LeadingAge Magazine · November-December 2018 • Volume 08 • Number 06

A Happy Culture Starts With Happy Staff

November 18, 2018 | by Debra Wood, R.N.

A nonprofit aging services provider can mitigate the challenges of finding and keeping good employees with a positive workplace culture.

Quality care depends on a positive workplace culture built and maintained with employees delivering the organization’s services, and as another benefit, supportive environments can enhance retention.

“Happy employees result in a happier customer experience,” says Reed VanderSlik, president of Glacier Hills Senior Living Community in Ann Arbor, MI, part of Trinity Health Senior Communities. “There are heartfelt reasons for improving the culture and business reasons.”

Alan Brown, chief operating officer of Methodist Senior Services (MSS) in Tupelo, MS, considers its employees “key people in carrying out our mission to serve older adults in the spirit of Christian love.”

Every organization has a culture, reports Stephen Tweed, CEO of Leading Home Care in Louisville, KY, a consultant in managing home health care, hospice, and private duty home care. But it may not be the culture you want.

To create a culture where residents and family members feel significant, the organization must start with the workers, says Donna Cutting, CEO of Red-Carpet Learning Systems in Asheville, NC, which provides skills training.

“The customer experience is only as good as the least-engaged employee,” Cutting says. “The employee or associate experience comes first. That is the customer-service-profit chain.”

Those organizations that develop and maintain positive workplace cultures can become an employer of choice and a community of choice for older adults.

Leadership Rounding

Creating a positive workplace culture requires a commitment from leadership.

“Everything starts with leadership, but it should not stop there,” Cutting says. “The excitement for the organization should build from people in the trenches. Ask for their ideas and involvement.”

VanderSlik rounds on all units and the lunchroom on a regular schedule and asks employees what one thing the organization could do to support those individuals better. One time that might be staffing levels, including when people call in sick. Another time, staff members might ask for better communication between shifts. Each time he rounds, VanderSlik provides feedback about what the organization has done to act on the employees’ past concerns.

“It’s a constant feedback loop,” VanderSlik says.

VanderSlik tries to know as many as possible of Glacier Hills’ 600 employees by name and has interacted, at least briefly, with most of them. He might ask about weekend plans or something going on in their life. He also tries to model the behavior he wants department leaders to adapt.

“It is important for the supervisors to show they care,” says VanderSlik, adding that those employees who stay for more than a year before leaving usually do so due to a supervisor.

Tweed adds that department heads are CEOs of their department and must support and reinforce the culture.

Offering Transparency

Some organizations invite employees to meetings to learn about the organization’s mission, values, strategic plans and other important information.

Every leader should have service standards for staff, Cutting says.

“You have to be clear about your expectations and why you want things done a certain way,” she adds.

Glacier Hills discusses strategic plans with employees and asks for their ideas to make the organization better and stronger. The meetings are not mandatory, but participation remains strong. Meetings are scheduled to accommodate people working all shifts. The organization has heard some good ideas and adjusts based on the feedback.

Karyn Lushinks, vice president of employee and business services at Whitney Center in Hamden, CT, reports that sharing information with employees shows that this is a journey and the organization can improve with everyone pulling in the same direction.

Competing Successfully for People

VanderSlik and Brown report that long-term care competes with many other fields for talent. Retention remains a major focus for senior care organizations, which are dealing with caregiver shortages and turnover.

“People stay when they feel valued, and they are doing meaningful work,” adds Tweed, explaining that organizations must create a culture of attraction and accomplishment.

Glacier Hills Photo
A team of Glacier Hills staff volunteered its time at a
community nonprofit—partly as good citizenship, but also as
a team-building exercise. Photo courtesy of Glacier Hills.

Glacier Hills tries to instill a sense of meaning in the job and is willing to pay above-market wages.

“We are competing with a lot of different opportunities,” VanderSlik says. “We do whatever we can do in the culture to support them and make them part of a bigger team.”

Brown adds that employees are looking for ways to grow as people, and MSS tries to provide that, including continued learning and training to fulfill the job and life skill goals.

“The job must have meaning, and they can see the value of their job,” Brown says. “I tell them, their interaction with the elder makes a difference in whether that person has a good or bad day.”

Mike Rambarose, president and CEO of the Whitney Center, says competing on wages is only part of the appeal. Relationships and feeling empowered to take on work with a passion will lead to better outcomes, he says.

Hiring the Right People

Retention starts with hiring people who will be a good fit for the organization. Most employers concerned about their workplace culture agree that you can train and improve competency in performing a job’s tasks, but you usually cannot change an individual’s personality and values.

