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I’ll take care of you: the use of supportive work practices to retain older workers

Hélène Mountford Macquarie University, Australia

While flexible work options are seen as the most important human resource management strategy for the retention of older workers, according to the employee literature a number of other strategies to improve working conditions are also influential. These include developing a supportive work environment; the recognition of skills and abilities; training opportunities leading to career progres- sion; and being able to pass on knowledge to younger staff. These strategies together contribute to employee well-being at work, and are here generically called supportive work practices. This article reports on part of a qualitative study based on interviews with 20 aged care facility managers and 20 personal carers and finds that despite poor pay, physical work and a predominantly immigrant labour force, many of these human resource strategies are effectively utilised to retain older workers in residential aged care. Most of these practices, which reduce recruitment, training and sick leave costs, could also be effective in other industries.

Keywords: aged care facilities, older workers, retention, supportive HR work practices

The ageing population and workforce in developed countries have seen policy-makers encourage employers to retain their older workers, principally baby boomers born between 1946 and 1964, to both reduce national economic liabilities and avoid labour and skills shortages. This is particularly so in Australia where despite the global financial crisis (GFC), continuous economic growth over the past 20 years has led to skills and labour shortages in some labour market sectors. To further encourage older worker employment,

Correspondence: Dr Hélène Mountford, Department of Marketing and Management, Macquarie University, North Ryde, NSW 2109, Australia; e-mail: [email protected]

Accepted for publication 1 July 2012.

Key points 1 The retention of older workers is important to the national economy and the skills

and labour shortage. 2 Older workers are quite specific about the working conditions they want to remain

at work. 3 In the main, these conditions are not being provided, but this study reveals the HR

practices one industry utilises to keep its older employees are very similar to those reportedly wanted.

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Asia Pacific Journal of Human Resources (2013) 51, 272–291 doi:10.1111/j.1744-7941.2012.00048.x

policy changes include an increase in the age at which women can claim the state pension to 65 years, and the age for all pension eligibility increased to 67 years by 2023 (Centrelink 2012). The latter change encompasses the younger baby boomer cohort, those born after 1957.

Despite official encouragement, few organisations in developed economies have effec- tive policies and practices for the ageing workforce (Harris, Foster and Sempik 2011; Parry and Harris 2011; Timmons et al. 2011). However, studies prior to the GFC show that many baby boomers want to stay at worker longer than the previous generation (born 1932–1945), but they want a variety of working conditions to make their work–life balance easier and personally rewarding (Mountford 2010; Proper, Deeg and van der Beek 2009). Studies after the GFC have found many more baby boomers need to work to rebuild retirement funds (e.g. O’Loughlin, Humpel and Kendig 2010). According to older worker research, the conditions sought by employees to remain at work comprise a range of flexible work options and other supportive work practices. Flexible work options are an important work condition for retention (Skinner et al. 2011; Walter and Jackson 2007) but this article is concerned with HR practices other than flexible work options which contrib- ute to staff retention. Previous research has not found consistent priorities among these HR practices but studies of workers find a number repeatedly occur. They are: the need for a supportive working environment (Armstrong-Stassen and Schlosser 2010; Timmons et al. 2011), recognition of skills (Armstrong-Stassen 2005), availability of training with career paths (Armstrong-Stassen and Ursel 2009; Bertolino, Truxillo and Fraccaroli 2011), and the opportunity to pass on knowledge to younger workers (Walter, Jackson and Felm- ingham 2008). In this article they are generically called supportive work practices because individually and as a group they contribute to a positive working environment which encourages commitment and satisfaction, thereby contributing to retention. While the employee studies reveal these desired conditions, there is little evidence that they are being implemented widely (Armstrong-Stassen 2008; Harris, Foster and Sempik 2011).

European scholars have predicted that older workers have more likelihood of working longer or being re-employed if there are skills or labour shortages (Karpinska, Henkens and Schippers 2011). Reflecting this in Australia, relatively low unemployment since the 2007 GFC has seen a substantially greater increase in labour market participation of the 55-to-64 years age groups (Mountford 2011, 167). One occupation suffering a labour and skills shortage is nursing. The worldwide shortage of registered nurses (Blake 2010) is compounded by many years of low intake so that the average age of nurses in Australia is around 50, with 12 per cent aged 60 or more (McDonald 2010). The nursing shortage has stimulated some research into workers’ retirement and retention attitudes in hospital set- tings. For example, Kuhar et al. (2004) found the top retention strategies for nurses over 56 years of age were co-worker support, teamwork, retirement benefits, adequate equip- ment, an open-door policy, shift choice, respect from doctors and administrators, and educational opportunities. Armstrong-Stassen (2005) found that the most important HR activities for nurse retention (other than flexible work options) were compensation, recog- nition and respect, job design, and training and development. Fewer than 10 per cent of

Hélène Mountford

registered nurses (RNs) reported their hospitals were engaged in any of these activities. Other research has found older nurse retention is assisted through organisationally sup- ported HR practices, supportive and fair supervisors and a hospital which values their contribution and cares about their well-being (Armstrong-Stassen and Schlosser 2010; Skinner et al. 2011). The relationships developed with supervisors are a significant con- tributor to nurse satisfaction and loyalty (Brunetto, Farr-Wharton and Shacklock 2011) and high levels of support from management, particularly supervisors, improves nurses’ morale and commitment also aids retention (Brunetto, Farr-Wharton and Shacklock 2010).

