associated with cases of work related stress. Staff turnover was about average for a sector that has a generally high turn over rate at around 25%. However, it was particularly high in one home after management problems, where analysis showed turnover in the previous two years of 57%.
As skilled staff are replaced by unskilled staff, it increases the training demands on management. It is well established that people who need help with social care want the same carer to care for them consistently; especially those who need help with washing, dressing etc. Where homes have a high turn over rate or rely on temporary or ‘bank’ staff they struggle to offer this consistency of care to the people who live at the home. Other issues identified as part of the testing included; low pay, high job demands, low staffing levels, IT issues and needs of residents as being key issues for staff. Job demands included:
1. The care needs of residents
2. Requirements to record information on care given
3. ‘Required’ skills and knowledge in over a dozen ‘mandatory’ areas of competence. Control issues included:
1. The care needs of residents
2. Lack of control over how work is carried out
3. Lack of control over when work is carried out
What did they do about it?
The initiative focused on improving the management of training and development in order to give staff the skills they need to do the job and satisfy the legal requirements set by Care Quality Commission (CQC). The aim of the work was to help managers understand the issues faced by staff and for Care Assistants to get the training they need so that they could be more skilled and perform better, stay in the role longer and give residents the care that the are looking for. The general study involved all staff and managers at The Partnership in Care homes, and subsets of staff for particular areas of research. One area involved asking care staff to rate themselves on a scale of 1-10 for a set of 17 areas of competency. These areas were based on the requirements set out by CQC and other areas identified as important by the local training manager. Managers were then asked to rate each of their staff in the same competency areas. They had not seen the results from their staff when they did their assessment.
This exercise helped staff identify their own Areas For Improvement (AFI) and managers to identify AFIs for staff. It also allowed comparison between staff and managers. This enabled the training manager to identify areas where members of staff did not feel confident in their role or where managers did not feel confident that staff had the necessary skills. It also allowed the training manager to look for trends within teams, for example where there were differences between the ratings given by staff and a manager. It could also identify where people may be over-confident or where they needed more support. The general findings from this competency exercise were shared with staff and managers in a supported environment to help them identify issues and properly interpret data, where training was needed and where staff felt there could be an improvement in the services offered to residents.
The detailed individual results were treated as confidential and discussed further in supervision. The final results of the project research were delivered to staff and managers at each home in a day-long session at the end of the project. This enabled the consultant to explain the exercises and the results and spend time with staff and managers to give them support in receiving and delivering the results. It also enabled them to explain how these results would be fed into the development needs of the people who had taken part. There are some 600-800 person training units to be delivered per home to skill all staff to a basic level, with a significant proportion repeated annually as ‘refreshers’ and for new unskilled staff. The organisation owns 6 homes, making this a huge and time consuming activity.
The Partnership in Care group has a full time training manager who is responsible for arranging and delivering these training units. Kevin and Malcolm worked with the training manager to help develop a spreadsheet that would enable trainers and managers to see at a glance who had the training they needed, what training was outstanding and when refresher training was due. “The training system has helped us see at a glance what training is outstanding and made sure that we can get people trained when they need it and nobody is missed out.” – Care home manager What else could have been done?
They feel that one of the things they would do differently is to help the organisation try to identify suitable people at interview stage. This would help The Partnership In Care group to identify staff development needs at an early stage and invest in those people who have the desire to forge a career or vocation in social care from the beginning of their employment. This would help keep them with the organisation. How can it prevent stress related ill health?
It must be made clear that this exercise was not put in place with work related stress in mind. The objective was to help improve the organisation and delivery of training and development within the company. However, demands and control issues were identified as part of this study. By improving the levels of competence of staff and managers and in helping them think about the skills they need to be successful in their work and improve the lives of the people who rely upon them, the work has helped address some of these demand and control issues.