"Is being a Carer the best job in the world?" That's a pretty broad question, and will most likely get a whole range of different answers back. Why even ask that question? Well, recently as part of my on-going work on employee engagement, retention, leadership and culture change on my Sticky From The Inside Podcast, I've been diving a little deeper into different industries to see where the commonalities and specific issues lie. I thought the Care industry would make an interesting case.
My own experiences of working with Care providers as a consultant and personally seeing care given to relatives has always shown me that the professional Carers working on the front line, have been wonderfully giving, selfless people, working incredibly hard, with great spirit and dignity to make people in their care feel looked after. When you speak to many of them, they speak of the job like a vocation, or a calling. They could describe the job, in one sense, as the best job in the world. But is the industry, or are we, taking advantage of these people?
Pay and working conditions in the sector aren't consistent, and often hover around the minimums expected. Is that right? If being a professional carer is to be seen as the best job in the world, what needs to change? In the latest episode of Sticky From The Inside, I spoke to Dan Archer, CEO of Visting Angels, a care at home provider, to try and answer the question "How do we professional carer the best job in the world?". You can listen to the full episode and see what it's going to take, on the player below, or read the full transcript which follows.
Podcast Introduction
00:00:10 - Andy Goram
Hello, and welcome to Sticky from the Inside, the employee engagement podcast that looks at how to build stickier, competition-smashing, consistently successful organisations from the inside out. I'm your host, Andy Goram, and I'm on a mission to help more businesses turn the lights on behind the eyes of their employees, light the fires within them, and create tons more success for everyone. This podcast is for all those who believe that's something worth going after and would like a little help and guidance in achieving that.
Each episode, we dive into the topics that can help create what I call stickier businesses. The sort of businesses where people thrive and love to work and where more customers stay with you and recommend you to others because they love what you do and why you do it. So if you want to take the tricky out of being sticky, listen on.
The Current Landscape of the Care Sector
Okay, in a recent episode, we examined how a whole industry could become stickier, and we used the UK Hospitality sector as our test case. Today, we are sort of continuing that theme, but looking at an entirely different industry, the care industry. And we're tackling a topic that I think is not only important, but incredibly close to many of our hearts. How do we make working in the care sector the very best job in the world?
The care sector is, I think, the backbone of many of our communities, providing invaluable support to our elders, those with disabilities, and individuals in need. It's a sector where dedicated caregivers work tirelessly to ensure our loved ones can age gracefully, either in the comfort of their own homes or in managed facilities. Yet, despite the incredible work many do in this sector, it's no secret that the professional carers working in the industry have often faced low wages, difficult working conditions, and as a result, employers in the sector experience high levels of employee attrition and turnover. But today, we're here to explore a brighter vision. How can we transform working in care into the best job in the world?
Our guest, Dan Archer, the CEO of Visiting Angels, a company dedicated to making aging in place a reality, has dedicated himself to just that. With his help, we'll dive into the current landscape with the care sector, understand the power of viewing caregiving as a vocation, discover the strategies and success stories that can pave the way to a brighter future. So if you're a professional carer or a leader in the care sector, or simply someone like me who cares about people having better work lives, then this episode is for you. Join us as we explore a path towards valuing, retaining, and elevating the incredible individuals who provide comfort and companionship to our loved ones.
Welcome to the show, Dan.
00:03:19 - Dan Archer
Andy, thank you for having me on. How are you?
00:03:21 - Andy Goram
I'm good, my friend, I'm good. It's nice to see you this bright and breezy morning. So, I mean, this could be quite emotive for a lot of people, I think. And we've come through a period of time that has all been about care, right? And looking out for people, looking after people. And in some ways that sector has been under the spotlight. It's been elevated in people's minds and we've seen a lot of it. And yet there's a lot more to it. There's not just the government stuff we hear about in the troubles of the care sector. We want to talk today about what it really feels like to work in that sector and what the vision of the future can be, to look like, to get to this dream of making it somewhere that can easily qualify as being one of the best jobs in the world. But before we get into all of that, my friend, do me a very quick favour. Can I just get a brief introduction to you, your background and what you're currently focused on, please?
Introduction to Dan Archer
00:04:16 - Dan Archer
Absolutely, no problem at all. And I think what I would say, Andy, is I regularly do say about the care sector is that people don't really know about our industry unless they work in care, or they've received care for a family member. For most in society, we don't think about this stuff until we absolutely have to think about it. And normally when we are thinking about it, then it becomes quite an urgent thing to do. But that was exactly my background. I've worked commercially for 25 years. For the last twelve years I've worked in the care industry and up until 2010 I'd never really thought about adult social care at all. And then we needed care for my Mum's Mum, for my Nan.
My Nan was more than just my Grandmother. My dad was pretty absent during our childhood. So my Dan played an active role in raising me, my brother and my sister. And she had arthritis for 15 years. And towards the end of her life, for the last two years of her life, that arthritis was arthritis in her spine. What went along with that were instances of pain which were very acute and dizziness light-headedness and the risk of falls. So as a family, we took a recommendation from a social worker who said you should probably get a home care provider come in to provide you now with some care and support. So that's what we did. And in the first eight weeks of care and support, we had 15 different carers visit my Dan's place. A constant sort of revolving door of new face after new face.
