Frontline Initiative Communication

For individuals with disabilities and their families, one of the greatest perceived obstacles to quality, long-term residential care is staff turnover. Individuals grieve the loss of good staff, and family surveys show that the major complaint is the frequency of staff turnover.

Many people in the disability profession believe that low wages are the primary reason for this turnover problem, and for more than 10 years, many have fought with government agencies for higher rates.

To date, this has been a relatively unsuccessful effort. Our agency, Living Resources, has been looking at the problem of turnover for many years. As director, I have a strong interest in both improving wages and in determining what factors cause turnover. To improve quality, we are seeking ways to retain staff, given that wages may not improve. In other words, we want to better manage factors within our control.

Living Resources, in partnership with Dianna Stone, Ph.D., New York State University at Albany, developed a survey instrument to determine which work-related and personality variables would encourage employees to stay. The questionnaire was distributed to all employees, who were asked to answer all the questions, sign the forms, and return them to Dr. Stone. We assured them anonymity. We were only interested in a broad understanding of what factors made employees choose to remain.

The result of the research, with 100 questionnaires returned, indicated that there are statistically significant relationships between (1) organizational climate, (2) organizational commitment, and (3) job satisfaction, and the intent to remain. The organizational climate is an expression about various aspects of the organization. For example, employees feeling that they can talk directly to their leaders about the jobs, and how effectively the organization routinely rewards success. Organizational commitment is an expression of employees’ emotional commitment to Living Resources. It shows willingness to put in a great deal of effort to make the agency successful. Job satisfaction centers on satisfaction with pay and benefits, feelings of worthwhile accomplishments from the job, and satisfaction with the quality of the supervision. When these three factors coexist, as defined by the employees, then they state that they “intend to remain.” One year after the survey was administered DSPs who indicated they intended to remain have stayed to an overwhelming extent.

Using the survey information to make improvements, Living Resources reduced its turnover rate from 50 to 20 percent during a 4- year period. We restructured our agency environment so that the DSP was recognized as a valuable contributor to the quality of services we provide. The following are several ways this value was promoted at Living Resources: 1) In hiring, we focused on a thorough selection process which included verifiable information, and assessment by a team of managers, long term staff and consumers of our services. We also provided each applicant with realistic job previews of work requirements and the agency’s value system; 2) New employees received a thorough introduction to the company through orientation sessions, vision workshops, and team goal setting, and 3) We made adjustments and administrative decisions based on an understanding that we can only get customer satisfaction if we first achieve employee satisfaction. Throughout a DSP’s employment with Living Resources, we strive to improve the critical process so that DSPs feel that they have a voice and that they can improve their job. Since we enacted these changes, staff morale has risen considerably, which is reflected in the reduced turnover and overall improvement in job satisfaction.

We have also demonstrated that this higher retention rate supports quality and satisfaction with services. Individuals and families express greater satisfaction with services, access, and communication at all levels in the organization. We have seen a large decline in worksite accidents, auto accidents, worker’s compensation losses, and reportable incidents in our programs since these relationships were recognized and changes were made to foster a better agency environment for DSPs.

Without wage increases, retention can improve through careful application and thorough commitment to human resource management issues. Living Resources enjoys shared values with its direct care employees, higher retention rates, and better quality.