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Do we care enough about care workers? An exploration of human resource development in adult social care

Lewis, Elizabeth Ann (2017) Do we care enough about care workers? An exploration of human resource development in adult social care. Doctoral thesis (PhD), Manchester Metropolitan University.


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This thesis contributes to the growing literature surrounding the application of Human Resource (HR) practices for Adult Social Care (ASC) in England. The need to recruit and retain staff within ASC will become more urgent within the next few decades, given that an exponential rise in older adults is predicted (Age UK 2014), and many of these adults will need support to remain autonomous. Skills for Care (2016a) have emphasized that ASC has a substantially higher vacancy rate than the national average, at 6.5%, with a turnover rate of 26% as of 2015. This calls into question the ASC employment environment and whether current recruitment and retention are acceptable and efficient. The lack of care workers also suggests a need to understand why turnover is high, and how we can enable retention in this sector. Aims for the thesis were to enhance our understanding of the current contributions of Human Resource Management (HRM), and particularly Human Resource Development (HRD), through a mixed methods design. This was in order to gain knowledge of the ways in which recruitment and retention in the sector can be improved, through making the management of ASC more efficient and productive. Following this, a conceptual framework was developed, which led to aims for the quantitative phase, developing and analyzing a model of HR practices; hourly pay and highest level of qualification, together with demographics of the workers (such as age, gender and contract type), and of the organization (such as size, sector and care type), investigating the link between these variables with the outcome worker turnover. The qualitative phase then explored care worker and manager opinions of the usefulness of HR in ASC, methods of improving current management, the required skills for ASC, beneficial areas of HRD and reasons why care workers may leave. This further refined the conceptual framework, as detailed in the discussion. In order to achieve these aims, a two phase mixed methods research design was undertaken, considering both national statistical data (NMDS-SC, Skills for Care 2014) and small scale interviews. Statistical data investigated the ways in which the sector may vary in providing HRD nationally, and allowed for analysis of how these variables may relate to one another. Interviews allowed for theorizing and documented ASC worker opinions to establish further knowledge regarding improvements that can be made, skills that are required, and the most beneficial HR practices in ASC. These methods in combination established particular areas of management need, as well as areas for change in the future. The research investigates current uses of HRM and particularly HRD in ASC, and there was a specific interest in whether HRD use differs in relation to organizational and individual demographics of the workforce. The thesis has established that variations in organization size appear to effect the retention rate and qualification level of employees most significantly, compared with other demographics. Findings contradict previous work regarding organisation size (Hussein & Manthorpe 2011), and suggest that size of the firm is the largest moderator of the worker outcome ‘turnover’, when mediated by highest qualification of the worker and the predictor, ‘hourly pay’. Qualitative findings imply that contrary to the belief that care workers require training to enhance motivation and engagement (Philpott 2014), some care workers and managers suggest it may be more helpful to offer enhanced communication, support and shadowing in order to retain staff. This contributes to HR theory in terms of the usefulness of more informal methods of HRD, when formal methods are currently emphasised in the literature. This highlights informal methods of training alongside formal qualifications, which may create a cost effective alternative. Retention was also linked by managers to the benefits and hourly pay offered to employees, supporting the quantitative phase of research, which contributes to the literature through emphasizing specific ways in which turnover could be reduced, particularly how HRD input relates to worker turnover.

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