And I'm a Sheffield lad. My Nan was from Sheffield as well. I always said my Dan had a northern sense of humour about it. She used to say she only knew she was getting care when the blue tabard showed up because the people changed every day. But she recognised the uniform, and the uniform became the basis for the relationship. One of the big questions we asked, actually, when we started the company is, why do we need a uniform? What's the purpose of the uniform? And I would argue in many instances, the uniform has become a proxy for the relationship which should exist between the client and the carer. But that was our first exposure. Lots and lots of different faces coming to the house.
We also had times of visits moving around the place. So it should have been an 08:00 breakfast call, but it was getting shunted forward or back. And I now know the reason it was moving around the rota was because the care provider couldn't do an 08:00 call because of staff turnover. And as a result of that, they were moving my Nan's call around the shift to be able to get it completed at a later point in the day. But long story short, I took a phone call from my Mum on a Tuesday morning to say that a carer had not attended my Nan's call that morning. And my Nan had a fall. She fell into the bedside table, quite a bad fall. And after a brief period in hospital, unfortunately, we lost her.
The Carer-Centric Approach
So I've seen the worst of our sector firsthand, my family's seen the worst of our sector firsthand. And when I came to working in the sector, I worked for a large national domiciliary care provider with a fantastic reputation and a better approach to staffing, in actual fact. I learned my trade with them. I, prior to starting visiting angels, was running a live in care business. So lots of exposure to the challenges that go around care. But when I started Visiting Angels, I looked at the sector and thought, you know what, there's a problem here. And the problem is recruitment and retention. I looked at close to 50 businesses, actually, when I was researching the start of the company, and none of them had a people-focused mission statement. When I wrote our mission for Visiting Angels, it was the first people focused mission statement in the care sector. I'm becoming increasingly proud to say I had a moment of clarity in summer 2017 when with a blank sheet of paper in front of me, I came up with the concept of being carer centric. And I think I was the first person on the planet to use the words carer centric. To put carers first, to make carers the most important people in the organisation. So there's a ton of stuff that we do which I'm sure we'll get into as we carry on talking about the things that we do which make us different in that respect. But the start point for the company when we launched it was putting carers first, because without carers, we do not have a company.
00:08:16 - Andy Goram
Yeah. And I think we will definitely get into what you see as the future, I think. I'm interested to pick up on what you said about the fact that we don't in the main, understand the care sector unless we have used it. So what is the current state of the care sector? As somebody who is slap bang in it, what are the issues it's facing? And what are some of the pinch points that perhaps general public don't see aren't aware of?
Transforming The Care Sector
00:08:43 - Dan Archer
I think that the media are pretty good at reporting some of this stuff, but I'm conscious that, as you say, because I'm in the middle of the sector, I'm hypersensitive to the stuff that yeah, (of course). Many people, if it's not relevant to them, will just dismiss it as news that's not appropriate for them. Right, so we currently have 152,000 vacancies in adult social care.
00:09:01 - Andy Goram
When you say vacancies, Dan, you're talking about job vacancies, right? You have understaffing of that amount, correct?
00:09:08 - Dan Archer
Yeah, vacant jobs. So that's over 150,000 empty jobs for the demand which exists today. Now we've got an aging population. People are living longer with increasingly complex medical conditions and because of the problems that exist elsewhere in the health service, those conditions are not able to be supported by nursing teams in a local community. So increasingly what's happening is that's pushing down onto social care providers for them to do increasingly complex work for a growing number of potential clients. So people living longer with more complex conditions is increasing the demand for the sector. And we've got over 150,000 empty jobs today. Where will we be in 5-10 years time, where we need more people, not less people?
Okay. In addition to that, the people living longer in the complexity of the conditions they live with, we've just got more elderly people. So population dynamics is at play. The baby boomer generation, the people who were born in the 40’s and 50’s there are more of them. It was a baby boom. Right? Those people are coming to a point where they now need some care and support. So there is excess demand and there is a supply side shortage in the care industry.
As to why that is, well, there are a combination of factors on that. Brexit has had a role to play on that. The company I was running prior to visiting Angels was a European business bringing carers in from Europe to the UK. When the UK voted for Brexit, that was an interesting day at work, put it that way.
The reality was long before anything changed in respect to the movement of people, European care workers were not feeling as welcome in the UK, because the UK was saying,
“Well, we don't want to be part of Europe.”
That has an impact. The pandemic had an impact in a couple of ways because lots of people that were already in the country but from another country went home during the pandemic because we got hit quite bad with coronavirus. And in addition to that, the job itself, I mean, look, be clear, nobody had a good pandemic, right? We all had issues and we all suffered through the pandemic. But our sector was required to face this thing head on and to carry on business as usual when we were dealing with people that were living with a disease that we didn't know anything about. So that increased the stress for those working in the sector. And that again led to people not wanting to be involved in care anymore. It's become more complex, it's become more dangerous. I want to get out of this country and go away. So there are a number of reasons around that where there are just not as many people prepared to work in care as they used to do.