The studies of nurses in hospitals may have limited applicability in aged care facilities (ACFs) where working conditions differ, notably, that staff is not rostered on rotating shifts over which they have no choice. However, there are numerous similarities such as increased workloads, job redesign and more equipment so that the reported demands of hospital nurses may well be reflected by ACF staff. Unfortunately, there has been little research into direct care workers in ACFs in Australia or overseas (Harley, Sargent and Allen 2010; Jeon et al. 2010), and most of the limited literature concentrates on registered nurses not personal carers (PCs), the largest group of staff in ACFs. Some research is based on the first comprehensive survey of ACFs and direct care workers for the federal Depart- ment of Health and Ageing in 2003 (Flavel 2007; Healy and Moskos 2005; King and Martin 2009; Martin 2005, 2007; Richardson and Martin 2004), a 2007 survey (Martin and King 2008) and a large survey of ACF carers (Moskos and Martin 2005). But most reports are aimed at establishing ACF staffing information and working conditions not HR strategies. It is believed that this paper is the first qualitative study based on personal interviews to investigate the application of HR strategies aimed at the retention of direct care workers in ACFs using as its base the expressed desires in the older worker employee literature.

Method

This is a qualitative study. Twenty facility managers (FMs) and 20 personal carers (PCs) were interviewed separately. The FMs were registered nurses and the PCs were permanent older workers. Interviews were semi-structured with the first half of the FMs’ questions providing statistical data on their ACF and staff, and the second half focusing on retention policies, strategies and practices. The PCs’ questions were primarily complementary to the FMs’. Both groups were given considerable latitude to express their views. The interviews were conducted at the ACFs, which were located in the northern, north-western and inner-city suburbs of Sydney, Australia. The FMs’ interviews, which were 1 to 1.5 hours long, were recorded, transcribed verbatim by a paid professional and analysed by the inter- viewer using NVivo software based on human resource management (HRM) retention themes. The shorter interviews of 30–40 minutes with PCs, who were aged 45 years or more, were similarly transcribed and analysed. Each group of FMs and PCs, by coinci- dence, comprised 18 women and two men. The ACFs were selected at random with no

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knowledge of their corporate structure or size. Ten were for profit and 10 were not; most of the latter were operated by religious charities. Research on the facilities, their corporate structure, a large number of official reports on ACFs, and nursing and ACF literature was not undertaken until after transcription. This ensured the interviews were undertaken with no prior knowledge or preconception of the industry or its HR practices.

This research was conducted in July and August 2010. The time available and geo- graphical constraints of the study limit its sample and size, which consequently influence the data collected. The aged care facilities and FMs were selected at random, but the PC interviewees were nominated by their FMs who, after their own interview, searched their roster to see which over 45-year-old PCs were working and may have time to be inter- viewed. Because of the selection method and the size of the sample, it is not possible to claim this group as typical of all PCs. As well, they were not representative in two particu- lar aspects of the study, i.e. half worked full-time, nine permanent part-time (PPT) and one was casual, which is contrary to the FMs’ estimates and industry research which puts PPT at about 80 per cent. As well, unlike estimates given by FMs of an average of 83 per cent non-English speaking background (NESB) PCs in their facilities, only 11 of this sample were NESB and nine were Australian born. However, the interviews obtained rich and in-depth data, reaching the point of saturation. Triangulation was achieved through separate interviews of FMs and PCs, and investigation of the ACFs’ web pages, govern- ment and industry association information and reports.

The interviewees’ names have been changed for their anonymity. When quoting the FMs, the number of years they have worked in aged care is also included to indicate the length of their experience. This experience does not include previous years spent in other nursing positions such as hospitals or community nursing. Where PCs are quoted, their chronological age is included because they were interviewed as older workers.

The aged care facilities

Australian residential aged care is an industry that provides generally only basic pay for its direct care workers – registered nurses (RNs), enrolled nurses (ENs) and personal carers (PCs). It is expected to be a growth industry as the baby boomers age and need full-time care. The number of Australians aged 85 and over is projected to more than quadruple to 1.8 million between 2010 and 2050 and the number of direct care workers will need to more than quadruple to 598 000 in 2050 (Productivity Commission 2011, E40). Aged care is already suffering from a skills and labour shortage, not only of nurses as previously mentioned, but also of PCs, as older workers retire and immigration policies place growing emphasis on skilled workers, restricting the numbers of unskilled migrants, a major labour supply for ACFs. As well, work visa restrictions for international students and the dominance of permanent part-time work requires ACFs to have a large number of PCs on its staff to make full-time equivalents. ACFs generally have a higher proportion of older workers than most other industries (Martin and King 2008). The 20 nursing homes in this study employed an average of 40 per cent older workers (aged 45 and over) com-

Hélène Mountford

pared with a national average of 60 per cent older workers in 2007 (Martin and King 2008), with some care staff in the study aged up to 75 years. The majority (average 77%) of direct care staff were employed on a permanent part-time basis (PPT). Neither manag- ers nor staff believed there was any age discrimination in employment, and a variety of flexible work and retirement options were readily available. On average nearly half of the RNs and 83 per cent of PCs in this study were from non-English speaking backgrounds (NESB) (see Table 1).

