In a roundtable sponsored by CoolCare, our panel of industry experts discusses how digital technology can help meet the unprecedented recruitment and retention challenges facing care home providers.
ATTENDEES: Rachel Canning (RC), Resourcing Business Partner, Bupa; Josh Hawker (JH), Relationship Manager, AbleCare Homes; Karin Brownlie (KB), Registered Manager- Frenchay House & Crossley House, AbleCare Homes; Iain Corrigan (IC), Sales Team Leader, CoolCare.
CHP: How would you describe the current climate for recruitment and retention?
RC: Like so many other sectors, recruitment is posing a challenge for social care. I think some of the challenges are that individuals who have joined the care home sector during the pandemic have then gone back to hospitality or retail as things have started opening back up. We did see a spike when things first started opening back up. But now again we have seen that people have started going back to the other sectors, which is causing additional challenges on top of factors like Brexit.
JH: What I think a lot of people don’t talk about is it’s not necessarily recruiting and retaining people, it’s the staff that we have got are just knackered. They have had COVID-19 for 18-20 months just full on. If there’s an outbreak, you come in and do extra shifts, and there’s no other option and you can see their resilience just goes if they come across a challenge. It would have been a bit of a challenge 18 months ago where you got your head down and worked through it but now it seems to derail them completely and it can turn into a major, major thing from a little bit of a molehill, really. That’s one of the things I’ve tried to nurture them through to keep them happy.
KB: One of my homes sailed through the pandemic and didn’t have an outbreak and we were in our little bubble, it was great. Now, this side of the pandemic, everyone’s knackered, and people are fed up with care. They’re looking at other sectors. And it’s just their mental health is in tatters at the moment.
CHP: What sort of strategies are you employing to cope with higher absence levels?
KB: I’ve got a huge bank team at the moment. I’ve employed a lot of people because there was this worry about the winter because COVID has reared its ugly head again, they were worried that we’d lose a lot of staff over the winter. We have a bank team in place, which is great, but usually they’ve got other jobs. So, for instance, I put a shift out for this afternoon. There’s about 20 people in the bank team, no one’s taking that. So you could have right now 100 in your bank team and still might not get the shift covered.
RC: We’re often fortunate that teams within the homes will step into support, but at the same time we want to make sure we’re not overloading them with hours, so bank staff do play an important role too. We work with a couple of trusted suppliers for bank staff, which help us ensure we’re getting the same people, wherever possible, so they can get to know our teams, homes and residents, and provide some continuity of care.
JH: That’s one thing that’s been much better with us in that we’ve never really worked as six homes with their own staff. Since the pandemic when we interview people we don’t say you’re going to work in Frenchay House, for example, you will be based there but you need to be able to work across all our homes.
IC: Many of our larger groups utilise banks staff pools that can be shared across multiple homes. They recruit for an area, not necessarily for a specific home. They have a main home and you can sometimes have main shifts if they are contracted for set hours. But they’re also down in the system as potential bank for various different locations, places that they could potentially work and then that manager can say, ‘I need some cover and I’ve got a larger pool which is like 80 or 90’ (to cover two to three homes) and then you just send that message out to all staff who are qualified and not already rostered to work and see what comes back and fill the shift in. You can’t be compartmentalised anymore really because you haven’t got enough of a pool for each home. Obviously, this only works where homes are close together or travelling is covered for more distant homes.
KB: I’ve done a similar call to a WhatsApp group with all the bank staff and we stick all the shifts down there and just pray they pick them up.
IC: One of the things that we get is people telling us that there is often staff friction created by having an open online discussion about extra shifts and cover such as people not being quick enough to respond to a call for cover and certain people always being first leading to comments such as ‘she’s always getting those extra shifts where she wasn’t on shift and saw the WhatsApp first’ or ‘she is always getting the overtime and no one else gets a chance’ … or perhaps an issue where the first person to respond is not chosen in order to be more fair and that results in accusations of favouritism. But we solved that problem by having a one-way mirror on the system so managers send out messages to the staff they want to provide cover and staff can respond but nobody sees the other side. Also, via the staff portal, staff can see empty shifts that need cover in the future and request them direct from their mobile. No-one sees the requests and no one can make judgements, thus reducing team friction.
JH: That’s amazing.
RC: We do that through our health rostering system. There’s a functionality where we can send a message out to all the bank staff or someone who’s not working on that shift that we need covering and it’s one line of communication. It’s an online rota you can access on an App.
CHP: What other digital HR systems are you using?
RC: We use numerous systems, as they all serve different parts of the process through HR and recruitment. We’re still working on ways of integrating them, and getting them to talk to each other, which I think is our biggest challenge – especially as we look to these systems and reports for insights, so we know what’s working well – and likewise what we need to change.
CHP: So you are looking obviously to try and get them to talk to each other?