Tweed recommends a culture-fit interview, based on core values. That includes asking about how the candidate behaved in the past in regard to a certain situation, which is a good predictor of how they will act in the future.

Brown reports asking interview questions that will determine if the prospect has “a heart for what we do—serving older adults. Not all people have that. If they have the right heart and calling, we can train them on the job skills.”

Most employers concerned about their workplace culture agree that you can train and improve competency in performing a job’s tasks, but you usually cannot change an individual’s personality and values.

To help ensure it hires the right people, the Whitney Center requires job candidates to go through up to 3 team interviews, which include a human resource representative, the hiring supervisor, and team members and/or a senior leader, looking for a fit within the organization.

“That process has helped us get a different perspective,” Lushinks says. “It is so easy to fake your way through one interview. To do it 3 times is harder.”

Introducing and Supporting the Culture

Once hired, the organization has to educate people about the culture and the desired behaviors. The core values should be kept to 3 or 4 things, which people can remember, Tweed advises. Then the organization can add actions that support the core value.

MSS shares its mission and vision with employees, but some found it unclear in how it related to them. The organization broke that down into service basics, such as being happy to serve, reach out and relate, love to learn and others. They role-play during the training sessions. MSS also educates all employees in Eden Alternative principles and elder-centered care.

“When people know what is expected, they do a better job, they relate better to our elders and life is better,” Brown says.

The Whitney Center calls its orientation “Compass.” During the 2-day session, leadership talks about the organization’s culture, values and expectations. New employees also meet with residents on the first day. Current employees also attend Compass annually.

“We dive into our why—why we exist—through sharing stories and [explaining] the alignment between the individual and organization,” Rambarose says.

Compass not only gives the organization an opportunity to share its values, it also gives leadership a chance to assess how the employee interacts with the older adults. That may lead to parting ways before the new hire starts on the unit.

Measuring Engagement

Many organizations seek feedback about how they are doing.

“What gets measured gets managed,” Tweed says.

Glacier Hills asks, on its employee-engagement surveys, open-ended questions about what employees think needs improvement and what improvements they have seen. Some items come up in both, including communication.

MSS alternates annual employee and resident engagement surveys to learn where it still needs to improve.

“Residents also tell us if they are pleased with the service, which reflects on how well employees are doing their job,” Brown says.

Whitney Center surveys staff twice annually, asking for honest feedback, and the organization will address concerns that surface in the survey. Additionally, supervisors at the Whitney Center engage in quarterly coaching conversations with each employee focused on values, engagement, competency and accountability.

“We can correct if they are not on the right path,” Rambarose says. “We are focused on building the relationship.”

Additionally, Rambarose meets quarterly with front-line staff who are informal leaders to ensure the cultural message remains intact. The group bounces ideas off of one another. Those people will soon be able to participate in a leadership development program.

“That is a powerful way of saying, ‘you matter, and we appreciate you.’”

Recognizing a Job Well Done

Organizations must recognize employees behaving in accordance with its values, and have consequences for staff members who do not act in desired ways, Tweed says. “People who want to work do not want to work with other people who do not want to work,” Tweed explains. “Part of building the culture is making sure everyone wants to do this work.”

Reward the behavior you want repeated, he advises, adding that “the behavior you permit is the behavior you promote.” Additionally, build the core values into the employee performance appraisal, so feedback includes how that employee lives the culture.

The Whitney Center recognizes employees for years of service and give on-the-spot nominations for being caught in the act of providing great care or customer service. Those people enjoy a luncheon with leadership.

“The more important recognition piece is demonstrating appreciation,” Rambarose says.

Glacier Hills sponsors employee-appreciation events on its 34-acre campus. Those might include a Super Bowl party or “welcome to spring” event.

“In our culture, having a chance to celebrate and interact with colleagues they do not often work with is valuable to them,” VanderSlik says.

MSS provides tuition assistance and encourages employees to succeed. The organization also offers a “Take Time to Give Time” program, an opportunity for employees to volunteer one day annually for a cause they care about.

“Additionally, on our campuses, employees are recognized when observed doing the right thing and those things are celebrated, Brown says.

Glacier Hills also has a “Wow program” to recognize employees who have done something above and beyond.

Reshaping a culture takes time and requires a commitment from leadership but is worth the effort, Tweed says.

“Companies with a strong culture are often focused on their customer with the premise if we take good care of our employees, they will take good care of our customers,” Tweed concludes. “Let’s build a culture where we have people who will go out of their way to serve the customer and live these core values, and in return, we will have a high level of satisfaction.”

Debra Wood, R.N., is a writer who lives in Orlando, FL.