This proportion is much higher than a 2007 national survey which estimated one- third were migrants (Martin and King 2008). However, migrants in aged care are substan- tially concentrated in metropolitan areas (Fine and Mitchell 2007) which is where this study took place. Fourteen of the nursing homes had between 80 per cent and 99 per cent NESB PCs while no facility had less than 50 per cent. The high level of NESB care staff in this study reflects the reliance of this group of nursing homes on international students in the younger age group, and older permanent migrants. The younger international student PCs are restricted to 20-hour-a-week work visas. A growing number of NESB RNs reflects the general RN shortage. More than 30 different countries of birth were nominated for direct carers in this research (see Table 2).

Many of the migrant PCs are qualified in health-related areas in their home countries, but their qualifications are not recognised in Australia. Often they cannot afford to pay for training to qualify locally. Prior experience can be advantageous, but practice standards vary between countries. Most direct care staff are from developing countries and their

Table 1 Proportion of NESB direct care staff in this study

Average % Highest % Lowest %

RNs 42 95 0 PCs 83 99 50

Table 2 Countries of origin of migrant personal carers

Afghanistan Africa (countries unspecified) Armenia Belgium Burma China Croatia Denmark Ecuador Fiji France

Ghana Greece India Japan Lebanon Malaysia Malta Middle East (countries

unspecified) Nepal Pakistan

Papua New Guinea Philippines Romania Samoa Solomon Islands South Africa Spain Syria Thailand Tibet Tonga

Source: author’s interviews with facility managers and direct care staff.

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culture includes home care for family members, as nursing homes are almost non- existent. As a consequence, many have had experience caring for elderly relatives.

The worldwide nurse shortage has encouraged some facilities to sponsor RNs on employer-sponsored work visas for four years, either importing them from countries where their qualifications are recognised, or sponsoring international students locally after they have finished a nursing degree. Locally sponsored nurses came from a variety of Asian countries such as Thailand, China, Korea and India. Zimbabwe is a common country of origin for qualified staff. One facility imported 15 RNs from South Africa six years ago. It provided a large amount of support for them and their families. Ten were still with the organisation and had become permanent residents. The same facility was about to sponsor four more nurses from overseas and many other facility managements were considering the move.

Despite aged care being female dominated, there are small numbers of male FMs, RNs and PCs. The average gender split between care staff was 85 per cent female and 15 per cent male. Two homes employed 30 per cent male PCs but were unable to nominate any specific reason for their (relatively) high count. New staff often join a facility on the rec- ommendation of existing staff (‘ethnic networks’ according to Mahuteau and Junankar 2008), so it is likely that male staff recommended the facility to friends and the male staff- ing ratio snowballed (Khatutsky, Wiener and Anderson 2010). The male staff are over- whelmingly immigrants with non-English speaking backgrounds. The dominant nationality in this study was Nepalese and these staff members were highly praised for their skills. Too many male staff can cause problems with older female residents (the majority of ACF residents are female) when it comes to intimate care. However, not one FM had declined to hire a care worker because of their gender or age.

The next section discusses the supportive work practices found in this study based on the employee literature and are divided into the four main groups outlined above: a sup- portive work environment, recognition of skills, training with career paths and the oppor- tunity to pass on knowledge. Individually, they may be present in organisations to a greater or lesser extent, but together as supportive work practices, they create a work place environment that helps retain older workers.

Supportive work practices

Supportive work environment A supportive work culture is key to many practices that help retain older workers through making them feel valued and heard while experiencing a sense of independence and autonomy (Armstrong-Stassen and Schlosser 2010; Timmons et al. 2011). A supportive environment contributes to the high level of satisfaction that many direct care workers personally gain from the work, and that is a significant contributor to performance and retention (Hogan, Moxham and Dwyer 2007; Jeon, Merlyn and Chenoweth 2010). While job satisfaction is reduced by the increasing workloads in aged care, it can be mitigated by both supervisor and co-worker support (Chou and Robert 2008).

Hélène Mountford

In ACFs this supportive environment is reflected many different ways, from thank you notes to above-award wages, from modified work methods to retirement planning. ACFs supply a supportive working environment organisationally, through supervisor empathy and co-worker support. Examples of a supportive environment considered here are the management/supervisor relationship, co-worker support, job and equipment redesign, and rewards.

