Consistency of Care: Part One
How Cambridge Caregivers Responds to an Industrywide Challenge
Part 1 in a 2-part series
“Today, a different personal care aide came to my home without the in-home care agency giving me any advance notice. I was so frustrated. My husband has dementia and Parkinson’s disease. When so many different aides come, he gets confused.”
“My in-home agency does not give me advance notice of the name or any background of the aide who’s coming to my home. They just show up at my door. I don’t feel comfortable because I don’t know what kind of training they have.”
These comments, shared by frustrated family members in an online forum, reflect an ongoing challenge of the in-home private duty care business: consistency of care.
No one wants a revolving door of caregivers in their home. When a client’s family finds one or more caregivers who work well for them, they’d naturally prefer to see those same caregivers from one week to the next, as much as possible. That’s especially important for clients living with dementia, who need a consistent routine. When an unfamiliar person comes to their home, that can trigger confusion and agitation for those clients.
Several factors, however, make consistency of care a big challenge. While the labor market is tight in general, the shortage of workers to provide home-based care has reached crisis proportions – and it’s only going to get worse.
“The workforce is insufficient to meet the needs of the population of adults 65 and older that is projected to double in the coming decade,” according to The Home Care Workforce Crisis: An Industry Report and Call to Action.
Plus, employee turnover is extraordinarily high industrywide. To retain employees, in-home care agencies must stand out as places where caring competent people want to work and feel they are valued, supported, and compensated fairly.
“In order to provide consistency of care to our clients, we must attract and retain good employees,” said Tammy Hooker, Chief Listener for Cambridge Caregivers, who handles human resources for the company. “We’re building a strategy to make sure we’re the company that good caregivers want to work for.”
Unlike many home care agencies that rely on contract workers, Cambridge Caregivers are W-2 employees, eligible for benefits and bonuses, including health insurance and a 401K. Caregivers receive paid vacation, one week for each year they’ve worked full-time, with the option of rolling over that week into the next year, if they choose. As W2 employees, full-time caregivers are also eligible for Texas Workforce Compensation, should they become injured while on the job, as well as unemployment.
Cambridge Caregivers’ strategy seems to be working. According to the 2023 Home Care Pulse (HCP) Benchmarking Report, the median turnover rate for caregiving employees jumped from 65% in 2021 to 77% in 2022. our turnover rate is less than half that number.
Cambridge Caregivers rewards caregivers with an hours-based bonus, designed to motivate them to work full-time and to stay with the company.
“We pay this bonus twice a year, and in July, the company made the second of those two payments for 2024,” said Hooker. “More than 90% of our caregivers who received a bonus at the beginning of 2024 are still with the company and received a second bonus payment in July. That’s almost unheard of in our industry, and it tells me we’re doing something right.”
Part of our “secret sauce” for retaining good people relates to how we schedule our caregivers to ensure consistency of care. More on that in Part 2.
