ATSI

Managing staffing levels proactively, not re-actively

Poorly managed work forces- ‘The insidious death of your work place culture’

There has been much debate about the need for standardized staffing levels across the industry. Calls for minimum numbers of care staff, minimum skill sets, based on resident numbers. Generally it is accepted that staffing levels are too low in the current environment and pressures are applied to government to fix the problem. But I can see a far greater problem emerging, and more and more frequently we see the reactive and rapid shedding of staff hours in response to what is generally a short term anomaly in resident numbers or cash flow to pay wages.

Aged care is about providing care and support to increasingly dependent residents. This is our core business. So why is it that when a provider is faced with reduced occupancy that translates into reduced income and cash flow, that the first response is to reduce the numbers of hours available to provide care and services or our core business. Is it that suddenly the other residents know longer need support either?

Having managed many aged care facilities over time in many different environments I understand the need to balance the budget, and i have reduced staffing hours ( and increased them as well) as conditions change. But I have always taken a proactive and balanced approach to managing the changes.

I recognize that every time we cut hours we are destabilizing the work and service environment. We are impacting on the carefully planned routines of our residents, and impacting on the lives of our staff. Building partnerships with staff is a critical factor in developing and maintaining work place culture. Yet some providers have little regard or understanding of the long term effects of constantly playing with staff rosters or shift patterns.

The first impact is that staff become devalued, and will stop respecting and valuing the employer. Sick leave , absenteeism increases and staff turnover all increase.

The second impact is that residents are no longer provided with consistent and planned services. This leads to mistrust and worry within the residents and families groups. Residents can see the changes in staffing, they can see that the meals a delivered later and the dining experience is poor. They hear the staff complaining!

The third impact is loss of control at an organizational level. Organizations that start to make poorly thought through, rapid response changes to service delivery hours, ultimately end in a spiral of uncontrolled cultural change. So rather than saving money, costs increase in other areas such as agency use, recruitment and reputational costs

So what are the opportunities to prevent the death of your culture. Firstly the “do nothing” opportunity should always be the first choice. If you have a down turn in occupancy, don’t just look at the vacancy, examine the changes in dependency of the remaining resident population and consider their needs. Do a financial plan for the next month and understand the risk ( if there is one), and manage the problem.

Secondly if there is there is a need to reduce hours, look at all operational services, not just care staff, after all this is our core business. There are other opportunities that will not impact on resident care, that can still reduce labor costs. I rarely see reductions in finance or HR, or administration, it is always care and hotel services that suffer. Care staff see this as well, and it does build high levels of resentment very quickly toward management.

Thirdly do not change work flow patterns, resident routines , or shift patterns that will impact on the more critical capacity to maintain complex care needs such as medication administration, wound care, or palliative care. Do not introduce short term staggered start or finish times, this leads to a breakdown in communication between staff, poor understanding of daily operational needs and can lead to utter chaos.

Finally, consult and discuss with staff, residents and families, do not dictate or make decisions in the absence of consultation. Your staff will often provide you with solutions that minimize the impact of reductions and if consulted and have an understanding of the broader issues are far more likely to support management, and develop trust, rahter than build resentment

Peter Vincent is Managing Director of Aged Care Management Australia and is an industry expert

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