Management/supervisors While organisations determine the implementation and administration of human resource policies, it is individual supervisors who manage the practices. All of the most important predictors of aged care worker satisfaction are primarily determined by how work is organised, which is largely under the control of FMs (Martin 2007). FMs are experienced RNs who have ‘risen through the ranks’ to become managers of a single facility. While they report to senior corporate or charity staff, or in the case of sole operators, directly to their boards, they have considerable discretion on how they run their operation on a day-to-day basis. While PCs are directly answerable to RNs on the floor in clinical matters, FMs or deputy FMs are the PCs’ supervisors for all administra- tive matters, such as flexible rostering, holidays and rewards. As RNs, FMs are in the ‘people business’, as are their staff. The occupation attracts caring or nurturing individu- als both at the RN and PC level. FMs develop relationships with their direct care workers.

We do tend to be people persons, and we pride ourselves on having good relationships with our staff as managers. (FM Margaret, in aged care four years)

The relationships FMs build with their staff leads to trust and loyalty. Trust has numerous benefits for an organisation such as superior work performance, organisational citizenship behaviours, organisational commitment, satisfaction and group performance (Ferrin and Dirks 2003). Trust also influences important behaviours such as absenteeism, turnover and job performance (Neves and Caetano 2006). Research also indicates that older super- visors are more supportive of older workers (Armstrong-Stassen and Lee 2009). In ACFs FMs are often similar ages or older than many direct care workers.

To facilitate the relationships, all FMs had open-door policies, not just allowing but encouraging staff to express their views whether they be about personal circumstances or work practice improvements. According to Timmons et al. (2011), open-door policies are critical to workplace policy development for older workers.

We have an open-door policy here and I find that staff just fall in the office and blurt out what- ever it is, or they’ll come in and shut the door and tell you, but I’m very visible. (FM Liz, in aged care 11 years)

I would say that the staff, like the people that you work with, are very supportive and friendly and the management is very supportive and you know if you’ve got any concerns they’re very approachable. (PC Marg, aged 52)

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Co-workers ACFs were often described by staff as families or communities, and colleagues as friends, adding to the supportive environment. Direct care workers not only care for their resi- dents but also for their co-workers (King and Martin 2009). The work relationships gener- ate and sustain emotional well-being which is particularly important in care work which uses high levels of emotional labour (King and Martin 2009).

I think a lot of it is the relationships that are formed within the facility. Relationships with the residents, with other staff members, it becomes like an extended family and I think that’s mainly why people stay. (FM Elizabeth, in aged care 21 years)

The only thing is, that’s why I stay here longer, the management and then the nurses, you know, the other staff members that are nice, they are very good, you know. The more you know them the longer the friendships and relationships are getting closer. (PC Maria, aged 57)

Direct care workers not only like the people they work with, but like the way work is carried out (Moskos and Martin 2005). This is usually in teams of two or more which rotate around sections of the ACF. Moskos and Martin (2005, 18) found in a large survey of direct care workers that appreciation of supportive co-workers increased with age to peak at 61 per cent for staff aged 65 and over. Engagement has been found to increase when workers are satisfied with their co-workers, particularly when both are over 55 (Avery, McKay and Wilson 2007).

Job redesign Experienced staff are in demand and FMs aim to retain them as long as possible. If age or infirmity affects their performance they may be offered fewer shifts, shorter shifts, an alter- native shift with a lighter load, or a different role, such as quality management documen- tation or activities for residents.

I’ve redesigned her position to fit in with quality management. She won’t be getting a pay rise for it though. She loves that kind of work, she’s a systems person, you work with the talent that you’ve got. (FM Gail, in aged care 17 years)

Some PCs planning to reduce their physical workload consider up-skilling to qualify to give medications or dress wounds.

Even though there’s a no-lifting policy, still it can be hard work, so as I get older that would probably be a bit easier for me, you’re doing paper work and dressings, going towards that direction, that’s one of the reasons I did [Certificate 4] so that I could stay in aged care as I get a bit older. (PC Amelia, aged 50)

Equipment The workload for all direct carers has increased in the last decade. The growth of home care services has delayed many residents’ entry into ACFs until they are older and frailer and often have complex and multiple degenerative conditions (McDonald 2010).

Hélène Mountford

People are coming in later, because they’ve got packages in the community and are maintained to a certain level, but now they’re coming in with technical issues, very clinically technical issues, which need to be dealt with, advanced dementias and the like. (FM Liz, in aged care 11 years)

Consequently, direct care staff, particularly older workers, benefit from improvements in work methods and equipment and increased availability of equipment. Mandatory no-lift policies are wide spread. Residents need to be lifted by equipment, ‘people lifters’, and mostly by two staff, not one. Electric, instead of wind-up beds, are particularly appreciated and are standard in new facilities. Older homes are staggering their introduction. New chair and door sensors alert staff to unexpected resident movements and many ACFs are assessing computerisation for clinical reporting to reduce paperwork. Medication trolleys have been made smaller, lighter or motorised, and deliveries of paper and chemicals made smaller, therefore lighter, but more frequent. Linen bags have been downsized.