RC: In an ideal world that would be great. I don’t think that’s a one-stop shop solution right now though, so it’s taking some work. At the minute, a lot of the focus is around the recruitment system, where we know there are a few holes that we need to fix, especially as we’re moving into these challenges and wanting to try new and different things, so we are looking at that.
CHP: How does your recruitment system work?
RC: We have Telao. It’s an oracle system. Candidates apply and we can screen them at that point, and we’re trying to get psychometric testing built into it. Candidates can apply for different roles, but they have to log on using the same email address so we can track them, and then onboard them. All of the new start paperwork is automated through that recruitment system and they complete things online with an esignature, and then it feeds back to us and automatically sends references out. Our Experian system, which is usually used for DBS, is separate. Ideally that whole process would feed into our HR system, so we can pay people but we’re still working on bringing the two systems together.
IC: We’ve got CareDocs which we use for care recording. It’s pretty good at that because it does do a lot – you can do the kitchen recording and staff functions. And WhatsApp is worth mentioning as a system that we use, because we do a lot of communications through it, because it’s so quick and instant. So we use that quite extensively.
KB: We have a website for online applications. We’ve got a chat resource on there as well.
IC: Do you guys use any social media?
JH: Karin’s daughter is our social media executive. We put out a lot of photos of our care life. And one of the things we’ve had quite a bit of success in recruitment is doing profiles of the carers saying ‘this is Kelly, she’s worked in care for this many years, etc’. A little bit of a profile. That’s worked really well for some recruitment. We’ve had some real success recently with recruiting off Facebook. Chefs have been a good area. I’ve been desperately trying to get some more cooks and chefs, and they’re just like hen’s teeth at the minute, since everything’s opened up. We put one on Facebook, and I’ve got five applications in overnight, and three of them turned up to the interviews. I haven’t had five chefs turn up for a long, long time.
RC: Pre-pandemic, we started using Facebook and posting onto Facebook groups, specifically around jobs and vacancies. We do tend to find that candidates come back to us an awful lot more from Facebook. They like the idea of a text or a chat or something rather than picking up the phone or maybe applying online because it doesn’t take five clicks on our website to get us through to the application. We find lots of candidates come back to us and we do a lot of recruitment from there.
KB: We have had a bit of success with LinkedIn as well.
IC: Do you advertise on social media as well?
JH: We do paid ads.
CHP: So when you’re looking to recruit people, social media is one of the most successful avenues?
KB: It’s good because if we’re advertising for a certain home, I might put an ad out, and then all the staff will share it. So it goes local. It’s attracting all the local people.
JH: The complete opposite end of that spectrum, though, is we’ve had a few invites recently to job fairs at the Job Centre, where they’ve had young people on Universal Credit, and they actually invite them down and you can make a new job offer on the day. That’s been really useful, because you’re suddenly in front of a crowd of people that would never have necessarily thought about applying for a job in care and actually, because you’re in the room, and you can have a chat to them, a lot of them are ‘thanks for the chat but not for me’. But we went to one three weeks ago, and we ended up with three people on a Kickstart scheme working for us, and they’re all really good and they would never have found us and we would never find them without the Job Centre Fair. That’s the complete opposite of social media – actually going out.
IC: It’s a quite traditional way of doing it. On a non-technical basis, are there any sort of preconceptions people have about social care and why they would not want to go into it?
KB: I have got students at the moment and they’re all studying health and social care in their first year, I’ve got six of them. All of them said, before they came, they had this preconception of a care home that would be dirty, smelly, no one’s looked after, so they’re just going off the bad news stories. And they were really surprised when they came in.
JH: They are consistently shocked by how nice it is working here.
RC: I think it’s the same for the nurses as well. Because their degrees are usually sponsored by the NHS, and they’re heavily encouraged to do placements in the NHS, they feel that working in a care home is for the end of their career. There are other myths too, like care homes won’t stretch or develop their nursing skills. In reality, our residents require more nursing care than ever before – so it’s a really interesting time to work in the sector. It’s about breaking those myths down, so we’ve been tweaking our campaigns on our social media platforms to try and break down some of those messages. It’s good when we can use real life case studies with nurses who have come through from being a student, and we can share those on social media and get them out there as much as possible. But we have just got to tease them in in the first instance, because then they’ll realise that it’s very different, and much more rewarding career, than their first impressions may suggest.
KB: Another thing I use is nextdoor.com. It’s universal. You log in and it attaches you to your area. So it’s all the locals, all the roads around your home. It’s like a community hub thing. You get all sorts of stuff on there but I use it for volunteers.
CHP: Are you having any joy attracting people from other sectors or is it going the other way now?
JH: It’s going the other way. We had a really good period of time and that was actually a real positive from the pandemic because you got a fresh perspective. My background is car sales, so I was car salesman before the pandemic and so I look at things much more from a customer service base than people in healthcare.
