Recruitment by Chance, Retention by Choice: A Qualitative Study of Managers Perspectives on Personal Care Workers' Intention to Stay in Residential Aged Care

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AIM: To explore the perceptions and experiences of managers in residential aged care settings regarding personal care workers' intention to stay and build a career. Specifically, this study sought to identify enablers and challenges influencing personal care workers' retention and to explore strategies that could improve workforce sustainability. DESIGN: A qualitative study utilising semi-structured interviews underpinned by the Theory of Planned Behaviour. METHODS: The study was conducted in Australia from July 2023 to March 2024. Eleven managers participated in this study. Data were analysed using inductive thematic analysis. RESULTS: Four themes emerged from the analysis and were conceptualised to illustrate the intricate relationship between recruitment practices, work environment, organisational culture and leadership in influencing personal care workers' intentions to stay in residential aged care. A botanical metaphor was used for each theme. The 'Diverse Seeds of Varied Potential' theme highlighted how ad-hoc recruitment processes were a primary driver of workforce instability. Challenging work conditions and differing expectations from personal care workers and management led to 'Wilting in Adverse Environments', which also contributed to a broader misalignment between facility culture and values, encapsulated within 'Mismatched Habitats'. Participants emphasised the need for 'Building a Greenhouse', a metaphor for cultivating sustainable leadership and workforce development to address these issues. CONCLUSION: This study's findings underscore the critical need for a cohesive approach to workforce development strategies in residential aged care. Transitioning from reactive, ad-hoc recruitment to strategic workforce planning, fostering a supportive organisational culture that aligns with personal care workers' expectations, and prioritising sustainable leadership practices are essential steps. Addressing these interconnected challenges can help build a more stable, committed and skilled workforce, ultimately enhancing the quality and continuity of care for residents. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Strategic workforce planning and sustainable leadership development are essential for building a stable workforce, which directly impacts the quality and continuity of resident care. IMPACT: This study addressed the critical issue of high turnover among personal care workers in residential aged care facilities, specifically examining managers' perspectives on retention challenges: an underexplored area that is crucial for developing sustainable workforce strategies. The findings revealed that current ad hoc recruitment practices, misalignment between diverse personal care worker profiles and established organisational cultures, have great impact on long-term engagement and retention. These insights are particularly valuable for residential aged care facilities struggling with staffing stability, industry bodies focused on workforce development and educational institutions preparing future aged care workers. Furthermore, the findings can inform policy development aimed at strengthening the aged care workforce, ultimately benefiting the quality of care received by residents. REPORTING GUIDELINE: The Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution.

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