Although some changes have resulted from a growing awareness of ageing staff needs, others have been introduced to reduce occupational health and safety (OH&S) risks.

I believe we really need to look at how we’re going to meet the needs of our ageing workforce because they are going to become more prone to injury ... so we need to look at what equip- ment we need, what procedures, policies, processes we’re going to need to actually bypass some of these risk factors, ’cos otherwise we’ll be paying workers comp like nobody’s business. (FM Elizabeth, in aged care 21 years)

Staff are regularly trained in the use of the equipment and reminder instructions are often located near residents’ beds. Effective equipment and sufficient quantities of it are appre- ciated by PCs.

Appreciation and rewards ACFs have a wide variety of staff benefits which aid retention. They range from formal awards nights, through a pair of movie passes to a small thank you note – what Timmons et al. (2011, 129) call a continuum from ‘hard’ traditional benefits to ‘soft’ informal prac- tices. While some benefits are formalised in HR policies, many are not and are distributed at the discretion of the FM. The former category includes a variety of leaves – carers’, maternity, paternity and grandparents’ – longevity awards, pay loadings, packaged benefits plans, enforced OH&S rules and Christmas bonuses or substantial presents. The informal group includes regular BBQs and bought-in meals, celebrations for special days, birthday flowers, chocolates or presents and cards, and a variety of small gifts for one-off recogni- tion (see Table 3).

The small gifts applaud staff efforts ‘above and beyond’ what is expected. For example, one site with multiple facilities gave each manager a ‘small bucket of money’ to purchase staff rewards at the manager’s discretion. This money was not accountable. Other FMs did not have budgets for ‘appreciation gifts’ so bought them with their own funds.

Probably every third month we have a pizza night or something and just give them a bit that way and we’re just about to do a reward recognition gift. We give a gift in the middle of the

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year and it’s just to make sure that they know what they do matters, even though there is no budget. I’d love to give each person $100 just because, but we can’t, so we give them a little trinket, something, a little saying, a little card ... (FM Michael, in aged care seven years)

I just give movie passes basically, mentions in meetings is huge, going up and saying thank you, that sort of thing. (FM Liz, in aged care 11 years)

The FMs are aware of the effect on morale and productivity of these small tokens of appreciation.

They know I appreciate them and I get that back in spades, simple as that. They all get a card for their birthday and some scratchies [instant lottery tickets]. Nothing big, but they know that they’re appreciated. (FM Nicola, in aged care 24 years)

Table 3 Staff benefits in ACFs

Formal Above-award payments Bonuses Carer’s leave Education: in-service

and external Education scholarships Extra week’s leave for over

45 year olds Grief counselling In charge, on call loadings Length of service recognition No lift policy Packaged staff benefits plan

including discounts for health fund, telecom, cable TV, computer purchase

Paid maternity, paternity leave Rostered day off (full timers) Salary packaging (charities

only) Shift allowances Staff awards night Staff newsletter Strict enforcement of

OH&S rules Uniforms Vaccinations

Informal Barbeques Birthday cards, presents,

cakes Cafe vouchers Children of staff allowed

at work in school holidays

Chinese tapping therapy Chocolates Christmas Day (all meals) Christmas gift or shopping

voucher Christmas hamper Christmas in July parties Christmas parties Counselling, personal Flexible shifts Flexible hours Flowers Free meals or at nominal cost Gift vouchers International days’

celebrations International Nurses’ Day

(all meals) Job redesign Laughter therapy

Management open-door policy

Massage therapy Lottery tickets Meditation Melbourne Cup celebrations Movie tickets New year parties Non-documented sick leave On site cafe On site gym, hydro therapy

pool One-off shift allowance Recognition gifts Relaxation therapy Short shifts Supply of takeaway meals Thank you notes, cards

Source: author’s interviews. This is a consolidated list from all ACFs in the study. None offered all these staff benefits, but many offered a large number of them.

Hélène Mountford

All direct care workers had access to work-related grief counselling, which was often made available for personal issues as well. Wellness programs, particularly recommended for older workers (Timmons et al. 2011), were only available at one facility in this study.

Recognition of skills and respect In a large-scale study Armstrong-Stassen (2008) found recognition and respect were rated as the most important HR strategies influencing employees to stay in the workforce. It is important for employers to bolster older employees’ feeling of being valued by the organ- isation (Armstrong-Stassen and Lee 2009) and this recognition is a significant predictor of performance, commitment and job satisfaction (Saba, Guerin and Wils 1998).

FMs display recognition and respect for their staff’s abilities and skills in a number of different ways, other than the immediate discretionary rewards discussed above. For example, FMs see their public attitude towards staff as important.