00:11:34 - Andy Goram
Yeah. And the very fact that this is going to sound ridiculous, but even the term essential worker, maybe in the last three years, that's become more common parlance in terms of referring to people in that sector as giving essential services. But my vision of people who work in care is, again, probably not dissimilar to yours. It comes from the experience of seeing them look after grandparents who, bless them, are no longer with us anymore. And my experience of those people has been incredible, their dedication. And then, luckily, I've had opportunity to work with some care clients and I'm never shocked anymore by the amount of wonderful people who work in these companies. Just the most unassuming, lovely people who I don't understand how they can carry, the amount of emotional baggage that they must have to deal with, as well as the physical toil and the hours. And yet it seems to me that it's a vastly undervalued resource, maybe from pay, working conditions, I don't know. We pay footballers millions of pounds for kicking a ball around and we pay pence for people who look after our loved ones. I mean, are we just taking advantage of these people because of their good nature? What's your view of the situation?
Society's Perception of Care Workers
00:13:00 - Dan Archer
And if I'm being blunt, “yes”, society is taking advantage of people's vocation, goodwill.
People have been punished for their vocations.
The way that I would see it, you're right. I mean, there's a huge disparity on pay between someone that kicks an inflated ball of vinyl around a football pitch and the essential work is done by carers. I would say that if I think about the tasks that we're involved in, the essential point of essential worker in care is that people can't get out of bed, people cannot receive the medication that they require, people cannot have their breakfast, they cannot wash without the support that we provide. But apart from those essential basics, people don't get chance to engage with the communities that they're in. People don't get chance their home, people don't get chance to have company and to talk about the things that are important to them if it's not for the essential work that's done by home care workers.
Our mission is to lead the UK care sector by 2030 as an employer of choice and to redefine the role of carers in society. We are trying to change society's perception on carers. And I thought during the pandemic foolishly, I thought, “Do you know what? We cracked it.” Because we had those instances on a Thursday night at 08:00 where everybody stood outside their house, was clapping and bashing their pots and pans. I thought, “Yes, eventually society realises what we do is so important.” And what's happened subsequently is people have gone back to work and stopped clapping and put their pots and pans away and we are still out there 24 hours a day, seven days a week, supporting people in the community.
I go to bed at night and I've got people who work for my organisation in someone's home, providing them with essential care. At 02:00 in the morning, if there's an emergency, a client may ring one of our teams, somebody has to be available to answer that call. So we are first responders for the elderly. That's where we are in this situation. And I think I did an interview for BBC News 24 about 18 months to two years ago and talking about the shortage of care workers. At that point, the shortage was 145,000. It increased subsequently to 160,000. It's now come back down to 152,000.
And I was interviewed by a guy said to me, “Can you understand why we've got a shortage of people?” I'm like, “Absolutely, yeah. The job is the problem. The job is not satisfying, the job is job is stressful, the job is mind limited, the job is poorly paid”
, right? And I sort of went home and my wife works in PR, so I went to my wife to look for some sort of reassurance that I'd done a decent job on the telly. And she said, “You can't say that on national TV. Are you aware you've just said on national TV that care is not a satisfying job?” And I'm like, “Yes, because it can be the most satisfying profession.” The difference that you can make, the joy that comes from the bond that's created between a carer and a client, is a beautiful thing. Helping people to reengage with things they used to do 20 years ago, helping people to reengage with the family and society and community, helping people to do all those things that can be hugely satisfying.
The Real Experience of a Care Worker
But I'm afraid for most that work in care, that is not their experience of working in care. Their experience of working in care is they go to a new place every single day. So if you think of it in terms of the stress involved in your first day in a job, many in home care who've got a changeable rotor are having their first day at work five times a day. They go to someone they've not been to before because they need to just go and do that at an emergency visit. They've never had enough time to complete their work because they're rushing off to do something else. They're paid minimum wage, or in some instances less. They're on zero hour contracts, so there's no commitment from the organisation they work for. To them, they drive around during the day in a car that they're running for themselves, but they don't get enough money to fuel and run that car. They're not paid for their travel time. So if you describe that job without talking about care, is it any wonder nobody wants to do that job? Right? Too much work to do and not enough time. Lots of stress, lots of responsibility because of the complexity of what we're doing. I mean,
"It's stressful to sit in a supermarket clearing a belt of shopping on a daily basis, right? But nobody dies in your arms in that job."
In our job, they can do that, right? So, yeah, I would say that what needs to change is the job. If people had more time, if people had more commitment from their employer, if people were paid better, if people had more stability in their rota, so they were seeing the same clients on a regular basis and could form a relationship. That's a job that can be the most satisfying job. But unfortunately for many, that's not their experience of working in care at the moment.
