27 Apr 2020 ● Liam Palmer, Registered Home Manager
Why it's important to always consider using agency staff in care home management
"They were exploiting the fact that some of the staff would keep going regardless."Beware the “no agency rule”. Care Home Manager, Liam Palmer, gives a brief case study on why not utilising agency staff can be detrimental to running your care home.
Topics covered in this article
There was an impending recruitment crisis in this home
I revisited the home yesterday
Introduction
This is just a brief article following a piece of work I did for a small care group in the south a few years ago.
I did some interim work to improve their leaders, develop the teams, fine tune the governance - the usual stuff.
What was unusual was there were pockets of excellence, together with a "no agency" policy.
They were proud that they'd not used agency for many years and had at least 10 homes.
Knowing the complexity, discipline and leadership skills required to achieve this, I was impressed.
I was keen to see how they did it..
The "no agency rule"
As I got to know this one particular home, I found there was something disturbing about this claim.
In refusing the agency, they simply allowed staff to work 24 / 36 hours, 10 days straight, they simply passed the minimum staffing requirement onto the small existing staff.
It was a reckless practice.
Unsafe and cruel.
They were exploiting the fact that some of the staff would keep going regardless.
There was an impending recruitment crisis in this home
The location of the home meant that there was no transport links, bus companies needed to be engaged to draw staff from the large towns nearby.
I outlined the threat, worked the numbers out and provided several strategies to overcome it.
I quantified the risk and suggested they set up an arrangement with a staffing agency in reserve as their staffing numbers were about to become unsafe.
As a registered manager I take my legal obligations around safety seriously.
The directors didn't appreciate my candour.
They refused to take the steps required to make the home safe, so we parted ways as a matter of principle on my side.
I revisited the home yesterday
They've been using agency for 3 years.
They started 3 weeks after I finished.
They now have 50% of the team as agency.
This means the home will be running at a marginal loss.
The moral of the story for me is simply that dynamics in care, the relationship between staff retention, use of agency, recruitment, leadership of the home at a local level and corporate level - they are all inextricably linked.
Failing to understand this and seniors making arbitrary decisions because they can will not change this fact.
Magic thinking
In CBT (cognitive behavioural therapy) - this is called "magic thinking". It is a thinking error, based on being egocentric - the idea being that if I say it is, it is.
It's magic!
The cost of this magic thinking to this home and care group over 3 years must be near £250 - £300k and counting.
As a home manager, delivering outstanding care and high-quality services requires keeping a skilled team with you, engaged, happy, well supported and skilfully managed.
Effective organisational leadership means knowing the numbers, listening to staff, and effectively supporting the managers running their services.
It's not magic!