If we expect them to treat our residents with respect and dignity, as managers we need to treat our staff the same or they’re not going to project it: if we don’t project it, they won’t project it. (FM John, in aged care 30 years)

Well apart from the care, we’re given respect and they treat us with respect ... It’s very client plus staff oriented. We’re just as important and it’s nice to be treated, you know, important. (PC Carmen, aged 54)

Commonly there are informal discussions with staff, either individually or in groups, to target problems or initiate change. One FM was particularly complimentary of her staff saying they often suggested new ways of doing things. She was happy to try the ideas out and if successful adopt them.

The main thing is that you have an open forum with your staff and listen to them and cer- tainly act on their concerns. I think that’s one of the best things that we can do. (FM Jean, in aged care 32 years)

If people don’t feel that their role is important or their opinions aren’t valued, then they have no commitment, so why would they turn up if they don’t feel like it? (FM Joan, in aged care 18 years)

Staff may also be asked to assess new work methods or equipment which encourages them to feel valued.

Anything new we try, any new piece of equipment goes out on the floor and the staff will trial it for a month before I’ll look at buying it. Well, I don’t have to use it, they’ve got to use it, so they’ve got to say this works or this doesn’t work. (FM Nicola, in aged care 24 years)

A significant recognition of ability is through appropriate remuneration. However, the pay for PCs, ENs and RNs is considered poor, and is the greatest source of dissatisfaction among carers (Armstrong-Stassen and Cameron 2005; Moskos and Martin 2005). As well, the gap between public hospital rates and aged care pay has widened over time (Productivity Commission 2008, 2011). Most facilities pay the basic award rate (or similar

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enterprise agreement amount) for most staff with no additional reward for maturity, lon- gevity or life experience (Watson 2010). In many developed countries, including Australia, insufficient government subsidies are blamed for this situation, making the work unat- tractive to native-born workers and giving opportunities to migrants (Cangiano and Shutes 2010; Lowell, Martin and Stone 2010).

In this study FMs recognised staff were low paid and it was frequently said that direct care workers could earn about $5 an hour more working in supermarkets.

I remember having a terrible fight with a relative one day and he said, ‘They’re just here for the money,’ and I said, ‘No, if they were here for the money, they’d be down in Franklins [super- market] packing shelves and making more’, and not being abused and spat on and pooped on and all the rest that goes with aged care and especially with your dementias and your behav- iours. (FM Nicola, in aged care 24 years)

Because of the poor pay, it is common for PCs to work at more than one facility, and for FMs to support them by showing considerable tolerance for lateness or tiredness, although there are concerns about OH&S ramifications.

All of ours pretty much [work elsewhere]. They do a day shift here then they’ll do an after- noon shift somewhere else. Not too many are full time. They’re probably doing up to 30 hours [a week] here and then they might do a short shift somewhere else ... some of them work seven days a week and they’re 50, 60 years old. (FM Anne, in aged care 23 years)

I have two jobs actually, I have to admit. So Saturday, Sunday mornings I work somewhere else in another nursing home. Four days a week here and two days a week in another place. (PC Crima, aged 52)

While some FMs pay above-award salaries to key individuals who may be team leaders or staff with special skills, it is not common for PCs who have only upgraded their skills from the basic Certificate 3 in aged care, to Certificate 4. A rarer view is the importance of above-award pay to reduce staff turnover and recruiting costs.

You have to pay more [for certificate 4s than 3s]. At the end of the day costs of recruiting and cost of agency [temporary] staff and cost of just turning over – just losing staff – it’s far better to have a slightly above-award staff, a paid and stable workforce, than to have to keep recruit- ing. (FM Jane, in aged care 17 years)

If a shift is short staffed (there is no mandated staff-to-resident ratio other than having one RN on site in high care), care staff may receive a one-off shift allowance in recognition of the extra work.

A financial benefit available only to ACFs operated by charities is salary packaging. It is a large benefit for low-paid workers and can mean up to A$200 extra per fortnightly pay for PCs. Not-for-profit operators see salary packaging as a competitive advantage over for- profit ACFs and a powerful retention factor.

We’re a charity and it’s excellent because you and I might have a fight and you go out of the office and say ‘Stick her job, horrible woman’, and then you think, ‘Gee if I tell her to stick her

Hélène Mountford

job, there’s $17 000 I’m out, so maybe I should just go away and cool down’. (FM Nicola, in aged care 24 years)

Recognition and respect play a vital role in carer retention in ACFs. They increase com- mitment and motivation and assist in overcoming concerns raised by low pay and physical work.

Training with career paths The lack of training opportunities for older workers is commonly decried for both its quantity and quality (Armstrong-Stassen and Templer 2005; Felstead 2010; Taylor and Urwin 2001). Yet by being able to update skills, older workers find greater organisational support and career satisfaction which contribute to retention (Armstrong-Stassen and Ursel 2009). Organisations have presumed workers over the age of 40 do not want training and career development and have paid less attention to the career development needs of baby boomers (Callanan and Greenhaus 2008:76). However, older workers do not show a lower intention to participate in training although they do perceive fewer career develop- ment opportunities (Bertolino, Truxillo and Fraccaroli 2011).