RC: Do you have an applicant tracking system where if someone applies, you can see all the applications in one place?
KB: They go to a hub and then they get sent to the homes that they’ve applied for.
IC: So that’s sort of like an ATS applicant tracking system to see all of your applicants, right top down. Do you track your success at source?
JH: We keep an eye on the trends.
RC: We track it. One of our other biggest sources is Indeed. It’s really good for us as well as
carehome.co.uk. We have access to their CVs and we have CV Library as well, they all provide us successes in some areas. For the sponsored adverts LinkedIn tends to perform well with nurses, while care assistant positions might do better on Indeed.
IC: Do you think there’s any systems that can help you retain staff?
RC: We use something called ePoints which is a way of saying thank you to the staff. It sends postcards with a little thank you message, along with ePoints, which are like vouchers and can be redeemed against a whole range of items. It’s just one of the ways we say thank you to staff, to make them realise how valued they are. Ultimately that’s so important for retention.
JH: One of the things we’re quite keen to do is use our social media, again not just to promote the sales of the business but to shout about successes. It’s not that I think sometimes the staff could think that we’re cynically marketing, but, for example, our chef that recently won best of the year, was plastered all over social media. It makes us look good for selling rooms but it’s a really big well done for her to see us promoting it so much. So we try and celebrate our successes as much as possible with computers, but a lot of it’s more of the traditional sort of employee of the week and supervisions.
RC: Our biggest challenge of being a bigger business has been engaging with the staff on the frontline because they don’t have access to emails. We’ve just introduced WorkVivo, which is an App on your phone or accessible on a desktop. It’s like Facebook and is accessible for all Bupa’s staff across the world. So you can share statuses, you can follow people and things like that, and connect with nursing and care communities worldwide to share ideas. It only launched a few weeks ago, but it’s already seems to be having an impact on engaging frontline staff.
IC: I have a couple of anecdotes from our customers about how our systems help retain staff. Number one, you can book your holidays and book and pick up shifts online, without having to speak to a manager. That appeals generally to younger staff such as student nursing staff. The fact you don’t have to interact to request holiday, you don’t have to go ‘cap in hand’, is preferable to many. It’s just completely online. Our feedback is that people like that option a lot.
Another one that was fed back to us was that by analysing care planning data of a 12-hour shift, providers can better identify and minimise errors and maximise productivity. If a staff member’s productivity is dropping, and they are struggling in their 12-hour shift, they probably know it but nobody else knows it until you’ve got the data and then the managers are able to talk to staff members and say, ‘Hang on, would you be interested in switching shifts?’ Doing an eight-hour instead of a 12-hour shift or considering days or ‘earlys’ or things like that. That impartial information helps manage the staff and provides better care for the residents. Our system’s got dashboards and a lot of widgets saying what’s happening in the home right now. One of the widgets the managers have been putting right at the top of their dashboards is unused holidays, ie staff holiday remaining because during the pandemic nobody could take a holiday, or even think of taking a holiday. So the manager has been proactive in asking those staff who are at the top of the list with the most remaining holiday and probably in most need of a holiday and approaching them and saying, ‘you should take a holiday’. The staff like the reminder and the care from the manager, the manager is also able to avoid rota conflicts and staff shortages by being proactive.
The final feedback was about consistent lateness. CoolCare is a time and attendance system. It has these parameters you can set as a homeowner as for what you consider late so it’s very flexible. Having that lateness data to hand is really interesting in the fact that you can blame the computer system and not a person – so it wasn’t Doreen’s fault that you were reported as coming in late, it was CoolCare that said it. It’s impartial. The staff member feels a little more pressed when they’re being asked in person. If there are good reasons and the manager and the team can accommodate the staff member’s needs then, the lateness can be managed and planned into the rota and the staff member could start later, etc (therefore not being late) and thus further reducing staff friction. We’ve got a great case study from Grosvenor House where that has created much stronger and resilient teams, because it reduced a whole lot of unspoken friction that nobody was talking about openly and addressed the issues of people being perceived as getting away with being late.
KB: I totally get that because my office is up in the gods. I can’t see what’s going on downstairs. I do come down a lot. But I don’t always see who’s late. And you’re right sometimes I will come down to a bit of friction.
CHP: Looking forward, where do you see yourselves using software more in the future in terms of recruitment and retention, workforce management, those sorts of issues?
RC: We’re looking at our recruitment system and our onboarding systems and seeing whether we can strip them right back. We appointed a new head of resourcing recently who’s joined from another part of the business. So they’ve been able to take a step back and look at what systems we currently have – and what systems would actually be useful. It’s early days but it’s exciting to have that fresh thinking and support.
JH: I think we will continue with more of the same with social media but we are also trying to get to more Job Fairs.