Reducing Turnover, Increasing Stability in ID/D and Home Care Agencies


It is never the wrong time to work on staff retention. Not when you are a small home and health care organization in your formative years or a large established one with years of experience. Not when the economy is stable and you have a pool of qualified candidates at your disposal or when it is a time of uncertainty and it is difficult to find qualified staff. When you have the right person in the right seat, you do what you can to keep them.

In the intellectual and developmental disabilities (I/DD) industry, retention is even more important as caregivers create bonds with the families and individuals they serve. Consistency is key to building trust. While these relationships may buy some time for an employee to stay on the team, it is only part of the equation that makes for the healthiest of workplace scenarios and provides your best shot at retention.

According to the 2020 Case for Inclusion Key Findings Report, nationally the turnover report for direct support professionals (DSPs) in the I/DD industry was 43.8%. Median hourly wages for DSPs were reported at $12.09 nationally. Turnover is not bias to any organization size, age, or region.

Engage in Listening

If you find your team in the “it must be because of this” camp, pause and ask if that is an assumption or based on facts, backed up by data. Information and clickbait headlines at our fingertips create more bias in our day-to-day decision making than we realize. The answer to this is to slow down and listen. Listen to the team’s candid feedback and to the nuances in quantitative data.

There is rarely one big lever to be pulled that will fix everything. There are patterns and sensitivity in the data that may take some digging to interpret.

What exactly does this mean? A common go-to answer is that increasing wages will fix everything. Yes, caregivers deserve more, but that isn’t an across the board solution for turnover. But combining it with other changes can assure a more certain return.

Get to the Data

If a home care or ID/D organization uses a suite of products to manage employee activities (think timesheets, schedules, reviews, hiring), collecting helpful data is a matter of reading reports with a keen eye and using data-parsing tools. However, a critical component to truly increasing staff tenure is qualitative data collected in the form of anonymous employee surveys, employee interviews, and observations.

Two fears get in the way of quality feedback. First, employers need to embrace the possibility that answers or issues they may have been overlooking could be found. Leadership has the opportunity to see this as the steps to move forward, rather than ignoring them over embarrassment or to avoid confrontation. Secondly, employees need to feel confident they can speak truthfully on their experience in surveys and interviews without concern for their employment. For this purpose, employee feedback is collected by a third-party and no identifiable information is shared with leadership. 

An example: leadership knows there are issues to be solved but doesn’t know where to start because the organization is following best practices and team members are genuinely good people. Quantitative data could show trends around who and when staff is leaving. Qualitative data helps reveal the why. Together, the story begins to unfold that indeed there are good people on the team but huge amounts of conflicting expectations, bad communication, and lack of training. Fixable, if the leadership is not afraid to open the dialog to discover and address it all.

What are some indicators of leadership being ready for this process? Vulnerability. Brené Brown covers this extensively in her work as a researcher and storyteller, most recently in her book Dare to Lead. Her Engaged Feedback checklist is a good starting point of the mindset and commitment it takes to make giving and receiving feedback a productive experience.

Benefits of this Work

What sounds like simple work is far more complex than can be summed up in an article or there wouldn’t be a need for workforce analytics. To materialize what needs faith to initiate, an analytics study concludes with a full analysis report and action plan. Best improvements come from 2-3 year commitments to collaborating together providing accountability and resources to implement change.

Agencies that commit to the process will likely see a 3:1 to 7:1 ROI, making it a worhtwhile investment both on the organizational and human resources side.

A recent Forbes article, “13 Ways HR Teams Can Benefit from Workforce Analytics,” contributors come together to describe the many ways the analytics effort has changed their organization for the better. Better decision making, more employee engagement, lowering costs, and driving strategy just to name a handful. Are you ready to start leading change at your organization?

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