00:17:44 - Andy Goram
So let's try and dig into the sort of brighter future. I mean, the issues that you face around recruitment and retention are applicable to many industries. I said at the start of the show, we just had a conversation recently about UK Hospitality. That is an industry that's been bashed and pushed from pillar to post over the last few years. These are very real issues that it is trying to face into and having to change a lot of stuff. I think it's even more in focus for me, this particular industry topic, because of all the things that you've just talked about, because of the subject matter that we're dealing with here. I would love to hear from you as to how do you start then to deliver this… I'm going to use the word wish, probably incorrectly, but this wish of making it the best job in the world. What does that look like? And within that, you've mentioned the word vocation. How do we kind of elevate that word because it can be mistaken for being a hobby. You get paid for your hobby. This doesn't sound like a hobby that we're dealing with here. How do we get away from people being taken advantage of and almost punished for being that kind of caring person? What's the vision for the future look like, Dan?
A Vision of the Future
00:19:02 - Dan Archer
I think the vision for the future has to be that those who employ care workers have to take responsibility for the position that they hold as the employer. Because very often the narrative around the sector is about the lack of funding. The lack of funding from central government, the lack of funding from local government, the difficulty then that a home care agency or an employer has in ensuring that there's a working environment that's attractive for the individuals working in care. But as people that own and run care businesses, we have a choice on what rate we are prepared to work at. We have a choice on what rate we choose to pay our staff. We are in control of that, okay? And sometimes it feels like people have lost sight of the fact that they are making that choice themselves.
So I would say that in a bid to see a brighter future there, we have to stop working at a non-economic rate. We work at a rate which is a fair rate and a rate which enables us to better look after the people that work in our sector. We need to take responsibility first and foremost for pay conditions and benefits. As an employer, I'm in control of that. I set my pay rate, I set the contract structure that we have in place with our care workers. I set the points at which we pay during the day. I design all of that. And every single care provider is in the same position as I am in that respect. And they would say, it's really difficult for me to do that on a council contract then. And I would say, if the council contract has not got enough money in it, don't do it at that rate. Because if there's not enough money from central government, if there's not enough money from local government, the people subsidizing care in that situation are the care workers themselves. And that's wrong.
00:20:42 - Andy Goram
Does that mean the person doesn't get the care, ultimately?
00:20:46 - Dan Archer
Ultimately, it means people don't quite get the time that they need. But the reality is that care workers are stopping beyond the end of their visits sometimes and not getting paid for it, and they're driving during the day and not getting paid for their drive time. Now, that's a subsidy from a low paid worker because the contract that they're working on through the agency they work for, to a local authority predominantly is not an economic contract. So don't do that work then. Stop doing that work, because the consequence otherwise is we're never going to be able to change this. So you've got to start with pay conditions, benefits and contracts, right?
But the problem I've always got with this thing, when I talk about these things within the sector, people look at me and go,
“It's all right for you, Dan, you're a private duty provider, you can afford to pay staff more. We've lost a member of staff for five pence an hour.” And I'm like, “You have not lost a member of staff for five pence an hour. You lost a member of staff because you were a dick to them. They told you it was five pence an hour. That was the reason they gave the excuse they gave you.” Right?
Culture and Employee Retention
Culture doesn't cost anything. Culture is about recognising the important people in your organisation. The important people in your organisation are the carers delivering care, right? So if you look through the world, look at the world through the eyes of a carer, you absolutely inevitably run your business differently. So you have proper contracts, not zero hour contracts. Why would a carer be loyal to an organisation that's not prepared to be loyal to them? A zero hour contract gives no loyalty and therefore you should expect no loyalty, right? So a proper contract, not a zero hour contract. Being paid a decent wage for the work that is being done. Because the industry is still addicted to a position we had 15-20 years ago where there was the plentiful supply of people and the job itself was far less skilled back then. It's always been a complicated job, but it's far more complex now than it ever has been. The job has changed, right? The approach of some within the industry hasn't changed necessarily.
So if you're going to say, well, if the job is equivalent to the job being done by an HCA in a hospital setting, then absolutely the pay should be the same, not 40% less than it would be if this job was being done in a hospital. The pay has to improve. People need to be paid for all of the work that they are doing. We stand on a hill over drive time. Our carers drive from point A to point B because we tell them to do that. We pay them for that time because that is their job. I think it's disgraceful that some providers will say “We do not pay for travel time because that is not work, that is people traveling to work. And your place of work is each instance that you go to deliver care”, right? That's nonsense, right? Because those same providers are also saying to their carers, “Oh, by the way, you need business insurance.” If you need business insurance, it's work, right?
So pay people for the work they're doing. When you start to make those changes, you get away with… some of the hygiene stuff needs to be cleaned up. You've got to give people that insurance, the base level of Maslow, you've got to give people the ability to know they're getting paid fairly for the work they're doing. But then beyond that, then you've got to understand, well, what motivates a carer? What motivates a carer is to make a difference. They've got caring in their hearts, they've got caring bones, right? So what you do is you then try to engineer that they can do that as much as possible. So you give them the consistency of seeing the same clients week in, week out. You give the client a choice of who their caregiver is so that there's a genuine chance that the clients and the caregiver will form a relationship. One of our brand values is family, another one of our brand values is relationship. That's not by accident. That's where we end up sitting in the interactions between carers and clients.
