Relational Care: some implications for care staff policy

Article by Jenny Kartupelis MBE | Looking briefly at the implications of ‘relational care’ for policy and planning in a previous issue, I concluded that ‘Current UK policy presents two major challenges: silo working ‚Ķ.and assumptions about the value of people (older citizens and the caring workforce) and their place in society.’ That article addressed the former issue, and this one will consider a few salient points about the latter.

Relational Care: some implications for care staff policy

Article by Jenny Kartupelis MBE

Looking briefly at the implications of ‘relational care’ for policy and planning in a previous issue, I concluded that ‘Current UK policy presents two major challenges: silo working ‚Ķ.and assumptions about the value of people (older citizens and the caring workforce) and their place in society.‘ That article addressed the former issue, and this one will consider a few salient points about the latter.

Just to recap: the concept of relational care, developed as a result of interview-based research in a variety of care settings, and explored in a new publication (1) is based on observations that good care is not about one party giving and the other receiving, but on a paradigm of reciprocity, where wellbeing and meaning in life are supported by networks of mutual knowledge, trust, and opportunities for contribution. The concept applies to both community-based and residential settings.

Care work is a tough job, physically and emotionally, but where the overall philosophy and environment favour good relationships, there are appreciable advantages in terms of staff retention, satisfaction and return on investment in training. One study found that ‘lack of attachment was a strong predictor of staff burnout’ and that when staff relationships with older people flourish it leads to ‘improved quality of care and lower staff turnover’ (2). This approach can only work if staff are supported by their employers, and the natural proclivity to form relationships in employment as elsewhere is not exploited through low pay or even extra unpaid hours. Authors of a recent study warn that if there is inadequate support, then relational care can only be provided if ‘individual workers ‚Ķ. pay the high personal cost’ (3).

However, where employers actively encourage stability and trust based on fair and realistic pay and flexibility to meet staff needs, the returns are not only about meeting the ethical imperative of optimising life for older people and care workers, but also financial, with reduced staff turnover, savings on the costs of recruitment and induction, and enhanced reputation.  Employers who recognise the benefits of relational care, will recruit for the long-term and be prepared to invest in training; one care home manager said to me: ‘We use a psychometric test for job fit, and we’ve identified what’s most important: honesty, emotional conscientiousness’, and another: ‘Caring has to come from the heart’. An owner summarised: ‘Our staff turnover is far less than average‚Ķ I think that’s our biggest saving’.

Insofar as policy is concerned, the perceived status of older people and that of the caring workforce are closely linked: if society recognises the value of older people to the community, in their interactions with younger generations for example, then similarly care workers who enable greater autonomy, self-articulation and flourishing will not be so easily dismissed as ‘low skilled’ or worthy only of short-term contracts based on immediate need rather than long-term planning and commitment. But that is another story.

Jenny Kartupelis started her career in public relations; in 1998, while still running her own PR business, she was invited by faith leaders to help establish a regional multi faith body and for her work as its director, she was awarded the MBE for services to interfaith relations. Since 2015, Jenny has given much of her time to research into, and reporting on care of older people, being given access to visit and interview in a wide variety of charitable, private and Local Authority care settings. Her work has resulted in two books about the theory and practice of relational care.

References

1. Making Relational Care Work for Older People: Exploring innovation and practice in everyday life (Kartupelis, J, 2021, Routledge, London, and New York) is available to readers at a discounted price from www.routledge.com using the code FLR40 at checkout.

2. Cited in My Home Life (Help the Aged, 2007) p 67.

3. Re-imagining Old Age: Wellbeing, care, and participation (Barnes et al., 2018, Vernon Press, Wilmington) p 181.