Workplace Stress: Time to Think About It Now

Many people will be back to work today. Faced with an inordinately high in-tray or seemingly endless list of unread e-mails to be tackled urgently they will feel an immediate ramp up in stress levels after being able to take it easy for a couple of weeks. Of course a few others will feel relief at getting back to work after a stressful fortnight at home with the kids but the majority of people returning to work today will feel an increase in their stress levels as they get down to their days work.

Obviously there are many who never stopped working and workplace stress is a constant factor that never goes away.

The issues of workplace stress are well recorded as is the impact it has on sickness levels and general well-being yet we talk very little about workplace stress in front line social care. The Health and Safety Executive state the 40% of work related illnesses are stress related and that ‘human health & social work’ is one of the areas where the highest rates occur (http://www.hse.gov.uk/statistics/causdis/stress/index.htm)

Front line care workers, whether providing care in a person’s home or working in a care home are subject to stress in the work place as much as (if not more) to anyone sitting in an office, working in a shop or factory etc. Stress is not limited to the ‘big’ events in life, stress accumulates as the small things niggle away at us and without the opportunity to release that stress externally it eats away inside us causing physical illness that, eventually, can do significant damage to our health.

Imagine the pressure on a home care worker who has to do a number of 30 minute visits to vulnerable people. The time pressure to get their work done in that 30 minutes followed by the pressure of travelling to visit the next person who needs support and care, this can be made even more demanding if the worker never knows who they will be visiting that day or they have a workload that means they have even less time to travel between homes.

Working in a care home can be stressful too. Meeting the needs of those who depend on others for many aspects of their daily lives can take its toll on those responsible for delivering that support and care. Imagine dealing daily with incontinence, challenging behaviour and even death. The stress of working in a shop or office is mild in comparison.

And if that stress is not enough for the front line care worker there are also the issues of low pay and unsociable hours to contend with.

Where people have high levels of stress they react by either internalising it, which leads to health problems or they externalise it, usually by demonstrating aggressive behaviour. In front line social care both are dangerous.

Internalising stress can affect our concentration and, in front line social care, which can lead to dangerous errors, stress also impacts on our immune system making us more prone to any bugs or ailments floating around. In front line social care this can lead to spreading those germs to vulnerable adults whose immune systems are already weak. Given the nature of front line social care, with its culture of low pay and only paying statutory sick pay there is a reluctance for many care workers to take time off for illness unless they are physically unable to leave their house.

Externalising stress is even more dangerous in front line social care. It can lead to abusive behaviour.

Yet despite the acknowledgment that workplace stress has a real impact on peoples’ lives, in social care this is something rarely mentioned or acknowledged. For example, the Skills for Care Manager Induction Standards do not mention the need to monitor and address workplace stress (http://www.skillsforcare.org.uk/Document-library/Standards/Manager-Induction-Standards/Manager-Induction-Standards.pdf) and the Care Quality Commission Standards focus more on competency in their “Guidance about Compliance” on the standard of supporting workers rather than tackle the real issue of workplace stress and its potential to lead to failure to deliver safe services (http://www.cqc.org.uk/sites/default/files/media/documents/guidance_about_compliance_summary.pdf).

If we truly want the best services for the most vulnerable in society then we need to recognise the stress that can be placed on those delivering the actual services. Everyone deals with stress in different ways and, because of that, there needs to be a focus on managers and providers having good quality training and awareness of the issues associated with workplace stress and being able to demonstrate competency in dealing with workplace stress issues.

Let's Change from ‘Being in a Home’ to Being ‘at Home’.

Do we pay enough attention to the ‘home’ part of care home?

Take a moment to think about what ‘home’ means to you, after all a home is more than just a dwelling place – e.g. house, flat etc. – it is about you. It is the place where you, hopefully, can retreat to, a place filled with memories, a place decked out in the style you like and filled with your things. It is not just a building but a fundamental part of your character and both sociologically and psychologically an important part of your life.

When we go into another person’s home we look around and make judgements about their character, their life, their likes and dislikes etc. and then make judgements on how we feel we will get on with them by making comparisons to our own home.

Yet if it becomes necessary to move a vulnerable person into a care home is there enough thought about the human aspect of a home rather than it just being a ‘placement’.

And what of moving into a care home?

It is well documented that one of life’s greatest stresses is moving home, yes there are the stresses of mortgages, solicitors etc. but the psychological change also creates stress, e.g. how do I create my home in this new house? How do I make it so I am comfortable here?

When a vulnerable person is moved from their home into a care home, for whatever reason, how much thought is given to that transition especially given the additional stresses involved that have forced the need to move in the first place.

Age UK have said that care homes are damaged by a culture of negativity (http://www.ageuk.org.uk/latest-news/care-homes-damaged-by-culture-of-negativity/) and this is certainly true in terms of reports of abusive behaviour and the general perception of care homes as places of ‘last resort’ and while I whole-heartedly agree with the Age UK recommendations I would, perhaps, suggest that we need to add to this the aspect of it being the person’s home and that it is vital that any individual feels ‘at home’.

We can have the most professional, caring staff, but if a person does not feel ‘at home’ there is always going to be difficulty in adjusting to their life in the care home. This may lead to depression, challenging behaviours or just a general malaise and dissatisfaction with life.

How would you feel if you had to live in a place you did not feel comfortable in? Many people have had to because of abusive relationships etc. but for the majority of us can we really comprehend what it is like to have to spend day after day in a place where we did not feel ‘at home’.

There is a need for care homes in the social care system and, in one sense, they should be the ‘last resort’ choice and only consider when it is a danger for a person to live alone and there are no other care alternatives possible. But when it is necessary care homes should not be merely a placement but a real home alternative. Many care homes provide this homely atmosphere yet many do not. Equally those that do may not be the type of home that appeals to the individual and every care should be taken to make sure that the choice of home reflects the individual’s needs, traits and characteristics to ensure the best possible outcomes in their new life.

We need to work to change attitudes, we need to create a new culture of care, we need to change from ‘being in a home’ to being ‘at home’.