Selection Processes for Recruitment of Carers

In my previous life I took a particular interest in the recruitment of carers and felt this may be of interest now that:
1. People with disabilities are becoming more in control of their own social care budgets
2. We, as a society are having to train nurses to care as I saw on the news recently

Now on this last point, what on earth has happened, we are having to train people in the caring profession to care?!? I couldn’t believe that those in the caring profession have become so depersonalised that we have forgotten basic human values such as compassion, care, respect, dignity – it is so frightening that this is where we are at. I really feel scared that this is the tip of an iceberg we do not want to run into.

What’s next along this continuum, euthanasia because we can’t be bothered. Some will say that this is a ridiculous assumption, but I recall in history a time when people stopped caring, and yes it was also wrapped up with fear, but people just stopped giving a damn about their neighbour, just stopped caring about what happened, and within 5 years over 6 million Jews were massacred and millions more, using a form of euthanasia, then called gas chambers. Again don’t think for one moment this could not happen again, every year there are episodes somewhere in the world of mass human culls due to people not caring what happens to the people or communities being slaughtered.

I pulled this list of war crimes involving massacres of one’s fellow communities in 1 minute of searching, and this isn’t all in the last 60 years by any means, just some of the thousands denounced by the International Courts of Justice at the Hague:
1939–1945 World War II
 German perpetrated crimes
 Italian perpetrated crimes
 Hungarian perpetrated crimes
 Japanese perpetrated crimes
 Romanian perpetrated crimes
1948 Arab–Israeli War
1954–1962 Algerian War
1968–1973: Vietnam War
 United States perpetrated crimes
 North Vietnamese and Vietcong perpetrated crimes
Bangladesh Liberation War
Cambodian civil war 1970–1975
Invasion of Cyprus 1974
Lebanese Civil War 1975–1990
Civil war in Afghanistan 1978-present
1980–1988: Iran – Iraq War
Uganda 1985-present
Yugoslav wars 1991–1999
 Croatian War of Independence 1991–1995
 Bosnian War 1992–1995
 Kosovo War 1998–1999
1990–2000: Liberia / Sierra Leone
1990: Invasion of Kuwait
1998–2006: Second Congo War
2003–2011: Iraq War
2003–2009/2010 Darfur conflict; 2005–2010 Civil war in Chad

So let’s start caring about what happens, let’s start giving a damn and making a positive difference to people, before we reach a point where the marginalised, the disenfranchised in our society, the vulnerable and those that don’t have political clout behind them or large donations to make to political parties, start becoming seen as unwanted burdens on society, as this is a bleak road to start travelling down.

Recruitment needs to be based on choosing the right personalities for a caring profession, it bothers me that we have to now teach carers to care, why were they selected in the first place if they don’t care about people, don’t want to serve in a caring capacity, and how did they get into the profession in the first place? Something must have gone badly wrong to not seek out people who want to make a difference and accept people into training that do not care; this is why one should make a real focal point of getting the right personalities from selection through to training to become a healthcare professional.

I used to invest heavily in recruitment of people with the ‘right personality’ for care, as I worked on the principles that I could not change people’s personalities but if they had the right building blocks, the right personality type, they can then maximise the training. Why on earth would one recruit people that don’t care, don’t have the right personality, true compassion, as they can’t be trained into someone, it’s an aspect of personality for goodness sake. By making sure I recruited the right personalities I meant:

Compassion -> Ability to work on one’s own
Empathy -> Ability to work as part of a team
Respect -> Understanding the need for being responsible

I did not prioritise needing prior knowledge, although it can be an advantage, I felt that I could give people the knowledge through training that they may need to fulfil their job specific functions, but life experience was an advantage, a big advantage, as life is the biggest training arena we all go through, as long as they did not have too much emotional baggage of course.

I did look for people who:
a) Wanted to make a difference to people
b) Wanted to care for one’s fellow members of society
c) Wanted to learn

To ensure I was getting this, as people may be able to cover up their personality during an interview for 40 minutes or so, but put them through a rigorous selection day, the veil drops and you see what someone is really like, and you see who really wants to enter this profession. So I developed a 4 stage selection process for this:

i. Personality Test – there are many tests available and Human Resources (HR) people are the best people to suggest which will be the most appropriate, there are several ones that can be done on a computer and then email the results to whoever is designated to read and highlight relevant elements. If you don’t have access through HR there are numerous free versions on the internet nowadays.

ii. Traditional Interview – short Q&A based on the traits and experience I was looking for, all of which are rated 1 to 4, the higher the score the more positive the results. We always asked people to do a short speech/presentation on:

 What qualities they thought a carer should possess
 What evidence did they have they possess such qualities

iii. Interview by Service Users – I found this invaluable and people were more than willing to participate, I even had parents and their loved ones, the whole family unit spending time with new candidates, and their feedback was invaluable, especially whether candidates had a bit of an attitude with regards the most profoundly of disabled people from a visual sense, if that makes sense? Their views were seen as crucial to passing someone.