In aged care, government subsidies have encouraged widespread training and the 2010–11 federal budget provided an additional $59.9 million over four years for ‘further studies’ for PCs, ENs and RNs (Department of Health and Ageing 2011). Whereas carers were traditionally seen as unskilled workers, a certificate 3 in aged care is now the basic entry requirement for PCs, and for pre-existing staff. Certificate 3 courses are held, often on site, to give staff formal training and a qualification. Increasingly common is an upgrade from certificate 3 to certificate 4 qualifying PCs to distribute a restricted range of medications and dress wounds. This latter qualification is used to relieve pressure on RNs or reduce the number of RNs needed (Palmer and Eveline 2012). Training is available to all staff. Opinions differ on medical grounds whether certificate 4 PCs should be used to give medications but the qualification provides PCs with a potential career move. Some- times a pay rise and promotion to team leader is given with the new qualification. Often, it is not, particularly when the new skills are not being utilised, although upgrading to cer- tificate 4 is seen to contribute to general work knowledge (see Palmer and Eveline 2010). Nonetheless, ongoing training and education is seen as a positive aspect of PCs’ work (Moskos and Martin 2005). A large increase in the availability of training has helped PCs’ morale. They no longer see themselves as ‘low status’ (Adams and Nelson 2009) and are passionate about what they do.

The idea is to offer career pathways to our certificate 3s so that we not only develop them and they feel valued and they cannot get bored, but also so that we can develop skills and increase the workforce’s experience on the floor because these people in the past have been treated as unskilled labour, we need to skill them up. (FM Jane, in aged care 17 years)

All the FMs in this study were enthusiastic about the availability and level of education for all staff and also saw it as an important retention factor. As well as numerous optional topics, regular mandatory training is also required.

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We have our own regular education and we get people from outside to come in and give edu- cation. CPR, diabetic management, asthma management. We’ve had a few this year and also we will send people out for the main ones, your OH&S and oral care and dementia care ... (FM Jean, in aged care 32 years)

PCs are encouraged to enrol in nursing degrees and are supported with changes of shift to fit their university timetables. Larger organisations offer nursing scholarships to help ease the nursing shortage, not necessarily their own.

All of our programs are geared without saying, to staff retention, but we look at our education programs and scholarships to support staff through additional training. (FM Joan, in aged care 18 years)

At the time of this study there was ample mandatory and optional continuing education and a culture which encouraged all employees, including older staff, to participate in it. While PCs are encouraged to upgrade their formal qualifications, career paths are limited and they may have to move to another facility to use the new skills and obtain increased pay. They are also encouraged, regardless of age, to enrol in EN and RN courses because of the nursing shortage. There is little in the way of vertical career development for RNs as there are few opportunities for promotion other than to deputy FM or FM. However, horizontal development is occurring through increased depth of knowledge and skills in specialised areas, such as dementia and palliative care.

Opportunities to pass on knowledge The first Australian Survey of Retirement Attitudes and Motivations, targeting more than 1000 workers aged 40–59, found that for 82 per cent of respondents the most important factor influencing their decision to stay at work was to pass on their knowledge to younger staff (Jackson, Walter and Felmingham 2006). In ACFs new employees are ‘buddied’ with a more experienced staff member when they start work. Daily duties are usually undertaken in teams of two or more to a section of a home, particularly as most facilities have ‘no lift’ policies and require two people to operate the lifting equipment. Older workers are fre- quently teamed with younger workers in ACFs. This has a dual purpose. It gives the younger worker the opportunity to learn from the experience of the older PC and it spreads the workload across both physical abilities. If care staff are planning to retire, they often reduce the number or length of shifts worked which provides an opportunity for mentoring before they leave. As well, retiring staff can return on casual shifts and take the opportunity to pass on their experience.

Discussion

The HR practices utilised in aged care facilities by supportive FMs, help mitigate the unat- tractive side of the industry such as the ‘dirty work’, low pay and 24-hour shifts. Support- ive work practices are part of the industry’s culture, with individual manifestations of it between facilities depending on the FM. Principally, having been frontline nurses

Hélène Mountford

themselves, FMs as supervisors implement the organisation’s HRM policies in a support- ive way. While appropriate HR policies are important to the retention of older workers, managers play a key role in not only effectively implementing them but reinforcing their positive impact on employees (Innocenti, Pilati and Peluso 2011). The supportive working environment FMs implement in ACFs contributes directly to carers wanting to stay at work. The most important HR strategies are predominantly practices rather than corpo- rate policies and are aligned with the FM personally, as can be seen when an FM leaves an ACF and a number of staff resignations follow (Castle 2005). It is common for PCs to try to follow an FM to a new facility.

However, the supportive work policies and practices are universal and not designed specifically for older workers. The FMs’ views were that regardless of age, everyone under- took the same work, even though most acknowledged the benefit of older workers’ emo- tional stability and greater patience. Frequently, the qualities of younger and older PCs were seen as different but complementary. As well, what were seen by FMs as the most important policies – education and safe work practices – applied to all age groups. Direct care workers’ personal circumstances, which prompted workplace change, could occur at any age, albeit for different reasons. As such, staff needed to be treated as individuals.

