Employee TurnoverThis week I am speaking at the Home Care Evolution conference on all things HR for the home care industry. One of my presentations is focused on caregiver retention. Let’s take a deep dive and look at what your agency can do every day to reduce the employee turnover of your caregivers. 

The annual study published by Home Care Pulse shows that caregiver turnover has remained flat since 2019. However, turnover remains at a very high level (around 65%). Home care has always been an industry with high employee turnover. When I first worked with the industry, it was hovering around 30%. Now it’s twice as high and doesn’t show signs of abating. 

Nonetheless, there are some things home care agencies can do every day to minimize the “flight risk” of their caregivers. It takes motivation to change and determination to implement new systems. These actions create a caregiver-centric culture at your agency.

Starting Up A Case To Reduce Employee Turnover of Caregivers

How your agency starts a case is a critical time for retention. The first shift on a case should be devoted to sharing the plan of care with the caregiver, getting to know the client and their home. Make sure the caregiver knows how to operate all the equipment in the client’s home.  “Caregivers often live in very different economic conditions from their clients”, reminds Steve “The Hurricane” Weiss. “So don’t assume they know how to use the appliances like the dishwasher and the microwave. Show them everything.”

It takes at least two hours for the case manager, or the nurse, to conduct this introduction. Agencies that only spend 20 to 30 minutes to start a case often see caregivers walk off in the first weeks. 

Learn how your agency can improve caregiver retention with training before discharge, acting on caregiver feedback, and focusing on caregiver needs. Those actions are easy to implement. They will make a sustainable difference in retention if your agency anchors those tweaks as part of their daily operations. 

Train Caregiver Before Client’s Discharge

When a client is about to be discharged from the hospital or a facility, Steve recommends for a caregiver to spend two hours before discharge with the client before they go back home. The client and the caregiver get to know each other before the real work starts. It’s a great opportunity for the caregiver to learn about the clinical needs of the patient: how they are used to being transferred and their daily rehab exercises. 

Agencies can charge for this time and explain to the client the incredible benefit of two hours of care time for continuity of care. It’s also gratifying for caregivers to feel like they are part of the true continuum of care. They might benefit from extra training as they observe the facility’s clinical staff at work.

As much as possible, ask the caregiver to meet the case manager in the office and to drive together to the facility. Spending time with the caregiver while driving is a golden opportunity to nurture the relationship and check in with them individually. These personal check-ins also contribute to reducing caregiver turnover.

Act on Caregiver Feedback to Reduce Employee Turnover of Caregivers

Caregivers observe the client’s condition daily and know when things are changing. They often see care needs not documented in the plan of care. When that happens, make sure your agency has a process in place to act on the feedback your receive from caregivers and pass it to the Care Manager or the Nurse. It not only improves patient care, but It’s also a very powerful way to demonstrate that caregivers’ feedback matters and is taken seriously.

Same idea with availability. If you have done your onboarding correctly, you know the availability of your caregivers. You understand their constraints and what hours they can work for your agency. Don’t call pleading to take a case if a caregiver has reached their work hour goal for the week. You will likely waste time and lose a little credibility in the eyes of your caregivers.

Similarly, never get angry when a caregiver declines to take a case. Don’t force them into accepting a case. If something goes wrong, the caregiver will end up resenting your agency for putting them in a position of failure.

Finally, always check the individual preferences and medical needs (e.g. injuries, allergies) of your caregivers. Don’t place a caregiver allergic to cats in a home with a feline. In these times of very high gas prices, the location of a case is more important than ever. Caregivers will not be able to afford to drive 30 minutes to a case when gas is over $5 per gallon. 

Focus on Caregivers’ Needs As If Your Agency Depended On It 

Create a sense of teamwork between caregivers and office staff. Agencies with an adversarial culture between the office and their caregivers experience very high turnover. Don’t fall into this trap! Train your office staff in mindful listening. Encourage them to see themselves as members of the care team serving caregivers who provide services (and generate the revenues!) Office staff plays a major part in caregiver retention.

When caregivers call the office, always take the time to speak with them. Caregivers are often lonely on the job and might be frustrated or struggling with a client. They need to connect with people who understand their challenges. Let them vent when they need to express their frustrations. Let them talk it out. Show them that they are heard even though you might not be able to “fix” the situation.

Consider new caregivers like new team members. Look at ways to integrate them into feeling part of your home care team. Make them feel welcome, and listened to. Newly hired caregivers are the greatest flight risk. Data shows that the first 90 days are critical to retention. According to Home Care Pulse, 52% of turnover happens during the first weeks on the job.

For more on caregiver management, check out the tips shared with me by Kelly, a Care Coordinator.

These actions are not difficult to grasp and do not require expensive new programs. They will make a sustainable difference in retention if your agency systematically embeds those tweaks as part of your daily operations.