Okay? And culture is about, as I say, thinking of things from a caregiver's perspective, meeting the challenges that they face, assisting them with that. We create a bond between a client and a carer and inevitably, unfortunately, what happens is that client passes away. Now what some in the industry will do is say to a carer, “Well dust yourself off, get on with it because Margaret over there needs some care.” Now you know, we need to recognise that if we create a relationship between the client and the carer, that carer needs help to cope with what happens when that client passes. We provide people with therapy around grief counselling, we provide them with training to understand how to process grief. And we do these things because we're looking at the job of being a carer through a carer's eyes.
00:25:05 - Andy Goram
And I'm assuming that that is not unique to you though Dan. As an outsider… I shouldn't actually say I'm an outsider because I've kind of obviously done a fair bit of work in the sector and I've seen some of the things that go on inside. So, are you just saying that there's not enough of this stuff, it's not consistent enough, it's not at the right level, or that in the main it doesn't exist?
00:25:30 - Dan Archer
I would say in the main it doesn't exist. And that is not to say that there are not people who… we talk about carer centric people because our vision is to be carer centric. There are some very care centric people working within organisational structures which are working against them. They are not able to be as carer centric as they want to be because there's either not the budget devoted to it or the structure and approach is wrong. There's an awful lot of learned behaviour in our industry. People who do what they do because of a reflex response. Their experience has been that they've done it this way therefore they're going to carry on doing it this way. And we are in a different world now to where we were five years ago and definitely to where we were ten or 15 years ago. Right? So you've got to change, you got to cut your cloth accordingly. If we've got to shortage of people, if the job is harder than it's ever been, you've got to start to recognise that and do something about it. And I think there are some that still deny that a little. (Okay) But what frustrates, I think a little bit, is that this stuff is really very straightforward when you start breaking it down.
There's a stat, a guy called Neil Eastwood who wrote a book called Saving Social Care, he's a fantastic chap and he's got a stat on the number of care workers who quit a job on day one.
16 percent of people quitting a job on day one do so because they didn't feel welcomed by the organisation.
Now, I don't care what your contract structure is, I don't care what your pay rate is. That is as simple as smiling, saying hello and saying to a new employee, “Welcome to the organisation. I recognise you had a choice on where you chose to work. Thank you for choosing Visiting Angels.”
More Challenges For The Care Sector
00:27:07 - Andy Goram
Do you think some of that comes from the stress on the environment, the busyness in the environment? You've talked about gap in people, gap in skills. So the people in these organisations, the people often, if you're in a home managing or leading the home, if you're working in the sort of like the more mobile piece, I guess you've got people who are trying to look after those individuals as well. Is it a case of people being head down, bum up and genuinely not having time for these things? Or is it just not a mental thought that we need to onboard this person in a manner that's appropriate?
00:27:44 - Dan Archer
I think it's too close to the problem to be able to stand back and see a way around it, Andy. I had the fortunate position, before I started the company, of having sort of six months of gardening leave to have enough time to be able to plan for what we were going to do. And I started with a blank sheet of paper. Now, I absolutely accept, if you're in the middle of a business that's struggling to find carers, that is losing carers, that's committed to a contract, which might be an economic contract in the first place, you're too busy fixing the problem of today, right? You've got 15 visits for this afternoon that need to be covered and just getting on and doing that, right? So, to have me come on here and talk about what we've managed to achieve, sometimes people look at me and go, “Just shut up, Dan, I don't want to hear it.” But we have to have this conversation.
I did an event down in London about two months ago now, and there was a conversation in the audience about what we call care workers: care assistants, carers, care professionals, caregivers, what's the terminology that's the right terminology? We'd like to use the word care team members because we think we need to make them feel like part of a team. And I genuinely said,
“Look, do you think when you're paying the minimum wage or less, and they're on a zero hour contract, they give a shit what name they've got? What the name badge says does not matter in that situation. Right? So resolve the situation with regard to pay, structure, contracts, time, stress, and then let's have a debate about what we call people.”
00:29:09 - Andy Goram
Yeah. This sounds to me not unlike other clients that I work with, or other industries, or other topics that we've talked about here on the podcast, in that the issues are pretty much the same. The execution and the landscape can be different, but we're facing similar issues. And we're talking here about, I guess, two pieces, really. One, you can't get away from the pay and working condition stuff, but that is table stakes. Your thing about people saying that we've lost someone for 5p, I genuinely don't believe it's the 5p. The 5p is the straw that's broken the camel's back. But it's all the other pieces. So the table stake stuff gets you into the game. It's what you do on top of that, which is the key to retention. Which is the key to brand reputation. And I think that's where the majority of focus needs to come. But if you don't get the table stakes sorted out, you've got no hope. You're just not at the game.
00:30:08 - Dan Archer
I will also say, and it's really difficult to overlay a culture on an existing business. Right. Again, the advantage we had is we started from scratch. We built this thing from the ground up with Carer centric being the vision for the organisation. Right? So at every point we ask commercial question we ask all the time as a business, if I do that, does it improve the life of a carer?
Making People Feel Seen, Heard and Valued
00:30:31 - Andy Goram
Yeah. And I think many, many businesses face the same problem. Dan, right? We don't all have the luxury of starting from scratch. Most businesses today who are looking and trying to evolve or improve their culture are doing it from a whole bunch of history, a whole bunch of baggage and trying to make it work. Which is why I think it's important that we kind of do focus in on different industries and look at their particular challenges. But it's no surprise that many of the challenges that all of these businesses face come back to similar things.