Of course I did always include family and service user if I was recruiting for them specifically, as this was the key element to empowering people and delivering the social model of disability in reality. People have the right to choose who works for them, anything less is substandard in reality.

iv. Group Activity – you tend to see how people really are when placed in a group and asked to design and construct one of the following out of black and white bin liners, plus sticky-tape and a staplers, can’t make it too hard – lol:

 2 Outfits, including hat and accessories that must be warn and described by group members, or
 A bridge able to span 1.5 metres, and carry the weight of the sticky-tape and stapler in the middle, or
 A four legged, winged dragon

This would show their ability to positively regard the opinions of others, or not, negotiation skills, team skills, supportiveness and solution finding skills. These were judged by a couple of invigilators and participants were given 1 hour to complete.

Of course none of this is important if one does not do Safeguarding Adult and Child Protections checks, CRB, references in accordance with Care Quality Commission (CQC) guideline, etc. – all of which can be done by other organisations on your behalf. But it is so important to make sure you check all references from previous jobs in the ‘care’ based industry, especially if multiple jobs in this sector – and make sure you ask why there have been so many. It helps to be overly cautious, some would say having social paranoia but if you suspect the worst, then you can plan for every eventuality, and once you are convinced they are the right person then the mind can settle, as you know you have done everything you can to make sure the right people are selected and not people with harm in mind.

I used the next phase, training, as further selection, the core training was 5 days, made up of several basic elements required by CQC, infection control, first aid, lone working, etc., etc., etc., each element of which had to be tested and passed. Anyone not passing an element was given the chance to resit; anyone not passing the resit was de-selected. This sounds harsh but one has to have the ability to learn and retain information, as some procedures are complex and take time to learn. The initial training was designed to be delivered to people that had no knowledge of the healthcare sector, so if they couldn’t learn and achieve at this level of knowledge, they had nothing we could build more advanced training on.

Those passing basic induction then went onto speciality training; this was supervised teaching and experiential learning with the Service User they were selected for. They were given academic and first-hand knowledge of the Service User’s:
 Condition
 Likes & dislike
 House rules
 Way of doing things
 Idiosyncratic elements
 Other team members

They were supervised and tested by an experienced community NVQ4 or above Carer, who reported directly to the Community Manager, a qualified & highly experienced Nurse, and this rigorous training, development and experiential learning went on for a minimum of a month, and depending on the complexity it could go on for 3 to 6 months.

A big part of this was actual competencies on specifics procedures and processes relating to the Service users, such as drug administration, catheter care, pressure area care, etc., all unique and customised to the needs of the Service User and how they and their family wanted things done. At the end of each week supervision with the Service User, any relevant family member, the Community Manager and the mentor was done in the presence of the Carer. Activities and attitudes were examined and competencies and learning elements we reviewed and set for the next week.

This continued, as said earlier, for at least a month and competencies were tested a minimum of 6 times to ensure standards of safety were maintained. The key was always how the Service User felt about the Carer and they could deselect someone from induction too.

The aim of this stage was simple in nature, to give people the academic and practical knowledge to be experts in their Service User, and this is key, not in the Service User’s condition, but in the Service User as a person and their needs, and the needs of the family. I did not need experts in Neurological conditions; I needed experts in the Service User. This delivered the highest level of Service User understanding and care in the North of England according to CQC.

Once through this stage new staff then went into the ‘continuous learning’ and the refresher scheme we ran and also into NVQ system of personal development, which recently changed to a diploma. This did not take into account the specialist courses I ensured that were invaluable to people in relation to the Service User they were serving and their own personal development. All staff had supervision at a minimum of 4 weekly, again the Service User was involved in this as we saw it key to sustaining staff focus on what they were there to do, “Serve the Service User” was my key phrase, being there to serve others.

Cutting back on training or recruitment processes is a false economy, it may save money in the short term but it costs one dearly in the medium to longer term. By this I mean you have a less competent staff group, and you run a much higher risk of having people in the company only for a wage and not because they care, and this was the original point. If you invest in staff and develop them, they are more likely to stay and grow with your company, more likely to deliver high quality of care, and more likely to want to make a difference, feeling valued, feeling their company cares about their future and even feeling appreciated for what they do. Less turnover of staff, where turnover of staff is a real issues in the care industry, is a money saver, so by spending more upfront, you save a significant amount in the future but better than this, the most important element of all, you get people who care and deliver empathy and compassion.

Training healthcare staff to care about others, what nonsense!