I don’t even see them as my older workers, it’s a fact. We’re a team of people who all bring in different skills and I value their knowledge and their experience ... you’re treating everyone, looking at them holistically, so you’re not just looking at an age thing, you’re looking at the person. (FM Jane, in aged care 17 years)

It could be argued that in ACFs these practices are implemented through a feminine culture and only exist to the extent that they do because ACF management is female dom- inated. As a consequence, we could look to a female management style to see if this is a retention factor. Research shows that women use more collaborative behaviours to create a climate of trust in work-teams (Moore, Moore and Moore 2011) and they are more effec- tive in team-based, consensually driven organisational structures which are more preva- lent today (Appelbaum, Audet and Miller 2003). Well-functioning teams need a climate of trust and the free exchange of information (Mannix and Neale 2005) which is epitomised by ACFs’ flat management structure and FMs’ ‘open-door’ policies. The female manage- ment style has been ‘relatively understudied’ and few researchers have examined how women build trust in entrepreneurial teams (Moore, Moore and Moore 2011, 222). This quote from Moore, Moore and Moore (2011, 222) well describes the FMs in this study:

They behave more democratically than men in leadership situations, use interactive skills, place emphasis on maintaining effective working relationships and value cooperation and being responsible to others, practices that all serve to further organizational goals by integrat- ing people into the group as respected individuals.

Despite women’s care work sitting on the boundary between unpaid work in the private domain and poorly paid, low-status work in the public sphere (Somerville 2006), its culture of flexibility, support and respect is common throughout ACFs. Some men, either

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as FMs, RNs or PCs, despite being few in number, have adapted to this culture. A male FM, previously a hospital RN, described his adaptation to the residential aged care culture thus:

When I first started [in aged care] I was very cocky and I thought I knew it all. It didn’t work for obvious reasons ... I learnt from that mistake ... I think we need to adopt a consultative approach and this holistic idea of, we’re here to provide a service, how can I best provide that service and how can I support the people that are providing that service and what do I need to do? (FM Michael, in aged care seven years)

Conclusion

This paper has reviewed the supportive HRM work strategies utilised to retain older workers in ACFs. The supportive working environment, provided organisationally and from supervisors and co-workers, is a major aspect of why PCs and RNs stay. Aged care work attracts a certain type of caring person. Many staff form attachments to residents as well as colleagues and supervisors. Recognition of direct care workers’ skills and respect for their abilities are part of the mutual support. Training, both mandatory and optional, has become more widely available and is encouraged. Some career paths are opening up but are still limited for both PCs and RNs. However, a benefit of the training is that direct care staff feel more skilled which improves morale. Job redesign and equipment assists rec- ognition and appreciation by finding ways to make work easier. And, finally, older workers have the opportunity to pass on their knowledge through the buddy system, working in teams and mentoring when near retirement or on recalls. These supportive HR practices implemented by supportive supervisors which foster a sense of belonging will retain older workers (Armstrong-Stassen and Schlosser 2010).

The question is can or will these HRM practices be widely applied in other, non- female dominated industries? Even where an industry is female dominated in the lower ranks but controlled by a male hierarchy, such as banking or hospital nursing, women say appropriate HR policies and practices like flexibility, consultation and relationship- building are not being put in place (e.g. Metz 2011). Are they in fact female practices and are they unlikely to be taken up by men who prefer other methods, or will they become more common when there are more women in middle and senior management to imple- ment them? Bloom, Kretschmrer and Van Reenen (2011) found family friendly work prac- tices were more common among a sample of manufacturers, inter alia, with a higher proportion of female managers. They suggest this is an area of future research.

Gender management issues aside, many of the HR retention practices outlined above could be adapted to other industries. A supportive working environment is appropriate for any workplace and can be encouraged through appropriate line manager training. The availability of training and options for further career paths are more industry specific but possible. Again supervisor training helps organisations to consider these possibilities, not stereotype older workers as not wanting career progression or change after the age of 40. The opportunity to pass on knowledge to younger workers should be pursued so that

Hélène Mountford

lengthy corporate knowledge does not cease to be available. Many of these practices have little or no budgetary implications. Recognition and respect, for example, can be imple- mented with minimal financial consequences (Armstrong-Stassen 2005). As an example, one FM said:

At the end of the day even if it’s just saying to them, ‘Thank you guys, you’ve done a good job today’. (FM Mary, in aged care 21 years)

Acknowledgements

The author would like to thank the 20 facility managers and 20 personal carers who par- ticipated for their willingness to help with this research. Their knowledge and candour have contributed greatly to the data.

Hélène Mountford (PhD, Macquarie), as an older worker, focuses her research interests primarily in the area of firm-level retention strategies, and policies and practices which inhibit older workers from staying in the labour force.

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