And I think this second port of call, which is perhaps more pointed for this particular industry, is how we get to this part of making people seen, heard and valued. And I think the tactics and strategies that we put in place for that to happen in this sector I think is really, really interesting. So what specifically, and we talked about a lot of the sort of, I guess, more technical things, the pay, the benefits, the working conditions, the workplace safety measures. But when it comes to recognition and valuing and appreciating what people do and how we show that and supporting them through the more emotional times, what's that future look like, Dan? What should be happening?
00:31:52 - Dan Archer
Well, I mean, we spend a lot of time on that. Think what I would say because we started prefacing the conversation about recruitment and retention. Right. Because it's always recruitment, it's always R and R recruitment and retention the wrong way around retention, then recruitment, right? Put a plug in the bath, then start filling it up. Otherwise it doesn't matter how fast you run the taps, you are not filling that bath up. Right? And in our industry 60% to 70% staff turnover common in domiciliary care businesses, right? So fix your retention problems first.
Now, retention is all about engagement with the people looking through the eyes of a caregiver, recognising what's important to them. It's about a clear point of communication where they understand the importance that they have within the organisation. So simple stuff. Even though I'm Chief Exec for an organisation now with 60 officers around the country we are growing phenomenally quickly. My business in Sheffield, the one that I started first and foremost I still meet every new caregiver that joins us. I still take time during their induction to go down and say hello and to make sure they've all got my mobile phone number. And I say to them “Look, don’t ring me at 02:00 in the morning on a Friday night when you're drunk, right? Because if you do that I'm going to want to know why I wasn't invited to the party. Right?” They need to know who I am. And they also need to know that they can, if they need to, contact me. Now that's very uncommon. The number of people says to me I've worked in care for ten years, I've never met the owner of the business before.
And equally workplace recognition we have Caregiver of the Month, we have Caregiver of the Year. We then have a national Caregiver of the Year program where each Caregiver of the Year from each of the other offices locally is brought together at our conference, which is 1 December this year in Birmingham. And at last year's conference in Manchester. a lady called Jane who works for our Burton office won our Caregiver of the Year award. She'd worked in Care for 34 years and her award with us was the first piece of workplace recognition she'd ever received. That again tells you that people are not focusing on things which are really quite straightforward to do.
So we've got an inverted organisational chart at Visiting Angels. So I started the business from my dining room table and you say I had the luxury of starting from scratch. I would argue that when it was just my dining room table it didn't feel like much of a luxury back then. As the guy that started the organisation I'm the least important person here. I'm at the bottom of our organisational chart as the least important person here. Our caregivers are at the top of the organisational chart. So we have an upside down pyramid if you want to look at it that way. Now because I am at the bottom of that pyramid and the point is on my shoulders the strength of belief I have to have in our vision has to feed those above me. But the larger we get as an organisation the less important my belief is. It's not that I believe it less it's just that when you've got more people in your organisation their belief becomes more important than yours does. Right?
So they need to be carer-centric as well. If I surpass a manager, if I loop past a manager and love a carer directly, I invalidate that manager's position in the organisation. So my job is to support them, to help them to love their staff more. Okay? And then they can love their staff more. Now, when you work that way, you end up with everybody in the organisation bearing some responsibility for being carer centric. It's possible at Visiting Angels for a carer working alongside another carer to be so impressed by the work that's done by a colleague on an evening shift, a double handed evening shift, that she can ring the office and ask the office to send that carer a thank you card from her arrives through the post. We facilitate a carer thanking another carer. Yeah. So these things are the things which really matter. Our conference theme last year actually was 1000 Tiny Thank Yous. Because whenever I talk about this stuff, I end up inevitably talking about the big commercial levers like pay, benefits and contracts. But actually, 1000 tiny thank yous is how you embed a culture. 1000 tiny thank yous is how you help people to feel like they belong to an organisation. That stuff's the stuff that's important when it comes to retention.
Recognising The Right Behaviours
00:35:52 - Andy Goram
And as you grow, Dan, the task of inculcating the same beliefs, the values, the attitudes, the behaviours that you're talking about, I mean, again, very similar to lots of businesses. That growth phase is a time when that can become a bit wobbly and more difficult. So in terms of your focus on leadership and values and really recognising and accentuating the right behaviours, how do you go about doing that, practically?
00:36:24 - Dan Archer
Practically, I would say the biggest problem we've got in that respect is we recruit from an industry or we are the outliers. And it's not completely alien to other people, but it's not common practice for us to operate the way we operate, right? So if we're bringing in an experienced individual into a new location 100 miles down the road from where I'm sat today, the danger is that they're carer-centric to our faces. Right? They say they believe in the mantra when they're going through the interview process, but they get into the organisation and then they start to do the things that they used to do in the other business that they worked in. And that's not the carer-centric way. Right?
