Private Duty

Survey your staff and act based on responses — it may help with retention rates

With turnover rates in home care hovering near 67%, it’s vital to poll your agency’s caregivers in order to better identify what they care about and how to best retain them.

One strategy to help with employee satisfaction and retention is to understand and appreciate your workforce’s cultural diversity, says Hayley Gleason, interim executive director of the Home Care Aide Council.

The Home Care Aide Council, a nonprofit trade association with over 150 members throughout Massachusetts, recently used funding from the Tufts Health Plan Foundation to assess the state’s home care aide workforce throughout 2016 and 2017. More than 650 aides filled out an assessment about their work experience and perception of the industry.

The assessment had surprising results about the industry’s makeup, though agencies should poll their own staff to get their own employees’ details and insights, Gleason says.

What did the assessment show?

About 48% of the home care aides who responded to the Home Care Aide Council’s assessment were born outside the United States.

“That was huge and really shocking to us,” Gleason says. “If you talk to most agency managers, they have a general understanding that we’re very culturally diverse, with different languages. But I don’t think there’s any real appreciation for how much we rely on immigrants and what that means for recruitment.”

Of those born outside the country, 55% were born in the Caribbean, 18% were born in Africa and 13.6% were born in Asia.

Roughly 35% of the assessment’s respondents identified as Caucasian, 12% identified as African American, 9% identified as Haitian and 8% identified as Puerto Rican.

Respondents also were asked to report their primary language and select only one language; many chose more than one language. About 56% listed English, while 13.3% listed Spanish and 9.8% listed Creole.

“Immigrants are our workforce, and we really need to understand their needs,” Gleason says.

Poll should cover more than diversity

Understanding caregivers’ needs is especially important since agencies have long struggled with retention among home care aides, Gleason says.

In fact, the national turnover rate for caregivers in 2017 inched up to 66.7%, according to the latest benchmarking study by Home Care Pulse of Rexburg, Idaho. That’s the highest turnover rate in the nine years Home Care Pulse has released its annual benchmarking study. The turnover rate was 65.7% in 2016, data show.

To cater to employees’ needs and interests, a poll to staff should cover more than just cultural diversity.

Leigh Davis, a private duty agency owner as well as the owner/partner for consulting firm Davis+Delany in Fayetteville, Ark., previously recommended polling caregivers about training needs they might have and then offering that training.

When Davis asked his team about its training interests, some of the top results included dealing with difficult clients, CPR, lifting mechanics and safety, and communication with clients suffering from dementia/Alzheimer’s.

Do this to boost recruitment, retention

  • Target community-based organizations that serve immigrants. Explain that your agency has jobs that are available, Gleason recommends.
  • Think about how you provide training and support to immigrants to make sure they’re prepared to work for your agency. Consider the unique needs they may have, Gleason says.
    For example, she says, consider whether to help employees receive English as a second language classes.
  • Consider the makeup of your workforce beyond cultural diversity. About 96% of home care aides responding to the assessment were female, with an average age of 48.
    About half of the respondents had a high school diploma or less.
    And 48% of respondents had an outside caregiving responsibility — caring for a child, other family member or friend. On average, among those respondents with children under 18, one day of work was missed per month due to a child’s illness, medical appointment or lack of childcare. — Josh Poltilove (


Editor’s note: Join us for the recruitment and retention-focused track at the 21st Annual Private Duty National Conference & Expo and find out how one agency reduced turnover to under 20% and doubled revenue over three years by redesigning its caregiver hiring and onboarding process.