So for a start, we interview hard and we interview hard for attitude. Not aptitude for people that understand the problem. If they can't identify the problem, they're the wrong person. Right? So identify the problem and also recognise the responsibility that they can take for doing something different. How can they make a change? How can they have some ownership for the vision and the mission we have as an organisation? Does their value base match our value base? Right? So scenario-based questions during interviewing to find a way of understanding how people think. Psychometric testing for everybody, by the way, we not only psychometric test managers and senior managers, we also every single caregiver that works for Visiting Angels has been psychometrically tested. So we understand our people as best as we possibly can do when they have day one in the organisation. But then we recognise day one in the organisation is when the hard work really starts, right? Because inevitably with volume and with growth and with pressure comes sometimes a suggestion of maybe stepping away, that's not the right way. Is it carer centric? Which means the question on, “is it carer-centric?” has got to be a very easy one for people to ask.
And on the walls of our organisations around the country, we have sort of graphics on the walls which are designed to make people think about the fact they are working collectively as a team towards a shared goal. The mission’s on the wall. We also ask the question “What have you done to be carer centric today?” And we have a ship's bell, or a last order's bell depending on where you come from, which is on the wall. And that's designed to be rung by any of the office team when someone does something carer centric. So there's an audible break in a busy office environment to get everyone thinking “Oh, we've just done something of note. The thing we've done of note is to help a caregiver. To benefit a caregiver.”
Improving the Lives of Caregivers
But the very basic question is as a business we ask ourselves the question if we do that, does it improve the life of a carer? Because if it doesn't improve the life of a carer, it doesn't matter how much money we might make in doing it, it's not carer-centric. So we just don't do it. And I'm aware that it makes us then sound like we're some sort of religious sect or some cult or something like that. And people have summed us up as a business which is too fluffy, because they just can't be bothered understanding it. People who are in very senior positions in organisations that also work in our sector think that it's a shame when I go on TV and talk about treating carers well and properly because they believe we need to stick together and I'm like, “No, we really don't. We need to change things.”
When you interview a caregiver who has been working 60 hours a week in their previous week, but only been paid for 50 of those 60 hours, they're struggling to make ends meet because of the fuel prices have gone up, because the heating costs have gone up, because the food prices have gone up. The cost of living is squeezing them really tight and you sit them down and point out that actually if they'd worked for Visiting Angels they would have been paid for all of their driving as well. People cry. That's the thing we're trying to drive out a change basically. And I'm sure when this podcast goes live, Andy, there'll be some people that listen to what we talk about today and will dismiss it. Hopefully there'll be some people who take a few nuggets away from this and things that they can potentially involve in their organisations and make some changes there as well. But as a sector, if we don't change, the problem is going to get worse, not better.
The Inconsistencies of the Care Sector
00:40:12 - Andy Goram
As I always say on these sorts of topics, Dan, we've got to talk about them and people have to express opinion to gain other people's opinion. You're expressing your opinion on it. I have a small insight in some of the work that I've done, but I'm not living in the industry, I'm not working in the industry, I don't experience the life of a carer. But I do think from this conversation, from research, from things that you read and things that you see on the telly, we are… I say we, the care sector is experiencing very similar issues with regards to retention and recruitments to lots of people. It's not just about the care industry. We're using the care industry today as a sort of tableau for some pretty standard stuff. I'm really always interested though, to hear what industry leaders are doing in their sector to try and move the dial. Sometimes we hear new things and they can be applied to other businesses, sometimes it's doubling down on the stuff that's really important and to use your words, they are mainly common sense, but unfortunately not common practice. So on many of the things that you've talked about today, I've seen snippets of this when I've gone into places and work with care. Is it consistent? I don't know. I have not seen everywhere. You're in it. You're telling me it's not consistent?
00:41:31 - Dan Archer
What I would say is if it was consistent, we wouldn't have the work crisis that we've got. Right. The response to the workforce crisis in itself is interesting, right? Because there was a report issued this last week actually, which estimates that the cost of moving the pay rate for a home care worker to an acceptable pay rate is 2 billion. So that means we're 2 billion adrift of an acceptable pay rate currently is the way to read that. Now, as a result of that, the government are quite happy to spend 15 million quid on a TV campaign to try and attract people to work in care because it's cheaper to do that than it is to fix the problem. There are some in the industry who believe that we fix the problem of sort of the shortage of care workers in the UK with overseas recruitment. And personally my view is I don't think we find 152,000 fill, 152,000 vacancies by finding people from around the world who don't know how difficult the job is bringing them to the UK and then hoping they don't find out because they figure it out pretty quickly, right? If you've not got your house in order, if you've not made the job a better job, then it's not going to appeal to those people that you need to come and do.
Sticky Notes Wisdom
00:42:39 - Andy Goram
Absolutely. I mean, for me, this conversation has been fascinating, Dan, to have an insider view into the issues and the potential solutions to making it the best job in the world. But we've come to the part in the show that I call Sticky Notes Dan, where I'm asking you to summarise all of the thoughts, pent up upset, whatever it might be, my friend, in that on three sticky notes, leave the audience today with how we can make the job of a carer the best job in the world.
00:43:12 - Dan Archer
Okay? Number one, we've talked about it already. They are the entry level things. They have to be on the table things. It's pay contracts and pay for work that's done, okay? If you are not creating a situation where people are earning what they should earn if they are driving between visits and not being paid for that, if they are stopping beyond the end of the visit and not being paid for that. If they are not getting enough money from their organisation to cover the cost of running the car that they're having to pay for themselves to get around and do the work, then these things are basics. You cannot equally expect loyalty if you're not going to extend loyalty. So zero hour contracts do not have a place in this as far as I'm concerned. Minimum wage is not enough. We're paying up to 16 pounds an hour across the country. We pay travel time, we have proper contracts, we find it easier to find people. Right? So number one is that.
Number two is absolutely the attitude that you take as an organisation to your people. Not when you're forced to think about it, but all of the time. People say to me, I can tell you that our staff turnover nationally across the UK is 13% against an industry average of 60% to 70%. And then people say to me, we've got pretty good staff retention in our organisation. And I will say, okay, what is it? And they can't give me a number, which means they wish it was. If you don't measure it, you can't improve it. Right? And we've got some key performance indicators that we regularly work with, including staff burn rate, staff turnover, cost of recruitment and the capacity for taking additional cases. How under or overworked the team that you've got currently are. Now, if you're measuring those things, you've got a barometer for whether your workforce and your attitude to your workforce is where you need it to be. Because I can guarantee you that all of these things are connected. Because if you pay people better, treat people better and have happier carers as a result of that, then it's easier to keep people because you've got the best job in town. It's easier to recruit people because they recommend to their friends, come and work here, and their friends are prepared to come and work there, right? If they're not enjoying their life, no one's saying to their friends, “Come over here, it's rubbish”, right? So you create that positive environment, then you get referrals. And about 30% of all of our new caregivers are a referral from an existing caregiver. We're running a happy ship. So that has got to be it as well, not thinking about it when you have to think about it, thinking about it all the time.
And I think the final thing I would say in terms of a sticky note is it's broken. We need to stop talking about the fact it's broken and we need to start doing something to fix it. And as an industry and the politicians that work around this and the civil servants that work around this, everybody has got caught up on what is a generational shift. The fixes that are needed are fixes, which are 10-15 year fixes, right? So politicians work in five year cycles, so they struggle with it because they can't see it within the electoral period that they're involved in, right? It's expensive. It requires people to recognize that social care is not free at the point of use like the NHS is, when many people believe it is. So they get to a point of thinking, I'm going to get this free care, and then they don't. There's a conversation around how care is paid for, there's a conversation with regard to how care is bought.
But we've got to have that conversation because, as I've said already, in the absence of enough money from central government, in the absence of enough money from local government and in a situation where some care employers are not treating their staff the way that we would expect them to treat their staff. The problem is that caregivers are the ones that end up subsidising care packages by doing all paid work and by not getting enough money to cover their cost of working. So, yeah, there's a problem there. Now, politician will say it's too big a problem to fix. We've got an industry in crisis. The hyperbole around describing how bad the situation is has just increased and increased and increased. We're at a point now where we need a Spielberg-esque movie to describe the crisis of disaster that is the care industry, right? Or we could just say, well, we can fix this. If I improve the working environment of one carer, that one carer can improve the life of three, five, 7-9-10, 15 clients over their time with the organisation, I can do that, I'm in control of that, I can take ownership of that. So that is what I am trying to do.
Episode Conclusion
00:47:32 - Andy Goram
And if that happens, my friend, the world becomes a better place. Some real food for thought in those sticky notes. Dan, thank you so much. Thank you for coming on and thank you for speaking so candidly about the industry that you clearly care about and are trying to affect some change in. It's been really interesting listening to you. Thank you very much for coming on.
00:47:55 - Dan Archer
Andy. Listen, thank you for having me on. It's interesting, right? So your podcast is Sticky from the Inside, right? We talk all the time in the organisation about how we are sticky as an employer. I didn't know that when I started doing that. I've not nicked it from you, I promise you. But that in itself is a conversation for a care provider. How do they make themselves sticky? How do they make it somewhere that people have a relationship with more want to stay? So it's been an absolute pleasure to speak to you. Thank you very much for letting me rant for a little bit. I will dismount my soapbox now in return to work.
00:48:31 - Andy Goram
Listen, I'm a massive fan of soapboxes, so you're welcome to use that any old time, my friend. You take care. Thanks for coming on.
00:48:36 - Dan Archer
Thanks, Andy.
Podcast Close
00:48:38 - Andy Goram
OK, everyone, that was Dan Archer and if you'd like to find out a bit more about him or any of the topics that we've talked about today, then please check out the show notes. So that concludes today's episode. I hope you've enjoyed it, found it interesting and heard something maybe that will help you become a stickier more successful business from the inside going forward. If you have, please like comment and subscribe. It really helps. I'm Andy Goram, and you've been listening to the Sticky from the Inside podcast. Until next time, thanks for listening.
Andy Goram is the owner of Bizjuicer, an employee engagement and workplace culture consultancy that's on a mission to help people have more fulfilling work lives. He's also the host of the Sticky From The Inside Podcast, which talks to experts on these topics from around the world.